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PubMed1992

Agitation in elderly persons: an integrative report of findings in a nursing home.

Agitated behaviors in the nursing home pose a major problem for caregivers. Our data showed that the three syndromes of agitation--aggressive behaviors, physically nonaggressive behaviors, and verbally agitated behaviors--are differentially related to medical and psychosocial variables. Physically nonaggressive behaviors may be adaptive for a resident who presents a deteriorated stage of dementia, since these behaviors offer stimulation and exercise. Verbally agitated behaviors may be a form of help-seeking behavior for residents with physical disease and depressed affect. Aggressive behaviors are those least understood, although these behaviors correlate with advanced stages of dementia and with poor interpersonal relationships. These findings should be a basis for further studies, with the ultimate goal being improved care for agitated elderly persons.

Activities of Daily Living↗
PubMed2003

Feelings about risk and the epidemic diffusion of adolescent sexual behavior.

Rapid initiation of sexual risk behavior in adolescents can be explained by diffusion processes similar to those used to model epidemics. These models suggest that novel behavior can spread to all individuals exposed to the behavior. An alternative interpretation places greater emphasis on developmental changes in feelings toward risk behavior that can explain or limit the diffusion process. This research examined the initiation of sexual behavior in adolescents living in high-poverty urban environments. A cross-section of African American youth (N = 355) ages 9-17 living in public housing were interviewed using privacy-enhancing "talking computers." Sexual risk behavior (unprotected sexual intercourse) was assessed along with perceived sexual behavior of friends and personal feelings about sexual intercourse and condom use. Age trends in both peer-group perceptions and personal feelings displayed increasing attraction toward risky sex. Diffusion processes were strongly related to sexual initiation and condom use even after controlling for changes in personal feelings. Nevertheless, feelings toward sexual risk behavior moderated the diffusion process. Adolescents with less favorable feelings toward sex were less susceptible to the diffusion of sexual initiation and those with more favorable feelings toward condoms were more likely to use them consistently. Interventions that focus on adolescents' feelings toward risk behavior can help to limit the diffusion of risk behavior in high-risk urban environments.

Adolescent↗
PubMed2001

The eating disorders NOS diagnostic profile among college women.

The authors examined a proposed profile of eating-related behaviors, associated features, developmental issues, and help-seeking behavior among college women, using an eating disorder response program. The most common symptom scenario was a pattern of regular binge eating, together with daily exercise and occasional purging. The most common associated features were distressing or dysfunctional overconcern about body image and self-esteem, usually with day-to-day stress and intermittent depression. The women who fit this pattern also presented developmental issues of perfectionism, conflictual relationships with parents, and struggles for independence; and they tended to be ambivalent about seeking services. Implications for practice, including the need to develop a framework for eating disorder responses on campus that includes preventive programs and developmental interventions to target emerging and moderate concerns are discussed; limitations and the preliminary nature of the findings are explicated.

Adolescent↗
PubMedDate not supplied

The role of children's lay theories about the malleability of human attributes in beliefs about and volunteering for disadvantaged groups.

Two studies with 9- to 12-year-old children supported the hypothesis that lay theories about the malleability of human traits impact judgments of and behavior toward groups in need of volunteer help. The more children endorsed an incremental view (attributes can change), the more they reported liking, desiring social contact with, and perceiving similarity between themselves and a disadvantaged outgroup (homeless, UNICEF-funded children). Moreover, children endorsing more of a malleable view reported greater past volunteering, active participation in collecting money for a UNICEF event, and intentions to volunteer again. These findings held when controlling for the effects of participants' gender, self-esteem, and perceived social pressure to help others. How a malleable view and intergroup volunteerism may be mutually sustaining is discussed.

Attitude↗
PubMedDate not supplied

Improving interactions between substance abusing mothers and their substance-exposed newborns.

