PubMed HealthSearch

Biomedical subjects

G Kok

Publications and source records attributed to G Kok.

At least 19 recordsLinked to original sources

Worry: a particular determinant of consultation illuminated.

In this study, exploring the worry experienced by patients in the GP waiting room and the reasons for being worried, 791 patients completed a structured questionnaire just before they consulted their GP, and afterwards. The perceptions of the patients concerning the complaint and the need for more information about the complaint played an important role in the degree of worry. Patients who wanted more information about the complaint were more worried than the patients who did not feel they needed more information. Not surprisingly, the more serious the patients perceived the complaint to be and the greater the perceived chance of serious disease, the more worried they were. General health status and frequency of consultations per year were related to the degree of general worry. According to the patient self-reports, worry was almost never due to information from the mass media or from other persons, or to a concern for the consultation itself. Patients generally evaluated the consultation as positive with respect to the way their worry was discussed. The decrease in worry after consulting the GP, in patients who were positive about the consultation was significantly higher than that in patients who were less positive. The theoretical and practical implications of this study are discussed.

Adult

The reliability and validity of a Dutch questionnaire on fat consumption as a means to rank subjects according to individual fat intake.

In this paper a short, 25-item, telephone-administered questionnaire, designed to rank individuals according to their dietary intake of fat, is presented. Based on two studies of 52 and 639 men and women, respectively, its relative validity regarding a 7-day diet record and its reproducibility are discussed. A Pearson correlation of 0.59 was observed between fat intake estimated by 7-day diet records and fat score derived from the short questionnaire. Gross misclassification, defined as disagreement between the two fat consumption assessments beyond an adjacent tertile, was 15.4%. A Pearson correlation of 0.71 was calculated by a test-retest procedure. It is concluded that the Dutch short questionnaire on fat consumption is a rapid, simple and inexpensive method that can very well be used in nutrition education research to rank individuals according to their dietary fat intake.

Adolescent

The utilization of qualitative and quantitative data for health education program planning, implementation, and evaluation: a spiral approach.

The process of development of a Dutch smoking prevention project is described. An essential feature of the project is the combination and interaction of qualitative and quantitative research methods. It is advocated that each method has its own contribution and can be considered as a separate methodology contributing to social science in general and health education research in particular. Combining the two approaches in a spiral approach will result in a synergistic effect, because of the interaction of both approaches. The results of both methods suggest that qualitative methods enhanced the generation of ideas and theories. Qualitative methods were used to formulate ideas for improving quantitative data gathering, analyzing and comparing ideas with respect to program development, and for testing the internal validity of a quantitative design. The quantitative method enabled testing of results in different groups and detecting detailed differences. It also provided information that one of the assumptions of the program, the development of a teacher independent program, was not completely realized. The major advantage of using both methods is that this provides feedback between assumptions and data, thus enhancing comparison of results and critical reflection during the whole project.

Health Education

Why do patients consult the general practitioner? Determinants of their decision.

In order to obtain more information about the reasons why patients consult their general practitioner 1000 patients completed a questionnaire in the waiting rooms of eight general practices. After the consultation the patients received a second questionnaire. The aim of the study was to determine why people decide to consult their general practitioner about one complaint but not about a second complaint. Both questionnaires were based on the health belief model, augmented by three other factors: the perceptions patients have of their own abilities to cope with their condition (efficacy of self care), their knowledge about the complaint and their need for information. The results showed that two of the additional factors (efficacy of self care and need for information) as well as most of the factors of the health belief model (efficacy of general practitioner care, perceived severity of complaint and cues to consult) were important determinants of consulting the general practitioner. The results suggest that patients sometimes expect information from their general practitioner rather than medical treatment. Furthermore, as the perceived efficacy of general practitioner care is also an important determinant, unnecessary consultation or unnecessary delay in treatment could be prevented by offering patients information about the potential effectiveness of medical care or self care for specific conditions. Implications for general practitioners' daily practice and future research are discussed.

