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PubMed2006

Risk denial about smoking hazards and readiness to quit among French smokers: an exploratory study.

In most developed countries, a significant part of the population is still smoking despite comprehensive tobacco control policies. Among other reasons, many smokers may endorse self-exempting beliefs that help them to deny the smoking hazards for themselves. We investigated the relationship between smokers' risk denial and their readiness to quit making use of a French cross-sectional survey conducted in the Paris Ile-de-France Region (N=939 smokers). Self-exempting beliefs were quite widespread among participants and two of them were significant predictors of a low readiness to quit: considering that one's cigarette consumption is too low to be harmful and believing that one's way of smoking can protect from smoking-related diseases. Future tobacco control messages and interventions should specifically address these self-exempting beliefs that reduce smokers' cognitive dissonance and then inhibit their willingness to quit.

Adult↗
PubMed2006

Protecting the self: a descriptive qualitative exploration of how registered nurses cope with working in surgical areas.

AIMS: This paper aims to explore and describe how qualified nurses working with in, in-patient surgical areas cope with the daily experiences they are exposed to. BACKGROUND: It has long been recognised that many aspects of nursing work can result in high levels of stress, with negative consequences for the individual nurse and patient care. Difficulties in coping with nursing work can also result in burnout, as well as raising concerns about cognitive dissonance, emotional labour and the use of emotional barriers. Why some nurses are more prone to experience these phenomena than others, is unclear. METHOD: A descriptive qualitative approach is taken using a purposive, theoretically congruent sample of 16 qualified registered nurses all of whom participated in a semi-structured interview during 2002. All interviews were tape recorded and transcribed verbatim and then analysed using the four stages outlined by Morse and Field [Morse, J.M., Field, P.A., 1996. Nursing Research: The Application of Qualitative Approaches. Chapman & Hall, London]. FINDINGS: Three key themes emerged from analysis; relationships with patients, being a person and the effect of experience. All three interlink to describe a process whereby the individual switches off from the environment around them by adopting a working persona which is different but related to their own personal persona and is beneficially enhanced as a consequence of experience. CONCLUSION: Working as a nurse results in exposure to potentially distressing and stressful events from which it is important to protect the self. Participants in this study achieve protection by the development of a working persona which facilitates switching off and is beneficially enhanced by experience.

Adaptation, Psychological↗
PubMed2006

A randomised controlled trial of group debriefing.

There has never been published a randomised controlled trial of group debriefing. In this study we employed an analogue study with students to conduct the first such trial. Sixty-four participants were shown a stressful video of paramedics attending to injured and dead victims of a road traffic accident. Half the participants were subsequently debriefed and half were provided with tea and biscuits and allowed to talk amongst themselves. A 1 month follow-up was administered. It was found that, while the video was rated as distressing, there were no significant differences between the debriefed and non-debriefed groups on measures of affective distress and trauma symptoms. Those who were debriefed later recalled having wanted to talk more to someone about the video than those who were not debriefed. It is suggested that cognitive dissonance may explain this result.

Adult↗
PubMed2004

The Airline Lifesaver: a 17-year analysis of a technique to prompt the delivery of a safety message.

INTRODUCTION: The Airline Lifesaver (AL) is a 13.3 cm x 9.8 cm card any passenger can deliver to the attendant of a commercial airline in order to prompt the delivery of an important safety message. In particular, the AL requests the following safety--belt reminder be added to the regular announcements given at the end of the flight-"Now that you have worn a seat belt for the safest part of your trip, the flight crew would like to remind you to buckle-up during your ground transportation." METHOD: The AL card was handed to 1,258 flight attendants over a 17-year period and compliance with the request for the safety message was systematically tracked. Slightly more than one-third of the AL cards (n=460) included an incentive for making the announcement. RESULTS: Without the incentive, compliance to give the buckle-up reminder was 35.5% of 798 flights. With the incentive, compliance was significantly higher (i.e., 53.3%). IMPACT: The validity of the AL intervention is discussed with regard to its: (a) relevance to cognitive dissonance and consistency theory, and (b) broad-based applicability as a component of community-wide efforts to facilitate a safety-focused culture. The 17-year study also demonstrated a practical and cost-effective application of a behavior-based incentive program.

Adult↗
PubMed2004

The impact of media coverage of the suicide of a well-known Quebec reporter: the case of Gaëtan Girouard.

