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PubMed2002

Medication- and illness-related factual knowledge, perceptions and behaviour in angina pectoris patients.

As part of a study in Danish internship pharmacies, 70 fourth-year pharmacy interns interviewed 123 angina pectoris patients. Information was collected about the patients' medication- and illness-related factual knowledge and perceptions as well as their medication use. The results obtained showed that patients' perceptions and factual knowledge about medications and illness varied greatly, and that they administered their medication in a variety of ways. Patients' factual knowledge on illness, illness prevention and the function of medication was generally low. The patients were grouped in different categories according to their perceptions of illness and medication. A quarter had actively and reflectively self-regulated their medication and the rest of the patients did not do any deliberate self-regulation in terms of their medication. Half of the patients occasionally forgot to take their medication. Health care personnel should incorporate the results of this study in their efforts to improve patient counselling on illness, medication and other health-related matters.

Aged↗

PubMed1989

Anxiety in parents seeking pediatric care.

Interviewed parents of 103 children brought to a pediatric walk-in clinic, before and after seeing a physician. Previsit state anxiety was minimally related to parent perceptions of child's condition or the hospital. Anxiety, perception of child's discomfort, and perception of illness severity decreased while perceived understanding of child's illness increased postvisit. Parent perceptions of their child's condition and of the visit contributed little to the prediction of postvisit anxiety. Parent perceptions of their child's illness and the hospital were minimally related to their level of state anxiety when they brought their child to an acute care service. The visit with the physician decreased parent anxiety and improved parent perceptions of their child's condition, but these effects had little relationship to postvisit anxiety.

Acute Disease↗

PubMed2003

Risk communication and foodborne illness: message sponsorship and attempts to stimulate perceptions of risk.

Foodborne illness represents a serious health hazard in the United States. Since foodborne illness can often be prevented by an individual's behavior, messages aimed at promoting safe food-handling behaviors should be a major tool to reduce the incidence of foodborne illness. This article argues that to achieve adoption of safe food-handling practices in the home, food-safety messages should both stimulate risk perceptions and promote self-efficacy, feelings that one can successfully enact recommended behaviors. A content analysis of nationally distributed food-safety messages questioned if messages incorporated these features. Since food-safety communicators operate in complex environments with multiple and sometimes competing objectives, this study also questioned if sponsorship of foodborne illness prevention messages was related to the amount of content designed to alter risk perceptions associated with foodborne illness. Results of the quantitative content analysis found that copywriters generally included content designed to stimulate risk perception about foodborne illness but virtually ignored self-efficacy needs of the audience. A marked difference in tendencies to stimulate risk perceptions was found based on sponsorship. Both in volume and proportion, results show that governmentally sponsored messages more aggressively attempted to heighten risk perceptions associated with foodborne illness than did messages sponsored by privately funded communicators.

Communication↗

PubMed2002

Illness attributions and myocardial infarction: the influence of gender and socio-economic circumstances on illness beliefs.

AIM: To present findings from a study conducted between 1996 and 1998 to investigate participants' perceptions of illness causation following a myocardial infarction. RATIONALE: The underlying assumption of many practitioners is that perceptions of illness causation will influence emotions and adjustment to illness. DESIGN: Phenomenology was the research methodology used to examine perceptions of illness causation. A convenience sample was taken of 24 men and women who were admitted to a regional hospital in Victoria, Australia, with a provisional diagnosis of myocardial infarction. Participants were interviewed shortly after hospitalization, and interviews were taped, transcribed and thematically analysed. FINDINGS: Stress was the most commonly cited cause of illness. Men and women demonstrated distinct differences in illness attribution. Participants who verbalized concerns about their loss of autonomy and their subsequent ability for self-management were predominantly female and uniformly members of the lowest socio-economic group CONCLUSION: The article concludes with a discussion of implications of the findings for practice.

Adaptation, Psychological↗

PubMed1989

Beliefs about aging and illness in a community sample.

