Health professionals: A source of variance in health outcomes

Abstract

The behaviour of health professionals is rarely considered systematically by psychologists. This paper makes the following argument: first, that the behaviour of health professionals is influenced by other factors as well as medical knowledge; second, that various psychological models of human behaviour previously used only in considering the behaviour of patients may also be used to explain, predict and change the behaviour of health professionals; third, to implement effective care the behaviour of health professionals needs to be considered alongside that of patients.     

Psychological models in predicting uptake of prenatal screening

Abstract

The purpose of the current study was to determine which psychological models are most useful in predicting uptake of a prenatal screening test, maternal-serum alphafetoprotein screening for spina bifida and Down's syndrome. 1000 women eligible for the test completed standardised self-report questionnaires at two routine clinic visits to an antenatal clinic prior to the time when the test could take place. 902 underwent the screening test; 51 declined the test; and 47 did not undergo the test, giving no reason for this to staff. Knowledge of the test, the subjective expected utility attached to the test, and attitudes to doctors and medicine were all significant predictors of uptake behaviour. Results of a discriminant function analysis demonstrated distinct psychological processes underlying each of these three uptake behaviours, explaining 21% of the variance in uptake of screening. If uptake of screening is examined not as a dichotomous variable but as a group of behaviours, predictive models are identified accordingly. This would lead to rnodels of health-related behaviours as a heterogeneous rather than homogeneous phenomena, predicted and influenced by different causes.     

Testing an integrated behavioural and biomedical model of disability in N-of-1 studies with chronic pain

Background: Previous research has supported an integrated biomedical and behavioural model explaining activity limitations. However, further tests of this model are required at the within-person level, because while it proposes that the constructs are related within individuals, it has primarily been tested between individuals in large group studies. We aimed to test the integrated model at the within-person level.

Method: Six correlational N-of-1 studies in participants with arthritis, chronic pain and walking limitations were carried out. Daily measures of theoretical constructs were collected using a hand-held computer (PDA), the activity was assessed by self-report and accelerometer and the data were analysed using time-series analysis.

Results: The biomedical model was not supported as pain impairment did not predict activity, so the integrated model was supported partially. Impairment predicted intention to move around, while perceived behavioural control (PBC) and intention predicted activity. PBC did not predict activity limitation in the expected direction.

Conclusions: The integrated model of disability was partially supported within individuals, especially the behavioural elements. However, results suggest that different elements of the model may drive activity (limitations) for different individuals. The integrated model provides a useful framework for understanding disability and suggests interventions, and the utility of N-of-1 methodology for testing theory is illustrated.     

Perceived Control and the Optimistic Bias: A Meta-Analytic Review

People consistently believe that negative events are less likely to happen to them than to others. Research suggests a relationship between this optimistic bias and perceived control such that the greater control people perceive over future events, the greater their optimistic bias. We conducted a meta-analysis of 27 independent samples to quantify the size of this relationship and examine what variables moderated the relationship. Greater perceived control was significantly related to greater optimistic bias, but this relationship was moderated by participant nationality, student status, risk status, and the type of optimistic bias measure used. We discuss the findings in the context of primary versus secondary control.     

Instructional Analogies and Elaborations in Science Text: Effects on Recall and Transfer Performance

Abstract

The present studies compared the recall and transfer performance of subjects receiving an extended instructional analogy or elaborations in science text presenting the basic anatomy and physiology of the human eye. In Experiment 1, the analogy group performed better at far transfer and less well at intermediate transfer. No differences between groups were observed for explanative recall or nonexplanative recall. In Experiment 2, a within subjects design, both groups excelled on near and intermediate transfer corresponding to the first half of the text, and on far transfer corresponding to the second half of the text. As in Experiment 1, no differences emerged between groups on explanative or nonexplanative recall. Implications for design of transfer items and science text materials with elaborations and analogies are suggested and directions for future research proposed.     

Parenting Programs to Reduce Young Children’s Externalizing Behavior: A Meta-Analytic Review of Their Behavioral or Cognitive Orientation

Abstract

This meta-analytic review evaluates 35 parenting programs to analyze their effectiveness at reducing young children’s externalizing behavior (EB). It looks at whether behavioral or cognitive orientation, informant or duration of these programs moderate their effect on such young children. It confirms that parenting interventions are effective at decreasing young children’s EB but no moderation effect was found for specific orientation or duration, only for the informant. This illustrates the current difficulty in comparing programs on the basis of their theoretical background, which prevents the understanding of which are the most efficient parenting variables and change processes to manipulate.     

Student Healthcare Clinicians' Illness Narratives: Professional Identity Development and Relational Practice

ABSTRACT

In this qualitative, grounded theory study we examine how the intersection of self-reflection, illness narratives and perceived messages of professional identity inform care provided by medical, nursing, and medical family therapy students to patients and families. We discovered four common challenges students faced navigating personal experiences of illness and connecting to patients: 1) discrepancies between ideal and lived experiences, 2) challenges of healthcare work and culture, 3) navigating power and hierarchy, and 4) developing a shell of privacy. Discussion and implications include interdisciplinary training and collaboration and the unique role of medical family therapists in healthcare.     

La enseñanza práctica de la Psicología: una experiencia de condicionamiento instrumental

RESUMEN

n este informe se presenta una experiencia docente en la que un elevado número de estudiantes de primero de Psicología (140), trabajando en grupos de cinco personas y utilizando unos recursos limitados, consiguieron llevar a cabo un condicionamiento instrumental con ratas en la caja de Skinner, cumpliendo adecuadamente los objetivos metodológicos propuestos. Esta experiencia confirma la posibilidad de realizar prácticas en Psicología a pesar de los numerosos impedimentos que existen para ello, destacados por los autores.     

La construcción situacional en la ingesta alcohólica

RESUMEN

En la primera parte de este artículo se elabora un modelo de “construcción situacional de ingesta alcohólica”; en la segunda parte se aplica este modelo al estudio de la influencia de la publicidad sobre la ingesta alcohólica. El presupuesto básico de esta investigación era que mientras el sistema perceptivo es diferentemente afectado por los estados momentáneos, los estados experimentales o la propaganda sufrida, la estructura abstracta reflejada por la taxonomía situacional es escasamente afectada por la influencia de las variables experimentales, en este caso, por la propaganda alcohólica recibida. Los resultados encontrados manifiestan que la construcción de las situaciones de ingesta alcohólica está, al menos, modelada por los factores publicitarios, y que esta influencia es mayor cuanto menos es la edad de quien recibe la información.