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Biomedical subjects

John Weinman

Publications and source records attributed to John Weinman.

At least 19 recordsLinked to original sources
PubMed2026

The impact of pharmacogenetic-informed care on medication adherence and psychological factors associated with adherence: A narrative review.

Improvement in medication adherence is often proposed as a potential advantage of pharmacogenetic-guided prescribing over a traditional one-size-fits-all approach. This paper provides a review of the published literature and presents the findings of studies that measure adherence to medication as an outcome of pharmacogenetic-informed care, or that measure the impact of pharmacogenetic-informed care on psychological factors that are associated with medication adherence. Adherence-related psychological factors are mapped to the Theoretical Domains Framework (TDF) to provide insight into how participants interact with pharmacogenetic-informed care as an intervention and to consider this in the context of medication adherence. A total of 23 studies were included, with 10 quantitative studies measuring medication adherence outcomes associated with pharmacogenetic-informed care. Five of these studies found a statistically significant improvement in adherence in the pharmacogenetic-tested group, two reported a small but non-significant trend, and three showed no difference. Additionally, 13 studies examined the impact of pharmacogenetic-informed care on psychological factors related to adherence. These factors were mapped to 10 TDF domains: knowledge (8 studies); social/professional role and identity (1); beliefs about capabilities (2); optimism (4); beliefs about consequences (10); intentions (5); goals (1); memory, attention and decision processes (7); social influences (4); and emotion (8). The findings suggest that although the evidence for pharmacogenetic-informed care improving medication adherence is mixed and limited, pharmacogenetic-informed care appears to positively influence psychological factors that may support adherence. These include improving knowledge, supporting decision-making and generally being perceived as a positive experience by patients.

adherence↗
PubMed2006

Sociodemographic, disease status, and illness perceptions predictors of global self-ratings of health and quality of life among those with coronary heart disease--one year follow-up study.

This one-year follow-up study (n = 130 at baseline, n =2745 at follow-up, aged 45-74 years) examined the relationship of patients' perceptions of coronary heart disease (CHD) and illness-related factors with global health status and global quality of life (QOL) ratings. The independent variables were CHD history (myocardial infarction, revascularisation), CHD severity (use of nitrates, CHD risk factors and co-morbidities) and illness perceptions. In multivariate regression analysis, CHD history and severity explained 13% of variance in global health status and 8% in global QOL ratings at the baseline. Illness perceptions increased the share of explained variance by 18% and 16% respectively. In the follow-up, illness perceptions explained a significant but modest share of variance in change in health status and QOL when baseline health status and QOL and CHD severity were adjusted for more symptoms being attributed to CHD, severe perceived consequences of CHD, as well as a weak belief in the controllability of CHD were related to poor global health status and QOL ratings. In structural path models associations of CHD severity factors were mediated by illness perceptions. The association of disease severity with dependent variables was weaker after controlling for illness perceptions. Cognitive representations of CHD contribute to both global health status and QOL ratings and they also mediate the associations between CHD severity and well-being. No gender differences were found in associations of illness perceptions with health status or QOL ratings.

Aged↗
PubMed2006

Exploring beliefs and practice of opioid prescribing for persistent non-cancer pain by general practitioners.

Persistent non-cancer pain is a common reason for consultation in primary care but treatment options, including non-opioid analgesics, are limited, and neither strong evidence nor established guidelines address when and how primary care doctors should prescribe opioid analgesics for persistent non-cancer pain. The aim of this study was to investigate associations between doctors' prescribing patterns for persistent non-cancer pain in primary care and their personal and practice characteristics and beliefs about appropriateness and risks of opioids. A pilot survey sampled beliefs concerning the need for and risks of opioid prescribing for persistent non-cancer pain among volunteers from primary care practices and postgraduate educational events, using a self-report questionnaire, and related these beliefs to their reported opioid prescribing. One quarter of the sample prescribed no opioids for persistent non-cancer pain. Prescribing opioids was predicted by moderate belief in the appropriateness of opioids within certain constraints, and to a lesser extent by younger age. While some beliefs distinguished prescribers from non-prescribers, predicting non-prescribing was poor. Both prescribers and non-prescribers expressed concern about the risks of opioids. In addition, most primary care doctors were dissatisfied with their training on pain; few had prescribing guidelines; and neither training nor guidelines influenced prescribing. In conclusion, whether or not GPs prescribe opioids for persistent non-cancer pain is mainly determined by their personal beliefs about appropriateness of opioids for this problem.