Findings from recent studies have demonstrated age group differences in coping with illness. One explanation for these age group differences has received little attention: perceptions of illness may differ with age and these differences in perception may account for the observed differences in coping. The purpose of this study was to examine the effects of age on illness perceptions along dimensions that influence coping. Specifically, we explored perceptions about aging as a cause of illness and perceptions about the effect of age on seriousness, curability and controllability of illness. Four hundred fifty-one community-dwelling adults (age range 20 to 90 years) participated in the study. The pattern of results showed respondents of all ages expressing the belief that aging is associated with increased susceptibility to disease and lowered potential for control or cure. Implications of these beliefs for health monitoring and coping with illness are discussed.

Adaptation, Psychological↗

PubMedDate not supplied

Whose illness is it anyway? Why patient perceptions matter.

Recent studies indicate it is frequently patients' implicit understanding and attitude towards their illness that affect health behaviours such as compliance with medication, follow-up and rehabilitation attendance--important mediators of physical and psychological outcome. An overview of the theory that forms the basis for such findings attempts to explain how illness perceptions mediate health outcome. By examining research which has demonstrated important relationships between illness beliefs and physiological/functional outcome in specific illnesses, this review attempts to bring together psychological theory and clinical outcome measurements; this should demonstrate the value and importance to health-care professionals of considering the patient perception framework.

Attitude to Health↗

PubMed1990

Recurrent pain, illness intrusiveness, and quality of life in end-stage renal disease.

Repeated episodes of headache and muscle cramp were hypothesized to contribute to increased patient perceptions of illness intrusiveness and to compromised quality of life. Standard measures of pain, illness intrusiveness, and quality of life were obtained on 2 occasions, each 6 weeks apart, from 100 end-stage renal disease patients. The impact of recurrent muscle cramps on perceptions of illness intrusiveness was conditional upon the occurrence of headache symptoms. Perceptions of illness intrusiveness were significantly higher when both muscle cramp and headache symptoms occurred during one or more assessment intervals as compared to when muscle cramps or headaches, only, occurred. Illness-related concerns and general feelings of pessimism were also significantly higher among patients who experienced recurrent episodes of muscle cramp. Although no direct relations were observed between pain and other quality of life indicators, previous research has documented a relation between illness intrusiveness and quality of life. Recurrent pain problems, thus, appear to contribute to increased illness intrusiveness and to reduced quality of life in end-stage renal disease patients.

Headache↗

PubMedDate not supplied

Uncertainty in prostate cancer. Ethnic and family patterns.

PURPOSE: Prostate cancer occurs 37% more often in African-American men than in white men. Patients and their family care providers (FCPs) may have different experiences of cancer and its treatment. This report addresses two questions: 1) What is the relationship of uncertainty to family coping, psychological adjustment to illness, and spiritual factors? and 2) Are these patterns of relationship similar for patients and their family care givers and for whites and African-Americans? DESCRIPTION OF STUDY: A sample of white and African-American men and their family care givers (N = 403) was drawn from an ongoing study, testing the efficacy of an uncertainty management intervention with men with stage B prostate cancer. Data were collected at study entry, either 1 week after post-surgical catheter removal or at the beginning of primary radiation treatment. Measures of uncertainty, adult role behavior, problem solving, social support, importance of God in one's life, family coping, psychological adjustment to illness, and perceptions of health and illness met standard criteria for internal consistency. Analyses of baseline data using Pearson's product moment correlations were conducted to examine the relationships of person, disease, and contextual factors to uncertainty. RESULTS: For family coping, uncertainty was significantly and positively related to two domains in white family care providers only. In African-American and white family care providers, the more uncertainty experienced, the less positive they felt about treatment. Uncertainty for all care givers was related inversely to positive feelings about the patient recovering from the illness. For all patients and for white family members, uncertainty was related inversely to the quality of the domestic environment. For everyone, uncertainty was related inversely to psychological distress. Higher levels of uncertainty were related to a poorer social environment for African-American patients and for white family members. For white patients and their family members, higher levels of uncertainty were related to lower scores on adult role behavior (shopping, running errands). For white family members, higher levels of uncertainty were related to less active problem solving and less perceived social support. Finally, higher levels of uncertainty were related to the importance of God for white patients and family care providers. CLINICAL IMPLICATIONS: The clearest finding of the present study is that there are ethnic differences in the relationship of uncertainty to a number of quality-of-life and coping variables. This has immediate implications for the assessment of psychosocial responses to cancer and cancer treatment. Much of what is in curricula is based on clinical and research experience primarily with white individuals. The experience of uncertainty related to cancer and its treatment is influenced by the cultural perspectives of patients and their families. To assist patients and families with the inevitable uncertainties of the cancer experience, healthcare providers need to reconsider their ethnocentric assumptions and develop more skill in assessing patient and family beliefs, values, cultural perspectives, and the influence of these on patient and family uncertainties.

