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Patient education for behavior change: help from the Transtheoretical and Harm Reduction models.

Promoting healthy behaviors at all levels of prevention is an important component of nursing care in the HIV epidemic. This paper explores two models that can be used to support behavior change efforts: the Transtheoretical Model, which describes stages in the change process, and the Harm Reduction Model, which offers an incremental approach to helping clients move toward safer and healthier habits. A review of the literature shows that these holistic and caring models can be combined effectively to assist clients who are dealing with HIV-related issues. The resulting theory-based approach can help nurses maintain consistency and direction in educational interventions for behavior change.

Empathy↗

Images of the physician and help-seeking behavior of the elderly: a multivariate assessment.

This research empirically examines the hypothesis that the aged person's attitudes toward doctors have behavioral consequences in terms of whether or not a doctor's help in sought. A multivariate analysis of data collected from 122 older respondents indicates that attitudes related to technical aspects of medicine or physician performance are insignificant in terms of help-seeking, but a perception of physicians as personally interested in the welfare of patients is a significant predictor of both the inclination and actual behavior of seeking medical help. Implications of these data are discussed.

Aged↗

Psychosocial factors associated with help-seeking behavior among depressive adolescents.

A group of 3,287 French school pupils between the age of 12 to 20 years, of whom 14.4% had sought consultation for depression, were investigated in order to analyse the factors related to the type of medical help obtained. Multivariate analyses showed that severe emotional distress alone did not explain the help-seeking behavior. Thus, among those adolescents with the same anxio-depressive level, girls, older adolescents, adolescents with parents living apart, with health worries, and adolescents often absent from school more often sought help for depression. Socio economic status, however, did not correlate with a higher level of consultation for depression. Adolescents attending medical services for depression had a higher consultation rate, for any reason, with general practitioners and with school nurses, in whom they confided more often than their counterparts. Nonmedical professionals also seemed to contribute to accessing to medical help for depression. Overall, those who consulted for depression, in very limited numbers turned to mental health services (8.4%).

Adolescent↗

Help-seeking behaviors by Korean immigrants for depression.

Underutilization of mental health services by Asian immigrants has been an ongoing concern for those attempting to provide accessible care for people suffering from mental illness. The author investigated Korean immigrants' help-seeking behaviors for depression to understand their underutilization of mental health services. The study involved 6 focus group discussions and 24 in-depth interviews with 70 Korean immigrants in New York City. Prolonged care within family and traditional Asian practices led to a delay in seeking mental health services, keeping many Korean immigrants with depression out of the delivery system. The lack of interface between formal service providers and psychiatric service providers also caused delayed treatment. This study suggests the need for a comprehensive care model based on community education, linking mental health care with other services, and cultural brokering, as ways to connect population needs with mental health service delivery.

Adolescent↗

[Men and depression: gender-related help-seeking behavior].

As epidemiological data concerning gender-related help-seeking behaviour indicate, consultation rate and help-seeking by men is consistently lower, especially in the case of emotional problems and depressive symptoms. There is empirical evidence that the poor treatment rate of men cannot be explained by a better health but must be attributed to a discrepancy of need and help-seeking behaviour. Social change and epidemiological trends in depression point to the male gender-role being an important factor of increasing rates among young men as well as an important determinant of help-seeking behaviour. It is argued that social norms of traditional masculinity make help-seeking more difficult because of the inhibition of expressiveness affecting symptom perception and symptomatology of depression. Besides these predisposing factors of male help-seeking other medical and social factors are mentioned producing further barriers to help-seeking. Further research is needed to investigate the question whether changing masculinity implies gender-role conflict or positive health effects.

Depressive Disorder↗

The help-seeking behavior of black Americans. A summary of findings from the National Survey of Black Americans.

In 1977, the National Institute of Mental Health funded the National Survey of Black Americans (NSBA). The NSBA was an omnibus, nationally representative sample (N = 2,107) of adult black Americans that explored numerous issues relevant to black quality of life. One topic that has received much attention is where blacks go for help during periods of crisis. This article provides a brief summary of NSBA findings on the use of informal help, professional help, and insurance coverage. Suggestions for future research directions for those interested in the help-seeking behavior of black Americans are provided.

Adolescent↗

Treatment of anxiety in the cognitively impaired elderly: can cognitive-behavior therapy help?

