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Characteristics of leisure time physical activity associated with risk of decline in perceived health--a 10-year follow-up of middle-aged and elderly men and women.

BACKGROUND: Leisure time physical activity (LTPA) has been found to prevent several diseases, but little is known about its protective effect against decline in perceived health. The purpose of the present study is to analyze the protective effect of LTPA against the risk of decline in perceived health in a cohort of 19- to 63-year-old Finnish men (n = 1205) and women (n = 1148) with good perceived health. METHODS: The incidence rate of decline in perceived health was monitored by self-administered questionnaire data from March 1980 through March 1985 through December 1990. LTPA was assessed by (1) a single-item self-assessment of global LTPA; (2) a compiled intensity-frequency measure of LTPA; (3) a total energy expenditure index of LTPA; and (4) three indexes of LTPA (i.e., commuting, fitness, and sport). The association between LTPA and risk of decline in perceived health was assessed using the Cox proportional hazard regression model. RESULTS: Among men, the multivariate analyses revealed an increased risk of decline in perceived health with no weekly vigorous global LTPA (RR = 1.49; 95% CI 1.12-1.98) and with no monthly sport activity (RR = 1.62; 95% CI 1.12-2.35). Among women, the results only showed an increased risk of decline in perceived health with fitness activity at less than once a week (RR = 1.62; 95% CI 1.06-2.48). The total energy expenditure of weekly LTPA and the index of commuting were not associated with the risk of decline in perceived health. CONCLUSIONS: Although energy expenditure of weekly LTPA did not prove to be a protective factor against the risk of decline in perceived health, global level, intensity, and type of weekly LTPA did. Physical activity interventions may need to emphasize the amount, intensity, and type of weekly LTPA, rather than energy expenditure of weekly LTPA, for promoting overall public health among middle-aged and older men and women with good perceived health.

Adult↗

Risk perception following exposure to a job-related electrocution accident: the mediating role of perceived control.

Perceived control was proposed to be a significant mediator for the relation often observed between mental simulation (simulation heuristic) and perceived personal risk for future lethal events. Baron and Kenny's (1986) procedure for testing a mediational hypothesis was used to evaluate this hypothesis. Employees of a recreational facility where a lifeguard was accidently electrocuted and a matched control group (N = 32) estimated their perceived risk for future electrocution events, how much personal control they believed they had over preventing future events, and the degree of clarity for mentally simulating future events. Although perceived control was not found to be a significant mediator for the relation between mental simulation and perceived risk as hypothesized, both mental simulation and perceived control accounted for a significant proportion of the variance in perceived risk for future electrocution events. The trauma group reported significantly higher ratings for perceived risk and mental simulation of future events. However, the trauma group did not differ from the non-trauma group on perceived control over future events. Possible explanations for the relatively high degree of perceived control over future electrocution events within the trauma group, in spite of their experience with a near-fatal electrocution event, are discussed.

Accidents, Occupational↗

Relationship of dental status, sociodemographic status, and oral symptoms to perceived need for dental care.

OBJECTIVE: Previous studies have noted a discrepancy between clinically determined oral health status (normative need), patients' perceptions, and perceived significance of dental signs and symptoms. Our objective was to quantify the relationships between normative need and self-reports to improve our understanding of the factors that contribute to perceived need for care. METHODS: Clinical examination and questionnaire data were derived from the Florida Dental Care Study, a study of oral health and dental care, in a representative sample of community-dwelling adults aged > or = 45 years. The questionnaire provided information about presence of signs and symptoms, self-ratings of oral health, perceived need for dental care, and sociodemographic status (SDS). Perceived need was measured on a 4-point nominal scale. RESULTS: Self-reported broken filling, broken denture, cavities, loose tooth, teeth that look bad, and toothache were strongly associated with self-reported perceived need for dental care. Satisfaction with dental health was also associated with perceived need, but self-rated oral health was not. Most measures of SDS were associated with perceived need. However, in a single multiple regression, with self-reported signs and symptoms accounted for, race, age group, sex, and educational attainment were not significantly associated with a currently perceived dental problem. CONCLUSIONS: Certain dental signs and symptoms were significantly associated with perceived need for dental care, as were certain aspects of SDS; even once differences in dental signs and symptoms had been taken into account. Disaggregating measurement of perceived need from a single dichotomous ('yes/no') scale to a 4-point nominal scale was elucidative.

