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PubMed2002

Adult attachment stance and spouses' marital perceptions during the transition to parenthood.

The relationship between adult attachment and marital perceptions was examined in couples making the transition to parenthood. The Adult Attachment Interview was administered to spouses prenatally, and marital perceptions were assessed prenatally and 3, 12, and 24 months postnatally. The couples were also observed during a marital interaction task. Spouses were assigned to groups based on their attachment security (secure/insecure) and mean level (low/high) of negative emotional escalation in their marital interactions. A series of two-way (attachment security by negative emotional escalation) repeated multivariate analyses of variance, followed by univariate analyses, revealed that insecure husbands and the wives of insecure husbands exhibited different patterns in their marital perceptions than secure husbands and the wives of secure husbands when in high negative escalation marriages. Insecure husbands and the wives of insecure husbands in high negative escalation marriages reported greater declines in positive marital perceptions or less positive marital perceptions overall across the two-year postnatal period than secure husbands and wives of secure husbands in similarly high conflict marriages. Such differences between secure and insecure husbands (and their wives) were not apparent in low negative escalation marriages. Findings are discussed in terms of the protective effect a secure attachment may convey upon spouses during stressful periods in their marriage.

Adult↗

PubMed2003

Perceptions and attitudes of adolescents with asthma.

BACKGROUND: Psychosocial factors can limit one's ability to effectively manage asthma. This can result in asthma morbidity that limits quality of life. While self-perceptions of asthmatic children and parents have been studied, less is known about self-perceptions of inner-city adolescents with asthma. OBJECTIVE: To examine perceptions and attitudes to treatment among inner-city adolescents with asthma. DESIGN/METHODS: We conducted a multistaged stratified sample survey at a high school located in the Bronx, NY. First, an asthma-screening survey was administered to 3800 registered students. Then, we identified a subset of 200 children with the most positive screening results for asthma. Next, a 32-item self-completion questionnaire was administered to this cohort. Students were surveyed regarding severity of asthma, perceptions and attitudes, and demographic information. Differences in proportions were tested by Chi-square analyses. Pearson rank-order correlation and multiple logistic regression were used to assess the relationship between perceptions and attitudes to self-treatment. RESULTS: A total of 160 (80%) students participated. Mean age was 15.7 years. Of the respondents, 63% were female. 68% were Hispanic, 26% were African American. 33% had weekly symptoms, and 14% had daily symptoms. Additionally, 41% did not know the name of their asthma medicine. Only 38% reported bringing an "asthma pump" when leaving the house. While 70% reported feeling in control over their asthma symptoms, 63% reported feelings of anxiety and 39% could remember a time when they felt like they were going to die from asthma. Subjects who reported feeling in control over their asthma were more likely to take an asthma pump with them when leaving the house (r = 72, p = 0.004). Only 39% had disclosed their asthma to their friends, and 29% felt embarrassed about having an asthma attack in front of their friends. Subjects who felt embarrassed about their asthma were significantly less likely to take their asthma pumps with them (r = 0.98, p < 0.001) and less likely to use their medications in front of their friends (r = .87, p < 0.001). CONCLUSIONS: Adolescents in this study reported feelings of anxiety, fear, and embarrassment about their asthma. Feelings of control over asthma symptoms were associated with positive attitudes toward self-treatment, while embarrassment was correlated with negative attitudes. These findings have implications for counseling adolescents with asthma about self-management strategies.

Adolescent↗

PubMed2001

When parties and candidates collide: citizen perception of house candidates' positions on abortion.

When candidates assume issue positions opposite those of their sponsoring political party do citizens recognize these positions? Relatedly, what role do candidates' actual issue positions play in citizens' perceptions of their issue positions? Examining citizens' perceptions of 1996 and 1998 House candidates' position on abortion, this research finds that citizens' perceptions are shaped largely by partisan and, to a lesser extent, gender stereotypes. However, candidates' individuating positions on abortion influence perceptions of the candidates' position, but the effects are considerably stronger for perceptions of Republican candidates. Democratic candidates are likely to adopt anti-abortion positions in districts characterized by lower than average levels of political awareness and education, reducing the likelihood their party-contradicting position is accurately perceived. In contrast, Republican candidates adopt a pro-choice position in districts characterized by high education and political awareness, increasing the likelihood their position is accurately perceived.

