Showing papers in "Journal of Health Psychology in 2001"

Decolonizing methodologies: research and indigenous people.

Abstract: but have felt out of place in organizations that are designed for and run by middle class white men. The women Campbell has worked with have often had the same experience, being unable to discuss their illness with partners or other members of their community and finding a dearth of accessible support organizations. Gender, class and ethnicity interact in the impact that HIV/AIDS has on individuals. Campbell shies away from the implication of her study, which is that there is a hierarchy of suffering, gay men being the disease’s most prominent victims but also the best supported. Yet it seems clear that there is such a hierarchy. Researchers should not be ashamed of naming it. The spread and impact of the disease reflects – though by no means perfectly – the differential access to resources, power and control of different groups in different parts of the world. Campbell has produced a moving work, drawing on extensive research: it certainly should be read by those in government who are meant to be formulating policies to combat HIV/AIDS and poverty. The message is that, without strong action at international, national and community levels, social exclusion and the virus combine to produce a tragic outcome for vulnerable men, women and children.

Workplace bullying in nurses.

Abstract: The article reports a study of workplace bullying in community nurses in an NHS trust. The aims were to determine the prevalence of bullying, to examine the association between bullying and occupational health outcomes, and to investigate whether support at work could moderate the effects of bullying. Forty-four percent of nurses reported experiencing one or more types of bullying in the previous 12 months, compared to 35 percent of other staff. Fifty percent of nurses had witnessed the bullying of others. Nurses who had been bullied reported significantly lower levels of job satisfaction and significantly higher levels of anxiety, depression and propensity to leave. They were also more critical of aspects of the organizational climate of the trust. Support at work was able to protect nurses from some of the damaging effects of bullying.

Introducing Narrative Psychology: Self, Trauma and the Construction of Meaning

Abstract: abilities on the part of the reader than does the chapter on visual impairment. Nevertheless, among all the practical advice there are some interesting issues that are relevant elsewhere in health. The first is the preeminence of values and attitudes in the delivery of appropriate care. The chapter by Carter on primary care raises the possibility that society’s ambivalence towards them results in inadequate health care for people with learning disabilities. The chapter by McCray on antenatal care describes how the partnership model that characterizes mainstream antenatal care is challenged when a woman with learning disabilities becomes pregnant. There is little shared planning of care and many babies are removed soon after birth as the mother is deemed unfit by virtue of her lack of intelligence. Second, several authors make reference to the dilemma posed by the choice of specialist or generic services. The chapter by Sant Angelo points out that we are naive to assume that including people with learning disabilities within mainstream health services will solve their problems of powerlessness, dependence and vulnerability. One of the less attractive side-effects of normalization theory was to deny that vulnerable people required specialized provision if they were to attain the level of health expected by most of our society. Jenkins and Shearman go further and question the distinction between specialist and generic services. Just as in ergonomics where design for those with a disability often leads to a product that suits the needs of the non-disabled population, services with adjustments to suit those with learning disabilities may increase satisfaction in a wide range of service users. In such a small volume, some issues inevitably get omitted. In their introduction the editors acknowledge that many health initiatives, e.g. tackling obesity, have failed in the mainstream population. There is no consideration of why they should work with this client group. In spite of this reservation expressed by the editors early on, all chapters end with a checklist for action some of which (Marler, chap. 10, p. 163) seem unaware of discussion elsewhere in the book: Communication between the two services needs to be enhanced. Thankfully most contributors recognize that recommending a practical checklist will not effect great changes: ultimately change will only be achieved through challenging philosophies and ideologies, not merely through extra staff training.

