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PubMed1991

General strategies for motivating people to change their behavior.

There is evidence of nurse dissatisfaction with the outcomes of patient education; some patients are seen as insufficiently motivated to change their health-related behavior. Research findings from the field of health psychology are relevant to the issue of increasing patient motivation to change. In terms of motivating health behavior change, the research findings indicate the importance of the client's belief in the severity of threat to health and personal vulnerability, as well as in the feasibility and effectiveness of a particular health measure. The HBM has generated much research confirming the importance of these beliefs. Research evidence also indicates the importance of the self-efficacy mechanism as a predictor of such outcomes as cessation of smoking and returning to a physically active life after a heart attack. There are unsettled questions about the role of fear in motivating behavior change, but experts agree that high levels of induced fear may result in denying or ignoring the threat. If fear is used, it must be coupled with recommendations for efficacious behavior change. The findings of attitude-change research have yielded practical information on increasing the persuasiveness of information appeals using such techniques as saving the most important point for the beginning and end of the message. Techniques such as self-monitoring and systematic desensitization are also available to help motivate change. The problem of maintaining behavior change is challenging, and further research is needed on how best to prevent relapse or to aid clients in restoring change once relapse occurs. The experts advise tailoring the interventions to aid maintenance of behavior change to the particular stage of change. For example, bolstering motivation to change is important in the initial stage. As important providers of health care education, nurses need to be fully informed of the research findings relevant to effective interventions designed to motivate health-related behavior change.

Health Behavior↗
PubMed1979

Development and evaluation of social skills training for schizophrenic patients in remission.

Investigated were measures of self-esteem, self-perceived attitudinal dimensions and locus of control to assess the effects of group social skills training for schizophrenic psychiatric inpatients. A pretest, posttest control group design was employed utilizing forty subjects currently in treatment. It was hypothesized that short-term cognitively structured group therapy would realize significant improvement in self-esteem, internal locus of control and assertive attitude change. Significant mean differences between the treatment group's level of self-esteem, perceived assertive behavior and internal locus of control as a result of treatment were realized. Discussion of training methodology, issues and import for clinical applications and research are discussed.

Behavior Therapy↗
PubMed1990

Empowerment and persons with cancer: politics in cancer medicine.

Persons with cancer are likely to encounter a loss of personal control as a result of their illness experience. An empowerment perspective, which emphasizes the possibility of patients "owning their own lives", is useful for understanding the interpersonal and social dynamics of patients' loss of control and for guiding the development of strategies aimed at maximizing control. Because the factors influencing an individual's sense of control are multi-leveled, optimal empowerment occurs when strategies are employed at several levels of social organization. In this paper, a number of barriers to the empowerment of cancer patients are identified and strategies recommended to enhance patient empowerment in cancer care. The empowerment needs and strategies discussed here include: (a) the provision of optimal care, (b) the enhancement of individual patient power, (c) the development of a strong consumer voice in policy decision-making processes, and (d) societal attitude change.

Attitude↗
PubMed1979

Effect of discussion seminars on the attitudes of dental students to clinical periodontal problems.

The effect of discussion seminars on the attitudes toward clinical problems within four affective domains in periodontics was studied in undergraduate dental students. Specially prepared case presentations which highlighted clinical problems were used in the seminars as well as for the evaluation. The tests were based upon the assumption that the viewpoints of the periodontal teachers are the correct ones and can be used to identify the affective objectives. The results of the present study indicate that the students' attitudes changed and became similar to the viewpoints of the faculty as an effect of the discussion seminars. This observation speaks in favor of the use of such seminars for effective teaching as a supplement to didactic teaching and clinical instruction.

Attitude↗
PubMed1978

[Influence of an active attitude towards induction of labour, on the occurrence of pathological amniotic fluid - a comparison of the birth years 1967 and 1976 (author's transl)].