Aged↗

Perceiver and relationship effects on perceptions of HIV status: A naturalistic study in a high drug use sample.

This article examines the effect of target, perceiver, and relationship characteristics on the perceiver's assessment that the target may be HIV seropositive (HIV+). A sample of 267 persons was recruited from low income, high drug use neighborhoods. Respondents (perceivers) were asked to name people (targets) with whom they had a social, drug sharing, or sexual relationship. Perceivers described 1,640 such relationships. Perceivers were asked about the targets' age, gender, and race/ethnicity, whether the targets were good-looking, their level of trust with the target, and how long they had known them. Perceivers were then asked to evaluate the chances that the target mentioned was HIV+. Two regression models were estimated on the 1,640 relationships mentioned. Model 1 included variables reflecting only target characteristics as independent variables. Model 2 included variables reflecting target characteristics as well as variables reflecting perceivers and perceiver-target relationship characteristics. The results showed that targets that were female, younger, and good-looking were perceived as being less likely to be HIV+. However, when accounting for perceiver and relationship effects, some of the target characteristic effects disappeared.

Female↗

Study of perceived norms, beliefs and intended sexual behaviour among higher secondary school students in India.

The objective of this paper is to understand the intended sexual and condom behaviour patterns among teenage higher secondary school students in India. To achieve this, variables including perceived norms, perceived peer group norms, risk behaviour patterns, perceived chances of getting AIDS and relevant sociodemographic variables were regressed on intended sexual behaviour. Regression of actual sexual behaviour was carried out with perceived norms, perceived peer group norms and intended sexual behaviour as the independent variables. In this paper a conceptual model has been framed based on the theory of reasoned action, health belief model and self-efficacy theory. Cumulative scores are computed for perceived norms, perceived peer group norms, risk behaviour patterns, opinion on handling condoms and perceived chances of getting AIDS. Along with these variables, possible confounding variables such as age, gender, type of family, mother's education and father's education were considered for their effect on intended sexual and condom behaviour. The results revealed that perceived norms and perceived peer group norms showed significant association with intended sexual behaviour and actual sexual behaviour and that children of more highly educated parents are less likely to engage in sexual activities in their adolescent years.

Adolescent↗

Self-worth, perceived competence, and behaviour problems in children with cerebral palsy.

PURPOSE: To examine the relevance of physical disabilities for self-worth and perceived competence in children with cerebral palsy (CP), and to examine associations between behaviour problems and self-worth and perceived competence. METHODS: The Harter scales for self-worth and perceived competence and a new scale for perceived motor competence were used in a sample of 80 children with CP. Their motor functioning was assessed with the Gross Motor Functioning Measure (GMFM) and behaviour problems with the Child Behaviour Check List administered to parents. RESULTS: Self-worth and perceived competence for children with CP were comparable to the Dutch norm sample, except for perceived athletic competence. Within the CP sample, the GMFM showed a domain-specific effect on perceived motor competence. In the multivariate analysis, internalizing problems were associated negatively with all perceived competence scales and self-worth, whereas aggression was positively associated with perceived motor competence, physical appearance, and self-worth. CONCLUSIONS: Children with CP appear resilient against challenges posed to their self-worth caused by their disabilities. The relevance of the physical disability appears to be domain-specific. For internalizing problems and aggression, different theoretical models are needed to account for their associations with self-worth and perceived competence.

Adolescent↗

Perceived ambiguity about cancer prevention recommendations: relationship to perceptions of cancer preventability, risk, and worry.

