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Biomedical subjects

B M DeVellis

Publications and source records attributed to B M DeVellis.

At least 19 recordsLinked to original sources
PubMed2001

Genetic testing for colorectal carcinoma susceptibility: focus group responses of individuals with colorectal carcinoma and first-degree relatives.

BACKGROUND: Colorectal carcinoma (CRC) may be the most frequent form of hereditary cancer. Genetic counseling and testing for heritable CRC is a promising approach for reducing the high incidence and mortality rates associated with the disease. Patients with CRC or those with at least one family member with the disease are the most likely persons to request or be offered genetic testing in the clinical or research setting. Currently, however, little is known about the behavioral, psychosocial, ethical, legal, and economic outcomes of CRC genetic counseling and testing. METHODS: Eight focus group interviews, four for CRC patients (n = 28) and four for first-degree relatives (n = 33), were conducted to obtain insights into attitudes, beliefs, and informational needs about genetic testing for hereditary CRC. RESULTS: Focus group interviews revealed a general lack of knowledge about cancer genetics and genetic testing; worry about confidentiality issues; strong concern for family members, particularly children; and a need for primary care providers to be informed about these issues. Major perceived advantages of genetic testing included improving health-related decisions, guiding physicians in making recommendations for surveillance, and informing relatives about risk potential. Disadvantages included potential discrimination, adverse psychologic effects, and financial costs associated with testing. CONCLUSIONS: As knowledge and media coverage of genetics continue to expand, it becomes increasingly important to continue efforts on behalf of, and in partnership with, those individuals most affected by genetic testing for hereditary cancer syndromes. These findings provide data needed to develop and implement informational, educational, counseling, and research-oriented programs that are sensitive to individuals' concerns and preferences.

Adult↗
PubMed1998

Psychosocial and educational outcomes associated with home- and clinic-based pretest education and cystic fibrosis carrier testing among a population of at-risk relatives.

We report on the psychosocial and knowledge outcomes of two different approaches to cystic fibrosis (CF) gene pretest education and carrier testing offered to 288 proactively recruited first-, second-, and third-degree relatives of people with CF. One group received pretest education and gene testing in a clinical setting from a certified genetic counselor. The other group received pretest education in their homes from a specially prepared pamphlet and were asked to send in a buccal cell sample for genotyping. No statistically significant differences between groups were noted on measures of CF knowledge, anxiety, and positive or negative affect, either while waiting for their test results or within a few weeks after they had learned their results. At both measurement points, participants who had received home education and testing reported that the testing was more convenient, but that they had received less information than they would have liked, and they were more likely to report being confused by the testing, although their level of CF knowledge was comparable to that of people who had been seen by a genetic counselor. In light of the increasing interest in home-based medical testing of all kinds, this study suggests that CF carrier testing in the home warrants further consideration as one possible approach to facilitating access to testing.

Adolescent↗
PubMed1998

Effect of satisfaction with one's abilities on positive and negative affect among individuals with recently diagnosed rheumatoid arthritis.

OBJECTIVE: The purpose of this study was to examine the effect that self-evaluation processes have on psychologic well-being among individuals with rheumatoid arthritis (RA). METHODS: The study used a longitudinal research design with 4 data collection points. Participants were 227 adults with recently diagnosed RA. Data were collected via mailed questionnaire and telephone interview. Two dimensions of psychologic well-being were assessed--positive affect and negative affect. RESULTS: We found that, among participants who viewed the abilities being evaluated as very important, greater satisfaction at time 1 was associated with less negative affect at time 2 and time 4. Satisfaction was not associated with positive affect at any of the time points, however. CONCLUSION: Study findings indicate that dissatisfaction with illness-related abilities can exacerbate psychologic distress. The findings also highlight the need for research examining the role that positive affect plays in adaptation to RA.

Activities of Daily Living↗
PubMed1998

Correlates of changes in mood following a mood induction in osteoarthritis patients.