The Relationship between Body Image and Depressed Mood in Adolescence: A 5-year Longitudinal Panel Study

Abstract: Much research interest has been devoted to reveal the psychosocial processes associated with the development of depressive symptoms during adolescence. One of the important factors that has been studied is body image. In a 5-year longitudinal investigation, we revealed and discussed the relationship between body image and depressed mood in a cohort of adolescents at ages 13, 15 and 18. Girls reported on average higher depressed mood levels and more negative body image than boys at all ages. However, the correlations between the variables were nearly as strong for boys as for girls. Structural equation modelling revealed that body image predicted change in depressed mood both for boys and girls, but at different ages. In contrast, we did not find any support for the existence of causal effects of depressed mood upon body image.

Adjustment to an Artificial Limb: A Qualitative Perspective

Abstract: The purpose of this study was to identify factors considered to be important in the adjustment to amputation and the wearing of a prosthetic limb from the perspective of the person who has had a lower limb amputation. Hence, focus group methodology was employed as a means of acquiring perspectives within a population of young adults who had a lower limb amputation. Preliminary thematic analysis revealed that factors such as self-image, social, physical and practical concerns, the meaning attributed to and the acceptance of the amputation and support among others were important in the adjustment process. These findings have substantial implications for directing future research.

Narrative Identities and the Management of Personal Accountability in Talk about ME: A Discursive Psychology Approach to Illness Narrative:

Abstract: This article takes a discursive psychology approach to the analysis of illness narrative The controversial topic of ME (myalgic encephalomyelitis), otherwise known as chronic fatigue syndrome (CFS), is used as a case study to examine the dilemmatics of illness talk Using data from an ME narrative, I explore the complex and subtle discursive work performed by participants to show how attributional stories and identity formulations are linked together in a narrative that works to construct ME as a physical disease while countering potential accusations of malingering or psychological vulnerability In working to counter such explanations, sufferers paradoxically implicate themselves in an interpretation of their illness as self-inflicted through overwork and mismanagement In previous research, tales of frenetic lifestyles prior to the onset of ME have provided analysts (and journalists) with grounds for constructing their own attributional stories in the form of 'opt-out' or 'burnout' theories of ME/CFS An ethnomethodologically informed discursive psychology provides a non-cognitivist approach to analysis which looks in detail at how sufferers themselves make sense of ME as a practical activity and how their identities are constructed as part of that process

Parents of Children with Autism using an Email Group: A Grounded Theory Study:

Abstract: Parents of children with autism have difficulties obtaining adequate information and support to guide them in the care of their children. However, the growth of communication technologies such as email has created greater opportunities for accessing such resources. This article presents a grounded theory analysis of the messages sent to an email group by parents of children with autism. The core category emerging from the analysis indicates that the group functioned in making sense of autism. The core category comprises four categories: searching for meaning; adjusting to changes; providing support and encouragement; and narrative sharing of experiences. Although email groups function as a social support mechanism, we suggest that this is not the only legitimate function: such groups may contribute towards the development of parental representations of autism.

Psychosomatic symptoms among victims of school bullying

Abstract: Associations between being a victim of bullying and psychosomatic health have been examined among 856 Norwegian school adolescents aged 13 to 15 years. Multiple logistic and linear regression analyses were applied. Pupils being bullied sometimes or more often during the previous term had significantly higher odds of every psychosomatic symptom except sleeplessness, compared to pupils who reported that they were never exposed to bullying. The highest odds ratio was observed in analysis of feeling low. No significant interactions with gender or age were seen, but the association with irritability, headache and backache tended to be strongest for boys, whereas the association with nervousness and sleeplessness was strongest for girls. Increasing exposure to bullying was associated with a highly significant increase in number of symptoms. The strong and consistent associations with different symptoms and the dose-response relationship suggest a causal relationship.

Reducing skin cancer risk: an intervention based on protection motivation theory.

