Whether and how people reach care.
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1876 to 1900 of 2,047The culture of faith and hope: patients' justifications for their high estimations of expected therapeutic benefit when enrolling in early phase oncology trials.
Background: Patients' estimates of their chances of therapeutic benefit from participation in early phase trials greatly exceed historical data. Ethicists worry that this therapeutic misestimation undermines the validity of informed consent.
Methods: The authors interviewed 45 patients enrolled in phase 1 or 2 oncology trials about their expectations of therapeutic benefit and their reasons for those expectations. They used a phenomenological, qualitative approach with 1 primary coder to identify emergent themes, verified by 2 independent coders.
Results: Median expectations of therapeutic benefit varied from 50% to 80%, depending on how the question was asked. Justifications universally invoked hope and optimism, and 27 of 45 participants used 1 of these words. Three major themes emerged: 1) optimism as performative, that is, the notion that positive thoughts and expressions improve cha…
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Parental perspectives of an adolescent/young adult stem cell transplant and a music video intervention.
Background: Parents experience high levels of distress during their child's stem cell transplant that can decrease the ability to support their child and effectively communicate with healthcare providers. Because parents are a primary source of support, their perspectives are very important when evaluating supportive care interventions for their adolescents/young adults.
Objectives: This study examined parents' perspective of their adolescents or young adults' (AYAs') experience with stem cell transplantation (SCT) and involvement in a therapeutic music video (TMV) intervention.
Methods: This was a phenomenological study using parents' interviews. The sample included 7 parents of 6 adolescents/young adults ranging in age from 13 to 21 years hospitalized for SCT for an oncology-related condition. Parents' interviews were conducted 100 days after transplantation. Sessions were audio taped,…
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Community attitudes to the appropriation of mobile phones for monitoring and managing depression, anxiety, and stress.
Background: The benefits of self-monitoring on symptom severity, coping, and quality of life have been amply demonstrated. However, paper and pencil self-monitoring can be cumbersome and subject to biases associated with retrospective recall, while computer-based monitoring can be inconvenient in that it relies on users being at their computer at scheduled monitoring times. As a result, nonadherence in self-monitoring is common. Mobile phones offer an alternative. Their take-up has reached saturation point in most developed countries and is increasing in developing countries; they are carried on the person, they are usually turned on, and functionality is continually improving. Currently, however, public conceptions of mobile phones focus on their use as tools for communication and social identity. Community attitudes toward using mobile phones for mental health monitoring and self-manag…
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A patient-specific version of the Disabilities of the Arm, Shoulder, and Hand Questionnaire.
Purpose: We modified the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire to be weighted according to a patient's priorities (patient-specific [PS-DASH]) and compared it with the DASH in terms of its mean and variance and its relationship with coping styles (pain avoidance, pain catastrophizing, anxiety sensitivity, and hypochondriasis), depression, and overall stress.
Methods: Ninety-eight patients with carpal tunnel syndrome completed questionnaires measuring depression, pain catastrophizing, avoidance, hypochondriasis, anxiety sensitivity, and ordinal measures of self-reported stress and disability. They also completed the DASH and a modification of the DASH that weighted each item according to personal priorities.
Results: The DASH scores had a significantly higher mean and greater standard deviation than the PS-DASH (mean +/- standard deviation, 54.1 +/- 16.8 vs 32.7…
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Adhikari R (2010)MEDLINE-indexed journal, not yet read by usBMC pregnancy and childbirth86 citations Demographic, socio-economic, and cultural factors affecting fertility differentials in Nepal.
Background: Traditionally Nepalese society favors high fertility. Children are a symbol of well-being both socially and economically. Although fertility has been decreasing in Nepal since 1981, it is still high compared to many other developing countries. This paper is an attempt to examine the demographic, socio-economic, and cultural factors for fertility differentials in Nepal.
Methods: This paper has used data from the Nepal Demographic and Health Survey (NDHS 2006). The analysis is confined to ever married women of reproductive age (8,644). Both bivariate and multivariate analyses have been performed to describe the fertility differentials. The bivariate analysis (one-way ANOVA) was applied to examine the association between children ever born and women's demographic, socio-economic, and cultural characteristics. Besides bivariate analysis, the net effect of each independent variabl…
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Religiosity and hope: a path for women coping with a diagnosis of breast cancer.
