Racial Attitudes, Physician-Patient Talk Time Ratio, and Adherence in Racially Discordant Medical Interactions

PubMed Central

Hagiwara, Nao; Penner, Louis A.; Gonzalez, Richard; Eggly, Susan; Dovidio, John F.; Gaertner, Samuel L.; West, Tessa; Albrecht, Terrance L.

2013-01-01

Physician racial bias and patient perceived discrimination have each been found to influence perceptions of and feelings about racially discordant medical interactions. However, to our knowledge, no studies have examined how they may simultaneously influence the dynamics of these interactions. This study examined how (a) non-Black primary care physicians’ explicit and implicit racial bias and (b) Black patients’ perceived past discrimination affected physician-patient talk time ratio (i.e., the ratio of physician to patient talk time) during medical interactions and the relationship between this ratio and patients’ subsequent adherence. We conducted a secondary analysis of self-report and video-recorded data from a prior study of clinical interactions between 112 low-income, Black patients and their 14 non-Black physicians at a primary care clinic in the Midwestern United States between June, 2006 and February, 2008. Overall, physicians talked more than patients; however, both physician bias and patient perceived past discrimination affected physician-patient talk time ratio. Non-Black physicians with higher levels of implicit, but not explicit, racial bias had larger physician-patient talk time ratios than did physicians with lower levels of implicit bias, indicating that physicians with more negative implicit racial attitudes talked more than physicians with less negative racial attitudes. Additionally, Black patients with higher levels of perceived discrimination had smaller physician-patient talk time ratios, indicating that patients with more negative racial attitudes talked more than patients with less negative racial attitudes. Finally, smaller physician-patient talk time ratios were associated with less patient subsequent adherence, indicating that patients who talked more during the racially discordant medical interactions were less likely to adhere subsequently. Theoretical and practical implications of these findings are discussed in the context of factors that affect the dynamics of racially discordant medical interactions. PMID:23631787

Talking Circles to Improve Diabetes Self-care Management.

PubMed

Wilken, Marlene; Nunn, Martha

2017-08-01

Purpose The purpose of this study was to determine if the use of both the Talking Circles (TCs) and diabetes self-management education (DSME) results in better adherence and outcomes for diabetes self-management than DSME alone in American Indians (AIs) with type 2 diabetes mellitus (T2DM). Methods A quasiexperimental, mixed-methods approach was used for AIs with uncontrolled T2DM, defined by an A1C > 7.0%. The experimental group (n = 20) participated in a TC and received DSME. The control group (n = 19) received only DSME. Talking Circles were audio-taped and analyzed qualitatively. Quantitative data were analyzed using the generalized estimating equation and Fisher exact test for all study participants every 3 months for 1 year. Results Themes identified by TC participants were spirituality, gratitude, and sharing. Major topics of discussion were the experiences of living with T2DM, including challenges and coping. Evidence of positive trends for the experimental group who received the TC intervention included lower systolic blood pressure, lower A1C, lower weight over time, and increased adherence without incentives. Conclusion Talking Circles may have utility in improving adherence in AI adults with uncontrolled T2DM. Further studies are warranted, including extending the use of the TCs after completion of DSME sessions.

Investigating Eight- to Nine-Year-Olds' Self-Regulatory Self-Talk in the Context of Their Classroom Tasks

ERIC Educational Resources Information Center

Lee, Scott; McDonough, Andrea; Bird, Jo

2014-01-01

Self-talk has been recognised as an important tool used by children to regulate their thinking and behaviour. Existing studies typically characterise children's self-talk according to broad categories that do not allow for investigation of self-regulatory aspects of children's internalised self-talk. The findings reported in this paper are based…

Exploring Seven- to Eight-Year-Olds' Use of Self-Talk Strategies

ERIC Educational Resources Information Center

Lee, Scott Weng Fai

2011-01-01

Self-talk has been recognised as a tool used by children to regulate their thinking and behaviour. To support children's use of self-regulatory verbal strategies, educators need to understand the context, content and dynamics of children's self-talk. While a significant amount of empirical research had been carried out on self-talk, most was…

Self-talk and affective problems in college students: valence of thinking and cognitive content specificity.

PubMed

Calvete, Esther; Estévez, Ana; Landín, Covadonga; Martínez, Yolanda; Cardeñoso, Olga; Villardón, Lourdes; Villa, Aurelio

2005-05-01

The aim of this study was to develop a Self-Talk Inventory for young adults. This inventory consisted of two scales. The Negative Self-Talk Scale included three categories of self-talk (depressive, anxious, and angry thoughts) and the Positive Self-Talk Scale, three categories (minimization, positive orientation, and coping self-instructions). Participants were 982 undergraduate students (Mean age = 20.35 years, SD = 2.16). They completed the self-talk scales together with the following scales to measure symptoms of affective disorders: the Center for Epidemiological Studies Depression Scale (CES-D), the State-Trait Anxiety Inventory (STAI), and the State-Trait Anger Expression Inventory (STAXI-T). Factor analyses confirmed the hypothesized structure for the Self-Talk Inventory. The relations between self-talk and symptoms of affective disorders (depression, anxiety, and anger) were also evaluated. In general, states-of-mind -SOM- ratios and negative cognitions showed a greater association with psychological symptoms than did positive cognitions. Results concerning the cognitive characteristics of depression, anxiety, and anger were mixed and partially supported the cognitive content specificity theory.

Young men's health: a balance between self-reliance and vulnerability in the light of hegemonic masculinity.

PubMed

Nobis, Regina; Sandén, Inger

2008-06-01

Masculinity, in its hegemonic form, can have the effect that men avoid talking about health problems and do not consult health care, even when help is needed. This study had two aims: firstly to describe how young men relate to health, ill health, masculinity and their bodies, and secondly to investigate their abilities of self-care. Interviews with eleven men were conducted using a semi-structured approach. Qualitative content analysis was used to analyse the transcribed interviews. The findings revealed five main themes; 'body awareness', 'the creation of self-reliance', 'feelings of freedom', 'the process of self-care awareness' and, finally, 'feelings of vulnerability'. Hegemonic masculinity impacted greatly on the men in this study and could be traced in expressions of dependency, vulnerability, loss of freedom and an altered body image. These were viewed as health disadvantages due to the threat to hegemonic masculinity.

The Use of Instructional and Motivational Self-Talk in Setting up a Physical Education Lesson

ERIC Educational Resources Information Center

Zourbanos, Nikos

2013-01-01

The main purpose of this article is to provide guidelines to physical educators for setting up a self-talk program during their lesson. The article briefly presents definitions of self-talk and research findings in sport and physical education to highlight the important benefits of positive self-talk in enhancing task performance. It also provides…

Associations of parents' self, child, and other "fat talk" with child eating behaviors and weight.

PubMed

Lydecker, Janet A; Riley, Kristen E; Grilo, Carlos M

2018-03-15

Fat talk, negative communication about weight, is common in the media, peer groups, and families. Little is known about parental fat talk directed at oneself or others. This study examined associations between different forms of parental fat talk and child disordered eating behaviors and weight, and differences by child sex and age. Parents of preadolescents or adolescents (n = 581) reported fat talk about themselves (self-fat talk), others (obesity-fat talk), and their child (child-fat talk). 76.0% of parents reported regular self-fat talk in front of children, 51.5% reported obesity-fat talk, and 43.6% reported child-fat talk. Fat talk did not differ significantly between parents of preadolescents and adolescents but was more common with sons than daughters. Of the three forms of fat talk, only child-fat talk was associated with all child eating and weight variables (binge eating, overeating, secretive eating, and overweight/obesity); associations were strongest for adolescent girls. Child sex was associated with secretive eating and overweight/obesity. Parents reported using different forms of fat talk frequently. Parent self- and obesity-fat talk were reported more frequently, but child-fat talk was the most strongly associated with children's eating and weight. Because of associations with disordered eating behaviors, intervening to reduce fat talk might contribute to improving pediatric disordered eating and weight-related interventions. © 2018 Wiley Periodicals, Inc.

The Impact of Teacher Feedback on Student Self-Talk and Self-Concept in Reading and Mathematics.

ERIC Educational Resources Information Center

Burnett, Paul C.

2003-01-01

Investigated the relationships between teacher feedback and students' self-talk and self-concepts in mathematics and reading. Data collected from students in six rural Australian elementary schools indicated that self-talk (positive and negative) mediated between subject-specific teacher feedback (ability, effort, and negative) and academic…

Why do women engage in fat talk? Examining fat talk using Self-Determination Theory as an explanatory framework.

PubMed

Guertin, Camille; Barbeau, Kheana; Pelletier, Luc; Martinelli, Gabrielle

2017-03-01

This study used Self-Determination Theory to examine the motivational processes involved in individuals' engagement in fat talk and its association with unhealthy eating behaviors. Female undergraduate students (N=453) completed an online questionnaire, which assessed general and contextual motivation, importance placed on goals, fat talk, and unhealthy eating behaviors. Structural equation modeling revealed that being generally non-self-determined and placing more importance on extrinsic goals, such as thinness, was associated with fat talk. Fat talk was further associated with non-self-determined motivation for eating regulation, which in turn was associated with unhealthy eating. General self-determination and placing more importance on intrinsic goals, such as health, were not associated with fat talk, but instead, were associated with more adaptive forms of eating regulation and diet quality. Findings further current knowledge on the respective roles of motivation and goals on the engagement in fat talk, and its consequences on eating regulation and behavior. Copyright © 2016 Elsevier Ltd. All rights reserved.

Self-talk functions: portrayal of an elite power lifter.

PubMed

Cutton, David M; Hearon, Christopher M

2014-10-01

The study presents the results of a case study with a repeated data collection design: a recent and former world champion power lifter provided weekly e-mails, during approximately 6 mo. of training and competition, with a description of his 'self-determined self-talk.' The instruction used for self-talk (ST) mentioned its associations with emotions, staying focused, maintaining motivation, and improving exercise skills. The obtained e-mails were coded using categories indicating functions of 'self-determined self-talk' mainly based on previous literature. The frequency of the functions during training and competition were compared and discussed following the qualitative research tradition.

Guiding Your Child through Those Tough and Turbulent Teen Years.

ERIC Educational Resources Information Center

Beck, Irene

1994-01-01

As adolescents work through issues like independence, identity, and intimacy, parents must establish their role and guide their children through difficult years. The article suggests that parents stay informed and connected, talk to their children, take a stand on issues, select battles carefully, be approachable, and enhance self-esteem. (SM)

Mother-child memory conversations and self-construal in Eastern Turkey, Western Turkey and the USA.

PubMed

Sahin-Acar, Basak; Leichtman, Michelle D

2015-01-01

Eighty-seven mothers and their four-year-old children from Eastern Turkey (N = 32 pairs), Western Turkey (N = 30 pairs) and the USA (N = 25 pairs) participated in a study of mother-child memory talk as a reflection of mothers' self construal, in view of differences in the function of memory talk across cultures. Mother-child pairs were audio-recorded while talking about shared past and anticipated future events. Mothers completed the Balanced Integration-Differentiation questionnaire measure of self-construal and were scored as high or low on individuation and relatedness orientations. Mothers' memory and future talk showed similar patterns of cultural differences: American mothers provided the most voluminous, descriptive and elaborative talk, while Eastern Turkish mothers showed the highest level of repetitiveness, and Western Turkish mothers' talk fell in between. Children's memory talk was similar across cultures. In all cultures, mothers who scored high on both individuation and relatedness (balanced self-construal subtype) engaged in more voluminous and contexted memory talk, and individuation was associated with more elaborative talk about future events. Results are discussed in light of literature on cultural differences in self-construal and memory function.

A naturalistic study of fat talk and its behavioral and affective consequences.