OBJECTIVE: To determine whether teaching comforting and interacting techniques within 24 hours of delivery to substance-abusing mothers will improve mother-infant interactions 48-72 hours after discharge. DESIGN: An experimental three-group, random assignment, pretest-posttest design. SETTING: Mothers attending a clinic serving a mostly indigent population. PARTICIPANTS: Eighty-three women whose urine was positive for drug use were invited to participate. Sixty mother-newborn couplets completed the study. INTERVENTIONS: Two observers, blind to the mothers' drug history, completed the Nursing Child Assessment Feeding Scale (NCAFS) of all participants within 24 hours of delivery. Mothers in the experimental group were given the intervention. The observers completed the NCAFS in the mothers' homes 48-72 hours after discharge. RESULTS: At the home visit, couplets in the treatment group showed significant improvement in their total NCAFS score (F = 5.18; p = .008). When analyzed separately, only maternal scores showed a significant difference between the treatment and control groups at the home visit (F = 6.48; p = .0029). CONCLUSIONS: Nurses, by demonstrating caregiving behavior, can help mothers recognize and respond to newborns' behavioral cues, thus enhancing mother-newborn interactions.

Adult↗
PubMed2004

Where is help sought for depression or suicidal ideation in an elderly population living in a rural area of Japan?

Although suicide is increasingly becoming a social problem in Japan, especially among the elderly, little early intervention or suicide prevention is done. A project was begun which, since 1999, has aimed to detect depression at an early stage as a suicide prevention measure in a model area of Town A, which had a high suicide rate. In order to promote early intervention and prevention in a community, it is important to know where residents seek help if they become depressed or have suicidal ideation. Therefore, in the present study, help-seeking behavior using case vignettes was investigated. Data from 230 residents (82 men, 148 women) in the model area of Town A, aged 65 or over, were analyzed in the present study. If participants were unable to answer by themselves due to physical condition, public health nurses read out each item and wrote in their answers. The relationship between help-seeking behavior and demographic variables, psychosocial variables, depressive symptoms and so forth, were examined. The results show that participation in mental health workshops facilitated consultation with specialists (e.g. primary care doctors and nurses). The expected effects of psychoeducation on the general public and specialists were considered.

Aged↗
PubMed2002

The impact of urinary incontinence in working women: a study in a production facility.

OBJECTIVES: The objectives of this study were to identify the impact of self-reported UI on working women, to describe urine loss symptoms, strategies used to control urine loss, and help-seeking behavior among full-time women working in a rural production facility. METHODS: A cross-sectional survey design was used and questionnaires were distributed to 500 women (response rate, 54%). Items elicited information on demographics, health, parity, symptoms and duration of urine loss, strategies to manage urine loss, effects of UI on work activities, level of knowledge about UI and treatment options, perceived importance of getting professional help, and actual help seeking behavior. RESULTS: Twenty-nine percent (n = 78) reported UI at least monthly. Incontinent women were older (44.8 years vs. 38.1 years) than continent women (t = -5.22, p < .001) and incontinent women had a significantly higher average body mass index (BMI) than continent women (t = -4.3, p < .001). More women reported urine loss with coughing, lifting, bending, and when hands were in water, and were more likely to use pads at work to control urine loss. Few women had reported UI to a health care provider (36%) and most wanted more information about UI (85%). CONCLUSIONS: UI is a prevalent problem for working women. Workplace programs designed to assist women with prevention, treatment, and management of UI are crucial.

Adolescent↗
PubMed1992

[The effects of role playing on prosocial behavior in preschool children].

The purpose was to examine the effects of two types of role-playing experience on prosocial behavior in preschool children. Subjects were 72 6-year-olds. In the Empathy role-playing (E), each pair of children enacted alternately a victim and an eyewitness using a glove puppet, in which the emphasis was only on empathizing with the victim. In the Empathy and Helping role-playing (EH), they enacted alternately a victim and a helper, in which the emphasis was on empathizing and helping a victim. In the Control role-playing (C), they played roles alternately of a customer and a salesman in a grocery store. All children were assessed as for helping and sharing behaviors for a real victim before and after the role playing session. In the comparison between pre- and post-tests for helping behavior. All groups (C, E, EH) increased helping tendency, but only in EH group the proportion of subjects, whose attitude changed from helper to non-helper. As for sharing behavior, all three groups increased the number of sharing significantly in the post-test.

