Whether and how people reach care.
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601 to 625 of 2,047Understanding discrepancies in parent-child reporting of emotional and behavioural problems: Effects of relational and socio-demographic factors.
Background: Discrepancies between parents and children in their assessment of children's mental health affect the evaluation of need for services and must be taken seriously. This article presents the differences between parents' and children's reports of the children's symptoms and social impairment, based on the results of the Strengths and Difficulties Questionnaire (SDQ). The interrelationship between relational aspects and socio-demographic factors with patterns of disagreement are explored.
Methods: Differences in the prevalence and means of SDQ symptom and impact scores were obtained from 8,154 primary school children, aged between 10 and 13 years, and their parents. Agreement between matched pairs was measured using Pearson's and Spearman's rho correlations. Socio-demographic variables, communication patterns and parental engagement were analysed as possible correlates of informa…
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Banning M, Hafeez H (2010)cohort or longitudinalMEDLINE-indexed journal, not yet read by usJournal of cancer education : the official journal of the American Association for Cancer Education18 citations A two-center study of Muslim women's views of breast cancer and breast health practices in Pakistan and the UK.
Breast health awareness practices of Pakistani Muslim women in the UK and Pakistan is unknown. Focus group interviews were used to investigate the impact of culture and psychosocial issues on breast health awareness involving 44 women in Lahore and London. Women based in Lahore were more inquisitive about breast cancer and held more developed views compared with British Pakistani Muslim women. Women concurred that concise and relevant breast health education is needed irrespective of faith to improve cultural sensitivity and awareness in both Pakistani communities (both men and women).
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Psychometric testing of the Breastfeeding Self-Efficacy Scale-Short Form in a sample of Black women in the United States.
The benefits of breastfeeding increase with duration and exclusivity, but significant racial disparities exist in breastfeeding rates. Breastfeeding self-efficacy, as measured by the Breastfeeding Self-Efficacy Scale Short-Form (BSES-SF), is a significant predictor of breastfeeding outcomes in diverse samples. The purpose of this study was to assess the psychometric properties of the BSES-SF in Black women in the US. The psychometric characteristics were consistent with previous studies, including internal consistency, comparison with contrasted groups, and correlation with the construct of breastfeeding network support. Breastfeeding self-efficacy significantly predicted breastfeeding at 4 and 24 weeks postpartum. The results are consistent with previous research, and they suggest the BSES-SF could be used to identify women at risk for prematurely discontinuing breastfeeding.
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Anxiety in the operating theatre: a study of frequency and environmental impact in patients having local, plexus or regional anaesthesia.
Aims: To estimate the frequency of intraoperative anxiety, the influence of environmental factors on intraoperative anxiety and to study the relationship between intraoperative anxiety and generalised anxiety and depression.
Background: Previous research has documented that surgery is associated with increased stress and anxiety, which have an adverse effect on patient outcomes. Few studies have been conducted to obtain patients' perspectives about the influence of the operating theatre environment on anxiety.
Design: The study used a survey design including questionnaires.
Method: Clinical variables were noted from the anaesthesia medical records. The sample (n = 119) comprised patients undergoing elective surgery and emergency operations within 24 hours of admission. Anxiety was assessed by the Jakobsen's questionnaire and the Hospital Anxiety and Depression scale.
Results: Twenty-thre…
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Friedman DB, Laditka JN, Hunter R, Ivey SL, Wu B, Laditka SB, Tseng W, Corwin SJ, Liu R, Mathews AE (2009)cohort or longitudinalMEDLINE-indexed journal, not yet read by usThe Gerontologist46 citations Getting the message out about cognitive health: a cross-cultural comparison of older adults' media awareness and communication needs on how to maintain a healthy brain.
Purpose: Evidence suggests that physical activity and healthy diets may help to maintain cognitive function, reducing risks of developing Alzheimer's disease and vascular dementia. Using a cross-cultural focus, we describe older adults' awareness about cognitive health, and their ideas about how to inform and motivate others to engage in activities that may maintain brain health.
Design and methods: Nineteen focus groups were conducted in 3 states (California, North Carolina, South Carolina) with 177 adults aged 50 years and older. Six groups were with African Americans (AAs), 4 with Chinese, 3 with Vietnamese, 4 with non-Hispanic Whites, and 2 with American Indians (AIs). A qualitative thematic analysis was conducted.
