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PubMed1991

Psychosocial and behavioral factors associated with risk of sexually transmitted diseases, including human immunodeficiency virus infection, among urban high school students.

The main purpose of this study was to evaluate the role of multiple psychosocial and knowledge-related antecedent factors that may predict sexual and alcohol and drug use behaviors that are associated with the transmission of sexually transmitted diseases (STDs), including human immunodeficiency virus infection. Five hundred forty-four ninth-grade urban high school students were surveyed regarding knowledge, attitudes, and behaviors related to STDs and acquired immunodeficiency syndrome (AIDS). Results of multiple regression analyses indicate that higher levels of STD and AIDS knowledge were associated with lower levels of STD and AIDS anxiety (R2 delta = 0.09; p less than 0.001), fewer negative attitudes toward people with AIDS (R2 delta = 0.09; p less than 0.001), stronger perceptions of self-efficacy (R2 delta = 0.03; p less than 0.01), and stronger peer affiliation (R2 delta = 0.02; p less than 0.05). Negative attitudes toward people with AIDS were inversely related to knowledge (R2 delta = 0.08; p less than 0.001), social support (R2 delta = 0.02; p less than 0.01), and perceived self-efficacy (R2 delta = 0.01; p less than 0.05). Predictors of alcohol and drug use included perceived peer norms (R2 delta = 0.08; p less than 0.001) and strong peer affiliation (R2 delta = 0.05; p less than 0.001). The best predictor of sexual risk behavior was alcohol and drug use (R2 delta = 0.07; p less than 0.001). Lower levels of knowledge (R2 delta = 0.14; p less than 0.01) and perceived peer norms (R2 delta = 0.05; p less than 0.05) predicted nonuse of condoms. Our results indicate that several factors relate to adolescent risk for STDs: the connection between peer influence and adolescent risk behaviors, the link between alcohol and drug use and sexual risk behavior, and the role of knowledge in determining nonuse of condoms.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Factors associated with condom use among sexually active female adolescents.

A health belief model of condom use was used to identify factors associated with condom use in 390 sexually active female adolescents, aged 12 through 19 years, recruited at the time of a visit for reproductive health care. Fifty-six percent were white and the remainder black. Nineteen percent had genitourinary infections with Chlamydia trachomatis. Forty-six percent reported having had more than one sexual partner in the preceding year. Reported condom use for at least one specific reason (prevention of pregnancy, sexually transmitted disease, or acquired immunodeficiency syndrome) increased as behavioral, emotional, and sexually transmitted disease risk decreased, and as cognitive maturity and positive condom attitudes increased. Although uses of condoms to prevent pregnancy, sexually transmitted disease, and acquired immunodeficiency syndrome were positively intercorrelated, each made a contribution to explaining condom use at most recent coitus (odds ratios 2.95, 3.96, and 2.81, respectively). After statistical adjustment for the reported reasons for previous condom use, behavioral risk was the only additional factor associated with condom use at the most recent sexual encounter; women who participated in more risk behaviors (substance and alcohol use and minor delinquency) were less likely to have used a condom (odds ratio 0.61). Knowledge about sexually transmitted disease and acquired immunodeficiency syndrome, and concurrent use of contraceptive pills, were not related to condom practices. The data suggest that adolescents' perceptions about condoms, including the individual functions of condoms for contraception and for prevention of sexually transmitted disease, may be important in determining their use. Engaging in unprotected intercourse may be part of a larger behavioral domain that includes other unhealthy behaviors.

Adolescent↗
PubMed1990

Perceived social support, self-efficacy, and adjustment to abortion.

Prior to their having a 1st trimester abortion, women's perceptions of social support from their partner, family, and friends and self-efficacy for coping were assessed. Depression, mood, physical complaints, and anticipation of negative consequences were measured after the 30-min recovery period. As predicted, perceived social support enhanced adjustment indirectly through its effects on self-efficacy. Women who perceived high support from their family, friends, and partners had higher self-efficacy for coping. Higher self-efficacy, in turn, predicted better adjustment on the psychological measures but not on the physical complaint measure. No direct path between social support and adjustment was observed. In addition, women who told close others of their abortion but perceived them as less than completely supportive had poorer postabortion psychological adjustment than either women who did not tell or women who told and perceived complete support.

Abortion, Induced↗
PubMed1991

Development and validation of a condom self-efficacy scale for college students.

