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PubMed2005

Evaluation of a decision-making aid for parents regarding childhood immunizations.

This intervention study evaluates a decision-making aid for parents considering childhood immunizations. Participants (women in 3rd trimester of pregnancy, n = 100) rated likelihood of immunizing their child, anxiety, and perceptions of risk of the diseases and immunizations. Individuals were allocated to intervention group (received a decision aid) or control group (received standard care). Ratings were then repeated, and further ratings were obtained when the infant was 10 weeks old. The intervention compared with the comparison condition was associated with significant increase in likelihood of immunizing the infant on time, decreased perceptions of risks of immunizations, increased perceptions of risk of the diseases, reduced anxiety, and increased satisfaction. This intervention may form a useful basis for decision aids in health care settings.

Adult↗
PubMed2007

Migrant mental health: a model for indicators of mental health and health care consumption.

OBJECTIVE: This study explores the relationship between mental health and health care consumption among migrants in the Netherlands. DESIGN: Samples of the Turkish (n = 648), Moroccan (n = 102), and Surinamese (n = 311) populations in Amsterdam were examined. The study tested a hypothesized model of risk factors for psychiatric morbidity, indicators of well-being, and indicators of health care consumption. The model was specified on the basis of information from earlier research on the sample and literature on the topic. The model was tested and refined using structural equation modeling. MAIN OUTCOME MEASURES: Psychiatric morbidity and well-being measures were assessed with the CIDI 1.1 and MOS-sf-36 subscales, respectively. Health care consumption was assessed by the question "Have you ever consulted one or more of these professionals or health care facilities with respect to mental health problems or problems related to alcohol or drugs usage?" RESULTS: The primary result of this study was the confirmation that health care consumption among migrants is predicted by need and predisposition factors, such as health condition and sociodemographic characteristics. In addition, mental health care consumption of migrants is predicted by acculturation characteristics. This result suggests an effect of cultural and migrant-specific factors in help-seeking behavior and barriers to mental health care facilities. CONCLUSIONS: Findings confirm the existence of migrant-specific mechanisms in health care consumption. Mental health care professionals should be aware of these. However, ignoring common ground for interventions unnecessarily creates distance between migrant groups and between migrant and indigenous Dutch groups.

Acculturation↗
PubMed2003

Legal and psychological perspectives on same-sex domestic violence: a multisystemic approach.

This article presents the legal and psychological aspects of same-sex domestic violence (SSDV) in a multisystemic model that encompasses family systems, friends and the gay-lesbian-bisexual communities, legal systems, and mental and physical health systems, encouraging family psychologists to be the leaders of reform. The current status of relevant laws is integrated into the literature on SSDV, which includes prevalence, myths regarding SSDV, help-seeking behavior of victims, and similarities and differences between SSDV and opposite-sex domestic violence. Recommendations for change in all of the overlapping systems and in the public policies of the larger society are included.

Domestic Violence↗
PubMed1990

Men as elder caregivers: a response to changing families.

Results are presented from a study that examined the relationship between gender orientation and the unique stresses and gratifications for men who are engaged in caregiving tasks traditionally performed by women. The men report having found emotional gratification an important motivating factor, and they tended to ascribe to themselves many affective traits usually associated with the female role.

Adaptation, Psychological↗
PubMed2000

Insurance-based advantage to helpers in a tropical hover wasp.

The origin and maintenance of eusociality is a central problem in evolutionary biology. Eusocial groups contain individuals that forfeit their own reproduction in order to help others reproduce. In facultatively eusocial taxa, offspring can choose whether to found new nests or become helpers in their natal groups. In many facultatively eusocial insects, offspring need continuous care during development, but adult carers have life expectancies shorter than the developmental period. When a lone foundress dies, her partly reared brood are usually doomed. Here, we show that helpers in a tropical hover wasp (Liostenogaster flavolineata) have an insurance-based advantage over lone foundresses because after a helper dies, most of the brood that she has partly reared will be brought to maturity by surviving nest-mates. After some of the helpers are experimentally removed from a multi-female nest, the reduced group is left with more brood than it would normally rear. We found that larger, more valuable extra brood were reared through to maturity, but not smaller, less valuable brood. Smaller brood may be sacrificed to feed larger brood, and reduced groups probably benefited from increased short-term helper recruitment. Rearing extra brood did not increase adult mortality or brood development time.

Animals↗
PubMed2000

Unrelated helpers in a social insect.

