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PubMed2002

Applying the theory of planned behavior: nursing students' intention to seek clinical experiences using the essential clinical behavior database.

This study examined the antecedents and determinants predictive of whether nursing students (N = 92) intend to ask for assignments to perform nursing behaviors after using a database to record essential clinical behaviors. The results of applying the theory of planned behavior (TPB) to behavioral intention using multivariant path analysis suggested that the endogenous variables, attitude and subjective norms, had a significant effect on the intention to ask for assignments to perform nursing behaviors. In addition, it was primarily through attitudes and subjective norms that the respective antecedents or exogenous variables, behavioral beliefs and normative beliefs, affected the intention to ask for assignments to perform nursing behaviors. The lack of direct influence of perceived behavioral control on intention and the direct negative impact of control belief on intention were contrary to expectations, given the tenets of the TPB.

Adolescent↗

PubMed2003

Intentional weight loss and death in overweight and obese U.S. adults 35 years of age and older.

BACKGROUND: Although weight loss improves risk factors for cardiovascular and metabolic disease, it is unclear whether intentional weight loss reduces mortality rates. OBJECTIVE: To examine the relationships among intention to lose weight, weight loss, and all-cause mortality. DESIGN: Prospective cohort study using a probability sample of the U.S. population. SETTING: Interviewer-administered survey. PARTICIPANTS: 6391 overweight and obese persons (body mass index > or = 25 kg/m2) who were at least 35 years of age. MEASUREMENTS: Intention to lose weight and weight change during the past year were assessed by self-report in 1989. Vital status was followed for 9 years. Hazard rate ratios (HRRs) were adjusted for age, sex, ethnicity, education, smoking, health status, health care utilization, and initial body mass index. RESULTS: Compared with persons not trying to lose weight and reporting no weight change, those reporting intentional weight loss had a 24% lower mortality rate (HRR, 0.76 [95% CI, 0.60 to 0.97]) and those with unintentional weight loss had a 31% higher mortality rate (HRR, 1.31 [CI, 1.01 to 1.70]). However, mortality rates were lower in persons who reported trying to lose weight than those in not trying to lose weight, independent of actual weight change. Compared with persons not trying to lose weight and reporting no weight change, persons trying to lose weight had the following HRRs: no weight change, 0.80 (CI, 0.65 to 0.99); gained weight, 0.94 (CI, 0.65 to 1.37); and lost weight, 0.76 (CI, 0.60 to 0.97). CONCLUSIONS: Attempted weight loss is associated with lower all-cause mortality, independent of weight change. Self-reported intentional weight loss is associated with lower mortality rates, and weight loss is associated with higher mortality rates only if it is unintentional.

Adult↗

PubMed2000

The impact of new antiretroviral treatments on college students' intention to use a condom with a new sexual partner.

The aim of this study was to evaluate possible changes in predisposing factors in sexual preventive behaviors that could result from the availability of an efficient new antiretroviral therapy. A total of 136 young adults were randomly assigned a vignette to read describing AIDS as a lethal or chronic disease. After reading the vignette, the participants completed a self-administered questionnaire assessing the psychosocial determinants of intention to use a condom with a new sexual partner. The variables were measured according to Ajzen's (1985, 1988, 1991) theory of planned behavior and Triandis's (1977) theory of interpersonal behavior. The experimental manipulation was more successful when the disease was described as lethal (66 of the 68 subjects) rather than chronic (30 of the 68 subjects). For the 96 participants who correctly identified the expected outcome of the disease presented in the vignette, a significant difference in intention was found between the two experimental situations (p < .05). Regression of intention to use condoms on the psychosocial variables yielded an adjusted R2 of .62. Perceived behavioral control, social norms, personal normative belief and anticipated affective reaction were the significant variables explaining this intention. The results suggest that intention to use condoms with a new sexual partner is likely to be modified by the expected outcome of the disease, that is, whether lethal or chronic. Thus, it is suggested that interventions aimed at young adults take into account the impacts the new antiretroviral treatments are likely to have on preventive behaviors.

