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Results for “Perception”

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PubMed1997

Impact of chronic pain patients' job perception variables on actual return to work.

OBJECTIVE: To examine the impact of preinjury job perceptions on chronic pain patients (CPPs) return to work after pain facility treatment. DESIGN: A total of 128 CPPs completed a series of rating scales and yes/no questions relating to their preinjury job perceptions and a question relating to "intent" to return to the same type of preinjury job following pain facility treatment. These CPPs were part of a grant study for prediction of return to work, and therefore their work status was determined at 1, 3, 6, 12, 18, 24, and 30 months after treatment. The preinjury job perceptions and other demographic variables were used to predict return to work. Stepwise discriminant analysis was used to predict return to work at the 1-month and final time points utilizing the above variables. Stepwise regression analysis was used to predict mean employment status (at all time points) also using the above variables. SETTING: Multidisciplinary Pain Center. PATIENTS: Consecutive CPPs. RESULTS: For the 1-month time point, employment status was predicted by "intent," educational status, work dangerous perception complaint, job stress, job physical demands, job liking, and job role conflicts. Here, 79.49% of the CPPs were correctly classified. For the final time point, employment status was predicted by the first three predictors for the 1-month time point (in the same order) and age, job stress, and gender. Here, 74.58% of the CPPs were correctly classified. Mean employment status was predicted by "intent" and educational status. CONCLUSIONS: There is a relationship between preinjury job perceptions and actual return to work after pain facility treatment. Voiced "intent" not to return to the preinjury type of job is highly predictive of not returning to work after pain facility treatment.

Accidents, Occupational↗

PubMed2003

Parental perception of problems and mental health service use for hyperactivity.

OBJECTIVE: To examine predictors of parental perception of hyperactivity as a serious problem and its role in determining the use of specialist mental health services. METHOD: A community sample of 5- to 11-year-old children with pervasive hyperactivity (n = 93) was identified. Children whose parents perceived the hyperactivity as a serious problem were compared with those whose parents did not. Predictors of parental perception of problem and the roles of this and child and parent clinical factors in predicting service use were examined. RESULTS: Controlling for child and parental mental health, the strongest predictor of parental perception of problems was the financial impact of the child's behavior on either parent's work (odds ratio [OR] = 17.43; 95% confidence interval [CI] 3.52-86.40). Other effects on the parent's working ability were also important. Parental perception of problems was the strongest predictor of service use (OR = 9.85; 95% CI 1.42-68.50). CONCLUSIONS: The effects of child behavior difficulties on perceptions of caregivers are multidimensional. The impact of hyperactivity on parents' work and family finances is substantial. Mental health service use is increased if these impacts reach the threshold for the parent to perceive the child's behavior as a problem.

Attention Deficit Disorder with Hyperactivity↗

PubMed2005

Parental perceptions of infant vulnerability in a preterm sample: prediction from maternal adaptation to parenthood during the neonatal period.

The present longitudinal study of African-American mothers of preterm infants tested the hypothesis that the quality of maternal adaptation to parenthood before infant discharge from the hospital is predictive of maternal perceptions of infant vulnerability later in the infant's first year. As hypothesized, perceptions of infant vulnerability at 3 to 4 months of infant corrected age were predicted by two theoretically relevant measures of maternal adaptation in the neonatal period: mothers' perceptions of their neonates as lethargic and unresponsive to mothers' bids and by low maternal self-efficacy beliefs about feeding the infant. Neonatally obtained maternal self-inefficacy beliefs about their ability to feed the infant in particular proved to be quite robust in predicting mothers' later perceptions of infant vulnerability. Findings collectively suggest that careful attention to the manner in which mothers of preterm infants adapt to parenthood, even before infant hospital discharge, can help clinicians identify mothers at particularly high risk of developing perceptions of infant vulnerability later in the infant's first year. Implications for intervention are discussed.

Adaptation, Psychological↗

PubMedDate not supplied

Women's perceptions of coronary heart disease: an integrative review.