In this study, we apply the concept of "ambiguity," as developed in the decision theory literature, to an analysis of potential psychological consequences of uncertainty about cancer prevention recommendations. We used Health Information National Trends Survey (HINTS) 2003 data to examine how perceived ambiguity about cancer prevention recommendations relates to three other cognitive variables known to influence cancer-protective behavior: perceived cancer preventability, perceived cancer risk, and cancer-related worry. Using logistic regression analyses, we tested several predictions derived from a review of literature on the effects of ambiguity perceptions on decision making, cognitions, and emotions. We found perceived ambiguity to have a strong negative relationship with perceived cancer preventability, consistent with "ambiguity aversion"-a pessimistic bias in the interpretation of ambiguity. Cancer worry moderated this relationship; ambiguity aversion increased with higher levels of worry. At the same time, perceived ambiguity was positively related to both perceived cancer risk and cancer worry. Furthermore, perceived risk partially mediated the relationship between perceived ambiguity and worry. These findings suggest that perceived ambiguity about cancer prevention recommendations may have broad and important effects on other health cognitions. We discuss ethical implications of these findings for health communication efforts, and propose a tentative causal model to guide future research.

Adult↗

Race, socioeconomic status, and perceived discrimination among healthy women.

OBJECTIVES: Perceived discrimination and socioeconomic status (SES) have been found to be related to health problems. However, little is known about how SES and ethnicity relate to perception and responses to discrimination. This study examined the relationship between race and a set of SES indicators, perceived discrimination (race and gender), and responses to perceived discrimination among healthy women. METHODS: The sample consisted of 460 women between the ages of 18 and 39 (194 black and 266 white). The independent variables included income, education, occupation, and race. The dependent variables included perceived discrimination (race/color and gender) and responses to unfair treatment. RESULTS: Income and education were both directly related to perceived racial discrimination. However, the relationship between education and perceived discrimination was modified by race. For white women, only higher education was related to less perceived discrimination, and there was no significant difference across education levels for black women. Education was the only variable significantly associated with perceived gender discrimination (more highly educated women reported more discrimination). Occupation and race were both related to responses to perceived discrimination. Black women were significantly less likely to talk to someone when treated unfairly than white women (OR = 0.37, 95% confidence interval [CI] = 0.191, 0.716), and women in managerial/professional positions were significantly more likely to do something about being treated unfairly than women in service occupations (OR = 4.76, CI = 2.14, 10.61). CONCLUSIONS: Our results suggest that both SES and race play important roles in women's perceptions of and responses to perceived discrimination.

Adolescent↗

Will public health's response to terrorism be fair? Racial/ethnic variations in perceived fairness during a bioterrorist event.

OBJECTIVES: Public health departments' effectiveness during catastrophic bioterrorism will require trust on the part of diverse communities. This study describes variations in perceptions that the public health system will respond fairly to one's needs in a bioterrorist event, regardless of race/ethnicity, income, or other characteristics. METHODS: Using the Los Angeles County Health Survey, a random-digit, population-based, telephone survey, we conducted multivariate logistic regression of race/ethnicity on perceived fairness, adjusting for demographic factors and perceived neighborhood safety. We performed similar analyses stratified by race/ethnicity subgroup. RESULTS: Overall, 72.7% of respondents perceived that the public health system will respond fairly in a bioterrorist event. African Americans (AA) and Asian/Pacific Islanders (API) reported the lowest perceived fairness (AA 63.0%, API 68.2%, Latino 73.1%, White 76.6%, p = 0.005 for group differences). Adjusting for demographic factors and neighborhood safety, African Americans had lower perceived fairness compared to whites (adjusted odds ratio, aOR 0.45; 95% confidence intervals, CI 0.26-0.79; p < 0.005). Other factors associated with lower perceived fairness included Asian-language compared to English-language interview (aOR 0.29; 95% CI 0.11-0.76; p < 0.05) and lower compared to higher neighborhood safety (aOR 0.48; 95% CI 0.31-0.74; p < 0.005). Among African Americans, participants aged 18-29 years were less likely to report perceived fairness (aOR 0.06; 95% CI 0.01-0.59) compared to participants older than 60 years of age. Among Asian/Pacific Islanders, Asian-language interview (aOR 0.07; 95% CI 0.01-0.48) and lower perceived neighborhood safety (aOR 0.01; 95% CI <0.01-0.13) were associated with perceived fairness. CONCLUSIONS: To strengthen bioterrorism preparedness, public health officials must continue to improve perceived fairness among African American and Asian/Pacific Islander communities.

