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PubMed2006

Directive and supportive behaviors used by families of hospitalized older adults to affect the process of hospitalization.

As part of a grounded-theory study exploring the social processes of hospitalized older adults, family members were asked about their roles in relation to their hospitalized relative. Participants included five hospitalized older adults (aged > or = 75 years), a family member, and a nurse for each older adult. Data saturation determined the number of participants. Data were analyzed using the constant comparative method to develop the substantive theory of managing personal integrity during hospitalization. Personal integrity is a concept encompassing the properties of health, dignity, and autonomy. Siblings, spouses, children, and grandchildren used a combination of supportive and directive behaviors to affect personal integrity and the hospitalization for their older relatives. In prior research, the entire family was viewed as the patient. This research is unique in that the family is viewed as a modifier of hospitalization affecting the older adult's hospital experience and not as the focus of care.

Activities of Daily Living↗
PubMed2000

Studies on common illnesses and medical care utilization patterns of adolescents in Hong Kong.

PURPOSE: To estimate the prevalences of common illnesses in Hong Kong adolescents, the sociodemographic and selected risk factors associated with these illnesses, and their health care utilization behavior and attitudes. METHODS: A cross-sectional questionnaire survey of 3355 participating secondary school students (response rate = 98%). RESULTS: Self-reported 3-month prevalences were obtained for cough/cold/influenza (55.2%), digestive disorders (34.6%), accidental injuries (29.5%), headache/dizziness (23.6%), chronic anxiety/insomnia (20.1%), skin problems (9.5%), asthma (3.8%), liver disease (1.3%), and menstrual pain (13.8% of female students). Self-perceived poor health, smoking, and alcohol consumption were associated with many of these illnesses. Treatment choice depended on the illness suffered (e.g., most students with respiratory problems consulted medical practitioners, whereas most with chronic anxiety/insomnia did not). Many students lacked trust in their doctors, doctor-shopped, relied heavily on self-medication, did not comply with prescribed treatments, would not seek help about medical problems, felt they had insufficient access to health information, and wanted confidential health care. CONCLUSIONS: This study examined for the first time the common illnesses and health care utilization patterns of Hong Kong adolescents. Students with chronic anxiety/insomnia were much less likely to seek care, indicating a need for better education on mental health. Efforts to prevent smoking and alcohol consumption among adolescents need to be strengthened. The students' attitudes, poor compliance and help-seeking behaviors suggest suboptimal use of the health care system. Our findings are useful for international comparisons by medical practitioners, health care managers, and researchers.

Adolescent↗
PubMedDate not supplied

Insecure attachment and college-age alcohol use disorders. A case report.

Teens and young adults with insecure attachment may be remarkably susceptible to alcohol and substance use disorders. Particularly in the separation process of leaving-home and entering college, an underlying insecure attachment may manifest through symptoms of alcohol or drug abuse; as these young adults engage in what is perceived to be adult drinking behavior, they become too "attached" to the alcohol as a substitute for earlier, sporadically-available objects (usually parents). That is, they enact a similar relationship to this drug that they may have learned to have with an insecure parent: too close at times, but ultimately fostering guilt, dependence and destructive action. Fear of abandonment, rejection and negative judgment may be intensified in this age group as they struggle at the cusp of independence, but these issues are particularly relevant for insecurely attached teens. In this report, attachment theory is briefly described and applied to the assessment and treatment of a college freshman diagnosed with an alcohol use disorder. By engaging the patient in evaluating her actions and motives through the attachment model, the therapy helps her to channel help-seeking behavior appropriately, to establish expectations for consistency and reliability from significant people in her life and to feel safer without turning to alcohol as a crutch. An argument is made for the general application of attachment theory to alcohol and drug use disorders in this significant phase of young adult development.

Adult↗
PubMedDate not supplied

Prevalence of common chronic pain in Hong Kong adults.

OBJECTIVE: Chronic pain is prevalent in many Western countries. Its prevalence in a non-Caucasian population is not known. The authors performed this study to measure the prevalence of chronic pain in the Hong Kong Chinese adult population, as well as the pattern of pain and the demographic characteristics, the impact on social and work function, and the help-seeking behavior of those with pain. DESIGN: Cross-sectional survey using telephone interview with a structured questionnaire. Chronic pain was defined as pain persisting for more than 3 months. SUBJECTS: A random sample of over 1,000 persons out of the entire Chinese adult population of Hong Kong. RESULTS: One thousand fifty-one adults were interviewed. One hundred thirteen (10.8% [95% C.I.: 8.9%-12.7%]) had chronic pain. The median number of pains was two. Of those with chronic pain, 38.3% reported their work was affected, and 19.8% had taken a median of 5 days' sick leave in the past year; 70.8% said the pain had interfered with their daily life, 88.5% had tried self-treatment, and 74.3% had sought medical advice. Only 35.7% considered the treatment definitely helpful. Two risk factors were identified: the female gender (O.R. 1.5, 95% C.I. 1.0-2.3) and age greater than 60 (O.R. 2.2, 95% C.I. 1.3-3.6). CONCLUSIONS: The study showed that the prevalence of chronic pain in Hong Kong adults was approximately 10.8%. Work and daily life are significantly affected and there is considerable demand on the health care system. Despite the ethnic difference, the prevalence, pattern, and demographic characteristics of chronic pain in Hong Kong are very similar to those seen in Western countries.

