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Biomedical subjects

R Pill

Publications and source records attributed to R Pill.

50 records · Page 3Linked to original sources
PubMed1987

Development of a measure of potential health behaviour: a salience of lifestyle index.

The development of a salience of lifestyle index to measure potential health behaviour is described with its validation, including the relationship between the new index and various measures of preventive health behaviour. The complex cascade of antecedents which contribute to a decision to make or not make a specific lifestyle choice is summarised to clarify the contribution of the salience of lifestyle index to pure research and evaluative studies.

Adult↗
PubMed1986

Irritable urethral syndrome: follow up study in general practice.

Two years after a microbiological study of the urethral syndrome 25 of 31 women had had further symptoms, but only two had sought medical help for their symptoms in the year after the study. Analysis of patients' records showed that women with the urethral syndrome had higher consultation and sterilisation rates and more psychosomatic symptoms and relationship problems than matched control patients. Using the Nottingham health profile women with the urethral syndrome were more likely to mention that health problems affected their sex lives and were more likely to see themselves as having health problems than control patients. Women who have the urethral syndrome are considerable drain on the doctor's time, and management needs to be directed towards the anxious patient who makes such demands. Seeing the condition as the "irritable urethral syndrome" may help both doctor and patient to recognize the psychosomatic aspect of the problem.

Family Practice↗
PubMed1985

Choice or chance: further evidence on ideas of illness and responsibility for health.

A study of 204 Welsh mothers using well validated research methods has demonstrated that better understanding of the antecedents to health behaviours contributes to a reorientation of stereotyped ideas about working class health beliefs and behaviour. Fatalism and an orientation to life-style choices for health are not necessarily contradictory concepts and this has important implications for those who are involved in education for health. The development of a Salience of Lifestyle Index (SLI) is described and studied in relation to concepts of blame for illness, education, house tenure, religious commitment, employment, health behaviours and social background.

Adult↗
PubMed1985

Preventive procedures and practices among working class women: new data and fresh insights.

Using a sample of lower working class mothers from South Wales, U.K. data is presented on the extent to which procedures, (behaviours which involve health professionals and services) and practices (behaviours which involve the individuals in day to day lifestyle choices) are interrelated and likely to be practised by the same people. The socio-demographic variables associated with each category separately and with the whole range of preventive behaviour are also described. The British data is considered in the light of current research on preventive health behaviour (PHB) which has relied heavily for both empirical data and theoretical insight on studies conducted in U.S.A. No evidence is found to support the proposition that PHB is undimensional nor on the other hand is there convincing support for the existence of hypothesized independent dimensions. It is argued that the failure of present theory to predict more than a comparatively small part of the variance in PHB has positive implications for researchers and health educators alike.

Adult↗
PubMed1982

Concepts of illness causation and responsibility: some preliminary data from a sample of working class mothers.

In recent years official policy in the U.K. has been marked by a shift in emphasis from curative to preventive medicine, with increasing stress being laid on the role of the individual in maintaining his/her health. However, we lack empirical data on the extent to which the concept of individual responsibility for health is accepted by various groups in our society and such data is essential before effective strategies for health education can be implemented. It is argued that readiness to accept responsibility for one's health depends partly on the views held about the aetiology of illness, and this proposition is explored using material on causation and the circumstances where blame is attributed, derived from semi-structured interviews with a sample of 41 working class mothers (Socioeconomic Group 9). Roughly half the sample held fatalistic views on the aetiology of illness and thought they were only morally accountable in very restricted circumstances. These women tended to be less well-educated than the rest of the group and they were less likely to be buying their own homes. The results are discussed in relation to current health education policies, consultation behaviours in primary medical care and consumer attitudes to the services provided by their doctors.

Adult↗
PubMed1981

Quality of life of mentally retarded adults transferred from large institutions to new small units.

