There is a widespread belief that positive thinking is a key strategy to cope with cancer. While dispositional optimism is associated with lower psychological distress, the literature supporting the efficacy of cognitive-behavioral therapy indirectly suggests that realistic thinking is also effective. This article describes the development of the Thoughts and Anticipations about Cancer questionnaire designed to directly compare the effect of realistic thinking versus positive thinking on adjustment to cancer. Preliminary data on its relationships with psychological distress gathered in 10 breast cancer patients are promising. The validity of the Thoughts and Anticipations about Cancer questionnaire will need to be confirmed in larger studies.
This pilot 3-month clinical trial investigated the feasibility, effectiveness, and acceptability of using the Track Health function of the Veterans Health Administration’s personal health record for eliciting a more positive physical activity and dietary intake lifestyle in a sample of 38 overweight and obese Veterans with prediabetes. Comparisons between baseline and 3 months post-intervention indicated significant improvements in weight, physical activity, abdominal circumference, and blood pressure. Use of a personal health record that users can identify with and find usable and useful coupled with instruction targeting critical functionalities could potentially promote healthy behavioral lifestyle changes.
Given the potentially long-standing emotional impact of breast cancer, theoretical models are needed to identify critical resources and coping strategies that optimize survivors’ long-term adjustment. This study tested a model of well-being recovery with breast cancer survivors at 4 years post-treatment. Structural equation modeling was used to examine relationships between affect, loneliness, self-compassion, self-efficacy for coping with cancer, well-being, and life satisfaction. Two model variations offered good fit to the data, accounting for large portions of the variance in well-being and life satisfaction. Coping efficacy mediated paths from affect and loneliness to emotional well-being and life satisfaction.
The purpose of this study was to test two models of the impact of mental health stigma on both attitudes toward seeking psychological help and physical health. General self-efficacy, self-esteem, and anxiety were tested as potential mediators of these two relationships. A sample of adults (N = 423) aged 18–72 years was surveyed using the participant pool of a large, distance learning university. Structural equation modeling results indicated that mental health stigma directly and indirectly influenced treatment attitudes and physical health. Internal self-variables mediated the relationship between mental health stigma and both study outcomes.
This study investigated perceptions of and engagement with the concepts of planning and problem-solving, within a weight management sample. A total of 53 participants (62% female, 20–74 years old) completed a semi-structured interview and quantitative measures after a 16-week weight maintenance period. Preliminary weight maintainers (who had maintained losses of, at least 10% of their original weight) were compared with heavier-than-baseline participants (who had re-gained more weight than was originally lost). The maintainers exhibited stronger problem-solving skills (p < .05). The heavier-than-baseline participants tended towards non-rational problem-solving styles. Qualitatively, the maintainers described more planning events and were more accepting of mistakes than the heavier-than-baseline participants. Implications are discussed.
This report presents qualitative and quantitative data from 103 UK healthcare professionals describing attitudes to the current system of animal testing (to produce medicines and health interventions). To gather qualitative testimony, these healthcare professionals were organised into six separate focus groups (of 18, 17, 17, 15, 17 and 19 participants) where they were asked ‘what is your opinion about the current system of animal testing?’ The study focussed on attitudes to the current system rather than attitudes to animal testing in general. The healthcare professionals also completed a quantitative attitude scale questionnaire consisting of 20 statements (all favourable) towards the system of animal testing as currently practised. Statements such as ‘Testing agencies abide by legislation to safeguard animal welfare’ were displayed and the healthcare professionals were invited to agree or disagree with these statements. The results from both the quantitative and qualitative data suggest that healthcare professionals were opposed to the current system of animal experimentation.
This qualitative study analyses the social representations of health, illness and care, considering the similarities and differences between 30 nurses from different regions. We conducted three intra-ethnic focus groups and two inter-ethnic focus groups. This study shows similarities between the nurses’ representations. All participants believed that the psychological sphere affects individual’s health, that disease is an imbalance between physical and psychological factors and that interpersonal aspects are essential for care. Differences emerged regarding many facets. Eastern European nurses placed more importance on psychological aspects, South American nurses emphasised interpersonal relationships and Italian nurses focused their attention on economic aspects and their impact on health, illness and care.
The Dietary Guidelines for Americans recommend a 20–35 percent daily intake of fat. Resisting the temptation to eat high-fat foods, in conjunction with stage of readiness to avoid these foods, has been shown to influence healthy behavior change. Data (N = 6516) from three randomized controlled trials were pooled to examine the relationships among direct intervention effects on temptations and stage of change for limiting high-fat foods. Findings demonstrate separate simultaneous growth processes in which baseline level of temptations, but not the rate of change in temptations, was significantly related to the change in readiness to avoid high-fat foods.
This study evaluated the impact on young women’s body satisfaction of an advertising campaign: Aerie Real, which included images of models who were not digitally modified. In total, 200 female students were randomly allocated to view either Aerie Real images or digitally modified images from previous campaigns. In the total sample, no condition differences appeared. However, participants with high appearance comparison reported a smaller decrease in body satisfaction after viewing the Aerie Real images as compared to those viewing previous images (p = .003). Findings provide preliminary support for the Aerie Real campaign as less deleterious form of media for body image.
Research has not yet examined the relationship between psychological need satisfaction, sleep, mindfulness, and health-related quality of life in people living with HIV. This cross-sectional study (N = 101; 84% male; mean age = 45.48, SD = 12.75) found need satisfaction to relate positively to physical and mental health. Sleep quality fully mediated the association with physical health and partially mediated the association with mental health. Furthermore, mindfulness related to higher sleep quality through higher need satisfaction. Findings underscore the role of need satisfaction in determining health-related quality of life and sleep quality in people living with HIV and suggest that mindfulness may facilitate need satisfaction.
We compared the psychometric properties of COMPI Fertility Problem Stress Scales, Fertility Problem Inventory, and Fertility Quality of Life Tool in 293 patients enrolled for assisted reproductive technology. COMPI Fertility Problem Stress Scales and Fertility Problem Inventory subscales presented higher internal consistency. COMPI Fertility Problem Stress Scales differentiated best between its domains. Fertility Problem Inventory revealed better concurrent validity. Fertility Quality of Life Tool presented better fit. While discrimination for depression was similar between measures, Fertility Quality of Life Tool was better at discriminating anxiety. Results suggest that while all compared measures are reliable and valid in assessing the psychosocial adjustment to infertility, the choice of measure should be based according to the assessment goals.
Undertaking a caregiving role at end of life can have enduring psychological consequences for carers, including poor adjustment in bereavement. Acceptance and commitment therapy–based interventions have demonstrated effectiveness in helping people cope with a range of life challenges. This article presents the protocol of a feasibility randomised controlled trial of an acceptance and commitment therapy self-help intervention for psychological distress and grief in carers of patients in palliative care. We will assess feasibility and acceptability of the trial procedures and intervention as well as preliminary effectiveness of the intervention on carer well-being outcomes.
Clinicians face the complex challenge of motivating their patients to achieve optimal health while also ensuring their satisfaction. Inspired by transformational leadership theory, we proposed that clinicians’ motivational behaviors can be organized into three patient care styles (transformational, transactional, and passive-avoidant) and that these styles differentially predict patient health outcomes. In two studies using patient-reported data and observer ratings, we found that transformational patient care style positively predicted patients’ satisfaction and health expectations above and beyond transactional and passive-avoidant patient care style. These findings provide initial support for the patient care style approach and suggest novel directions for the study of clinicians’ motivational behaviors.
This article presents the validation of the ‘Echelle de Motivation envers l’Activité Physique en contexte de Santé’ including the six forms of motivation underlined by self-determination theory. Study 1 underlines the content validity of a pool of 30 items (N = 20). Study 2 supports the six-factor structure validity of the 18-item Echelle de Motivation envers l’Activité Physique en contexte de Santé (N = 309). Study 3 (N = 191) confirms structure validity, as well as concurrent validity and 2-week temporal reliability. The Echelle de Motivation envers l’Activité Physique en contexte de Santé can be considered as a valid and reliable tool to use in prevention or rehabilitation contexts.
The study investigated threat versus challenge appraisals of acculturative stressors and their impact on the changes in psychological symptoms. It also examined information processing styles (informational, normative, and diffuse-avoidant) as moderators of these relationships. A 6-month longitudinal study with two measuring points was conducted with a sample of immigrants. Threat appraisal was associated with more psychological symptoms, and challenge appraisal interacted with information processing styles to predict the changes in somatic symptoms. Analytical and exploratory informational styles enhanced the positive effects of challenge appraisal on psychological symptoms, whereas styles involving avoidance and normative orientation to one’s home country dampened these positive effects.
A dismantling study of body dissatisfaction prevention was conducted. Adolescent girls (N = 260) were randomly allocated to a media literacy (Happy Being Me – Media Literacy) or appearance comparison (Happy Being Me – Appearance Comparison) intervention or healthy eating behaviour control (Happy Being Me – Healthy Eating Behaviour) condition. In the Happy Being Me – Appearance Comparison condition, improvements from baseline to post-programme and follow-up for upward appearance comparison and fear of negative appearance evaluation were observed. In the Happy Being Me – Media Literacy condition, improvements were observed from baseline to post-programme for upward appearance comparison and realism scepticism. Findings were similar in a high-risk subsample and overall are moderately supportive of appearance comparison-based interventions, but less supportive of a stand-alone media literacy intervention.
This study sought to identify salient factors associated with the Problem Areas in Diabetes Scale to facilitate improved assessment and treatment of diabetes-related burden. Exploratory factor analysis assessed the factor structure of the Problem Areas in Diabetes Scale among 224 Veterans with uncontrolled type 2 diabetes and depressive symptoms. A four-factor solution of emotional, diabetes management, treatment, and social support burden subscales was extracted. These factors represent clinically relevant components of diabetes burden that include but go beyond symptoms of depression. The Problem Areas in Diabetes subscales may expand assessments for depression and improve medical and behavioral health interventions for patients with diabetes.
We investigated the associations of perceived risk and cancer worry with colorectal cancer screening by the faecal occult blood test, colonoscopy or both. This study was based on the 2013 Korean National Cancer Screening Survey, including 2154 randomly selected, cancer-free and over 50-year-old adults. Individuals with higher cancer worry were 1.53 times more likely to undergo colorectal cancer screening, influenced by emotional reaction; individuals with greater perceived risk were 1.61 times more, affected by subjective awareness. However, cancer worry was only associated with the faecal occult blood test. Better understanding of cancer worry and perceived risk on screening behaviours may help to increase colorectal cancer screening rates.
The Affective Style Questionnaire is a self-report instrument for assessing affective style. Study 1 investigated the psychometric properties of the Chinese Affective Style Questionnaire in a sample of 459 Chinese participants. The confirmatory factor analysis supported a three-factor structure. Study 1 indicated that the Chinese Affective Style Questionnaire can be used as a simple, reliable, and valid scale for measuring individual differences in affective style. Study 2 examined the moderating role of different affective styles in the relationship between stress and negative affect. Concealing and tolerating moderated the relationship between stress and anxiety, and adjusting moderated the relationship between stress and depression.
This randomised controlled trial verified the efficacy of an implementation intentions intervention (n = 24) to promote fruit and vegetable consumption among childbearing age women at risk for gestational diabetes mellitus against a control condition based on the question–behaviour effect (n = 26). There was only a significant time effect (F(2,85) = 5.69, p = 0.0048). Both groups increased their vegetable consumption compared to baseline at 3 months (p = 0.0022) and 6 months (p = 0.0042). There were no significant effects on weight, waist circumference and blood glucose levels. Implementation intentions and the question–behaviour effect appear to be effective behaviour change techniques to promote vegetable intake among this high-risk population.
The #fitspo ‘tag’ is a recent trend on Instagram, which is used on posts to motivate others towards a healthy lifestyle through exercise/eating habits. This study used a mixed-methods approach consisting of text and network analysis via the Netlytic program (N = 10,000 #fitspo posts), and content analysis of #fitspo images (N = 122) was used to examine author and image characteristics. Results suggest that #fitspo posts may motivate through appearance-mediated themes, as the largest content categories (based on the associated text) were ‘feeling good’ and ‘appearance’. Furthermore, #fitspo posts may create peer influence/support as personal (opposed to non-personal) accounts were associated with higher popularity of images (i.e. number of likes/followers). Finally, most images contained posed individuals with some degree of objectification.
Guided by the Integrative Model of Behavioral Prediction, we identify mothers’ salient beliefs regarding their daughters’ initiation of the human papillomavirus vaccine series. In all, 34 Hispanic mothers responded to elicitation questions. Salient beliefs included the following: (1) feeling secure, happy, relieved, concerned, and fear about vaccinating; (2) believing that vaccinating prevents and protects from human papillomavirus but may result in side effects and sexual disinhibition; (3) identifying the daughter, father, mother, aunt, friends, and grandmothers as supporters/non-supporters; and (4) affordability, transportation, clinic distance, and making appointments as facilitators/barriers. This study begins the process of building a model of human papillomavirus vaccine initiation for this population.
This study explores the efficacy of BEfree, a 12-session group intervention that integrates psychoeducation, mindfulness, compassion and value-based action, in a sample of overweight and obese women with binge eating disorder (N = 31). We used repeated measures analyses of variance and explored processes of change in binge eating and eating psychopathology. At post-intervention, participants decreased in binge eating severity, eating psychopathology, external shame, self-criticism, psychological inflexibility, body image cognitive fusion and increased self-compassion and engagement with valued actions. These results were maintained at 3- and 6-month follow-up. The changes in binge eating were mediated by the changes in the psychological processes promoted by BEfree.
To explore experiences and perceptions of assistive technology, 14 people with multiple sclerosis, 5 carers and 4 occupational therapists participated in focus groups. Transcripts were analysed thematically drawing from illness self-regulation theory. Identified themes are as follows: critical multiple sclerosis events (developing symptoms/disability, delayed diagnosis and coping, public reaction and multiple sclerosis progression to assistive technology), matching assistive technology for continued use (acceptance of multiple sclerosis and assistive technology, realistic expectations, occupational therapist responsiveness, timing is crucial and carers and others) and impact of assistive technology (promoting or losing independence, stigma and embarrassment and redefining the carer). Acceptance and communication among those involved ensures assistive technology matches needs and maximises health and psychosocial outcomes.
Aim of this study was to investigate relationship between preoperative psychological factors and % total weight loss after gastric bypass. 76 adult patients scheduled for bariatric surgery were preoperatively asked to complete anxiety and depression Hamilton scales and Toronto Alexithymia Scale. At 3- and 6-month follow-up, body weight was assessed. At 6-month follow-up, alexithymic patients showed a poorer % total weight loss compared with non-alexithymic patients (p = .017), and moderately depressed patients showed a lower % total weight loss compared with non-depressed patients (p = .011). Focused pre- and postoperative psychological support could be useful in bariatric patients in order to improve surgical outcome.
A cross-sectional study was conducted to explore the role of belief in a just world between negative life events and life satisfaction. The results revealed that two dimensions of belief in a just world played partial mediating roles between negative life events and life satisfaction. Moreover, belief in a just world was also a moderator between negative life events and life satisfaction that mitigates the adverse effects of negative life events. In conclusion, these results suggest that belief in a just world could be both a mediator and a moderator between negative life events and life satisfaction.
This research used the National Longitudinal Study of Adolescent to Adult Health (N = 15,359; age range 25–34) to examine the cross-sectional relation between personality and four components of metabolic syndrome (elevated glucose, blood pressure, cholesterol, and waist circumference) and a metabolic risk index in young adulthood. Consistent with research on older adults, higher Neuroticism and lower Conscientiousness were associated with greater risk of metabolic dysfunction; Agreeableness, however, was unrelated to it. The relation between personality and metabolic health may unfold across the lifespan, with the association between Neuroticism/Conscientiousness and metabolic dysfunction starting early and the association with Agreeableness emerging at older ages.
The aim of this study was to compare the sleep quality, depression, anxiety, and autonomic function of a group of kidney-transplanted recipients who joined a combined exercise program (KTRt) or remained sedentary (KTRs). A total of 20 kidney-transplanted recipients, split into two groups (10 KTRt and 10 KTRs), joined the study. Heart rate variability, cardiorespiratory capacity, depression, and sleep questionnaires were evaluated. KTRt presented lower Pittsburgh Sleep Quality Index and greater entropy, and increased parasympathetic and decreased sympathetic modulation than KTRs. Anxiety level was minimal and depression was absent in both groups. KTRt group presented better sleep quality and better autonomic modulation than KTRs.
By retrieving literature published from 2005 to 2015 from Chinese National Knowledge Infrastructure, Wanfang, Vip, PubMed, and Web of Science, we filtered out studies using the Children’s Depression Inventory only and compared left-behind children and non-left-behind children. The methodological quality of the papers was evaluated using the Newcastle–Ottawa Scale. Finally, we included six studies to carry out a meta-analysis. The results showed that the Children’s Depression Inventory scores of left-behind children are significantly higher than those of non-left-behind children (standardized mean difference: –0.233, 95% confidence interval: –0.036 to –0.430, p < 0.05).
This multicenter study investigates the efficacy of the guided disclosure protocol in promoting post-traumatic growth, through meaning reconstruction, in cancer patients after adjuvant chemotherapy. Participants will be randomized to guided disclosure protocol or to an active control condition. Both conditions consist of three 20-minute writing sessions. Experimental participants verbalize emotions, describe events, and reflect on trauma effects. Control participants write about their past week’s daily routine. Patients, blinded to treatment assignment, will complete questionnaires at pre-intervention, post-intervention, and 6-month follow-up. This study will improve knowledge concerning the effects of writing interventions on psychological health and well-being in cancer patients.
Several investigators have observed lowered risk of depression among obese older adults, coining the "jolly fat" hypothesis. We examined this hypothesis using baseline and a 5-year follow-up body mass index, depressive symptoms, and covariates from 638 community-based older adults. High objectively measured body mass index and functional limitations predicted increased future depressive symptoms. However, symptoms did not predict future body mass index. Self-reported body mass index showed similar associations despite underestimating obesity prevalence. Results did not differ on the basis of gender. Results for this study, the first longitudinal reciprocal risk analysis between objectively measured body mass index and depressive symptoms among older adults, do not support the "jolly fat" hypothesis.
The study examined the mechanisms underlying the link between socioeconomic status and subjective well-being and explored the role of social activities using a representative sample of older adults (N = 2773) in Shanghai, China. Results show that frailty mediated the relationship between socioeconomic status and subjective well-being, and social activities moderated the model, such that the mediation effect of frailty was significant only when social activities were lower. Moreover, the moderated mediation model was significant only for women, not for men. Findings highlight the importance of addressing frailty of older adults and promoting social activities (especially for elderly women) in future interventions.
Although obesity presents a serious health problem in children, parents often underestimate their children’s overweight and obesity status. Therefore, scientific literature was systematically screened through PubMed and PsycINFO to demonstrate the psychological, social, and cultural processes that underlie this evaluation bias. A total of 37 papers that focused on research conducted in different geopolitical contexts were taken into account. Furthermore, a lexicometric analysis of the papers’ conclusions was performed. The findings showed that education plays a key role in promoting parents’ awareness and their realistic recognition of their children’s weight. Accordingly, adequate educational support for parents should be implemented in all healthcare policies addressing childhood obesity.
Potential associations between systemic inflammation and social support received by a sample of 120 older adults were examined here. Inflammatory markers, cognitive function, social support and psychosocial wellbeing were evaluated. A structural equation modelling approach was used to analyse the data. The model was a good fit
This study investigated the relationship among emotional intelligence, gratitude, and subjective well-being in a sample of university students. A total of 365 undergraduates completed the emotional intelligence scale, the gratitude questionnaire, and the subjective well-being measures. The results of the structural equation model showed that emotional intelligence is positively associated with gratitude and subjective well-being, that gratitude is positively associated with subjective well-being, and that gratitude partially mediates the positive relationship between emotional intelligence and subjective well-being. Bootstrap test results also revealed that emotional intelligence has a significant indirect effect on subjective well-being through gratitude.
This study explored relationships between body appreciation, health-related quality of life, and age, in an age-diverse sample of 289 women in the United States. Linear regression indicated the relationship between body appreciation and the physical component of health-related quality of life varied by age. For women aged 36 years and older, there was a positive relationship between body appreciation and health-related quality of life; however, a negative relationship was present for other age groups. Findings have clinical implications and suggest body appreciation may buffer the decline in physical health-related quality of life that occurs as age increases.
Univariate and multivariate relationships between perfectionistic self-presentation and reactions to impairment and disability following spinal cord injury were examined. A total of 144 adults with spinal cord injury (M = 48.18 years old, SD = 15.96) completed self-report measures. Analyses revealed that, after controlling for time since injury and gender, perfectionistic self-presentation predicted six of eight reactions, shock, depression and internalised anger particularly strongly. In addition, at multivariate level, perfectionistic self-presentation was positively related to non-adaptive reactions and negatively related to adaptive reactions. The findings suggest that perfectionistic self-presentation may contribute to poorer psychosocial adaptation to spinal cord injury.
While music has been found to motivate exercisers during workouts, its potential as a pre-exercise motivator has rarely been investigated. This study evaluated a self-selected, pre-exercise music intervention against implementation intentions (writing down ‘if ... then ...’ sentences relating to overcoming barriers) and a control condition. A total of 50 participants (Mage = 43) took part in a longitudinal, randomised, between-participants study, from 99 recruited. For both interventions, participants had significantly more success meeting self-set exercise goals than the control group, and the music group exercised significantly more frequently than the control group. There was support for music as a comparable intervention to implementation intentions.
We modified the Weight Control Behaviours scale to explore unhealthy/healthy behaviours to increase, decrease or maintain weight in young adults (N = 1082) and associations with body mass index, depression and body image. Females reported more use of all strategies except those which increase body size or exercising to exhaustion. Although the sample reported more use of healthy weight management strategies, the use of dangerous ones warrants attention by healthcare professionals. Feelings of fatness was an important predictor of weight management behaviours. Public health campaigns should focus on the harmfulness of unhealthy weight management practices as well as the importance of healthy ones.
This study examined whether mild cognitive impairment affects the associations between personal expectations (i.e. optimism and self-efficacy), illness-related coping, and quality of life. In total, two groups of older adults participated: 127 persons diagnosed with mild cognitive impairment and 225 cognitively healthy older persons (cognitively non-impaired group). Several significant relationships observed in the cognitively non-impaired group did not reach significance among mild cognitive impairment patients, with the opposite trend noted for others (e.g. between palliative coping and physical health). These findings indicate that mild cognitive impairment may lead to problems in the self-regulation process and highlight the significance of the interplay between neurocognitive and psychosocial aspects of self-regulation.
Body dissatisfaction may play some role in the pathophysiology of chronic diseases. This study examined relations between body dissatisfaction and circulating levels of inflammatory biomarkers C-reactive protein, tumour necrosis factor-α, interleukin-6 and anti-inflammatory adiponectin, and to explore positive changes in relevant lifestyle behaviour after these associations. A total of 33 asymptomatic overweight men and women were evaluated at the baseline and after a 6-month lifestyle behaviour intervention. Body dissatisfaction emerged as an important predictor of pro- and anti-inflammatory biomarkers and may promote the production of inflammatory cytokines by reducing the level of anti-inflammatory and increasing the level of pro-inflammatory cytokine production.
This study tested if habit strength for taking oral hypoglycemic medication moderated the association between poor mental health symptoms (i.e. depressive symptoms, diabetes distress) and unintentional non-adherence in 790 adults with type 2 diabetes. Data were cross-sectional. A habit strength x depressive symptom interaction was observed. Depressive symptoms were negatively associated with adherence if habit was weak or of average strength; no association was observed if habit was strong. A similar interaction emerged when diabetes distress was examined. Results suggest that habit strength might operate as a buffer in the association between poor mental health symptoms and medication adherence.
Patient motivation is important in managing medication regimens such as antiretroviral treatment for HIV/AIDS. We tested whether self-determination theory could predict adherence behavior among 115 HIV-positive patients in the China Adherence through Technology Study, a randomized controlled trial of an intervention using text reminders and supportive counseling to increase adherence. Being in the treatment group had a significant effect on improving adherence; however, we did not find evidence that self-determination theory predicts adherence in this population of HIV-positive patients. Autonomous motivation was strongly associated with perceived competence; among low adherers, external regulation was negatively correlated with adherence.
This study elicited the information needs, motivations, and behavioral skills related to human papillomavirus vaccine decision-making among young adult women. Interviews were conducted with college women, aged 18–26 years, and stratified by recently vaccinated (N = 25) and unvaccinated (N = 25). Comparative thematic analysis using the Information, Motivation, and Behavioral Skills Model was conducted. Healthcare providers were identified as the most trusted sources for information. While unvaccinated women did not have experience receiving the vaccine, they reported the same procedural knowledge for vaccination. These findings suggest that young adult women have the information and procedural knowledge for human papillomavirus vaccination, but motivations may influence their decision-making.
The objective of this study was to examine the content validity and test–retest reliability of the Intuitive Eating Scale among pregnant women. A qualitative think-aloud study of the Intuitive Eating Scale analysed the content validity. Overall, the Intuitive Eating Scale made sense to pregnant women, but food safety affected the interpretation of some items. A version with instructions modified accounting for food safety, the Intuitive Eating Scale–Pregnancy, was subsequently shown to have stable scores over 5 weeks during the second trimester, mean change = –0.08 (95% limits of agreement: –0.61 to 0.45), r = 0.79, n = 240. The Intuitive Eating Scale–Pregnancy was acceptable for use in this New Zealand pregnant population.
This study examines how romantic relationship cognitions are associated with changes of condomless anal sex among emerging adult gay and bisexual men. The sample was drawn from four waves of a prospective cohort study (N = 598; Mage = 18.2). Results suggest that condomless anal sex increased over the emerging adulthood period. Romantic relationship fear was associated with increased receptive condomless anal sex. Perceptions of greater romantic relationship control increased the likelihood of having insertive and receptive condomless anal sex. Findings suggest that romantic relationship cognitions are important to consider when understanding longitudinal changes in condomless anal sex in this population.
Despite conflicting guidelines, a significant subset of high-risk men decide to undergo routine prostate cancer screening. Yet, there is a scarcity of available programs, and no studies evaluating interventions to support men in dealing with the psychosocial impact of screening. In this study, one of the first to explore the responses of high-risk men enrolling in a Prostate Cancer Risk Assessment Program (N = 128), patients underwent a prostate cancer risk counseling visit immediately followed by either a cognitive–affective preparation session designed to help them process the information they received or a general health education session. All men in this self-selected sample chose to participate in prostate cancer screening. Men were assessed 3 weeks and 6 months post-counseling. The impact of the enhanced counseling condition on knowledge, perceived risk, expectancies, and intrusive ideation was a function of racial and coping style group. Implications for tailored interventions to maximize preparedness for risk and screening counseling are discussed.
This study examined a graduated severity level approach to food addiction classification against associations with World Health Organization obesity classifications (body mass index, kg/m2) among 408 people with type 2 diabetes. A survey including the Yale Food Addiction Scale and several demographic questions demonstrated four distinct Yale Food Addiction Scale symptom severity groups (in line with Diagnostic and Statistical Manual of Mental Disorders (5th ed.) severity indicators): non-food addiction, mild food addiction, moderate food addiction and severe food addiction. Analysis of variance with post hoc tests demonstrated each severity classification group was significantly different in body mass index, with each grouping being associated with increased World Health Organization obesity classifications. These findings have implications for diagnosing food addiction and implementing treatment and prevention methodologies of obesity among people with type 2 diabetes.
This study sought to identify parent-feeding behaviours in real-life difficult feeding situations through the use of a set of scenarios. These were then used to examine links between parent feeding and child snack intake. Mothers of children aged 2–7 years (n = 611) completed an online survey containing five snack food request scenarios, two commonly used parent-feeding scales (Restriction and Covert Control), and reported on their child’s snack intake. Results showed that parent-feeding styles (restrictive or covert) translated into specific behaviours in response to the scenarios. These parent behaviours predicted children’s intake of unhealthy snack food over and above the feeding style.
This study examined the difficulties couples face in relation to anorexia nervosa. Using interpretative phenomenological analysis, five couples in which one of the partners lives with anorexia nervosa were interviewed separately. The findings are conceptualized into three areas: first, the encounter ‘at the crossroads between remission and relapse’; second, the way that ‘anorexia reveals itself’; and finally, the way the ‘ménage à trois’ works, including the illness fully as part of the couple. Psychotherapists should take into account the context of the couple and the complex interaction between the couple and the illness to support both partners’ development of appropriate responses.
Little is known about social influences on long-term rehabilitation outcomes for traumatic brain injury, particularly social comparisons (i.e. self-evaluations relative to others). Patients in long-term rehabilitation (n = 31) completed assessments at baseline and 1 year. Self-reported social comparison orientation was comparable to existing samples and showed stability over 1 year; affective responses to comparisons (e.g. frustration) were less stable. Social comparison orientation and affective responses were related to baseline executive and psychosocial functioning (rs = 0.34–0.53) and predicted worse impairment and depression at 1 year (ds = 0.67, 1.39). Greater attention to comparisons in long-term rehabilitation could improve outcomes.
This study explored the psychosocial experiences of patients with cancer during the course of oncology treatment with curative intent. Our aim was to gather in-depth insights into the shared elements of oncology treatment across a range of cancer types. A total of 10 individuals undergoing oncology treatment participated in semi-structured interviews. Six themes were identified using interpretative phenomenological analysis: diminished well-being, perceived role changes in intimate relationships, heightened awareness of limited time, a new order of priorities, taking things as they come and development of trust in health professionals. These themes indicate relevant areas of patients’ well-being, which might be enhanced through psychosocial support services.
In-depth interviews and focus group discussions were conducted to inform the development of an instrument to measure the health-related quality of life of children living with HIV. The QOL-CHAI instrument consists of four generic core scales of the "Pediatric Quality of Life Inventory" and two HIV-targeted scales—"symptoms" and "discrimination." A piloting exercise involving groups of children living with HIV and HIV-negative children born to HIV-infected parents provided evidence for the acceptable psychometric properties and usability of the instrument. It is expected that the QOL-CHAI can serve well as a brief, standardized, and culturally appropriate instrument for assessing health-related quality of life of Indian children living with HIV.
The purpose of this prospective cohort study was to investigate whether Type D personality was related to periodontal disease in Japanese university students. Among students (n = 600) who were interested in receiving oral health examinations, logistic regression analysis showed that the risk of developing periodontal disease during a 3-year period was associated with body mass index >= 25 (odds ratio: 2.543; 95% confidence interval: 1.297–4.989; p = 0.007) and Type D personality (odds ratio: 1.473; 95% confidence interval: 1.027–2.111; p = 0.035). In this short-term prospective cohort study, a significant association between periodontal disease and Type D personality was observed in Japanese university students.
Mind–body interventions can improve vulnerabilities that underlie smoking behavior. The characteristics of smokers who use mind–body medicine have not been explored, preventing the development of targeted interventions. Patients (N = 593) presenting to a mind–body medicine clinic completed self-report measures. Patients were 67 percent never smokers, 27 percent former smokers, and 6 percent current smokers. Current smokers were younger; more likely to be single, unemployed, or on disability; and report greater depression symptoms, greater pain, and lower social support (ps < .05).Current smokers who use mind–body medicine have unique psychosocial needs that should be targeted in mind–body smoking cessation interventions.
The Canadian Heart and Stroke Foundation launched the Heart Truth campaign to increase women’s awareness of heart disease. However, little is known about how such campaigns intersect with broader understandings of gender and health. This discourse analysis examined the construction of gender, risk, and prevention within campaign material. Two primary discourses emerged: one of acceptable femininity, which outlines whose risk, survivorship, and prevention matters, and another of selfless prevention. Women of diverse ethnic, sexual, and socio-economic background were largely absent. Prevention was portrayed as a personal choice, eclipsing conversations about social determinants of health and the socio-political context of heart disease.
The Short Health Anxiety Inventory is a brief instrument to assess health anxiety widely used across countries; however, no validated version is available for Portuguese-speaking population. Factorial structure, reliability, and equivalency factor with the Spanish version were analyzed with Portuguese adolescents aged 14–18 years. A Portuguese adolescent cohort (N = 629) and a comparative Spanish adolescent cohort (N = 1502) were evaluated. The original two-factor version was the best fitting model for the Portuguese version. The reliability was excellent. Complete measurement invariance across both countries was supported. The Portuguese version of the Short Health Anxiety Inventory is a valid screening inventory to assess health anxiety in adolescents.
In light of the contention surrounding breast health practices, the research aimed to explore post-menopausal women’s experiences of such practices. Semi-structured interviews were conducted in July and August 2015 with 13 Australian women aged 54–74 years. Data were analysed thematically. Participants deemed their engagement with breast health practices as the ‘right’ thing. However, engaging in these ‘right’ practices appeared to be fostered by misconceptions. The findings suggest that women may not be making evidence-informed decisions to engage in breast screening; identify contemporary barriers to promoting informed decisions; and may inform information pertinent to breast screening policy, campaigns and decision aid designs.
The dominant research approach to both food insecurity and charitable meal provision is nutritionistic, deficit-orientated and ignores wider socio-economic issues. This reinforces existing power dynamics and overlooks the agency of people living food-insecure lives. We critique this dominant approach and draw on the everyday experiences of families facing food insecurity to ground an alternative approach that emphasises food as a social determinant of health.
This qualitative study compares and contrasts the perspectives of healthcare professionals who treat hepatitis C with those of patients in treatment. Comparative analysis of semi-structured interviews with 20 healthcare professionals and 20 patients undergoing treatment for hepatitis C concluded that patients and healthcare professionals disagreed on the source of communication breakdowns, but both felt that individualised clinical information improved adherence. Stigma was recognised as a barrier to treatment adherence by both patients and healthcare professionals. Limitations of the healthcare system, such as patients receiving inconsistent information and long wait times, negatively impacted both patients and providers.
The objective of this study was to examine the factor structure, reliability, and validity of the Form C of the Multidimensional Health Locus of Control scales in adolescents. A confirmatory factor analysis indicated that adequate fit of a four-factor model and the internal consistency of the scales were adequate. Criterion validity of the four scales of the Form C of the Multidimensional Health Locus of Control was also supported by significant correlations with measures of pain-related self-efficacy, anxiety, and coping strategies. The results indicate that the four Form C of the Multidimensional Health Locus of Control scale scores are reliable and valid and therefore support their use to assess pain-related locus of control beliefs in adolescents.
Few studies address the daily challenges faced by parents of children diagnosed with Tourette’s syndrome. This article reports on a qualitative interview study with 15 parents exploring their experiences, the challenges they face and the support mechanisms they have found to be most helpful. Thematic analysis identified four core categories which represented shared experiences of the participants: coping with children’s challenging behaviours, misconceptions and lack of understanding of professionals and the lay public, negative experiences of their children’s education and lack of support and services for families with Tourette’s syndrome. The findings highlight the challenges of parenting a child with Tourette’s syndrome, particularly with respect to family life and the child’s schooling.
This article endeavored to determine the topics of discussion during open-ended peer mentoring between adolescents and young adults living with chronic illness. This study occurred alongside a study of the iPeer2Peer Program. Fifty-two calls (7 mentor–mentee pairings) were audio recorded, transcribed verbatim, and analyzed using inductive coding with an additional 30 calls (21 mentor–mentee pairings) coded to ensure representativeness of the data. Three categories emerged: (1) illness impact (e.g., relationships, school/work, self-identity, personal stories), (2) self-management (e.g., treatment adherence, transition to adult care, coping strategies), and (3) non-illness-related adolescent issues (e.g., post-secondary goals, hobbies, social environments). Differences in discussed topics were noted between sexes and by diagnosis. Peer mentors provided informational, appraisal, and emotional support to adolescents.
Many impulsive behaviors, unpleasant emotions, and misguided cognitions increase the incidence of type 2 diabetes and other conditions. This study tests the premise that such risk factors are inversely related to future clarity—the extent to which the future seems vivid and certain. Specifically, 211 participants completed the measures of future clarity and various determinants of health. Future clarity was positively associated with the inclination of participants to consume healthy food, abstain from cigarettes, participate in physical activity, and experience positive emotions. Future research should examine whether interventions designed to help individuals clarify and pursue their aspirations could stem lifestyle diseases.
This review aims to synthesise the literature examining the psychosocial variables related to self-management (insulin adherence, non-adherence and administration, blood sugar monitoring, dietary behaviour, exercise behaviour) in adolescents with type 1 diabetes. A systematic search of three electronic databases was carried out and, after the application of eligibility criteria, 21 articles were assessed for quality prior to data extraction. Numerous psychological factors were found to be associated with self-management; however, correlations were typically small to moderate. The strongest associations were found between social anxiety and diet (among males); greater intrinsic motivation, conscientiousness and diet; and extraversion and exercise.
Although cigarette smoking is a major contributor to continued health problems after stroke, the majority of stroke survivors do not quit smoking. This may be due in part to the high rate of smoking among committed partners of stroke survivors. This study investigated the experiences of 11 dual-smoker stroke survivor–caregiver dyads, identifying themes which may be useful for understanding this entrenched population: managing the addiction as a dyad; conflicting feelings about whether smoking is an individual versus mutual concern; and dyad-level barriers and facilitators of quitting. We also present specific cessation strategies that dual-smoker dyads participating in the study described.
Cognitive behavioural therapy is increasingly promoted as a treatment for chronic fatigue syndrome. There is limited research on informed consent using cognitive behavioural therapy in chronic fatigue syndrome. We undertook a narrative review to explore efficacy and to identify the salient information that should be disclosed to patients. We found a complex theoretical model underlying the rationale for psychotherapy in chronic fatigue syndrome. Cognitive behavioural therapy may bring about changes in self-reported fatigue for some patients in the short term, however there is a lack of evidence for long-term benefit or for improving physical function and cognitive behavioural therapy may cause distress if inappropriately prescribed. Therapist effects and placebo effects are important outcome factors.
Online, virtual group interactions may help adherence to health promotion programs. The purpose of this study was to explore longitudinal relationships among dimensions of group cohesion and group-interaction variables to inform and improve group-based strategies within programs aimed at promoting physical activity in virtual communities. In all, 56 online virtual users completed a group dynamics–based physical activity promotion intervention and assessments of group cohesion and group interaction at baseline and 4 weeks. Friendly competition and cooperation were consistently strong predictors of cohesion. Facilitating a sense of friendly competition and cooperation may increase engagement in physical activity programs by bolstering group cohesion.
Our objective is to identify links between physical health and community participation among individuals with schizophrenia or a psychosis mental illness. Semi-structured qualitative and quantitative interviews and community tours were conducted over 10 months (N = 30). Interviews were transcribed and analyzed using a grounded theory coding strategy. Physical health played an important role in community participation both as a cause and consequence. Key processes included mobility issues impeding physical community involvement; a multi-directional relationship between social relationships, community involvement, and physical health; identity as a mechanism linking physical health problems and community engagement; and the potential for community-based mental health programs.
Optimistic bias defines the tendency for human beings to underrate risk when it pertains to themselves compared with their view of risk pertaining to other people in the same conditions. The aim of this work is to investigate the optimistic bias in risk perception and health-related behaviours for three specific conditions in a young adult sample: cancer, respiratory disorders and cardiovascular diseases. Young adults showed an optimistic bias related to cancer, and to cardiovascular diseases. Our findings suggest that optimistic bias is linked to specific behavioural patterns, largely widespread in young adults, such as tobacco cigarette smoking and alcohol consumption.
Binge drinking represents a major clinical and public health concern. Here, we investigated the prevalence of binge drinking and its related consequences, in a population of young adults. A questionnaire was administered to a sample of 4275 healthy subjects. In the overall sample, the percentage of binge drinkers was 67.6 per cent; among regular alcohol users, 79.5 per cent reported episodes of binge drinking. Among binge drinkers, several serious consequences were identified (staggering and stuttering, amnesia, loss of control, aggressiveness, sexual disinhibition). Raising awareness about the seriousness of binge drinking may help health care providers to identify cases early on and provide appropriate treatments.
Since dentists play an important role in the emergence and maintenance of dental anxiety in patients, it is imperative to understand how dentists themselves evaluate their work with anxious patients and how they perceive their environment. Semi-structured interviews explored the working lives of six dentists. Interpretative phenomenological analysis revealed four superordinate themes: Negotiating identities, Control, Perceptions of dentistry and being a dentist and Stress related to treating dentally anxious patients. Warranting investigation in other settings, specialist dentists experienced conflicts between being a helper and inflictor of pain, as well as dealing with conflicting views concerning their status as a dentist.
This study examined psychometric properties of the Levenson’s Locus of Control Scale among Iranian infertile patients. In all, 312 infertile patients completed the Levenson’s Locus of Control Scale and Hospital Anxiety and Depression Scale. The confirmatory factor analysis indicated that the original three-factor model of Levenson’s Locus of Control Scale was adequate (2/df = 2.139; goodness-of-fit index = 0.88; root mean square error of approximation = 0.061; and standardized root mean square residual = 0.076). The Cronbach’s alpha of the subscales ranged from 0.56 to 0.67. The Levenson’s Locus of Control Scale subscales significantly correlated with anxiety and depression, showing an acceptable convergent validity. In conclusion, the Levenson’s Locus of Control Scale has adequate reliability and validity and can be used to measure locus of control orientation in Iranian infertile patients.
We examined the relationship between recognition of a 3-kg weight gain in 1 year with metabolic syndrome parameters and lifestyle status related to metabolic syndrome or cardiovascular disease in Japanese workers. Data were collected twice between April 2009 and March 2011, and self-reported questionnaires were completed at a follow-up by 275 workers who gained more than 3 kg in 1 year. This study showed that ~40 per cent of those who gained more than 3 kg in a year did not recognise their weight gain, and a weight gain over 3 kg was associated with worse metabolic syndrome parameters regardless of weight gain recognition.
This study explores the role of others in supporting younger women who opt not to reconstruct their breast post-mastectomy. Semi-structured interviews were conducted with six women diagnosed with breast cancer in their 30s/40s. The women lived in England, had been diagnosed a minimum of 5 years previously and had undergone unilateral mastectomy. An interpretative phenomenological analysis revealed three themes: Assuring the self: ‘I’ll love you whatever’, Challenging the self: ‘Do you mean I’m not whole?’ and Accepting the self: ‘I’ve come out the other side’. The women’s experiences of positive support and challenges to their sense of self are discussed.
The aim was to explore shared representations of alcohol use in students who were to travel abroad to study. Focus group data from Italian students (N = 69) were collected. Analyses used Grounded Theory Methodology and were informed by the four key components of Social Representation Theory (cognition, emotion, attitude and behavioural intentions). The study abroad experience was described as one that would involve an increase in alcohol consumption compared to pre-departure levels. Reasons given included greater social and leisure opportunities involving alcohol, reduced social control and features of the host country environment. Opportunities to intervene and address risky alcohol use in this group are discussed.
Individual differences in avoidant coping were hypothesized to exacerbate quality of life impairment associated with somatization and illness anxiety symptoms; psychological flexibility was expected to moderate this impairment. Individuals from a random community sample (N = 298; 182 females), who met screening criteria for somatization and illness anxiety, reported lower quality of life and psychological flexibility and greater avoidant coping compared to controls. Psychological flexibility significantly moderated the impact of somatization and illness anxiety on quality of life domains. Findings suggest that decreasing avoidant coping through therapy may be promising in mitigating the negative impact of these symptom categories.
Heavy drinking among HIV-infected individuals is associated with health complications. Health-behavior self-efficacy may be characteristically low among this population or negatively affected by HIV-infected status. We assessed whether self-efficacy to resist drinking increased during brief educational and motivational drinking-reduction interventions within HIV primary care and whether increases in self-efficacy predicted drinking among HIV-infected heavy drinkers. Results indicate that increases in self-efficacy from baseline to end-of-intervention inversely predicted drinking at end-of-intervention and at follow-up. Findings suggest that brief treatment interventions within HIV primary care may promote self-efficacy and that increases in self-efficacy predict initiation and maintenance of drinking reductions among HIV patients.
We interviewed 15 South Africans seeking HIV testing to understand the factors that influenced their seeking an HIV test. Reasons in favour of testing included having had unprotected sex, availability of social support if testing HIV positive and modelling test-seeking behaviour to others. Reasons against seeking testing included fear testing HIV positive, the possibility of receiving treatment too late, HIV-related stigma and long distances to testing sites. Participants also discussed ways to increase the uptake of HIV testing, such as workplace testing, the role of the media and the role of cultural rituals such as male circumcision.
Psychosocial adjustment to living with a chronic condition was explored in this grounded theory study, focusing on type 2 diabetes. Despite a range of relevant theories, there is limited understanding of the process of adjustment. The study aimed to address this issue. That was achieved through collecting and analysing personal narratives using individual interviews and focus groups. This allowed for the development of a normative integrative model of adjustment to chronic conditions based on biopsychosocial principles. The integrative model of adjustment to chronic condition has the potential to lead to improved understanding of adjustment processes.
Post-exertional malaise is a cardinal symptom of myalgic encephalomyelitis and chronic fatigue syndrome. There are two differing focuses when defining post-exertional malaise: a generalized, full-body fatigue and a muscle-specific fatigue. This study aimed to discern whether post-exertional malaise is a unified construct or whether it is composed of two smaller constructs, muscle fatigue and generalized fatigue. An exploratory factor analysis was conducted on several symptoms that assess post-exertional malaise. The results suggest that post-exertional malaise is composed of two empirically different experiences, one for generalized fatigue and one for muscle-specific fatigue.
Pain-related cognitive biases have been demonstrated in chronic pain patients, yet despite theoretical predictions are rarely investigated in combination. Combined cognitive biases were explored in individuals with chronic headache (n = 17) and pain-free controls (n = 20). Participants completed spatial cueing (attentional bias), sentence generation (interpretation bias) and free recall tasks (memory bias), with ambiguous sensory-pain, disability and neutral words. Individuals with chronic headache, relative to controls, showed significantly greater interpretation and memory biases favouring ambiguous sensory-pain words and interpretation bias favouring ambiguous disability words. No attentional bias was found. Further research is needed exploring the temporal pattern of cognitive biases.
Associations between self-sufficiency and advice seeking with mortality risk were examined to assess the long-term implications of individualistic and interpersonally oriented strategies. Wave 1 participants from the National Survey of Midlife Development in the United States (N = 6116, 25–75 years, Mage = 46.38 years) completed questionnaires assessing demographics, self-sufficiency, advice seeking, social support, and health. Cox proportional hazard models indicated that each standard deviation increase in seeking advice was associated with an 11 percent decreased hazard of dying 20 years later. Self-sufficiency was not significantly related. Future research should examine contexts in which interpersonal strategies are adaptive, as seeking advice from others promotes longevity.
This cross-sectional study contributes to the literature on whether body dissatisfaction is a barrier/facilitator to engaging in physical activity and to investigate the impact of mass-media messages via computer-time on body dissatisfaction. High-school students (N = 1501) reported their physical activity, computer-time (homework/leisure) and body dissatisfaction. Researchers measured students’ weight and height. Analyses revealed that body dissatisfaction was negatively associated with physical activity on both genders, whereas computer-time was associated only with girls’ body dissatisfaction. Specifically, as computer-homework increased, body dissatisfaction decreased; as computer-leisure increased, body dissatisfaction increased. Weight-related interventions should improve body image and physical activity simultaneously, while critical consumption of mass-media interventions should include a computer component.
This is the first study to measure the ‘sense of community’ reportedly offered by the CrossFit gym model. A cross-sectional study adapted Social Capital and General Belongingness scales to compare perceptions of a CrossFit gym and a traditional gym. CrossFit gym members reported significantly higher levels of social capital (both bridging and bonding) and community belongingness compared with traditional gym members. However, regression analysis showed neither social capital, community belongingness, nor gym type was an independent predictor of gym attendance. Exercise and health professionals may benefit from evaluating further the ‘sense of community’ offered by gym-based exercise programmes.
Anaphylaxis is a serious, rare condition increasing in prevalence. This study explored the psychological experience of adult-onset anaphylaxis from patient, family and staff perspectives. Semi-structured interviews were conducted with 12 participants. Two global themes emerged from thematic analysis: ‘controllability’ (‘an unknown and distressing experience’, ‘the importance of control over triggers’ and ‘responsibility but no control: the impact on others’) and ‘conflict’ (‘rejecting illness identity’, ‘minimisation of risk’, ‘accessing specialist care: running in slow motion’ and ‘patient-centred versus service-centred care’). Findings highlight the importance of perceived control and emphasise the presence of conflict in the experience of this complex, episodic condition.
This essay uses autoethnography to relate the experience of being diagnosed with lupus. By using my personal experiences and a discussion of illness and Black women’s health, I critically examine larger critical race issues of race, gender, and the social barriers to health care. Specifically, the essay focuses on the ways in which race impacts my experiences with the healthcare system, from my own insecurities of being stereotyped to the ways that doctors interact with me. The essay is framed by popular quotes from Charlie Brown because they help mediate the very personal experiences I am recounting.
Cancer fatalism is the belief that cancer is uncontrollable and lethal. Individuals with less education are more likely to hold fatalistic beliefs about cancer, but the mechanism accounting for the relationship is unknown. We tested whether negative health information seeking experiences explain this relationship. Structural equation modeling was used to test this relationship across three datasets from the Health Information National Trends Survey. Across all datasets, the model showed good fit: Cycle 1 (coefficient of determination = .11, comparative fit index = .96, root mean square error of approximation = .047), Cycle 2 (coefficient of determination = .06, comparative fit index = .96, root mean square error of approximation = .046), and Cycle 3 (coefficient of determination = .08, comparative fit index = .95, root mean square error of approximation = .052). The link between lower education level and higher cancer fatalism was partially mediated by negative health information seeking experiences.
This study explored narrative responses following abnormal Pap tests among Hispanic migrant farmworkers (N = 18; ages 22–50 years) via in-depth interviews in Florida. Qualitative analyses utilized health literacy domains (obtain/process/understand/communicate) as a conceptual framework. Participants described how they (1) obtained information about getting a Pap test, (2) processed positive and negative reactions following results, (3) understood results and recommended health-promoting behaviors, and (4) communicated and received social support. Women had disparate reactions and understanding following an abnormal Pap result. Health literacy was a meaningful conceptual framework to understand assets and gaps among women receiving an abnormal Pap test result. Future interventions should incorporate health literacy domains and facilitate patient–provider communications and social support to assist women in decision-making and health-promoting behaviors, ultimately decreasing cancer disparities.
This study assessed the reliability and concurrent validity of the prenatal section of the Postpartum Depression Predictors Inventory–Revised for 250 pregnant women receiving prenatal care in Mexico. The Postpartum Depression Predictors Inventory–Revised has shown adequate psychometric properties for English-speaking perinatal women, but no similar data have been reported for Spanish-speaking samples. The results show that the Postpartum Depression Predictors Inventory–Revised is highly reliable and exhibits adequate concurrent validity compared to the Edinburgh Postnatal Depression Scale. These findings suggest that the Postpartum Depression Predictors Inventory–Revised can be a reliable instrument in prenatal care services for detecting risk factors for perinatal depression in Mexican women and potentially in other Spanish-speaking populations.
Positive school bonding is a significant precursor to students’ school success. However, African American youth report lower school success compared with their White counterparts. This study examined correlates of school bonding among 633 African American youth who were recruited from community settings in Chicago. Major findings indicated that negative peer norms, exposure to community violence, and poor mental health were negatively correlated with school bonding, while parental monitoring, positive self-regard, and future orientation were correlated with higher school motivation. Students classified as having high or moderate school bonding were more likely to live with both parents, experience higher levels of parental monitoring, and exhibit positive self-regard. Implications are discussed in view of these findings.
This study analyses the factor structure and psychometric properties of the Chinese version of Beck Anxiety Inventory on Chinese doctors. Participants include 762 doctors sampled in 18 public hospitals in three cities in Eastern China. Exploratory factor analysis is employed to identify the potential factor structure of the inventory. Confirmatory factor analysis is referred to for model fit. The results indicate that the Chinese version of Beck Anxiety Inventory has satisfactory reliability and validity, but its factor structure is unstable and has great differences compared with international versions. Naming the four extracted factors is difficult. In general, the Chinese version of Beck Anxiety Inventory is appropriate for Chinese doctors and can be used as a good screener to detect the anxiety of Chinese doctors.
A survey of 217 older adults assessed physical activity–related positive and negative social control and emotional and informational support, using structural equation modeling to investigate mediational effects of emotional responses and behavioral intentions on physical activity. There were significant indirect effects of social control and social support on intentions as mediated by positive, but not negative, emotional responses, and significant indirect effects of emotional responses on physical activity as mediated by intentions. These findings help to identify the cognitive and emotional pathways by which social control and social support may promote or detract from physical activity in later life.
Despite high levels of psychological distress, there is a scarcity of research on unmet supportive care needs in haematological cancer patients. This qualitative study used an in-depth interpretative phenomenological approach to investigate the needs reported by six non-Hodgkin’s lymphoma patients and explored how these needs consequently shaped the patient experience. Emergent themes included the following: concerns for family, information needs and the need for psychological support. Participants reported feeling different to other cancer patients. Lack of understanding of their diagnosis by friends and family and lack of access to relevant support services are notable unmet needs that differ from previous findings.
This study aimed to explore the experiences of adults with anorexia nervosa who took part in a perfectionism group intervention in an inpatient setting. Thematic analysis was used to explore patient feedback collected in focus groups. Patient feedback was generally positive and centred around three main themes: perceived benefits of the group, the content of the group and suggested improvements. The findings suggest that a brief perfectionism group intervention is an acceptable treatment with a range of perceived benefits for patients with severe anorexia nervosa. Understanding patients’ experiences of the intervention can provide further important information to maximise therapeutic impact of the group in inpatient settings.
Poor breast cancer–related quality of life is associated with flattened cortisol rhythms and inflammation in breast cancer survivors and women with advanced disease. We explored the associations of cancer-specific distress (Impact of Events Scale), mood (Profile of Mood States), activity/sleep (wake after sleep onset, 24-hour autocorrelation coefficient) and cortisol (diurnal slope) circadian rhythms, and inflammation (interleukin-6) with quality of life (Functional Assessment of Cancer Therapy–Breast) among patients awaiting breast cancer surgery (N = 57). Models were adjusted for differences in age and cancer stage. Distress and mood disturbance were significantly correlated with lower quality of life. Ethnic differences in the relationship between distress and mood disturbance with global quality of life and subscales of quality of life were observed. Actigraphic measures showed that in comparison with non-Hispanic patients, African Americans had significantly poorer activity/sleep (wake after sleep onset, 24-hour autocorrelation coefficient). Circadian disruption and inflammation were not associated with quality of life. Physiological dysregulation and associated comorbidities may take time to develop over the course of disease and treatment.
This Swedish register-based cohort study examined whether asthma, hay fever and allergic dermatitis in late adolescence identified in the early 1970s are associated with antidepressant medication in middle age, between 2006 and 2009. After adjustment for childhood and adulthood sociodemographic characteristics, psychological, cognitive and physical function, and comorbidity, the magnitude of the associations diminished for asthma, while hay fever and atopic dermatitis retained associations. Hay fever and atopic dermatitis in adolescence have potentially important implications for future mental health, while asthma may already have influenced an individual’s ability to cope with stress by late adolescence.
Development of psychiatric symptoms during interferon-alpha therapy may be influenced by psychological factors. We examined illness perceptions using the Revised Illness Perceptions Questionnaire in 55 patients with chronic hepatitis C virus infection, due to receive interferon-alpha. The Hospital Anxiety and Depression Scale was used to assess the development of symptoms. Negative identity, consequences and emotional representation beliefs were significantly associated with both higher depression and anxiety scores. Negative illness perceptions play a predictive role in the development of interferon-alpha-induced psychiatric symptoms.
Symptoms after inflammatory activation, so-called sickness behaviour, overlap with trans-diagnostic complaints. As no self-report questionnaire to assess sickness behaviour exists, we aimed to develop such an instrument, the Sickness Questionnaire. Items responsive to experimentally induced inflammatory activation (randomized double-blind study endotoxin (0.6 ng/kg) versus placebo, n = 52) were selected and the statistical properties were examined in 172 primary care patients. A principal component analysis indicated a one-factor solution (Cronbach’s alpha = .86). This 10-item scale correlated with depression (β = .41, p < .001), anxiety (β = .36, p < .001), self-rated health (β = .28, p < .001) and a single item of feeling sick (β = .55, p < .001). The results support the adequacy of Sickness Questionnaire as a brief assessment instrument of perceived sickness behaviour.
In this autoethnographic study, I analyse my birthing event, in order to point out some relevant cultural aspects of the experience. I explore the role of expectations, childbirth place, medicalization and relationships with healthcare professionals and partner. My experience and the analysis of the context where childbirth takes place leads to the conclusion that hospital organization is central to women’s experiences of giving birth, but the hospital culture is still too centred on the security that medical interventions guarantee, relegating people to a passive position. Health services should address personal agency, in order to guarantee more respectful childbirth care.
The aim of this study is to explore whether different coping strategies are able to mediate the association between Type D personality and quality of life. We collected information from 156 consecutive patients (response rate: 72.9%; 75.0% women; median age: 40 ± 3 years). Patients completed the Type D Scale-14, the Coping Self-Efficacy Scale and the Short-Form Health Survey for measuring physical and mental quality of life. The mediating effect of coping was analysed using correlations, linear regressions and the Sobel z-test. In the mental quality of life, all three studied coping strategies mediated the association between Type D personality and quality of life.
Cancer, like other chronic illnesses, changes the patients’ way of living significantly. Although some may think, for instance, that religiousness would increase with the diagnosis of cancer, no previous studies have been performed in the Turkish society to confirm this. We, as the Turkish Oncology Group, conducted a survey in seven different oncology centres, representing a large majority of Turkey, to investigate how patients’ lifestyles changed following a cancer diagnosis; we used dialysis patients as a chronic illness control group. The study findings showed how changes in spiritual practices are completely in line with what is observed in other chronic illnesses. These findings may help to address cancer patients’ needs and facilitate resource allocation accordingly.
The goal of this study was to analyze the relationships between anxiety, depression symptoms, and functionality as predictors of quality of life, in patients with diabetic foot ulcer taking in consideration clinical variables. A sample of 202 participants indicated for a lower limb amputation surgery, were assessed before the surgery, on physical and mental quality of life, functionality, a anxiety and depression symptoms. Anxiety and depression symptoms, as well as functionality level were predictors of mental quality of life. Pain, having a first amputation, depression symptoms, and functionality were predictors of physical quality of life. In order to promote quality of life, psychological variables should be targeted, in clinical practice.
Although numerous factors have been demonstrated in laboratory settings to lead to more successful health goal attainment, their actual use in daily goal pursuit is unknown. This study examines spontaneously reported health goals and their characteristics in a sample of 557 American adults. Participants responded to questions about health and health goals, with items assessing motivation, social support, and implementation intentions. In all, 66 percent of respondents had a health goal, 26 percent of participants had implementation intentions, and 47 percent received support from close others. Results suggest that interventions should focus on encouraging goal setting, teaching implementation intentions, and educating close others in providing support.
Research has emphasized the important role of recalling childhood experiences on adult mental health, and also the benefits of self-compassion on well-being. This study explored self-compassion as a mediator between early memories with family and peers and quality of life, on a wide age range female sample (N = 645). Path analysis revealed that self-compassion mediated the impact of both types of memories on women’s perceived quality of life. Overall, results revealed that the recall of early positive memories, either with family and peers, associate with a more compassionate self-to-self relationship, and the perception of greater psychological and social well-being.
We examined the effect of acute exercise compared to a cognitive task on implicit approach/avoidance motivation to dessert food images using the Dessert–Approach–Avoidance Task. Participants randomized to exercise had a greater increase in approach motivation to dessert images compared to those completing cognitive tasks (p=0.046), adjusting for disordered eating, task difficulty, and changes in negative affect. This study provides the first evidence for the use of the Dessert–Approach–Avoidance Task to evaluate the effects of acute exercise on implicit motivations for dessert images. Future studies should examine implicit response to food images using the Dessert–Approach–Avoidance Task in response to chronic exercise.
The objective of this review was to summarize the literature supporting narrative interventions that target health-promoting behaviours. Eligible articles were English-language peer-reviewed studies that quantitatively reported the results of a narrative intervention targeting health-promoting behaviours or theoretical determinants of behaviour. Five public health and psychology databases were searched. A total of 52 studies met inclusion criteria. In all, 14 studies found positive changes in health-promoting behaviours after exposure to a narrative intervention. The results for the changes in theoretical determinants were mixed. While narrative appears to be a promising intervention strategy, more research is needed to determine how and when to use these interventions.