Abstract: Caucasian college students who intentionally tanned participated in a brief skin cancer intervention based on protection motivation theory (PMT). This intervention targeted skin appearance and consisted of brief lectures, a comprehensive essay, video clips about a young man who died of melanoma, and short discussions. Compared to a waitlist control group, the intervention group showed increases on PMT variables and intentions at post-test. The waitlist group later received the intervention and showed similar increases. Additionally, all but one PMT variable maintained post-test levels at a one-month follow-up. Photographs taken at post-test and at the one-month follow-up were judged by raters blind to the hypothesis. Seventy-two percent of participants were judged to have lighter skin whereas only 16 percent had darker skin. These results provide additional support for theory-based methods for changing maladaptive attitudes and behaviors associated with skin cancer risk.

Material discourses of health and illness.

Abstract: presently complex and variable, employers can evade them without much difficulty. And this is also true of programs for the rehabilitation and compensation of injured workers. However, the politics of occupational health are not limited to governments; the implicit politics of health research methodology comes in for critique in the paper by Loewenson, Laurel and Hogstedt. Their thesis is that where occupational health is concerned, the traditional methods of scientific research which separate investigators from their subjects, and impose barriers between them in the name of preserving ‘objectivity,’ also tend to prevent insight and obscure or distort important substantive issues. The solution they suggest for this problem is one that has been widely discussed in the recent social science literature, namely, the development of participatory research methods whereby scientists and their subjects work together in a collaborative fashion. Although the authors acknowledge that such an approach poses a potential conflict between the values of ‘rigor’ and ‘relevance’, they cite exemplary worker health studies indicating that any losses of rigor are outweighed by gains in relevance. At a recent conference on health psychology, I suggested that because of its obvious virtues, the field of occupational health had generally escaped critical scrutiny. Thanks to the contributors and editors of this anthology, that is no longer true. I heartily recommend it to any student or professional in the field, and given its lively, readable quality, I think it would make an excellent text for advanced undergraduate or graduate classes.

Male bodies: health, culture and identity.

Abstract: ceding it in an exposition of Wilkinson’s well known thesis regarding the importance of relative deprivation and psychosocial factors as social determinants of health (cf. Wilkinson, 1996). Whilst reading the book I was reminded of the observation by medical sociologists that conventional inequalities research frequently remains under-theorized (e.g. Fenton & Charsley, 2000; Popay et al., 1998). This criticism is perhaps particularly germane in relation to the editors’ and authors’ evidently uncritical acceptance of positivistic methodologies that underpin the quantitative epidemiological traditions well represented here. The almost complete omission of qualitative research from the text is curious given the editors’ explicit concern with the influence of the social context on health and an increasing acceptance of the importance of qualitative work in this agenda (cf. Graham, 2000). Therefore, although this book has an admirable political intent, nowhere are the voices of people themselves living in inequitable circumstances heard (cf. Popay & Williams, 1996). Further theoretical discussion would also perhaps have been particularly beneficial in exploring some of the advantages and disadvantages of the psychosocial approach the editors favour. These weaknesses are, however, both indicative of the wider literature and attributable to a valid editorial emphasis on empirical reviews for policy that necessitates minimal theoretical discussion. Overall, this book is a timely and useful addition to the literature on the social determinants of health. Individual chapters are lucidly written and, far from being simple review pieces, they always consider the policy implications of research, often making valuable contributions to the field in their own right. This work should not be treated as a textbook and is perhaps especially useful to those with an interest in the psychosocial aspects of health inequalities. In conclusion, the editors and chapter authors should be commended in writing an important contemporary overview of many areas of research relevant to both understanding of and intervention with the social determinants of health.

Associations between attachment representations and health behaviors in late adolescence.

Abstract: In this study, we tested the associations among attachment ratings and health behaviors by relationship status. For individuals in relationships, attachment security was associated positively with health promotion and quality sleep and negatively with risk behaviors; fearfulness was associated positively with risk behaviors. With the exception of sleep behaviors, associations with security and fearfulness were reversed for single participants. Associations between dismissingness and quality of sleep support the proposal that individuals who deny or dismiss their attachment needs may experience physical symptoms of distress that affect their health. Future work exploring the benefits of security when coping with illness or lifestyle change is discussed.