PubMed

Jones, Michelle D; Crowther, Janis H; Ciesla, Jeffrey A

2014-09-01

Fat talk is a style of verbal expression among young women involving negative self-statements, complaints about physical appearance, and weight management. This research used ecological momentary assessment to examine the impact of naturalistic fat talk experiences on body dissatisfaction, body checking, negative affect, and disordered eating behaviors. We examined trait self-objectification as a moderator. Sixty-five female college students completed a baseline questionnaire and responded to questions when randomly prompted by palm pilot devices for five days. Results indicated fat talk is common and associated with greater body dissatisfaction, body checking, negative affect, and disordered eating behaviors. Fat talk participation was associated with greater body checking than overhearing fat talk. Greater trait self-objectification was associated with greater body dissatisfaction and body checking following fat talk. These results suggest that fat talk negatively impacts the cognitions, affect, and behavior of young women and has increased negative effects for women higher in self-objectification. Copyright © 2014 Elsevier Ltd. All rights reserved.

Coping with Secondary Traumatic Stress by General Duty Police Officers: Practical Implications

ERIC Educational Resources Information Center

Conn, Stephanie M.; Butterfield, Lee D.

2013-01-01

This study used the Critical Incident Technique to examine the factors that helped, hindered, or might have helped 10 general duty police officers to cope with secondary traumatic stress. The data were best represented by 14 categories: self-care, family/significant other support, talking with co-workers, emotional engagement, work environment,…

Primary care nurses' communication and its influence on patient talk during motivational interviewing.

PubMed

Östlund, Ann-Sofi; Wadensten, Barbro; Häggström, Elisabeth; Lindqvist, Helena; Kristofferzon, Marja-Leena

2016-11-01

The aim of this study was to describe what verbal behaviours/kinds of talk occur during recorded motivational interviewing sessions between nurses in primary care and their patients. The aim was also to examine what kinds of nurse talk predict patient change talk, neutral talk and/or sustain talk. Motivational interviewing is a collaborative conversational style. It has been shown to be effective, in addressing health behaviours such as diet, exercise, weight loss and chronic disease management. In Sweden, it is one of the approaches to disease prevention conversations with patients recommended in the National Guidelines for Disease Prevention. Research on the mechanisms underlying motivational interviewing is growing, but research on motivational interviewing and disease prevention has also been called for. A descriptive and predictive design was used. Data were collected during 2011-2014. Fifty audio-recorded motivational interviewing sessions between 23 primary care nurses and 50 patients were analysed using Motivational Interviewing Sequential Code for Observing Process Exchanges. The frequency of specific kinds of talk and sequential analysis (to predict patient talk from nurse talk) were computed using the software Generalized Sequential Querier 5. The primary care nurses and patients used neutral talk most frequently. Open and negative questions, complex and positive reflections were significantly more likely to be followed by change talk and motivational interviewing-inconsistent talk, positive questions and negative reflections by sustain talk. To increase patients' change talk, primary care nurses need to use more open questions, complex reflections and questions and reflections directed towards change. © 2016 John Wiley & Sons Ltd.

The Effect of Self-Talk on the Penalty Execution in Goalball

ERIC Educational Resources Information Center

Stamou, Eirini; Theodorakis, Yiannis; Kokaridas, Dimitrios; Perkos, Stefanos; Kessanopoulou, Melpomeni

2007-01-01

The purpose of this study was to examine the effectiveness and preference of the two different types of self-talk (instructional and motivational) on penalty execution skill in goalball and gain insight on the athletes' perceptions concerning self-talk use and its influence on their performance. The sample consisted of six female athletes, aged…

Self-Talk Repertoire of Physical Education Teachers: Awareness, Reflection and Action

ERIC Educational Resources Information Center

Cutton, David M.; Killion, Lorraine; Burt, Daniel

2015-01-01

Self-talk (ST) is a strategy that has been found to change behavior by decreasing interference or distractions to better face challenges related to an impending task. Self-talk is typically a dynamic use of words, phrases or cues that may be positive, negative, instructional or motivational in nature. Physical education teachers and coaches have…

Dementia communication using empathic curiosity.

PubMed

McEvoy, Phil; Eden, John; Plant, Rachel

Communication skills training materials in dementia care usually focus on reminiscence. This is important because talking about past events can help people with dementia to retain their sense of self. This article examines the use of an alternative set of communication skills known as empathic curiosity, which may help to promote meaningful communication in the here and now with people who are living with dementia.

Self-determination theory in health care and its relations to motivational interviewing: a few comments

PubMed Central

2012-01-01

The papers of this special issue have the dual focus of reviewing research, especially clinical trials, testing self-determination theory (SDT) and of discussing the relations between SDT and motivational interviewing (MI). Notably, trials are reviewed that examined interventions either for behaviors such as physical activity and smoking cessation, or for outcomes such as weight loss. Although interventions were based on and intended to test the SDT health-behavior-change model, authors also pointed out that they drew techniques from MI in developing the interventions. The current paper refers to these studies and also clarifies the meaning of autonomy, which is central to SDT and has been shown to be important for effective change. We clarify that the dimension of autonomy versus control is conceptually orthogonal to the dimension of independence versus dependence, and we emphasize that autonomy or volition, not independence, is the important antecedent of effective change. Finally, we point out that SDT and MI have had much in common for each has emphasized autonomy. However, a recent MI article seems to have changed MI's emphasis from autonomy to change talk as the key ingredient for change. We suggest that change talk is likely to be an element of effective change only to the degree that the change talk is autonomously enacted and that practitioners facilitate change talk in an autonomy supportive way. PMID:22385839

Self-determination theory in health care and its relations to motivational interviewing: a few comments.

PubMed

Deci, Edward L; Ryan, Richard M

2012-03-02

The papers of this special issue have the dual focus of reviewing research, especially clinical trials, testing self-determination theory (SDT) and of discussing the relations between SDT and motivational interviewing (MI). Notably, trials are reviewed that examined interventions either for behaviors such as physical activity and smoking cessation, or for outcomes such as weight loss. Although interventions were based on and intended to test the SDT health-behavior-change model, authors also pointed out that they drew techniques from MI in developing the interventions. The current paper refers to these studies and also clarifies the meaning of autonomy, which is central to SDT and has been shown to be important for effective change. We clarify that the dimension of autonomy versus control is conceptually orthogonal to the dimension of independence versus dependence, and we emphasize that autonomy or volition, not independence, is the important antecedent of effective change. Finally, we point out that SDT and MI have had much in common for each has emphasized autonomy. However, a recent MI article seems to have changed MI's emphasis from autonomy to change talk as the key ingredient for change. We suggest that change talk is likely to be an element of effective change only to the degree that the change talk is autonomously enacted and that practitioners facilitate change talk in an autonomy supportive way.

Evaluation of a training programme to induct medical students in delivering public health talks

PubMed Central

Tan, Ngiap Chuan; Mitesh, Shah; Koh, Yi Ling Eileen; Ang, Seng Bin; Chan, Hian Hui Vincent; How, Choon How; Tay, Ee Guan; Hwang, Siew Wai

2017-01-01

INTRODUCTION It is uncommon for medical students to deliver public health talks as part of their medical education curriculum. This study evaluated the effectiveness of a novel training programme that required medical students to deliver public health talks during their family medicine (FM) clerkship in a Singapore primary care institution. METHODS The FM faculty staff guided teams of third-year medical students to select appropriate topics for health talks that were to be conducted at designated polyclinics. The talks were video-recorded and appraised for clarity, content and delivery. The appraisal was done by the student’s peers and assigned faculty staff. The audience was surveyed to determine their satisfaction level and understanding of the talks. The students also self-rated the effectiveness of this new teaching activity. RESULTS A total of 120 medical students completed a questionnaire to rate the effectiveness of the new teaching activity. 85.8% of the students felt confident about the delivery of their talks, 95.8% reported having learnt how to deliver talks and 92.5% perceived this new training modality as useful in their medical education. Based on the results of the audience survey, the speakers were perceived as knowledgeable (53.1%), confident (51.3%) and professional (39.0%). Assessment of 15 video-recorded talks showed satisfactory delivery of the talks by the students. CONCLUSION The majority of the students reported a favourable overall learning experience under this new training programme. This finding is supported by the positive feedback garnered from the audience, peers of the medical students and the faculty staff. PMID:26891745

Women's Fat Talk Can "Kill the Mood" for Men.

PubMed

Mikell, Christine M; Martz, Denise M

2016-04-01

This study examined men's perceptions of women engaging in "Fat Talk," a style of conversation that expresses discontent towards one's physical appearance, especially focusing on and criticizing body fat, shape, and weight. Male undergraduates were shown a vignette illustrating a courting scenario wherein the target female's body size was manipulated to be "sexy" and: (a) "lean," (b) "average," or (c) "larger." And to another woman, the men overheard the target female either: (a) self-degrade herself (fat talk) or (b) self-accept herself. As a third independent variable, participants' self esteem was divided into high and low with a median split. Dependent variables included self-created Likert items on his attraction towards the target and perceptions of her health and popularity. Men found the target female to have poorer mental health when he overheard her fat talking versus self-accepting. Further, his desire for a more exclusive committed relationship was stronger when she was described as leaner, especially for the lower self-esteemed men. As a pilot study, this has implications for interventions to decrease women's fat talk and begins research on the dynamic interplay between women's fat talk and heterosexual courtships. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Effects of Feedback Valence and Style on Need Satisfaction, Self-Talk, and Perseverance Among Tennis Players: An Experimental Study.

PubMed

De Muynck, Gert-Jan; Vansteenkiste, Maarten; Delrue, Jochen; Aelterman, Nathalie; Haerens, Leen; Soenens, Bart

2017-02-01

Grounded in self-determination theory, this experimental study examined whether the valence (i.e., positive vs. negative) and style (i.e., autonomy-supportive vs. controlling) of normative feedback impact the self-talk, motivational experiences (i.e., psychological need satisfaction and enjoyment), and behavioral functioning (i.e., perseverance and performance) of tennis players (N = 120; M age  = 24.50 ± 9.86 years). Positive feedback and an autonomy-supportive style positively influenced players' enjoyment and perseverance, with psychological need satisfaction and self-talk playing an intervening role. While positive feedback yielded its beneficial effect via greater competence satisfaction and decreased negative self-talk, the beneficial impact of an autonomy-supportive communication style was explained via greater autonomy satisfaction.

Development and evaluation of the Dignity Talk question framework for palliative patients and their families: A mixed-methods study.

PubMed

Guo, Qiaohong; Chochinov, Harvey Max; McClement, Susan; Thompson, Genevieve; Hack, Tom

2018-01-01

Effective patient-family communication can reduce patients' psychosocial distress and relieve family members' current suffering and their subsequent grief. However, terminally ill patients and their family members often experience great difficulty in communicating their true feelings, concerns, and needs to each other. To develop a novel means of facilitating meaningful conversations for palliative patients and family members, coined Dignity Talk, explore anticipated benefits and challenges of using Dignity Talk, and solicit suggestions for protocol improvement. A convergent parallel mixed-methods design. Dignity Talk, a self-administered question list, was designed to prompt end-of-life conversations, adapted from the Dignity Therapy question framework. Participants were surveyed to evaluate the Dignity Talk question framework. Data were analyzed using qualitative and quantitative methods. A total of 20 palliative patients, 20 family members, and 34 healthcare providers were recruited from two inpatient palliative care units in Winnipeg, Canada. Most Dignity Talk questions were endorsed by the majority of patients and families (>70%). Dignity Talk was revised to be convenient and flexible to use, broadly accessible, clearly stated, and sensitively worded. Participants felt Dignity Talk would be valuable in promoting conversations, enhancing family connections and relationships, enhancing patient sense of value and dignity, promoting effective interaction, and attending to unfinished business. Participants suggested that patients and family members be given latitude to respond only to questions that are meaningful to them and within their emotional capacity to broach. Dignity Talk may provide a gentle means of facilitating important end-of-life conversations.

