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Forsberg A, Jansen N, Paredes D, Maple H. Time for transplant care professionals to face recipients' fear of graft rejection-an opinion paper. FRONTIERS IN TRANSPLANTATION 2023; 2:1277053. [PMID: 38993928 PMCID: PMC11235246 DOI: 10.3389/frtra.2023.1277053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 09/18/2023] [Indexed: 07/13/2024]
Affiliation(s)
- Anna Forsberg
- Institute of Health Sciences at Lund University, Lund, Sweden
- Department of Cardiothoracic Surgery, Skane University Hospital, Lund, Sweden
- Chair of European Transplant Allied Healthcare Professionals (ETAHP), a Section of the European Society for Organ Transplantation, Padua, Italy
| | - Nichon Jansen
- Policy Department, Dutch Transplant Foundation, Leiden, Netherlands
- Past-Chair of European Donation and Transplantation Coordination Organization (EDTCO), a Section of the European Society for Organ Transplantation, Padua, Italy
| | - David Paredes
- Past-Chair of European Donation and Transplantation Coordination Organization (EDTCO), a Section of the European Society for Organ Transplantation, Padua, Italy
- Donation and Transplant Coordination Unit, Hospital Clinic, Associate Professor Surgical Department, University of Barcelona, Barcelona, Spain
| | - Hannah Maple
- Department of Transplantation, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
- Chair of Ethical, Legal, and Psychosocial Aspects of Transplantation (ELPAT), a Section of the European Society for Organ Transplantation, Padua, Italy
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2
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Odunsi IA, Farris KL. Predicting College Students’ Preventative Behavior During a Pandemic: The
Role of the Health Belief Model, Source Credibility, and Health Literacy. THE AMERICAN BEHAVIORAL SCIENTIST 2023:00027642231164044. [PMCID: PMC10186130 DOI: 10.1177/00027642231164044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
In this study, we examined the effects of perceived source credibility of the Centers for Disease Control (CDC) and college student health literacy in predicting the likelihood of enacting preventative behaviors related to mitigating COVID-19. Using the Health Belief Model (HBM) as an explanatory tool, we analyzed how perceived source credibility and health literacy levels predict college students’ likelihood to enact preventative behaviors during a public health crisis. Sample population entirely consisted of undergraduate students enrolled in a basic communication course at a large, southern university. The participants completed survey questionnaires about their perceived health literacy, health beliefs, trust in the CDC, perceptions of COVID-19, and demographic measures during the fall 2020 semester. A multiple regression analysis revealed that (a) HBM predictors, health literacy and CDC source credibility accounted for 44% of the variance in likelihood of enacting preventative health behaviors, and (b) health literacy, CDC source credibility, and perceived severity were all positive predictors of enacting preventative health behaviors, while (c) perceived barriers negatively predicted enactment of preventative health behaviors. Perceived susceptibility and perceived benefits were not significant predictors of college student risk mitigation. Our data suggests the importance of health literacy and source credibility in predicting college students’ likelihood to enact preventative behaviors during public health crises.
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Affiliation(s)
| | - Kristen Leblanc Farris
- Department of Communication Studies, College
of Fine Art and Communication, Texas State University, San Marcos, TX, USA
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Henk K, Rosing F, Wolff F, Frenzel SB, van Dick R, Erkens VA, Häusser JA, Mojzisch A, Boer D. An examination and extension of the Peltzman effect during the Covid-19 pandemic. CURRENT RESEARCH IN ECOLOGICAL AND SOCIAL PSYCHOLOGY 2023; 4:100091. [PMID: 36744173 PMCID: PMC9888029 DOI: 10.1016/j.cresp.2023.100091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 01/12/2023] [Accepted: 01/24/2023] [Indexed: 06/08/2023]
Abstract
Since the first COVID-19 case was confirmed in Germany, the German government has introduced various measures to counteract the pandemic. The implementation of safety measures can have counterproductive effects: people engage in risk compensatory behavior (fewer safety behaviors) after regulations are introduced and obligated by the government, which is known as the Peltzman effect (Peltzman, 1975). Based on the Peltzman effect, the researchers of this study hypothesized that people complied less with safety behaviors and took more health risks (e.g. keep less distance) after the implementation of more stringent COVID-19-related regulations (quarantine obligation and face mask duty) between the two measurement periods of this study. They also extended the Peltzman model by hypothesizing moderating roles of age, gender, and perceived COVID-19 threat. Results of the longitudinal survey study (N = 989, T1: 26 March - 31 March 2020 and T2: 27 April - 4 May 2020) confirm that people indeed complied less with safety recommendations over time associated with strengthened COVID-19-related regulations. Perceived COVID-19 threat to those in a person's surroundings (e.g. family, neighbors) had a positive impact on compliance, but age and gender had no effect. This extends the literature on the Peltzman effect by adding perceived COVID-19 threat as a new relevant construct, enabling the development of more effective safety preventions in the future.
