Attitudes to doctors and medicine: The preliminary development of a new scale

Abstract

The preliminary development of a new scale to measure attitudes towards medicine and doctors is described. The scale comprises four factors: “positive attitude towards doctors,” “positive attitude towards medicine,” “negative attitude towards doctors,” and “negative attitude towards medicine.” Alpha coefficients for the four scales were satisfactory, ranging from 0.69 to 0.76. Test re-test reliabilities ranged from 0.69 to 0.81. Evidence of criterion-related validity was obtained from comparison of the attitudes of five groups involved in health care: nurses, medical students, patients, and sociologists and psychologists who are teachers in medical schools. Patients and medical students held significantly more positive attitudes towards doctors and medicine that did nurses and behavioural scientists. While nurses were as negative towards doctors as sociologists and psychologists, they were significantly less negative about medicine.     

Implementing a behavioral medicine program in an internal medicine residency: A description of curriculum content,resources and barriers encountered

Abstract

Many internal medicine training programs are currently developing curricula designed to teach the psychosocial aspects of patient care and doctor-patient communication skills. However, faculty may lack expertise regarding how to accomplish new educational goals in these areas. This article is designed to assist programs by describing in detail how a comprehensive behavioral medicine program was integrated into a general internal medicine program at a university-affiliated community hospital. It describes the program goals, resources needed, content included, obstacles to implementation and potential solutions to the problems encountered.     

Day-to-day living with severe chronic obstructive pulmonary disease: Towards a family-based approach to the illness impacts

Objective: This study explores the perspectives of both patients and family members regarding the impact of chronic obstructive pulmonary disease (COPD) in their family life.

Design: An exploratory qualitative study was conducted with patients and their family members in the chronic phase of COPD. Individual interviews were performed to explore participants’ perspectives and submitted to thematic analysis.

Results: Six major themes emerged from patients’ perspective: (1) impact of COPD symptoms on personal and family daily life; (2) (over)protective family support; (3) difficulties in couple communication; (4) sense of identity loss; (5) fear of COPD progression; and (6) coping resources. Five main themes emerged from the family members’ perspective: (1) restrictions in family’s social life; (2) emotional distress related to COPD exacerbations; (3) tension in couple relationship; (4) financial strain of COPD; and (5) coping resources.

Conclusions: The overall findings illustrate the complex interaction between the experience of living with COPD and communication patterns, emotional states, social support and social roles within the family. The results highlight the need to develop family-based interventions to facilitate a functional adjustment to COPD. However, these interventions in COPD remain undeveloped and empirical evidence is needed.     

Parent-adolescent health conversations as action: Theoretical and methodological issues

Abstract

A qualitative research method based on action theory is proposed and illustrated for use in health psychology and health promotion research. Action refers to the goal-directed and intentional behaviors of individual and groups. Action theory has the advantage of using the perspectives provided by manifest behavior, internal processes, and social meaning in the analysis of action. In this article, the actions under consideration are the health-related conversations of parents and their adolescent children. The approach is premised on an understanding of health promotion as a family task constructed through actions such as conversations between family members. Health conversations in two parent-adolescent dyads are used to illustrate the method. The analysis includes the identification of goals, functional steps, and elements and their relation to the family health promotion project. Specific attention is paid to data gathering and analysis issues and their implications for health promotion research.     

Personal and family determinants of dietary behaviour in adolescents and their parents

Abstract

The first aim of the present study was to investigate the contribution of personal and family determinants in explaining variance in dietary behaviour using objective as well as subjective food scores as dependent variables. The second aim was to provide insight into the aggregation of determinants of dietary behaviour within families. 104 family dyads (n = 208) consisting of an adolescent and his/her parent were recruited. All participants went through a computer routine and completed questionnaires to investigate personal determinants, family interactions around food and more general family characteristics. Results revealed that family determinants explained a maximum of 10% additional variance in dietary behaviour over and above personal determinants. Further, considerably more variance in subjective food scores could be explained (R mainly between .35 and .65) when compared to variance in objective food scores (R mainly between .10 and .40). Finally, the family aggregation was rather low. This argues against the hypothesis of a strong family base of the traditionally used personal determinants. It also shows that a subject?s reports of family interactions are mainly a reflection of an individual's perception and can hardly be considered to be objective truth.     

