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Andersson PA, Vartanova I, Västfjäll D, Tinghög G, Strimling P, Wu J, Hazin I, Akotia CS, Aldashev A, Andrighetto G, Anum A, Arikan G, Bagherian F, Barrera D, Basnight-Brown D, Batkeyev B, Berezina E, Björnstjerna M, Boski P, Bovina I, Huyen BTT, Čekrlija Đ, Choi HS, Contreras-Ibáñez CC, Costa-Lopes R, de Barra M, de Zoysa P, Dorrough AR, Dvoryanchikov N, Engelmann JB, Euh H, Fang X, Fiedler S, Foster-Gimbel OA, Fülöp M, Gardarsdottir RB, Gill CMHD, Glöckner A, Graf S, Grigoryan A, Gritskov V, Growiec K, Halama P, Hartanto A, Hopthrow T, Hřebíčková M, Iliško D, Imada H, Kapoor H, Kawakami K, Khachatryan N, Kharchenko N, Kiyonari T, Kohút M, Leslie LM, Li Y, Li NP, Li Z, Liik K, Maitner AT, Manhique B, Manley H, Medhioub I, Mentser S, Nejat P, Nipassa O, Nussinson R, Onyedire NG, Onyishi IE, Panagiotopoulou P, Perez-Floriano LR, Persson M, Pirttilä-Backman AM, Pogosyan M, Raver J, Rodrigues RB, Romanò S, Romero PP, Sakki I, San Martin A, Sherbaji S, Shimizu H, Simpson B, Szabo E, Takemura K, Teixeira MLM, Thanomkul N, Tiliouine H, Travaglino GA, Tsirbas Y, Widodo S, Zein R, Zirganou-Kazolea L, Eriksson K. Anger and disgust shape judgments of social sanctions across cultures, especially in high individual autonomy societies. Sci Rep 2024; 14:5591. [PMID: 38454068 PMCID: PMC10920647 DOI: 10.1038/s41598-024-55815-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 02/28/2024] [Indexed: 03/09/2024] Open
Abstract
When someone violates a social norm, others may think that some sanction would be appropriate. We examine how the experience of emotions like anger and disgust relate to the judged appropriateness of sanctions, in a pre-registered analysis of data from a large-scale study in 56 societies. Across the world, we find that individuals who experience anger and disgust over a norm violation are more likely to endorse confrontation, ostracism and, to a smaller extent, gossip. Moreover, we find that the experience of anger is consistently the strongest predictor of judgments of confrontation, compared to other emotions. Although the link between state-based emotions and judgments may seem universal, its strength varies across countries. Aligned with theoretical predictions, this link is stronger in societies, and among individuals, that place higher value on individual autonomy. Thus, autonomy values may increase the role that emotions play in guiding judgments of social sanctions.
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Affiliation(s)
- Per A Andersson
- Department of Behavioral Sciences and Learning, Linköping University, 581 83, Linköping, Sweden.
- JEDILab, Division of Economics, Department of Management and Engineering, Linköping University, Linköping, Sweden.
| | - Irina Vartanova
- Institute for Futures Studies, Box 591, 101 31, Stockholm, Sweden
| | - Daniel Västfjäll
- Department of Behavioral Sciences and Learning, Linköping University, 581 83, Linköping, Sweden
| | - Gustav Tinghög
- JEDILab, Division of Economics, Department of Management and Engineering, Linköping University, Linköping, Sweden
- JEDILab, Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Pontus Strimling
- Institute for Futures Studies, Box 591, 101 31, Stockholm, Sweden
- The Institute for Analytical Sociology, Linköping University, Linköping, Sweden
| | - Junhui Wu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Lincui Road 16, Chaoyang District, Beijing, 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Isabela Hazin
- Institute for Futures Studies, Box 591, 101 31, Stockholm, Sweden
- Department of Women's and Children's Health, University of Uppsala, Uppsala, Sweden
| | - Charity S Akotia
- Department of Psychology, University of Ghana, Legon, P.O. Box LG 84, Accra, Ghana
| | - Alisher Aldashev
- International School of Economics, Kazakh-British Technical University, 59 Tole Bi Street, 050000, Almaty, Kazakhstan
| | - Giulia Andrighetto
- Institute for Futures Studies, Box 591, 101 31, Stockholm, Sweden
- Mälardalen University, 721 23, Västerås, Sweden
- Institute of Cognitive Sciences and Technologies, National Research Council of Italy, 00185, Rome, Italy
| | - Adote Anum
- Department of Psychology, University of Ghana, Legon, P.O. Box LG 84, Accra, Ghana
| | - Gizem Arikan
- Department of Political Science, Trinity College Dublin, 2-3 College Green, Dublin 2, Ireland
| | - Fatemeh Bagherian
- Faculty of Education and Psychology, Shahid Beheshti University, Tehran, 1983969411, Iran
| | - Davide Barrera
- University of Turin and Collegio Carlo Alberto, Lungo Dora Siena 100, 10124, Turin, Italy
| | - Dana Basnight-Brown
- School of Humanities and Social Sciences, United States International University Africa, Box 14634 00800, Nairobi, Kenya
| | - Birzhan Batkeyev
- International School of Economics, Kazakh-British Technical University, 59 Tole Bi Street, 050000, Almaty, Kazakhstan
| | - Elizaveta Berezina
- Sunway University, No. 5, Jalan Universiti, Bandar Sunway, 47500, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | | | - Paweł Boski
- SWPS University, Chodakowska 19-31, 03-815, Warsaw, Poland
| | - Inna Bovina
- Moscow State University of Psychology and Education, Sretenka Str., 29, 127051, Moscow, Russia
| | - Bui Thi Thu Huyen
- Hanoi National University of Education, 136 Xuan Thuy Street, Cau Giay District, Hanoi, Vietnam
| | - Đorđe Čekrlija
- Faculty of Philosophy, University of Banja Luka, Vojvode Petra Bojovića 1A, 78000, Banja Luka, Bosnia and Herzegovina
- Institute of Psychology, University of Greifswald, Greifswald, Germany
| | - Hoon-Seok Choi
- Department of Psychology, Sungkyunkwan University, 25-2, Sungkyunkwan-Ro, Jongno-Gu, Seoul, 03063, Republic of Korea
| | - Carlos C Contreras-Ibáñez
- Departamento de Sociología, Universidad Autónoma Metropolitana-Unidad Iztapalapa, Av. Rafael Atlixco 186, Col. Vicentina, 09340, Ciudad de México, México
| | - Rui Costa-Lopes
- Instituto de Ciências Sociais, Universidade de Lisboa, Av. Prof. Anibal de Bettencourt, 9, 1600-189, Lisboa, Portugal
| | - Mícheál de Barra
- Center for Culture and Evolution, Brunel University London, Uxbridge, UB8 3PH, UK
| | - Piyanjali de Zoysa
- Faculty of Medicine, University of Colombo, Kynsey Road, Colombo 8, Sri Lanka
| | - Angela R Dorrough
- Department of Psychology, University of Cologne, Richard-Strauss-Str. 2, 50931, Cologne, Germany
| | - Nikolay Dvoryanchikov
- Moscow State University of Psychology and Education, Sretenka Str., 29, 127051, Moscow, Russia
| | - Jan B Engelmann
- Center for Research in Experimental Economics and Political Decision Making (CREED), Amsterdam School of Economics, University of Amsterdam, P.O. Box 15867, 1001 NJ, Amsterdam, The Netherlands
| | - Hyun Euh
- Gies College of Business, University of Illinois at Urbana-Champaign, 1206 S 6Th St., Champaign, IL, 61820, USA
| | - Xia Fang
- Department of Psychology and Behavioral Sciences, Zhejiang University, 148 Tianmushan Road, Hangzhou, Zhejiang, China
| | - Susann Fiedler
- Vienna University of Economics and Business, Welthandelsplatz 1, 1020, Vienna, Austria
| | - Olivia A Foster-Gimbel
- Stern School of Business, New York University, 40 West 4Th Street, Tisch Hall, Suite 700, New York, NY, 10012, USA
| | - Márta Fülöp
- HUN-REN Institute of Cognitive Neuroscience and Psychology, Research Centre of Natural Sciences, Budapest, Hungary
- Károli Gáspár University of the Reformed Church, Bécsi Út 324, Budapest, 1034, Hungary
| | - Ragna B Gardarsdottir
- Faculty of Psychology, University of Iceland, Nyi Gardur, Saemundargata 12, IS-102, Reykjavík, Iceland
| | - C M Hew D Gill
- Sunway University, No. 5, Jalan Universiti, Bandar Sunway, 47500, Petaling Jaya, Selangor Darul Ehsan, Malaysia
- Universal College Bangladesh, Dhaka, Bangladesh
| | - Andreas Glöckner
- Department of Psychology, University of Cologne, Richard-Strauss-Str. 2, 50931, Cologne, Germany
- Max Planck Institute for Research on Collective Goods, Kurt-Schumacher-Str. 10, 53113, Bonn, Germany
| | - Sylvie Graf
- Institute of Psychology, Czech Academy of Sciences, Veveří 97, 602 00, Brno, Czech Republic
| | - Ani Grigoryan
- Department of Personality Psychology, Yerevan State University, Alex Manoogian 1, 0025, Yerevan, Armenia
| | - Vladimir Gritskov
- Saint Petersburg State University, 7-9 Universitetskaya Emb., St Petersburg, 199034, Russia
| | | | - Peter Halama
- Center for Social and Psychological Sciences, Slovak Academy of Sciences, Dubravska Cesta 9, 841 04, Bratislava, Slovakia
| | - Andree Hartanto
- School of Social Sciences, Singapore Management University, 90 Stamford Road, Singapore, 178903, Singapore
| | - Tim Hopthrow
- School of Psychology, University of Kent, Canterbury, CT2 7NP, UK
| | - Martina Hřebíčková
- Institute of Psychology, Czech Academy of Sciences, Veveří 97, 602 00, Brno, Czech Republic
| | - Dzintra Iliško
- Daugavpils University, Latvia, Parades Street 1, Room 432, Daugvapils, 5400, Latvia
| | - Hirotaka Imada
- Department of Psychology, Royal Holloway, University of London, Egham, TW20 0EX, UK
| | - Hansika Kapoor
- Department of Psychology, Monk Prayogshala, 4114, C Wing, Oberoi Garden Estates, Off Saki Vihar Road, Andheri East, Mumbai, Maharashtra, 400072, India
| | - Kerry Kawakami
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, Canada
| | - Narine Khachatryan
- Department of Personality Psychology, Yerevan State University, Alex Manoogian 1, 0025, Yerevan, Armenia
| | - Natalia Kharchenko
- Kyiv International Institute of Sociology, Voloska Str., 8/5, Build. 4, Kyiv, 04070, Ukraine
| | - Toko Kiyonari
