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A california managed care company is applying new technology to Medicare managed care patients with congestive heart failure. The program allows patients to monitor medications and daily vital signs--and it is resulting in fewer hospitalizations and a reduction in the need for other skilled care.
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Late adolescent women at a large, mid-Atlantic university were surveyed. Of the 578 who completed the survey, 17% were found to have eating disorders as defined by a score of 20 or above on the Eating Attitudes Test (EAT-26; Garner, Olmstead, Bohr, & Garfinkel, 1982). Participants who scored 20 or above were younger and more likely to be white, in a sorority, and Christian than were those who scored below 20 on the EAT-26. No correlation was found between EAT-26 scores and participation in organized athletics. In addition, the participants were asked about their choice of help and support should they have any worries about their eating. They were most likely to say that they would prefer a close friend to support them when dealing with disordered eating, followed by their parents and their significant other. In terms of professional services, most women reported that they would prefer individual assistance such as a consultation with a physician, a nutritionist, or a therapist, followed by family therapy, if they ever had questions about eating or thought they needed professional help with disordered eating.
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Self-awareness is key to better understanding behavior. Discover how emotional intelligence drives behavior and can be learned to improve ineffective behaviors.
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In this paper, an overview of the literature relevant to the issues of illness behavior and help-seeking behavior in relation to mental health and illness, focusing on the Taiwan area is presented. Arguments for the prioritization and appreciation of the folk perspective of mental illness and health are addressed. The traditional medical beliefs in the Chinese culture that emphasize integration and continuity, instead of differentiation, of/between body and mind, person and nature, nature and super-nature, the visible (with form) and the invisible (without form), and yang and yin, have laid the basis for the theoretical framework of somatization as normative illness behavior rather than psychologization, and also dissociation as normative illness behavior rather than repression. A case report on folk psychotherapy is given here to illustrate the argument. The continuum models illustrated in this paper, either the shen-kuei syndrome in its broad sense extending from koro to neurasthenia, frigophobia or the spirit possession syndrome in its broad sense extending from the pathological and peripheral (Hsieh-ping) to the normative and ritual (shamanism), could well remind us of the powerful influence of the folk and popular contexts of culture that underlie illness behavior in relation to mental health in Taiwan.
This paper reports on knowledge and behavior among Dutch adults (n = 1530) regarding early detection of cancer (passive detection, active detection and help-seeking behavior). Written questionnaires assessed knowledge of detection methods and cancer symptoms, symptom recognition, detection behaviors, and help-seeking behaviors. Respondents did not have much general knowledge of detection methods and cancer symptoms, but recognized most cancer symptoms. More women than men paid attention to cancer symptoms. For most symptoms, medical help would be sought within the appropriate time by the majority of the respondents. Principal component analyses revealed relations between symptoms pertaining to the 'interior' body and those pertaining to the 'exterior' body. Correlations between symptom recognition, detection behavior and help-seeking behavior were low. Differences in demographic groups and differences in knowledge and behavior require adaptation of future health education on early detection of cancer to different groups.
Most studies of professional help use among black Americans fail to describe this group's relationship to blacks experiencing distress but not requesting professional help, and generally ignore the salience of informal social support processes. A more comprehensive understanding of black help-seeking behavior would come from an approach which describes both the users and nonusers of formal helping services, and examines the benefits derived from the interpersonal relationships that comprise black friend- and kin-based networks. These analyses focused on four patterns of informal and formal help use in the National Survey of Black Americans. The findings indicated that most people use informal help only, or they use informal and professional help together. In addition, gender, age, income, and problem-type were significantly related to the different patterns of illness behavior. The implications of these findings for help seeking in the black community were discussed.
PURPOSE: To ascertain the most helpful and least helpful faculty teaching behaviors as perceived by primary care and non-primary care residents and to assess differences in those perceptions between the two resident groups. METHOD: A cross-sectional mailed survey was undertaken in 1993-94 of all 1,046 residents (including interns) in U.S. Army graduate medical education programs. The survey asked the residents to rate the 38 teaching behaviors of Wolverton and Bosworth. Mean ratings were calculated for each teaching behavior, and the ratings of the two resident groups were compared using Kendall's coefficient of concordance. RESULTS: In all, 490 (47%) of the residents responded: 191 (45%) of 421 in primary care, and 299 (48%) of 625 in non-primary care. The primary care and non-primary care groups had a high degree of concordance in ranking of the 38 teaching behaviors (W = .953). The exact rank orders differed slightly, but there was disagreement on only one behavior each within the rankings of both the ten most helpful and the ten least helpful behaviors. CONCLUSION: Army residents in all of the major specialties have similar perceptions of what they consider helpful behaviors from their faculty.