Activities of Daily Living↗
PubMed1988

Confrontation and politeness strategies in physician-patient interactions.

The therapeutic success of physician-patient interactions depends in large part on how physicians interpret and respond to patients' implicit and explicit messages. Using a hypothetical vignette, in which a patient refuses to comply with a recommended therapeutic regimen, we found that first-year medical students with no classroom training in medical interviewing implicitly recognized that the situation called for face preserving or polite linguistic behavior. Ninety percent of them used culturally sanctioned politeness forms to repair the conversational breakdown depicted in the vignette. They responded to this clinical scenario, however, with linguistic behaviors borrowed from their everyday interactions, some of which were culturally appropriate, but not necessarily therapeutic. We suggest that students can learn to adapt their culturally appropriate behaviors and engage in therapeutic communication as physicians if they are given the necessary conceptual tools. We discuss how Brown and Levinson's theories of politeness and strategic language usage can (1) provide a framework for interpreting communication in general and physician-patient interaction in particular, (2) illuminate some of the problems inherent in doctor-patient encounters, and (3) be used prescriptively for teaching students and health professionals how to avoid some communication difficulties.

Communication↗
PubMed2001

Measuring supportive and unsupportive responses during cancer treatment: a factor analytic assessment of the partner responses to cancer inventory.

This study examined the psychometric structure of a measure of positive and negative spouse responses to individuals with cancer, the Partner Responses to Cancer Inventory (PRCI). The forty-eight items were either developed by the authors or adapted from the Inventory of Socially Supportive Behaviors. Seven a priori subscales of the PRCI, four positive support scales and three negative spouse behavior scales, were hypothesized. The instrument was administered to 304 cancer patients undergoing cancer treatment. Exploratory factor analyses yielded four factors that were subsequently confirmed by confirmatory factor analysis: (a) Emotional and Instrumental Support, (b) Cognitive Information and Guidance, (c) Encouraging Distancing and Self-Restraint, and (d) Criticism and Withdrawal. The measure satisfied standard criteria for internal consistency and construct validity, and thus may be useful for social support theory and research.

Adaptation, Psychological↗
PubMed2006

Listening to girls and boys talk about girls' physical activity behaviors.

As part of the formative assessment for the Trial of Activity for Adolescent Girls (TAAG), a multicenter study to reduce the decline of physical activity in adolescent girls, girls and boys with diverse ethnicity from six states participated in focus groups and semistructured interviews. Data from 13 girls' focus groups (N = 100), 11 boys' focus groups (N = 77), and 80 semistructured interviews with girls are examined to identify perceptions of girls' physical activity behaviors to help develop TAAG interventions. Both girls and boys talk about physically active girls as being "tomboys" or "too aggressive." Girls are more likely to characterize active girls as "in shape," whereas boys say they are "too athletic." Girls report boys to be influential barriers and motivators in shaping their beliefs about physical activity. Given the strong influence of peers, developing successful interventions for girls should include verbal persuasion, modeling, and social support from both girls and boys.

Adolescent↗
PubMedDate not supplied

Cytokines and cognitive behavior.

Proinflammatory cytokines help orchestrate host responses to infection and are a major communication link between peripheral immunity and the CNS. These cytokines initiate a number of CNS events that culminate in both physiological and behavioral changes. Peripheral IL-1beta also affects information processing. A series of experiments examining the effect of learning intensity, motivation, and cytokine dose are reported. Using a well-established Morris water maze (MWM) system with female C57BL/6 mice, we report that (1) IL-1 (100 ng/mouse, i.p.) has no effect on MWM learning when mice are subjected to a spaced as opposed to a massed learning protocol; (2) water temperature is critical to the IL-1 effect on learning insofar as IL-1 interferes with learning in a warm-water but not a cold-water maze, and (3) higher doses (1,000 ng/mouse, i.p.) of IL-1 in experimental systems known to produce the IL-1-induced learning deficit with lower doses (100 ng/mouse, i.p.) show consistent facilitation, not impairment, of learning.

Animals↗
PubMed2002

The concept of protection: a dimensional analysis and critique of a theory of protection.