OBJECTIVE: To determine the relationship of mood management skills, and affective and cognitive states to changes in moods following mood induction among people with osteoarthritis. METHODS: After completing questionnaires, participants underwent a negative mood induction. Momentary moods were assessed prior to, immediately following, and several minutes after the mood induction. RESULTS: A specific mood management skill, mood clarity, consistently predicted changes in positive mood following the mood induction: people who scored high on mood clarity experienced less diminution in positive affect. In contrast, changes in negative affect were unrelated to mood management skills. However, people who scored higher on measures of depressive symptoms and pessimism rebounded from the negative induced mood less strongly than others. CONCLUSION: Positive and negative emotional states operate largely independently and are differentially influenced by mood clarity, depressive symptoms, and pessimism. High levels of mood clarity may be adaptive in illnesses such as osteoarthritis because negative affective experiences that may be unavoidable need not preclude positive affective states.

Affect↗
PubMed1997

Do people with rheumatoid arthritis develop illness-related schemas?

OBJECTIVE: To assess, using both qualitative/inductive and quantitative data, whether people with rheumatoid arthritis (RA) have schemas related to arthritis. METHODS: Themes identified from interview and focus group transcripts were used to develop 1) questionnaire items, and 2) statements participants were asked to recall during home interviews. Two hundred one people with RA completed questionnaires and recall tasks of the type used in cognitive research, followed 10 days later by another recall assessment by telephone. RESULTS: Qualitative methods, item-level questionnaire data, and category-level recall data yielded convergent results supporting 4 final categories: mastery, support, loss of independence, and depression. Regression analyses indicated that category of earlier recollections predicted subsequent recollections assessed via phone. CONCLUSIONS: Results from widely different methods offer at least partial support for arthritis schemas and suggest that the concepts identified are meaningful to patients as well as to researchers.

Activities of Daily Living↗
PubMed1996

Osteoporosis prevention in premenopausal women: using a stage model approach to examine the predictors of behavior.

The precaution adoption process model was used to examine the predictors of 2 behaviors recommended to reduce the risk of developing osteoporosis: calcium consumption and weight-bearing exercise. A total of 452 premenopausal women completed a mailed questionnaire assessing stage in the precaution adoption process and 12 knowledge and attitudinal variables. Participants were also given an opportunity to request information about osteoporosis. In all, 11 of the 12 knowledge and attitudinal variables were associated with calcium stage; 8 were associated with exercise stage. Information requests were associated with both calcium and exercise stage. Findings provide substantial support for the precaution adoption process model and suggest that the model can be usefully applied in this area to increase understanding of why many women do not practice behaviors that could reduce their risk of developing osteoporosis.

Adult↗
PubMed1995

The physiological impact of arthritis: prevalence of depression.

Attempts to estimate the prevalence of depression in people with arthritis are complicated by conceptual, definitional, and measurement problems and inconsistencies. Following a description of these methodologic problems, recent studies of depressive disorders and depressive symptoms in clinical and community samples are reviewed. The review suggests that although most people with rheumatic diseases do not experience them, depressive disorders and symptoms are probably more prevalent among people with rheumatic diseases than among people with no chronic diseases. This somewhat increased prevalence is probably no greater than that found in other serious chronic diseases, however. Additional research is needed.

Adaptation, Psychological↗
PubMed1995

Arthritis and perceptions of quality of life: an examination of positive and negative affect in rheumatoid arthritis patients.

The utility of measuring both positive and negative affective states for assessing rheumatoid arthritis (RA) patients was examined in 3 independent samples of male and female RA patients (Sample A: 179 women, 48 men; Sample B: 177 women, 24 men; Sample C: 134 women, 38 men). Confirmatory factor analyses of each sample indicated that positive and negative affect constituted separate, negatively correlated factors. The relations among disease variables, coping, and affects were consistent with a model in which coping mediates the relationship between disease variables and positive and negative affect. Patients with higher pain and limitation from RA had higher levels of maladaptive coping, and maladaptive coping was associated with lower positive affect and higher negative affect. Those RAs with higher activity limitation also reported less adaptive coping, which was associated with less positive affect.