Adult↗
PubMed2006

Development and preliminary validation of a new measure to assess satisfaction with information among head and neck cancer patients: the satisfaction with cancer information profile (SCIP).

BACKGROUND: Our objective was to develop and examine the psychometric properties of the Satisfaction With Cancer Information Profile (SCIP), a new measure designed to assess the extent to which patients with head and neck cancer (HNC) are satisfied with information received about their treatment. METHODS: Patients with head and neck cancer (HNC) from 4 hospitals in the UK completed the SCIP before treatment and again 1 month after treatment. Psychometric properties of the measure were evaluated: internal consistency, subscale intercorrelations, discriminant validity, concurrent validity, and predictive validity. The responsiveness of the measure to change and ease of completion was also assessed. RESULTS: The SCIP performed well on all the psychometric tests; level of satisfaction with information was related to a number of key outcomes and patient beliefs, demonstrating criterion-related validity. CONCLUSIONS: The SCIP was developed to assess HNC patient satisfaction with treatment information and has demonstrated good reliability and validity. This measure may prove appropriate for use with patients with different types of cancer due to its applicability with a variety of treatment modalities. Preliminary psychometric testing has demonstrated its potential for use in routine clinical settings and research settings as a predictive tool or for audit, in addition to assessing individual patient satisfaction with information.

Adult↗
PubMed2006

The brief illness perception questionnaire.

OBJECTIVE: This study evaluates the Brief Illness Perception Questionnaire (Brief IPQ), a nine-item scale designed to rapidly assess the cognitive and emotional representations of illness. METHODS: We assessed the test-retest reliability of the scale in 132 renal outpatients. We assessed concurrent validity by comparing the Brief IPQ with the Illness Perception Questionnaire-Revised (IPQ-R) and other relevant measures in 309 asthma, 132 renal, and 119 diabetes outpatients. Predictive validity was established by examining the relationship of Brief IPQ scores to outcomes in a sample of 103 myocardial infarction (MI) patients. Discriminant validity was examined by comparing scores on the Brief IPQ between five different illness groups. RESULTS: The Brief IPQ showed good test-retest reliability and concurrent validity with relevant measures. The scale also demonstrated good predictive validity in patients recovering from MI with individual items being related to mental and physical functioning at 3 months' follow-up, cardiac rehabilitation class attendance, and speed of return to work. The discriminant validity of the Brief IPQ was supported by its ability to distinguish between different illnesses. CONCLUSION: The Brief IPQ provides a rapid assessment of illness perceptions, which could be particularly helpful in ill populations, large-scale studies, and in repeated measures research designs.

Adaptation, Psychological↗
PubMed2006

Illness perceptions predict attendance at cardiac rehabilitation following acute myocardial infarction: a systematic review with meta-analysis.

OBJECTIVE: Early reports indicated that the illness perceptions of patients following acute myocardial infarction (AMI) predict attendance at cardiac rehabilitation. However, null findings have subsequently been reported, and there is variation between studies in terms of which illness perception constructs predict attendance. The aim of this meta-analysis was to examine whether illness perceptions really predict attendance at cardiac rehabilitation and to examine factors that moderate this relationship. METHODS: The strategy and procedures recommended by Hunter and Schmidt [Hunter JE, Schmidt FL. Methods of meta-analysis: correcting error and bias in research findings. Thousand Oaks (CA): Sage, 2004] were followed. Based on a systematic literature search, eight studies (N=906 patients) that examined the relationship between illness perceptions and attendance at cardiac rehabilitation were included. RESULTS: Four illness perception constructs significantly predicted attendance at cardiac rehabilitation: patients with more positive identity (r=.123), cure/control (r=.111), consequences (r=.081), and coherence (r=-.160) beliefs were more likely to attend cardiac rehabilitation. For all relationships, except that between cure/control beliefs and rehabilitation attendance, there was significant heterogeneity, which was attributable to two studies: one that assessed illness perceptions after leaving the hospital yielded higher effect size estimates, whereas another that involved an intervention yielded effect size estimates in the direction opposite to those of most other studies. The exclusion of these studies resulted in largely unchanged, but homogeneous, effect size estimates. CONCLUSION: Illness perceptions of AMI patients predict attendance at cardiac rehabilitation, although the effect sizes are small and often heterogeneous. AMI patients who view their condition as controllable, as symptomatic, and with severe consequences, and who feel that they understand their condition are more likely to attend.