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Affiliation(s)
| | | | | | | | - Rolf van Dick
- Department of Social psychology, Goethe University Frankfurt
| | - Valerie A Erkens
- Department of Social psychology, Justus-Liebig-University Gießen
| | - Jan A Häusser
- Department of Social psychology, Justus-Liebig-University Gießen
| | | | - Diana Boer
- Institute of Psychology, University of Koblenz
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4
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Block R, Burnham M, Kahn K, Peng R, Seeman J, Seto C. Perceived risk, political polarization, and the willingness to follow COVID-19 mitigation guidelines. Soc Sci Med 2022; 305:115091. [PMID: 35690035 PMCID: PMC9161674 DOI: 10.1016/j.socscimed.2022.115091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Risk assessment and response is important for understanding human behavior. The divisive context surrounding the coronavirus pandemic inspires our exploration of risk perceptions and the polarization of mitigation practices (i.e., the degree to which the behaviors of people on the political "Left" diverge from those on the "Right"). Specifically, we investigate the extent to which the political polarization of willingness to comply with mitigation behaviors changes with risk perceptions. METHOD Analyses use data from two sources: an original dataset of Twitter posts and a nationally-representative survey. In the Twitter data, negative binomial regression models are used to predict mitigation intent measured using tweet counts. In the survey data, logit models predict self-reported mitigation behavior (vaccination, masking, and social distancing). RESULTS Findings converged across both datasets, supporting the idea that the links between political orientation and willingness to follow mitigation guidelines depend on perceived risk. People on the Left are more inclined than their Right-oriented colleagues to follow guidelines, but this polarization tends to decrease as the perceived risk of COVID-19 intensifies. Additionally, we find evidence that exposure to COVID-19 infections sends ambiguous signals about the risk of the virus while COVID-19 related deaths have a more consistent impact on mitigation behaviors. CONCLUSIONS Pandemic-related risks can create opportunities for perceived "common ground," between the political "Right" and "Left." Risk perceptions and politics interact in their links to intended COVID-19 mitigation behavior (as measured both on Twitter and in a national survey). Our results invite a more complex interpretation of political polarization than those stemming from simplistic analyses of partisanship and ideology.
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Affiliation(s)
- Ray Block
- Penn State Departments of Political Science and African American Studies, 308 Pond Laboratory, University Park, PA, 16802, USA
| | - Michael Burnham
- Penn State Department of Political Science and the Center for Social Data Analytics, Pond Laboratory, University Park, PA, 16802, USA,Corresponding author. Penn State Department of Political Science, Pond Laboratory, University Park, PA, 16802, USA
| | - Kayla Kahn
- Penn State Department of Political Science and the Center for Social Data Analytics, Pond Laboratory, University Park, PA, 16802, USA
| | - Rachel Peng
- Penn State Donald P. Bellisario College of Communications and the Center for Social Data Analytics, 8 Carnegie Building University Park, PA, 16802, USA
| | - Jeremy Seeman
- Penn State Department of Statistics and the Center for Social Data Analytics, 122 Chemistry Building University Park, PA, 16802, USA
| | - Christopher Seto
- Penn State Department of Sociology and Criminology and the Center for Social Data Analytics, 1001 Oswald Tower University Park, PA, 16802, USA
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5
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Yu B, Jia P, Huang YL, Zhou JM, Xie T, Yu J, Liu C, Xiong J, Han JY, Yang SF, Dong PJ, Yang C, Wang ZX, Yang SJ. Self-efficacy as a crucial psychological predictor of treatment adherence among elderly people living with HIV: analyses based on the health belief model. AIDS Care 2021; 34:1041-1047. [PMID: 34156890 DOI: 10.1080/09540121.2021.1938964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Medication adherence to antiretroviral therapy (ART) among elderly people living with HIV (PLWH) is of serious concern. Our study aimed to understand the medication adherence of elderly PLWH under ART based on the health belief model (HBM). A baseline survey with a total of 529 elderly PLWH was conducted in Sichuan. Logistic and linear regression analysis, mediation analysis, and path analysis based on prior evidence were used. Only self-efficacy showed direct associations with medication adherence in the last four days (ORm = 1.37, 95%CI: 1.11, 1.70) and the last month (ORm = 1.39, 95%CI: 1.18, 1.63) in the multivariate analysis. Self-efficacy mediated the relations between perceived benefits, perceived barriers, cues to action and medication adherence. Inner relations existed within the HBM. In addition to the direct effects, perceived benefits (β = 0.149, p = 0.031; β = 0.093, p = 0.005), perceived barriers (β = -0.070, p = 0.008; β = -0.062, p = 0.012), and cues to action (β = 0.184, p = 0.013; β = 0.135, p = 0.014) showed indirect effects on medication adherence in the last four days and the last month, respectively. HBM may be effective in predicting medication adherence of elderly PLWH, and self-efficacy may be a crucial predictor and mediator. Efforts should be focused on how to enhance elderly PLWH's self-efficacy without neglect of other medication beliefs.