Activities of Daily Living↗
PubMed1994

Appraisal of and coping with arthritis-related problems in household activities, leisure activities, and pain management.

PURPOSE: We examined whether or not there are systematic differences in how people appraise different types of illness-related problems and in how they cope with these problems. METHODS: Two hundred thirty-five adults with recently diagnosed rheumatoid arthritis completed a mailed questionnaire followed by a telephone interview. A series of stress appraisal and coping variables were assessed in relation to three areas: household activities, leisure activities, and pain management. RESULTS: Pain differed significantly from household and leisure activities with regard to several appraisal and coping variables. Participants reported the least control over problems with pain, while attaching the most importance to pain control. Leisure activities also stood out as unique on several variables. Participants perceived greater ability and were more satisfied with their ability in relation to leisure activities. CONCLUSION: These findings show that, at least early in the disease, appraisal and coping strategies differ across the areas of household activities, leisure activities, and pain management.

Activities of Daily Living↗
PubMed1994

Improving dietary behavior: the effectiveness of tailored messages in primary care settings.

OBJECTIVES: To achieve the Healthy People 2000 objectives, public health professionals must develop effective dietary interventions that address psychosocial and behavioral components of change. This study tested the effect of individually computer-tailored messages designed to decrease fat intake and increase fruit and vegetable intake. METHODS: Adult patients from four North Carolina family practices were surveyed at baseline and then randomly assigned to one of two interventions or to a control group. The first intervention consisted of individually computer-tailored nutrition messages; the second consisted of nontailored nutrition information based on the 1990 Dietary Guidelines for Americans. Patients were resurveyed 4 months postintervention. RESULTS: The tailored intervention produced significant decreases in total fat and saturated fat scores compared with those of the control group (P < .05). Total fat was decreased in the tailored group by 23%, in the nontailored group by 9%, and in the control group by 3%. Fruit and vegetable consumption did not increase in any study group. Seventy-three percent of the tailored intervention group recalled receiving a message, compared with 33% of the nontailored intervention group. CONCLUSIONS: Tailored nutrition messages are effective in promoting dietary fat reduction for disease prevention.

Adult↗
PubMed1993

Coping with rheumatoid arthritis: is one problem the same as another?

This study examined how individuals with rheumatoid arthritis (RA) cope with illness-related problems in four different areas: daily activities, leisure activities, work, and social relationships. Eighty-five people with RA took part in the study. They participated in an in-depth interview that focused on the types of changes they had experienced in their lives as a result of their arthritis and how they had coped with these changes. Audiotapes of the interviews were transcribed and content analyzed to assess participants' coping behavior. In addition, standardized measures of psychological and physical functioning were administered shortly following the original interview and at a 4-month follow-up. Three major findings emerged. First, people relied less heavily on behavioral coping strategies when dealing with problems involving social relationships than when dealing with problems involving daily activities, leisure activities, or work. Second, there was little consistency in individuals' use of either cognitive or behavioral strategies across different problem areas. Finally, individuals who exhibited limited flexibility in their coping responses experienced poorer psychological functioning compared with more flexible copers. Implications of these findings for health education practice and future research on coping with RA are discussed.

Activities of Daily Living↗
PubMed1993

Development and validation of the Parent Health Locus of Control scales.

We describe the development and validation of the Parent Health Locus of Control (PHLOC) scales. Using factor analytic and item analytic methods, 30 items comprising six scales were extracted from a pool of 84 items. The individual scales correspond to beliefs in Child, Divine, Fate, Media, Parental, and Professional Influence over child health. Results were compared for six samples totalling 822 parents. Internal consistency reliabilities were above .70 for all scales with all samples. Test-retest correlations based on a separate sample were all above .60. Validity was assessed by means of a known groups strategy that made use of presumed differences among the six samples studied. The results generally agreed with predicted differences, offering good initial evidence of the validity for the PHLOC scales.