A growing tendency to refuse child vaccination is commonly regarded as a reason for concern. Attempts to promote vaccination by authorities often prove to be unsuccessful or even counter-productive. The aim of this study was to explore how parents perceived four messages used to promote vaccination. In eight focus groups (N = 73), we presented participants with messages and asked them to assess them. Using thematic analysis, we identified themes that our participants considered the most important. Messages that promote vaccination should be unambiguous, more balanced, not focus on repeating the negative effects of vaccine-preventable diseases and provide links to the evidence.
This study explores the relationships between the various subtypes of global and diabetes-specific peer support and health outcomes in adolescents with type 1 diabetes. Global peer support significantly predicted self-care and glycated haemoglobin, although no associations were identified for diabetes-specific support overall, nor its factors. When comparing participants with above or below average glycaemic control, significantly greater diabetes-specific support was reported in those with poorer control. It is suggested that this may be related to feelings of nagging, in which diabetes-specific support is perceived as harassment.
This study tested the hypotheses of irritable bowel syndrome showing (1) comorbidity with chemical and sound intolerance, other types of functionally somatic syndromes, and psychiatric disorders and (2) stronger than normal affective reactions to and behavioral disruptions from odorous/pungent chemicals and sounds in daily life. These hypotheses were tested by means of data from a large-scale population-based questionnaire study. The results showed comorbidity in irritable bowel syndrome with chemical and sound intolerance, fibromyalgia, migraine, post-traumatic stress disorder, generalized anxiety disorder, panic syndrome, and depression as well as strong reactions/disruptions from odorous/pungent chemicals and sounds in irritable bowel syndrome.
Nine adults who had completed an exercise referral scheme participated in a semi-structured interview to uncover the key psychological factors associated with adherence to the scheme. Through thematic analysis, an exercise identity emerged to be a major factor associated with adherence to the scheme, which was formed of a number of underpinning constructs including changes in self-esteem, changes in self-efficacy and changes in self-regulatory strategies. Also, an additional theme of transitions in motivation to exercise was identified, showing participants’ motivation to alter from extrinsic to intrinsic reasons to exercise during the scheme.
This study assessed the relationships between self-efficacy, outcome expectations, fear-avoidance beliefs and adherence to an exercise for a home-based exercise programme for adults with venous leg ulcers. Patients (n=63) were randomised to receive either an intervention or usual care group. Of those in the exercise intervention group, 59per cent adhered to the exercise protocol more than 75per cent of the time. There was a significant relationship between self-efficacy and outcome expectations, and both of these constructs were significantly related to adherence to the leg exercise programme. Adherence significantly correlated with wound healing indicating a possible pathway to healing.
We examined whether shifting young women’s (N =322) attention toward functionality components of media-portrayed idealized images would protect against body dissatisfaction. Image type was manipulated via images of models in either an objectified body-as-object form or active body-as-process form; viewing focus was manipulated via questions about the appearance or functionality of the models. Social comparison was examined as a moderator. Negative outcomes were most pronounced within the process-related conditions (body-as-process images or functionality viewing focus) and for women who reported greater functionality comparison. Results suggest that functionality-based depictions, reflections, and comparisons may actually produce worse outcomes than those based on appearance.
The aim of this study was to qualitatively examine weight stigma in individuals who exercise frequently. In total, six focus groups, comprising 30 participants aged 18–25 years, were conducted using convenience sampling. All participants were frequent exercisers. Five themes emerged in the data with participants discussing bullying, the consequences of obesity, causes of obesity, lack of willpower and interventions to reduce obesity. This study is the first qualitative examination of weight stigmatisation in frequent exercisers, where the beliefs reported by focus group participants suggest that frequent exercisers stigmatise, discriminate and dehumanise obese people. Future research to examine the impact of weight stigma on exercise motivation and behaviour of obese people appears warranted.
This article describes the influence of a peer education programme on skills development among 22 women participating in HIV prevention trials. Interviews were used to collect data on peer educator experiences and their opinions of the trainings. The training enhanced their agency and confidence to engage their family and community on health promotion, including HIV prevention research procedures, thus improving their self-esteem and communication skills. Training and partnering with clinical trial participants as peer educators is an effective and sustainable community-based approach for HIV prevention.
This study was designed to examine the relationships between problem-solving skills, hardiness, and perceived stress and to test the moderating role of hardiness in the relationship between problem-solving skills and perceived stress among 500 undergraduates from Malaysian public universities. The analyses showed that undergraduates with poor problem-solving confidence, external personal control of emotion, and approach–avoidance style were more likely to report perceived stress. Hardiness moderated the relationships between problem-solving skills and perceived stress. These findings reinforce the importance of moderating role of hardiness as an influencing factor that explains how problem-solving skills affect perceived stress among undergraduates.
By conducting a content analysis of online communities connected by the Weight Watchers’ online message boards, this study examined the relationship between conversational interactivity and consumer-generated content about consumer health information, self-efficacious content, and experiences with dieting and physical activities. The results showed that discussion about successful experiences with weight loss tended to be more interactive. Discussion about consumer health information tended to be non-interactive. The findings suggest that online communities generate social support through interactive discussion about successful experiences, and the interactive discussion, in return, sustains active participation in the community.
Managing type 1 diabetes mellitus is an ongoing and challenging process; we investigated children’s experience of different treatment regimens. Interviews with 17 children (7–15 years) at two time points were analysed using the grounded theory approach. Illness phase and treatment regimen shaped how bodily cues were interpreted. Insulin pump therapy allowed children to listen to and trust their bodily cues rather than override. Shame was a barrier to support engagement. Different internalised and externalised views of type 1 diabetes mellitus emerged. Overall, children were insightful experts of their own experiences. Recommendations for psychological interventions would benefit from empirical testing.
The mediating effect of acceptance and mindfulness in the relationship between pain, depression, and physical disability was examined in 55 rheumatoid arthritis patients. Results showed that the relationship between pain and depression was mediated by both nonreact and acceptance. By contrast, the relationship between pain and physical disability was mediated by acceptance but not by nonreact. This study provides evidences that the influence of these processes is different on depression and on physical disability. These findings support models that take both general measures of mindfulness and content-specific measures of acceptance into account when conceptualizing rheumatoid arthritis. Theoretical and clinical implications are discussed.
This article analyzed how sexual satisfaction, suffering, severity and impact of urinary incontinence, and psychological morbidity affected women’s quality of life and whether suffering mediated the relationship between psychological morbidity and quality of life. The study included 80 women diagnosed with urinary incontinence receiving rehabilitation treatment. Regression analysis showed that sexual satisfaction, suffering, and urinary incontinence severity and impact predicted quality of life and that suffering mediated the relationship between psychological morbidity and quality of life. The findings suggest that interventions should be tailored according to the suffering reported by women and the impact of the urinary incontinence on the couple’s sexual relationship.
Fatigue is a common symptom associated with vasculitis and contributes significantly to impaired quality of life. Motivational control theory suggests a role for perseverative cognition and goal adjustment in fatigue. Therefore, this study investigated these potential predictors of fatigue in individuals with vasculitis. A total of 249 participants completed online questionnaires assessing fatigue, perseverative cognition, goal disengagement and goal reengagement, in addition to demographic and disease-related variables. Hierarchical regression analysis found only pain, sleep disturbance, disease activity and perseverative cognition to significantly predict fatigue. This highlights the importance of psychological factors in determining fatigue in those with vasculitis.
Medical adult male circumcision has been shown to offer men significant protection against HIV infection during peno-vaginal sex. This has resulted in calls for a national roll-out of medical adult male circumcision in South Africa, a rights-based constitutional democracy. This article explores the ways that the potential tensions between this call to circumcise as a practice of good health citizenship and the guaranteed right to bodily integrity are negotiated in interviews with 30 urban-based men in Johannesburg. The results suggest that despite its demonstrable biological efficacy, these tensions may paralyse decision- and policy-makers in grappling with the potential scaling up of medical adult male circumcision for HIV prevention in South Africa.
This study explores ways women, who endured prolonged fertility difficulties, after which they eventually conceived, integrate the two phases within their life stories. A total of 12 women were interviewed during their first pregnancy after having experienced 2–6 years of infertility. Three types of narratives were identified: (1) the infertility overshadows the pregnancy and approaching motherhood, (2) the pregnancy leads to a dissociation concerning the infertile period, and (3) the two states coexist together along an integrated continuum. We suggested that the different narrative types may occur in diverse circumstances that entail integrating a crisis or prolonged illness into a constructive and meaningful life story.
The SLC6A3 gene is involved in the dopamine pathway, which influences smoking behavior. This study was conducted to present updated results of a meta-analysis to evaluate the association between SLC6A3 polymorphism and smoking cessation. In total, eight studies were assessed, and 9-repeat alleles and no 9-repeat alleles were compared by smoking cessation outcomes. No significant association between SLC6A3 genotype and smoking cessation was observed for the main analysis (odds ratio = 1.128; 95% confidence interval = 0.981–1.298). In conclusion, the genetic variations in SLC6A3 are not associated with smoking cessation, which is not consistent with the results of the previous meta-analysis.
A confirmatory analysis was performed to validate the Questionnaire on the Health Staff’s Perceptions Regarding Doutores da Alegria’s Intervention, a 40-item instrument designed to assess pediatric staff’s perceptions regarding the effects of Doutores da Alegria, a Brazilian hospital clowning professional organization. Eight dimensions were evaluated: the permanence of Doutores da Alegria’s interventions; Doutores da Alegria’s intrapersonal and interpersonal effects on their relation to health staff; themselves; staff–children; and staff–family relationships; as well as their effect on staff’s cultural development; children’s relation to their own disease; and families’ attitude regarding their child’s condition. In all, 567 health professionals from 13 Brazilian hospitals participated. The instrument’s good psychometric features are acknowledged.
The incidence of lung cancer is very high and evidence suggests that patients experience imbalanced emotional capabilities due to less survival rate compared to other cancers. Direct and indirect psychological interventions are mandatory to improve the outcome of lung cancer treatment. Although such interventions are being practiced in developed nations, the effects of psychological interventions on the treatment outcome in the Indian context are lacking. Since there is a definite correlation between treatment outcome and psychological issues, it is high time that clinicians in developing countries including India adopt practices to enhance the quality of life of lung cancer patients.
This study aimed to explore the construct of recovery from anorexia nervosa through the medium of weblogs, focusing on the benefits and barriers to the recovery process. Data were extracted from female (n = 7) and male (n = 1) participants’ textual pro-recovery weblogs, all of which were posted between 2013 and 2015 in the public domain. Data were analysed using interpretative phenomenological analysis. Three superordinate themes were identified: (1) barriers to recovery, (2) factors increasing the likelihood of recovery and (3) support. Results suggest supportive relationships, regaining control and recognising the consequences of the eating disorder benefit recovery, whereas public perceptions, the anorexia nervosa voice and time act as barriers to recovery. Out of eight participants, four described seeking professional help as part of their recovery, of which three believed their professional therapy experience helped aid recovery. Implications for anorexia nervosa treatment are discussed in detail.
This study explored the association between parental fear of hypoglycemia, anxiety, and subjective well-being in parents of children and adolescents with type 1 diabetes. A total of 120 mothers and 79 fathers participated. Mothers’ and fathers’ fear of hypoglycemia was significantly associated with anxiety and negative affect as well as with worse glycemic control in child. Paired-samples t-test showed that mothers were more involved in diabetes management and reported more fear and anxiety compared to fathers, but they did not differ in worries about hypoglycemia. The findings suggest screening for fear of hypoglycemia and subjective well-being in all parents regardless of whether their child experienced severe hypoglycemia.
Bariatric surgery is currently the most viable and cost-effective treatment for obesity. This study aimed to understand, from a female patient’s perspective, what contributed to not achieving or maintaining excess weight loss from a primary laparoscopic adjustable gastric band surgery, leading to subsequent multiple revisional bariatric surgeries. The purposive sample of participants (N = 17 females) were over 18 years, had a primary failed laparoscopic adjustable gastric band and had more than three revisional procedures. Participants were individually interviewed and data were analysed from a grounded theory methodology to build a causal model with the core category of unrealistic expectations of bariatric surgery and other important conceptual categories.
Exercise-related cognitive errors reflect biased processing of exercise-relevant information. The purpose of this study was to examine whether differences existed between individuals reporting low and high exercise-related cognitive errors on information processed about a relevant exercise decision-making situation. In all, 138 adults completed an online questionnaire. The high exercise-related cognitive error group primarily focused on negative content about the situation compared to the low exercise-related cognitive error group who focused on both positive and negative content. The high exercise-related cognitive error group displayed biased processing of exercise information, as suggested by the cognitive errors model. Future research should examine whether biasing information processing caused by exercise-related cognitive errors can be modified and attenuated.
This study investigated how women with secondary breast cancer experience telling their adolescent children. Semi-structured interviews were conducted with women who had been diagnosed with secondary breast cancer at least 1 year prior to the interview. Seven women, who had at least one child between 12 and 19 years old living at home at the time of diagnosis, were interviewed. The interviews were analysed using interpretative phenomenological analysis for an in-depth understanding of women’s experiences. Women found that it was easier to tell their children of their secondary breast cancer diagnosis compared to their primary cancer. However, they talked about the impact the diagnosis had on their family.
Unexpected health-endangering events that lead to an emergency department visit may be perceived as "wake-up calls" and induce significant changes in health-related behavior ("health shock" effect). This study uses two waves of a survey of 826 adults with depression and finds that having an emergency department visit(s) increased medication adherence by 7.6 percentage points (p < 0.05) relative to non-emergency department visitors but had no significant effect on counseling attendance (0.02% points, p = 0.380). Emergency department visits may provide an opportune teachable moment to initiate targeted interventions for positive behavioral change in adults with depression.
This investigation explores Ebola conspiracy beliefs, a form of medical mistrust, and their potential impact on health behavior. Results of an online survey in the United States in December 2014 demonstrated that 16 percent of 202 participants held conspiracy beliefs. Participants who were less knowledgeable about Ebola, more mistrustful of medical organizations, and more xenophobic more strongly endorsed conspiracy beliefs. Participants who more strongly endorsed conspiracy beliefs reported that they would be less likely to seek care for Ebola and were less supportive of quarantining people returning from West Africa. Results suggest that medical mistrust may influence health behaviors during infectious disease outbreaks.
This study investigates whether illness representations predict changes in asthma control or vice versa. Illness perceptions and asthma control were assessed in N = 113 asthma patients at the begin/end of an inpatient rehabilitation. Bivariate cross-lagged panel analyses showed that the illness representation dimensions Personal control, Consequences, Coherence, and Emotional representation predicted the change in asthma control, but asthma control did not predict illness representations. In multiple regression analyses with covariates, Personal control still predicted the change in asthma control. Illness beliefs assessed at the beginning of an intervention might help to identify patients with lower probability of treatment success.
This study sought feedback from teachers and adolescents on a novel intervention to reduce alcohol misuse based on the Prototype Willingness Model. A qualitative, think-aloud interview study was conducted with 17 adolescents aged 11–14 years and nine teachers. Transcripts were analysed using thematic analysis. Adolescents found the content of the intervention appealing and credible. Teachers welcomed the content and format as a means of generating discussion. ‘Moderate’ drinking appeared to be an acceptable message, although difficult to define. Enacting ‘if-then’ plans in real social situations might be challenging and representations of drinking on social media should be considered.
This article analyses research exploring medication adherence, help-seeking behaviour, screening and behaviour change to argue that all interventions have the potential for both benefit and harm. Accordingly, health psychology may have inadvertently contributed to psychological harms (e.g. lead times, anxiety, risk compensation and rebound effects); medical harms (e.g. medication side effects, unnecessary procedures) and social harms (e.g. financial costs, increased consultations rates). Such harms may result from medicalisation or pharmaceuticalisation. Or, they may reflect the ways in which we manage probabilities and an optimistic bias that emphasises benefit over cost.
Hematopoietic stem cell transplant survivors often share advice with patients undergoing this difficult treatment. We content analyzed narratives written by 59 transplant survivors given the opportunity to share advice with patients. Analyses described categories of advice they shared and evaluated their perceptions of the helpfulness of advice they had received. We found nine advice categories and evidence for variation in their perceived helpfulness, especially for advice to "be your own advocate," "have someone you can rely on," and "think positive." Findings suggest the need to investigate how seemingly innocuous advice can be unhelpful and potentially distressing to some patients.
Patients aged 18–65 years with newly diagnosed diabetes mellitus (n = 89) or rheumatoid arthritis (n = 100) were studied by the General Coping Questionnaire at baseline and after 24 months. In total, 34 diabetes mellitus and 46 rheumatoid arthritis patients were diagnosed with psychosocial problems. The use of negative coping strategies, such as protest, isolation, and intrusion, was associated mostly with being classified as having psychosocial problems. With the risk of experiencing a strong impact of the disease at 2 years of follow-up as outcome, intrusion was a significant and independent risk factor, while minimization was a significant and independent protective factor.
This interview study documented how individuals with sickle cell disease make decisions about who to talk with concerning their illness based on psychological and interpersonal issues that are important to them. Reasons for sickle cell disease disclosure to specific persons were self-related (receiving support, venting feelings), other-related (educating others about sickle cell disease, forewarning others about sickle cell disease-related problems, someone asked for information about the disease), or situational (mostly focusing on another person being physically close or available to talk to). Reasons for sickle cell disease nondisclosure to specific persons were self-related (fear of rejection, being stereotyped, maintaining privacy) or other-related (lack of support, not worrying someone).
Fibroline is a mobile application with a self-administered cognitive behavioral treatment for young people with fibromyalgia or chronic widespread pain, designed to reduce pain and other common negative symptoms and improve quality of life. Our aims are to report on the usability and feasibility protocols used to assess the app. Two usability cycles were implemented. A group of patients followed the cognitive behavioral treatment intervention to test its feasibility. Qualitative data were collected and content analyses were conducted. The results demonstrated that the app is error-free, easy to use, liked by the users, and acceptable.
Implicit theories of smoking refer to people’s beliefs about whether smoking behavior is something that is changeable (incremental belief) or fixed (entity belief). This study examines implicit theories of smoking and its association with smoking behavior in a nationally representative sample of US adults using data from the Health Information National Trends Survey. The current results show that implicit theories of smoking are associated with smoking. Among former smokers, 90 percent endorsed an incremental belief about smoking compared to 70 percent of current smokers. Our study provides initial evidence for the role of implicit theories of smoking as a psychological factor associated with smoking behavior.
Self-affirmation may reduce defensive processing towards health messages. We tested the effects of a self-affirmation implementation intentional intervention with regard to salt risk message acceptance, estimates of daily-recommended intake and self-reported intake. Participants (n = 65) who consumed over 6 g/day of salt were randomised into three conditions: self-affirmation, self-affirming implementation intention and control. Participants attended the laboratory and completed a 2-week follow-up. There was no effect of the condition on message acceptance, salt estimation and 2-week salt intake. Across conditions, 2-week salt intake was reduced. We found no evidence for either intervention with regard to salt risk message acceptance and behaviour change.
While eating in response to emotional cues is associated with intake of unhealthy foods, less is known about the extent to which obesity and depression may differentially influence food intake in a buffet-style setting where low- and high-calorie foods are available to choose from. Using a counterbalanced design, 154 participants were grouped by depression and obesity categories, then asked to read a series of vignettes that were sad (on 1 day) and neutral (on a different day), followed by a buffet to eat until full. Food intake (in grams and calories) and food choice (number of high- or low-calorie food options) were recorded. Results showed that participants who were obese and depressed had significantly greater energy intake following the sad versus happy vignette, largely due to increased intake of high-calorie foods. The results corroborate recent theories on emotional eating and extend the ecological validity of such effects in a buffet-style setting.
The purpose of this study was to explore the experiences of parenting a child with a dual diagnosis of childhood deafness and autism spectrum disorder who underwent cochlear implantation. Experiences of these parents are rarely discussed within the literature. Interpretive Phenomenological Analysis was used to examine nine mothers of boys (4–9 years old) for understanding their parenting experiences. Three superordinate themes were identified: complexity, personal and family sacrifices and parent–professional partnerships. These themes provide a rich account of mothers’ interpretations of their experiences, and reflect the numerous challenges they face. This study helps expand the literature on cochlear implantation for children with autism spectrum disorder, and discusses implications for clinical and educational practice.
Emerging evidence suggests that individuals spontaneously self-affirm, by reflecting on values and strengths, in response to daily threats. We examined the prevalence and demographic and well-being correlates of spontaneous self-affirmation in the general population. Participants (n = 3185) completed the cross-sectional, nationally representative 2013 Health Information National Trends Survey (HINTS 4, Cycle 3), and answered questions about spontaneous self-affirmation, demographic factors, well-being, and affect. The majority of the population reported spontaneously self-affirming. Black and Hispanic respondents reported engaging in more spontaneous self-affirmation. Engaging in spontaneous self-affirmation was related to greater happiness, hopefulness, optimism, subjective health, and personal health efficacy, and less anger and sadness.
School children are usually encouraged to tell an adult whether they are being bullied. Despite this encouragement, a significant percentage of bullied students do not disclose victimization. Previous research has often failed to include this group of hidden victims, thereby limiting the available knowledge about victimization disclosure. This study aimed to investigate the process of disclosing bullying victimization from the victim’s point of view. Interviews with Swedish youth who had been or currently were victims of bullying in school were carried out and analyzed with grounded theory methods using two-step coding.
Persons with mental health diagnoses use tobacco at alarming rates, yet misperceptions remain about the effect of quitting on mental health outcomes. This article examines the relationship between tobacco cessation and changes in severity of mental illness. Participants were N = 577 veterans with a history of mental health treatment enrolled in a tobacco cessation study. The effects of abstinence and time on Behavior and Symptom Identification Scale–24 summary scores and subscales were examined. Abstinence at both 2 and 6 months post-baseline was related (p < .0001) to lower Behavior and Symptom Identification Scale–24 summary scores and improvement on three Behavior and Symptom Identification Scale–24 subscales. Providers should recommend and provide tobacco treatment to all mental health patients to improve their physical and mental health functioning.
The ‘necessity–concerns framework’ postulates that patients’ adherence behaviour is influenced by beliefs about the necessity and the concerns patients have regarding their prescribed medicines. We hypothesized that depression moderates the associations between beliefs about medicines and medication adherence among people with rheumatoid arthritis. Using multivariate logistic regression, we observed that people experiencing more depressive symptoms showed stronger associations between necessity beliefs and adherence as well as attenuated associations between concerns and adherence, respectively, in a cross-sectional sample (N = 361). Thus, depression moderates the associations postulated in the ‘necessity–concerns framework’ in a differential way in people with rheumatoid arthritis.
Depression is prevalent among people living with HIV in South Africa and interferes with adherence to antiretroviral therapy. This study evaluated a nurse-delivered, cognitive behavioral therapy intervention for adherence and depression among antiretroviral therapy users with depression in South Africa (n = 14). Primary outcomes were depression, antiretroviral therapy adherence, feasibility, and acceptability. Findings support robust improvements in mood through a 3-month follow up. Antiretroviral therapy adherence was maintained during the intervention period. Participant retention supports acceptability; however, modest provider fidelity despite intensive supervision warrants additional attention to feasibility. Future effectiveness research is needed to evaluate this nurse-delivered cognitive behavioral therapy intervention for adherence and depression in this context.
To test the hypothesis that self-compassion predicts better physical health and that this is partially mediated through health-promoting behaviours, 147 adults completed self-report measures of self-compassion, health-promoting behaviours and physical health. Self-compassion and health-promoting behaviours were negatively associated with physical symptom scores. Self-compassion was positively associated with health-promoting behaviours. A bootstrapped mediation model confirmed a significant direct effect of self-compassion on physical health through health-promoting behaviours (R2 = 0.13, b = –8.98, p = 0.015), which was partially mediated through health-promoting behaviours (R2 = 0.06, b = –3.16, 95 per cent confidence interval [–6.78, –0.86]). Findings underscore the potential health-promoting benefits of self-compassion.
Previous research has examined factors thought to influence individuals’ interest in cosmetic surgery, yet few studies have examined these issues among midlife women. This study examines predictors of cosmetic surgery attitudes among midlife women (N = 114; age = 45–65 years; Mage = 53.7) and considers a previously unexplored variable: fear of negative appearance evaluation. Results indicated that lower weight and appearance esteem were associated with more positive cosmetic surgery attitudes and greater fear of negative appearance evaluation. Furthermore, fear of negative appearance evaluation mediated the relationship between appearance and weight esteem and cosmetic surgery attitudes. We conclude that fear of negative appearance evaluation is an important factor to consider in examining cosmetic surgery attitudes.
We assessed among a sample of 724 Dutch lesbian, gay, and bisexual–identified adults (Mage = 31.42) whether experiences with homophobic stigmatization and internalized homophobia simultaneously mediated the relation of gender nonconformity with mental health. Results indicated that homophobic stigmatization and internalized homophobia partially mediated the relation between gender nonconformity and mental health. Gender nonconformity was related to more mental health problems via increased experiences with homophobic stigmatization and to less mental health problems because of reduced levels of internalized homophobia. However, the mediated relation of gender nonconformity with mental health via homophobic stigmatization was only significant for men.
A consistent/stable sense of the self is more valued in middle-class contexts than working-class contexts; hence, we predicted that middle-class individuals would have higher self-concept clarity than working-class individuals. It is further expected that self-concept clarity would be more important to one’s well-being among middle-class individuals than among working-class individuals. Supporting these predictions, self-concept clarity was positively associated with higher social class. Moreover, although self-concept clarity was associated with higher life satisfaction and better mental health, the association significantly attenuated among working-class individuals. In addition, self-concept clarity was not associated with physical health and its association with physical health did not interact with social class.
Depression and alcohol misuse are common co-occurring conditions. This study aimed to determine the accuracy of general practitioner identification of depression and alcohol misuse. Participants from 12 Australian general practices reported demographic and health risk behaviour data. General practitioners were asked to indicate the presence or absence of six health risk factors for individual patients. Accuracy of general practitioner identification was low at 21 per cent. Those with severe alcohol misuse, no chronic diseases and lower education levels were more likely to be identified. Routine screening prior to patient appointments may be a simple and efficient way to increase identification rates.
This study investigated depression and anxiety among Chinese elderly earthquake survivors, addressing relevant correlations. We sampled one earthquake-prone city, utilising the Geriatric Depression Scale and Beck Anxiety Inventory. In addition, explorative factor analysis and structural equation model methods were used. Results indicated elderly earthquake survivors exhibited symptoms of moderate depression and anxiety; depression and anxiety are highly positively correlated. The overlap between these two psychological problems may be due to subjective fear and motoric dimensions; subjective fear and motoric dimensions of Beck Anxiety Inventory are more strongly related to Geriatric Depression Scale domains. The two scales exhibit high reliability and validity.
This study used Rasch analysis to examine the psychometric validity of the Diabetes Distress Scale and the Problem Areas in Diabetes scale to assess diabetes distress in 3338 adults with diabetes (1609 completed the Problem Areas in Diabetes scale (n = 675 type 1 diabetes; n = 934 type 2 diabetes) and 1705 completed the Diabetes Distress Scale (n = 693 type 1 diabetes; n = 1012 type 2 diabetes)). While criterion and convergent validity were good, Rasch analysis revealed suboptimal precision and targeting, and item misfit. Unresolvable multidimensionality within the Diabetes Distress Scale suggests a total score should be avoided, while suboptimal precision suggests that the Physician-related and Interpersonal distress subscales should be used cautiously.
While there is evidence that spouses can impact the self-management of adults with type 2 diabetes mellitus, less is known about the influence of the wider social network. This qualitative study explored the perceived impact of the family as well as friends and work colleagues on type 2 diabetes mellitus self-management. A total of 25 adults with type 2 diabetes mellitus participated in semi-structured interviews regarding their social experiences of living with diabetes. Deductive thematic analysis was applied to the data. Pre-existing themes of health-related social control and social support were identified in the wider social network, with additional themes of non-involvement and unintentional undermining also emerging.
To determine whether coping strategies modify the risk of depression among allogeneic recipients experiencing post-transplant-related symptomatology, 105 participants (mean age = 52 years, 42% female) completed questionnaires 90 days post-transplant. A total of 28 percent reported depressive symptoms. Univariate correlations indicated that depression was associated with greater transplant-related symptomatology and avoidance, acceptance/resignation, and emotional discharge coping. Depression was negatively associated with problem-solving coping. Moderator analyses indicated that transplant-related symptomatology was significantly associated with depression among patients who frequently used maladaptive coping and rarely used adaptive coping. These data suggest that transplant-related symptomatology, combined with maladaptive coping, place patients at risk of depression.
Through focus groups, we explored 22 third- to fifth-grade teachers’ perceptions about their eating habits, including barriers and facilitators to healthy eating. It also explored teachers’ thoughts about how to teach students healthy eating habits. The information was transcribed and treated using the content analysis technique. Results were evaluated using the concept of majority and minority group and presented in a sequential way: teachers’ perceptions about eating habits, barriers to healthy eating, teacher’s culinary habits, abilities to teach students healthy eating habits through Information and Communication Technologies, and cooking activities. Teachers’ eating habits were poor, with lack of time, money, and will to improve. They had culinary habits skills and the desire to instruct and guide their students in eating healthier food. They need a program with Information and Communication Technologies and cooking workshops to apply in the classroom.
A recent systematic review suggests that minimally invasive venous surgery for the treatment of leg ulcers may have a greater impact on quality of life than traditional approaches. A total of 11 participants who had previously undergone surgical management for leg ulcers took part in semi-structured interviews regarding their experiences. Using thematic analysis, three themes were identified: ‘Living in Flux’, ‘Perceptions of Chronicity’ and ‘Expectations’. Surgical treatment may not only improve patients’ quality of life due to treatment of the condition but also by opening up a sense of hope, investment and agency not associated with traditional treatment approaches.
Binge watching is a relatively new behavioural phenomenon that may have health implications. The aim of this study was to estimate the frequency of, and identify modifiable factors associated with, TV binge watching. A total of 86 people completed an online questionnaire assessing self-efficacy, proximal goals, outcome expectations, anticipated regret, automaticity, goal conflict and goal facilitation, and self-reported binge watching over the last week. Participants reported binge watching a mean 1.42 days/week (standard deviation = 1.42). Intention and outcome expectations accounted for variance in binge watching, and automaticity, anticipated regret and goal conflict each separately accounted for additional variance in binge watching. Binge watching is commonplace and associated with both reflective and impulsive factors.
We evaluated the association of social factors and weight control practices in adolescents, and the mediation of this association by weight perception, in a national survey of students in Mexico (n = 28,266). We employed multinomial and Poisson regression models and Sobel’s test to assess mediation. Students whose mothers had a higher level of education were more likely to perceive themselves as overweight and also to engage in weight control practices. After adjusting for body weight perception, the effect of maternal education on weight control practices remained significant. Mediation tests were significant for boys and non-significant for girls.
The politics of silence is central to disability experience and the field of disability studies. In this analytical autoethnography, I write about my silences as a visually impaired woman. I explore and make sense of personal life stories through a theoretical perspective. The analysis of these personal experiences lead me to argue that disability-related silences are mostly created through the confluence of inaccessible physical and social environments and the psychological internalisation of these worlds. I also discuss the ways in which I am currently regaining my voice. Further research on resistance by disabled persons is recommended.
Men’s experiences of infertility help seeking are under-researched and thus less widely understood than women’s experiences, with men’s needs for support often missing from reproductive research knowledge. This article presents a thematic analysis of peer-to-peer posts within the context of a UK men-only online infertility forum. The key themes demonstrate that men value male support from those with experience, and that masculinity influences help-seeking requests and men’s accounts more broadly. We highlight the value of such online communities in offering support to men in need while recognising the importance of further research across other online settings in order to inform practice around supporting men in the reproductive realm.
Taking a feminist health psychology approach, we conducted a systematic review of published research on abortion featured in PsycINFO over a 7-year period. We analysed the 39 articles included in the review in terms of countries in which the research was conducted, types of research, issues covered, the way the research was framed and main findings. Despite 97 per cent of abortions performed in Africa being classifiable as unsafe, there has been no engagement in knowledge production about abortion in Africa from psychologists, outside of South Africa. Given this, we outline the implications of the current knowledge base for feminism, psychology and feminist health psychology in Africa.
Hepatitis C virus is stigmatised because of its association with injecting drug use. Although treatment is available, uptake remains low, especially among people who inject drugs. Ninety health workers completed a survey assessing attitudes towards people who inject drugs and support for treatment for three client scenarios: one who stopped injecting, one on methadone, and one continuing to inject. Support for hepatitis C virus treatment was significantly higher, where the client was not injecting. Participants who showed more negative attitudes towards people who inject drugs were less supportive of clients entering hepatitis C virus treatment, illustrating the influence of health workers’ attitudes in determining treatment options offered to clients.
Chronic fatigue syndrome/myalgic encephalomyelitis can limit functional capacity, producing various degrees of disability and psychological distress. Semi-structured interviews explored the experiences of adults with chronic fatigue syndrome/myalgic encephalomyelitis being physically dependent on other people for help in daily life, and whether physical dependency affects their psychological well-being. Thematic analysis generated six themes: loss of independence and self-identity, an invisible illness, anxieties of today and the future, catch-22, internalised anger, and acceptance of the condition. The findings provide insight into the psychological impact of dependency. Implications for intervention include better education relating to chronic fatigue syndrome/myalgic encephalomyelitis for family members, carers, and friends; ways to communicate their needs to others who may not understand chronic fatigue syndrome/myalgic encephalomyelitis; and awareness that acceptance of the condition could improve psychological well-being.
Significant challenges remain in tackling the global HIV/AIDS epidemic. Effective action requires both appropriate policy at a global level and informed practice on the local level. Here, we report how workers in a project in Johannesburg, South Africa, make sense of HIV transmission. Discourse analysis of data from interviews with 63 participants shows that project workers routinely attribute transmission to men’s sexual relationships with multiple female partners. This explanation is so pervasive that it renders invisible other routes to transmission. Absence of consideration of other routes to infection potentially restricts front-line practice, so hindering local attempts to tackle HIV/AIDS.
The aim of our research is to highlight the role of social representations of the traumatic brain-injured person in the adjustments made by caregivers in building and maintaining quality of care. Twenty-three semi-structured interviews were conducted with nursing assistants and medico-psychological assistants, working in a long-term care facility. The interviews were the subject of a thematic content analysis. The analysis shows the role of representations of the traumatic brain-injured person in the way caregivers explain behaviours and situations and in the orientation of their professional practices. In explaining the inexplicable, caregivers establish a more human relationship through individualized care.
This study examines the associations between symptoms of mental disorders and diabetes and hypertension in a nationally representative sample of South Africans. We examined unadjusted and adjusted associations of socio-demographic characteristics, alcohol use and psychological distress with diabetes and hypertension. Multivariate logistic regression revealed that hypertension is significantly associated with age, while diabetes is significantly associated with age, population group and psychological distress. The association between psychological distress and diabetes found here suggests the usefulness of additional research using more detailed measures of psychiatric disorders in local studies and reinforces clinical calls for attention to psychiatric screening in patients with diabetes.
This article discusses the condition of continuous traumatic stress as common on the African continent and in other international settings characterised by very high levels of ongoing violence and threat of community, political or war-related origin. Through consideration of three case studies from South Africa, contexts of continuous traumatic stress are described, and the mental health and physical health effects of living in such contexts are elaborated. Cautions are raised about attempting to transpose existing posttraumatic stress models onto individuals exposed to situations of continuous traumatic stress, and guidelines for optimal interventions with such cases are proposed.
This study examined health-related quality of life among a sample of South African women diagnosed with endometriosis. Semistructured interviews were conducted with 25 participants in South Africa. Participants discussed the ways in which endometriosis affected their health-related quality of life. A total of 10 categories emerged from the data, namely, (1) medical factors, (2) physical functioning, (3) psychological functioning, (4) sexual functioning, (5) reproductive functioning, (6) interpersonal functioning, (7) occupational functioning, (8) information and knowledge, (9) healthcare and medical treatment and (10) financial impact and considerations. Each category was described and compared with findings from other health-related quality of life research in women with endometriosis.
Recent studies have shown that mindfulness training has a promising potential for smoking treatment. In order to examine the efficacy of mindfulness training in smoking cessation, we performed a systematic review of the literature and meta-analysis of randomized controlled trials. Four randomized controlled trials with 474 patients were included in our analysis. The results showed that 25.2 percent of participants remained abstinent for more than 4 months in the mindfulness group compared to 13.6 percent of those who received usual care therapy (relative risk, 1.88; 95 percent confidence interval, 1.04–3.40). Our results suggest that mindfulness training may have an important role to play in efforts to lower cigarette smoking rates.
This study compares maladaptive coping, measured as substance use, behavioral disengagement, self-blame, and emotional eating, among adults (>18 years) who have experienced early parental loss (N = 1465 women, N = 331 men) with non-bereaved controls (N = 515 women, N = 115 men). We also compared bereaved adults who received grief counseling (N = 822 women, N = 190 men) with bereaved controls who had not (N = 233 women, N = 66 men). Bereaved adults reported significantly more substance use, behavioral disengagement, and emotional eating than non-bereaved adults. Counseling participants reported significantly more substance use and self-blame than non-participants. Our results suggest that early loss may negatively impact the development of adulthood coping.
In anticipation of a future HIV vaccine, we mapped the different personal positions regarding HIV vaccination of people in Togo. In early 2014, 363 adults indicated their willingness to receive a future HIV vaccine under different conditions varying as a function of five factors: perceived susceptibility to HIV, vaccine effectiveness, perceived severity of AIDS, vaccine cost, and family’s influence. We found five qualitatively different positions: unconditional acceptance (49%), depends on cost/effectiveness ratio (20%), depends on cost (18%), total indecision (10%), and complete reluctance (3%). Accordingly, HIV vaccination strategies in Togo and elsewhere in Africa need to be multifaceted and tailored.
This study explored appearance-related images and messages present in pregnancy magazines (e.g. Fit Pregnancy, Pregnancy & Newborn, and Pregnancy Magazine). A substantial portion of advertisements and articles promoted appearance-related products or products for postpartum weight loss. Health messages and messages related to diet and exercise were also present. Images also sexualized pregnant women’s bodies. Appearance-related messages aimed toward pregnant women may be problematic and may contribute to body dissatisfaction in these women.
‘Fitspiration’ is an online trend designed to inspire viewers towards a healthier lifestyle by promoting exercise and healthy food. This study provides a content analysis of fitspiration imagery on the social networking site Instagram. A set of 600 images were coded for body type, activity, objectification and textual elements. Results showed that the majority of images of women contained only one body type: thin and toned. In addition, most images contained objectifying elements. Accordingly, while fitspiration images may be inspirational for viewers, they also contain a number of elements likely to have negative effects on the viewer’s body image.
Many women with gynecological cancer report psychosocial distress, and clarification of the risks, vulnerabilities, and protective factors is required. The aim of this study was to investigate the lived experience of gynecological cancer patients and to understand the factors that underlie psychosocial distress. Semi-structured interviews with seven women diagnosed with gynecological cancer revealed the role of social support, or its absence, selective withholding of information, and existential loneliness in women’s experience of distress. Social support provided a buffer against distress, while feelings of alienation and being alone exacerbated distress. Interventions to address these concerns may lead to improved quality of life for this patient group.
In this study, we investigated the relationship between work–family conflict and job burnout as well as the potential mediation/moderation effects of psychological capital. Participants were 357 university teachers who completed a questionnaire packet containing a work–family conflict scale, psychological capital questionnaire, and Maslach Burnout Inventory–General survey. According to the results, work–family conflict and psychological capital were both significantly correlated with job burnout. In addition, psychological capital cannot mediate—but can moderate—the relationship between work–family conflict and job burnout. Taken together, our findings shed light on the psychological capital underlying the association of work–family conflict and job burnout.
This study examined how coping styles are related to functional status in patients with medically unexplained physical symptoms and to what extent depression and anxiety account for this relationship. In 90 Dutch adult patients presenting medically unexplained physical symptoms, coping styles, health-related functional status, anxiety, and depression were measured. Multiple regression analyses and mediation analysis showed that coping styles were directly and indirectly related to functional status. In this relationship, depression and anxiety played an important role. The findings highlight the relevance of addressing coping styles, depression, and anxiety when targeting the functional status of patients with medically unexplained physical symptoms in clinical practice.
College waterpipe tobacco smokers who feel more ambivalence, that is, conflicted about its use, may have a stronger desire to quit. Using baseline survey data of 315 college waterpipe smokers, we examined this relationship. While frequency of feeling ambivalence was low, greater ambivalence was related with desire to quit (r = .46, p < .001). This relationship remained significant after accounting for several correlates of desire to quit (e.g. perceived risk and worries about harm and addiction). Findings suggest that ambivalence may be an important independent variable linked with desire to quit and should be explored further as a factor influencing waterpipe tobacco use.
In this study, a survey of Sri Lankan adolescents explored relationships between thin-ideal internalization and body dissatisfaction—issues that have received greater research attention in East Asia and the West. Girls scored lower in thin-ideal internalization and awareness and higher in self-esteem compared to boys; however, unlike in previous studies, body dissatisfaction did not differ significantly by gender. Hierarchical linear multiple regression analyses revealed that self-esteem moderated the relationship between thin-ideal internalization and body dissatisfaction among girls, but this was not observed for boys. Self-esteem as a protective factor against body dissatisfaction among Sri Lankan female adolescents was confirmed.
This study uses blog analysis, a new and novel technique, to explore the positive outcomes experienced by burn survivors. This study examined 10 burn survivor blogs to offer a unique, longitudinal insight into burn survivor recovery. Using thematic analysis, three themes emerged: shift in self-perception, enhanced relationships and a change in life outlook. Many of these themes contained stories and experiences unique to a traumatic burn injury, suggesting that standardised trauma scales are not effectively measuring the impact of a burn in this population. Reflections on blog analysis are discussed, along with a recommendation that health researchers utilise the vast amount of data available from online blogs.
We present a thematic discourse analysis of 94 Australian women’s written comments about women’s presumed dissatisfaction with their genital appearance. Two themes emerged: ‘from natural to normal’ and ‘the difficulty of resistance’. In the first theme, participants discuss genital dissatisfaction with reference to hegemonic constructions of femininity and to postfeminist, neoliberal discourses that position the natural female body as inadequate, with beauty practices necessary to achieve acceptability. The second theme addresses the difficulty of challenging this positioning, referencing discourses that position the vagina as unpleasant and discussion of it as taboo. We consider implications of these constructions for women’s well-being.
Breast cancer is number one in incidence and sixth in mortality among all cancers of women in China. Prior work identified positive consequences following diagnosis and treatment, including benefit finding among breast cancer survivors from Western countries. This study evaluated psychosocial correlates of benefit finding in breast cancer survivors in China. A total of 148 participants completed measures of coping, perceived stress, depressive symptoms, social support, and benefit finding. Results indicated that benefit finding was positively related to active coping and negatively related to depression. Future research may evaluate whether interventions to enhance active coping will improve outcomes among Chinese breast cancer survivors.
The complex linguistic profile of South Africa has the potential to limit the efficiency of emergency calls. Emergency services depend on rapid resolution of a call, dispatch of an ambulance and response at scene. Resolving language mismatches is a critical feature of everyday practice in such a setting. This study examined accommodation to language shifts in a call centre using conversation analysis methods. Three main call trajectories were identified and the analysis suggested marked differences in responsivity, reflecting attitudinal and societal stratification. Conversation analysis provided insight into communication barriers and contextual features, which have implications for training.
This study aims at examining the attachment states of mind in 50 female outpatients with eating disorders compared with 50 matched control participants using the Adult Attachment Interview. Moreover, the differences in attachment states of mind among eating-disordered women with and without borderline personality disorders’ diagnosis were explored. The results showed an over-representation of insecure-dismissing and unresolved states of mind in clinical group compared to controls. Patients with both diagnosis showed higher scores on involving anger and unresolved loss compared with those with only eating disorder. Implications for further research and clinical practice are discussed.
Subsyndromal posttraumatic stress among pediatric cancer survivors has been associated with negative physical and mental health outcomes. However, adolescent self-report and mother-proxy report of adolescents’ posttraumatic stress symptoms evidenced varying concordance depending on methodology. There was moderate concordance, particularly among younger respondents, when total posttraumatic stress symptoms were viewed continuously and low-moderate concordance when viewed categorically; moderate-strong concordance for only one posttraumatic stress disorder symptom cluster; low-moderate agreement for high-frequency items; and no concordance for identifying caseness. Although a significant subset of pediatric cancer survivors experience posttraumatic stress, mothers and adolescents demonstrate limited symptom, categorical, and caseness agreement, potentially impacting adolescents’ healthcare service utilization.
UK government guidance for alcohol consumption is expressed in ‘units’ of alcohol. This study employed semi-structured interviews to explore university students’ knowledge of, attitudes towards, and use of unit-based guidelines. Thematic analysis revealed that participants were not motivated to adhere to unit-based guidelines and that they lacked the skills required to apply them to reduce their own drinking. Instead, interviewees used individual strategies to monitor their drinking. The results suggest that public health interventions should include provision of information, efforts to motivate young people to change their behaviour and strategies to develop skills for managing alcohol consumption.
The objective of this work was to study the agreement between four pain intensity scales when administered electronically: the Numerical Rating Scale-11, the Faces Pain Scale-Revised, the Visual Analogue Scale and the Coloured Analogue Scale. In all, 180 schoolchildren between 12 and 19 years old participated in the study. They had to report the maximum intensity of their most frequent pain using the electronic versions of the four scales. Agreement was calculated using the Bland–Altman method. Results show that the electronic versions of Numerical Rating Scale-11, Coloured Analogue Scale and Visual Analogue Scale can be used interchangeably.
This qualitative study aimed to explore home haemodialysis and in-centre haemodialysis patients’ experience, to illuminate barriers and facilitators in the uptake and maintenance of home haemodialysis. Thirty-two semi-structured interviews with patients receiving home haemodialysis or in-centre haemodialysis were analysed using framework analysis. Four themes emerged: ‘perceptions of self’; ‘impact of haemodialysis on family’; ‘perceived advantages and disadvantages of home haemodialysis and in-centre haemodialysis’ and ‘practical issues and negotiating haemodialysis’. The lived experience of home haemodialysis was in contrast to the lived experience of in-centre haemodialysis and to the anticipated experience of home haemodialysis, highlighting patient factors that contributed to under-usage of home haemodialysis.
We examined whether the dispositional optimism of patients suffering from an autoimmune disease as well as of their partners can predict, at a dyadic level, their representations of illness consequences, and personal and treatment control, assessed 1 year later. Patient optimism predicted several patient and partner illness representations. Partner optimism was unrelated to own or patient illness representations. Results highlight the strong long-term predictive power of patient optimism and underline the importance of the interpersonal function of personality traits. At the same time, study findings indicate that the dyadic effects of optimism are complex and probably conditional on several factors.
Many people who have rheumatoid arthritis report low levels of physical activity. We conducted 17 interviews with people who have rheumatoid arthritis to gain insight into how they view physical activity and to explore how their levels of activity may be increased. Interviews were transcribed verbatim and analysed using thematic analysis. Four main themes were generated: being active, barriers and facilitators, information and advice, and supporting physical activity. A lack of information about being active fostered negative emotions limiting physical activity participation. Improved provision of physical activity advice is warranted to promote physical activity in people who have rheumatoid arthritis.
Reducing exposure to environmental tobacco smoke significantly reduces lung cancer risk. We used family communication patterns theory and the theory of planned behavior to examine whether perceived norms and lung cancer worry more strongly influenced intentions to avoid environmental tobacco smoke in families higher in conformity and conversation orientations. Results from 52 individuals in 17 high-risk lung cancer families showed injunctive norms were positively related to intentions when families conformed and conversed more. Lung cancer worry was positively related to intentions in high conformity families and negatively related to intentions in low conformity families. Findings can benefit interventions to reduce environmental tobacco smoke exposure.
This study examined gender differences in how internalizing and externalizing symptoms affect adolescents’ decisions about smoking in Chile, where girls smoke at some of the highest rates in the world. In multivariate logistic regression analyses with 607 adolescents, internalizing symptoms, such as depressed mood and anxiety, predicted smoking among girls more than boys, with girls who were low in internalizing symptoms being more likely to smoke than those who were high in internalizing symptoms. In Chile’s high-risk context, internalizing symptoms may be indirectly protective for girls by decreasing their exposure to peer pressure and related influences that encourage cigarette use.
Six young adults (aged 19–21 years) with repeat self-harm for over 5 years were interviewed about their self-harm, why they continued and what factors might help them to stop. Interpretative phenomenological analysis identified six themes: keeping self-harm private and hidden; self-harm as self-punishment; self-harm provides relief and comfort; habituation and escalation of self-harm; emotional gains and practical costs of cutting, and not believing they will stop completely. Young adults presented self-harm as an ingrained and purposeful behaviour which they could not stop, despite the costs and risks in early adulthood. Support strategies focused on coping skills, not just eradicating self-harm, are required.
We examined the evolution of the subjective burden of romantic partners caring for women with non-metastatic breast cancer and investigated the moderating role of couple satisfaction on caring stress. Forty-seven partners filled out questionnaires 3 and 12 months after surgery. Using a stress process model, we examined caring stressors and moderating factors (couple satisfaction, coping and social support) as predictors of subjective burden. Results showed that subjective burden decreases over time and that the couple satisfaction largely explains it above and beyond other influential variables. Partners dissatisfied with their couple relationship are especially vulnerable to the stress of caregiving.
Alcohol and other drug use is prevalent among peri-urban, South African adolescents. We identified correlates of alcohol and other drug use by gender among adolescents (age = 16–18 years; N = 822) in peri-urban Johannesburg. Interviewer-administered surveys assessed sexual activity, alcohol and other drug use, and relevant psychosocial factors. In separate logistic regression models of alcohol and other drug use stratified by gender, violence exposure and sexual activity were associated with alcohol use for both males and females. For females only, depressive symptoms were associated with drug use. For males only, being older and sexually active were associated with drug use. Substance use interventions for South African adolescents should consider psychological health, sexual health, and tailoring by gender.
This research investigated the differential effects of sociocultural pressures from media, peers, and parents on the thin ideal internalization and body dissatisfaction of 472 Korean female college students using structural equation modeling. Results indicated that after controlling for body mass index and exercise, media pressure exerted the largest effects, followed by peer pressure and parental pressure, on thin ideal internalization, and in turn, body dissatisfaction. Furthermore, parent and media pressures were found to exert direct effects on body dissatisfaction as well as indirect effects through thin ideal internalization. The results and implications of the study are discussed.
While obtaining voluntary informed consent for research participation is an ethical imperative, there appears to be little consensus regarding what constitutes a voluntary consent decision. As a result, considerable controversy exists in the research ethics literature, with researchers and ethicists advancing numerous concerns about the voluntariness of consent to research. However, without a valid conceptualisation of voluntariness and an appropriate means of assessing it, it is impossible to determine whether commonly expressed concerns about voluntariness are well founded. For this reason, a comprehensive review of conceptual and empirical work on voluntary consent to research was conducted. On the basis of this conceptualisation, an instrument to assess influences on participants’ consent decision and perceived voluntariness was developed and piloted in two South African HIV clinical trials. The pilot study found high levels of perceived voluntariness. The feeling of having no choice but to participate was significantly associated with lower perceived voluntariness. An absence of controlling influences from other people was observed for the majority of research participants. The need for health care and trust in the researchers were primary influences on participation. Overall the data suggest that it is possible to obtain voluntary and valid consent for research participants in ethically complex HIV clinical trials in a developing country context.
Health avatars were created to deliver previously tested live interventions for tobacco dependence and cholesterol management. The exploratory aims were to develop and test whether the avatar can be reliably assessed for autonomy supportiveness using the Health Care Climate Questionnaire and estimate the mean changes in motivation variables and correlate the avatars’ autonomy supportiveness with the motivation variables and health outcomes. The avatars were found to be reliably assessed for autonomy supportiveness on the Health Care Climate Questionnaire. Autonomy support was positively correlated with the change in motivations and reduction in low-density lipoprotein. These findings suggest that health avatars may be tested in clinical trials.
While youth with emotional and behavioral disorders experience increased rates of obesity, few obesity interventions exist that are tailored to their needs. Qualitative methods were employed to elucidate obesity management practices in this population. In all, 56 participants (i.e. 21 youths with emotional and behavioral disorders, 20 caregivers of youth with emotional and behavioral disorders, and 15 mental health providers) were recruited from community mental health centers. Participants completed a demographic form and semi-structured interview regarding obesity-related behaviors. Barriers (e.g. psychiatric symptoms) and facilitators (e.g. social support) to obesity management were identified. These results highlight preferred intervention components for this unique population.
Mexican American women are disproportionately affected by overweight/obesity and the health complications accompanying them, but weight loss treatments are less successful in this ethnic group. High levels of familism, a value reflecting obligation to family that supersedes attention to oneself, interfere with weight loss for Mexican American women. This mixed methods study investigated overweight Mexican American women’s beliefs about how familism, and Mexican American culture, might hinder weight loss success, and how treatments might be culturally adapted. Results suggest a need to support women in their commitment to family while also helping them make changes. Recommendations for culturally adapted treatments are made.
In Uganda, increasing male involvement in reproductive health services may improve women’s access to care. The purpose of this study was to explore factors influencing male support for women’s reproductive health services and to elicit suggestions for strategies to increase male involvement. In 2008–2009, focus groups (N = 76) were conducted with men and women in a rural hospital in Uganda. A content analysis approach was used for data analysis. Our findings point to the need for multi-level approaches that educate and mobilize men, while improving quality of care at the facility level to increase male involvement in reproductive health services.
This study investigated the effects of illness perceptions and coping with disease on health-related quality of life in chronic obstructive pulmonary disease. Therefore, participants (N = 444) completed online questionnaires assessing illness severity (chronic obstructive pulmonary disease stage), Illness Perceptions Questionnaire, coping with disease (Essener Coping Questionnaire), and health-related quality of life (short form-12). Hierarchical regression and moderation analyses were conducted. The results showed that health-related quality of life was predicted by illness perceptions and several aspects of coping with disease. The association between illness perceptions and health-related quality of life was mediated by the corresponding coping with disease subscales. It is concluded that in order to prevent decreasing health-related quality of life in chronic obstructive pulmonary disease, treatment may be adjusted by promoting coping with disease and functional illness perceptions.
This brief report tests the mediating effect of self-esteem in the relationship between body dissatisfaction and symptoms of depression and anxiety. A sample of 409 adolescents (females = 58.4%) aged between 14 and 18 years completed the Rosenberg Self-Esteem Scale, the Contour Drawing Rating Scale, the Multidimensional Anxiety Scale for Children, and the Center for Epidemiologic Studies Depression Scale. Overall, results for the indirect effects analysis were significant for both anxiety and depression, which confirmed the mediating role of self-esteem. Thus, a negative perception of one’s body image has the effect of lowering self-esteem, which in turn increases psychological distress.
The purpose of this survey study was to evaluate a model of body image influences on indoor tanning behavior. Participants were 823 young adult women recruited from a probability-based web panel in the United States. Consistent with our hypothesized model, tanning-related sociocultural experiences were indirectly associated with lifetime indoor tanning use and intentions to tan as mediated through tan surveillance and tan dissatisfaction. Findings suggest the need for targeting body image constructs as mechanisms of behavior change in indoor tanning behavioral interventions.
Identifying psychological factors associated with engagement in healthy behaviors in later life is a key to effective behavior interventions. In all, 204 adults (Mage = 80) took a questionnaire assessing objective and perceived health, positive affect and negative affect, aging attitudes, and three classes of health behaviors: eating/nutrition, exercise, and general health behavior. Regression models found better eating behavior was best explained by older age, more exercise was best explained by more positive affect, and better general lifestyle behavior was best explained by worse perceived health. Programs promoting health behaviors in older adults can utilize the findings to tailor interventions to the health behavior of interest.
This study investigated younger women’s body image after mastectomy. In all, 49 women, aged 29–53 years (mean age: 39 years) who had had bilateral (n = 8) or unilateral (n = 41) mastectomy responded to open-ended questions online. Inductive thematic analysis revealed that aesthetics were less important than survival between diagnosis and mastectomy. Following mastectomy, women negotiated new body identities. Treatment effects such as weight gain were significant concerns. However, impacts on body confidence varied, and some participants rejected mainstream body shape ideals and reported feeling proud of their scars. Implications for supporting younger women post-mastectomy, including promotion of body acceptance, are discussed.
Little is known about the role of age and gender in the association between psychosomatic symptoms and common mental illness in Ghanaian adolescents. This cross-sectional study examined age and gender as moderators between psychosomatic symptoms and common mental illness using data from a school-based survey (N = 770). Males reported higher psychosomatic symptoms and common mental illness, while younger adolescents reported higher common mental illness only. Psychosomatic symptoms were positively associated with common mental illness, but age and gender did not moderate this association. Interventions aimed at reducing the prevalence rate in psychosomatic symptoms are crucial in decreasing common mental illness in Ghanaian adolescents.
People who attend hospital following a suicide attempt represent a well-delineated high-risk group of patients who may be amenable to targeted interventions to reduce the risk of suicidal behaviour. Little is, however, known about how hospitals in South Africa respond to suicide attempters, what quality of care these patients receive or what possibilities exist for hospital-based suicide prevention interventions. We describe an ethnographic study conducted at a large hospital in South Africa to investigate the impact of current procedures and practices on the care received by those who attempt suicide. Findings suggest that the organisation of care within the hospital is a significant barrier to patients receiving optimal care and represents a lost opportunity for suicide prevention. Findings highlight the mismatch between the needs of suicide attempters and current services and call attention to the need for greater psychological input as well as hospital-based suicide prevention interventions that can be offered to patients without necessitating admissions.
Little is known about the experiences of fathers of children with congenital heart disease. Using interpretative phenomenological analysis, the lived experiences of six fathers were explored. Two master themes emerged: ‘relinquishing and reclaiming control’ and ‘living in the shadow of illness’. Subordinate themes included playing the support act, a pragmatic/emotional dichotomy, and becoming the child’s protector. Other themes included living in limbo and redefining ‘normality’ to encompass the condition. Theoretical links are made between these findings and existing literature while clinical implications include the need to involve fathers in decision-making and to respect their need to maintain control.
We review 20 studies that examined persuasive processing and outcomes of health messages using neurocognitive measures. The results suggest that cognitive processes and neural activity in regions thought to reflect self-related processing may be more prominent in the persuasive process of self-relevant messages. Furthermore, activity in the medial prefrontal cortex, the superior temporal gyrus and the middle frontal gyrus were identified as predictors of message effectiveness, with the medial prefrontal cortex accounting for additional variance in behaviour change beyond that accounted for by self-report measures. Incorporating neurocognitive measures may provide a more comprehensive understanding of the processing and outcomes of health messages.
This study examined the interactive role of perceived control and preference for control on adherence in a sample of patients with chronic kidney disease. As part of a randomized controlled trial assessing adherence to fluid-intake restrictions, 119 hemodialysis patients completed measures of these constructs; results indicated that patients with high perceived control and high preference for control demonstrated the most favorable adherence. This suggests that patients who believe health-related outcomes are a function of one’s own behaviors—and having the opportunity to exert control over aspects of treatment—may be most adherent to complex regimens in which self-management is key.
This article explores the experiences of a small group of Nairobi women caring for a family cancer patient at home. On the basis of literature on women as caregivers in Africa, and on other literature more broadly, it was anticipated that issues around generational roles, gender and women’s cultural role would be relevant. Seven women participated in semi-structured in-depth interviews, while thirteen women participated in four mini focus groups. Data were analysed using interpretative phenomenological analysis. Findings underscore the socio-cultural complexities of caregiving as a basis for evidence-based culturally appropriate structures to support family caregivers.
Few evidence-based interventions to improve adherence to antiretroviral therapy have been adapted for use in Africa. We selected, culturally adapted and tested the feasibility of a cognitive-behavioural intervention for adherence and for delivery in a clinic setting in Harare, Zimbabwe. The intervention consisted of a single, 50-minute problem-solving cognitive-behavioural intervention session with four skill-based booster sessions, delivered by four lay adherence counsellors in the context of HIV care. Adaptation followed a theoretically driven approach to intervention adaptation, Assessment-Decision-Administration-Production-Topical Experts-Integration-Training-Testing (ADAPT-ITT), and included modifications to language, session length, tailoring content for delivery by lay counsellors and inclusion of culturally competent probes. The feasibility of the intervention was evaluated using a mixed-methods assessment, including ratings of provider fidelity of intervention delivery, and qualitative assessments of feasibility using individual semi-structured interviews with counsellors (n = 4) and patients (n = 15). The intervention was feasible and acceptable when administered to 42 patients and resulted in improved self-reported adherence in a subset of 15 patients who were followed up after 6 months. Next steps from this study include conducting a randomised control trial to evaluate the adapted intervention compared to standard of care in a larger sample over a long-term follow-up.