Attitude to Health↗
PubMed2006

Can genetic risk information enhance motivation for smoking cessation? An analogue study.

Protection motivation theory and the extended parallel processing model are used to predict the motivational impact of information regarding a genetic susceptibility to heart disease. One hundred ninety-eight smokers read 1 of 3 vignettes: gene positive, gene negative, or standard smoking risk information. Analyses examined whether the impact of type of risk information was moderated by smokers' self-efficacy (SE) levels. Key outcomes were intention to quit and intention to attend an information session about quitting. There were significant main effects of SE and of receiving gene-positive risk information on intentions to quit. There was a significant Risk x SE interaction on intentions to attend an information session. SE was not associated with intentions to attend the information session for smokers in the gene-positive group. Intentions to attend the session were negatively associated with SE for smokers in the lower risk groups. Implications for using genetic risk information to motivate smoking cessation are discussed.

Adolescent↗
PubMed2005

Self-regulation and the behavioural response to DNA risk information: a theoretical analysis and framework for future research.

The few studies conducted to date suggest that DNA risk information may be less likely to achieve behaviour change than other types of health risk information. We draw upon self-regulation theory to explain and predict the characteristics of risk information that are more and less likely to motivate behaviour change. Self-regulation theory describes how information about a health threat is processed within individuals' pre-existing cognitive schema, and how the cognitive representations within these schemas activate coping procedures for dealing with the perceived threat. We explore the proposition that the initial impact of information about a health threat depends upon how well it "fits" with existing cognitive representations of that threat. For example, in one study DNA risk information regarding an inherited form of bowel cancer was perceived as more accurate and had a greater impact on risk perceptions in those whose representation of the threat included genes as the single cause, as opposed to one of several. Since the cognitive representation of a threat activates coping procedures that fit with that representation, we also explore the proposition that cognitive representations of a threat that has a genetic identity are less likely to activate coping procedures that include risk-reducing behaviours. For example, using DNA risk information to assess an inherited predisposition to heart disease increased the extent to which the condition was seen as caused by genes, which in turn reduced the expectation that a behavioural means of coping would be effective (eating a low fat diet), but increased the expectation that a biological means was effective (taking lipid lowering medication). Describing the heuristics that operate between risk information, the cognitive representations of threat and coping procedures could be used to identify the cognitions to target so as to optimize the motivational impact of DNA and other risk information.

Adaptation, Psychological↗
PubMed2005

Managing time: an interpretative phenomenological analysis of patients' and physiotherapists' perceptions of adherence to therapeutic exercise for low back pain.

PURPOSE: Physiotherapy for low back pain (LBP) includes exercise therapy. Unfortunately adherence is problematic. This study explores patients' and physiotherapists' perceptions of exercise adherence. METHOD: Nine LBP patients and eight physiotherapists were interviewed. Interpretative Phenomenological Analysis (IPA) was used to explore transcript data. RESULTS: The main theme 'managing time', reveals how pressure on time reflects society's view of time as a commodity. Theme components include 'the bargaining process': physiotherapists spend time listening, exploring patient beliefs, but modify patients' expectations of quick cures with the need to own their back care. 'Reviewing the future' identifies fears about long-term disability, highlighting the importance of recovery time knowledge. CONCLUSIONS: Interpreting participants' stories illustrates how investing in routine exercise could help re-interpret LBP as part of everyday life.

Adult↗
PubMed2005

Perceptions of illness in individuals with anorexia nervosa: a comparison with lay men and women.

OBJECTIVE: The current study examined and compared perceptions of illness in individuals with anorexia nervosa (AN) and lay men and women. METHOD: Participants with AN (n = 95) completed the Revised Illness Perception Questionnaire (IPQ-R). Lay participants (n = 80) completed a modified IPQ-R to elicit perceptions of AN. RESULTS: Participants with AN viewed their illness as chronic and highly distressing, with strong negative consequences. They had fairly negative perceptions of illness controllability and curability, which contrasted with the more optimistic beliefs held by lay participants. Both groups implicated emotional and psychological causes. DISCUSSION: The profile of illness perceptions expressed by the AN sample is associated with poor mental health and functioning and may inform the treatment approach. Lay perceptions of AN differed in the conceptualization of AN as a "slimming disease" amenable to change. This discrepancy may contribute to the stigmatization of AN.

Adult↗
PubMed2005

Illness perceptions in coronary heart disease. Sociodemographic, illness-related, and psychosocial correlates.