Adult↗

Relationship between physical performance and self-perceived physical function.

OBJECTIVE: The objective of this study was to compare two methods of measuring physical function in subjects with a broad range of abilities and to evaluate the effects of cognitive, social, educational, and age factors on the relationship between the two methods. DESIGN: Multiple regression analysis was used to compare self-perceived (dependent variables) with performance measures (independent variables). Covariates included age, gender, Mini-Mental State Exam score, education, living status, and depression score. SETTING: Five community-dwelling and two nursing home sites. PARTICIPANTS: 417 community-dwelling subjects and 200 nursing home residents aged 62-98 years. MEASUREMENTS: Self-perceived physical function was assessed with the physical dimension summary score of the Sickness Impact Profile, which comprises three subscales: ambulation, mobility, and body care and movement. Physical performance was evaluated by self-selected gait speed, chair-stand time, maximal grip strength, and a balance score. RESULTS: Nursing home residents and community-dwellers were significantly different (P < .0001) in all variables except age and gender. Self-perceived and performance-based measures were moderately correlated, with a range from r = -.194 to r = -.625 (P < .05). Gait speed was the strongest independent predictor of self-perceived physical function in both groups. Symptoms of depression were also an independent predictor of self-perceived function in nursing home residents; subjects who had such symptoms report more self-perceived dysfunction than would be predicted based on performance tests. CONCLUSIONS: Self-selected gait speed is a global indicator of self-perceived physical function over a broad range of abilities. External determinants (depressive symptoms, cognitive function, marital status, etc.) affect self-perceived function in both groups, but gait speed is the greatest single predictor of self-perceived function. In nursing home residents depressive symptomatology is related to self-perceived.

Activities of Daily Living↗

Return of fear: perceived skill and heart-rate responsivity.

The hypothesis that high heart rate and low perceived skill would be associated with greater return of fear than low heart rate and high perceived skill was investigated in a group of 63 anxious musical performers. Musicians were taught progressive muscle relaxation and attention-focusing skills over the course of four weekly sessions. Return of subjective fear was assessed between training programme sessions and at a three-month follow-up assessment. Performance quality ratings served as the behavioural measure, anticipatory heart rate as the physiological measure, and subjective units of distress scales as the subjective measure. Four classification groups (high heart rate, low perceived skill; high heart rate, high perceived skill; low heart rate, low perceived skill; and low heart rate, high perceived skill) were formed on the basis of median splits of heart rate and perceived skill pre-assessment levels. Each group demonstrated subjective fear reduction, while heart rate reduced in the high heart-rate subjects, and performance quality improved overall at post-assessment. Follow-up return of fear was apparent in high heart-rate subjects, regardless of their perceived skill status. High heart-rate subjects reported more anxious thoughts than did low heart-rate subjects. Perceived skill was not clearly associated with return of fear. Post-hoc comparisons indicated that subjects who demonstrated follow-up return of fear had higher heart rate, lower perceived skill, more anxious thoughts, less performance skill and fewer performances over the follow-up interval than subjects who did not demonstrate a return of fear. However, initial heart rate was the only significant predictor of follow-up fear levels.

Adolescent↗

The role of perceived need within the theory of planned behaviour: a comparison of exercise and healthy eating.