Re-appraising HIV Testing among Scottish Gay Men: The Impact of New HIV Treatments:

Abstract: This paper explores Scottish gay men's understandings of HIV testing within the context of changes stemming from the availability of new treatments for HIV. Transcripts of one-to-one interviews with 18 gay men were analysed together with those from four focus groups (n = 19) concerning HIV testing, HIV status and HIV risk management. Interpretative Phenomenological Analysis was employed to identify recurrent themes. We focus upon a rise of HIV-optimism, risk-complacency and HIV fatigue and chart the apparent transformation of HIV diagnosis from 'death sentence' to 'life sentence'. In turn, we explore how these changes have impacted upon HIV testing. As HIV management becomes increasingly medicalized, we highlight the ongoing need to attend to psychological and social issues.

Responses to Information about Psychosocial Consequences of Genetic Testing for Breast Cancer Susceptibility: Influences of Cancer Worry and Risk Perceptions

Abstract: We assessed the impact of information about psychosocial consequences of genetic testing for breast cancer susceptibility on interest in and beliefs about genetic testing, and whether these effects vary by levels of either cancer worry or perceived cancer risk. Women (N = 180) in an experimental study were randomly assigned to read one of four messages consisting of standard information along with information about either psychosocial advantages, potential disadvantages, both advantages and disadvantages, or no additional information. Women receiving only standard information reported higher interest in obtaining genetic testing than did women who received additional information about advantages, disadvantages, or both advantages and disadvantages. Cancer worry (but not perceived risk) predicted greater interest and more favorable beliefs about the benefits of testing. Beliefs that testing causes emotional distress were positively associated with worry and negatively associated with risk perceptions.

Do Patients Want Control over their Own Health Care? A Review of Measures, Findings, and Research Issues

Abstract: Across a wide variety of medical settings, patients report that they want detailed information about their condition and their treatment whereas stated desire for input into decision making is skewed more in the direction of physician-only or at least collaborative decision-making. These results, along with the contextual and individual difference factors associated with increased willingness to relinquish control (lower educational level, more serious illness, increasing age), indicate that patients want to assume control if they feel it will be beneficial to them to do so. The findings, however, are based largely on the relationship of patients' mean scores to arbitrarily determined scale midpoints on measures with little or no criterion-related validity. These measures also show insufficient overlap with better validated measures of desire for health care control, which indicate more normally distributed scores and a broader range of individual differences among respondents. Findings are discussed in terms of the need for further research on the structure (dimensionality) and stability of the construct desire for health care control and issues involved in conducting needed criterion-related validational work.

An Exploratory Investigation of the Relationship between Proxy Efficacy, Self-efficacy and Exercise Attendance.

Abstract: The purpose of the study was to examine the relationship between perceptions of self-efficacy, proxy efficacy, and exercise class attendance of participants involved in a 10-week structured group fitness program. At week 3, 127 females completed measures of self-efficacy and proxy efficacy and their class attendance was monitored for the subsequent four weeks. Self-efficacy was assessed through measures of exercise, scheduling, and barrier self-efficacy. Proxy efficacy was assessed through a measure of fitness instructor efficacy defined as participants' confidence in their fitness instructors' communication, teaching, and motivating capabilities. Results revealed positive correlations between self-efficacy variables and proxy efficacy. Hierarchical multiple regression analyses indicated that among those who were classified as exercise initiates (n = 33), self-efficacy and proxy efficacy accounted for 34 percent of the variance in exercise class attendance with the latter variable explaining a unique 12 percent. Consistent with theorizing, these preliminary findings indicate that for instructor-led, group physical activities such as aerobics classes, proxy efficacy perceptions are related to self-efficacy and may also be an important predictor of exercise behavior.

Experiences of Family Caregiving among Older Australian Women.