This study proposed to develop and validate a scale for the college population that measures self-efficacy in using condoms. The Condom Use Self-Efficacy Scale (CUSES) was derived from several sources and consisted of 28 items describing an individual's feelings of confidence about being able to purchase condoms, put them on and take them off, and negotiate their use with a new sexual partner. This scale was administered to a sample of 768 college students. It was found to possess adequate reliability (Cronbach's alpha = .91; test-retest correlation = .81) and correlated well with the Attitude Toward the Condom Scale (r = .51) and the Contraceptive Self-Efficacy Scale for women (r = .55). Our scale also correlated with a measure of intention to use condoms (r = .40) but was unrelated to a measure of social desirability. Students who differed on measures of previous condom use as well as on sexual intercourse experience also showed significant differences on this scale in the expected direction, indicating evidence of this scale's discriminant validity. The potential uses of this scale in a college population are discussed, along with the issues underlying condom usage self-efficacy.

Adolescent↗
PubMed1992

The sexual behaviour of bisexual men in relation to HIV transmission.

Relatively little is known about the behaviour of bisexual men which may help in assessing their role in HIV transmission. A sample of 60 behaviourally bisexual men were asked about their sexual behaviour with male and female partners and their perceptions of risk of HIV infection. Only a minority of men engaged in unprotected anal sex with their male partners while two thirds had unprotected vaginal sex with their female partners. This asymmetrical pattern of sexual behaviour reflects a differential perception of risk of HIV infection with male and female partners. A quarter of the men had unprotected penetrative sex with both male and female partners in the previous year. The pattern of risk behaviour varied amongst men living in gay, heterosexual or bisexual contexts.

Adult↗
PubMed1991

Health perceptions and survival: do global evaluations of health status really predict mortality?

Self-evaluations of health status have been shown to predict mortality, above and beyond the contribution to prediction made by indices based on the presence of health problems, physical disability, and biological or life-style risk factors. Several possible reasons for this association are discussed: (a) methodological shortcomings of previous studies render the association spurious; (b) other psychosocial influences on mortality are involved and explain the association; and (c) self-evaluations of health status have a direct and independent effect of their own. Four-year follow-up mortality data from the Yale Health and Aging Project (N = 2812) are used to explore these possibilities. The analysis controls for the contribution of numerous indicators of health problems, disability and risk factors, and also makes adjustments of standard errors for the complex sample design. The findings favor the third possibility, an independent effect, to the extent that the particular set of psychosocial factors examined did not explain the basic association, and to the extent that the control variables were an adequately comprehensive set.

Activities of Daily Living↗
PubMed1991

Health and social predictors of mortality in an elderly Chinese cohort.

A total of 1,054 Hong Kong Chinese subjects aged 70 years or over were recruited into a cohort study to investigate the relation between social support and health outcomes. More than 30 social, health, and behavioral characteristics were recorded as baseline information when the study began in 1985. Mortality data were obtained during a 2-year follow-up. Logistic regression analyses were used to determine the roles of these variables in predicting mortality. The mortality patterns of Hong Kong and of the studied cohort closely resemble that of Western developed countries with cancer, heart disease, and cerebrovascular diseases as the leading causes of death. Besides sex and place of residence (whether living in the community or in homes for the elderly), the independent predictors of mortality included five baseline variables: being single or widowed, limited ability in activities of daily living, smoking habit, low body mass index, and poor self-evaluated health status. Subjects with at least three of these predictors had a relative risk of 3.9 (95% confidence interval 2.4-6.2) compared with those with zero to two of these characteristics.

Activities of Daily Living↗
PubMed1991

The pre- and poststerilization predictors of poststerilization regret in husbands and wives.

Husbands and wives from 141 tubal sterilization couples and 162 vasectomy couples were interviewed just prior to sterilization and then again 1 and 2 years later. We conducted linear regression analyses to determine the pre- and poststerilization predictors of poststerilization regret in each of the four gender x method groups (tubal husbands, tubal wives, vasectomy husbands, vasectomy wives). We confirmed a number of hypotheses based on the research literature and our own earlier work. Both individual and couple factors contributed to the development of regret, as did both pre- and poststerilization factors. An important finding was the degree to which regret among the nonsterilized respondents (tubal husbands, vasectomy wives) was affected by pre- and poststerilization interaction with their spouses.

Adult↗
PubMed1991

Ethics and embryos.

In this paper we argue that the human form should be seen to exist, in a longitudinal way, throughout the continuum of human growth and development. This entails that the moral value of that form, which we link analytically to the adult, interacting, social and rational being, attaches to all phases of human life to some extent. Having established this we discuss the consequences it has for the moral status of the human embryo. We then apply this argument, and the resulting moral status, to the area of reproductive technology. In doing this we show that there are certain regulations and controls which ought to apply to the use of these infertility treatments.

Abortion, Induced↗
PubMedDate not supplied

Parenting enhancement among Egyptian mothers in a tertiary care setting.

