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 relationship between self-reported oral symptoms and life-events

Abstract

This paper investigates whether eight specific life-events were related to self-reported chronic (persistent trouble over the last 12 months) and acute (trouble in the last 14 days) oral symptoms in a sample of 3861 civil servants aged 35-44 years. The results of a logistic regression analysis taking age, social class and gender into account showed that a range of life-events—marital or family problems other than divorce, death of a relative, personal serious illness, serious illness of a close relative, major financial difficulty and mugging and robbery—were significantly associated with either acute or chronic oral symptoms. Further analysis showed that marital or family problems other than divorce was found to be the most important life event studied. The results support the argument that marital dissatisfaction leads to poorer physical and psychological health.     

Work strain and the post-discharge adjustment of patients following a heart attack

Abstract

The role of work characteristics in determining return to work after an acute coronary event was examined. One hundred and forty nine patients were enrolled. One year post-discharge, 74 had returned to work. Work characteristics (decision latitude, and opportunity for social interaction at work), together with age, depression, and medical prognosis, correctly classified work status in 78% of cases. At 12 months post-discharge, patients who had not returned to work recorded significantly poorer levels of adjustment compared to those who had returned to work. A better quality of life is associated with a lower level of depression pre-hospitalization, ownership of a larger home, being male, and having a more positive work environment. The findings suggest that the pre-illness work environment of the patient is a factor influencing return to work, which needs to be considered in rehabilitation programmes.     

The immunoenhancing effects of humor on secretory IgA and resistance to respiratory infections

Abstract

In three different studies involving exposun to two differcot humorous and comparison videotapes, it was demonstrated that humor arousal signiticantly increases S-IgA in college students. Furthermore significantly more of the subjects exposed to the humor films showed an increese in S-IgA than the subjects exposed to the comparison films. A good sense of humor, measured as a trait, was associated with higher baseline concentrations of S-IgA and with greater increases in S-IgA in response to a humor arousing film. Higher bascline kvels and gains in S-IgA in respoase to humor were associated with lower reported severity of colds in the past twelve months and in the three months following assessment. However, a good sense of humor was related to lesser cold incidence and severity only if it involved appreciation rather than production of humor. While those who actively tell jokes also show higher S-IgA levels, they show greater susceptibility to colds than those who only appreciate humor probably because they sodalize more often under conditions that expose them more to cold infections.     

Religious Research in Gerontology, 1980–1994: A Systematic Review

ABSTRACT

This article presents results of an NIA-funded systematic review of research on religion and aging published from 1980–1994 in mainstream gerontology and religion journals, including the Journal of Religious Gerontology. Findings are summarized from 73 empirical studies, a subset of the 115 articles included in NIA's bibliography on this topic. In general, these studies use multiethnic samples, include multiple religious dimensions, and focus on age comparative analyses and on analyses of religious effects on life satisfaction, health, and well-being. Also summarized is gerontological research on patterns, predictors, outcomes, and measures of religious involvement, and an agenda for future research is proposed.     

Diagnosing depression in patients with physical diseases using the beck depression inventory (BDI)

Abstract

Four-hundred-and-forty-three patients with a physical illness (355 with coronary heart disease and 88 with chronic pain), 150 unemployed persons and 623 subjects from the normal population in Jämtland, Sweden were tested using the BDI (Beck Depression Inventory). The aim of the study was to investigate whether scores on both the physical and non-physical components of the BDI differed between the patients and the other groups, or whether only the physical component was significantly higher in the patient group, and in such a case whether this could be interpreted as symptomatic of physical disease and not of depression. A cutoff score of ≥ 10 to determine mild depression and two different alternative physical and non-physical components were used. Forty-three percent of the patients with coronary heart disease and 50% of patients with chronic pain were categorized as being at least mildly depressed. Factor analyses indicated that a physical component comprising five items was the most meaningful and could best discriminate the physical symptoms. The patients' scores were significantly higher than those of the other two groups on the physical component but only higher than the normal population sample on the nun-physical component. This supports the idea that the items for physical symptoms in the BDI might be confounding when determining depression in patients with physical diseases. The non-physical component seems to be the best indicator of depression and is recommended as a complement to the total BDI scale when determining the degree of depression in patients suffering from a physical disease.     

Cognitive-behavioural Treatment of a Patient Suffering from Menière's Disease

Abstract

Vertigo and dizziness may cause considerable discomfort and feelings of uncertainty. It is no surprise that vertigo is the most disabling symptom in Menière's disease, an inner ear disorder. The other two cardinal symptoms are tinnitus and hearing impairment. In this study, one severely disabled woman was treated with a cognitive-behavioural treatment comprising, among other components, relaxation training, stabilization of gaze, cognitive restructuring and behavioural task setting. The patient responded well to the treatment, during which her vertigo attacks disappeared. During the follow-up period, she experienced vertigo attacks again, but after two booster sessions the vertigo attacks vanished for the rest of the follow-up period. The results are further discussed.     

The Portuguese version of Addenbrooke’s Cognitive Examination–Revised (ACE-R) in the diagnosis of subcortical vascular dementia and Alzheimer’s disease

The aim of this study was to investigate the accuracy of the Portuguese version of Addenbrooke’s Cognitive Examination–Revised (ACE-R) in detecting and differentiating early stage subcortical vascular dementia (SVD) from early stage Alzheimer’s disease (AD). Ninety-two subjects (18 SVD patients, 36 AD patients, and 38 healthy controls) were assessed using the ACE-R. Between-group’s differences were evaluated using the Quade’s rank analysis of covariance. The diagnostic accuracy and discriminatory ability of the ACE-R were examined via receiver operating characteristic (ROC) analysis. The ACE-R was able to successfully discriminate between patients and healthy subjects. The mean ACE-R total scores differed between SVD and AD patients; there were also significant differences in attention and orientation and in memory measures between the groups. An optimal cut-off of 72/73 was found for the detection of AD (sensitivity: 97%; specificity: 92%) and SVD (sensitivity: 100%; specificity: 92%).     

Modeling recall memory for emotional objects in Alzheimer's disease

ABSTRACT

Objective: To examine whether emotional memory (EM) of objects with self-reference in Alzheimer's disease (AD) can be modeled with binomial logistic regression in a free recall and an object recognition test to predict EM enhancement.?Method: Twenty patients with AD and twenty healthy controls were studied. Six objects (three presented as gifts) were shown to each participant. Ten minutes later, a free recall and a recognition test were applied. The recognition test had target–objects mixed with six similar distracter objects. Participants were asked to name any object in the recall test and identify each object in the recognition test as known or unknown.?Results: The total of gift objects recalled in AD patients (41.6%) was larger than neutral objects (13.3%) and a significant EM recall effect for gifts was found (Wilcoxon: p < .003). EM was not found for recognition in AD patients due to a ceiling effect. Healthy older adults scored overall higher in recall and recognition but showed no EM enhancement due to a ceiling effect. A logistic regression showed that likelihood of emotional recall memory can be modeled as a function of MMSE score (p < .014) and object status (p < .0001) as gift or non-gift.?Conclusion: Recall memory was enhanced in AD patients for emotional objects indicating that EM in mild to moderate AD although impaired can be provoked with strong emotional load. The logistic regression model suggests that EM declines with the progression of AD rather than disrupts and may be a useful tool for evaluating magnitude of emotional load.