- Aoyama Gakuin University, 5-10-1, Fuchinobe, Chuo-Ku, Sagamihara-City, Kanagawa, 252-5258, Japan
| | - Michal Kohút
- Faculty of Philosophy and Arts, University of Trnava, Hornopotočná 23, 918 43, Trnava, Slovakia
| | - Lisa M Leslie
- Stern School of Business, New York University, 40 West 4Th Street, Tisch Hall, Suite 700, New York, NY, 10012, USA
| | - Yang Li
- Melbourne School of Psychological Science, University of Melbourne, 1116 Redmond Barry Building, Melbourne, VIC, 3010, Australia
| | - Norman P Li
- School of Social Sciences, Singapore Management University, 90 Stamford Road, Singapore, 178903, Singapore
| | - Zhuo Li
- Department of Psychology, University of Western Ontario, 1151 Richmond St, London, ON, N6A 5C2, Canada
| | - Kadi Liik
- School of Natural Sciences and Health, Tallinn University, Narva Rd 25, 10120, Tallinn, Estonia
| | - Angela T Maitner
- Department of Psychology, American University of Sharjah, PO Box 26666, Sharjah, United Arab Emirates
| | - Bernardo Manhique
- Faculty of Arts and Social Sciences, Department of Sociology, Eduardo Mondlane University, Av. Julius Nyerere, 3453, Main Campus, Maputo, Mozambique
| | - Harry Manley
- Faculty of Behavioral Sciences, Education, & Languages, HELP University Subang 2, Subang Jaya, Malaysia
- Faculty of Psychology, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok, 10330, Thailand
| | - Imed Medhioub
- Department of Finance, Imam Mohammad Ibn Saud Islamic University (IMSIU), P.O. Box 5701, Riyadh, Saudi Arabia
| | - Sari Mentser
- Department of Education and Psychology, The Open University of Israel, 1 University Road, 4353701, Raanana, Israel
| | - Pegah Nejat
- Faculty of Education and Psychology, Shahid Beheshti University, Tehran, 1983969411, Iran
| | - Orlando Nipassa
- Faculty of Arts and Social Sciences, Department of Sociology, Eduardo Mondlane University, Av. Julius Nyerere, 3453, Main Campus, Maputo, Mozambique
| | - Ravit Nussinson
- Department of Education and Psychology, The Open University of Israel, 1 University Road, 4353701, Raanana, Israel
- Institute of Information Processing and Decision Making, University of Haifa, Abba Khoushy Ave 199, 3498838, Haifa, Israel
| | - Nneoma G Onyedire
- Department of Psychology, University of Nigeria, Nsukka, 41000, Nigeria
| | - Ike E Onyishi
- Department of Psychology, University of Nigeria, Nsukka, 41000, Nigeria
| | - Penny Panagiotopoulou
- Department of Education and Social Work, University of Patras, 26500, Rion, Patras, Greece
| | - Lorena R Perez-Floriano
- Facultad de Economía y Empresa, Universidad Diego Portales, Av. Sta. Clara 797, Huechuraba, Región Metropolitana, Chile
| | - Minna Persson
- Institute for Futures Studies, Box 591, 101 31, Stockholm, Sweden
| | - Anna-Maija Pirttilä-Backman
- Faculty of Social Sciences, Social Psychology, University of Helsinki, PO Box 54 (Unioninkatu 37), 00014, Helsinki, Finland
| | - Marianna Pogosyan
- Leadership and Management, Amsterdam Business School, University of Amsterdam, PO Box 15953, 1001 NB, Amsterdam, The Netherlands
| | - Jana Raver
- Queen's University, Goodes Hall, Kingston, ON, K7L 3N6, Canada
| | - Ricardo Borges Rodrigues
- Instituto Universitário de Lisboa ISCTE-IUL, CIS, Avenida das Forças Armadas, 1649-026, Lisbon, Portugal
| | - Sara Romanò
- Department of Culture, Politics and Society, University of Turin, 10135, Turin, Italy
| | - Pedro P Romero
- Experimental and Computational Economics Lab (ECEL), School of Economics, Universidad San Francisco de Quito USFQ, Diego de Robles y Pampite, Quito, Ecuador
| | - Inari Sakki
- Faculty of Social Sciences, Social Psychology, University of Helsinki, PO Box 42 (Unioninkatu 33), 00014, Helsinki, Finland
| | - Alvaro San Martin
- IESE Business School, Camino del Cerro del Águila, 3, 28023, Madrid, Spain
| | - Sara Sherbaji
- Department of International Studies, American University of Sharjah, PO Box 26666, Sharjah, United Arab Emirates
- Department of Anthropology, University College London, Gower Street, London, WC1E 6BT, UK
| | - Hiroshi Shimizu
- Kwansei Gakuin University, 1-155 Uegahara 1Bancho, Nishinomiya, Hyogo, 662-8501, Japan
| | - Brent Simpson
- Department of Sociology, University of South Carolina, Columbia, SC, 29208, USA
| | - Erna Szabo
- Department of International Management, Johannes Kepler University, Altenberger Str. 69, 4040, Linz, Austria
| | - Kosuke Takemura
- Faculty of Economics, Shiga University, 1-1-1 Banba, Hikone, Shiga, 522-8522, Japan
| | - Maria Luisa Mendes Teixeira
- Mackenzie Presbyterian University, Business Administration Postgraduate Program, Consolação St, 930, São Paulo, CEP 01302-000, Brazil
| | - Napoj Thanomkul
- Faculty of Psychology, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok, 10330, Thailand
| | - Habib Tiliouine
- Labo-PECS, Faculty of Social Sciences, Université d'Oran 2, 31000, Oran, Algeria
| | - Giovanni A Travaglino
- Department of Law and Criminology, Institute for the Study of Power, Crime, and Society, Royal Holloway, University of London, Egham, TW20 0EX, UK
| | - Yannis Tsirbas
- Department of Political Science and Public Administration, University of Athens, 6 Themistokleous Street, 10678, Athens, Greece
| | - Sita Widodo
- Department of Psychology, Universitas Airlangga, Kampus B Unair Jalan Airlangga 4-6, Surabaya, 60286, Indonesia
| | - Rizqy Zein
- Department of Psychology, Universitas Airlangga, Kampus B Unair Jalan Airlangga 4-6, Surabaya, 60286, Indonesia
| | - Lina Zirganou-Kazolea
- Department of Political Science and Public Administration, University of Athens, 6 Themistokleous Street, 10678, Athens, Greece
| | - Kimmo Eriksson
- Institute for Futures Studies, Box 591, 101 31, Stockholm, Sweden
- Mälardalen University, 721 23, Västerås, Sweden
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2
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Andrighetto G, Szekely A, Guido A, Gelfand M, Abernathy J, Arikan G, Aycan Z, Bankar S, Barrera D, Basnight-Brown D, Belaus A, Berezina E, Blumen S, Boski P, Bui HTT, Cárdenas JC, Čekrlija Đ, de Barra M, de Zoysa P, Dorrough A, Engelmann JB, Euh H, Fiedler S, Foster-Gimbel O, Freitas G, Fülöp M, Gardarsdottir RB, Gill CMHD, Glöckner A, Graf S, Grigoryan A, Growiec K, Hashimoto H, Hopthrow T, Hřebíčková M, Imada H, Kamijo Y, Kapoor H, Kashima Y, Khachatryan N, Kharchenko N, León D, Leslie LM, Li Y, Liik K, Liuzza MT, Maitner AT, Mamidi P, McArdle M, Medhioub I, Teixeira MLM, Mentser S, Morales F, Narayanan J, Nitta K, Nussinson R, Onyedire NG, Onyishi IE, Osin E, Özden S, Panagiotopoulou P, Pereverziev O, Perez-Floriano LR, Pirttilä-Backman AM, Pogosyan M, Raver J, Reyna C, Rodrigues RB, Romanò S, Romero PP, Sakki I, Sánchez A, Sherbaji S, Simpson B, Spadoni L, Stamkou E, Travaglino GA, Van Lange PAM, Winata FF, Zein RA, Zhang QP, Eriksson K. Changes in social norms during the early stages of the COVID-19 pandemic across 43 countries. Nat Commun 2024; 15:1436. [PMID: 38365869 PMCID: PMC10873354 DOI: 10.1038/s41467-024-44999-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/12/2024] [Indexed: 02/18/2024] Open
Abstract
The emergence of COVID-19 dramatically changed social behavior across societies and contexts. Here we study whether social norms also changed. Specifically, we study this question for cultural tightness (the degree to which societies generally have strong norms), specific social norms (e.g. stealing, hand washing), and norms about enforcement, using survey data from 30,431 respondents in 43 countries recorded before and in the early stages following the emergence of COVID-19. Using variation in disease intensity, we shed light on the mechanisms predicting changes in social norm measures. We find evidence that, after the emergence of the COVID-19 pandemic, hand washing norms increased while tightness and punishing frequency slightly decreased but observe no evidence for a robust change in most other norms. Thus, at least in the short term, our findings suggest that cultures are largely stable to pandemic threats except in those norms, hand washing in this case, that are perceived to be directly relevant to dealing with the collective threat.
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Grants
- 2016.0167. Knut och Alice Wallenbergs Stiftelse (Knut and Alice Wallenberg Foundation)
- 20178TRM3F Ministero dell'Istruzione, dell'Università e della Ricerca (Ministry of Education, University and Research)
- 019.183SG.001 Nederlandse Organisatie voor Wetenschappelijk Onderzoek (Netherlands Organisation for Scientific Research)
- Ministero dell'Istruzione, dell'Università e della Ricerca (Ministry of Education, University and Research)
- Czech Science Foundation, 20-01214S Institute of Psychology, Czech Academy of Sciences, RVO: 68081740 Grant 23-061770S of the Czech Science Foundation RVO: 68081740 of the Institute of Psychology, Czech Academy of Sciences
- Shimabara Science Promotion Foundation
- RA Science Committee, research project N.20TTSH-020
- Open University of Israel, 511687
- HSE University Basic Research Program
- US Army Research Office Grant W911NF-19-1-910281
- Netherlands Organisation for Scientific Research, 019.183SG.001 Netherlands Organisation for Scientific Research, VI.Veni.201G.013 European Commission, Horizon 2020-ID 870827
- UKRI Grant “Secret Power” No. EP/X02170X/1 awarded under the European Commission’s “European Research Council - STG” Scheme
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Affiliation(s)
- Giulia Andrighetto
- Institute of Cognitive Sciences and Technologies, National Research Council of Italy, Rome, Italy.
