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PubMed1983

Exploring patient beliefs. Steps to enhancing physician-patient interaction.

Most physicians are skilled at collecting medical information important for clinical diagnosis. However, they obtain less information about the attitudes and beliefs patients have about their illnesses. Patients' beliefs determine their responses to an illness and the strategies they use for coping with it. Without knowing those beliefs, physicians may find themselves and their patients frustrated by misunderstandings and differing agenda. Beliefs can be explored fairly simply by careful listening and a few directed questions. Once recognized, they can be modified or incorporated into joint approaches to treatment. Learning patients' beliefs is an important early step in developing the physician-patient relationship.

Adolescent↗

PubMed1994

Mental contamination and mental correction: unwanted influences on judgments and evaluations.

We define mental contamination as the process whereby a person has an unwanted response because of mental processing that is unconscious or uncontrollable. This type of bias is distinguishable from the failure to know or apply normative rules of inference and can be further divided into the unwanted consequences of automatic processing and source confusion, which is the confusion of 2 or more causes of a response. Mental contamination is difficult to avoid because it results from both fundamental properties of human cognition (e.g., a lack of awareness of mental processes) and faulty lay beliefs about the mind (e.g., incorrect theories about mental biases). People's lay beliefs determine the steps they take (or fail to take) to correct their judgments and thus are an important but neglected source of biased responses. Strategies for avoiding contamination, such as controlling one's exposure to biasing information, are discussed.

Cognition↗

PubMed2001

Whose evidence counts? An exploration of health professionals' perceptions of evidence-based practice, focusing on the maternity services.

OBJECTIVES: to gain an insight into how health professionals in the maternity services define evidence and how they perceive different types of evidence are valued in maternity care. DESIGN: using a qualitative approach data were collected by semi-structured interviews: the content of each was analysed thematically. SETTING: England. PARTICIPANTS: a purposeful sample of ten midwives, two obstetricians and one research nurse. FINDINGS: definitions of evidence vary widely among health practitioners. These definitions are affected by individuals' own beliefs and give rise to a hierarchy in which some types of evidence are valued above others. All the participants made direct or indirect reference to cultural beliefs inherent within the health service, and indicated that these beliefs determine the extent to which different types of evidence are seen as legitimate. IMPLICATIONS FOR PRACTICE: the concept of evidence-based practice is not value-free. Evidence that reinforces notions of authoritative knowledge may be transposed into clinical practice quickly and easily. Conversely, health practitioners may have difficulty putting evidence into practice that challenges the cultural norms of the profession. There is a need for further work to make explicit the values that underpin different sources of knowledge and expose the hierarchies of evidence that exist.

Anecdotes as Topic↗

PubMed2005

Prior belief and polarity in multicue learning.

We report two experiments in which participants are trained using a multicue probability learning (MCPL) task, which attempts to simulate the acquisition of expert judgement by experience in the real world. Participants were asked to predict performance in certain occupations given a profile of personality test results with trial-by-trial outcome feedback. Only some cues were relevant, and the polarity of the cues (positive or negative predictors) was unspecified. In addition, 25% of random noise was added to the feedback to simulate real world uncertainty. The main factor of interest was that the role of prior belief (determined in a separate study of stereotypes) interfered with the learning process. Experiment 1 failed to find any influence of prior belief in the cues that were irrelevant to the criterion being trained. However, in Experiment 2 people learned to use the relevant cues better when their effect conformed with rather than conflicted with prior belief Both experiments showed strong effects of cue polarity, with positive predictors much more easily learned. The results are discussed with reference to the cognitive processes involved in MCPL and closely related tasks.

Achievement↗

PubMed2005

Prevalence, consequences, and determinants of nonadherence in adult renal transplant patients: a literature review.