Adaptation, Psychological↗

PubMed1982

Children's perception of vulnerability to illness and dental disease.

Dental health education attempts to change behaviour by altering an individual's knowledge, attitudes, and beliefs about health matters. Perception of vulnerability to illness and dental disease is a central, but poorly understood, health belief. In this study of 303 New Zealand and 297 Australian schoolchildren perceived vulnerability was measured by the degree of expectancy to which subjects believed they would contract health problems. The pattern of health problem expectancy was consistent across age groups, cultures, and other demographic divisions. High expectancies of general health problems and dental caries were associated with potential preventive dental visits and with potential denture wearing. New Zealand schoolchildren, and children from lower socioeconomic backgrounds, had higher expectancies of general health problems and dental caries than Australian or middle class children.

Adolescent↗

PubMed1995

Aspects of quality of life in hemodialysis patients.

The proper means of measuring quality of life in chronically ill patients is unclear. Because different measures may assess varied aspects of patients' experience and because they may be interrelated in different ways, the relationship between several of these quality-of-life measures, including indices of psychological well-being, social support, and severity of illness in ESRD patients treated with hemodialysis (HD), was prospectively assessed. In addition, it was determined whether patients' assessment of quality of life, along any dimension, was related to patient compliance in three urban HD units, in a population largely composed of African-American patients. Severity of illness scores correlated with both attendance and compliance with the dialysis prescription. Karnofsky scores correlated inversely with age, depression, social environment, and level of severity of illness, as expected, but not with behavioral compliance measures. Social support scores correlated with perception of illness, depression, satisfaction with life, and adjustment to illness scores, but not with behavioral or standard compliance measures. Perception of illness scores correlated with depression, social support, adjustment to illness, and satisfaction with life scores, but not with Karnofsky ratings, severity scores, or standard and/or behavioral compliance measures. Social environment scores correlated with almost all assessed variables, with the exception of anthropometric measurements, predialysis phosphorus levels, and behavioral compliance measures. Satisfaction with life scores (a global, subjective measure of quality of life) correlated with advancing age, level of social support, severity of illness, and the presence of a relationship, but were not correlated with Karnofsky scores. These data suggest that quality of life in patients treated with HD must be measured in several ways. The Psychological Adjustment to Illness Scale Social Environment score may be a useful, generalizable adjunct measure of quality of life in HD patients, in addition to the Satisfaction With Life Scale. Quality of life and perception of the effects of illness are not necessarily associated with functional ability in HD patients. These findings must be considered where making decisions about the discontinuation of HD treatment.

Adult↗

PubMed1988

Criminalization of the mentally ill: Part I. Police perceptions.

This paper reports the findings from Phase I of an ongoing prospective, longitudinal study of mentally ill offenders. The study documents the nature, extent and location of mentally ill offenders in the criminal justice system in Southern Alberta, evaluates mechanisms which are used to identify mentally ill offenders in need of treatment, identifies existing psychiatric services available within the criminal justice system and documents their psychiatric service utilization patterns. A study cohort of 611 was identified at their time of arrest and followed through the justice process from initial detention until final release. Part I on this study focuses on the period of arrest. More specifically, police perceptions of disturbed behaviour are examined. The prevalence of police-identified offenders is reported and police judgments regarding possible causes of disturbed behaviour (that is, mental illness, drugs, alcohol) and recommendations for psychiatric treatment are examined. Discrepancies between official recommendations made by police to a bail magistrate (and recorded on the arrest report) and unofficial recommendations collected as part of the study are explained in terms of differing decision-making models; clinical versus legal. Finally, the importance of police perceptions concerning the presence of mental illness as opposed to substance abuse are identified as important factors which influence the decision to recommend psychiatric examinations.

