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Seeking medical care for a breast cancer symptom: determinants of intentions to engage in prompt or delay behavior.

This study examined the cognitive structures underlying women's intentions to delay or not delay seeking medical care for a breast cancer symptom. Middle-aged women imagined that they had just discovered a particular change in their breast, and they completed a questionnaire that assessed variables specified by Ajzen and Fishbein's theory of reasoned action with respect to two alternative courses of action: immediately calling the doctor (i.e., prompt behavior) and monitoring the breast change on one's own (i.e., delay behavior). Also assessed were variables external to the theory that were drawn from previous research on cancer delay. Results showed that intentions to delay were positively associated with having favorable attitudes toward delay and with perceived social pressure to delay; the attitudinal factor, however, was more influential than the social factor in determining intentions. Underlying favorable attitudes toward delay were beliefs that delay would be likely to result in maintaining control over and avoiding the disruption of one's own and others' lives but would be unlikely to result in negative health outcomes. No external variable was found to contribute to intentions to delay above and beyond attitudinal and normative considerations.

Adult↗

Influence of physical attractiveness and alcohol on men's perceptions of potential sexual partners and sexual behavior intentions.

The current research presents the results of 2 related experimental studies designed to evaluate the influence of physical attractiveness and a moderate dose of alcohol on men's perceptions of potential sexual partners and sexual behavior intentions. Analyses revealed significant effects of physical attractiveness on partner perceptions and sexual behavior intentions. Although no main effects of alcohol were observed, alcohol differentially moderated the relations between perceived risk and sexual behavior intentions by limb of absorption. Results suggest that greater attention should be focused on identifying the specific physical characteristics of a potential sexual partner--beyond attractiveness--that influence perceptions of risk and intentions to engage in safer sex behaviors and highlight the importance of assessing limb of absorption in evaluating the complex association between alcohol and risky sexual behavior.

Adult↗

Jewish identity and intentions to obtain breast cancer screening.

This study explored the associations between 2 dimensions of Jewish identity (cultural identification and religious practice) and intentions to perform breast cancer screening. Ashkenazi Jewish women (N = 220) completed surveys as part of an ongoing study of breast cancer risk counseling. Multiple regressions examined the relationships between the 2 identity measures and intention to follow routine recommendations for mammography, intention to perform monthly breast self-exam, and interest in genetic testing for breast cancer susceptibility. Cultural identity positively predicted interest in testing, whereas religious identity was inversely related. Religious identity was a significant predictor of intention to adhere to mammography recommendations. Findings show that culture and religion, although correlated, may have different associations with health attitudes.

Adolescent↗

What do facial expressions convey: feeling states, behavioral intentions, or action requests?

Emotion theorists assume certain facial displays to convey information about the expresser's emotional state. In contrast, behavioral ecologists assume them to indicate behavioral intentions or action requests. To test these contrasting positions, over 2,000 online participants were presented with facial expressions and asked what they revealed-feeling states, behavioral intentions, or action requests. The majority of the observers chose feeling states as the message of facial expressions of disgust, fear, sadness, happiness, and surprise, supporting the emotions view. Only the anger display tended to elicit more choices of behavioral intention or action request, partially supporting the behavioral ecology view. The results support the view that facial expressions communicate emotions, with emotions being multicomponential phenomena that comprise feelings, intentions, and wishes.

Adult↗

Intentional weight loss and incidence of obesity-related cancers: the Iowa Women's Health Study.

OBJECTIVE: To examine the association of voluntary vs involuntary weight loss with incidence of cancer in older women. DESIGN: Prospective cohort study from 1993 to 2000, with cancer incidence identified through record linkage to a cancer registry. SUBJECTS: A total of 21,707 postmenopausal women initially free of cancer. MEASUREMENTS: Women completed a questionnaire about intentional and unintentional weight loss episodes of > or =20 pounds during adulthood. RESULTS: Compared with women who never had any > or =20 pounds weight loss episode, women who ever experienced intentional weight loss > or =20 pounds but no unintentional weight loss had incidence rates lower by 11% for any cancer (RR=0.89, 95% CI 0.79-1.00), by 19% for breast cancer (RR=0.81, 95% CI 0.66-1.00), by 9% for colon cancer (RR=0.91, 95% CI 0.66-1.24), by 4% for endometrial cancer (RR=0.96, 95% CI 0.61-1.52), and by 14% for all obesity-related cancer (RR=0.86, 95% CI 0.74-1.01) after adjusting for age, body mass index, waist-to-hip ratio, physical activity, education, marital status, smoking status, pack-years of cigarettes, current estrogen use, alcohol use, parity, and multivitamin use. Furthermore, although overweight women were at increased risk of several cancers, women who experienced intentional weight loss episodes of 20 or more pounds and were not currently overweight were observed to have an incidence of cancer similar to nonoverweight women who never lost weight. Unintentional weight loss episodes were not associated with decreased cancer risk. CONCLUSIONS: These findings suggest that intentional weight loss might reduce risk of obesity-related cancers.

