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1.
Electronic caps, pill caps that record the date and time of pill bottle opening provide an objective measure of adherence to prescribed medication. A promising intervention to improve adherence, cue-dose training, involves reviewing patients' pill cap-generated reports concerning their medication-taking and offering individualized recommendations for remembering to take medications at specific times of day. In this preliminary study, 79 patients prescribed the antihyperglycemic medication metformin had adherence assessed during a 4-week baseline period. Adherence, defined as proportion of prescribed doses taken within a predetermined 4-h window, was measured using electronic MEMS caps. Those who had less than 80% baseline adherence (n = 33) were randomly assigned to either receive 4 months of cue-dose training (n = 16) or to a control group (n = 17). Cue-dose training was associated with significantly better adherence to metformin (mean improvement of 15%). The effects of cue-dose training on adherence to other antihyperglycemic medication did not reach statistical significance. Glycosylated hemoglobin (a measure of blood sugar control) did not differ between groups. Data from nine patients who reviewed pill cap-generated data with their primary care providers suggested that both patients and providers found the discussion moderately helpful and not at all uncomfortable.  相似文献   

2.
Advances in the medical treatment of HIV have made it clear that adherence to highly active antiretroviral treatment is a crucial feature for treatment success. The present paper had two goals: (1) to examine psychosocial predictors of adherence in persons receiving HIV antiretroviral therapy; (2) to compared two minimal-treatment interventions to increase HIV medication adherence in a subset of persons who self-reported less than perfect adherence. One of the interventions, Life-Steps, is a single-session intervention utilizing cognitive-behavioral, motivational interviewing, and problem-solving techniques. The other intervention, self-monitoring, utilizes a pill-diary and an adherence questionnaire alone. Significant correlates of adherence included depression, social support, adherence self-efficacy, and punishment beliefs about HIV. Depression was a significant unique predictor of adherence over and above the other variables. Both interventions yielded improvement in adherence from baseline, and the Life-Steps intervention showed faster improvements in adherence for persons with extant adherence problems.  相似文献   

3.
The purpose of this study was to determine the effects of different levels of eye contact and fluency on observers' perceptions of a speaker. One of four videotapes depicting an actor (playing the part of a supervisor) interviewing another actor (who played a subordinate) were shown to 127 college students. The four videotapes represented four different conditions comprising combinations of fluent vs nonfluent speech and normal vs low eye contact. Results indicated that these combinations of fluency and eye contact differentially influence listeners' perceptions of a speaker. Highest ratings were obtained for the fluent-normal eye-contact speaker, with lower ratings for all other conditions. In addition, it was determined that the frequency of eye contact rather than fluency was more strongly related to listeners' perceptions. The clinical implications of these findings are discussed.  相似文献   

4.
OBJECTIVE: This study examined whether social network size and partner stress predicted medication adherence, cardiac rehabilitation attendance, and quality of life 12 months following hospitalization for an acute coronary syndrome (ACS). DESIGN: ACS patients (N = 193, M age = 60.6 years, SD = 11.4 years, 23% female) were recruited shortly following admission to 4 local hospitals. A prospective design was employed with follow-up data collected 12 months following hospital admission. MAIN OUTCOME MEASURES: Data were gathered on social network size and partner stress. The main outcomes assessed at 12 months were medication adherence, cardiac rehabilitation attendance, and quality of life (Short Form 36). RESULTS: Partner stress predicted medication nonadherence, odds ratio: 2.89, (95% CI = 1.21, 6.95). ACS patients with large social networks were more likely to attend rehabilitation, odds ratio: 3.42, (95% CI = 1.42, 8.25). Analyses were adjusted for age, gender, clinical risk scores, readmission/recurrence, and negative affectivity. Both partner stress and smaller social network size were associated with poorer quality of life. CONCLUSION: Social network size and partner stress may partly exert their influence on coronary heart disease morbidity and mortality through recovery behaviors and maintenance of quality of life.  相似文献   

5.
ObjectiveFor many injured athletes, a safe and successful return to sport following injury is the ultimate aim of injury recovery. Little consensus exists however, regarding the meaning of a “successful” return to sport following injury recovery [Evans, L., Mitchell, I., &; Jones, S. (2006). Psychological responses to sport injury: a review of current research. In S. Hanton, &; S. D. Mellalieu (Eds.), Literature reviews in sport psychology (pp. 289–319). New York, NY: Nova Science Publishers]. The purpose of this investigation was to obtain greater insight into this issue by examining high-level athletes' perceptions of a successful return to play following injury.MethodUsing a longitudinal design, 12 elite athletes from Australia and Canada were interviewed on a total of 40 occasions over a six–eight month period.ResultsPerceptions of success centered on (but were not limited to): a return to pre-injury levels and attaining pre-injury goals, staying on the “right” path, creating realistic expectations of post-injury performance, and remaining uninjured.ConclusionsConsistent with previous research [Podlog, L., &; Eklund, R. C. (2007a). Professional coaches perspectives on the return to sport following serious injury. Journal of Applied Sport Psychology, 1, 44–68], findings from this investigation highlight the importance of self-determination theory (SDT) constructs – namely, competence, autonomy and relatedness – in relation to athlete perceptions of a successful return to sport from injury. Such findings support the value of an SDT perspective in guiding future research and intervention efforts aimed at facilitating successful return from injury.  相似文献   

