Biomedical subjects

C Knussen

Publications and source records attributed to C Knussen.

13 recordsLinked to original sources

PubMed1999

HIV/AIDS and health care workers: contact with patients and attitudes towards them.

Data on a range of variables associated with contact with patients with HIV/AIDS and attitudes towards them were collected from 174 Scottish health care workers. Measures of attitudes and contact (overall, social and physical) were derived from the scales devised by Pleck et al. (1988). The measure of overall contact was not significantly related to attitudes, but those with predominantly social contact with patients with HIV/AIDS had more positive attitudes towards them. This relationship was moderated by occupational characteristics, concern about working with people of unknown HIV status and neuroticism. With all these variables controlled, including social contact, those who had not received in-service training relating to HIV/AIDS had more negative attitudes. The results are discussed with regard to the measurement of social contact with patients, salient beliefs, the occupational characteristics associated with attitudes, and in-service education.

Acquired Immunodeficiency Syndrome↗

PubMed1999

Measuring the stress associated with caring for clients with HIV/AIDS.

The AIDS-stress scale (Pleck et al., 1988) provides measures of the sources of stress faced by health care workers caring for people with AIDS. The aim of the study was to consider the utility of the scale as a means of identifying groups of health care workers who would benefit from intervention. Data were collected from a sample of Scottish health care workers (n = 140), all with known contact with clients with HIV or AIDS within the year prior to data collection. Three factors were derived from the AIDS-stress scale: 'lack of knowledge', 'discomfort' and 'work load'. Each showed a different pattern of association with occupational, training and attitudinal measures. The factor scores had some degree of concurrent validity and were not, in the main, associated with the desire to give socially desirable responses. The results were discussed in relation to appropriate interventions.

Acquired Immunodeficiency Syndrome↗

PubMed1996

Pain memories in phantom limbs: a case study.

Pain experienced in a limb prior to amputation may influence the course of phantom limb pain many months later. Katz and Melzack (1990) found that 42% of their sample reported a 'somatosensory pain memory' which resembled the quality and location of a painful, or non-painful pre-amputation sensation. For many amputees, pain memories are vivid experiences which incorporate both emotional and sensory aspects of the pre-amputation pain (Katz 1992). Katz and Melzack (1990) suggest that sensory input will 'trigger' somatosensory pain memories while the affective component of a pain memory is generated by the intensity, quality and location of the current experience of phantom limb pain. The present case study used a diary design to examine whether 'triggers' could be identified for somatosensory pain memories. Over a 9-month period, the patient reported daily experience of ongoing phantom limb pain, generally confined to the distal part of the limb, and 5 episodes of injury-related phantom limb pain, primarily experienced in the calf of the missing limb. A 'trigger' was identified for each of the episodes of injury-related phantom limb pain, and a significant finding in this study was that two episodes of injury-related phantom limb pain were associated with cognitive and/or emotional, rather than sensory 'triggers'.

Abscess↗

PubMed1995

The role of coping in adjustment to phantom limb pain.

Research has indicated that the way individuals cope with pain may influence pain, and physical and psychological adjustment. The present study assessed the relationship between coping strategy use and adjustment in amputees with phantom limb pain (PLP). Coping strategies were measured using the Coping Strategies Questionnaire (CSQ) and their relationship with adjustment was examined using both composite scores and individual strategy scores. The results indicated that the relationship between coping and adjustment was primarily explained by the use of strategies within the 'Helplessness' factor of the CSQ. A clearer picture of coping strategy use was gained from examining individual strategies rather than the composite measures. Catastrophizing explained the largest proportion of variance in pain report (26%), while increasing behavioral activity and hoping or praying strategies explained a smaller proportion of the variance (3% and 1%, respectively). Catastrophizing also explained a large proportion of the variance in physical and psychosocial dysfunction (11% and 22%), while hoping or praying strategies accounted for only a small proportion of the variance in physical dysfunction (3%), and re-interpreting pain sensations accounted for a small proportion of the variance in psychosocial dysfunction (3%). The findings in this study have important clinical implications in that coping strategy use was associated with increased, rather than decreased, levels of pain and disability. However, since the reported use of coping strategies in the present study was low, further research, perhaps utilizing other measures of coping, is required to clarify these findings.

Adaptation, Psychological↗

PubMed1995

The stability of the Ways of Coping (Revised) Questionnaire over time in parents of children with Down's syndrome: a research note.

The stability of the Ways of Coping (Revised) Questionnaire over time was assessed by comparing the scores of 68 mothers and 53 fathers of school-aged children with Down's syndrome over a 3-year time interval on the five coping strategy subscales described by Knussen et al. (1992). For this analysis, mothers' and fathers' scores were analysed separately. It was shown by t tests that mothers' and fathers' scores on the coping strategy subscales had not significantly changed over the three-year period. Time 1 and Time 2 scores on all of the coping subscales were strongly positively associated, with the exception of fathers' scores on the Stoicism subscale. Test-retest reliability was adequate for all subscales except mothers' scores on the Passive Acceptance subscale and fathers' scores on the Stoicism subscale. These results, by demonstrating the stability of the Ways of Coping (Revised) Questionnaire over a 3-year time period, further illustrate the utility of this instrument for investigating coping with families with special problems.

Adaptation, Psychological↗

PubMed1992

The use of the Ways of Coping (Revised) questionnaire with parents of children with Down's syndrome.