High-resolution genetic markers have revolutionized our understanding of vertebrate mating systems, but have so far yielded few comparable surprises about kinship in social insects. Here we use microsatellite markers to reveal an unexpected and unique social system in what is probably the best-studied social wasp, Polistes dominulus. Social insect colonies are nearly always composed of close relatives; therefore, non-reproductive helping behaviour can be favoured by kin selection, because the helpers aid reproductives who share their genes. In P. dominulus, however, 35% of foundress nestmates are unrelated and gain no such advantage. The P. dominulus system is unlike all other cases of unrelated social insects, because one individual has nearly complete reproductive dominance over subordinates who could have chosen other reproductive options. The only significant advantage that subordinates obtain is a chance at later reproduction, particularly if the queen dies. Thus, P. dominulus societies are functionally unlike other social insects, but similar to certain vertebrate societies, in which the unrelated helpers gain through inheritance of a territory or a mate.

Animals↗
PubMed2004

Pre-social benefits of extended parental care.

The evolution of helping, in which some individuals forfeit their own reproduction and help others to reproduce, is a central problem in evolutionary biology. Recently proposed insurance-based mechanisms rely on a pre-existing life history with a long period of offspring dependency relative to the short life expectancies of adult carers: a lone mother's offspring are doomed if she dies young, whereas after a helper dies, other group members can finish rearing the offspring. A critical question, however, is how this life history could evolve in ancestral non-social populations, as offspring survival would then depend on a single, short-lived carer. Here, we resolve this paradox by focusing on the extended parental care inherent in prolonged dependency. We show experimentally that in non-social wasps, extended care can significantly reduce the impact of interspecific parasites. Under extended care, offspring are less vulnerable by the time they are exposed to parasites, and costs of parasitism are reduced because mothers have the option to terminate investment in failing offspring. By experimentally simulating aspects of extended care in a species where it is lacking, we demonstrate that neither benefit requires specialized behaviour. Such benefits could therefore offset the disadvantage of prolonged dependency in non-social species, thereby facilitating the evolution of helping.

Animals↗
PubMed2026

Genome-wide association meta-analysis of eating behavior traits revealed one susceptibility locus for emotional eating.

In order to identify new and genome-wide significant loci for eating behavior traits (cognitive restraint, uncontrolled eating and emotional eating), we conducted a meta-GWAS with seven studies of European ancestry (n&#x2009;=&#x2009;11,250). Eating behavior was assessed using the Three-Factor Eating Questionnaire. Genotype effects of single studies were estimated using additive models adjusting for age, sex, BMI, and principal components and single study results were combined by fixed-effect meta-analysis.For cognitive restraint and uncontrolled eating, no genome-wide significant association could be detected. For emotional eating, one genomic region on chromosome 5 comprising two polymorphisms attained genome-wide significance (P&#x2009;=&#x2009;4.0&#xd7;10-8 for rs6877636 and P&#x2009;=&#x2009;3.2&#xd7;10-8 for rs6897090). The minor alleles were associated with higher emotional eating scores (&#x3b2;=0.093&#x2009;&#xb1;&#x2009;0.017), with a similar direction of effect in each study. Both SNPs, in near perfect linkage disequilibrium, mapped to RP11-24P24.1, a processed pseudogene of ornithine decarboxylase 1 (ODC1). Enrichment analysis revealed a significant overlap between genome-wide BMI-associated variants and nominal emotional eating variants, supporting the hypothesis that shared genetic factors may influence both eating behavior traits and obesity risk. Finally, we observed a number of interesting associations reaching suggestive significance (P&#x2009;<&#x2009;10-6) involving BMI candidate genes, including a suggestive association between FTO variants and cognitive restraint (rs9922708, &#x3b2;&#x2009;=&#x2009;0.069, P&#x2009;=&#x2009;5.9&#xd7;10-7).In conclusion, our meta-GWAS identified for the first time a robust chromosomal region associated with emotional eating in seven studies. Given that emotional eating strongly influences body weight but is often stigmatized, recognizing genetic susceptibility to certain eating behaviors may help reduce stigma and alleviate guilt.

Journal Article↗
PubMed2003

Patients' opinion on what constitutes good psychiatric care.

The present study investigates patients' opinion on what constitutes good psychiatric care. It was a qualitative study using an open-ended in-depth interview centering on the patient's experiences of receiving psychiatric care. The subjects were selected to ensure maximum variation and heterogeneity. A model of deliberate sampling for heterogeneity and a modified, stratified sampling method were used. One outpatient and one inpatient sample were selected. The description and analysis of data were based on a variable-oriented, cross-case technique. The analysis was made separately for the two sub-samples. The main result for both samples was the emergence of one main category: the quality of the helping encounter. The quality of the relationship between patient and therapist/staff, and being understood by the therapist/staff, formed the most central aspects of good care. For the inpatient group the analyses also pointed to stability and structure and relief of pressure as main categories. Though the focus of the study was on satisfaction with general psychiatric care, the results revealed a construct initially identified within the field of psychotherapy, namely the 'helping alliance', as the most crucial factor. The results also gave some further indications of what bring about a good therapeutic relationship; and prominent in this study, and not very often reported in the context of helping alliance, was that ambivalence, time and meaning were important constituents of the relationship. The findings emphasize the importance and quality of the therapeutic relationship and point to the incorporation of psychotherapeutic principles in all provider-patient relationships in general psychiatric care.

