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Biomedical subjects

H Leventhal

Publications and source records attributed to H Leventhal.

At least 55 records · Page 3Linked to original sources
PubMed1985

Factors associated with active participation in a Cancer Prevention Clinic.

To investigate factors that influence individuals at higher than average risk for cancer to seek preventive care, we studied 78 people by questionnaires designed to assess a variety of psychological, familial, and personal demographic variables. Twenty-six of these subjects (probands) had actively sought the services provided by a Cancer Prevention Clinic whereas the other subjects (nonprobands) did not initiate contact with the clinic. The results of a discriminant analysis indicate that prior involvement in cancer preventive activities, interest in cancer-specific information, and level of perceived susceptibility to cancer all contributed significantly to active participation in the Cancer Prevention Clinic. Level of psychological discomfort was found to be associated with cancer-specific variables, but did not contribute significantly to proband status. Involvement in preventive behaviors and perceived cancer susceptibility were most highly associated with familial factors, such as the proportion of first-degree relatives with cancer, whereas interest in cancer information was primarily related to perceived risk level.

Adult↗
PubMed1985

Common-sense models of illness: the example of hypertension.

Our premise was that actions taken to reduce health risks are guided by the actor's subjective or common-sense constructions of the health threat. We hypothesized that illness threats are represented by their labels and symptoms (their identity), their causes, consequences, and duration. These attributes are represented at two levels: as concrete, immediately perceptible events and as abstract ideas. Both levels guide coping behavior. We interviewed 230 patients about hypertension, presumably an asymptomatic condition. When asked if they could monitor blood pressure changes, 46% of 50 nonhypertensive, clinic control cases said yes, as did 71% of 65 patients new to treatment, 92% of 50 patients in continuing treatment, and 94% of 65 re-entry patients, who had previously quit and returned to treatment. Patients in the continuing treatment group, who believed the treatment had beneficial effects upon their symptoms, reported complying with medication and were more likely to have their blood pressure controlled. Patients new to treatment were likely to drop out of treatment if: they had reported symptoms to the practitioner at the first treatment session, or they construed the disease and treatment to be acute. The data suggest that patients develop implicit models or beliefs about disease threats, which guide their treatment behavior, and that the initially most common model of high blood pressure is based on prior acute, symptomatic conditions.

Attitude to Health↗
PubMed1985

"I can tell when my blood pressure is up, can't I?".

Forty-four insurance company employees were measured on blood pressure, moods, symptoms, and predictions of their blood pressures, twice daily for 10 days. Twenty subjects had elevated blood pressure and 24 did not. The measures were correlated within-subjects to determine if blood pressure predictions were associated with moods, symptoms, or blood pressure readings, and if moods and symptoms were related to blood pressure. Predictions of pressure were expected to be correlated with symptoms and moods, but not with blood pressure. No strong relationship was expected when blood pressure was compared to symptoms or to moods. The data showed that self-predictions of blood pressure were most strongly associated with reported symptoms, next with reported moods, and least with actual blood pressure. A comparison of subjects who were accurate in predicting their blood pressure with those who were not showed no differences in blood pressure levels, systolic blood pressure variation, self-esteem, or private body-consciousness. Subjects' beliefs that they could monitor blood pressure were little influenced by contrary information. The results suggest it would be an error to encourage subjects to believe they can successfully treat blood pressure elevations by monitoring symptoms related to blood pressure change.

Adult↗
PubMed1985

Health practices and illness cognition in young, middle aged, and elderly adults.

The present paper examines reported frequencies of 21 health practices, beliefs that these health practices can prevent six different illnesses, and beliefs about those illnesses in a community sample of 396 people: 173 young (20 to 39 years), 111 middle-aged (40 to 59 years), and 112 elderly adults (60 to 89 years). Elderly respondents report higher frequencies of health-promoting actions (e.g., regular medical check-ups, avoidance of salt, regular sleep, and eating a balanced diet) than younger respondents. Health practices aimed at reinterpreting stress and controlling emotions (e.g., avoiding emotional stress, staying mentally alert and active) also increased with age. Belief that these 21 practices prevent specific illnesses was consistent across the three age groups. Beliefs about the six illnesses were consistent across age with three exceptions: Elderly people considered themselves more vulnerable to disease, saw it as more serious for them, and were less likely to use chronic mild symptoms, like weakness and aches, as illness warnings.