OBJECTIVES: This study examined the effect of perceived need on exercise and healthy eating using the theory of planned behaviour (TPB). In addition, it investigated the determinants of perceived need. METHOD: Participants completed a questionnaire measuring components of TPB and perceived need. A follow-up questionnaire 1 week later measured behaviour. The questionnaires were completed by e-mail. The initial questionnaire was completed by 331 adults, and 286 follow-up questionnaires were returned. RESULTS: Perceived behavioural control was the main predictor of exercise intention and affective attitude was the main predictor of healthy eating intention. Perceived need significantly contributed to the prediction of healthy eating intention but not to exercise intention. Intention and perceived behavioural control predicted actual behaviour but perceived need did not. Reasons reported for the perception of needing to engage in both behaviours mainly focused on physical health and weight control. CONCLUSIONS: Reasons reported for low perceived need suggest that the concept of perceived need may be rather ambiguous, particularly in the case of exercise. Therefore, further research is needed to elucidate the role of perceived need in relation to a variety of health behaviours.

Adult↗

Normative misperceptions and temporal precedence of perceived norms and drinking.

OBJECTIVE: Previous research has shown that students overestimate the drinking of their peers, and that perceived norms are strongly associated with drinking behavior. Explanations for these findings have been based largely on cross-sectional data, precluding the ability to evaluate the stability of normative misperceptions or to disentangle the direction of influence between perceived norms and drinking. The present research was designed to evaluate (1) the stability of normative misperceptions and (2) temporal precedence of perceived norms and drinking. METHOD: Participants were college students (N = 164; 94 women) who completed assessments of perceived norms and reported behavior for drinking frequency and weekly quantity. Most participants (68%) completed the same measures again two months later. RESULTS: Results indicated large and stable overestimations of peer drinking for frequency and weekly quantity. Results also showed that for weekly quantity, perceived norms predicted later drinking, but drinking also predicted later perceived norms. Results for frequency revealed perceived norms predicted later drinking, but drinking did not predict later perceived norms. CONCLUSIONS: These findings underscore the importance of longitudinal designs in evaluating normative influences on drinking. The present findings suggest that normative misperceptions are stable, at least over a relatively short time period. Findings support a mutual influence model of the relationship between perceived norms and drinking quantity but are more strongly associated with conformity explanations for the relationship between perceived norms and drinking frequency. Results are discussed in terms of implications for prevention interventions.

Adolescent↗

Perceived exertion during isometric quadriceps contraction. A comparison between men and women.

BACKGROUND: 1) To examine the validity and accuracy of the CR-10 scale for evaluating perceived exertion, and 2) to assess gender differences in perceived exertion across different levels of contraction intensity. METHODS EXPERIMENTAL DESIGN: cross-sectional, comparative design. SETTING: Human Performance and Fatigue Laboratory, Eastern Washington University. SUBJECTS: 30 healthy, college age volunteers (15 males, 15 females). MEASURES: All subjects were assessed for isometric torque and perceived exertion of the quadriceps femoris muscles, via the CR-10 scale. One low anchor was applied under resting conditions with the knee flexed to 60 degrees, and a high anchor was applied during a maximal voluntary muscle contraction (MVC). SUBJECTS performed five-second isometric contractions equivalent to 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, and 90% of their MVC, in a random order, and were assessed for perceived exertion by visually observing the CR-10 scale. One sample "t"-tests and 95% confidence intervals were calculated for perceived exertion at each relative torque level. A single factor ANOVA with repeated measures was performed across al levels of exercise intensity. Linearity for perceived exertion was assessed via regression analysis. RESULTS: Perceived exertion at each exercise intensity were as follows: 10%: 1.87+/-1.14, 20%: 2.43+/-1.19, 30%: 3.5+/-1.36, 40%: 3.97+/-1.52, 50%: 4.73+/-1.28, 60%: 5.53+/-1.28, 70%: 6.73+/-1.62, 80%: 7.57+/-1.72, and 90%: 8.6+/-1.52. The increase in perceived exertion across the intensity spectrum was found to fit both linear and quadratic trends. There were no gender differences in perceived exertion across all levels of exercise intensity. CONCLUSIONS: The findings demonstrate that the CR-10 scale closely approximates perceived exertion of the quadriceps femoris muscles during sub-maximal, static contractions, and is not gender specific.