Attitude to Health

Determinants of behavioural risk factors for burn injuries.

Systematically developed health education should be based on a thorough knowledge of the determinants of the behavioural risk factors. Compared to other health-related behaviours, safety behaviour has some specific characteristics, which complicate studying its determinants. First, there is a multitude of circumstances leading to injuries, which means that it is not possible to pinpoint one desired behaviour to be linked with the prevention of injuries. Secondly, people are often not familiar with (the advantages and disadvantages of) all the possible preventive measures. Thirdly, the usefulness of preventive measures may depend on housing situations. So far, no elegant way of coping with these problems in examining the determinants of safety behaviour seems to have been suggested in the literature. In this article an approach to the study of determinants of safety behaviour is presented. The general description of this approach is illustrated by a study on the determinants of the behavioural risk factors for burn injuries in young children, which was conducted among Dutch and Turkish parents of children aged 0-4 years. The results indicate, for instance, that parents who implemented the safety behaviour reported that safety behaviour had become habitual to them.

Accidents, Home

Determinants of active self-care behaviour of insulin treated patients with diabetes: implications for diabetes education.

The most important aim of diabetes education is to alter the self-care behaviour of patients with diabetes. In order to change their behaviour its determinants must be known. The pretest of a multicentre evaluation study with 558 participating insulin treated patients with diabetes was analysed to test the usefulness of the attitude-behaviour theory of Fishbein & Ajzen in explaining and possibly changing diabetes related active self-care behaviour. The theory of Fishbein & Ajzen is based on the assumption that human behaviour is reasoned behaviour. The theory views a person's intention as the immediate determinant of action. Determinants of intention are attitude and social norm. The results showed that the attitude was the most important determinant of active self-care, while a sufficient level of knowledge and a low orientation on the powerful others health locus of control scale were prerequisites for a positive attitude. The influence of the social environment was detrimental; although people tried to motivate patients to active self-care, they could not provide any real help in performing this desired behaviour. According to the results of this study, diabetes education should first aim at improving the level of knowledge and the health locus of control of the patients and second, at a positive attitude to active self-care. It is necessary to educate the social environment to create a more supportive atmosphere for the patient with diabetes.

Adult

Importance of planned health education for burn injury prevention.

The planning of health education in the prevention of burn injuries is typically incomplete and not stated explicitly, while the evaluation is executed only partially or is altogether non-existent. This article presents a theoretical framework for planning and evaluating health education for those at risk for burns. Systematic planning consists of an assessment of the magnitude and severity of the problem, an analysis of the behavioural risk factors, a study of the determinants of the most risky modes of behaviour, the design of an optimal intervention, and the implementation of this intervention. The evaluation phase deals with the effects on these five levels (implementation, intervention, determinants, behaviour and injury risk). Some common pitfalls are mentioned and special attention is given to the study of determinants of behaviour and to the design of the intervention. Furthermore, the importance of pretesting health education material is underlined. There appears to be a strong need for further research on the aetiology of burn injury and the relevant determinants of behaviour, before effective prevention can be realized.

Age Factors

Attributions for previous failures and subsequent outcomes in a weight reduction program.

This prospective study examines the effects of causal attributions given to previous weight control failures on subsequent success in controlling weight. Adult participants enrolled in a weight control program were screened to identify those who had made previous weight reduction attempts through a formal program. Once identified, subjects (n = 158) were asked to make causal attributions for their previous failures. Subjects were then followed through the 15-week program to determine their degree of success. Subjects who attributed the cause of previous failures to stable, immutable conditions were more likely to have low expectations of success. Low success expectancies, in turn, were associated with lack of goal attainment through the program. The number of previous failures in formal weight control programs was associated with a perception of the respondents that previous failures had stable causes. Neither the number of former failures nor the attributions of their causes were directly related to goal attainment. Practice implications of the results are discussed.

Achievement