Coronary heart disease (CHD) is the leading cause of death in American women and is a major cause of morbidity. The American Heart Association (AHA) reports that in the year 2000, 515,661 women died from all categories of cardiovascular disease. An estimated 254,630 women suffer a myocardial infarction annually. Women diagnosed with CHD experienced greater morbidity and mortality than men. Women's perceptions of their risk for heart disease can greatly influence their decision-making process in regard to healthcare decisions. The general public still perceives heart disease as primarily a health problem for men. Evidence shows that women perceive breast cancer as a greater risk than CHD. These misperceptions may lead women to underestimate their risk for CHD and fail to seek early interventions to prevent unnecessary morbidity and mortality. The purpose of this article is to report the results of an integrative review of nursing research related to women's perceptions of risks for heart disease. CINAHL, Medline, EBSCO host, and Proquest databases were searched for nursing research conducted between the years of 1985 and 2002. Key search terms were women, heart disease, coronary artery disease, perceptions, risk factors, and health promotion behaviors. Study selection was limited to the first author being a nurse researcher. Twenty articles and dissertations were retrieved that met the key search terms. Eleven articles were excluded because the first author was not a nurse researcher. This integrative review includes 5 articles and 4 dissertations. Results revealed that women's perceptions of their CHD risks are underestimated, that health-promoting behaviors are not influenced by risk perceptions, that society imposes barriers that prevent participation in health promotion behavior, and that communication between women and their healthcare providers is lacking.

Adolescent↗

PubMed1996

The effect of a professional practice model on staff nurse perception of work groups and nurse leaders.

OBJECTIVE: The objective of the study was to measure the effect of an enhanced professional practice model on perception of work groups and nurse leaders. BACKGROUND: Previous studies of staff nurse perception of work environment and nurse leaders were used to guide development of the professional practice model and the selection of variables. Implementation of the model was expected to result in more favorable perceptions of the work group and a desire for facilitative leadership style. METHODS: A quasi-experimental design was used to compare change over time in five-hospitals--an urban medical center, two community hospitals, and two rural hospitals. FINDINGS: Introduction of the model resulted in more favorable perceptions about the work group and a desire for a more facilitative nurse leader. CONCLUSION: Change in perception of work group and leader rather than job satisfaction may be an early indication of favorable outcome of planned change. Changes in nurse satisfaction may be a late outcome, which may be the reason findings from previous studies are mixed.

Attitude of Health Personnel↗

PubMed1998

Physicians' perceptions of managed care: a structural equation model assessment of key dimensions.

OBJECTIVES: To assess the interrelationship of physicians' own interest with that of the methods and the anticipated benefits of managed care, the authors developed a new instrument to assess physician's perception of job satisfaction, risk, need to adapt their practice behavior, quality of care, cost of care, and access under managed care. METHODS: One hundred sixty-one attending physicians of an urban public hospital in a metropolitan area with low to moderate managed care penetration participated. A 24-item questionnaire with good psychometric properties was developed based on literature reviews, qualitative interviews with the key informants, and focus group discussion among a group of selected physician representatives. Confirmatory factory analysis and structural equation models were applied. RESULTS: The study reveals that when physicians perceived that high job satisfaction would ensue, they also perceived that quality and access to care would improve under managed care. Physician's perception of the need to modify their practice behavior was associated with a perception of increasing the cost of care. Risk sharing, from the physician's perspective, did not translate to cost savings as expected by managed care organizations, and only resulted in a fractional improvement on a perception of quality and access of care. CONCLUSIONS: Although this study reports the perceptions of a small group of physicians from a single hospital, the data suggest that increasing quality and decreasing cost may be included in the same equation, if physician job satisfaction also is included through organizational support and user-friendly work environment.

Adult↗

PubMedDate not supplied

Influence of attention and judgment on perception of breathlessness in healthy individuals and patients with chronic obstructive pulmonary disease.