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Affiliation(s)
- Bin Yu
- West China Second University Hospital of Sichuan University and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, People's Republic of China.,Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Peng Jia
- School of Resources and Environmental Science, Wuhan University, Wuhan, People's Republic of China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, People's Republic of China
| | - Yu-Ling Huang
- Sichuan Center for Disease Control and Prevention, Chengdu, People's Republic of China
| | - Jun-Min Zhou
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Tian Xie
- Pidu District Center for Disease Control and Prevention, Chengdu, People's Republic of China
| | - Jun Yu
- Lu County Center for Disease Control and Prevention, Luzhou, People's Republic of China
| | - Chang Liu
- Lu County Center for Disease Control and Prevention, Luzhou, People's Republic of China
| | - Jun Xiong
- Lu County Center for Disease Control and Prevention, Luzhou, People's Republic of China
| | - Jia-Yu Han
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Shi-Fan Yang
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Pei-Jie Dong
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Chao Yang
- Department of epidemiology and statistics, School of Public Health, Southwest Medical University, Luzhou, People's Republic of China
| | - Zi-Xin Wang
- Centre for Health Behaviors Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Shu-Juan Yang
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, People's Republic of China
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6
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Kao K, Lust E, Dulani B, Ferree KE, Harris AS, Metheney E. The ABCs of Covid-19 prevention in Malawi: Authority, benefits, and costs of compliance. WORLD DEVELOPMENT 2021; 137:105167. [PMID: 32904501 PMCID: PMC7455236 DOI: 10.1016/j.worlddev.2020.105167] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
A wide array of authorities-from religious leaders to government ministers-call upon citizens to take preventative measures against Covid-19. Which authorities can most effectively gain public compliance, and which measures will the public take up? Moreover, do people comply with authorities out of respect for their legitimacy, due to their expertise, or for fear of sanctioning? Answers to these questions are important for development practitioners, who need to understand how different partnerships might affect health behavior, and for scholars interested in understanding authority, legitimacy, and compliance. We explore these questions using a conjoint experiment embedded in a telephone survey of 641 Malawians. Individuals in our sample are more likely to say that they will comply with precautionary measures when the costs are low and expected benefits are high. Respondents view both traditional authorities and hospital heads as legitimately issuing directives and having the ability to monitor and sanction non-compliance, but appear to comply more with hospital heads and to do so out of respect for their expertise. These results emphasize how who issues directives affects whether individuals comply and provides insights as to why they do so. The findings also reflect individuals' cost-benefit calculations when considering precautionary measures, highlighting the importance of steps that can reduce costs (e.g., food security or income measures) or accurately reflect risks (e.g., information signaling the prevalence of Covid-19). The study not only helps to address the Coronavirus crisis but also has important implications for broader questions of authority and compliance.
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7
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Pishkhani MK, Dalvandi A, Ebadi A, Hosseini MA. Adherence to a Rehabilitation Regimen in Stroke Patients: A Concept Analysis. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2020; 25:139-145. [PMID: 32195160 PMCID: PMC7055185 DOI: 10.4103/ijnmr.ijnmr_170_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 12/07/2019] [Accepted: 12/23/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Adherence to rehabilitation regimens is a major issue in the treatment of stroke. Despite the agreement on the importance of adherence, there is still no clear definition of this concept in rehabilitation. The aim of this study was the concept analysis of the concept of adherence to rehabilitation regimens in stroke patients. MATERIALS AND METHODS This qualitative concept analysis was performed using Walker and Avant's method. English and Persian articles were searched using keywords such as "adherence", "compliance", "rehabilitation", "stroke", and other related keywords among articles published from 1997 to 2018 in PubMed, Scopus, Web of Science, Google Scholar, Iranmedex, Magiran, and Scientific Information Database (SID). Related textbooks were also searched and all articles containing definitions, attributes, antecedents, and consequences of the concept were included in the study. RESULTS The attributes of the concept included complex, multidimensional, and dynamic behavior in the treatment process, personal experience, and adaptive behavior in patients, changeable, situational, voluntary, and collaborative behavior, and active communication between the patient and the healthcare provider. Common antecedents of the concept of adherence to the rehabilitation regimen were classified into patient-related and environmental-related categories and the consequences were classified into the three categories of patient-related, healthcare professional-related, and healthcare system-related. CONCLUSIONS This concept analysis can be useful in eliminating any ambiguity of the concept of adherence to rehabilitation regimens. It helps clarify the vague concepts used in nursing rehabilitation instead of adherence. The results of this study can be helpful for researchers for further studies in this context.
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Affiliation(s)
- Maryam Khoshbakht Pishkhani
- Department of Nursing, School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Asghar Dalvandi
- School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- School of Nursing and Midwifery, Islamic Azad University of Tehran, Central Branch, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Hosseini
- Department of Rehabilitation Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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8
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Forsberg A, Nilsson M, Jakobsson S, Lennerling A, Kisch A. Fear of graft rejection 1-5 years after lung transplantation-A nationwide cohort study. Nurs Open 2018; 5:484-490. [PMID: 30338093 PMCID: PMC6177545 DOI: 10.1002/nop2.184] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 03/21/2018] [Indexed: 11/25/2022] Open
Abstract
AIM To explore the perceived threat of the risk of graft rejection and its relationship to psychological general well-being and self-efficacy 1-5 years after lung transplantation. DESIGN A nationwide, cross-sectional cohort study as a part of the Self-management after thoracic transplantation study. METHODS A total of 117 lung transplant recipients due for their yearly follow-up one (N = 35), two (N = 28), three (N = 23), four (N = 20) and 5 years (N = 11) after lung transplantation were included. We used three instruments; the Perceived Threat of the Risk of Graft Rejection, the Psychological General Well-being and Self-efficacy in chronic illness. RESULTS The lung recipients reported an overall low perceived threat of the risk of graft rejection with no gender differences. Intrusive anxiety explained 24.7% of the variance in the PGWB-sum (p ≤ 0.001) and makes a statistically significant (β = -497; p ≤ 0.001) unique contribution to the overall psychological general well-being (95%CI 3.004-1.515).