- Institute for Futures Studies, Stockholm, Sweden.
- Institute for Analytical Sociology, Linköping University, Linköping, Sweden.
| | - Aron Szekely
- Institute of Cognitive Sciences and Technologies, National Research Council of Italy, Rome, Italy
- Collegio Carlo Alberto, Turin, Italy
| | - Andrea Guido
- Institute of Cognitive Sciences and Technologies, National Research Council of Italy, Rome, Italy
- Institute for Futures Studies, Stockholm, Sweden
- CEREN EA 7477, Burgundy School of Business, Université Bourgogne Franche-Comté, Dijon, France
| | - Michele Gelfand
- Graduate School of Business and Department of Psychology, Stanford University, Stanford, USA
| | - Jered Abernathy
- Department of Sociology, University of South Carolina, Columbia, USA
| | - Gizem Arikan
- Department of Political Science, Trinity College Dublin, Dublin, Ireland
| | - Zeynep Aycan
- Department of Psychology, Koç University, Istanbul, Turkey
- Faculty of Management, Koç University, Istanbul, Turkey
| | | | - Davide Barrera
- Collegio Carlo Alberto, Turin, Italy
- Department of Culture, Politics, and Society, University of Turin, Turin, Italy
| | | | - Anabel Belaus
- Instituto de Investigaciones Psicológicas (IIPsi), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET); CABA, Córdoba, Argentina
- Facultad de Psicología, Universidad Nacional de Córdoba (UNC), Córdoba, Argentina
| | | | - Sheyla Blumen
- Departamento de Psicología, Pontificia Universidad Católica del Perú, Lima, Perú
| | | | | | - Juan Camilo Cárdenas
- Universidad de los Andes, Bogota, Colombia
- University of Massachusetts Amherst, Amherst, USA
| | - Đorđe Čekrlija
- Faculty of Philosophy, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
- Institute of Psychology, University of Greifswald, Greifswald, Germany
| | - Mícheál de Barra
- Centre for Culture and Evolution, Brunel University London, Uxbridge, UK
| | | | - Angela Dorrough
- Department of Psychology, University of Cologne, Cologne, Germany
| | - Jan B Engelmann
- Center for Research in Experimental Economics and Political Decision Making (CREED), Amsterdam School of Economics, University of Amsterdam, Amsterdam, The Netherlands
| | - Hyun Euh
- Gies College of Business, University of Illinois at Urbana-Champaign, Champaign, USA
| | - Susann Fiedler
- Vienna University of Economics and Business, Vienna, Austria
| | | | - Gonçalo Freitas
- Instituto de Ciências Sociais, Universidade de Lisboa, Lisboa, Portugal
| | - Marta Fülöp
- HUN-REN Institute of Cognitive Neuroscience and Psychology, Research Centre of Natural Sciences, Budapest, Hungary
- Institute of Psychology, Karoli Gáspár University of the Reformed Churches, Budapest, Hungary
| | | | | | - Andreas Glöckner
- Department of Psychology, University of Cologne, Cologne, Germany
| | - Sylvie Graf
- Institute of Psychology, Czech Academy of Sciences, Brno, Czech Republic
| | - Ani Grigoryan
- Department of Personality Psychology, Yerevan State University, Yerevan, Armenia
| | | | | | - Tim Hopthrow
- School of Psychology, University of Kent, Canterbury, UK
| | - Martina Hřebíčková
- Institute of Psychology, Czech Academy of Sciences, Brno, Czech Republic
| | | | | | - Hansika Kapoor
- Department of Psychology, Monk Prayogshala, Mumbai, India
| | - Yoshihisa Kashima
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Narine Khachatryan
- Department of Personality Psychology, Yerevan State University, Yerevan, Armenia
| | | | | | - Lisa M Leslie
- Stern School of Business, New York University, New York, USA
| | - Yang Li
- Nagoya University, Nagoya, Japan
| | - Kadi Liik
- School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Marco Tullio Liuzza
- Department of Medical and Surgical Sciences, "Magna Græcia" University of Catanzaro, Catanzaro, Italy
| | - Angela T Maitner
- Department of Psychology, American University of Sharjah, Sharjah, United Arab Emirates
| | | | - Michele McArdle
- Department of Political Science, Trinity College Dublin, Dublin, Ireland
| | - Imed Medhioub
- Department of Finance and Investment, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | | | - Sari Mentser
- The Hebrew University of Jerusalem, Jerusalem, Israel
| | | | | | | | - Ravit Nussinson
- Department of Education and Psychology, The Open University of Israel, Ra'anana, Israel
- Institute of Information Processing and Decision Making (IIPDM), University of Haifa, Haifa, Israel
| | | | - Ike E Onyishi
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
| | | | - Seniha Özden
- Department of Psychology, Koç University, Istanbul, Turkey
| | | | | | | | | | - Marianna Pogosyan
- Leadership and Management, Amsterdam Business School (ABS), University of Amsterdam, Amsterdam, The Netherlands
| | - Jana Raver
- Queen's University at Kingston, Ontario, Canada
| | - Cecilia Reyna
- Instituto de Investigaciones Psicológicas (IIPsi), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET); CABA, Córdoba, Argentina
| | - Ricardo Borges Rodrigues
- Centro de Investigação e Intervenção Social, Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
| | - Sara Romanò
- Department of Culture, Politics, and Society, University of Turin, Turin, Italy
| | - Pedro P Romero
- School of Economics, Universidad San Francisco de Quito, Quito, Ecuador
- Experimental and Computational Economics Lab (ECEL), Universidad San Francisco de Quito, Quito, Ecuador
| | - Inari Sakki
- Faculty of Social Sciences, Social Psychology, University of Helsinki, Helsinki, Finland
| | - Angel Sánchez
- Grupo Interdisciplinar de Sistemas Complejos (GISC), Departamento de Matemáticas, Universidad Carlos III de Madrid, Leganés, Spain
- Instituto de Biocomputación y Física de Sistemas Complejos (BIFI), Universidad de Zaragoza, Zaragoza, Spain
| | - Sara Sherbaji
- Department of Psychology, American University of Sharjah, Sharjah, United Arab Emirates
- Department of Anthropology, University College London, London, UK
| | - Brent Simpson
- Department of Sociology, University of South Carolina, Columbia, USA
| | - Lorenzo Spadoni
- Department of Economics and Law, University of Cassino and Southern Lazio, Cassino (FR), Italy
| | - Eftychia Stamkou
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Paul A M Van Lange
- Department of Experimental and Applied Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | | | | | | | - Kimmo Eriksson
- Institute for Futures Studies, Stockholm, Sweden
- Center for Cultural Evolution, Stockholm University, Stockholm, Sweden
- Malardalens University, Vasteras, Sweden
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de Barra M, Hakimy K, de Bruin M. Signalling need for care: a neglected functional role of medical treatment. Evol Med Public Health 2023; 11:363-378. [PMID: 37899938 PMCID: PMC10611421 DOI: 10.1093/emph/eoad024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 07/07/2023] [Indexed: 10/31/2023] Open
Abstract
Background and Objectives While the primary goals of medical treatment are typically to shorten illness or relieve symptoms, we explore the idea that an important additional goal for some patients is to communicate their needs. Drawing on signalling theory, we argue that undergoing treatments can help patients legitimize their illness and thereby enable access to crucial support during convalescence. Methods and Results Four pre-registered within-subjects experiments (n = 874) show that participants are more inclined to provide care to people who undergo treatment, especially when that treatment is painful. Results show this incentivizes the use of antibiotic treatments for viral infections as well as drug treatments for mental illness. A cross-sectional study of 194 chronic pain patients shows that those who experience stigma and doubt over the legitimacy of their illness are more likely to accept aversive treatments. Furthermore, two experiments (n = 653) indicate that subtle manipulations of one's sense of social support may increase willingness to accept treatment. Conclusions and Implications These results indicate that people make decisions to provide care in part based on the presence or absence of treatment and furthermore that patients' treatment decision-making is informed by the social consequences of their choices. Signalling theory may help explain the surprising longevity of some ineffective and costly medical procedures.
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Affiliation(s)
- Mícheál de Barra
- Centre for Culture and Evolution, Brunel University London, London, UK
| | - Kawthar Hakimy
- Division of Psychology, Brunel University London, London, UK
| | - Marijn de Bruin
- Health Psychology Group, University of Aberdeen, Aberdeen, UK
- Radboud University Medical Centre, Radboud Institute of Health Sciences, IQ Healthcare, Nijmegen, Netherlands
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4
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Abstract
AbstractThis paper discusses the ethics of public health communication. We argue that a number of commonplace tools of public health communication risk qualifying as non-honest and question whether or not using such tools is ethically justified. First, we introduce the concept of honesty and suggest some reasons for thinking it is morally desirable. We then describe a number of common ways in which public health communication presents information about health-promoting interventions. These include the omission of information about the magnitude of benefits people can expect from health-promoting interventions, and failure to report uncertainty associated with the outcomes of interventions. Next we outline some forms of behaviour which are generally recognised by philosophers as being non-honest, including deception, manipulation, and so on. Finally, we suggest that many of the public health communicative practices identified earlier share features with the non-honest behaviours described and suggest this warrants reflection upon whether such non-honesty is justified by the goals of public health communication.