The principal aim of this study was to assess the validity and usefulness of the Ways of Coping (Revised) questionnaire (Folkman & Lazarus, 1985) with a British sample of parents of children with Down's syndrome. Factor analysis yielded five subscales which were compared with those reported elsewhere. Other properties of the instrument were investigated. It was concluded that the instrument was potentially valuable to those investigating coping in families with special problems.

Adaptation, Psychological↗

PubMed1991

The validity and applicability of the ADIECAS classroom rating scale in a sample of children with Down's syndrome.

The ADIECAS classroom behaviour rating scale (Evans & Hogg, 1984) was used with a sample of 123 children with Down's syndrome as part of a wider study of child and family adaptation. According to Evans & Hogg, the ADIECAS scale measures two types of behaviour: attentiveness-distractability, and inhibition-excitability. Such measures of behaviour style may be related to behaviour problems and child and family relationships for children with mental handicap. The factor structure of the 16 ADIECAS items was investigated by using confirmatory factor analysis within the LISREL program. Overall, the original factor structure was found to be a poor fit to the new data, in that, while the distractability factor replicated well, the excitability factor split into three. After examining the components of the four factors, two were discarded as containing unreliable items, and goodness of fit statistics on the two revised factors, using 10 of the original 16 items, gave the best results. Thus, the factors structure showed only limited replicability with a different subject group from the original Evans & Hogg study.

Arousal↗

PubMed1991

Factors relating to self-sufficiency in children with Down's syndrome.

An index of self-sufficiency in children with Down's syndrome was developed for use in a study of the process of adaptation in families living in the Greater Manchester area. The children were 6-14 years old, and living at home. Index scores were based on the mothers' responses to a questionnaire covering their children's personal and domestic functioning and community self-sufficiency, and were obtained from 111 of the 117 mothers who took part in the study. A wide range of child- and family-related variables were found to be significantly associated with self-sufficiency scores on a univariate level. Multiple regression analysis was used to identify those variables which best predicted the level of self-sufficiency achieved. After the child's mental age, the most significant variables were excitability, behaviour problems, the extent the mother used practical means of coping, and the level of social activity experienced by the child. Together, these five variables explained 63% of the variance in self-sufficiency scores. The dynamics by which such factors may relate to self-sufficiency in children with Down's syndrome are discussed, and intervention aimed at promoting the use of practical ways of coping by parents is suggested.

Activities of Daily Living↗

PubMed1991

Factors related to stress and satisfaction with life in families of children with Down's syndrome.

In a study of families of children with Down's syndrome, measures of parent, family and child characteristics were obtained from mothers and fathers. Multivariable analyses investigated their relationships to outcome measures of psychosomatic symptoms of stress and parents' perceived satisfaction with life. Personality factors were related to outcome for both parents. For mothers, the children's levels of behaviour problems, excitability and self-sufficiency were strongly related to outcome. Coping strategies, family relationships and socio-economic factors also showed significant effects. For fathers, child characteristics were not related to outcome. The marital relationship was an important factor and there was evidence that factors external to the family acted as stressors.

Adaptation, Psychological↗

PubMed1991

Is the appearance of children with Down syndrome associated with their development and social functioning?

The appearance of 111 children with Down syndrome, aged six to 14 years, was rated by their class teachers as part of a larger study on factors associated with their development, social life-style and family functioning. There were no significant associations between measures of child development, communicative or independent functioning, social life, behaviour problems or with parental stress, parent-child relationships or quality of family life. Typical features of Down syndrome are not major correlates of development and social functioning, and no support could be found to justify routine cosmetic surgery aimed at ameliorating such features.

Achievement↗

PubMed1990

Factors related to the academic attainments of children with Down's syndrome.

The attainments in reading, number and writing skills, of 117 children with Down's syndrome, aged 6 to 14 years, were assessed using checklists completed by teachers. In a study of child and family functioning a wide range of variables was measured and the relationships of these to academic attainments were investigated using multivariable analysis. The children's mental age scores were most strongly related to academic attainments scores, but, in addition, type of school attended, gender, chronological age and fathers' scores on a measure of locus of control were significantly related. The results are discussed in terms of their implications for educational placement and curriculum, and the role of fathers in their children's education.

Achievement↗

PubMedDate not supplied

Health problems in children with Down's syndrome.

The health problems of 117 children with Down's syndrome were identified through a questionnaire to their mothers, as part of a wider study of the process of adaptation among families in the Manchester Down's Syndrome Cohort. At the time of the present study, the children were all of school age: mean age 9 years 2 months, range 6 to 14 years. Results from the current study are compared with that from earlier studies involving these children. Vision and hearing problems and respiratory infections were identified as the most common health problems, affecting a large percentage of the children. While a high proportion had been hospitalized and had undergone operations, the proportion of children who had missed more than 4 weeks of schooling in the previous 12 months was not high compared to the general child population. Equally, the numbers who had suffered accidents did not appear unduly high. Poor child health was found to be associated with a higher level of behaviour problems and increasing maternal stress over time. The need for health screening to continue during this period of childhood is identified.

Adolescent↗

PubMedDate not supplied

Social life of school children with Down's syndrome.

Frequency of participation in organized activities and informal play contacts with other children were investigated for a group of 118 children with Down's syndrome. Measures were based on mothers' reports. As part of a study of child and family functioning, a wide range of child, parent and family variables was measured and the relationships of these to the extent of the children's social contacts were investigated in multivariable analyses. Family variables of social class, parental education, marital relationship, and achievement and recreational orientation were found to be significantly related to the measures of the child's social life. In addition, children at the lower end of the IQ range in this sample were likely to have fewer informal play contacts. These results point to the influence of the family in stimulating and maintaining the children's social activities.

Adolescent↗