Journal Article↗

PubMed2005

Attitudes and perceptions toward hand hygiene among healthcare workers caring for critically ill neonates.

BACKGROUND: Infectious complications are frequent among critically ill neonates. Hand hygiene is the leading measure to prevent healthcare-associated infections, but poor compliance has been repeatedly documented, including in the neonatal setting. Hand hygiene promotion requires a complex approach that should consider personal factors affecting healthcare workers' attitudes. OBJECTIVE: To identify beliefs and perceptions associated with intention to comply with hand hygiene among neonatal healthcare workers. METHODS: An anonymous, self-administered questionnaire (74 items) based on the theory of planned behavior was distributed to 80 neonatal healthcare workers to assess intention to comply, attitude toward hand hygiene, behavioral and subjective norm perceptions, and perception of difficulty to comply. Variables were assessed using multi-item measures and answers to 7-point bipolar scales. All multi-item scales had satisfactory internal consistency (alpha > 0.7). Multivariate logistic regression identified independent perceptions or beliefs associated with a positive intention to comply. RESULTS: The response rate was 76% (61 of 80). Of the 49 nurses and 12 physicians responding, 75% believed that they could improve their compliance with hand hygiene. Intention to comply was associated with perceived control over the difficulty to perform hand hygiene (OR, 3.12; CI95, 1.12 to 8.70; P = .030) and a positive perception of how superiors valued hand hygiene (OR, 2.89; CI95, 1.08 to 7.77; P = .035). CONCLUSION: Our data highlight the importance of the opinions of superiors and a strong perceived controllability over the difficulty to perform hand hygiene as possible internal factors that may influence hand hygiene compliance.

Adult↗

PubMed2001

Change of patients' perceptions of TeleHomeCare.

The study's objectives were to measure patients' perceptions of a telehomecare system before and after they have participated in it and identify the features of the system that patients perceived differently after experiencing it. The study setting was the TeleHomeCare Project, which uses videoconferencing and Internet equipment to enable interactions between patients and nurses. An instrument that measures perceptions of telehomecare was used. Patients viewed a videotape that demonstrates a "virtual home care visit" and filled out the questionnaire (pre-test). They were then randomly assigned to a control group receiving standard care or to an experimental group receiving videoconferencing and Internet access in addition to standard care. Both groups filled out the questionnaire when exiting the system (post-test). Paired t-tests were performed to compare total scores and responses to each of the items within the groups and an unpaired t-test was used to compare change of perceptions between groups. The control group consisted of 11 patients, and the experimental group included 17 patients. There was no statistically significant change of perception in the control group. The experimental group showed an overall more positive perception of the system after their experience (total score increase by 6.059, p < 0.0001), and the mean score difference was higher compared to the control group (mean 6.241, p < 0.0001). Elderly patients evaluated their telehomecare experience as being positive, and they felt more comfortable with the technology, believing that the nurse can understand their medical problem over the television. This suggests that telehomecare has the potential for wide acceptance among patients.

Aged↗

PubMed2003

Women smokers' perceptions of smoking-related health risks.

OBJECTIVE: Unrealistic perceptions of personal susceptibility to the health hazards of smoking may be an important determinant of cigarette smoking and a barrier to smoking cessation. This study was undertaken to assess perceptions of smoking-related health risks among women smokers. METHODS: A secondary analysis was conducted using cross-sectional data collected from 1184 (response rate 61%) perimenopausal women patients from one university-affiliated health system. RESULTS: The majority of respondents were white and college-educated and had an annual household income of over $60,000. Twelve percent of respondents were current smokers, 37% were former smokers, and 51% were never smokers. Sixty percent of current smokers rated their lifetime risk for developing heart disease or lung cancer as average or below average, and 75% of current smokers rated their lifetime risk for developing osteoporosis as average or below average. Multivariable logistic regression analysis revealed that any smoking history (past or current) was associated with perception of above average risk for developing lung cancer, but only heavier smoking (> or =10 cigarettes per day) was associated with perception of above average risk for developing heart disease. No level of smoking was associated with perception of above average risk for developing osteoporosis. CONCLUSIONS: The majority of women smokers surveyed perceived their lifetime risk for developing heart disease, lung cancer, and osteoporosis as average or below average. It appears that women smokers are more aware of their increased risk for developing lung cancer than their increased risk for developing heart disease or osteoporosis.