Abstract: This article uses quantitative and qualitative methods to examine the effects of family caregiving on physical and emotional wellbeing, finances and leisure among a cohort of Australian women aged 70 to 75 years. A total of 11,939 women was examined. Of these, 10 percent (n = 1235) identified themselves as caregivers for frail, ill or disabled family members and 168 made open-ended comments about their caregiving experiences. Unlike other surveys with younger respondents, the data failed to demonstrate any differences in physical health between caregivers and others. Caregivers were, however, significantly more likely to have low levels of emotional wellbeing and to feel stressed, rushed and pressured. Qualitative analysis supported the value of the concept of the 'ethic of care' in understanding the social and individual forces that propel older women into providing family care despite its demonstrably negative effects on their wellbeing.

Longitudinal influences of knowledge and self-efficacy on exercise behavior : Tests of a mutual reinforcement model

Abstract: The central tenet of social cognitive theory, that individuals' construal processes and behaviors mutually reinforce each other, is tested for exercise behavior. Two longitudinal data sets (year 1 to year 2 and year 1 to year 6) from the Stanford Five-City Project, a field experiment to promote cardiovascular disease prevention in California, are analyzed through structural equation modeling techniques to evaluate the effects of demographics, exercise knowledge, and exercise self-efficacy on exercise behavior. The effects of exercise behavior on subsequent knowledge and self-efficacy are also examined. In both data sets (year 1 to year 2, N = 1254 and year 1 to year 6, N = 939), education, income, age, and sex were significant predictors of exercise behavior. Self-efficacy and knowledge also predicted behavior. Prior exercise behavior predicted subsequent knowledge and self-efficacy. Prior knowledge and self-efficacy, in turn, predicted subsequent exercise behavior. Recommendations are made for enhancing the effectiveness of public health efforts designed to promote healthy behaviors.

The Impact of Iatrogenically Acquired Hepatitis C Infection on the Well-being and Relationships of a Group of Irish Women.

Abstract: The views of 32 women with iatrogenic Hepatitis C on its impact on their sense of wellbeing were elicited through focus groups. The views obtained were analysed using 'interpretative phenomenological analysis'. Accounts of profound fatigue, reactive depression, and deterioration in cognitive functioning predominated. Work outside and inside the home was severely curtailed or stopped. Marital relationships were affected, sometimes adversely, as were relationships with children and other family members. Participants experienced a general lack of understanding of their level of disability, yet also felt the need to shield others from worry. Overall results suggested that participants' compromised health was having a major impact on their sense of identity.

The social construction of anorexia nervosa.

Abstract: the groundwork in terms of the importance of psychology as a factor in healthcare. The perspective taken by the author together with the main aims of the book are clearly defined in chapter 1 and set the tone for future chapters. Chapter 2 moves on to lay the theoretical groundwork of the book and establishes a reference point for later reading. Chapters 3–6 tackle standard issues of health psychology within the clinical setting including stress, coping and psycho-oncology. These issues are dealt with in a rather introductory fashion and are presented in a ‘common sense’ way. More advanced readers may find this lacking in challenge, but for clinicians unused to this field it creates a smooth transition from psychological theory to clinical practice, and increases awareness of the potential benefits of psychology on a day-to-day basis. The relationship between client and clinician and the social, emotional, psychological and physical factors that may impact upon this are explored in some depth through chapters 7, 9, 10 and 11. These chapters illustrate the considerable understanding of the patient perspective that the author has achieved through his practice. Issues range from the motivations and expectations expressed by clients and clinicians to the subsequent behaviours that can arise and how to deal with these. The final chapters, in contrast, focus upon the identification and treatment of both physical and non-physical symptoms (the latter being a section that is often missing from other introductory texts). These sections appropriately conclude the flow of the book which focuses upon the medical process as experienced by the patient. The book covers a wide spectrum of issues within the health psychology arena. Each topic area is divided into numerous subsections, which can often leave the reader with a faint sense of disappointment, as the section ends just as it is becoming interesting. It would perhaps have been more beneficial to offer greater attention to a smaller number of topics. In addition, reflecting the author’s own clinical experience, topics are generally illustrated through the use of a small number of medical conditions, namely cancer, heart disease and renal failure. Although this again contributes to the well-established flow of the book, it may limit the transition of knowledge to practical settings for those clinicians not working within these fields. Although the book offers clear and relevant illustrations, this should not be taken by readers as a step-by-step manual which offers ‘all they need to know’ in order to improve their practice. Instead it offers an excellent introduction to the psychological aspects of healthcare, allowing clinicians to see where, with further reading and training, they may expand their practice to take account of the psychological factors affecting both themselves and their clients. In addition, the book offers a clear overview of this field for those interested in entering further into the field of health psychology and provides much food for thought from which a wide selection of research ideas could be generated.

