Uncovering and managing denial during the research process

Denial of Chronic Illness and Disability

Denial has been an integral part of the psychological and disability literature for more than 100 years. Yet, denial is an elusive concept and has been associated with mixed, indeed conflicting, theoretical perspectives, clinical strategies, and empirical findings. In this two-part article, the author provides an overview of the existing literature on denial that addresses the most prominent and rehabilitation-relevant features of it. Part I provides a generic yet clinically based discussion of denial and focuses on the following: historical perspective of denial, the definitions of denial, the types or forms of denial most often encountered in the literature, the functions served by denial, the indicators or markers most frequently associated with denial, the dynamics and processes inherent in the operation of denial, and the costs and benefits of denial.

A review of psychosocial models in psychogeriatrics: implications for care and research

Based on an examination of the relevant literature, this article presents a survey of psychosocial models used in the psychogeriatric field. Models with a multidimensional approach to behavior problems in dementia and a focus on the individual were selected. The utility of these psychosocial models as a theoretical framework for emotion-oriented care for people with dementia, especially Alzheimer disease, is examined. In addition to describing the models, this article also reports on the target group for which these models were developed, the degree to which they have been operationalized for psychogeriatrics, and the degree to which they have been subjected to empirical testing. This study shows that all psychosocial models described may be called emotion-oriented, although they also contain, in varying degrees, elements from the consequences model. It was found that the models are used not only as a theoretical framework for research, but also in the provision of care. Despite the fact that most models have been used in the psychogeriatric field, therefore proving their practicability for psychogeriatric practice, only one of the models described has been tested empirically so far. The theoretical validity of the models in question is, therefore, not yet clear.

Denial: a conceptual analysis

The term denial is used in nursing to describe a client's behavior. A random sample of 18 articles published in English from 1990 to 1999 was identified for conceptual analysis using Rogers' methodology. The 2 main definitions identified ranged from an adaptive to maladaptive coping process. Anxiety or perceived threats evolving from situational or maturational crises were antecedents. Events that followed typically resulted in either positive or negative outcomes. Related concepts used most often were avoidance, unrealistic hopefulness, and repression.