Anxiety is commonly reported in patients with dementia, resulting in a further decline in functioning. An overview of the clinical application of cognitive-behavioral techniques in treating anxiety in elderly patients with brain damage is presented. Two cases are described with a focus on clinical anxiety management techniques that have been modified to suit cognitively impaired elderly patients. These modifications include simplifying material, using more structured techniques, and recognizing the critical role of the patient's caregiver in therapy. It is concluded that cognitive-behavior therapy can help in reducing anxiety in the demented population; the potential benefits of this therapy are an increase in patients' self-esteem and independence and the prevention of hospitalization.

Aged↗

Families of adolescent clients and nonclients: their environments and help-seeking behaviors.

Family demographic characteristics, family structure, family environment, and help-seeking variables were explored through interviews with two groups of Afro-American adolescents, including 52 clients and 52 nonclients. One parent of each adolescent was also interviewed. The ratio of single-parent families in the two groups differed significantly. Using one-way analysis of variance, significant differences were found between the means of the groups on five of the ten Family Environment Scale (FES) subscales. The family groups differed significantly on only one help-seeking variable, use of formal helpers. Adolescent client families reported using formal helpers more than did adolescent nonclient families (F = 2.69; df 102; p less than 0.05).

Adolescent↗

Help-seeking behaviors in relatives of schizophrenics in Taiwan.

Despite its merits, the Western-style psychiatric community rehabilitation model is not well accepted by caregivers in Taiwan. We examined factors affecting the utilization of community rehabilitation programs in Taiwan. Our stepwise logistic regression revealed that psychoeducation regarding the biological cause of schizophrenia emerged as the major factor for increasing utilization treatment modality. Eighty-nine pairs of schizophrenic patients (who had been recommended for rehabilitation) and their relatives were divided into two groups, the rehabilitation group and the nonrehabilitation group. Both groups were surveyed on help-seeking behavior scales and mental function measurements. The results showed no significant differences in patients' psychopathology, though the rehabilitation group had higher employment rates. As for caregivers, the rehabilitation group scored significantly better on some cognitive appraisals, whereas the nonrehabilitation group was more inclined to institutionalize the patients for life. No significant differences were noticed on rejection attitude, subjective care burden, or expressed emotion measures. Improving caregiver's knowledge about the disease, providing activities that lend emotional, physical, and financial support and thereby reduce the burden and increase the satisfaction of caregivers may be useful. Besides making the Western-style psychiatric community rehabilitation model more effective and accessible for patients and caregivers in Taiwan, cultural adaptation is also needed.

Adolescent↗

Help-seeking behavior prior to nearly lethal suicide attempts.

The association between help-seeking and nearly lethal suicide attempts was evaluated using data from a population-based, case-control study of 153 13- to 34-year-old suicide attempt case-patients treated at emergency departments in Houston, Texas, and a random sample of 513 control-subjects. Measures of help-seeking included whether the participant sought help for health/emotional problems in the past month, type of consultant contacted, and whether suicide was discussed during the interaction. Overall, friends/family were consulted most frequently (48%). After controlling for potential confounders, case-patients were less likely than control-subjects to seek help from any consultant (OR = 0.5, 95% CI = 0.3-0.8) or a professional (e.g., physician, counselor) consultant (OR = 0.5, 95%CI = 0.29-0.8). Among those who sought help, case-patients were more likely than to discuss suicide (OR = 2.6, 95% CI = 1.2-5.4), particularly with professionals (OR = 11.8, 95% CI = 3.2-43.2). Our findings suggest that efforts to better understand the role of help-seeking in suicide prevention, including help sought from family and friends, deserves further attention.

Adolescent↗

Giving and receiving help: interpersonal transactions in mutual-help meetings and psychosocial adjustment of members.

The helping transactions that occur in group meetings have been theorized to be important therapeutic mechanisms within mutual-help (or self-help) groups. Hypothesized links between giving and receiving help and psychosocial adjustment were examined in a mutual-help group for individuals with serious mental illness (GROW). Participants' adjustment was assessed at two time points and helping behaviors were measured with observational coding of weekly group interactions during the period between assessments. Frequencies of helping behaviors were used to predict Time 2 adjustment after controlling for initial adjustment. Consistent with the helper therapy principle, giving help to others predicted improvements in psychosocial adjustment; giving advice was a unique predictor. Total amount of help received was not associated with adjustment, but receiving help that provided cognitive reframing was associated with better social adjustment. A predicted interaction suggested that receiving help was related to better functioning when members experienced high levels of group integration.