Child↗
PubMed1988

Practice compatibility and type of framework: essential dimensions in the salaried primary care practitioners' approach to practice.

A multivariate paradigm, aimed at furthering the understanding of the factors underlying the devotion to practice of salaried primary care practitioners, has been developed and subjected to empirical verification. A study among a sample of Israeli primary care practitioners (N = 134) revealed an empirical structure of "Practice Compatibility', suggesting that the devotion to practice is conditioned by the clinical and professional role compatibility. Compatibility in turn is contingent on the practitioners' conviction in the sincerity of manifest health care oriented goals of the care-providing-framework. The herein developed notion of "Practice Compatibility' facilitated the distinction between types of employing frameworks according to the factors predicting the salaried primary care practitioners' devotion to practice. In this respect the contribution of the present study is in identifying the factors underlying the salaried practitioners' motivation to practice. However, contrary to the expected, practice compatibility does not predict the primary care practitioners' likelihood to demonstrate affective behavior. Thus the data were unable to repudiate earlier evidence regarding the significance of the private fee-for-service framework in predicting affective behavior.

Helping Behavior↗
PubMedDate not supplied

Combining behavioral and self-help approaches in the inpatient management of dually diagnosed patients.

The combination of a token economy and a self-help model made it feasible to organize and maintain an intensive dual-diagnosis treatment program in a public municipal hospital acute psychiatric ward. The program described here, which integrates the token economy and 12-step approaches, fosters voluntary and active patient participation in the process of simultaneous recovery from mental illness and addiction; it also networks the patient with community resources. Implementation of the clinical program involved addressing multiple clinical and organizational obstacles, including a multihandicapped and often nonmotivated patient population, a lack of psychiatric staff trained in managing substance abuse, and the need to integrate mental health with substance abuse clinical interventions. The program has been operating more than 5 years and has treated more than 1,000 patients. As the token economy became an integral part of the ward routine, violence on the ward declined substantially, and patient participation in group activities increased significantly.

Activities of Daily Living↗
PubMed1998

Evolution of indirect reciprocity by image scoring.

Darwinian evolution has to provide an explanation for cooperative behaviour. Theories of cooperation are based on kin selection (dependent on genetic relatedness), group selection and reciprocal altruism. The idea of reciprocal altruism usually involves direct reciprocity: repeated encounters between the same individuals allow for the return of an altruistic act by the recipient. Here we present a new theoretical framework, which is based on indirect reciprocity and does not require the same two individuals ever to meet again. Individual selection can nevertheless favour cooperative strategies directed towards recipients that have helped others in the past. Cooperation pays because it confers the image of a valuable community member to the cooperating individual. We present computer simulations and analytic models that specify the conditions required for evolutionary stability of indirect reciprocity. We show that the probability of knowing the 'image' of the recipient must exceed the cost-to-benefit ratio of the altruistic act. We propose that the emergence of indirect reciprocity was a decisive step for the evolution of human societies.

Altruism↗
PubMed1999

Insomnia in primary care patients.

STUDY OBJECTIVES: To determine the prevalence and characteristics of insomnia in primary care patients, to examine patients' help-seeking behavior, and to compare the frequency of insomnia in primary care patients to the general population. METHODS: 286 patients from primary care clinics in San Diego, California (n = 96), and in Haleiwa and Honolulu, Hawaii (n = 190) participated. Sleep study questionnaires were distributed by front desk receptionists to all patients over 18 years of age upon arrival at the clinic for an appointment with the physician. Completed questionnaires were collected at the clinic or returned by mail. Comparisons were made by using nonparametric statistics. A logistic regression analysis using backward elimination was done to develop a model showing predictors of who would consult with the physician about a sleep problem. RESULTS: The prevalence of insomnia in primary care patients was 69%, with 50% reporting occasional insomnia and 19% reporting chronic insomnia. As expected, patients with chronic insomnia had the most severe sleep complaints as well as the poorest daytime functioning, and exhibited the most help-seeking behaviors. The four predictors of discussing insomnia with a physician were how patients felt physically, number of years of insomnia, age, and income. CONCLUSIONS: The primary care population has a higher prevalence of insomnia than the general population, probably because of concomitant psychiatric and medical illnesses. Although many of the characteristics of the sleep complaints are easily detected, most patients with insomnia are not treated effectively.