Results: Many participants did not recall reading or hearing about brain health in the media. Participants recommended a multimedia approach to inform others about brain h…
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Genberg BL, Hlavka Z, Konda KA, Maman S, Chariyalertsak S, Chingono A, Mbwambo J, Modiba P, Van Rooyen H, Celentano DD (2009)cohort or longitudinalMEDLINE-indexed journal, not yet read by usSocial science & medicine (1982)214 citations A comparison of HIV/AIDS-related stigma in four countries: negative attitudes and perceived acts of discrimination towards people living with HIV/AIDS.
HIV/AIDS-related stigma and discrimination have a substantial impact on people living with HIV/AIDS (PLHA). The objectives of this study were: (1) to determine the associations of two constructs of HIV/AIDS-related stigma and discrimination (negative attitudes towards PLHA and perceived acts of discrimination towards PLHA) with previous history of HIV testing, knowledge of antiretroviral therapies (ARVs) and communication regarding HIV/AIDS and (2) to compare these two constructs across the five research sites with respect to differing levels of HIV prevalence and ARV coverage, using data presented from the baseline survey of U.S. National Institute of Mental Health (NIMH) Project Accept, a four-country HIV prevention trial in Sub-Saharan Africa (Tanzania, Zimbabwe and South Africa) and northern Thailand. A household probability sample of 14,203 participants completed a survey including …
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Reexamining the domain of hypochondriasis: comparing the Illness Attitudes Scale to other approaches.
The present study examined utility of the Illness Attitudes Scale (IAS; [Kellner, R. (1986). Somatization and hypochondriasis. New York: Praeger Publishers]) in a non-clinical college sample (N=235). Relationships among five recently identified IAS dimensions (fear of illness and pain, symptom effects, treatment experience, disease conviction, and health habits) and self-report measures of several anxiety-related constructs (health anxiety, body vigilance, intolerance of uncertainty, anxiety sensitivity, and non-specific anxiety symptoms) were examined. In addition, this study investigated the incremental validity of the IAS dimensions in predicting medical utilization. The fear of illness and pain dimension and the symptom effects dimension consistently shared stronger relations with the anxiety-related constructs compared to the other three IAS dimensions. The symptom effects dimension…
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Are spirituality and religiosity resources for patients with chronic pain conditions?
Objective: We studied whether or not spirituality/religiosity is a relevant resource for patients with chronic pain conditions, and to analyze interrelations between spirituality/religiosity (SpREUK Questionnaire; SpREUK is an acronym of the German translation of "Spiritual and Religious Attitudes in Dealing with Illness"), adaptive coping styles that refer to the concept of locus of disease control (AKU Questionnaire; AKU is an acronym of the German translation of "Adaptive Coping with Disease"), life satisfaction, and appraisal dimensions.
Patients: In a multicenter cross-sectional study, 580 patients with chronic pain conditions were enrolled.
Results: We found that the patients relied on both external powerful sources of disease control and on internal powers and virtues, while Trust in Higher Source (intrinsic religiosity) or Illness as Chance (reappraisal) were valued moderately; S…
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Cultural differences in child delivery: comparisons between Jewish and Arab women in Israel.
Objective: To compare Jewish and Arab women characteristics regarding pregnancy follow-up, compliance to a health regime and behavioural expressions during labour, delivery and the post-partum period.
Design: The participants answered a 45-item questionnaire designed for the current research.
Setting: The first three post-partum days in the delivery ward at one of the biggest hospitals in Israel.
Participants: A total of 126 Jewish and Arab-Muslim parturients.
Results: Significant differences were found (P < 0.01) concerning pregnancy follow-up attendance and participation in a prenatal course, which were lower among Arab women. Several differences were found regarding delivery room attendance, type and number of companions, and behavioural expressions of pain, which were demonstrated more among Arab women. Epidural anaesthesia was highly prevalent among Jewish women, in comparison with …
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Longitudinal association of adolescents' sense of coherence with tooth-brushing using an integrated behaviour change model.
Objective: To determine the association between adolescents' sense of coherence (SOC) and their tooth-brushing behaviour.
Methods: This 18-month longitudinal study involved a representative sample of 8th-graders (n = 1025) from 11 randomly selected public high schools in the Limpopo Province, South Africa. Data collected by means of a self-administered questionnaire included respondents' socio-demographic profiles, vulnerability to depression, smoking status, dental treatment attendance pattern, frequency of and motivation for tooth-brushing. Based on the responses to the question on readiness to change brushing behaviour and in line with the integrated change model, respondents were also categorized as being in the pre-contemplation, contemplation or preparation/action stages. Respondents' SOC was measured using a six-item adapted Antonovsky SOC scale. Data analysis included chi-squared…
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Factors related to perceived quality of life in patients with Alzheimer's disease: the patient's perception compared with that of caregivers.