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5
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Brown RCH, de Barra M, Earp BD. Broad Medical Uncertainty and the ethical obligation for openness. Synthese 2022; 200:121. [PMID: 35431349 PMCID: PMC8994926 DOI: 10.1007/s11229-022-03666-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 03/20/2022] [Indexed: 06/14/2023]
Abstract
This paper argues that there exists a collective epistemic state of 'Broad Medical Uncertainty' (BMU) regarding the effectiveness of many medical interventions. We outline the features of BMU, and describe some of the main contributing factors. These include flaws in medical research methodologies, bias in publication practices, financial and other conflicts of interest, and features of how evidence is translated into practice. These result in a significant degree of uncertainty regarding the effectiveness of many medical treatments and unduly optimistic beliefs about the benefit/harm profiles of such treatments. We argue for an ethical presumption in favour of openness regarding BMU as part of a 'Corrective Response'. We then consider some objections to this position (the 'Anti-Corrective Response'), including concerns that public honesty about flaws in medical research could undermine trust in healthcare institutions. We suggest that, as it stands, the Anti-Corrective Response is unconvincing.
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Affiliation(s)
| | - Mícheál de Barra
- Centre for Culture and Evolution, Brunel University London, London, UK
| | - Brian D. Earp
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
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6
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van Leeuwen F, Inbar Y, Petersen MB, Aarøe L, Barclay P, Barlow FK, de Barra M, Becker DV, Borovoi L, Choi J, Consedine NS, Conway JR, Conway P, Adoric VC, Demirci E, Fernández AM, Ferreira DCS, Ishii K, Jakšić I, Ji T, Jonaityte I, Lewis DMG, Li NP, McIntyre JC, Mukherjee S, Park JH, Pawlowski B, Pizarro D, Prokop P, Prodromitis G, Rantala MJ, Reynolds LM, Sandin B, Sevi B, Srinivasan N, Tewari S, Yong JC, Žeželj I, Tybur JM. Disgust sensitivity relates to attitudes toward gay men and lesbian women across 31 nations. Group Processes & Intergroup Relations 2022. [DOI: 10.1177/13684302211067151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Previous work has reported a relation between pathogen-avoidance motivations and prejudice toward various social groups, including gay men and lesbian women. It is currently unknown whether this association is present across cultures, or specific to North America. Analyses of survey data from adult heterosexuals ( N = 11,200) from 31 countries showed a small relation between pathogen disgust sensitivity (an individual-difference measure of pathogen-avoidance motivations) and measures of antigay attitudes. Analyses also showed that pathogen disgust sensitivity relates not only to antipathy toward gay men and lesbians, but also to negativity toward other groups, in particular those associated with violations of traditional sexual norms (e.g., prostitutes). These results suggest that the association between pathogen-avoidance motivations and antigay attitudes is relatively stable across cultures and is a manifestation of a more general relation between pathogen-avoidance motivations and prejudice towards groups associated with sexual norm violations.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Leah Borovoi
- National Institute for Testing and Evaluation, Israel
| | | | | | | | | | | | | | | | | | | | | | | | | | - David M. G. Lewis
- College of Science, Health, Engineering and Education, and Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Australia
| | | | | | | | | | | | | | - Pavol Prokop
- Comenius University, Slovakia
- Slovak Academy of Sciences, Slovakia
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7
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Eriksson K, Strimling P, Gelfand M, Wu J, Abernathy J, Akotia CS, Aldashev A, Andersson PA, Andrighetto G, Anum A, Arikan G, Aycan Z, Bagherian F, Barrera D, Basnight-Brown D, Batkeyev B, Belaus A, Berezina E, Björnstjerna M, Blumen S, Boski P, Bou Zeineddine F, Bovina I, Huyen BTT, Cardenas JC, Čekrlija Đ, Choi HS, Contreras-Ibáñez CC, Costa-Lopes R, de Barra M, de Zoysa P, Dorrough A, Dvoryanchikov N, Eller A, Engelmann JB, Euh H, Fang X, Fiedler S, Foster-Gimbel OA, Fülöp M, Gardarsdottir RB, Gill CMHD, Glöckner A, Graf S, Grigoryan A, Gritskov V, Growiec K, Halama P, Hartanto A, Hopthrow T, Hřebíčková M, Iliško D, Imada H, Kapoor H, Kawakami K, Khachatryan N, Kharchenko N, Khoury N, Kiyonari T, Kohút M, Linh LT, Leslie LM, Li Y, Li NP, Li Z, Liik K, Maitner AT, Manhique B, Manley H, Medhioub I, Mentser S, Mohammed L, Nejat P, Nipassa O, Nussinson R, Onyedire NG, Onyishi IE, Özden S, Panagiotopoulou P, Perez-Floriano LR, Persson MS, Pheko M, Pirttilä-Backman AM, Pogosyan M, Raver J, Reyna C, Rodrigues RB, Romanò S, Romero PP, Sakki I, San Martin A, Sherbaji S, Shimizu H, Simpson B, Szabo E, Takemura K, Tieffi H, Mendes Teixeira ML, Thanomkul N, Tiliouine H, Travaglino GA, Tsirbas Y, Wan R, Widodo S, Zein R, Zhang QP, Zirganou-Kazolea L, Van Lange PAM. Perceptions of the appropriate response to norm violation in 57 societies. Nat Commun 2021; 12:1481. [PMID: 33674587 PMCID: PMC7935962 DOI: 10.1038/s41467-021-21602-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 01/29/2021] [Indexed: 11/23/2022] Open
Abstract
Norm enforcement may be important for resolving conflicts and promoting cooperation. However, little is known about how preferred responses to norm violations vary across cultures and across domains. In a preregistered study of 57 countries (using convenience samples of 22,863 students and non-students), we measured perceptions of the appropriateness of various responses to a violation of a cooperative norm and to atypical social behaviors. Our findings highlight both cultural universals and cultural variation. We find a universal negative relation between appropriateness ratings of norm violations and appropriateness ratings of responses in the form of confrontation, social ostracism and gossip. Moreover, we find the country variation in the appropriateness of sanctions to be consistent across different norm violations but not across different sanctions. Specifically, in those countries where use of physical confrontation and social ostracism is rated as less appropriate, gossip is rated as more appropriate. Little is known about people’s preferred responses to norm violations across countries. Here, in a study of 57 countries, the authors highlight cultural similarities and differences in people’s perception of the appropriateness of norm violations.
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Affiliation(s)
- Kimmo Eriksson
- Center for Cultural Evolution, Stockholm University, Stockholm, Sweden. .,Mälardalen University, Västerås, Sweden.
| | | | - Michele Gelfand
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Junhui Wu
- CAS Key Laboratory of Behavioral Sciences, Chinese Academy of Sciences, Chaoyang District, Beijing, China
| | - Jered Abernathy
- Department of Sociology, University of South Carolina, Columbia, SC, USA
| | - Charity S Akotia
- Department of Psychology, University of Ghana, P.O. Box LG 84 Legon, Accra, Ghana
| | - Alisher Aldashev
- New School of Economics, Satbayev University, Almaty, Kazakhstan
| | - Per A Andersson
- Center for Cultural Evolution, Stockholm University, Stockholm, Sweden.,Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
| | - Giulia Andrighetto
- Mälardalen University, Västerås, Sweden.,Institute for Futures Studies, Box 591, Stockholm, Sweden.,Institute of Cognitive Sciences and Technologies, National Research Council of Italy, Rome, Italy
| | - Adote Anum
- Department of Psychology, University of Ghana, P.O. Box LG 84 Legon, Accra, Ghana
| | - Gizem Arikan
- Department of Political Science, Trinity College Dublin, Dublin 2, Ireland
| | - Zeynep Aycan
- Koç University, Rumelifeneri, Sarıyer Rumelifeneri Yolu, Istanbul, Turkey
| | - Fatemeh Bagherian
- Department of Psychology and Education, Shahid Beheshti University, Tehran, Iran
| | - Davide Barrera
- University of Turin and Collegio Carlo Alberto, Turin, Italy
| | - Dana Basnight-Brown
- United States International University - Africa, Box 14634 00800, Nairobi, Kenya
| | - Birzhan Batkeyev
- International School of Economics, Kazakh-British Technical University, Almaty, Kazakhstan
| | - Anabel Belaus
- Instituto de Investigaciones Psicológicas (IIPsi), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), CABA, República Argentina.,Universidad Nacional de Córdoba (UNC). Facultad de Psicología (UNC), Ciudad Universitaria, Bv. de la Reforma esquina, Enfermera Gordillo s/n, Córdoba, Argentina
| | - Elizaveta Berezina
- Sunway University, No. 5, Jalan Universiti, Bandar Sunway, Selangor, Darul Ehsan, Malaysia
| | | | - Sheyla Blumen
- Departamento de Psicología, Pontificia Universidad Católica del Perú, San Miguel, Lima, Peru
| | - Paweł Boski
- SWPS University of Social Sciences and Humanities, Warsaw, Chodakowska, Poland
| | | | - Inna Bovina
- Moscow State University of Psychology and Education, Moscow, Russia
| | - Bui Thi Thu Huyen
- Hanoi National University of Education, Cau Giay District, Hanoi, Vietnam
| | | | - Đorđe Čekrlija
- Faculty of philosophy, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Hoon-Seok Choi
- Department of Psychology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Carlos C Contreras-Ibáñez
- Departamento de Sociología, Universidad Autónoma Metropolitana - Unidad Iztapalapa, Ciudad de México, Mexico
| | - Rui Costa-Lopes
- Instituto de Ciências Sociais, Universidade de Lisboa, Lisboa, Portugal
| | - Mícheál de Barra
- Center for Culture and Evolution, Brunel University London, Uxbridge, UK
| | | | - Angela Dorrough
- Department of Psychology, University of Cologne, Cologne, Germany
| | | | - Anja Eller
- Facultad de Psicología, Universidad Nacional Autónoma de México. Av. Universidad 3004, Ciudad Universitaria, Ciudad de México, Mexico
| | - Jan B Engelmann
- Center for Research in Experimental Economics and Political Decision Making (CREED), Amsterdam School of Economics, University of Amsterdam, P.O. Box 15867, Amsterdam, NJ, The Netherlands
| | - Hyun Euh
- Department of Psychology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Xia Fang
- Department of Psychology, York University, Toronto, ON, Canada
| | - Susann Fiedler
- Max Planck Institute for Research on Collective Goods, Bonn, Germany
| | | | - Márta Fülöp
- Institute for Cognitive Neuroscience and Psychology, Research Centre of Natural Sciences, Budapest, Hungary.,Eötvös Loránd University, Faculty of Psychology and Education, Budapest, Hungary
| | | | - C M Hew D Gill
- Sunway University, No. 5, Jalan Universiti, Bandar Sunway, Selangor, Darul Ehsan, Malaysia
| | - Andreas Glöckner
- Department of Psychology, University of Cologne, Cologne, Germany.,Max Planck Institute for Research on Collective Goods, Bonn, Germany
| | - Sylvie Graf
- Institute of Psychology, Czech Academy of Sciences, Brno, Czech Republic
| | - Ani Grigoryan
- Department of Personality Psychology, Yerevan State University, Yerevan, Armenia
| | | | - Katarzyna Growiec
- SWPS University of Social Sciences and Humanities, Warsaw, Chodakowska, Poland
| | - Peter Halama