An analysis was made of discolored amniotic fluid when our attitude changed towards artificial birth induction. Whereas during 1967 only 8.2% of all births were induced, the total birth inductions during the second comparable year increased to 23.5%. This active interference at the end of the gestation period made it possible to reduce the occurrence of discolored amniotic fluid cases from 13.6% to 6.4%. It was thereby established that the lowered perinatal mortality was partially due to this very significantly reduced occurrence of discolored amniotic fluid. The increased surgical termination of pregnancy, in this group lowered the infant mortality from 2,1% to 0,9%. Based on our observations we feel that in a secured gestation period close to the end of term, active obestrical interference is indicated and in cases of discolored amniotic fluid immediate assistance in terminating the pregnancy is required.

Amniotic Fluid↗
PubMed1977

Reducing the risk of cardiovascular disease: effects of a community-based campaign on knowledge and behavior.

In 1972 the Stanford Heart Disease Prevention Program launched a three-community field study. A multimedia campaign was conducted for two years in two California communities (Watsonville and Gilroy), in one of which (Watsonville) it was supplemented by an intensive-instruction program with high-risk subjects. A third community (Tracy) was used as a control. The campaigns were designed to increase participants' knowledge of the risk factors for cardiovascular disease, to change such risk-producing behavior as cigarette smoking, and to decrease the participants' dietary intake of calories, salt, sugar, saturated fat, and cholesterol. Results of a sample survey indicate that substantial gains in knowledge, in behavioral modification, and in the estimated risk of cardiovascular disease can be produced by both methods of intervention. The intensive-instruction program, when combined with the mass-medica campaign, emerged as the most effective for those participants who were initially evaluated to be at high risk. The results after two years of intervention are reported for effects on knowledge and behavioral change for the total participant samples and for the high-risk subsamples in each of the three communities.

Attitude to Health↗
PubMed1992

Relationship of AIDS-related attitudes to sexual behavior changes in adolescents.

The impact of the acquired immunodeficiency syndrome (AIDS) epidemic on a group of adolescents was investigated by surveying 197 sexually active, predominantly African-American, urban high school students. Reported sexual behavior changes were evaluated in relation to AIDS-related knowledge and attitudes. Over 50% of the students decreased their frequency of sexual activity, increased their condom use, and/or decreased their number of partners. These students had significantly higher scores on a measure of worry about vulnerability to human immunodeficiency virus (HIV) infection than those whose behavior had not changed. AIDS knowledge, AIDS beliefs, and AIDS-related anxiety interacted with gender to affect sexual behavior change. Male students reporting decreased frequency of sexual activity, for example, had more accurate beliefs about AIDS than males reporting no decrease. Among female students, however, those reporting decreased frequency had less accurate beliefs than those reporting no decrease. These results highlight the importance of considering gender and specific sexual behaviors when designing AIDS education interventions.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Complacency, risk perception and the problem of HIV education.

Many public surveys on the issue of HIV and AIDS have concentrated on the relationship between attitudes and knowledge. Often this relationship has been found wanting or at most tenuous. A recent survey of 1,002 people in Wales has supported these earlier findings, but found additionally that discriminatory and complacent attitudes on AIDS or towards people with the 'AIDS virus' are held by a significant proportion of the population. The survey also discovered that people correctly perceive the risk of HIV infection as being minimal. Depending on the question 17%-65% of the sample expressed discriminatory attitudes towards people that have the 'AIDS virus'. There was also no marked change over previous surveys in the degree of complacency surrounding AIDS. Younger people (aged (15-34) considered themselves to be more at risk of infection with the 'AIDS virus' but overall the perceived risk of infection was low. A sustained low key education programme in a variety of settings and independent of perceived risk is necessary to combat prejudice and complacency.

Adolescent↗
PubMed1992

An experiential program to reduce AIDS risk among female sex partners of injection-drug users.

This article describes the development and implementation of an acquired immune deficiency syndrome (AIDS) intervention program for female sex partners of male injection-drug users. Four psychoeducational workshops were designed to motivate personal risk reduction, provide participants with necessary cognitive and behavioral skills, and enhance participants' perceived ability to enact positive changes in their lives. The development of the workshop modules was guided by traditional theories of health behavior change and social learning. Also included in the intervention are referral and advocacy services, personal risk reduction counseling, and human immunodeficiency virus (HIV) antibody testing. Preliminary results indicate that the program has made a significant impact on the AIDS risk of participants--91 percent of women who completed the program reported that they had made positive changes in their lives to reduce their risk of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed2024

Emotional and Cognitive Processes Underlying Persuasion, Moderating Factors, and Physiological Reactions: A Systematic Review.