Background: Both religiosity and hope are known for their positive role in coping with cancer.
Objective: This study examines the mediating role of hope between religiosity and coping for women diagnosed with breast cancer.
Method: Israeli Jewish women with breast cancer (N=233) completed the Mental Adjustment to Cancer Scale, The Systems of Belief Inventory, and The Hope Scale.
Results: By use of hierarchical regression, hope was found to be a mediator between religiosity and three coping styles.
Conclusion: Special attention should be given to the role of hope for religious patients because it increases the positive effects of religion in coping with cancer.
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Caregiver depression is associated with a low sense of coherence and health-related quality of life.
Objectives: The main objective is to examine the sense of coherence (SOC) of spouse caregivers. The aim was further investigate the association of SOC, health-related quality of life (HRQoL), depressive symptoms, distress and how severity of Alzheimer's disease (AD) affects SOC.
Method: 17O patient-spouse caregiver dyads in which the patient has recently diagnosed mild AD. Caregivers completed SOC scale (SOC-29), HRQoL (15D), Beck depression and general health questionnaire scale. The assessment of AD-related symptoms was made using mini mental state examination, clinical dementia rating, neuropsychiatric inventory and functional performance using activities of daily living (ADCS-ADL) scale.
Results: Male caregivers' SOC was significantly higher than female caregivers. The main predictor for low SOC was depression, with 37% of spousal caregivers reporting depressive symptoms. Women repor…
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Relationships between the Brief Multidimensional Measure of Religiousness/Spirituality and health outcomes for a heterogeneous rehabilitation population.
Purpose: To determine relationships between the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS; i.e., positive/negative spirituality, forgiveness, religious practices, positive/negative congregational support) and physical and mental health (Medical Outcomes Scale-Short Form 36; SF-36) for individuals with chronic disabilities.
Research method: A cross-sectional analysis of 118 individuals evaluated in outpatient settings, including 61 with traumatic brain injury (TBI), 32 with cerebral vascular accidents (CVA), and 25 with spinal cord injury (SCI).
Results: Three of 6 BMMRS factor scores (i.e., positive spiritual experience, forgiveness, negative spiritual experience) were significantly correlated with the SF-36 General Health Perception (GHP) scale, and only 1 of 6 BMMRS factor scores (i.e., negative spiritual experience) was significantly and negatively correlated…
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Cornwell EY, Waite LJ (2009)MEDLINE-indexed journal, not yet read by usThe journals of gerontology. Series B, Psychological sciences and social sciences267 citations Measuring social isolation among older adults using multiple indicators from the NSHAP study.
Objectives: The National Social Life, Health, and Aging Project (NSHAP) data contain multiple indicators of social connectedness, social participation, social support, and loneliness among older adults. We suggest that these indicators can be combined to measure two aspects of social isolation: social disconnectedness (i.e., physical separation from others) and perceived isolation (i.e., feelings of loneliness and a lack of social support). We use the NSHAP data to create scales measuring social disconnectedness and perceived isolation and examine their distribution among older adults.
Methods: We assess the reliability of the scales using Cronbach's alpha and item-total correlations and perform confirmatory factor analysis to test the model against the data. Finally, we test differences in scale means across subgroups to assess the distribution of social disconnectedness and perceived i…
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Measuring health anxiety: moving past the dichotomous response option of the original Whiteley Index.
The Whiteley Index [WI; Pilowsky, I. (1967). Dimensions of hypochondriasis. British Journal of Psychiatry, 113, 89-93] is a widely used self-report measure of health anxiety, hypochondriasis, and illness phobia; however, the factor structure of the WI has proven unstable. Moreover, factorial investigations of the WI persist in the original true/false response format despite criticisms of dichotomous scales and the availability of a Likert scale version [Barsky, A. J., Cleary, P. D., Wyshak, G., Spitzer, R. L., Williams, J. B. W., & Klerman, G. L. (1992). A structured diagnostic interview for hypochondriasis: a proposed criterion standard. The Journal of Nervous and Mental Disease, 180, 20-27]. The current investigation explores the factor structure of the 5-point Likert scale version of the WI using a sample of 287 students (64 men, ages 18-34 [M=20.6; SD=3.2]; 223 women ages 18-45 [M=20…
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Attitudes and behaviours of students from the faculty of theology regarding organ donation: a study from Turkey.