Aged↗

Relative analgesia and general dental practitioners: attitudes and intentions to provide conscious sedation for paediatric dental extractions.

AIM: To examine the attitudes and intentions of general dental practitioners (GDPs) who work within the remit of the National Health Service (NHS) to provide relative analgesia (RA) for paediatric extractions. METHODS: All 45 GDPs working within the boundaries of one Trust were asked to complete a questionnaire to assess demography, etc., intention and attitudes to provide RA for paediatric extractions. RESULTS: Ninety-eight per cent of GDPs took part. All GDPs worked within the NHS. Twenty-nine per cent of GDPs stated that they had RA equipment available in their practices and 68% stated that they discussed RA as treatment alternative. Eighty-seven per cent referred their paediatric extraction cases for dental general anaesthesia. The behavioural intention was predicted by total attitude score and the availability of RA equipment in the practice (R2=0.97, F(37,5)=260.11, P<0.001). Total attitude was predicted by clinical competency, few financial worries or time concerns and the availability of RA equipment (R2=0.91, F(38,4)=106.21, P<0.001). CONCLUSIONS: This study suggests that GDPs' concerns of clinical competence and costs have an inhibiting effect upon their intention to provide RA for paediatric extractions. These concerns must be addressed by planners and policy makers if there is to be a shift from hospital-based DGA to surgery-based RA services for paediatric extractions.

Analgesia↗

Effect of attitudes, subjective norms and perceived control on nurses' intention to assess patients' pain.

This study examines the underlying determinants of nurses' behaviour regarding the conduct of pain assessments. One hundred nurses in a variety of health care facilities were invited to complete an Attitude Intention Questionnaire based upon the theory of planned action which is an extension of the theory of reasoned action. Results provide some support for the theory of planned action, as nurses' intention to conduct pain assessment was shown to be predicted by attitude, subjective norms and perceived control, although the latter was the only variable to make an independent contribution to intention. Additional support for the importance of perceived control was provided by the analysis of 'intenders' and 'non-intenders' (to conduct pain assessments), as perceived control was the only variable which differed significantly between the groups. The findings are consistent with earlier studies which showed that the variables in the theory of planned behaviour provided reasonably accurate predictions of behavioural intention.

Adult↗

Immediate postoperative laser resurfacing improves second intention healing on the nose: 5-year experience.

BACKGROUND: Mohs surgery defects on convex nasal surfaces do not reliably heal well by second intention. Prior to the availability of laser resurfacing we found that immediate postoperative dermabrasion improved the predicted outcome from second intention healing for these defects. OBJECTIVE: To determine the ability of immediate postoperative CO2 and Er:YAG laser resurfacing to improve predicted healing by second intention. METHODS: Seventy-four patients with Mohs surgical defects on the nose underwent immediate postoperative resurfacing with either a scanned CO2 or long-pulsed Er:YAG laser. Thirty patients had photographs of appropriate quality and follow-up for evaluation by a panel of nine objective physicians. RESULTS: All 74 patients were satisfied with their result and none have requested scar revision. Of the 30 patients evaluated by the panel, all were scored acceptable to excellent. CONCLUSION: Immediate laser resurfacing can improve the predicted outcome from second intention healing on the nose and should be considered for select patients.

Adult↗

Psychosocial correlates of suicidal intent among patients with schizophrenia.

Suicidal intent is common among patients with schizophrenia, resulting in extreme personal distress, increased hospitalizations and healthcare expenditures, and early mortality. However, the psychosocial correlates of current suicidality among schizophrenic patients are not fully understood. This study attempted to identify psychosocial correlates of current suicidal intent in a sample of 267 patients with schizophrenia. Multiple regression analyses were used to assess the relationship between suicidality and current symptomatology, psychosocial problems, global functioning, and demographic characteristics. Results showed that depressive symptomatology as a single variable accounted for approximately 50% of the variance in ratings of suicidal intent. In addition, female gender, younger age, recent traumatic stress, and less severe psychotic symptoms each significantly predicted current suicidality independent of depressive symptoms. The combination of depression among younger female schizophrenic patients whose psychotic symptoms have abated and who are experiencing current traumatic stress may indicate extreme suicidal intent.

