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PubMed2003

Psychological outcomes and risk perception after genetic testing and counselling in breast cancer: a systematic review.

OBJECTIVES: To conduct a systematic review of the effects of genetic counselling and testing for familial breast cancer on women's perception of risk and psychological morbidity. DATA SOURCES: MEDLINE, PsychLIT and EMBASE were searched for the period 1980-2001. STUDY SELECTION: Studies were eligible if published in a peer-reviewed journal in English, included women with a family history of breast cancer who underwent genetic counselling or testing and had either a randomised controlled trial or prospective design, with a pre- and at least one post-counselling assessment. DATA SYNTHESIS: As there was considerable heterogeneity in populations and measures, results were summarised rather than subjected to meta-analysis. RESULTS: Overall, genetic counselling and testing appear to produce psychological benefits and to improve accuracy of risk perception. Carriers of mutations in cancer predisposition genes did not experience significant increases in depression and anxiety after disclosure of their mutation status, while non-carriers experienced significant relief. Women who were tested but declined to learn their results seemed to be at greater risk of a worse psychological outcome. CONCLUSIONS: To date, the data on psychological outcomes after genetic counselling and testing are reassuring. However, few studies used a randomised trial design, limiting the strength of the conclusions. Follow-up to date has been short, and we know little about the long-term impact of testing on patient behaviours, perceptions and psychological state.

Adaptation, Psychological↗

PubMed1993

Dimensions of risk perception for financial and health risks.

This study of 29 MBA students compares two models of risk perception for both financial and health risk stimuli. The first, inspired by Luce and Weber's Conjoint Expected Risk (CER) model, uses five dimensions: probability of gain, loss and status quo, and expected benefit and harm. The second, inspired by the Slovic et al. psychometric model, employs seven dimensions: voluntariness, dread, control, knowledge, catastrophic potential, novelty, and equity. The CER-type model provided a better fit for most subjects and stimuli. Adding the psychological risk dimensions from the Slovic et al. model explained only modestly more variance. Relationships between the dimensions of the two models are described and the construction of a hybrid model explored.

Accidents↗

PubMed1998

Does risk perception affect behaviour and exposure? A pilot study amongst asbestos workers.

It is hypothesised that there is a causal association between workers' perceptions of the risks from handling hazardous materials, their behaviour while working and their consequent exposure. This has been investigated in a small group of workers carrying out remedial work on amosite insulating boards and similar products. Risk perception was first assessed using a questionnaire and then the workers' behaviour was recorded alongside task-based measurements of fibre exposure. There was a clear association of higher cumulative exposures when workers used power tools compared to manual methods (about seven times higher). Careful bagging was shown to reduce exposures by a smaller margin, (approximately half). Workers whose perception of the risks was poorer were found to be more likely to use power tools to remove the asbestos containing material. However, fibre exposure was not found to be directly associated with risk perception. Further work is necessary to clarify the validity of the original hypothesis.

Adult↗

PubMed1997

Health impacts of large releases of radionuclides. Mental health, stress and risk perception: insights from psychological research.

Risk perceptions are only slightly correlated with the expected values of a probability distribution for negative health impacts. Psychometric studies have documented that context variables such as dread or personal control are important predictors for the perceived seriousness of risk. Studies about cultural patterns of risk perceptions emphasize different response sets to risk information, depending on cultural priorities such as social justice versus personal freedom. This chapter reports the major psychological research results pertaining to the factors that govern individual risk perception and discusses the psychometric effects due to people's risk perception and the experience of severe stress. The relative importance of the psychometric context variables, the signals pertaining to each health risks and symbolic beliefs are explained.

Attention↗

PubMed1999

A model of consumers' risk perceptions toward recombinant bovine growth hormone (rbGH): the impact of risk characteristics.

This study estimates the effect risk characteristics, described as outrage factors by Hadden, have on consumers' risk perceptions toward the food-related biotechnology, recombinant bovine growth hormone (rbGH). The outrage factors applicable to milk from rbGH treated herds are involuntary risk exposure, unfamiliarity with the product's production process, unnatural product characteristics, lack of trust in regulator's ability to protect consumers in the marketplace, and consumers' inability to distinguish milk from rbGH treated herds compared to milk from untreated herds. An empirical analysis of data from a national survey of household food shoppers reveals that outrage factors mediate risk perceptions. The results support the inclusion of outrage factors into the risk perception model for the rbGH product, as they add significantly to the explanatory power of the model and therefore reduce bias compared to a simpler model of attitudinal and demographic factors. The study indicates that outrage factors which have a significant impact on risk perceptions are the lack of trust in the FDA as a food-related information source, and perceiving no consumer benefits from farmers' use of rbGH. Communication strategies to reduce consumer risk perceptions therefore could utilize agencies perceived as more trustworthy and emphasize the benefits of rbGH use to consumers.