BACKGROUND: Cognitive processes mediate judgments of sensation intensity and the perception of breathlessness. These processes depend on focused attention to make a determination, which has not been systematically investigated. OBJECTIVE: To examine the effect of attention on the perception of breathlessness given alterations in attentional focus based on the subject's experience with the perception. METHODS: Magnitude estimation techniques with inspiratory airflow resistance were used to examine the influence of variations in attentional focus on the judgments associated with the perception of breathlessness. Two experimental magnitude estimation conditions were used to alter the focus of attention and compare it with traditional techniques as a control condition (CC). The subject's typical breathing pattern (EXP-T) and clearest memory of breathlessness (EXP-M) were used as references in the experimental conditions. RESULTS: Findings revealed a significant main effect for condition (CC vs. EXP-T: F= 4.82, p < .01; CC vs. EXP-M: F= 14.82, p < .01) and an interaction effect for group by condition (CC vs. EXP-T: F = 4.82, p < .03; CC vs. EXP-M: F = 5.15, p < .03). Post hoc analysis revealed significant differences only for the chronic obstructive pulmonary disease (COPD) group in both comparisons. CONCLUSIONS: Findings indicate that different focuses of attention based on previous exposure to sensations have an impact on judgments used to determine the intensity of a sensation given similar presentation of stimuli, and thus contribute to alterations in the perception of breathlessness.

Aged↗

PubMed1989

Health perceptions and medical care opinions of inner-city adults with sickle cell disease or asthma compared with those of their siblings.

Inner-city adults (n = 108) with a chronic disease (sickle cell disease or asthma) and their unaffected siblings (n = 50) were interviewed and ratings of health perceptions and opinions about medical care were compared. Persons with a chronic disease reported unfavorable ratings of their health (P less than .001). Their siblings reported moderately favorable health perceptions but much worry and concern about their health. When compared with the asthma subgroup, persons with sickle cell disease reported more adverse ratings of health outlook susceptibility to illness, sickness orientation, humaneness of medical care, and satisfaction with medical care (P less than .05). These observations demonstrate low health perceptions in adults with two chronic medical conditions and more negative perceptions in persons with sickle cell disease. They indicate possible opportunities for improving medical care for patients with these conditions to achieve better perceptions of health, outlook, and medical services.

Adolescent↗

PubMed2005

Self-perception of body changes in persons living with HIV/AIDS: prevalence and associated factors.

BACKGROUND: Highly active antiretroviral therapy has brought about a substantial improvement in the prognosis of HIV/AIDS. In this context, therapy-related body changes (lipodystrophy) gain in importance, in light of the psychological distress they cause and of their association with adherence to treatment. This study analyses patients' self-perception of central fat gain (CFG) and peripheral fat loss (PFL). METHODS: A total of 457 patients were interviewed in a university outpatient facility for the treatment of adults and adolescents with HIV/AIDS in the city of São Paulo, Brazil, between September and December 2001. RESULTS: Two-thirds of subjects (64.3%) perceived body changes. The self-perception of CFG and PFL was associated with greater schooling. The self-perception of CFG was more frequent among women and in patients who used protease inhibitors for longer periods. The self-perception of PFL was more frequent among older patients, patients who used stavudine for longer periods, and patients who reported a lack of adherence to antiretroviral agents. The quality of affective/social relationships with friends and family was inversely associated with the self-perception of PFL. CONCLUSION: The evaluation of self-perceived body changes and their determinants in individuals living with HIV/AIDS may help improve provided care. Listening to what patients have to say concerning antiretroviral therapy-related body changes and how they perceive them, as well as including the patient in therapeutic decisions in this regard will contribute towards greater adherence to proposed interventions and towards an improvement in the quality of life.

Adipose Tissue↗

PubMed2005

Optimistic perception of HIV/AIDS, unprotected sex and implications for prevention among men who have sex with men, São Paulo, Brazil.

