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Biomedical subjects

L Lechner

Publications and source records attributed to L Lechner.

17 recordsLinked to original sources
PubMed2006

Definite involuntary childlessness: associations between coping, social support and psychological distress.

BACKGROUND: Around 4% of all couples remain involuntarily childless. These people often experience insufficient social support, which further aggravates the distress symptoms such as physical health problems, anxiety, depression and complicated grief. This study investigates the association of coping style and the degree of satisfaction regarding social support from primary support groups with distress symptoms of involuntarily childless individuals. MATERIALS AND METHODS: Subjects in this cross-sectional study were people who wanted to have children with their partner but were unable to conceive and had acknowledged their involuntary childlessness. The sample consisted of 116 persons (response 88%) with an average age of 39 years (SD = 6.0), with 75% women. The sample group completed a questionnaire consisting of passive and active coping styles from the Utrecht Coping List (UCL), the discrepancy variant of the Social Support List (SSL-D), the short version of the Questionnaire on Experienced Health Complaints (VOEG-21), the Hospital Anxiety and Depression Scale (HADS) and the Inventory of Complicated Grief-Revised (ICG-R), adapted for this study. RESULTS: Women especially experienced more health complaints, more anxiety and depression symptoms and more complicated grief than the general population. Regression analysis shows that when controlled for sex and the duration of involuntary childlessness, the concepts passive coping style and dissatisfaction with social support were positively associated with health complaints, depression, anxiety and complicated grief. The concept active coping style was negatively associated with depression, anxiety and complicated grief. Explained variance of the different distress symptoms varied from 30 to 65%. A moderating association of perceived social support is only found between a passive coping style and health complaints. CONCLUSIONS: Psychosocial interventions should be continued after the childlessness has become definite. By teaching couples how to cope actively with their childlessness and how to ask for support, the negative consequences of their childlessness may be decreased.

Adaptation, Psychological↗
PubMed2006

Factors related to misperception of physical activity in The Netherlands and implications for health promotion programmes.

With respect to health risk behaviours, many people are unaware of their own risk behaviour and regard their behaviour as more healthy than it really is. This article studied differences between people with and without misperception of their physical activity with respect to several reference points: the social comparison style of people (upward, equal and downward); the body self-image with regard to their weight [body mass index (BMI) and self-rated weight]; and linkages of physical activity with different outcome expectancies (health, appearance, weight, feeling fit, relaxation and stress relief). Results from 516 respondents (response 52%; 56% women) with a mean age of 53.7 years found that respondents who incorrectly think that their physical activity is adequate (overestimators) tend to rate their physical activity more often in comparison to others. Furthermore, overestimators and people who correctly think they exercise enough more often use downward comparison, while underestimators and people who know they exercise too little mostly use upward comparison. People who, rightly or not, think their weight is adequate or who have a lower BMI, more often assume that their physical activity is sufficient or high. People who, rightly or not, think that their physical activity is adequate more often score higher on other reasons to be physically active besides health. Increasing the accuracy of people's self-perceptions of physical activity may be important to incorporate into strategies to promote physical activity in populations at risk of inactivity.

Attitude to Health↗
PubMed2004

Breast self-examination: longitudinal predictors of intention and subsequent behaviour.

This study analysed in a longitudinal design the relationship between past breast self-examination (BSE) behaviour, determinants, intention and future BSE behaviour in a population of adult Dutch women. Past behaviour and psychosocial determinants were assessed at T1, followed 6 weeks later (T2) with the assessment of the intention to perform BSE monthly. Half a year after the first measurement the current BSE behaviour was assessed by means of a telephone survey (T3) (total end response 78%, n=364). The questionnaires included BSE behaviour, intention, attitude (pros and cons of BSE, anticipated regret, moral obligation), social influence (support, modelling) and self-efficacy. Other background variables assessed were past BSE behaviour, and demographics. Although 81% of the women stated that they performed BSE, only 41% of the women performed BSE correctly. Women who performed BSE correctly differed from women who did not on all psychosocial determinants assessed a half year earlier, with the exception of anticipated regret. Stepwise multiple regression analyses showed that the psychosocial determinants explained 51% of the variance in intention to perform BSE, assessed 6 weeks later; past behaviour accounted for 2% of extra explained variance. Logistic regression analyses showed that past behaviour, the psychosocial determinants and intention were significant predictors of correct BSE behaviour a half year later (Nagelkerke's total explained variance was 47%). It was concluded that misperceptions of correct BSE behaviour was highly prevalent. Both the psychosocial determinants as well as past behaviour were important predictors of intention to perform BSE and subsequent BSE behaviour.