Three decades into the HIV pandemic, the issues affecting people with disabilities remain less known. Increasing attention has been given to this overlooked population when it comes to HIV prevention, treatment and care. This is related to the significant unmet sexual and reproductive healthcare needs facing people with disabilities worldwide. This article discusses the barriers to sexual health for people with disabilities in Africa and presents an argument about how mainstream HIV prevention work and research do not adequately attend to the sorts of systemic barriers that exclude people with disabilities, which a more targeted and critical approach could.
The impact of health message framing on cervical cancer screening uptake is poorly understood.
We undertook a prospective randomized control study between August 2013 and February 2014 within a health-insuered population. The study consisted of 748 females, aged 21–65 years who had not had a Pap smear in the previous 3 years and were randomly selected to receive either a loss-framed, gain-framed, or neutral health message (control) regarding cervical cancer screening via email. Pap smear uptake was determined from medical claims data. The median age was 43 years (interquartile range: 26–60 years). Overall Pap smear screening rate was found to be 8.36 percent (confidence interval: 8.08%–8.64%). Screening rate in the control group was 9.58 percent (confidence interval: 9.29%–9.87%), 5.71 percent (confidence interval: 5.48%–6.98%) in the gain-framed group, and 8.53 percent (confidence interval: 8.24%–8.81%) in the loss-framed group. Statistically there was no difference between the screening rates of the groups (p = 0.75). Females were 43 percent (odds ratio = 0.57) less likely to have a Pap smear if exposed to a gain-framed message, compared to a neutral-framed message; however, this finding was non-significant (p = 0.13). When receiving a loss-framed message, females were only 23 percent (odds ratio = 0.87) less likely to have a Pap smear compared to a neutral-framed message, also not significant (p = 0.69). In addition, further age stratification revealed no differences in Pap smear uptake between different age groups. These findings indicate that Pap smear uptake in this health-insured population is low, with no difference in exposure to differently framed health messages when emailed. Framing of health messages may not be a significant consideration when constructing population-based communication through emails.
This study aimed to test acute reactivity during a physical activity in an outdoor setting and to verify the relative perceived performance. In all, 38 volunteers wore accelerometers or not and completed two 20-minute sessions of self-selected pace physical activity. Covered distance, exertional responses, and perceived efficacy were recorded at the end of every session. Relevant finding of this study has been that reactivity to accelerometers also occurs in acute condition. Consequently, this condition leads to a better performance and a greater perceived exertion. Moreover, this situation seems to occur in a state of awareness.
Despite the prevalence of depression and alcohol use among HIV-infected individuals, few studies have examined their association together in relation to nonadherence to antiretroviral therapy in sub-Saharan Africa. This study examined depressive symptoms, alcohol use, and other psychosocial factors (stigma, demographic characteristics) in relation to nonadherence to antiretroviral therapy among clinic-attending, HIV-infected individuals in South Africa (n = 101). Nonadherence was assessed using event-level measurement (missed doses over the past weekend). Multivariable logistic regression analyses revealed that only alcohol use, over and above depressive symptoms and education level, was associated with antiretroviral therapy nonadherence(AOR = 1.15; 95%CI = 1.02–1.29; p < .05). Findings point to the independent association of alcohol use and nonadherence to antiretroviral therapy above and beyond depressive symptoms.
The opening sequence of an emergency call influences the efficiency of the ambulance dispatch time. The greeting sequences in 105 calls to a South African emergency service were analysed. Initial results suggested the advantage of a specific two-part opening sequence. An on-site experiment aimed at improving call efficiency was conducted during one shift (1100 calls). Results indicated reduced conversational repairs and a significant reduction of 4 seconds in mean call length. Implications for systems and training are derived.
This study aimed to explore the relationships among perceived organizational support, self-esteem, and suicidal ideation of young employees. A total of 447 unmarried employees completed the survey of perceived organizational support, Rosenberg self-esteem scale, and suicide ideation scale. The results revealed that perceived organizational support, self-esteem, and suicidal ideation were significantly correlated with each other. Stepwise regression analysis and path analysis both indicated that self-esteem partially mediated the effect of perceived organizational support on suicidal ideation.
This qualitative study compares and contrasts the perspectives of healthcare professionals who treat hepatitis C with those of patients in treatment. Comparative analysis of semi-structured interviews with 20 healthcare professionals and 20 patients undergoing treatment for hepatitis C concluded that patients and healthcare professionals disagreed on the source of communication breakdowns, but both felt that individualised clinical information improved adherence. Stigma was recognised as a barrier to treatment adherence by both patients and healthcare professionals. Limitations of the healthcare system, such as patients receiving inconsistent information and long wait times, negatively impacted both patients and providers.
Mast cell disorders are rare, chronic diseases involving unpredictable physical symptoms ranging in severity, duration, and frequency. Almost two-thirds of participants with these disorders (n = 180) experienced clinically meaningful depressive symptoms. Depressed mood was associated with somatic symptomatology, poorer quality of life, lower resilience, and indirectly with ways of coping. Newly developed measures for this population performed psychometrically well. There was no gender difference in depression but women reported greater use of several ways of coping, greater disease-related distress, poorer quality of life, and more symptoms. Results underscore the need for further research and development of effective psychosocial interventions for this population.
This study focused on the contribution of the extended theory of planned behavior regarding intention to perform physical activity, adherence to physical activity, and its mediator role in the relationship between trust in the physician and adherence to physical activity, in a sample of 120 patients with type 2 diabetes. The results revealed that positive attitudes and perception of control predicted a stronger intention to do physical activity. The intention to do physical activity was the only predictor of adherence to physical activity. Planning mediated the relationship between trust in the physician and adherence. Implications for patients with type 2 diabetes are discussed.
Type D personality is associated with health-damaging behaviours among the general population. This study assessed the relationship between Type D personality, physical activity and self-efficacy. A total of 189 participants completed measures of Type D personality, physical activity and self-efficacy. Type D individuals had significantly lower levels of self-efficacy and engaged in significantly less walking and total exercise compared to non-Type D’s. Furthermore, self-efficacy fully mediated the relationship between Type D and physical activity. Low levels of self-efficacy may be one mechanism to help explain why Type D individuals engage in more disease-promoting behaviours.
Social Cognitive Theory has been used to explain findings derived from focus group discussions (N = 4) held in the United Kingdom with the aim of informing best practice in personalised nutrition. Positive expectancies included weight loss and negative expectancies surrounded on-line security. Monitoring and feedback were crucial to goal setting and progress. Coaching by the service provider, family and friends was deemed important for self-efficacy. Paying for personalised nutrition symbolised commitment to behaviour change. The social context of eating, however, was perceived a problem and should be considered when designing personalised diets. Social Cognitive Theory could provide an effective framework through which to deliver personalised nutrition.
Previous research has shown that satisfaction mediates the relationship of state mindfulness (i.e. during physical activity) with physical activity. This study aimed to replicate this finding and to explore the role of trait mindfulness with a cross-sectional design. In all, 305 participants completed measures on trait and state mindfulness, satisfaction with physical activity, and physical activity. Mediation analyses were used. Satisfaction mediated the effect of state mindfulness on physical activity. Trait mindfulness related to physical activity via an indirect path, namely through two consecutive mediators, first state mindfulness and then satisfaction. Our results suggest that to enhance satisfaction, both state and trait mindfulness should be considered.
Noma disease often results in impairment, morbidity and severe facial disfigurement. This article reports a systematic review of literatures published between 2006 and 2015 to establish existing knowledge about social stigma associated with facial disfigurements. Five databases were searched and 114 citations were screened, of which only 15 met the relevant criteria. Titles and abstracts of the retrieved articles were independently reviewed. The research was heterogeneous; therefore, overall synthesis using meta-analysis was inappropriate. It can be seen that the review demonstrates that facial disfigurements are far more complex than was previously thought.
To assess satisfaction with care in acute spinal cord injury patients admitted to a specialized rehabilitation unit prior and after a tailored training in communication skills for the staff, the Picker Patient Experience-33 ((1) Content of the information, (2) Quality of the information, and (3) Quality of the relationship), the Spinal Cord Independence Measure-III, and the Hospital Anxiety and Depression Scale were administered. The more troublesome dimension regarding patients’ satisfaction was content of the information, with 88.37 and 91.43 percent (pre/post-intervention) reporting problems with information provided concerning their rights, and 51.15 and 58.72 percent (pre/post-intervention) with the information received at discharge. Overall, functionality (Spinal Cord Independence Measure-III) improved at discharge, but Hospital Anxiety and Depression Scale pre/post-scores revealed to be high.
This study extended the literature by examining whether three profiles of depression predicted breast cancer status. In 1076 women of the Baltimore Epidemiologic Catchment Area study, depression status and hopelessness were measured at baseline and breast cancer status was ascertained 24 years later. Double depression, but not major depression or dysthymia, was associated with breast cancer. Hopelessness predicted fewer new cases of breast cancer. When double depression and hopelessness were simultaneously entered as predictors, the regression weights of both predictors increased. The role of severe and extended duration depression as well as possible explanations for unexpected findings are discussed.
This study explored oncology healthcare professionals’ perspectives on the psychosocial support needs of diverse cancer patients during oncology treatment. Six themes were identified using thematic analysis. Healthcare professionals highlighted the importance of their sensitivity, respect and emotional tact during appointments in order to effectively identify and meet the needs of oncology patients. Participants also emphasised the importance of building rapport that recognises patients as people. Patients’ acceptance of treatment-related distress and uncertainty was described as required for uptake of available psychosocial supportive services. We offer some practical implications that may help improve cancer patients’ experiences during oncology treatment.
A qualitative design was used to explore the experience of positive adjustment following a heart attack. Ten men attending a cardiac rehabilitation programme completed in-depth semi-structured interviews. An overarching theme: ‘I was in control of it from the start’ emerged with six subthemes, relating to intrapersonal and interpersonal factors and processes. The subthemes reflected the importance of identifying controllable versus non-controllable factors and employing adaptive coping strategies.
Adolescent smoking is a major public health problem, which has led to the development of cessation programs such as Project EX. However, there is no evidence for the long-term efficacy of cessation among Spanish adolescents. This study provides a 1-year follow-up evaluation of the Project EX tobacco use cessation program among 211 smokers. The intent-to-treat 30-day smoking quit rate for the program group was 7.81 percent (p = .04), whereas no smokers quit in the control group (p = .02). The intervention had a significant influence on future smoking expectation, intention, motivation to quit, and overall level of 30-day smoking. Long-term outcomes of the Project EX clinic-based program are promising for adolescent smokers in Spain.
The aim of this study was to validate the French-language version of the Type D personality scale-14 among general and clinical populations (acute coronary syndrome and breast cancer patients). The two-factor structure of the Type D personality scale-14 was confirmed by factorial and confirmatory analyses. Internal consistency for both subdimensions of Type D personality scale-14 (negative affectivity and social inhibition) was very good with α = .87 for each. Contrary to our expectations, the Type D prevalence was much higher in the breast cancer group than in the acute coronary syndrome patients. In conclusion, the French-language Type D personality scale-14 showed good psychometric properties among general and clinical populations.
The goal of this study was to examine lifetime weight stigmatization as a mediator of the relationships among current body mass index, childhood overweight, depression, and body dissatisfaction. Participants were 299 female undergraduates (mean age = 20.52, standard deviation = 2.57; mean body mass index = 23.29, standard deviation = 4.51). Weight stigmatization significantly mediated the relationships between body mass index and body dissatisfaction, body mass index and depressive symptoms, and childhood overweight and depressive symptoms. The model accounted for 44.7 percent of the variance in depressive symptoms and 28.2 percent of the variance in body image dissatisfaction. Findings indicated that a decrease in weight stigmatization may predict better mental health.
Compensatory health beliefs (the beliefs that an unhealthy behaviour can be compensated by a healthy behaviour) can interfere with adherence to fruit and vegetable consumption recommendations. Fruit and vegetable consumption, social cognitive variables and compensatory health beliefs were investigated via self-report at baseline (T0) and 8-week follow-up (T1) in N = 790 participants. Self-efficacy predicted fruit and vegetable consumption intentions. Planning mediated between intentions and T1 fruit and vegetable consumption. Compensatory health beliefs negatively predicted intentions at low self-efficacy levels only. The results propose the use of self-efficacy interventions to diminish the negative effects of compensatory health beliefs when forming fruit and vegetable consumption intentions and foster planning to translate intentions into behaviour.
The experience of weight-based bullying in young adult bariatric patients has not yet been examined. Thirteen young adults (age, 18–24) that were seeking or had undergone bariatric surgery participated in semi-structured in-depth interviews. A thematic analysis informed by grounded theory principles was conducted. Analysis revealed the following three major themes: (1) being the biggest kid, (2) coping through avoidance, and (3) compromised peer and intimate relationships. Victims of weight-based bullying often avoid and withdraw socially in response to persistent verbal abuse. The decision to pursue bariatric surgery at a relatively young age adds another dimension of difficulty when navigating peer relationships.
This study examined self-efficacy (confidence to exercise), pros (exercise’s advantages), and cons (exercise’s disadvantages) as variables associated across the transtheoretical model’s six stages of change in 403 Japanese college students. A series of logistic regression analyses were conducted. Results showed that higher pros and lower cons were associated with being in contemplation compared to precontemplation. Lower cons were associated with being in preparation compared to contemplation. Higher self-efficacy was associated with being in action compared to preparation as well as being in maintenance compared to action. Lower cons were associated with being in termination compared to maintenance.
Thirty students (mean age = 18 ± 0.5 years) completed self-report (Self-Control Scale) and objective (isometric handgrip squeeze performance) measures of self-control, provided their exercise and academic (study/schoolwork) plans for the next month, and then logged these behaviors over the subsequent 4-week period. Trait self-control predicted exercise and academic behavior. Handgrip squeeze performance predicted academic behavior and adherence to academic plans. Further, regression analysis revealed that trait self-control and handgrip performance explained significant variance in academic behavior. These findings provide a new understanding of how different self-control measures can be used to predict first-year students’ participation in, and adherence to, exercise and academic behaviors concurrently.
A qualitative study among women living with HIV assessed the aspects of an evidence-based intervention targeting HIV transmission risk reduction (Women Involved in Life Learning from Other Women [WiLLOW]) that women valued and how their lives were impacted. Thirty-one women (80.6% African American) completed interviews. Women valued the personal stories and positive group dynamics (i.e. safety, trust, openness, getting feedback, bonding, and socializing). As a result of WiLLOW, women embraced a strong woman image, joined groups, changed behaviors, accepted their HIV status, became optimistic, and spoke up/advocated in their relationships and communities. Interventions for HIV-positive women may benefit from incorporating the sharing of stories in their curricula and factors that build positive group dynamics.
The aim of this study is to explore whether self-esteem and social participation are associated with the physical and mental quality of life (Physical Component Summary, Mental Component Summary) and whether self-esteem can mediate the association between these variables. We collected information from 118 consecutive multiple sclerosis patients. Age, gender, disease duration, disability status, and participation were significant predictors of Physical Component Summary, explaining 55.4 percent of the total variance. Self-esteem fully mediated the association between social participation and Mental Component Summary (estimate/standard error = –4.872; p < 0.001) and along with disability status explained 48.3 percent of the variance in Mental Component Summary. These results can be used in intervention and educational programs.
This study focused on cognitive representations of low back pain patients receiving chiropractic (n = 213) versus physiotherapy treatment (n = 125). Variables assessed included satisfaction with care, illness perceptions, beliefs about pain and medicines, attitudes towards doctors and medicine, suffering, adherence and functional incapacity. In the chiropractic treatment, functional incapacity was predicted by painful symptoms, suffering and personal control, and in the physiotherapy treatment by age, pain intensity, positive suffering, care satisfaction, illness identity and medication adherence. The groups differed on all cognitive variables assessed. Interventions should take into consideration cognitive dimensions, across treatment modalities.
An online survey examined the effects of parental bonding during childhood on adult workers’ stress-coping ability (Sense of Coherence) and stress reactions (General Health Questionnaire and Self-Rating Depression Scale). Participants who completed the questionnaire were grouped into optimal bonding and poor bonding groups. Analyses of covariance by gender with age as a covariate were conducted for the Sense of Coherence, General Health Questionnaire, and Self-Rating Depression Scale scores for 9525 participants. For both genders, the scores of the poor bonding group were significantly lower for the Sense of Coherence and significantly higher for the General Health Questionnaire and Self-Rating Depression Scale compared to those of the optimal bonding group.
This study examined the collective image of the 2014–2015 Ebola outbreak, to understand how people incorporate this epidemic in their everyday thinking. A free association exercise elicited by Ebola was answered by 294 people from Spain and the content was analysed using Alceste software. First, results showed that Ebola was represented as inherently African. Second, it was also depicted as a global threat creating fear. People also felt anger, and they blamed political authorities and the mass media for the failure to manage this crisis. Finally, this research underlines the importance of the social representations to understand how current outbreaks are cognitively represented and emotionally faced as a key factor to appropriately manage future epidemics.
Alcohol misuse among university students is commonplace. This study aimed to assess whether Alcohol Brief Intervention would be effective in reducing hazardous alcohol consumption in students compared to an alcohol information leaflet. Participants (n = 125) assessed as higher risk drinkers using the Alcohol Use Disorders Identification Test Consumption were randomly assigned to receive an Alcohol Brief Intervention (n = 67) or an information leaflet (n = 58), with 82 (66%) completing a follow-up assessment. Alcohol consumption (F(1, 80) = 14.52, p < 0.001) and the Alcohol Use Disorders Identification Test Consumption scores (F(1, 80) = 23.63, p < 0.001) significantly decreased in both groups post-intervention; however, the groups did not significantly differ. Further research is recommended.
This systematic review aimed to examine the effectiveness of Mindfulness-based interventions in reducing diabetes-related physiological and psychological symptoms in adults with types 1 and 2 diabetes. Five databases were systematically searched. A total of 11 studies satisfied the inclusion criteria. Mindfulness-based intervention effectiveness for physiological outcomes (glycaemic control and blood pressure) was mixed. Mindfulness-based interventions appear to have psychological benefits reducing depression, anxiety and distress symptoms across several studies. Studies’ short-term follow-up periods may not allow sufficient time to observe physiological changes or illustrate Mindfulness-based interventions’ potential long-term efficacy. More long-term studies that include a consistent, standardised set of outcome measures are required.
The aim of this study was to identify illness trajectories in leg ulcers by analysing personal, social and relational dimensions related to leg ulcer onset and to the care process. Semi-structured interviews were conducted with 21 patients, one physician and four nurses. Patients’ medical records were also examined. Data were analysed using the grounded theory approach. Four illness trajectories were identified: possibility, denial, focus on illness and tragedy. The findings highlighted that leg ulcers can be experienced in different ways depending on the personal characteristics of the people suffering from them and the kind of relationship that exists between patients and healthcare professionals.
Previous research has drawn on theoretical models and clinical observations to develop propositions regarding the mechanisms of diet failure, with only one study examining it directly from the perspective of dieters themselves. Furthermore, research to date has failed to provide an empirically validated, multi-factorial model of diet failure, despite the issue being recognised as a complex and multifaceted one. This study extended on previous research by examining themes of diet failure from the perspective of dieters (n = 22) and health professionals in the field (n = 5).
Safely returning to sexual activity after being diagnosed with a cardiac condition is at the core of sexual counseling strategies. To further inform sexual counseling, this study examined changes in sexual activity before and after a cardiac diagnosis. Logistic analysis was used to suggest factors that can contribute to a change in sexual activity among cardiac patients. Reduced frequency in sexual activity after a cardiac diagnosis was influenced by greater sexual concerns and a history of smoking, as well as by education and employment status. These findings suggest that cardiac patients experiencing significant concerns about resuming sexual activity need added support through the mental health system.
This study examined effects of an order form intervention on choice of healthy ingredients among college students ordering submarine sandwiches (subs). Over eight weekly sub-nights, college students submitted 9765 orders. The order form format was manipulated in one condition making the healthier selections more salient. Main outcome measures were selection of ingredients. Multi-level logistic regression, chi square, and analysis of variance were used to examine the effect of experimental conditions on selection of ingredients. The health-salient form increased selection of healthier and decreased selection of unhealthy ingredients. The manipulation increased fiber, decreased sodium, but did not impact calorie/fat levels of the subs served.
Weight loss programs evidence considerable variability in treatment outcomes, and weight regain is common, signaling the need for the refinement of effective treatments. This study compared the recently developed Transforming Your Life program to the Diabetes Prevention Program, considered the "Gold Standard" in behavioral weight loss treatment. A total of 98 participants (Transforming Your Life = 51; Diabetes Prevention Program = 47) were randomized to the two weight loss interventions. The Transforming Your Life program and Diabetes Prevention Program produced comparable weight loss and maintenance outcomes. Individuals may benefit from engagement in the Transforming Your Life program, if they are searching for a somewhat novel approach to losing weight other than that offered by the Diabetes Prevention Program.
Rural cancer survivors report more distress than non-rural survivors. Little research has examined whether rural residence might also be linked to positive psychological outcomes. Rural (n = 117) and non-rural (n = 76) lung cancer survivors completed measures of posttraumatic growth, benefit-finding, and distress. Rural survivors reported more posttraumatic growth than urban survivors. There were no differences in benefit-finding. Mediation analyses indicated distress mediated the relationship between rural residence and posttraumatic growth. Findings suggest rural residence might be beneficial with regard to potential for posttraumatic growth among cancer survivors. Consistent with trauma theory, distress mediated the relationship between rural residence and posttraumatic growth.
There were 5834 participants with complete data on parental social class at birth, childhood cognitive ability tests scores at 11 years, educational qualifications at 33 years, the Big Five-Factor personality traits, occupational levels and eczema (measured at age 50 years). Results showed that eczema in childhood, educational achievement and occupational levels were significantly associated with the occurrence of reported eczema in adulthood. Emotionally Stable people (non-neurotic) were less likely to have eczema, but those with high Agreeableness and Openness more likely to have eczema. Childhood cognitive ability was significantly and positively associated with eczema in adulthood.
The impact of the financial crisis on health was investigated (N = 312). Intraindividual intercept, slope, and quadratic parameters capturing trends in income, subjective financial situation, and perceived stress across the period predicted physical health, controlling for baseline health. For those experiencing a decline in financial situation, a decrease in financial situation and an increase in perceived stress predicted poorer health; neither financial situation nor perceived stress predicted health in those not experiencing this decline. Although we cannot intervene in contextual factors like the financial crisis, health outcomes may be improved by targeting perceived impact and stress levels in those who feel affected.
This longitudinal study explores the lived experience of four couples where one person from each couple is prescribed an oxygen concentrator to use at home. Transcripts were analysed using interpretative phenomenological analysis. The findings reported here focus on two super-ordinate themes: ‘the journey of acceptance’ and ‘negotiating changing relationships’. Participants described a gradual process of accepting the device into their lives, the impact on couple’s relationships and the role that expectations have in mediating that process. These themes suggest that patient education that considers the psychological and social issues may prove useful in facilitating the acceptance process.
This study identified predictors of anxiety and depression in patients with acute coronary syndrome. Predictors included illness beliefs, fear/threat at the time of the cardiac event, threat reappraisal over time and social support. A total of 97 participants completed questionnaires in hospital and 1- and 6-month follow-up. Perceived threat and fear at the time of the cardiac event predicted affective response at both time points, partly mediated by threat reappraisal. Contemporaneous measures of illness beliefs contributed additional variance, although not always in the predicted direction: high concern and control over the illness were associated with emotional distress. Assessment of patients for risk of negative emotional outcomes of acute coronary syndrome needs to consider their beliefs about their illness and the degree of threat and fear experienced at the time of the event. Interventions need to help people cope with negative emotional states as well as challenging inappropriate illness beliefs.
Using a prospective design, the aim of this study was to examine the relationship between coping and psychological well-being (distress and positive affect) in a sample of Greek cancer patients (N = 86), giving a special emphasis on the role of religiosity (religious beliefs and coping). Results showed that religious coping during chemotherapy was the only predictor of positive affect 7 months later, when engagement and disengagement strategies were included in the model. The present findings suggest that religious coping may play a positive role in the well-being of patients facing a life-threatening disease, such as cancer.
Prostate cancer is the most common cancer among males in the United States, and there is lack of consensus as to whether active surveillance or radical prostatectomy is the best course of treatment. In this study, we examined the role of numeracy, time discounting, and risk taking on decision-making about prostate cancer treatment—in 279 men over age 50 without a prior prostate cancer diagnosis. Results showed that active surveillance was the most chosen option and its preference was predicted by numeracy and time discounting. However, radical prostatectomy was significantly predicted by participants’ propensity to take risks.
This cross-sectional study evaluated locus of control and its subscales in Parkinson’s disease. A total of 50 consecutive Parkinson’s disease participants and 50 healthy volunteers (control group) were enrolled. External locus of control was significantly higher in Parkinson’s disease participants, whereas internal locus of control had no significant differences. External locus of control and internal locus of control were correlated in control group, but not in Parkinson’s disease. In Parkinson’s disease participants, external locus of control was negatively associated with health-related quality of life as well as positively associated with emotional distress and disease severity (but not with disability). After adjusting to confound variables, the associations remained. On the other hand, internal locus of control was negatively associated with depression.
Social comparisons are related to the development of body dissatisfaction among adolescents and adults, yet this relationship remains relatively unexamined among children. This study examines children’s peer and media-related social comparisons, and how this impacts on their body image. Children aged 8–10 years completed interviews (17 girls and 19 boys in individual interviews, and 16 girls and 16 boys in focus groups). Analyses revealed that appearance-related comparisons were more common among girls, whereas sports/ability-related comparisons were more common for boys. In addition, boys viewed media comparisons as inspiring, whereas girls reported negative emotions. Implications for future research and prevention programmes are discussed.
Little is known about how middle-aged and older men are affected by idealized depictions of male singers in music television. A total of 116 males completed pre- and post-test measures of body satisfaction, mood, and social comparison and viewed 5 minutes of clips containing scenery, muscular- or average-looking singers. Negative effects were restricted to young men who viewed the muscular clips. The younger men also reported more comparison while viewing the muscular and average-looking singers compared to the middle-aged and older men. These findings suggest that younger (but not middle-aged or older) men are particularly susceptible to idealized depictions of the male appearance.
The Injustice Experience Questionnaire has shown promising ability to predict problematic rehabilitation in pain conditions, especially concerning work status. A Danish language version of the Injustice Experience Questionnaire was developed and completed by 358 patients with long-lasting pain/somatoform symptoms. These patients also completed questionnaires concerning sociodemographics, anxiety and depression, subjective well-being, and overall physical and mental functioning. Our results showed satisfactory interpretability and face validity, and high internal consistency (Cronbach’s alpha = .90). The original one-factor structure was confirmed, but subscales should be interpreted cautiously. The Danish version of the Injustice Experience Questionnaire is found to be valid and reliable.
This study examined the psychometric properties of the Chinese Post-Traumatic Growth Inventory among Hong Kong chronic disease patients. Using a cross-sectional design and multistage stratification sampling, 265 chronic disease patients were recruited from a selection of non-governmental organizations and patient self-help groups across Hong Kong. The Chinese Post-Traumatic Growth Inventory total scale and subscales showed satisfactory internal consistency, reliability and concurrent validity. The factor structure of the Chinese Post-Traumatic Growth Inventory fit well with a higher-order intrapersonal factor (self, spiritual and life orientation) and a first-order interpersonal factor. The Chinese Post-Traumatic Growth Inventory was predictive of hope and positive coping but negatively predictive of anxiety. The five Chinese Post-Traumatic Growth Inventory subscales can help practitioners identify meaningful health outcomes for Chinese chronic disease patients.
Positively framed messages seem to promote walking in older adults better than negatively framed messages. This study targeted elderly people in communities unfavorable to walking. Walking was measured with pedometers during baseline (1 week) and intervention (4 weeks). Participants (n = 74) were informed about either the benefits of walking or the negative consequences of not walking. Perceived neighborhood walkability was assessed with a modified version of the Neighborhood Walkability Scale. When perceived walkability was high, positively framed messages were more effective than negatively framed messages in promoting walking; when perceived walkability was low, negatively framed messages were comparably effective to positively framed messages.
The current study used the theory of planned behavior to examine rural college students’ attitudes, normative beliefs, and perceived behavioral control regarding intent to register as organ donors. This effort is done in light of a need to increase intervention efforts among college students, particularly those in rural areas where these undertakings may need to be tailored in grassroots approaches. The study made use of perceived behavioral control as a moderator and found partial support for the model. Findings offer results that scholars, practitioners, and educators can utilize for interventions.
The objectives of this study were to describe illness representations in dementia caregiving and examine the relationship between illness perceptions and carers’ sense of coherence. Illness perceptions were assessed by the Brief Illness Perception Questionnaire. We measured sense of coherence, symptoms of anxiety and depression and carer burden. Regression analyses indicated that after controlling for demographic factors, burden and psychological distress in carers, illness coherence and emotional responses to the disease independently contributed towards explaining variance in carers’ sense of coherence. Results provide support for the usefulness of the self-regulation model in understanding dementia caregiving.
This study asked whether traceable knowledge transformations are occurring among indigenous Mexican women and, if so, the processes through which these shape their engagements with sexual health values and views. Thirty-nine interviews with rural and urban indigenous Mexican female adolescents were analysed through the lenses of social representations theory. Results evince that participants express transformations in terms of their social context, what constitutes a healthy youth and the uses of folk medicine, which are brought about by selecting, displacing and hybridising knowledge. Discussion centres on the consistency of themes across the sample and the variety of processes mapped.
This study examined psychological differences between individuals (1) with varying perceptions of their exercise adherence pattern and (2) who do and do not make exercise-related cognitive errors. A total of 364 adults completed an exercise pattern and cognitive errors questionnaire. Individuals perceiving themselves as consistent exercisers reported more adaptive social cognitive outcomes (e.g. higher self-regulatory efficacy) than those perceiving themselves as inconsistent. Individuals expressing stronger exercise-related cognitive errors exercised less and reported problematic cognitions (e.g. more struggle with exercise decisions). These results link inconsistent adherence perceptions to weaker social cognitions and exercise-related cognitive errors, a novel form of bias related to limited exercise engagement.
Seminal health behaviour theories and behaviour modification techniques are applied to health behaviours individually. Limited empirical work investigates how change in one health behaviour may change another. This study proposes a food–alcohol competition hypothesis, where individuals tend to consume one rewarding substance to the other’s exclusion. In a large sample of adolescent girls assessed yearly from age 15 to 19, Latent Growth Modelling indicated that a tendency to consume processed or sweet high-fat foods ‘competed’ with a tendency to drink alcohol. In order to best improve overall health, it is important to consider interrelationships between food and alcohol consumption.
Individuals with postural orthostatic tachycardia syndrome share many symptoms with those who have chronic fatigue syndrome; one of which is severe fatigue. Previous literature found that those with chronic fatigue syndrome experience many forms of fatigue. The goal of this study was to investigate whether individuals with postural orthostatic tachycardia syndrome also experience multidimensional fatigue and whether these individuals can be clustered into subgroups based on the types of fatigue they endorse. A convenience sample of 138 participants (aged 14–29) with postural orthostatic tachycardia syndrome completed questionnaires that assessed fatigue, brain fog symptom severity, activities that improve brain fog, and brain fog-related disability. An exploratory factor analysis was conducted on the Fatigue Types Questionnaire, and a three-factor solution was produced. Factor scores were then used to cluster the patients into groups using a TwoStep cluster analysis. This resulted in two clusters, a high severity group and a low severity group. The clusters were then compared on a number of items related to symptom expression. Individuals within the more severe cluster had significantly more brain fog at the beginning and end of the survey when compared to cluster two. Those in the more severe cluster also described more activity impairment as well as more frequent, more severe, and more debilitation from postural orthostatic tachycardia syndrome and brain fog. The findings of the factor analysis suggest that patients with postural orthostatic tachycardia syndrome experience fatigue as a multidimensional construct and they also can be subgrouped based on symptom severity.
The purpose of this study was to explore young British men’s understandings of prostate health and cancer of the prostate. A total of 16 White-British men between 31–50 years of age took part in interviews face-to-face or through computer-mediated communication. Thematic analysis broadly informed by grounded theory identified two key themes; ‘limited knowledge about the prostate’ and ‘early detection & unpleasant procedures’. Accounts are discussed with reference to implications for improving men’s understandings of prostate cancer, and likelihood of self-referral for prostate screening where necessary.
The main aim of this cross-sectional study was to analyse the degree to which coping may act as a mediator between disability and psychosocial loss in people with relapsing remitting multiple sclerosis. Participants (N = 158) completed measures of psychosocial loss and ways of coping. Disability status was evaluated by attending neurologists. Coping partially mediated the relationship between disability and psychosocial loss. Disability leads to the experience of psychosocial loss but it is not the sole factor determining the formation of psychosocial loss. Coping is also associated with such losses in multiple sclerosis.
This article aims to provide a community-specific understanding of a subgroup of South African men who exhibit particularly high rates of hazardous alcohol consumption. Adopting a social constructionist framework, we interviewed 13 Cape Winelands men who lived on farms to explore their drinking constructions. We present three themes that shed light on problematic drinking in this group: (1) the notion of weekend binge-drinking as ‘respectable’ drinking, (2) drinking as shared activity that fulfils various psycho-social needs and (3) a sense of powerlessness to affect their own or their children’s alcohol consumption. These findings are viewed against a specific socio-historical backdrop.
This study investigated authenticity as a moderator of the association between loneliness and depressive symptoms, anxiety, physical symptoms, and alcohol-related problems. It was expected that loneliness and health outcomes would be negatively related and that relationship would be weaker among those higher in authenticity. Significant interactions emerged between authenticity and loneliness for each outcome such that authenticity mitigated the relationship between higher loneliness and negative health outcomes. Results suggest that authenticity may be an underutilized resource for lonely individuals and warrants future investigation. The potential implications are diverse and could be incorporated in college adjustment and health promotion programs.
This prospective study examined the longitudinal effects of psychological resilience on depression in a Chinese sample of left-behind children. A total of 386 left-behind children completed both a baseline and a 1-year follow-up survey. The prevalence of depression at the baseline and 1-year follow-up was 12.7 and 8.5 per cent, respectively. Multivariate analysis revealed that older age and baseline depressive symptoms were positively associated with follow-up depression, while psychological resilience and quality of life were negatively related to follow-up depression. Our findings provided preliminary evidence that higher psychological resilience was a significantly protective factor of developing depression among left-behind children.
Symptoms of post-traumatic stress disorder are common in fibromyalgia patients. This study compared post-traumatic stress disorder symptoms in fibromyalgia patients and healthy controls and determined whether patient-control differences in post-traumatic stress disorder symptoms mediated differences in mental health. In all, 30 patients and 30 healthy controls completed questionnaires assessing symptoms of post-traumatic stress disorder and mental health. Fibromyalgia patients had greater symptoms of post-traumatic stress disorder and mental health than controls. Patient-control differences in mental health symptoms were fully or partially mediated by differences in post-traumatic stress disorder symptoms. Healthcare providers should understand the role of trauma as management of trauma symptoms may be one strategy for improving mental health.
The purpose of the present investigation was to explore the relationship between self-reported childhood health anxiety and self-reported parent health anxiety and associated constructs. Participants were 77 children (8–15 years) and one parent or guardian of each child. Children completed a measure of health anxiety and parents completed measures of health anxiety, anxiety sensitivity, and depression. Results demonstrated a significant association between child health anxiety and all measures of self-reported parent measures, with the exception of the measure of anxiety sensitivity. No self-reported parent measures independently predicted child health anxiety. Future directions and implications are discussed.
This study aims to explore the process of posttraumatic growth for individuals who have sustained a traumatic spinal cord injury. Semi-structured interviews were conducted with 12 participants with spinal cord injury from the local community. Interviews were recorded on audiotape and transcribed verbatim. Transcripts were analyzed using interpretative phenomenological analysis. Three superordinate themes emerged: struggling in hopelessness, disentangling from disability, facing challenge, and achieving positive growth. Our findings reveal how individuals with spinal cord injury overcome their disability to achieve personal growth, and can contribute to clinicians’ understanding of psychological responses to spinal cord injury while promoting physical and psychological recovery in these individuals.
Following a biopsychosocial model of food insecurity, this study examined differences in physical health and mental health outcomes among young adults (N = 98) with and without a history of food insecurity. Young adults with a history of food insecurity had higher average levels of body mass index, waist-to-height ratio, depressive symptoms, stress, and disordered eating scores than individuals with no history of food insecurity. No differences were found with symptoms of anxiety. Future research should examine interventions targeted at decreasing negative mental health outcomes and risk for overweight among young adults who have experienced food insecurity.
Poor success rates and high levels of dropout are common features in the treatment of anorexia nervosa. Using semi-structured interviews, this study elicited the views of 12 women who were recovered, or in recovery, for anorexia nervosa and had received treatment. Results derived from a thematic analysis revealed the women’s high degree of dissatisfaction with treatment and their perception that the treatment system is overly focused on, and driven by, food and weight. In contrast, what the women really wanted was to be seen and treated as a ‘whole person’ and to have a ‘real’ relationship with their therapist.
Overall, 544 children (mean age ± standard deviation = 14.2 ± .94 years) completed self-report measures of physical activity goal content, behavioral regulations, and physical activity behavior. Body mass index was determined from height and mass. The indirect effect of intrinsic goal content on physical activity was statistically significant via autonomous (b = 162.27; 95% confidence interval [89.73, 244.70]), but not controlled motivation (b = 5.30; 95% confidence interval [–39.05, 45.16]). The indirect effect of extrinsic goal content on physical activity was statistically significant via autonomous (b = 106.25; 95% confidence interval [63.74, 159.13]) but not controlled motivation (b = 17.28; 95% confidence interval [–31.76, 70.21]). Weight status did not alter these findings.
We tested whether the relationship between subjective physical age and physical activity is mediated by planning. Participants came from a broad age range (25–78 years, M = 39.57, standard deviation = 10.75) and reported relatively good health (M = 3.36, standard deviation = 0.90). The model supported the suggested mediation (β = –.01, standard error = .01, p = .042). Feeling physically younger is associated with higher planning to adopt higher levels of physical activity and more planning is associated with more subsequent physical activity. Results open avenues for interventions that help people to become more active by focusing on subjective age. One way to do so might be tailoring approaches for interventions.
Health locus of control may be an important predictor of health care utilization. We analyzed associations between health locus of control and frequency of emergency department visits and hospital admissions, and investigated self-rated health as a potential mediator. Overall, 863 patients in an urban emergency department completed the Multidimensional Health Locus of Control instrument, and self-reported emergency department use and hospital admissions in the last year. We found small but significant associations between Multidimensional Health Locus of Control and utilization, all of which were mediated by self-rated health. We conclude that interventions to shift health locus of control may change patients’ perceptions of their own health, thereby impacting utilization.
This study investigated the association between the 3-month postoperative sense of coherence and the 5-year postoperative outcome of decompressive surgery for lumbar spinal stenosis. The participants with a lower sense of coherence at the 3-month follow-up had a poorer functional ability and lower satisfaction with surgery, higher pain ratings, lower life satisfaction and more depressive symptoms 5 years postoperatively. A low 3-month sense of coherence associated with greater pain and a poorer functional ability 5 years postoperatively. Evaluating sense of coherence and depressive symptoms in patients who have had lumbar spinal stenosis surgery may help in identifying those in need of enhanced support for postoperative recovery.
Research into how people perceive risk has highlighted the interaction between the available information and personal variables and their impact on judgement. This study sought to identify demographic and health variables that influenced risk and the influence of individual risk assessment, dispositional optimism and negative affect on judgement. A total of 476 participants were asked to make risks judgements of 24 vignettes depicting hypothetical risk scenarios. The findings showed that while people are able to correctly recognise, in others, relevant risk factors for coronary heart disease, risk perception is likely to imply a personal consideration of the same risk factors in themselves.
The aim of this study was to evaluate psychological differences and quality of life between kidney recipients from living (mother) and multi-organ donor. Overall, 40 patients who had undergone both living (mother) and multi-organ kidney transplantation 3–6 months before were asked to complete four self-report instruments: Toronto Alexithymia Scale, Short Form Health Survey, Regulatory Emotional Self-efficacy, and Attachment Style Questionnaire. A greater difficulty in emotional, social, and mental health functioning was found in recipients receiving kidney from mother living donor. Moreover, in these patients, higher levels of avoidant attachment dimensions were associated with a worse quality of life.
The purpose of the study was to assess the burnout levels in nurses (N = 161) versus physicians (N = 373). The levels of burnout were evaluated by the Polish adaptation of the Spanish Burnout Inventory (Cronbach’s alpha > .70). High burnout level was found in 18.63 percent nurses and 12.06 percent anesthesiologists, and critical level in 3.74 percent nurses and 5.90 percent anesthetists. There were statistically significant differences in Burnout global score, Enthusiasm toward the job, Psychological exhaustion, and Indolence subscales between nurses and physicians. No significant differences were found between sexes in any variable.
This article examines role stress, key psychosocial variables, and well-being in adults recently diagnosed with rheumatoid arthritis. Patients recently diagnosed with rheumatoid arthritis must often learn to balance disease and role-related responsibilities. This was cross-sectional, descriptive study (N = 80). Data were analyzed using correlation coefficients and linear regression models. Participants were predominantly female (78%), married, and employed. Mean age and disease duration were 54.2 years and 24.2 months, respectively. The findings suggest that well-being is influenced by feelings of being self-efficacious and having balance in their roles and less to do with social support received from others.
There has been an increased usage of online cancer support groups as a resource for health-related information and social support. This work analyzes message blog posts from an anonymous online support community to better understand issues related to gender and identity among female adolescent and young adults. This work sheds further light into the nuances of gender and identity issues including motherhood and reproductive issues, physical appearance, and romantic relationships. Specifically, findings reveal that female adolescent and young adults experience issues pertaining to infertility, feeling like a bad mom, hair loss, scarring, dating, and intimacy. These findings of this work offer further guidance about how healthcare providers and caregivers can attempt to meet the needs of female adolescent and young adults.
This study investigated how time from breast biopsy recommendation to biopsy procedure affected pre-biopsy anxiety (N = 140 women), and whether the relationship between wait time and anxiety was affected by psychosocial factors (chronic life stress, traumatic events, social support). Analyses showed a significant interaction between wait time and chronic life stress. Increased time from biopsy recommendation was associated with greater anxiety in women with low levels of life stress. Women with high levels of life stress experienced increased anxiety regardless of wait time. These results suggest that women may benefit from shorter wait times and receiving strategies for managing anxiety.
Several studies have shown the influence of personality in risky sexual behaviors. This work has sought to establish which personality variables favor or hinder condom use in Spanish youth. A total of 408 young heterosexuals were assessed, divided into risk group (60.8%) and no-risk group (39.2%), according to systematic condom use. The results show statistically significant differences in Openness to Experience (p = .039), Conscientiousness (p = .047), Actions (p = .001), Competence (p = .024), and Self-discipline (p = .046). The regression analysis revealed that Compliance explained about 14 percent of the variance in condom use. The tendency to behave in a cooperative, peace-making, and indulgent manner influences in HIV prevention.
Men’s help seeking for depression continues to gain focussed research and clinical attention. In this study, 125 men (M = 39.02 years) provided data on perceived barriers to mental health help seeking, and self-reported depression at baseline, and 15 weeks. Longitudinal depression caseness was used to investigate group differences in perceived barriers to help seeking. Those experiencing unremitting depression reported the highest perceived help-seeking barriers. This finding was consistent over all domains of help-seeking barriers, and it was independent of previous mental health help-seeking efforts. Findings are discussed in the broader context of men’s mental health and health psychology.
Health outcomes of adults with type 1 diabetes may be affected by relationship status and quality. Our objective was to examine associations between relationship status, relationship factors, and outcomes in adults with type 1 diabetes. N = 1660 participants completed surveys measuring relationship satisfaction and perceived partner support style (active engagement, protective buffering, over-protection). Differences in glycemic control and adherence for those married/partnered versus not were insignificant. Higher relationship satisfaction, and having an engaged, not over-protective, partner was associated with better glycemic control and self-care. Helping partners support patients, avoiding over-protection, may enhance relationship and diabetes-related patient outcomes for adults with type 1 diabetes.
Once an older adult develops type 2 diabetes, they often need to change their diet as part of the treatment. We report differences in dietary barriers and strategies to overcome them in 17 older adults without type 2. Data were gathered through 24-hour diet recalls, collected barriers and strategies in changing diet, and the health locus of control scales. Differences in barriers and strategies were partially explained by health locus of control subscales. People who believed that others (e.g. doctors) controlled their health were less likely to identify barriers or strategies to overcome them. The results contribute to training materials and decision aids.
Among adults living with HIV, unstable housing is a barrier to health. Stably- and unstably-housed adults living with HIV were assessed for over 25 months. At baseline, unstably-housed adults living with HIV had a more recent HIV diagnosis, higher viral loads, worse physical and mental health, lower rates of antiretroviral therapy use and insurance coverage, and higher rates of hard drug use than stably-housed adults living with HIV. At follow-up, the health of both groups was similar, but unstably-housed adults living with HIV reported significantly more hard drug use and mental health symptoms when compared to the stably-housed adults living with HIV. Drug and mental health risks decreased for both groups, but decreases in unprotected sex were greater among unstably-housed adults living with HIV.
Health information can be presented in different formats, such as a statistically-based or a story-based (e.g. narrative) format; however, there is no consensus on the ideal way to present screening information. This systematic review summarizes the literature pertaining to narrative interventions’ efficacy at changing screening behaviour and its determinants. Five psychology and public health databases were searched; 19 studies, 18 focused on cancer and 1 on sexual health, met eligibility criteria. There is consistent evidence supporting the efficacy of narratives, but mixed evidence supporting an advantage for narratives over statistical interventions for screening behaviour and its determinants. Further investigation is warranted.
Health-related behaviours and psychological distress were examined after kidney transplantation. Patients were evaluated at 1 month, 6 months and 1 year after transplantation. Participants completed the Healthy Behaviours Questionnaire and the Hospital Anxiety and Depression Scale. No significant differences in Healthy Behaviours Questionnaire’s total score and psychological comorbidity were observed at three time points. However, there was an increase in drug-consumer habits (p < 0.05) and a reduction in sedentary lifestyle (p < 0.05) at 6 months and 1 year. Moreover, at 1 year, post-transplant had increased the harmful health habits (p < 0.05). In regression analysis, anxiety symptoms were significant predictors of Healthy Behaviours Questionnaire change at a year post-transplantation.
Alexithymia is a multifaceted personality construct associated with several medical illnesses. However, no studies have focused on food allergy. We investigated alexithymia among food-allergic youths, compared to a matched healthy sample. A total of 220 participants aged 9–25 years were assessed using the Toronto Alexithymia Scale and the Alexithymia Questionnaire for Children. Food-allergic patients reported higher levels of alexithymia compared to a matched healthy sample. Furthermore, an association between alexithymia and a clinical history of anaphylaxis was found among patients. Some possible hypotheses have been discussed considering physiological, psychological, developmental, and cognitive/behavioral factors.
Walking is an effective but underused treatment for intermittent claudication. This qualitative study explored people’s experiences of and beliefs about their illness and walking with intermittent claudication. Using the Framework method, semi-structured in-depth interviews included 19 individuals with intermittent claudication, and were informed by the Theory of Planned Behaviour and Common Sense Model of Illness Representations. Walking was overlooked as a self-management opportunity, regardless of perceptions of intermittent claudication as severe or benign. Participants desired tailored advice, including purposeful and vigorous exercise, and the potential outcome of walking. Uncertainties about their illness and treatment may explain low walking participation among people with intermittent claudication.
The study examined whether the items of the World Health Organization Quality of Life—Brief questionnaire can assess its four underlying domains (Physical, Psychological, Social, and Environment) in a sample of lung cancer patients. All patients (n = 1150) were recruited from a medical center in Tainan, and each participant completed the World Health Organization Quality of Life—Brief. Several Rasch rating scale models were used to examine the data-model fit, and Rasch analyses corroborated that each domain of the World Health Organization Quality of Life—Brief could be unidimensional. Although three items were found to have a poor fit, all the other items fit the unidimensionality with ordered thresholds.
The aim of this study was to understand experiences of wait time among patients awaiting scheduled orthopaedic or cardiac surgery. Using a qualitative approach, 32 patients completed two interviews each regarding their wait time experiences, including effects of waiting. Patient experiences of wait time varied regardless of actual wait time and included reports of restriction, uncertainty, resignation, coping and opportunity. Participants’ waiting experiences indicate a complex relationship between greater symptom severity and less tolerance for wait time. We suggest healthcare resources focus on alleviating the deleterious effects of waiting for certain patients rather than reducing absolute wait times.
The role and potential significance of romantic partners have been acknowledged in the eating disorder literature; yet, few studies have addressed partner perspectives, and none of these have involved dating relationships or considered the implications of the initiation of recovery for partner perceptions. In this study, common themes in the analysis of 12 partner interviews included changing understandings of disordered eating, development of strategies to support their partners, and lack of resources. In addition, participants whose partners did not initiate recovery reported confusion and helplessness, while those whose partners initiated recovery expressed responsibility for and gratification in the positive changes.
Although intimate partner violence is prevalent among Southeast Asian American women, little is known about the associations between the experience of intimate partner violence and negative health outcomes in this population. Resnick et al. proposed a model explaining the development of health problems following violent assault. This article assesses the applicability of Resnick et al.’s model to Southeast Asian American women who have experienced intimate partner violence by reviewing cultural, historical, and social factors in this population. Our review indicates that the applicability of Resnick et al.’s model to Southeast Asian American women is mixed, with some components of the model fitting well with this population and others requiring a more nuanced and complex perspective. Future studies should take into consideration cultural, historical, and social factors.
Osteoporosis is the most common metabolic bone disease. In this experimental study, 120 patients (60 experimental and 60 control) from women aged 30 to 50 years old, who were registered under the health centers in Fasa City, Fars Province, Iran, were selected. After intervention, the experimental group showed a significant increase in the health belief model constructs, self-regulation, social support, and nutrition and walking performance compared to the control group. After 6 months of intervention, the value of lumbar spine and hip bone mineral density T-score in the experimental group increased, while in the control group it reduced. This study showed the effectiveness of health belief model and structures of self-regulation and social support in prevention of osteoporosis in women.
This study examined the longitudinal association of depressive symptoms and stressful life events with inflammation in the Women’s Health Initiative. Women aged 50 years and older (N = 7477) completed questionnaires assessing depressive symptoms and stressful life events at baseline and 15 years later. Serum measures of C-reactive protein were collected at both assessments. In bivariate analyses, C-reactive protein predicted 15-year depressive symptoms and stressful life events (ps < .03) and baseline depressive symptoms and stressful life events predicted later C-reactive protein (ps < .03). These longitudinal relationships were not maintained in multivariate adjusted analyses. Combined with previous research, this suggests the relationship between depression, stressful life events and inflammation attenuates with time.
This study investigated 30 male smokers’ experiences of an appearance-focused, facial-ageing intervention. Individual interviews (n = 21) and three focus groups (n = 9) were conducted. Transcripts were analysed using thematic analysis. Male smokers explained that viewing the impacts of smoking on their own faces was the most effective part of the intervention and 22 men (73%) said that they intended quitting smoking or reducing number of cigarettes smoked post-intervention. It is recommended that designers of appearance-focused interventions target men in the future as the current findings demonstrated that the majority of men engaged well with the intervention.
This study explored the effects intervening in the linkages of optimism and hope with subjective health in the short term after myocardial infarction. A two-wave study design was used. The sample consisted of 222 myocardial infarction survivors. When adopting a cross-sectional design, optimism and hope predicted subjective health at Time 1 and Time 2. After controlling for baseline subjective health, they were no longer significant predictors of subjective health at Time 2. Parallel indirect effects of seeking social support and problem solving were significant for both optimism and hope. After controlling for the shared variance between optimism and hope, these effects remained significant only for optimism.
Advances in medical treatment mean more older people are living with burn injuries. However, little is known about experiences and support needs of this group. Interpretative Phenomenological Analysis of semi-structured interviews with 10 burn survivors aged 51–71 years identified four themes: time and adjusting to an altered appearance; living with a visible difference in the eyes of others; me, myself and I; importance of maintaining appearance. Adjusting to burns was a long process. Participants discussed feeling isolated, needing information about how ageing impacts on scars and maintaining a socially acceptable appearance. Implications for care and further research are discussed.
Existing findings on body dissatisfaction in older adults are sparse. In addition, research suggests that chronic illness may elevate risk for body dissatisfaction. Accordingly, this study examined predictors of body dissatisfaction in 274 older adults with a disabling health condition. Most participants reported dissatisfaction with their weight, shape, and/or appearance. Higher body mass index and negative impact of health on appearance predicted body dissatisfaction. Gender comparisons revealed that depressed mood may fuel body dissatisfaction in women. Somatic symptoms predicted body dissatisfaction in men, despite men reporting lower somatic symptoms. Overall, results indicate substantial incidence of and unique risk factors for body dissatisfaction in this population.
This study investigated understandings of health among lesbian, gay, bisexual, pansexual, queer and/or transgender people, who are under-represented in research. The study involved 12 focus groups in Aotearoa/New Zealand with 47 participants who identified as lesbian, gay, bisexual, pansexual, queer and/or transgender and responded to an advert inviting participants without chronic illnesses. Three themes were inductively formulated: health is important because education and protection efforts are seen as required to preserve health, health is seen as holistic, and contextual factors are seen as creating health risks. These findings provide insights into how lesbian, gay, bisexual, pansexual, queer and/or transgender people’s understandings of health draw upon notions of healthism.
Psychological characteristics associated with eating motives of the Palatable Eating Motives Scale (PEMS) were identified in 192 undergraduates. Coping was characterized by greater BMI, emotion-triggered eating, and eating concern and also by binge-eating and perceived stress reactivity in females. Reward Enhancement was characterized by greater BMI, anxiety- and depression-eating in females and by anger/frustration-eating in males. Conformity was strongly characterized by binge-eating and by failure-based stress and all eating disorder traits in females and by anger/frustration- and anxiety-eating in males. The sex-divergent patterns of these traits across PEMS motives highlight the heterogeneity of hedonic eating. The traits may also be maintaining the motives, hence adresseing them should improve treatments for obesity, binge-eating, and foster healthier coping, reward, and psychosocial interactions.
The aim of this study was the validation of a brief form of the Perceived Neighborhood Social Cohesion questionnaire using data from 5065 men from the "Cohort Study on Substance-Use Risk Factors." A 9-item scale covering three factors was proposed. Excellent indices of internal consistency were measured (α = .93). The confirmatory factor analyses resulted in acceptable fit indices supporting measurement invariance across French and German forms. Significant correlations were found between the brief form of the Perceived Neighborhood Social Cohesion questionnaire, and satisfaction and self-reported health, providing evidence of the concurrent validity of the scale. Perceived neighborhood social cohesion, and depression and suicide attempts were negatively associated, sustaining the protective effect of perceived social cohesion.
Medical mistrust has emerged as a significant barrier to medication adherence among African Americans living with HIV. This study sought to determine whether the relationship between medical provider mistrust and antiretroviral therapy adherence is accounted for by beliefs that may be more amenable to change. African American men and women receiving antiretroviral therapy (N = 380) in a large southern US city completed computer-administered measures of health, antiretroviral therapy adherence, race-based medical provider mistrust, and medication necessity and concerns beliefs. Multiple mediation modeling showed that medical provider mistrust was associated with medication beliefs and antiretroviral therapy adherence. In addition, medication beliefs predicted antiretroviral therapy adherence. Based on 5000 bootstrap resamples, the indirect effects of medical provider mistrust on adherence via medication beliefs were significant, unstandardized b = –1.24, 95 percent confidence interval = –2.47 to –0.29; the indirect effect was significant for medication concerns beliefs, b = –1.10, 95 percent confidence interval = –2.33 to –0.21, but not medication necessity beliefs, b = –0.14, 95 percent confidence interval = –0.66 to 0.02. We conclude that medication concerns beliefs mediates the association between medical provider mistrust and antiretroviral therapy adherence. Interventions that directly elicit and address medication concerns may resolve intentional and unintentional antiretroviral therapy non-adherence even when patients mistrust medical providers.
The purpose of the study was to investigate whether experiencing fear of dying after acute coronary syndrome predicts later posttraumatic stress symptoms. We enrolled 90 patients hospitalized with main diagnosis of acute coronary syndrome and assessed baseline characteristics. One month after discharge, we collected the Posttraumatic Stress Scale. A total of 24 patients (26.7%) developed posttraumatic stress symptoms 1 month after the acute coronary syndrome event. Patients with posttraumatic stress symptoms reported significantly greater fear of dying, helplessness, avoidance-focused coping, and severe anxiety. In our prospective study, fear of dying was associated with occurrence of posttraumatic stress symptoms in patients hospitalized with acute coronary syndrome.
To assess the impact of distraction on subsequent eating, 60 females consumed a cereal bar while watching TV, walking or talking, and their subsequent desire to eat and food intake were assessed. No effects were found for desire to eat. But while those higher in restrained eating consumed less overall and fewer calories after watching TV or talking, they consumed more overall and more calories (specifically five times more chocolate) if the cereal bar was eaten while walking. ‘Eating on the go’ may disinhibit restrained eaters either as a form of distraction or by offering a justification to overeat.
A particular form of social pain is invalidation. Therefore, this study (a) investigates whether patients with chronic low back pain experience invalidation, (b) if it has an influence on their pain, and (c) explores whether various social sources (e.g. partner and work) influence physical pain differentially. A total of 92 patients completed questionnaires, and for analysis, Pearson’s correlation coefficients and hierarchical linear regression analyses were conducted. They indicated a significant association between discounting and disability due to pain (respective β = .29, p > .05). Especially, discounting by partner was linked to higher disability (β = .28, p > .05).
Adverse events during childhood, including loss of a parent, are related to a higher risk of adult obesity. We investigated whether childhood parental loss is related to adult rapid weight gain through exposition to a later loss event. We assessed the mediation effect of recent loss and non-loss events on the association between childhood loss and rapid weight gain in 138 individuals seeking bariatric surgery. Our results showed that recent loss events mediate the effect of childhood parental loss on rapid weight gain (0.790; p < .001), suggesting the need for specific programs to prevent and treat obesity in individuals with multiple losses.
Disclaimer labels on airbrushed media images have generated political attention and advocacy as a social policy approach to promoting positive body image. Experimental research suggests that labelling is ineffective and consumers’ viewpoints have been overlooked. A mixed-method study explored British consumers’ (N = 1555, aged 11–78 years) opinions on body image and social policy approaches. Thematic analysis indicated scepticism about the effectiveness of labelling images. Quantitatively, adults, although not adolescents, reported that labelling was unlikely to improve body image. Appearance diversity in media and reorienting social norms from appearance to function and health were perceived as effective strategies. Social policy and research implications are discussed.
Besides habituation, conscious decision-making remains important for healthcare workers’ hand hygiene compliance. This study compared 307 physicians and 348 nurses in intensive care at a German university medical centre regarding their belief that hand disinfection prevents pathogen transmission. Physicians perceived less risk reduction (p < 0.001; variance explained: 4%), a comparison outscored only by lower self-rated guideline knowledge (8%). In both groups, the transmission-preventive belief was associated with high response efficacy, behavioural intention and self-efficacy, but not with self-rated knowledge. Consistent with the Health Action Process Approach, hand hygiene interventions targeting risk reduction beliefs may promote high motivation, but not action control.
This study aims at examining whether adolescent girls diagnosed with anorexia nervosa and their parents differ in perceiving the different aspects of family functioning. Moreover, the discrepancy between adolescent girls and healthy controls on Family Adaptability and Cohesion Evaluation Scales dimensions, family communication, and family satisfaction is investigated. The study includes 36 female anorexia patients and their parents and 36 healthy controls. The results showed a different view between mothers and their daughters with regard to the dimension of rigidity. In addition, girls with anorexia nervosa were less satisfied about family environment and rated their families as less communicative, flexible, cohesive, and more disengaged, compared to controls.
Stress-reduction interventions have been linked with enhanced well-being and health. This study examined affect and cortisol in 111 individuals randomly assigned to a single 35-minute guided relaxation or a stress management lecture control group. Positive affect increased more in the relaxation compared to the control group (F = 6.62, p = .01). Dispositional stress reactivity had a moderating influence (R2 = .248, p < .001), such that individuals high in stress reactivity showed highest increases in positive affect to the relaxation. Results indicate that a single guided relaxation intervention improves positive affect among individuals high in stress reactivity.
The aim of this study was to conduct an in-depth investigation of experiences with pain before knee and hip replacement surgery. A total of 20 patients were interviewed, and interpretative phenomenological analysis was used to identify themes. These were as follows: living with pain, pain conceptualised, pain treatments and healthcare system. Pre-surgical pain is very disabling and is viewed as biological. There was an associated loss of independence. Pharmaceutical management is used by all but not entirely effective, psychological therapies are underutilised. Patients were frustrated, angry, and confused about qualifying for surgery. Many areas of care could be improved to help these pre-surgical patients.