Persuasion is a type of social influence aiming to produce changes in others' attitudes or behaviors. This study explores the relationship between emotions and persuasion, principal moderating factors, and physiological reactions during persuasive attempts. Following PRISMA guidelines, 28 empirical articles were analyzed, addressing emotions, affective/cognitive orientations, framing effects, and psychophysiological reactions. Mixed findings emerged regarding emotions, with fear appeals being effective in health education, while more recent studies favor the use of positive persuasive messages to increase behavior intention. Principal moderating factors included personal relevance, need for cognition (NFC) and need for affect (NFA), thought confidence, vulnerability, and efficacy beliefs. Psychophysiological studies revealed distinct physiological arousal during persuasion processing compared to a rest state. In addition, a greater misalignment between current behavior and the persuasive attempt led to perceived freedom threat and psychological reactance. These insights enhance persuasive effectiveness and deepen understanding of persuasion processes, guiding future research directions.

Humans↗
PubMed1992

Abortion attitudes, 1984-1987-1988: effects of item order and dimensionality.

The comparability of surveys is often hampered by differences in the item order of presentation. The major focus of the present study was to investigate whether a general item or a specific item at the beginning of the questionnaire would affect the endorsement as well as the scalability of a set of attitude items. By using a quasi-A-B-A experimental design for the six abortion items that appeared in the Edmonton Area Survey for the years 1984, 1987, and 1988, we found that the order of presentation of the items affected dramatically the endorsement of the abortion items. Approval of a general item was considerably higher when asked first than when asked after a specific item. In contrast, it was shown by means of a nonparametric item response theory model (the Mokken scale analysis) that the unidimensionality of the six abortion items was not affected by the manipulations of item order (i.e., the six abortion items measured the same concept in the three surveys). It was concluded that the six items are unidimensional and, therefore, create a single scale to measure the change in abortion attitudes across the three periods.

Abortion, Legal↗
PubMed1992

Black males who always use condoms: their attitudes, knowledge about AIDS, and sexual behavior.

One hundred six black males completed a questionnaire concerning attitudes and knowledge about the use of condoms and acquired immunodeficiency syndrome (AIDS). Of the 106 males in the study, 27 (26%) reported that they "always" used condoms, 31 (29%) did not use condoms and had low intentions of using them, and 48 (45%) reported high intentions to use condoms. Results indicated that knowledge about AIDS was exceptionally high for black males in all three groups. Black males with low intentions to use condoms reported significantly more negative attitudes about the use of condoms (eg, using condoms is disgusting) and reacted with more intense anger when their partners asked about previous sexual contacts, when a partner refused sex without a condom, or when they perceived condoms as interfering with foreplay and sexual pleasure. A significantly larger percentage of low intenders were treated for gonorrhea, syphilis, herpes, and genital warts than males in the other groups. Drug use did not differentiate the three groups, although marijuana was used more often by males in the low-intender group. Finally, a larger percentage of black males in the low-intender group reported experiences with anal intercourse and sex with a prostitute, but considered themselves at lower risk for AIDS than did their high-intender or steady-user counterparts.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Attitudes to AIDS and sexual behaviour among a cohort of medical students in Singapore.

A survey conducted in 1990 among final year medical students found that most respondents had a good knowledge about AIDS and its routes of transmission. Among the 13.7% of respondents that were sexually active, it was noted that only 35% had used the condom before and that only 20% had used it in the most recent occasion of sexual intercourse. It was noted that only 30% of the sexually active had intention using the condom when they next have sexual intercourse despite the fact that 40% of them were having sexual intercourse with causal partners. Despite having a high knowledge of AIDS, medical students at the National University of Singapore have a low use of condoms.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Complications in a series of 1224 vasectomies.