Quality of life of mentally retarded adults was assessed in large institutions and after transfer to new small units. Environmental changes in management practices and staff-resident interaction for both types of living units indicated significant improvement after transfer. Total adaptive behavior of transferred residents increased in the new units, but only the increase 9 months after transfer was significant when compared with behavior of matched control subjects. Total maladaptive behavior and antipsychotic drug prescription increased initially, with the former declining at subsequent assessments. Higher ability residents from "free" wards decreased participation in culturally normative activities and did not significantly change their adaptive behavior. Both higher and lower ability residents from "restricted" wards increased their participation in culturally normative activities and improved with regard to adaptive behavior. Significant increases and decreases in adaptive behavior over time paralleled the lack and subsequent initiation of off-unit occupations for residents with IQs over 50.

Adaptation, Psychological↗
PubMedDate not supplied

Relationship between health locus of control and belief in the relevance of lifestyle to health.

The relationship between the Multidimensional Health Locus of Control (MHLC scales) and other beliefs about health behavior were explored in a sample of working-class women living in South Wales, U.K. Contrary to our original hypothesis, those who scored higher on an index measuring salience of lifestyle (i.e., showed awareness that day-to-day behavior influences health status) were not significantly more likely to score high on the internal control scale or low on the belief in chance scale; however, they were significantly less likely to believe that "powerful others" controlled their health. Evidence is presented for the construct validity of the Index of Salience, and the reasons for the low correlations found are discussed. Because the internal HLC scale, in particular, fails to distinguish between health maintenance and illness behavior and between individual behavior and behaviors involving professionals, the value of the MHLC scales in predicting the specific forms that preventive health behavior will take is weakened.

Attitude to Health↗
PubMedDate not supplied

Presenting risk information--a review of the effects of "framing" and other manipulations on patient outcomes.

Discussing risks and benefits of treatments or care options is becoming an increasingly important part of modern health care. This paper reviews the literature about manipulations of risk and benefit information in the clinical setting. There is a paucity of evidence in this field, particularly when examining specific manipulations. Only three categories of manipulation had three or more studies. The available evidence shows that the way information is presented can have significant effects on decisions made. The largest effects are evident when relative risk information is presented, as compared with absolute risk data. In addition, "loss framing" is more effective in influencing screening uptake behaviors than "gain framing" (odds ratio 1.18 [95% confidence interval 1.01-1.38]). There is also a pattern of evidence from studies comparing simpler with more complex information, more data with less, and those comparing numerical with verbal descriptions of risks. These studies suggest that providing more information, and which is more understandable to the patient, is associated with improved patient knowledge and a greater wariness to take treatments or participate in trials. These findings can contribute to efforts to improve communication between professionals and patients.

Decision Making↗
PubMedDate not supplied

The effectiveness of one-to-one risk communication interventions in health care: a systematic review.

OBJECTIVES: To assess whether risk-communication interventions are associated with changes in patient knowledge, attitudes, and behaviors, and to identify aspects of these interventions that modify these effects. DESIGN: Systematic review. DATA SOURCES: 96 studies from the period 1985-1996 retrieved by electronic searching of eight databases, hand searching of four journals, contacting key authors, and reference list searching. MAIN OUTCOME MEASURES: The effect size of the principal outcome was identified from each study. Outcomes measuring behavioral change were preferred; if these were not available, knowledge, anxiety, or risk perceptions were used, according to the focus of the study. Data were available to calculate the principal effect sizes for 82 of the studies. ANALYSIS: Meta-regression. RESULTS: The methodologic qualities of the studies varied. Nevertheless, risk-communication interventions generally had positive (beneficial) effects. Interventions addressing treatment choices were associated with larger effects than were those in other contexts, such as prevention or screening. Interventions using individual risk estimates were associated with larger effects than were those using more general risk information. Two design variables were identified as effect modifiers: randomized controlled trials were associated with smaller effects than other designs, and dichotomous outcomes were associated with larger effects than continuous outcomes. CONCLUSIONS: Risk communication interventions may be most productive if they include individual risk estimates in the discussion between professional and patient. Patient decisions about treatment appear more amenable to change by these interventions than attendance for screening or modification of risky behavior.

Communication↗