Development and evaluation of the Dignity Talk question framework for palliative patients and their families: A mixed-methods study

PubMed Central

Guo, Qiaohong; Chochinov, Harvey Max; McClement, Susan; Thompson, Genevieve; Hack, Tom

2017-01-01

Background: Effective patient–family communication can reduce patients’ psychosocial distress and relieve family members’ current suffering and their subsequent grief. However, terminally ill patients and their family members often experience great difficulty in communicating their true feelings, concerns, and needs to each other. Aim: To develop a novel means of facilitating meaningful conversations for palliative patients and family members, coined Dignity Talk, explore anticipated benefits and challenges of using Dignity Talk, and solicit suggestions for protocol improvement. Design: A convergent parallel mixed-methods design. Dignity Talk, a self-administered question list, was designed to prompt end-of-life conversations, adapted from the Dignity Therapy question framework. Participants were surveyed to evaluate the Dignity Talk question framework. Data were analyzed using qualitative and quantitative methods. Setting/participants: A total of 20 palliative patients, 20 family members, and 34 healthcare providers were recruited from two inpatient palliative care units in Winnipeg, Canada. Results: Most Dignity Talk questions were endorsed by the majority of patients and families (>70%). Dignity Talk was revised to be convenient and flexible to use, broadly accessible, clearly stated, and sensitively worded. Participants felt Dignity Talk would be valuable in promoting conversations, enhancing family connections and relationships, enhancing patient sense of value and dignity, promoting effective interaction, and attending to unfinished business. Participants suggested that patients and family members be given latitude to respond only to questions that are meaningful to them and within their emotional capacity to broach. Conclusion: Dignity Talk may provide a gentle means of facilitating important end-of-life conversations. PMID:29130367

Spirituality in end-of-life care: attending the person on their journey.

PubMed

Hayden, Deborah

2011-11-01

Spirituality is a fundamental element to the human experience of health and healing, illness and dying. Spiritual care is an essential component of palliative and end-of-life care provision and is the responsibility of all staff and carers involved in the care of patients and families. As end-of-life care is a significant element of community nursing, this article explores the relevancy of spirituality to end-of-life practice, the challenge of defining spirituality and the attributes and skills required for the practice of spiritual care. The aim of is to encourage self reflection and open dialogue about the subject, thus enhancing community nurses' understanding of spiritual care practice. By reflecting and generating talk about the practice of spiritual care, it may become more normalized, recognized, and practically meaningful, thereby retaining its significance in holistic nursing.

Children's Self-Esteem and Moral Self: Links to Parent-Child Conversations Regarding Emotion

ERIC Educational Resources Information Center

Reese, Elaine; Bird, Amy; Tripp, Gail

2007-01-01

The current study has two aims: (1) to examine associations between the emotional content of parent-child past event conversations and two aspects of children's self-concept--moral self and self-esteem; and (2) to examine the degree to which talk about past events is uniquely associated with self-concept when compared with talk about ongoing…

Cell phone use diminishes self-awareness of the adverse effects of cell phone use on driving.

DOT National Transportation Integrated Search

2017-03-01

Multitasking may diminish the self-awareness of performance that is often essential for self-regulation : and self-knowledge. Participants in an experiment drove on a simulator while talking or not talking on a : cell phone. The errors they made whil...

Interpretation of Self-Talk and Post-Lecture Affective States of Higher Education Students: A Self-Determination Theory Perspective

ERIC Educational Resources Information Center

Oliver, Emily J.; Markland, David; Hardy, James

2010-01-01

Background: Self-determination theory posits that informational versus controlling interpretations of intra-personal events have positive and negative implications, respectively, for well-being. Self-talk represents an intra-personal event that could be interpreted as informational or controlling and may attenuate or exacerbate the negative…

Patient contributions during primary care consultations for hypertension after self-reporting via a mobile phone self-management support system.

PubMed

Bengtsson, Ulrika; Kjellgren, Karin; Hallberg, Inger; Lundin, Mona; Mäkitalo, Åsa

2018-03-01

This paper reports on how the clinical consultation in primary care is performed under the new premises of patients' daily self-reporting and self-generation of data. The aim was to explore and describe the structure, topic initiation and patients' contributions in follow-up consultations after eight weeks of self-reporting through a mobile phone-based hypertension self-management support system. A qualitative, explorative study design was used, examining 20 audio- (n = 10) and video-recorded (n = 10) follow-up consultations in primary care hypertension management, through interaction analysis. Clinical trials registry: ClinicalTrials.gov NCT01510301. Four primary health care centers in Sweden. Patients with hypertension (n = 20) and their health care professional (n = 7). The consultations comprised three phases: opening, examination and closing. The most common topic was blood pressure (BP) put in relation to self-reported variables, for example, physical activity and stress. Topic initiation was distributed symmetrically between parties and BP talk was lifestyle-centered. The patients' contributed to the interpretation of BP values by connecting them to specific occasions, providing insights to the link between BP measurements and everyday life activities. Patients' contribution through interpretations of BP values to specific situations in their own lives brought on consultations where the patient as a person in context became salient. Further, the patients' and health care professionals' equal contribution during the consultations showed actively involved patients. The mobile phone-based self-management support system can thus be used to support patient involvement in consultations with a person-centered approach in primary care hypertension management Key points   The clinical consultation is important to provide opportunities for patients to gain understanding of factors affecting high blood pressure, and for health care professionals to motivate and promote changes in life-style. This study shows that self-reporting as base for follow-up consultations in primary care hypertension management can support patients and professionals to equal participation in clinical consultations. Self-reporting combined with increased patient-health care professional interaction during follow-up consultations can support patients in understanding the blood pressure value in relation to their daily life. These findings implicate that the interactive mobile phone self-management support system has potential to support current transformations of patients as recipients of primary care, to being actively involved in their own health.

The importance of campaign saliency as a predictor of attitude and behavior change: A pilot evaluation of social marketing campaign Fat Talk Free Week.

PubMed

Garnett, Bernice Raveche; Buelow, Robert; Franko, Debra L; Becker, Carolyn; Rodgers, Rachel F; Austin, S Bryn

2014-01-01

Fat Talk Free Week (FTFW), a social marketing campaign designed to decrease self-disparaging talk about body and weight, has not yet been evaluated. We conducted a theory-informed pilot evaluation of FTFW with two college samples using a pre- and posttest design. Aligned with the central tenets of the Elaboration Likelihood Model (ELM), we investigated the importance of FTFW saliency as a predictor of fat talk behavior change. Our analytic sample consisted of 118 female participants (83% of original sample). Approximately 76% of the sample was non-Hispanic White, 14% Asian, and 8% Hispanic. At baseline, more than 50% of respondents reported engaging in frequent self fat talk; at posttest, this number dropped to 34% of respondents. Multivariable regression models supported campaign saliency as the single strongest predictor of a decrease in self fat talk. Our results support the social diffusion of campaign messages among shared communities, as we found significant decreases in fat talk among campaign attenders and nonattenders. FTFW may be a promising short-term health communication campaign to reduce fat talk, as campaign messages are salient among university women and may encourage interpersonal communication.

The Effects of Rational and Irrational Self-Verbalizations on Performance Efficiency and Levels of Anxiety.

ERIC Educational Resources Information Center

Rosin, Lindsay; Nelson, W. M. III

1983-01-01

Investigated effects of rational vs. irrational belief systems and rational vs. irrational self-verbalizations on anxiety and persistence. Subjects (N=40) were instructed to assemble a virtually insolvable task called Soma, and were assigned to either a rational or irrational self-talk condition. Rational self-talk subjects showed a significant…

Thought and talk. The intrapersonal component of human communication.

PubMed

Farley, M J

1992-09-01

The intrapersonal component of human communication, self-talk, influences what we say and how we respond to another in interpersonal dialogues. A model of communication that incorporates the notion of self-talk, both that of the speaker and that of the listener, is useful in assisting nurses in making more realistic appraisals of communication interactions and addressing problems in communication failures.

Cell-phone use diminishes self-awareness of impaired driving.

PubMed

Sanbonmatsu, David M; Strayer, David L; Biondi, Francesco; Behrends, Arwen A; Moore, Shannon M

2016-04-01

Multitasking diminishes the self-awareness of performance that is often essential for self-regulation and self-knowledge. Participants drove in a simulator while either talking or not talking on a hands-free cell phone. Following previous research, participants who talked on a cell phone made more serious driving errors than control participants who did not use a phone while driving. Control participants' assessments of the safeness of their driving and general ability to drive safely while distracted were negatively correlated with the actual number of errors made when they were driving. By contrast, cell-phone participants' assessments of the safeness of their driving and confidence in their driving abilities were uncorrelated with their actual errors. Thus, talking on a cell phone not only diminished the safeness of participants' driving, it diminished their awareness of the safeness of their driving.

Mediators of Change in the Child/Adolescent Anxiety Multimodal Treatment Study

PubMed Central

Kendall, Philip C.; Cummings, Colleen M.; Villabø, Marianne A.; Narayanan, Martina K.; Treadwell, Kimberli; Birmaher, Boris; Compton, Scott; Piacentini, John; Sherrill, Joel; Walkup, John; Gosch, Elizabeth; Keeton, Courtney; Ginsburg, Golda; Suveg, Cindy; Albano, Anne Marie

2015-01-01

Objective Test changes in (a) coping efficacy and (b) anxious self-talk as potential mediators of treatment gains at 3-month follow-up in the Child/Adolescent Anxiety Multimodal Treatment Study (CAMS). Method Participants were 488 youth (ages 7-17; 50.4% male) randomized to cognitive-behavioral therapy (CBT; Coping cat program), pharmacotherapy (sertraline), their combination, or pill placebo. Participants met DSM-IV criteria for generalized anxiety disorder, social phobia, and/or separation anxiety disorder. Coping efficacy (reported ability to manage anxiety provoking situations) was measured by youth and parent reports on the Coping Questionnaire, and anxious self-talk was measured by youth report on the Negative Affectivity Self-Statement Questionnaire. Outcome was measured using the Pediatric Anxiety Rating Scale (completed by Independent Evaluators blind to condition). For temporal precedence, residualized treatment gains were assessed at 3-month follow-up. Results Residualized gains in coping efficacy mediated gains in the CBT, sertraline, and combination conditions. In the combination condition, some unique effect of treatment remained. Treatment assignment was not associated with a reduction in anxious self-talk, nor did anxious self-talk predict changes in anxiety symptoms. Conclusions The findings suggest that improvements in coping efficacy are a mediator of treatment gains. Anxious self-talk did not emerge as a mediator. PMID:26460572

Emancipatory actions displayed by multi-ethnic women: "Regaining control of my health care".

PubMed

Alexander, Ivy M

2010-11-01

Despite the recognized importance of patient involvement in primary care interactions, little information describing women's needs and expectations for these interactions is available. This participatory action study was based in Critical Action Theory and designed to describe any emancipatory interests that surfaced when eight ethnically diverse women examined their interactions with primary care nurse practitioners (PCNPs) over the course of five successive focus group meetings. Focus group meeting transcripts, field notes, interaction notations, seating maps, and first impression summaries. Participants wanted to learn how to "stand up" for themselves in primary care interactions. They believed this could be accomplished by developing a positive sense of self-esteem. Ultimately, they identified the right way to "talk back" to clinicians and created a method for regaining control of their own health care and maintaining equality in interactions with primary care clinicians. Nurse practitioners working in the primary setting are especially well situated to support self-management and foster patient participation by women as they live with chronic disease, engage in health promotion activities, and deal with common symptomatic problems for themselves and their families. ©2010 The Author Journal compilation ©2010 American Academy of Nurse Practitioners.

