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PubMed1998

Brief report: acceptance of behavioral interventions for children with cancer: perceptions of parents, nurses, and community controls.

OBJECTIVE: To examine the treatment acceptability of behavioral interventions targeting noncompliance in children with cancer, in medical versus general situations. METHODS: Participants included 40 parents of children on active medical treatment for cancer, 42 pediatric oncology nurses, and 34 parents of medically healthy children. After reading a clinical vignette, participants rated the acceptability of five behavioral interventions via the Treatment Evaluation Inventory-Short Form. RESULTS: Positive reinforcement, response cost, and reprimand generally were perceived as moderately acceptable. Overcorrection was perceived as unacceptable by all groups. Compared with nurses and parents of medically well children, parents of children with cancer provided significantly lower acceptability ratings for response cost and time-out, two of the punitive strategies studied. CONCLUSIONS: Results suggest that clinicians should assess the acceptability of specific treatments prior to intervening. Methods for enhancing acceptability should be explored in future research.

Adult↗
PubMed2001

The acceptability of reuse of the female condom among urban South African women.

This study assessed whether reuse of the female condom was acceptable among two groups of women in central Johannesburg, South Africa, who were taking part in two separate studies of female condom reuse. The first group consisted of women (aged 17 to 43 years) attending a family planning/sexually transmitted infections (STIs) clinic who were participating in a cross-sectional survey of the acceptability of female condoms reuse (n = 100). The second group included women (aged 18-40 years) at high risk for STI (80% self-declared sex workers) who were taking part in an ongoing cohort study to investigate the safety of reuse of the female condom through a structural integrity and microbial retention study (n = 50). Among women participating in the acceptability study, 83% said that they would be willing to reuse the female condom, and 91% thought the idea of reuse of the female condom was acceptable. All women taking part in the safety of reuse study and who reused the female condom up to seven times (n = 49) reported that the steps involved in reusing the device were easy to perform and acceptable. All 49 women said they would reuse the female condom at least once, while 45% said they would use it a maximum of seven or eight times. From the results of the interviews with both study groups, it can be concluded that, among women in a South African urban environment who have used a male and/or female condom, the concept of reuse of the female condom is acceptable and thought to be a good idea.

Adolescent↗
PubMed1999

Risk taking in patients with rheumatoid arthritis: are the risks of haemopoietic stem cell transplantation acceptable?

OBJECTIVES: Autologous haemopoietic stem cell transplantation (HSCT), which carries defined risks of early treatment-related mortality (TRM), has recently been proposed as an experimental therapy for severe rheumatoid arthritis (RA). The aim of this study was to establish whether the risks of this approach are acceptable to patients with RA and whether risk taking related to disease-associated or personal/social parameters. METHODS: A standard gamble questionnaire was used to determine the acceptable risk of mortality for a potentially curative procedure in patients with RA aged <70 yr. Additional data collected included age, sex, duration of RA, number of second-line agents, domestic and workforce information, and self-assessed disability. RESULTS: The 53 patients (age range 24-69 yr, 39 female, 14 male, disease duration 2-43 yr) interviewed were prepared to accept a broad range of treatment-related mortality in order to be returned to normality off all drugs (median 5%, range 0-50%). Risk taking was significantly related to degree of disability measured by the disability section of the Health Assessment Questionnaire (HAQ; P = 0.001) and negatively related to age (P = 0.04), although only HAQ score maintained significance on multivariate analysis. Using linear regression, we were able to determine that current TRM of autologous HSCT in Australia (3.3%) would be acceptable to patients with HAQ scores of >0.44 (84% of our sample), but allogeneic HSCT (with a TRM of 13.1%) would be acceptable only to severely disabled patients with HAQ scores of >2.45 (4% of our sample), assuming the procedure to be curative. CONCLUSION: Along with previous studies, these results suggest that, if long-term efficacy can be proven, then the risks of autografting may be acceptable to most patients with RA, particularly those with significant disability.

Adult↗
PubMed1996

Predictors of hepatitis B vaccine acceptance in health care workers.