BACKGROUND: This study examines the association between optimistic perceptions about AIDS and unprotected sex among men who have sex with men (MSM) in the city of São Paulo, Brazil. METHODS: A cross-sectional study was carried out among MSM in leisure areas of São Paulo in 2003. We interviewed 161 participants aged 18-30 years. RESULTS: Thirty-nine per cent (95% confidence interval 32-47%) reported unprotected anal sex with steady or casual partners in the previous 6 months. The optimistic perception score created for this study was associated with unprotected sex (P = 0.01) and higher education (P = 0.02). The quartile with the most optimistic perception was 1.8 times more likely to engage in unprotected anal sex compared with the quartile with the least optimistic perception. CONCLUSION: This study suggests that the current situation regarding AIDS, which is seemingly favourable, may create optimistic perceptions leading to unprotected sexual practices. Prevention programmes, particularly for MSM, need to take this into account.

Adolescent↗

PubMed2006

Parents' and patients' perceptions of postoperative appearance in adolescent idiopathic scoliosis.

STUDY DESIGN: A cross-sectional evaluation of patients after surgery for adolescent idiopathic scoliosis (AIS). OBJECTIVES: To determine the agreement between patients' and parents' perceptions of the patient's postoperative appearance and to compare those perceptions with physical and radiographic measures of deformity. SUMMARY OF BACKGROUND DATA: Improving cosmesis is an important aim of surgery. Patients' appearances may influence their evaluation of its outcome. METHODS: Physical and radiographic data were collected 2 years after surgery for 128 patients with AIS. Patients and parents independently rated shoulder blades, shoulders, waist, and overall appearance. Additionally, patients completed the Quality of Life Profile for Spinal Disorders (QLPSD). Agreement was evaluated with the weighted kappa statistic ranging between 0 and 1 where higher values indicate better agreement. RESULTS: Fair to moderate agreement was found between patient and parent ratings of the patient's shoulder blades (kappa = 0.39; 95% confidence interval [CI], 0.29-0.48), shoulders (kappa = 0.38; 95% CI, 0.26-0.50), waist (kappa = 0.45; 95% CI, 0.25-0.55), and overall appearance (kappa = 0.22; 95% CI, 0.04-0.40). Patients rated the appearance of their waist (P = 0.013) and overall appearance (P = 0.039) significantly worse than their parents. Patients' perceptions of their overall appearance had higher correlations with the body image subscale score (r = 0.45, P = 0.000) and the total quality of life score on the QLPSD (r = 0.37, P = 0.000) than did parents' perceptions of those same measures (r = 0.21, P = 0.025; and r = 0.08, P = 0.369, respectively). CONCLUSIONS: Radiographic and physical measures of deformity do not correlate well with patients' and parents' perceptions of appearance. Patients and parents do not strongly agree on the cosmetic outcome of AIS surgery. Therefore, given that the adolescents themselves undergo the surgery, patients' assessments of their deformity, rather than radiographic measures or parents' assessments, should play a major role in the evaluation of surgical success.

Adolescent↗

PubMed2002

The correlation between perceptions of control and hope status in home-based cancer patients.

The purpose of this study was to analyze correlation between perceptions of control and status of hope in home-based cancer patients. One hundred thirty-seven home-based cancer patients from two hospital-based oncology centers in Taipei were interviewed using a structured questionnaire. The results showed that subjects' perceptions of control and status of hope were at a moderate level. Patient's religion, marital status and stage of cancer were significantly related to their hope status. The greater the age and the more serious the symptoms, the lower the status of hope was. The healthier the patients, the higher the status of hope was. Perceptions of control for patients was positively correlated with status of hope, when patients felt more sense of control in their ill situation, they had a higher status of hope. The findings of this study suggest that it is advantageous to establish support groups for home-based cancer patients and their families, so as to improve perceptions of control and facilitate their hope status. In addition, the model of case management can alleviate hopelessness due to physical function changes and distress of symptoms. In the future, more research on how to increase perception of control in patients, especially on internal control, is necessary in order to make appropriate and specific care plans for cancer patients.

Adult↗

PubMed2002

Entry-level skill competency : a comparison of head nurses expectations and new graduates perceptions.