Much of the focus on sexual health for people living with HIV has been on promoting safe sex behaviours. However, also important for sexual health is a positive sexual self-esteem. This article reports on an interpretative phenomenological analysis of interviews with seven men about the impact that having HIV has had on their sense of sexual self. Five overarching themes were identified: the ‘destruction’ of a sexual self; feeling sexually hazardous; sexual inhibition; reclaiming a sexual self and finding a place through sero-sorting. With HIV now being a chronic illness, interventions are required to support people to lead sexually satisfying lives.
Perceiving ethnic discrimination can have aversive consequences for health. However, little is known about whether perceiving language-based (how one speaks a second language) discrimination poses the same risks. This study examined whether perceptions of language-based and ethnic discrimination are associated with mental and physical health. Among 132 Mexican and Dominican immigrant women, perceiving ethnic and language-based discrimination each predicted psychological distress and poorer physical health. When examined together, only ethnic discrimination remained a significant predictor. These results emphasize the importance of understanding how perceived ethnic and language-based discrimination play an integral role in the health of Latina immigrant women.
In order to better understand drivers of dangerous indoor tanning behaviors, researchers developed the Comprehensive Indoor Tanning Expectations scale. To examine the longitudinal effectiveness of Comprehensive Indoor Tanning Expectations, we surveyed young women in the Southeastern United States at two time points (N = 553). The scale demonstrated strong test–retest reliability. Participants who believed indoor tanning would improve their mood and afford social approval were significantly more likely to tan 6 months later, while participants who believed indoor tanning leads to psychological/physical discomfort were significantly less likely to tan 6 months later. Knowing the psychological bases for indoor tanning can inform intervention and message design.
Current interventions to reduce obesity have limited success. This study aimed to determine the characteristics of successful champions (non health professional/community leaders) and to assess how these relate to acceptability ratings of an obesity reduction intervention—the Waist Disposal Challenge. A total of 200 peer participants completed questionnaires. Positive ratings of champions’ performance were significantly correlated with perceptions of the success and suitability of the Waist Disposal Challenge. The qualitative feedback concurred that the program prompted weight loss and was a positive social experience which resulted in actual behavioral changes. Selecting suitable champions is likely to influence the success of such community health programs.
This survey examined the oral health knowledge and psychological determinants of oral health behavior of 1019 undergraduate and postgraduate nursing students. Overall, most of the students perceived their oral health to be average, and their flossing and dental visiting frequencies were inadequate. Moreover, the students’ oral health knowledge was suboptimal, regardless of the type of study, and it was not significantly associated with oral health behavior. Binary logistic regression showed that toothbrushing self-efficacy and the type of study were both significantly associated with toothbrushing behavior. Furthermore, flossing self-efficacy and dental visiting self-efficacy were both significantly associated with flossing and dental visiting behaviors, respectively.
Moral distress occurs when professionals cannot carry out what they believe to be ethically appropriate actions. This review describes the publication trend on moral distress and explores its relationships with other constructs. A bibliometric analysis revealed that since 1984, 239 articles were published, with an increase after 2011. Most of them (71%) focused on nursing. Of the 239 articles, 17 empirical studies were systematically analyzed. Moral distress correlated with organizational environment (poor ethical climate and collaboration), professional attitudes (low work satisfaction and engagement), and psychological characteristics (low psychological empowerment and autonomy). Findings revealed that moral distress negatively affects clinicians’ wellbeing and job retention. Further studies should investigate protective psychological factors to develop preventive interventions.
This research validates a computerized dietary selection task (Food-Linked Virtual Response or FLVR) for use in studies of food consumption. In two studies, FLVR task responses were compared with measures of health consciousness, mood, body mass index, personality, cognitive restraint toward food, and actual food selections from a buffet table. The FLVR task was associated with variables which typically predict healthy decision-making and was unrelated to mood or body mass index. Furthermore, the FLVR task predicted participants’ unhealthy selections from the buffet, but not overall amount of food. The FLVR task is an inexpensive, valid, and easily administered option for assessing momentary dietary decisions.
Type 1 diabetes is a lifelong physical and emotional challenge. The concept of emotional intelligence may offer better understanding of personal resources facilitating management of such challenges. We therefore hypothesized that emotional intelligence will negatively associate with two measures of diabetic management: HA1c and blood sugar levels. A total of 78 young adults with type 1 diabetes mellitus reported their last HA1c test result and their blood sugar level, as well as demographics and took the audio-visual test of emotional intelligence. The results showed a negative association between emotional intelligence and HA1c and marginal results in the same direction with blood sugar levels even when controlling for demographics.
Disabilities and resultant handicaps may impair health-related quality of life to the degree that individuals feel that life is not worth living. Using archived 2009 Canadian Community Health Survey data, this study found that each of seven measures of disabilities (Health Utilities Index sub-scales of problems in (1) vision, (2) hearing, (3) speech, (4) mobility, (5) dexterity, (6) cognition, and (7) pain) had small but significant (p < 0.001) positive correlations with each of seven measures of suicidality: (1) Health Utilities Index emotion problems, (2) diagnosed depression, (3) dissatisfaction with life in general, (4) feeling helpless dealing with problems in life, (5) feeling hopeless during the past month, (6) feeling worthless during the past month, and (7) suicidal thoughts ever in life). A second study examined the 724 individuals in the 2009 Canadian Community Health Survey data with Health Utilities Index scores less than 0.00, which Health Utilities Index protocol defines to be "worse than dead." These individuals were described by demographic, disability, health, social, and suicidality measures, which showed the Health Utilities Index categorization of "worse than dead" to have doubtful validity. For example, mean measures of emotion problems and dissatisfaction with life were mid-range; only half reported depression or suicidal thought; and only 18 percent chose the Health Utilities Index response that "life is not worth living."
Cerebral stroke causes a significant worsening of health-related quality of life. This review was conducted on studies investigating whether the levels of quality of life were influenced by the coping strategies used by stroke patients. We searched on PubMed and Web of Science databases and screening references of included studies and review articles for additional citations. From initial 389 publications, we included only 6 studies that met search criteria and described the association between coping and quality of life. Results showed that patients who prefer accommodative or active coping strategies had a better quality of life after stroke when compared with patients who adopted assimilative coping.
This research explores the intended and unintended consequences of eating disorder public service announcements. We assessed participants’ attitudes toward eating disorders and people with eating disorders, willingness to interact with people with eating disorders, and experience with eating disorders (covariate) at Time 1. At Time 2, participants were randomly assigned to watch a stigmatizing or a non-stigmatizing eating disorder public service announcement. Exposure to the stigmatizing public service announcement resulted in more negative attitudes toward eating disorders and in less willingness to interact with people with eating disorders, but not in significantly more negative attitudes toward people with eating disorders. The discussion highlights the practical implications for health communication campaigns.
This study used an Actor–Partner Interdependence Model to examine the relationship between attachment behaviors and health practices, as measured by physical activity levels and dietary habits. The sample included 1031 married couples, the majority of which is Caucasian (83.8%). Results suggest that women’s attachment behaviors significantly influenced their own health practices (p = .038), such that for every unit increase in poor attachment behaviors, women were 199.8 percent more likely to have poor diet and low physical activity levels (exp(1.098) = 2.998). Men’s attachment behaviors were not significantly related to their own health practices. There were also no significant partner paths. Implications for treating women who present with health problems are discussed, as are directions for future research.
We explored how people negotiate, and respond to, identity transitions following a diagnosis of pancreatic cancer. Interviews with 19 people with pancreatic cancer were analysed using thematic discourse analysis. While discursively negotiating two transitions, ‘moving from healthy to ill’ and ‘moving from active treatment to end-of-life care’, participants positioned themselves as ‘in control’, ‘optimistic’ and managing their health and illness. In the absence of other discourses or models of life post-cancer, many people draw on the promise of survival. Moving away from ‘survivorship’ may assist people with advanced cancer to make sense of their lives in a short timeframe.
Muscular strength is a well-known predictor of morbidity and mortality. Similarly, self-esteem is a predictor of health and well-being. The relationship between these two variables, however, is currently unknown. This study examined the cross-sectional relationship between maximal muscular strength (i.e. handgrip and one-repetition-maximum (1-RM) squat) and global self-esteem in 126 college students. Significant correlations were found between both measures of muscular strength and self-esteem. Further analyses revealed that these relationships were only significant for men. Based on these results, additional research is needed to further explore the relationship between muscular strength and self-esteem, especially in other demographic groups and longitudinally.
People with multiple sclerosis experience barriers to physical activity. Thought processes are interwoven with garnering motivation to overcome these barriers. This study investigated in-depth the role of positive thinking in physical activity motivation of two women and two men with multiple sclerosis. Participants thought aloud while completing standardised measures of physical activity, stages of change and self-efficacy, and in response to planned and spontaneous questions. Four themes were formulated using inductive thematic analysis: thoughts about purpose, self-efficacy, the past and reinforcement through positive thinking. These findings have implications for physical activity theories and delivering appropriate physical activity interventions to the multiple sclerosis community.
A total of 64 pregnant women were assigned into two groups of cases and controls. Both groups filled out the Perceived Stress Scale at pre-test. Cognitive-behavioral coping skill training was delivered to the case group. After the end of the intervention, both groups completed the same scale again. The results showed that the mean perceived stress of the cases and controls was 27.77 ± 6.033 and 18.97 ± 3.268, respectively (p = 0.001). Therefore, midwives are recommended to plan educational interventions to decrease perceived stress in pregnant women.
Resilience contributes to better chronic disease adjustment but is understudied in Parkinson’s disease. Although nonmotor symptoms affect quality of life, their effect on other aspects of Parkinson’s disease adjustment is less understood. Hierarchical regression analyses from a cross-sectional survey of 138 community-dwelling adults with Parkinson’s disease (mean (standard deviation) age = 64.15(10.09) years) investigated relationships between nonmotor symptoms and resilience on depression, apathy, life satisfaction, and quality of life. After controlling for demographic variables, functional status, and nonmotor symptoms, resilience was associated with all adjustment variables. Nonmotor symptoms were associated with depression and worse quality of life. Nonmotor symptoms and resilience appear to play critical roles in Parkinson’s disease adjustment.
Based on the existing literature, relevant determinants of availability for on-premises locations, off-premises locations, and the Internet were qualitatively explored and categorized by "experts" consisting of underage alcohol purchasers. In total, 14 focus group discussions were conducted with 94 Dutch adolescents. For on-premises locations, the high prices were perceived as the biggest disadvantage, and the ease to circumvent legal age limits as the biggest advantage. For off-premises locations, the cheap pricing was perceived as the most positive aspect, and the legal age limit as the biggest disadvantage. For online purchases, the waiting time was perceived as the most negative aspect, and the proximity of online stores as the biggest advantage.
This study explored the perspectives of Black men, originally from East Africa, living in the United Kingdom and their partners on what it means to live with diagnosed HIV. This article reports on concealment of HIV-positive status as a strategy adopted by the affected participants to manage the flow of information about their HIV-positive status. Analysis of the data, collected using in-depth interviews involving 23 participants, found widespread selective concealment of HIV-positive status. However, a few respondents had ‘come out’ publicly about their condition. HIV prevention initiatives should recognise concealment as a vital strategy in managing communication about one’s HIV-positive status.
Both psychological distress and fatigue are common post stroke. Although there is recognition that the phenomena are related, the nature of the relationship is unclear.Cross-sectional study of 98 independently functioning participants within 2 years of stroke. Significant relationships were observed between fatigue and general anxiety, health-related anxiety and stroke-specific anxiety (r range from .31 to .37). In the final regression model, depression, pain and stroke-specific anxiety were significant, accounting for 32 per cent of the variance in fatigue scores (p < .001). The findings provide insight into the importance of anxiety-related factors post stroke, their relevance to our understanding of post-stroke fatigue and their implications for post-stroke intervention.
Through focus groups, we examined the development and maintenance of an eating disorder in 16 females with type 1 diabetes and an eating disorder. The quotes and qualitative data summaries provide rich insights into understanding why those with type 1 diabetes are at increased risk for eating disorders. Content analyses revealed five themes pertinent to the dual diagnosis (feeling different, difficulty with control/coping, body image, feelings, and quality of life) of which four themes were relevant to eating disorder development. Findings support early identification of those at risk and inform interventions to mitigate development of an eating disorder.
Breast cancer–related lymphedema is associated with numerous adverse outcomes. This study investigated the extent clinical factors, lymphedema symptoms, lymphedema-related appearance, and coping strategies predicted quality of life. Female patients who underwent microsurgical treatment for lymphedema (n = 54) participated. Lymphedema symptoms were associated with physical and functional well-being, but not emotional and social well-being. Clinical factors and lymphedema-related appearance were not significantly associated with quality of life. Compared to adaptive coping strategies, maladaptive coping strategies (e.g. denial, venting, self-blame) were more strongly associated with quality of life. This suggests psychosocial interventions aimed at modifying maladaptive coping behaviors can potentially improve quality of life for this patient population.
Living donor kidney transplant is the ideal treatment option for end-stage renal disease; however, the decision to pursue living donor kidney transplant is complex and challenging. Measurement invariance of living donor kidney transplant Decisional Balance and Self-Efficacy across gender (male/female), race (Black/White), and education level (no college/college or higher) were examined using a sequential approach. Full strict invariance was found for Decisional Balance and Self-Efficacy for gender and partial strict invariance was found for Decisional Balance and Self-Efficacy across race and education level. This information will inform tailored feedback based on these constructs in future intervention studies targeting behavior change among specific demographic subgroups.
This study examined whether adaptive cognitive emotion regulation strategies mediate the relationship between forgiveness and health-related quality of life in a sample of 350 Spanish people aged 55 years and older. Positive refocusing and positive reappraisal strategies partially mediated the relation between forgiveness and mental health. Thus, focusing on planning partially mediated the relation between forgiveness and physical health. Our findings contribute to an emerging understanding of the underlying coping process between forgiveness and health outcomes and might provide preliminary insight for potential intervention for increasing quality of life via the promotion of forgiveness and adaptive coping in the elderly.
The aim of this study was to assess, in the immediate postsurgical period, the influence of attachment avoidance and anxiety on distress and body image disturbances in women facing breast cancer. Seventy-five women participated in the study 3 weeks after surgery. Questionnaires were used to assess study variables. To predict distress and body image disturbances, we controlled for several variables known to influence adjustment to the stress of breast cancer. The results of hierarchical regression analyses show that attachment explains the outcomes above and beyond other influential variables. Insecurely attached women are especially vulnerable to the stress of the disease.
In addition to individual-level socioeconomic and psychological factors, the neighborhood environment has been found to be related to medication nonadherence, particularly among low-income, minority populations managing a chronic disease. In this article, we synthesize the relevant literature on how neighborhood factors contribute to engagement in health behaviors and reasons for medication nonadherence among this population. We propose a theoretical framework for understanding the mediating and moderating mechanisms whereby the neighborhood environment may impact medication nonadherence among individuals most at risk for adverse disease outcomes. Guided by this model, we provide recommendations for future research, practice, and policy.
This study investigated coping with chronic illness in the adult patient–caregiver relationship for sickle cell disease, marked by debilitating acute and chronic pain. One-on-one interviews (N = 16) were conducted with eight primary caregivers of eight adults with extremely high hospital use, severe sickle cell disease with hospital admissions several times monthly over successive years. Caregivers were predominantly parents; two were romantic partners. Caregivers attributed disruptions to the disease’s variability, tensions in how much support to give, and adults’ inability to fulfill parental obligations. Both groups expressed fears of patients’ increasing age, declining health, and early death. Targeted counseling and resilience training is recommended.
This research examined whether the relationship between perceived social support and health would be moderated by level of outness for people living with different concealable stigmatized identities (mental illness, substance abuse, domestic violence, rape, or childhood abuse). A total of 394 people living with a concealable stigmatized identity completed a survey. Consistent with hypotheses, at high levels of outness, social support predicted better health; at low levels of outness, social support was less predictive of health. People concealing a stigmatized identity may only be able to reap the health benefits of social support if they are "out" about the stigmatized identity.
Experimental research is needed to examine whether weight monitoring impacts weight and whether it has unintended harmful effects. This study randomly assigned 49 first-year university women (body mass index: 20–30 kg/m2) to daily weight monitoring or a control condition and measured weight, mood, body dissatisfaction, and unhealthy weight control behaviors at baseline and 8 weeks, and weight at 20-week follow-up. No harmful effects of daily weighing were detected; acceptability and adherence were high. Weight monitoring did not impact weight; both groups showed little weight gain. Results suggest that weight monitoring has minimal harmful effects and may be useful for preventing weight gain.
Experiences of parents who care for sons or daughters with severe myalgic encephalomyelitis are rarely discussed within the literature. Narratives of parent–carers in Lost Voices from a Hidden Illness were analyzed using interpretative phenomenological analysis. This study aimed to give voices to those who care for individuals with myalgic encephalomyelitis and are often stigmatized and inform future research supporting parent–carers. Results included themes of identity change, guilt, feeling like outsiders, uncertainty, changing perceptions of time, coping mechanisms, and improvement/symptom management. Findings could inform the development of carer-focused interventions and provide vital information to health professionals about parent–carers’ lived experience.
The extent to which mental health problems, including current anxiety and depressive symptoms, may co-occur, or are associated, with the acquisition of sexually transmitted infections other than HIV remains largely unexplored among men who have sex with men. In a cross-sectional survey of 8,381 US men who have sex with men recruited from a sexual networking website, 15 percent reported a past 60-day sexually transmitted infection diagnosis. Among HIV-negative men, increased odds of reporting a sexually transmitted infection were associated with current anxiety symptoms and past 60-day drug use. Findings underscore the need to better understand causal pathways among anxiety, drug use, and sexually transmitted infection acquisition and transmission among men who have sex with men.
With increasing mammogram rates, identifying attributes of non-attending women entails going beyond differences in demographic groups to reveal complex interactions among personality attributes. In this study, we analyzed survey data from 474 women aged 41 years and older using decision trees. By incorporating personality, religiousness, and age, we were able to correctly classify 42.9 percent of non-attenders compared to 4.4 percent with logistic regression analysis. Our findings suggest that incorporating personality and religiousness attributes may increase non-attender identification. Furthermore, the simple profile generated by decision trees provides a clear map useful for intervention planning.
This study examined the possible intergenerational transmission of eating beliefs and intentions between 60 mothers and their adult children. Maternal restrictive feeding practices were correlated with mothers’ own healthy eating attitudes and subjective norms, and with their adult children’s subjective norms. Mothers’ beliefs and intentions were correlated with their adult children. Adult children’s intentions to eat healthily were predicted by their attitudes and perceived behavioural control, and also by their mothers’ intentions and perceived behavioural control. Mothers’ own beliefs and intentions may be involved in shaping their children’s beliefs and intentions into adulthood but their child feeding practices may have less of an influence.
This qualitative study was designed to identify patients’ experiences and perceptions related to living with late-stage chronic kidney disease. Interviews were held for 15 patients with late-stage chronic kidney disease from two medical centers in Taiwan. Five themes were identified using content analysis: experiencing moderate to severe symptoms and signs; tracing back to causes; realizing the long-term, irreversible nature of the disease; facing the consequence of unavoidable deterioration; and coping with the disease. The findings present the special lived experiences of Taiwanese chronic kidney disease patients and highlight the need for healthcare providers to assess patients’ illness representation before offering interventions for patients coping with chronic kidney disease.
The questionnaire study aimed to evaluate the relative contribution of body awareness, subjective symptoms, and anxiety to the construct of somatosensory amplification in both healthy controls (n = 475) and patients visiting their general practitioner (n = 236). Regression analysis explained 52.0 percent of total variance of the somatosensory amplification scale scores. Body awareness was the most influential predictor (β = 0.489, p < 0.001) when considering all predictors simultaneously. The results suggest that dispositional interoceptive focus, as indicated by body awareness, may be an important aspect of somatosensory amplification, over and above dispositional anxiety or subjective symptom report.
It is well-established that physical activity is beneficial to physical and psychological health. However, how physical activity contributes to psychological health is still unclear. In this investigation, we examined the association between physical activity and negative emotions assessed in real-time during simulated-peer-rejection. Moreover, we explored mediation of this association by higher-order neurocognitive functioning and cardiovascular flexibility. Although we found no evidence for mediation, we did find that greater physical activity predicted contextually responsive negative emotion. Specifically, greater physical activity predicted generation of negative emotions in response to peer-rejection and flexible reduction of negative emotions in response to peer-acceptance.
Clinical practice guidelines recommend tobacco treatment for all cancer patients. However, little is known about how to integrate tobacco treatment into cancer care. The results of our pilot study of an evidence-based tobacco treatment integrated into a thoracic oncology clinic demonstrated good feasibility and efficacy, providing an opportunity to inform future tobacco treatment integration efforts. Here, we describe the process of intervention development, clinic integration, patient identification, and patient enrollment. We report on the intervention content and delivery, patterns of quitting for participants in the tobacco treatment group, and changes in smoking-related psychosocial variables. Clinical implications and suggestions for future research are discussed.
This study aimed to test the effects of inflammatory bowel disease symptomatology and associated medical complications on physical and psychological quality of life and to explore whether these relationships are mediated by experiential avoidance. A total of 200 inflammatory bowel disease patients reported demographic and medical data and completed self-report instruments. Results revealed that the tested model presented an excellent fit, explaining 51 per cent of physical quality of life and 53 per cent of psychological quality of life. Inflammatory bowel disease–associated complications directly impacted on physical quality of life, and experiential avoidance significantly mediated the relationships between inflammatory bowel disease symptomatology and physical and psychological quality of life. These results highlight the importance of implementing psychological interventions for inflammatory bowel disease patients.
How the social and institutional context is structured and represented by its actors has an impact on positive aging representations. This qualitative study explores professionals’ views on positive aging, how they promote positive aging in their practice and what disparities occur between their discourses and the actual practice of promoting positive aging. Interviews were conducted with professionals from different active aging promotion services and analyzed with thematic coding. Findings show professionals hold negative views on aging while trying to promote positive views in their work, illustrating an existing theory-practice gap. Strategies used in practice can be integrated in existing agency models and inform interventions and active aging policies.
Women’s experiences of pregnancy, birth, and postpartum adjustment are often characterized by feelings of disempowerment, trauma, and emotional pain. Psychosocial perinatal care has not kept up with medical advances in perinatal care. Access to psychosocial care appears to be inadequate because of the following: (a) perinatal health care providers are insufficiently prepared to address emotional aspects of maternal care and (b) traditional, compartmentalized psychological services benefit only a subsection of perinatal women, often in an untimely manner. Practical and innovative psychosocial services, integrated into routine perinatal care, can provide widespread access to psychosocial resources for mothers and supports providers in delivering optimal care.
In this study, we analyzed the relationships among clinical, emotional, social, and spiritual dimensions of patients with advanced illness. It was a cross-sectional study, with a sample of 108 patients in an advanced illness situation attended by palliative care teams. Statistically significant correlations were found between some dimensions of spirituality and poor symptomatic control, resiliency, and social support. In the structural model, three variables predicted spirituality: having physical symptoms as the main source of discomfort, resiliency, and social support. This work highlights the relevance of the relationships among spirituality and other aspects of the patient at the end of life.
We made an inventory of the reasons for inhabitants of Benin to be reluctant to undergo the amputation of a limb. A robust six-factor structure of motives was found: Change in Appearance, Lack of Information, Fear of Hospitals and Medical Staff, Loss of Others’ Consideration and Affection, Denial of Necessity, and Spiritual and Religious Concerns. The first three motives were the most strongly endorsed. To improve people’s timely acceptance, it is important to attack the main emotional–motivational barriers by using artificial limbs imitating real ones, by providing complete information on post-operative care and rehabilitation, and by strengthening family support.
Epilepsy has been reported as one condition that can cause psychological difficulties and distress to care givers of patients suffering from the condition. This study explored psychological difficulties experienced by lay care givers of patients with epilepsy in an urban township in South Africa. Nine individual in-depth interviews were conducted with lay carers who provide care to their relatives, friends and neighbours who have epilepsy. A thematic data analysis method was used. Some fears, social concerns and worries affecting care giving were reported. Community interventions that promote cultural sensitivity in mental health care and empowerment of these carers are needed.
Poor self-care is common among adults with heart failure and leads to poor health outcomes. Low self-efficacy, depression, and low social support are associated with poor self-care, but knowledge about these relationships in heart failure is limited. Secondary data analysis of cross-sectional data from 346 adults with heart failure measuring self-efficacy, depressive symptoms, social support, and self-care adherence was conducted. Tests of mediation using multiple linear regressions indicate that self-efficacy fully mediates the relationships between depression and adherence, and social support and adherence. Bolstering self-efficacy may have a greater impact on self-care adherence than targeting either depression or social support alone.
Worsening depressive symptoms and walking impairment are significant burdens in multiple sclerosis. We explored the reciprocal relationship between depressive symptoms and walking impairment in a cohort of 269 people with relapsing-remitting multiple sclerosis over 2 years. The data were examined using longitudinal panel analysis in Mplus. Baseline depressive symptoms predicted change in walking impairment at 1-year follow-up (path coefficient = .074), and change in walking impairment at 1-year follow-up predicted change in depressive symptoms at 2-year follow-up (path coefficient = .177). Our study provides preliminary evidence for initiation of a reciprocal relationship between depressive symptoms and walking impairment in relapsing-remitting multiple sclerosis.
This article reports a case of a 5-year-old girl with clinical manifestations of a conversion disorder. Children presenting with a conversion disorder very often have multiple investigations and more than two-thirds of them are admitted to the hospital. This case illustrates the necessity of adapting, from the outset, a multidisciplinary approach to diagnosis and management, which helps in providing an explanatory model that takes into account stressors, factors within the child and the family, and aids in planning an appropriate psychotherapeutic intervention based on the child’s and family’s needs.
Few individuals with arthritis are sufficiently active. We surveyed a convenience sample of exercisers (N = 134) to examine the utility of social cognitive theory variables, namely, self-regulatory efficacy, negative outcome expectations, and pain acceptance for predicting planned physical activity according to Weinstein’s two prediction suggestions. Logistic regression revealed, after controlling for pain intensity, self-regulatory efficacy, negative outcome expectations, and pain acceptance distinguished groups achieving/not achieving planned physical activity, p < 0.001 (28% variance). A second model adding past physical activity also predicted the groups, p < 0.001 (57% variance). This is one of the first arthritis studies examining planned physical activity relative to Weinstein’s recommendations.
This grounded theory study explores conceptualisations of chronic fatigue syndrome/myalgic encephalomyelitis from semi-structured interviews with 10 health-care professionals working with children and adolescents. The findings suggest that a lack of a clear empirical understanding of chronic fatigue syndrome/myalgic encephalomyelitis leads to ‘working with uncertainty’, whereby health-care professionals utilise previous experiences to make sense of the condition and inform their clinical practice. How health-care professionals make sense of chronic fatigue syndrome/myalgic encephalomyelitis may influence the labels given to young people and the interventions they receive. The findings provide insight into a currently understudied area, and highlight potential avenues for further research and clinical practice.
This study examines the moderating role of dispositional optimism on the relationship between perceived stress and depression of the Chinese "Ant Tribe." A total of 427 participants from an Ant Tribe community completed the measures of perceived stress, optimism, and depression. The structural equation modeling (SEM) analysis showed that dispositional optimism moderated the association between perceived stress and depression. The Ant Tribe with high perceived stress reported higher scores in depression than those with low perceived stress at low dispositional optimism level. However, the impact of perceived stress on depression was insignificant in the high dispositional optimism group.
Stress is associated with higher blood glucose in patients with diabetes, but the strength of this association varies considerably across patients. The current daily diary study of 129 patients with type 2 diabetes examined whether individual differences in emotional stress reactivity were associated with fasting blood glucose and whether emotional support provided by spouses moderated this association. Greater stress reactivity was related to greater variability in patients’ fasting glucose readings and, among patients with less support, to higher fasting glucose levels. Investigating individual differences in emotional stress reactivity may help to clarify the role of stress in blood glucose control.
Gay men with diagnosed HIV can adopt a number of strategies to reduce the risk of transmitting HIV to others, although research has typically focussed on condom use. Interviews with 42 HIV-positive gay men who reported recent engagement in anal intercourse without condoms explored their awareness of sexual risk and their perceptions of non-condom-related strategies to reduce it. In articulating men’s ambivalence for strategies that can only reduce the risk of transmission, rather than eliminating, the findings have implications for the consideration and integration of new biomedical interventions to reduce the likelihood of HIV transmission.
This study provides insight into the lived experience of mirror gazing using Interpretative Phenomenological Analysis and Photo Elicitation. A total of 10 participants who identified themselves as suffering from body dysmorphic disorder took photographs that related to their body dysmorphic disorder experience. Photographs were discussed in interviews. It was found that mirror gazing in body dysmorphic disorder is an embodied phenomenon. Motivations for mirror gazing were confusing, complex and masochistic. Overall, participants described mirrors as being controlling, imprisoning and disempowering forces that had a crippling and paralysing effect on life. It is argued that health psychologists must ask clients about their embodied experiences when looking in the mirror.
We examine the cross-sectional association between subjective social status and self-rated physical and mental health functioning in 518 Black and White patients enrolled in a community-based hypertension control research study. We found that (1) subjective social status, measured using both a proximal and distal referent group, was positively associated with physical and mental health functioning scores independent of educational level, household income, or both; (2) the effect of subjective social status on physical and mental health functioning differed significantly by race when using the distal, not the proximal, referent group. When the associations differed, they were stronger for Whites than Blacks.
Awake craniotomy with language mapping enables maximum resection of tumours in eloquent areas while preserving function. This study aims to understand the lived experiences of those undergoing an awake craniotomy. Six participants who underwent awake craniotomy were interviewed, and the data were analysed using Interpretative Phenomenological Analysis. Themes were identified as ‘Unspeakable Fear’, ‘Dissociation’ and ‘Control and Responsibility’. Participants discussed how surgery was a threat to the sense of self. Dissociation during surgery operated as a protective mechanism, while the surgical team all had roles in maintaining this bubble of dissociation, such as being a support to the patient’s emotional needs.
This study aims to investigate the effectiveness of web-based intervention on social acknowledgement and disclosure of trauma and to examine the mediating effect of the improvement in social acknowledgement and disclosure of trauma on the reduction of posttraumatic stress disorder symptoms. A randomized controlled trial was used, with 21 participants in a web-based intervention group and 29 participants in a wait-list control group completing a pre-test and post-test. Results showed that social acknowledgement and disclosure of trauma improved significantly after 1-month intervention, and this improvement mediated the reduction in the posttraumatic stress disorder symptoms. Implications and limitations of this study are discussed.
This study examined the prevalence of unresolved attachment-related trauma and its association with physical and psychological health status in 34 patients with fibromyalgia. Unresolved trauma was assessed with the Adult Attachment Interview. In addition, participants completed self-report measures of childhood trauma, fibromyalgia-related health status and depression. Of the sample, 50 per cent was classified as unresolved on the Adult Attachment Interview. Neither interview-based ratings of unresolved trauma nor self-reported childhood sexual or physical abuse were associated with health outcomes. Only for self-reported emotional abuse, a positive correlation with depression emerged. The implications of the findings are discussed.
Much previous research into living kidney donation has focused on the decision-making of the donor, despite evidence suggesting this may be a more psychologically challenging time for the recipient. This longitudinal study explores the experiences of four recipients of kidneys from living donors throughout the transplant process. Transcripts were analysed using interpretative phenomenological analysis. Three themes arose from the data, which were as follows: changing perceptions of relationships with kidney donors; upbeat, temporal strategies for remaining positive and journey of the self. Findings from the first theme are presented in detail here. It was found that each participants’ relationship with their donor grew and developed in different ways, presenting their own complex challenges in terms of developing relationships and ambiguity around the decision to use the chosen donor.
There is little qualitative data on the emotional effect of stroke upon which to base hypotheses for psychological interventions. We used Interpretative Phenomenological Analysis of semi-structured interviews with 10 individuals in the clinical range for psychological distress on the Hospital Anxiety and Depression Scale to explore their experiences of psychological distress. Three super-ordinate themes (the fear of stroke, loss of self and sense of isolation and aloneness) emerged. Processes involving a lack of acceptance and self-compassion underlined these themes. Internal isolation was found as a great problem. These themes may indicate targets for directed psychological interventions in people following stroke.
Loved ones of cancer patients are vulnerable, often reporting psychological distress and inadequate information provision. This research examined the use and emotional and behavioral effects of online cancer information. Compassion and fear were the strongest emotions elicited by online content, and respondents reported several cognitive, communicative, and helping behaviors. Multiple relationships between emotions and behaviors were found, including between hope and helping behaviors, anger and problem-solving, fear and seeking comfort, and sadness and a decreased likelihood of engaging in cancer prevention and detection. This study extends research on emotions and action tendencies and provides guidance for developing future online resources.
Chemical intolerance is a long-standing illness with minimal guidelines regarding treatment. Hence, individual attempts to cope with the illness gain importance in dealing with its consequences. This study used data from 164 persons with self-reported chemical intolerance to understand the nature of coping with the illness. Coping was studied along two dimensions, the extent and predominant orientation of coping. The association of these coping dimensions with mental health variables of stress, depression, anxiety, burnout, and non-restorative sleep was examined as well. Results revealed that the persons with chemical intolerance used a moderate amount of coping strategies which were slightly more emotion-focused than problem-focused in orientation. Users of both problem-focused and emotion-focused orientations report scores in the normal range on all mental health indices. However, significantly higher level of anxiety was found to be associated with predominantly emotion-focused coping, whereas coping orientation did not differ with respect to the four other mental health indices. The above findings are discussed in relation to existing literature on coping with long-term illness.
Functional gastrointestinal disorders have been related with different psychological conditions. On the contrary, the role of psychological factors within gastrointestinal motor disorders remains unclear. The objective of this study was to explore the differences and congruence with clinical performance of the psychological profile and subjective functionality among patients diagnosed with functional gastrointestinal disorders and gastrointestinal motor disorders. Using a double-blind design, 56 inpatients from a Gastroenterology Department were included in the study. No major differences were detected between the two groups. However, clinical performance was coherent with subjective physical functioning only among patients diagnosed with gastrointestinal motor disorders. These results may provide useful information for gastroenterologists dealing with patients’ complaints not consistent with their clinical profile.
We compared adolescent and young adult cancer patient and survivor language between mediated and face-to-face support communities in order to understand how the use of certain words frame conversations about family, friends, health, work, achievement, and leisure. We analyzed transcripts from an online discussion board (N = 360) and face-to-face support group (N = 569) for adolescent and young adults using Linguistic Inquiry and Word Count, a word-based computerized text analysis software that counts the frequency of words and word stems. There were significant differences between the online and face-to-face support groups in terms of content (e.g. friends, health) and style words (e.g. verb tense, negative emotion, and cognitive process).
African-Americans sometimes rate their health as Poor/Fair in the absence of chronic diseases. Theoretically, this lack of correspondence between self-rated health and objective health is due to racial discrimination that results in rating one’s health negatively and in terms of social rather than health variables. We tested this Health Pessimism model with 2118 African-Americans. Results revealed that Poor/Fair self-rated health was predicted mostly by objective health for the Low Discrimination group but mostly by demographic variables for the High Discrimination group, in a manner consistent with Health Pessimism. Inconsistencies among prior studies might reflect differences in the prevalence of high discrimination among their samples.
This study investigates the lived experience of inflammatory bowel disease with the aim of examining the process of adapting to life with inflammatory bowel disease. Adaptation is often referred to as the desirable outcome in chronic illnesses such as inflammatory bowel disease; yet little is known as to how this is achieved. A total of 10 Crohn’s and 12 ulcerative colitis patients recruited from online support networks participated in individual, semi-structured interviews. The study has identified the notion of a ‘new normal’ as central to adaptation, whereby patients seek to recover a sense of normality by finding an equilibrium between their lives before and after diagnosis.
This investigation explored the association between anxiety sensitivity and attentional bias for threatening information in children and adolescents (N = 40). Participants completed a pictorial version of the visual-probe task, featuring pain-related, health-threat and general-threat images presented for 500 and 1250 ms. Regression analyses revealed significant associations between anxiety sensitivity and attentional bias towards pain-related images presented for 500 ms and between state anxiety and attentional bias towards general-threat images presented for 1250 ms. These results suggest that in children and adolescents, anxiety sensitivity is associated with attentional bias for negative information of personal relevance.
Healthy eating in women of childbearing age is critical to the health of future generations. Interventions that increase women’s dietary self-efficacy may be particularly effective at improving healthy eating. However, no validated tool exists to measure self-efficacy for healthy eating in this specific population. We therefore designed a new questionnaire (the 8-Item Self-Efficacy for Healthy Diet Scale) using a think-aloud study and expert panel consultation. We then pilot-tested the 8-Item Self-Efficacy for Healthy Diet Scale in an interviewer-administered survey of 94 women recruited primarily from community settings. The 8-Item Self-Efficacy for Healthy Diet Scale is an 8-item measure of self-efficacy for healthy eating with promising psychometric properties including internal consistency, convergent, criterion and divergent validity.
Adolescent chronic pain has an extensive impact on parents, with research typically focused on exploring maternal experiences. This exploratory study sought to identify the specific experiences of six UK fathers who parent an adolescent with chronic pain. Data from semi-structured interviews were analysed using interpretative phenomenological analysis. Paternal experiences were characterised by four themes: ‘helplessness’, ‘containment’, ‘balance’ and ‘re-evaluation’. Findings highlighted paternal efforts to manage the impact of adolescent chronic pain by focusing inwardly on the family and adopting multiple roles. Fathers identified ways in which they could renegotiate their relationship with their adolescent to manage pain-related disruption.
We examined the prospective impact of injury severity, functional impairment, and pain on participation in the community and subsequently on life satisfaction and self-rated health of 260 burn survivors 5 years post-discharge. Predictor variables include injury severity and total body surface area burned (assessed during acute care), functional independence (assessed at 12 months post-discharge), pain (assessed at the 24th month), and participation (assessed at the 48th month). Participation predicted life satisfaction and self-rated health. Functional independence and injury severity had significant indirect influences on adjustment via their influence on participation. Pain predicted both outcome variables. Clinical and research implications are discussed.
Young people with congenital heart disease are often marginalised and may compensate for restricted physical and social abilities by substance abuse or risk-taking behaviour. We report on the judicial encounters of patients in an Adult Congenital Heart unit. Fifteen patients had court appearances and all were male. Seven served jail sentences, including four indigenous adolescents. All had multiple interventions for their cardiac conditions and four are now deceased. The majority of patients had mental health issues and substance misuse. These patients need psychological and medical support, and help with judicial authorities. Recommendations for ongoing care are provided.
This study explored long-term consequences of obesity surgery. Interpretative phenomenological analysis was used to analyse transcripts of 10 interviews with patients who underwent surgery 8 or more years ago. Experiences were described under three broad themes: eating behaviours, relationship with food and quality of life. Although patients described variability within these themes, describing different patterns of change, analysis revealed associations between themes and outcomes. In particular, those who reported successful weight loss also described the functionalization of food, the development of new coping strategies and a process of positive reinvention creating a new sense of self.
The Wechsler Intelligence Scale for Children – Third Edition UK test was administered to groups of children between the ages of 6 and 12 years with vertically transmitted HIV infection (n = 70) and a control group who were not infected by the virus (n = 70). The study was conducted in India. The two groups were matched for general verbal abilities, age and gender. The children were assessed for Verbal IQ, Performance IQ and Full-Scale IQ. The Verbal Comprehension Index, Perceptual Organization Index and Freedom from Distractibility Index were also obtained. A three-factor analysis of variance disclosed that school-age children with vertically transmitted HIV infection notched below in the areas of Verbal IQ, Performance IQ, Full-Scale IQ, Verbal Comprehension Index, Perceptual Organization Index and Freedom from Distractibility Index when collated with normal uninfected cohorts. Findings are discussed in the light of both theoretical and clinical implications.
This study considers whether socioeconomic status influences the impact of social isolation on mortality risk. Using data from the Alameda County Study, Cox proportional hazard models indicate that having a high income worsens the mortality risk of social isolation. Education may offset risk, however, and the specific pattern that emerges depends on which measures for socioeconomic status and social isolation are included. Additionally, lonely people who earn high incomes suffer especially high risk of accidents and suicides as well as cancer. Further research is needed that contextualizes the health risks of social isolation within the broader social environment.
Latent profile analysis identified health locus of control profiles among 436 Hispanic Americans who completed the Multidimensional Health Locus of Control scales. Results revealed four profiles: Internally Oriented-Weak, -Moderate, -Strong, and Externally Oriented. The profile groups were compared on sociocultural and demographic characteristics, health beliefs and behaviors, and physical and mental health outcomes. The Internally Oriented-Strong group had less cancer fatalism, religiosity, and equity health attributions, and more alcohol consumption than the other three groups; the Externally Oriented group had stronger equity health attributions and less alcohol consumption. Deriving multidimensional health locus of control profiles through latent profile analysis allows examination of the relationships of health locus of control subtypes to health variables.
This study examined the day-to-day lives of early stage lung cancer survivors who were discharged from treatment between 2 and 24 months prior to the study. Lung cancer survivors were called on eight consecutive nights and completed an interview about their daily experiences. Repeated measures, multilevel analysis of the phone interview data was conducted. Survivors reported few daily stressor exposures or somatic symptoms. Daily moods were generally positive, and survivors reported living quite independently. Lung cancer survivors did not report experiencing health-related worry on a daily basis. The findings from this study create a much more positive picture of lung cancer survivorship relative to prior studies.
We investigated whether a positive intervention (i.e. granting a wish) in children with a chronic illness could promote positive psychological responses in their parents. Hospitalized children were randomly assigned to either the wish group or to a waiting-list control group. Mothers and fathers’ responses (N = 86 and 38, respectively) were studied. Parents from the wish group showed higher levels of positive emotions and beliefs in a benevolent world than the control group. Mothers from the wish group reported higher benefit finding, gratitude, and love than those in the control group. Given that the child’s illness inevitably affects their parents, it is important to promote studies that include parents’ well-being dimensions.
We sought to examine the existential challenges that cancer survivors may experience as they strive to make meaning, regain their self-identity, cope with fear of recurrence, and experience feelings of grief and guilt. Lymphoma survivors (n = 429) completed the 2010 LIVESTRONG survey and provided responses about meaning, cancer worry, security, identity, grief, guilt, and perceived functional impairment due to these concerns. Most survivors (73%–86%) endorsed existential concerns, with 30–39 percent reporting related perceived functional impairment. Concerns were associated with being female, younger, unmarried, and having undergone stem cell transplantation. Lymphoma survivors experience existential challenges that impact their life even years after diagnosis.
The study examined caregivers’ interest in using potentially reduced exposure tobacco products for smoking cessation, reduction, and to help them not smoke in places such as around their child, as all three methods would potentially lead to reduced secondhand smoke exposure for their children. A sample of 136 caregivers completed carbon monoxide testing to assess smoking status and a brief survey. Few caregivers had ever used potentially reduced exposure tobacco products (<1%), but a majority were interested in trying them as means of smoking reduction (54%), to quit/stay quit from smoking (51%), and to help them not smoke around their child or in the home (55%). Caregivers less motivated to quit smoking and with no home smoking ban were more interested in using potentially reduced exposure tobacco products to help them quit/stay quit from smoking (p < .05).
This article describes the development of the Eating Maturity Questionnaire, a self-reported measurement of eating maturity that initiates and gives direction to human eating behaviors. The Eating Maturity Questionnaire was designed to study individuals’ biological and psychosocial motives for eating. The Eating Maturity Questionnaire is a 21-item tool with satisfactory psychometric values (Cronbach’s α coefficients between 0.83 and 0.88) consisting of two subscales: Rational Eating and Psychosocial Maturity. Eating Maturity Questionnaire results may be used to design programs that target eating behaviors and body mass modification.
This study focuses on the relationships of workaholism to job burnout and depression of university teachers. The direct and indirect (via job burnout) effects of workaholism on depression were investigated in 412 Chinese university teachers. Structural equation modeling and bootstrap method were used. Results revealed that workaholism, job burnout, and depression significantly correlated with each other. Structural equation modeling and bootstrap test indicated the partial mediation role of job burnout on the relationship between workaholism and depression. The findings shed some light on how workaholism influenced depression and provided valuable evidence for prevention of depression in work.
The study investigated the associations between social and psychological factors in childhood and adulthood and the occurrence of adulthood hay fever in a longitudinal birth cohort study. A total of 5780 participants with data on parental social class, childhood hay fever up to age 7 years, childhood cognitive ability at age 11 years, educational qualifications at age 33 years, personality traits, occupational levels and adult hay fever (all measured at age 50 years) were included in the study. Using logistic regression analyses, results showed that childhood hay fever identified by medical doctors and traits Emotional Stability and Conscientiousness were significantly and independently associated with the occurrence of hay fever in adulthood.
The present study aim determine sub-group trajectories of change on measures of diet and exercise following acute coronary syndrome. 150 participants were assessed in hospital, 1 month and 6 months subsequently on measures including physical activity, diet, illness beliefs, coping and mood. Change trajectories were measured using latent class growth modelling. Multinomial logistic regression was used to predict class membership. These analyses revealed changes in exercise were confined to a sub-group of participants already reporting relatively high exercise levels; those eating less healthily evidenced modest dietary improvements. Coping, gender, depression and perceived control predicted group membership to a modest degree.
Disclosure is often a challenge for individuals living with genital herpes. This study explores determinants of genital herpes disclosure with one’s most recent sexual partner using an online questionnaire (n = 93). The majority of participants reported (80.4%) disclosure. Among non-disclosers, fear of negative partner reactions was the primary reason for non-disclosure. Age, relationship commitment, time in relationship, and expectations of partner’s reaction were statistically significant predictors at the bivariate level. Reaction expectations and relationship commitment remained significant in the multivariate logistic regression model. Findings indicate that future disclosure research should focus on relationship context and managing negative expectations to increase disclosure.
Five-factor personality was examined as an element of self-report diabetic control accuracy versus biomarker control (HbA1c) for 1474 diabetics in the 2006 and 2008 Health and Retirement Study. Correlations of extraversion and self-reported control (r = –.06, p < .01), and extraversion and HbA1c (r = .03, non-significant), were significantly different (t = 2.87, p < .01). Correlations of openness and self-reported control (r = –.05, p < .05), and openness and HbA1c (r = .01, non-significant), were significantly different (t = 1.91, p < .05). Associations were found between self-reported control and conscientiousness (r = –.05, p < .05), neuroticism (r = .04, p < .05), and openness (r = –.05, p < .05). Neuroticism was associated with self-reports that diabetes was worse (r = .07, p < .01). Other correlations and comparisons were non-significant.
The study objectives were (1) comparison of baseline characteristics between individuals with metabolic syndrome, adhering/not adhering to a primary prevention program modificação do estilo de vida e risco cardiovascular; and (2) determination of risk factors for program adherence. The sample included 127 participants with mean age (±standard deviation) of 49.58 (±7.77) years, participating in the modificação do estilo de vida e risco cardiovascular between 2010 and 2012. Results show that program adherence predictors were age (odds ratio: 1.134, 95% confidence interval: 1.106–1.833); practicing physical exercise (odds ratio: 1.322, 95% confidence interval: 1.115–7.589); self-efficacy for regular eating habits (odds ratio: 2.044, 95% confidence interval: 1.184–3.377); low binge eating scores (odds ratio: 1.922, 95% confidence interval: 1.118–3.974); and low isolation and depression scores (odds ratio: 0.721, 95% confidence interval: 0.322–0.917).
This study assesses resilience and general self-efficacy among Kenyan orphans and vulnerable children (n = 1060) active in a community-based program combining economic household strengthening with psychosocial support. Quantile regression analyses modeled associations between the 25th, 50th, and 75th percentiles of resilience and general self-efficacy and multiple covariates. Program participation positively predicted increased general self-efficacy at all levels. Program participation predicted increased resilience at the 25th percentile but decreased resilience at the 75th percentile. Other significant predictors included economic, educational, sexual behavior and other demographic factors. This study suggests support for an integrated approach to economic and psychosocial empowerment.
Essays about distressing events written by 58 older adults on three occasions (n = 174) were coded to identify how older adults responded when confronting an emotionally upsetting event. Participants limited the experience of negative emotion by transitioning from negative to positive aspects of the event within a writing session, and across sessions, switched writing topics and moved from writing about past events to current problems. The use of attentional deployment tactics was associated with lower negative affect. This study confirms results found in quantitative studies and uncovers new processes that promote emotion regulation.
This study explored how South African patients attending public health facilities reported coping with endometriosis. A total of 16 women with endometriosis were interviewed, and we explored how participants coped with endometriosis. All interviews were audio-recorded and transcribed. Thematic analysis was used to identify themes. Participants reported employing both problem-focused and emotion-focused strategies to cope with endometriosis. Problem-focused strategies included limiting physical activities, increasing knowledge about endometriosis, scheduling social and work activities around menstrual cycle, engaging in self-management and relying on social support. Emotion-focused coping strategies included accepting the disease, adopting a positive attitude, engaging in self talk and evoking spirituality.
The objective was to explore the general public’s views on the role of health professionals in the management of weight with diet and the implementation of behaviour change. Semi-structured interviews were conducted. An inductive grounded theory approach utilised a coding framework; recurring concepts/themes explored in future interviews and thematic saturation achieved. Two themes summarised views on the role of health professionals in supporting dieting and weight management: responsibility to initiate talk and what patients expect. Individuals perceive health professionals as having a role in their weight management. Individuals have disparate views about responsibility for initiation of weight management talk.
Rheumatoid arthritis is a chronic disease affecting fewer men than women. We systematically reviewed the literature on impact and self-management of rheumatoid arthritis in men. A total of 28 papers were included and grouped into two categories: psychosocial impact of rheumatoid arthritis, and coping and self-management. This review finds gender differences relating to quality of life, work, distress, self-management, coping and support. We conclude that there is a dearth of literature focussing on rheumatoid arthritis in men only, and mixed gender studies include insufficient men to draw strong conclusions about men. Thus, further research is needed to understand the support needs of men with rheumatoid arthritis in depth.
This randomised controlled experiment tested whether a brief subjective well-being intervention would have favourable effects on cardiovascular and neuroendocrine function and on sleep. We compared 2 weeks of a gratitude intervention with an active control (everyday events reporting) and no treatment conditions in 119 young women. The treatment elicited increases in hedonic well-being, optimism and sleep quality along with decreases in diastolic blood pressure. Improvements in subjective well-being were correlated with increased sleep quality and reductions in blood pressure, but there were no relationships with cortisol. This brief intervention suggests that subjective well-being may contribute towards lower morbidity and mortality through healthier biological function and restorative health behaviours.
Goals of this study were to examine the mental health processes whereby everyday discrimination is associated with physical health outcomes. Data are drawn from a community health survey conducted with 1299 US adults in a low-resource urban area. Frequency of everyday discrimination was associated with overall self-rated health, use of the emergency department, and one or more chronic diseases via stress and depressive symptoms operating in serial mediation. Associations were consistent across members of different racial/ethnic groups and were observed even after controlling for indicators of stressors associated with structural discrimination, including perceived neighborhood unsafety, food insecurity, and financial stress.
Atopic dermatitis is a common skin disease in adolescents, which may have a negative effect on the mental and emotional health. We investigated the relationship between atopic dermatitis and suicidal behaviors in Korean adolescents. Participants included 74,186 adolescents (38,221 boys and 35,965 girls) in middle and high school who completed the Eighth Korea Youth Risk Behavior Web-Based Survey. There were significant associations between atopic dermatitis and suicidal behaviors for girls. The overestimation of weight perception might have an additive impact on suicidal risk among girls. However, there were no significant associations between atopic dermatitis and suicidal behaviors in boys.
This study investigated relationships of income and self-reported racial discrimination to diabetes health behaviors following an acute stressor. A total of 77 diabetic women (51% Black, 49% White) completed a laboratory public speaking stressor. That evening, participants reported same-day eating, alcohol consumption, and medication adherence; physical activity was measured with actigraphy, and the next morning participants reported sleep quality. Measures were repeated on a counterbalanced control day. There was no mean level difference in health behaviors between stressor and control days. On stressor day, lower income predicted lower physical activity, sleep quality, and medication adherence, and higher racial discrimination predicted more eating and alcohol consumed, even after accounting confounders including race and control day behaviors.
Research suggests that optimal couple functioning depends on adopting a "we" orientation to health. Using qualitative data from 20 male couples in which at least one partner was HIV-positive, we examined how couples viewed their health involvement and its relation to social support. One group described their health as highly interconnected; in a second group, at least one partner viewed health as a personal responsibility. Results revealed that there was not a uniform "we" approach toward health; rather, sero-concordance, sero-discordance, and coping with other chronic illnesses strongly contributed to orientations toward health. Orientations toward health were not found to determine social support.
Chronic pain is a critical public health problem that affects over 100 million Americans. Medical pain treatments carry undesirable side effects, whereas low-risk psychosocial treatments offer notable benefits, in combination or in isolation. This report presents the protocol for the Learning About My Pain study, one of the first comparative-effectiveness trials funded by the Patient-Centered Outcomes Research Institute. Adhering to published standards for clinical trials (e.g. Standard Protocol Items: Recommendations for Intervention Trials), it provides an overview of the trial (n = 294), comparing cognitive-behavioral and education pain interventions to usual care, and a detailed description of how its methodology reduces the risks from bias.
Type D personality is associated with unhealthy behaviour and poor subjective health in the general population. This study investigated whether health behaviour mediates the relationship between Type D and subjective health. There were 217 participants who completed measures of Type D, health-related behaviour, physical symptoms and quality of life. Type D individuals reported significantly less healthy behaviour and significantly poorer subjective health than non-Type Ds. In addition, it was found that health behaviour partially mediates these relationships. The study demonstrates that health behaviour may partly explain the relationship between Type D and poor health outcomes.
Predictors of breast cancer worry in healthy women remain unclear. Healthy women less than 50 years (N = 857) completed measures of family history, anxiety, absolute and comparative risk perceptions, illness perceptions, and breast cancer worry. Regression analyses revealed that having a family history of breast cancer, greater anxiety, higher absolute risk perceptions and negative illness perceptions predicted 45 per cent of the variance in breast cancer worry. Risk perceptions also partially mediated the relationship between illness perceptions and worry. This study provides novel evidence that both illness and risk perceptions are predictors of breast cancer worry in younger women from the community.
Depression has been strongly associated with poor HIV treatment adherence, but little research has explored how individuals manage to follow their regimens despite symptoms of major depression. Using a sample of antiretroviral therapy patients with clinically significant depressive symptoms (n = 84), we examined whether patients with optimal adherence differed from those with suboptimal adherence in terms of the types of depressive symptoms experienced and treatment self-efficacy. There were no significant differences between participants with regard to types of depressive symptoms. Findings indicate that patients with high treatment self-efficacy were more likely to report optimal levels of adherence than patients with low self-efficacy.
The current study aimed to explore the phenomenon of disease-related ‘query escalation’ in high/low health anxious Internet users (N = 40). During a 15-minute health-related Internet search, participants rated their anxiety and the perceived seriousness of information on each page. Post-search interviews determined the reasons for, and effects of, escalating queries to consider serious diseases. Both groups were found to be significantly more anxious after escalating queries. The high group was significantly more likely to escalate queries. Evaluating personal relevance of material was the main reason for escalations and moderated anxiety post-escalation. We conclude that searching for online disease information can increase anxiety, particularly for people worried about their health.
One particularly vulnerable population for HIV treatment non-adherence is persons with poor health literacy skills. For these individuals, it is important to simplify medication taking as much as possible by integrating medication adherence into other routine health behaviors. This study aims to ascertain the relationship between medication adherence and other health behaviors. Adults living with HIV (N = 422) completed intake measures and 3 months of unannounced pill counts. Endorsement of diet and exercise behaviors at intake predicted higher medication adherence, over and above other known predictors of medication adherence such as HIV symptoms, depression, social support, and stress. These results support integrating strategies for medication management into a constellation of routine health practices.
Although researchers norm and validate measures of psychological constructs largely on educated samples, they often use these instruments more broadly, assuming generalizability. We examined whether the assumption of generalizability is warranted. We administered three commonly used psychological measures—the Behavioral Activation/Behavioral Inhibition Scale, the Regulatory Focus Questionnaire, and the Need for Cognition Scale—to a community sample (N = 332) with limited education. For the three instruments, five of seven scales/subscales had unsatisfactory reliabilities. Internal consistency was lowest among participants with less education. The results suggest that instruments normed on educated samples may not generalize to uneducated samples.
Two studies suggest that cognitive dissonance can lead people to adopt negative attitudes toward beneficial—yet unpleasant—medical screenings. People who thought that they were candidates for an unpleasant medical screening reported less favorable attitudes toward the screening than people who thought that they were ineligible (Study 1). The unpleasantness of a medical screening affected candidates’ attitudes toward the screening to a greater extent than non-candidate’s attitudes (Study 2). Limitations, including ambiguity regarding the extent to which participants’ attitudes were affected specifically by dissonance, are discussed. This preliminary research suggests people attempt to reduce dissonance associated with their anticipated behavior.
Few studies have considered confrontation in the context of coping with discriminatory experiences. These studies test for the first time whether confronting racial discrimination is associated with greater psychological well-being and physical health through the promotion of autonomy. In two separate samples of racial minorities who had experienced racial discrimination, confrontation was associated with greater psychological well-being, and this relationship was mediated by autonomy promotion. These findings did not extend to physical health symptoms. These studies provide preliminary evidence that confrontation may aid in the process of regaining autonomy after experiencing discrimination and therefore promote well-being.
Risk for suicidality (current or past suicidal ideation or attempt) increases after bariatric surgery; however, there is a paucity of research investigating suicidality predictors in this population. This study involved a retrospective chart review of individuals seeking psychological clearance for bariatric surgery. In total, 32 participants (15.8%) were classified as reporting suicidality. These participants endorsed greater depressive symptomatology and hopelessness, and hopelessness and mood disorder diagnosis each uniquely predicted whether or not a patient was classified as reporting suicidality. The findings within suggest that increased attention to the relationship among these variables may improve methods for identification of high-risk patients. Implications for clinical practiced are discussed.
This study examined the role of narcissism in health-risk and health-protective behaviors in a sample of 365 undergraduate students. Regression analyses were used to test the influence of narcissism on health behaviors. Narcissism was positively predictive of alcohol use, marijuana use, and risky driving behaviors, and it was associated with an increased likelihood of consistently having a healthy eating pattern. Narcissism was also positively predictive of physical activity. Results are discussed with reference to the potential short-term and long-term health implications and the need for future research on the factors involved in the relationship between narcissism and health behaviors.
Despite the detrimental impact of smoking on health, its prevalence remains high. Empirical research has provided insight into the many causes and effects of smoking, yet lay perceptions of smoking remain relatively understudied. This study used a form of network analysis to gain insight into the causal attributions for smoking of both smoking and non-smoking college students. The analyses resulted in highly endorsed, complex network diagrams that conveyed the perceived causal structures of smoking. Differences in smoker and non-smoker networks emerged with smokers attributing less negative consequences to smoking behaviors. Implications for intervention are discussed.
Research on the role of social media use in the workplace has gained more interest, yet little is known about personal characteristics that might influence the outcomes that employees experience when they use social media during work. This research aims to investigate the impact of the intensity of social media use at work on three aspects of burnout: emotional exhaustion, depersonalization, and lack of personal accomplishment. Results from partial least squares regression found that mindfulness significantly mediated the relationship between the intensity of social media use at work on emotional exhaustion and lack of personal accomplishment. These findings suggest that using social media during work tends to increase burnout in employees who have a low level of mindfulness, but it lowers burnout in employees who have a high level of mindfulness.
A total of 120 18- to 56-year-olds, divided into six groups containing equal numbers of men and women, were shown a textual message and associated photograph featuring alcohol-related behaviour. Subsequently, questions were answered about intentions to reduce consumption, to drink moderately and how positive and negative the messages made participants feel. Loss-framed messages, in particular those featuring health-related disgust, were the most effective for increasing intentions to reduce alcohol intake. In conclusion, studies have over-focused on fear-loss frames, neglecting the utility of disgust-loss frames in health messages. This study suggests that disgust-loss frames deserve equivalent attention.
This study explored whether physical activity and sleep, combined with the biomarker C-reactive protein, indexed positive health in older men. Many were former prisoners of war, with most remaining psychologically resilient and free of any psychiatric diagnoses. Activity and sleep were recorded through actigraphy in 120 veterans (86 resilient and 34 nonresilient) for 7 days. Resilient men had higher physical activity, significantly lower C-reactive protein levels, and 53 percent had lower cardiac-disease risk compared to nonresilient men. Sleep was adequate and not associated with C-reactive protein. Results suggest continued study is needed in actigraphy and C-reactive protein as means to index positive health.