The aim of this study was to investigate the knowledge and attitude of students from the Faculty of Theology of Erciyes University regarding organ donation. This study comprising all students (n = 264) showed that 51.6% of subjects to the kidney is an organ that may be donated; other organs were less known. 16.5% of the students thought that organ donation is not in accord with Islamic beliefs; 22.0% thought that it is permitted in Islam for Muslims to donate to non-Muslims, and 23.6% were willing to accept organs from non-Muslims. 23.6% of the students were willing to donate their organs, whereas 57.3% were undecided. None of the students had an organ donation card. Among students who did not consider donation or were undecided, 16.5% stated that it was "religiously inappropriate" and 13.3% stated that they did not "approve the loss of body integrity." Students declared that they had li…
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The meaning of feeling well in people with moderate or severe traumatic brain injury.
Aim: The aim of this study was to elucidate the meaning of feeling well for people with moderate or severe traumatic brain injury.
Background: Considerable attention has been given to research consequences, quality of life and satisfaction with life in people with traumatic brain injury. Most studies reveal negative aspects of living with traumatic brain injury. Knowledge that provides an understanding of the meaning of feeling well for people with a traumatic brain injury entails the possibility that they could receive support to feel well, despite their injury.
Design: This study used a qualitative research approach, as the aim was to elucidate meaning.
Methods: Data were collected through qualitative research interviews with two women and six men with moderate or severe traumatic brain injury who had lived with the injury for between 7-15 years. A phenomenological hermeneutic method w…
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Locker D (2009)MEDLINE-indexed journal, not yet read by usJournal of public health dentistry67 citations Self-esteem and socioeconomic disparities in self-perceived oral health.
Objective: To determine if psychosocial factors explain the socioeconomic disparities in self-perceived oral health that persist after controlling for oral status variables.
Methods: Data came from the participants in the Canadian Community Health Survey 2003 who were residents in the city of Toronto. Oral health variables included self-rated oral health, a 13-item oral health scale, denture wearing, and having a tooth extracted in the previous year. The last two measures were regarded as proxy indicators of tooth loss. Psychosocial variables included a self-esteem scale, a depression scale, and single items measuring life satisfaction, life stress, and sense of cohesion. Socioeconomic status was assessed using total annual household income.
Results: Interviews were completed with 2,754 dentate persons aged 20 years and over. Bivariate analyses confirmed that there were income gradients …
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Gharaibeh M, Oweis A (2009)MEDLINE-indexed journal, not yet read by usJournal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing36 citations Why do Jordanian women stay in an abusive relationship: implications for health and social well-being.
Purpose: The purpose of this study was to explore why Jordanian women stay with an abusive husband.
Design: The study used a qualitative approach to collect data from 28 abused women who were recruited through their community during the summer and fall of 2007.
Methods: Data were collected using an open-ended question through one-on-one in-depth interviews.
Findings: Results from analysis of the qualitative data revealed that abused Jordanian women identified five main reasons for staying with an abusive husband: the inherited social background, financial dependency, lack of family support, sacrificing self for the sake of the children, and the adverse social consequences of divorce.
Conclusions: The results indicate that Jordanian women are strongly bound by traditions and cultural rules and lack all means of empowerment. Results of the study have implications for healthcare providers, …
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The relationship among sense of coherence, socio-economic status, and oral health-related behaviours among Finnish dentate adults.