- Center for Social and Psychological Sciences, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Andree Hartanto
- School of Social Sciences, Singapore Management University, Singapore, Singapore
| | - Tim Hopthrow
- School of Psychology, University of Kent, Canterbury, UK
| | - Martina Hřebíčková
- Institute of Psychology, Czech Academy of Sciences, Brno, Czech Republic
| | | | - Hirotaka Imada
- School of Psychology, University of Kent, Canterbury, UK
| | | | - Kerry Kawakami
- Department of Psychology, York University, Toronto, ON, Canada
| | - Narine Khachatryan
- Department of Personality Psychology, Yerevan State University, Yerevan, Armenia
| | | | | | - Toko Kiyonari
- Aoyama Gakuin University, Sagamihara-city, Kanagawa, Japan
| | - Michal Kohút
- Faculty of Philosophy and Arts, University of Trnava, Trnava, Slovakia
| | - Lê Thuỳ Linh
- National Economics University, Hai Ba Trung, Dong Tam District, Hanoi, Vietnam
| | - Lisa M Leslie
- New York University, Stern School of Business, New York, NY, 10012, USA
| | - Yang Li
- Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi, Japan.,Melbourne School of Psychological Science, University of Melbourne, Parkville, VIC, Australia
| | - Norman P Li
- School of Social Sciences, Singapore Management University, Singapore, Singapore
| | - Zhuo Li
- Department of Psychology, University of Western Ontario, London, ON, Canada
| | - Kadi Liik
- School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Angela T Maitner
- Department of International Studies, American University of Sharjah, PO Box 26666, Sharjah, United Arab Emirates
| | - Bernardo Manhique
- Eduardo Mondlane University, Faculty of Arts and Social Sciences, Department of Sociology, Maputo, Mozambique
| | - Harry Manley
- Faculty of Psychology, Chulalongkorn University, Bangkok, Thailand
| | - Imed Medhioub
- Department of Finance and Investment, Al Imam Mohammad Ibn Saud Islamic University (IMSIU), P.O. Box 5701, Riyadh, Saudi Arabia
| | | | - Linda Mohammed
- Institute of Criminology and Public Safety, Valsayn Campus, Graver Road, Valsayn, University of Trinidad and Tobago, Arima, Trinidad and Tobago
| | - Pegah Nejat
- Department of Psychology and Education, Shahid Beheshti University, Tehran, Iran
| | - Orlando Nipassa
- Eduardo Mondlane University, Faculty of Arts and Social Sciences, Department of Sociology, Maputo, Mozambique
| | - Ravit Nussinson
- The Open University of Israel, Raanana, Israel.,University of Haifa, Haifa, Israel
| | - Nneoma G Onyedire
- Department of Psychology, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Ike E Onyishi
- Department of Psychology, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Seniha Özden
- Koç University, Rumelifeneri, Sarıyer Rumelifeneri Yolu, Istanbul, Turkey
| | | | | | | | - Mpho Pheko
- Department of Psychology, University of Botswana, Private Bag UB 00705, Gaborone, Botswana
| | - Anna-Maija Pirttilä-Backman
- University of Helsinki, Faculty of Social Sciences, Social Psychology, PO Box 54 (Unioninkatu 37), Helsinki, Finland
| | - Marianna Pogosyan
- Politics, Psychology, Law and Economics (PPLE), University of Amsterdam, PO Box 15575, Amsterdam, The Netherlands
| | - Jana Raver
- Queen's University, Goodes Hall, Queen's University, Kingston, ON, Canada
| | - Cecilia Reyna
- Instituto de Investigaciones Psicológicas (IIPsi), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), CABA, República Argentina
| | | | - Sara Romanò
- Department of Culture, Politics and Society, University of Turin, Turin, Italy
| | - Pedro P Romero
- Experimental and Computational Economics Lab (ECEL), School of Economics, Universidad San Francisco de Quito, Diego de Robles y Pampite, Quito, Ecuador
| | - Inari Sakki
- University of Eastern Finland, Department of Social Sciences, P.O. Box 162770211, Kuopio, Finland
| | | | - Sara Sherbaji
- Department of International Studies, American University of Sharjah, PO Box 26666, Sharjah, United Arab Emirates
| | | | - Brent Simpson
- Department of Sociology, University of South Carolina, Columbia, SC, USA
| | - Erna Szabo
- Department of International Management, Johannes Kepler University, Linz, Austria
| | - Kosuke Takemura
- Faculty of Economics, Shiga University, Hikone, Shiga, Japan
| | - Hassan Tieffi
- Université Félix Houphouët-Boigny Cocody-Abidjan, Centre Ivoirien d'Etude et de Recherche en Psychologie Appliquée (CIERPA), Abidjan, Côte d'Ivoire
| | | | - Napoj Thanomkul
- Faculty of Psychology, Chulalongkorn University, Bangkok, Thailand
| | - Habib Tiliouine
- Labo-PECS, Faculty of Social Sciences, Université d'Oran 2, Oran, Algeria
| | - Giovanni A Travaglino
- School of Psychology, University of Kent, Canterbury, UK.,School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Longgang District, Shenzhen, P. R. China
| | - Yannis Tsirbas
- University of Athens, Department of Political Science and Public Administration, Athens, Greece
| | - Richard Wan
- Department of International Management, Johannes Kepler University, Linz, Austria
| | - Sita Widodo
- Department of Personality and Social Psychology, Universitas Airlangga, Surabaya, Indonesia
| | - Rizqy Zein
- Department of Personality and Social Psychology, Universitas Airlangga, Surabaya, Indonesia
| | - Qing-Peng Zhang
- Guangzhou University, Guangzhou Higher Education Mega Center, Guangzhou, P.R. China
| | - Lina Zirganou-Kazolea
- University of Athens, Department of Political Science and Public Administration, Athens, Greece
| | - Paul A M Van Lange
- VU Amsterdam, Department of Experimental and Applied Psychology, Institute for Brain and Behavior Amsterdam (IBBA), Amsterdam, Amsterdam, The Netherlands
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de Barra M, Gon G, Woodd S, Graham WJ, de Bruin M, Kahabuka C, Williams AJ, Konate K, Ali SM, Said R, Penn-Kekana L. Understanding infection prevention behaviour in maternity wards: A mixed-methods analysis of hand hygiene in Zanzibar. Soc Sci Med 2021; 272:113543. [PMID: 33578309 PMCID: PMC7938378 DOI: 10.1016/j.socscimed.2020.113543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 12/16/2022]
Abstract
RATIONALE Although women in low- and middle-income countries are increasingly encouraged to give birth at facilities, healthcare-associated infection of both the mother and newborn remain common. An important cause of infection is poor hand hygiene. There is a need to understand how environmental, behavioural, and organisational factors influence hygiene practice. OBJECTIVE To understand variations between facilities and between people in hygiene behaviour and to explore potential intervention targets in four labour wards in Zanzibar. METHODS Site visits including observation of deliveries and of day-to-day workings of the facilities. Thirty-three semi-structured interviews, totalling more than 46 hours, with birth attendants, orderlies, managerial staff and mothers. Transcribed interviews and observation notes were read and coded by two authors. Themes were developed and analysed in light of existing research. RESULTS The physical preconditions for hand hygiene were met more regularly in the two highvolume facilities, where soap, water, gloves were almost always available. However, in all of the facilities, hand hygiene appeared impeded by poor ergonomics, like, for example, physical distance between water taps, gloves, or delivery beds. Recontamination of gloved hands following good hand hygiene was commonly observed, a pattern that the birth attendants attributed to high and unpredictable workload and equipment shortages. Interviews and focus groups suggested that birth attendants typically understood when and why hand hygiene should be implemented, and that they were aware of low handwashing rates among co-workers. In poorer performing facilities, managers were less inclined to visit wards and more likely to perceive hand hygiene as beyond their influence. CONCLUSIONS Observations and interviews suggest improvements in the ergonomic design of delivery rooms, including convenient availability of sinks, soap, hand gel, hand towels and gloves, may be a low-cost way to reduce the infection burden from poor hand hygiene.
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Affiliation(s)
| | - Giorgia Gon
- London School of Hygiene and Tropical Medicine, UK
| | | | - Wendy J Graham
- University of Aberdeen, UK; London School of Hygiene and Tropical Medicine, UK
| | - Marijn de Bruin
- University of Aberdeen, UK; IQ Healthcare, Radboud University Medical Centre, the Netherlands
| | | | | | | | - Said M Ali
- Public Health Laboratory Ivo de Carneri, Zanzibar
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9
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Gon G, Ali SM, Aunger R, Campbell OM, de Barra M, de Bruin M, Juma M, Nash S, Tajo A, Westbrook J, Woodd S, Graham WJ. A Practical Guide to Using Time-and-Motion Methods to Monitor Compliance With Hand Hygiene Guidelines: Experience From Tanzanian Labor Wards. Glob Health Sci Pract 2020; 8:827-837. [PMID: 33361245 PMCID: PMC7784080 DOI: 10.9745/ghsp-d-20-00221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/19/2020] [Indexed: 12/05/2022]
Abstract
Understanding hand hygiene behaviors is critical in hospitals. We developed the HANDS at birth tool—and provide information on its design and implementation–to capture the complex patterns of health care workers’ hand hygiene including hand rubbing/washing, glove use, and recontamination. Background: Good-quality evidence on hand hygiene compliance among birth attendants in low-resource labor wards is limited. The World Health Organization Hand Hygiene Observation Form is widely used for directly observing behaviors, but it does not support capturing complex patterns of behavior. We developed the HANDS at Birth tool for direct observational studies of complex patterns of hand rubbing/washing, glove use, recontamination, and their determinants among birth attendants. Understanding these behaviors is particularly critical in wards with variable patient volumes or unpredictable patient complications, such as emergency departments, operating wards, or triage and isolation wards during epidemics. Here we provide detailed information on the design and implementation of the HANDS at Birth tool, with a particular focus on low-resource settings. We developed the HANDS at Birth tool from available guidelines, unstructured observation, and iterative refinement based on consultation with collaborators and pilot results. We designed the tool with WOMBAT software, which supports collecting multidimensional time-and-motion data. Our analysis of the tool’s performance centered on interobserver agreement and convergent validity and the implications of the data structure for data analysis. The HANDS at Birth tool encompasses various hand actions and context-relevant information. Hand actions include procedures relevant during labor and delivery; hand hygiene or glove actions; and other types of touch. During field implementation, we used the tool for continuous observation of the birth attendant. Interobserver agreement was good (kappa range: 0.7–0.9), and the tool showed convergent validity. Using the HANDS at Birth tool is a feasible way to obtain useful information about compliance with hand hygiene procedures. The tool could be used after simple training and allows for collection of reliable information about the complex pattern of hygiene behaviors. Future studies should explore using this tool to observe behavior in labor wards in other settings and in other types of wards.