This literature review summarizes the evidence on the prevalence, determinants, clinical and economic consequences of nonadherence with immunosuppressive drugs in renal transplant patients. A literature search yielded 38 articles measuring nonadherence by self-report, collateral report, assay, refill prescriptions or electronic monitoring. The weighted mean prevalence of self-reported nonadherence was 28%. Nonadherence is associated with poor clinical outcomes, contributing to 20% of late acute rejection episodes and 16% of the graft losses (weighted means). In addition, nonadherence results in lower lifetime costs because of shorter survival, yet also in a lower number of quality adjusted life years. Consistent determinants of nonadherence were younger age, social isolation, and cognitions (e.g. low self-efficacy, certain health beliefs). Determinants concerning the health care system/team seem to be under-investigated. Because the evidence summarized in this review is based on older immunosuppressive regimens, further research should focus on prevalence, determinants and consequences of nonadherence with newer immunosuppressive regimens.

Adult↗

PubMed1995

Euthanasia: mercy, morals and medicine.

The case of Sue Rodriguez has made it painfully clear that it is the ethical responsibility of every nurse to become involved in the debate on euthanasia. If advocacy is the essence of nursing,as has been suggested, then that advocacy must extend to clients such as Rodriguez. It is our responsibility to help our clients reach decisions that are truly their own, to help them determine the unique meaning that health, illness, suffering and dying have for them as individuals. It is also our responsibility to assist our clients to exercise their freedom of self-determination. To participate fully in this debate it is essential that we examine our own beliefs, determine how they concur or conflict with our role as client advocates, and how they apply to this issue.

Amyotrophic Lateral Sclerosis↗

PubMedDate not supplied

Understanding the determinants of preventive oral health behaviours.

Achieving oral health for the client is the goal of dental hygiene practice. The two major threats to oral health, dental caries and periodontal disease, can almost always be controlled if clients adopt appropriate oral health behaviours. A review of the literature indicates that many factors determine whether or not a client will adopt appropriate oral health behaviours. These factors include demographics, socialization, emotional status, perceptions and dental beliefs. Determining a client's attitudes towards oral health requires the active participation of both the client and the dental hygienist. Interview techniques borrowed from participatory and ethnographic research can be used during the assessment phase of the dental hygiene process to allow the dental hygienist to systematically explore the factors that may affect the practice of preventive oral health behaviours. Data gathered during this phase can then be used in the planning phase of the dental hygiene process to develop a strategy which is specifically designed to meet the assessed needs of the individual client.

Dental Hygienists↗

PubMed1997

Mortality risk perceptions: a Bayesian reassessment.

"This study uses data on perceived and actual mortality risks to test several alternative Bayesian models of the factors influencing risk beliefs. The analysis...indicates that while the hazard rate for the individual age group is an influential factor, the overall population death rate and the discounted expected number of life years lost due to the cause of death are also influential in affecting risk perceptions.... The predictive power of a linear perception model increases with the level of the risk and is least accurate for very small risks."

Behavior↗

PubMed1992

Context and content: the impact of school-leaving and school-based health education on AIDS-relevant cognitions.

A survey examined health beliefs and intentions among 690 16-18 year-olds in Dundee. Respondents in the younger cohort (n = 363) were classified according to their educational situation (at school vs left) and self-reports of having received AIDS/HIV-relevant health education. Both remaining in school and receiving AIDS/HIV-relevant health education had independent beneficial effects, but the effects of leaving school also interacted with sex of respondent and with amount of relevant education received prior to leaving. Males' and females' reliance on mass media and other information sources diverged once they left school, indicating that males who leave school early are most likely to disregard useful or important information regarding AIDS. Consistent with this finding, leaving school reduced the difference between males' and females' intention to use condoms with a new partner. The beneficial impact of having previously received AIDS/HIV-relevant education on beliefs concerning the controllability of the epidemic and on feeling worried about everyday contact with a person with HIV/AIDS, was most marked among those who had left school. The results are discussed in terms of their implications for health education strategies.

Adolescent↗