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Biomedical subjects

J Ogden

Publications and source records attributed to J Ogden.

At least 37 records · Page 2Linked to original sources
PubMed1999

Sixteen to nineteen year olds' use of, and beliefs about, contraceptive services.

Unwanted pregnancies, sexually transmitted diseases and unprotected sex in young people highlight a need to improve the provision of contraceptive services for this age group. The aim of the present study was to examine young men and women's use of and beliefs about, contraceptive services. A questionnaire was completed by 967 16 to 19 year olds from South Thames concerning their use of and beliefs about, a range of services which provide contraception. The results showed variability in both service use and belie about services which related to the respondent's sexual experience and gender In terms of use, the chemist and the condom machine had been used by the largest number of respondents, with more men using the condom machine and women favouring the GP or family planning clinic. In terms of beliefs, the condom machine was regarded as the easiest and most comfortable to use but the least confidential for all respondents with men reporting higher ratings for ease of use than women and non virgins reporting more positive beliefs for all criteria. The results are discussed in terms of the implications for health education. It is suggested that contraception use in young people could be promoted by embracing rather than challenging this variability. Accordingly, health education interventions would involve providing young people with information about contraception services which was designed to be in line, rather than conflict, with their existing concerns and beliefs. Such an approach would enable them to make informed choices about the kind of contraceptive service which matched their own personal needs.

Adolescent↗
PubMed1999

Shifting the paradigm in tuberculosis control: illustrations from India.

Drawing on literature from India and key contributions from social science, this paper asks and attempts to answer the question 'who is to blame for treatment failures in TB'? Some key lessons emerge: effective tuberculosis control cannot be achieved so long as the disease is considered in isolation from the social processes that maintain it, create the conditions facilitating its spread and act as barriers to care. Insights into the economic and social burdens incurred with a diagnosis of TB are essential to understand why many patients, especially the most disadvantaged, are unable to comply with treatment regimens. TB and health care interventions need to be appropriate to the health service contexts in which they are applied, and sensitive to the competing demands, needs and priorities of people's lives. The paper argues for the need to reorient TB control programmes towards enabling patients to obtain care. The problem of access emerges as central to people's ability to obtain and maintain appropriate therapy. Examples and characteristics of successful non-governmental projects, from which policy makers, programmers and practitioners could learn, are outlined and contrasted with more rigid directly observed treatment approaches. We conclude that treatment failures are not patient failures, and that TB control programmes need to address the social dimensions of TB, and adhere to the principles of good TB care, with the same commitment that is devoted to ensuring patients follow treatment guidelines. We suggest a paradigm shift away from a focus on diseased patients towards enabling health in the community.

Antitubercular Agents↗
PubMed1999

The timing, format and content of school based sex education: an experience with a lasting effect?

School based sex education provides an opportunity to prepare young people for their sexual careers. However, research has criticised the education provided in terms of it being too late, using didactic teaching methods and focusing on biological information. The present study aimed to explore young peoples' experiences of, and beliefs about, their school sex education in terms of its timing, format and content, and to examine the relationship between these factors and their intentions to use condoms. Sixteen to 19 year olds (n = 967) from educational institutions within the South Thames region completed a questionnaire about their sex education. The results showed that the median age of first receiving sex education was 11, that the majority of subjects believed that the timing was about right and a third believed it was too late. In terms of format, didactic methods such as facts, videos and leaflets were more commonly reported than interactive methods such as role-play and discussions about relationships, with the subjects reporting a preference for the latter. In terms of content the results suggested that the greatest emphasis was on biological information, with least emphasis being placed on relationship information. However, many subjects indicated that they had received practical advice such as how to use a condom correctly. In addition, the results indicated that although the timing and format of sex education were unrelated to behavioural intentions, a greater emphasis on practical advice was related to a greater intention to use a condom in the future. The results are discussed in terms of the contemporary nature of school based sex education programmes and evidence for changes following recent recommendations.

Adolescent↗
PubMed1998

The role of family status and ethnic group on body image and eating behavior.