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Affiliation(s)
- Giorgia Gon
- London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Said M Ali
- Public Health Laboratory-Ivo de Carneri, Pemba, Zanzibar, Tanzania
| | - Robert Aunger
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Oona M Campbell
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mícheál de Barra
- Brunel University London, Department of Life Sciences, Uxbridge, United Kingdom
| | - Marijn de Bruin
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.,Department of IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Mohammed Juma
- Public Health Laboratory-Ivo de Carneri, Pemba, Zanzibar, Tanzania
| | - Stephen Nash
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Amour Tajo
- Public Health Laboratory-Ivo de Carneri, Pemba, Zanzibar, Tanzania
| | | | - Susannah Woodd
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Wendy J Graham
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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10
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Gon G, de Barra M, Dansero L, Nash S, Campbell OMR. Birth attendants' hand hygiene compliance in healthcare facilities in low and middle-income countries: a systematic review. BMC Health Serv Res 2020; 20:1116. [PMID: 33267879 PMCID: PMC7713338 DOI: 10.1186/s12913-020-05925-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 11/15/2020] [Indexed: 12/13/2022] Open
Abstract
Background With an increasing number of women delivering in healthcare facilities in Low and Middle Income Countries (LMICs), healthcare workers’ hand hygiene compliance on labour wards is pivotal to preventing infections. Currently there are no estimates of how often birth attendants comply with hand hygiene, or of the factors influencing compliance in healthcare facilities in LMICs. Methods We conducted a systematic review to investigate the a) level of compliance, b) determinants of compliance and c) interventions to improve hand hygiene during labour and delivery among birth attendants in healthcare facilities of LMICs. We also aimed to assess the quality of the included studies and to report the intra-cluster correlation for studies conducted in multiple facilities. Results We obtained 797 results across four databases and reviewed 71 full texts. Of these, fifteen met our inclusion criteria. Overall, the quality of the included studies was particularly compromised by poorly described sampling methods and definitions. Hand hygiene compliance varied substantially across studies from 0 to 100%; however, the heterogeneity in definitions of hand hygiene did not allow us to combine or compare these meaningfully. The five studies with larger sample sizes and clearer definitions estimated compliance before aseptic procedures opportunities, to be low (range: 1–38%). Three studies described two multi-component interventions, both were shown to be feasible. Conclusions Hand hygiene compliance was low for studies with larger sample sizes and clear definitions. This poses a substantial challenge to infection prevention during birth in LMICs facilities. We also found that the quality of many studies was suboptimal. Future studies of hand hygiene compliance on the labour ward should be designed with better sampling frames, assess inter-observer agreement, use measures to improve the quality of data collection, and report their hand hygiene definitions clearly.
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Affiliation(s)
- Giorgia Gon
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Mícheál de Barra
- Brunel University London, Department of Life Sciences, Uxbridge, UK
| | | | - Stephen Nash
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Oona M R Campbell
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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Scott C, de Barra M, Johnston M, de Bruin M, Scott N, Matheson C, Bond C, Watson MC. Using the behaviour change technique taxonomy v1 (BCTTv1) to identify the active ingredients of pharmacist interventions to improve non-hospitalised patient health outcomes. BMJ Open 2020; 10:e036500. [PMID: 32933960 PMCID: PMC7493093 DOI: 10.1136/bmjopen-2019-036500] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The aim of this study was to identify which behaviour change techniques (BCTs) were present in intervention and control groups of randomised controlled trials (RCTs) included in a Cochrane systematic review. SETTING The RCTs included were conducted in community, primary and/or ambulatory-care settings. PARTICIPANTS The data set was derived from 86 RCTs from an interim update of the Cochrane review of the effectiveness of pharmacist services on non-hospitalised patient outcomes. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the identification of BCTs scheduled for delivery in intervention and control groups of the RCTs. The secondary outcome measure was to identify which BCTs are not being utilised in intervention and control groups of the RCTs. RESULTS The intervention and control groups included 31 and 12 BCTs, respectively. The number of identifiable BCTs/study ranged from 0 to 12 in the intervention groups (mean 3.01 (SD 2.4)) and 0 to 6 in the control groups (mean 0.38 (SD 0.84)). The most commonly identified BCTs in the intervention groups were: instruction on how to perform the behaviour (55%, n=47) (also the most common BCT in control groups); problem solving (29%, n=25); information about health consequences (24%, n=21); social support (practical) (24%, n=21); and social support (unspecified) (23%, n=20) (the second most common BCT in control groups). Thirteen trials had no identifiable BCTs in either group. CONCLUSION The pharmacist interventions presented in this study did not use the full range of available BCTs. Furthermore, the reporting of BCTs was incomplete for both intervention and control groups, thereby limiting the utility and reproducibility of the interventions. Future interventions should be designed and reported using relevant taxonomies and checklists for example, BCT taxonomy and TIDieR (the template for intervention description and replication).
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Affiliation(s)
- Claire Scott
- Dental Clinical Effectiveness, NHS Education for Scotland, Dundee, UK
| | | | - Marie Johnston
- Health Psychology, University of Aberdeen Institute of Applied Health Sciences, Aberdeen, UK
| | - Marijn de Bruin
- Health Psychology, University of Aberdeen Institute of Applied Health Sciences, Aberdeen, UK
- Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, Gelderland, The Netherlands
| | - Neil Scott
- Medical Statistics, University of Aberdeen, Aberdeen, UK
| | | | - Christine Bond
- Academic Primary Care, University of Aberdeen Institute of Applied Health Sciences, Aberdeen, UK
| | - Margaret C Watson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
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12
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Gon G, Virgo S, de Barra M, Ali SM, Campbell OM, Graham WJ, Nash S, Woodd SL, de Bruin M. Behavioural Determinants of Hand Washing and Glove Recontamination before Aseptic Procedures at Birth: A Time-and-Motion Study and Survey in Zanzibar Labour Wards. Int J Environ Res Public Health 2020; 17:ijerph17041438. [PMID: 32102276 PMCID: PMC7068290 DOI: 10.3390/ijerph17041438] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 11/16/2022]
Abstract
Recent research calls for distinguishing whether the failure to comply with World Health Organisation hand hygiene guidelines is driven by omitting to rub/wash hands, or subsequently recontamination of clean hands or gloves prior to a procedure. This study examined the determinants of these two behaviours. Across the 10 highest-volume labour wards in Zanzibar, we observed 103 birth attendants across 779 hand hygiene opportunities before aseptic procedures (time-and-motion methods). They were then interviewed using a structured cross-sectional survey. We used mixed-effect multivariable logistic regressions to investigate the independent association of candidate determinants with hand rubbing/washing and avoiding glove recontamination. After controlling for confounders, we found that availability of single-use material to dry hands (OR:2.9; CI:1.58–5.14), a higher workload (OR:29.4; CI:12.9–67.0), more knowledge about hand hygiene (OR:1.89; CI:1.02–3.49), and an environment with more reminders from colleagues (OR:1.20; CI:0.98–1.46) were associated with more hand rubbing/washing. Only the length of time elapsed since donning gloves (OR:4.5; CI:2.5–8.0) was associated with avoiding glove recontamination. We identified multiple determinants of hand washing/rubbing. Only time elapsed since washing/rubbing was reliably associated with avoiding glove recontamination. In this setting, these two behaviours require different interventions. Future studies should measure them separately.
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Affiliation(s)
- Giorgia Gon
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London WC1E 7HT, UK; (O.M.C.); (W.J.G.); (S.N.); (S.L.W.)
- Correspondence:
| | - Sandra Virgo
- University of Kent, Higher Education Access Tracker, Catenrbury CT2 7NZ, UK;
| | - Mícheál de Barra
- Department of Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK;
| | - Said M. Ali
- Public Health Laboratory-Ivo de Carneri, Chake Chake, Pemba, Zanzibar 9820, Tanzania;
| | - Oona M. Campbell
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London WC1E 7HT, UK; (O.M.C.); (W.J.G.); (S.N.); (S.L.W.)
| | - Wendy J. Graham
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London WC1E 7HT, UK; (O.M.C.); (W.J.G.); (S.N.); (S.L.W.)
| | - Stephen Nash
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London WC1E 7HT, UK; (O.M.C.); (W.J.G.); (S.N.); (S.L.W.)
| | - Susannah L. Woodd
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London WC1E 7HT, UK; (O.M.C.); (W.J.G.); (S.N.); (S.L.W.)
| | - Marijn de Bruin
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB24 3FX, UK;
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, 6525 GA Nijmegen, The Netherlands
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de Barra M, Scott C, Johnston M, De Bruin M, Scott N, Matheson C, Bond C, Watson M. Do pharmacy intervention reports adequately describe their interventions? A template for intervention description and replication analysis of reports included in a systematic review. BMJ Open 2019; 9:e025511. [PMID: 31862736 PMCID: PMC6937059 DOI: 10.1136/bmjopen-2018-025511] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 05/28/2019] [Accepted: 06/25/2019] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Scientific progress and translation of evidence into practice is impeded by poorly described interventions. The Template for Intervention Description and Replication (TIDieR) was developed to specify the minimal intervention elements that should be reported. OBJECTIVES (1) To assess the extent to which outpatient pharmacy interventions were adequately reported. (2) To examine the dimension(s) across which reporting quality varies. (3) To examine trial characteristics that predict better reporting. METHODS The sample comprised 86 randomised controlled trials identified in a Cochrane review of the effectiveness of pharmacist interventions on patient health outcomes. Duplicate, independent application of a modified 15-item TIDieR checklist was undertaken to assess the intervention reporting. The reporting/non-reporting of TIDieR items was analysed with principal component analysis to evaluate the dimensionality of reporting quality and regression analyses to assess predictors of reporting quality RESULTS: In total, 422 (40%) TIDieR items were fully reported, 395 (38%) were partially reported and 231 (22%) were not reported. A further 242 items were deemed not applicable to the specific trials. Reporting quality loaded on one component which accounted for 26% of the variance in TIDieR scores. More recent trials reported a slightly greater number of TIDieR items (0.07 (95% CI 0.02 to 0.13) additional TIDieR items per year of publication). Trials reported an 0.09 (95% CI 0.04 to 0.14) additional TIDieR items per unit increase in impact factor (IF) of the journal in which the main report was published. CONCLUSIONS Most trials lacked adequate intervention reporting. This diminished the applied and scientific value of their research. The standard of intervention reporting is, however, gradually increasing and appears somewhat better in journals with higher IFs. The use of the TIDieR checklist to improve reporting could enhance the utility and replicability of trials, and reduce research waste.