BACKGROUND: The assessment of a vasectomy technique should be based on the incidence of complications resulting from the procedure. Differing diagnostic criteria for defining complications and the belated occurrence of some adverse events, however, have made such appraisals difficult. The purpose of this paper is to suggest criteria for defining vasectomy-related problems and to present the results of a long-term study of 1224 vasectomies. METHODS: The records of 1224 men who had a vasectomy performed by the same technique during a 4-year period were reviewed, and documented complications were tabulated and evaluated. Patients were referred residents of the lower mainland of British Columbia, and the majority were married. The group included a wide spectrum of ages, races, and occupations. Twelve categories of potential complications were defined, of which 10 were actually encountered in the study group. Infection was defined as having had antimicrobial drugs prescribed, and regret as having returned to discuss a reversal; all other complications were diagnosed based on a documented clinical diagnosis. RESULTS: Complications had been documented in 124 cases (10.6%) and included 46 minor infections (3.8%), 2 serious infections (0.16%), 23 instances of epididymitis (1.9%), 16 cases of sperm granuloma (1.3%), and 4 minor hemorrhages (0.33%). Of 3 failures, only one (0.08%) was due to recanalization. No serious hemorrhages or late failures were seen. CONCLUSIONS: Satisfactory results were believed to be related to surgical technique and the liberal use of antimicrobial drugs. The low recanalization rate was attributed to the treatment of the ends of the vas with multiple loops of polyglycolic acid ligature.

Adult↗
PubMedDate not supplied

The behaviour of health care providers in managing diarrheal disease in Palembang City, south Sumatera, Indonesia.

A study on knowledge, attitude and practice of health care providers in Palembang had been conducted at the end of 1989 and beginning of 1990. Four approaches were carried out: (1) by recording the help obtained by cases who consulted researchers for further help for the same diarrheal diseases (DD) episode, (2) by studying the medical records of DD cases admitted to three hospitals, (3) by studying prescriptions dispensed by three pharmacies and (4) by focus group discussions. The findings were analysed to evaluate the achievement of the Indonesian Diarrheal Diseases Control Program (CDD). ORT, avoiding antimotility drugs and appropriated feeding have been accepted and practiced by the providers in Palembang. The target of promotion now is to support the acquisition of these behaviours to be implemented as a routine habit of the providers and as a part of the ongoing system of health care delivery system. Specifically the danger of loperamide promotion to the policy on antimotility must be stressed. Rapid iv rehydration and avoiding surface precipitating agents have been accepted, but are not practiced consistently yet due to practical considerations. It seems that there is no impact at all of CDD towards the rate of antibiotic therapy in DD. Besides intensifying the campaign, enforcing group pressure, may be we have to elaborate more the perception of health care provider as a practitioner, and conforming the strategy of the CDD campaign towards the findings. Health education had not been practiced effectively yet. Morale and value system of the providers are important for the success of this program. In general the medical-technic aspect of the CDD has been accepted by the providers, but there is still a lot to do in communicating them to be adopted as an effective behaviour.

Anti-Bacterial Agents↗
PubMedDate not supplied

Tailoring family planning services to the special needs of adolescents.

Experimental service protocols tailored to the needs of teenage family planning patients were developed that emphasized indepth counseling, education geared to an adolescent's level of development, and the provision of reassurance and social support. These protocols were tested against usual service delivery practices in a study involving 1,261 patients under 18 years of age at six nonmetropolitan family planning clinics. A comparison with teenagers obtaining services at control sites found that six months after their first clinic visit, patients at the experimental sites were more likely to be using a method, were less likely to experience difficulty in dealing with problems, were more likely to continue using their method despite problems and had learned more during the educational session. Teenage patients at the experimental clinics were also less likely to have become pregnant within one year than those who went to control clinics. Attrition during the year following the first study visit was similar among both groups; patient satisfaction was very high, and equivalent at experimental and control sites. The data show that the extra time and effort required to meet the special needs of teenagers is justified by their improved contraceptive use, greater knowledge and lower pregnancy rates.

Adolescent↗