Adult↗

PubMed1996

Changes in perceived health status of depressed elderly patients treated until remission.

OBJECTIVE: The authors predicted that depressed elderly patients who responded to treatment would rate their baseline health more positively than nonresponders, that responders would again rate their health more positively once they were in remission, and that lower baseline self-ratings of health would predict lack of response to protocol treatment. METHOD: The Perception of Illness Scale was administered to 61 depressed elderly patients at baseline and again upon completion of the acute phase of a depression treatment protocol. A logistic regression was performed to ascertain whether Perception of Illness Scale scores predicted response to protocol treatment. RESULTS: Baseline Perception of Illness Scale scores were poorer among the nonresponders, accurately predicted response or lack of response in 75% of the subjects, and showed before-to after-treatment improvement among the responders. CONCLUSIONS: Patients who initially rated their health as fair to poor were less likely to recover from depression in a standardized treatment protocol. Self-ratings of health improved with resolution of depression.

Age Factors↗

PubMed1977

Ethnicity and illness behaviour.

The 52-item Illness Behaviour Questionnaire (IBQ) was administered to 134 general practice patients of Greek, Anglo-Greek, and Anglo-Saxon origin. Responses were scored on 7 dimensions of illness behaviour labelled general hypochondriasis, disease conviction, psychological versus somatic perception of illness, affective inhibition, affective disturbance, denial and irritability. Results of a three-way analysis of variance (ethnicity, age and sex) indicated that Greek patients were significantly more likely to differ from Their Anglo-Saxon counterparts on the initial 3 IBQ scales. Compared with the Anglo-Saxon group, the Greek sample showed greater hypochrondriacal concern, were more likely to manifest conviction as to the presence of serious physical disease, and took a more somatic view of illness. Anglo-Greek patients varied from one scale to another in the degree to which their responses resembled the pattern of illness behaviour reported by Greek patients. They were most similar to the latter in their hypochondriacal attitude, and least similar in their psychological perception of illness. Although the IBQ responses to the Greek sample were consistent with patterns described in other studies of Mediterranean cultural groups, it was found that relationships observed between ethnicity and illness behaviour were to some extent dependent upon age and sex.

Adult↗

PubMed1993

Congruence in uncertainty between individuals with multiple sclerosis and their spouses.

The purpose of this study was to examine differences in the perception of illness uncertainty between husband and wife and to explore how these differences influence emotional well-being. Mood and family satisfaction were used as indicators of emotional well-being. The sample consisted of sixty-one married couples in which one spouse had multiple sclerosis. Results supported that both individual perceptions of illness uncertainty and congruence in perceived uncertainty between spouses may have negative effects on marital partners. For both spouses, those who reported higher levels of uncertainty were more likely to have lower moods and feel more dissatisfied with family life. However, the most crucial factor in determining family satisfaction for spouses with multiple sclerosis was their own perception of illness uncertainty, while for well spouses, it was the congruence between each partner's perception of the illness uncertainty.

Activities of Daily Living↗

PubMed2000

The mother-child interaction and clinical judgment during acute pediatric illnesses.

OBJECTIVES: For acutely ill children living in less than optimal environments, mothers and pediatricians may have a heightened perception of illness severity, a lower specificity of clinical judgments, and a tendency to over-utilize resources. We examined the mother-child interaction in order to understand the relation of less optimal environments to clinical judgment and resource use. STUDY DESIGN: At the 2-week and 6-, 15-, and 24-month well child visits of 316 children, the mother-well child interaction was assessed by using the Biringen's Emotional Availability Scales (EAS). Data were gathered regarding maternal depression and sense of competence, infant temperament, maternal social support, life events, the home environment, and demographics. At ill visits, the mother-ill child interaction was assessed by using the EAS, and mothers and pediatricians independently assessed illness severity using the Acute Illness Observation Scales. Resource use during the illness was evaluated. RESULTS: One thousand nine hundred eight-three acute illnesses were assessed. A less optimal mother-child interaction was significantly (P <.05 for all comparisons) associated with poorer reliability of mothers' judgments, lower specificity of mothers' judgments (71% vs 85%) and pediatricians' judgments (92% vs 97%), and greater use of resources (eg, for hospitalizations, 2.6% of visits vs 0.7%). Adverse maternal, infant, and demographic characteristics were associated with a less optimal mother-well child (r = 0.68) and mother-ill child (r = 0.80) interaction, a heightened perception of illness severity, and greater resource use. CONCLUSION: Less optimal environments adversely affect the mother-child interaction; a poor mother-child interaction is correlated with low specificity of clinical judgment and over-utilization of resources.