Preferences for Depression Treatment Including Internet-Based Interventions: Results From a Large Sample of Primary Care Patients

PubMed Central

Dorow, Marie; Löbner, Margrit; Pabst, Alexander; Stein, Janine; Riedel-Heller, Steffi G.

2018-01-01

Background: To date, little is known about treatment preferences for depression concerning new media. This study aims to (1) investigate treatment preferences for depression including internet-based interventions and (2) examine subgroup differences concerning age, gender and severity of depression as well as patient-related factors associated with treatment preferences. Methods: Data were derived from the baseline assessment of the @ktiv-trial. Depression treatment preferences were assessed from n = 641 primary care patients with mild to moderate depression regarding the following treatments: medication, psychotherapy, combined treatment, alternative treatment, talking to friends and family, exercise, self-help literature, and internet-based interventions. Depression severity was specified by GPs according to ICD-10 criteria. Ordinal logistic regression models were conducted to identify associated factors of treatment preferences. Results: Patients had a mean age of 43.9 years (SD = 13.8) and more than two thirds (68.6%) were female. About 43% of patients had mild depression while 57% were diagnosed with moderate depression. The majority of patients reported strong preferences for psychotherapy, talking to friends and family, and exercise. About one in five patients was very likely to consider internet-based interventions in case of depression. Younger patients expressed significantly stronger treatment preferences for psychotherapy and internet-based interventions than older patients. The most salient factors associated with treatment preferences were the patients' education and perceived self-efficacy. Conclusions: Patients with depression report individually different treatment preferences.Our results underline the importance of shared decision-making within primary care. Future studies should investigate treatment preferences for different types of internet-based interventions. PMID:29867605

Emotions and Behavior

MedlinePlus

... Competitive Sports: Helping Kids Play it Cool Cutting Cyberbullying Depression Developing Your Child's Self-Esteem Eating Disorders ... Therapist Teaching Your Child Tolerance Teens Talk About Bullying (Video) Teens Talk About Love (Video) Teens Talk ...

Time To Talk with Your Health Care Providers: 4 Tips to Start the Conversation

MedlinePlus

... Y Z 4 Tips: Start Talking With Your Health Care Providers About Complementary Health Approaches Share: When patients ... fully informed and can help patients make wise health care decisions. Here are 4 tips to help you ...

Concordance Between Veterans' Self-Report and Documentation of Surrogate Decision Makers: Implications for Quality Measurement.

PubMed

Garner, Kimberly K; Dubbert, Patricia; Lensing, Shelly; Sullivan, Dennis H

2017-01-01

The Measuring What Matters initiative of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association identified documentation of a surrogate decision maker as one of the top 10 quality indicators in the acute hospital and hospice settings. To better understand the potential implementation of this Measuring What Matters quality measure #8, Documentation of Surrogate in outpatient primary care settings by describing primary care patients' self-reported identification and documentation of a surrogate decision maker. Examination of patient responses to self-assessment questions from advance health care planning educational groups conducted in one medical center primary care clinic and seven community-based outpatient primary care clinics. We assessed the concordance between patient reports of identifying and naming a surrogate decision maker and having completed an advance directive (AD) with presence of an AD in the electronic medical record. Of veterans without a documented AD on file, more than half (66%) reported that they had talked with someone they trusted and nearly half (52%) reported that they had named someone to communicate their preferences. Our clinical project data suggest that many more veterans may have initiated communications with surrogate decision makers than is evident in the electronic medical record. System changes are needed to close the gap between veterans' plans for a surrogate decision maker and the documentation available to acute care health care providers. Published by Elsevier Inc.

Cognitive Preparation and Coping Self-Talk: Anxiety Management during the Stress of Flying.

ERIC Educational Resources Information Center

Girodo, Michel; Roehl, Julius

1978-01-01

Investigated the effectiveness of coping strategies in undergraduate females reporting fear of flying. Self-reports of anxiety were obtained before takeoff, during flight, and after landing. Under serious threat with the cockpit door open, self-talk and combined subjects coped better. With the door closed, all groups increased in anxiety.…

A View from the Inside: An In-Depth Look at a Female University Student's Experience with a Feel-Based Intervention to Enhance Self-Confidence and Self-Talk

ERIC Educational Resources Information Center

Guerin, Eva; Arcand, Isabelle; Durand-Bush, Natalie

2010-01-01

The primary goal of this investigation was to document, using the participatory paradigm, a female university student's experience with a feel-based intervention intended to enhance the quality of her academic experiences including her self-confidence and self-talk. In this unique qualitative case study, the student participated in a 15-week…

Third-Person Self-Talk Reduces Ebola Worry and Risk Perception by Enhancing Rational Thinking.

PubMed

Kross, Ethan; Vickers, Brian D; Orvell, Ariana; Gainsburg, Izzy; Moran, Tim P; Boyer, Margaret; Jonides, John; Moser, Jason; Ayduk, Ozlem

2017-11-01

During the fall of 2014, the threat of an Ebola outbreak gripped the United States (Poll, 8-12 October 2014; see Harvard School of Public Health & SSRS, 2014), creating a unique opportunity to advance basic knowledge concerning how emotion regulation works in consequential contexts and translate existing research in this area to inform public health and policy. We addressed these issues by examining whether third-person self-talk, a simple technique that promotes emotion regulation, could nudge people into reasoning about Ebola more rationally. In all, 1,257 people from across the United States were asked to write about their feelings about Ebola using their name or I (i.e. third-person self-talk vs. first-person self-talk) as concerns about Ebola swelled (24 October 2014-26 October 2014). Third-person self-talk led participants who scored high on Ebola worry at baseline to generate more fact-based reasons not to worry about Ebola, which predicted reductions in their Ebola worry and risk perception. These findings held when controlling for several theoretically relevant covariates, highlighting their robustness. These results demonstrate how a simple linguistic technique can enhance rational thinking and quell worry about a pressing public health threat. © 2017 The International Association of Applied Psychology.

Eating and Nutrition for Hemodialysis

MedlinePlus

... talk with your health care provider before using probiotics, dietary supplements, or any other medicine together with ... Talk with your health care provider before using probiotics, dietary supplements, or any other medicine together with ...

How Healthcare Provider Talk with Parents of Children Following Severe Traumatic Brain Injury is Perceived in Early Acute Care

PubMed Central

Savage, Teresa A.; Grant, Gerald; Philipsen, Gerry

2013-01-01

Healthcare provider talk with parents in early acute care following children’s severe traumatic brain injury (TBI) affects parents’ orientations to these locales, but this connection has been minimally studied. This lack of attention to this topic in previous research may reflect providers’ and researchers’ views that these locales are generally neutral or supportive to parents’ subsequent needs. This secondary analysis used data from a larger descriptive phenomenological study (2005 – 2007) with parents of children following moderate to severe TBI recruited from across the United States. Parents of children with severe TBI consistently had strong negative responses to the early acute care talk processes they experienced with providers, while parents of children with moderate TBI did not. Transcript data were independently coded using discourse analysis in the framework of ethnography of speaking. The purpose was to understand the linguistic and paralinguistic talk factors parents used in their meta-communications that could give a preliminary understanding of their cultural expectations for early acute care talk in these settings. Final participants included 27 parents of children with severe TBI from 23 families. We found the human constructed talk factors that parents reacted to were: a) access to the child, which is where information was; b) regular discussions with key personnel; c) updated information that is explained; d) differing expectations for talk in this context; and, e) perceived parental involvement in decisions. We found that the organization and nature of providers’ talk with parents was perceived by parents to positively or negatively shape their early acute care identities in these locales, which influenced how they viewed these locales as places that either supported them and decreased their workload or discounted them and increased their workload for getting what they needed. PMID:23746606

The effects of rational and irrational self-verbalizations on performance efficiency and levels of anxiety.

PubMed

Rosin, L; Nelson, W M

1983-03-01

Investigated the effects of rational vs. irrational belief systems (as measured by the Ellis Irrational Values Scale) and rational vs. irrational self-verbalizations on levels of anxiety and persistence on a performance task. Ss (N = 40) were instructed to assemble a virtually insolvable task call Soma. The variables of interest were how long each S would persist on this task and how much anxiety (as measured by the A-State portion of the State-Trait Anxiety Inventory) was aroused in working on this task. Following a baseline trial trying to solve Soma, Ss were assigned to either a rational or irrational self-talk condition and were led to believe that such self-talk would help in a second attempt to solve Soma. In line with cognitive models of psychology, it was found that rational self-talk Ss showed a significant decrease in levels of state anxiety compared to irrational self-talk Ss in attempting to solve Soma in the second trial. Contrary to cognitive models of psychology, scores obtained from the EIVS and the A-Trait portion of the STAI were not found to be related to persistence.

WONCA 2015 preconference exchange: Self-discovery, friendship, and innovation amidst diversity and uncertainty

PubMed Central

Hoorick, Indra Van; Yakubu, Kenneth; Tsipou, Alexandra; Figueiredo, Ana Beatriz; Özkan, Nurşah; Atalay, Süheyla

2016-01-01

This commentary is the result of a long-distance creative writing project between young general practitioners (GPs) from around the world. They wrote this after participating in an exchange program in Turkey, where they had the opportunity to shadow a Turkish GP, and talk about primary health care around the world. This program was organized by the Vasco da Gama Movement (Vasco da Gama Movement is WONCA Europe's Working group for New and Future GPs: http://vdgm.woncaeurope.org/). PMID:27843816

The “Silent Dog” Method: Analyzing the Impact of Self-Generated Rules When Teaching Different Computer Chains to Boys with Autism

PubMed Central

Arntzen, Erik; Halstadtro, Lill-Beathe; Halstadtro, Monica

2009-01-01

The purpose of the study was to extend the literature on verbal self-regulation by using the “silent dog” method to evaluate the role of verbal regulation over nonverbal behavior in 2 individuals with autism. Participants were required to talk-aloud while performing functional computer tasks.Then the effects of distracters with increasing demands on target behavior were evaluated as well as whether self-talk emitted by Participant 1 could be used to alter Participant 2's performance. Results suggest that participants' tasks seemed to be under control of self-instructions, and the rules generated from Participants 1's self-talk were effective in teaching computer skills to Participant 2. The silent dog method was useful in evaluating the possible role of self-generated rules in teaching computer skills to participants with autism. PMID:22477428

The "silent dog" method: analyzing the impact of self-generated rules when teaching different computer chains to boys with autism.

PubMed

Arntzen, Erik; Halstadtro, Lill-Beathe; Halstadtro, Monica

2009-01-01

The purpose of the study was to extend the literature on verbal self-regulation by using the "silent dog" method to evaluate the role of verbal regulation over nonverbal behavior in 2 individuals with autism. Participants were required to talk-aloud while performing functional computer tasks.Then the effects of distracters with increasing demands on target behavior were evaluated as well as whether self-talk emitted by Participant 1 could be used to alter Participant 2's performance. Results suggest that participants' tasks seemed to be under control of self-instructions, and the rules generated from Participants 1's self-talk were effective in teaching computer skills to Participant 2. The silent dog method was useful in evaluating the possible role of self-generated rules in teaching computer skills to participants with autism.

Social buffering by God: prayer and measures of stress.

PubMed

Belding, Jennifer N; Howard, Malcolm G; McGuire, Anne M; Schwartz, Amanda C; Wilson, Janie H

2010-06-01

Social buffering is characterized by attenuation of stress in the presence of others, with supportive individuals providing superior buffering. We were interested in learning if the implied presence of a supportive entity, God, would reduce acute stress. Participants were randomly assigned to one of three conditions: prayer, encouraging self-talk, and control. They were subsequently placed in a stressful situation. Self ratings of stress were lower among the prayer and self-talk conditions relative to controls. Systolic and diastolic blood pressures only among those who prayed were lower than controls; however, prayer and self-talk did not differ. Prayer alone did not significantly reduce stress, perhaps because the majority of students in the prayer condition did not consider reading a prayer to constitute praying.