OBJECTIVE: To examine the role of ethnic group and family status on body dissatisfaction and eating behavior. METHOD: One hundred women (Asian mothers and daughters, n = 50; white mothers and daughters, n = 50) completed a questionnaire about their perceived ethnic identity (acculturation), body image, and eating behavior. RESULTS: The results showed no matching between mothers and daughters and no effect of acculturation on body image and eating behavior. However, mothers reported greater body dissatisfaction and white subjects reported higher levels of restrained eating. In addition, the results showed a significant Ethnic Group x Family Status interaction for both body image and eating behavior irrespective of body mass index (BMI). Accordingly, white daughters were found to be the most dissatisfied with their bodies and most concerned with the calorie content of their food, followed by the Asian mothers. White mothers were found to be the most satisfied with their body and Asian daughters were the least concerned with calories. DISCUSSION: The results are discussed in terms of the changing nature of media images in both Asian and white cultures and the impact of the transition between these two cultures.

Acculturation↗
PubMed1998

The role of knowledge and beliefs in help seeking behaviour for cancer: a quantitative and qualitative approach.

The study involved quantitative methods to assess the relationship between knowledge about cancer related symptoms and help seeking behaviour and qualitative methods to explore the role of patient's beliefs about cancer in explaining the gap between knowledge and behaviour. Patients (288) (response rate 72%) from one urban general practice completed a questionnaire consisting of 25 symptoms which they rated for whether they were cancer symptoms (knowledge) and whether the symptoms would prompt them to visit the doctor (hypothetical help seeking behaviour). Twenty patients were then selected who represented a range of knowledge levels and help seeking behaviour and interviewed about their beliefs about cancer. The results showed that the majority of patients had fair knowledge and appropriate help seeking behaviour and indicated a significant association between these variables. However, this relationship was not absolute and although significant the correlation was low. Accordingly, although the subjects knew which symptoms were indicative of cancer, this knowledge was not entirely predictive of their help seeking behaviour. The interviews provided insights into the beliefs which may explain the knowledge/behaviour gap. In particular, analysis of the interviews indicated that the interviewees represented cancer in terms of feelings of fear and death, that they described the process of symptom recognition as involving a fear of finding out the truth, they regarded screening programmes as something to be avoided and understood the causes of cancer either in terms of personal behaviour and internal causes which may result in recriminations or external causes which were beyond their control. The results are discussed in terms of the role of beliefs in mediating the association between knowledge and behaviour and the possible implications for developing educational programmes.

Adolescent↗
PubMed1998

Effect of chronic duodenal ulceration and its treatment with lanzoprazole or sucralfate on gastroduodenal mucosal protein turnover and TGF-alpha, bFGF, and EGF receptor expression in humans.

In order to investigate whether chronic duodenal ulcer disease is a consequence of disturbed mucosal turnover and growth factor expression, we studied 16 patients with duodenal ulcers before, during, and after endoscopic healing with lansoprazole or sucralfate. Before treatment, gastric fundal and antral mucosal protein turnover rates were higher in patients than controls, without parallel increases in growth factors. Both forms of therapy produced similar changes, with overall increases in duodenal mucosal turnover and transforming growth factor-alpha (TGF-alpha) and epidermal growth factor receptor (EGF-r) levels. Measurements after healing showed persistent elevations of mucosal turnover in the antrum and duodenum and depressions of basic fibroblast growth factor (bFGF) in gastric fundal and duodenal mucosa. We conclude that mucosal turnover is abnormally high in patients with chronic duodenal ulcer disease and is not easily explained by growth factor changes. The failure of lansoprazole and sucralfate to normalize rates, despite endoscopic healing, may explain the high ulcer relapse rates in non-HP-eradicated patients.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1998

Explaining the effect of ethnic group on weight concern: finding a role for family values.