Adult↗
PubMed2002

Sunbed use at home: risk behaviour and psychosocial determinants.

The objective of this study was to analyse the behaviour of people with regard to sunbed use at home, and to analyse the psychosocial determinants of intention and behaviour with regard to limiting the health risk of using sunbeds at home. Data were collected by means of a telephone survey among 349 adults from the Dutch general public who use sunbeds at home (response=95%). Determinants that were assessed were: attitude with respect to safer use and the use of sunbeds in general, the social influences people encounter to use sunbeds in a safer way, and the self-efficacy expectations people have of their ability to use sunbeds more safely. The results showed that there were great differences between people's perceptions of their safe sunbed behaviour, and their actual safety behaviour. Almost all respondents (94%) thought that their sunbed behaviour was safe, while in reality only 37% of the respondents used the sunbed in accordance with the safety guidelines. The safer users of sunbeds differed on many determinants from the unsafe users. Intention to minimize the health risk when using sunbeds could be predicted by a person's perceived self-efficacy, the overall attitude and anticipated regret beliefs (R2=0.52). Sunbed users should be made aware of their risk behaviour with regard to sunbeds as well as providing information on changing determinants, in order to positively change people's intentions and behaviour with regard to the safer use of sunbeds.

Adolescent↗
PubMed2001

A qualitative study on detecting cancer symptoms and seeking medical help; an application of Andersen's model of total patient delay.

Patient delay is the interval between the day someone first becomes aware of an unexplained symptom and the day they seek medical consultation. This pre-diagnostic period is comprised of several stages which may involve delay on the part of the individual. This study investigated factors influencing the process of detecting cancer symptoms and consulting a general practitioner (GP). Twenty-three patients were interviewed about their experiences during this process. Among factors stimulating the process of detection and consultation were associating symptoms with cancer, and discussing symptoms with others. Being ashamed or embarrassed about the symptoms and attributing symptoms to common ailments were among the impeding factors. The findings of the present study suggest that future health education on early detection of cancer should focus on increasing knowledge and providing positive information about early detection of cancer. It is recommended that educational materials be disseminated to the general public via more channels, including non-medical channels.

Adult↗
PubMed2001

Web-based tailored nutrition education: results of a randomized controlled trial.

There is ample evidence that printed, computer-tailored nutrition education is a more effective tool for motivating people to change to healthier diets than general nutrition education. New technology is now providing more advanced ways of delivering tailored messages, e.g. via the World Wide Web (WWW). Before disseminating a tailored intervention via the web, it is important to investigate the potential of web-based tailored nutrition education. The present study investigated the immediate impact of web-based computer-tailored nutrition education on personal awareness and intentions related to intake of fat, fruit and vegetables. A randomized controlled trial, with a pre-test-post-test control group design was conducted. Significant differences in awareness and intention to change were found between the intervention and control group at post-test. The tailored intervention was appreciated better, was rated as more personally relevant, and had more subjective impact on opinion and intentions to change than the general nutrition information. Computer literacy had no effect on these ratings. The results indicate that interactive, web-based computer-tailored nutrition education can lead to changes in determinants of behavior. Future research should be aimed at longer-term (behavioral) effects and the practicability of distributing tailored interventions via the WWW.

Adult↗
PubMed2000

Motives for protective behavior against carcinogenic substances in the workplace: a pilot study among Dutch workers.

Exposure to carcinogenic substances in the workplace creates an increased risk of certain types of cancer among employees. In The Netherlands, more than one million of the total working population of 10 million are exposed to toxic substances in more than 100,000 Dutch companies. To motivate workers to comply with protective recommendations, it is important to know their reasons for complying or not complying. The goal of the present study was to analyze the differences between workers who show a relatively high degree of protective behavior and those who show a relatively low degree of such behavior. The beliefs of workers exposed to carcinogenic substances at four worksites were analyzed. Data on attitudes, perceptions of social support, and self-efficacy expectations toward compliance with protective behavior were collected among 164 workers. The results showed that non-compliant workers perceived fewer benefits, encountered less social support, and, most importantly, encountered more barriers to complying with safety recommendations. It is concluded that health education programs must address these specific items to motivate non-compliant workers to comply more fully with protective recommendations.

Adult↗
PubMed1997

Consumption of fruit and vegetables: how to motivate the population to change their behavior.