Aims: To compare care recipient and caregiver perceptions of quality of life in patients (QoL-p) with Alzheimer's disease (AD). To identify associated factors, and the concordances-discrepancies.
Method: Cross-sectional analytic study of 236 patients and their carers using the Quality of Life in Alzheimer's Disease (QoL-AD) scale, socio-demographic data and clinical examination.
Results: Patients scored the QoL-AD more favourably than did caregivers (34.4 vs 31.3, p < 0.001). Cognitive deterioration did not affect the perception of QoL-AD (rho = -0.05, p = 0.394). The neuropsychiatric symptoms was associated with a negative perception of the QOL-AD in both patients (rho = -0.22, p < 0.01) and caregivers (rho = -0.47, p < 0.001). Greater functional autonomy was associated with a better perception of the QOL-AD in patients (rho = 0.17, p < 0.01) and even more so in caregivers (rho = 0.56, …
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Chronic pain syndrome associated with health anxiety: a qualitative thematic comparison between pain patients with high and low health anxiety.
Objectives: Based on the high prevalence of health anxiety among patients with chronic pain and the conceptual overlap between the diagnostic criteria for hypochondriasis and pain disorder, it has been suggested that the cognitive-behavioural theory of severe and persistent health anxiety can be applied to understand the problems presented by a subgroup of chronic pain patients. This study aimed to provide qualitative data to complement the progress of the existing experimental research and theory development.
Design: A cross-sectional design with two groups was adopted.
Method: In-depth semi-structured interviews were conducted with 60 chronic pain patients seeking medical treatment from a specialist clinic, and theoretical thematic analysis was performed on a subset of interview transcripts drawn from the five most health anxious and the five least health anxious of this sample.
Result…
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Development and validation of the collaborative parent involvement scale for youths with type 1 diabetes.
Objective: To develop and test a youth-report measure of collaborative parent involvement in type 1 diabetes management.
Methods: Initial item development and testing were conducted with 81 youths; scale refinement and validation were conducted with 122 youths from four geographic regions. Descriptive statistics, Cronbach's alpha, and factor analyses were conducted to select items comprising the scale. Correlations with parenting style and parent diabetes responsibility were examined. Multiple regression analyses examining associations with quality of life, adherence, and glycemic control were conducted to assess concurrent validity.
Results: The measure demonstrated strong internal consistency. It was modestly associated with parenting style, but not with parent responsibility for diabetes management. A consistent pattern of associations with quality of life and adherence provide suppor…
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Wong IC, Asherson P, Bilbow A, Clifford S, Coghill D, DeSoysa R, Hollis C, McCarthy S, Murray M, Planner C, Potts L, Sayal K, Taylor E (2009)cohort or longitudinalMEDLINE-indexed journal, not yet read by usHealth technology assessment (Winchester, England)57 citations Cessation of attention deficit hyperactivity disorder drugs in the young (CADDY)--a pharmacoepidemiological and qualitative study.
Objectives: To estimate the prevalence of attention deficit hyperactivity disorder (ADHD) pharmacological treatment, and its demographic and clinical details, and to estimate the proportion of patients in the target group who stopped ADHD treatment and investigate possible factors for continuation or cessation of treatment.
Design: A pharmacoepidemiological study using an automated database and a qualititative study using patient interviews. Part 1 was a pharmacoepidemiological study that provided accurate data on use and cessation of ADHD drugs. Part 2 was an in-depth interview study to investigate the reasons, processes and outcomes of treatment cessation.
Setting: Part 1: primary care using the General Practice Research Database (GPRD). Part 2: secondary and tertiary care paediatric clinics, child and adolescent mental health and adult mental health clinics in London, Nottingham, Dund…
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Barriers and facilitators to chronic pain self-management: a qualitative study of primary care patients with comorbid musculoskeletal pain and depression.
Objective: To identify barriers and facilitators to self-management of chronic musculoskeletal pain among patients with comorbid pain and depression.
Design: A qualitative study using focus group methodology.
Setting: Veteran Affairs (VA) and University primary care clinics.
Patients: Recruited after participation in a clinical trial.