Acquired Immunodeficiency Syndrome↗

PubMed2000

Prevalence of urinary incontinence and intention to seek treatment in the elderly.

BACKGROUND AND PURPOSE: Urinary incontinence (UI) is a common, distressing, and often disabling condition in the elderly. The objectives of this study were to estimate the prevalence and clinical characteristics of UI among elderly individuals living at home and to explore their perceptions of UI and intention to seek medical care. METHODS: A total of 504 elderly subjects aged 65 and older residing in Tungkang town (located in the southwestern part of Taiwan) were randomly sampled and surveyed face to face by registered nurses. The prevalence, clinical types, and perceptions of UI, and intention to seek treatment, were compared with chi-square statistics across various sociodemographic characteristics. Logistic regression analyses were conducted to identify factors associated with UI experience and intention to seek treatment. RESULTS: About 22% of respondents reported that they had experienced involuntary loss of urine in daily life. Women, people who were overweight, and those who were aged 70 years or older were at higher risk of UI. While women were more likely to suffer from stress incontinence, men were at higher risk of urge incontinence. Women, illiterate individuals, and those who perceived UI as a normal part of the aging process showed low intention to seek treatment for UI. CONCLUSIONS: The results of this study suggest that public awareness programs about UI and promotion of available treatment options are necessary to increase the intention to seek treatment among the elderly. Culturally sensitive programs should be designed, particularly for female and illiterate elderly, to provide incentives to seek medical care. The increasing availability of various treatment modalities coupled with education to correct commonly held misconceptions about UI might enable more elderly individuals to receive treatment for this common condition.

Aged↗

PubMed2001

The influence of significant others on attitudes, subjective norms and intentions regarding dietary supplement use among adolescent athletes.

Dietary supplement use has increased significantly over the past decade. The use of supplements among adolescents seems to be influenced by their beliefs and attitudes. The influence of coaches, parents, and athletic trainers also may be important. The purpose of this study was (1) to determine whether attitudes are a better predictor of adolescents' intentions to use dietary supplements than are subjective norms, and (2) to assess the influence of significant others (coaches, parents, and trainers) on attitudes, subjective norms, and intentions among adolescent athletes. Adolescents (N = 1,626) who were enrolled in grades six through twelve in nine public schools completed a self-report questionnaire that measured attitudes, subjective norms, and intentions regarding dietary supplement use. Results indicated that attitudes were a better predictor of intentions to use dietary supplements than were subjective norms. It was also found that trainers had more influence on the attitudes, subjective norms, and intentions of adolescents regarding supplement use than did parents and coaches. Implications for prevention are addressed.

Adolescent↗

PubMed1975

Children's use of motives and intentionality in person perception and moral judgement.

Preschool, second-, and fifth-grade children watched films and heard stories which portrayed an actor who intentionally or accidentally injured another for either good or bad motives. After each film or story, children were interviewed to determine their understanding of the actor motives and the intentionality of his act and their moral judgements. The results suggest that children of all ages understood the concepts of motive and intentionality, but that the ability to make accurate inferences about motives and intentionality develops with age. Motives affected children's evaluations at all ages, but intentionality affected only grade school children's evaluations. The results for moral judgment were discussed in terms of a theory which included features of both cognitive-developmental and social learning explanations of moral development.

Age Factors↗

PubMed1996

Gender, values, and intentions to move in rural Thailand.

"This article explores gender differences in the intentions to move among a sample of young adults in rural northeastern Thailand. Based on the value-expectancy framework of migration decisionmaking, an explanatory model is tested which includes migration-related value measures along with individual, household and community-level determinants of both intentions to move and change in intentions to move. Multinomial logistic regression results based on data from the 1992 Thailand National Migration Survey provide some support for the hypothesis of gender-specific determinants of both intentions to move and the reconsideration of migration intentions. For men, value measures of affiliation and comfort, social networks, the presence of young children in the family, and land holdings are significant determinants of migration decisionmaking; for women income and comfort values, the presence of elderly persons in the household, community size, and crop losses are the salient factors."