Evidence of a media impact on suicide is mixed and needs further research. The main objective of this article is to document the effects of the media coverage following the suicide of a well-known and popular television reporter in Quebec, Canada. A content analysis of the printed media and an analysis of suicide rates during the following year, of coroners' records and of calls to Suicide Prevention Centres during the following 3 months was conducted. Most guidelines for responsible reporting of a suicide were not applied. The results showed a rise in the suicides rates immediately after the reporter's suicide, especially by hanging as in the original case. A cluster of six suicides by hanging also took place in the small municipality where the reporter's suicide occurred. There was also an indication of direct influence in the coroners' records and a rise in calls to Suicide Prevention Centres. This research indicates that the reporting of the suicide of a popular figure preceded an important rise in the number of suicides. A possible theoretical explanation is that a positive role model appeared to suddenly fail to cope with life, thus creating high distress and cognitive dissonance in the audience. The news media should apply more caution and follow recommended guidelines in reporting this type of news.

Adolescent↗
PubMed2000

An extended Glasgow Coma Scale (GCS-E) with enhanced sensitivity to mild brain injury.

OBJECTIVE: The Glasgow Coma Scale-Extended (GCS-E) was developed to flag mild cases of concussion (corresponding to Grades I and II concussion as defined by the American Academy of Neurology) at the time of first contact with the health care system. SUBJECTS AND SETTING: The GCS-E was applied to 561 consecutive admissions with GCS scores of 13 to 15 at two hospitals in South Africa and two in the United Kingdom (UK). RESULTS: The amnesia scale was readily learned and reliably applied by emergency department staff without affecting the standard scoring of the GCS itself. Among patients with an admitting GCS of 15, 27% in the UK and 31% in South Africa reported amnesia of some duration. CONCLUSIONS: Wide use of the GCS-E would hold mild traumatic brain injury cases in the treatment loop, improve access to counselling, rehabilitation services, and personal injury compensation, and reduce the "cognitive dissonance" between victims of mild traumatic brain injury and treating professionals.

Adult↗
PubMed2001

The evolution of women's primary health care in california: the role of the obstetrician/gynecologist.

The role of the obstetrician/gynecologist as the primary health care provider for women has evolved rapidly in the past decade. There has not always been agreement in the specialty about the directions in which it should proceed. In particular, a cognitive dissonance has arisen regarding the primary care role for any one physician. Just as there are strong advocates,1,2 so are there dissentients.3,4 Access to care for women and patient choice of physician are universally acknowledged as desirable and central to the issue. The often acrimonious debate derives from more theoretical constructs of subspecialty identity and integrity, economics, dilution of specialty training, and educational barriers to successful implementation. The practical, salutary implications of primary care obstetrician/gynecologists have infrequently been evaluated in any formalized fashion. Five years ago, the State of California designated obstetrician/gynecologists as primary care physicians. This paper is a retrospective analysis of how the designation was achieved and the subsequent experience of the specialty over this period of time.

Journal Article↗
PubMedDate not supplied

Childbearing experiences of abused Hispanic women.

Previous research has documented that abused childbearing women have longer and more difficult labors than non-abused women. Prevalence of abuse differs depending on the ethnic group involved. Hispanic women experience higher rates of abuse and endure higher rates before reporting abuse than do Caucasian women. The purpose of this study was to explore the experience of childbearing for abused Hispanic women to provide guidance for clinical practice and further research. Cognitive dissonance theory guided the study. A sample of seven abused Hispanic women was recruited from a rural prenatal clinic. Criteria for selection of subjects included self-identification as Hispanic, less than 24 months postpartum, disclosure of abuse status, and willingness to be interviewed in English or Spanish. An acculturation scale and demographic form were completed. Interviews were conducted individually, and data were analyzed by using Van Kaam's 12-step psychophenomenologic technique. Findings indicated that subjects experienced the normal responses associated with having a baby. However, the women also demonstrated a kindled neuroendocrine trauma response that was based on, and often similar to, their prior abuse experiences. The kindled emotional response was triggered by the normative events of childbearing. Understanding of the childbearing experiences of abused Hispanic women will facilitate the development of cultural-specific interventions that may ease the difficulties associated with birth for these women.

Adult↗
PubMed1997

Beyond pleasure and pain.

People approach pleasure and avoid pain. To discover the true nature of approach-avoidance motivation, psychologists need to move beyond this hedonic principle to the principles that underlie the different ways that it operates. One such principle is regulatory focus, which distinguishes self-regulation with a promotion focus (accomplishments and aspirations) from self-regulation with a prevention focus (safety and responsibilities). This principle is used to reconsider the fundamental nature of approach-avoidance, expectancy-value relations, and emotional and evaluative sensitivities. Both types of regulatory focus are applied to phenomena that have been treated in terms of either promotion (e.g., well-being) or prevention (e.g., cognitive dissonance). Then, regulatory focus is distinguished from regulatory anticipation and regulatory reference, 2 other principles underlying the different ways that people approach pleasure and avoid pain.

Emotions↗
PubMed2000

Cultural psychology of surprise: holistic theories and recognition of contradiction.