Eating your words: discursive psychology and the reconstruction of eating practices.

Abstract: Psychological research into eating practices has focused mainly on attitudes and behaviour towards food, and disorders of eating. Using experimental and questionnaire-based designs, these studies place an emphasis on individual consumption and cognitive appraisal, overlooking the interactive context in which food is eaten. The current article examines eating practices in a more naturalistic environment, using mealtime conversations tape-recorded by families at home. The empirical data highlight three issues concerning the discursive construction of eating practices, which raise problems for the existing methodologies. These are: (1) how the nature and evaluation of food are negotiable qualities; (2) the use of participants' physiological states as rhetorical devices; and (3) the variable construction of norms of eating practices. The article thus challenges some key assumptions in the dominant literature and indicates the virtues of an approach to eating practices using interactionally based methodologies.

Getting more people on the stairs: the impact of a new message format.

Abstract: Previous research has found that poster prompts are associated with significant increases in stair use. The present study examined the use of messages on the stair risers, as an alternative to posters, to encourage stair climbing. Observers monitored shoppers' stair and escalator use over a 2-week baseline and 6-week intervention period. The prevalence of stair use increased from a baseline value of 8.1 percent to 18.3 percent when the motivating messages were in place. This increase is greater than that found in studies that used poster prompts in shopping centre venues. The apparent advantage of stair-riser banners is discussed in terms of their visibility and attractiveness, as well as their capacity to present multiple messages likely to appeal to a broader constituency. It is concluded that promoters of physical activity should use colourful, tailored stair-riser banners, rather than posters, to encourage stair climbing.

Mediators of increased physical activity and change in subjective well-being : Results from the Activity Counseling Trial (ACT)

Abstract: The purpose of this study was to examine whether change in satisfaction with physical function (SF), satisfaction with physical appearance (SA), and self-efficacy (SE) mediate the effects that increased physical activity has on change in subjective well-being (SWB). Participants in this investigation consisted of 854 men (n = 471) and women (n = 383) who took part in the Activity Counseling Trial (ACT). ACT was a 24-month multicenter, randomized controlled trial to evaluate the effectiveness of interventions to promote physical activity in the primary care setting. Participants were assigned to one of three treatments: standard care control, staff-assisted intervention, or staff-counseling intervention. Results revealed that, irrespective of treatment arm, change in physical activity was related to change in SBW and to change in all mediators of interest. A statistical test of mediation revealed that the influence of change in physical activity on SWB was due to change in all three mediators with change in SF making the greatest contribution to the model.

Lay Attitudes toward Genetic Testing for Susceptibility to Inherited Diseases.