Intervention: The Stepped Care for Affective Disorders and Musculoskeletal Pain (SCAMP) trial tested an intervention of optimized antidepressant therapy combined with a pain self-management program versus usual care for primary care patients with comorbid chronic pain and depression.
Outcome measures: Thematic content analysis from focus group data was used to identify patient-perceived barriers and facilitators to self-management of chronic musculoskeletal pain.
Results: Patients (N = 18) were 27 to 84 years old (M = 54.8), 61% women, 72% white, and 22% bl…
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Associations between parenting styles and teen driving, safety-related behaviors and attitudes.
Objective: The goal was to explore the association between parenting style and driving behaviors.
Methods: The 2006 National Young Driver Survey gathered data on driving safety behaviors from a nationally representative sample of 5665 ninth-, 10th-, and 11th-graders. A parenting style variable was based on adolescent reports and separated parents into 4 groups, (1) authoritative (high support and high rules/monitoring), (2) authoritarian (low support and high rules/monitoring), (3) permissive (high support and low rules/monitoring), and (4) uninvolved (low support and low rules/monitoring). Associations between parenting style and driving behaviors and attitudes were assessed.
Results: One half of parents were described as authoritative, 23% as permissive, 8% as authoritarian, and 19% as uninvolved. Compared with teens with uninvolved parents, those with authoritative parents reported on…
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Secular trends in self reported sexual activity and satisfaction in Swedish 70 year olds: cross sectional survey of four populations, 1971-2001.
Objective: To study secular trends in self reported sexual behaviour among 70 year olds.
Design: Cross sectional survey. Settings Four samples representative of the general population in Gothenburg, Sweden.
Participants: 1506 adults (946 women, 560 men) examined in 1971-2, 1976-7, 1992-3, and 2000-1.
Main outcome measures: Sexual intercourse, attitudes to sexuality in later life, sexual dysfunctions, and marital satisfaction.
Results: From 1971 to 2000 the proportion of 70 year olds reporting sexual intercourse increased among all groups: married men from 52% to 68% (P=0.002), married women from 38% to 56% (P=0.001), unmarried men from 30% to 54% (P=0.016), and unmarried women from 0.8% to 12% (P<0.001). Men and women from later birth cohorts reported higher satisfaction with sexuality, fewer sexual dysfunctions, and more positive attitudes to sexuality in later life than those from earl…
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Development and validation of a religious health fatalism measure for the African-American faith community.
Health researchers struggle to understand barriers to improving health in the African-American community. The African-American church is one of the most promising venues for health promotion, disease prevention, and disparities reduction. Religious fatalism, the belief that health outcomes are inevitable and/or determined by God, may inhibit healthy behaviors for a subset of religious persons. This study reports the development and validation of the Religious Health Fatalism Questionnaire, a measurement tool for studying faith-related health beliefs in African-Americans. Participants included 276 members of seven predominantly African-American churches. Factor analysis indicated three dimensions: (1) Divine Provision; (2) Destined Plan; and (3) Helpless Inevitability. Evidence is presented for the reliability, convergent and predictive validity of the Religious Health Fatalism Questionna…
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Factors associated with oral health-related quality of life in community-dwelling elderly persons with disabilities.
Objectives: To examine, in community-dwelling elderly persons with disabilities, the association between oral health-related quality of life (OHRQOL) as measured using the 14-item Oral Health Impact Profile (OHIP-14) and specific oral health, health, and disability status variables; life satisfaction; living alone; and low income.
Design: Observational cross-sectional.
Setting: A Medicare demonstration conducted in 19 counties in three states.
Participants: Six hundred forty-one disabled, cognitively intact, community-dwelling individuals aged 65 and older.
Measurements: The subjects' OHRQOL was assessed using the OHIP-14, which was scored using three different methods. Data on oral health, health and functional status, life satisfaction, prior health services use, and sociodemographics were collected using interviewer-administered questionnaires.
Results: The participants' mean age was …
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Primary caregivers of schizophrenia outpatients: burden and predictor variables.
This article explores family burden in relation to relatives' coping strategies and social networks, as well as in relation to the patients' severity of positive and negative symptoms. Data on the severity of symptoms (Positive and Negative Syndrome Scale for Schizophrenia [PANSS]), social functioning (Social Functioning Scale [SFS]), caregivers burden (Interview on Objective and Subjective Family Burden or Entrevista de Carga Familiar Objetiva y Subjetiva [ECFOS]), coping skills (Family Coping Questionnaire [FCQ]), and social support (Social Network Questionnaire [SNQ]) were gathered from a randomized sample of 101 Chilean outpatients and their primary caregivers, mostly mothers. Low levels of burden were typically found, with the exception of moderate levels on general concerns for the ill relative. A hierarchical regression analysis with four blocks showed that clinical characteristic…
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Knowledge and willingness toward living organ donation: a survey of three universities in Changsha, Hunan Province, China.