Animals↗

PubMed1998

Risk perception during information system development in non-profit health care organizations.

The perception of risk exposure among design team members during the early phases of information system development projects can provide valuable strategic information for clinical organizations. To develop a typology of perceived risks during information system development projects in health care, interviews were performed with key team members from a specialist clinic, primary health care, and an informatics research group, during the requirements specification. Phenomenological data analysis and secondary integration of the results in available theories were performed. System objectives, the user requirements definition procedure, the communication pattern between design team members and project management were found to be perceived as the main risk areas. In the secondary analysis, the technical factors, identified as preventing a maximization of the use of the resources, were lack of informatics knowledge among economic decision makers and differences between customers and suppliers regarding their views on the nature of system design. During the implementation of a given strategy, decision makers may consider the requests of their own sponsors in the first place and maximize the use of the project resources in the second place. Informatics knowledge plays a key role in risk perception during the development of an information system in health care. Political considerations by team members are important to take into regard, since these may influence technical and economic decisions.

Humans↗

PubMed2000

Risk perception in the U.K. oil and gas production industry: are expert loss-prevention managers' perceptions different from those of members of the public?

This article investigates potential differences in risk perception between experts (loss-prevention managers in the U.K. oil and gas production industry) and nonexperts (managers and students). Extant research on expert versus nonexpert perceptions of risk is reviewed, followed by the present study concerning risk perceptions of seven pen-picture scenarios involving the occurrence of hazardous events in the U.K. oil and gas production industry. In contrast to many of the earlier studies of expert versus nonexpert perceptions of risk, the present analysis concludes that experts did not judge the overall riskiness of the portrayed hazardous events as less risky than the nonexperts. Nevertheless, the experts believe more strongly than our nonexperts that the risks portrayed in the scenarios pose little threat to future generations, are more precisely known, and are relatively controllable. Use of multiple regression analysis to help uncover the basis of overall riskiness assessments for expert and lay respondents was inconclusive, however. Finally, little evidence was found that nonexperts were any more heterogeneous in their risk perceptions than experts. It may be that the nature of the risks assessed in the present study may account for the general lack of clear expert versus nonexpert differences in overall perceptions of the riskiness of hazardous events in the North Sea. Earlier findings of strong expert versus nonexpert differences in risk perception assessed hazards of major public concern. It is inferred that using such extreme hazards may have resulted in an exaggerated view of differences in expert versus public (nonexpert) perception of risk.

Journal Article↗

PubMed2006

Personal values, beliefs, and ecological risk perception.

A mail survey on ecological risk perception was administered in the summer of 2002 to a randomized sample of the lay public and to selected risk professionals at the U.S. Environmental Protection Agency (US EPA). The ranking of 24 ecological risk items, from global climate change to commercial fishing, reveals that the lay public is more concerned about low-probability, high-consequence risks whereas the risk professionals are more concerned about risks that pose long-term, ecosystem-level impacts. To test the explanatory power of the value-belief-norm (VBN) theory for risk perception, respondents were questioned about their personal values, spiritual beliefs, and worldviews. The most consistent predictors of the risk rankings are belief in the new ecological paradigm (NEP) and Schwartz's altruism. The NEP and Schwartz's altruism explain from 19% to 46% of the variance in the risk rankings. Religious beliefs account for less than 6% of the variance and do not show a consistent pattern in predicting risk perception although religious fundamentalists are generally less concerned about the risk items. While not exerting as strong an impact, social-structural variables do have some influence on risk perception. Ethnicities show no effect on the risk scales but the more educated and financially well-off are less concerned about the risk items. Political leanings have no direct influence on risk rankings, but indirectly affect rankings through the NEP. These results reveal that the VBN theory is a plausible explanation for the differences measured in the respondents' perception of ecological risk.

Adult↗

PubMedDate not supplied

[Risk target effect on risk perception in an industrial area].

This study describes the results of a survey, carried out by the Department of Public Health between October and December 2002, about the perception of the main risk factors for health and environment in Portoscuso (Ca), an industrial area in south west of Sardinia, declared "Environmental high-risk area " with DPCM 23.04.1993. The aim of survey was to investigate the different risk perception between local and global level analyzed by McNemar test. The results showed that risk perception was significantly higher at global level. We didn't observe any difference about local problematics as industrial pollution, work accidents, acid rain, industrial accident. Regarding risk factors, as food safety and life style, the "unrealistic optimism effect" described by Sjöberg with people risk perception higher at global level, is confirmed. Perception of industrial risk, considered only similar and not higher than in other areas, is influenced by citizens' consciousness of living in an area declared at high risk of environmental crisis. These results should be taken into account in future risk communication process in order to avoid interpretation bias.