This article examines the relative importance of occupational, epidemiologic, and attitudinal factors in hepatitis B vaccine acceptance. A stratified random sample of 1,018 health care workers at risk for occupational blood exposure at our university hospital were contacted in 1992 and 919 (90%) participated. Potential reasons for vaccine acceptance or refusal were evaluated with factor analysis. Logistic regression models were calibrated on a stratified random subsample to identify independent predictors of initiating and completing the series, then validated on the remaining subjects. Fifty-four percent (482 of 898) of previously nonimmune workers had completed the series, while 70% (626) had received one or more doses. Hepatitis B vaccine acceptance was related strongly to social influence (physicians, supervisors, role models, friends, and spouse) and knowledge of the disease and vaccine, whereas refusal was primarily related to concern about vaccine side effects and problems with vaccine access. Independent predictors of initiating the vaccine series included younger age (odds ratio [OR] 0.98 per year, 95% confidence interval [CI95] 0.96-0.997), occupation (housestaff: OR 2.9, CI95 1.1-7.9; nurses: OR 2.1, CI95 1.0-4.3 versus housekeepers), increased blood exposure frequency (OR 2.4, CI95 1.6-3.5 for 1-6 versus 0 exposures in past year), and increased frequency of recent influenza vaccination (OR 3.3, CI95 2.0-5.3 for 1 versus 0 doses in prior 3 years). Occupation (increased acceptance among housestaff, nurses, nursing assistants, laboratory technicians), increased frequency of blood exposure, and recent influenza vaccination also were predictors of series completion. Factors such as occupation, blood exposure frequency and acceptance of other preventive services may help identify health care worker groups with low vaccine acceptance most likely to benefit from targeted vaccine delivery. Hepatitis B vaccine should be offered routinely during evaluation for occupational blood exposure. Future vaccine implementation efforts should emphasize the involvement of physicians and supervisors and education about occupational disease risk, liability, and the safety of the vaccine.

Adult↗
PubMed1996

Tolerance to rat liver allografts: IV. Acceptance depends on the quantity of donor tissue and on donor leukocytes.

Liver allografts in some rat strains are often spontaneously accepted across a complete major histocompatibility barrier without the requirement for immunosuppression while other nonliver allografts are rejected. In previous studies, we have shown that spontaneous acceptance is dependent on liver passenger leukocytes. Depletion of passenger leukocytes by donor irradiation allows rejection, with DA recipients of irradiated PVG livers having a median survival time (MST) of 16 days. Here we show that, in this model, spontaneous acceptance is reconstituted by intravenous injection of donor leukocytes. Intravenous injection of 3-5x10(7) PVG liver leukocytes significantly prolonged DA survival time (MST=96 days, P=0.026), as did 5x10(7) spleen leukocytes (MST>100 days, P=0.002). Deletion of T cells from the reconstituting inoculum reduced survival time (MST=78 days, P=0.039), whereas deletion of B cells or monocytes/macrophages had no effect on survival time. In contrast, PVG hearts are regularly rejected by DA recipients, and PVG liver or spleen leukocytes, even at doses of greater than 3x10(8) cells/recipient, were unable to induce heart acceptance. To investigate the possibility that acceptance of the irradiated liver but not the heart might be due to the large mass of the liver, two kidneys and two hearts of PVG origin were transplanted to each DA recipient together with 1.5x10(8) PVG leukocytes. These organs survived for greater than 200 days, thereby showing that a large mass of donor tissue, in association with donor leukocytes, leads to acceptance of organs that are rejected if transplanted singly. It appears likely that spontaneous liver transplant tolerance is a high-dose or activation-associated immune phenomenon.

Animals↗
PubMed2000

The influence of trust and perceptions of risks and benefits on the acceptance of gene technology.

A causal model explaining acceptance of gene technology was tested. It was hypothesized that trust in institutions using gene technology or using modified products has a positive impact on perceived benefit and a negative influence on perceived risk of this technology. Furthermore, perceived benefit and perceived risk determine acceptance of biotechnology. In other words, trust has an indirect influence on the acceptance of the technology. The postulated model was tested using structural equation modeling procedures and data from a random quota sample of 1001 Swiss citizens between 18 and 74 years old. Results indicated that the proposed model fits the data very well. The same causal model explains females' and males' acceptance of gene technology. Gender differences were found for the latent variables trust, perceived benefit, and acceptance of gene technology. Females indicated more trust, perceived less benefit, and demonstrated less acceptance than did males. No significant difference was observed for perceived risk. The implications of the results are discussed.