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Affiliation(s)
- Anna Forsberg
- Institute of Health SciencesLund UniversityLundSweden
- Department of Thoracic Transplantation and CardiologySkåne University HospitalSkåneSweden
| | - Madeleine Nilsson
- Queen Silvia Children´s Hospital, Sahlgrenska University HospitalGothenburgSweden
| | - Sofie Jakobsson
- Institute of Health and Care SciencesUniversity of GothenburgGothenburgSweden
| | - Annette Lennerling
- Institute of Health and Care SciencesUniversity of GothenburgGothenburgSweden
- The Department of TransplantationSahlgrenska University HospitalGothenburgSweden
| | - Annika Kisch
- The Department of HaematologySkåne University HospitalSkåneSweden
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Williams IL, Mee-Lee D. Coparticipative Adherence: The Reconstruction of Discharge Categories in the Treatment of Substance Use Disorders. ALCOHOLISM TREATMENT QUARTERLY 2017. [DOI: 10.1080/07347324.2017.1322432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Izaak L. Williams
- Department of Psychology, University of Hawaii, Honolulu, Hawaii, USA
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10
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Carpenter R. A Review of Instruments on Cognitive Appraisal of Stress. Arch Psychiatr Nurs 2016; 30:271-9. [PMID: 26992882 DOI: 10.1016/j.apnu.2015.07.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 06/30/2015] [Accepted: 07/04/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this paper is to present a review of theoretically based measures of cognitive appraisal, and discuss psychometric strengths and limitations. BACKGROUND Understanding how an individual appraises stressful events becomes important when faced with alterations in mental health. Cognitive appraisals influence how an individual copes with stressful events and life crises that leads to changes in mental health. Measures on how an individual appraises a stressful event lack conceptual soundness and are limited by weak psychometric properties. DATA SOURCES Health and Psychosocial Instruments (HAPI) electronic database was searched using combinations of the key words cognitive appraisal, primary appraisal, secondary appraisal, appraisal of illness, appraisal of health, and stress appraisal. The quality of these instrument sources was assessed by published psychometric data in the primary source. RESULTS Five instruments were found that measure cognitive appraisal as theoretically described: the Meaning of Illness Questionnaire, the Stress Appraisal Measure, the Appraisal of Illness Scale, the Cognitive Appraisal of Health Scale, and the Primary Appraisal/Secondary Appraisal scale. A description of each tool, including purpose, scoring, and psychometric support, is provided. CONCLUSION There are a limited number of instruments that measure cognitive appraisal as theoretically described. Theoretically sound instruments with established psychometric support are needed to make accurate inferences about the role of cognitive appraisal in the mental and physical health of individuals experiencing stress.
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11
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Kähkönen O, Kankkunen P, Saaranen T, Miettinen H, Kyngäs H, Lamidi ML. Motivation is a crucial factor for adherence to a healthy lifestyle among people with coronary heart disease after percutaneous coronary intervention. J Adv Nurs 2015; 71:2364-73. [DOI: 10.1111/jan.12708] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Outi Kähkönen
- Department of Nursing Science; University of Eastern Finland; Kuopio Finland
| | - Päivi Kankkunen
- Department of Nursing Science; University of Eastern Finland; Kuopio Finland
| | - Terhi Saaranen
- Department of Nursing Science; University of Eastern Finland; Kuopio Finland
| | | | - Helvi Kyngäs
- Department of Health Science; University of Oulu; Finland
| | - Marja-Leena Lamidi
- Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
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12
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Forsberg A, Lennerling A, Fridh I, Karlsson V, Nilsson M. Understanding the Perceived Threat of the Risk of Graft Rejections: A Middle-Range Theory. Glob Qual Nurs Res 2015; 2:2333393614563829. [PMID: 28462294 PMCID: PMC5342851 DOI: 10.1177/2333393614563829] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 11/17/2014] [Indexed: 11/18/2022] Open
Abstract
From a clinical viewpoint, graft rejection is one of the greatest threats faced by an organ transplant recipient (OTR). We propose a middle-range theory (MRT) of Perceived Threat of the Risk of Graft Rejection (PTRGR) as a contribution to the practice of transplant nursing. It could also apply to the detection of risky protective behavior, that is, isolation, avoidance, or non-adherence. The proposed MRT covers the following concepts and the relationship between them: transplant care needs, threat reducing interventions, intervening variables, level of PTRGR, protective strategies, and evidence-based practice. Parts of this theory have been empirically tested and support the suggested relationship between some of the concepts. Further tests are needed to strengthen the theoretical links. The conceptual framework might serve as a guide for transplant nurses in their efforts to promote post-transplant health and reduce threat-induced emotions.