The purpose of this study was to compare the differences between head nurses expectations and new graduates perceptions of the entry-level skill competency. Subjects included 147 new graduates and 126 head nurses from four schools of nursing and their affiliated medical centers located in northern, central and southern Taiwan. The results showed that among 213 skills, 153 skills were reported by over 60% of head nurses to be performed precisely under clinical settings. In contrast to the graduates perceptions, over 60% of the graduates had confidence to perform only 82 skills precisely. The percentage of head nurses expectation and the perception of the graduates in skills that were reported to be performed precisely in clinical situations were significantly different in 145 skills (68%). For seventy-six skill items there was congruence between the percentage of head nurses expectations and new graduates perceptions. The percentage of the head nurses expectation were higher than the graduates perception in 55 skills. On the other hand, for 14 skills the percentage of graduates who perceived themselves as being able to perform them precisely was significantly higher than the percentage of head nurses. The results can be applied to improve nursing skills teaching and students pre-job preparation.

Academic Medical Centers↗

PubMedDate not supplied

Impact of depression on experimental pain perception: a systematic review of the literature with meta-analysis.

OBJECTIVE: This systematic review and meta-analysis was performed to examine the impact of depression on the perception of experimental pain stimuli. METHODS: CD-ROM databases and bibliographies were searched to identify studies comparing the psychophysical responses to experimental pain stimuli of depressed subjects with that of healthy controls. Effect sizes (Cohen's d) and probabilities were combined across studies; positive effect sizes indicated higher thresholds in depressed groups. RESULTS: Six methodologically rigorous, independent studies were found comparing psychophysical responses to experimental pain stimuli in depressed subjects and healthy controls. Pain perception threshold was higher in depressed subjects (6 studies, d = 0.38, p =.001). This finding was not the result of publication bias. Absolute sensory perception threshold was much higher in depressed subjects (2 studies, d = 0.68, p =.002), though the findings for pain tolerance (2 studies) were too heterogeneous to enable us to combine results. CONCLUSIONS: Depressed subjects are less likely to perceive a sensory stimulus as being painful compared with nondepressed controls. The influence of depression on attention to the pain stimulus may account for this effect. More studies are required to enable us to determine the impact of depression on absolute sensory perception threshold and pain tolerance. Furthermore, more studies would enable the examination of depression on the perception of different modalities.

Attention↗

PubMedDate not supplied

The patients' illness perceptions and the use of primary health care.

OBJECTIVE: To investigate if primary care patients' perceptions of a current health problem were associated with use of health care. METHOD: One thousand seven hundred eighty-five patients presenting a new health problem to 1 of 38 physicians from 28 general practices in Aarhus County, Denmark. Patients completed a questionnaire on their illness perceptions and emotional distress before the consultation. The physicians completed a questionnaire for each patient on diagnostics and prognostics. Register data on primary health care utilization 3 years before and 2 years after baseline were obtained. Odds ratios were estimated to examine associations between previous health care use and illness perceptions. Linear regression analysis was performed to examine if illness perceptions predicted later health care use. RESULTS: Previous use: Higher use was associated with psychosocial, stress, and lifestyle attributions. Accident/chance attributions were associated with higher use for patients with a chronic disorder but with lower use for patients without a chronic disorder. A strong illness identity (number of self-reported symptoms), illness worry, a long timeline perspective, a belief that the symptoms would have serious consequences, and all emotional distress variables were associated with higher use. Use during follow-up: Infection/lowered immunity attributions were associated with higher use for patients with a chronic disorder, whereas psychosocial and lifestyle attributions were associated with higher use for all patients. Illness worry and all emotional distress variables predicted higher health care use. A strong illness identity, a long timeline perspective, a belief in serious consequences, and stress and accident/chance attributions were among the strongest predictors of health care use in a multivariate model including all variables. CONCLUSIONS: Patients' perceptions of a current health problem are associated with health care use and may offer an obvious starting point for a biopsychosocial approach in primary care.

Adolescent↗

PubMed2005

The Arabidopsis receptor kinase FLS2 binds flg22 and determines the specificity of flagellin perception.