'I can actually talk to them now': qualitative results of an educational intervention for emergency nurses caring for clients who self-injure.

PubMed

McAllister, Margaret; Moyle, Wendy; Billett, Stephen; Zimmer-Gembeck, Melanie

2009-10-01

This Australian study evaluated the effectiveness of a solution-focused education intervention in extending and improving emergency nursing responses to patients who present because of self-injury. Emergency nurses commonly report lack of training and feeling unskilled in managing people who present because of self-harm. Most educational interventions have provided content knowledge, yet rarely have they focused on conveying the value of health promotion strategies such as proactive skills and coping strategies. A mixed method pretest-posttest group design was used. Nurses (n = 36) were interviewed to examine differences in professional identity, awareness of self-injury and clinical reasoning. The qualitative results are presented in this paper and these showed improvements in knowledge and understanding of self-harm, self-belief in nurses' capacity to positively influence clients and the value of health promotion skills. The intervention produced a positive attitudinal shift towards clients and an expressed intention to act in ways that were more person-centred and change oriented. The solution-focused education intervention appears to show promise as an intervention for enabling nurses to value their unique contribution to providing a health service that is more proactive and health-promoting. Interactive education bringing psychosocial skills to technical nursing staff builds confidence, competence and more person-focused care.

Student Self-Disclosure

ERIC Educational Resources Information Center

Lucas, Janet; DeGenaro, William

2007-01-01

This article presents two essays that focus on the challenges presented by students' self-disclosures in their writing. The authors have read each other's essays and provided their brief responses. This cross talk between the writers continues, in a more deliberate way, the cross talk generated by their essays.

Countering the Consequences of Ego Depletion: The Effects of Self-Talk on Selective Attention.

PubMed

Gregersen, Jón; Hatzigeorgiadis, Antonis; Galanis, Evangelos; Comoutos, Nikos; Papaioannou, Athanasios

2017-06-01

This study examined the effects of a self-talk intervention on selective attention in a state of ego depletion. Participants were 62 undergraduate students with a mean age of 20.02 years (SD = 1.17). The experiment was conducted in four consecutive sessions. Following baseline assessment, participants were randomly assigned into experimental and control groups. A two-session training was conducted for the two groups, with the experimental group using self-talk. In the final assessment, participants performed a selective attention test, including visual and auditory components, following a task inducing a state of ego depletion. The analysis showed that participants of the experimental group achieved a higher percentage of correct responses on the visual test and produced faster reaction times in both the visual and the auditory test compared with participants of the control group. The results of this study suggest that the use of self-talk can benefit selective attention for participants in states of ego depletion.

Talking about intimate partner violence in multi-cultural antenatal care: a qualitative study of pregnant women's advice for better communication in South-East Norway.

PubMed

Garnweidner-Holme, Lisa Maria; Lukasse, Mirjam; Solheim, Miriam; Henriksen, Lena

2017-04-19

Intimate partner violence (IPV) against women constitutes a major public health problem. Antenatal care is considered a window of opportunity to disclose and to communicate about IPV. However, little is known about how women from different ethnic backgrounds wish to communicate about their experiences with IPV during pregnancy in antenatal care. The aim of the present study was to explore how women from different ethnic backgrounds experienced IPV and what their recommendations were about how midwives should communicate about IPV in antenatal care. Qualitative individual interviews with eight women who had experienced IPV during pregnancy were conducted and analysed using thematic analysis. The participants were purposively recruited from three crisis shelters in South-East Norway. The participants either had immigrant backgrounds (n = 5) or were ethnic Norwegians (n = 3). All participants received antenatal care by a midwife. Although none of the participants were asked about IPV during antenatal care, they wished to talk about their experiences. Most participants felt that it would be important for the midwife to make them aware that they were victims of violence. Participants offered different suggestions on how and when midwives should talk about IPV. Facilitators to talk about IPV with the midwife were a good relationship with and the trustworthiness of the midwife, information about possible negative health outcomes for the newborn owing to IPV and knowing that the midwife could help them. The main barriers to talk about IPV with the midwife were that the participants were accompanied by their husbands during antenatal care, fear that the Child Welfare Service would take away their children after disclosure and cultural acceptance of violence. Participants with immigrant backgrounds also experienced difficulties in talking about IPV owing to their limited language skills. They thought that professionally trained interpreters with experience of IPV could overcome this barrier. Even though none of the participants were asked about IPV in antenatal care, they offered different suggestions on how and when midwives should talk about IPV. Participants irrespective of their ethnical backgrounds perceived antenatal care as a key area to facilitate disclosure of IPV. Midwives' communication and strategic skills to address IPV are crucial for help-seeking women. Training midwives' skills in culture-sensitive communication might help to overcome cultural barriers to talk about violence.

Don't Push Your Luck! Educational Family Board (Not Bored) Game for School-Age Children Living with Chronic Conditions.

PubMed

Kennedy, Andrea; Semple, Lisa; Alderson, Kerri; Bouskill, Vanessa; Karasevich, Janice; Riske, Brenda; van Gunst, Sheri

Children who are living with chronic conditions may be supported in self-care through enjoyable active learning and family social processes. This research focused on development and evaluation of "Don't Push Your Luck!", an educational board game designed to inspire family discussion about chronic conditions, and help affected children learn about self-care choices and consequences. Mixed-method research was conducted with families from one outpatient Cystic Fibrosis Clinic and four Hemophilia Treatment Centres in Canada and United States (N=72). In phase I, board game prototype and questionnaires were refined with affected boys, siblings, and parents living with hemophilia (n=11), compared with families living with cystic fibrosis (n=11). In phase II, final board game was evaluated with families living with hemophilia (n=50). Data collection included pre-post-game questionnaires on decision-making and Haemo-QoL Index©, and post-game enjoyment. Analysis included descriptive statistics, inferential statistics (non-parametric), and qualitative themes. Findings revealed this game was an enjoyable and effective resource to engage families in self-care discussions. Key themes included communication, being involved, knowing, decisions and consequences, and being connected. Qualitative and quantitative findings aligned. Statistical significance suggests the game enhanced family engagement to support decision-making skills, as parents identified that the game helped them talk about important topics, and children gained insight regarding family supports and self-care responsibility. This board game was an effective, developmentally appropriate family resource to facilitate engagement and conversation about everyday life experiences in preparation for self-care. There is promising potential to extend this educational family board game intervention with a greater range of school-age children and families living with chronic conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

Nature and consequences of positively-intended fat talk in daily life.

PubMed

Mills, Jacqueline; Fuller-Tyszkiewicz, Matthew

2018-06-05

The current study used ecological momentary assessment to explore the frequency, trait predictors, and momentary consequences of positively-intended fat talk, a specific sub-type of fat talk that involves making negative comments about one's own appearance with the view to making someone else feel better. A total of 135 women aged 18-40 completed trait measures of appearance-based comparisons, thin-ideal internalisation, body shame, and body surveillance, before completing a state-based component, involving six short surveys delivered via a smartphone app at random points during the day for seven days. Findings indicate that both self- and other-fat talk are common in daily social interactions, and that individuals with higher levels of trait negative body image were more likely to engage in fat talk. Self-fat talk negatively impacted state body satisfaction levels. Possible theoretical and practical implications are outlined. Copyright © 2018 Elsevier Ltd. All rights reserved.

Coping strategies employed by women with endometriosis in a public health-care setting

PubMed Central

Roomaney, Rizwana; Kagee, Ashraf

2015-01-01

This study explored how South African patients attending public health facilities reported coping with endometriosis. A total of 16 women with endometriosis were interviewed, and we explored how participants coped with endometriosis. All interviews were audio-recorded and transcribed. Thematic analysis was used to identify themes. Participants reported employing both problem-focused and emotion-focused strategies to cope with endometriosis. Problem-focused strategies included limiting physical activities, increasing knowledge about endometriosis, scheduling social and work activities around menstrual cycle, engaging in self-management and relying on social support. Emotion-focused coping strategies included accepting the disease, adopting a positive attitude, engaging in self talk and evoking spirituality. PMID:25769875

An experimental investigation of the consequences and social functions of fat talk in friendship groups.

PubMed

Cruwys, Tegan; Leverington, Carly T; Sheldon, Anne M

2016-01-01

Fat talk is a form of self-degrading, thin-ideal endorsing communication that occurs within female friendship groups. Previous studies have suggested negative associations with wellbeing, but have been predominantly correlational and based on self-report. This study aimed to assess the causal relationship between fat talk and the correlates of disordered eating (thin-ideal internalization, body dissatisfaction, negative affect, and dieting intentions) by experimentally manipulating fat talk in existing friendship groups and measuring naturalistic expression of fat talk and its effects. Participants were 85 women aged 17-25 who completed the experiment in friendship pairs. They were randomly assigned to a condition in which their friend expressed fat talk, positive body talk, or neutral talk. This study found evidence of a causal link between listening to friends fat talk and increased correlates of disordered eating. The negative effects of listening to fat talk were fully mediated by fat talk expression. This study also revealed a social function of fat talk, whereby participants rated their friends more positively when they were perceived to behave consistently with group norms, either pro- or anti-fat talk. Positive body talk showed none of the negative effects of fat talk, and was considered socially acceptable regardless of existing friendship group norms. These findings indicate that fat talk is a mechanism through which the thin ideal is transmitted between individuals. Interventions at the level of the friendship group to challenge norms and communication styles may break the link between societal risk factors and individual risk of eating disorders. © 2015 Wiley Periodicals, Inc.

Can We Talk? Helping Families Talk about Self-Esteem, Sex, and Peer Pressure. Training Package = Conversamos? Ayudando a Familias a Hablar sobre la Autoestima, el Sexo, y la Presion de los Amigos. Paquete de Capacitacion.

ERIC Educational Resources Information Center

Cappello, Dominic; Newberry, Jerald

This English and Spanish language multimedia packet comprises an educational curriculum designed to help families talk about self-esteem, sex, and peer pressure with their children in grades 4 through 8. The packet consists of a planning and training manuals, family activity books, and a videotape. The curriculum is comprised of four parent…

Predictors of Health Behavior from a Behavior-Analytic Orientation.

ERIC Educational Resources Information Center

Birkimer, John C.; And Others

1996-01-01

Discovers a high correlation between positive emotional states, supportive self talk, and specific healthy behaviors in college students. The correlated health behaviors were vigorous exercise, mild exercise, seat belts, and avoidance of alcohol and junk food. Considers the impact of negative self talk on the avoidance of negative behavior. (MJP)

Compassion fatigue, burnout and compassion satisfaction in neonatologists in the US.

PubMed

Weintraub, A S; Geithner, E M; Stroustrup, A; Waldman, E D

2016-11-01

Compassion fatigue (CF) is distress experienced by caregivers from ongoing contact with patients who are suffering. Burnout (BO) is occupational stress directly related to dissonance between job demands and available resources. Compassion satisfaction (CS) is professional fulfillment experienced through helping others. CF in physicians is not well studied. Neonatologists may be at particular risk for CF by virtue of recurrent exposure to distress in patients and their families. The objectives of this study were to determine the prevalence of CF, BO and CS, and to identify potential predictors for these phenomena in neonatologists. A modified Compassion Fatigue and Satisfaction Self-Test and a questionnaire of professional details and personal characteristics were distributed electronically to neonatologists nationally. Multivariable logistic and linear regression models for CF, BO and CS as a function of potential predictors were constructed. The survey response rate was 47%. The prevalence of CF, BO and CS was 15.7, 20.8 and 21.9%, respectively. Female gender, emotional depletion, distress from 'a clinical situation', 'co-workers', 'personal health issues' and 'not talking about distressing issues' were each significant determinants of CF. Emotional depletion, distress from the 'physical work environment' and 'co-workers', and 'not talking about distressing issues' were significant determinants of BO. Self-identification as Hispanic; 'not currently feeling distressed'; talking about distressing issues; and utilization of pediatric palliative care services were significant determinants of higher CS. CF and BO may impact emotional well-being and professional performance of neonatologists. Enhancement of CS is a potential target for intervention.