Adult↗

PubMed2005

SARS risk perceptions in healthcare workers, Japan.

In coping with severe acute respiratory syndrome (SARS), infection control measures are a key aspect of protecting healthcare workers. We conducted a survey concerning perception of risk and countermeasures for SARS in 7 tertiary hospitals in Japan from July through September 2003, immediately after the SARS epidemic in neighboring countries. Based on 7,282 respondents out of 9,978 questionnaires administered, we found the perception of risk to be relatively high and the perception of countermeasures at the institutional level to be relatively low. Knowledge of preventive measures, concept of (opinions regarding) institutional measures, and perception of risk differed substantially among the 3 job categories, notably between physicians and nurses. The concept of institutional measures was the most important predictor of individual perception of risk. In view of the potential for future epidemics, planning and implementing institutional measures should be given a high priority.

Adult↗

PubMed2006

Risk perception and acceptance--one process or two? The impact of aspirations on perceived risk and preferences.

The experiments discussed here are aimed at determining whether risk perception and risk acceptance are two distinct psychological processes. This study is motivated by the idea of a double-criterion model of choice. In particular, in line with risk-value (R-V) models, in which risk is treated as a primitive, it is tested whether risk is independent of aspirations and whether preferences depend on aspirations. In two experiments, 305 university students were presented with pairs of risky projects and were asked to compare their riskiness and select one. The aspiration level, defined as the target return on the project, was set through an explicit instruction. In Experiment 1, a within-subject designwas applied, and thus aspirations were set at two different levels. In Experiment 2, with a between-subject design, two different aspiration levels were set for each group. The results indicate that risk ordering is insensitive to changes in aspirations, but preferences are sensitive to those changes. This supports distinctness of risk perception and risk acceptance. The findings are discussed in terms of the CPT and SP/A models and the R-V approach. It appears that double-criterion models provide better and psychologically sounder predictions of subjects' preferences.

Aspirations, Psychological↗

PubMed1993

Injecting drug users and HIV/AIDS: risk behaviours and risk perception.

This paper reports on the incidence of risk taking behaviours, and the relationship between risk perception and risk behaviours in a sample of 1245 Sydney injecting drug users (IDUs). Almost all respondents reported engaging in behaviours that placed them at risk of HIV infection: 32.9% through unsafe injecting, 84.4% because of unsafe sexual behaviour and 89.2% because of either injecting or sexual behaviour. Injecting and sexual behaviour were poorly correlated. This study also found that risk perception is unrelated to injecting or sexual behaviours, previous history of sexually transmitted diseases, a range of demographic characteristics including age and gender, and the number of times tested for HIV. Social policy and prevention programs should aim to change unsafe injecting and sexual behaviours directly, rather than attempting to achieve change indirectly by changing risk perception.

AIDS Serodiagnosis↗

PubMed2000

Colorectal cancer risk perceptions and screening intentions in a minority population.

This is a 2-year follow-up to a previously reported baseline paper. We focused on a predominantly low-income African-American population from a community health center and investigated the relationships among perceptions of perceived risks for colorectal cancer (CRC), concerns about getting CRC, screening intentions, and whether participants had a fecal occult blood test (FOBT) on schedule at follow-up. Baseline absolute risk did not predict screening intentions or being on schedule (15% of sample), nor did it predict follow-up perceived absolute risk, comparative risk, or CRC concerns. Participants who expressed greater perceived absolute risk, comparative risk, and concerns at follow-up were more likely to report thinking about or definitely planning to get an FOBT within the next 2 years (49% of the sample). In addition, baseline absolute risk and whether or not a person had an FOBT on schedule at baseline did not predict being on schedule at follow-up. A significant percentage of the population (20%) were not able to state whether their CRC risk was below average, average, or above average. In addition, 44% of the population viewed their risks as lower than their peers, and 58% reported being not at all or slightly concerned about getting CRC. These results suggest that educational efforts are needed especially for low-income minority populations to enhance knowledge and accuracy of risk perceptions for CRC and interventions that explicitly manipulate risk are needed to assess to what extent risk perceptions can be modified and subsequently affect screening.

Black or African American↗

PubMed2005

Relationships between risk-taking behaviour and subsequent risk perceptions.

Research has suggested that engagement in patterns of risk-taking behaviour might have a negative influence on the processing of risk information. However, risk-takers display higher risk perceptions than non-risk takers. This paradox might be resolved by removing the confounding effect of risk takers' increased exposure to risk. A longitudinal survey was administered to 255 motorists to examine the extent to which Time 1 (T1) self-reported speeding behaviour predicted exposure-free measures of Time 2 (T2) risk perceptions. Hierarchical regression analyses, controlling for demographics and T1 risk perceptions, showed that T1 speeding, and T1 to T2 speeding changes, both inversely predicted T2 risk perceptions. This suggests that successive increments in risk-taking behaviour will lead to progressively lower increases in personal risk perception. Possible foundations and implications of this effect are discussed.

