Objective: This study investigated changes in illness perceptions from diagnosis to six months later in patients with head and neck cancer (HNC) and their caregivers. The study also examined whether discrepancy in patient and caregiver perceptions at diagnosis predicted patient health-related quality of life (HRQL) at six months.
Design: Forty-two patient–caregiver dyads completed the Brief Illness Perception Questionnaire (Brief IPQ) at diagnosis and again six months later. Patients also completed a HRQL questionnaire at both time points. Analyses were performed using the Actor–Partner Interdependence Model.
Main Outcome Measure: Total patient HRQL assessed by the Functional Assessment of Cancer Therapy (FACT-H&N).
Results: Perceptions of emotional impact and illness concern reduced over time in patients and caregivers. Perceptions of treatment control and identity increased in caregivers only. After controlling for the effects of baseline HRQL, and the individual contribution of patient and caregiver illness perceptions, greater discrepancy in perceptions of timeline, personal control, and illness identity among dyads at diagnosis predicted lower patient HRQL at six-month follow-up.
Conclusion: Patients’ and their caregivers’ perceptions of HNC are dynamic over time. Greater discrepancy between patients’ and caregivers’ illness perceptions at diagnosis predict poorer subsequent patient HRQL. 相似文献
Introspective as well as empirical evidence indicates that emotions shape our thinking in numerous ways. Yet, this modificatory aspect of emotions has received relatively little interest in the philosophy of emotion. I give a detailed account of this aspect. Drawing both on the work of William James and adverbialist conceptions of perception, I sketch a theory of emotions that takes these aspects into consideration and suggest that we should understand emotions as manners of thinking. 相似文献
This paper addresses several objections that have been leveled against a behavioral approach to psychological categories. It reconstructs and critically assesses (a) the so-called causal objection; (b) alleged counterexamples whereby one can exhibit the typical behaviors associated with a psychological phenomenon without exhibiting the latter, including Lewis’ “perfect actor” case and Kirk’s “zombie”; (c) alleged counterexamples whereby organisms can exemplify psychological phenomena without exhibiting any behavior associated with them, including Armstrong’s imagined brain in a vat, Putnam’s “super-super-spartans” scenario, and related cases; and (d) the holistic objection. Mistaken assumptions in each of these objections are pinpointed. The paper starts with a brief characterization of behaviorism about psychological categories and a summary of the particular version thereof supported here, which draws upon Ryle and Skinner, among others. 相似文献
In the widely used Corsi Block Test and Wechsler Spatial Span Tests, participants must reproduce sequences of blocks in the order touched by the examiner until two trials are missed at the same sequence length. The examiner records either the maximum number of blocks correctly reported or the total number of correct lists. Here, we describe a computerized spatial span test (C-SST) that uses psychophysical procedures to quantify visuospatial mean span (MnS) with sub-digit precision. Results from 187 participants ranging in age from 18 to 82 years showed that accuracy declined gradually with list length around the MnS (by ~30% per item). Simulation studies revealed high variance and biases in CBT and Wechsler measures, and demonstrated that the C-SST provided the most accurate estimate of true span (i.e., the sequence length producing 50% correct). MnS declined more rapidly with age than mean digit span (MnDS) measured in the same participants. Response times correlated with both MnS and MnDS scores. Error analysis showed that omission and transposition errors predominated, with weaker primacy and recency effects in spatial span than digit span testing. The C-SST improves the precision of spatial span testing and reveals significant differences between visuospatial and verbal working memory. 相似文献
Clinical practice guidelines have been critiqued for prescribing standardized care that neglects patients’ personal circumstances and knowledge in health care decisions. To make care more patient centred, standard-setters are urged to involve patients and the public in guideline development and use. Despite widespread principled support for such Patient and Public Involvement (PPI), the underlying principles guiding PPI in standardization of care are mired on confusion and contradiction. Based on the PPI literature in general, and informed by empirical research on guideline development, it is possible to identify three rationales that justify PPI in clinical standard setting. Each rationale gives rise to a conceptual model which outlines a distinct purpose of participation, who is to be included, and what they are expected to contribute. The Consumer Choice model aims to involve autonomous consumers to personalize clinical care. The Democratic Voice model aims for health care recommendations to better reflect collective values of citizens. The Lay Expertise model aims to re-contextualize universal evidence by including experiential patient knowledge. However, these models can and should not function as ‘Gold Standards’ to be consistently followed in practice. First, the models rely on two distinct types of representation, resulting in contradictory notions of how to be a good representative. Second, imposing models on practice requires a top-down control that is practically and politically problematic. Not only is control difficult to achieve, it may compromise the participatory ideal of participants co-determine practice, and may result in excluding the values and views of ‘real’ patients and public entirely. 相似文献
Institutional review board (IRB) delays may hinder the successful completion of federally funded research in the U.S. military. When this happens, time-sensitive, mission-relevant questions go unanswered. Research participants face unnecessary burdens and risks if delays squeeze recruitment timelines, resulting in inadequate sample sizes for definitive analyses. More broadly, military members are exposed to untested or undertested interventions, implemented by well-intentioned leaders who bypass the research process altogether. To illustrate, we offer two case examples. We posit that IRB delays often appear in the service of managing institutional risk, rather than protecting research participants. Regulators may see more risk associated with moving quickly than risk related to delay, choosing to err on the side of bureaucracy. The authors of this article, all of whom are military-funded researchers, government stakeholders, and/or human subject protection experts, offer feasible recommendations to improve the IRB system and, ultimately, research within military, veteran, and civilian populations. 相似文献
This study integrates three theoretical perspectives provided by social identity theory, realistic group conflict theory, and social dominance theory to examine the relationship between religious identification and interreligious contact. It relies on a unique dataset collected among Christian and Muslim students in ethnically and religiously diverse regions of Indonesia and the Philippines, where social cleavages occur along religious lines. Religious identification directly predicts a higher quality of interreligious contact, whereas it indirectly predicts a lower quantity and quality of contact, mediated by higher perception of group threat, and a higher quality of contact, mediated by lower social dominance orientation. Furthermore, these direct and indirect relationships are moderated by religious group membership and relative group size. We conclude that religious identification functions as a ‘double‐edged sword’ predicting both higher quality and lower quantity and quality of interreligious contact through various pathways and with a varying strength depending on intergroup context. 相似文献