What Latino Puerto Ricans and non-Latinos say when they talk about Alzheimer's disease.

PubMed

Karlawish, Jason; Barg, Frances K; Augsburger, Deborah; Beaver, James; Ferguson, Allison; Nunez, Jessica

2011-03-01

To discover whether Latino Puerto Rican and non-Latino communities differ in the words they use to talk about Alzheimer's disease (AD). Four groups of 30 persons per group defined by self-identified ethnicity and caregiver status: Latino Puerto Ricans and non-Latino Whites, who were either caregivers or non-caregivers completed free-listing exercises to identify the words they use when they describe AD causes, symptoms, caregiving, and research risks and benefits. Both Latino Puerto Ricans and non-Latino Whites recognize AD as a disease of memory loss and other cognitive problems. Although both groups used the term "sadness" to describe AD, non-Latino Whites did not feature emotional, behavioral, or psychological problems as among the causes of AD. Although all the groups' descriptions of a person who lives with and cares for a person with AD shared the word "loving," Latino Puerto Ricans focused on a good spouse who exercises intelligence, patience, and attention on behalf of the person with AD and did not use the term "caregiver." In contrast, non-Latino Whites typically used the term "caregiver." Both groups' lists shared words that describe research as presenting harms to an AD patient and requiring a commitment of time. Latino Puerto Ricans' lists suggested an understanding of research benefits akin to clinical care. Notable differences exist in how Latino Puerto Ricans and non-Latino Whites talk about AD and AD research. Clinicians, clinical investigators, and patient educators need to consider these differences when they conduct clinical care and research and design outreach and educational materials. Copyright © 2011 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

The Critical Care Communication project: improving fellows' communication skills.

PubMed

Arnold, Robert M; Back, Anthony L; Barnato, Amber E; Prendergast, Thomas J; Emlet, Lillian L; Karpov, Irina; White, Patrick H; Nelson, Judith E

2015-04-01

The aim of this study was to develop an evidence-based communication skills training workshop to improve the communication skills of critical care fellows. Pulmonary and critical care fellows (N = 38) participated in a 3-day communication skills workshop between 2008 and 2010 involving brief didactic talks, faculty demonstration of skills, and faculty-supervised small group skills practice sessions with simulated families. Skills included the following: giving bad news, achieving consensus on goals of therapy, and discussing the limitations of life-sustaining treatment. Participants rated their skill levels in a pre-post survey in 11 core communication tasks using a 5-point Likert scale. Of 38 fellows, 36 (95%) completed all 3 days of the workshop. We compared pre and post scores using the Wilcoxon signed rank test. Overall, self-rated skills increased for all 11 tasks. In analyses by participant, 95% reported improvement in at least 1 skill; with improvement in a median of 10 of 11 skills. Ninety-two percent rated the course as either very good/excellent, and 80% recommended that it be mandatory for future fellows. This 3-day communication skills training program increased critical care fellows' self-reported family meeting communication skills. Copyright © 2014 Elsevier Inc. All rights reserved.

Selective Capture of CWAs and Containment of Their Neutralization Byproducts by Porous Frameworks Presenting Self-Amplifying and Self-Regulating Reactivities

DTIC Science & Technology

2013-02-04

Intl. Symposium on Macrocyclic and Supramolecular Chemistry, June 2010, Nara, Japan (Plenary talk). O. M. Yaghi, Zeolitic imidazolate frameworks, 5th...International Zeolite Membrane Meeting, May 2010, Loutraki, Greece (Plenary talk). O. M. Yaghi, Reticular chemistry and its applications to clean energy

"Money talks. And the society we live in is very harsh." Cancer Care-Seeking from the Perspectives of Guam's Chamorros.

PubMed

Moss, John

2013-09-01

Cancer mortality is rising at an astonishing rate on the island of Guam compared to the US. The indigenous people of Guam, the Chamorro, suffer from the highest rates of cancer death compared to other ethnic groups. To better understand some of the factors underlying these mortality rates, in-depth interviews were conducted with 11 self-identified Chamorros of Guam to explore their experiences seeking screening and treatment for cancer. Respondent's care-seeking was significantly influenced by their family's wealth and their health insurance coverage. Informants who did not seek regular cancer screening reported financial barriers along with a lack of awareness of cancer screening. Immediate family members facilitated increased access to cancer care, but extended family members sometimes caused increased stress for participants with cancer. Public awareness campaigns promoting cancer screening need to be tied to structural changes to the health care system to make cancer care financially accessible for care-seekers.

How healthcare provider talk with parents of children following severe traumatic brain injury is perceived in early acute care.

PubMed

Roscigno, Cecelia I; Savage, Teresa A; Grant, Gerald; Philipsen, Gerry

2013-08-01

Healthcare provider talk with parents in early acute care following children's severe traumatic brain injury (TBI) affects parents' orientations to these locales, but this connection has been minimally studied. This lack of attention to this topic in previous research may reflect providers' and researchers' views that these locales are generally neutral or supportive to parents' subsequent needs. This secondary analysis used data from a larger descriptive phenomenological study (2005-2007) with parents of children following moderate to severe TBI recruited from across the United States. Parents of children with severe TBI consistently had strong negative responses to the early acute care talk processes they experienced with providers, while parents of children with moderate TBI did not. Transcript data were independently coded using discourse analysis in the framework of ethnography of speaking. The purpose was to understand the linguistic and paralinguistic talk factors parents used in their meta-communications that could give a preliminary understanding of their cultural expectations for early acute care talk in these settings. Final participants included 27 parents of children with severe TBI from 23 families. We found the human constructed talk factors that parents reacted to were: a) access to the child, which is where information was; b) regular discussions with key personnel; c) updated information that is explained; d) differing expectations for talk in this context; and, e) perceived parental involvement in decisions. We found that the organization and nature of providers' talk with parents was perceived by parents to positively or negatively shape their early acute care identities in these locales, which influenced how they viewed these locales as places that either supported them and decreased their workload or discounted them and increased their workload for getting what they needed. Copyright © 2013 Elsevier Ltd. All rights reserved.

Talking about Complementary and Alternative Medicine with Health Care Providers: A Workbook and Tips

Cancer.gov

A workbook to help patients and doctors talk about the use of complementary and alternative medicine(CAM) during and after cancer care. Worksheets, tips, and resources are provided for patients and doctors to help track CAM use.

Talking about Complementary and Alternative Medicine with Health Care Provider: A Workbook and Tips

Cancer.gov

A workbook to help patients and doctors talk about the use of complementary and alternative medicine(CAM) during and after cancer care. Worksheets, tips, and resources are provided for patients and doctors to help track CAM use.

Sustain talk predicts poorer outcomes among mandated college student drinkers receiving a brief motivational intervention.

PubMed

Apodaca, Timothy R; Borsari, Brian; Jackson, Kristina M; Magill, Molly; Longabaugh, Richard; Mastroleo, Nadine R; Barnett, Nancy P

2014-09-01

Within-session client language that represents a movement toward behavior change (change talk) has been linked to better treatment outcomes in the literature on motivational interviewing (MI). There has been somewhat less study of the impact of client language against change (sustain talk) on outcomes following an MI session. This study examined the role of both client change talk and sustain talk, as well as therapist language, occurring during a brief motivational intervention (BMI) session with college students who had violated college alcohol policy (N = 92). Audiotapes of these sessions were coded using a therapy process coding system. A series of hierarchical regressions were used to examine the relationships among therapist MI-consistent and MI-inconsistent language, client change talk and sustain talk, as well as global measures of relational variables, and drinking outcomes. Contrary to prior research, sustain talk, but not change talk, predicted poorer alcohol use outcomes following the BMI at 3- and 12-month follow-up assessments. Higher levels of client self-exploration during the session also predicted improved drinking outcomes. Therapist measures of MI-consistent and MI-inconsistent language, and global measures of therapist acceptance and MI spirit were unrelated to client drinking outcomes. Results suggest that client sustain talk and self-exploration during the session play an important role in determining drinking outcomes among mandated college students receiving a BMI addressing alcohol use.

Narrating the self-injured body

PubMed Central

Chandler, Amy

2014-01-01

Illness narratives have traditionally been used as a conceptual tool for exploring experiences of chronic illness or disease. In this paper, I suggest that Frank's typology of illness narratives (chaos, restitution and quest) also offers an illuminating approach to analysing accounts of self-injury, demonstrating the diverse ways in which self-injury is practiced, experienced and narrated. Drawing on 24 narrative interviews with 12 people who had self-injured, I focus on participants’ accounts of their self-injured bodies. The approach is phenomenological, and concerned with talk about the experience of living with and in a body that has been marked by self-injury. Thus, the act of self-injury is not the sole focus, and particular attention is paid to accounts of the bodily aftermath: scars, marks and wounds. Scars left by self-injury can be seen as communicative, and the analysis developed here demonstrates some of the various ways that these marks may be read. Attending to these diverse narratives can contribute to the provision of compassionate, non-judgemental care for patients who have self-injured. Further, highlighting the existence of different ways of narrating the self-injured body may offer an optimistic resource for people who have self-injured. PMID:24812335

Talking about Complementary and Alternative Medicine with your Health Care Provider: A workbook and tips

Cancer.gov

A workbook to help patients and doctors talk about the use of complementary and alternative medicine(CAM) during and after cancer care. Worksheets, tips, and resources are provided for patients and doctors to help track CAM use.

Talking about complementary and alternative medicine with your health care provider: A workbook and Tips

Cancer.gov

A workbook to help patients and doctors talk about the use of complementary and alternative medicine(CAM) during and after cancer care. Worksheets, tips, and resources are provided for patients and doctors to help track CAM use.

Development and psychometric evaluation of a quantitative measure of "fat talk".

PubMed

MacDonald Clarke, Paige; Murnen, Sarah K; Smolak, Linda

2010-01-01

Based on her anthropological research, Nichter (2000) concluded that it is normative for many American girls to engage in body self-disparagement in the form of "fat talk." The purpose of the present two studies was to develop a quantitative measure of fat talk. A series of 17 scenarios were created in which "Naomi" is talking with a female friend(s) and there is an expression of fat talk. College women respondents rated the frequency with which they would behave in a similar way as the women in each scenario. A nine-item one-factor scale was determined through principal components analysis and its scores yielded evidence of internal consistency reliability, test-retest reliability over a five-week time period, construct validity, discriminant validity, and incremental validity in that it predicted unique variance in body shame and eating disorder symptoms above and beyond other measures of self-objectification. Copyright 2009 Elsevier Ltd. All rights reserved.

Destructive Dialogue: Negative Self-Talk and Effective Imaging.

ERIC Educational Resources Information Center

Weaver, Richard L., II; Cotrell, Howard W.

Destructive dialogue, originating from frustration and disappointment, is an intrapersonal process that always involves a person in a relationship to others and that can be defined as inner talk cast in a negative tone. It is so powerful, influential, and pervasive that it can affect all aspects of a person's life and become a self-fulfilling…

Teachers' Report of Strategies Used to Facilitate Language Development in Students with Hearing Loss

ERIC Educational Resources Information Center

Handley, Candace Michele

2013-01-01

The purpose of this study was to identify the extent to which teachers of the deaf report using four identified language facilitation strategies: recasting, extension, responsivity, and self-talk/parallel talk. Participants self-selected in response to an advertisement on a state-wide listserv and to the state's residential school internal news.…

Multicenter Retrospective Cohort Study of "Talk and Die" After Traumatic Brain Injury.