This study reports the discrepancy between two methods to assess fruit and vegetable consumption in a Dutch adult population (N = 367). The consumption of fruit and vegetables was assessed by using a food frequency method (the number of grams of fruit and vegetables subjects ate every day) and by assessing subjects' own estimates of their fruit and vegetable intake. Besides the behavior, intention and determinants were measured using a theoretical model including attitude, self-efficacy and social influence to eat fruit and vegetables. Results showed that there were large differences between the self-rated and estimated objective consumption of fruit and vegetables. Subjects rated their own intake as much higher than their estimated actual intake. Furthermore, multiple regression analyses showed that the determinants predicted the self-rated consumption much better than the estimated consumption.

Adult↗
PubMed1997

Effects of an employee fitness program on reduced absenteeism.

The effect of participation in an employee fitness program on reduction of absenteeism due to illness on three different worksites (police force, chemical industry, banking) was studied. The study used a longitudinal pretest-posttest design. From 884 subjects, data were collected on absenteeism in the pre-intervention year and on absenteeism in the first year of the fitness program. The subjects were divided into three groups: high participation, low participation, and no participation in the employee fitness program. Results of covariance analyses show that the high participation group had a significant decline in sick days (4.8 days), while the low and no participation groups showed no change in sick days. Even when self-selection in the participation in an employee fitness program seems to be present, there is potentially for a great deal to be gained from participation of this self-selected group in terms of changed sick days.

Absenteeism↗
PubMed1996

The Dutch cancer information helpline: experience and impact.

A study was performed to evaluate the experience and impact of the Dutch national cancer information helpline. During a period of 4 weeks all callers from the target groups general public, cancer patients and friends/relatives of patients were asked to fill in a structured postal questionnaire (response 73%; N = 532). Different characteristics of the helpline were evaluated: the overall quality of the information given, the communication skills of the educators and the telephone as a channel for getting information concerning cancer. Also, several outcomes were measured: the overall satisfaction with the helpline, the impact on anxiety and the impact on meeting expectations. Most of the callers evaluated the different characteristics of the helpline very positively. Most callers were positive concerning the outcomes of the helpline. However, different target groups showed different predictors of these outcomes. The general public were mostly interested in general information, while relatives/friends and patients also seemed much in need of communicational feedback and reassurance. To maintain the high quality of the helpline it is of great importance to keep the line's expertise at a constant high level. This can be realized by training educators to attune more to the specific needs and questions of the different target groups and to try to get the 'real' questions to the surface.

Adult↗
PubMed1995

Psychosocial determinants of fruit and vegetable consumption.

Psychosocial correlates of fruit and vegetable consumption were studied in an adult Dutch population (n = 367) based on the ASE model of attitudes, social influence and self-efficacy. Attitudes were a summation of beliefs about taste, different health consequences, and costs in time and money. Social influences were measured through the social stimulation respondents expected to get from important others to consume adequate amounts of fruit and vegetables and by asking the subjects about the behaviour of important others. Self-efficacy reflected the respondents' ability to consume adequate amounts of fruit and vegetables in various situations. Self-efficacy and attitudes were consistently and significantly associated with consumption of boiled or otherwise heated vegetables, of salads, and of fruit. Furthermore, respondents reporting low consumption of these food groups had lower self-efficacy expectations and less positive attitudes than subjects with relatively high consumption of fruit and vegetables. It is concluded that nutrition education aimed at stimulating fruit and vegetable consumption should focus especially on changing attitudes and self efficacy expectations.

Adult↗
PubMed1995

Starting participation in an employee fitness program: attitudes, social influence, and self-efficacy.

BACKGROUND: This article presents a study of the determinants of starting participation in an employee fitness program. Information from 488 employees, recruited from two worksites, was obtained. From these employees the determinants of participation were studied. METHODS: A questionnaire based on two theoretical models was used. The Stages of Change model was used to measure the health behavior, consisting of precontemplation (no intention to participate), contemplation (considering participation), preparation (intending to participate within a short period), and action (participating in fitness). The possible determinants were measured according to the ASE model, including the attitude toward an employee fitness program, social influence, and self-efficacy expectations. RESULTS: Subjects in action stage were most convinced of the benefits of participation in the employee fitness program and of their own skills to participate in a fitness program. Subjects in precontemplation stage were least convinced of the advantages of participation and had the lowest self-efficacy scores. Subjects in action stage experienced the most social support to participate in the employee fitness program. CONCLUSIONS: Health education for employees within industrial fitness programs can be tailored toward their motivational stage. Promotional activities for industrial fitness programs should concentrate on persons in the precontemplation and contemplation stages, since people in these stages are insufficiently convinced of the advantages of a fitness program and expect many problems with regard to their ability to participate in the program.

