Planning and Self-Efficacy in the Adoption and Maintenance of Breast Self-Examination: A Longitudinal Study on Self-Regulatory Cognitions

Many women may be reluctant to perform breast self-examination (B.S.E.) regularly due to motivational or self-regulatory deficits. The Health Action Process Approach (Schwarzer, R. (1992). Self-efficacy in the adoption and maintenance of health behaviors: theoretical approaches and a new model. In: Schwarzer, R. (Ed.), Self-efficacy: Thought Control of Action , pp. 217-243. Hemisphere, Washington DC; Schwarzer, R. (2001). Social-cognitive factors in changing health-related behavior. Current Directions in Psychological Science , 10 , 47-51.), a health behavior change model that advocates the separation of motivation and action phases, such as goal setting and goal pursuit, was applied to data from 418 young women whose risk perceptions, outcome expectancies, self-efficacy, intention to perform B.S.E., planning, and reported examination behaviors were examined at two points in time. Risk perception was found to have a negligible influence in a path analysis, whereas self-efficacy emerged as the best predictor of intention and planning. Planning, in turn, appeared to be the best predictor of B.S.E. behaviors, followed by self-efficacy. The results point to the influential role that self-regulatory strategies (such as planning) play in translating goals into action. The study contributes to the current debate on stage theories of health behavior change and the orchestration of self-beliefs and strategies in the context of goal-directed behaviors.     

Development of decisional balance and self-efficacy measures for adolescent sedentary behaviors

Writing about traumatic events can produce health benefits, yet emotionally non-expressive or cognitively avoidant individuals may be unwilling or unable to express their emotions. This study examined non-expression, cognitive avoidance, response to writing, and subsequent health. As part of a larger study, participants ( N = 71) with asthma or rheumatoid arthritis (RA) wrote about traumatic experiences for 20 min on three consecutive days. Alexithymia, denial, behavioral disengagement, mental disengagement, focus on/venting of emotions, avoidant thoughts, and health status were assessed at baseline, health status again 4 months after writing. Essays were coded for how personal and how emotional they were, and for narrative structure. Non-expression and cognitive avoidance were neither related to how personal or emotional essays were, nor to affective response to writing. High levels of denial or avoidant thoughts predicted less narrative structure. Avoidant thinking marginally predicted health improvements in RA patients. Results suggest that non-expression and cognitive avoidance do not interfere with writing in terms of emotional engagement, but may influence narrative use.     

Book Review of Health and the Construction of the Individual. J. Ogden. London: Routledge, 2002. i–viii + 130 pages ISBN 0415233070

Abstract

Recent theoretical and empirical research has challenged the assumption of health psychologists employing social cognitive models that beliefs can confidently be inferred on the basis of questionnaire responses. It is charged that responses to questionnaires are a function of the intelligibility of the items, constructs and theoretical framework to survey participants. To investigate this contention, cognitions specified by Protection Motivation Theory (PMT) were measured with respect to intentions to use a condom and intentions to use dental floss. Three alternative formats of a questionnaire which varied the order of presentation of PMT items were distributed to student samples. Analyses showed that while questionnaire format did not affect the reliability of cognition measures, there was some variation in the significance and strength of correlations between PMT cognitions across formats. Individual differences in social desirability and salience of the target behaviour had small and predictable effects upon reliabilities and intercorrelations. Implications for the measurement of health beliefs and the status of questionnaire responses are outlined and suggestions are made for controlling bias associated with respondents' capacity to “read” a questionnaire.     

Forgiveness is an emotion-focused coping strategy that can reduce health risks and promote health resilience: theory,review, and hypotheses

Experimental evidence suggests that when people are transgressed against interpersonally, they often react by experiencing unforgiveness. Unforgiveness is conceptualized as a stress reaction. Forgiveness is one (of many) ways people reduce unforgiveness. Forgiveness is conceptualized as an emotional juxtaposition of positive emotions (i.e., empathy, sympathy, compassion, or love) against the negative emotions of unforgiveness. Forgiveness can thus be used as an emotion-focused coping strategy to reduce a stressful reaction to a transgression. Direct empirical research suggests that forgiveness is related to health outcomes and to mediating physiological processes in such a way as to support the conceptualization that forgiveness is an emotion-focused coping strategy. Indirect mechanisms might also affect the forgiveness-health relationship. Namely, forgiveness might affect health by working through social support, relationship quality, and religion.     

Health Literacy,Health Inequality and a Just Healthcare System

Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the least well-off and argue that poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy.     