Cross-Sectional Studies↗

Perceived effect on shortness of breath of an acute inhalation of saline or terbutaline: variability and sensitivity of a visual analogue scale in patients with asthma or COPD.

The purpose of the study was to validate a bipolar visual analogue scale (VAS) to assess the perceived effect on shortness of breath of an acute inhalation and to search for differences in perception between asthmatics and subjects with chronic obstructive pulmonary disease (COPD). Thirty two subjects with airway obstruction and a diagnosis of either asthma (n = 16) or COPD (n = 16) received three consecutive inhalations of isotonic saline, followed by two inhalations of 400 micrograms terbutaline. Saline was perceived by asthmatics as a slight improvement: VAS (median, 95% confidence interval) 9%, 0-18% of line length. COPD subjects could be separated into two subgroups: "high perceivers" (n = 8, VAS 43%, 33-53%) and "low perceivers" (n = 8, VAS 5%, 3-7%). The median intrasubject coefficient of variation of the three post-saline VAS ratings was 19.4% (asthma), 12.5% (COPD high perceivers), and 14.5% (COPD low perceivers). After terbutaline, asthmatics had, by selection, a larger increase in forced expiratory volume in one second (FEV1) than COPD subjects. However, for other indices (expiratory specific resistance, inspiratory vital capacity and maximal inspiratory flow at 50% forced vital capacity) the changes were smaller in COPD low perceivers than in both asthmatics and COPD high perceivers. The parallel improvement in VAS was 24%, 20-39% (asthma), 15%, 6-25% (COPD high perceivers) and 1%, -1-8% (COPD low perceivers). The most sensitive index was FEV1 in asthmatics, vital capacity in COPD subjects, VAS being among the most sensitive indices in the former, but among the least sensitive in the latter. We conclude that the sensitivity of this VAS to bronchodilation is better in asthmatics than in COPD subjects. The latter can however be separated into subgroups with high and low level of perception.

Asthma↗

Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study.

CONTEXT: Medical errors are associated with feelings of distress in physicians, but little is known about the magnitude and direction of these associations. OBJECTIVE: To assess the frequency of self-perceived medical errors among resident physicians and to determine the association of self-perceived medical errors with resident quality of life, burnout, depression, and empathy using validated metrics. DESIGN, SETTING, AND PARTICIPANTS: Prospective longitudinal cohort study of categorical and preliminary internal medicine residents at Mayo Clinic Rochester. Data were provided by 184 (84%) of 219 eligible residents. Participants began training in the 2003-2004, 2004-2005, and 2005-2006 academic years and completed surveys quarterly through May 2006. Surveys included self-assessment of medical errors and linear analog scale assessment of quality of life every 3 months, and the Maslach Burnout Inventory (depersonalization, emotional exhaustion, and personal accomplishment), Interpersonal Reactivity Index, and a validated depression screening tool every 6 months. MAIN OUTCOME MEASURES: Frequency of self-perceived medical errors was recorded. Associations of an error with quality of life, burnout, empathy, and symptoms of depression were determined using generalized estimating equations for repeated measures. RESULTS: Thirty-four percent of participants reported making at least 1 major medical error during the study period. Making a medical error in the previous 3 months was reported by a mean of 14.7% of participants at each quarter. Self-perceived medical errors were associated with a subsequent decrease in quality of life (P = .02) and worsened measures in all domains of burnout (P = .002 for each). Self-perceived errors were associated with an odds ratio of screening positive for depression at the subsequent time point of 3.29 (95% confidence interval, 1.90-5.64). In addition, increased burnout in all domains and reduced empathy were associated with increased odds of self-perceived error in the following 3 months (P=.001, P<.001, and P=.02 for depersonalization, emotional exhaustion, and lower personal accomplishment, respectively; P=.02 and P=.01 for emotive and cognitive empathy, respectively). CONCLUSIONS: Self-perceived medical errors are common among internal medicine residents and are associated with substantial subsequent personal distress. Personal distress and decreased empathy are also associated with increased odds of future self-perceived errors, suggesting that perceived errors and distress may be related in a reciprocal cycle.