Keeping Engaged During Deployment: The Interplay Between Self-Efficacy,Family Support,and Threat Exposure

This study investigated the importance of 2 resilience resources for service members’ ability to deal with threat during deployment. Military self-efficacy and family support were measured before deployment and related to work engagement and burnout levels of service members during deployment. We hypothesized that in high threat situations, low self-efficacy would lead to unfavorable outcomes, whereas in low threat situations, high self-efficacy could have negative consequences. In addition, we hypothesized that family support would compensate for both effects. The results showed these expected 3-way interactions. We found that strong self-efficacy helped service members deal with exposure to threatening situations during deployment, leading to more work engagement and less burnout. However, having strong self-efficacy without being exposed to threat during deployment reduced service members’ work engagement and increased burnout. In addition, we found that the presence of family support compensated for these effects. Service members with low self-efficacy benefitted from family support when threat exposure was high, whereas service members with high self-efficacy benefitted from family support when threat exposure was low. As such, family support seemed to act as a compensatory mechanism for the potential negative effects of self-efficacy. This underlines the importance of studying the interplay between resources that help service members deal with deployment experiences. Practical implications relate to supporting service members’ resilience through enhancing multiple resources.     

Spouse and Family Functioning Before and After a Marine’s Suicide: Comparisons to Deaths by Accident and in Combat

The impact of service member suicides on families is not well understood. Civilian studies have demonstrated that family survivors of suicide deaths experience complicated grief, feel guilt and shame, and often do not receive sufficient social support. In this exploratory study, spouse survivors of Marines who died by suicide (N = 17), accident (N = 19), and in combat (N = 34) retrospectively reported on their immediate pre- and postmortem and current personal and family functioning. Nonparametric analyses revealed that several between-group differences existed. Observation of the means suggested that the spouses and families of Marines who died by suicide exhibited significantly poorer pre- and postmortem functioning compared with those whose spouses died in combat. Specific challenges included low family cohesion, high family conflict, perceived stigma, and shame. There were no differences in current spouse or family functioning, and there was weak evidence for posttraumatic growth among surviving spouses of those dying by suicide. These results should be considered preliminary and interpreted with caution given several methodological challenges.     

A crisis mental health intervention service: an innovative model for working intensively with young people on the edge of care

This paper describes the setting up and the first year of running of an innovative outreach service for adolescents on the edge of care that aimed at redressing family breakdown and preventing placements in the care system. It was a collaborative endeavour between social services and a child and adolescent mental health provision to facilitate the engagement of hard to reach young people and families that often presented high levels of risk. This article describes a distinctive model of applied psychoanalytic work with individuals, families and the networks of practitioners and agencies around the case. It focuses on the integration of two perspectives: the individual and the family on the one hand and the organisation on the other. Case examples illustrate how our psychoanalytic and developmental framework illuminated our understanding of frequently extreme acting out behaviour and parental difficulties in terms of underlying intergenerational trauma, which was often re-enacted. This framework also helped in understanding the difficulties that practitioners experienced and how these related to individual and family dynamics. The article describes the significance of containment in the treatment of adolescents and families in crisis as well as in supporting the professional network.     

MUTUALITY AND ONE-SIDEDNESS IN KJELL ASKILDSEN'S THE DOGS OF THESSALONIKI: THE PSYCHOLOGY OF EVERYDAY LIFE

The aim of this paper is to bring to the fore how a talented writer is able to describe everyday human relationships in a way that makes visible their most central, underlying dynamics. After reviewing some of the psychoanalytic literature, the author presents a collection of short stories by the Norwegian author, Kjell Askildsen. These works illustrate how the fear of incest, sado-masochistic, exhibitionistic, and addictive defenses can play the rôle of “directors” of human dramas. Askildsen, with relentless accuracy, decribes a longing for reciprocity and defences against it. In such a conflict, reciprocity is felt dangerous and only momentarily fulfilled, and defences are necessary.     

Is family-to-work interference related to co-workers' work outcomes?

Previous studies have convincingly shown that employees' family lives can affect their work outcomes. We investigate whether family-to-work interference (FWI) experienced by the employee also affects the work outcomes of a co-worker. We predict that the employee's FWI has an effect on the co-worker's outcomes through the crossover of positive and negative work attitudes. Using a sample of 1430 co-worker dyads, we found that the employee's FWI had a positive relationship with the co-worker's sickness absence through the crossover of feelings of burnout. Similarly, employee FWI was positively related to co-worker turnover intention through the crossover of (reduced) work engagement. The results show that family matters at work, affecting not only employee but also co-worker work outcomes.