The authors tested the hypothesis that East Asians, because of their holistic reasoning, take contradiction and inconsistency for granted and consequently are less likely than Americans to experience surprise. Studies 1 and 2 showed that Korean participants displayed less surprise and greater hindsight bias than American participants did when a target's behavior contradicted their expectations. Studies 3 and 4 further demonstrated that even when contradiction was created in highly explicit ways, Korean participants experienced little surprise, whereas American participants reported substantial surprise. We discuss the implications of these findings for various issues, including the psychology of conviction, cognitive dissonance, and the development of science.

Adult↗
PubMed2002

Antibiotic prophylaxis of infective endocarditis during digestive endoscopy: over- and underuse in Switzerland despite professed adherence to guidelines.

BACKGROUND AND STUDY AIMS: Guidelines for antibiotic prophylaxis of infective endocarditis associated with gastrointestinal endoscopy are not uniform. Though based on weak scientific evidence, they do represent an attempt to unify the management of antibiotic prophylaxis. We investigated whether physicians who profess to adhere to these guidelines actually do apply them correctly. MATERIALS AND METHODS: A questionnaire was sent to all 195 Swiss gastroenterologists asking whether they adhered to antibiotic prophylaxis guidelines and under what conditions did they apply antibiotic prophylaxis in gastrointestinal endoscopy. We analysed whether the Swiss gastroenterologists who claim to adhere to these guidelines actually do so in practice. RESULTS: The response rate to our questionnaire was 95%. Of the Swiss gastroenterologists, 60% correctly employ antibiotic prophylaxis guidelines in gastroscopy, as do 47% in colonoscopy. In therapeutic endoscopy, the percentage of correct antibiotic prophylaxis use depends upon the type of intervention and varies between 21 and 58%. Overuse of antibiotic prophylaxis is at least twice as frequent in colonoscopy and therapeutic endoscopy than in gastroscopy. CONCLUSIONS: Guidelines for antibiotic prophylaxis are not well applied and do not lead to uniform management despite a high degree of professed adherence to them. This phenomenon can be explained by "cognitive dissonance" and "reactance." We conclude that guidelines based on unconvincing data may even prove harmful.

Antibiotic Prophylaxis↗
PubMedDate not supplied

[Preoperative education consultation from the viewpoint of the patient].

By means of semi-standardized interviews 64 patients at a university orthopedic clinic were asked about the information supply and decision-taking process, in particular concerning their impressions of the consultation which takes place just prior to surgery (usually on the preceding day) and leads to the formal declaration of consent. It was found that this discussion does not have the central significance in the information and decision process which is often ascribed to it. Nevertheless, in addition to the legal aspect, it fulfills a number of important psychological functions: - The patient is given supplementary information, in particular concerning events surrounding the operation. - Immediately prior to the operation and its risks, the patient's binding consent is confirmed: this represents a formal termination of the decision process. - Considering the anxiety and doubt associated with the operation (cognitive dissonance) the patients needs emotional support. - The talk provides an opportunity to establish or consolidate a personal relationship between the patient and the responsible physician. Contrary to widely-held opinion almost all the patients were highly interested in detailed information and demonstrated considerable knowledge of their complaints, the surgical method and the risks involved. Though the preoperative talk was positively assessed by most patients, it was nonetheless apparent that current practices in furnishing medical information require correction in a number of respects. Above all, the provision of information simply by listing points, and in the form of a monologue, should be abandoned; instead, the patient should be involved as an active partner in an exchange of information and a decision-making process.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1998

Motives for social decision-making strategies among Finnish and Estonian adolescents [corrected].

Justifications for aggression and withdrawal were compared between Finnish and Estonian adolescents. The former had grown up in a pluralistic Western culture; the latter, in a communist Soviet culture. After receiving a questionnaire with descriptions of 2 everyday social problems, teasing and backbiting, and a list of problem-solving strategies, the participants were asked how they would justify the use of each strategy. The Estonian participants more frequently chose instrumental justifications for aggression, whereas the Finnish participants tended to report that aggressive behavior was "fun." Aggression may be perceived as more deviant in Finland than in Estonia. Among the Finnish participants, withdrawal was motivated by a desire to avoid harm; among the Estonian participants, withdrawal reflected helplessness. The Estonian participants experienced cognitive dissonance between official education and the informal information learned in families; there was also dissonance between inner speech (banned history) and the official history taught in the schools.

Adolescent↗
PubMed2002

Abstinence versus alcohol use among elderly rural Baptists: a test of reference group theory and health outcomes.

