A meta-analysis of empirical studies (N ¼ 45) adopting Leventhal, Meyer and Nerenz’s (1980) Common Sense Model (CSM) of illness representations is presented. The average corrected intercorrelation matrix for the sample of studies showed that the CSM illness cognition dimensions of consequences, control/cure, identity and timeline followed a logical pattern supporting their construct and discriminant validity across illness types. A content analysis classified coping strategies into seven distinctive categories and health outcomes into six categories. Examining the average corrected correlation coefficients across the studies revealed that perceptions of a strong illness identity were significantly and positively related to the use of coping strategies of avoidance and emotion expression. In addition, perceived controllability of the illness was significantly associated with cognitive reappraisal, expressing emotions and problem-focused coping strategies. Perceptions of the illness as highly symptomatic, having a chronic timeline and serious consequences was significantly correlated with avoidance and expressing emotions coping strategies. Further, perceptions that the illness was curable/controllable was significantly and positively related to the adaptive outcomes of psychological well-being, social functioning and vitality and negatively related to psychological distress and disease state. Conversely, illness consequences, timeline and identity exhibited significant, negative relationships with psychological well being, role and social functioning and vitality. The analyses provide evidence for theoretically predictable relations between illness cognitions, coping and outcomes across studies.

A Meta-Analytic Review of the Common-Sense Model of Illness Representations

Contents: J. Gale, Preface. Part I:Radical Constructivism and Social Constructionism. E. von Glasersfeld, A Constructivist Approach to Teaching. K.J. Gergen, Social Construction and the Educational Process. J. Shotter, In Dialogue: Social Constructionism and Radical Constructivism. J. Richards, Construct[ion/iv]ism: Pick One of the Above. Part II:Information-Processing Constructivism and Cybernetic Systems. F. Steier, From Universing to Conversing: An Ecological Constructionist Approach to Learning and Multiple Description. R.J. Spiro, P.J. Feltovich, M.J. Jacobson, R.L. Coulson, Cognitive Flexibility, Constructivism, and Hypertext: Random Access Instruction for Advanced Knowledge Acquisition in Ill-Structured Domains. K. Tomm, Response to Chapters by Spiro et al. and Steier. P.W. Thompson, Constructivism, Cybernetics, and Information Processing: Implications for Technologies of Research on Learning. Part III:Social Constructivism and Sociocultural Approaches. H. Bauersfeld, The Structuring of the Structures: Development and Function of Mathematizing as a Social Practice. J.V. Wertsch, C. Toma, Discourse and Learning in the Classroom: A Sociocultural Approach. C. Konold, Social and Cultural Dimensions of Knowledge and Classroom Teaching. J. Confrey, How Compatible Are Radical Constructivism, Sociocultural Approaches, and Social Constructivism? Analysis and Synthesis I: Alternative Epistemologies. M.H. Bickhard, World Mirroring Versus World Making: There's Gotta Be a Better Way. Part IV:Alternative Epistemologies in Language, Mathematics, and Science Education. R. Duit, The Constructivist View: A Fashionable and Fruitful Paradigm for Science Education Research and Practice. G.B. Saxe, From the Field to the Classroom: Studies in Mathematical Understanding. N.N. Spivey, Written Discourse: A Constructivist Perspective. T. Wood, From Alternative Epistemologies to Practice in Education: Rethinking What It Means to Teach and Learn. E. Ackermann, Construction and Transference of Meaning Through Form. D. Rubin, Constructivism, Sexual Harassment, and Presupposition: A (Very) Loose Response to Duit, Saxe, and Spivey. Part V:Alternative Epistemologies in Clinical, Mathematics, and Science Education. E. von Glasersfeld, Sensory Experience, Abstraction, and Teaching. R. Driver, Constructivist Approaches to Science Teaching. T. Wood, P. Cobb, E. Yackel, Reflections on Learning and Teaching Mathematics in Elementary School. P. Lewin, The Social Already Inhabits the Epistemic: A Discussion of Driver Wood, Cobb, and Yackel and von Glasersfeld. J. Becker, M. Varelas, Assisting Construction: The Role of the Teacher in Assisting the Learner's Construction of Preexisting Cultural Knowledge. E.H. Auerswald, Shifting Paradigms: A Self-Reflective Critique. Analysis and Synthesis II: Epsitemologies in Education. P. Ernest, The One and the Many. Analysis and Synthesis III: Retrospective Comments and Future Prospects. L.P. Steffe, Alternative Epistemologies: An Educator's Perspective. J. Gale, Epilogue.