Adaptation, Psychological↗

Organizational citizenship behavior and the quantity and quality of work group performance.

Despite the widespread interest in the topic of organizational citizenship behaviors (OCBs), little empirical research has tested the fundamental assumption that these forms of behavior improve the effectiveness of work groups or organizations in which they are exhibited. In the present study, the effects of OCBs on the quantity and quality of the performance of 218 people working in 40 machine crews in a paper mill located in the Northeastern United States were examined. The results indicate that helping behavior and sportsmanship had significant effects on performance quantity and that helping behavior had a significant impact on performance quality. However, civic virtue had no effect on either performance measure.

Adult↗

Family practice house officer perceptions of faculty teaching behaviors.

In 1985, Wolverton and Bosworth published an often referenced study of family practice teaching behaviors. Their research identified 20 "most helpful" and 10 "least helpful" behaviors. In 1994 all United States Army family practice house officers were asked by survey to rate each of the original 38 Wolverton and Bosworth teaching behaviors as "not at all helpful," "somewhat helpful," "moderately helpful," "very helpful," or "most helpful" in aiding their learning. Mean values were calculated for each teaching behavior. Twenty most helpful and 10 least helpful faculty teaching behaviors were identified for U.S. Army family practice house officers; several differences were identified in comparison with Wolverton and Bosworth's original study. Additionally, three most helpful and four least helpful teaching behaviors were clearly illuminated. Incorporating the results of this new study into residency programs could improve the learning opportunities afforded family practice house officers during their internships and residencies.

Attitude of Health Personnel↗

[Can adolescents with behavioral disorders be helped? Problems among young people--behavioral disorders--preventive attempts--follow-up studies--evaluation].

Adolescents with serious behavioural disorders are often met with pessimism and neglect. Too often the prisons become the caretaker. The paper presents a follow-up study from a five year project in Buskerud county. The aim was to find alternatives for adolescents under 16 years of age with serious behaviour problems. The project included 70 youngsters aged 13-16. After a follow-up period of 3-7 years, 61% were found to be in a good situation without criminality or drug abuse. Child care communes and special foster homes were found to be most effective with a success rate of 80%.

Adolescent↗

Conceptualization of psychiatric illness and help-seeking behavior among Chinese.

Problem conceptualizations of Chinese psychiatric patients were studied in relation to the patterns of help-seeking and ways of coping. Patients who conceptualized their initial problems in purely psychological terms were more likely to use self-directed psychological coping methods, delay initial professional consultation, and approach mental health professionals. Patients who used only somatic concepts were least likely to approach mental health professionals initially or any time during their previous consultation history, and tended to approach medical resources to cope with their problems. Patients who conceptualized their problems in mixed terms approached professional help early on and reached psychiatric resources soonest. These results provide a clearer perspective to understand the somatization tendency among Chinese patients.

Adaptation, Psychological↗

Cognitive behavioral and behavioral interventions help young children cope during a voiding cystourethrogram.

OBJECTIVE: To reduce young children's distress and increase coping behavior among children undergoing a voiding cystourethrogram (VCU). METHODS: Three- to seven-year-old children were stratified based on prior VCU experience and randomly assigned to an intervention (n = 20) or a standard care (n = 20) condition. The intervention included provision of information, coping skills training, and parent coaching. We hypothesized that the intervention would reduce children's distress as assessed by child report, parent and technician ratings, and behavioral observations. RESULTS: Children in the intervention displayed fewer distress behaviors and greater coping behaviors and were rated as more cooperative than children receiving standard care. Children's fear and pain ratings did not differ significantly between groups. CONCLUSIONS: A cognitive-behavioral treatment package effectively reduced children's distress, increased coping, and increased cooperation during voiding cystourethrogram procedures. This type of an intervention should be integrated into routine pediatric radiological procedures.

Adaptation, Psychological↗

Help-seeking behavior in families of schizophrenics.

To meet the exigencies of coping with the onset of schizophrenia in the family, caregivers sought out an array of professional and nonprofessional supports. The respondents to a questionnaire, all members of a self-help group, reported considerable merit to the help of friends, relatives, and group members. In contrast, the various forms of therapy were valued little; nearly half found no value at all. These findings are better understood when needs of families are expressed. Of highest priority are understanding of the illness, practical guidance in patient management, and community resources such as housing. These are not typical functions of therapy. Self-help groups may serve these needs better.

Adaptation, Psychological↗