Asia↗

PubMedDate not supplied

Psychosocial variables, race, and intention to seek care for breast cancer symptoms.

This study was designed to assess whether the influences of affect, utility, norm, and habit on intention to seek care promptly for a breast cancer symptom were conditional upon race. Ninety-six participants (68% Caucasian and 32% African American) in community settings completed measures of psychosocial, demographic, and clinical variables, and intention to seek care promptly for a breast lump. Controlling for education, financial coverage for health care, and family history of breast disease, the interactions of both utility and norm with race significantly explained intention. The positive influence of utility on intention was stronger among Caucasians than African Americans, but significant among both groups. The positive influence of social norm on intention was significant for Caucasians, but not for African Americans.

Adult↗

PubMed1992

A randomized comparison of secondary closure and secondary intention in patients with superficial wound dehiscence.

OBJECTIVE: To determine whether secondary closure or secondary intention results differ with respect to time for complete healing and number of postoperative visits in patients with superficial wound dehiscence. METHODS: A randomized trial involved 33 obstetric and gynecologic patients at the University of Mississippi Medical Center who experienced superficial wound dehiscence. Subjects were assigned to secondary-closure or secondary-intention groups. The two groups were similar in age, absolute body weight, percent ideal body weight, length of the primary surgical procedure, estimated blood loss at the primary surgical procedure, portion of the would that opened, preoperative hemoglobin concentration, and preoperative hematocrit. RESULTS: Patients randomized to secondary closure required a mean (+/- standard deviation) of 17.6 +/- 7.2 days from dehiscence to complete healing, whereas those assigned to secondary intention required 61.2 +/- 35.8 days (P less than .001). The secondary-closure group required a mean of 2.0 +/- 0.7 postoperative visits, compared with 8.4 +/- 6.2 visits in the secondary-intention group (P less than .001). CONCLUSION: Secondary closure of superficial wound dehiscence is superior to healing by secondary intention.

Adult↗

PubMedDate not supplied

The impact of nursing care and other healthcare attributes on hospitalized patient satisfaction and behavioral intentions.

Healthcare organizations in the United States are struggling to find ways to survive in their uncertain and competitive environments. One of the survival strategies used by those organizations is to increase patient satisfaction. This article presents research on factors that influence hospitalized patients' satisfaction and their intention to return to and recommend the hospital. The first objective of this study was to find out, using a comprehensive set of healthcare attributes, which attributes play a more important role in increasing patient satisfaction and behavioral intentions. The second objective was to analyze the relative importance of those attributes and the nature of the relationships across the values of the attributes. More specifically, this study attempted to identify any existing curvilinear relationships among these variables. If any curvilinear relationships exist, do they show an increasing or a decreasing marginal-utility function? Included in this article is an example, featuring a hospital-discharged patient, that explains the importance and uniqueness of this curvilinear relationship. This study found that among six attributes, nursing care showed the largest parameter estimate for the patient satisfaction and behavioral intentions models. Thus, simply improving the nursing care attribute seems to be the most effective manner to enhancing patient satisfaction and behavioral intentions. However, nursing care also showed a diminishing marginal-utility function for both models. To assess the effect of this diminishing marginal-utility function, the impact of nursing care was computed for each unit of improvement together with other attributes. The finding from this study provides information needed to increase patient satisfaction and behavioral intentions and should result in more effective and efficient healthcare management.

Adolescent↗

PubMedDate not supplied

Predicting AIDS patient care intentions among nursing students.

Predictors of intentions to care for AIDS patients were examined among 153 sophomore and senior nursing students. Multiple regression analysis revealed that students who had relatively less AIDS knowledge and who perceived greater occupational risk of HIV infection expressed stronger intentions to avoid caring for AIDS patients. However, avoidance intentions were not simply a function of concern about personal health and inadequate knowledge. Students who held more negative attitudes toward intravenous drug users also had stronger intentions to avoid caring for AIDS patients, even when the effects of AIDS knowledge and perceived occupational risk of HIV infection were controlled. AIDS content is incorporated in the nursing curriculum for these students beginning in the junior year. Multivariate analysis of variance performed to determine the effects of this content revealed a significant effect for year in school considering all the dependent variables simultaneously. Seniors had lower avoidance intentions, lower perceived occupational risk, and greater AIDS knowledge than did sophomores.