Abstract: One of the most important issues facing legal and medical policy makers in the coming years will be whether to employ populationbased testing for genetic markers of inherited diseases. Two hundred and twenty-six randomly selected individuals from Easton, Pennsylvania completed a mail questionnaire that was designed to assess the general public's attitudes toward many of the personal and societal issues surrounding genetic testing for disease susceptibility. Respondents were generally optimistic about the potential benefits of genetic testing, and their attitudes about genetic testing were associated with their personal interest in getting a genetic test. Respondents were more likely to be interested in undergoing genetic testing for disease susceptibility if they might have some control over the targeted disease (i.e. there was a cure) and if the test was highly predictive of their chances of developing the disease. Respondents were wary of granting access to genetic testing results to anyone other than doctors and family members, and they did not want the government, religious leaders, or the courts involved in regulating genetic testing. These results have important implications for psychologists, genetic scientists, bioethicists, and legal scholars who are grappling with the many issues related to population-based genetic testing for inherited diseases.

Predicting Intended and Self-perceived Sugar Restriction among Tanzanian Students using the Theory of Planned Behavior.

Abstract: This study examines the applicability and sufficiency of the Theory of Planned Behavior (TPB) in predicting intention and self-perceived behavior with respect to avoiding between-meal intake of sugared snacks and drinks. One thousand one hundred and twenty-three Tanzanian students (mean age 26.4 years) completed self-administered questionnaires designed to measure the components of the TPB during May–July, 1999. Self-perceived sugar consumption was obtained in a subsample of respondents (n = 228) four weeks later. The TPB provided a significant prediction of intention (R2= 0.44), with attitude (= 0.25), subjective norms (= 0.28) and perceived behavioral control (= 0.35) significant, and subsequent behavior (R2 = 0.15, with intention (= 0.25) and perceived behavioral control (= 0.18) significant. Frequency of past behavior explained a significant, albeit small, amount of additional variance in intention (1 percent) and behavior (4 percent). The results indicate that the TPB is applicable to the prediction ...

Resources for Health: A Social-Ecological Intervention for Supporting Self-management of Chronic Conditions.

Abstract: There is a pressing need for practical interventions to support self-management of chronic illness that can be integrated with primary care, and that take into account the patient's social environment. This pilot study was conducted with low-income clients of a community health center and focused on enhancing use of social-environmental resources supportive of self-management. Twenty-eight patients having at least one chronic illness, randomized to immediate versus delayed treatment conditions, met once with a health educator to develop a self-management plan, and received one follow-up phone call and two newsletters. Significant improvements in use of community resources, minutes of physical activity, and medication adherence were obtained compared to control. Integrating brief self-management counseling with social environmental support appeared effective, although much more can be done to better link counseling to primary care practice.

Assessing Family Members’ Motivational Readiness and Decision Making for Consenting to Cadaveric Organ Donation

Abstract: This study assessed the applicability of two important components of the transtheoretical model of behavior change (TTM) to family consent for cadaveric organ donation. Men and women (N = 169), who consented or refused to donate the organs of a family member, completed a telephone survey reflecting the stage of change and decisional balance constructs. Psychometric analyses resulted in a two-factor decisional balance scale: a seven-item scale representing negative perceptions of consent (cons), and a seven-item scale representing positive perceptions of consent (pros). The pros and cons were significantly associated with stage of readiness for donation consent and with the family consent decision. Research utilizing this measure has the potential to enhance intervention programs to increase donation consent rates.

Correlates and Predictors of Self-reported Psychological and Physical Morbidity in Chronic Caregiver Stress

Abstract: An investigation was conducted to explore: (1) whether psychological and physical morbidity share similar psychosocial determinants; (2) the long-term stability of these determinants; and (3) the role of neuroticism in predicting psychological and physical morbidity. Fifty spousal caregivers of dementia patients were recruited into a 12-month study. Participants were followed up at six-monthly interva ls during which they completed scales measuring psychosocial mediators, psychological morbidity, physical morbidity and neuroticism. Psychological morbidity was influenced primarily by indices of coping and neuroticism. Physical morbidity was influenced primarily by indices of psychological morbidity (increased psychological morbidity was associated with perceptions of greater physical morbidity). Neuroticism exhibited significant cross-sectional and longitudinal relationships with the indices of psychological morbidity, but only cross-sectional relationships with the indices of physical morbidity.