Acute Disease↗

PubMed2005

Diverse and changing perceptions of the body: communicating illness, health, and risk in an age of medical pluralism.

There has been a marked increase in the use of complementary and alternative medicine (CAM) in the West since the 1970s. However, biomedicine is still prevailing within public health services and health services covered by private insurance. Different therapies, conventional and CAM, represent different perceptions of the the body. Perceptions of the body are closely related to perceptions of illness, health, disease, and risk. The cultural models of the body are related to social organization and the development of technologies. In a study on spiritual healers and their clients in Norway, I found that clients adapted to a multitude of medical regimes by processes of recognition through cognitive models, learning, and socialization. I describe five models that are evident in communication between healers and clients; the model of the body as machine, plumbing system, energetic, programmable, and as wireless network. People hold diverse perceptions of health, illness, body, and risk, which influence attitudes and behavior. Changes in perceptions of body, health, and illness may be one factor enforcing that CAM is increasingly becoming a first-line intervention. Health authorities meet this challenge emphasizing the regulation of CAM to safeguard patients but could also choose to focus on what clients define as their needs. The shift in cultural understandings of the body, and how people cope with this diversity, ought to be an area for further investigation, as it may affect the choices citizens make and the legitimacy of health authorities.

Attitude to Health↗

PubMed1995

Behavioral compliance with dialysis prescription in hemodialysis patients.

The relationship between compliance and outcome is poorly understood, partially because there has been no gold standard for measuring compliance in hemodialysis patients. To investigate interrelationships between psychological, medical, and compliance factors, hemodialysis (HD) patients were studied with the Beck Depression Inventory, and a subset, the Cognitive Depression Index, the Perception of Illness Effects scale, and the Multidimensional Scale of Perceived Social Support. Behavioral compliance was measured in three ways: (1) percent time compliance (signifying "shortening behavior"); (2) percent attendance (signifying "skipping behavior) (3) percent total time compliance, assessing patients' time on dialysis normalized for prescribed time, including all shortenings and absences. Standard compliance indicators (predialysis serum potassium and phosphorus concentrations and interdialytic weight gain) were also analyzed. The patients' mean Beck Depression Inventory was in the range of mild depression. The prevalence of depression was 25.5%. Both depression indices correlated with Perception of Illness Effects scale scores. In general, social support was related to both measures of depression and perception of illness effects. Total time compliance was 95.8 +/- 5.0%. Younger patients were more likely to skip treatments compared with older patients. Time compliance comprised a wide spectrum, with most patients relatively compliant, whereas a small proportion received far less than their prescribed dialysis. Skipping and shortening behaviors did not correlate, suggesting that these constitute two separate types of noncompliant behaviors. Time compliance parameters did not correlate with potassium levels or interdialytic weight gain, but did correlate with phosphorus levels. Interrelationships between behavioral compliance measures and other parameters varied between units and patients of different gender. Finally, behavioral compliance patterns were stable over months in patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1991

[Subjective perception of psychotic events. Illness concepts of patients, relatives, therapists in comparison].

The study explains, from an academic and psychiatric point of view, the need of qualitative research in the field of self-perception when suffering from an psychosis. It compares illness concepts and the subjective assessment (diagnosis) voiced by patients, their close relatives and the responsible medical staff. Surprising conclusions, which are carefully discussed, are the result of the study. When looking at future research on this issue, the need of stronger consideration of psychotic matters and the biographical as well as institutionalised context becomes obvious.

Adaptation, Psychological↗