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Application of the theory of planned behavior to understand intentions to engage in physical and psychosocial health behaviors after cancer diagnosis.

A cancer diagnosis can trigger change in both lifestyle behaviors and mental health outcomes such as 'growth' and 'benefit-finding'. Assuming changes in mental health outcomes are based upon changes in specific behaviors, the Theory of Planned Behavior (TPB) may facilitate understanding of post-diagnosis change in physical and psychosocial 'health' behaviors. Adults (n = 130) < or =2 years post-cancer diagnosis completed an internet survey. Current performance and future behavior intentions for two physical (e.g. eating a healthy diet) and four psychosocial (e.g. spending quality time with family/friends; engaging in spiritual or religious activities) health behaviors were assessed. TPB constructs (subjective norm, behavior attitudes, perceived behavioral control) for each of the six behaviors were also assessed. Multiple regression analyses indicated the set of TPB constructs accounted for an increment of 25-53% of variance in behavioral intentions beyond that accounted for by clinical and demographic variables. Among individual TPB constructs, behavioral attitude was most consistently associated with behavioral intentions while subjective norm was least consistently associated with behavioral intentions. The TPB could serve as a comprehensive model for understanding change in both physical and psychosocial health behaviors after cancer diagnosis and could suggest innovative approaches to developing interventions to enhance post-diagnosis 'growth' and 'benefit finding'.

Adaptation, Psychological↗

Scene perception: a failure to find a benefit from prior expectancy or familiarity.

In our everyday world, we typically have an expectancy as to the kinds of scenes that we will see from one glance to the next. Also, many of the scenes that we do see are familiar in the sense that they have been experienced before. Do these factors influence the perception of a scene? In three experiments, priming subjects with a verbal descriptor of a scene was not found to improve reliably the perception of that scene as assessed by the speed and accuracy of detecting an incongruity between an object and its setting (Experiments 1 and 2) or a specified target object (Experiment 3). Also, in attempting to perceive these scenes, subjects could not capitalize on the residue from prior exposures of a scene's background, even though those backgrounds had been processed to the point where semantic information had been extracted from them. Although these results are inconsistent with recent speculations on the role of frames in scene perception, recent experiments on the perception of a scene from a single fixation, and film-editing practice with "flash cuts." The implications of these results are that the mechanisms for perceiving and interpreting nondegraded real-world scenes are so quick and efficient that conditions can readily be found in which priming and prior exposures of substantial portions of scenes are not helpful for perceiving and judging certain aspects of those scenes.

Cognition↗

Abdominal sonography in asymptomatic executives: prevalence of pathologic findings, potential benefits, and problems.

Abdominal ultrasonography was performed on 1000 asymptomatic executives over a period of 6 months as part of a comprehensive health examination. The use of ultrasonography in these persons was evaluated with regard to the prevalence and variety of pathologic conditions detected as well as potential benefits, risks, and use as a screening tool. Significant sonographic diagnoses included renal cell carcinoma in four patients (0.4%) and abdominal aortic aneurysm in four patients (0.4%). Abdominal sonography performed on 7925 asymptomatic executives over a subsequent 2 1/2 year period led to detection of 23 (0.3%) additional renal cell carcinomas. The prevalence of renal cell carcinoma in this population is substantially greater than that of the general population. Abdominal sonography facilitates detection of occult renal neoplasms and aortic aneurysms. The cost effectiveness and potential use of sonography as a screening tool remains to be determined, however, given the relatively low overall prevalence of these pathologic conditions.

Abdomen↗

Income of new retired workers by social security benefit levels: findings from the New Beneficiary Survey.

This article, based on New Beneficiary Survey (NBS) data, examines the sources and amounts of income available to newly retired workers by the level of their primary insurance amount (PIA). For this analysis, the PIA distribution was divided into quartiles. Retired workers with high PIA's were found to be more likely to have private pensions or asset income and thus to have the highest total income. When a spouse's income is taken into account, married retired workers at all PIA levels have higher total income than do the unmarried retirees. The difference between the income of married and unmarried retirees is greatest for those with PIA's in the lowest quartile, where the median total income of the married retirees is roughly three times as high as that of the unmarried group. New retirees with PIA's in the lowest quartile were a mixed group: Many had additional important sources of income; others did not and had income that was quite low. About 21 percent of those with PIA's in the lowest quartile had pensions and their median total income was about $19,100. An additional 55 percent were married women without pensions of their own who, together with their husbands, had a median total income of $15,900. The remaining 24 percent were married men and unmarried retirees without a pension and with much lower median income--$7,100 for the married men and their wives, and $5,000 for the unmarried men and women.

Aged↗

The peer-professional interface in a community-based, breast feeding peer-support project.

OBJECTIVE: to explore key elements of the peer-professional interface within one breast feeding peer-support project. DESIGN: a descriptive, qualitative study design. Data were generated through focus-group discussions with volunteer peer supporters and health professionals. SETTING: the Breastfriends scheme was a community-based, peer-support project located in Doncaster, a town in the North of England. PARTICIPANTS: all of the volunteer peer supporters who were involved in the scheme at the time of data collection (n=7). In addition, a convenience sample of health professionals (community midwives and health visitors [n=9]) was also generated. ANALYSIS: thematic analysis of the data was undertaken. Two key themes that have relevance to understanding the peer-professional interface were derived: benefits of working together, and constraints on enabling working relationships. FINDINGS: benefits associated with participating in the breast feeding peer-support scheme were highlighted by volunteers and health professionals. Volunteers experienced enhanced social support and increased self-esteem and personal development. Health professionals benefited from being able to 'spread the load' of breast feeding support. Some health professionals were also able to learn from volunteers' specialist experiential and cultural knowledge. Health professionals were concerned about volunteers transgressing (poorly defined) boundaries. Both volunteers and health professionals described gate-keeping activities and surveillance behaviours practised by health professionals in an effort to control aspects of volunteers' access to, and work with, breast feeding women. DISCUSSION: as a cohort of peer supporters develops, members may derive benefits from their participation that extend beyond those predicted and planned for in the project. They may also exert a proactive influence upon the evolution of the peer-support project and upon the relationships between volunteers and health professionals. However, midwives and health professionals may also seek to exert influence over the work of peer supporters, preferring the volunteers to work for, rather than with, them as health professionals. It is at the peer-professional interface that any disjuncture between the project ideal and the reality of the group may be most evident and most problematic. CONCLUSION AND IMPLICATIONS FOR PRACTICE: in order to reduce tension at the peer-professional interface, and optimise relationships between volunteers and health professionals, an ongoing process of development involving volunteers and health professionals is essential. Such a process would need to proactively identify and diffuse professionals' concerns while addressing both volunteers' vulnerabilities and their potential for semi-autonomous development within and beyond the context of the peer-support scheme.

Adult↗