Dimensional analysis clarifies the concept of protection, which has a commonly understood definition but is used inconsistently in research literature. Concepts such as protective factors and protective behaviors are often used interchangeably without adequately representing the phenomenon of protection itself. This article critiques a situation-specific theory of protection and presents dimensions of a model with an ecological view of protection. It uses dimensional analysis methods to derive the social construction of protection from its use in a broad range of literature; vigilant management and vigilant communication are salient dimensions of protection. The article compares conceptual literature with research literature to identify inconsistencies in use.

Adult↗
PubMed2006

Hoarding in obsessive-compulsive disorder: results from the OCD Collaborative Genetics Study.

Hoarding behavior occurs frequently in obsessive-compulsive disorder (OCD). Results from previous studies suggest that individuals with OCD who have hoarding symptoms are clinically different than non-hoarders and may represent a distinct clinical group. In the present study, we compared 235 hoarding to 389 non-hoarding participants, all of whom had OCD, collected in the course of the OCD Collaborative Genetics Study. We found that, compared to non-hoarding individuals, hoarders were more likely to have symmetry obsessions and repeating, counting, and ordering compulsions; poorer insight; more severe illness; difficulty initiating or completing tasks; and indecision. Hoarders had a greater prevalence of social phobia and generalized anxiety disorder. Hoarders also had a greater prevalence of obsessive-compulsive and dependent personality disorders. Five personality traits were independently associated with hoarding: miserliness, preoccupation with details, difficulty making decisions, odd behavior or appearance, and magical thinking. Hoarding and indecision were more prevalent in the relatives of hoarding than of non-hoarding probands. Hoarding in relatives was associated with indecision in probands, independently of proband hoarding status. The findings suggest that hoarding behavior may help differentiate a distinct clinical subgroup of people with OCD and may aggregate in some OCD families. Indecision may be a risk factor for hoarding in these families.

Adolescent↗
PubMed1993

Perceived importance of caring behaviors to Swedish psychiatric inpatients and staff, with comparisons to somatically-ill samples.

The present study identified psychiatric inpatient (N = 61) and staff (N = 63) perceptions of most and least important nurse caring behaviors using a modified Swedish version of the CARE-Q instrument (Larson, 1981) and compared the results with data from somatic care (von Essen & Sjödén, 1991a, 1991b). The results demonstrated 13 significant mean between-group differences in the rating of 50 specific CARE-Q behaviors. Two significant mean value differences out of six subscales combining individual items were demonstrated between groups. Psychiatric inpatients considered the cognitive aspect, and somatic inpatients the task-oriented aspect of caring as the most important. Staff, in psychiatric as well as somatic care, considered the emotional aspect of caring as the most important. The results suggest that staff has a relatively invariant, human-oriented perception of caring, irrespective of subdisciplines, while patients' perceptions of caring vary more over specialties.

Adult↗
PubMed2006

Sharing tips with strangers: exploiting gift culture in computer gaming.

The aim of this study was to look at motivations behind altruistic behavior in virtual communities by studying the sharing of game tips by experienced gamers. We examine several possible motivations (pure altruism, generalized reciprocity, and reputation) and qualitatively analyze tip types in terms of usefulness, visibility, and skill level. We found that in games that do not support a "performance stage" for skill demonstration, players often share game tips as a strategy to attract attention. To a certain degree, reciprocity can be used to explain small favor exchanges, but earning social reputation is often a much stronger motivating factor.

Adult↗
PubMed1986

Disability, stress and readjustment: the function of the professional's latent goals and affective behavior in rehabilitation.

The paper focuses on the factors which may possibly explain why rehabilitation agencies' assistance may eventually result in maladjustment--a conclusion inferred from recent studies on the readjustment of disabled persons. Multivariate analysis of data from a study among Israeli disabled war veterans ascertains that the rehabilitant's perception of the rehabilitator as pursuing a predominant though latent goal of promoting his/her own interests, constitutes a major factor in the intervention's detrimental outcomes. The rehabilitator's demonstration of 'affective' (sincerely humane) behavior, on the other hand, counteracts the eventually deleterious consequences. The study renders further support to the frequently emphasized significance of the rehabilitant's subjective assessment of the demands confronting him in their becoming stressors. The data ascertains that it is not the severity of the impairment itself, but rather the subjective assessment of its implication that may have stress-arousing consequences. The present study contributes a further development of the previously established paradigm of 'Readjustment of Disabled Persons', contributing to the understanding of the factors facilitating and impeding readjustment.

Adaptation, Psychological↗
PubMed1975

Group selection, altruism, reinforcement, and throwing in human evolution.

