Predicting short and long-term exercise intentions and behaviour in patients with coronary artery disease: A test of protection motivation theory

The purpose of this study was to examine the utility of protection motivation theory (PMT) in the prediction of exercise intentions and behaviour in the year following hospitalisation for coronary artery disease (CAD). Patients with documented CAD (n?=?787), recruited at hospital discharge, completed questionnaires measuring PMT's threat (i.e. perceived severity and vulnerability) and coping (i.e. self-efficacy, response efficacy) appraisal constructs at baseline, 2 and 6 months, and exercise behaviour at baseline, 6 and 12 months post-hospitalisation. Structural equation modelling showed that the PMT model of exercise at 6 months had a good fit with the empirical data. Self-efficacy, response efficacy, and perceived severity predicted exercise intentions, which, in turn predicted exercise behaviour. Overall, the PMT variables accounted for a moderate amount of variance in exercise intentions (23%) and behaviour (20%). In contrast, the PMT model was not reliable for predicting exercise behaviour at 12 months post-hospitalisation. The data provided support for PMT applied to short-term, but not long-term, exercise behaviour among patients with CAD. Health education should concentrate on providing positive coping messages to enhance patients’ confidence regarding exercise and their belief that exercise provides health benefits, as well as realistic information about disease severity.     

The role of attitudes towards the targets of behaviour in predicting and informing prenatal testing choices

Research considering the role of attitudes in prenatal testing choices has commonly focused on the relationship between the attitude towards undergoing testing and actual testing behaviour. In contrast, this study focused on the relationship between testing behaviour and attitudes towards the targets of the behaviour (in this case people with Down syndrome (DS) and having a baby with DS). A cross-sectional, prospective survey of 197 pregnant women measured attitudes towards the targets of prenatal testing along with intentions to use screening and diagnostic testing, and the termination of an affected pregnancy. Screening uptake was established via patient records. Although attitudes towards DS and having a baby with DS were significantly associated with screening uptake and testing and termination intentions, unfavourable attitudes were better than favourable ones at predicting these outcomes. For example, in the quartile of women with the ‘most favourable’ attitude towards people with DS 67% used screening although only 8% said they would terminate an affected pregnancy. Qualitative data suggested that not all women considered personal attitudes towards DS to be relevant to their screening decisions. This finding has implications for the way in which informed choice is currently understood and measured in the prenatal testing context.     

Understanding the impact of HIV diagnosis amongst gay men in Scotland: An interpretative phenomenological analysis

Objectives: Although a wide literature details the psychological impact of human immunodeficiency virus (HIV) diagnosis, it predates the introduction of effective treatment for HIV (i.e. anti-retroviral therapies, ARTs). This article explores the psychological impact of HIV diagnosis in post-ART accounts. This is important, given the recent policy developments which focus upon increasing HIV testing and thus diagnoses.

Design: This study presents a qualitative exploration of the experiential accounts of HIV-positive gay men living in Scotland. A total of 14 HIV-positive gay men took part in open-ended interviews.

Methods: Interpretative phenomenological analysis was employed to identify recurrent themes across the interviews.

Results: Our analysis focuses upon the participants’ struggles in adjusting to their HIV status. Diagnosis was a deeply shocking and unexpected experience. Stigma and fear of prejudice dominated their accounts. HIV was understood, variously, as a shameful, fatal and life-changing condition. Overall, within these accounts there was little sense of HIV normalisation.

Conclusions: In Scotland, where HIV prevalence is low, and where no accessible HIV-positive sub-culture exists, there is on-going psychological distress and morbidity amongst gay men testing HIV positive. As HIV-related policy increasingly focuses on increasing rates of antibody testing, there is a need to reduce the psychosocial costs associated with HIV-positive diagnoses.     

Juggling roles and expectations: dilemmas faced by women talking to relatives about cancer and genetic testing

Health professionals do not inform their patients’ kin about BRCA1/2 test results or genetic testing without their written consent. Thus, the onus is on women attending genetic counselling to talk to relatives about the family history and their potential increased risk. This communication process within the family is largely unexplored and provides the focus of the present study. Fifteen healthy women attending a genetics clinic for predictive testing were interviewed prior to receiving their test result and again 6 months later. A grounded theory approach was used. Findings illustrate the dilemmas women faced in juggling social roles and expectations, which had an impact on communication within the family in the context of predictive genetic testing. Tensions between responsibilities towards themselves and others and their fulfilment of social roles had an impact on who women informed and on how they did so. These factors should be considered when assigning patients the role of information provider.     