Adolescent↗
PubMed2006

Acceptance and denial: implications for people adapting to chronic illness: literature review.

AIM: This paper reports an exploration of the terms acceptance and denial by exploring the literature, with the aim of understanding the implications of using these concepts to categorize people's responses to living with chronic illness. BACKGROUND: People learning to live with a chronic illness or condition may be judged and labelled by others as being in denial, particularly when they do not adhere to prescribed treatment regimes. METHOD: A literature search for the period between 1989 and 2003 was conducted using the electronic databases Medline, CINAHL, PSYCArticles, Health Source Nursing/Academic Edition, Academic Search Elite and Sociological Abstracts. Key terms used were 'acceptance and denial' and variations of such themes as 'chronic illness', 'disability', 'adjustment', 'illness discourse', 'medical discourse', 'illness experience', 'labelling', 'self' and 'identity'. DISCUSSION: The theoretical background of the common constructs 'acceptance and denial' are discussed using the psychoanalytic theories of Freud and Kubler-Ross's work on death and dying. Healthcare professionals and lay people commonly refer to the terms acceptance and denial when describing a person's response to chronic illness. Those whose understanding of the illness experience relies on the acceptance-denial framework may not listen when people with chronic illness attempt to tell their own unique story of how they have experienced life with illness. Instead, their listening antennae may be focused on fitting aspects of the experience with stages of adjustment. When others use labels of acceptance and denial, people who are learning to live with a chronic illness may internalize these labels as reflections of the self. This may be most likely when the person using the label is perceived to have authority, such as a healthcare professional. The internalization of negative information associated with these labels may obstruct the reshaping of self-identity that is fundamental when making a transition to living well with chronic illness. CONCLUSION: Healthcare professionals are urged to challenge the stage model of adjustment as a way of understanding the response to illness and to listen instead to the stories people tell. They are encouraged to privilege the person's experience as the basis for developing a sensitive, client-focussed response that takes into account the wider social context of people's lives as well as the medical aspects.

Adaptation, Psychological↗
PubMed2006

Self-esteem and self-acceptance: an examination into their relationship and their effect on psychological health.

Nurses are increasingly using cognitive behaviour therapy as an intervention for psychological problems attached to a variety of clinical conditions. Developing both self-acceptance and self-esteem have been identified as ways to enhance cognitive interventions. However, there are disagreements about the relationship between self-esteem and self-acceptance and their influence on psychological health. The study examined the relationship between these concepts and also the association between the concepts and psychological health. Fifty-eight participants with a diagnosis of severe and enduring mental health problems were assessed recording levels of self-esteem, self-acceptance, depression, anxiety and psychological well-being. The results revealed that, in comparison with the general population, the sample were more likely to have lower self-acceptance and self-esteem, and higher levels of anxiety, depression and psychological ill health. The concepts of self-esteem and self-acceptance were found to be similar but not synonymous. Self-esteem was more closely associated with affect, with higher levels of self-esteem being indicative of lower levels of depression. Self-acceptance appeared to be more closely associated with general psychological well-being and to be more helpful when undertaking clinical work for general psychological problems.

Adaptation, Psychological↗
PubMed1994

Alcohol acceptance, preference, and sensitivity in mice. I. Quantitative genetic analysis using BXD recombinant inbred strains.

Although the recombinant inbred strain method was designed for molecular genetic analysis of linkage, it also provides powerful quantitative genetic analyses of heritability and genetic correlations. Measures of alcohol acceptance, alcohol preference, and hypnotic dose sensitivity (HDS) were assessed in 21 strains of mice from the BXD RI series. Sex differences were found to be significant at a phenotypic level. However, heritability estimates for acceptance, preference, and HDS are similar in males and females. Heritability estimates for the three measures are approximately 0.20 for acceptance and preference, and 0.10 for HDS. Analyses of genetic correlations reveal that acceptance and preference share some degree of genetic influence, although they mostly operate under different genetically mediated mechanisms. HDS did not show a significant genetic relationship to either acceptance or preference. Strong correlations were obtained when acceptance, preference, and HDS strain means were correlated across male and female recombinant inbreds, suggesting substantial genetic similarity across sexes.