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Affiliation(s)
- Mícheál de Barra
- Life Sciences, Brunel University London, Middlesex, UK
- The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Claire Scott
- The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Dental Clinical Effectiveness, NHS Education for Scotland, Dundee, UK
| | - Marie Johnston
- The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - M De Bruin
- The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud, The Netherlands
| | - Neil Scott
- The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | | | - Christine Bond
- The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Margaret Watson
- The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Department of Pharmacy & Pharmacology, University of Bath, Bath, UK
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de Barra M, Cownden D, Jansson F. Aversive medical treatments signal a need for support: a mathematical model. Evol Hum Sci 2019; 1:e4. [PMID: 37588405 PMCID: PMC10427312 DOI: 10.1017/ehs.2019.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Ineffective, aversive and harmful medical treatments are common cross-culturally, historically and today. Using evolutionary game theory, we develop the following model to explain their persistence. Humans are often incapacitated by illness and injury, and are unusually dependent on care from others during convalescence. However, such caregiving is vulnerable to exploitation via illness deception, whereby people feign or exaggerate illness in order to gain access to care. Our model demonstrates that aversive treatments can counter-intuitively increase the range of conditions where caregiving is evolutionarily viable, because only individuals who stand to gain substantially from care will accept the treatment. Thus, contemporary and historical "ineffective" treatments may be solutions to the problem of allocating care to people whose true need is difficult to discern.
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Affiliation(s)
| | | | - Fredrik Jansson
- Centre for Cultural Evolution, Stockholm University
- Division of Applied Mathematics, Mälardalen University
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15
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Abstract
Researchers have long noted that many of the multiple elicitors of disgust have some relation to infectious disease. There is an emerging consensus that disgust evolved in Animalia to direct the behaviours that reduce risk of infection, so-called 'parasite avoidance theory'. If this is correct, then the disgust motive should be structured in a manner that reflects the ways in which infectious disease can be avoided. In this study, we generated a set of items based on the epidemiology of disease transmission. These were then rated for their capacity to elicit disgust by a large, predominantly North American/UK sample and subjected to factor analysis to identify latent variables. While a number of plausible factor solutions emerged, Velicer's MAP (minimum average partial) test suggested six domains: atypical appearance, lesions, sex, hygiene, food and animals. This structure did not exactly mirror the transmission routes of infections, as we initially predicted, but it may rather reflect distinct kinds of behavioural tasks involved in avoiding disease. This finding makes sense from the perspective of a cognitive system that evolved under selection for a behavioural response to threats from the social and biological environment. We suggest that regularly occurring types of infectious disease problems have produced regularities in the domain structure of pathogen disgust and discuss the implications of these results for understanding the structure, function and measurement of motives such as disgust in humans and other animals.This article is part of the Theo Murphy meeting issue 'Evolution of pathogen and parasite avoidance behaviours'.
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Affiliation(s)
- Val Curtis
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Mícheál de Barra
- Center for Culture and Evolution, Depatment of Life Sciences, Brunel University London, Uxbridge, Middelsex UB8 3PH, UK
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16
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Gon G, de Bruin M, de Barra M, Ali SM, Campbell OM, Graham WJ, Juma M, Nash S, Kilpatrick C, Penn-Kekana L, Virgo S, Woodd S. Hands washing, glove use, and avoiding recontamination before aseptic procedures at birth: A multicenter time-and-motion study conducted in Zanzibar. Am J Infect Control 2019; 47:149-156. [PMID: 30293743 PMCID: PMC6367567 DOI: 10.1016/j.ajic.2018.07.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 07/27/2018] [Accepted: 07/27/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Our primary objective was to assess hand hygiene (HH) compliance before aseptic procedures among birth attendants in the 10 highest-volume facilities in Zanzibar. We also examined the extent to which recontamination contributes to poor HH. Recording exact recontamination occurrences is not possible using the existing World Health Organization HH audit tool. METHODS In this time-and-motion study, 3 trained coders used WOMBATv2 software to record the hand actions of all birth attendants present in the study sites. The percentage compliance and 95% confidence intervals (CIs) for individual behaviors (hand washing/rubbing, avoiding recontamination and glove use) and for behavioral sequences during labor and delivery were calculated. RESULTS We observed 104 birth attendants and 781 HH opportunities before aseptic procedures. Compliance with hand rubbing/washing was 24.6% (95% CI, 21.6-27.8). Only 9.6% (95% CI, 7.6-11.9) of birth attendants also donned gloves and avoided recontamination. Half of the time when rubbing/washing or glove donning was performed, hands were recontaminated prior to the aseptic procedure. CONCLUSIONS In this study, HH compliance by birth attendants before aseptic procedures was poor. To our knowledge, this is the first study in a low- to middle-income country to show the large contribution to poor HH compliance from hand and glove recontamination before the procedure. Recontamination is an important driver of infection risk from poor HH. It should be understood for the purposes of improvement and therefore included in HH monitoring and interventions.
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Affiliation(s)
- Giorgia Gon
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, United Kingdom.
| | - Marijn de Bruin
- University of Aberdeen, Institute of Applied Health Sciences, Aberdeen, United Kingdom
| | - Mícheál de Barra
- Brunel University London, Department of Life Sciences, Uxbridge, United Kingdom
| | - Said M Ali
- Public Health Laboratory-Ivo de Carneri, Chake Chake, Pemba, Zanzibar, Tanzania
| | - Oona M Campbell
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, United Kingdom
| | - Wendy J Graham
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, United Kingdom
| | - Mohammed Juma
- Public Health Laboratory-Ivo de Carneri, Chake Chake, Pemba, Zanzibar, Tanzania
| | - Stephen Nash
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, United Kingdom
| | - Claire Kilpatrick
- Consultant, World Health Organization IPC Global Unit, Service Delivery and Safety Department, Geneva, Switzerland
| | - Loveday Penn-Kekana
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, United Kingdom
| | - Sandra Virgo
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, United Kingdom
| | - Susannah Woodd
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, United Kingdom
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17
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de Barra M, Scott CL, Scott NW, Johnston M, de Bruin M, Nkansah N, Bond CM, Matheson CI, Rackow P, Williams AJ, Watson MC. Pharmacist services for non-hospitalised patients. Cochrane Database Syst Rev 2018; 9:CD013102. [PMID: 30178872 PMCID: PMC6513292 DOI: 10.1002/14651858.cd013102] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND This review focuses on non-dispensing services from pharmacists, i.e. pharmacists in community, primary or ambulatory-care settings, to non-hospitalised patients, and is an update of a previously-published Cochrane Review. OBJECTIVES To examine the effect of pharmacists' non-dispensing services on non-hospitalised patient outcomes. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, two other databases and two trial registers in March 2015, together with reference checking and contact with study authors to identify additional studies. We included non-English language publications. We ran top-up searches in January 2018 and have added potentially eligible studies to 'Studies awaiting classification'. SELECTION CRITERIA Randomised trials of pharmacist services compared with the delivery of usual care or equivalent/similar services with the same objective delivered by other health professionals. DATA COLLECTION AND ANALYSIS We used standard methodological procedures of Cochrane and the Effective Practice and Organisation of Care Group. Two review authors independently checked studies for inclusion, extracted data and assessed risks of bias. We evaluated the overall certainty of evidence using GRADE. MAIN RESULTS We included 116 trials comprising 111 trials (39,729 participants) comparing pharmacist interventions with usual care and five trials (2122 participants) comparing pharmacist services with services from other healthcare professionals. Of the 116 trials, 76 were included in meta-analyses. The 40 remaining trials were not included in the meta-analyses because they each reported unique outcome measures which could not be combined. Most trials targeted chronic conditions and were conducted in a range of settings, mostly community pharmacies and hospital outpatient clinics, and were mainly but not exclusively conducted in high-income countries. Most trials had a low risk of reporting bias and about 25%-30% were at high risk of bias for performance, detection, and attrition. Selection bias was unclear for about half of the included studies.Compared with usual care, we are uncertain whether pharmacist services reduce the percentage of patients outside the glycated haemoglobin target range (5 trials, N = 558, odds ratio (OR) 0.29, 95% confidence interval (CI) 0.04 to 2.22; very low-certainty evidence). Pharmacist services may reduce the percentage of patients whose blood pressure is outside the target range (18 trials, N = 4107, OR 0.40, 95% CI 0.29 to 0.55; low-certainty evidence) and probably lead to little or no difference in hospital attendance or admissions (14 trials, N = 3631, OR 0.85, 95% CI 0.65 to 1.11; moderate-certainty evidence). Pharmacist services may make little or no difference to adverse drug effects (3 trials, N = 590, OR 1.65, 95% CI 0.84 to 3.24) and may slightly improve physical functioning (7 trials, N = 1329, mean difference (MD) 5.84, 95% CI 1.21 to 10.48; low-certainty evidence). Pharmacist services may make little or no difference to mortality (9 trials, N = 1980, OR 0.79, 95% CI 0.56 to 1.12, low-certaintly evidence).Of the five studies that compared services delivered by pharmacists with other health professionals, no studies evaluated the impact of the intervention on the percentage of patients outside blood pressure or glycated haemoglobin target range, hospital attendance and admission, adverse drug effects, or physical functioning. AUTHORS' CONCLUSIONS The results demonstrate that pharmacist services have varying effects on patient outcomes compared with usual care. We found no studies comparing services delivered by pharmacists with other healthcare professionals that evaluated the impact of the intervention on the six main outcome measures. The results need to be interpreted cautiously because there was major heterogeneity in study populations, types of interventions delivered and reported outcomes.There was considerable heterogeneity within many of the meta-analyses, as well as considerable variation in the risks of bias.