PubMed

Shibahashi, Keita; Sugiyama, Kazuhiro; Okura, Yoshihiro; Hoda, Hidenori; Hamabe, Yuichi

2017-11-01

Patients who "talk and die" after traumatic brain injury (TBI) are potentially salvageable. The reported incidences and risk factors for the "talk and die" phenomenon are conflicting and do not take into account recent improvements in trauma care. The aim of this study was to determine the incidences of "talk and die" after TBI in a modern trauma care system, as well as associated risk factors. We identified patients who experienced TBI (abbreviated injury scale 3-5) between 2004 and 2015 who talked on admission (i.e., their verbal component on the Glasgow Coma Scale was ≥3 on admission) using a nationwide trauma registry (the Japan Trauma Data Bank). The end point was in-hospital mortality. We compared patients who talked and died with those who talked and survived. During the study period, 236,698 patients were registered in the database. Of the 24,833 patients who were eligible for analysis, 956 (4.0%) patients subsequently died in the hospital. The in-hospital mortality rate significantly decreased over the past 12 years. Older age; male sex; a higher injury severity score; a lower Glasgow Coma Scale score; comorbidities (congestive heart failure, chronic kidney disease, liver cirrhosis, and hematologic disorders); hypotension on arrival; subdural hemorrhage; contusion; and vault fracture were independently associated with higher in-hospital mortality. Even in modern trauma care systems, some patients still talk and die after TBI. We identified certain risk factors in patients with TBI that elicit the requirement for close observation, even if these patients talk after TBI. Copyright © 2017 Elsevier Inc. All rights reserved.

A Peer-Led Decision Support Intervention Improves Decision Outcomes in Black Women with Breast Cancer

PubMed Central

Wallington, Sherrie F.; Willey, Shawna C.; Hampton, Regina M.; Lucas, W.; Jennings, Y.; Horton, S.; Muzeck, N.; Cocilovo, C.; Isaacs, C.

2013-01-01

Previous reports suggest that Black breast cancer patients receive less patient-centered cancer care than their White counterparts. Interventions to improve patient-centered care (PCC) in Black breast cancer patients are lacking. Seventy-six women with histologically confirmed breast cancer were recruited from the Washington, DC area. After a baseline telephone interview, women received an in-person decision support educational session led by a trained survivor coach. The coach used a culturally appropriate guidebook and decision-making model—TALK Back!© A follow-up assessment assessed participants’ acceptability of the intervention and intermediate outcomes. After the intervention, participants reported increased: self-efficacy in communicating with providers (70 %) and self-efficacy in making treatment decisions (70 %). Compared to baseline scores, post-intervention communication with providers significantly increased (p=.000). This is the first outcome report of an intervention to facilitate PCC in Black breast cancer patients. Testing this intervention using RCTs or similar designs will be important next steps. PMID:23576067

Using the RPE-Talk Scale to Individualize Physical Activity for Students

ERIC Educational Resources Information Center

Nye, Susan B.; Todd, M. Kent

2013-01-01

For some students, self-selecting a pace during exercise may not provide enough of a physical challenge. Others push themselves so hard that they tire out before they can experience the benefits of exercise. In order to improve self-monitoring of exercise intensity, a variety of tools using the perception of effort and the ability to talk while…

Nightmare Help: A Guide for Adults Working with Children (Slide Talk).

ERIC Educational Resources Information Center

Wiseman, Ann Sayre

This slide talk offers advice to adults to help children cope with nightmares. Children are encouraged (1) to assume power over the dream by drawing it; (2) separate the frightened part of the self from the problem-solving self; (3) let the picture describe the problem; (4) ask the picture to speak; (5) see how the dreamer's power matches the…

EM Talk: communication skills training for emergency medicine patients with serious illness.

PubMed

Grudzen, Corita R; Emlet, Lillian L; Kuntz, Joanne; Shreves, Ashley; Zimny, Erin; Gang, Maureen; Schaulis, Monique; Schmidt, Scott; Isaacs, Eric; Arnold, Robert

2016-06-01

The emergency department visit for a patient with serious illness represents a sentinel event, signalling a change in the illness trajectory. By better understanding patient and family wishes, emergency physicians can reinforce advance care plans and ensure the hospital care provided matches the patient's values. Despite their importance in care at the end of life, emergency physicians have received little training on how to talk to seriously ill patients and their families about goals of care. To expand communication skills training to emergency medicine, we developed a programme to give emergency medicine physicians the ability to empathically deliver serious news and to talk about goals of care. We have built on lessons from prior studies to design an intervention employing the most effective pedagogical techniques, including the use of simulated patients/families, role-playing and small group learning with constructive feedback from master clinicians. Here, we describe our evidence-based communication skills training course EM Talk using simulation, reflective feedback and deliberate practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Does Universally Accessible Child Care Protect Children from Late Talking? Results from a Norwegian Population-Based Prospective Study

ERIC Educational Resources Information Center

Lekhal, Ratib; Zachrisson, Henrik Daae; Wang, Mari Vaage; Schjolberg, Synnve; von Soest, Tilmann

2011-01-01

This study examines the association between type of child care arrangement at age 1, 1.5 and 3 years and late talking (LT). The data were from 19,919 children in the population-based prospective Norwegian Mother and Child Cohort Study (MoBa) and included information about child care arrangement, LT and a variety of covariates. Attendance at…

A comparison of mental strategies during athletic skills performance.

PubMed

Peluso, Eugenio A; Ross, Michael J; Gfeller, Jeffrey D; Lavoie, Donna J

2005-12-01

The current study examined the effects of performance enhancement techniques (PET's) on motor skill performance. Specifically, one hundred fifty college student volunteers (Men = 41; 27.3% and Women = 109; 72.6%) were randomly assigned to one of the nine conditions (Cond): Cond 1 and 2, simultaneous, externally verbalized self-talk or imagery (e.g., participants were instructed to say "aim, back, birdie "or engaged in imagery out loud while putting); Cond 3 and 4, delayed externally verbalized self-talk or imagery (e.g., participants were instructed to say "aim, back, birdie "or engaged in imagery out loud before putting); Cond 5 and 6, simultaneous, internally verbalized self-talk or imagery (e.g., participants were instructed to say "aim, back, birdie "or engaged in imagery silently to oneself while putting); Cond 7 and 8, delayed internally verbalized (e.g., participant were instructed to say "aim, back, birdie "or engaged in imagery silently to oneself before putting); and Cond 9, no instruction control group. All participants were asked to perform a golf-putting task. Results indicated that participants who implemented several (PET's) increased their putting accuracy across overall difference score evaluations F (8, 141) = 4.01, p < 0.05 when compared to a no instruction control condition. Follow-up analyses indicated that participants who reportedly engaged in ten hours or less of athletic activities per week preferred self-talk strategies F (2, 119) = 4.38, p < 0.05 whereas participants who endorsed ten hours or more of athletic activity per week preferred imagery strategies F (2, 25) = 5.27, p < 0.05. Key PointsMental imagery and self-talk strategies are implemented by athletes in order to regulate arousal, reduce maladaptive behaviors, reconstruct negative thoughts, and to increase one's concentration and focus.Results of the current study suggest that participants who engaged in several performance enhancement techniques exhibited enhanced performance on a golf putting task when compared to participants in a control condition.Participants who endorsed limited athletic familiarity and activity (e.g., ten hours or less) preferred self-talk practice whereas participants who endorsed higher ratings scores of athletic familiarity and activity (e.g., ten hours or more) preferred imagery strategies.The results of this study demonstrate the flexibility of Performance Enhancement Techniques (e.g., imagery v. self-talk, internal v. external, simultaneous v. delayed) and how they can be implemented to help an athlete reach his or her full potential.

Naptime Data Meetings to Increase the Math Talk of Early Care and Education Providers

ERIC Educational Resources Information Center

Trawick-Smith, Jeffrey; Oski, Heather; DePaolis, Kim; Krause, Kristen; Zebrowski, Alyssa

2016-01-01

Classroom conversations about mathematics--math talk--between early care and education providers and young children have been associated with growth in mathematical thinking. However, professional development opportunities to learn about math teaching and learning are limited in many community-based child development centers. New approaches that…

Self-Talk in Wheelchair Basketball: The Effects of an Intervention Program on Dribbling and Passing Performance

ERIC Educational Resources Information Center

Harbalis, Thomas; Hatzigeorgiadis, Antonis; Theodorakis, Yannis

2008-01-01

The purpose of this study was to examine the effectiveness of a self-talk intervention program on performance of wheelchair basketball drills. Twenty-two (N = 22) wheelchair basketball athletes from two different clubs of the same league participated in the study. The duration of the intervention was 12 weeks and its aim was the improvement of two…

Personalization in Mother-Child Emotion Talk across Three Contexts

ERIC Educational Resources Information Center

Kucirkova, Natalia; Tompkins, Virginia

2014-01-01

An unexplored aspect of contextual variation in emotion talk is the extent to which the emotions mothers and children discuss relate to the child, mother, or another self. To establish the extent to which mothers and children personalize the emotions they discuss, we examined the emotion talk of 40 American mother-child dyads in three…

ToonTalk(TM)--An Animated Programming Environment for Children.

ERIC Educational Resources Information Center

Kahn, Ken

This paper describes ToonTalk, a general-purpose concurrent programming system in which the source code is animated and the programming environment is a video game. The design objectives of ToonTalk were to create a self-teaching programming system for children that was also a very powerful and flexible programming tool. A keyboard can be used for…

Approaches for targeting self-renewal pathways in cancer stem cells: implications for hematological treatments.

PubMed

Horne, Gillian A; Copland, Mhairi

2017-05-01

Self-renewal is considered a defining property of stem cells. Self-renewal is essential in embryogenesis and normal tissue repair and homeostasis. However, in cancer, self-renewal pathways, e.g. WNT, NOTCH, Hedgehog and BMP, frequently become de-regulated in stem cells, or more mature progenitor cells acquire self-renewal properties, resulting in abnormal tissue growth and tumorigenesis. Areas covered: This review considers the conserved embryonic self-renewal pathways, including WNT, NOTCH, Hedgehog and BMP. The article describes recent advances in our understanding of these pathways in leukemia and, more specifically, leukemia stem cells (LSC), how these pathways cross-talk and interact with the LSC microenvironment, and discusses the clinical implications and potential therapeutic strategies, both in preclinical and in clinical trials for hematological malignancies. Expert opinion: The conserved embryonic self-renewal pathways are frequently de-regulated in cancer stem cells (CSC), including LSCs. There is significant cross-talk between self-renewal pathways, and their downstream targets, and the microenvironment. Effective targeting of these pathways is challenging due to cross-talk, and importantly, because these pathways are important for normal stem cells as well as CSC, adverse effects on normal tissues may mean a therapeutic window cannot be identified. Nonetheless, several agents targeting these pathways are currently in clinical trials in hematological malignancies.

Improvement of 10-km time-trial cycling with motivational self-talk compared with neutral self-talk.

PubMed

Barwood, Martin J; Corbett, Jo; Wagstaff, Christopher R D; McVeigh, Dan; Thelwell, Richard C

2015-03-01

Unpleasant physical sensations during maximal exercise may manifest themselves as negative cognitions that impair performance, alter pacing, and are linked to increased rating of perceived exertion (RPE). This study examined whether motivational self-talk (M-ST) could reduce RPE and change pacing strategy, thereby enhancing 10-km time-trial (TT) cycling performance in contrast to neutral self-talk (N-ST). Fourteen men undertook 4 TTs, TT1-TT4. After TT2, participants were matched into groups based on TT2 completion time and underwent M-ST (n=7) or N-ST (n=7) after TT3. Performance, power output, RPE, and oxygen uptake (VO2) were compared across 1-km segments using ANOVA. Confidence intervals (95%CI) were calculated for performance data. After TT3 (ie, before intervention), completion times were not different between groups (M-ST, 1120±113 s; N-ST, 1150±110 s). After M-ST, TT4 completion time was faster (1078±96 s); the N-ST remained similar (1165±111 s). The M-ST group achieved this through a higher power output and VO2 in TT4 (6th-10th km). RPE was unchanged. CI data indicated the likely true performance effect lay between 13- and 71-s improvement (TT4 vs TT3). M-ST improved endurance performance and enabled a higher power output, whereas N-ST induced no change. The VO2 response matched the increase in power output, yet RPE was unchanged, thereby inferring a perceptual benefit through M-ST. The valence and content of self-talk are important determinants of the efficacy of this intervention. These findings are primarily discussed in the context of the psychobiological model of pacing.