The quality of the doctor–patient relationship has been shown to impact upon a number of health outcomes in diabetes, including psychological well-being. This cross-sectional study investigated illness perceptions as mediators of the association between the doctor–patient relationship and diabetes-related distress. Individuals with diabetes completed questionnaires which measured the perceptions of their relationship with their doctor, diabetes-related distress and illness perceptions. The association between doctor–patient relationship and diabetes-related distress was fully mediated by Personal Control, suggesting that the individuals’ beliefs surrounding their capacity to control their diabetes mediate the association between the doctor–patient relationship and diabetes-related distress.
There is emerging evidence for talking therapies in the treatment of tic disorders. This study explored experiences of young people who self-identified as having had a successful or helpful talking therapy, in order to understand the phenomenology, value and meaning of outcomes. The experiences of seven participants aged 10–17 years were described in semi-structured interviews and analysed using Interpretative Phenomenological Analysis. Themes included the challenging battle with tics and process of re-defining self-identity, making sense of and managing experiences, the value of control, and spectrum of positive change. The results highlighted valued outcomes that could be incorporated into clinical practice and future evaluation.
This study explored associations between health behaviors and human papillomavirus vaccine receipt/intentions among female undergraduates. Participants (N = 286) completed a survey assessing human papillomavirus vaccine uptake (receiving 1–3 shots vs no shots), completion (receiving 3 shots vs 1–2 shots), and intentions as well as various health behaviors. Human papillomavirus vaccine uptake and completion were associated with receipt of other preventive medical care; completion was associated with having a regular healthcare provider. Among unvaccinated students (n = 115), increased human papillomavirus vaccine intentions were associated with flu shot and human immunodeficiency virus test receipt. Findings suggest promoting human papillomavirus vaccination with other preventive medical care might improve vaccine receipt.
Synthol is an injectable oil used by bodybuilders to make muscles appear bigger. Widely available on the Internet, it is reported to carry a wide range of health risks and side effects such as localised skin problems, nerve damage and oil-filled cysts, as well as muscle damage and the development of scar tissue. Given the tension between health risk and quick muscle enlargement, how lay users explain and justify their synthol intake becomes an important question. Drawing on discourse analysis, we focus on how lay expertise is worked up by users in the absence of available specialist knowledge by invoking medical and pharmaceutical discourses as legitimation, providing novices with support, gaining trust through positive personal narratives and thus gaining credibility as experts. Results have clear implications for health promotion interventions with bodybuilders.
This study compared coping strategies and psychological immunity of parents with a child conceived with assisted reproductive technology (n = 84) and parents with a naturally conceived child (n = 84) in a Hungarian fertility-age population. Results showed that in vitro fertilization parents are able to control their emotions in a better way than comparison couples. They interpret trials as challenges and consider themselves more worthy than the members of the control group. Our research confirms that consideration and management of psychological factors in treating infertility have an important preventive role to play.
We examined whether a positive intervention (i.e. granting a wish) could promote positive psychological and physical changes (e.g. reduced nausea and pain) in seriously-ill children. Children and their parent were randomly assigned to a wish group (completed measures 2–3 days before the wish and 3 weeks later) or to a waiting-list control group (with an equivalent time-lag and receiving the wish after the assessment). Wish intervention significantly increased levels of positive emotions, satisfaction with life, personal strengths, and reduced rates of nausea compared with the control group. Mothers in the wish group also perceived positive changes in children’s benefit finding and quality of life.
Harmful alcohol consumption among university students continues to be a significant issue. This study examined whether variables identified in the positive deviance literature would predict responsible alcohol consumption among university students. Surveyed students were categorized into three groups: abstainers, responsible drinkers and binge drinkers. Multinomial logistic regression modelling was significant (2 = 274.49, degrees of freedom = 24, p < .001), with several variables predicting group membership. While the model classification accuracy rate (i.e. 71.2%) exceeded the proportional by chance accuracy rate (i.e. 38.4%), providing further support for the model, the model itself best predicted binge drinker membership over the other two groups.
Both satisfaction and mindfulness relate to sustained physical activity. This study explored their relationship. We conducted a cross-sectional study with 398 Dutch participants who completed measures on trait mindfulness, mindfulness and satisfaction with physical activity, physical activity habits, and physical activity. We performed mediation and moderated mediation. Satisfaction mediated the effect of mindfulness on physical activity. Mindfulness was related to physical activity only when one’s habit was weak. The relation of mindfulness with satisfaction was stronger for weak compared to strong habit. Understanding the relationship between mindfulness and satisfaction can contribute to the development of interventions to sustain physical activity.
The objective of this study is to compare and examine the relationships between levels of loneliness, anxiety, depression, and other variables on primary caregivers and cancer inpatients. The study involved 100 Turkish primary caregivers of inpatients with advanced or terminal stages of cancer. Loneliness and anxiety scores were significantly higher for the primary caregivers of inpatients with terminal stage of cancer than primary caregivers of inpatients with advanced stage of cancer. Excluding the cancer stage, loneliness and anxiety were primarily associated with the socio-demographic factors of primary caregivers rather than the characteristics of patients.
Stress-related growth can occur after various traumas or stressful events. In order to investigate how anxiety and depression relate to stress-related growth, this study was conducted with 443 Chinese army recruits who had just finished a 3-month recruit training program. Path analyses revealed that resilience and positive/negative coping partially mediated the effect of anxiety on perceived stress-related growth, while negative coping fully mediated the relationship between depression and perceived stress-related growth. Moreover, positive coping partially carried the influence of resilience on perceived stress-related growth. Anxiety and depression may be potential targets for intervention to enhance the development of stress-related growth among Chinese army recruits.
The aim was to see whether qualitative analysis improved quantitative measurement of illness perception after heart transplant. Two methods of evaluating illness representations were compared: one quantitative (administration of the Illness Perception Questionnaire-Revised) and one qualitative (phenomenological reduction). The qualitative analysis provided greater insight into the idiosyncratic and dynamic nature of the concept of illness representations. Adjustments to the Illness Perception Questionnaire-Revised are suggested to improve the evaluation of illness perception in terms of dispersion of scores, emotional impact, coping strategies and treatment, and social support, and ultimately to enhance interventions designed to promote treatment compliance.
Physical activity level is an important contributor to overall human health and obesity. Research has shown that humans possess a number of traits that influence their physical activity level including social cognition. We examined whether the trait of "need for cognition" was associated with daily physical activity levels. We recruited individuals who were high or low in need for cognition and measured their physical activity level in 30-second epochs over a 1-week period. The overall findings showed that low-need-for-cognition individuals were more physically active, but this difference was most pronounced during the 5-day work week and lessened during the weekend.
This study’s objective is to examine the relationship between emotional demands and emotional social support at work, and the impact of resilience on health. A cross-sectional study of 156 firefighters was conducted. Descriptive analyses of the study’s variables were performed, along with structural equation analysis and hierarchical regression analysis. The results suggest statistically significant relationships among the study’s variables. Social support from one’s boss and intense emotional demands were found to have an interaction effect on firefighters’ resilience. The findings confirm the mediating role of resilience and the relationship with emotional social support from the boss on firefighters’ occupational health.
Among other factors, optimism has been shown to significantly influence the course of some diseases (cancer, HIV, coronary heart disease). This study investigated whether optimism of a patient before a total hip replacement can predict the functionality of the lower limbs 3 and 6 months after surgery. A total of 325 patients took part in the study (age: 58.7 years; w: 55%). The functionality was measured with the Western Ontario and McMaster Universities arthrosis index, and optimism with the Life Orientation Test. To analyse the influences of age, gender and optimism, general linear models were calculated. In optimistic patients, functionality improved significantly over time. The study showed a clear influence of dispositional optimism on the recovery after total hip replacement in the first 3 months after surgery.
Overweight men often underestimate their weight status. Here, we examine whether underestimation occurs when visually judging the weight status of men and whether exposure to heavier body weights may be a cause of visual underestimation of male weight status. Participants systematically underestimated the weight status of overweight and obese men (Study 1) and participants reporting more frequent exposure to heavy male body weights were most likely to underestimate (Study 2). Experimental exposure to different body weights influenced underestimation of weight status (Study 3). Frequent exposure to heavier body weights may cause visual underestimation of the weight status of overweight men.
The objective of this study was to examine the impact of workplace bullying on self-esteem, including the mediating effect of internalized stigma and the moderating effect of spirituality, among hepatitis C virus patients. Data were collected from 228 employed hepatitis C virus patients who had been admitted to Gastroenterology and Hepatology wards in Pakistani hospitals. We found support for the hypothesis that workplace bullying is associated with low self-esteem via internalized stigma. In addition, spirituality moderated the association such that participants with greater spirituality were buffered from the impact of stigma on self-esteem.
Support from close others predicts smoking abstinence, yet little research has investigated what factors promote support. This study investigates predictors of support for a quit attempt. Partners of smokers (N = 131) reported their relationship quality, concern for partner’s health, own smoking status, and intended support for a quit attempt. Smokers were less supportive than were nonsmokers. Relationship quality, concern for partners’ health, and motivation to quit were positively associated, and nicotine dependence was negatively associated, with intended support. The findings suggest that support for smoking cessation depends on one’s own smoking behaviors as well as characteristics of the relationship.
The purpose of this study was to examine happiness and social determinants across age cohorts in Taiwan. The data were obtained from the 2011 Taiwan Social Change Survey (aged 18 +, n = 2,199). The social determinants of happiness included socioeconomic status and social connection. Happiness was not different across the age groups. Receiving less family support, less formal support, more social trust and more control over life were significant for the younger group. Being married and having more social participation were significant for the middle-aged. Receiving less family support and having a higher economic status were significant for the older group.
The study evaluates the psychometric properties of a Polish translation of the Brief Illness Perception Questionnaire. A total of 276 patients with chronic conditions (58.7% women) completed the Brief Illness Perception Questionnaire and the Hospital Anxiety and Depression Scale. The internal consistency of the Polish Brief Illness Perception Questionnaire measured with Cronbach’s alpha was satisfactory (α = 0.74). Structural validity was demonstrated by significant inter-correlations between the Brief Illness Perception Questionnaire components. Discriminant validity was supported by the fact that the Brief Illness Perception Questionnaire enables patients with various conditions to be differentiated. Significant correlations were found between Brief Illness Perception Questionnaire and depression and anxiety levels. The Polish Brief Illness Perception Questionnaire thus evaluated is a reliable and valid tool.
The aim of the study was to develop and to assess the psychometric properties of the Problematic Support Scale, among patients with systemic lupus erythematosus. An online questionnaire was filled in by 344 systemic lupus erythematosus patients with a mean age of 39.66 years. Explorative factor analysis, later validated by confirmative factor analysis, showed the emergence of a two-factor structure in types of support provided: denying/uninformed support and oppressive support. Denying/uninformed support includes offers of support that neglect the disease manifestations and consequences. Oppressive support describes social support offers which are perceived as excessive and oppressive. Results confirm previous qualitative evidence and demonstrate good reliability and concurrent validity of the Problematic Support Scale. Theoretical and methodological implications for the study of social support are discussed.
This longitudinal study applied a stress and coping model to examine the differential pathways of perceived positive and negative health behavior changes. Participants with congestive heart failure completed self-report measures of psychological resources, coping strategies, and perceived behavior changes and were assessed again 6 months later. Patients with higher positive affect and spiritual well-being reported more positive health behavior changes over time, effects mediated by approach coping. Alternatively, patients with lower psychological resources reported more negative behavior changes over time, effects mediated by avoidance coping. The results suggest that different psychological resources are related to different types of coping which, in turn, are associated with perceived positive or negative changes in health behavior over time.
The aim of the study was to test whether a screening navigation program leads to more favorable health beliefs and decreases social inequalities in them. The selected 261 noncompliant participants in a screening navigation versus a usual screening program arm had to respond to health belief measures inspired by the Protection Motivation Theory. Regression analyses showed that social inequalities in perceived efficacy of screening, favorable attitude, and perceived facility were reduced in the screening navigation compared to the usual screening program. These results highlight the importance of health beliefs to understand the mechanism of screening navigation programs in reducing social inequalities.
We tested the theory of planned behaviour with additional norms to predict the sun-protective decisions of young female beachgoers in Australia. Participants (N = 336) completed standard theory of planned behaviour measures and additional normative factors (group, image and personal norms). Attitude, subjective norm, and both personal and group norms predicted intention. Intention and group norm predicted follow-up behaviour. These findings provide further evidence that it is the more proximal sources of norms reflecting one’s personal and referent group influences, rather than perceptions of broader societal norms about the attractiveness of tanned images, that are important in determining young women’s sun-protective decisions.
Psychological stress can negatively impact multiple sclerosis. To further understand how stress is addressed in the multiple sclerosis medical visit, 34 people with multiple sclerosis participated in focus groups. Transcripts were analyzed by inductive thematic analysis. The majority of participants did not discuss stress with their provider, citing barriers to communication such as lack of time, poor coordination between specialties, physician reliance on pharmaceutical prescription, and patient lack of self-advocacy. Participants recommended several ways to better manage psychological well-being in the clinical setting. These findings provide a foundation for future studies aimed at minimizing the detrimental effect of stress in multiple sclerosis.
Most women do not reconstruct their breast(s) post-mastectomy. The experiences of younger women who maintain this decision, although important to understand, are largely absent in the research literature. This interview-based study uses interpretative phenomenological analysis to explore the experiences of six women, diagnosed with primary breast cancer in their 30s/40s, who decided against delayed reconstruction. Findings reported here focus on one superordinate theme (decision-making) from a larger analysis, illustrating that the women’s drive to survive clearly influenced their initial decision-making process. Their tenacity in maintaining their decision is highlighted, despite non-reconstruction sometimes being presented negatively by medical teams. Patient-centred support recommendations are made.
This study examines how often depression and anxiety, in patients with diabetes, are detected by health professionals; and whether detection is influenced by patient characteristics (age, gender), illness factors (duration of illness, diabetes control), and self-reported levels of depression and anxiety. Prevalence rates of clinically significant depression and anxiety were high (57% and 36%, respectively); however, of those identified, only 44 and 36 per cent, respectively, were detected by staff as depressed or anxious. The only significant predictors of detection were severity of depressive and anxious symptoms. Patient and illness characteristics did not influence whether professionals identified emotional problems in their patients.
We examined associations between numeracy and sociocognitive factors associated with colorectal cancer screening uptake (n = 964). Nearly half (45.7%) of the respondents incorrectly answered a numeracy question (low numeracy). Low numeracy respondents were less knowledgeable about colorectal cancer (p < .001), less positive towards screening (emotional, p < .001 and practical, p = .001) and less likely to intend to participate in screening (p = .001). They also reported greater defensive processing of cancer information (p = .001). Sociocognitive factors fully mediated the relationship between numeracy and screening intention. Addressing numeracy issues may reduce inequalities in CRC screening participation, but communication strategies could be limited by the tendency process cancer information defensively.
Under-reporting tobacco consumption is common, although there is lack of evidence whether under-reporting is associated with health risk perception. In this study, smoking topography from 110 smokers was recorded over 24 hours, aiming to capture a representative average of smoking behaviour. Participants significantly under-reported the duration of secondary exposure, and there was a significant interaction between self-report distortion type and risk perception. Analysis showed that smokers under-reporting puff number declared perceiving significantly less susceptibility to acquiring airway diseases, which is correlating significantly with the level of under-reporting. The present findings may suggest that under-reporting smoking behaviour have psychological functions beyond achieving social desirability.
Although extensive research has investigated the benefits of physical activity in cystic fibrosis, minimal exploration of the experiences for individuals from a qualitative, phenomenological perspective has been carried out. The aim of this study was to explore the subjective experiences of physical activity for individuals with cystic fibrosis. The health-care team, at an Adult Cystic Fibrosis Unit in the United Kingdom, recruited 12 participants to take part. Interview data were analysed using interpretative phenomenological analysis. A central theme of ‘self-monitoring’ emerged from the accounts and was embedded in the three super-ordinate themes.
This pilot study tested a novel program to promote adoption and maintenance of aerobic activity in midlife women. Lifestyle modification group sessions were held weekly for 3 months, followed by two booster sessions during the 3-month maintenance phase. During all 6 months of the program, participants used a physical activity sensor to automate self-monitoring and a web platform to facilitate social connectivity. Aerobic exercise increased from 63 to 132 minute/week from baseline to 3 months (p < .01), and activity was maintained at 6 months (135 minute/week). Technology enhancements have strong potential to promote maintenance of behavior change.
Children with sickle cell disease are at risk of cognitive deficits and somatic growth delays beginning in early childhood. We examined growth velocity from age 2 years (height and body mass index progression over time) and cognitive functioning in 46 children with sickle cell disease 4 to 8 years of age. Height-for-age velocity was not associated with cognitive outcomes. Higher body mass index velocity was associated with higher scores on global cognitive and visual-motor abilities but not processing resources or academic achievement. Body mass index progression over time may be a clinically useful indicator of neurocognitive risk in sickle cell disease, as it may reflect multiple sickle cell disease–related risk factors.
Fat talk, conversations in which women disparage the size/shape of their bodies, acts as both a reflection of and contributor to body dissatisfaction. We assessed the impact of age, body mass index, and ethnicity on fat talk in two large, online surveys of adult women. Body mass index showed a small, positive correlation with fat talk, but only for women who were not overweight. Fat talking was common across all ages. In contrast to the common belief that fat talk is limited to young, thin women, these studies demonstrate that women of many body sizes and ages engage in fat talk.
Adolescents facing cancer may need to adjust their personal life goals. Theories identified several goal adjustment strategies, but their use has not been tested. Therefore, this study operationalises goal adjustment strategies and examines their use. Adolescent cancer patients listed their goals 3 and 12 months post-diagnosis. Goals received scores on five goal characteristics: life domain, level of abstraction, importance, attainability and effort. Results showed that adolescents with cancer (N = 30, mean age: 14.2 years, 60% female) used four of five strategies described in theory, while one additional strategy was found. These findings suggest that adolescents with cancer use goal adjustment strategies as measured by goal characteristics over time.
This empirical study investigates psychological practitioners’ experience of worksite training in acceptance and commitment therapy using an interpretative phenomenological analysis methodology. Semi-structured interviews were conducted with eight participants, and three themes emerged from the interpretative phenomenological analysis data analysis: influence of previous experiences, self and others and impact and application. The significance of the experiential nature of the acceptance and commitment therapy training is explored as well as the dual aspects of developing participants’ self-care while also considering their own clinical practice. Consistencies and inconsistencies across acceptance and commitment therapy processes are considered as well as clinical implications, study limitations and future research suggestions.
This study examined whether particular coping strategies influence attentional bias in individuals with health anxiety. A total of 84 participants were divided into four groups on the basis of their health-anxiety level (high/low) and coping strategy (monitor/blunter). The participants were shown screens displaying health-related pictures paired with non-health-related pictures. As a result, the high health-anxiety group was more attentive to health stimuli than the low health-anxiety group, regardless of the coping strategy. When maintaining attention, the high health-anxiety blunter shifted attention away from health stimuli, whereas the high health-anxiety monitor shifted attention toward the stimuli. These results indicated differences in how individuals manage attention processing according to their coping strategy.
Psychologists in medical settings may be confronted with Jehovah’s Witness parents refusing blood transfusions for their children as an ethical dilemma. The purpose of this discussion is to help psychologists provide informed, ethical consultations and support by investigating the values of the Jehovah’s Witness community and the origin of the blood transfusion taboo, how medical and legal professionals have approached this dilemma, exploring relevant ethical principles and standards for psychologists, and suggestions for how to move toward a better understanding of harm with Jehovah’s Witness families.
This study examined whether daily or almost daily lower-intensity physical activity was associated with reduced obesity, among 4824 African American, Hispanic, and White youth assessed in fifth and seventh grades. Regular lower-intensity physical activity was associated with reduced obesity only among Hispanic and White males and only in seventh grade, and not among youth in fifth grade, females, or African American males or females. Findings from this study suggest that the reduced obesity risk generally attributed to physical activity may not be consistent across racial/ethnic and gender groups of early adolescents.
Burnout has been suggested to be related to depression. We examined the relationship between burnout and allostatic load, and whether this association is independent of psychological distress and depression. We measured burnout psychological distress, depression, and allostatic load in 3283 participants. Higher burnout (β = 0.06, p =0.003) and cynicism (β = 0.03, p = 0.031) and decreased professional efficacy (β = 0.03, p = 0.007) were related to higher allostatic load independent of age, sex, education, occupation and psychological distress. Depression, however, explained 60 percent of the association. Burnout is related to higher allostatic load, and this association partly overlaps with co-occurring depression.
This article describes a study of attitudes to the current system of animal experimentation (for the production of health interventions) among 52 UK healthcare professionals. These healthcare professionals participated in three separate focus groups (of 18, 17 and 17 participants) and were invited to respond to the question ‘what is your opinion about the current system of animal testing?’ The study focused specifically on their views of the current system (rather than their views of animal testing in general). The healthcare professionals were critical of the current system, particularly with regard to regulation, secrecy, validity, unnecessary suffering and welfare.
This study examined the associations among weight status, body dissatisfaction, and negative body talk with a sample of young adult male friends (N = 55 pairs). Actor–Partner Interdependence Model revealed that individuals’ body dissatisfaction was positively associated with their own body mass index, but was negatively associated with their friend’s body mass index. In addition, having a friend with low body mass index escalated the association between individuals’ own body mass index and body dissatisfaction. Further, when individuals with higher body mass index engaged in higher negative body talk, they had lower body dissatisfaction compared to those who engaged in lower negative body talk.
This study investigated the relationship of medical and non-medical fears to children’s anxiety, pain, and distress during an invasive medical procedure, the voiding cystourethrogram. Parents of 34 children completed the Fear Survey Schedule-II prior to their child’s procedure. Child distress behaviors during the procedure were audiotaped and coded using the Child–Adult Medical Procedure Interaction Scale-Revised. Ratings of child procedural anxiety and pain were obtained from children, parents, and examining technologists within minutes following the procedure. Associations were observed between medical fears, procedural anxiety (parent and staff reports), and coded distress behaviors. Findings may inform preparation efforts to reduce anxiety around invasive medical procedures.
Interventions and activities that influence health are often concerned with intangible outcomes that are difficult to value despite their potential significance. Social Return on Investment is an evaluation framework that explores all aspects of change and expresses these in comparable terms. It combines qualitative narratives and quantitative measurements with a financial approach to enable outcomes that can otherwise be overlooked or undervalued to be incorporated appropriately. This article presents Social Return on Investment as an effective tool for supporting the development of a holistic appreciation of how interventions impact on the health and well-being of individuals, communities and societies.
The aim of this study was to clarify the difference between perceptions of injury and illness. A qualitative study using semi-structured interviews was conducted with 38 individuals who had been injured in the past, 8 medical psychologists, 62 graduate psychology students, and 19 health professionals treating injured patients. Data were analyzed by modified analytic induction and constant comparison methods. Common-sense perceptions of injury overlapped with some perceptions of illness, and 4 new themes were elicited. It was concluded that there are themes unique to injury perceptions that should be recognized in research as well as in clinical interventions.
A random sample of 291 9- and 10-year-old schoolchildren from Asturias (Spain) was taken. Using path analysis, a model was tested in which bedtime, the number of hours spent sleeping and leisure activities were the independent variables and the body mass index was the dependent variable. The results show that sedentary and active leisure time and hours spent sleeping are predictors of the body mass index in children. Those children who go to bed late and who use that extra time to watch the television or play with the computer tend to have a greater body mass index, while those children who go to bed earlier and have spent more time reading or playing in the park or at home have a lower body mass index. Encouraging active leisure activities can have an extremely positive effect on their body mass index.
Psychosocial evaluation is recommended prior to bariatric surgery. Practice guidelines have been published on assessment methods for bariatric surgery candidates, but they have not emphasized ethical issues with this population. This review outlines ethical and professional considerations for behavioral healthcare providers who conduct pre-surgical assessments of bariatric surgery candidates by merging ethical principles for mental health professionals with current practices in pre-surgical assessments. Issues discussed include the following: (a) establishing and maintaining competence, (b) obtaining informed consent, (c) respecting confidentiality, (d) avoiding bias and discrimination, (e) avoiding and addressing dual roles, (f) selecting and using psychological tests, and (g) acknowledging limitations of psychosocial assessments.
This study assessed the psychosocial outcomes of adolescent cancer survivors and their relationship with personal and socio-familiar factors. Using a cross-sectional design, 41 survivors answered the four psychosocial dimensions of the KIDSCREEN-52 questionnaire and measures for social support and coping. Similarly, 41 parents answered coping and cancer-related distress measures. All psychosocial scores were within normative values (50 ± 10). Multiple linear regression analyses revealed four models with a range of explained variance between 9.4 percent and 31.9 percent that include the informative and emotional support, parental distress, and coping. This study contributes to the understanding of psychosocial outcomes of childhood cancer survivors and its correlates.
This study explored the moderating and mediating influences of self-acceptance and tolerance to others in the relationship between mindfulness and subjective well-being. In total, 301 (130 males) university students completed the Five-Facet Mindfulness Questionnaire, Index of Well-being, Self-acceptance Questionnaire, and Tolerance Scale. The results showed that the positive link between mindfulness and subjective well-being was significantly mediated by self-acceptance only. Tolerance played a moderating role. The implications of the results for relevant research and mindfulness training were discussed.
This study examined whether young Iranian women’s perceived control and self-efficacy, as a component of cognitive social capital, predicts health and well-being. A total of 391 women aged between 18 and 35 years completed a survey including scales measuring control and self-efficacy and health outcomes including quality of life, satisfaction with life and lifestyle behaviours. Statistical analyses indicated that participants had low perceived control and influence over community affairs together with high perceived control over their personal lives. Multiple regression analyses indicated the predictive role of control and self-efficacy for well-being outcomes suggesting the potential role for health interventions targeting control and self-efficacy.
This study evaluated the effectiveness of a psychological intervention in amyotrophic lateral sclerosis patients, consisting of four semi-structured sessions of cognitive behavioural therapy combined with counselling techniques. An intervention group and a control group were established. The Hospital Anxiety and Depression Scale was used to assess levels of anxiety and depression. In total, fifty-four patients took part. Prior to the intervention, the intervention group displayed rates of 63.3 and 36.7 per cent for anxiety and depression, respectively, falling to 16.7 and 10.0 per cent afterwards. The psychological intervention demonstrated potential for the reduction of levels of anxiety and depression in amyotrophic lateral sclerosis patients.
From a social ecological perspective, this study examined the effects of stigma (societal level), trusting relationships with current caregivers (familial level), and self-esteem (individual level) on future orientation of children affected by HIV infection and AIDS. Comparing self-report data from 1221 children affected by parental HIV infection and AIDS and 404 unaffected children, affected children reported greater stigma and lower future orientation, trusting relationships, and self-esteem. Based on structural equation modeling, stigma experiences, trusting relationships, and self-esteem had direct effects on future orientation, with self-esteem and trusting relationships partially mediating the effect of stigma experiences on children’s future orientation. Implications are discussed.
This study investigated the relationship between anxiety and feelings of being connected to nature. Two standardised self-report scales, the Nature Relatedness Scale and the State Trait Inventory for Cognitive and Somatic Anxiety, were used in tandem with a qualitative question. Quantitative results indicated that connection to nature was significantly related to lower levels of overall, state cognitive and trait cognitive anxiety. Qualitative results revealed seven themes: relaxation, time out, enjoyment, connection, expanse, sensory engagement and a healthy perspective. Taken together, these results suggest that opportunities that enhance experiences of being connected to nature may reduce unhelpful anxiety.
Working mothers are less physically active than working women without children and mothers who do not work. The purpose of this study was to examine concurrent self-regulatory efficacy and barriers to physical activity in a sample of working mothers. Women completed a mixed-methods survey which included measures of physical activity, concurrent self-regulatory efficacy, and barriers. Sufficiently active women experienced significantly greater concurrent self-regulatory efficacy and significantly less barrier limitation and frequency. No significant group differences were found for age, domestic duties performed, and children’s extracurricular activities. Thematic analysis of barriers revealed six themes of common and unique factors, including limited time and family activities.
Mal de Debarquement Syndrome is a neurological disorder of motion perception, triggered by external motion. This study aimed to determine the importance of psychosocial factors in relation to depression and quality of life in Mal de Debarquement Syndrome. A total of 66 participants with self-reported Mal de Debarquement Syndrome completed quality-of-life, symptom severity, stigma, depression, and illness intrusiveness measurements in this naturalistic correlational study. Mal de Debarquement Syndrome was associated with high levels of depression and illness intrusiveness. Illness intrusiveness mediated between stigma and quality of life; also the level of stigma moderated the effect of illness intrusiveness on quality of life. Targeted interventions aimed at alleviating psychological distress may improve quality of life in Mal de Debarquement Syndrome.
This study investigated the impact of war trauma on behavioral and emotional disorders, and neuroticism in children by prospectively examining the potential mediator and/or moderator effects of parental psychological distress. The sample consisted of 205 parents and their children. The results indicated that parent’s psychological distress did mediate and moderate the effect of trauma exposure on emotional and behavioral disorders in children. An integrated intervention which simultaneously targets children and parental distress symptoms is needed. The integrated intervention may intend to use trauma-focused cognitive behavioral therapy model that integrates cognitive, behavioral, interpersonal, and family therapy principles with trauma interventions.
Public attention focuses on breast cancer treatment and fundraising; however, there is limited discussion about life post-treatment. Once treatment is complete, there can be societal expectations of newfound wellness. To understand this phenomenon, the narratives of nine women post-treatment were explored. Analysis revealed the adoption of the sick role by the participants, the vulnerability experienced with the cessation of treatment, the disturbance of moving on from the security of the medical system and the patient and doctor relationship. Findings emphasised that survivorship can remain challenging and can present adverse psychosocial implications for women and those close to them.
This study aimed to develop a Chinese Mental Resilience Scale. A total of 2500 healthy participants, in two representative samples of the Chinese population, were administered the scale. Exploratory factor analysis, confirmatory factor analysis, and correlation analysis were used to obtain the relevant coefficients and verify the reliability and validity of the scale. Five factors were extracted: willpower, family support, optimism and self-confidence, problem solving, and interpersonal interaction, plus a lying subscale, which together accounted for 54 percent of the total variance. The Chinese Mental Resilience Scale demonstrated good psychometric properties. It can be used to evaluate the mental resilience level of general Chinese population.
Tanning increases dramatically through the teenage years, but the family context of this health risk behavior is relatively unstudied. We conducted videotaped conversations between teenage girls (10th and 11th grade) and their mothers. We developed a coding system for discussion content and highlight findings including inadequate knowledge concerning the harms of tanning and positive views of outdoor tanning over indoor tanning, yet agreement that all tans are attractive. Many teens believed that indoor tanning is sometimes necessary to achieve the tanned look. These findings can usefully guide intervention development regarding the harms of all tanning, rather than indoor or outdoor tanning specifically.
This study examined the mediating effect of self-esteem on the relationship between locus of control and depression among Chinese university students. In all, 457 students (232 men and 225 women) completed measures of locus of control, self-esteem, and depression. Correlational analyses indicated that external locus of control was related to self-esteem and depression, and self-esteem was related to depression. Structural equation modeling analysis showed that self-esteem partially mediated the influence of locus of control on depression. The significance of the results is discussed.
The purpose of this study was to examine mental health treatment use among Vietnam Veterans with posttraumatic stress disorder and determine whether undergoing major surgery interrupted mental health treatment or increased the risk of psychiatric hospitalization. Using retrospective data from Veterans Health Administration’s electronic medical record system, a total of 3320 Vietnam-era surgery patients with preoperative posttraumatic stress disorder were identified and matched 1:4 with non-surgical patients with posttraumatic stress disorder. The receipt of surgery was associated with a decline in overall mental health treatment and posttraumatic stress disorder–specific treatment 1 month following surgery but not during any subsequent month thereafter. Additionally, surgery was not associated with psychiatric admission.
This study explored the fears and concerns of 19 Iranian diabetic women using a phenomenological approach. Semistructured individual interviews were conducted; each interview was transcribed verbatim and analyzed simultaneously using Van Manen’s method. Data analysis resulted in the emergence of two main themes: (1) "a vague and uncertain future" with sub-themes of "fears of dependency," "loneliness," "disease complications," and "children’s future"; and (2) "changing lifestyles" with sub-themes of "dietary restrictions" and "insulin injection." Psychological concerns are common in Iranian diabetic women. These concerns can contribute to poor disease self-management. Thus, it is hoped that identifying these concerns can lead to better management of these issues and a better outcome in diabetic patients.
Research demonstrated that by reformulating smoking warnings into questions, defensive responses in smokers are reduced and smoking-related risk perception increases. We explored whether these positive outcomes can be generalised to actual behaviour. Participants saw either a movie presenting subheadings with smoking-related questions or statements. Afterwards, the time was measured until participants lit their first cigarette. Smokers who were presented with questions about the harms of smoking waited longer before lighting up a cigarette than smokers who were presented with statements. Presenting questions instead of the statements seems to be an effective means to prolonging smokers’ abstinence.
We investigated effects of metacognitive detached mindfulness therapy and stress management training on hypertension and symptoms of depression and anxiety, as compared to a control condition. A total of 45 female patients (mean age: M = 36.49 years) were randomly assigned to one of three conditions: metacognitive detached mindfulness therapy, stress management training, and the control condition. Blood pressure and symptoms of depression and anxiety decreased from baseline to post-test, to follow-up. Group comparisons showed that blood pressure and symptoms of depression and anxiety decreased more in psychotherapeutic groups than in the control group. Psychotherapeutic treatment of hypertension reduced blood pressure and symptoms of depression and anxiety. Positive effects were observable at follow-up 8 weeks later.
This study explored five young women’s experiences of living with Mayer–Rokitansky–Küster–Hauser to offer a unique insight into the social challenges of Mayer–Rokitansky–Küster–Hauser in the transition to adulthood. Non-directive semi-structured interviews took place within the National Health Service settings, and transcripts were analysed using interpretative phenomenological analysis. Four inter-related themes were identified: hindering independence, a sensitivity to difference, managing intimacy and managing threat to identity. The women managed their presentation to others in order to minimise the impact of their diagnosis. Recommendations for further research and implications for services are noted.
Gender beliefs contribute to men’s healthcare avoidance, but little research examines these outcomes in women. This article models healthcare avoidance related to masculine contingencies of self-worth in men and women. Nested path modelling tested relationships between social role beliefs, masculine contingencies of self-worth, barriers to help seeking and avoidance of health care in university and non-university-student adult samples. Results indicated social role beliefs predicted masculine contingencies of self-worth in men but not in women. Regardless of gender, masculine contingencies of self-worth predicted barriers to help seeking, which predicted healthcare avoidance in both men and women. Thus, masculine contingencies of self-worth have downstream consequences for men and women through barriers to help seeking.
Using a cross-sectional design, we examined coping stages (Kübler-Ross) among patients with end-stage renal disease at nephrology practices incorporating professional social workers as patient navigators, providing person-centered education and support (N = 420). We evaluated associations with behavioral counseling constructs (assess–advise–agree–assist–arrange). Coping stages comprised denial = 35.24 percent, acceptance = 24.05 percent, depression = 21.43 percent, bargaining = 12.86 percent, and anger = 6.43 percent. Compared to denial, other coping stages showed increased odds ratios for transplant referral agreement, transplant referral evaluations, understanding treatments, understanding donation procedures, plans to recruit donors, active donor recruitment, and potential living donor(s). Assessment of coping stages, and strategies to influence these, may be key factors in guiding patients to living donor kidney transplantation.
African-Americans living with HIV show worse health behaviors (e.g. medication adherence) and outcomes (e.g. viral suppression) than do their White counterparts. In a 6-month longitudinal study, we investigated whether medical mistrust among African-American males with HIV (214 enrolled, 140 with longitudinal data) predicted lower electronically monitored antiretroviral medication adherence. General medical mistrust (e.g. suspicion toward providers), but not racism-related mistrust (e.g. belief that providers treat African-Americans poorly due to race), predicted lower continuous medication adherence over time (b = –.08, standard error = .04, p = .03). Medical mistrust may contribute to poor health outcomes. Intervention efforts that address mistrust may improve adherence among African-Americans with HIV.
This study examined the role of ethnicity (Black vs White) in the extent to which patients’ appraisal of the impact of cancer on themselves and their family members relates to their physical health. Colorectal cancer patients provided self-reports for study variables at 2 and 12 months post-diagnosis (N = 60). Hierarchical regression analysis revealed that African American patients’ perception of the cancer as disruptive to their family, but not to themselves, related to poorer health recovery, which association was absent among Whites (p < .02). Findings suggest that cancer-related family stress plays a different role between two ethnic groups in elucidating their health recovery during the early survivorship.
The MOVE!23, a questionnaire to assess weight-related domains in veterans, was examined. Factor analysis of Perceived Contributors to Weight Change revealed three factors (psychosocial, eating behavior, and medical) that were positively correlated with body mass index, and psychiatric and medical comorbidity (p’s < 0.001). Multivariable cumulative logit models modeling the factor scores indicated that women were more likely than men to endorse psychosocial (odds ratio = 2.15, confidence interval = 2.04–2.27) and medical (odds ratio = 1.69, confidence interval = 1.59–1.79) items. The MOVE!23 Perceived Contributors to Weight Change subscale is a reliable and valid measure that is associated with body mass index and may assist in tailoring treatments according to gender and comorbidity.
In this cross-sectional study, we investigated the associations between patient communication self-efficacy and self-reported symptoms in doctor–patient communication, as perceived by patients, and the mental health and illness of hospital outpatients. Using data from a sample of 74 outpatients (mean age = 37.58 years, standard deviation = 12.54), a structural equation model was calculated. The results showed that communication self-efficacy and respectful behaviour were associated with mental health and illness. Furthermore, self-reported symptoms were correlated with mental illness. Gender and educational differences also occurred. The findings suggest that enhancing patients’ communication skills could benefit outpatients in general, but female and less educated patients in particular.
This study distinguished constructive (e.g. planning/problem-solving) and unconstructive (e.g. worry) processing in expressive essays and their impact on depressive symptoms, healthcare visits, and physical symptoms. Affect labeling, achievement orientation, and insight utilization were examined as mediators. Essays from 43 medical students were coded; mediators were identified through linguistic text analysis. Outcomes were assessed at baseline and 3 months. Constructive processing predicted declining depressive symptoms (β = –.33, p < .05) and healthcare visits (β = –.61, p < .01). Unconstructive processing predicted increasing healthcare visits (β = .42, p < .05). Higher affect labeling mediated the effect of constructive processing, and lower achievement orientation mediated the effect of unconstructive processing.
This study was designed to increase parents’ awareness of their role in their preschool child’s body image and increase positive body image attitudes. In total, 118 parents (54 intervention, 64 control) of boys aged –3–6 years completed a two-session educational workshop. At post-test and the 3 months’ follow-up, parents in the intervention group compared to the control group reported a greater level of perceived knowledge on how they may influence their son’s body image and a greater level of body appreciation. These results indicate that educational workshops are effective in improving parents’ knowledge to improve their son’s body image.
This study reports development of a scale assessing communication with family about brain-dead organ donation. Two cross-sectional studies demonstrated scale validity. Tests of internal, external, and predictive validity were conducted using confirmatory factor analysis. In both studies, the same 6 items were shown to be unidimensional with acceptable reliability. Parallelism was shown between the Brain Death Scale and a measure of communication with family. Predictive validity was exhibited between participants’ donor status and the Brain Death Scale. The scale was associated with knowledge about brain death confirming misconceptions about brain-dead organ donation.
This study aims to understand whether, and possibly how, caregivers of patients in a vegetative state experience an emotional paradox between life and death. Individual semi-structured interviews were conducted with 24 (19 females and 5 males) caregivers of vegetative state patients living in northern Italy. Data were analysed using interpretative phenomenological analysis. Caregivers felt they were the only ones able to understand and give answer to patients’ needs, but neglected their own lives in their total commitment to the patient. The findings highlight the importance for vegetative state caregivers in considering new possibilities of life that go beyond the assistance of vegetative state patients.
We evaluated a cognitive behaviour therapy–based programme to improve glycaemic control and psychosocial wellbeing in adolescents with type 1 diabetes. A total of 147 adolescents aged 13–16 years were randomized to the intervention (n = 73) or standard care (n = 74). The primary outcome was glycaemic control at 3 and 12 months post randomization, and secondary measures were stress, self-efficacy and quality of life. Mixed-effects regression models were used to assess differences in means between groups at each time point. There was little evidence of differences in glycaemic control between groups. However, psychosocial wellbeing improved in the intervention group compared to the control group. Recommendations for future programmes are discussed. The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12608000368336).
The psychosocial pathways underlying associations between benefit finding and quality of life are poorly understood. Here, we examined associations between benefit finding, social support, optimism and quality of life in a sample of 84 caregivers. Results revealed that quality of life was predicted by benefit finding, optimism and social support. Moreover, the association between benefit finding and quality of life was explained by social support, but not optimism; caregivers who reported greater benefit finding perceived their social support be higher and this, in turn, had a positive effect on their overall quality of life. These results underscore the importance of harnessing benefit finding to enhance caregiver quality of life.
The mental health of the elderly is an important issue in the area of health psychology. This study investigated the effect of intergeneration social support on the subjective well-being of 429 elderly participants. Results suggested that intergeneration social support, self-esteem, and loneliness were significantly correlated to subjective well-being. Structural equation modeling indicated that self-esteem and loneliness partially mediated the effect of intergeneration social support on subjective well-being. These findings provided insights into the effect of intergeneration social support on the subjective well-being of the elderly.
Identifying risk factors for psychological distress in patients with cancer may help providers more efficiently screen, identify, and manage distress. This article presents predictors of psychological distress in a large heterogeneous sample of cancer patients. In total, 836 patients were enrolled in a large randomized control trial and completed computerized psychosocial assessments Mental Health Assessment and Dynamic Referral for Oncology. Multivariate regressions examined predictors of distress and interest in mental health services. Final models suggest that psychological distress was related to six variables, and interest in mental health services was related to previous history of mental health counseling, total number of cancer-related symptoms, and race/ethnicity. Results may be used to identify high-risk patients who may benefit from proactive psychosocial interventions.
Polycystic ovary syndrome affects 6 percent of women. Symptoms include hirsutism, acne, and infertility. This research explores the impact of polycystic ovary syndrome on women’s lives using photovoice. Nine participants photographed objects related to their quality of life and made diary entries explaining each photograph. Three themes emerged from thematic analysis of the diaries: control (of symptoms and polycystic ovary syndrome controlling their lives), perception (of self, others, and their situation), and support (from relationships, health care systems, and education). These findings illuminate positive aspects of living with polycystic ovary syndrome and the role pets and social networking sites play in providing support for women with polycystic ovary syndrome.
Using a cross-sectional qualitative design involving focus groups and interviews, we sought to gain a more detailed understanding of adolescents’ physical activity, eating habits and health perceptions during the transition from secondary school (or high school) to work. Based on thematic analyses, three themes were extracted: (1) perceptions of lifestyle and health, (2) changes in priorities and (3) passive acceptance of internal and external influences on physical activity and diet. Poor diet and physical inactivity appeared to reflect participants’ amotivation towards health behaviours, reluctance to divert from perceived peer norms and efforts to assert independence from parents.
This study examined factors associated with the unwanted exposure to online pornography and unwanted online sexual solicitation victimization and perpetration of youth in Taiwan. A total of 2315 students from 26 high schools were assessed in the 10th grade, with follow-up performed in the 11th grade. Self-administered questionnaires were collected. Multivariate analysis results indicated that higher levels of online game use, pornography media exposure, Internet risk behaviors, depression, and cyberbullying experiences predicted online sexual solicitation victimization, while higher levels of Internet chat room use, pornography media exposure, Internet risk behaviors, cyberbullying experiences, and offline sexual harassment predicted online sexual solicitation perpetration.
To examine risk and resilience factors that affect health, lifetime stress exposure histories, dispositional forgiveness levels, and mental and physical health were assessed in 148 young adults. Greater lifetime stress severity and lower levels of forgiveness each uniquely predicted worse mental and physical health. Analyses also revealed a graded Stress x Forgiveness interaction effect, wherein associations between stress and mental health were weaker for persons exhibiting more forgiveness. These data are the first to elucidate the interactive effects of cumulative stress severity and forgiveness on health, and suggest that developing a more forgiving coping style may help minimize stress-related disorders.
We examined whether long QT syndrome status moderates the association between stressful life events and depressive symptoms. Participants were 562 (n = 246 symptomatic) long QT syndrome mutation carriers. Depressive symptoms were measured with a modified version of the Beck’s Depression Inventory. There was an interaction between long QT syndrome status and stressful life events on depressive symptoms. In the symptomatic long QT syndrome patients, stressful life events were associated with depressive symptoms (B = 0.24, p < 0.001). In the asymptomatic long QT syndrome mutation carriers, this association was 62.5 percent weaker (B = 0.09, p = 0.057). Compared to asymptomatic long QT syndrome mutation carriers, symptomatic long QT syndrome patients are more sensitive to the depressive effects of stressful life events.
This study tested depression as a mediator between childhood sexual abuse and adherence to antiretroviral therapy, an effect moderated by resilience. In total, 149 HIV+ Latino men who have sex with men were recruited for this study. Using a regression-based bootstrap approach, depression mediated the relationship between childhood sexual abuse and antiretroviral therapy adherence, with worse adherence for participants at lowest percentiles of the resilience index. The prevalence of childhood sexual abuse and depression in HIV+ men who have sex with men is high and must be addressed to better prevent disease progression and reduce transmission, especially in expanding Latino populations.
Burn wounds have a significant impact on the mental health of patients. This study aimed to investigate the impact of perceived social support and dispositional optimism on depression of burn patients. A total of 246 burn patients accomplished the Multidimensional Scale of Perceived Social Support, the Revised Life Orientation Test, and Depression Scale. The results revealed that both perceived social support and optimism were significantly correlated with depression. Structural equation modeling indicated that optimism partially mediated the relationship between perceived social support and depression. Implications for prevention of depression in burn patients were discussed.
This study investigated the effects of a brief tailored intervention on self-efficacy beliefs and exercise energy expenditure in active and inactive overweight and obese women. Participants were randomly assigned to either control (N = 50) or intervention (N = 47) conditions, and their exercise self-efficacy was assessed three times over a 12-week period. Results showed that the intervention increased schedule, physical, exercise-worries efficacy, and energy expenditure in the previously inactive group. The results suggest that self-efficacy interventions are effective at increasing exercise energy expenditure in inactive overweight and obese women.
The relationship between attention deficit hyperactivity disorder (ADHD) and obesity in children has received considerable attention in recent years. However, the literature currently overlooks the potential causal and maintaining role that sleep problems may play in this relationship. Using a biopsychosocial framework, this article highlights how sleep problems impact the biological, psychological, and social aspects of both ADHD symptomatology and obesity. An in-depth examination of this model illustrates the imperative need for future research and clinical practice to recognize and explore the role sleep has in the link between obesity and ADHD symptomatology.
The aim of this study was to evaluate the predictive effects of infertility-related stress on psychological distress and marital satisfaction. Structural equation modeling was used to estimate a nonrecursive model hypothesizing the impact of infertility-related stress on both emotional distress and marital dissatisfaction, which were supposed to have a reciprocal influence on each other. The model was estimated using data from a sample of 150 infertile patients (78 males and 72 females). Findings confirmed the predictive effects of infertility-related stress on both emotional and marital distress. However, infertility-related stress was found to have more impact on emotional distress than on marital satisfaction.
This study examined the moderator effect of psychological resilience on the relationship between social support and loneliness of the "left-behind" children. A total of 200 left-behind girls and 214 left-behind boys completed the measures of psychological resilience, social support, and loneliness. Hierarchical regression analysis showed that psychological resilience moderated the association between social support and loneliness. When left-behind children reported a low level of psychological resilience, those with high social support reported lower scores in loneliness than those with low social support. However, the impact of social support on loneliness was much smaller in the high psychological resilience group, compared with that in low psychological resilience group.
This research applied self-determination theory to examine the degree to which satisfaction of basic psychological needs for autonomy, relatedness, and competence explained the association between socioeconomic status and physical and mental health outcomes, while controlling for age, exercise, and smoking status. This was a survey research study with 513 full-time employees in professions representative of a hierarchal organization. The results of the structural equation model verify that psychological need satisfaction mediates the inverse association between socioeconomic status and physical and mental health. Self-determination theory contributes to understanding the psychosocial roots of the uneven distribution of health across the socioeconomic gradient.
Positive psychological states are linked to superior cardiac outcomes, possibly mediated through increased participation in health behaviors. Trained study staff conducted in-depth semi-structured interviews in the hospital and 3 months later for 34 patients diagnosed with an acute coronary syndrome. These interviews focused on positive psychological states, cardiac health behaviors, and their connection; the interviews were transcribed and independently coded using directed content analysis. Both optimism and positive affect were associated with completion of physical activity and healthy eating in a bidirectional manner. In contrast, gratitude, while common, was infrequently linked to completion of health behaviors.
This natural experiment examines the effect of a public bicycle share program on cognitions and investigates the moderating influence of socioeconomic status on this effect. Two cross-sectional population-based surveys were conducted. Intention and self-efficacy to use the public bicycle share program were assessed by questionnaire. A difference-in-differences approach was adopted using logistic regression analyses. A significant effect of the public bicycle share program was observed on intention (exposure x time; odds ratio = 3.41; 95% confidence interval: 1.50–7.73) and self-efficacy (exposure; odds ratio = 1.61; 95% confidence interval: 1.28–2.01). A positive effect on intention was observed among individuals with low income (exposure x time; odds ratio = 27.85; 95% confidence interval: 2.51–309.25). Implementing a public bicycle share program is associated with increases in intention and self-efficacy for public bicycle share use, although some social inequalities persist.
Previous research has shown that purpose in life, the belief that one’s life is meaningful and goal-directed, is associated with greater engagement in self-reported physical activity. The purpose of this study was to examine the relationship between purpose in life and accelerometer-measured physical activity. Community volunteers (N = 104) completed measures of purpose in life and potential confounds and wore accelerometers for three consecutive days. Purpose in life was positively associated with objectively measured movement, moderate to vigorous physical activity, and with self-reported activity. These relationships were largely unchanged after controlling for potential confounds. These results suggest that purpose in life is a reliable correlate of physical activity.
Low socioeconomic status, racial discrimination, and low acculturation are the major sociocultural correlates of smoking among African-American adults. This study is the first to examine all three variables simultaneously and to analyze gender differences in their association with smoking. Results for the sample revealed that low education and low acculturation predicted smoking but racial discrimination did not. For women, low acculturation was the sole predictor of smoking, whereas for men, socioeconomic status variables were the sole predictors. This suggests that low acculturation may be associated with smoking among African-American women only. Hence, culturally specific smoking cessation programs designed for low-acculturated African-Americans might be effective for African-American women alone.
This study examined associations between anticipated future health behaviour and participants’ attitudes. Three Implicit Association Tests were developed to assess safety, efficacy and overall attitude. They were used to examine preference associations between conventional versus complementary and alternative medicine among 186 participants. A structural equation model suggested only a single implicit association, rather than three separate domains. However, this single implicit association predicted additional variance in anticipated future use of complementary and alternative medicine beyond explicit. Implicit measures should give further insight into motivation for complementary and alternative medicine use.
This study aimed to validate the Chinese version of the Optimism and Pessimism Scale in a sample of 730 adult Chinese individuals. Confirmatory factor analyses confirmed the bidimensionality of the scale with two factors, optimism and pessimism. The total scale and optimism and pessimism factors demonstrated satisfactory reliability and validity. Population-based normative data and mean values for gender, age, and education were determined. Furthermore, we developed a 20-item short form of the Chinese version of the Optimism and Pessimism Scale with structural validity comparable to the full form. In summary, the Chinese version of the Optimism and Pessimism Scale is an appropriate and practical tool for epidemiological research in mainland China.
This prospective study in 119 patients with cardiovascular diseases aimed to examine whether (a) illness representations mediate the relation of general maladaptive health beliefs to patients’ coping behaviours and (b) these relations are moderated by the patients’ perception of the amount of information provided by their physicians. Personal control and illness coherence mediated the relation of maladaptive health beliefs to coping behaviour. The amount of the provided information buffered the negative relation of maladaptive health beliefs to illness representations and coping. Thus, the detrimental effect of general maladaptive health beliefs may be counterbalanced by the amount of information provided by physicians.
The current study examined the impact of size of social network on subjective well-being of elderly, mainly focused on confirmation of the mediator role of perceived social support. The results revealed that both size of social network and perceived social support were significantly correlated with subjective well-being. Structural equation modeling indicated that perceived social support partially mediated size of social network to subjective well-being. The final model also revealed significant both paths from size of social network to subjective well-being through perceived social support. The findings extended prior researches and provided valuable evidence on how to promote mental health of the elderly.
Despite several models of coping have been proposed in chronic pain, research is not integrative and has not yet identified a reliable set of beneficial coping strategies. We intend to offer a comprehensive view of coping using the social problem-solving model. Participants were 369 chronic pain patients (63.78% women; mean age 58.89 years; standard deviation = 15.12 years). Correlation analyses and the structural equation model for mental health revealed potentially beneficial and harmful problem-solving components. This integrative perspective on general coping could be used to promote changes in the way patients deal with stressful conditions other than pain.
The purpose of this study was to test an intervention to increase mammography screening in women 51–75 years of age who had not received a mammogram in the last 15 months. A total of 1681 women were randomized to (1) a mailed tailored interactive DVD, (2) a computer-tailored telephone counseling, or (3) usual care. Women with income below US$75,000 who were in the interactive DVD group had significantly more mammograms than women in usual care. Women with income above US$75,000 had significantly fewer mammograms than women with income less than US$75,000 regardless of group. Further investigation is needed to understand why women with income above US$75,000 did not show the same benefit of the intervention.
We aimed to determine the association between attachment style and health problems during pregnancy, as well as perinatal health variables. In 122 mothers who were 2–18 months postpartum, hot flushes, vaginal discharge, back pain, breast tenderness, hair changes, and psychological problems were shown to be associated with insecure attachment as measured by the Adult Attachment Style Questionnaires. Babies born to mothers with insecure attachment were more likely to have a low birth weight. It is vital to increase awareness of insecure attachment style as a risk factor among perinatal health care providers to optimize services.
The aim of this study was to explore the association between mental toughness, subjective sleep, physical activity, and quality of life during early and mid-adolescence. A total of 1475 participants (mean age = 13.4 years; range: 11–16 years) took part in the study. They completed questionnaires related to mental toughness, physical activity, subjective sleep, and quality of life. Greater mental toughness was related to more favorable quality of life and increased subjective sleep. Mental toughness was not related to physical activity. Increased mental toughness, favorable quality of life, and sleep are related during early and mid-adolescence. Against our expectations, mental toughness was not related to physical activity.
This research identified psychosocial factors associated with post-traumatic stress and health anxiety following a venous thrombotic embolism. In all, 158 participants, largely registered with a venous thrombotic embolism information website (Lifeblood: The Thrombosis Charity), completed an online survey. Post-traumatic symptom scores were linked to health threat, and not moderated by perceived control over risk for further venous thrombotic embolism. Health anxiety was associated with continuing symptoms and a negative emotional response to the venous thrombotic embolism. There is a need to intervene to reduce both short- and long-term distress in this population, ideally using a stepped-care model.
‘Adjustment’ in health refers to both processes and outcomes. Its measurement and conceptualisation in African cultures is limited. In total, 263 people living with HIV and receiving anti-retroviral therapy in clinics in Uganda completed a translated Mental Adjustment to HIV Scale, depression items from the Hopkins checklist and demographic questions. Factor analysis revealed four Mental Adjustment to HIV factors of active coping, cognitive–social adjustment, hopelessness and denial/avoidance. Correlations with depression supported the Mental Adjustment to HIV’s validity and the importance of active adjustment, while the role of cognitive adjustment was unclear. Factors were process or outcome focussed, suggesting a need for theory-based measures in general.
We examined motives for adopting and maintaining yoga practice in a national survey of yoga practitioners (360 yoga students, 156 yoga teachers). Both students and teachers adopted yoga practice primarily for exercise and stress relief, but reported many other reasons, including flexibility, getting into shape, and depression/anxiety relief. Over 62 percent of students and 85 percent of teachers reported having changed their primary reason for practicing or discovering other reasons; for both, the top changed primary reason was spirituality. Findings suggest that most initiate yoga practice for exercise and stress relief, but for many, spirituality becomes their primary reason for maintaining practice.
There is a trend of rapid growth in both the level and occurrence of depression when people reach adolescence. The present study aimed to investigate the impact of the parent–adolescent relationship on depression in adolescents, and mainly focused on the confirmation of the mediator role of self-esteem. A total of 364 senior middle school students accomplished the Parent–Adolescent Relationship Scale, Rosenberg Self-Esteem Scale, and Zung Self-Rating Depression Scale. The results suggested that both parent–adolescent relationship and self-esteem were significantly correlated with depression. Structural equation modeling indicated that self-esteem partially mediated the relationship between parent–adolescent relationship and depression.
Numerous studies of various populations and settings link patient–provider communication or beliefs to medication adherence. A better understanding of this interplay may help to improve patient-centred communication. To predict adherence, this study used the Beliefs about Medicines Questionnaire and indications of the quality of the nurse’s communication in terms of patient satisfaction. Patient satisfaction with the information provided and the degree to which the information was tailored to them were related to adherence via the patient’s beliefs. This study supports the argument that tailoring is an effective strategy for improving adherence via beliefs and can contribute to medical education and to adherence interventions.
Research about the influence of stigma on health outcomes in sickle cell disease is limited. We administered the recently developed Measure of Sickle Cell Stigma to 262 patients in the United States. The Measure of Sickle Cell Stigma yielded very good internal consistency and four interpretable factors. Significant associations among stigma, pain-related healthcare utilization, and perceived disease severity were observed for three of the four stigma factors (F range = 2.78–5.44). The Measure of Sickle Cell Stigma appears to be a useful tool for measuring disease-specific stigma among adults living with sickle cell disease, and further assessment of its clinical utility is warranted.
Social constructions of men towards the availability of a male hormonal contraceptive, the ‘male pill’, were explored. A qualitative approach applying semi-structured interviews and scenarios with 22 men (mean age 35 years) from the North East of England revealed two core constructs and six sub-constructs using a Thematic-Construct Analysis in line with the method of Toerien and Wilkinson and Clarke and Kitzinger. Verbal accounts were inductively used to balance the deductively created two core constructs ‘Constructing the male pill norm: dominant system of sensemaking’ and ‘Living by the male pill norm’ to represent a normative framework within a changing ideology of shared responsibility in contraceptive choice. Constructing the male pill norm was divided into two sub-constructs: ‘Male pill: we are going to join the women and become responsible – too!’ and ‘Male pill: you look so girly – what are they going to think of me?’ The ‘Living by the male pill norm’ was further divided into four sub-constructs ‘Male pill – thank you for giving me promises not to have to become a dad as yet!’; ‘Male pill: thank you for the idea of fun – sorry about my morals!’; ‘Male pill: in stable relations – yes, I would have you now – sorry, I am too late!’ and ‘Male pill, we love you – but we are too anxious – we are not ready as yet!’ From this male discourse, it is clear that discussions over the male pill follow the line of a vicious circle. In order to establish long-term side effects, Phase IV studies are necessary, and these cannot commence without the male hormonal contraception being a marketable product. So, unless this circle gets broken by some brave men, the male pill will remain a virtual rotating idea for a long time.
Getting insufficient sleep has serious consequences in terms of mental and physical health. The current study is the first to approach insufficient sleep from a self-regulation perspective by investigating the phenomenon of bedtime procrastination: going to bed later than intended, without having external reasons for doing so. Data from a representative sample of Dutch adults (N = 2431) revealed that a large proportion of the general population experiences getting insufficient sleep and regularly goes to bed later than they would like to. Most importantly, a relationship between self-regulation and experienced insufficient sleep was found, which was mediated by bedtime procrastination.
Risk perception studies have focused on personal risks; yet many decisions are taken for others. Some studies have suggested that parents are especially sensitive to risks to their children. We compared 245 parents’ willingness to vaccinate their child versus themselves in nine hypothetical scenarios relating to influenza strains. Scenarios varied according to non-vaccination risk (low, medium and high) and ‘risk target’ (oneself, one’s child or, as a comparator, one’s elderly parent). Participants were more willing to vaccinate their child (61% acceptance) than themselves (54%) or their parent (56%). Parents may be more risk-sensitive when deciding for their child than for themselves.