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Affiliation(s)
- Mícheál de Barra
- University of AberdeenInstitute of Applied Health SciencesAberdeenUK
| | - Claire L Scott
- NHS Education for ScotlandScottish Dental Clinical Effectiveness ProgrammeDundee Dental Education CentreSmall's WyndDundeeUKDD1 4HN
| | - Neil W Scott
- University of AberdeenMedical Statistics TeamPolwarth BuildingForesterhillAberdeenScotlandUKAB 25 2 ZD
| | - Marie Johnston
- University of AberdeenInstitute of Applied Health SciencesAberdeenUK
| | - Marijn de Bruin
- University of AberdeenInstitute of Applied Health SciencesAberdeenUK
| | - Nancy Nkansah
- University of CaliforniaClinical Pharmacy155 North Fresno Street, Suite 224San FranciscoCaliforniaUSA93701
| | - Christine M Bond
- University of AberdeenDivision of Applied Health SciencesPolwarth BuildingForesterhillAberdeenUKAB25 2ZD
| | | | - Pamela Rackow
- University of AberdeenInstitute of Applied Health SciencesAberdeenUK
| | - A. Jess Williams
- Nottingham Trent UniversitySchool of PsychologyNottinghamEnglandUK
| | - Margaret C Watson
- University of BathDepartment of Pharmacy and Pharmacology5w 3.33Claverton DownBathUKBA2 7AY
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de Barra M. Reporting bias inflates the reputation of medical treatments: A comparison of outcomes in clinical trials and online product reviews. Soc Sci Med 2017; 177:248-255. [DOI: 10.1016/j.socscimed.2017.01.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 01/10/2017] [Accepted: 01/20/2017] [Indexed: 01/03/2023]
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Abstract
Research on cultural transmission among Americans has established a bias for transmitting stories that have disgusting elements (such as exposure to rats and maggots). Conceived of as a cultural evolutionary force, this phenomenon is one type of emotional selection. In a series of online studies with Americans and Indians we investigate whether there are cultural differences in emotional selection, such that the transmission process favours different kinds of content in different countries. The first study found a bias for disgusting content (rats and maggots) among Americans but not among Indians. Four subsequent studies focused on how country interacts with kind of emotional content (disgusting vs. happy surprises and good news) in reactions to transmission of stories or information. Whereas Indian participants, compared to Americans, tended to be less interested in, and excited by, transmission of stories and news involving common disgust-elicitors (like rats), the opposite pattern held for transmission of happy surprises and good news (e.g., the opening of a new public facility). We discuss various possible explanations and implications.
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Affiliation(s)
- Kimmo Eriksson
- Centre for the Study of Cultural Evolution, Stockholm UniversitySchool of Education, Communication and Culture, Mälardalen UniversitySwedenWallenberglab, se-10691 Stockholm
| | - Julie C. Coultas
- Centre for the Study of Cultural Evolution, Stockholm UniversityUniversity of SussexSwedenWallenberglab, se-10691 Stockholm
| | - Mícheál de Barra
- Centre for the Study of Cultural Evolution, Stockholm UniversitySwedenWallenberglab, se-10691 Stockholm
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de Barra M, Eriksson K, Strimling P. How feedback biases give ineffective medical treatments a good reputation. J Med Internet Res 2014; 16:e193. [PMID: 25147101 PMCID: PMC4147705 DOI: 10.2196/jmir.3214] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 05/23/2014] [Accepted: 07/14/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Medical treatments with no direct effect (like homeopathy) or that cause harm (like bloodletting) are common across cultures and throughout history. How do such treatments spread and persist? Most medical treatments result in a range of outcomes: some people improve while others deteriorate. If the people who improve are more inclined to tell others about their experiences than the people who deteriorate, ineffective or even harmful treatments can maintain a good reputation. OBJECTIVE The intent of this study was to test the hypothesis that positive outcomes are overrepresented in online medical product reviews, to examine if this reputational distortion is large enough to bias people's decisions, and to explore the implications of this bias for the cultural evolution of medical treatments. METHODS We compared outcomes of weight loss treatments and fertility treatments in clinical trials to outcomes reported in 1901 reviews on Amazon. Then, in a series of experiments, we evaluated people's choice of weight loss diet after reading different reviews. Finally, a mathematical model was used to examine if this bias could result in less effective treatments having a better reputation than more effective treatments. RESULTS Data are consistent with the hypothesis that people with better outcomes are more inclined to write reviews. After 6 months on the diet, 93% (64/69) of online reviewers reported a weight loss of 10 kg or more while just 27% (19/71) of clinical trial participants experienced this level of weight change. A similar positive distortion was found in fertility treatment reviews. In a series of experiments, we show that people are more inclined to begin a diet with many positive reviews, than a diet with reviews that are representative of the diet's true effect. A mathematical model of medical cultural evolution shows that the size of the positive distortion critically depends on the shape of the outcome distribution. CONCLUSIONS Online reviews overestimate the benefits of medical treatments, probably because people with negative outcomes are less inclined to tell others about their experiences. This bias can enable ineffective medical treatments to maintain a good reputation.
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Abstract
Disgust can be considered a psychological arm of the immune system that acts to prevent exposure to infectious agents. High disgust sensitivity is associated with greater behavioral avoidance of disease vectors and thus may reduce infection risk. A cross-sectional survey in rural Bangladesh provided no strong support for this hypothesis. In many species, the expression of pathogen- and predator-avoidance mechanisms is contingent on early life exposure to predators and pathogens. Using childhood health data collected in the 1990s, we examined if adults with more infectious diseases in childhood showed greater adult disgust sensitivity: no support for this association was found. Explanations for these null finding and possible directions for future research are discussed.
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Affiliation(s)
- Mícheál de Barra
- Environmental Health Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | | | - Val Curtis
- Environmental Health Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Abstract
Disgust is an evolved psychological system for protecting organisms from infection through disease avoidant behaviour. This ‘behavioural immune system’, present in a diverse array of species, exhibits universal features that orchestrate hygienic behaviour in response to cues of risk of contact with pathogens. However, disgust is also a dynamic adaptive system. Individuals show variation in pathogen avoidance associated with psychological traits like having a neurotic personality, as well as a consequence of being in certain physiological states such as pregnancy or infancy. Three specialized learning mechanisms modify the disgust response: the Garcia effect, evaluative conditioning and the law of contagion. Hygiene behaviour is influenced at the group level through social learning heuristics such as ‘copy the frequent’. Finally, group hygiene is extended symbolically to cultural rules about purity and pollution, which create social separations and are enforced as manners. Cooperative hygiene endeavours such as sanitation also reduce pathogen prevalence. Our model allows us to integrate perspectives from psychology, ecology and cultural evolution with those of epidemiology and anthropology. Understanding the nature of disease avoidance psychology at all levels of human organization can inform the design of programmes to improve public health.
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Affiliation(s)
- Valerie Curtis
- The Hygiene Centre, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
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Dodrill L, Schmidt WP, Cobb E, Donachie P, Curtis V, de Barra M. Male commuters in north and south England: risk factors for the presence of faecal bacteria on hands. BMC Public Health 2011; 11:31. [PMID: 21226924 PMCID: PMC3031219 DOI: 10.1186/1471-2458-11-31] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Accepted: 01/12/2011] [Indexed: 11/16/2022] Open
Abstract
Background A previous study found that the prevalence of contamination with bacteria of faecal-origin on the hands of men differed across UK cities, with a general trend of increased contamination in northern cities. The aim of this study was to (1) confirm the north-south trend (2) identify causes for the trend. Methods Hand swabs from commuters (n = 308) at train stations in 4 cities were tested for the presence of faecal bacteria. Results The prevalence of hand contamination with faecal bacteria was again higher in cities in the north compared to the south (5% in London, 4% in Birmingham, 10% in Liverpool and 19% in Newcastle). Contamination risk decreased with age and better personal hygiene (self-reported). Soil contact and shaking hands increased contamination with faecal bacteria. However, in multivariable analysis, none of these factors fully explained the variation in contamination across cities. Conclusion The study confirmed the north-south differences in faecal contamination of hands without finding a clear cause for the trend. Faecal contamination of hands was associated with personal hygiene indicators suggesting that microbiological testing may contribute to evaluating hygiene promotion campaigns.
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Affiliation(s)
- Laura Dodrill
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
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Fleischman DS, Webster GD, Judah G, de Barra M, Aunger R, Curtis VA. Sensor recorded changes in rates of hand washing with soap in response to the media reports of the H1N1 pandemic in Britain. BMJ Open 2011; 1:e000127. [PMID: 22116088 PMCID: PMC3225584 DOI: 10.1136/bmjopen-2011-000127] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objectives To examine how the frequency of information regarding a real disease threat influences hand washing with soap. Design and setting The authors installed wireless devices in highway service station lavatories in England to record the proportion of individuals washing hands with soap from May 2009 to January 2010. Participants Participants were users of men's and women's toilets. Combined there was an average of 6800 participant entrances into the lavatories daily. Primary outcome measure The primary outcome measure is the proportion of soap usage to the number of entries into the lavatories. Results Hand-washing rates were positively related to both H1NI coverage in blogs and the news; however, these relationships were stronger for men than for women. Conclusions Hand washing with soap increases proportionally to the frequency of media key words related to H1N1. Women's hand washing was more strongly associated with incidence of media keywords than men's.
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Affiliation(s)
- Diana S Fleischman
- Hygiene Centre, Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Gregory D Webster
- Department of Psychology, University of Florida, Gainesville, Florida, USA
| | - Gaby Judah
- Hygiene Centre, Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Mícheál de Barra
- Hygiene Centre, Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Robert Aunger
- Hygiene Centre, Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Valerie A Curtis
- Hygiene Centre, Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
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