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Affiliation(s)
- Anna Forsberg
- Lund University, Lund, Sweden.,Skåne University Hospital, Lund, Sweden
| | - Annette Lennerling
- Sahlgrenska University Hospital, Gothenburg, Sweden.,University of Gothenburg, Göteborg, Sweden
| | - Isabell Fridh
- University of Gothenburg, Göteborg, Sweden.,University of Borås, Borås, Sweden
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13
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Wood RY, Della-Monica NR. Breast cancer threat appraisal: design and psychometric analysis of a new scale for older women. Int J Older People Nurs 2014; 10:94-104. [PMID: 24965939 DOI: 10.1111/opn.12054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 01/15/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND The prospect of being diagnosed with breast cancer generates emotional responses associated with a high degree of health threat. When considering screening, older women are faced with physical and psychological consequences inherent in considering the threat of disease. AIMS AND OBJECTIVES To describe the development and evaluate initial reliability and validity of the Breast Cancer Threat Appraisal Scale (BCTAS), a self-report instrument measuring psychosocial and situational factors related to breast cancer threat appraisal in older women. DESIGN AND METHODS Preliminary survey items for the Breast Cancer Threat Appraisal Scale (BCTAS) were designed using content experts and focus groups and subsequently tested by a sample of older women. Two hundred forty-three (n = 243) complete data sets were submitted to principal components analysis (PCA). Internal consistency reliability and construct validity of resulting factors were measured. RESULTS PCA with orthogonal rotation resulted in four components defined by 34 items with loadings of ≥0.40. Internal consistency reliability was evident in all four components (Component # 1 = 0.87, Component # 2 = 0.81, Component # 3 = 0.70 and Component # 4 = 0.72). Correlations between Breast Cancer Fear and total BCTAS (r = 0.29, P < 0.001) and Component # 3 (r = 0.39, P < 0.001) provided partial construct validity. CONCLUSIONS Psychometric analysis provided initial evidence of reliability for four conceptually meaningful scales and partial construct validity for total score and one factor. IMPLICATIONS FOR PRACTICE Using these empirically derived scales may clarify for health providers how older women perceive personal threat of breast cancer and inform collaborative decision-making to foster screening.
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Affiliation(s)
- Robin Y Wood
- William F. Connell School of Nursing Boston College, Chestnut Hill, MA, USA
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14
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Mallow JA, Theeke LA, Barnes ER, Whetsel T, Mallow BK. Free Care Is Not Enough: Barriers to Attending Free Clinic Visits in a Sample of Uninsured Individuals with Diabetes. ACTA ACUST UNITED AC 2014; 4:912-919. [PMID: 25767743 PMCID: PMC4354849 DOI: 10.4236/ojn.2014.413097] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Free care does not always lead to improved outcomes. Attendance at free clinic appointments is unpredictable. Understanding barriers to care could identify innovative interventions. The purpose of this study was to examine patient characteristics, biophysical outcomes, and health care utilization in uninsured persons with diabetes at a free clinic. A sample of 3139 patients with at least one chronic condition was identified and comparisons were made between two groups: those who attended all scheduled appointments and those who did not. Geographic distance to clinic and multiple chronic conditions were identified as barriers to attendance. After one year, missing more than one visit had a positive correlation with increased weight, A1C, and lipids. Additionally, patients who missed visits had higher blood pressure, depression scores, and numbers of medications. Future research should further enhance understanding of barriers to care, build knowledge of how social and behavioral determinants contribute to negative outcomes in the context of rurality. Innovative methods to deliver more frequent and intensive interventions will not be successful if they are not accessible to patients.
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Affiliation(s)
- Jennifer A Mallow
- School of Nursing, West Virginia University, Morgantown, West Virginia, USA
| | - Laurie A Theeke
- School of Nursing, West Virginia University, Morgantown, West Virginia, USA
| | - Emily R Barnes
- School of Nursing, West Virginia University, Morgantown, West Virginia, USA
| | - Tara Whetsel
- School of Nursing, West Virginia University, Morgantown, West Virginia, USA
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Matthews EE, Arnedt JT, McCarthy MS, Cuddihy LJ, Aloia MS. Adherence to cognitive behavioral therapy for insomnia: a systematic review. Sleep Med Rev 2013; 17:453-64. [PMID: 23602124 PMCID: PMC3720832 DOI: 10.1016/j.smrv.2013.01.001] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 01/02/2013] [Accepted: 01/02/2013] [Indexed: 10/27/2022]
Abstract
Chronic insomnia is a significant public health problem worldwide, and insomnia has considerable personal and social costs associated with serious health conditions, greater healthcare utilization, work absenteeism, and motor-vehicle accidents. Cognitive behavioral therapy for insomnia (CBTI) is an efficacious treatment, yet attrition and suboptimal adherence may diminish its impact. Despite the increasing use of CBTI, surprisingly little attention has been devoted to understanding the role of adherence. This review describes a comprehensive literature search of adherence to CBTI. The search revealed 15 studies that evaluated adherence to CBTI in adults using valid and reliable measures of sleep, and measure of adherence other than study withdrawals. The primary purposes of this review were to 1) synthesize current study characteristics, methodology, adherence rates, contributing factors, and impact on outcomes, 2) discuss measurement issues, and 3) identify future practice and research directions that may lead to improved outcomes. Strong patterns and inconsistencies were identified among the studies, which complicate an evaluation of the role of adherence as a factor and outcome of CBTI success. The importance of standardized adherence and outcome measures is discussed. In light of the importance of adherence to behavior change, this systematic review may better inform future intervention efforts.