6.
Locus of control as a moderator of the relationship between medication barriers (e.g., side-effects, forgetting to take medication, and keeping track of pills) and anti-hypertensive medication adherence was examined. Baseline data were obtained from 588 hypertensive veterans. In general, fewer medication barriers, higher internal locus of control and lower external locus of control was associated with better hypertensive medication adherence. Furthermore, internal locus of control served as a moderator (beta = -.74, p < .01) for the relationship between medication barriers and medication adherence; effect size was large. Decomposition of the interaction revealed that the relationship between medication barriers and medication adherence was strongest when internal control was high (b = -.24, p < .01). Higher internal locus of control was beneficial when barriers to medication adherence are low, but at high perceived barriers, locus of control plays less of a role in medication adherence. Future efforts to improve medication adherence should consider the patient's perceived level of medication barriers in conjunction with their locus of control.  相似文献   

7.
New treatments for HIV can improve immune functioning and decrease mortality. However, lapses in adherence may render these complex regimens ineffective. Sixty-three men and 9 women on highly active antiretroviral therapy completed measures of medication adherence, psychological characteristics, and barriers to adherence. HIV viral load, a health outcome measure of virus amount present in blood, was also obtained. The sample was 36% African American and 56% Caucasian, with 35% reporting disability. Nearly one third of patients had missed medication doses in the past 5 days, and 18% had missed doses weekly over the past 3 months. Frequency of missed doses was strongly related to detectable HIV viral loads. Depression, side-effect severity, self-efficacy, and social support distinguished patients with good and poor adherence. Barriers also varied with adherence level. Implications for interventions promoting HIV treatment adherence are discussed.  相似文献   

8.
This study examined whether there is overall agreement amongst professional cricketers on the factors which are most important for the occurrence of repeatable good performances in the sport. Also, the consistency of the rank-order of such variables was investigated across individuals and roles within the same sport. A total of 198 cricketers (100 batters and 98 bowlers) who play or have played first class cricket in the English County Championship completed a rank-order task, which enabled them to use their experiences to judge the importance of 15 selected performance-influencing variables. Cultural consensus analysis indicated that no one factor for either batters or bowlers was significantly more important, despite many batters and bowlers ranking the need for 'total self-confidence' highest. Whilst no over-all agreement was found for batters and bowlers in their ranking of variables, a group of similar 'core elements', e.g., total self-confidence, following a set prematch routine, set performance plans, optimal arousal, and using mental rehearsal, were highly ranked by both groups, which may be an important consideration for practitioners endeavoring to produce strategies that encourage more consistent and higher performance for cricketers.  相似文献   

9.
Why it won't happen to me: perceptions of risk factors and susceptibility   总被引:14,自引:0,他引:14  
Four studies were conducted with college student subjects to examine: (1) perceptions of susceptibility to health and safety risks; (2) factors that subjects see as important in determining their susceptibility; and (3) subjects' actual standing on objective risk factors. Subjects were generally unbiased about hereditary risk factors and were even somewhat pessimistic about environmental risk factors. Their views of their own actions and psychological attributes, however, were excessively optimistic. Few acknowledged actions or psychological attributes that increased their risk. This pattern of findings helps to explain why risks thought to be controllable (i.e., preventable by personal action) are likely to evoke unrealistic optimism about susceptibility. Family histories of health problems were incorporated into judgments of susceptibility, but, except for smoking, correlations between behavioral risk factors and judgments of susceptibility were surprisingly weak. Self-esteem enhancement is suggested as a motive that could explain many of the present findings. Several recommendations are offered for health campaigns that seek to produce more realistic perceptions of susceptibility to health and safety problems.  相似文献   

10.
A young man who had glomorulonephritis at age five was treated psychotherapeutically for an anxiety neurosis with phobic and obsessional features. He was referred for psychoanalysis at a time when he was approaching kidney failure, but was referred back for more psychotherapy with the possibility of future psychoanalysis. He underwent renal dialysis and then received a kidney transplant from a brother. The psychoneurosis became worse, and a psychoanalysis was begun about one year after the transplant operation. The clinical report illustrates the developmental effects of the childhood illness, as well as the patient's response to the adult treatment and the renal transplant. Nonanalytic observations by others on renal dialysis and transplant patients are reviewed and compared with the findings in this analysis. The psychoanalysis of a renal transplant patient is feasible if other indications for analysis are present. A previously unreported finding is the problem of changing a lifetime adaptation from illness to relative health. This involved the analysis of the narcissistic conflicts of the oedipal stage of development as well as the preoedipal maternal transference.  相似文献   