OBJECTIVES: This study examined illness perceptions (IP) and their correlates in coronary heart disease (CHD). METHODS: The sample of the questionnaire study (n = 3130 at baseline and n = 2745 at 1-year follow-up, aged 45-74 years) was drawn from the drug reimbursement register, which covers persons with various drug-treated conditions. Independent variables were CHD severity and history, vicarious experiences, and psychosocial resources. RESULTS: Men attributed their CHD more often to risk behaviours and internal factors (own attitude/behaviour), while women perceived stress as the cause of their CHD more often. Women also perceived more symptoms associated with CHD but reported less severe consequences. CHD severity was the most important correlate of IP and also predicted change in IP at the follow-up. Stronger perceived competence was related to weaker illness identity, stronger control/cure, and less severe consequences. CONCLUSIONS: Although disease-related factors are powerful correlates of CHD-related illness cognitions, also social and psychosocial factors are related to IP.

Aged↗
PubMed2005

The effect of psychological stress on symptom severity and perception in patients with gastro-oesophageal reflux.

OBJECTIVE: Using an experimental paradigm this investigation explored whether exposure to psychological stress would produce a significant increase in acid-reflux episodes or modify subjective perceptions of gastro-oesophageal reflux (GOR) symptoms. METHODS: Forty-two patients presenting with heartburn and acid regurgitation underwent 24-h oesophageal pH monitoring. During the last 90 min of this monitoring period, 21 patients received a psychological stressor, while the remaining participants were randomly assigned to a no-stress control condition. State anxiety and subjective GOR symptom ratings were obtained 1 min pretest, 1 min posttest, and 40 min posttest. Cortisol samples were collected at 10-min intervals. RESULTS: The stressor induced a significant increase in cortisol and state anxiety; however, this was not associated with any increase in reflux. Instead, the experimental group reported a dissociation between objectively measured reflux episodes and subjective symptom ratings. A similar pattern was established for participants who reported greater state anxiety, produced larger cortisol responses, or exhibited certain stress-related personality characteristics. CONCLUSION: The perception of symptoms in the absence of increased reflux when one is stressed may account for low response rates to traditional treatments. This highlights a need to bridge the gap between psychosomatic research and clinical practice to develop more successful GOR therapies.

Adult↗
PubMed2005

Effects of emotional disclosure on psychological and physiological outcomes in patients with rheumatoid arthritis: an exploratory home-based study.

The effects of an exploratory, home-based emotional disclosure intervention on psychological and physiological outcomes were assessed in patients with rheumatoid arthritis. Patients were randomly assigned to a disclosure group (n = 19) in which they wrote/talked about traumatic personal experiences, or to a control group (n = 15) in which they wrote/talked about the events of a particular day. Participants undertook these tasks for periods of 20 minutes on 4 consecutive days. The disclosure group demonstrated increases in negative mood and objective markers of disease activity at 1 week post-intervention. However, there were significant trends for the disclosure group to demonstrate minor improvements in mood and stability in disease activity, compared with the control group. These group differences appeared to be due to deteriorations in the control group more than improvements in the disclosure group.

Activities of Daily Living↗
PubMed2005

The use and reporting of cluster analysis in health psychology: a review.

PURPOSE: Cluster analysis is a collection of relatively simple descriptive statistical techniques with potential value in health psychology, addressing both theoretical and practical problems. There are many methods of cluster analysis from which to choose, with no clear guidelines to aid researchers. In the absence of guidelines it is likely that methods already reported by published researchers will be adopted, and so clear reporting of statistical methodology, while always important, is particularly crucial with cluster analysis. The aim of this review is to describe and evaluate the reporting of cluster analysis in health psychology publications. METHODS: Electronic searches of 18 health psychology journals identified 59 articles using cluster analysis published between 1984 and 2002. Articles were submitted to systematic evaluation against published criteria for the reporting of cluster analysis. RESULTS: Just 27% of the papers reviewed met all five criteria, although 61% met at least four. Details of the similarity measure and the computer program used were most frequently omitted. Furthermore, while researchers usually reported the procedures employed to determine the number of clusters and to validate the clusters, these procedures were often lacking in rigour, and were reported in insufficient detail for replication. CONCLUSIONS: The reporting of cluster analysis was found to be generally unsatisfactory, with many studies failing to provide enough information to allow replication or the evaluation of the quality of the research. Clear guidelines for conducting and reporting cluster analyses in health psychology are needed.