Acquired Immunodeficiency Syndrome↗

PubMed2005

Genes, causation and intentionality.

I want to exhibit the deeper metaphysical reasons why some common ways of describing the causal role of genes in development and evolution are problematic. Specifically, I show why using the concept of information in an intentional sense in genetics is inappropriate, even given a naturalistic account of intentionality. Furthermore, I argue that descriptions that use notions such as programming, directing or orchestrating are problematic not for empirical reasons, but because they are not strictly causal. They are intentional. By contrast, other notions that are part of the received view in genetics and evolutionary theory are defensible if understood correctly, in particular the idea that genes are the main replicators in evolution. The paper concludes that dropping all intentional or intentionally laden concepts does not force us to accept the so-called causal parity thesis, at least not in its stronger form.

Animals↗

PubMed1989

Breast-feeding intentions and practice among Hispanic mothers in southern California.

Breast-feeding intentions, breast-feeding in the hospital, and breast-feeding at home were studied among 132 Hispanic mothers participating in the Expanded Food and Nutrition Education Program in southern California. There was not a large difference between total breast-feeding intention (77.7%) and total breast-feeding practice (63.8%). However, the 67.7% intention of exclusive breast-feeding drastically decreased to 19.7% and 17.2% in the hospital and at home, respectively. Formula supplementation, increased by 4.5 times from intention to practice. Exclusive formula feeding increased from 10.0% to approximately 37.0% in the hospital and at home. Stepwise logistic regression identified that the likelihood of intending breast-feeding was greater for mothers who migrated from Mexico than for mothers born in the United States (odds ratio 4.75). The likelihood of breast-feeding practice was greater for mothers who initiated breast-feeding within the first 10 hours after birth as opposed to 11 or more hours (odds ratio 1.27), for mothers who had a vaginal rather than cesarean delivery (odds ratio 12.76), for mothers who did not return to work postpartum as opposed to working mothers (odds ratio 28.26), and for mothers who migrated from Mexico compared with mothers born in the United States (odds ratio 8.54). The importance of assessing and supporting mothers' breast-feeding intentions in the pre- and post-partum period is documented. Training in the clinical aspects of breast-feeding and improvement of hospital protocols is recommended. Mothers intending to breast-feed should be identified and supported.

Adult↗

PubMed1988

Adolescent poisoning: a comparison of accidental and intentional exposures.

The fact that intentional drug and toxic substance use/abuse by adolescents has dramatically increased during the past 2 decades often overshadows the knowledge that adolescents also suffer accidental poisonings as well. A 1-year retrospective analysis of 1,879 poison exposures involving children 13 to 17 years of age revealed 894 (47.6%) were due to accidental circumstances and 945 (50.2%) were intentional in nature. Nonpharmaceuticals were involved in 63.5% of all accidental adolescent poisonings versus 36.5% involving various drugs. Intentional nonpharmaceutical exposures were 17.5% compared to total intentional adolescent poisonings, while 82.5% involved drugs. Site of exposure was the child's own home in 1,252 (66.7%) cases, school in 201 (10.8%), the workplace in 35 (1.9%), and other/unknown sites accounted for 387 (20.6%) poisonings. Poisoning by ingestion accounted for 1,408 (74.9%) of the adolescent exposures, inhalations 147 (7.8%), ocular 219 (11.5%), and dermal 110 (5.8%). Management at the nearest health care facility (HCF) was necessary in 1,252 (66.6%) of the poisonings versus 627 (33.4%) who were treated in non-HCF environments. Regional poison centers must be cognizant that accidental as well as intentional poisoning can occur with adolescents. Distinct viable prevention strategies should be developed to address these problems.

Accidents↗

PubMed1983

The impact of physical fitness evaluation on behavioural intentions towards regular exercise.