Adult↗
PubMed1993

Benevolence, a central moral concept derived from a grounded theory study of nursing decision making in psychiatric settings.

Fourteen experienced nurses participated in an explorative study aimed at describing the experiential aspects of moral decision making in psychiatric nursing practice. In-depth interviews were conducted according to the grounded theory method. These were transcribed, coded and categorized in order to generate conceptual categories. The concept of benevolence was identified as a central motivating factor in the nurses' own accounts of situations in which decisions were made on behalf of the patient. This seems to conceptualize the nurses' expressed aim to do that which is 'good' for the patient in responding to his or her vulnerability. This study indicates the need for further research into the subjective, experiential aspect of ethical decision making from a contextual perspective.

Altruism↗
PubMed1993

Developing trusting, caring relationships: home care nurses and elderly clients.

Trusting as an area of research has not been critically examined in nursing research literature. In this study, nurses working in home care and elderly clients were interviewed to ascertain the process of developing a trusting relationship. Data were obtained from seven home care nurses and six elderly clients who were interviewed from one to three times. The data were analysed using grounded theory methodology and sorted using Microsoft Word software on a Macintosh computer. The core category which was identified in the data was labelled 'trusting, caring relationships'. This core category encompassed trusting which is developed and the caring which the nurses provide. Home care nurses and elderly clients moved through four phases: initial trusting; connecting; negotiating; and helping. The findings have implications for novice nurses working with elderly people, as well as for programme development and education. More research needs to be done on trust in different contexts to assist all nurses in establishing nurse-client relationships.

Aged↗
PubMed1995

Nursing as the promotion of well-being: the client's experience.

An essential question of the discipline of nursing is: What do nurses do to promote the client's well-being? Using a phenomenological-hermeneutic approach to inquiry, this study explored the client's experience of nursing as the promotion of well-being, explicating in three distinct metathemes the meaning of well-being as transforming and nursing as caring. Based on this critical view of nursing, prospective directions for education, research and practice are suggested.

Adaptation, Psychological↗
PubMed1996

The relevance of health visiting policy to contemporary mothers.

This research project examines whether health visiting policy, which developed at the beginning of the twentieth century, is relevant to contemporary mothers. Although previous studies have looked at clients' perceptions of the health visiting service, the fundamental question of whether or not such provision is needed or wanted by mothers of today has not been addressed. This research provides evidence that a client-centred health visiting service is very relevant to the needs of contemporary first-time mothers and is a service which they greatly value.

Adolescent↗
PubMed1997

Supportive learning in distance education.

This paper argues that tutorial support should enhance the learning experience of students who enrol on a distance education programme. A rationale for such support is given as well as a definition of support for distance learners. The complex role of the tutor in distance learning is described which suggests the need for tutor preparation, particularly for tutors adapting to this mode of course delivery. The paper reports on two existing models used within distance education which have focused on the outcome of study. The paper introduces an alternative model of supportive learning which focuses on the development of the educational experience throughout the length of a distance-learning course.

Education, Nursing↗
PubMed1997

Relational capacity: the foundation for interpersonal nursing practice.

Nurses have the opportunity to make a profound difference in peoples' health and healing experiences. However, our emphasis and reliance on mechanistic models of relating often results in our failure to realize this opportunity. This paper challenges the appropriateness of mechanistic models of human relating that focus on behavioural communication skills, and suggests an alternate approach that emphasizes the enhancement of relational capacity. Five relational capacities are described including: initiative, authenticity, and responsiveness; mutuality and synchrony; honouring complexity and ambiguity; intentionality in relating; and re-imagining.

Communication↗
PubMed1998

Fruits without labour: the implications of Friedrich Nietzsche's ideas for the caring professions.

Seldom is the work of philosophers invoked by health professionals when examining aspects of care from a philosophical perspective. Instead, students of health care, especially nurses, have been introduced to 'philosophies' which are often superficially examined and poorly understood. This practice fails to develop in students an appreciation of the work of philosophers or to acquire the art of critical thinking. The introduction of models and theories of nursing in the past three decades has alerted nurses to the importance of possessing critical skills in order to identify sound theory and implement good practice. This paper goes beyond mere philosophising and examines aspects of mental health care from the perspectives of one of nineteenth century Europe's most notable philosophers, Friedrich Nietzsche. It argues that understanding his work can enhance one's ability to reflect on nursing practice, as well as bringing a new dimension to how we analyse 'mental health' problems. His work provides many insights into how we can improve our understanding of the effect of mental illness and mental health care on the individual, and how we conceptualise the process of care. This paper provides an overview of his life's work, his impact on the history of ideas and develops some of the more provocative implications of his work for mental health care.

Empathy↗