Reference groups, such as religious groups, are thought to provide individuals with normative frameworks which set and maintain standards for them. Persons who belong to a reference group, yet do not comply with the standards of that group, i.e. non-conformists, are thought to experience cognitive dissonance which in turn may lead to psychological discomfort and adverse physical health outcomes. In a community-based, racially mixed sample of elderly Baptists in the rural south of the United States (n = 1155), where Baptist churches proscribe alcohol use, we studied whether alcohol use was associated with adverse physical and mental health assessments. No relationship was found between non-conformist behavior among rural Baptists and adverse health outcomes for either Whites or African-Americans in controlled analyses. More frequent church attendance among African-American Baptists, but not for White Baptists, was strongly associated with abstinence from alcohol.

Aged↗
PubMed1976

The stereotype of "old." A review and alternative approach.

Within the literature, a negative stereotype of "old" has been emphasized which, it has been argued, is important for self-concept in late life. This paper questions the validity of this argument and presents an alternative model more congruent with extant data. Forty-seven reports of research on stereotypes of old age were analyzed. It was found that 21 studies utilized older persons in the sample, and half of these were based on institutionalized or indigent aged. A positive stereotype of old age was reported in several studies. Thus, the assumption that the aged accept a negative stereotype of old age may not be valid. An alternative theoretical model is presented. From the framework of cognitive dissonance theory, it is argued that the acceptance of a negative or positive stereotype by the aged is related to objective indicators of old age, the subjective definition of self, and self-concept.

Aged↗
PubMed2000

The importance of a genetic link in mothers commissioning a surrogate baby in the UK.

Reproductive technologies have enabled genetic and gestational links between parents and children to become separate from social relationships and inter-personal ties within families. The meaning of family is discussed, by drawing on research with infertile women who become parents as the result of surrogacy. The complexities of family are highlighted by addressing the consequences of babies carried and delivered by women who are not the biological parents of the child, or by women who are the biological mother of the child but who relinquish their genetic material to another woman. In all, 29 women completed a questionnaire on various aspects of their infertility, surrogacy, and the importance of a genetic link. The study identified some characteristics of women who have become mothers as a result of surrogacy, and some of their reactions to this way of creating families. In general, women who could use their own genetic material tended to believe a genetic link was important. Those who could not use their own genetic material were less uniform in their beliefs about the importance of a genetic link. The cognitive dissonance observed in this population has implications for the future of reproductive technology assisting couples in becoming a family with or without genetic relatedness.

Adoption↗
PubMed1990

Kingdom Animalia: the zoological malaise from a microbial perspective.

Pain and cognitive dissonance abounds amongst biologists: the plant-animal, botany-zoology wound has nearly healed and the new gash--revealed by department and budget reorganizations--is "molecular" vs. "organismic" biology. Here I contend that resolution of these tensions within zoology requires that an autopoietic-gaian view replace a mechanical-neodarwinian perspective; in the interest of brevity and since many points have been discussed elsewhere, rather than develop detailed arguments I must make staccato statements and refer to a burgeoning literature. The first central concept is that animals, all organisms developing from blastular embryos, evolved from single protist cells that were unable to reproduce their undulipodia. The second points to the usefulness of recognizing the analogy between cyclically established symbioses and meiotic sexuality.

Animal Population Groups↗
PubMed2006

A study of nurses' inferences of patients' physical pain.

AIM: The aim of this study was to establish if postregistration education and clinical experience influence nurses' inferences of patients' physical pain. BACKGROUND: Pain is a complex, subjective phenomenon making it an experience that is elusive and difficult to define. Evaluation of an individual's pain is the product of a dynamic, interactive process that frequently results in ineffective pain management. Educating nurses should address the deficit, however the clinical environment is thought to be most influential in the acquisition of knowledge. DESIGN: A series of vignettes was used to consider nurses' inferences of physical pain for six hypothetical patients; these were employed within a self-administered questionnaire that also addressed lifestyle factors of patients in pain, general attitudes and beliefs about pain management and general knowledge of pain control. METHOD: One hundred questionnaires were distributed; 86 nurses returned the questionnaire giving a response rate of 86%. Following selection of the sample 72 nurses participated in the study: 35 hospice/oncology nurses (specialist) and 37 district nurses (general). Data analysis was carried out using SPSS and qualitative analysis of the written responses. RESULTS: The specialist nurses tended to infer lower levels of physical pain than the general nurses when considering the patients in the vignettes. CONCLUSION: Education and clinical experience influence nurses' knowledge, attitudes and beliefs about pain. However, it would appear that the specialist nurses' working environment and knowledge base engenders a practice theory divide, resulting in desensitization to patients' physical pain. RELEVANCE TO CLINICAL PRACTICE: It is suggested that the specialist nurses use defence mechanisms to protect them from the conflict that arises from working within the clinical environment. These cognitive strategies have the potential to ease cognitive dissonance for the nurse, but may increase patient suffering.

Defense Mechanisms↗