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Affiliation(s)
- Ellyn E Matthews
- University of Colorado Denver, College of Nursing, Aurora, CO 80045, USA.
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16
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Butow P, Sharpe L. The impact of communication on adherence in pain management. Pain 2013; 154 Suppl 1:S101-S107. [DOI: 10.1016/j.pain.2013.07.048] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 07/19/2013] [Accepted: 07/25/2013] [Indexed: 11/15/2022]
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17
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Nilsson M, Forsberg A, Lennerling A, Persson LO. Coping in relation to perceived threat of the risk of graft rejection and Health-Related Quality of Life of organ transplant recipients. Scand J Caring Sci 2012. [DOI: 10.1111/scs.12007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Anna Forsberg
- The Sahlgrenska Academy at University of Gothenburg, Institute of Health and Care Sciences; Gothenburg Sweden
- Department of Health Sciences, Faculty of Medicine; Lund University; Gothenburg Sweden
| | - Annette Lennerling
- The Sahlgrenska Academy at University of Gothenburg, Institute of Health and Care Sciences; Gothenburg Sweden
- The Transplant Institute; Sahlgrenska University Hospital; Gothenburg Sweden
| | - Lars-Olof Persson
- The Sahlgrenska Academy at University of Gothenburg, Institute of Health and Care Sciences; Gothenburg Sweden
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18
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Bender A, Peter E, Wynn F, Andrews G, Pringle D. Welcome intrusions: An interpretive phenomenological study of TB nurses’ relational work. Int J Nurs Stud 2011; 48:1409-19. [DOI: 10.1016/j.ijnurstu.2011.04.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2010] [Revised: 04/19/2011] [Accepted: 04/21/2011] [Indexed: 10/18/2022]
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19
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Yeh KH. Mediating effects of negative emotions in parent-child conflict on adolescent problem behavior. ASIAN JOURNAL OF SOCIAL PSYCHOLOGY 2011. [DOI: 10.1111/j.1467-839x.2011.01350.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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20
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Hoogbruin A. Complementary and alternative therapy (CAT) use and highly active antiretroviral therapy (HAART): current evidence in the literature, 2000-2009. J Clin Nurs 2011; 20:925-39. [PMID: 21306453 DOI: 10.1111/j.1365-2702.2010.03322.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
AIM AND OBJECTIVE To determine current evidence about the use of complementary and alternative medicine in the context of highly active antiretroviral therapy. The following objectives included identifying the risks and benefits of using complementary and alternative medicine when living with the human immunodeficiency virus (HIV) and taking such medications. BACKGROUND In Canada and the USA, HIV/AIDS service organisations recognise that people affected or infected by HIV are increasingly choosing to use complementary and alternative medicine to cope with this disease. These same organisations advocate for increased access to complementary and alternative medicine and more information about the safe use of complementary and alternative medicine to make informed decisions. Based on the increased integral use of complementary and alternative medicine and conventional medicine in Canada and the USA, the literature review was limited to these two countries. DESIGN Systematic review. METHOD Available full-text abstracts published in English from 2000-2009 were retrieved by electronic searches of selected databases, including the websites of Health Canada and American National Center for Complementary and Alternate Medicine (NCCAM). Forty studies were examined and were categorised by referring to the NCCAM (2007) four types of complementary and alternative medicine. RESULTS Insufficient evidence exists to support the use of a particular complementary and alternate therapy to enhance the management of HIV disease. CONCLUSION Decisions about using complementary and alternative medicine in conjunction with highly active antiretroviral therapy are often poorly informed. Safety risks and potential drug interactions are frequently ignored as people who use highly active antiretroviral therapy prefer to focus on the physical and mental benefits of using selected complementary and alternate therapies to promote their quality of life. RELEVANCE TO CLINICAL PRACTICE As life expectancy increases, from the use of highly active antiretroviral therapy, it is important for health professionals like nurses to be knowledgeable about the prevention, assessment and treatment of HIV symptoms and treatment side effects. Given the increased trend of using complementary and alternative medicine by the general population, it is also important to understand the appropriate use of complementary and alternative medicine for symptom management in HIV/AIDS care.
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Affiliation(s)
- Amandah Hoogbruin
- Faculty of Community & Health Studies, Kwantlen Polytechnic University, Surrey, BC, Canada.