Adult↗
PubMed1995

Participation in an employee fitness program: determinants of high adherence, low adherence, and dropout.

This article presents the results of a study of the determinants of adherence level in an employee fitness program. Of all 236 employees who started participating in the program the determinants of level of participation (high adherence, low adherence, and dropouts) during the program were studied by means of a pretest and posttest design. The questionnaire was based on different theoretical concepts. The determinants measured included the attitude toward an employee fitness program, self-efficacy expectation, and social support. The results show that there were no differences in determinants between the groups at the start of the program. During the second measurement the high- and low-adherence groups were most convinced of the benefits of participation in the program. The low-adherence group and the dropouts were least convinced of their ability to participate in a fitness program. Theoretical and practical implications are discussed.

Analysis of Variance↗
PubMedDate not supplied

Help-seeking behaviour for cancer symptoms: perceptions of patients and general practitioners.

The aim of this study is to increase our understanding of the relationship between knowledge and interpretation of symptoms, fear and trust on the one hand, and the decision to consult a general practitioner (GP) for cancer symptoms on the other. Qualitative interviews were used to evaluate the various factors. Twenty-three patients and ten GPs were interviewed. A number of factors were found to play different roles for different patients groups, i.e. patients that consult their doctor prematurely, at the right time, or those that delay. A lot of the findings can be tested using various concepts of socio-psychological theory. Further research should provide an improved understanding of the way these models can be applied to help-seeking behaviour. In terms of implications for health education, we conclude that each patient group has different needs and requires different information.

Adult↗
PubMedDate not supplied

Participation in a breast cancer screening program: influence of past behavior and determinants on future screening participation.

BACKGROUND: This study analyzed the relationship between past screening behavior, determinants, intention, and future screening participation in the Dutch national breast cancer screening program. METHODS: Participation at the first and second screening rounds was monitored. Furthermore, between the first and the second screening rounds, women received a questionnaire (response 58%, n = 395). The questionnaire was based on the ASE model, including attitude (consequences, anticipated regret, and moral obligation), social influence (support and modeling), and self-efficacy. Other distal variables assessed were previous screening behavior, evaluation of screening characteristics, and demographics. RESULTS: Participants at the second screening differed from nonparticipants on all ASE determinants. Stepwise multiple regression analyses showed that for previous participants and nonparticipants different ASE determinants and distal variables explained the variance in intention to participate in the next screening (30 to 45%). Logistic regression analyses showed that past behavior and intention (which mediated the effects of the ASE variables) were significant predictors of participation in the second screening. CONCLUSIONS: Differences between previous participants and nonparticipants in determinants of intention and future screening behavior can be used to improve participation and adherence to breast cancer screening.

Aged↗
PubMedDate not supplied

Factors associated with the intention to use vitamin D supplements: quantitative study among a sample of elderly people in a medium-sized town in the Netherlands.

The objective of this study was to assess which factors are related to the intention of elderly people to use vitamin D supplements.A questionnaire that was based on several theories, feedback of experts, and personal interviews with members of the target group was distributed among a random sample of 497 elderly people in a medium-sized town in the Netherlands (response 46%). Variables measured included perceived susceptibility, severity and control with respect to developing a vitamin D deficiency or getting a bone fracture, and beliefs, perceived social norms, modeling, self-efficacy, and intention with respect to the use of vitamin D supplements. Univariate analyses of variance, chi-square tests, stepwise multiple regression, and stepwise logistic regression analysis were performed. Respondents reporting a high intention had more positive attitudes and normative beliefs, higher self-efficacy expectations with respect to using vitamin D supplements, and more often used other supplements than respondents with a low intention. Subjects who already used vitamin D supplements were more often female and already familiar with the advice and had more positive attitudes and normative beliefs than nonusers. It was concluded that many elderly people have high intentions to start using vitamin D supplements as soon as they hear about the advice. A health promotion campaign to promote the use of vitamin D supplements should aim at making elderly people familiar with the Health Council of the Netherlands' advice. Furthermore, the campaign should place emphasis on changing attitudes, perceived social norms, and self-efficacy expectations toward vitamin D supplement use.

Aged↗