This study assessed the independent and interactive associations between sense of coherence (SOC) and socio-economic status (SES) with oral health-related behaviours. Data from 5,399 dentate adults regarding their demographic characteristics, years of education, SOC score, and oral health-related behaviours were analysed. Household income was obtained from tax authorities. Logistic regression was used to test the adjusted association of SOC with each behaviour and to test the statistical interaction between each SES indicator and the SOC score. Subjects were 1.20 [95% confidence interval (95% CI): 1.11-1.28] and 1.22 (95% CI: 1.12-1.32) times more likely to visit dentists regularly for check-ups and to brush their teeth twice daily or more often, respectively, and were 1.11 (95% CI: 1.03-1.20) and 1.21 (95% CI: 1.12-1.32) times less likely to be daily smokers and to consume sugar-added p…
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Medical versus spiritual orientations: Differential patient views toward recovery.
Background: Relapse among patients in substance abuse treatment has generated interest in identifying attitudinal factors that sustain recovery.
Objective: To assess the relationship of attitudes toward approaches to motivation for treatment and Twelve Step beliefs.
Methods: Dually diagnosed patients (N = 100) completed a survey assessing treatment attitudes, motivation, and Twelve Step beliefs.
Results: Endorsement of medical services was positively correlated with motivation but unrelated to Twelve Step beliefs. Endorsement of religious services was unrelated to motivation but was associated with Twelve Step beliefs.
Conclusions: Patients may have differing perceptions regarding routes to recovery based on preferences for professional services or spiritual resources.
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Emotional reactions of Arab lay persons to a person with Alzheimer's disease.
Aims: To assess emotional reactions of Israeli Arab people to persons with Alzheimer's Disease (AD) and assess the associations of perceptions of threat of AD, personal experience with AD and socio-demographic characteristics with emotional reactions to persons with AD.
Method: A total of 170 Israeli Arab adults, aged 40-85, were interviewed in person by the vignette methodology for their emotional reactions to people with AD, an issue not yet studied in this population. Their perceptions of dangerousness of persons with AD to themselves and to others, familiarity with the disease and perceptions of personal threat were also probed.
Results: Four dimensions of emotional reactions to a person with AD emerged: anxiety, aggressiveness, prosocial reactions and rejection. More positive than negative emotions were expressed. Levels of education and religiosity, and perceived dangerousness of t…
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Prognostic importance and long-term determinants of self-rated health after initial acute myocardial infarction.
Background: Self-rated health (SRH) is a valid measure of health and its trajectories over time have been found to predict mortality. A better understanding of the determinants of changes in SRH is required, particularly post-myocardial infarction (MI), where rapid changes in health may occur.
Objectives: To evaluate the prognostic importance of SRH and the determinants of its long-term trajectory in patients with MI.
Patients and methods: Between February 1992 and February 1993, 1521 consecutive patients aged <or=65 years (19% women) discharged from all hospitals in central Israel after initial acute MI were enrolled and followed-up for a mean of 12 years. Extensive data were obtained at study entry, with SRH measured at baseline (retrospective assessment of pre-MI health status) and at 5 and 10 years.
Results: Baseline SRH showed a strong graded association with mortality post-MI. The …
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Interventions to manage compassion fatigue in oncology nursing.
Work-related stress emanating from close interpersonal contact with patients with cancer and their families may result in physical, emotional, social, and spiritual adversity for oncology nurses. The negative result of this cumulative distress has historically been referred to as burnout. However, this dated term does not truly depict the result of the longitudinal workplace ramifications of sadness and despair on nursing staff. This article proposes that the phrase compassion fatigue replace the outdated notion of burnout in describing this phenomenon. Although not clearly and uniformly described in the literature, this occurrence is seen regularly in clinical practice and is conceptually known by nurses. Limited information is available about interventions to manage compassion fatigue; therefore, a national survey was conducted to identify resources available to oncology nurses to coun…
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The impact of social support and sense of coherence on health-related quality of life among nursing home residents--a questionnaire survey in Bergen, Norway.
Background and objectives: Few studies have examined the association between social support and health-related quality of life (HRQOL) among nursing home residents and whether the sense of coherence (SOC) modifies the effect of social support on health-related quality of life. The main aims of this study were to determine the relationship between social support and HRQOL and to investigate whether the SOC modifies the effect of social support on HRQOL.
Design: A cross-sectional, descriptive, correlational design.
Settings: All 30 nursing homes in Bergen in western Norway.
Participants: Two hundred and twenty-seven mentally intact long-term nursing home residents 65 years and older.