Attitude to Health↗

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↗

PubMed2003

Taste perception with age: generic or specific losses in supra-threshold intensities of five taste qualities?

The influence of ageing on supra-threshold intensity perception of NaCl, KCl, sucrose, aspartame, acetic acid, citric acid, caffeine, quinine HCl, monosodium glutamate (MSG) and inosine 5'-monophosphate (IMP) dissolved in water and in 'regular' product was studied in 21 young (19-33 years) and 21 elderly (60-75 years) persons. While the relative perception (intensity discrimination) seems to be remarkably resistant to the effect of ageing, the absolute perception (intensity rating) decreased with age for all tastants in water, but only for the salty and sweet tastants in product. When assessed while wearing a nose clip, only the perception of salty tastants was diminished with age. The slopes of the psychophysical functions were flatter in the elderly than in the young for the sweet, bitter and umami tastants in water, and for the sour tastants in product only. The age effects found were almost exclusively generic and never compound-specific within a taste. This study indicates that the relevance of determining intensities of tastants dissolved in water for the 'real life' perception of taste in complex food is rather limited.

Adult↗

PubMed2005

Self-perception of malocclusion among north Jordanian school children.

This study was undertaken to assess the factors affecting self-perception and the demand for orthodontic treatment among north Jordanian school children. In total, 1404 students randomly selected to represent five geographical areas of northern Jordan were examined. The students were further subgrouped according to gender (858 females, 546 males), age (985 13 year olds, 419 17 year olds) and rural/urban place of residence (212 rural, 1192 urban). The aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN) was used as an assessment measure of the need for orthodontic treatment. The self-perception of malocclusion was evaluated by asking each student to identify which photograph on the AC scale most closely matched the appearance of their anterior teeth. The demand for orthodontic treatment was measured by asking the students: "Do you feel it is necessary to have your teeth straightened by an orthodontist?" Differences between the self-perception of malocclusion among the different groups were tested using the chi-squared test.The results showed that the majority of students rated their dentition from grades 1 to 4, with a tendency for the females and older school children to score their teeth as more attractive than males and younger children (P < 0.05, P < 0.001, respectively). Rural and urban school children did not differ in the perception of their own dentition. The self-perception scores of subjects within the no aesthetic need, borderline need and definite need groups differed significantly (P < 0.001). The subjects who reported a definite need perceived their teeth to be worse than the other two groups. The demand for orthodontic treatment was found to be affected by gender (P < 0.01) and rural/urban areas of living (P < 0.05).

Adolescent↗

PubMed2005

Influences of aging on taste perception and oral somatic sensation.

BACKGROUND: Many elderly persons report reduced taste perception of the foods they eat. Any disturbance of taste and oral somatic sensations can induce this phenomenon. To determine the cause of decreased taste perception in older persons, the authors investigated age-related changes in taste perception and somatic sensations in the anterior tongue. METHODS: Thirty healthy young and elderly persons participated in this study. Recognition thresholds of four basic tastes (sweet, salty, sour, and bitter) and the threshold of irritating sensation induced by capsaicin were measured by local stimulation using filter-paper disks. Two-point discrimination thresholds were measured to evaluate the spatial acuity of touch sensation. All measurements were carried out at the tip of the dorsal tongue. RESULTS: The recognition thresholds of all four basic tastes of elderly participants were significantly higher than those of young participants. On the contrary, age-associated changes were not observed in 2-point discrimination and capsaicin sensation. CONCLUSIONS: Significant age-associated deterioration was observed in taste but not somatic sensations such as touch and burning pain in the tongue, showing that aging affects taste perception and oral somatic sensations differently. This suggests that decreased taste perception of foods in elderly people may be caused primarily by perceptual loss of taste among oral sensations.

Adolescent↗

PubMed2006

After the fall of the Berlin Wall: perceptions and consequences of stability and change among middle-aged and older East and West Germans.