The Fishbein model was used to assess the impact of physical fitness evaluation with subsequent counselling by professional staff on individual intentions to exercise regularly. The subjects for this study were 172 self-selected adults seeking an evaluation of their current physical fitness. Experimental subjects were given a sequence of fitness testing and counselling; however, this did not significantly change the intention to exercise relative to control subjects. The only significant differences in intentions to exercise regularly were found (i) between subjects differing in fitness level (p less than .002), and (ii) between subjects differing in current exercise behaviour (p less than .001). Thirty-five percent (35%) of the variance in intentions to exercise were explained by a combination of (i) the two components of the Fishbein model (attitude and social norm) and (ii) an index of current physical activity. Since most of our subjects reported a positive intention to exercise, the most appropriate tactic for an increase of community activity may be to initiate policy changes facilitating behaviour in accordance with existing attitudes.

Adult↗

PubMedDate not supplied

Breast cancer screening behaviors and intentions among asymptomatic women 50 years of age and older.

We examined predictors of (1) compliance with yearly mammography and clinical breast examination (CBE) and (2) intention to obtain mammography and CBE within the following year. Subjects were 312 asymptomatic female hospital employees, 50 years or older, who had participated in a free worksite breast cancer screening program. Mammograms and CBEs had been obtained by 79% and 76% of the subjects, respectively, during the preceding 12 months. The majority of the subjects indicated that they were very/extremely likely to obtain a mammogram and CBE in the next 12 months (88% and 87%, respectively). Multivariate analyses showed that perceived barriers to and physician recommendation of mammography were the strongest predictors of both breast cancer screening behaviors and intentions. Recency of participation in the educational component of the screening program was related to both compliance with mammography in the past 12 months and intention to obtain CBE in the next year. Having a first-degree female relative with a history of breast cancer was related to compliance with CBE in the past 12 months. Perceived efficacy of mammography was related to intention to obtain both mammography and CBE in the next year, and number of reasons for mammography was related to intention to obtain mammography in the next year. Our results suggest that physicians play a key role in motivating women to comply with breast cancer screening and that reducing barriers to obtaining mammography may increase use further.

Aged↗

PubMed1994

Examination and prediction of elementary school teachers' intentions to teach HIV/AIDS education.

Although studies have looked at school teachers' beliefs and attitudes toward AIDS and students with HIV/AIDS, none have specifically addressed teachers' intentions and attitudes toward teaching HIV/AIDS education. This study examines and predicts elementary school teachers' intentions to teach their students about HIV/AIDS. The postulates of the theories of reasoned action and planned behavior provided the framework for the examination of teachers' beliefs, attitudes, subjective norms, and perceived behavioral control regarding AIDS education. A sample of 198 elementary school teachers employed in the Commonwealth of Massachusetts completed self-administered questionnaires. Multiple regression analysis was used to predict intentions to teach HIV/AIDS, and to identify the determinants of intentions. Attitude, subjective norm, and perceived behavioral control, the variables of the theory of planned behavior, explained 64% of the variance in teachers' intentions; perceived behavioral control contributed the greatest weight to the prediction. Significant variance was additionally explained by three variables external to the theory of planned behavior: in-service training, grade taught, and past HIV/AIDS teaching behavior.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Predictors of physical activity intentions and behaviour for rural homemakers.

This research combined social psychological theory testing with the practical concern of gathering information useful for the social marketing of active living. The study examined variables related to the intentions and behaviour of rural homemakers with respect to moderate physical activity, using the theory of planned behaviour as a framework. Rural homemakers (n = 630) in four Alberta communities were surveyed by telephone concerning their attitudes, self-efficacy, perceived social support, intentions, and present activity behaviour. Intentions, self-efficacy, and various beliefs related to barriers and social support discriminated active from inactive homemakers. For active homemakers (n = 473), attitude, perceived social support, and self-efficacy predicted future intentions. For inactive homemakers (n = 157), only attitude and self-efficacy predicted intentions. The practical implications of the findings are discussed, in terms of fostering enjoyable experiences, reducing barriers, and providing supportive environments.

Adult↗