Methods: Data were obtained through face-to-face interviews using the SF-36 Health Survey, Social Provisions Scale and Sense of Coherence Scale. Possible relationships between the Social Provisions Scale and t…
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Distanciation in Ricoeur's theory of interpretation: narrations in a study of life experiences of living with chronic illness and home mechanical ventilation.
Within the caring science paradigm, variations of a method of interpretation inspired by the French philosopher Paul Ricoeur's theory of interpretation are used. This method consists of several levels of interpretation: a naïve reading, a structural analysis, and a critical analysis and discussion. Within this paradigm, the aim of this article is to present and discuss a means of creating distance in the interpretation and the text structure by using narration in a poetic language linked to the meaning of the text. Ricoeur's 'Hermeneutical function of distanciation' will be introduced, and this concept of distanciation will be illustrated with reference to narrations from a study of patient's life experiences living with chronic illness and home mechanical ventilation in Denmark. Distanciation in the interpretation objectifies the text, and narration in a poetic language creates a partic…
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Individual, social, environmental, and physical environmental correlates with physical activity among Canadians: a cross-sectional study.
Background: The identification of various individual, social and physical environmental factors affecting physical activity (PA) behavior in Canada can help in the development of more tailored intervention strategies for promoting higher PA levels in Canada. This study examined the influences of various individual, social and physical environmental factors on PA participation by gender, age and socioeconomic status, using data from the 2002 nationwide survey of the Physical Activity Monitor.
Methods: In 2002, 5,167 Canadians aged 15-79 years, selected by random-digit dialling from household-based telephone exchanges, completed a telephone survey. The short version of the International Physical Activity Questionnaire was used to collect information on total physical activity. The effects of socio-economical status, self-rated health, self-efficacy, intention, perceived barriers to PA, hea…
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Socioeconomic status, working conditions and self-rated health in Switzerland: explaining the gradient in men and women.
Objectives: Epidemiological research has confirmed the association between socioeconomic status (SES) and health, but only a few studies considered working conditions in this relationship. This study examined the contribution of physical and psychosocial working conditions in explaining the social gradient in self-rated health.
Methods: A representative sample of 10 101 employees, 5003 women and 5098 men, from the Swiss national health survey 2002 was used. SES was assessed according to the EGP-scheme. Working conditions included exposure to physical disturbances, physical strain, job insecurity, monotonous work and handling simultaneous tasks. For data analysis logistic regression analyses were performed.
Results: Data show a social gradient for self-rated health (SRH) as well as for physical and psychosocial working conditions. Logistic regression analysis controlling for age, gender a…
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The role of religious activity and spirituality in the health and well-being of older adults.
Older adults completed questionnaires of religiosity, spirituality and health, as well as of the potential mediators of healthy behaviors and social support. Church membership related to potential mediators and positive health; given membership, frequency of attendance contributed less to health. Existential well-being was strongly related to all outcome health measures. Regression analyses indicated that spiritual wellbeing and prayer contributed to the prediction of psychological wellbeing, subjective well-being, physical symptoms and depression, even when the contributions of age, gender, healthy behaviors and social support were included. Healthy behaviors and social support operated only as partial mediators of the existential-health effects.
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Low LF, Anstey KJ (2009)MEDLINE-indexed journal, not yet read by usAlzheimer's & dementia : the journal of the Alzheimer's Association115 citations Dementia literacy: recognition and beliefs on dementia of the Australian public.
Background: Dementia is a growing health problem worldwide and in Australia. Little research has been conducted on dementia literacy in the community.
Methods: The aim of this study was to investigate the recognition of dementia and beliefs regarding prognosis, cause, and risk reduction in the Australian public. A cross-sectional telephone survey of 2,000 randomly selected community-dwelling adults (23.4% response rate) was conducted.
Results: Eighty-two percent of the sample correctly identified "dementia" or "Alzheimer's" from a vignette. There were no differences in recognition rates between vignettes describing mild or moderate dementia symptoms. Almost half thought that at least partial recovery would occur, given appropriate treatment. More than 80% of the sample thought that genetics, old age, brain disease, and stroke or mini-stroke contributed to a person getting dementia. Seven…
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