We examined the extent to which lay people and health professionals are able to assess occurrence risks for multifactorial diseases. We asked 341 participants to assess the risk of developing lung cancer, coronary artery disease or rheumatoid arthritis in 16 scenarios, each featuring a combination of four factors (family history, daily alcohol intake, daily tobacco consumption and genetic test results). Participants considered all factors. However, they accorded more weight to tobacco and genetic test results. Moreover, it appears that where one of the factors (e.g. the presence of the incriminated gene) exerted a strong influence, the influence of the other factor(s) was correspondingly weaker. The health risk judgements of health professionals were more dependent on the specific disease and were also influenced to a greater degree by genetic information than lay people.
Guided by pain-related attachment models and coping theory, we used structural equation modeling to test an appraisal-based coping model of how insecure attachment was linked to arthritis adjustment in a sample of 365 people with arthritis. The structural equation modeling analyses revealed indirect and direct associations of anxious and avoidant attachment with greater appraisals of disease-related threat, less perceived social support to deal with this threat, and less coping efficacy. There was evidence of reappraisal processes for avoidant but not anxious attachment. Findings highlight the importance of considering attachment style when assessing how people cope with the daily challenges of arthritis.
This study explored changes over time and in the internal standards of the quality of life, prolonged grief and family strain of informal caregivers of patients in vegetative state. Data obtained from 52 caregivers showed high levels of prolonged grief and family strain, and low quality of life. A decrease of caregivers’ quality of life and an increase of family strain were found by adopting a response shift procedure. Only prolonged grief did not change during time. Clinical intervention with the caregivers of vegetative state patients should be differentiated on the basis of the duration of the caring experience.
Pandemic influenza represents an ongoing public health threat. Understanding the associated behavioural domain is vital for future intervention development. Cross-sectional qualitative research employing purposive sampling employed a combination of one-to-one semi-structured interviews (n = 57) and focus groups (n = 59). Data were analysed using (1) inductive thematic analysis and (2) theoretical thematic analysis focusing upon resonance with psychosocial and sociocultural constructs. Two broad themes highlighted an important duality regarding the determinants of pandemic behaviour: (1) psychosocial determinants (e.g. agency, cognitions and identity) and (2) sociocultural determinants (e.g. social context and capacity). These findings suggest this duality should shape future intervention development.
This study investigated the effect of loneliness on depression and further tested the mediating effect of social support. A total of 320 elderly persons completed the Emotional and Social Loneliness Scale, Multidimensional Scale of Perceived Social Support, and Self-Rating Depression Scale. Results revealed that loneliness and social support significantly correlated with depression. Structural Equation Modeling indicated that social support partially mediates loneliness and depression. The final model illustrated a significant path from loneliness to depression through social support. This study sheds light on the concurrent effects of loneliness and social support on depression, providing evidence on how to reduce depression among the elderly.
This study implemented and evaluated the effectiveness of an expressive writing intervention among patients with Stargardt’s disease, a rare disease due to macular degeneration. Participants were randomly assigned to either an expressive writing intervention or a neutral writing condition. Participants completed measures at three time points: baseline, 3 weeks, and 6 weeks post-intervention. Psychological health outcomes improved at the 3-week follow-up for the intervention condition compared to control. Self-reported physical health improved at the 6-week follow-up in the intervention condition compared to control. These results suggest that expressive writing may be an effective, practical, and low-cost intervention for those with Stargardt’s disease.
This study investigated the role of Type D personality in health behaviors and perceived social support in individuals with coronary heart disease. Different from other related studies, this study assessed a broader range of health behaviors in an eastern population while controlling for anxiety and depression. In all, 386 Indonesian individuals with coronary heart disease completed the measures assessing Type D, perceived social support, depression, anxiety, and health behaviors. Compared with non-Type D, Type D individuals reported more unhealthy behaviors, less healthy behaviors, and perceived less social support. For those identified as Type D, tailored interventions might be considered.
Secondary analysis of data from 30 people in three interview studies shows that bereaved people use their own and the deceased’s body in their continuing efforts to maintain a relationship with the departed. Following the continuing bond perspective, the study reveals three body-associated strategies for maintaining post-death relationships: (a) the presence of the deceased in the bereaved’s body, (b) body-associated actions and activities, and (c) sensing and caring for the deceased’s body. The conceptual dimension of embodiment is used to interpret results. Attention is also given to the bereaved’s sense of disembodiment due to social rejection of these strategies for maintaining post-death relationships. Implications for health psychologists are offered.
This descriptive cross-sectional study aimed to explore emotional representation and illness coherence, the understanding a person has about an illness which helps them make sense of the experience, in Russians with tuberculosis. In a secondary analysis of questionnaires from 105 Russians treated for pulmonary tuberculosis, social isolation and disease consequences were predictors of negative emotions related to tuberculosis and accounted for 49 percent of the variance. Participants who scored higher on illness coherence were less likely to experience negative emotions. Development of programs to help patients understand tuberculosis and to manage emotional responses and stigma is suggested.
This study examined the effect of the audience’s similarity to, and parasocial identification with, spokespersons in obesity public service announcements, on perceived source credibility, and diet and exercise self-efficacy. The results (N = 200) indicated that perceived similarity to the spokesperson was significantly associated with three dimensions of source credibility (competence, trustworthiness, and goodwill), each of which in turn influenced parasocial identification with the spokesperson. Parasocial identification also exerted a positive impact on the audiences’ diet and exercise self-efficacy. Additionally, significant differences were found between overweight viewers and non-overweight viewers on perceived similarity, parasocial identification with the spokesperson, and source credibility.
This study aimed to investigate the impact of perceived social support on the depression of postpartum women, and mainly focuses on confirming the mediator role of self-efficacy. A total of 427 new mothers from two general hospitals in Beijing accomplished the Multidimensional Scale of Perceived Social Support, General Self-efficacy Scale, and Edinburgh Postnatal Depression Scale. The results revealed that both social support and self-efficacy significantly correlate with postpartum depression. Structural equation modeling indicated that self-efficacy partially mediates the relationship between social support and postpartum depression.
Sleep is preceded by physiological and behavioural events that inform the subject that it is time to sleep. Our hypothesis is that insomniacs do not adequately recognize such signals, thus missing the best time to go to bed. Eighty-seven chronic insomniac participants and 76 age-matched good sleeper controls were recruited. Semi-structured interviews focused on three aspects of nocturnal sleep: features, habitual activities and signals that they usually rely on in order to decide their readiness to sleep. The results showed that insomniacs relied more than good sleepers on external signals (time) than on bodily ones to decide to go to sleep.
The purpose of this mixed methods study was to identify participants’ attributions for their global impression of change ratings in a behavioral intervention for unexplained chronic fatigue and chronic fatigue syndrome. At 3-month follow-up, participants (N = 67) were asked "Why do you think you are (improved, unchanged, worse)?" Improved patients pointed to specific behavioral changes, unchanged patients referred to a lack of change in lifestyle, and worsened patients invoked stress and/or specific life events. Identifying patient perceptions of behaviors associated with patient global impression of change–rated improvement and non-improvement may assist in developing more effective management strategies in clinical care.
Growing evidences highlight the co-existence of negative and positive (e.g. posttraumatic growth) identity changes following stroke. Identity changes were assessed by comparing 42 survivors 21 months after stroke and healthy controls. A total of 26 stroke survivors participated in a semi-structured interview. Stroke survivors showed significantly higher posttraumatic growth (F(1, 75) = 9.79, p = .003) and integrated the critical life event to a higher extent into their identity (event centrality) (F(1, 74) = 37.54, p < .001). Qualitative analysis revealed increased appreciation of life and more intense/selective relationships as the most common positive changes. Considering positive changes might provide additional perspectives for rehabilitation.
Stroke among adults of working age is increasing. We aimed to explore the experience of stroke among young women in Ireland. In total, 12 women (aged between 18 and 50 years) participated in semi-structured interviews. Data were analysed using interpretative phenomenological analysis. Four super-ordinate themes were identified: stroke as an illness of later life (‘obviously it’s for older people’), post-stroke selves, a desire for peer support and the impact of stroke on relationships. Findings indicate the importance of addressing the specific needs of younger stroke patients from admission to recovery through provision of inclusive all-age acute stroke services with tailored rehabilitation.
We synthesised evidence on biological correlates of psychological stress in hospital-based healthcare professionals, and examined whether there was evidence of consistent biological changes. Electronic databases were searched for empirical studies; 16 articles (0.6%) met the inclusion criteria. Evidence of a relationship between indices of psychological stress and biological parameters was limited and inconsistent. There was some evidence of a consistent relationship between natural killer cells and lymphocyte subpopulations. Considerable heterogeneity in the methods used was seen. Future prospective studies examining the relationship between indices of psychological stress and natural killer cells, including lymphocyte subsets, is required.
Malnutrition is a life-threatening condition among older people living in nursing care homes. This qualitative analysis of interview data from five care staff aimed to understand their perceptions of ‘caring for’ residents’ nutritional needs. Tensions in the delivery of care and institutionalisation and disempowerment were identified. Despite carers’ good intentions, they often failed to recognise the importance of the psychosocial aspects of mealtimes. Staff shortages, routine-driven, medically based working practices and residents’ resistance to institutionalisation emerged as barriers to quality caregiving. The findings indicate that the relational aspects of care are constrained by social, structural and ideological contexts.
Hypnotherapy can address the biopsychosocial aspects of disability-related pain, although the available evidence is limited in quality and quantity. Meta-analytic techniques were utilised to evaluate 10 controlled studies. Hypnotherapy produced significant short-term improvements in fatigue, pain experience and affect. However, a lack of significance was noted at 3- to 6-month follow-up. A beneficial effect size (dw = 0.53; confidence interval = 0.28–0.84) in comparison to control conditions was reported, although comparability with other cognitive-behavioural treatments could not be confirmed across the few studies reporting this data (dw = 0.06; confidence interval = –0.33 to 0.45). The findings highlight the need for further controlled and longitudinal research in this area.
Orlistat is currently the only prescribed form of pharmacological management for obesity and functions by reducing the amount of fat absorbed from food eaten. Although frequently prescribed, there is marked variability in outcomes. A total of 10 participants’ experiences of gaining weight after taking orlistat were analysed using thematic analysis. Participants attributed their failed weight loss to mechanisms of the medication, emphasised a medical model of obesity with barriers to their weight loss and other weight-loss methods which had also failed. Overall, their weight gain was considered an inevitable part of their self-identity, reflecting their self-fulfilling prophecy of being a perpetual dieter.
Resilience may mitigate impact of secondary symptoms such as pain and fatigue on quality of life in persons aging with disability. This study examined resilience in a large sample of individuals with disabling medical conditions by validating the Connor–Davidson Resilience Scale, obtaining descriptive information about resilience and evaluating resilience as a mediator among key secondary symptoms and quality of life using structural equation modeling. Results indicated that the measure’s psychometric properties were adequate in this sample. Resilience was lowest among participants who were middle-aged or younger, and participants with depression. Resilience mediated associations between secondary symptoms and quality of life.
This study examined whether school engagement was protective with regard to externalizing behaviors, gang involvement, sexual debut, and unsafe sexual behaviors among African American adolescent males. Self-administered surveys were administered to 219 male students from an urban Chicago high school. Controlling for age and socioeconomic status, higher school engagement levels were associated with lower rates of aggressive behaviors, lower levels of gang involvement, delay of sexual debut, and lower levels of unsafe sexual behaviors. Findings support the development of school-based interventions designed to promote student–teacher bonds, academic performance, and after-school activities for African American youth.
Emotion context sensitivity is the ability to respond emotionally in a manner that is functionally appropriate for the context in which the emotion arises. This study examined the relationship between emotion context sensitivity and treatment adherence in adults with the chronic illness Thalassemia. Emotional responses were measured by examining the frequency of positive and negative emotional words used to answer two interview questions that created two different emotional contexts. Consistent with previous research on adaptive and contextually appropriate emotions, negative emotion words were related to adherence in the context of the disease itself, while positive emotion words were related to adherence in the context of coping.
A number of outcome studies showed that kidney transplantation is associated with improvements in health-related quality of life relative to the pre-transplant period, but comparisons with the general population produced mixed results. This study aimed to compare 30 successful (>1 year) kidney transplantation recipients with 30 matched-pair healthy controls on psychosocial well-being. Independent of gender, age and time since transplantation, transplanted patients equalled healthy people in the intrapersonal domains but scored worse in the interpersonal domains of psychosocial well-being. Identifying aspects of life that remain impaired after kidney transplantation may assist the development of interventions targeted at improving patients’ adjustment.
Four White British women who had not signed up to be organ donors were interviewed in depth to investigate their feelings on organ donation. Transcripts were analysed using Interpretative Phenomenological Analysis to reveal how the ability to detach from the body affects the acceptance of organ donation, how organ donation can trigger difficult thoughts and how the family can be used to explain not having signed up. The findings confirm previous empirical evidence but also offer original insight on the discrepancy between attitudes and behaviours, how fears can inhibit action and the importance of communicating organ donation wishes to family.
Teenage binge drinking is a significant health issue. To explore teenagers talk about binge drinking, four peer-group interviews were conducted with 20 teenagers, aged 16–18 years, with experience of excessive alcohol use. A discourse analysis showed that a ‘drinking is cool’ discourse constructed ‘getting wasted’ as an integral part of social life, while a ‘drinking as a social lubricant’ discourse described the behavioural functions of alcohol use. Participants also actively resisted an ‘alcohol is bad’ discourse, which acknowledges the risks of alcohol use. The findings illustrate how teenagers use these resources in sophisticated ways to position the teen drinker positively and negatively.
This study examined the relationship of media exposure and media literacy to alcohol and tobacco use among adolescents in Taiwan. A total of 2992 10th-grade students recruited from 26 high schools in Taipei, Taiwan, completed a questionnaire in 2010. The multivariable analysis results indicated that the students with higher alcohol and tobacco media exposure were more likely to use alcohol and tobacco and have intentions to drink and smoke, while students with higher media literacy were less likely to use alcohol and have intentions to drink and smoke.
This study evaluated the influence of overweight adolescents’ lifestyle on the adherence to weight control, and identifies their predictors. Participants were 94 adolescents, aged 12–18 years, attending a Paediatric Obesity Clinic. Lifestyle was assessed using the "Adolescent Lifestyle Profile" and treatment adherence through the "Therapeutic Adherence to Weight Control Questionnaire." Adherence to weight control was associated with various lifestyle domains. Several predictors were identified for lifestyle and adherence to weight control among overweight adolescents. A broad array of inter-correlations and predictors were identified and should be taken into account when designing adolescent weight control interventions.
This long-term prospective study examined whether illness self-concept (or the degree to which chronic illness becomes integrated in the self) mediated the pathway from self-esteem to problem areas in diabetes in emerging adults with Type 1 diabetes. Having a central illness self-concept (i.e. feeling overwhelmed by diabetes) was found to relate to lower self-esteem, and more treatment, food, emotional, and social support problems. Furthermore, path analyses indicated that self-esteem was negatively related to both levels and relative changes in these problem areas in diabetes over a period of 5 years. Illness self-concept fully mediated these associations.
Body dissatisfaction can be significantly detrimental to wellbeing. Little is known about older adults’ body image, despite the fact that ageing causes unique bodily changes and that sociocultural pressures to resist these changes abound. We conducted six focus groups with a UK community sample of White British and South Asian older adults aged 65–92 years. Thematic analysis highlighted four themes: appearance indicates capability and identity; physical ability trumps appearance; felt pressures to age ‘gracefully’ while resisting appearance changes; and gender and cultural differences. These findings suggest that older adults’ body image can have important implications for their wellbeing and merits researchers’ attention.
Depression in people with amyotrophic lateral sclerosis, a fatal and progressive neurodegenerative disorder, is a serious issue with important clinical consequences. However, physical impairment may confound the diagnosis when using generic questionnaires. We conducted a comprehensive review of literature. Mean scores from depression questionnaires were meta-regressed on study-level mean time since onset of symptoms. Data from 103 studies (3190 subjects) indicate that the Beck Depression Inventory and, to a lesser degree, the Hospital Anxiety and Depression Scale are influenced by the time since symptom onset, strongly related to physical impairment. Our results suggest that widely used depression scales overestimate depression due to confounding with physical symptoms.
This study evaluated the body image perception in children with type 1 diabetes in order to identify symptoms of disordered eating behaviours early. Children with type 1 diabetes and controls showed underestimation and dissatisfaction with body size. The patients, especially girls, were more accurate in their perception of body size than the control group. The study sheds light on some of the underlying factors that may contribute to the development of disordered eating behaviours in adolescence. The causes of the differences of perception of body size are discussed.
Dance interventions have physical benefits for the elderly, especially those with Parkinson’s disease. This study assessed the psychological benefits of dance. A total of 37 participants, with either Parkinson’s disease (n = 22) or age-matched controls (n = 15) completed mood questionnaires before and after a 10-week dance intervention. An overall reduction in total mood disturbance and a specific reduction in anger were observed. In addition, less fatigue was found for those initially scoring higher in depression. This suggests that dance can provide psychological benefits for both people with Parkinson’s disease and the elderly, with findings suggesting that this is an avenue to be explored further.
Cardiovascular rehabilitation has been designed to decrease the burden of cardiovascular disease. This study described (1) patient–health-care provider interactions regarding cardiovascular rehabilitation and (2) which discussion elements were related to patient referral. This was a prospective study of cardiovascular patients and their health-care providers. Discussion utterances were coded using the Roter Interaction Analysis System. Discussion between 26 health-care providers and 50 patients were recorded. Cardiovascular rehabilitation referral was related to greater health-care provider interactivity (odds ratio = 2.82, 95% confidence interval = 1.01–7.86) and less patient concern and worry (odds ratio = 0.64, 95% confidence interval = 0.45–0.89). Taking time for reciprocal discussion and allaying patient anxiety may promote greater referral.
A participatory action approach was used to design and evaluate the acceptability of the Realshare online community. Pre- and post-intervention focus groups were conducted and participants were asked to test out Realshare during two intervention periods: when a facilitator was present and when one was not. Focus group data and forum messages were thematically analysed. The themes identified related to participants’ website design requirements, how they used the community and the evaluation of Realshare after having used it. Amendments were made to Realshare throughout the project. Realshare is available to young oncology patients in the South West of England.
A total of 148 health and social care practitioners were trained in skills to support behaviour change: creating opportunities to discuss health behaviours, using open discovery questions, listening, reflecting and goal-setting. At three time points post-training, use of the skills was evaluated and compared with use of skills by untrained practitioners. Trained practitioners demonstrated significantly greater use of these client-centred skills to support behaviour change compared to their untrained peers up to 1 year post-training. Because it uses existing services to deliver support for behaviour change, this training intervention has the potential to improve public health at relatively low cost.
Considered to be a chronic recidivist condition, obesity places significant burdens on the society. The search for appropriate interventions remains challenging. Research suggests individuals’ environments should be considered when addressing eating behaviours. Nomothetic accounts of the dieting experiences of eight self-selected British Jews within a commercially run, community-based weight-management programme adapted to Jewish participants’ cultural needs were explored using interpretative phenomenological analysis. Four themes were identified: ‘Me, myself and I’, ‘behaviour change’, ‘structural framework’ and ‘social interaction’. Emergent aspects were social support and structural flexibility to motivate participants to initiate and sustain behaviour change. Implications for future weight-loss interventions are discussed.
Nonsuicidal self-injury e-communication has gained heightened empirical and public interest. This is the first study to examine possible motives for nonsuicidal self-injury e-communication. A total of 68 nonsuicidal self-injury e-community members responded to open-ended questions concerning reasons for starting, temporarily stopping, and continuing nonsuicidal self-injury e-communication. Results from a thematic analysis indicated that being motivated to obtain support, get nonsuicidal self-injury help, help others, and better understand nonsuicidal self-injury represented motives for starting nonsuicidal self-injury e-communication. For some, negative interactions and accessing triggering material contributed to e-communication stoppage; these individuals continued e-communication to get support and help. Implications for research and e-outreach are discussed.
Based on the fluency theory, a recent study by Dohle and Siegrist revealed that complex pharmaceutical drug names are perceived as more hazardous than simple drug names and thus negatively influence patients’ willingness to buy. This study explored the malleability of the name fluency effect on pharmaceutical drug perception by examining the fluency effect in the domain of risk versus advancedness judgment. The findings indicated that depending on how the fluency feeling is interpreted in the context of initial judgment task (e.g. advancedness vs risk), disfluent drug names can positively influence a patient’s perception of the drug, reversing the typical fluency effect.
Fatigue is a debilitating symptom of chronic illness that is deleteriously affected by perceived stress, a process particularly relevant to inflammatory disease. Hopefulness, a goal-based motivational construct, may beneficially influence stress and fatigue, yet little research has examined these associations. We assessed the relation between hope and fatigue, and the mediating effect of stress, in individuals with fibromyalgia, arthritis, and inflammatory bowel disease. Covarying age, sex, and pain, stress partially mediated the association between hope and fatigue; those with greater hope reported less stress and consequent fatigue. Therapeutically, bolstering hope may allow proactive management of stressors, resulting in less fatigue.
This study explored whether fertility-specific distress varied by race/ethnicity among a nationally representative sample of US women. Participants were 2363 White (n = 1266), Black (n = 569), Hispanic (n = 453), and Asian (n = 51) women who participated in the National Survey of Fertility Barriers. Participants were given the Fertility-Specific Distress Scale and assessed for strength of pregnancy intent, primary versus secondary infertility, and socioeconomic hardship. Black women reported lower levels of fertility-specific distress than White women, but these were fully mediated by the strength of pregnancy intentions. Primary versus secondary infertility and economic hardship were not associated with fertility-specific distress.
This study investigated the relationship between attachment representations and help received from informal caregivers after elective surgery. In total, 98 respondents reported on their attachment toward their informal caregiver before surgery and on the amount of help they received from the caregiver after surgery. We found that anxious attachment was negatively related to all types of support except for ensuring and explaining medical care, whereas avoidant attachment was negatively related to emotional types of support. This study extends previous findings by demonstrating the influence of attachment representations on help received in the context of the unique help provided after elective surgery.
This study set out to explore the experience of food cravings and thirst, and their management strategies in patients on hemodialysis. Semi-structured interviews with N = 32 hemodialysis patients were analyzed thematically. Findings indicated that food cravings and thirst were common in everyday life of patients and resulted in different emotional responses. A combination of cognitive and behavioral strategies was employed, including avoidance, controlled consumption, and substitution. Self-monitoring and compensatory strategies were also used to prevent or compensate for lapses. These findings lay the groundwork for future work aimed to improve adherence in end-stage renal disease patients.
To inform the development of a measure of caregiver burden for carers of children with chronic kidney disease, interviews were conducted with 16 caregivers and 10 renal healthcare professionals. A pool of 97 items generated from interviews was reduced to 60 items following review. A piloting exercise provided evidence for the usability, readability and relevance of items and informed further adaptations resulting in the 51-item Paediatric Renal Caregiver Burden Scale. Further to assessment of its psychometric properties, it is hoped that that the Paediatric Renal Caregiver Burden Scale will serve as a useful measure of caregiver burden in paediatric chronic kidney disease.
In this article, we examine how HIV/AIDS caregivers negotiate stigma in their discourse of providing care to HIV-positive individuals. Using interview data, we demonstrate how participants employed discourse of control in attempting to avoid and counter HIV-related stigma: participants rejected fear of associating with HIV-positive individuals by drawing on their knowledge of HIV transmission and their ability to control and avoid infection. Such discourses backfire, however, as the concept of HIV infection being controllable and thus avoidable maintains accountability for the disease. Thus, participants’ micro discourse of control can maintain the macro discourse that produces HIV-related stigma.
Research focused on assessing weight stigmatization has typically been conducted using cross-sectional, retrospective designs. Such designs may impair the scientific understanding of this stigma by limiting participants’ recall of frequencies and/or details about stigmatizing events. To address this, 50 overweight/obese women were recruited from public weight forums to complete week-long daily diaries. A total of 1077 weight-stigmatizing events were reported on the Stigmatizing Situations Inventory. Hierarchical linear modeling was used to investigate potential relationships between participant-level factors and reported stigmatization. Results indicate that body mass index, education, age, daily activities, and interpersonal interactions all may impact individuals’ levels of stigmatization.
The results of research linking age and sexual risk among men who have sex with men have been inconsistent. This study assessed the relationship between age and sexual risk among 193 Black men who have sex with men in Pretoria. Older men who have sex with men reported engaging in more frequent unprotected insertive anal intercourse. We examined whether components of Information–Motivation–Behavioral Skills model mediated this relationship. Results showed that (1) older age predicts less positive attitudes toward condoms, (2) less positive attitudes predict more frequent unprotected insertive anal intercourse, and (3) attitudes mediate the relationship between age and frequency of unprotected insertive anal intercourse. We consider two possible explanations for these findings: a developmental trajectory and a cohort effect.
We examined the association of mothers’ thin-ideal internalization and children’s drive for thinness. Early adolescents (175 girls and 198 boys) completed a questionnaire to assess their drive for thinness and perceptions of mothers’ attitudes and behaviors related to body shape. The questionnaire for mothers (n = 206) measured mothers’ thin-ideal internalization. Mothers’ thin-ideal internalization was associated with girls’ drive for thinness through the perception of mothers’ attitudes directed to girls, and with boys’ drive for thinness through mothers’ weight-loss behavior. The findings suggest the possibility that mothers transmit social standards on body shape to their children.
Participation in regular physical activity promotes physical health and psychosocial well-being. Interventions are thus needed to promote physical activity, particularly among groups of individuals, such as persons with disability, who are marginalised from physical activity. This study explored the experiences of a group of South African adolescents with cerebral palsy. In-depth semi-structured interviews were conducted with 15 adolescents with cerebral palsy. The results provided insight into a range of factors that promote and hinder participation in physical activity among adolescents with cerebral palsy in resource-scarce environments.
This study main purpose was the validation of both French and German versions of a Perceived Neighborhood Social Cohesion Questionnaire. The sample group comprised 5065 Swiss men from the "Cohort Study on Substance Use Risk Factors." Multigroup Confirmatory factor analysis showed that a three-factor model fits the data well, which substantiates the generalizability of Perceived Neighborhood Social Cohesion Questionnaire factor structure, regardless of the language. The Perceived Neighborhood Social Cohesion Questionnaire demonstrated excellent homogeneity (α = 95) and split-half reliability (r = .96). The Perceived Neighborhood Social Cohesion Questionnaire was sensitive to community size and participants’ financial situation, confirming that it also measures real social conditions. Finally, weak but frequent correlations between Perceived Neighborhood Social Cohesion Questionnaire and alcohol, cigarette, and cannabis dependence were measured.
Identifying variables associated with patient activation in the multiple sclerosis population could serve to facilitate better multiple sclerosis self-management behaviors. Using a cross-sectional survey design, 199 participants were recruited from a multiple sclerosis center in the Southeastern United States. Depression, multiple sclerosis quality of life, and multiple Sclerosis self-efficacy were all significantly correlated with patient activation. Results of a hierarchical regression indicated that patient activation was significantly related to educational attainment, depression, and self-efficacy but not to quality of life. The results suggest several possible targets for intervention to increase patient activation, including health literacy, depression symptoms, and self-efficacy for multiple sclerosis disease management.
This study examined adolescent girls’ views of cosmetic surgery. Seven focus groups were run with girls aged 15–18 years (N = 27). Participants read case studies of women having cosmetic surgery, followed by discussion and exploration of their views. Thematic analysis identified four themes: (1) dissatisfaction with appearance, (2) acceptability of cosmetic surgery, (3) feelings about undergoing cosmetic surgery and (4) cosmetic surgery in the media. Results suggest the acceptability of cosmetic surgery varies according to the reasons for having it and that the media play an important role by normalising surgery and under-representing the risks associated with it.
This article focuses on limited knowledge regarding the associations among three levels of resilience and the importance of these associations: individual, community, and national. The few studies that have examined these associations indicated the following: (a) There are significant positive low correlations among individual, community, and national resilience. (b) Some demographic variables significantly predict all three of them. (c) There is limited knowledge whether and to what degree there are mutual influences among these levels of resilience. (d) All three levels of resilience predict individual well-being and successful coping with potential traumatic events.
This review aimed to provide an overview of the current research on the psychological impact of overactive bladder. A systematic search yielded 32 papers. It was found that people with overactive bladder tended to have greater levels of depression, anxiety and embarrassment/shame; difficulties with social life; impact on sleep and sexual relationships; and a lower quality of life than people without overactive bladder. A psychological impact on family members was also found. Psychological health should be considered an important aspect of managing overactive bladder and further research is required to determine how best to provide psychological care and support in this area.
Data from a cross-sectional study of gay, bisexual, and other men who have sex with men who were active methamphetamine users were analyzed to assess temporal relations between HIV seroconversion and initiation of methamphetamine use. Of the 100 men, 58 reported being HIV-positive. Most HIV-positive participants (65%) initiated methamphetamine use after seroconverting. Among those who initiated use before seroconversion, 8 years elapsed between onset of use and time of infection. Findings suggest the need to develop nuanced and targeted interventions aimed at disentangling the "meth-sex" link in this population. Findings also suggest use of the drug as a coping mechanism for those living with HIV.
This study assessed the extent to which older adults attribute a recent heart attack/stroke to "old age," and examined consequences for subsequent lifestyle behavior and health-care service utilization. Community-dwelling adults (N = 57, ages 73–98 years) were interviewed about their heart attack/stroke, and an objective health registry provided data on health-care utilization over a 3-year period. Endorsement of "old age" as a cause of heart attack/stroke negatively predicted lifestyle behavior change, and positively predicted frequency of physician visits and likelihood of hospitalization over the subsequent 3 years. Findings suggest the importance of considering "old age" attributions in the context of cardiovascular health events.
This study aimed to explore how core self-evaluations influenced job burnout and mainly focused on the confirmation of the mediator roles of organizational commitment and job satisfaction. A total of 583 female nurses accomplished the Core Self-Evaluation Scale, Organizational Commitment Scale, Minnesota Satisfaction Questionnaire, and Maslach Burnout Inventory–General Survey. The results revealed that core self-evaluations, organizational commitment, job satisfaction, and job burnout were significantly correlated with each other. Structural equation modeling indicated that core self-evaluations can significantly influence job burnout and are completely mediated by organizational commitment and job satisfaction.
This study examined the link between positive body image and a range of health behaviours. Participants were 256 women who completed an online questionnaire measuring body appreciation, body dissatisfaction, sun protection, cancer screening, seeking medical attention, weight-loss behaviour and alcohol and tobacco consumption. Results indicated that body appreciation was positively related to sun protection, skin screening and seeking medical attention and negatively related to weight-loss behaviour. Body appreciation explained unique variance, over and above body dissatisfaction, in sun protection, skin screening and weight-loss behaviour. These results have implications for interventions to improve adherence to health behaviours.
Considerable discussion has transpired regarding whether chronic fatigue syndrome is a distinct illness from Myalgic Encephalomyelitis. A prior study contrasted the Myalgic Encephalomyelitis International Consensus Criteria with the Fukuda and colleagues’ chronic fatigue syndrome criteria and found that the Myalgic Encephalomyelitis International Consensus Criteria identified a subset of patients with greater functional impairment and physical, mental, and cognitive problems than the larger group who met Fukuda and colleagues’ criteria. The current study analyzed two discrete data sets and found that the Myalgic Encephalomyelitis International Consensus Criteria identified more impaired individuals with more severe symptomatology.
Diverse works have associated externalizing problem behavior with impulsivity, parental styles, and attitudes toward violence. The aim of this study is to analyze the association between these variables and externalizing behavior. A cross-sectional correlational design was used with a sample of 252 adolescents, aged between 12 and 15 years, from the general population. The results obtained indicate a significant association of externalization with high impulsivity, ingrained attitudes toward violence, and inconsistent parental styles, as well as gender and age differences. These results are discussed in relation with the influence of gender stereotypes and their implications in the development of attitudes toward violence.
This qualitative study aimed to explore experiences of women currently undergoing specialist inpatient treatment for anorexia nervosa. Interviews were carried out with 21 women with a diagnosis of anorexia nervosa from a specialist adult inpatient eating disorder unit. Five master themes emerged using thematic analysis: (1) shifts in control, (2) experience of transition, (3) importance of supportive staff relationships, (4) sharing with peers and (5) process of recovery and self-discovery. Findings suggest that patients experience a process of change and adjustment in relation to levels of perceived personal control, attachment to the treatment environment and a sense of self-identity.
This study investigated the effects of experiences with weight stigma and weight bias internalization on exercise. An online sample of 177 women with overweight and obesity (M age = 35.48 years, M BMI = 32.81) completed questionnaires assessing exercise behavior, self-efficacy, and motivation; experiences of weight stigmatization; weight bias internalization; and weight-stigmatizing attitudes toward others. Weight stigma experiences positively correlated with exercise behavior, but weight bias internalization was negatively associated with all exercise variables. Weight bias internalization was a partial mediator between weight stigma experiences and exercise behavior. The distinct effects of experiencing versus internalizing weight bias carry implications for clinical practice and public health.
Puerto Rican adults in the United States mainland live with socioeconomic and health disparities. To understand their contextual experience of aging, we interviewed participants in the Boston Puerto Rican Health Study. Through a Thematic Analysis we identify themes and tensions: normalization and acceptance of aging; gratitude; the importance of aging within social networks; longing to return to Puerto Rico at older age. We address the tensions between ‘acceptance’ and fatalismo as a cultural belief, and a function of structural barriers. The experience of aging is discussed in the context of Puerto Rico’s history and continued dependence on the United States.
The purpose of this study was to explore the relationship between health literacy and specific cognitive abilities in hospital users. A neuropsychological battery was administered and the Short Test of Functional Health Literacy in Adults was used to classify individuals as having adequate or limited functional health literacy. Of the 322 participants, 102 (31.7%) presented limited health literacy. Even after adjusting for demographics, years of education, and quality of education, health literacy was strongly associated with measures of cognitive performance, but the strength of association was variable across different cognitive abilities.
This study examined illness representations of new influenza Human Swine Influenza A (H1N1) and association with H1N1 preventive behaviors among 300 Chinese adults using a population-based randomized telephone survey. Results showed that relatively few participants thought H1N1 would have serious consequences (12%–15.7%) and few showed negative emotional responses toward H1N1 (9%–24.7%). The majority of the participants thought H1N1 could be controlled by treatment (70.4%–72.7%). Multiple logistic regression analyses showed that treatment control (odds ratio = 1.78) and psychological attribution (odds ratio = .75) were associated with intention to take up influenza vaccination. Emotional representations were associated with lower likelihood of wearing face mask (odds ratio = .77) and hand washing (odds ratio = .67). Results confirm that illness representation variables are associated with H1N1 preventive behaviors.
Results of a cluster-randomized trial of a Screening and Brief Intervention for heavy drinkers in dental practice are reported. Data were obtained from 103 heavy drinking patients recruited from randomized intervention (7; n = 50) and control (6; n = 53) practices. Analysis of data revealed that 6-month decreases in total drinks per week were significantly (p < .05) greater for heavy drinking intervention (43%) than control patients (21%)—a 4 drink per week difference. Similar decreases were obtained for quantity and frequency among intervention patients compared to control patients. Despite power limitations, the 6-month results support the effectiveness of the Screening and Brief Intervention.
Self-esteem can be derived from the relationships with significant others (relational self-esteem). However, it is unclear what the importance of relational self-esteem is for mental health and whether social support from others promotes relational self-esteem. The aim of this study was to examine the relationship between relational self-esteem and a multitude of indicators of psychological well-being among children affected by HIV. We also examined how social support from others would affect relational self-esteem. Results indicated that relational self-esteem was positively associated with psychological well-being. Support from significant others rather than others predicted increased relational self-esteem. Implications and directions for future research are discussed.
This focus group study examined the social experiences of 10 adolescents aged 12–17 years with Moebius Syndrome, a rare condition involving congenital facial paralysis. Content analysis revealed five themes: social engagement/disengagement, resilience/sensitivity, social support/stigma, being understood/misunderstood, and public awareness/lack of awareness of Moebius Syndrome. Compared to previous research on adults with Moebius Syndrome, adolescents were more likely to experience bullying and social strain. Like adults, teenagers displayed resilience and communication skills. Greater public awareness is key to reducing the stigma associated with this condition, and social skills programs should be developed to support those who struggle with social functioning.
This study sought to investigate the role of weight status and body mass index percentile in risky smoking behaviors in male and female adolescents. Analyses of the data obtained in the 2011 Youth Risk Behavior Surveillance System were conducted. The national sample size included 15,425 adolescents. Questions addressing weight status and smoking behaviors were used in analyses. Significant effects of perceived weight status, weight change status, and body mass index percentile on smoking behaviors were found for both genders. The current findings indicate the importance of accounting for both gender and weight status when developing prevention and cessation programs targeting smoking behaviors.
In the development of somatosensory amplification, health anxiety, and modern health worries, environmental factors seem more important than genetic background. Parental attitudes might represent a major source of learning. In total, 186 adolescents and their parents completed a questionnaire assessing modern health worries, somatosensory amplification, health anxiety, and somatic symptoms. Adolescents’ modern health worries, somatosensory amplification, and health anxiety were positively related to respective parental characteristics in regression analyses even after controlling for sociodemographic variables and somatic symptoms. Parental beliefs may play a role in the development of these characteristics.
Many emerging adults live with mild-to-moderate visible facial acne, but little is known about their experiences. A qualitative interview study was conducted with 11 adults aged 18–22 years, which aimed to explore the meaning of living with visible acne. A thematic analysis revealed three superordinate themes: coping strategies, self-perceptions and interpersonal relationships. Results revealed the utility of researching visible acne in emerging adulthood, including the use of multiple coping strategies. Health psychologists need to consider individual differences for young adults who are living with a visible difference. The importance of the peer group and family is also explicated.
This study examined the Social Comparison Scale in Spanish chronic illness context and analyzed its psychometric properties. The article presented the results of two studies. The first explored the test’s dimensional structure in a sample of 202 patients in a range of several chronic illnesses. The second study examined the instrument’s structure in a sample of 186 patients with specific chronic illness. The results replicated the original structure of the scale and proved to be valid for use with optimum reliability.
The purpose of the study was to develop a Short-Form Chinese version of the Health and Safety Executive’s Management Standards Indicator Tool that can be used to measure work-related stress among nurses in Taiwan. Three subscales (supportive climate, role perception, and workload) were developed from an exploratory factor analysis. The three-factor confirmatory factor analysis indicated that the model fit the data well. The evidence based on convergent validity was supported by a significant correlation between the Short-Form Chinese version of the Health and Safety Executive’s Management Standards Indicator Tool and the job satisfaction subscale of the Chinese Patient Safety Attitude Questionnaire. Cronbach’s α values demonstrated internal item consistency for the Short-Form Chinese version of the Health and Safety Executive’s Management Standards Indicator Tool.
This study used Rasch analysis to examine the psychometric validity of the Illness Perception Questionnaire–Revised to assess beliefs about diabetes in 470 participants with Type 2 diabetes and 71 participants with Type 1 diabetes. All Illness Perception Questionnaire–Revised scales had psychometric issues, which included poorly utilised response categories, poor scale precision and multidimensionality. Following re-engineering, only four of the eight scales (Consequences, Illness coherence, Timeline cyclical and Emotional representations) were psychometrically adequate according to the Rasch model. The diabetes-specific version of the Illness Perception Questionnaire–Revised provides suboptimal assessment of beliefs held by patients with diabetes.
Our article illustrates the importance of authenticity to student non-drinkers. Semi-structured interviews focussing on the lived experiences of five non-drinking students were subjected to interpretative phenomenological analysis. We present four inter-related themes: ‘Retaining authenticity by not drinking’, ‘Tainting the self by drinking alcohol’, ‘Feeling trapped by superimposition and self-exposition’ and ‘Doing what you want to do with your life’. Self-authenticity informed the decision not to drink, became relevant within conversations about non-drinking and underscored issues of choice and agency raised by alcohol consumption. Entrenched assumptions about alcohol’s self-realising utility are challenged in our discussion, and future research recommendations are suggested.
Depression and diabetes have been linked in a variety of ways, and the presence of depression in those with diabetes can negatively affect adherence to care recommendations. A sample of 201 participants with Type 2 Diabetes completed a cross-sectional survey that assessed depressive symptoms, adherence, self-efficacy, social support, and personal characteristics. Multiple regression analysis was used to test whether self-efficacy and social support mediate the relationship between depressive symptoms and adherence. The findings suggest complete mediation via self-efficacy and some types of social support. Intervening to bolster self-efficacy and social support may decrease the negative effect of depression on adherence.
This study examined the relationship between resilience, social capital and self-rated health among 263 HIV-positive South Africans living in poverty, using questionnaires. Self-rated good health was predicted by younger age, trust in community-based organizations and having contacts of different religions. The findings highlight the importance of community-based networks and resources for care and support for persons living with HIV/AIDS in poor, rural areas. Furthermore, resilience, which also related positively to education and income, contributed positively to self-rated health, drawing attention to the interplay between resources at individual and community levels.
We examined the role of comorbidity in models that use the illness perceptions of patients with somatoform disorders to explain their outcomes. A total of 138 primary care patients with somatoform disorders completed the Patient Health Questionnaire and Brief Illness Perception Questionnaire and rated their general health status. Medical comorbidity was rated by the general practitioner. Patients’ illness perceptions were consistently related to their outcomes independent of medical and psychological comorbidity in our models. At the same time, inclusion of comorbidity enhanced our models, revealing differences in the relevance of the specific comorbidity depending on the outcome measure.
This article reports on two major quality-of-life perception changes for patients who had undergone plastic surgery following dramatic weight loss. The exploratory, qualitative study was undertaken with 20 patients from one teaching hospital. In-depth interviews were conducted, and a thematic analysis of the data was undertaken. The results provide unique glimpses of surgical consumption empowering and facilitating ‘identity transformation’, embracing improved physical function and enhanced self-esteem, confidence and quality of life, and a ‘changed lifestyle’. For a minority, identity transformation was sometimes interrupted by ‘identity lag’, posing the need for additional health-care support throughout the adjustment process. The study provides additional insight into existing quantitative studies, adding to the body of knowledge in this area.
The concept of resilience remains under-researched in the multiple sclerosis literature. Consequently, current understanding of the unique and joint contribution of disability-specific variables, cognitive-behavioural skills and social resources to this dynamic process is limited. A holistic model of resilience was therefore developed and tested. Results of an online survey completed by 196 adults with multiple sclerosis revealed both direct and indirect pathways to resilience, with positive affect and self-efficacy being the strongest predictors. The findings lend support to psychological interventions which focus on promoting the personal resources and assets needed to cope effectively with multiple sclerosis.
This study used Q-methodology to explore systematically parental judgements about infant immunisation. A total of 45 parents completed a 31-statement Q-sort. Data were collected after vaccination in general practitioner practices or a private day nursery. Q factor analysis revealed four distinct viewpoints: a duty to immunise based on medical benefits, child-orientated protection based on parental belief, concern and distress and surprise at non-compliance. Additionally, there was a common view among parents that they did not regret immunising their children. Implications of these results are discussed in terms of health-care policy and future research.
This study examined child anxiety as a potential moderator of the relationship between parenting stress and child physical health. Low-income youth (N = 109, M = 9.51 years old) and their parents completed measures of anxiety, health-related quality of life, and parenting stress in an outpatient clinic. As an objective measure of physical health, medical service utilization was extracted from medical records. Parenting stress was associated significantly with worse health-related quality of life and higher service utilization. Child anxiety moderated the relationship between stress and health. Health psychologists should target both family stress and child anxiety in promoting better health outcomes among low-income families.
To study emotional distress in symptomatic and asymptomatic long QT syndrome mutation carriers who had experienced a recent stressful life event. The participants were 209 symptomatic and 279 asymptomatic long QT syndrome mutation carriers. Emotional distress was assessed with the Cope questionnaire and stressful life events with the Social Readjustment Rating Scale. Symptomatic long QT syndrome mutation carriers with burdening recent stressful life events reported a higher emotional distress (β = 0.35, p < 0.001), while the asymptomatic did not show such difference (β = 0.13, p = 0.393). Symptomatic long QT syndrome mutation carriers who have experienced stressful life events recently report an increased emotional distress.
Studies have shown that preterm birth significantly influences mothers’ psychological health. This study aimed to identify factors associated with preterm birth and assess postnatal depression and anxiety symptoms in mothers of preterm infants (n = 75) compared to mothers who delivered at term (n = 125) in a Greek sample. Multiple pregnancies, assisted reproduction technology, caesarean section, non-Greek ethnicity and smoking during pregnancy were associated with preterm delivery. Moreover, preterm infants’ mothers had higher depression, state anxiety and trait anxiety scores. These findings suggest that addressing preventable causes of preterm delivery is crucial, while mothers of preterm infants should receive postnatal support.
Acute spinal cord injury leaves patients severely impaired and generates high levels of psychological distress among them and their families, which can cause a less active role in rehabilitation, worse functional recovery, and less perceived satisfaction with the results. Additionally, rehabilitation professionals who deal with this psychological distress could ultimately experience higher stress and more risk of burnout. This article presents the study protocol of the ESPELMA project, aimed to train rehabilitation professionals in the clinical management of acute spinal cord injury–associated psychological distress, and to measure the impact of this training on the patients’ perceived satisfaction with treatment.
This article reports on a study, utilising phenomenological methodology, which used interview and video narratives to collect data from 10 young people with autism and their parents. Data analysis employed multistage, primarily ethnomethodological methods in order to interpret and understand experiences of autism. The study found that parents, arguably influenced by the medical and psychological perspectives through which ‘autism’ has evolved, problematise what children with autism do as pathological. This article juxtaposes parents’ understandings against how children with autism, themselves, account for what they do, by exploring respective accounts of children’s obsessions and ritualistic behaviours.
Despite its popularity, few studies have assessed the temporal stability and cross-lagged effects of the Theory of Planned Behavior factors: Attitude, subjective norms and self-efficacy. For this study, 298 adolescent learners from KwaZulu-Natal, South Africa, filled out a Theory of Planned Behavior questionnaire on teenage pregnancy at baseline and after 6 months. Structural equation modeling showed that there were considerable cross-lagged effects between attitude and subjective norms. Temporal stability was moderate with test–retest correlations ranging from 0.37 to 0.51 and the model was able to predict intentions to have safe sex (R2 = 0.69) Implications for practice and future research are discussed.
Reducing perceptions of illness intrusiveness may improve quality of life and mental health among patients with cardiopulmonary disease. To better understand relationships between coping style, locus of control, perceived illness intrusiveness, and disease severity, we analyzed data from 227 older Veterans with chronic obstructive pulmonary disease or congestive heart failure. Regressions revealed illness intrusiveness to be associated with younger age and greater disease severity, less internal locus of control, and avoidant/emotion-focused coping. Avoidant/emotion-focused coping but not active coping mediated the relationship between illness severity and illness intrusiveness. Findings suggest that supportive psychological interventions may reduce illness intrusiveness by targeting an avoidant/emotion-focused coping style and associated behaviors.
The present studies examine whether information contained in medical records can be used to predict outcomes following two orthopedic procedures: repair of hip fracture and total knee replacement. Study 1 reports the acute, in-hospital recovery data from the medical records of 119 hip fracture patients. Study 2 is a prospective, longitudinal investigation of 3-month postoperative recovery of 110 total knee replacement patients. Patients characterized by a greater number of post-traumatic stress risk factors experienced poorer outcomes following orthopedic surgery. Our results suggest that patients at risk for negative outcomes can be identified by information readily available to medical personnel.
Two studies (N = 136) investigated whether or not gender or mortality reminders would impact middle-aged and older adults’ appraisal of a novel point-of-care testing device for cardiovascular disease risk. Middle-aged females were significantly more likely to positively appraise and commit to using the device compared to middle-aged males, but there were no such gender differences among older adults. Both studies also failed to support hypotheses that existential concerns would lead to avoidance of the device. When taken together, the findings suggest that similar devices may beneficially affect screening behaviours and underscore a need to target middle-aged males for cardiovascular screening interventions.
In this article, we present an idiographic analysis of a couple’s experience of living and coming to terms with age-related macular degeneration. Interpretative phenomenological analysis was used to explore three joint interviews, conducted over an 18-month period, with a married couple (aged 82 and 77 years) both living with age-related macular degeneration. Three themes are discussed: the disruption of vision impairment, managing mutual deterioration and resilience through togetherness. We discuss the existential challenges of vision impairment and consider the applicability of Galvin and Todres’ typology of well-being as a means of understanding well-being in older adults.
Insufficient attention has been given to the influence of context on health-related behaviour change. This article reports on walk-along interviews conducted with 10 leaders of walking groups while leading their groups to investigate the influence of contextual factors on walking behaviours in groups. Data analysis used ideas from thematic analysis and grounded theory, approaching the data inductively. We identified that characteristics of place influenced the type of walking that people do in groups and the processes used by walkers to make sense of their behaviours in the places they walk. This research provides insight into how place influences walking in groups. It also suggests recommendations for co-ordinators and policymakers that could be used to facilitate behaviour change, when designing interventions targeting public health within the community.
Little is known about the use of lapse prevention strategies to help smokers manage situation-triggered urges to smoke. Pregnant smokers (N = 174) participating in an intervention trial reported use of cognitive–behavioural lapse prevention strategies and smoking abstinence (biochemically verified). Participants typically enacted few strategies. Distraction strategies were most commonly used. Total number of strategies used did not predict abstinence. However, using ‘self-talk’ (odds ratio (OR) = 3.44, 95% confidence interval = 1.14–10.40) or ‘avoiding spending time with other smokers’ (OR = 4.01, 95% confidence interval = 1.34–11.95) independently increased the odds of abstinence. The promotion of these and other under-utilised evidence-based strategies warrants further attention.
The Theory of Planned Behavior was used to identify the key behavioural, normative and control beliefs underlying intentions to test regularly for chlamydia among young people living in socially and economically deprived areas – a high-risk group for infection. Participants (N = 278, 53% male; mean age 17 years) were recruited from a vocational college situated in an area in the most deprived national quintile (England). Participants completed measures of behavioural, normative and control beliefs, plus intention to test regularly for chlamydia. The behavioural, normative and control beliefs most strongly correlated with intentions to test regularly for chlamydia were beliefs about stopping the spread of infection, partners’ behaviour and the availability of testing. These beliefs represent potential targets for interventions to increase chlamydia testing among young people living in deprived areas.
This article provides the first assessment of theory of mind, that is, the ability to reason about mental states, in adult patients with congenital heart disease. Patients with congenital heart disease and matched healthy controls were administered classical theory of mind tasks and a semi-structured interview which provides a multidimensional evaluation of theory of mind (Theory of Mind Assessment Scale). The patients with congenital heart disease performed worse than the controls on the Theory of Mind Assessment Scale, whereas they did as well as the control group on the classical theory-of-mind tasks. These findings provide the first evidence that adults with congenital heart disease may display specific impairments in theory of mind.
We investigated whether older adults with diabetes mellitus and lower resilience have an increased risk of diabetic neuropathy as compared to older adults with higher resilience, and whether this association varies by socioeconomic position. In total, 3942 individuals took part in a health survey in Augsburg, Germany, in 2008–2010 (KORA-Age study). We found that among participants with low socioeconomic position, those with higher resilience had a lower probability of suffering from neuropathy as compared to participants with lower resilience (absolute risk reduction = 10%). Adjusted odds ratio with 95% confidence intervals for the outcome diabetic neuropathy also showed that lower resilience scores had an independent effect in increasing the risk of diabetic neuropathy among elderly individuals with a low socioeconomic position (odds ratio: 1.83; confidence interval: 1.09–3.08). Health-promoting strategies focussing on resilience should be further explored.
This study explored the relationship between implicit theories of the body (ITB) and self-reported physical activity. ITB are beliefs about the malleability of the body. Individuals may hold entity ITB (that body appearance is fixed) or incremental ITB (that body appearance can be changed). Female undergraduate students (N = 313) completed an online survey assessing ITB, physical activity, and discrepancy between actual and ideal body weight. Participants endorsing incremental ITB reported more physical activity. A significant ITB by weight discrepancy interaction emerged. Developing interventions targeting implicit theories of the body may be one way to increase physical activity.
This study examined the direct and stress-buffering effects of global hope and its components (agency and pathways) on changes in adjustment to multiple sclerosis caregiving over 12 months. A total of 140 carers and their care-recipients completed questionnaires at Time 1 and 12 months later, Time 2. Focal predictors were stress, hope, agency and pathways, and the adjustment outcomes were anxiety, depression, positive affect, positive states of mind and life satisfaction. Results showed that as predicted, greater hope was associated with better adjustment after controlling for the effects of initial adjustment and caregiving and care-recipient illness variables. No stress-buffering effects of hope emerged. Regarding hope components, only the agency dimension emerged as a significant predictor of adjustment. Findings highlight hope as an important protective resource for coping with multiple sclerosis caregiving and underscore the role of agency thinking in this process.
This study explored the association between personal resilience and distress, coping, and diabetes outcomes in 50 adolescents with type 1 diabetes. Resilience was defined by a factor score derived from validated instruments measuring self-efficacy, optimism, and self-esteem. Variable- and person-focused methodologies were used to explore these associations. Low resilience was associated with higher distress, poor quality of life, and poor glycemic control. Participants with low resilience used more maladaptive coping strategies and were at greatest risk of poor outcomes. Findings suggest that resilience is a promising candidate for interventions designed to reduce distress and improve outcomes for adolescents with type 1 diabetes.
Health workers who work with people who inject drugs may believe that their colleagues hold less favorable attitudes toward health services for people who inject drugs than themselves—a phenomenon termed pluralistic ignorance. This research explores whether the presumed attitudes of their colleagues, rather than their own attitudes, predict the behavioral intentions of health workers toward people who inject drugs. A total of 57 hospital-based health workers were surveyed to assess their attitudes toward harm reduction services for people who inject drugs and their perceptions of colleagues’ attitudes. They then responded to a scenario assessing their likelihood of prescribing opiate-based medication to people who inject drugs. Data illustrate that participants support harm reduction services for people who inject drugs more than they believe their colleagues do, demonstrating pluralistic ignorance. Interestingly, participants’ prescription of opiate-based pain medication was predicted by beliefs about their colleagues’ support for services for people who inject drugs, rather than their own beliefs.
The aim of this study was to examine the mental health of cardiac patients with diabetes and whether symptoms varied by gender and/or age. Screening for depression and posttraumatic stress symptoms was conducted on 1003 patients with cardiovascular disease. Correspondence analysis was utilized to identify clinical core profiles. Results suggested that cardiovascular disease patients with diabetes, particularly males, experience high rates of depression, suicide ideation, and posttraumatic stress symptoms. Clinical implications of these findings include targeted mental health screening options as well as offering a closer look at the specific concerns of cardiovascular disease patients with diabetes.
Little is known about the impact of HIV and aging on cognitive functioning. This New York City cross-sectional study of aging HIV-positive gay and bisexual men assessed their neuropsychological state. Working memory and verbal abstract reasoning were relatively intact. After 55 years of age, attention abilities were impaired. Executive function impairment was present regardless of age and education. Results suggest the need for HIV-specific norms, and the use of neuropsychological assessments (i.e. baseline and over time) as a cost-effective way to assess HIV-related cognitive decline in developed and under-developed countries.
The workplace is an important location to access community members, and employers have a direct interest in employee well-being. A survey administered to a random sample of employees at a Midwestern US university tested the ability of a model informed by the theory of planned behavior to predict hand hygiene practices and beliefs using structural equation modeling. Questions demonstrated acceptable validity and reliability. Constructs predicted self-reported hand hygiene behaviors, and hand hygiene behaviors reduced the odds of reporting sickness from respiratory tract and gastrointestinal infections. The findings support multi-modal hand hygiene improvement interventions.
The article explores the Freirian theory of social change underpinning health-related community mobilisation in poor and marginalised communities. Highlighting potential shortcomings of its essentialist understandings of power and identity, and linear notions of change, it examines how lessons from the ‘new left’, and burgeoning global protest movements, can rejuvenate the field given the growing complexity of 21st-century social inequalities. It suggests the need for a pastiche of approaches to accommodate health struggles in different times and places. However, while needing some updating, Freire’s profound and actionable understandings of the symbolic and material dimensions of social inequalities remain a powerful starting point for activism.
Although research suggests that posttraumatic stress disorder symptoms in relation to physical health diagnoses may be related to poor adherence to treatment regimens, so far, whether parental posttraumatic stress disorder symptoms have an impact on their child’s adherence to insulin-dependent diabetes mellitus treatment has not been investigated. Using self-report questionnaires, the present study found that children of mothers who have posttraumatic stress disorder symptoms in relation to their child’s diagnosis of type I diabetes showed poorer adherence to treatment than the children of mothers without posttraumatic stress disorder. However, this was only the case for younger children (aged 0–8 years) where mothers played a more active role in their child’s treatment.
In this study, participants (N = 223) were randomised to visualise snacking on fruit, visualise snacking on biscuit bars or no visualisation, and intentions and attitudes towards fruit and biscuit bars, immediate selection of fruit or biscuit bars and subsequent consumption were measured. No effects of visualising snacking on fruit were found once background variables were taken into account. Visualising snacking on biscuit bars, however, resulted in greater intentions to consume biscuit bars (smallest β = 0.19, p < 0.01). These findings suggest that specifics of the visualised target behaviour may be important in visualisation. Further investigation is needed before recommending visualisation for increasing fruit consumption.
Clustering patterns, among health-care personnel, of excessive concerns pertaining to perceived electromagnetic field–related health impacts, as contrasted to those from other environmental factors, were explored. Knowledge/excessive concerns of 722 health-care personnel were assessed using a 22-item structured questionnaire along with a double-phase qualitative study comprising semistructured interviews and focus groups. Over 75 percent of the participants had high perceived knowledge, whereas accuracy was limited to <20 percent and correctness to 8 percent. An "excessive concern" group was clearly distinguished from a "relaxed attitude" one. Clustering of excessive concerns may derive from personal beliefs, suggesting a risk governance issue for health education policies.
Human papillomavirus has largely been framed as a women’s health issue, and the psychosocial impact of human papillomavirus among men remains unclear. In this study, we found that women infected with human papillomavirus (n = 154) experienced a greater degree of negative emotions and stigma than human papillomavirus–infected men (n = 190). Among women, younger age and less education were associated with greater expression of negative emotions and stigma. Conversely, being single was significantly associated with a greater degree of negative emotions and stigma beliefs among men. These findings suggest the need to re-frame messages that both men and women receive regarding human papillomavirus.
In this article, we present a psychosocial theory of partnership, illustrated with case studies from Cambodia and Brazil. Partnerships are conceptualised as encounters with the knowledge of self and others, entailing processes of representation and communication between all stakeholders involved, and shaped by institutional and sociocultural contexts. We argue that partnership is an evolving practice that requires critical reflection and the creation of enabling institutional contexts. As such, it must be understood not as a tool for intervention, but as part of the intervention and definition of success.
In order to examine mindfulness as an intervention for pain, 107 migraineurs, predominantly college students, were randomly assigned to brief training in standardized mindfulness, spiritualized mindfulness, and simple relaxation instructions. After 2 weeks of daily practice, participants completed the cold-pressor task while practicing their assigned technique, and their experience of the task was assessed. Among the 74 study-completers, standardized mindfulness led to significantly reduced pain-related stress relative to simple relaxation, providing modest support for the utility of mindfulness in pain management. Pain-related outcomes in the spiritualized mindfulness condition were similar to those of standardized mindfulness, though spirituality did appear to enhance mindful awareness.
This study examined the association between propensity for emotional rehearsal, body image self-perception and weight status in Chinese Hong Kong pre-adolescents. Children 8–12 years of age (n = 278) completed measurement of body mass index, body image and emotional rehearsal. Multinomial regression analyses revealed that body mass index was positively associated with body image dissatisfaction and a significant predictor of body size estimation. However, only body size underestimation was associated with lower rehearsal tendencies. The prevalence of body image dissatisfaction and body size estimation was also reported for this population. Future research is suggested for greater understanding of emotional coping in body image dissatisfaction in young children.
This study investigated the relationship between lay theories of cigarette smoking and expectations to smoke. An incremental lay theory of smoking entails the belief that smoking behavior can change; an entity theory entails the belief that smoking behavior cannot change. Undergraduate nonsmokers and smokers completed a survey that assessed lay theories of smoking and smoking expectations. Results demonstrated that lay theories of smoking were differentially associated with smoking expectations for nonsmokers and smokers: stronger incremental beliefs were associated with greater expectations of trying smoking for nonsmokers but lower expectations of becoming a regular smoker for smokers. Implications for interventions are discussed.