Adult↗

PubMed2004

Psychological distress in women at increased risk for breast cancer: the role of risk perception.

The magnetic resonance imaging screening (MRISC) study evaluates a surveillance programme for women with a hereditary risk for breast cancer. The psychological burden of surveillance in these women may depend on inaccurate risk perceptions. To examine differences in risk perceptions between three predefined risk categories and associations with psychological distress. BC-specific distress, general distress, and RP (cognitive and affective) were assessed, two months before a surveillance appointment. Cumulative lifetime risk (CLTR) of developing breast cancer was trichotomised into: (1) CLTR of 60-85% (mutation carriers), (2) CLTR of 30-50%, and (3) CLTR of 15-30%. In a total group of 351 women (mean age 40.5 years, range 21-63 years) the three risk categories significantly differed in their accuracy of assessing cognitive risk perceptions. In category 1, 60% had an accurate risk perceptions, in category 2, 43.7% and in category 3, 33.3%. Overestimators reported significantly more breast cancer-specific distress. After adding affective risk perception to the model, this effect disappeared. Affective risk perceptions showed significant associations with breast cancer-specific and general distress. Affective risk perception is a more important determinant for psychological distress than cognitive risk perception. This knowledge should be used during surveillance appointments in order to improve and individualise support for these women.

Adult↗

PubMed1998

Risk perceptions of offshore workers on UK oil and gas platforms.

Knowledge of the workforce's risk perceptions and attitudes to safety is necessary for the development of a safety culture, where each person accepts responsibility for working safely. The ACSNI Human Factors report stresses the importance of assessing workforce perceptions of risk to achieve a proper safety culture. Risk perception research has been criticized for insufficient analysis of the causal relationships between risk factors and perceived risk. The present study reports some of the factors which predicted risk perception in a sample of 622 employees from six UKCS offshore oil installations who completed a 15-section questionnaire. This paper focuses on the accuracy of workers' risk perceptions and what underlying factors predict the perception of personal risk from both major and minor hazards.

Accidents, Occupational↗

PubMed1988

Industrial risk perceptions.

The risks of occupational exposure to radiation need fuller and more explicit characterization. They also need a more developed quantitative comparison with more familiar occupational hazards. To achieve this, some criterion is needed for establishing the amount of detriment one should attribute to different harmful effects, e.g., from accidents at work which cause death, temporary or permanent disability; from fatal and nonfatal cancers; from developmental abnormalities and any likely nonstochastic effects; and from a range of genetic defects. No such criterion for comparing incommensurable kinds of harm can be scientifically defined, but one is essential if occupational exposure standards are to be put into perspective. A comparison of the frequency of fatal cancers and "severe" genetic defects with that of accidental deaths at work is admittedly incomplete. One possible starting point is from a review of the average length of healthy life and activity lost as a result of nonfatal industrial accidents and some curable cancers, or of gross impairment during the course of an active disease or as a result of many types of genetic defect, or of life expectancy lost absolutely owing to fatal accidents and diseases. Estimates are discussed to emphasize the areas in which opinion is most needed to translate measures of risk based simply on total time lost into acceptable criteria of perceived detriment. Standards of industrial safety are reviewed on this basis, both for risk from accidents at work and from radiation exposure, with evidence on the rate at which both types of risk are being reduced.

Abnormalities, Radiation-Induced↗

PubMedDate not supplied

[Survey about risk perception between citizens resident in a municipal at high risk of environmental crisis].

OBJECTIVE: This paper describes the result of a survey carried out in 2002 about the risk perception of the main risk factors for health and environment in an industrial area at high risk of environmental crisis, in order to contribute to risk communication programs aiming to make the population informed and conscious about industrial risk. DESIGN: The survey was carried out in 2002 through questionnaire to investigate citizens' risk perception SETTING: Municipality of Portoscuso, industrial district located along the South-west coast of Sardinia, and active in the chemical, electrochemical fusion and rolling, thermoelectric fields. PARTICIPANTS: The survey has been carried out, through home interviews, on a representative sample of the population of Portoscuso, consisting of 148 citizens aged between 18 and 70. MAIN OUTCOME MEASURES: The results showed that industrial pollution is considered high by more than 80% of the sample at global and even more at local level showing how this represents an important worrying factor for the local people. CONCLUSION: This is the basis to develop an effective risk communication process, that involves actively all stakeholders (people, experts, industry and local authorities) in risk management.

Adolescent↗