Sociocultural variables of acculturation, enculturation, cultural congruity, and perceived social support were used as predictors of psychological help-seeking attitudes and behaviors among 162 Mexican American college students. Multivariate multiple regression analyses indicated that higher cultural congruity, lower perceived social support from family, and higher perceived social support from significant others were significant predictors of positive help-seeking attitudes. In addition, higher acculturation into the dominant society, lower perceived social support from family, and lower perceived social support from friends were significantly predictive of greater help-seeking behavior. Implications for research and practice are discussed.
The purpose of this study was to explore the impact of education about urinary incontinence on the subsequent help-seeking behaviors of older adults. Forty-five community-dwelling seniors were randomized to two groups. One group received individualized instruction supported by written information, the other received written information alone. All participants received a list of local health care professionals specializing in the assessment and treatment of urinary incontinence. Seventeen participants sought professional help following the intervention; however, there was no significant difference in help-seeking behaviors between intervention groups, chi2 = 1.42, alpha = 0.05. The most common reasonfor lack of help-seeking postintervention was a preference for self-care. Eighty-eight percent of those who initiated self-help behaviors reported a subjective improvement in the frequency or volume of their incontinence. Results emphasize the important role registered nurses should play in the dissemination of complete and accurate information about urinary incontinence.
Helping patients modify risky health behaviors, including cigarette smoking, at-risk alcohol use, sedentary lifestyle and unhealthy diet, is a common and sometimes frustrating task. Motivational interviewing was developed from the notion that simple advice usually does not lead to behavioral change and may be even misperceived by patients. Based on active listening and an empathic attitude, some principles of motivational interviewing may be easily adapted to a primary care consultation. These principles facilitate positive, relaxed and constructive atmosphere for behavior change discussions and have been associated with promising results. This article presents key concepts of motivational interviewing such as ambivalence, resistance and stages of change, illustrated with practical examples.
The authors studied the striped mouse (Rhabdomys pumilio) in the semiarid succulent karoo of South Africa. Mice forage alone, but they live in groups that share a common nest. Groups consist of 1 to 4 breeding females, 1 to 2 breeding males, and their offspring of both sexes, which remain in their natal group even after reaching adulthood, participating in territorial defense and nest building without showing signs of reproductive activity. Interactions are typically amicable and take place inside or in front of the nest. In contrast, encounters with mice from other groups are aggressive. Group living in the succulent karoo is possibly due to ecological constraints imposed by habitat saturation because of a year-round stable food supply as well as associated benefits of philopatry.
The aim of this phenomenological study was to construct an interpretation of the experience of nurse-patient relationships, in the context of community psychiatric nursing. The purpose of this paper is to focus on the experience of the relationship from the perspective of the clients. Themes of 'having someone looking out for me', 'working in collaboration', and 'being understood and gaining understanding' were identified. This thematic structure was used to understand the meaning of the relationship for the clients. Implications for practice, education, clinical supervision and mental health services are discussed.
A population genetic approach is presented for general analysis and comparison of kin selection models of sib and half-sib altruism. Nine models are described, each assuming a particular mode of inheritance, number of female inseminations, and Mendelian dominance of the altruist gene. In each model, the selective effects of altruism are described in terms of two general fitness functions, A(beta) and S(beta), giving respectively the expected fitness of an altruist and a nonaltruist as a function of the fraction of altruists beta in a given sibship. For each model, exact conditions are reported for stability at altruist and nonaltruist fixation. Under the Table 3 axions, the stability conditions may then be partially ordered on the basis of implications holding between pairs of conditions. The partial orderings are compared with predictions of the kin selection theory of Hamilton.
PURPOSE: This article reports on a within-family study to identify factors that lead mothers to expect that a particular child will serve in the role of primary caregiver. DESIGN AND METHODS: Data for this study were collected by in-person interviews with a representative sample of 566 mothers between the ages of 65 and 75 years residing in the greater Boston area, who provided detailed information regarding all of their adult children. Both multivariate and qualitative data analyses were conducted. RESULTS: Emotional closeness and similarity of gender and attitudes were strongly associated with which children mothers identified as probable caregivers. Findings regarding exchange were mixed. Mothers were more likely to name adult children who had provided them with support; however, mothers' past provision of assistance to children was unrelated to expectations regarding care. No aspects of children's availability besides proximity and employment of adult children affected mothers' expectations. In selecting a primary caregiver, mothers emphasized expressive characteristics of intergenerational relationships, rather than instrumental and contextual factors associated with children's availability. IMPLICATIONS: The findings indicated a discrepancy between maternal preference for care and actual patterns of support from adult children. Practitioners who work with older adults and their families should incorporate parents' views of the "likely" caregiver into family counseling protocols. Family counseling in both the precaregiving and actual care provision stages may be useful to clarify expected roles for children.