Adult↗
PubMed1992

Psychological well-being among people with recently diagnosed rheumatoid arthritis. Do self-perceptions of abilities make a difference?

OBJECTIVE: Satisfaction with abilities and perceived importance of abilities are 2 factors involved in the process of self-evaluation. We examined the role that these factors play in adjustment to rheumatoid arthritis (RA). METHODS: Data were collected, via telephone interview and mailed questionnaire, from 234 individuals with recently diagnosed RA. Disease severity information was obtained from participants' physicians. RESULTS: Consistent with study hypotheses, satisfaction was associated with psychological well-being only among those who viewed as very important the abilities being evaluated. CONCLUSION: These findings increase understanding of the conditions under which low levels of satisfaction are likely to be associated with psychological distress.

Adaptation, Psychological↗
PubMed1992

Nutrition education for cardiovascular disease prevention among low income populations--description and pilot evaluation of a physician-based model.

Low income Americans are at greatest risk for coronary heart disease but have least access to health promotion programs for life style modification. Primary care physicians may represent one of the few sources of preventive care available to the poor. However, the majority of physicians feel unprepared to help patients achieve dietary change, and few existing nutrition intervention programs address the special needs of low literacy populations. The Food for Heart Program was developed to facilitate dietary counseling experienced by primary care physicians who care for low literacy patients and to overcome barriers to behavior change faced by patients. The program consists of three components: (1) a validated dietary risk assessment that rapidly identifies atherogenic eating habits and requires no nutritional expertise to administer or interpret, (2) a structured diet treatment program that is culturally specific for a southern patient population and links practical behavior change recommendations with results of the diet assessment, and (3) a system for monitoring and reinforcement that prompts physicians to review progress, reinforce prior messages, and reward positive change. Behavior change theory is used to guide the intervention and readability of the material has been assessed at the 5-6th grade level. An evaluation study of the Food for Heart Program suggests that it has a positive impact on physician counseling and that patients are responding favorably to these efforts.

Cardiovascular Diseases↗
PubMed1992

Illness attributions and hopelessness depression: the role of hopelessness expectancy.

According to hopelessness theory, hopelessness expectancy is the proximal, sufficient cause of hopelessness depression. Consequently, hopelessness expectancy is viewed as mediating the influence of all other factors on hopelessness depression. Using a longitudinal research design, we examined hopelessness expectancy as a mediator of the relation between illness attributions and hopelessness depression in a sample of 57 adults with rheumatoid arthritis. Although hopelessness expectancy was a strong predictor of hopelessness depression, it moderated rather than mediated the relation between attributions and depression. Finding support for a moderating rather than a mediating model is inconsistent with theory but is consistent with the findings of Riskind, Rholes, Brannon, and Burdick (1987).

Activities of Daily Living↗
PubMed1991

Disease experience and psychosocial adjustment in children with juvenile rheumatoid arthritis: children's versus mothers' reports.

Adjustment in children with juvenile rheumatoid arthritis (JRA) has been evaluated most frequently by parental or teacher reports and with reference to disease severity. In this study, 38 children, ages 7 to 13 with JRA, and their mothers were interviewed. Modest correlations were found between children and mothers in their assessments of children's perceived competence in several domains (i.e., athletic competence, social acceptance, physical attractiveness, and global self-worth) and in their perceptions of how JRA is experienced by children and families. Children's perceptions of the disease experience were significantly correlated with the four measures of perceived competence, even after controlling for disease severity. The results highlight the importance of cross-validating parental reports with children's self-reports, and demonstrate the need to consider variables other than disease severity--in particular how JRA is interpreted by children--in predicting their adjustment.

Adaptation, Psychological↗