Adult↗
PubMed1985

Spontaneous hematomyelia secondary to factor XI deficiency. Case report.

A 34-year-old woman with Factor XI deficiency presented with rapidly progressive quadriplegia following a 1-week prodrome of cervical pain. At operation, a spontaneous hematomyelia was evacuated from the C4-6 vertebral level. The pathophysiology of spontaneous hematomyelia is discussed.

Adult↗
PubMed1985

A cognitive developmental approach to smoking prevention.

Most smoking prevention programs for middle-schoolers target non-smokers. These programs seek to educate young people about the hazards of smoking, influence young peoples' attitudes toward smoking, and reduce initial experimentation with cigarettes by providing social- and life-skills training. The program described in this chapter incorporates these features and adds a component which explores, in some depth, the nature of the user's response to cigarettes. This component focuses on the young person's physical and psychological reaction to cigarette smoking, and provides a knowledge base which promotes a negative evaluation of that reaction. This component targets all young people, but it is anticipated that it will be especially effective with pre-addictive experimenters who are wondering what smoking can "do for them". One challenge for the future is the development of intervention strategies that have something to offer the young addicted smoker who wishes to quit smoking. These young people are largely unserved by school-based smoking education programs, drug abuse programs, and organized smoking therapies.

Adolescent↗
PubMed1983

The impact of communications on the self-regulation of health beliefs, decisions, and behavior.

The models used in the study of communication and health behavior have changed from those describing how to impose health actions on relatively passive respondents to models describing how respondents regulate their own health practices. We have traced the change from the fear-drive model, which described how fear induced change, to the parallel response model, which described how subjects processed information and generated coping responses to solve the problem posed by both the objective health threat and by their subjective fear. The data supporting this change showed that increasing fear led to more favorable attitudes but that fear alone was insufficient to create action: Specific action instructions had to be added to both high and low fear and both combinations produced the same level of health action. Neither the data nor the parallel model specified what subjects learned about the threat that made exposure to a high or low fear message necessary for behavior change. The parallel response model has been elaborated into a more complete systems model and new studies show how health threats are represented. They have found attributes such as IDENTITY (label and symptoms), CAUSES, TIME LINES or duration, and CONSEQUENCES, that set goals and criteria to generate and evaluate problem solving (coping) behavior. Suggestions are made for applying this more complete model to public health practice.

Attitude to Health↗
PubMed1982

Factors contributing to emotional distress during cancer chemotherapy.

Recent studies have demonstrated that patients receiving cancer chemotherapy are more likely to have a successful treatment outcome if they receive optimal doses of drug continually. The current study was designed as a first step toward discovering factors that are associated with emotional distress during treatment and subsequent decisions by patients to delay, reduce, or terminate treatment. Interviews were conducted with 61 patients receiving chemotherapy for malignant lymphoma. Patients reported on side effects of treatment and their efforts to control them, their knowledge and beliefs about their illness, their strategies for monitoring the effectiveness of treatment, and the extent to which they had been prepared for the experiences of chemotherapy. Ratings of emotional distress were obtained on an 11-point self-report scale, and information about treatment schedules was obtained from medical records. The number of side effects experienced, but not the duration or severity, was positively correlated with distress. Vague, diffuse side effects such as tiredness and pain were more likely to be associated with distress than were acute, specific side effects such as nausea and vomiting. Patients who reported either unsuccessful attempts to cope with side effects or no attempts at all had greater distress than those who were coping successfully. Patients who developed conditioned nausea during treatment reported higher distress than those who did not.

Antineoplastic Agents↗
PubMed1981

Cesarean section--a review of two annual periods separated by a ten-year interval.

In the Soroka Medical Center in Beer-Sheba during the two annual periods 1969 and 1979, 693 cesarean sections were performed, of which 633 are presented. The main reasons for the rise in cesarean section rate from 2.6% in 1969 to 8.0% in 1979 were evaluated. Cesarean sections were performed more often for fetal indications during 1979 than in 1969, reflecting the change in our approach to the management of the fetus at risk. The increase in the cesarean section rate was concomitant with a drop in the perinatal mortality from 23/1000 in 1969 to 13.1/1000 in 1979.

Breech Presentation↗
PubMed1979

Effects of preparatory information about sensations, threat of pain, and attention on cold pressor distress.