教育中的建构主义 = Constructivism in Education

UNIT I Introduction to Theory CHAPTER 1 Philosophy, Science, and Nursing CHAPTER 2 Overview of Theory in Nursing CHAPTER 3 Concept Development: Clarifying Meaning of Terms CHAPTER 4 Theory Development: Structuring Conceptual Relationships in Nursing CHAPTER 5 Theory Analysis and Evaluation UNIT II Nursing Theories CHAPTER 6 Overview of Grand Nursing Theories CHAPTER 7 Grand Nursing Theories Based on Human Needs CHAPTER 8 Grand Nursing Theories Based on Interactive Process CHAPTER 9 Grand Nursing Theories Based on Unitary Process CHAPTER 10 Introduction to Middle Range Nursing Theories CHAPTER 11 Overview of Selected Middle Range Nursing Theories UNIT III Borrowed Theories Used by Nurses CHAPTER 12 Theories From the Sociologic Sciences CHAPTER 13 Theories From the Behavioral Sciences CHAPTER 14 Theories From the Biomedical Sciences CHAPTER 15 Theories, Models, and Frameworks From Administration and Management CHAPTER 16 Learning Theories UNIT IV Application of Theory in Nursing CHAPTER 17 Application of Theory in Nursing Practice CHAPTER 18 Application of Theory in Nursing Research CHAPTER 19 Application of Theory in Nursing Administration and Management CHAPTER 20 Application of Theory in Nursing Education CHAPTER 21 Future Issues in Nursing Theory

Theoretical Basis for Nursing

• Simulations are of particular advantage in research studies where large samples are necessary to achieve statistical power and the information must be collected under uniform conditions in order to aid interpretation.

• In the study reported below, simulation was achieved through the use of medical photography accompanied by case studies of the same patients. All information was collected on the same day. The purpose of the study was to determine the validity of the three pressure ulcer risk assessment scales most commonly used in clinical nursing practice in the UK.

• Each clinical nurse assessed the same four patients using three risk assessment scales and a visual analogue scale designed to capture their own clinical judgement. External validity was assessed by a panel of tissue viability experts who provided independent ratings.

• Data were obtained from 236 clinical nurses, yielding 941 risk assessments.

• Experience with this approach to data collection suggests that it requires careful planning. This should include measures to ensure that the simulated information is valid and that all data collectors have been adequately trained and are able to motivate the nurses participating in the study. Providing consideration is given to these issues, the use of simulation can help to collect data that would be difficult to obtain by more conventional means. It is also important to recognize that clinical decisions are de-contextualized in simulations because they are reduced to verbal and visual summaries. The decision to use simulations should thus be taken only if this is acknowledged.

Examining the validity of pressure ulcer risk assessment scales: developing and using illustrated patient simulations to collect the data

According to the common-sense model of self-regulation, individuals form lay representations of illnesses that guide coping procedures to manage illness threat. We meta-analyzed studies adopting the model to (a) examine the intercorrelations among illness representation dimensions, coping strategies, and illness outcomes; (b) test the sufficiency of a process model in which relations between illness representations and outcomes were mediated by coping strategies; and (c) test effects of moderators on model relations. Studies adopting the common-sense model in chronic illness (k = 254) were subjected to random-effects meta-analysis. The pattern of zero-order corrected correlations among illness representation dimensions (identity, consequences, timeline, perceived control, illness coherence, emotional representations), coping strategies (avoidance, cognitive reappraisal, emotion venting, problem-focused generic, problem-focused specific, seeking social support), and illness outcomes (disease state, distress, well-being, physical, role, and social functioning) was consistent with previous analyses. Meta-analytic path analyses supported a process model that included direct effects of illness representations on outcomes and indirect effects mediated by coping. Emotional representations and perceived control were consistently related to illness-related and functional outcomes via, respectively, lower and greater employment of coping strategies to deal with symptoms or manage treatment. Representations signaling threat (consequences, identity) had specific positive and negative indirect effects on outcomes through problem- and emotion-focused coping strategies. There was little evidence of moderation of model effects by study design, illness type and context, and study quality. A revised process model is proposed to guide future research which includes effects of moderators, individual differences, and beliefs about coping and treatment.

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The Common Sense Model of Self-Regulation: Meta-Analysis and Test of a Process Model

Attendance at diabetes clinic isassociated with improvedmedical outcome, however,signiﬁcant numbers of peoplewith type 1 diabetes choose notto attend. In order tounderstand the reasonsunderlying this decision,qualitative interviews werecarried out with 12 long-termnon-attenders. Three distinctgroups emerged differing interms of their cognitive andemotional responses to diabetesand their coping strategies: (1)the ‘High fear’ group; (2) the‘Patient as expert’ group; and(3) the ‘Low motivation’ group.These differences should berecognized and suitableapproaches developed to ensurethat all people with diabetes areable to accept appropriatespecialist support. Keywords clinic attendance, diabetes,interpretative phenomenologicalanalysis, qualitative research COMPETING INTERESTS : None declared. ADDRESS . Correspondence should be directed to: DR V . L . LAWSON , Wales College of Medicine, Cardiff University,Gwenfro Academic Unit, Wrexham Technology Park, Wrexham, LL137YP, UK. [email: val.lawson@new-tr.wales.nhs.uk]

Diabetes Who Do Not Attend Diabetes Clinic Advice: A Qualitative Analysis of the Views of People with Insulin-dependent Understanding Why People with Type 1 Diabetes Do Not Attend for Specialist

Patricia A. Lyne

Papers

Diabetes Who Do Not Attend Diabetes Clinic Advice: A Qualitative Analysis of the Views of People with Insulin-dependent Understanding Why People with Type 1 Diabetes Do Not Attend for Specialist