OBJECTIVES: This study empirically tested the self-systems theory of subjective change in light of the rapid change after the fall of the Berlin Wall. The theory predicts that individuals have a tendency to perceive stability and that perceived stability exerts a strong positive effect on subjective well-being. We would expect perceptions of decline and, to a lesser extent, perceptions of improvement to be related to lower levels of subjective well-being. METHODS: Data were from respondents aged 40-85 years who participated in the German Aging Survey. We used measures of well-being and temporal comparisons during the past 10 years (1986-1996). RESULTS: West Germans reported more stability than East Germans, in particular in the public domain and in older age groups. Compared with perceptions of stability, perceptions of decline were related to less life satisfaction and more negative affect, and perceptions of growth to more negative affect. Temporal comparisons were unrelated to positive affect. DISCUSSION: Our findings both confirm and reject the self-systems theory of subjective change as it relates to the fall of the Berlin Wall. Studying temporal comparisons is important in understanding the effects of historical events and their timing within an individual life course.

Adaptation, Psychological↗

PubMed1978

Organizational position and perceptions of problems in a nursing home.

This paper examines perceptions of problems expressed by persons living and working in a 100-bed skilled nursing home. Data were obtained from administrative staff, professional and nonprofessional nursing staffs, therapy staff, auxiliary staff, and residents by means of interview, observation, and analyses of records. The relationship between perceptions of problems and location within the organization and the scope and content of roles played was studied. We sought to ascertain the extent to which members agree or disagree with one another as to what are problems, to locate areas of agreement and disagreement, and to relate the results to the broader issue of the quality of care provided elderly institutionalized persons. Position and associated roles of members were found to be related to perceptions of problems. Differential perceptions of the numbers of problems and their priority were observed. Some problems were mentioned more frequently than others. Perceptions of problems varied both within and between organizational units. A person's location within the nursing home was related to the identification of problems as important and the frequency with which different problems were mentioned.

Adult↗

PubMed2004

Unraveling women's perceptions of risk for breast cancer.

Inconsistent reports of the prevalence of risk perception accuracy may be related to the use of different classification strategies. The purpose of this study was to compare two approaches for assessing the accuracy of women's breast cancer risk perceptions. A telephone survey was conducted with an age-stratified random sample of British Columbian women 20-79 years of age without a breast cancer diagnosis (n = 761). A comparison of two methods employed to determine perception accuracy revealed substantial differences between the methods with regard to the classification of women as under- and over-estimators. The study highlights the need for researchers to consider the method used to determine the accuracy of risk perceptions and the implications of using different strategies to assess risk perception accuracy when such information is used in research or to guide interventions.

Adult↗

PubMed1992

Personal factors related to the perception of occupational exposure: an application of a job exposure matrix.

Whether certain personal characteristics influence the perception of exposure to dusts, gases or fumes was assessed in 6803 men and 6765 women drawn from nonmanual worker households in seven French cities. Factors modifying the strength of the association between two estimates of exposure (here a job exposure matrix estimate and exposure reported by the subjects) are potential recall determinants of exposure. This association was significantly stronger in men than in women, suggesting a better perception of exposure in men. The strength of the association between both estimates of exposure increased significantly among men according to educational level. Smoking habits had no effect on the perception of exposure. The perception of exposure did not vary significantly according to respiratory symptoms in women. In men, subjects without chronic cough or chronic bronchitis had a significantly higher perception of exposure than the others, but no difference was shown for wheezing, dyspnoea or asthma.

Adult↗

PubMed2002

Longitudinal influence of perceptions of peer and parental factors on African American adolescent risk involvement.

To explore the long-term contributions of perceived peer and parental influences on adolescent risk and protective behaviors (sexual involvement, condom use, and drug use), we assessed self-reported behaviors and perceptions of peer risk involvement and parental supervision and communication among 383 low-income, urban African Americans aged 9 to 15 years at baseline over a 4-year period. Baseline perceptions of peer sexual involvement were significantly associated with youth sexual behavior at baseline and were predictive of sexual involvement through all 4 years of follow-up. Perceived parental monitoring was inversely correlated with sexual involvement through 3 years of follow-up. Perceptions of peer condom use were associated with increased levels of condom use at baseline and through 6 months of follow-up. Positive parental communication was correlated with increased condom use. Drug use was higher among youths who perceived peers or family members to be using drugs and was inversely correlated with increased parental monitoring and supervision. Stepwise regression revealed peer and parental influences for all three behaviors. Perceptions of both peer and parental behaviors influence long-term risk and protective behaviors of adolescents. Therefore, parents should be included in adolescent risk-reduction intervention efforts. Inclusion of friends and/or changing youth perceptions of peer involvement may also be effective intervention strategies.