This study tested the efficacy and effectiveness of systematically planned parenting enhancement program aimed toward breaking the cycle of high-risk mothers producing high-risk babies in Egypt. The assumption is that self-esteem and self-care are requisites to effective parenting, which can be enhanced or impeded by human and environmental forces. Given that parenting is a learned behavior, it can be repatterned by modifying human-environmental processes.

Adolescent↗
PubMed1992

Differential impact of abortion on adolescents and adults.

The purpose of this study was to compare adolescent and adult reactions to abortion. A sample of 252 women from 42 states was obtained from a national survey of organizations serving as support groups for women who have had negative reactions to abortion. The age analysis was run using t-tests. Results indicated that the adolescents were significantly more likely to be dissatisfied with the choice of abortion than were the older subjects, to have abortions later in the gestational period, to be dissatisfied with services at the time of the abortion, to feel forced by circumstances to have the abortion, to report being misinformed at the time of the abortion, and to report greater severity of psychological stress. The conclusions suggest that the adolescents' problems may be due to a combination of developmental limitations and the nature of counseling at the time of the abortion.

Abortion Applicants↗
PubMed1992

Patterns of demographic change in the Americas.

Considerable scholarly debate has focused on the nature of demographic change in the Americas before and after 1492. Recent research on human skeletal samples and related archeological materials suggests that morbidity and mortality were increasing throughout much of the Western Hemisphere before 1492 in response to increased population density, increased sedentism, and changing subsistence. The evidence suggests that after 1492 population reduction was caused not by continental pandemics but by localized or regional epidemics augmented by social and economic disruption. The twentieth century has witnessed remarkable Native American population recovery, fueled both by improvements in health care and changing definitions of "being Indian."

Disease Outbreaks↗
PubMed1992

Targeting the audience for AIDS messages by actual and perceived risk.

Since there are many ways to segment an audience into target groups, we suggest that a productive strategy for AIDS education is to divide the audience by their actual and perceived risk. We provide an example in which we segmented an urban U.S. sample and make suggestions as to how messages appropriate for each group can be constructed. In our sample, the "unthreatened" accurately assessed their low risk of AIDS, and showed high knowledge and tolerance rates. The "panicked," who included more women and Hispanics, inaccurately thought themselves at high risk because of misunderstandings about the causes of AIDS, and showed more intolerance of people with AIDS. "Deniers" continued to have multiple sexual partners and take precautions irregularly, despite seeing AIDS as a social problem and having more education and AIDS knowledge. In contrast, "gamblers" recognized their higher risk of AIDS and were most likely to have taken some action, although not enough to prevent sexual transmission of the HIV virus.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Hispanic adolescent pregnancy testers: a comparative analysis of negative testers, childbearers and aborters.

Fifty-six Hispanic adolescents who requested a pregnancy determination at a municipal outpatient adolescent clinic participated in a comparative study of negative testers, childbearers, and aborters. The study's purposes were to assess differences between negative and positive pregnancy testers and to evaluate the pregnancy resolution decision-making process of positive testers. Data were collected using a two-part structured interview administered prior to and following knowledge of pregnancy test results. Results indicated that negative and positive pregnancy testers were similar in all areas evaluated. However, positive testers were slightly older and had higher self-esteem than negative testers. Of the 36 positive testers, 29 chose to deliver and keep the baby. None of the adolescents chose adoption. Adolescents were consistent in their pregnancy resolution decision before and after knowledge of pregnancy test results. The pregnant adolescents considered themselves to be the most influential person in the decision-making process. There were no significant differences between the childbearers and the aborters, although the former demonstrated higher self-esteem and greater religiosity. Most of the teenagers were at risk for unintended pregnancy; therefore, subsequent family planning counseling efforts should be directed at this population.

Abortion, Induced↗
PubMed1991

AIDS knowledge and risk behaviors among culturally diverse women.

This article reports results from a survey of women at risk for HIV infection. The sample (n = 620) included black (50.6%), white (28.7%), Hispanic (13.4%), and Haitian (5.0%) adult women from south Florida. Data concerning their AIDS knowledge, prevalence of risk behaviors, and perceived vulnerability are presented. Results indicate differences in certain knowledge areas and risk behaviors by race/ethnicity and a consistent incidence of unprotected sex with their main partners across all racial/ethnic groups.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Nurses, midwives and health research.

Despite the wealth of researchable topics in maternal and child health, it is rare for studies in this field to be carried out by nurse-midwives. This article explores the historical origins of nursing, its educational characteristics and its dominance by women, identifying obstacles to independent research and pointing to ways of overcoming them.

Attitude of Health Personnel↗