Alcohol Drinking↗
PubMed2001

Family support and acceptance, gay male identity formation, and psychological adjustment: a path model.

While heterosexist family undermining has been demonstrated to be a developmental risk factor in the life of persons with same-gender orientation, the issue of protective family factors is both controversial and relatively neglected. In this study of Israeli gay males (N = 114), we focused on the interrelations of family support, family acceptance and family knowledge of gay orientation, and gay male identity formation, and their effects on mental health and self-esteem. A path model was proposed based on the hypotheses that family support, family acceptance, family knowledge, and gay identity formation have an impact on psychological adjustment, and that family support has an effect on gay identity formation that is mediated by family acceptance. The assessment of gay identity formation was based on an established stage model that was streamlined for cross-cultural practice by defining three basic processes of same-gender identity formation: self-definition, self-acceptance, and disclosure (Elizur & Mintzer, 2001). The testing of our conceptual path model demonstrated an excellent fit with the data. An alternative model that hypothesized effects of gay male identity on family acceptance and family knowledge did not fit the data. Interpreting these results, we propose that the main effect of family support/acceptance on gay identity is related to the process of disclosure, and that both general family support and family acceptance of same-gender orientation play a significant role in the psychological adjustment of gay men.

Adaptation, Psychological↗
PubMedDate not supplied

The therapeutic aspects of acceptance.

PROBLEM: What does acceptance mean to hospitalized adolescents? METHODS: Using a phenomenological research approach, the authors asked hospitalized adolescents (N = 6) on a psychiatric unit to describe how acceptance from psychiatric-mental health nurses was experienced by them. FINDINGS: Three essential themes emerged: (a) the nurse who shows acceptance is seen as a friend, (b) acceptance generates a sense of well-being, and (c) acceptance produces feelings of comfort with the nurse. CONCLUSIONS: In acceptance, adolescents experience nurses as unique individuals who provide comfort and nurturing. This relationship connection helps adolescent clients to use their inner strength to gain a sense of well-being.

Adolescent↗
PubMed2006

A fourier analysis on the maximum acceptable grid size for discrete proton beam dose calculation.

We developed an analytical method for determining the maximum acceptable grid size for discrete dose calculation in proton therapy treatment plan optimization, so that the accuracy of the optimized dose distribution is guaranteed in the phase of dose sampling and the superfluous computational work is avoided. The accuracy of dose sampling was judged by the criterion that the continuous dose distribution could be reconstructed from the discrete dose within a 2% error limit. To keep the error caused by the discrete dose sampling under a 2% limit, the dose grid size cannot exceed a maximum acceptable value. The method was based on Fourier analysis and the Shannon-Nyquist sampling theorem as an extension of our previous analysis for photon beam intensity modulated radiation therapy [J. F. Dempsey, H. E. Romeijn, J. G. Li, D. A. Low, and J. R. Palta, Med. Phys. 32, 380-388 (2005)]. The proton beam model used for the analysis was a near monoenergetic (of width about 1% the incident energy) and monodirectional infinitesimal (nonintegrated) pencil beam in water medium. By monodirection, we mean that the proton particles are in the same direction before entering the water medium and the various scattering prior to entrance to water is not taken into account. In intensity modulated proton therapy, the elementary intensity modulation entity for proton therapy is either an infinitesimal or finite sized beamlet. Since a finite sized beamlet is the superposition of infinitesimal pencil beams, the result of the maximum acceptable grid size obtained with infinitesimal pencil beam also applies to finite sized beamlet. The analytic Bragg curve function proposed by Bortfeld [T. Bortfeld, Med. Phys. 24, 2024-2033 (1997)] was employed. The lateral profile was approximated by a depth dependent Gaussian distribution. The model included the spreads of the Bragg peak and the lateral profiles due to multiple Coulomb scattering. The dependence of the maximum acceptable dose grid size on the orientation of the beam with respect to the dose grid was also investigated. The maximum acceptable dose grid size depends on the gradient of dose profile and in turn the range of proton beam. In the case that only the phantom scattering was considered and that the beam was aligned with the dose grid, grid sizes from 0.4 to 6.8 mm were required for proton beams with ranges from 2 to 30 cm for 2% error limit at the Bragg peak point. A near linear relation between the maximum acceptable grid size and beam range was observed. For this analysis model, the resolution requirement was not significantly related to the orientation of the beam with respect to the grid.