Adolescent↗

Secondary intention healing of exposed scalp and forehead bone after Mohs surgery.

For Mohs surgical wounds that show exposed bone (ie, bone denuded of periosteum), healing by secondary intention may be preferable to surgical reconstruction. To determine the appropriateness of secondary intention healing, we reviewed surgical outcome in 205 patients with Mohs wounds of the scalp and forehead that had healed by secondary intention. Of these patients, 38 had Mohs wounds showing exposed bone. The mean area of exposed bone was 1074 mm(2); the mean area of exposed soft tissue was 1575 mm(2). The mean time for wounds with intact periosteum to epithelialize was 7 weeks; the mean time for bare bone to epithelialize was 13 weeks. All wounds healed without infection or tissue breakdown. We conclude that secondary intention healing of scalp and forehead wounds showing exposed bone is a safe and effective method of wound management after Mohs surgery.

Elasticity↗

Assessing communicative intents: a situated pragmatics approach.

The analysis of communicative intents is described as it has developed over time, beginning with J.L. Austin's work published in 1975. Recommendations for best practice are offered in which a situated approach is advocated. Key elements of this approach are a focus on contextual variables and open-ended, rather than list-oriented, assessments of range of intents. It is argued that intents must be assessed relative to the environment, with documentation of environmental variables such as barriers to communicative opportunity. Further, caution is urged in using lists of intents as the sole guide to analysis, because such lists serve to limit awareness of individual differences and multifunctionality of utterances.

Child↗

Factors determining cardiac nurses' intentions to continue using a smoking cessation protocol.

OBJECTIVE: Our objective was to facilitate the continued use of a smoking cessation protocol among cardiac nurses by assessing their intentions and motives for continuation. A model that combines attitude, social influence, and self-efficacy constructs as predictors of intentions (ASE model) served as the theoretical framework. SETTING: The study took place in the cardiology wards of 5 hospitals. RESPONDENTS: Respondents were 85 nurses who worked in the cardiology wards of the hospitals. OUTCOME MEASURES: The outcome measures were nurses' intentions and motives for continuing to use a smoking cessation protocol for patients who smoke. RESULTS: Greater perceived simplicity and advantages of the protocol were associated with increased intentions to continue, whereas perceived social influences and self-efficacy were not. The influence of the level of experience in using the protocol and the nurses' own smoking behavior was mediated by attitude about the smoking cessation protocol. CONCLUSIONS: Nurses who do not intend to continue using the protocol need to be convinced of the advantages of working with such a protocol and of its user-friendliness.

Adult↗

Intentionality detection and "mindreading": why does game form matter?

By around the age of 4 years, children "can work out what people might know, think or believe" based on what they say or do. This is called "mindreading," which builds upon the human ability to infer the intentions of others. Game theory makes a strong assumption about what individual A can expect about B's intentions and vice versa, viz. that each is a self-interested opponent of the other and will reliably analyze games by using such basic principles as dominance and backward induction, and behave as if the normal form of an extensive form game is equivalent to the latter. But the extensive form allows intentions to be detected from actual sequential play and is therefore not necessarily equivalent psychologically to the normal form. We discuss Baron-Cohen's theory of the mindreading system [Baron-Cohen, S. (1995) Mindblindness: An Essay on Autism and Theory of Mind (MIT Press, Cambridge, MA)] to motivate the comparison of behavior in an extensive form game with its corresponding normal form. As in the work of Rapoport [Rapoport, A. (1997) Int. J. Game Theory 26, 113-136] and Schotter et al. [Schotter, A., Wiegelt, K. & Wilson, C. (1994) Games Econ. Behav. 6, 445-468], we find consistent differences in behavior between the normal and extensive forms. In particular, we observe attempts to cooperate, and in some treatments we observe the achievement of cooperation, occurring more frequently in the extensive form. Cooperation in this context requires reciprocity, which is more difficult to achieve by means of intentionality detection in the normal as opposed to the extensive form games we study.

Behavior↗

Action perception and outcome valence: effects on children's inferences of intentionality and moral and liking judgments.

The influences of different action-outcome scenarios on children's evaluative judgments and inferences of outcome intentionality were assessed. One hundred forty-five kindergartners, 2nd graders, and 4th graders heard 4 stories about child actors who engaged in 1 action or 3 equifinal actions and caused a positive or negative outcome. The stories made no mention of the actors' anticipated outcome so that we could assess the children's inferences of whether the actors wanted and had tried to cause the outcome. Children also rated their liking for the actors and the actors' morality. Children's moral and liking judgments were not significantly differentiated by action condition. However, actors who caused positive outcomes received favorable liking and moral judgments, and actors who caused negative outcomes received neutral liking and moral judgments. Children's intentionality inferences varied by the actors' actions and were moderated by outcome valence. The authors discuss children's apparent use of the valence rule when inferring intentionality and their reluctance to judge harshly actors who cause negative outcomes when not privy to the actors' intentions.