Adolescent↗

PubMed1995

Physical therapist assistants' perceptions of the documented roles of the physical therapist assistant.

BACKGROUND AND PURPOSE: This study investigated physical therapist assistants' (PTAs) perceptions of the documented roles of PTAs and compared those perceptions with those of physical therapists from a previous study. SUBJECTS AND METHODS: A questionnaire that described 79 physical therapy activities was distributed to a sample (n = 400) of PTAs derived from the American Physical Therapy Association membership. The response rate was 56% (n = 225). Respondents indicated whether each activity was included in the documentation describing PTA roles. Discriminant analyses were used to determine whether demographic factors predicted the pattern of responses. In addition, meta-analytic techniques were used to determine whether PTA responses were different from those of physical therapists gathered previously. RESULTS: The greatest agreement of PTA opinions with published guidelines occurred for treatment implementation activities, and the lowest level of agreement occurred for items designated as administrative activities. Responses of PTAs were different from those of physical therapists on 21 of the 79 activities. The greatest number of these differences occurred for evaluative functions (n = 9). Physical therapist assistants' perceptions of documented PTA roles were generally less consistent with published guidelines than were those of physical therapists. CONCLUSION AND DISCUSSION: Physical therapist assistants' perceptions of the roles of the PTA were, for some activities, not consistent with written guidelines. Using the data provided in this study, discussions to revise the documentation of the scope of PTA practice may focus on those activities for which disagreement between PTAs and physical therapists exists and for which opinions differ markedly from published guidelines. [Robinson AJ, DePalma MT, McCall M. Physical therapist assistants' perceptions of the documented roles of the physical therapist assistant.

Allied Health Personnel↗

PubMed1989

Effect of a major curriculum revision on students' perceptions of well-being.

The impact of a major curriculum revision on students' perceptions of the quality of the medical school learning environment, social supports, and their own mental and social well-being was determined. First-year students' perceptions one year before the curriculum revision were compared with first-year students' perceptions two years after the introduction of the new curriculum. In the new curriculum, students reported better overall quality of the learning environment (p = .019), a trend toward fewer stresses (p = .091), no difference in social supports (p = .721), better mental well-being (p = .043), and a trend toward better social well-being (p = .099). Students at a comparison school that did not undergo curriculum revision did not have more favorable perceptions during the study period. The findings suggest that well-considered and well-executed efforts to improve the quality of a medical school's learning environment can be successful and can raise students' perceptions of their overall well-being.

Attitude↗

PubMed1997

Assessing medical students' perceptions of mistreatment in their second and third years.

PURPOSE: To study medical students' perceptions of mistreatment in their second and third years of training. METHOD: A questionnaire was distributed at Wayne State University School of Medicine to the class of 1993 at the end of its third year and to the class of 1994 at the end of its second and third years. The students were asked if they had been subjected to various forms of mistreatment; the third-year students were asked to rate their perceptions of each clinical department's response to them on the basis of gender and race-ethnicity, as well as their overall treatment. The students also completed demographic information about age, gender, and marital status, number of children, and race-ethnicity. Results were analyzed using chi-square statistics, multivariate statistical analyses, analyses of variance, and Duncan's post-hoc comparisons. RESULTS: The response rate for the class of 1993 was 71.5%; response for the class of 1994 were 66.9% in their second year and 75.2% in their third year; 41.7% were women, and the racial-ethnic breakdown was 71.2% white/Caucasian, 11.7% black/African American and 16.8% other. There was a significant difference between the percentages of second-year and third-year students reporting any experience of mistreatment (37.2% vs 75.8%, p < .001). Canonical correlation analysis revealed bias in the third year based on gender (p < .0001) and race-ethnicity (p < .0002); both variates were related to sexual humor. The students' perceptions of mistreatment were lowest for family medicine and highest for obstetrics-gynecology and surgery. Perceptions of mistreatment in departments varied significantly by gender and race-ethnicity. The nonwhite males reported the least favorable treatment in most departments. CONCLUSION: Marked variability in the students' perceptions of mistreatment within departments suggest that a variety of approaches will be required to improve the medical training environment.

Education, Medical, Undergraduate↗