Algorithms↗
PubMed1988

Subjective acceptability of various regular twelve-tone tuning systems in two-part musical fragments.

Musically trained subjects rated the overall acceptability of the performance of two-part musical fragments. With the help of a computer these fragments were produced with intonations according to various regular 12-tone tuning systems: Pythagorean tuning (tempering T of the fifths equal to 0.0 cent), equal temperament (T = -2.0 cents), Silbermann (T = -3.9 cents), mean-tone (T = -5.4 cents), and Salinas tuning (T = -7.2 cents). In experiment 1, two systems in which T = 2.0 or T = -10.0 cents were also included. In both the lower and the higher parts of the fragments we used complex tones with a spectral-envelope slope of -6 dB/oct. Mean acceptability ratings were about the same for -5.4 less than or equal to T less than or equal to 0.0 cent, whereas for T greater than 0.0 and T less than -5.4 cents the ratings strongly decreased. This effect of tuning system was also found when acceptability was determined by means of the method of paired comparisons. The specific effect of tuning system was not affected by the tempo of the fragments. The perception of beats in the harmonic intervals was manipulated in experiment 2 by varying the spectral content of the tones. The condition in which the interference of the nearly coinciding harmonics was canceled resulted in higher acceptability. The effect of tuning system was the same as in experiment 1. In both experiments overall acceptability could be accurately predicted from a linear combination of the purity ratings of the isolated harmonic fifths and major thirds. It is not precluded, however, that for T greater than 0.0 and T less than -5.4 cents, the subjects based their acceptability ratings partly on the subjective purity of the melodic intervals.

Acoustic Stimulation↗
PubMed1993

Comparison of acceptance of clinical versus basic studies on drugs and therapeutics in infants and children.

Many clinicians and clinician-scientists have serious concerns that clinical studies (i.e. studies with patients) are less favorably accepted than basic ('bench') projects by funding agencies and by promotion committees of university departments. However, this commonly held view has not been previously verified. To test whether bias exists against clinical studies, we compared the acceptance rate of clinical vs. basic studies dealing with drugs and therapeutics in children, which were submitted to a large scientific meeting. Of 197 abstracts reporting on drug/therapeutic studies, submitted to the Society for Pediatric Research in 1993, there were 133 clinical and 64 basic studies. Fifty-nine (44.3%) of the clinical studies were accepted, significantly less than the basic projects (n = 47 or 73.4%, p < 0.0001). A basic paper was 66% more likely to be accepted (95% CI 50.7-82.6%). This trend was consistent for different groups of drugs/therapeutics, including analgesics, surfactants, corticosteroids, vaccines, hormones, and antiasthmatics. To examine whether the lower rate of acceptance of clinical papers is the result of lower scientific standard, all papers were scored for their quality by raters who were blinded to their acceptance or rejection status. In general, rejected clinical papers scored significantly higher than rejected basic papers (16 +/- 1.8 vs. 14.8 +/- 1.0, p < 0.05). Our study supports the commonly held but previously unproven view that there is a bias against clinical research, in the context of patient-based studies, when compared to basic (bench) research.

Congresses as Topic↗
PubMed2004

Computerized symptom and quality-of-life assessment for patients with cancer part II: acceptability and usability.

PURPOSE/OBJECTIVES: To determine the acceptability and usability of a computerized quality-of-life (QOL) and symptom assessment tool and the graphically displayed QOL and symptom output in an ambulatory radiation oncology clinic. DESIGN: Descriptive, cross-sectional. SETTING: Radiation oncology clinic located in an urban university medical center. SAMPLE: 45 patients with cancer being evaluated for radiation therapy and 10 clinicians, who submitted 12 surveys. METHODS: Acceptability of the computerized assessment was measured with an online, 16-item, Likert-style survey delivered as 45 patients undergoing radiation therapy completed a 25-item QOL and symptom assessment. Usability of the graphic output was assessed with clinician completion of a four-item paper survey. MAIN RESEARCH VARIABLES: Acceptability and usability of computerized patient assessment. FINDINGS: The patient acceptability survey indicated that 70% (n = 28) liked computers and 10% (n = 4) did not. The program was easy to use for 79% (n = 26), easy to understand for 91% (n = 30), and enjoyable for 71% (n = 24). Seventy-six percent (n = 25) believed that the amount of time needed to complete the computerized survey was acceptable. Sixty-six percent (n = 21) responded that they were satisfied with the program, and none of the participants chose the very dissatisfied response. Eighty-three percent (n = 10) of the clinicians found the graphic output helpful in promoting communication with patients, 75% (n = 9) found the output report helpful in identifying appropriate areas of QOL deficits or concerns, and 83% (n = 10) indicated that the output helped guide clinical interactions with patients. CONCLUSIONS: The computer-based QOL and symptom assessment tool is acceptable to patients, and the graphically displayed QOL and symptom output is useful to radiation oncology nurses and physicians. IMPLICATIONS FOR NURSING: Wider application of computerized patient-generated data can continue in various cancer settings and be tested for clinical and organizational outcomes.