Background: This study was conducted to clarify the knowledge and attitudes of Chinese university students regarding living organ donation and analyze the determinants impacting their decisions.
Methods: A questionnaire was delivered to college students chosen by random assignment. The data was analyzed by Statistics Package for Social Science (SPSS) software.
Results: Of 434 participants, 49.8% indicated they would be willing to be living organ donors, 58.4% believed living organ donation could ease the organ shortage, 48.2% thought that the recovery rate of recipients of living organ donors transplants was equal to or even better than deceased donation, 62.4% designated relatives as their most probable recipients, 48.0% argued that partial compensation was an effective method to increase live organ donation, and 53.7% wished to donate through transplantation centers. According to univa…
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Risk and protective factors for psychological well-being of children orphaned by AIDS in Cape Town: a qualitative study of children and caregivers' perspectives.
By 2020, an estimated 2.3 million South African children will be orphaned by HIV/AIDS (Actuarial Society of South Africa, 2005), but little is known about risk and protective factors for their emotional and behavioural well-being. This qualitative study explores perspectives of affected families. Orphaned children (n = 60), caregivers of orphaned children (n = 42) and social care professionals (n = 20) completed semi-structured interviews and focus groups. Participants were recruited from schools, shelters and welfare services. Findings from multiple sources indicate potential risk and protective factors in a range of dimensions, including bereavement, family functioning, social support, poverty, access to education and perceived stigma. Many factors reflected international literature on children experiencing similar stressors (e.g. non HIV/AIDS-related bereavement). However, this study …
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Physical activity levels in children and adolescents are reduced after the Fontan procedure, independent of exercise capacity, and are associated with lower perceived general health.
Objectives: To determine physical activity levels in paediatric patients who underwent the Fontan procedure, and their relationship to functional status and exercise capacity.
Study design: We studied 147 patients (ages 7-18 years) at a median of 8.1 years after Fontan, as part of the Pediatric Heart Network cross-sectional study of Fontan survivors. Assessment included medical history, self-reported physical activity, parent-completed Child Health Questionnaire (CHQ), cardiopulmonary exercise testing and physical activity level measured by accelerometry (MTI Actigraph).
Results: Measured time spent in moderate and vigorous activity was markedly below normal at all ages, particularly in females, and was not significantly related to self-reported activity levels, or to maximum Vo2, Vo2 at anaerobic threshold or maximum work rate on exercise testing. Lower measured activity levels were sig…
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Physiologic correlates of perceived therapist empathy and social-emotional process during psychotherapy.
The present study was designed to investigate the relationship among physiologic concordance, patient-perceived therapist empathy, and social-emotional process during psychotherapy. Simultaneous measures of skin conductance (SC) were obtained from 20 unique and established patient-therapist dyads during a live therapy session followed by patient ratings of therapist empathy. Paired SC data of hypothetical dyads were used to test the reliability of the proposed measure of SC concordance. Observer microanalyses of social-emotional process were used to compare short segments of high versus low physiologic concordance. Results show a significant positive correlation (r=0.47, p=0.03) between SC concordance and patient ratings of perceived therapist empathy. Microanalyses suggest that during moments of high versus low SC concordance, there were significantly more positive social-emotional inte…
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Religious beliefs in schizophrenia: their relevance for adherence to treatment.
The study examined how religious beliefs and practices impact upon medication and illness representations in chronic schizophrenia. One hundred three stabilized patients were included in Geneva's outpatient public psychiatric facility in Switzerland. Interviews were conducted to investigate spiritual and religious beliefs and religious practices and religious coping. Medication adherence was assessed through questions to patients and to their psychiatrists and by a systematic blood drug monitoring. Thirty-two percent of patients were partially or totally nonadherent to oral medication. Fifty-eight percent of patients were Christians, 2% Jewish, 3% Muslim, 4% Buddhist, 14% belonged to various minority or syncretic religious movements, and 19% had no religious affiliation. Two thirds of the total sample considered spirituality as very important or even essential in everyday life. Fifty-sev…
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