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Butow P, Palmer S, Pai A, Goodenough B, Luckett T, King M. Review of Adherence-Related Issues in Adolescents and Young Adults With Cancer. J Clin Oncol 2010; 28:4800-9. [DOI: 10.1200/jco.2009.22.2802] [Citation(s) in RCA: 177] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose This review aims to provide a broad overview of the issues and clinical challenges of nonadherence in adolescents and young adults (AYAs) with cancer. Nonadherence can reduce treatment efficacy, which places the patient at higher risk of relapse, adverse effects, and poor outcomes. Design A review of the English-speaking literature between 1980 and 2008 was conducted to identify relevant publications, which were supplemented by reference and author searches. Results Definition and measurement of adherence varies. Most studies have not clearly delineated an AYA age group (ie, 15-25 years) and have been dominated by leukemia and lymphoma samples. Estimates for nonadherence in this population range from 27% to 60%, with openness of family relationships and support found to predict adherence. Strategies to avoid, assess, and manage nonadherence are presented. Conclusion Overall, the evidence base for adherence and strategies to promote it in AYAs with cancer is woefully lacking. There is a need for high-quality studies that target clinically important questions, randomized controlled trials of theoretically based interventions, and development and evaluation of training programs for oncology staff in the special issues faced by AYAs with cancer.
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Affiliation(s)
- Phyllis Butow
- From the Centre for Medical Psychology and Evidence-Based Decision-Making; and Psycho-Oncology Co-operative Research Group, University of Sydney; Consultant Psychologist; School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; and Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
| | - Susan Palmer
- From the Centre for Medical Psychology and Evidence-Based Decision-Making; and Psycho-Oncology Co-operative Research Group, University of Sydney; Consultant Psychologist; School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; and Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
| | - Ahna Pai
- From the Centre for Medical Psychology and Evidence-Based Decision-Making; and Psycho-Oncology Co-operative Research Group, University of Sydney; Consultant Psychologist; School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; and Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
| | - Belinda Goodenough
- From the Centre for Medical Psychology and Evidence-Based Decision-Making; and Psycho-Oncology Co-operative Research Group, University of Sydney; Consultant Psychologist; School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; and Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
| | - Tim Luckett
- From the Centre for Medical Psychology and Evidence-Based Decision-Making; and Psycho-Oncology Co-operative Research Group, University of Sydney; Consultant Psychologist; School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; and Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
| | - Madeleine King
- From the Centre for Medical Psychology and Evidence-Based Decision-Making; and Psycho-Oncology Co-operative Research Group, University of Sydney; Consultant Psychologist; School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; and Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
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Lee SJC. Uncertain Futures: Individual Risk and Social Context in Decision-Making in Cancer Screening. HEALTH RISK & SOCIETY 2010; 12:101-117. [PMID: 20563321 DOI: 10.1080/13698571003637048] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A core logic of cancer control and prevention, like much in public health, turns on the notion of decision-making under conditions of uncertainty. Population-level data are increasingly used to develop risk profiles, or estimates, that clinicians and the consumer public may use to guide individual decisions about cancer screening. Individual risk perception forms a piece of a larger social economy of decision-making and choice that makes population screening possible. Individual decision-making depends on accessing and interpreting available clinical information, filtered through the lens of personal values and both cognitive and affective behavioral processes. That process is also mediated by changing social roles and interpersonal relationships. This paper begins to elucidate the influence of this "social context" within the complexity of cancer screening. Reflecting on current work in risk and health, I consider how ethnographic narrative methods can enrich this model.
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Affiliation(s)
- Simon J Craddock Lee
- Department of Clinical Sciences Division of Ethics & Health Policy University of Texas Southwestern Medical Center at Dallas, USA
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Yeh KH, Tsao WC, Chen WW. Parent–child conflict and psychological maladjustment: A mediational analysis with reciprocal filial belief and perceived threat. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2010; 45:131-9. [DOI: 10.1080/00207590903085505] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Cohen SM. Concept analysis of adherence in the context of cardiovascular risk reduction. Nurs Forum 2009; 44:25-36. [PMID: 19187051 DOI: 10.1111/j.1744-6198.2009.00124.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
TOPIC Cardiovascular disease is the number one cause of death in the United States. Examination of the concept of adherence is essential to provide informed patient-centered care to prevent the development and progression of this largely preventable disease. OBJECTIVE The purpose of this concept analysis is to explore and clarify the concept of adherence. This analysis will provide a framework for those seeking a better understanding of patient decision-making, reduction of relapse to unhealthy behaviors, and increased long-term adherence to cardiovascular health recommendations. Reviews of major theories related to health behavior are reviewed in the second part of the article and are linked to the concept of adherence. METHOD Following a review of the literature, Morse's guidelines were utilized to present a concept analysis of adherence and the related terms concordance and compliance from the disciplines of nursing, health psychology, ethics, pharmacy, and medicine. RESULTS Adherence is dependent on the collaborative relationship between patient and healthcare provider. Adherence is influenced by the meaning of health, heart disease, and sense of personal risk as well as socioeconomic status, decision support, motivation, and desire for change, self-efficacy, and sources of credible health information. Attributes of successful adherence include alignment of patient behavior and health recommendations, mastery of new health knowledge and behavior, continued collaborative relationships between the patient and healthcare provider, and ability to meet outcome targets. CONCLUSION Adherence is defined as persistence in the practice and maintenance of desired health behaviors and is the result of active participation and agreement. Adherence is dependent on the development of a concordant relationship and its measurement should be specific utilizing the correct tools. Special attention should be paid to shared decision-making between patient and healthcare provider.