Behavioral Medicine↗
PubMed2005

Causal beliefs and behaviour change post-myocardial infarction: how are they related?

INTRODUCTION: Weinman, Petrie, Sharpe, and Walker (2000) showed that the causal attributions of a sample of first-time myocardial infarction (MI) patients and their spouses from Auckland, New Zealand, were associated with changes in health-related behaviour over the first 6 months post-MI. However, their analyses did not control for pre-MI health-related behaviour. METHOD: This paper reports a re-analyses of the Auckland data, and a replication study conducted with 155 first-time MI patients in Brighton, United Kingdom (UK), to investigate whether baseline attributions for MI were related to health-related behaviour change at 6 months (N=132). Spouses (N=85) also completed the attribution questionnaire at baseline. RESULTS: There was no consistent relationship between the causal attributions of patients and subsequent behaviour change in Auckland and Brighton. For both samples, causal attributions were associated with pre-MI behaviour. CONCLUSIONS: The data from both samples suggest that the causal attributions of MI patients and their spouses may be realistic, but not predictive of subsequent changes in behaviour.

Aged↗
PubMed2004

Psychological impact of genetic testing for familial hypercholesterolemia within a previously aware population: a randomized controlled trial.

This trial tests the hypothesis that confirming a clinical diagnosis of familial hypercholesterolemia (FH) by finding a genetic mutation reduces patients' perceptions of control over the disease and adherence to risk-reducing behaviors. Three hundred forty-one families, comprising 341 hypercholesterolemia probands and 128 adult relatives, were randomized to one of two groups: (a) routine clinical diagnosis; (b) routine clinical diagnosis plus genetic testing (mutation searching in probands and direct gene testing in relatives). The main outcome measures were perceptions of control over hypercholesterolemia, adherence to cholesterol-lowering medication, diet, physical activity, and smoking. There was no support for the main hypothesis: finding a mutation had no impact on perceived control or adherence to risk-reducing behavior (all P-values > 0.10). While all groups believed that lowering cholesterol was an effective way of reducing the risk of a heart attack, participants in whom a mutation was found believed less strongly in the efficacy of diet in reducing their cholesterol level (P = 0.02 at 6 months) and showed a trend in believing more strongly in the efficacy of cholesterol-lowering medication (P = 0.06 at 6 months). In conclusion, finding a mutation to confirm a clinical diagnosis of FH in a previously aware population does not reduce perceptions of control or adherence to risk-reducing behaviors. The pattern of findings leads to the new hypothesis that genetic testing does not affect the extent to which people feel they have control over a condition, but does affect their perceptions of how control is most effectively achieved. Further work is needed to determine whether similar results will be obtained in populations with little previous awareness of their risks.

Adult↗
PubMed2004

Self-reported adherence to cholesterol-lowering medication in patients with familial hypercholesterolaemia: the role of illness perceptions.

BACKGROUND: The objectives of this study are to describe levels of adherence to cholesterol-lowering medication and to identify predictors of adherence in patients with familial hypercholesterolaemia (FH). DESIGN: Descriptive questionnaire study. METHODS: 336 adults patients with FH attending one of five outpatient lipid clinics in South East England underwent a clinical assessment by a nurse and completed a questionnaire. The questionnaire assessed self-reported adherence to cholesterol-lowering medication, anxiety, depression, and patient perceptions of heart disease. RESULTS: Overall, participants reported high levels of medication adherence, although 63% reported some level of non-adherence. Total medication adherence (never deviating from the regimen) was more likely to be reported by older participants, those with no formal educational qualifications, those with a personal history of cardiovascular disease, those with a lower total cholesterol level, and those with a greater difference between untreated cholesterol levels and current cholesterol levels. The illness perceptions associated with reported total adherence were lower perceived risk of raised cholesterol, perceiving greater control over FH, and perceiving genes and cholesterol to be important determinants of a heart attack. Emotional state was not associated with medication adherence. In logistic regression analysis, predictors of total medication adherence were having personal history of cardiovascular disease, having no formal qualifications, and perceiving genes to be important determinants of a heart attack. CONCLUSIONS: Both clinical factors and patients' illness perceptions were associated with self-reported cholesterol-lowering medication adherence. The association with illness perceptions was small and many of these associations may be a consequence, rather than a cause, of greater adherence. Given this, intervention strategies aimed at helping patients' to establish routines for medication taking may be more effective in increasing adherence than interventions designed to alter perceptions related to taking statins.

Anticholesteremic Agents↗