Executive function outcomes of children with traumatic brain injury sustained before three years

Traumatic brain injury (TBI) is a common cause of disability in childhood. While the outcomes of TBI sustained in school years has been heavily researched, very little is known about the impact of TBI in infants and young children. The aim of this study was to investigate the impact of TBI on executive function (EF) in children who sustained a TBI before 3 years of age. A group of 55 children, 19 with a mild TBI, 16 children with a moderate-severe TBI, and 20 uninjured comparison children participated. The EF of children aged 3 to 6 years were compared using child-based measures of attentional control and information processing. Parents completed questionnaires rating their child's EF. Severity groups differed on the child-based EF measure of attentional control with children with TBI performing below the control group. There were no significant group differences for information processing or parent-rated EF. It appears that children who sustain a TBI before the age of 3 years display impairments in some areas of attentional control 3–4 years postinjury. The findings fit with the existing EF literature for older children.     

Life design counselling effects on the career adaptability of learners in a selective independent school setting

This collective case study applied life design counselling to augment the career adaptability of learners in a South African independent school setting. Five purposively selected learners attending Grade 11 (age range: 16–18) completed eight group-based life design counselling sessions. Data on their career adaptability pre- and post-intervention were gathered from sessional notes. The data were thematically analysed. Following the intervention the participants displayed improved career adaptability as evidenced by their demonstrated efforts to address aspects related to career concern, control, curiosity and confidence. Life design counselling appeared to have a positive effect on the career adaptability of learners in an independent school setting.     

A psychobiographical analysis of Dambudzo Marechera's personal development through his writings

This study applied psychobiography to explore the personal development of Zimbabwean novelist Dambudzo Marechera – and particularly focus on psychological disintegration. For the evidence, we examined primary and secondary works on his life history with special attention to his literary works. Findings indicate that his early writings were autobiographical in nature, chronicling lived poverty, war and violence experiences. Later writings were somehow surrealistic and unstructured, marking a culmination of significant personal disintegration that started in early childhood. Other ancillary biographical evidence suggests self-perceptions as a cult-like figure, and what appears to be a limited social interest.     

Cue competition effects in the planarian

The learning abilities of planarian worms (Dugesia tigrina) were assessed by using a number of Pavlovian conditioning paradigms. Experiment 1 showed that planaria were susceptible to basic conditioning in that they readily developed a conditioned response to a change in ambient luminance when it was consistently paired with an electric shock over a number of trials. In Experiment 2, the change in luminance was presented in a compound with a vibration stimulus during conditioning. Subsequent tests revealed poor conditioning of the elements compared with control groups in which the animals were conditioned in the presence of the elements alone, an instance of overshadowing. In Experiment 3, pre-training of one of the elements before compound conditioning resulted in blocking of learning about the other element. These results add to other studies that have reported cue competition effects in animal species belonging to different phyla (chordate, mollusk, arthropod), suggesting that learning in these phyla could be ruled by similar principles. The results are discussed adopting an evolutionary-comparative approach.     

Uncertainty in ethical consumer choice: a conceptual model

The market place has seen significant growth in the demand for ‘ethical’ products and services. Yet, consumers often experience knowledge, evaluation and choice uncertainties in decision‐making processes, particularly in relation to products such as ethical clothing. The authors explore this pertinent form of consumer uncertainty through three qualitative studies of ethical consumers that examine their approaches to clothing consumption. In‐depth interviews and focus groups confirm uncertainty arises; the results also identify the causes and consequences of consumer uncertainty in this context. The causes of uncertainty pertain to issues surrounding complexity, ambiguity, conflict and credibility that give rise to uncertainties that result in delaying purchase decisions, compromising beliefs and negative emotions. This study contributes to literature by offering a holistic understanding of the challenges facing consumers when making ethical choices. Copyright © 2013 John Wiley & Sons, Ltd.     

'You get used to it': Working with trauma in a burns unit of a South African children's hospital

I report here on the first stages of my work as a consultant clinical psychologist in a burns unit of a South African children's hospital. I show how the enormous trauma of the work leads inevitably to the adoption of defences on the part of staff against the pain and load of their work. I use the writing of Menzies Lyth and other authors as a basis for understanding staff defences in their daily work. I then describe the process whereby it has become possible to institute a form of group support for the staff. It has been important to think not only of the maladaptive but also of the helpful function of defences, and to recognize the staff's need for continuity and acceptance on the part of the consultant.