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Abstract
AIM This paper is a report of an analysis of the concept of adherence. BACKGROUND The transition in terminology from compliance to adherence, and more recently to concordance, requires re-clarification of 'adherence' as a concept in nursing practice. Differences exist in the use of the term adherence and how or if it differs from compliance or concordance. DATA SOURCES Using the Medical Subject Headings terms adherence, non-adherence and treatment refusal, the Cumulative Index to Nursing and Allied Health Literature, Medline, PsychINFO and Cochrane library databases were searched for publications between 1970 and 2007. Method. The evolutionary analytic method was used to identify and explore transitions in the concept of adherence over time and across healthcare disciplines. A representative sample of papers was identified from the disciplines of nursing, medicine, psychology and pharmacy. RESULTS We identified 114 papers: 27 from nursing, 39 from psychology, 33 from general medicine and 15 from pharmacology sources. The final sample included eight from pharmacy and 15 from mental health, medicine and nursing. We found no distinct differentiation between adherence and compliance. The surrogate terms serving as manifestations of adherence are concordance, agreement, cooperation and partnership. The most common definition found was as follows: 'Adherence can be defined as the extent to which patients follow the instructions they are given for prescribed treatments'. No definition of adherence exists that reflects a patient-centred approach, the dynamic nature of adherence behaviour and the power imbalance implied by these terms. CONCLUSION This concept analysis of adherence is a preliminary step towards broadening nurses' appreciation of the complexity of patient adherence behaviour.
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Affiliation(s)
- Janice M Bissonnette
- Advanced Practice Nurse Renal Transplant Program, Faculty of Health Sciences, School of Nursing Graduate Studies, The Ottawa Hospital, University of Ottawa, Ontario, Canada.
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26
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Cole M. Compliance and infection control guidelines: a complex phenomenon. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2008; 17:700-704. [PMID: 18773585 DOI: 10.12968/bjon.2008.17.11.29615] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Healthcare-acquired infection has become a global health phenomenon affecting approximately 8.7% of the world's population. Despite a plethora of evidence-based guidelines, policies and procedures, knowledge of these can be poor, and when this is the case, sub-optimum care may follow. Historically, enhancement strategies have focused on the provision of education by making the tacit assumption that an increase in knowledge will result in an improvement in compliance. However, compliance is a multi-dimensional, abstract, complex concept that is difficult to define. Decision-making is rarely objective and the capacity of personal experience to outweigh scientific evidence is a hallmark of the post-modern times in which we live. It is well established in social psychology research that when faced with complex encounters, individuals turn to simple reasoning rules called 'heuristics', to make decisions. These heuristics are potentially dangerous as they can introduce flawed probability judgements in relation to compliance behaviour. If the raison-d'être of infection control nursing is to attain compliance with the best available evidence, organizations need to reject a reductionist, cause-and-effect view of compliance and acknowledge that compliance and infection control practice is a complex social construct.
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Affiliation(s)
- Mark Cole
- University of Nottingham, Grantham and District Hospital, Grantham, Lincolnshire
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Ingadottir B, Halldorsdottir S. To discipline a "dog": the essential structure of mastering diabetes. QUALITATIVE HEALTH RESEARCH 2008; 18:606-619. [PMID: 18420535 DOI: 10.1177/1049732308316346] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
In this article we describe the findings of a study in which the essential structure of mastering diabetes was explored from the patient's viewpoint, emphasizing the lived experience of adhering and not adhering to a complex treatment regimen for diabetes.
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Lehane E, McCarthy G, Collender V, Deasy A. Medication-taking for coronary artery disease - patients' perspectives. Eur J Cardiovasc Nurs 2007; 7:133-9. [PMID: 17904422 DOI: 10.1016/j.ejcnurse.2007.08.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2007] [Revised: 08/22/2007] [Accepted: 08/22/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND Medication adherence as a healthcare issue has preoccupied researchers and clinicians for several decades. Sustained investigation is justified given the extent and consequences of non-adherence. While quantitative methodologies conducted predominately from a healthcare professionals' perspective have generated numerous relevant factors involved in adhering to medical regimens, patients' perspectives are required for a more comprehensive appreciation of patient priorities in medication-taking. AIM The aim of this study was to gain a dynamic understanding of the perspectives of patients with coronary artery disease (CAD) on the factors relating to medication-taking. METHODS A qualitative, descriptive research design was adopted. Ten semi-structured interviews were conducted over a three month period and analysed using content analysis techniques. FINDINGS Three key dimensions to medication-taking were identified: "Keeping track"-ways of taking tablets; Reasoning about medications and Social/Professional influences on medication-taking. CONCLUSION Research results add to the existing body of knowledge on patients' perspectives on medication-taking. They provide clinicians with an insight into the different dimensions and complex interactions involved.
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Affiliation(s)
- Elaine Lehane
- Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, National University of Ireland, Cork College Road, Cork, Ireland.
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