The reliability of an item designed to measure health belief is often confounded with response consistency at the person level. The study applied contemporary measurement methods to an inventory of common sense beliefs about diabetes and used a sample of N = 563 adults with diabetes to test the hypothesis that individuals whose beliefs are congruent with a biomedical model are more consistent in their responses. Item-level analysis revealed that the domains of Causes and Medical Management were the least reliable. Person-level analysis showed that respondents who held views congruent with the biomedical model were more consistent than people who did not.
We adopted an intersectionality framework and examined whether the relationship between internalized HIV stigma and depressive symptoms is moderated by internalized substance use stigma. A total of 85 people living with HIV with a history of substance use in the Bronx, New York, completed a survey. Results revealed evidence of moderation: Participants who internalized HIV stigma experienced greater depressive symptoms only if they also internalized substance use stigma. Researchers should examine stigma associated with multiple socially devalued characteristics to best understand how stigma impacts mental health among people living with HIV. Healthcare providers should address stigma associated with the full range of socially devalued characteristics with which people living with HIV live.
Fibromyalgia is associated with widespread pain, depression, and declines in physical functioning. The purpose of this study was to examine the trajectory of these symptoms over time related to physical activity adoption and maintenance via motivational interviewing versus education, to increase physical activity. There were no treatment group differences; we divided the sample (n = 184) based on changes in physical activity. Repeated measures analyses demonstrated differential patterns in depression, pain, and physical functioning at 24 and 36 weeks. Findings suggest increased physical activity may serve as a multiple-target intervention that provides moderate to large, long-lasting benefits for individuals with fibromyalgia.
Previous research has indicated that both cognitive and behavioral variables mediate the positive effect of optimism on quality of life; yet few attempts have been made to accommodate these constructs into a single explanatory framework. Adopting Fredrickson’s broaden-and-build perspective, we examined the relationships between optimism, self-rated health, resilience, exercise, and quality of life in 365 Chinese university students using path analysis. For physical quality of life, a two-stage model, in which the effects of optimism were sequentially mediated by cognitive and behavioral variables, provided the best fit. A one-stage model, with full mediation by cognitive variables, provided the best fit for mental quality of life. This suggests that optimism influences physical and mental quality of life via different pathways.
This study provides a preliminary investigation of the role of stress management in multiple behavior change. Risk status on stress management and five health behaviors (healthy eating, exercise, alcohol, smoking, and depression management) was assessed before and after a multiple behavior change intervention. Findings suggested a link between stress management and a worse health risk behavior profile at baseline. Results also showed relationships between improved stress management over 6 months and heightened odds of improving on specific behaviors as well as improving one’s overall behavioral risk profile. Particularly strong links between stress management and energy balance and other affective behaviors were observed.
This systematic review synthesizes the complex literature on prognostic awareness in cancer. A total of 37 studies examining cancer patients’ understanding of their prognosis were included. Prognostic awareness definitions and assessment methods were inconsistent across studies. A surprisingly high percentage of patients (up to 75%) were unaware of their poor prognosis, and in several studies, even their cancer diagnosis (up to 96%), particularly in studies conducted outside of North America. This review highlights surprisingly low rates of prognostic awareness in patients with advanced cancer as well as discrepancies in prognostic awareness assessment, suggesting the need for empirically validated measures of prognostic awareness.
Eosinophilic gastrointestinal disorders (EGIDs) are chronic inflammatory conditions with increasing global prevalence. Self-efficacy is important for patients’ ability to manage chronic disease. We sought to evaluate disease-specific self-efficacy in the EGIDs via a modified version of the Inflammatory Bowel Disease Self-Efficacy Scale (IBD-SES). Ninety-one Participants reported demographic, clinical, and psychosocial variables. The IBD-SES demonstrated excellent reliability and validity in this population. Self-efficacy was higher in men, patients with less severe disease, and those who had consulted a dietitian. The IBD-SES is a useful measure of disease-specific self-efficacy in the EGIDs. Further research is necessary to understand the role of self-efficacy in the management of these illnesses.
This article develops a topological approach derived from Kurt Lewin to analyse the psychological life space/s produced in a mental health service user’s home. Drawing on arguments that space plays an important part in the organisation and management of mental distress, photographs of a service user’s home are analysed as topological spaces. The article argues that topological theory can contribute to community health psychology through framing psychological distress as spatially distributed, meaning individual bodies, environments and action are conceptualised as equally contributing to the organisation and management of health-related experience and activity.
This study investigates the relationship between psychosocial factors and functional gastrointestinal disorder symptomatology by testing a more comprehensive and integrated model than found in prior research. A total of 233 respondents completed an online battery to assess factors such as personality, dysfunctional cognitions and gastrointestinal anxiety. Results based on path modelling provided support for the majority of the hypothesised pathways. This study implicates a number of personality factors and dysfunctional cognitive processes as relevant to functional gastrointestinal disorder symptom burden. These findings have implications for future research, including which dysfunctional cognitive processes should be targeted therapeutically.
This research aimed to study tobacco advertising between 1950–2003 and to evaluate the role of the cigarette box in advertising. Tobacco company advertisements (n = 204) were coded for content and meanings used to promote their product. There was a significant shift from cigarettes being displayed to the cigarette box only. Changes in advertising and the meanings evoked were unrelated to changes in smoking behaviour. It is argued that the cigarette box has absorbed the meanings associated with smoking and has become an effective vehicle for advertising. It is also argued that this can only be minimised with plain packaging.
The 2004 Indian Ocean tsunami resulted in a tragic loss of life and immense suffering. This article explores the ways in which a group of people from Sri Lanka worked to address the disruption to their life narratives caused by the loss of loved ones. We go beyond a focus on ‘talk’ in narrative research in health psychology to explore the importance of material objects in sustaining continued bonds with the deceased. This article provides an alternative to the tendency in mainstream psychology to pathologise grief and highlights the importance of culturally patterned responses to disaster.
This qualitative study explores the experience of hepatitis C virus treatment for people with pre-existing mental health problems within a large city hospital. Four men and four women with pre-existing mental health problems who had received hepatitis C virus treatment took part in semi-structured interviews which were analysed using interpretative phenomenological analysis. A central theme of ‘Self, stigma and change’ was identified which interlinked with three other main themes of ‘Coping and responding to treatment’, ‘Connectedness to others’ and ‘The impact of information’. These themes and their sub-themes are discussed in relation to existing literature and clinical practice guidelines.
The current study assessed the reliability and validity of the Health Care Alliance Questionnaire, which was developed using a Delphi process and embedded in an ongoing perinatal outcomes study. The Health Care Alliance Questionnaire exhibited content and face validity and high reliability. Results indicated concurrent validity in relation to satisfaction with practitioner and discriminant validity in relation to interpersonal sensitivity and posttraumatic stress disorder. The Health Care Alliance Questionnaire demonstrated predictive validity in relation to perceptions of practitioner’s care during labor and postpartum depression. Overall, results suggest that alliance may be an important factor in maternity care processes and outcomes. Further psychometric work is warranted.
This article provides population norms for the Short Form Perceived Stress Scale (PSS-4) and investigates the relationship between PSS-4 scores and sociodemographic variables. The PSS-4 was administered to an English sample (n = 1568) and was found to have acceptable psychometric properties. Sociodemographic variables explained 19.5% of variance in PSS-4 scores, and mean PSS-4 scores were significantly different from the mean scores reported in Cohen and Williamson’s original study. Greater levels of perceived health status, greater levels of social support, being male and being older were predictive of lower PSS-4 scores. Norm values for interpreting PSS-4 scores are presented.
The article sets out the value of theorizing collective action from a social science perspective that engages with the messy actuality of practice. It argues that community health psychology relies on an abstract version of Paulo Freire’s earlier writing, the Pedagogy of the Oppressed, which provides scholar-activists with a ‘map’ approach to collective action. The article revisits Freire’s later work, the Pedagogy of Hope, and argues for the importance of developing a ‘journey’ approach to collective action. Theories of practice are discussed for their value in theorizing such journeys, and in bringing maps (intentions) and journeys (actuality) closer together.
While educational interventions to increase patient motivation to pursue living donor kidney transplant have shown success in increasing living donor kidney transplant rates, there are no validated, theoretically consistent measures of Stage of Change, a measure of readiness to pursue living donor kidney transplant; Decisional Balance, a weighted assessment of living donor kidney transplant’s advantages/disadvantages; and Self-Efficacy, a measure of belief that patients can pursue living donor kidney transplant in difficult circumstances. This study developed and validated measures of these three constructs. In two independent samples of kidney patients (N1 = 279 and N2 = 204), results showed good psychometric properties and support for their use in the assessment of living donor kidney transplant interventions.
This study investigated individual and incremental contributions of somatization and trait anxiety to pain report in children with pain-related functional gastrointestinal disorders. Eighty children (7–10 years) with pain-related functional gastrointestinal disorders completed the State-Trait Anxiety Inventory for Children, the Children’s Somatization Inventory, and 2-week pain diaries (assessing pain frequency and maximum pain). Hierarchical regressions indicated that both trait anxiety and somatization were significantly related to maximum pain and pain frequency, with somatization explaining more variance. Trait anxiety did not significantly add to prediction above somatization. Assessment of somatization may assist with treatment planning for children with functional abdominal pain.
Stigma-based bullying is associated with negative mental and physical health outcomes. In a longitudinal study, surveys and physical assessments were conducted with mostly Black and Latino, socioeconomically disadvantaged, urban students. As hypothesized, greater weight- and race-based bullying each was significantly indirectly associated with increased blood pressure and body mass index, as well as decreased overall self-rated health across 2 years, through the mechanism of more negative emotional symptoms. Results support important avenues for future research on mechanisms and longitudinal associations of stigma-based bullying with health. Interventions are needed to reduce stigma-based bullying and buffer adolescents from adverse health effects.
This study investigated the association between anxiety experienced by the mother, a request for analgesia, and the level of pain at maternity hospital admission in early labour. Anxiety levels were measured by the State-Trait Anxiety Inventory and pain was assessed using a Visual Analogue Scale. Anxiety and Visual Analogue Scale scores were compared using a linear regression model and indicated a statistically significant association between the anxiety state and degree of pain (p < 0.016; Y = 0.895 x score + 32.656). There was no significant association between anxiety and a request for epidural analgesia. During labour, an evaluation of anxiety should be associated with an assessment of the perceived degree of pain.
We investigated the cognitive and emotional reactions resulting from a human papillomavirus–related illness threat (i.e. testing positive for human papillomavirus) and the potential behavioral implications resulting from these psychosocial processes among men (N = 536). Structural equation modeling was used to explore a theoretical model explaining human papillomavirus vaccine intentions. The model fit the data well and explained 16 percent of the variance in vaccine intentions. Negative emotional response mediated the path between illness threat and vaccine intentions. Threat of genital warts was a salient concern and was positively associated with negative emotional response and subsequent vaccine intentions. Implications for vaccine promotion are discussed.
This study examined the relationship between self-esteem, restrained eating, body image and body mass index during pregnancy. A total of 110 pregnant Israeli and UK women completed the Rosenberg Self-Esteem Questionnaire, the Dutch Eating Behaviour Questionnaire, scales to assess body image and demographics. Body mass index was calculated from antenatal records. Regression modelling determined the relationship between variables, countries and body mass index categories. High correlations were found between body image and body mass index with significantly higher body dissatisfaction for Israeli women. Self-esteem scores for pregnant women were similar to those reported for non-pregnant women. Poorer body image and higher prevalence of restrained eating were found in healthy weight Israeli women.
Accurate illness perceptions are essential to the self-management of chronic illness. This study explored trajectories of illness perceptions in persons with morbid obesity (n = 53) and persons with chronic obstructive pulmonary disease (n = 52) following a patient education course. Participants completed the Brief Illness Perception Questionnaire five times over a 1-year period. Repeated measures analysis of variance was employed. Over time, obese participants perceived shorter illness duration, fewer consequences, less emotional stress, and more personal control. Chronic obstructive pulmonary disease participants had initial increases in personal control and understanding, but these changes were not maintained throughout the follow-up period.
A new non-pharmacological method of distraction was tested with 57 children during their annual flu vaccination. Given children’s growing enthusiasm for technological devices, a humanoid robot was programmed to interact with them while a nurse administered the vaccination. Children smiled more often with the robot, as compared to the control condition, but they did not cry less. Parents indicated that their children held stronger memories for the robot than for the needle, wanted the robot in the future, and felt empowered to cope. We conclude that children and their parents respond positively to a humanoid robot at the bedside.
This case study illustrates a participatory framework for confronting critical community health issues using ‘grass-roots’ research-guided community-defined interventions. Ongoing work in Cambodia has culturally adapted research, theory and practice for particular, local health-promotion responses to HIV/AIDS, alcohol abuse and other challenges in the community of Siem Reap. For resource-poor communities in Cambodia, we recycle such ‘older’ concepts as ‘empowerment’ and ‘action research’. We re-imagine community health psychology, when confronted with ‘critical’, life-and-death issues, as adjusting its research and practices to local, particular ontological and epistemological urgencies of trauma, morbidity and mortality.
Despite the technological and organisational advances of 21st century health-care systems, care scandals and burgeoning complaints from patients have raised concerns about patient neglect in hospitals. This article reviews the concept of patient neglect and the role of community health psychology in understanding its occurrence. Patient neglect has previously been conceptualised as a problem associated with hospital staff attitudes and behaviours, with regulation and training cited as solutions. Yet, a community health psychology perspective shows that the wider symbolic, material and relational aspects of care are crucial for understanding why patient neglect occurs and for outlining new solutions to augment existing interventions.
Inclusive, unconstrained and honest communication is widely advocated as beneficial and ethical. We critically explore this assumption by reflecting upon our research in acute care, informal care and public health. Using Habermas’ ideals of dialogue to conceptualise ideal speech, we concur with observations that health care is often characterised by intractable exclusions and constraints. Rather than advocating implementing the ideals of dialogue, however, we examine how people adapt to these difficult and intransigent contexts. Non-ideal contexts, we find, sometimes call for non-ideal responses. Deception and furthering personal interests, and thus departing from the ideals of dialogue, can be adaptive responses.
Freire’s theory of social change informs analysis of youth-focused participatory research, with researchers describing links between participation and young people’s critical thinking. There is less analysis of how youth move from the safe social space of a participatory research project to take health-promoting action in difficult real-world contexts. This article analyses a project conducted with Papua New Guinean youth, disrupting assumptions that critical thinking inevitably leads to critical action on health. Findings suggest the need to shift the focus of participatory research from supporting ‘safe social spaces’ to supporting ‘transformative action in context’ to concretely contribute to improving youth health.
Against the background of evidence for links between ill-health and prejudice, in this article we discuss how to promote inclusive communities in contexts of diversity. A brief critical overview of dominant psychological approaches to prejudice reduction reveals the apolitical nature of these approaches, and thus, we argue for a more contextual and political model on how to promote inclusive communities. Drawing on examples of different school practices on cultural diversity from across England, we argue that we need to develop a perspective that connects local contexts of everyday practice, resistance and agency to the institutional and structural realities of prejudice.
Patient and public involvement in health research, including mental health research, is promoted by research funders in England. However, it is poorly conceptualised. One argument is that patient and public involvement in research is an ethical imperative because those who research is for should have a stake in how it is done. This could be developed through concepts of citizenship and democratic science. More strongly, it can be argued that changing the knowledge producers will change knowledge itself. Starting with feminist standpoint epistemology, it is argued that a political conceptualisation best captures the new knowledge that marginalised health groups can produce.
Queer-theoretical resources offer ways of productively rethinking how central concepts such as ‘person-context’, ‘identity’ and ‘difference’ may be understood for community health psychologists. This would require going beyond consideration of the problems with which queer theory is popularly associated to cautiously engage with the aspects of this work relevant to the promotion of collective practice and engaging with processes of marginalisation. In this article, we will draw upon and illustrate the queer-theoretical concepts of ‘performativity’ and ‘cultural intelligibility’ before moving towards a preliminary mapping of what a queer-informed approach to community health psychology might involve.
This special issue celebrates and maps out the ‘coming of age’ of community health psychology, demonstrating its confident and productive expansion beyond its roots in the theory and practice of small-scale collective action in local settings. Articles demonstrate the field’s engagement with the growing complexity of local and global inequalities, contemporary forms of collective social protest and developments in critical social science. These open up novel problem spaces for the application and extension of its theories and methods, deepening our understandings of power, identity, community, knowledge and social change – in the context of evolving understandings of the spatial, embodied, relational, collaborative and historical dimensions of health.
This article argues that community health psychology’s core strategy of ‘community mobilisation’ is in need of renewal and proposes a new way of conceptualising community health action. Taking the Occupy movement as an example, we critique modernist understandings of community mobilisation, which are based on instrumental action in the service of a predetermined goal. Aiming to re-invigorate the ‘process’ tradition of community health psychology, we explore possibilities of an open-ended, anti-hierarchical and inclusive mode of community action, which we label ‘trusting the process’. The gains to be made are unpredictable, but we suggest that the risk is worth taking.
Adherence to antiretroviral therapy, while often conceptualised as an individual or community-level concern, needs to be understood in the context of political and historical developments that have characterised many resource-constrained societies. This article identifies some of these dimensions of antiretroviral therapy adherence in South Africa and outlines the implications for community health psychology in taking this perspective. Using the conceptual apparatus of therapeutic citizenship, we demonstrate the importance of historical, political and other structural barriers to adherence. We conclude by examining the implications of these debates for community health psychology that go beyond the individual as the unit of intervention and analysis.
The purpose of this study is to test cross-cultural predictions of the associations between goal pursuits and subjective well-being among 601 college students (200 in Japan and 401 in the United States). The results indicated that interdependence in all cultures was associated with socially oriented subjective well-being. In the United States, it was also correlated with social goal pursuit. However, independence in the United States correlated with individual-oriented subjective well-being, while in Hawaii, it also correlated with hedonic goal pursuit. Discussion of these results and their implications are provided.
Positive perceptions of illness are typically associated with good health outcomes. However, this may not be true for all domains of illness perception in neurodegenerative diseases because of their progressive incurable nature. The appropriateness of current measures of illness belief in these conditions is not known. The validity and reliability of the Illness Perception Questionnaire–Revised was evaluated in 215 participants with Parkinson’s disease. A confirmatory factor analysis supported the structure of the Illness Perception Questionnaire–Revised with the exception of the treatment control domain. It is important to consider the nature of neurodegenerative diseases and limits of symptom control when planning interventions.
The objective of this study was to develop the Pro-Change Functional Well-Being Scale, a measure that provides an informative evaluation of general functioning loss due to well-being-related barriers. Exploratory and confirmatory analyses on data from 642 individuals supported a one-factor solution with good model fit. A strong positive correlation existed between the Pro-Change Functional Well-Being Scale and Well-Being Assessment for Productivity. Initial construct validity was demonstrated by predictable relationships between functioning loss and other measures of health and well-being. This initial psychometric evidence suggests that the Pro-Change Functional Well-Being Scale is a reliable and valid assessment of functioning loss due to common well-being-related barriers.
The Short Health Anxiety Inventory is a common screening tool for assessing health anxiety among adolescents; however, its psychometric properties and internal structure have not been evaluated within a Spanish-speaking population. The goodness of fit of four models of the latent structure of the Short Health Anxiety Inventory was tested by using confirmatory factor analysis in a sample of 832 Spanish secondary school adolescents. Based on these results, the reliability of the original two-factor model was tested. Differences in health anxiety by gender and age were also examined. The results support use of the Spanish version of the Short Health Anxiety Inventory by researchers and clinicians among Spanish adolescents.
The purpose of this study was to examine the extent to which transformational teaching, exhibited by secondary school physical education teachers, predicts within-class physical activity and leisure-time physical activity among adolescents. The study used a prospective observational design and involved data collected from 874 Grade 10 adolescents (Mage = 15.41, (SD) = .61). Through use of structural equation modeling, the results revealed that adolescents’ perceptions of transformational teaching were positively related to within-class physical activity and leisure-time physical activity, and these effects were mediated by adolescents’ estimation of their teacher’s confidence in their abilities (i.e. relation-inferred self-efficacy) and self-efficacy beliefs.
Community participation in health has conventionally been described and analysed from a non-historical perspective, neglecting the central role that disadvantaged communities have played in the construction of health institutions in our societies, alienating collective health from its historical subject. From a socio-psychological perspective, this study explores the experiences of community participation in health during the Unidad Popular government in Santiago de Chile from 1970 to 1973, evidencing a radical pedagogical process inside poor urban settlements, aimed to transform Chilean classist health institutions. These findings contribute to a critical understanding of community participation in health, conceived as a dialectic and transformative action.
While feminist arts-based projects have gained legitimacy, theory guiding the use of visual images in field research has lagged. Drawing on psychoanalytic-feminist theory and participatory action research methods, the article presents a study carried out with women refugee and asylum seekers that focuses on their experiences in seeking a place of safety in the United Kingdom. The aim was to produce through photography and videography a collective account of asylum as a daily process. In discussing the study, the authors provide a psychoanalytic framework for working through ethical, political, and methodological dilemmas in the use of visual imagery in feminist research.
In the postindustrial era, global economic processes have constrained the ability of local agencies, service providers, and civic groups to respond to systemic challenges in public health. Community health psychology can benefit by focusing on interventions through mediating structures that develop innovative methods of leveraging power in the context of globalizing economic forces. Promising methods include careful analysis of power within targeted policy domains and developing strategic alliances with others, so as to exercise social power to affect policy change. The case of ISAIAH, an organizing group based in Minnesota, illustrates innovative avenues for intervention in the context of globalization.
Urban poverty and health inequalities are inextricably intertwined. By working in partnership with service providers and communities to address urban poverty, we can enhance the wellness of people in need. This article reflects on lessons learned from the Family100 project that explores the everyday lives, frustrations and dilemmas faced by 100 families living in poverty in Auckland. Lessons learned support the need to bring the experiences and lived realities of families to the fore in public deliberations about community and societal responses to urban poverty and health inequality.
Critics of empowerment have highlighted the concept’s mutability, focus on individual transformation, one-dimensionality and challenges of operationalisation. Relating these critiques to children’s empowerment raises new challenges. Drawing on scholarship on children’s subjecthood and exercise of power, alongside empirical research with children affected by AIDS, I argue that empowerment envisaged as individual self-transformation and increased capacity to act independently offers little basis for progressive change. Rather it is essential to adopt a relational approach that recognises the need to transform power relationships at multiple levels. This analysis has implications for our wider understanding of empowerment in the 21st century.
Street life can compromise a person’s health. In response, homeless people exert considerable agency in attempts to preserve their health. Drawing on ethnographic research in central Auckland, this article explores the ways in which a homeless man maintains his health. We consider the tactics Clinton develops to maintain his health and to gain respite while living on the streets, an unhealthy place. Of particular note are the ways in which he works to transform a ‘landscape of despair’ into a ‘landscape of care’. The case of Clinton foregrounds the fundamentally emplaced and relational nature of homeless peoples’ health.
This study investigated the prevalence of weight control and binge eating behaviors in a sample of 767 adolescent girls aged 16–20 years, and the differences between adolescents with and without altered eating behaviors regarding anthropometric and body image variables and beliefs associated with eating disorders. Adolescents who engaged in unhealthy strategies were found to be at a higher risk of eating disorders, since these behaviors were accompanied by higher levels of drive for thinness and body dissatisfaction, as well as by beliefs associated with the importance of weight and body shape as a means of personal and social acceptance.
The 10-item version of the Pregnancy-Related Anxiety Questionnaire–Revised was developed based on a sample of nulliparous women. Whether this measure is also a valuable tool for future research on pregnancy-specific anxiety is unclear. Our study tested for invariance of this measure across nulliparous women and parous women by using a dataset of 6004 women pregnant up to 35 weeks. Results showed that whereas the factor structure of the 10-item version of the Pregnancy-Related Anxiety Questionnaire–Revised was noninvariant, removing item 8 from the measure created a measure with invariant factor loadings that can be used for all pregnant women.
In Uganda, a nationwide scale-up of provider-initiated HIV testing and counselling presents an opportunity to deliver HIV-prevention services to large numbers of people. In a rural Ugandan hospital, focus group discussions and key informant interviews were conducted with outpatients receiving provider-initiated HIV testing and counselling and staff to explore the HIV-prevention information, motivation and behavioural skills strengths and weaknesses, and community-level and structural barriers to provider-initiated HIV testing and counselling acceptability and HIV prevention among this population. Strengths and weakness occurred at all levels, and results suggest brief client-centred interventions during provider-initiated HIV testing and counselling may be an effective approach to increase prevention behaviours in outpatient settings.
Chronic fatigue syndrome receives little attention in the medical curriculum. This study explores UK medical students’ knowledge of and attitudes towards chronic fatigue syndrome. Semi-structured interviews (average length 22 minutes) were conducted with 21 participants (7 females and 14 males) in years 3 (n = 4), 4 (n = 11) and 5 (n = 6) of their studies. Inductive thematic analysis taking a realist perspective produced three themes: limited knowledge, influences on attitudes and training needs. Students acquired their knowledge and attitudes largely from informal sources and expressed difficulty understanding chronic fatigue syndrome within a traditional biomedical framework. Incorporating teaching about chronic fatigue syndrome into the medical curriculum within the context of a biopsychosocial understanding of illness could encourage more positive attitudes towards chronic fatigue syndrome.
The study tested a moderated mediation model to examine the mechanisms underlying the link between media exposure and adolescent smoking intention by utilizing a modification of cultivation theory. A total of 12,586 non-current smoker adolescents in California were included in the analysis. Results showed that media exposure was positively related to smoking intention via perceived prevalence of peer smoking when friend disapproval of cigarette use was low. This study contributes to a better understanding of the mechanism regarding the media effects on smoking intention, but the findings should be interpreted with caution due to the small effect size.
We investigated the relationships between secondary traumatization, marital adjustment, and self-rated health among wives of former prisoners of war. Participants were Israeli wives of former prisoners of war (N = 116) and a matched control group of wives of combat veterans (N = 56). Wives of former prisoners of war reported worse self-rated health compared to the control group of wives of combat veterans. Wives of former prisoners of war also reported higher levels of secondary traumatization, and marital adjustment moderated the relationship between wives’ secondary traumatization and their general health. The experience of living with former prisoners of war who might also suffer from posttraumatic stress disorder is associated with wives’ own psychological and self-rated health outcomes.
Our aims were to compare the psychosocial functioning of a sample of adults with beta-thalassaemia major to that of a control sample and to examine the protective role of quality of relationship with parents during adolescence and perceived quality of care. A total of 85 Italian beta-thalassaemia major participants and 73 controls completed an ad hoc questionnaire. Compared with controls, beta-thalassaemia major participants did not differ on relationships with significant others and coping strategies. Beta-thalassaemia major participants reported higher scores on job satisfaction, self-esteem and self-description. The relationship with parents during adolescence and the perceived quality of care significantly predicted higher well-being and psychosocial functioning.
Using grounded theory methodology, this study examined the experiences of six BRCA1/2 gene mutation carriers (mean age = 38.5 years). Three types of stigmatization were identified: stigmatization by anticipation, stigmatization through rejection, and stigmatization by affiliation. Participants described potential impacts on their womanhood, felt threatened by others, and revealed fears that their children would inherit their stigmatization. These findings indicate the importance of psychological support in the follow-up of such patients.
A qualitative study was conducted within a randomised trial of facilitated physical activity for depression based on Self-Determination Theory and motivational interviewing. Interviews were held with 19 participants at 4 months, and 12 participants were re-interviewed 8 months later. The interviews were analysed in accordance with Grounded Theory using framework. Themes consisted of the following: relationship with the physical activity facilitators, mode of facilitation, impact of contact with physical activity facilitator/assimilation and future plans, change in activity, and effectiveness of physical activity facilitator techniques. Engagement in physical activity was enhanced within an autonomy-supportive environment.
The influence of acceptance in the progression of pain, physical limitation and depression was explored in the first 2 years of rheumatoid arthritis. Latent growth curve models showed significant increases in pain, physical limitation and depression. Besides that, the levels of pain and physical limitation at the baseline were associated with acceptance but not its progression across time. Therefore, patients with higher scores of acceptance reported less pain and physical limitation. The progression of depression was associated with acceptance; higher acceptance patients had slower growth rates of depression across time, even when pain and physical limitations increased. The inclusion of pain acceptance in clinical practice is discussed.
The present study examined the factor structure of 3 smoking-related items administered as part of the California Health Interview Survey. Factorial invariance was examined across Asian Americans (N = 377), Caucasians (N = 1739), African Americans (N = 115), and Latin Americans (N = 814), and across young men (N = 1612) and women (N = 1767). Factorial invariance analyses revealed all minority ethnic groups to be significantly different (p < .05) from Caucasians, and men to differ significantly from women. These findings suggest that the types of smoking behaviors assessed in the California Health Interview Survey do not predict behaviors uniformly across groups.
Chronic disease is an epidemic, one that requires patients to play an active role in managing symptoms and disease affect. This study used ethnomethodology (N = 8231) to understand how patients with arthritis use online health communities to exchange disease-related information to better manage their chronic disease. The findings show that online health communities facilitate self-management behaviors through the exchange of health information and disease experience. These online health communities act as self-management programs led by peers with the same chronic disease through the exchange of health information based on experience, working to improve members’ health literacy related to arthritis.
The evidence about psychological therapies used to manage co-morbid depression after a spinal cord injury is presented here. A comprehensive search of five electronic databases identified nine studies (participants, n = 591) meeting inclusion criteria. Pooled statistical analyses were conducted in combination with narrative synthesis. Overall, multimodal cognitive behavioural therapy was found to be moderately effective (standardised mean difference = –0.52; 95% confidence interval = –0.85, –0.19). Activity scheduling, psychoeducation, problem solving and cognitive therapy may be particularly beneficial therapies within cognitive behavioural therapy. Further high-quality randomised controlled trials are needed to better substantiate these findings.
Depression and hopelessness predict myocardial infarction, but it is unclear whether depression and hopelessness are independent predictors of myocardial infarction incidents. Hopelessness, depression, and myocardial infarction incidence rate 18 years later were measured in 2005 men. Cox regressions were conducted with hopelessness and depression serving as individual predictors of myocardial infarction. Another Cox model examined whether the two predictors predict myocardial infarction when adjusting for each other. Depression and hopelessness predicted myocardial infarction in independent regressions, but when adjusting for each other, hopelessness, but not depression, predicted myocardial infarction incidents. Thus, these results suggest that depression and hopelessness are not independent predictors of myocardial infarction.
The Drive for Muscularity Scale and Male Body Dissatisfaction Scale were developed for use with men and correspond to measures of drive for thinness and body dissatisfaction in women. The psychometric properties of these measures were evaluated in a sample of 655 Italian men, who completed other 11 measures also. Both scales demonstrated excellent internal consistency and temporal stability as well as criterion-related and concurrent validity. Both measures distinguished between men with high and low levels of disordered eating. Confirmatory factor analysis replicated the unidimensional factor structure of both scales. Directions for future research are discussed.
A study was conducted to examine the influence of a risk-oriented future self on self-reported marijuana use among college students. Drawing on theoretical work on possible selves, it was hypothesized that the extent to which a future self is viewed as risk-oriented will be associated with reported marijuana use and that effects of a risk-oriented future self on use would be partially mediated by risk-oriented attitudes and perceived attractiveness of users. Analysis of data from an online survey of college students supported hypotheses, with the additional finding that the effect of user attractiveness on use is mediated by attitudes.
Body dissatisfaction is recognized as a robust risk factor for eating disorders. Despite over 80% of college men are body dissatisfied, not all men report several levels of eating disorder symptoms. In this study, we examined poor impulse control, social anxiety and internalization of media ideals as potential moderators. Data collected from 405 college-aged men were analysed, using latent variable structural equation modelling approach. All variables investigated have been found to moderate the body dissatisfaction–eating disorder symptomatology, such that male body dissatisfaction was strongly related to men’s eating disorder symptomatology when each moderator was at its highest level. Practical implications are discussed.
Psychology is viewed by medical students in a negative light. In order to understand this phenomenon, we interviewed 19 medical students about their experiences of psychology in medical education. Interviews were transcribed verbatim and analysed using thematic analysis. Four main themes were generated: attitudes, teaching culture, curriculum factors and future career path; negative attitudes were transmitted by teachers to students and psychology was associated with students opting for a career in general practice. In summary, appreciation of psychology in medical education will only happen if all educators involved in medical education value and respect each other’s speciality and expertise.
Community-based health promotion has focussed on empowering disadvantaged groups, but there is growing awareness of the need to address everyday practices used to maintain power and privilege across social divisions. Participatory Action Research projects have proved subject to problems of resistance from dominant social groups. Social movements seeking to reshape power relations, give voice to excluded people and promote a social environment in which their problems are understood have been suggested as an alternative approach. A model of social movements based on theories and observations of social movement dynamics offers a practical framework for initiating such social change.
The graphic novel Cancer Vixen about breast cancer was used as an example to examine whether reading of graphic novels may enhance insight into illness experiences. Content analysis showed that the graphic novel depicts the full range of distress, by portraying practical, social, emotional, religious/spiritual and physical problems. Findings were illustrated with descriptions from the book. The results indicate that – from a content perspective – this graphic novel may be of value in medical education and health psychology settings to teach students and patients about the human side of being ill.
Inmates face a disproportionate burden of HIV. This study sought to explore the relationship between social support and physical and mental well-being and the possibility that housing stability moderates this relationship among jail detainees living with HIV. Data for this cross-sectional analysis come from 438 clients who underwent a structured interview. Results indicate a significant positive relationship between social support and both types of well-being (ps < .05); the experience of homelessness was associated with less mental well-being (p < .01). There was no evidence of moderation. Results highlight the importance of social support and economic considerations in understanding well-being among HIV+ jail detainees.
Several studies have found disruptions in cortisol awakening response in informal caregivers. Institutional support may modulate these effects, and this study analyses how the health of caregivers is affected when institutional support is provided for families of people with high-functioning autism. Self-reported health, depression and cortisol awakening response were analysed in three groups: supported caregivers, non-supported caregivers and non-caregivers. Non-supported caregivers presented higher somatic symptoms and lower cortisol awakening response than the supported caregiver and non-caregiver groups. A high number of somatic symptoms and low functionality of offspring were related to a lower cortisol awakening response only in the non-supported caregiver group. These findings demonstrate the importance of institutional support for improving the health of caregivers.
Chronic anorexia nervosa (cAN) is a challenging presentation for the clinician. Motivation to recover is low, and outcomes are often poor. Within this study. six participants, currently in treatment, were interviewed. These interview transcripts were analysed using Interpretative Phenomenological Analysis. The results highlighted five superordinate themes resulted from the analysis and these referred to the following points: (1) ‘making sense of AN’, (2) ‘experience of treatment/treatment’, (3) ‘interpersonal relationships’, (4) ‘battling with anorexia’ and (5) ‘staff pessimism in the treatment of cAN’. These results highlighted how the self is entwined with anorexia nervosa and thus making it incredibly difficult to perceive a life without cAN.
Waterpipe tobacco smoking is increasing in the United States among college students. Through a web-based survey, we explored associations among factual and perceived knowledge, perceived risks and worry about harm and addiction, and desire to quit among 316 college waterpipe tobacco smoking users. Overall, factual knowledge of the harm of waterpipe tobacco smoking was poor, factual and perceived knowledge was weakly correlated, both forms of knowledge were related inconsistently to perceived risks and worry, and neither form of knowledge was associated with the desire to quit. Findings provide preliminary insights as to why knowledge gaps may not predict cessation among waterpipe users.
This study investigated how people’s attitudes and motivations towards losing weight are influenced by societal pressures surrounding weight loss, their interaction with the obesogenic environment and individuals’ attitudes and motivations towards weight. Semi-structured qualitative interviews were conducted with 10 women currently attending commercial weight-loss programmes. Participants experienced conflicting messages regarding weight norms, with the media portraying powerful social norms relating to thinness and beauty, and changes to the food environment and interactions with family and friends commonly undermining weight-loss activities and promoting increased consumption. Providing social and environmental support for the behaviours needed to produce weight loss may need to be a primary focus for obesity policy.
To develop effective interventions to increase cervical cancer screening among Latinas, we should understand the role of cultural factors, such as time perspective, in the decision to be screened. We examined the relation between present time orientation, future time orientation, and self-reported cervical cancer screening among Latinas. A group of 206 Latinas completed a survey measuring factors associated with screening. Logistic regression analyses revealed that future time orientation was significantly associated with self-reported screening. Understanding the influence of time orientation on cervical cancer screening will assist us in developing interventions that effectively target time perspective and screening.
There is a high unmet need for contraceptives in developing countries such as Uganda, with high population growth, where efforts are needed to promote family planning and contraceptive use. Despite this high need, little research has investigated applications of health-behaviour-change theories to contraceptive use among this population. This study tested the Theory of Planned Behaviour’s ability to predict contraceptive-use-related behaviours among post-partum women in rural Uganda. Results gave modest support to the theory’s application and suggest an urgent need for improved theory-based interventions to promote contraceptive use in the populations of developing countries.
This study examined the association between mental adjustment styles and quality of life, and affect as a mediator among 238 Chinese cancer survivors. Regression analysis showed that quality of life was positively associated with fighting spirit and negatively associated with fatalism. Path analysis showed that greater fighting spirit was associated with more positive affect, which in turn was associated with higher quality of life. Greater fatalism was associated with less positive affect and more negative affect, which in turn was associated with lower quality of life. Findings suggest that positive affect and negative affect are important in understanding mental adjustment styles and its health implications.
To reduce negative psychological affect from information or behavior that is inconsistent with one’s positive self-concept, individuals use a variety of defensive strategies. It is unknown whether correlates differ across defenses. We examined correlates of four levels of defensive information processing about colorectal cancer screening. Cross-sectional surveys were completed by a convenience sample of 287 adults aged 50–75 years. Defenses measures were more consistently associated with individual differences (especially avoidant coping styles); however, situational variables involving health-care providers also were important. Future research should examine changes in defenses after risk communication and their relative impact on colorectal cancer screening.
A key role of clinicians is to motivate their patients to initiate and maintain beneficial health behaviors. This article integrates research on transformational leadership, clinician–patient communication, and health behavior to introduce a novel approach to understanding and improving clinicians’ effectiveness as motivators. We describe three dominant clinician styles or patterned approaches to patient care that derive from leadership theory (in order of least to most effective): laissez-faire, transactional, and transformational. Additionally, we suggest potential mediators and effects of the transformational style of care. Finally, we discuss future research directions for the study of clinician styles of care.
Millions of people in Bangladesh drink arsenic-contaminated water despite increased awareness of consequences to health. Theory-based and evidence-based interventions are likely to have greater impact on people switching to existing arsenic-safe wells than providing information alone. To test this assumption, we first developed interventions based on an empirical test of the Risk, Attitudes, Norms, Abilities and Self-regulation (RANAS) model of behaviour change. In the second part of this study, a cluster-randomised controlled trial revealed that in accordance with our hypotheses, information alone showed smaller increases in switching to arsenic-safe wells than information with reminders or information with reminders and implementation intentions.
This study aimed at exploring the hematologists’ internal representation of a difficult encounter with a hemophilic patient, using a written open format. Narrations were analyzed with Interpretative Phenomenological Analysis. Three main issues were identified, each with sub-issues: (1) Inside the relationship: to tell or not to tell, the balance between a normal life and a deviant medical condition, the guilt; (2) The borders of the professional role: professional values, the "do-it-all" doctor; and (3) The existential confrontation. This study reveals the deep involvement of physicians with their patients, at a professional level and, strongly, at a personal level. The experience of being so deeply involved should be considered in the continuing medical programs for physicians dealing with hemophilia.
This research assessed whether affective factors promote and prevent family members from donating their loved one’s organs. Participants (N = 191) imagined that a family member had died and that they had to decide whether or not to donate their organs and body parts for transplantation purposes. The least organs and body parts were donated when the deceased opposed donation. Moreover, participants who were not registered organ donors donated fewer organs than registered donors. This effect was mediated by anticipated regret, disgust and the perceived benefits of donation. Organ donation campaigns should target such factors to increase donor rates.
In India in 2009, it was estimated that 2.4 million people were living with HIV, which equates to a prevalence of 0.3 percent. While this seems low, because India’s population is so large, this rate is third in the world in terms of the absolute number of people living with HIV/AIDS. This study evaluated the self-esteem and quality of life of people living with HIV/AIDS in the Indian population using a correlational design. A significant positive correlation between self esteem and the different dimensions of quality of life was established. Interventions designed for people with HIV/AIDS could well include self esteem as a moderator of quality of life.
Research suggests that perceiving cancer as a death sentence is a critical determinant of health care–seeking behaviors. However, there is limited information regarding the prevalence of this perception in the US population. Cross-sectional analysis of data (n = 7674 adults) from the 2007-2008 administration of the nationally representative Health Information National Trends Survey (HINTS 3) was performed. A majority (61.6%) of respondents perceived cancer as death sentence, and more than one-third (36%) of respondents reported that they avoid seeing their physicians. In the adult US population, perceiving cancer as a death sentence is common and is associated with education level and avoidance of physicians.
The aim of this study was to validate the measurement properties of the Danish version of the Illness Perception Questionnaire–Revised adapted to measure symptom representations among patients with colorectal cancer symptoms. A total of 488 colorectal cancer patients completed a questionnaire derived from the Illness Perception Questionnaire–Revised to retrospectively assess cognitive and emotional representations of experienced symptoms. A confirmatory factor analysis indicated no good comparative fit with the Illness Perception Questionnaire–Revised. Using exploratory factor analysis, a 7-factor structure was conducted, which fairly supported the Illness Perception Questionnaire–Revised. The modified Illness Perception Questionnaire–Revised is a promising tool for measuring symptom representations among Danish colorectal cancer patients.
The ‘Teddy Bear Hospital’ is a medical students’ project, which has been increasingly established in many countries. To evaluate this concept, we examined the effects of a German Teddy Bear Hospital on children’s knowledge relating to their body, health and disease. Using a quasi-experimental pre/post design, we examined 131 preschool children from 14 German kindergartens with pictorial interview-based scales. The analysis of covariance revealed that the children who visited the Teddy Bear Hospital had a significantly better knowledge concerning their body, health and disease than the children from the control group. This German Teddy Bear Hospital is a good health education vehicle for preschool children.
This study analyzed the mediating role of psychological morbidity and the variables that discriminated low versus high disability, in patients receiving physiotherapy and acupuncture. A total of 203 patients answered measures of illness and medication representations, coping, depression, anxiety, quality of life, and functional disability. Morbidity was a mediator between functional disability and quality of life. Treatment consequences and quality of life, in the acupuncture group, and emotional representations, quality of life, depression, anxiety, and active strategies for pain relief, in the physiotherapy group, discriminated patients with low versus high disability. These results have important implications for identifying high-risk patients.
This study investigated ‘healthy’ participants’ perceptions of types 1 and 2 diabetes using mixed methods. A total of 38 participants were asked about their perceptions of both types of diabetes using video-based vignettes of four cases. Participants answered standardised questionnaires while thinking aloud and could expand during semi-structured interview sections. Four themes were identified: knowledge of diabetes, power to influence diabetes, limitations of responsibility or blame for diabetes and feelings about individuals with diabetes. Perceived controllability of causes and perceptions of illness management informs understanding of stigma and risk and emphasises the importance of comparing perceptions of both types of diabetes.
This study explored six women’s experiences of primary dysmenorrhoea using semi-structured interviews analysed using interpretative phenomenological analysis. Rather than focusing on pain, participants broadened the study focus to coping with the menstrual process as a whole. This was seen to be mediated by menstrual taboos and by the theme of ‘order’, arising from a strong feeling of a menstrual timetable and the need for rational explanation. Another theme was pain as a separate entity, which was connected to the theme of order. Placing dysmenorrhoea in its context may be useful for health-care professionals treating women with the condition.
Criterion validity of a novel accelerometry device that measures caloric expenditure (Fitbit) was evaluated against a self-report estimation of caloric expenditure (Community Healthy Activities Model Program for Seniors) in older adults. Community Health Activities Model Program for Seniors and Fitbit estimates of total caloric expenditure per day were significantly correlated (r = .61, p < .05). Bland–Altman plots indicated that 70 percent of participants’ data were within 1 standard deviation of the mean difference between measures. These preliminary findings suggest that the Fitbit may be considered a viable instrument for measuring daily caloric expenditure among older adults. However, further work is required to determine the optimal measurement technique for caloric expenditure among older adults.
Rumination is a vulnerability factor for the onset and maintenance of emotional distress. This study examined whether writing about life goals is associated with a decrease in ruminative thinking and a reduced cortisol awakening response. 68 healthy participants either wrote about their personal life goals or a control topic. Writing about life goals was associated with a modest decrease in ruminative thinking and a reduced cortisol awakening response at the post-intervention assessment. Results provide initial evidence that writing about life goals can be a helpful aid in decreasing rumination and physiological stress reactivity.
This study (n = 304) examined the relationship between somatic symptoms and social anxiety. Significant differences in the experience of somatic symptoms were found among four groups (i.e. performance anxious, interaction anxious, generalized socially anxious, and controls). Post hoc analyses revealed that those who exceeded the clinical cutoff for generalized social anxiety exhibited more somatic symptoms than those who exceeded the clinical cutoff in the other two social anxiety domains or controls. Individuals in each group exhibited more somatic symptoms than controls, but subtypes did not differ in the amount of somatic symptoms experienced. Additionally, regression analyses revealed that type of somatic symptoms experienced varied depending on subtype.
Using baseline data from ELSA-Brasil (N = 15,105), we investigated whether subjective social status, measured using three 10-rung "ladders," is associated with self-rated health and smoking, independently of objective indicators of social position and depression symptoms. Additionally, we explored whether the magnitude of these associations varies according to the reference group. Subjective social status was independently associated with poor self-rated health and weakly associated with former smoking. The references used for social comparison did not change these associations significantly. Subjective social status, education, and income represent distinct aspects of social inequities, and the impact of each of these indicators on health is different.
This study examines the relationship of personality traits and affect on cancer-related pain in 150 older adults receiving outpatient treatment at a comprehensive cancer center. Regression analyses revealed extraversion as a significant predictor of current pain, with openness to experience as a significant indicator of average pain. Similarly, positive affect and negative affect were significant predictors of self-efficacy for pain management. Moderation models showed that conscientiousness and extraversion were significant moderators in the relationship between self-efficacy for pain management and worst pain. These findings suggest that different personality types may influence perceptions of pain severity.
This study examined whether engagement in fat talk would moderate the association between weight status (body mass index) and depression between female friends. Individuals’ body mass index was significantly related to their own (actor effect) and friend’s (partner effect) depression. For low-fat-talk friends, higher actor’s body mass index was associated with higher actor’s depression, but not for high-fat-talk friends. For high-fat-talk friends, higher actor’s body mass index was associated with higher partner’s depression, but not for low-fat-talk friends. Theoretical and practical implications are discussed.
The impact of pharmaceutical drug names on people’s evaluations and behavioural intentions is still uncertain. According to the representativeness heuristic, evaluations should be more positive for complex drug names; in contrast, fluency theory suggests that evaluations should be more positive for simple drug names. Results of three experimental studies showed that complex drug names were perceived as more hazardous than simple drug names and negatively influenced willingness to buy. The results are of particular importance given the fact that there is a worldwide trend to make more drugs available for self-medication.
If perfectionists avoid engaging in preventive health behaviours, they may be putting their long-term health and well-being at risk. Correlational analyses based on a sample of 370 university students identified maladaptive perfectionism to be associated with decreased levels of engagement in preventive health behaviours, life satisfaction and well-being and increased levels of self-concealment and psychological distress. Adaptive perfectionism was associated with higher levels of engagement in preventive health behaviours. Self-concealment was identified as a partial mediator in the relationship between maladaptive perfectionism and both engagement in preventive health behaviours and psychological distress. Implications of the findings are discussed.
Based on self-determination theory, this study explored the potential mediating role of basic psychological need satisfaction in the relationship between materialism and well-being among Chinese college students. The results showed that basic psychological need satisfaction partially mediated the relationship between materialism and life satisfaction and fully mediated the relationships among materialism and emotional well-being, subjective vitality, and self-actualization. The findings indicated the importance of considering both subjective and psychological well-being and the interpretative power of basic psychological need satisfaction and Chinese culture in the flow from materialism to well-being.
This study aimed to examine the effects of 75 cardiac patients’ and their spouses’ illness cognitions of acceptance and helplessness on their own and their partner’s psychological symptoms, as well as the impact of marital quality. Dyadic responses were examined with the Actor–Partner Interdependence Model, while PROCESS was used to examine possible conditional indirect effects. Patients’ and spouses’ cognitions were related to their partners’ symptoms through the partners’ cognitions. These relationships were not statistically significant at the higher levels of marital quality. Thus, there seems to be a flow of information between partners, while marital quality may impact self-regulation processes.
This study examined the latent factor structure of the General Health Questionnaire–28 (GHQ-28) in a Black South African sample (N = 523). Results of the single-group confirmatory factor analysis support the universal four-factor structure of general psychological health observed in Western samples. However, multigroup confirmatory factor analyses (i.e. split-sample cross-validation approach, conducted with invariance analyses) for a three-factor structure suggest that psychological health could have a less differentiated dimensional structure in some African populations. Theoretical and practical implications of the study results are discussed.
Little is known about how outcome expectations change after physical activity initiation and whether changes are associated with physical activity experiences. In a diary study, physically inactive adults (N = 102) initiated an exercise regimen and reported their experiences daily (e.g. progress toward goals) and corresponding outcome expectations weekly (e.g. how much progress they expect this week). Average levels (between-person effects) for eight experiences (ps < .01) and deviations from the average levels (within-person effects) for three experiences (ps < .05) were associated with changes in outcome expectations. The findings demonstrate that outcome expectations for exercise vary over time and are associated with people’s subjective experiences.
Previous work suggests a four-factor structure of the Modern Health Worries Scale. This study is the first to investigate its dimensionality and factorial invariance across age and sex in a representative population sample (N = 2524) using confirmatory factor analysis. The proposed four-factor model failed to achieve good model fit. Model fit was optimized by allowing correlating error terms resulting in acceptable model fit. Multi-group analysis revealed invariance across age and sex. Our study proved the proposed four-factor structure across age and sex. Consequently, the Modern Health Worries Scale can be applied in general population surveys using subscale scores.
This study investigated whether gender-role related traits agency and communion contribute to successful health behavior change, in an interplay with domain-specific psychosocial factors, namely, agency, mediated by health-related self-efficacy, and communion, moderated by social support. Data from women (N = 282) participating in the GOAL Lifestyle Implementation Trial were analyzed using structural equation modeling. Agency and increase in self-efficacy both independently predicted waist circumference reduction in the 1-year follow-up. Individuals high in communion succeeded in waist reduction only if they received social support. Initial self-efficacy increase predicted 3-year waist reduction. Gender-role orientation, together with social environment, influences behavior change intervention outcomes.
This study assessed whether people’s affective attitudes predicted organ donor registration at a later time. People who were not registered as an organ donor prior to completing the study (N = 150) first rated their affective attitudes towards organ donation. We then measured whether they clicked on a hyperlink to register as an organ donor. Believing that the body should be kept whole for burial (bodily integrity) was the only affective attitude to predict this organ donation behaviour. Future campaigns should target this concern in order to increase organ donor registration and the availability of donor organs.
Men’s help-seeking behaviour for health issues is apparent in advice columns in men’s magazines. This study discursively analysed men’s help-seeking letters and expert replies within two international and popular men’s magazines, Men’s Health and For Him Magazine or FHM. Findings showed that the texts reinforced hegemonic ideals. Letters positioning men as self-reliant, independently knowledgeable, stoic and avoiding associations with femininity were positively reinforced in expert replies, while other types of positioning were responded to with condescension or ridicule. Results suggest the policing of boundaries by ‘experts’ around unacceptable/acceptable enactments of masculinity, which may have implications for if, how and when men seek help from experts.
The Sleep Quality Questionnaire was developed and its reliability and validity were estimated. Four samples involving approximately 1400 Japanese college students and employees were used to examine the factor structure, the test–retest reliability, convergent validity, and incremental validity. Sleep Quality Questionnaire scores were associated with well-being, such as general health states, depressive symptoms, chronic fatigue, and quality of life. Test–retest estimates indicated that Sleep Quality Questionnaire scores were stable over an 8-week period. The Sleep Quality Questionnaire incrementally contributes to well-being even beyond the Epworth Sleepiness Scale and to sleep duration. Overall, the data suggest that the Sleep Quality Questionnaire scale is both reliable and valid.
Chronic pain is common in individuals with multiple sclerosis and spinal cord injury and is associated with depressed mood. This may be because pain creates interference in performing and enjoying valued activities. The importance of pain interference may also vary with age, since older adults may have lowered expectations regarding function. This study analyzed relationships among pain variables, age, and mood in 521 individuals with multiple sclerosis or spinal cord injury. As predicted, pain interference mediated the relationship between pain severity and depressed mood. There was no evidence that older adults were less distressed by pain interference than were younger adults.
Inconsistent results have been reported on the effects of distraction on negative emotions during medical procedures in infants. These differing results may be attributable to the fact that the effects are apparent under a mildly stressful medical procedure. A total of 17 infants, 18 preschoolers, and 15 school-aged children who were hospitalized were administered, monitoring for vital signs, a mildly stressful medical procedure, by a nurse in a uniform with attractive character designs as a distractor. Consistent with the hypothesis, participating infants showed fewer negative behaviors and lower salivary α-amylase levels when distracted. The results support the efficacy of distraction in infants under a mildly stressful medical procedure.
The current study examined the prototypical profiles of posttraumatic stress reactions among a sample of 282 adolescent survivors of the 2008 Wenchuan earthquake in China. Based on a dimensional perspective, the results of profile analysis via multidimensional scaling (PAMS) model revealed a two-dimensional solution corresponding to four profiles: intrusion, avoidance/arousal, partial avoidance, and hyperarousal. These profiles of posttraumatic stress symptoms equally manifested across gender. In addition, the Intrusion Profile was found to be associated with more elevated psychological distress symptoms. Results are discussed with respect to the typical posttraumatic stress symptoms following the earthquake.
The congruency hypothesis posits that approach-orientated individuals are persuaded to engage in prevention behaviours by positively framed messages; conversely, negatively framed messages are more persuasive in encouraging those who are avoidance-orientated. A 2 (frame: loss vs gain) x 2 (motivation: avoidance vs approach) design examined the effects of skin cancer information on sun-protective intentions and free sunscreen sample requests among 533 young adults. Gain-framed messages had the strongest effect on sun-protective intentions for approach-oriented individuals, whereas loss-framed messages had the strongest effect on avoidance-oriented individuals. Message framing effects on precautionary sun behaviour intentions were moderated by motivational differences.
This research encompasses a community sample of 497 women in peri- and post-menopause and uses structural equation modelling to investigate the structural models of weight variation and weight gain. Variables such as body shape concerns, depression, stress and life events are explored. Weight gain (from pre-menopause to current menopausal status) was observed in 69 per cent of participants. The predictors of weight gain were lower education level (β = –.146, p = .017), less or no physical exercise (β = –.111, p = .021), having a recent psychological problem (β = .191, p < .001), transition from peri- to post-menopause (β = .147, p = .013) and more frequent body shape concerns (β = .313, p < .001). Prevention of weight gain in pre-menopause is recommended; risk groups should be targeted considering the predictors of weight increase.
Undergraduate women (N = 143) completed self-reports on exercise behavior, body orientation, body appreciation, and body-related talk. Results showed that conversations about weight loss/dieting and conversations about exercise differentially predicted body appreciation. Importantly, multiple regression analyses showed that the relationship between talk type and body appreciation was explained by the object–process dichotomy: Conversations about exercise oriented women to consider what their bodies can do which, in turn, predicted appreciation of one’s body. In contrast, the relationship between conversations about weight loss/dieting and body appreciation was mediated by negative attitudes about one’s body but not by an object orientation.
This study explored adjustment in people with spinal cord injury; data from four focus groups are presented. Thematic analysis revealed four themes, managing goals and expectations, comparison with others, feeling useful and acceptance, showing participants positively engaged in life, positively interpreted social comparison information and set realistic goals and expectations. These positive strategies show support for adjustment theories, such as the Cognitive Adaptation Theory, the Control Process Theory and Response Shift Theory. These results also provide insight into the adjustment process of a person with spinal cord injury and may be useful in tailoring support during rehabilitation.
We examined the hypotheses that proposing higher levels of emotional intelligence (ability test and self-report) and lower neuroticism, extraversion, and agreeableness associate with lower levels of disordered eating. In a correlational study, 126 Israeli college students completed two measures of emotional intelligence, a brief five-factor personality test, demographic data questionnaires, and questionnaires assessing food preoccupation, namely, the Body Weight, Image and Self-Esteem Scale and the Appearance Schema Inventory. Results suggested that ability emotional intelligence is associated with disordered eating beyond gender and personality. Self-reported emotional intelligence did not associate with any of the outcomes after controlling for personality. Implications and applications are briefly discussed.
This study assessed the prevalence of and factors associated with HIV testing among male street laborers. In a cross-sectional survey, social mapping was done to recruit and interview 450 men aged 18–59 years in Hanoi. Although many of these men engaged in multiple risk behaviors for HIV, only 19.8 percent had been tested for HIV. A modified theoretical model provided better fit than the conventional Information–Motivation–Behavioral Skills model, as it explained much more variance in HIV testing. This model included three Information–Motivation–Behavioral components and four additional factors, namely, the origin of residence, sexual orientation, the number of sexual partners, and the status of condom use.
In this article, we examine the bodily experiences of Mexican women, to investigate their acceptance of the thin ideal and resulting body dissatisfaction. We conducted semi-structured individual interviews with 30 adult participants in Mexico City. Interviewees accepted the thin body ideal, but experiencing their bodies as signifiers of motherhood protected them from body dissatisfaction. Instead of a personal body project, they engaged in a project of caring for their children’s bodies. We suggest that health campaigns directed to adult women should consider the relational aspects of their lives.
This study explored whether women’s beliefs about, and emotional responses to, pregnancy could account for variations in maternal mental and physical health outcomes, using the self-regulatory model as a theoretical framework. Women in the last trimester of pregnancy (N = 408) completed an online survey including measures of representations of pregnancy, coping, and physical and mental health. Results revealed that representations of pregnancy accounted for up to 30 and 39 per cent of the variance in indicators of physical and mental health, respectively. Findings suggest that beliefs about pregnancy may have important implications for maternal health.
Two experimental studies test the effectiveness of health versus appearance-related arguments in two-sided messages. The first study shows that two-sided messages to discourage suntanning are more effective when using appearance-focused instead of health-focused arguments. Study 2 elaborates on the underlying mechanism and extends the generalization of the results of the first study, by investigating two-sided messages to promote physical exercise. The results show that for health-motivated consumers, a health-focused message is more effective, whereas for appearance-motivated consumers, an appearance-focused message is more effective. This matching effect is mediated by argument relevance.
As part of a prospective cohort study of 1354 female and 347 male healthcare personnel, we examined the stability of subjective social status over ~7 months and the prospective association between subjective social status and self-rated health status. Most (82%) subjective social status ratings were stable (within ±1 point). Lower baseline subjective social status among healthcare personnel was associated with more subsequent reports of fatigue and headache and worsening global self-rated health status. Healthcare personnel who placed themselves on the bottom half of the subjective social status ladder were four times more likely to experience a decline in global self-rated health status and half as likely to improve to excellent self-rated health status.
The aim was to understand experiences of male competitive bodybuilders from a non-pathologizing perspective. Six male Norwegian competitive bodybuilders were interviewed. The interviews were analysed using a meaning condensation procedure resulting in five themes: being proud of capacity for discipline, seeing a perfectionist attitude as a necessary evil, experiencing recognition within the bodybuilding community, being stigmatized outside the bodybuilding community and going on stage to display a capacity for willpower and discipline. We suggest that bodybuilders may be stigmatized for breaking social norms: by their distinctive appearance, by the way they handle suspected drug use and by challenging gender norms.
Skin cancer is the most commonly diagnosed cancer in many Western countries. This systematic review provides a comprehensive overview of the relationship between skin cancer knowledge and sun-protective, exposure and tanning behaviours in the general population. A total of 34 studies, published in peer-reviewed journals over three decades, were reviewed and synthesised. Sun-protective behaviour was positively associated with skin cancer knowledge in most cases. Findings were inconsistent regarding other sun-related behaviours. Heterogeneity in measurement compromised the capacity to definitively link knowledge and sun-related behaviours. There is a need for development and utilisation of a standardised skin cancer knowledge scale, and guidelines are suggested.