Evolution of altruism by group selection involves sacrifice of some individuals, not to the "group as a whole," but to other individuals in the group. Deme-group selection may establish strictly altruistic genes in a population, but only under limited conditions, and perhaps never among vertebrates, among which apparently altruistic behaviors may always potentially benefit the altruists. Responsive-group selection is a more effective mode of evolution of altruism, conspicuous in man. Evolutionary reinforcement increases the force of selection of advantageous behaviors, including altruistic ones, by making them pleasant or rewarding. It is probably involved also in ecological habitat selection, and may be the source of many human emotions, including esthetic ones. Throwing (of stones and weapons) exemplifies both the possible importance of a difficult-to-measure evolutionary factor and the role of reinforcement; in human evolution throwing may have been decisive in food-getting and fighting, in shifting emphasis from brute force to skill, and in inducing evolution of a brain able to handle three-body geometric problems precisely and thus preadapted for more complex functions.

Anthropology, Physical↗
PubMed2005

Ethnicity as manifest in drug-specific vocabulary and subsequent risk of starting cannabis use in early adolescence.

Working knowledge or vocabulary of drug slang, as a manifestation of learned behavior, might help predict or explain risk of starting to use cannabis in early adolescence. To study this issue, an epidemiologic sample of 1,255 11- to 12-year-olds was assessed for knowledge of cannabis slang terms in 1992, with follow-up in 1993 and 1994. The basic design is that of a prospective and longitudinal study, with recruitment of an epidemiologic sample of children as they entered primary school in a single metropolitan area, also with baseline assessments and randomization to intervention conditions, and subsequent multiple waves of follow-up assessment. Youths assessed in 1992 and who were familiar with terms such as blunts, Mary Jane, roach, and herb were more likely to start using cannabis within the subsequent two years of the follow-up interval, as compared to other youths (estimated relative risk, RR=11.0; 95% CI 3.6-33.7; P<.001). A youth's working vocabulary may signal important variations in health- and disease-related behavior, such as illegal drug use.

Adolescent↗
PubMed1976

Some cognitive, behavioral and personality correlates of maturity of moral judgment.

This study was designed to test the hypothesis that maturity of moral judgment is related to moral behavior and to certain personality characteristics. The Ss, 33 fifth grade boys (approximately 10 1/2-years of age), were given the Kohlberg test of moral judgment, and scores on this test were related to a measure of general intelligence, moral conduct as judged by peers (sociometric nominations), honesty in a structured test, and certain personality variables. Maturity of moral judgment was found to be significantly correlated with general cognitive ability (intelligence test performance) and, even with intelligence partialed out, with resistance to temptation, reputation for being concerned with the welfare of others, self-confidence, and security in social relationships with peers.

Child↗
PubMed2006

Interpersonal violence in the lives of urban American Indian and Alaska Native women: implications for health, mental health, and help-seeking.

OBJECTIVE: We surveyed American Indian/Alaska Native (AIAN) women in New York City to determine the prevalence of 3 types of interpersonal violence among urban AIAN women and the behavioral health and mental health factors associated with this violence. METHODS: Using a survey, we questioned 112 adult AIAN women in New York City about their experiences with interpersonal violence, mental health, HIV risk behaviors, and help-seeking. The sampling plan utilized a multiple-wave approach with modified respondent-driven sampling, chain referral, and target sampling. RESULTS: Among respondents, over 65% had experienced some form of interpersonal violence, of which 28% reported childhood physical abuse, 48% reported rape, 40% reported a history of domestic violence, and 40% reported multiple victimization experiences. Overwhelmingly, women experienced high levels of emotional trauma related to these events. A history of interpersonal violence was associated with depression, dysphoria, help-seeking behaviors, and an increase in high-HIV risk sexual behaviors. CONCLUSIONS: AIAN women experience high rates of interpersonal violence and trauma that are associated with a host of health problems and have important implications for health and mental health professionals.

Adolescent↗
PubMed1992

[Patients and solicitude].

Patients are not only passive and vulnerable beings who need to be cared for. They are also autonomous, active and capable of caring for others as well as for themselves. In this study, the author has completed lengthy interviews with five women in order to identify different types of caring. Complicity-based caring is characterized by verbal and nonverbal behavior of patients who are sharing a common experience. This type of caring can be encouraged by a third-party who brings patients together with similar experiences. Action-oriented caring consists of intervening for other patients as an antidote for one's own fear, panic and anguish. Solidarity-based caring corresponds with assisting fellow patients in finding and maintaining their own identity, pride and dignity. Co-operative caring can be observed in group-type settings such as the behavior observed during support groups or vegetarian cooking classes for cancer patients. Self-centred caring refers to the various forms of concern one has for one's self. The experience of suffering can determine how caring is expressed. Concern can force individuals to examine their way of acting and interacting more carefully. Conscious choices are made to avoid empty and exhausting relationships and encourage the growth of positive relationships. Paradoxically, this change in perspective brings about an open mind and heart. It is at this time that caring for healthy individuals appears. Unfortunately, there is very little distinction between patients and healthy individuals, but rather sensitive relationships between individuals facing difficult life challenges.

Female↗