Flagellin, the main building block of the bacterial flagellum, acts as a pathogen-associated molecular pattern triggering the innate immune response in animals and plants. In Arabidopsis thaliana, the Leu-rich repeat transmembrane receptor kinase FLAGELLIN SENSITIVE2 (FLS2) is essential for flagellin perception. Here, we demonstrate the specific interaction of the elicitor-active epitope flg22 with the FLS2 protein by chemical cross-linking and immunoprecipitation. The functionality of this receptor was further tested by heterologous expression of the Arabidopsis FLS2 gene in tomato (Lycopersicon esculentum) cells. The perception of flg22 in tomato differs characteristically from that in Arabidopsis. Expression of Arabidopsis FLS2 conferred an additional flg22-perception system on the cells of tomato, which showed all of the properties characteristic of the perception of this elicitor in Arabidopsis. In summary, these results show that FLS2 constitutes the pattern-recognition receptor that determines the specificity of flagellin perception.

Alkalies↗

PubMed2004

Perception of risk: a study of A&E nurses and NHS managers.

This exploratory study investigates perceptions of two groups of NHS staff, of a range of risks, topical and relevant to accident and emergency (A&E). Literature suggests that the effectiveness of a risk management strategy is lessened if staff exposed to risk, and managers, have different perceptions of the nature and severity of the risk. A self-administered questionnaire was distributed to registered A&E nurses and to Trust managers at directorate level and above, working in five large inner-city NHS Trusts. Managers and nurses were asked to quantify their perceptions of nine defined adverse events. They were also asked to identify the jobholder with day-to-day responsibility for managing four specific risks. Completed forms were obtained from 38 per cent of managers and nurses. Results showed broadly that managers tended to quantify risks of violence and stress to A&E nurses less highly than did nurses. By contrast, they tended to quantify risks to patients more highly than did nurses. Overall, a coherent pattern of difference in risk perception between the two groups was identified. It is argued that identification of differences of perception is an essential part of the risk management process. Illustrations are given of ways in which these differences can undermine the effectiveness of a risk management strategy.

Administrative Personnel↗

PubMed2006

Women's perceptions of events impeding or facilitating the detection, investigation and treatment of breast cancer.

An integrated network is currently being implemented in the province of Quebec in order to improve the cancer care continuum. In this context, formal trajectories for cancer patients through healthcare services are being established. The investigation of patients' perceptions of the healthcare continuum is essential as it allows us to identify the issue of continuity/discontinuity of health services. In addition, patients' perceptions of continuity of cancer care should be documented since they could influence the implementation of optimal trajectories through the healthcare services. An exploratory qualitative study was conducted in order to identify events, based on the perceptions of women with breast cancer, that made the patient progress more rapidly, facilitating events, or more slowly, impeding events, within the cancer care continuum. Two consecutive series of women receiving adjuvant radiation therapy in 2002 and 2003 at the University Hospital of Quebec City were recruited, for a total of 120 participants. A semi-structured interview was administered in order to identify women's perceptions regarding impeding and facilitating events during the detection, investigation and treatment periods of cancer, as well as the actors and reasons involved. Overall, 64% of women reported having at least one impeding event, while 68% reported at least one facilitating event. The periods most frequently affected by impeding or facilitating events were the investigation period, followed by the treatment period. The main stages affected by impeding or facilitating events were the scheduling of an appointment, during the investigation period, and the onset of treatment. Impeding events particularly affected the scheduling of mammography, the initial exam of the investigation for breast cancer, as well as the onset of radiation treatment. On the other hand, facilitating events mainly occurred at the time of the scheduling of medical consultations with specialists, during the investigation period, and of the onset of surgery. Finally, women generally perceived that impeding events were due to a lack in the availability of services and that facilitating events resulted from human intervention. Patients' perceptions, such as those regarding the importance of human intervention in the process of continuity of care, should be taken into account by healthcare authorities in charge of implementing cancer control programmes.

Appointments and Schedules↗