This study investigated the characteristics contributing to successful goal attainment of a weight-loss and a non-weight-loss goal simultaneously. Weight-loss and non-weight-loss goals, self-efficacy, persistence, temptations, intergoal interference and facilitation were measured via an online questionnaire (N = 103, Mage = 25.36 ± 6.9, 80% women). Weight-loss self-efficacy, persistence, temptations and intergoal facilitation significantly predicted weight-loss goal attainment. Those who were more successful in attaining both their goals simultaneously had higher self-efficacy and persistence and experienced less temptation towards both goals. This study provides an insight into the characteristics necessary for successful simultaneous management of a weight-loss goal with another goal.
Confounding of depressive and cardiac symptoms may hold implications for assessment. This study investigated psychometric properties and sex differences in two depression scales among cardiac patients. Cardiac inpatients from 11 hospitals were recruited and completed a mailed survey including the Beck Depression Inventory-II and Gotland Scale of Male Depression 1 year later. The scales were significantly correlated and both were associated with social desirability. Females scored higher than males on the fatigue factor only (p < .001). Psychometric properties of the Beck Depression Inventory-II were more favorable in this population. Practitioners must not overlook reports of fatigue in female cardiac patients.
A body of evidence is developing that describes harmful effects of religious struggle that includes struggle with the divine (e.g. feeling abandoned or punished by God). We examined the prevalence and correlates of divine struggle among 540 Swiss hospital patients. Some divine struggle was reported by 46 percent of the sample. Unexpected hospital admission and scores on a measure of faith were associated with a greater likelihood of reporting any divine struggle. Higher levels of anxiety and depression were also associated with divine struggle. Screening for divine struggle or other forms of religious struggle will permit, where indicated, appropriate religious assessment and care to mitigate the harmful effects that may accompany religious struggle.
The goal of the study was to examine the relationships among fatigue catastrophizing, core dysfunctional beliefs, and fatigue in breast cancer radiotherapy patients. Seventy-eight patients participated in the study (mean age = 56.3, standard deviation = 10.5). Patients completed questionnaires on fatigue catastrophizing, core dysfunctional beliefs, and fatigue in their last week of radiotherapy. Using bootstrapping procedures to obtain estimates and confidence intervals for indirect effects, results showed that core beliefs (Need for Comfort and Demandingness for Fairness) had significant indirect effects on fatigue through fatigue catastrophizing, as indicated by the 95 percent confidence interval (.02–.19 for Need for Comfort; .01–.16 for Demandingness for Fairness).
We explored the significance of religious faith/coping and spirituality and existential considerations reported during hospitalisation on depressive symptoms at 6-month follow-up and addressed patients’ perceived influence of their faith among 97 consecutive acute coronary syndrome patients (72.2% male patients; mean age, 60.6 years) in a secular society. All faith variables were found unrelated to depressive symptoms. Having unambiguous religious or spiritual faith at follow-up was associated with a perceived positive influence of this faith on quality of life and the disease itself compared to patients with ambiguous faith. These findings underscore the importance of examining degrees of faith in secular settings.
As the mechanisms of the associations between substance use and risky sex remain unclear, this study investigates the interactive roles of conflicts about casual sex and condom use and expectancies of the sexual effects of substances in those associations among gay men. Conflict interacted with expectancies to predict sexual behavior under the influence; low casual sex conflict coupled with high expectancies predicted the highest number of casual partners, and high condom use conflict and high expectancies predicted the highest number of unprotected sex acts. Results have implications for intervention efforts that aim to improve sexual decision-making and reduce sexual expectancies.
Higher socioeconomic status smokers are more successful at smoking cessation. Few studies have investigated the prospective association between multiple measures of socioeconomic status and Hispanic smoking cessation. We assessed four measures to examine which predicted smoking cessation. Hispanics without debt had 18.5 times higher odds of 30-day cessation (odds ratio = 18.47, 95% confidence interval = 3.26–104.66, p < .01) and 11-fold increased odds of 7-day point prevalence abstinence (odds ratio = 11.32, 95% confidence interval = 2.45–52.24, p < .01) at 3-month follow-up. Yearly income, education, work status, money to see a doctor, and money for medications were not predictive of smoking cessation. Debt level may better measure socioeconomic inequities by capturing objective and subjective social status associated with Hispanic smoking cessation.
Eighty participants took part in a 5-day intervention Qi Gong study to enhance well-being and were randomised to either positive or body focus and either high or low hand position. The high hand position improved negative affect and was reported more intrinsically motivating but was unrelated to perceived effort. Positive focus produced better positive affect. For all groups combined, intrinsic motivation and effort predicted all three outcomes. The association between expectancy and perceived benefit was mediated via intrinsic motivation and perceived effort. Results support motivational concordance and positive focus as mechanisms of benefit but not response expectancy.
The Perceptions of Parental Illness Questionnaire was developed based on interviews with 15 adolescents with a parent with multiple sclerosis and refined using cognitive interviews. In total, 104 adolescents with a parent with multiple sclerosis then completed the Perceptions of Parental Illness Questionnaire and adjustment measures at two time points 6 months apart. Principal component analysis resulted in 11 Perceptions of Parental Illness Questionnaire sub-scales. Mixed-effect models showed that adolescents’ perceptions of parental multiple sclerosis at baseline rather than disease severity were associated with their psychosocial well-being 6 months later. The results indicate that Perceptions of Parental Illness Questionnaire may be a reliable and valid measure of adolescents’ representations of parents’ multiple sclerosis. Further studies are needed to replicate these findings with other illness groups.
This study evaluated the differences between normal-weight and overweight adolescents in psychopathology, social support and emotional competences, and the role of social support in the relationship between psychopathology and weight. We examined a clinical group of 83 overweight/obese adolescents, a community group of 82 overweight/obese adolescents, and 205 adolescents with normal weight. No differences were found in psychopathology and emotional skills. Compared to healthy peers, however, the overweight/obese community group was less satisfied with their friendships, and the clinical group was less satisfied with their intimate support and social activities. Social support mediates the relationship between weight and psychopathology.
Previous studies have shown that chronic conditions have a negative impact on quality of life. Furthermore, this impact appears to be different in males and females, but it is not yet clear what factors may mediate this relationship. Females with chronic health conditions had poorer quality of life in the physical and psychological domains as compared to males with chronic health conditions. The difference between male and female patients in the psychological domain disappeared when the analysis was adjusted for confounding factors such as age, presence of a chronic health condition, socioeconomic status, and depressive symptoms.
Social capital refers to various levels of social relationships formed through social networks. Measurement differences have lead to imprecise measurement. A meta-analysis of eligible studies assessing the bivariate association between social capital and self-reported health and all-cause mortality was performed. Thirty-nine studies met inclusion criteria, showing social capital increased odds of good health by 27 percent (95% confidence intervals [CI] =21%, 34%). Social capital variables, reciprocity increased odds of good health by 39 percent (95% CI = 21%, 60%) and trust by 32 percent (95% CI =19%, 46%). Future research suggests operationalizing measures by assessing differences by race/ethnicity, gender and socioeconomic status.
We investigated everyday odor experiences in 55 people (14–75 years old) who rated their sense of smell as far better than average. Compared to 55 gender- and age-matched controls, the self-reported hyperosmics scored higher on the Affective Impact of Odor Scale, rated negative consequences and unpleasant memories due to odors as more likely, rated environmental odors as more annoying, reported increased sensitivity to specific odors more frequently, paid more attention to odors, and agreed more strongly that their sense of smell has caused inconvenience to them. Based on these data, subjective hyperosmia is associated with primarily negative odor-related experiences.
The objective of this study was to construct the integrated model of alexithymia (ALEX) based on the method of response function approach that allows to predict the impact of the subjects’ psychological variables on the actual level of alexithymia. Extraversion, neuroticism, autonomy, locus of control and hostility were selected as the appropriate predictors of the alexithymia level. Evaluation of ALEX model’s parameters and its validation was provided on a wide set of experimental data (N = 224). ALEX model predicts the level of alexithymia satisfactorily and allows obtaining the partial response functions of its psychological predictors.
To examine whether perceived peer/parent norms or personal beliefs about adolescent substance use influence substance use among female adolescents with chronic medical conditions. Sixty-eight females reported on substance use, personal beliefs, and perceived peer/parent norms. Personal beliefs and perceived peer/parent norms were associated with adolescent’s current and future substance use. Although perceived peer norms accounted for variance in current substance use, only personal beliefs accounted for variance in future alcohol use. Targeting perceived peer norms may be effective for intervention efforts among adolescents endorsing current substance use, whereas alcohol use prevention efforts should target personal beliefs.
Studies on the effects of guided imagery in patients with fibromyalgia show varying results. This randomized controlled trial (n = 65) aims to give more insight into the effects on pain, functional status, and self-efficacy. Daily pain was assessed with a pain diary using a Visual Analogue Scale. Functional status and self-efficacy were measured at pretest, posttest, and follow-up using the Fibromyalgia Impact Questionnaire and the Chronic Pain Self-Efficacy Scale. No effects of guided imagery could be established. Explanations for the diverging results between studies might be found in the content of the exercises, length of the intervention period, and background of participants.
Intimate relationships have received increasing attention as a context for HIV transmission. We examined the relationships among perceptions that condoms interfere with intimacy, gay-related stigma, and unprotected/protected anal intercourse. Participants included 245 single-identified men who have sex with men. Intimacy Interference was positively associated with number of unprotected anal intercourse acts, and this effect was stronger among participants who reported high levels of gay-related stigma. In contrast, Intimacy Interference was negatively associated with number of protected anal intercourse acts, and gay-related stigma was positively associated with this outcome with no evidence of interaction effects. The findings are explained in the context of rejection sensitivity theory, and implications for public health and clinical intervention are discussed.
To investigate the relationship between worry tendency and sleep quality and the mediating effect of state–trait anxiety, 1072 adolescents and young adults from Jiangxi and Fujian Provinces in China were administered questionnaires pertaining to worry tendency, sleep quality, and state–trait anxiety. The results showed significant grade differences for worry tendency, sleep quality, and state–trait anxiety. Worry tendency was negatively associated with sleep quality, which was mediated by state anxiety and trait anxiety. There is a need for interventions that aim to reduce the level of worry tendency to ensure good sleep quality and the progression from worry tendency to anxiety and to poor sleep quality.
Little is known about the psychosocial circumstances under which children develop excessive body mass. A community sample was followed up from age 2–10 years to determine which early problems were predictive of increased body mass index. Hypothesized mediators (i.e. eating habits, physical activity, and "screen time") were also examined. After controlling for parental psychopathology, family income, child’s gender, and child’s body mass index, externalizing behaviors, aggressive behaviors, and anger predicted a relatively high body mass index. Exploratory analyses did not support hypothesized mediators, although low power was an issue.
To explore the psychosocial benefits of participating in a 2-year community arts project, eight people living with long-term mental health problems were interviewed. The project involved participants in selecting items of professional artwork, creating personal responses and curating a public exhibition. Interviews were analysed using interpretative phenomenological analysis. Participants experienced the arts project as improving self-worth, emancipating self from illness labels, offering a sense of belonging, enabling acquisition of valued skills and offering meaningful occupation and routines. Some regarded their developing creative skills as improving their self-management of mental health. However, some anticipated the project’s ending with anxiety.
Psychologically focused group interventions for multiple sclerosis were reviewed. Studies reviewed (14) were quantitative, experimental and involved a comparison group (control or other intervention). Compared with controls, psychologically focused group interventions achieved considerable improvements in depression and moderate improvements in self-efficacy and quality of life but little change in anxiety. Psychologically focused group interventions compared well with other interventions, although evidence was limited. Psychologically focused group intervention was less effective short term for depression than individual cognitive behavioural therapy or medication but comparable long term. Intervention heterogeneity made comparisons difficult. Specificity of effect is unclear. Limited evidence suggests psychologically focused group intervention is effective in improving certain outcomes.
Latino adolescents living in rural settings may be at increased risk of health problems; however, data describing the health status of this population are limited. This study examined 60 rural Latino adolescents and found high rates of health risk, including at-risk/clinical results for hemoglobin A1C (23.3%), high-density lipoprotein cholesterol (55%), systolic blood pressure (21.7%), and overweight/obesity (55%). Time in sedentary behaviors was high and physical activity was limited. Adolescent language use was associated with health risk status, with greater use of English associated with lower risk. Health psychologists could promote improved health by providing health behavior interventions to this underserved population.
The aim of this study was to identify coping strategies experienced by Omani women after breast cancer diagnosis. Individual semistructured interviews were conducted with 19 women diagnosed with breast cancer. Several coping strategies were identified including denial, optimism, withdrawal, Islamic beliefs and practices, and the support of family members and health-care providers, but Islamic beliefs and practices were the commonest. Health-care professionals should be aware of and respect women’s coping strategies and encourage them to use to reduce the psychological symptoms. They should also make family members and friends aware of their role in supporting and encouraging coping strategies.
Individuals with bleeding disorders are at increased risk of variant Creutzfeldt-Jakob disease. This study explored social cognitive predictors of screening intentions. Ninety men and women with bleeding disorders, recruited through the Haemophilia Society, completed an extended Theory of Planned Behaviour questionnaire to predict intention to screen for variant Creutzfeldt-Jakob disease. Extended Theory of Planned Behaviour variables accounted for 57 per cent of the variance in intention. Self-efficacy and anticipated affect predicted intention directly, while attitudes were mediated by anticipated affect. Simple interventions that already exist address relevant predictive components of intention to screen for variant Creutzfeldt-Jakob disease and could be used to aid decision-making.
To evaluate differences in early life events (ELE) on adult victims of severe interpersonal violence among patients who developed posttraumatic stress disorder (PTSD) and control group. Adult victims of interpersonal violence were evaluated to diagnose the presence of PTSD and ELE. 308 subjects were included, 141 in patient’s group (PTSD+) and 167 in control group (PSTD-). PTSD+ group had more severe PTSD, depressive symptoms and higher ETI scores than PTSD- group. Patients in PTSD+ group had a more frequent history of ELE. Some ELE were more significant for the development of this predisposition.
Risk attitudes play important roles in health behavior and everyday decision making. It is unclear, however, whether these attitudes can be predicted from birth order. We investigated 200 mostly male volunteers from two distinct settings. After correcting for multiple comparisons, for the number of siblings and for confounding by gender, ordinal position predicted perception of health-related risks among participants in extreme sports (p < .01). However, the direction of the effect contradicted Adlerian theory. Except for alcohol consumption, these findings extended to self-reported risk behavior. Together, the data call for a cautious stand on the impact of birth order on risk attitudes.
The influence of threat expectancy upon attentional biases for pain-related information and pain thresholds was explored in healthy participants. Participants were randomized to receive either threatening (n = 32) or nonthreatening (n = 31) information regarding an upcoming computerized task assessing cold and heat pain thresholds. Participants receiving threatening information were more worried about the pain task and, relative to those receiving nonthreatening information, showed attentional bias toward sensory-pain words. No between-group differences were found in terms of cold and heat pain thresholds. These results show that the type of information participants receive can influence their attentional processes and emotional concerns.
This study investigated the associations among trait perfectionism, perfectionistic self-presentation, Type D personality, and illness-specific coping styles in 100 cardiac rehabilitation patients. Participants completed the Multidimensional Perfectionism Scale, the Perfectionistic Self-Presentation Scale, the Type D Scale-14, and the Coping with Health Injuries and Problems Scale. Correlational analyses established that emotional preoccupation coping was associated with trait perfectionism, perfectionistic self-presentation, and Type D personality. Perfectionism was linked with both facets of the Type D construct (negative emotionality and social inhibition). Our results suggest that perfectionistic Type D patients have maladaptive coping with potential negative implications for their cardiac rehabilitation outcomes.
Twenty-eight young men took part in two online focus groups exploring understandings of health, help-seeking and health service use. Techniques from Foucauldian discourse analysis were used to elucidate how the young men framed health-related practices within gendered identities in online environments. The discourses are discussed within three discursive themes: ‘conceptualising health: everyday health versus "cover man" health’, ‘help-seeking: the restrictions of masculinity’ and ‘using health care: legitimising help-seeking through masculine identity’. Young men are interested in their health and construct their health practices as justified while simultaneously maintaining masculine identities surrounding independence, autonomy and control over their bodies.
This article presents the Antenatal Perceived Stress Inventory. The originality of this scale is to assess the impact of events experienced during pregnancy on the stress perceived by mothers. Scale validation was performed using data from 150 French-speaking nulliparous mothers and collected between 36 and 39 weeks of gestation (T1), and between 2 days (T2) and 6 weeks postpartum (T3). Factor analysis revealed a hierarchical three-factor structure that closely fit the data, including medical and obstetric risks/fetal health (F1), psychosocial changes (F2), and the prospect of childbirth (F3). The Antenatal Perceived Stress Inventory is a valid French prenatal stress scale with good psychometric properties.
Although effective type 2 diabetes management is essential for the prevention of complications, it is rarely carried out. Type 2 diabetes deaths in rural areas are higher than in metropolitan areas. A focus group (n = 8) and telephone interviews with patients (n = 10), and telephone interviews with health professionals (n = 18) in rural areas were conducted to examine this issue in a rural context. Inductive thematic analysis was used to generate 13 themes of barriers and facilitators to type 2 diabetes management at intrapersonal (denial of the illness, motivation, knowledge and skills and lack of time), interpersonal (stress and relationships), organisational (access to recommended foods, transport, health professionals, and exercise options) and societal (engagement and societal attitudes) levels of influence. Across all themes, participants highlighted the difficulty of maintaining management behaviours.
The cue-reactivity model, which is based on conditioning processes, posits that repeated food exposure (in the absence of consumption) should decrease cue reactivity. To examine whether repeated chocolate exposure attenuates cravings and intake, relative to those exposed to an acute cue, a 2 (repeated vs acute cue) x 2 (restrained vs unrestrained eaters) design was employed. Fifty female participants were recruited. Repeated exposure reduced cravings in unrestrained eaters (relative to acute exposure), but increased cravings in restrained eaters. An interaction between restraint and exposure emerged on intake, such that restrained eaters ate less after acute exposure than did unrestrained eaters.
This study aimed to compare levels of depressive symptoms between normal-weight and obese Israeli adolescents and to identify sociodemographic factors that may explain differences in depression between these groups. Thirty normal-weight and 49 obese patients aged 12–18 years participated in this study. The obese group had a significantly higher depression score. On linear regression analysis, obesity, lower parental income, and lower self-esteem were significantly associated with a higher depression score. This model explained 32.4 percent of the variance. The results indicate that psychosocial assessment and identification of depressive signs should be considered integral components in the management of adolescent obesity.
This study explored the health-care experiences of women diagnosed with pelvic inflammatory disease. Semi-structured interviews were conducted with 23 women diagnosed with pelvic inflammatory disease. Many women felt empowered about their health post-diagnosis; however, a smaller number reported becoming hyper-vigilant towards symptoms. Infertility was the greatest concern for women. Inadequate information and treatment resulted in negative health experiences, whereas clinician honesty and concern were viewed positively. The findings highlight the need for community education encouraging early presentation for the treatment of pelvic pain and emphasise the need for health practitioners to be responsive to the psychosocial aspects of pelvic inflammatory disease.
The habit of smoking may have automatic behavioral components guided by implicit attitudes. Smokers’ attitudes toward smoking should thus be less negative than nonsmokers’, so that a salient smoking cue (smell) is able to activate positive aspects of these attitudes. An affective priming task was used to explore this hypothesis. Unexpectedly, smokers and nonsmokers showed equally negative implicit attitudes, irrespective of smell. Smokers exposed to the cigarette smell did, however, display generally slower responses than nonsmokers, suggesting attentional bias. This could have implications for smoking policies in contexts where attentional factors affect performance.
This study explored experiences of obesity, its perceived causes and motives for surgery, as described by seven Saudi women contemplating bariatric surgery. The women experienced cultural restrictions on their physical and social activities. Obesity embodied these restrictions, attracting stigma and moral failure. Traditional clothing, foods, hospitality norms and limited outdoor female activities were regarded as barriers to weight loss. Bariatric surgery was chosen to protect health and to access normative female roles. Some were encouraged by relatives who had undergone surgery. Opting for surgery reflected both participants’ sense of powerlessness to self-manage weight and the social acceptability, within their family context, of this biomedical approach.
We attempted to identify whether and how the gender of the patient influences interpretations of an illness narrative. We investigated how medical and psychology undergraduates’ (n = 313) views change according to the patient’s gender, students’ gender, and field of study. A short story about a female patient was chosen as stimulus material, and a gender-modified version with a male protagonist was created for comparison. Responses were content analyzed by qualitative and quantitative methods. The female patient elicited more detailed descriptions and somatizing attributions. The gender of students had a stronger impact on responses than their field of study.
Fatigue is a debilitating and common condition in cancer patients. This study examined pretreatment predictors of fatigue before chemotherapy and also assessed whether these could prospectively predict fatigue posttreatment. A total of 100 patients completed questionnaires assessing psychological factors, physical activity and sleep. A subsample of 26 participants wore actigraphs to objectively assess sleep/wake and activity/rest. Fatigue was measured pretreatment and posttreatment and at follow-up several months later. Greater pretreatment pain, depression, stress and sleep disruption significantly predicted greater fatigue before chemotherapy, explaining 55 percent of the variance. Pretreatment fatigue significantly predicted posttreatment fatigue. No other significant prospective predictors of posttreatment fatigue emerged.
Internet forums represent a useful but understudied resource to understand psychosocial aspects of living with systemic lupus erythematosus. This study was aimed to describe the demand/supply of social support through the Internet in relation with the description of personal illness experiences. All the posts (118) from an Italian forum for systemic lupus erythematosus patients were collected and analyzed combining qualitative content analysis with statistical textual analysis. The results showed different purposes for posts: starting new relationships, seeking information, receiving emotional support, and giving a contribution. Lexical analysis identified three ways of describing patients’ experiences. Discussion focuses on the relationship between the requested/offered support and systemic lupus erythematosus experiences.
This study aims to explore the experience of renal patients undergoing dialysis treatment focusing on beliefs about their illness, prescribed treatment and the challenge of adherence. Interpretative phenomenological analysis was used to analyse the accounts of seven haemodialysis patients. Patients have a range of beliefs about their illness and their treatment consistent with the self-regulatory model of illness, that is, identity, cause, consequences, timeline and cure. Patients sometimes consciously did not act in accordance to advice when they considered an aspect of treatment less important or less easy to adhere to. Psychological factors like beliefs might play a role in non-adherence behaviour.
The aim of this study was to determine the effect of problem-solving education on self-efficacy and distress in informal caregivers of allogeneic hematopoietic stem cell transplantation patients. Patient/caregiver teams attended three 1-hour problem-solving education sessions to help cope with problems during hematopoietic stem cell transplantation. Primary measures included the Cancer Self-Efficacy Scale–transplant and Brief Symptom Inventory–18. Active caregivers reported improvements in self-efficacy (p < 0.05) and distress (p < 0.01) post-problem-solving education; caregiver responders also reported better health outcomes such as fatigue. The effect of problem-solving education on self-efficacy and distress in hematopoietic stem cell transplantation caregivers supports its inclusion in future interventions to meet the multifaceted needs of this population.
We examined whether a brief education and a brief mindfulness exercise would reduce the effect of portion size on food intake. Participants were randomly assigned to one of the three information conditions (education, mindfulness, or control) and then received a small or large portion of pasta for lunch. Neither education nor mindfulness was effective in reducing the effect of portion size: Overall, participants served a large portion consumed 34 percent more pasta than did those served a small portion. Participants in the mindfulness condition tended to eat less overall than participants did in the two other conditions, but this trend was not significant.
This study examined the psychometric properties of the General Self-Efficacy Scale by applying Rasch analysis to data from 102 persons with spinal cord injury. Our results suggest that the General Self-Efficacy Scale is a psychometrically robust instrument suitable for application in a spinal cord injury population. The General Self-Efficacy Scale shows an overall fit to the Rasch model (2 = 15.5, df = 20, p = .75), high reliability (rp = 0.92), ordered response scale structure, and no item bias by gender, age, education, and lesion levels. However, the analyses indicate a ceiling effect and potential to enhance the differentiation of the General Self-Efficacy Scale across self-efficacy levels.
We explored the role of residential segregation in obesity among a national sample of Hispanics for the first time. Data on the 8785 Hispanic adults in the 2000 Behavioral Risk Factor Surveillance System were linked to 2000 census data on the segregation of 290 metropolitan statistical areas. Multilevel modeling revealed that after controlling for individual-level variables, the odds of being obese for Hispanics residing in high-segregated metropolitan statistical areas were 26.4 percent higher than for those residing in low-segregated metropolitan statistical areas. This segregation effect might be mediated by the obesogenic features (e.g. paucity of recreational facilities and abundance of fast-food outlets) of segregated Hispanic neighborhoods.
The current study examined the influence of health insurance, psychological processes (i.e. psychological competency and vulnerability), and the interaction of these two constructs on older African Americans’ utilization of five preventive care services (e.g. cholesterol screening and mammogram/prostate examination) using data from 211 older African Americans (median age = 60). In addition to direct effects, the influence of health insurance sometimes varied depending on respondents’ psychological competency and/or vulnerability. Policies and interventions to increase older African Americans’ use of preventive health services should consider structural (e.g. health insurance) and psychological (e.g. psychological competency and vulnerability) factors along with the interaction between these factors.
As induction of pediatric anesthesia can elicit anxiety in children and parents alike, this study was aimed at evaluating the effectiveness of clown intervention in decreasing maternal anxiety and stress in the preoperative phase. Before anesthesia induction, 25 children were randomly assigned to clown intervention and 25 to a control group with a routine procedure. In the waiting room and after separation from the child, maternal anxiety and stress were measured. The results showed that after separation, only in the clown group, maternal state anxiety significantly decreased and the tendency to somatization did not increase. Moreover, after clown intervention, older children’s mothers significantly reduced the level of perceived stress. As clown intervention can positively influence maternal anxiety and stress in the preoperative period, its promotion in clinical–hospital environments is recommended.
This study examines the relationship among posttraumatic stress disorder severity, depression severity, and subjective and objective physical health in a sample of 200 adults with posttraumatic stress disorder. Posttraumatic stress disorder severity was correlated with subjective, but not objective, health. Similarly, depression symptoms had an indirect effect on the relationship between posttraumatic stress disorder symptom severity and three measures of subjective physical health. Finally, depression symptoms had an indirect effect on the relationship between both reexperiencing and hyperarousal symptoms and subjective physical health. This research underscores the important role that posttraumatic stress disorder, particularly reexperiencing and hyperarousal symptoms, and depression may have on perceptions of physical health.
The purpose of this study was to examine the associations between God Locus of Health Control, health behaviors, and beliefs utilizing a cross-sectional online survey (N = 549). Results indicated that God Locus of Health Control was correlated with alcohol use, physical activity, perceived risk of chronic disease, and beliefs that poor health behaviors contribute to chronic disease (all p values < .05). Multiple regression analyses including covariates and other locus of control variables revealed that God Locus of Health Control was only an independent correlate of the belief that physical inactivity contributed to chronic disease. Insights from this study may be important for future faith-based health behavior change interventions.
Nurses, nurse’s aides, and physicians were presented with vignettes describing elderly patients and were asked to assess their level of pain from four external cues (facial expression, verbalizations, avoidance of movements and positions, and interpersonal contact) in three conditions: when the illness was not known, when it was known to be arthritis, and when it was known to be cancer. For all health caregivers, the most important cue for judging pain was patients’ facial expression. When the nature of the illness was not known, the impact of this cue was stronger than when the nature of the illness was known.
This experiment examined how reactions to HIV disclosure by a male stimulus person are influenced by the discloser’s HIV status and sexual orientation as well as the disclosure recipient’s gender. Participants (152 male and female college students) disclosed more intimately about themselves (revealing highly personal facts and personal feelings) when the man’s HIV test result was positive versus negative. The effects of HIV status disclosure on participants’ self-disclosure and social support were also moderated by the man’s sexual orientation and participants’ gender. The results document circumstances when HIV disclosure may lead to positive reactions instead of avoidance and exclusion.
This study investigated how men and women made sense of multiple goals during fertility treatment. Both members of three heterosexual couples participated in two or three semi-structured interviews over 6 months, producing 14 accounts, which were analysed using interpretative phenomenological analysis. The goal of biological parenthood dominates assumptions in infertility research, but its importance varied between participants, who balanced that goal with retaining emotional well-being, avoiding financial difficulties and maintaining their relationship. These themes are discussed in the context of the self-regulation model, which allows fertility treatment experiences to be conceptualised more broadly than do other models.
This study explored the processes of significance about the risk communication in prenatal/preconception setting within 1 month to the end of genetic counselling intervention. Participants were all attending a programme of Cardiomyology and Medical Genetics in Naples, Italy, for the first time. Transcripts of 18 semi-structured interviews were analysed using interpretative phenomenological analysis. Themes arising included the following: the familiar outcomes of genetic counselling, the risk representation and the impacts on decision-making. The findings suggest the significance of the experience of genetic risk and the implications for the support of individuals and their family after the conclusion of the genetic counselling intervention.
Sickle-cell disease is a genetic disorder characterized by severe pain episodes or "vaso-occlusive crises" that may require hospitalization. This study examined the associations among emotion regulation, somatization, positive and negative affect, and hospitalizations for pain crises in youth with sickle-cell disease. Multivariate analyses indicated that emotional suppression and somatization were significantly associated with more frequent hospitalizations for pain crises in the previous year after controlling for sickle-cell disease type and pain. These results suggest that efforts to reduce emotional suppression and somatization may assist in decreasing the frequency of hospitalizations for pain crises among youth with sickle-cell disease.
The psychological impact of living with congenital heart disease in adulthood was explored using semi-structured interviews with seven adults. Participants described living with congenital heart disease as a constant and limiting presence, which impacts upon the relationship with self and others. Psychological and emotional reactions ranged from depression, shame, trauma, lack of control and an ongoing struggle with issues of uncertainty and life expectancy. Various coping strategies were identified such as denial and overcompensation. Participants reported that they were not psychologically supported by health professionals. Implications of findings are discussed with regard to service provision.
Considering the significant negative consequences that are directly related to binge eat and drink behaviors, many studies have explored the reasons why adolescents engage in them. This study examined the differences in the development, maintenance, and co-occurrence of "binge" behaviors associated with adolescent’s identity style and the level of commitment. One thousand four hundred Italian adolescents completed self-report measures assessing binge behaviors and identity styles. Overall, results show that diffused adolescents were more likely to be engaged in binge eating and binge drinking behaviors than others, validating the idea that the achievement of a consolidated ego identity is important for enhancing well-being.
This study mainly compared the prevalence of internalizing symptoms of 834 Spanish and 159 Latin-American immigrant adolescents. Participants completed self-report measures about depression, anxiety and somatic symptoms and a socio-demographic questionnaire. The results indicated that being Latin-American was associated with higher levels of depressive symptoms and being female was related to higher depressive and anxiety symptoms. Gender differences were more prevalent in Spaniards than in Latinos, with girls showing more symptoms than boys. High socio-economic status was negatively related to depressive symptoms and anxiety. The results may alert clinicians of the importance of assessing depressive symptoms in Latino adolescents in order to treat this group of youths effectively.
In the fight against the type 2 diabetes epidemic, patients might be asked to discuss familial susceptibility to type 2 diabetes in their family. Illness representations of patients (N = 546) were assessed to explore their impact on perceived type 2 diabetes threat in relatives. Reporting high type 2 diabetes burden, emotional impact and perceiving type 2 diabetes as an inheritable disease seemed to increase patients’ family risk perception and worries about relatives’ future health. Patients with coherent illness understanding reported positive beliefs regarding type 2 diabetes prevention in relatives. Findings may give direction in how illness representations may be used to guide patients in the process of family risk disclosure.
This study analyzed how the culture of origin, educational level, sexual orientation, and experience of male sex workers may mediate their commercial sexual behaviors. A total of 100 Spanish agency male sex workers were interviewed. Most of them were young men, Latin American, homosexual, and had middle-level education. Our results showed that cultural differences and sexual orientation could influence male sex workers when engaging in sexual behaviors with their clients. Social and health projects with male sex workers may have to take into account sexual myths and taboos related to sexual orientation and cultural differences.
This study investigated whether a clown doctor intervention could reduce preoperative anxiety in children hospitalized for minor surgery and in their parents. A randomized controlled trial was conducted with 77 children and 119 parents: the clown group consisted of 52 children accompanied in the preoperating room by their parents (n = 89) and two clowns while the comparison group consisted of children accompanied by the parents only. The clown intervention significantly reduced the children’s preoperative anxiety: children benefited from the clown’s presence and showed better adjustment than children in the comparison group. No significant results were found in parents.
This randomized controlled study evaluated the effect of massage on affect, relaxation, and experimental pain induced by electrical stimulation. Participants were 96 healthy women (M age = 20.13 ± 5.93 years; 84.4% White) randomly assigned to a 15-minute no-treatment control, guided imagery, massage or massage plus guided imagery condition. Multilevel piecewise modeling revealed no group differences in pain intensity, threshold, or tolerance. The two massage conditions generally reported decreased pain unpleasantness, lower unpleasant affect, maintenance of pleasant affect, and increased relaxation compared to the no-treatment condition. The results suggest that massage may alter immediate affective qualities in the context of pain.
This study compared treatment outcomes for a new weight loss program that emphasized reducing unhealthy relationships with food, body image dissatisfaction, and internalized weight bias (New Perspectives) to a weight loss program that emphasizes environmental modification and habit formation and disruption (Transforming Your Life). Fifty-nine overweight and obese adults (body mass index ≥ 27 kg/m2) were randomly assigned to either a 12-week New Perspectives or Transforming Your Life intervention. Despite equivalent outcomes at the end of treatment, the Transforming Your Life participants were significantly more effective at maintaining their weight loss than New Perspectives participants during the 6-month no-treatment follow-up period.
Health anxiety has been infrequently examined in individuals with diabetes. In this study, individuals with Type 1 or 2 diabetes (n = 414) completed questionnaires assessing health anxiety and related constructs. Elevated health anxiety was reported by 24.1 percent of the sample and was greater among younger individuals, females, unmarried participants, and those recently diagnosed with diabetes. The construct was related to trait anxiety, fear of diabetes complications, poorer adherence to dietary and exercise self-care activities as well as lower physical quality of life. The research improves our understanding of health anxiety among individuals with diabetes.
This study investigated the effect of a smoking health message on smokers’ comparative optimism. Two groups watched an anti-smoking scenario, with one group imagining being part of the scenario. Participants, including controls, completed comparative optimism ratings for four smoking-related illnesses. The intervention had negative consequences with both intervention groups reporting significantly higher comparative optimism versus the control group for all four smoking-related illnesses. It is concluded that media health messages can be powerful tools in changing comparative optimism but are influenced by peoples’ prior perceptions. Health messages need to be systematically assessed to understand prior beliefs of the target audience.
Early care seeking is important for prognosis of malignant melanoma. Coping styles in decision-making to seek care can relate to prognosis since avoidant strategies could delay care seeking. The aim of this study was to compare self-reported coping styles in decision-making between men and women diagnosed with malignant melanoma. We used the Swedish version of the Melbourne Decision-Making Questionnaire to assess coping styles. Men generally scored higher in buck-passing while women and those living without a partner scored higher in hypervigilance. This knowledge could be used in the development of preventive programmes with intention to reach those who delay care seeking.
This study examined the effects of personality dimensions in relation to the symptoms of depression and anxiety on health-related quality of life in coronary artery disease patients (N = 514). A linear regression analysis showed that symptoms of depression and anxiety as well as personality trait of emotional stability have independent significant effect on the health-related quality of life in patients with coronary artery disease. Psychological interventions in coronary artery disease patients should not only be limited to the treatment of symptoms of depression and anxiety but should also be extended to the management of personality traits.
Positive body image is defined as healthy body-related attitudes that go beyond the absence of distressful symptoms. A warm and secure relationship with an important other person has been linked with attitudes of acceptance and appreciation toward one’s body as well as adaptive eating patterns. This study tested whether a warm and secure relationship with God was similarly related to positive body image. Undergraduate women completed self-report measures of religiosity, life satisfaction, body appreciation, body acceptance by others, functional orientation, and intuitive eating. Multiple regression analyses showed that relationship with God contributed variance to most of the well-being variables.
Marriage can enhance health for individuals with a chronic disease, yet spouses may also undermine disease management. The current study investigated spousal undermining of dietary regimen in 129 patients with type 2 diabetes mellitus. A total of 40 patients reported that their spouses tempted them with forbidden foods, and 15 reported that their spouses conveyed disregard for their diabetic diet. Spousal tempting was associated with worse dietary adherence, and spousal disregard with worse nondietary adherence. Spousal undermining is relatively rare but is associated with patients’ disease management and warrants further investigation to better understand how spouses influence partners’ day-to-day management of chronic diseases.
This study examined the Dieting Peer Competitiveness Scale; it is an instrument for evaluating this social comparison in young people. This instrumental study has two aims: The objective of the first aim was to present preliminary psychometric data from the Spanish version of the Dieting Peer Competitiveness Scale, including statistical item analysis, research about this instrument’s internal structure, and a reliability analysis, from a sample of 1067 secondary school adolescents. The second objective of the study corresponds to confirmatory factor analysis of the scale’s internal structure, as well as analysis for evidence of validity from a sample of 1075 adolescents.
This research was conducted to describe Taiwanese mothers’ lived experience of caring for their child diagnosed with adrenoleukodystrophy. Analysis of eight interviews by Colaizzi’s method revealed six themes: (1) difficulty confirming the diagnosis; (2) powerlessness toward unsatisfactory treatment; (3) struggles with decisions around carrier testing; (4) guilt about being a carrier; (5) support from family, other parents, and religion; and (6) lack of integrated resources and support. The results suggest the need to raise public and physician awareness about adrenoleukodystrophy via the media and medical education. A central organization to provide parents with comprehensive information is needed.
To test the hypothesis that self-compassion buffers people against the emotional impact of illness and is associated with medical adherence, 187 HIV-infected individuals completed a measure of self-compassion and answered questions about their emotional and behavioral reactions to living with HIV. Self-compassion was related to better adjustment, including lower stress, anxiety, and shame. Participants higher in self-compassion were more likely to disclose their HIV status to others and indicated that shame had less of an effect on their willingness to practice safe sex and seek medical care. In general, self-compassion was associated with notably more adaptive reactions to having HIV.
Generalized anxiety disorder prevalence and comorbidity with depression in coronary heart disease patients remain unquantified. Systematic searching of Medline, Embase, SCOPUS and PsycINFO databases revealed 1025 unique citations. Aggregate generalized anxiety disorder prevalence (12 studies, N = 3485) was 10.94 per cent (95% confidence interval: 7.8–13.99) and 13.52 per cent (95% confidence interval: 8.39–18.66) employing Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria (random effects). Lifetime generalized anxiety disorder prevalence was 25.80 per cent (95% confidence interval: 20.84–30.77). In seven studies, modest correlation was evident between generalized anxiety disorder and depression, Fisher’s Z = .30 (95% confidence interval: .19–.42), suggesting that each psychiatric disorder is best conceptualized as contributing unique variance to coronary heart disease prognosis.
The relationship of attributed source (commercial or nonprofit) and credibility of exercise advertisements to explicit and implicit exercise-related attitudes and intentions was examined. Male and female participants (N = 227) were randomly assigned to watch health or appearance-related advertisements and then completed an implicit attitudes task and questionnaires. Health advertisements and those attributed to a nonprofit source were rated more credible. Appearance condition participants who attributed the advertisement to a nonprofit source also rated the advertisement as more credible. Participants who rated a commercial advertisement as credible reported higher implicit instrumental attitudes. Implications for exercise promotion are discussed.
This study examines whether parents of children with developmental disorders are at risk of elevated allostatic load relative to control parents and whether positive affect moderates difference in risk. In all, 38 parents of children with developmental disorders and 38 matched comparison parents were analyzed. Regression analyses revealed a significant interaction between parent status and positive affect: parents of children with developmental disorders had lower allostatic load when they had higher positive affect, whereas no such association was evident for comparison parents. The findings suggest that promoting greater positive affect may lower health risks among parents of children with developmental disorders.
Weight-loss history was examined as a predictor of outcome in group self-help obesity treatment. Participants (n = 128; 83% women; mean body mass index = 34.2 kg/m2; mean age = 47.2 years) in self-help, group behavioral weight-loss treatment reported a mean of 5.1 prior weight-loss attempts and lost 13.8 percent of initial weight in current treatment. A greater number of past attempts independently predicted greater 6-month, 18-month, and intent-to-treat weight losses. Greater magnitude of largest past loss predicted greater 18-month weight loss. In contrast to studies on professional treatment, group self-help participants might benefit from repeated weight-loss efforts despite previous failures.
Heterosexual women in Western cultures are known to experience body image concerns, dieting and disordered eating as a result of intense social pressures to be thin. However, it is theorised that lesbian and bisexual women belong to a subculture that is ‘protective’ of such demands. Fifteen non-heterosexual women were interviewed about their experiences of social pressure. Thematic analysis of their accounts suggests that such theorising may be inaccurate, because these lesbian and bisexual women did not feel ‘protected’ from social pressures and experienced body dissatisfaction. While they might attempt to resist thin idealisation, resistance is not centred around their sexuality.
Drawing on focus group discussions, this article explores how young, Finnish university students view the cultural ideals of health and appearance. The young adults noted how body practices aiming at health can turn into unhealthy obsessions. As a result, a healthy-looking body may serve to cover an underlying body image distortion. Health and well-being were defined as appropriate motives for engaging in body projects, while appearance as a motive was questioned. I argue that the current promotion of health may cause individuals to experience pressure to outwardly appear healthy at the cost of neglecting the subjective experience of well-being, and that this may especially influence young women.
The Regan Attitudes towards Non-Drinkers Scale was developed to address the concept that consumption of alcohol may serve as a means of avoiding social costs associated with being a non-drinker. This study sought to examine the Regan Attitudes towards Non-Drinkers Scale within a sample of Irish school-age adolescents. Results indicated that the Regan Attitudes towards Non-Drinkers Scale was a statistically significant predictor of self-reported problematic drinking. The findings of this study underscore the importance of this newly identified construct and highlight the necessity of further empirical tests of the Regan Attitudes towards Non-Drinkers Scale.
This study tested the effectiveness of an adventure-based training programme in promoting the psychological well-being of primary schoolchildren. A randomised controlled trial was conducted, with 56 primary school pupils randomly assigned to the experimental group participating in the adventure-based training programme and 64 to the attention placebo control group. Children in the experimental group reported significantly fewer depressive symptoms, lower anxiety levels and higher self-esteem than those in the attention placebo control group. This study provides some evidence that the adventure-based training programme is effective in promoting the psychological well-being of Hong Kong Chinese schoolchildren.
This study examines whether sexually transmitted infection prevention knowledge predicts the acquisition of biologically confirmed sexually transmitted infections among African-American adolescent females. A total of 715 females were recruited from public health clinics in Atlanta, Georgia, and using audio computer-assisted self-interview technology, we assessed for demographics, sexually transmitted infection prevention knowledge, risky sexual behaviors, and sexually transmitted infections. After controlling for demographics and prior risky sexual behaviors, participants with high prevention knowledge were 0.09 times less likely to report sexually transmitted infections, and those with multiple sexual partners were 1.3 times more likely to report sexually transmitted infections. Our findings suggest that the promotion of accurate sexually transmitted prevention knowledge is critical especially among females with multiple sex partners.
We examined the relationships among age, health, beliefs, and possible-selves. Using a new approach based on health-related possible-selves, young-old and older individuals were separated into specific health types: (1) improvement or maintenance health hopes and (2) preventable or unpreventable health fears. The young-old perceived greater capability to achieve health hopes and reported more health activities than older individuals; the older group reported more maintenance than improvement. More unpreventable fears were related to experiencing higher pain and worse physical functioning. Health types provide useful information about individual differences in health behavior and beliefs and are sensitive to current health status.
This study investigated the dentists’ knowledge about psychosomatic medicine. Anxiolytic techniques, considerations about psychosomatic medicine, and referrals to psychotherapists were examined by a questionnaire. Overall, 65 percent felt negatively affected by patients with dental fear. Few dentists used relaxation techniques and hypnosis. The relationship between psychosomatic factors and pain perception was well known, but not their impact on wound healing. The frequency of continuing education courses correlated with a broader range of treatment techniques and less difficulties in treatment. Research evidence about the impact of psychological factors on dental treatment has not been translated into dental practice.
Millions of people worldwide use over-the-counter analgesics on a regular basis; yet little is known about how decisions to self-medicate are made. This study used the theory of planned behavior to explore the influence of beliefs about medicines (Beliefs about Medicines Questionnaire) and individual pain experience as predictors of intent to self-medicate. Both emerged as significant predictors of intent to self-medicate. Furthermore, intent to self-medicate significantly predicted reported use of analgesics. These findings indicate that use of over-the-counter pain medication is more likely when the value of the pain relief is greater than concerns about harm.
This qualitative research explored how cancer patients’ writing and reading on the Internet play a role in their illness experience. Focus-group interviews were conducted, with 34 cancer patients participating. A grounded qualitative analysis method was applied to analyze the interview transcripts. The results show that by writing personal blogs, cancer patients reconstructed their life story, expressed their closure of life, and expected to be remembered after death. Reading fellow cancer patients’ stories online significantly influenced cancer patients’ perceptions and expectations of their own illness prognosis, and that influence was sometimes greater than that of the doctors’ influence.
This qualitative think aloud study explored how Black women (n = 32) processed information from a White or Black fashion magazine. Comments to the ‘White’ magazine were characterised by rejection, being critical of the media and ambivalence, whereas they responded to the ‘Black’ magazine with celebration, identification and a search for depth. Transcending these themes was their self-identity of being a Black woman that was brought to the fore either by a sense of exclusion (White magazine) or engagement (Black magazine). Such an identity provides resilience against the media’s thin ideals by minimising the processes of social comparison and internalisation.
This article systematically reviews the literature pertaining to correlates of body dissatisfaction during pregnancy. A total of 8 electronic databases were searched and 251 papers identified, 56 of which met inclusion criteria. Full text scrutiny of these papers reduced the final list of reviewed papers to 22. Results of the review highlight that psychological factors were associated with body dissatisfaction during pregnancy, and noted the surfeit of studies examining the relationship was between body dissatisfaction and depression. It is concluded that the prevention of heightened body dissatisfaction during the reproductive phase will only be effective when models of risk factors have been examined systematically and rigorously.
Modern footwear has been associated with the development of foot pain and pathology in the ageing adult. Yet this foot health issue does not seem to alter the footwear purchases made by younger women. In total, 162 teenage girls were questioned regarding shoes purchased over a 6-month period. The results indicated that footwear choices are activity specific and participants chose the style and design of shoes related to the image they wanted to portray. Association of footwear choice to foot function and health was not found to influence choice of footwear.
This study adopted a discursive approach to explore how not drinking alcohol (non-drinking) is construed in relation to masculine identity among 12 undergraduate interviewees. Three prominent discourses were revealed. First, non-drinking was constructed as something strange requiring explanation. Second, contradictory discourses constructed non-drinking as, simultaneously, unsociable yet reflective of greater sociability. Third, non-drinking was constructed as something which has greater negative social consequences for men than for women. Opportunities for challenging traditional gender role expectations are considered.
The present study aimed to examine whether caretakers of children with a food allergy experience distress and to determine their family’s mental health-care needs and utilization. An anonymous survey was given to a sample of 454 caretakers during conferences hosted by the Food Allergy & Anaphylaxis Network. Overall, 32 percent of caretakers reported above threshold levels of distress while 70 percent stated that mental health support would have been helpful, but only 23 percent sought it. Even when mental health support was desired and available, few received it. Routine discussion of mental health needs with families receiving medical care may help address barriers to utilization.
This study examined how framed messages affect viewer attention to and cognitive processing of osteoporosis prevention print ads. Attention was measured with eye tracking technology. Cognitive processing was assessed through masked recall. A total of 60 college-aged women viewed 12 gain-framed, 12 loss-framed, and 12 neutral-framed ads. Number of fixations, dwell time, and recall of gain-framed osteoporosis prevention ads were higher than loss-framed or neutral-framed ads, p < .01. Message recall was positively correlated with the number of fixations and dwell time for the gain-framed and neutral-framed messages, p < .01. These findings provide preliminary insight into potential mechanisms underlying message framing effects.
Longitudinal blood- and cognitive data from 879 adults were analyzed to extract a multidimensional health structure for prediction of cognitive change. Six health components were identified and replicated at two waves. Following, cognitive outcomes were regressed on the health components. Large proportions of cognitive age related variations were accounted for by baseline health in both cross-sectional and prospective analyses. Less variation was accounted for when health change and cognitive change were contrasted. Cardiovascular health was particularly important for prediction of cognitive change. Our study underlines causal relations between health and cognitive functions, and suggests that some effects are long term.
Some studies suggest that cognitive function is impaired in rheumatoid arthritis patients. One possible influence may be commonly used rheumatoid arthritis treatment, methotrexate. This study examined cognitive function in long-term methotrexate users with rheumatoid arthritis and, using a 24-hour pre- and post-methotrexate dose administration, investigated whether there may be transient cognitive function changes. Rheumatoid arthritis patients (n = 35) were assessed immediately before taking methotrexate and 24 hours later. Low and high methotrexate dose groups were then compared. Cognitive performance was unchanged across two assessment points and was within the normal range, although lower in high methotrexate dose group.
Research on the human papillomavirus vaccine has largely focused on parents’ attitudes toward vaccinating their young daughters. Yet, little is known about the factors that influence human papillomavirus vaccination in college-age women who are still eligible for the vaccine. This study examined attitudes toward the human papillomavirus vaccine in 150 college-age women who had received the vaccine and 58 who had not. The Health Belief Model was used to predict vaccine intentions and to compare vaccinated and unvaccinated women. Women’s self-efficacy, social environment, and perceptions of the vaccine predicted vaccine intentions and behaviors. Interventions might include these factors to promote vaccination.
A psychosocial health programme using movement, games and sport was developed and evaluated in the rural area of Guatemala, with two groups of women who suffered violence. Participatory observation and 32 interviews were conducted; 33 of the 56 participants filled out initial and final questionnaires. Research challenges were discussed and contextualised. Various health factors such as sense of coherence and self-esteem improved. The psychosocial approach and culturally grounded use of movement, games and sport as active and participatory tools in combination with verbal expression, provide a significant way to foster health in the context of violence and conflict.
The aim of this study is to investigate psychosocial factors related to the diagnosis and treatment of patients with restless legs syndrome. Fifteen patients were interviewed at the Neuro-Sono Outpatient Clinic, Universidade Federal de São Paulo. The results were submitted to a qualitative analysis. We identified four content categories: illness description, illness history, illness experience, and relationships. Lack of control over the body and lack of recognition by professionals produce stigma and lead patients to suffering. The research underscores the relevance of psychosocial factors to the diagnosis and treatment of patients with restless legs syndrome and the importance of having interdisciplinary teams when attending patients with restless legs syndrome.
This study examined the reciprocal relationship between Latinas’ leisure-time physical activity and neighborhood cohesion following the implementation of a 6-month promotora-delivered pilot intervention. A one-group study design was used to promote leisure-time physical activity and build neighborhood cohesion among 143 churchgoing Latinas in San Diego, California. Using a three-wave autoregressive cross-lagged panel model, leisure-time physical activity and neighborhood cohesion (assessed at baseline, 3 and 6 months) were analyzed. Leisure-time physical activity and neighborhood cohesion increased across time. Neighborhood cohesion at 3 months predicted leisure-time physical activity at 6 months. A promotora model in the context of a faith-based setting may be appropriate to promote Latinas’ leisure-time physical activity and make socioenvironmental improvements.
We investigated the effects of gain-framed versus loss-framed messages and motivational orientation on calcium consumption. After completing a motivational orientation scale (behavioral inhibition system/behavioral activation system), undergraduate women (N = 141) were randomly assigned to read a gain-framed or loss-framed pamphlet promoting calcium consumption. Calcium consumption was assessed 1 month later. For calcium supplement behavior, a gain-framed advantage was observed for behavioral activation system–oriented individuals, whereas a loss-framed advantage was observed for behavioral inhibition system–oriented individuals. For dietary calcium intake, a gain-framed advantage was observed among behavioral activation system–oriented individuals; however, no framing effect emerged for behavioral inhibition system–oriented individuals. The success of framed messages depends on the message recipient’s motivational orientation.
This study examines the psychological factors linking childhood abuse and HIV/sexually transmitted infection outcomes among 190 single homeless women in New York City. Participants were assessed for mental health symptoms, sexually transmitted infections, and exposure to childhood sexual and physical abuse. Findings indicate that the relationship between childhood abuse and HIV/sexually transmitted infection diagnoses during adulthood is mediated by a combination of posttraumatic stress disorder and borderline personality disorder symptoms. Screening single homeless women who report childhood abuse histories for symptoms of both disorders may aid in the identification of individuals particularly vulnerable for HIV infection. Implications for clinical interventions are discussed.
To test an attribution–emotion model of reactions to chronic fatigue syndrome/myalgic encephalomyelitis, 30 significant others of 30 adult patients with chronic fatigue syndrome/myalgic encephalomyelitis were administered a semi-structured interview about their beliefs regarding the patient’s illness and completed questionnaire measures of distress and behavioural responses to the patient. Spontaneous causal explanations (attributions) for illness events, symptom exacerbation and negative patient mood were extracted and coded. Significant others’ distress and negative behavioural responses towards the chronic fatigue syndrome/myalgic encephalomyelitis patient were associated with attributing illness events to causes personal and internal to the patient. Our findings may inform the future family-based interventions for chronic fatigue syndrome/myalgic encephalomyelitis.
Patients have previously reported differences in their experiences of treatments received in the public and private sectors; it remains unclear whether such perceived differences are particular to or shared across different interventions. This study explored whether patients’ appraisals of public and private treatments are similar when appraising a complementary therapy (osteopathy) compared to a mainstream therapy (physiotherapy). Thirty-five qualitative interviews were analysed thematically. Patients’ appraisals varied by health-care sector and therapy type: physiotherapy was appraised more negatively in the National Health Service than the private sector but osteopathy was appraised similarly within both health-care sectors. Potential reasons for this are discussed.
Life satisfaction and control beliefs are established indicators of successful aging and predict mortality. However, it has not yet been examined whether they independently predict mortality or interact. We examined main and interaction effects using Cox proportional hazards models in a sample of older adults (N = 1402; age range: 65–91). Only the interaction of life satisfaction and control beliefs significantly predicted mortality when controlling for socio-demographic variables and health. These findings suggest that detrimental effects of low control beliefs can be buffered by life satisfaction, and unexpectedly, that high levels of both factors are not most protective against mortality.
We examined Type D personality (combination of negative affectivity with social inhibition) and its assessment with the DS14 in 543 Lithuanian coronary patients. Psychometric analyses confirmed the two-factor structure, internal consistency (α = 0.84/α = 0.75), and test–retest reliability (r = 0.69/0.81) of the DS14 negative affectivity and inhibition components. Negative affectivity correlated (r = –0.58) with emotional stability and social inhibition (r = –0.46) with extraversion; correlations with other Big-Five traits ranged between r = –0.11 and –0.19. Type D patients (34%) had a ninefold increased odds of depression (95% confidence interval = 5.01–17.36) and a fivefold increased odds of anxiety (95% confidence interval = 3.47–7.97). These findings support the validity of the Type D construct in Lithuania.
Anxiety regarding food challenges may serve an important role in parents’ decisions to adhere to their child’s food challenge referrals. This study examined the role of intolerance of uncertainty in food challenge referral adherence by assessing state/trait anxiety among mothers whose children were referred for a food challenge. Mothers whose children passed a food challenge reported significant decreases in anxiety regarding allergic reactions, but intolerance of uncertainty did not predict adherence. Trust in the physician was a primary reason mothers attended the food challenge, suggesting that physicians should consider the impact of the physician–patient relationship when treating these families.
Community-based young offenders are at high risk of self-harm and unlikely to be in contact with mental health services. Semi-structured interviews with community youth justice staff and a content analysis of 50 records of self-harm not only revealed staff concerns about the impact of stigma on disclosure and service use, but also found dismissive attitudes towards socially motivated self-harm, which was equated with lower suicide risk and less emotional distress. Efforts to improve identification of self-harm will need to address the perceived – and false – distinction between ‘genuine’ and socially motivated self-harm.
In this study, we examined the structural relationships among constructs from the Health Belief Model as they relate to human papillomavirus vaccine intentions in young gay and bisexual men in the United States (N = 183). A model was identified that fit the data well and accounted for 56% of the variance in vaccine intentions. Perceived benefits and barriers were the most proximate predictors of intentions, whereas knowledge and perceived threat exerted only indirect influence. Clarifying the propositional structures within the Health Belief Model can help to advance our understanding of human papillomavirus–related cognitions and behaviors and inform vaccine promotion programs.
The objective of the current study was to explore the relationship between resilience and psychological adjustment in Chinese adolescents who experienced the 2008 Sichuan earthquake. Study 1 compared the scores and factor structures on the Resilience Scale for Chinese Adolescents for 1436 adolescents, who were divided into a high-adversity group and a low-adversity group. The results showed that resilience following exposure to an earthquake included cognitive and emotive components. In Study 2, 311 Chinese adolescents who resided in the most severely affected areas were surveyed at 15 months (T1) and 20 months (T2) following the earthquake. The results revealed that resilience mediated the relationship between positive future expectations at T1 and adjustment at T2.
Studies have shown that chronic illness patients encounter difficulties in the social sharing of emotions. Do HIV/AIDS patients present distinguishing traits in the inhibition of illness and non-illness-related emotions? The differences in the social sharing of emotion between 35 HIV/AIDS, 35 diabetic and 34 cancer outpatients were studied. A questionnaire assessed illness-related emotions, social sharing of emotion and emotional inhibition. The HIV/AIDS group significantly presented superior scoring in shame, guilt and non-sharing of illness-related emotions, lower frequencies of social sharing of emotion and less sharing partners. These findings could lead to future research examining the emotional expression of guilt and shame in HIV/AIDS.
The present study examined the moderating role of social support and challenging behaviour on the stress–physical health relationship in parents caring for children with intellectual disabilities. Parents of children with intellectual disabilities (n = 70) reported more physical health problems compared to control parents (n = 45) and were more likely to visit their general practitioner. Furthermore, challenging behaviours, but not social support, moderated this association: parents of children with intellectual disabilities reported poorer physical health when both challenging behaviours and stress were perceived to be high. These findings suggest that interventions need to be directed towards ameliorating the impact of challenging behaviours.
The rate of casual sexual encounters is increasing on college campuses. To decrease sexual risk behavior, information used to judge sexual risk in others needs to be identified. Women rated male targets on willingness to have unprotected sex with the target and likelihood that the target has a sexually transmitted infection. Physical attractiveness was the strongest predictor of ratings, accounting for all the target variance in willingness to have unprotected sex. However, risk factors reported by the target were inconsistent predictors of perceived sexual risk. Findings are discussed within the context of safer sex interventions for college students.
This is the second article in a phenomenological study of hope among 10 Israeli reserve soldiers with chronic posttraumatic stress disorder. The aim of the second analysis was to learn about the veterans’ conceptualization of hope. The picture of hope that emerges from the analysis of their interviews is of a binary phenomenon in which hope develops but may also be arrested, is conscious but also unconscious, and strengthens the individual but may also weaken one. These findings show the binary phenomenon of hope and how it contributes to coping with traumatic events and therefore can assist professional workers who treat individuals suffering from posttraumatic stress disorder.
We examined the extent to which prior knowledge about nutrition moderates age differences in remembering newly learned nutrition information. Younger and older adults with varying levels of knowledge read an article on fats and cholesterol and then completed a memory task. Participants responded to statements that were—or were not—presented in the text, which enabled us to examine memory accuracy overall as well as hits and memory errors. Results showed age differences were present in the low-knowledge group but not in the high-knowledge group. Findings illustrate the importance of knowledge for older adults’ memory for health information.
We hypothesized that parents’ emotional intelligence associates with their children’s type I diabetes outcomes. Eighty-one parents, the main caregivers of their diabetic children, filled out two measures of emotional intelligence and a demographic questionnaire. Three indicators of diabetes management were collected from the patients’ files: hemoglobin A1c, mean blood tests per day, and mean blood glucose levels. Emotional intelligence associated with all glycemic management indices, though differences were found between the two measures. Of the demographic factors, income level showed some association with the outcome measures. The results are discussed in light of existing theories and models.
This study explored the embodied experience of body change using a qualitative design. Eight previous plastic surgery patients of a London hospital took part in in-depth, semi-structured interviews 1 year post a plastic surgery procedure to remove excess skin around their abdomen, resulting from weight loss. Participant interviews were analysed using Interpretative Phenomenological Analysis. Two sub-themes titled ‘Shame of the hidden body’ and ‘Lack of acceptance; the future focused body’ are presented in this article. Findings are considered in relation to theories of ‘Body Shame’ and in the current cultural context.