OBJECTIVE: To examine the impact of ethnic group on aspects of weight concern and to assess the role of family values in explaining this association. SUBJECTS AND MEASURES: 20 Asian and 20 white daughters gave a questionnaire to their mother, father and sibling closest in age, concerning their profile characteristics (age, education) values and beliefs and completed a matched questionnaire containing additional measures of aspects of their weight concern. RESULTS: The results showed no differences between the white and Asian daughters in terms of either their restrained eating or body dissatisfaction. However, the results showed consistent differences between the members of the two family groups in terms of the value placed on achievement, child/parent relationships, competition, the role of women, and some differences in terms of materialism, the value of appearance and their idea of the perfect female body. The results were then analysed to assess the best predictors of the daughter's weight concern. Whereas restrained eating was related to the mother's rating of the value of physical appearance and the sibling's ratings of competitiveness and a non-traditional role for women (40% of the variance), the results showed that body dissatisfaction was related to the daughter's rating of materialism, having a father who preferred a thinner female body, the siblings ratings of a non-traditional role for women, degree of concordance within the family concerning the value of competitiveness and the educational level of the 'head of the family' (49% of variance). CONCLUSION: Whereas a dichotomous model of ethnicity may be insufficient to explain differences in aspects of weight concern, an expanded model of cultural beliefs may be a more powerful construct. Accordingly, the absence or presence of differences in weight concern according to ethnic group may simply reflect the extent to which the different groups chosen for analysis are differentiated by these predictive values.

Adolescent↗
PubMed1998

Developing, validating and consolidating the doctor-patient relationship: the patients' views of a dynamic process.

BACKGROUND: Previous research has examined the doctor-patient relationship in terms of its therapeutic effect, the need to consider the patients' models of their illness, and the patients' expectations of their doctor. However, to date, no research has examined the patients' views of the doctor-patient relationship. AIM: To examine patients' views of the process of creating a relationship with their general practitioner (GP). METHOD: A qualitative design was used involving in-depth interviews with 27 frequently attending patients from four urban general practices. They were chosen to provide a heterogeneous group in terms of age, sex, and ethnicity. RESULTS: The responders described creating the relationship in terms of three stages: development, validation, and consolidation. The development stage involved overcoming initial reservations, actively searching for a doctor that met the patient's needs, or knowing from the start that the doctor was the right one for them. The validation stage involved evaluating the nature of the relationship by searching for evidence of caring, comparing their doctor with others, storing key events for illustration of the value of the relationship, recruiting the views of others to support their own perspectives, and the willingness to make tradeoffs. The consolidation stage involved testing and setting boundaries concerned with knowledge, power, and a personal relationship. CONCLUSION: Creating a relationship with a GP is a dynamic process involving an active patient who searches out a GP who matches their own representation of the 'ideal', selects and retains information to validate their choice, and locates mutually acceptable boundaries.

Adult↗
PubMed1997

The waiting game.

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Bed Occupancy↗
PubMed1997

Practice nurses' beliefs about obesity and weight related interventions in primary care.

OBJECTIVE: To examine practice nurses' beliefs about obesity and their current practices and the role of the weight management context and their own BMI on these factors. DESIGN: Cross sectional questionnaire. SUBJECTS: Questionnaires concerning beliefs about obesity and current practices were completed by 586 practice nurses. RESULTS: The subjects rated lifestyle as the main cause and cardiovascular problems as the main consequences of obesity, regarded weight loss as beneficial and reported high confidence in their ability to give advice to obese patients. However, their expectations of patient compliance and actual weight loss were low indicating that practice nurses rate their advice giving skills as independent to the outcome of this advice. Further, failed weight loss was explained in terms of patient and not professional factors. In addition, the results indicated variability in their beliefs and behaviour according to the location of this advice and the practice nurse's own BMI. In particular, practice nurses who run weight loss clinics reported giving weight loss advice more frequently, spending longer counselling obese patients, reported greater confidence in giving weight loss advice and more optimism about outcomes. Further, those with low BMIs rated obesity as more preventable, reported being less likely to advise patients to use a calorie controlled diet and more likely to suggest eating less in general. CONCLUSION: Education programmes for practice nurses should not only include skills training but emphasise both the factors involved in advice giving and self appraisal. Such appraisal should include a role for both the practice nurse's and the patient's behaviour to minimise the 'operation was a success but the patient died' approach to obesity management.