Roles of Leisure in Coping with Stress Among University Students: A Repeated-Assessment Field Study

This article reports findings of a study to examine the effects of leisure coping on various stress coping outcomes including: immediate outcomes (perceived coping effectiveness, perceived satisfaction with coping outcomes, and perceived stress reduction) and distal or long-term outcomes (physical and mental ill-health and psychological well-being), above and beyond the contributions of general coping - coping not directly associated with leisure. A repeated-assessment field design was used to examine ways in which university students cope with stressors in their daily lives. The study found that leisure coping beliefs (leisure-generated dispositional coping resources) significantly predicted lower levels of mental and physical ill-health and greater levels of psychological well-being above and beyond the effects of general coping. Also, the use of leisure coping strategies (situation-specific stress coping strategies through leisure) was significantly associated with higher levels of perceived coping effectiveness and stress reduction when the effects of general coping were taken into account. Significant contributions of specific leisure coping dimensions were found as well.     

Les interventions préventives en santé mentale du jeune enfant vues par leurs bénéficiaires : l’exemple du projet CAPEDP

ObjectiveHome-visiting programs have become one of the most popular early childhood interventions, though their impact on parents and children remain uncertain. Outcomes measures often rely on experimental quantitative design and little space is offered for the voices of those served by these interventions. This paper presents the results of a qualitative protocol performed by the research team with participants in the CAPEDP project which took place in France from 2005 to 2011.MethodAll 184 women who had accepted at least one home visit in the CAPEDP programme were contacted and invited to participate. Individual and group interviews were conducted with the first 16 who accepted to participate. The semi-structured interview schedule addressed their overall appreciation of the project, their initial concerns, the quality of their relationship with their home visiting psychologist, positive and negative aspects of the intervention and any recommendations they might have for future interventions. Interviews were recorded, transcribed and anonymised. An inductive categorical thematic analysis was performed by the research team.ResultsParticipants expressed overall satisfaction with the CAPEDP intervention, underlining the quality of the relationships with the home visitors, usefulness of parental guidance, the fact that the intervention could be adapted to suit their own personal agenda, routine and needs, the importance of learning how to accept help and give help to others. Less positive aspects included the fact that the home visitors were not mothers themselves and that they lacked technical experience, the difficulty ending the relationship at the end of the 27-month project, insufficient integration of fathers, the difficult and time-consuming evaluation protocol and the lack of interaction with other parents during the intervention.ConclusionAlthough mothers who accepted to participate in the qualitative interview schedule may have had a more positive overall experience of the CAPEDP project than those who declined to participate, participants’ points of view provide potentially useful indications for adapting future home-visiting programs to the French context.     

Demands,resources, and work ability: A cross-national examination of health care workers

Understanding work ability, with the goal of promoting it, is important for individuals as well as organizations. It is especially important to study work ability in health care workers, who face many work-related challenges that may threaten work ability. We studied various job demands, job resources, and interactions of demands and resources relating to work ability using the Job Demands–Resources model as a framework. Acute care health care workers from six nations (US, Australia, UK, Brazil, Croatia, and Poland) completed a survey. Role demands related to work ability in the Australia sample only, and supervisor support related to work ability in the Australia sample only. Yet, high levels of supervisor support significantly moderated (buffered) negative relationships between physical demands and work ability in the US sample, along with negative relationships between role demands and work ability in both the Croatia and UK samples. Skill discretion related to work ability in every nation sample, and therefore appears to be particularly important to work ability perceptions. In addition, skill discretion moderated (buffered) a negative relationship between role demands and work ability in the Australia sample. We therefore recommend that interventions to help preserve or improve work ability target this important job resource.     

Health numeracy and cognitive decline in advanced age

ABSTRACT

The study aimed at investigating health numeracy in cognitively well performing healthy participants aged from 50 to 95 years as well as in participants with cognitive impairment, but no dementia (CIND). In cognitively well performing participants (n = 401), demographic variables and cognitive abilities (executive functions, reading comprehension, mental calculation, vocabulary) were associated with health numeracy. Older age, lower education, female gender as well as lower cognitive functions predicted low health numeracy. The effect of older age was partly mediated by executive functions and calculation abilities. Participants with CIND (n = 51) performed significantly lower than healthy controls in health numeracy. The findings suggest that cognitively well performing old individuals have difficulties in understanding health-related numerical information. The risk of misunderstanding health-related numerical information is increased in persons with CIND. As these population groups are frequently involved in health care decisions, particular attention has to be paid to providing numerical information in comprehensible form.     

Assessing the Readability of Mental Health Internet Brochures for Children and Adolescents

We investigated the readability of seven mental health brochures on mental, emotional, and behavioral disorders in children that were selected from a website developed by the Center for Mental Health Services at http://www.mentalhealth.org. The reading grade levels of the brochures ranged from 11.1 to 14.8 (mean 13.23), considerably higher than the 8th grade level recommended for educational material by the U. S. Department of Education (1986). On other readability variables, assessed using the Readability Assessment Instrument (RAIN; Singh, 1994), all brochures met criterion on most variables but failed on those for new words (audience appropriateness) and print size. This is a favorable result in comparison with other studies that have assessed readability of mental health information on the Internet using the RAIN, although less so with reading grade levels.