Academic Medical Centers↗
PubMedDate not supplied

Factors affecting and affected by user acceptance of computer-based nursing documentation: results of a two-year study.

OBJECTIVES: The documentation of the nursing process is an important but often neglected part of clinical documentation. Paper-based systems have been introduced to support nursing process documentation. Frequently, however, problems such as low quality of documentation are reported. It is unclear whether computer-based documentation systems can reduce these problems and which factors influence their acceptance by users. DESIGN: We introduced a computer-based nursing documentation system on four wards of the University Hospitals of Heidelberg and systematically evaluated its preconditions and its effects in a pretest-posttest intervention study. For the analysis of user acceptance, we concentrated on subjective data drawn from questionnaires and interviews. MEASUREMENTS: A questionnaire was developed using items from published questionnaires and items that had to be developed for the special purpose of this study. RESULTS: The quantitative results point to two factors influencing the acceptance of a new computer-based documentation system: the previous acceptance of the nursing process and the previous amount of self-confidence when using computers. On one ward, the diverse acceptance scores heavily declined after the introduction of the nursing documentation system. Explorative qualitative analysis on this ward points to further success factors of computer-based nursing documentation systems. CONCLUSION: Our results can be used to assist the planning and introduction of computer-based nursing documentation systems. They demonstrate the importance of computer experience and acceptance of the nursing process on a ward but also point to other factors such as the fit between nursing workflow and the functionality of a nursing documentation system.

Attitude of Health Personnel↗
PubMed1999

Predicting dysphoria in adolescence from actual and perceived peer acceptance in childhood.

Predicted dysphoria in midadolescence using actual and perceived peer acceptance of 68 4th and 5th graders (48% male, 30% minority). Main effect, additive, and interactive models for predicting dysphoria were examined. Perceived acceptance predicted later dysphoria, after controlling for initial levels of dysphoria, supporting the main effect model. Actual acceptance did not uniquely contribute to prediction of later dysphoria, and actual acceptance did not moderate the prediction of dysphoria from perceived acceptance. Sex differences in dysphoria were significant, but sex did not moderate the predictive links between perceived acceptance and dysphoria.

Adolescent↗
PubMed2002

Effectiveness and relevance of MR acceptance testing: results of an 8 year audit.

The effectiveness and relevance of independent acceptance testing was assessed by means of an audit of acceptance procedures for 17 MRI systems, with field strengths in the range 0.5-1.5 T, acquired over 8 years. Signal-to-noise ratio and geometric linearity were found to be the image quality parameters most likely to fall below acceptable or expected standards. These received confirmed successful corrective action in 69% of instances. Non-uniformity, ghosting and poor fat suppression were the next most common non-compliant parameters, but yielded less satisfactory outcomes. Spatial resolution was not found to be a sensitive parameter in determining acceptability. 49% of all non-compliant parameters received verifiable corrective attention. A schedule of actual acceptance criteria is presented and shown to be reasonable. Parameter failure rates were shown not to have improved with time. A safety audit of 11 of the installations revealed the most common failings to be inadequate suite layout and poor use of signs. The mean number of safety issues per installation identified as requiring attention was 5, from a questionnaire of 100 points. A number of anecdotal errors and omissions are reported. The data support the importance of an appropriate acceptance procedure for new clinical MRI equipment and for the involvement of a suitably qualified safety adviser on the project team from the outset.

Equipment Safety↗