Child Behavior↗

Intentional switching between patterns of bimanual coordination depends on the intrinsic dynamics of the patterns.

Two predictions arising from previous theoretical and empirical work which demonstrated that spontaneous changes of bimanual coordination patterns result from a loss of pattern stability (i.e., a nonequilibrium phase transition) were tested: (a) that the time it takes to intentionally switch from one pattern to another depends on the differential stability of the patterns themselves; and (b) that an intention, defined as an intended behavioral pattern, can change the dynamical characteristics, e.g., the overall stability of the behavioral patterns. Subjects moved both index fingers rhythmically at one of six movement frequencies while performing either an in-phase or antiphase pattern of finger coordination. On cue from an auditory signal, subjects switched from the ongoing pattern to the other pattern. The relative phase of movement between the two fingers was used to characterize the ongoing coordinative pattern. The time taken to switch between patterns, or switching time, and relative phase fluctuations were used to evaluate the modified pattern dynamics resulting from a subject's intention to change patterns. Switching from the in-phase to the antiphase pattern was significantly slower than switching in the opposite direction for all subjects. Both the mean and distribution of switching times in each direction were found to be in agreement with model predictions. movement frequency had little effect on switching time, a finding that is also consistent with the model. Relative phase fluctuations were significantly larger when moving in the antiphase pattern at the highest movement frequencies studied. The results show that, although intentional influences act to modify a coordinative pattern's intrinsic dynamics, the influence of these dynamics on the resulting behavior is always present and is particularly strong at high movement frequencies.

Journal Article↗

Psychological correlates of perception of sexual intent in women.

In a sample of 183 men and 186 women, the authors assessed (a) the relative contributions of gender and level of nonverbal social cues to the perception of a female actor's sexual intent during a videotaped social interaction with a man and (b) the association between those variables and personality traits implicated in faulty sexual-information processing. The authors assessed those variables while the participants viewed 1 of 3 film segments depicting a female-male interaction. The authors experimentally manipulated eye contact, touch, physical proximity, and female clothing. At all levels of those nonverbal cues, the men perceived more sexual intent in the female actor than did the women. The perception of the female actor's sexual intent increased as the nonverbal cues in the film segments were magnified: Both actors displayed more eye contact, touch, and physical proximity, and the female actor wore more revealing clothing. Relative to the women, the men demonstrated greater sexual preoccupation and reduced sociosexual effectiveness, variables associated with inferring greater sexual intent in the female actor.

Adult↗

Identification of social cognitive variables as predictors of safer sex behavior and intent in heterosexual college students.

The purpose of this study was to identify social cognitive factors significantly associated with consistent condom use and safer sex intentions for heterosexual college students. No or new relationship involvement, positive attitudes toward condoms, higher HIV risk perceptions, being male, and being younger were associated with more consistent condom use. Higher HIV risk perceptions, positive attitudes toward condoms, safer sex negotiation, no or newer relationship involvement, lower classification, and higher safer sex perceptions of self-efficacy were associated with increased intent to engage in safer sex. HIV knowledge was not associated with safer sex intent or condom use. HIV intervention must go beyond presenting information. Intervention must incorporate social cognitive factors associated with safer sex intent and practice into their design, targeting groups and building safer sex skills.

Acquired Immunodeficiency Syndrome↗

Contraceptive intentions of women seeking induced abortion in the city of Jos, Nigeria.

This is a prospective study involving 120 women who requested abortion for an unplanned and unwanted pregnancy. We sought to determine their contraceptive intentions and use. The characteristics of these women revealed that the majority were young, single schoolgirls with 68.5% of them being nulliparous. Over 90% had had their first sexual experience before the age of 20 years. Although, 113 (94%) were aware of the availability of contraceptive services only 70 (62%) of these had ever used a method and the majority of the contraceptive methods selected were ineffective. Although 97 (80.8%) had a positive intention towards post-abortion family planning, only 18 (18.5%) eventually agreed and were offered a method after the termination of pregnancy. The study revealed a high risk group of unplanned and unwanted pregnancy in Jos but low contraceptive use despite the high positive intentions expressed by this cohort of patients. Effective post-abortion contraception counselling should be incorporated into family planning in Nigeria in order that clients who express positive intentions to the use of family planning actually use the method thereby reducing the incidence of repeated induced abortions and its social and medical consequences.

Journal Article↗