Adolescent↗
PubMed1979

Hairdressers as caregivers. I. A descriptive profile of interpersonal help-giving involvements.

The interpersonal help-giving behaviors of 90 hairdressers were explored in depth in an interview study. On the average, hairdressers saw 55 customers a week, and talked 25 minutes with each. About one-third of the talking time concerned clients' moderate to serious personal problems--particularly problems with children, physical health, marriage, depression, and anxiety. Hairdressers reported that offering sympathy and support, being lighthearted, just listening, and presenting alternatives were among their most frequent response strategies. Although they often enjoyed fielding clients' personal problems, at times they felt perplexed by them. Hairdressers perceived listening to customers' interpersonal problems to be an important part of their everyday function and expressed a need for professional inputs in that domain.

Adult↗
PubMedDate not supplied

A candid conversation about men, sexual health, and diabetes.

While the profound relationship between human sexuality and diabetes can affect quality of life for both men and women, male sexual health issues in the published literature have primarily focused on physical aspects of erectile dysfunction. The purpose of this article is to move this important discussion regarding aspects of human sexuality and diabetes further to consider the absence of and need for more male-focused research. Attention is given to define and discuss how male perceptions of control and masculinity shape male views on male sex roles. The author offers 4 published explanations to explain factors that influence whether men, regardless of age, nationality, or ethnic group, initiate help-seeking behaviors for sexual health concerns. These explanations can help health care professionals have candid, consistent, and nonjudgmental conversations with their patients and each other. This article concludes with strong recommendations that health care providers engage patients in timely conversations, jointly select and implement tailored treatment options, and, when necessary, link patients with social support systems to maximize improvements in both physical and psychological aspects of sexual health.

Diabetes Mellitus↗
PubMed1983

The helper-therapy principle applied to weight management specialists.

One hundred twenty applicants to a weight management specialist training program were studied over a 33-month period. Following a nine-month training period, Specialists (N = 29; those leading at least one posttraining weight management group) were compared to Contact Controls (N = 31; persons participating in the weight management program, but not in the helper role) and No Contact Controls (N = 60; those not accepted into the training program and whose only contact with the program was for data collection purposes) in a test of the helper-therapy principle. The major question was, "What are the long-term physical, psychological, and behavioral effects on overweight and formerly overweight individuals involved in helping other persons manage their weight?" Data gathered at 12 and 24 months post-training revealed few differences between the total group of specialists and persons in the two control groups. However, when the data were analyzed by the amount of commitment to the specialist role, it was found that the Higher Involved Specialists (N = 16; those who led two or more weight management groups in the year posttraining) were significantly more likely to lose additional weight (or maintain earlier weight losses), to be more consistent in their adherence to the eating and activity levels advocated by the program, to feel better about themselves and their bodies, and to maintain their levels of general well-being than control subjects or the Lesser Involved Specialists. These latter individuals (N = 13) were significantly the worse for having gone through specialist training, but not fully carrying out the specialist role.

Adult↗
PubMed1979

Student physical symptoms and the social climate of college living groups.

Student physical symptoms were related to the social climates of university living groups. A Physical Symptom Risk Scale, a new subscale of the University Residence Environment Scale, which relates consistently to physical symptom complaints for male, female, and coed living groups, was developed. Living groups characterized by high student physical symptoms were perceived by students as low in involvement and support, high in competition, and low in student influence. The results indicate that certain types of social environments may be "high risk" settings in that they support and possibly facilitate complaints of physical symptoms. These settings may be amenable to early "environmental diagnosis," preventive counseling, and change-oriented social systems intervention.

Competitive Behavior↗