Pain experience is conceptualized as a combination of stimulus sensations (e.g., aching) and emotional distress. In Experiment 1, less distress was reported to cold pressor stimulation by subjects first told about stimulus sensations than by subjects who were uninformed or were told about symptoms of bodily arousal (e.g., tension). Adding a pain warning to sensation information blocked distress reduction, presumably by eliciting an emotional interpretation of the stimulus. In Experiment 2, subjects attending only to hand sensations reported less distress than subjects attending to their bodies. This decrease in the power of the stimulus to provoke emotion is presumably mediated by a schema of hand sensations formed by attention. In Experiment 3, subjects attending to hand sensations early in the immersion and distracting themselves later reported the same low levels of distress as did subjects who attended to hand sensations throughout. Subjects distracted throughout and subjects attending to hand sensations later showed no distress reduction. Therefore, stimulus schematization must precede distress reduction. Implications for distress control are discussed.

Arousal↗
PubMed1979

Determinants of three stages of delay in seeking care at a medical clinic.

Factors affecting delay were studied in patients seeking treatment for the first time for a particular symptom at clinics in a major, innercity hospital. On the basis of the patients' retrospective report, the total time from first noticing a symptom to the seeking of treatment was divided into three sequential stages: 1) appraisal delay--the time the patient takes to appraise a symptom as a sign of illness; 2) illness delay--the time taken from deciding one is ill until deciding to seek professional medical care; and 3) utilization delay--the time from the decision to seek care until the patient goes to the clinic and uses its services. The variables used to predict the length of delay for each of the three stages and for total delay included reports on concrete, sensory perceptions and abstract, conceptual beliefs about one's symptoms, behavioral factors such as strategies for self-appraisal and techniques for coping with illness, emotional reactions, negative imagery elicited by the illness threat, situational barriers, and socio-demographic factors. Patients experiencing a very painful symptom and patients who did not read about their symptom had a short appraisal delay. Patients with old symptoms and those who imagined possible, severe consequences of their illness had long illness delays. Utilization delay was shortest for persons who were not concerned about the cost of treatment, who had a painful symptom, and who were certain that their symptom could be cured. Patients who had short total delays were persons who did not have a competing personal problem and who had a painful symptom. All of these predictors were significantly correlated with the measure of delay at or beyond the p = .01 level. It was concluded that different factors mediate delay in each of the three stages and that studies which use only a single measure of total delay are likely to be of limited value in understanding delay.

Attitude to Health↗
PubMed1978

Type A behavior, self-involvement, and cardiovascular response.

Coronary-prone Type A and noncoronary-prone Type B students were challenged by a battery of tasks including cold pressor, mental arithmetic, behavior type interview, and the generation and expression of emotions. Measures of blood pressure, heart rate, and digital vasoconstriction were intercorrelated with reported distress, performance, speech characteristics, emotional intensity, and self-references. The major difference between the two behavior types concerned self-references, measured as the frequency of personal pronouns employed in speech. The Type A's who referred to themselves frequently had a markedly higher systolic blood pressure, a slightly higher diastolic blood pressure, a lower heart rate, higher distress ratings to cold water, and more extreme voice emphasis and emotional intensity than Type A's who referred to themselves less frequently. The Type B's have little relationship of self-references to any of the measures taken. The possible role of self-involvement in generating Type A behavior and cardiovascular response is discussed.

Autonomic Nervous System↗
PubMed1977

Ear differences in evaluating emotional tones of voice and verbal content.

Two experiments are presented in which lateralization of monaural, auditory input affected the evaluation of verbal passages. In Experiment 1, subjects listened to taped passages that consisted of three levels (positive, neutral, and negative) of tone of voice crossed with three similar levels of content or meaning, making a total of nine different tone/content combinations. Subjects rated these passages as positive, neutral, or negative, and although they were not instructed about which cues (tone or content) to use, 29 of 36 subjects who listened on the left ear primarily used the tone-of-voice cues to rate the passages, whereas 21 of 36 subjects who listened on the right ear used the content cues (p less than .01). In Experiment 2, subjects were asked to make objective ratings of both tone of voice and content. Subjects who listened on the right ear were more accurate in rating both cues. The lateral differences in evaluating the auditory stimuli are discussed in the framework of the left hemisphere's specialization for analytic processing of objective information and the right hemisphere's specialization for the holistic processing of subjective or emotional information. However, each hemisphere's specialization for tone and content cues can be greatly affected by the demands of the experimental task.

Auditory Perception↗