Adult↗
PubMed1997

The relative effectiveness of two styles of educational package to change practice nurses' management of obesity.

OBJECTIVE: To examine the impact of two styles of educational package on practice nurses' management of obesity. SUBJECTS AND MEASURES: A questionnaire was completed by 66 practice nurses concerning their obesity related beliefs and the content and style of their weight related practices before and one month after being randomly allocated to either the 'learner centred' group (who received a leaflet and were invited to attend an interactive seminar), the 'expert group' (who received the leaflet) or the control group. At the one month follow up, practice nurses were also asked to give a brief questionnaire to five consecutive patients, who they saw for weight loss advice, concerning the content and style of the consultation. After 6 months, practice nurses, and patients were sent a questionnaire about their consultation style and weight loss, respectively. RESULTS: The packages had no differential effects on practice nurses' beliefs about obesity. However, practice nurses in the 'learner group' reported spending longer on their consultations and being more patient centred. Their patients rated themselves as more satisfied with the consultation and reported that they were offered calorie controlled diets less often. In contrast, practice nurses in the 'expert group' reported giving weight loss advice more frequently, being less patient centred and their patients reported greater confidence in, and likelihood of, weight loss and reported that they were more likely to be offered traditional weight loss interventions. The packages had no differential effects on patient weight. CONCLUSION: Practice nurses' and patients' beliefs and behaviour and the style of their interactions can be changed by both expert and learner centred educational packages. The style of packages should be chosen in terms of both the available resources and the desired outcomes.

Adult↗
PubMed1997

To treat? To befriend? To prevent? Patients' and GPs' views of the doctor's role.

OBJECTIVE: To examine and compare patients' and GPs' views of the doctor's role and patients' reasons for going to the doctor. DESIGN: A cross sectional questionnaire survey. SETTING: General practices across England. SUBJECTS: 501 patients and 68 GPs. MAIN OUTCOME MEASURES: Beliefs about the doctors' role and beliefs about patients' reasons for going to the doctor in terms of illness treatment, a psychosocial approach and preventive health care. RESULTS: A majority of both patients and GPs agreed that the doctor's role was primarily to treat illness. However, whereas patients showed greater endorsement for preventive health care and a belief that the doctor's role was to keep people healthy, GPs showed greater support for an emphasis on personal problems. In terms of patients' reasons for visiting their doctor, a majority of both patients and GPs agreed that illness prevention and illness treatment were important. However, more patients believed that patients visit the doctor for illness prevention than GPs, more of whom felt that patients seek help with their personal problems. CONCLUSION: The results indicate a mismatch between patients' and GPs' beliefs, which has implications for understanding the impact of recent changes in primary care and the effects on GPs' job satisfaction.

Adult↗
PubMed1996

The problem with weighing: effects on mood, self-esteem and body image.

OBJECTIVE: To examine the effect of weighing and comparison with social norms on self-esteem, mood and body dissatisfaction. DESIGN: An experimental design was used. SUBJECTS: Seventy-four normal weight individuals took part in the study. PROCEDURE: Subjects completed a set of measures before and after being weighed and sequentially allocated to either the under, average or over weight conditions according to a fictional height-weight chart. RESULTS: The results showed that subjects allocated to the overweight group showed an increase in depression and a decrease in self esteem following the manipulation, compared to subjects in the average weight group who reported improvements in these measures and the underweight group who similarly showed decreased depression, but showed some deterioration of their self-esteem. CONCLUSION: Weighing and comparison with height weight charts of weight norms is used both to detect and treat overweight and obesity. The results from this study indicate that this procedure may not be as benign as believed and may contribute to the negative psychological state of the individual.

Adolescent↗
PubMed1995

Training. Women only.

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Administrative Personnel↗
PubMed1995

Psychosocial theory and the creation of the risky self.

This paper examines the transformation of individual identity in twentieth century psychological theory from the passive through to the interactive to the intra-active using models of behaviour, learning, beliefs, stress and pain. This shift in identity and the corresponding realignment of individual and environment is discussed in terms of changing locations of risks to health and the construction of the contemporary risky self.

Attitude to Health↗