Patient Adherence With Medical Treatment Regimens: An Interactive Approach

Inadequate patient adherence to treatment regimens is a ubiquitous problem in health care and carries a profound personal, societal, and economic cost. This article illustrates a general theoretical framework we believe to be useful for the interpretation, conception, and design of adherence research. The core tenet of this framework is that factors that influence adherence can be better understood by considering the interactive effects of patients' characteristics, type of adherence intervention, and characteristics of the illness and medical treatment context. This framework represents an extension and application of previous theory and research from personality, social, and clinical psychology concerning the value of an interactionalist perspective. We illustrate the framework using some of our past work involving treatment adherence among patients with chronic renal failure.     

Does service failure influence customer loyalty?

There is a general consensus that customer loyalty to service providers is not solely dependent upon their level of satisfaction or dissatisfaction. However, the identified antecedents of loyalty remain, at best, highly speculative. The aim of this extensive literature review is to give some understanding of the nature of customer loyalty and the antecedent effects of service dissatisfaction. The research reviewed suggests that customer loyalty is an attitudinal state, reflecting value, trust and commitment within supplier–customer relationships. Satisfaction is one of several antecedents of loyalty. A key influence on loyalty is the offer of unique value‐delivering advantages not provided by competitors. Thus firms need to develop positive value‐based exit barriers to achieve loyalty. When service failures occur, the recovery process is likely to have a greater impact on loyalty than the original service failure. The key to successful recoveries was found to be the customer's perception of ‘fairness’. Recovery programmes must get it right first time. Customers who remain dissatisfied after a complaint has been handled are more dissatisfied than if no recovery attempt had been made. Dissatisfaction and customer satiation are major causes of a customer's exit. The solution to customer satiation is dynamic value creation. Collection and monitoring of customer data is needed for success and two‐way communication is vital. Copyright © 2002 Henry Stewart Publications.     

IN DEFENSE OF THE BODY: THE EFFECT OF MORTALITY SALIENCE ON FEMALE BODY OBJECTIFICATION

Previous research has illustrated the negative psychological consequences of female body objectification. The present study explores how female body objectification may serve as a defense against unconscious existential fears. Drawing from terror management theory, an experiment was designed to test the potential functionality of female body objectification. Men and women were primed to think about either their own mortality or an aversive control topic, and levels of body objectification were then assessed for both self- and other (women)-objectification. Findings supported the hypothesis that priming mortality would increase both self- and other-objectification among women, and self-objectification among those who derive self-esteem from their body. Implications for this research are discussed.     

Social-cognitive processes as moderators of a couple-focused group intervention for women with early stage breast cancer.

OBJECTIVE: The purpose was to examine whether social-cognitive variables would moderate the efficacy of a couple-focused group intervention (CG) for women diagnosed with early stage breast cancer. DESIGN: Participants (N = 238) were randomly assigned to 6 sessions of a couple-focused group versus usual care. Intent to treat growth curve modeling analyses indicated that emotional expression and emotional processing moderated CG effects on depression. MAIN OUTCOME MEASURES: The primary outcome measures for this study were psychological distress and psychological well-being. RESULTS: Treatment attrition analyses separating out participants assigned to but not attending CG indicated that emotional expression, emotional processing, and protective buffering moderated the effects of CG among those who attended CG with the most consistent effects noted for emotional processing on indicators of distress and well-being. CONCLUSION: The CG intervention may be more effective for patients who begin the group experience using emotional approach coping strategies to deal with cancer.     

State work engagement and state affect: Similar yet distinct concepts

State work engagement (SWE), a multidimensional construct of work-related well-being, was originally conceptualized as a trait, but diary studies have revealed substantial within-person fluctuations. Given that SWE is conceptualized as a work-related affective-motivational construct, the question arises as to whether SWE can be differentiated from other affective constructs. Thus, the goal of the present study was to compare SWE and state affect with respect to their degree of within-person variability and to examine their distinct relationships with health and performance variables (i.e., sleep quality and job performance). Fifty-two employees (44% female) participated in the study, which included 3 assessments per day over the course of 2 weeks. Our results revealed that energetic arousal and tense arousal fluctuated more strongly within days than vigor and absorption. Multilevel analyses demonstrated that high sleep quality predicted higher state affect but not higher SWE. In addition, vigor exhibited an inverted U-shaped relation with performance. In sum, SWE as a time-varying construct showed some overlap with state affect but also demonstrated discriminant validity.     

Acceptance and Commitment Therapy and Implementation Intentions Increase Exercise Enjoyment and Long-Term Exercise Behavior Among Low-Active Women

The current study evaluated the long-term effectiveness of acceptance and commitment therapy (ACT) for promoting exercise behavior in comparison with planning in the form of implementation intentions (forming situational cues and action plans as to when, where, and how to incorporate exercise). We expected both interventions to increase exercise behavior (assessed using the Godin Leisure-Time Exercise Questionnaire; Godin and Shephard 1985) from baseline to 6-months post-intervention, but expected only ACT to also increase exercise enjoyment (assessed using the Physical Activity Enjoyment Scale; Kendzierski and DeCarlo 1991). A total of 32 women, randomized to receive a single session of either ACT training or instructions to form implementation intentions for exercise activities, took part in this study. The participants were contacted by email 6-months following the intervention to determine the amount of self-reported exercise. As expected, exercise amount increased in both groups. Contrary to our expectations, both groups also increased in exercise enjoyment. This study provides initial evidence that exercising can be increased through an ACT intervention. ACT and implementation intentions may both be effective and brief interventions for promoting exercise behavior and exercise-related enjoyment in low-active women. Future research needs to establish the psychosocial and personality factors that lead to the effectiveness of ACT and implementation intentions.     

Continuous Response Monitoring of Relative Time-to-Contact Judgments: Does Effective Information Change During an Approach Event?

In many previous studies of time-to-contact (TTC) judgments of approaching objects, a response was measured after observers viewed the entire event and was used to infer the informational basis for the judgment. Such measures primarily reflect the information used at the end of the approach event and may not reveal whether observers used different information at different times during the event. Evidence indicates that observers use multiple information sources and that the effectiveness of information varies with distance. We introduce a method in which observers continuously report which of 2 approaching objects would reach them first, throughout the approach. We identified the occurrence and time of response reversals. Most observers changed their relative TTC judgments during the event. The pattern of responses indicated that observers did not use tau early during the approach when objects were far and did not use optical size later when the objects were closer. Most observers relied on either optical size or optical expansion rate early during the approach and expansion rate later during the event, although there were individual differences. A single relative TTC judgment measured after observers view an approach event may not reflect judgments or their informational basis throughout the entire event.     

Contrast and contradiction: Being a black adolescent in contemporary South Africa

This study aimed to gain in-depth understanding of the lived identity of black African adolescents in a contemporary South African setting. A purposive sample of 59 adolescents (females = 47%; Sesotho = 46%, Setswana = 36%, Other = 18%) from the Motheo district of the Free State, South Africa, participated in focus group discussions and in-depth individual interviews. Thematic analysis suggested that black South African adolescents experience transitional identities characterised by contrasts and contradictions. Altruism, autonomy, religiosity and cultural experiences were important to their lived identities. The interplay between African rituals, Christian principles, Western values and the globalisation of cultures provided fertile ground for developing a nuanced and multi-dimensional identity as an adolescent living in contemporary South Africa.