Adult↗

How the inner world is reflected in relation to perceived ward atmosphere among patients with psychosis.

BACKGROUND: This study focused on how cognitive ability, personality traits, self-rated psychiatric symptoms, and social functioning were related to the way in which patients with psychosis perceived supportive aspects of the ward atmosphere. METHODS: Patients at a psychiatric rehabilitation unit (PRU) in southern Sweden completed a ward atmosphere questionnaire (COPES), rated their psychiatric symptoms (SCL-90), self-image (SASB), and were tested on cognitive functioning (WAIS-R) and global social functioning (GAF). They were diagnosed according to ICD-10. Data were analysed by means of logistic regression analyses. RESULTS: Self-monitoring and restraining (self-control), one cluster in the SASB, was the strongest factor associated with how the patients perceived the ward atmosphere. A perceived high level of self-control indicated high levels of perceived Support, Practical orientation, and Order and organisation of the ward atmosphere. A high level of self-rated paranoid symptoms (SCL-90) increased the risk of perceiving a high level of Anger and aggression and a low level of Program clarity. Regarding cognitive ability (WAIS-R), two factors were important for predicting perceived ward atmosphere. A low level of social competence was associated with a low level of perceived Order and organisation. Furthermore, a low level of abstract thinking was related to a low level of perceived Anger and aggression, while a high level of abstract thinking was associated with a low level of Program clarity. Patients with schizophrenia exhibited a lower level of Self-monitoring and restraining than patients with other psychoses. CONCLUSION: The results from this study indicate that individual factors such as self-control, paranoid symptoms and social competence may be important for how the ward atmosphere is perceived. This is important knowledge when monitoring the ward atmosphere to better fit a unit's target group.

Adult↗

Growth of self-perceived clinical competence in postgraduate training for general practice and its relation to potentially influencing factors.

OBJECTIVE: To examine the increase in self-perceived clinical competence during a three-year postgraduate training in general practice and to explore the relation between the growth of self-perceived competence and several background variables. DESIGN: Cohort, 1995-1998. SETTING: Three-year Postgraduate Training for General practice in the Netherlands PARTICIPANTS: All Dutch trainees who followed postgraduate training from September 1995 to September 1998 (N=191). INTERVENTION: We asked the trainees at the start and at the end of their postgraduate training to complete a questionnaire, which assessed their self-perceived knowledge, clinical skills and consultations skills. We collected information about potentially influencing background variables. Amongst these were variables such as: age, gender, prior medical experience, the effort someone has spent upon her/his education, insight in weak and strong areas of clinical competence and knowledge and skills levels. MAIN OUTCOME MEASURE: Self-perceived competence. RESULTS: A total of 127 trainees completed both questionnaires (190 at the first administration and 128 at the second one). We found statistically significant growth of self-perceived clinical competence. Self-perceived consultation skills increased more than self-perceived knowledge and clinical skills. The afore mentioned background variables did not relate in any way with the growth of self-perceived clinical competence. CONCLUSION: This study shows that a 3-year postgraduate training in general practice enhances self-perceived clinical competence. However, we still do not know how to explain this improvement. Further study into the theoretical concept of self-assessment in medical education and into the factors contributing to the feeling of being competent, is required.

Age Factors↗