11.
ObjectiveThe objective of this study was to examine coaches' perceptions of athletes' stress-related growth following sport injury.DesignQualitative inquiry, grounded in a post-positivism paradigm was used to gain an in-depth understanding of the study's objective.MethodA purposeful sample of eight coaches (M age = 45.7; SD = 11.2) were interviewed across different sports and competitive standards. The semi-structured life world interviews were analysed using content analysis, and two trustworthiness procedures were employed to bolster the rigour of the findings (i.e., peer-debriefing and member checking).ResultsFindings revealed four general dimensions of stress-related growth: personal growth (e.g., beliefs), psychological growth (e.g., sporting qualities), social growth (e.g., social support), and physical growth (e.g., strength). The coaches also reported a number of behavioural indicators that reflected the four general dimensions (e.g., health and performance).ConclusionsFindings ‘validate’ or provide coherence with athletes' self-reports of stress-related growth in previous research and also extend the literature by identifying a number of novel types of growth and perceived behavioural correlates. Future avenues of research include the need to conduct prospective studies and explore related concepts (e.g., vicarious stress-related growth).  相似文献   

12.
13.
Anthropologists have long noted that the use of ritual and magic is linked to conditions of risk and uncertainty. In this study, the authors examined how perceived task difficulty, participants' level of preparation, and the value of the outcome interact to influence the self-reporting of superstition and ritual. College students rated the likelihood of their using charms or rituals for various scenarios involving academic, artistic, and athletic performances. Reports of use of ritual increased as the stakes of the event increased and decreased with perceived expertise or level of preparation. Additional findings included participants' reporting frequent use of ritual while denying any causal effectiveness. The authors discuss results in terms of the rituals providing participants with an illusion of control.  相似文献   

14.
To determine the factors that influence placement recommendations, 356 working school psychologists evaluated nine psychological reports on special educational referral cases. The reports presented various combinations of IQ-level, emotional-social problems, and IQ-achievement discrepancies which were hypothesized to yield EMR, LD, and ED placement recommendations. It was found that when one of these characteristics was present at a greater level of severity than the others, predictable placement recommendations were made. In more complex combinations, however, no general decision-rules could be found to explain the recommendations.  相似文献   

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17.
Reversal and non-reversal shifts were studied in rural Mexican children ranging in age from 4–10 years. Experimental variations within each group were arranged to provide for evaluation of the influence of temporal pairing and the presence of common attributes in different discriminanda on transfer. Under some presentation conditions, all of the groups studied manifested independent learning of subproblems which are ordinarily thought of as constituting a single problem by experimenters. The contributions of the various experimental factors change with age in ways that are consistent with a general “single-unit to mediational” formulation, but the details of the mediational behavior are not fully describable by any currently formulated theory.  相似文献   

18.
Abstract

The relationship between causal attributions for recovery and adherence was examined in a sample of 80 individuals (25 females and 55 males) undergoing rehabilitation following anterior cruciate ligament reconstruction. Participants estimated their speed of recovery and then rated their open-ended attributions for recovery on the Revised Causal Dimension Scale (McAuley, Duncan and Russell, 1992). Adherence was assessed in terms of attendance at rehabilitation sessions and practitioner ratings for the remainder of the rehabilitation period. Participants who perceived themselves as recovering rapidly attributed their recovery to more stable and personally controllable factors than participants who perceived themselves as recovering slowly. Causal dimension ratings predicted attendance at rehabilitation sessions, but not practitioner ratings of adherence. The results, which further demonstrate the relevance of causal attributions to health behavior, are compared with previous cross-sectional findings.  相似文献   

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20.
Metacognitive monitoring is a central element of metacognitive processing exerting widespread influences on information processing. Albeit being subject to numerous empirical investigations referring to memory performance, there is little research investigating metacognitive monitoring in other cognitive domains. The present study investigated in 45 healthy students whether factors that are known to influence monitoring of memory performance, i.e. task difficulty, time of assessment, and practice, also exhibit a significant impact on monitoring of attention performance. A multivariate analysis of variance with three within-subject repeated measures factors on two dependent variables (monitoring of (a) time, and (b) errors in an attention task) was conducted. Results showed that monitoring ability significantly decreased with increasing task difficulty, was significantly better for post than for pre-assessment, and significantly increased with practice. Therefore, results suggest that the examined factors influenced monitoring of attention performance equivalent to the influence of these factors found in metamemory research.  相似文献   

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