"You better not leave me shaming!": Conditional indirect effect analyses of anti-fat attitudes, body shame, and fat talk as a function of self-compassion in college women.

PubMed

Webb, Jennifer B; Fiery, Mallory F; Jafari, Nadia

2016-09-01

The present investigation provided a theoretically-driven analysis testing whether body shame helped account for the predicted positive associations between explicit weight bias in the form of possessing anti-fat attitudes (i.e., dislike, fear of fat, and willpower beliefs) and engaging in fat talk among 309 weight-diverse college women. We also evaluated whether self-compassion served as a protective factor in these relationships. Robust non-parametric bootstrap resampling procedures adjusted for body mass index (BMI) revealed stronger indirect and conditional indirect effects for dislike and fear of fat attitudes and weaker, marginal effects for the models inclusive of willpower beliefs. In general, the indirect effect of anti-fat attitudes on fat talk via body shame declined with increasing levels of self-compassion. Our preliminary findings may point to useful process variables to target in mitigating the impact of endorsing anti-fat prejudice on fat talk in college women and may help clarify who is at higher risk. Copyright © 2016 Elsevier Ltd. All rights reserved.

Advancing the recovery orientation of hospital care through staff engagement with former clients of inpatient units.

PubMed

Kidd, Sean A; McKenzie, Kwame; Collins, April; Clark, Carrie; Costa, Lucy; Mihalakakos, George; Paterson, Jane

2014-02-01

This study was undertaken to assess the impact of consumer narratives on the recovery orientation and job satisfaction of service providers on inpatient wards that focus on the treatment of schizophrenia. It was developed to address the paucity of literature and service development tools that address advancing the recovery model of care in inpatient contexts. A mixed-methods design was used. Six inpatient units in a large urban psychiatric facility were paired on the basis of characteristic length of stay, and one unit from each pair was assigned to the intervention. The intervention was a series of talks (N=58) to inpatient staff by 12 former patients; the talks were provided approximately biweekly between May 2011 and May 2012. Self-report measures completed by staff before and after the intervention assessed knowledge and attitudes regarding the recovery model, the delivery of recovery-oriented care at a unit level, and job satisfaction. In addition, focus groups for unit staff and individual interviews with the speakers were conducted after the speaker series had ended. The hypothesis that the speaker series would have an impact on the attitudes and knowledge of staff with respect to the recovery model was supported. This finding was evident from both quantitative and qualitative data. No impact was observed for recovery orientation of care at the unit level or for job satisfaction. Although this engagement strategy demonstrated an impact, more substantial change in inpatient practices likely requires a broader set of strategies that address skill levels and accountability.

Emotion talk in the context of young people self-harming: facing the feelings in family therapy.

PubMed

Rogers, Alice; Schmidt, Petra

2016-04-01

This article describes the use of emotion talk in the context of using a manualised approach to family therapy where the presenting problem is self-harm. Whilst we understand that there is an internal aspect to emotion, we also consider emotions to be socially purposeful, culturally constructed and interactional. We found that within the presenting families, negative emotions were often talked about as located within the young person. Through using 'emotion talk' (Fredman, 2004) in deconstructing and tracking emotions and exploring how emotions connected to family-of-origin and cultural contexts, we developed an interactional understanding of these emotions. This led to better emotional regulation within the family and offered alternative ways of relating. The article discusses the use of relational reflexivity, and using the therapist and team's emotions to enable the therapeutic process, encouraging reflexivity on the self of the therapist in relation to work with emotions. Emotions can be seen as both a reflection of feelings experienced by the individual and as a communication.An interactional understanding of emotions can be used therapeutically.Therapists should explore emotional displays and track the interactional patterns within the therapeutic system.Therapists should self-reflexive about ways of doing emotions and use this awareness in practice.

The effects of a walking/talking program on communication, ambulation, and functional status in residents with Alzheimer disease.

PubMed

Cott, Cheryl A; Dawson, Pamela; Sidani, Souraya; Wells, Donna

2002-01-01

The purpose of this study was to investigate the effects of a walking/talking program on residents' communication, ambulation, and level of function when there were two residents to one care provider (2:1). A randomized control trial design was used. Subjects were residents with Alzheimer disease in three geriatric long-term care facilities in Metropolitan Toronto. Residents who met the inclusion criteria were randomly assigned to one of three groups: walk-and-talk group (30 min, 5 times per week for 16 weeks, walking/talking in pairs), talk-only group (30 min, 5 times per week for 16 weeks, talk only in pairs), or no intervention. The outcome measures were the Functional Assessment of Communication Skills for Adults, the 2-min walk test, and London Psychogeriatric Rating Scale. Residents who received the walk-and-talk intervention did not demonstrate statistically significant differences in the outcome variables measured posttest when compared with residents who received the talk-only intervention or no intervention, even after controlling for individual differences. Variability in the outcomes measured posttest is explained by differences in the residents' level of cognitive impairment before the study rather than by study group membership. These findings are contradictory to those of previous studies.

Estimates of Social Contact in a Middle School Based on Self-Report and Wireless Sensor Data.

PubMed

Leecaster, Molly; Toth, Damon J A; Pettey, Warren B P; Rainey, Jeanette J; Gao, Hongjiang; Uzicanin, Amra; Samore, Matthew

2016-01-01

Estimates of contact among children, used for infectious disease transmission models and understanding social patterns, historically rely on self-report logs. Recently, wireless sensor technology has enabled objective measurement of proximal contact and comparison of data from the two methods. These are mostly small-scale studies, and knowledge gaps remain in understanding contact and mixing patterns and also in the advantages and disadvantages of data collection methods. We collected contact data from a middle school, with 7th and 8th grades, for one day using self-report contact logs and wireless sensors. The data were linked for students with unique initials, gender, and grade within the school. This paper presents the results of a comparison of two approaches to characterize school contact networks, wireless proximity sensors and self-report logs. Accounting for incomplete capture and lack of participation, we estimate that "sensor-detectable", proximal contacts longer than 20 seconds during lunch and class-time occurred at 2 fold higher frequency than "self-reportable" talk/touch contacts. Overall, 55% of estimated talk-touch contacts were also sensor-detectable whereas only 15% of estimated sensor-detectable contacts were also talk-touch. Contacts detected by sensors and also in self-report logs had longer mean duration than contacts detected only by sensors (6.3 vs 2.4 minutes). During both lunch and class-time, sensor-detectable contacts demonstrated substantially less gender and grade assortativity than talk-touch contacts. Hallway contacts, which were ascertainable only by proximity sensors, were characterized by extremely high degree and short duration. We conclude that the use of wireless sensors and self-report logs provide complementary insight on in-school mixing patterns and contact frequency.

Estimates of Social Contact in a Middle School Based on Self-Report and Wireless Sensor Data

PubMed Central

Leecaster, Molly; Toth, Damon J. A.; Pettey, Warren B. P.; Rainey, Jeanette J.; Gao, Hongjiang; Uzicanin, Amra; Samore, Matthew

2016-01-01

Estimates of contact among children, used for infectious disease transmission models and understanding social patterns, historically rely on self-report logs. Recently, wireless sensor technology has enabled objective measurement of proximal contact and comparison of data from the two methods. These are mostly small-scale studies, and knowledge gaps remain in understanding contact and mixing patterns and also in the advantages and disadvantages of data collection methods. We collected contact data from a middle school, with 7th and 8th grades, for one day using self-report contact logs and wireless sensors. The data were linked for students with unique initials, gender, and grade within the school. This paper presents the results of a comparison of two approaches to characterize school contact networks, wireless proximity sensors and self-report logs. Accounting for incomplete capture and lack of participation, we estimate that “sensor-detectable”, proximal contacts longer than 20 seconds during lunch and class-time occurred at 2 fold higher frequency than “self-reportable” talk/touch contacts. Overall, 55% of estimated talk-touch contacts were also sensor-detectable whereas only 15% of estimated sensor-detectable contacts were also talk-touch. Contacts detected by sensors and also in self-report logs had longer mean duration than contacts detected only by sensors (6.3 vs 2.4 minutes). During both lunch and class-time, sensor-detectable contacts demonstrated substantially less gender and grade assortativity than talk-touch contacts. Hallway contacts, which were ascertainable only by proximity sensors, were characterized by extremely high degree and short duration. We conclude that the use of wireless sensors and self-report logs provide complementary insight on in-school mixing patterns and contact frequency. PMID:27100090

Crafting the group: Care in research management.

PubMed

Davies, Sarah R; Horst, Maja

2015-06-01

This article reports findings from an interview study with group leaders and principal investigators in Denmark, the United Kingdom and the United States. Taking as our starting point current interest in the need to enhance 'responsible research and innovation', we suggest that these debates can be developed through attention to the talk and practices of scientists. Specifically, we chart the ways in which interview talk represented research management and leadership as processes of caring craftwork. Interviewees framed the group as the primary focus of their attention (and responsibilities), and as something to be tended and crafted; further, this process required a set of affective skills deployed flexibly in response to the needs of individuals. Through exploring the presence of notions of care in the talk of principal investigators and group leaders, we discuss the relation between care and craft, reflect on the potential implications of the promotion of a culture of care and suggest how mundane scientific understandings of responsibility might relate to a wider discussion of responsible research and innovation.

Parallel vigilance: parents' dual focus following diagnosis of Type 1 diabetes mellitus in their young child.

PubMed

Niedel, Selaine; Traynor, Michael; McKee, Martin; Grey, Margaret

2013-05-01

There is consensus that enabling patient self-care and expertise leads to better management of chronic illness. Clinicians are being encouraged to manage clinical encounters in ways that promote these outcomes rather than perpetuate hierarchical relationships. This article describes one part of a larger study of 55 outpatient consultations conducted within 14 months of the diagnosis of Type 1 diabetes mellitus in young children. Participants were parents and the specialist doctors, nurses, dieticians and social workers who oversee the child's secondary care. Consultations were audio-recorded and transcribed. Our analysis draws on aspects of conversation analysis (CA) to investigate how parents' talk enacts a growing confidence in the management of their child's disease in the face of questioning from professionals. Analysis reveals how this talk distinguishes a duality of focus that combines the normal watchfulness exhibited by all parents as they protect their children, with an additional intense, parallel watchfulness for signs of potentially serious manifestations of diabetes. We term this phenomenon parallel vigilance and illustrate its development using five representative extracts from consultations. The concept of parallel vigilance extends the chronic illness literature and informs our understanding of a process that contributes to parents' developing expertise and provides new and important insights into the way in which parents conceptualize and implement their evolving role in the care of their child. Moreover, parallel vigilance serves as an enabler of parental contributions to the specialist consultation.

Caring for muscle spasticity or spasms

MedlinePlus

High muscle tone - care; Increased muscle tension - care; Upper motor neuron syndrome - care; Muscle stiffness - care ... and doing daily tasks. Talk with your health care provider or physical therapist first before starting any ...

Caregivers' Use of Metacognitive Language in Child Care Centers: Prevalence and Predictors

ERIC Educational Resources Information Center

Frampton, Kristen L.; Perlman, Michal; Jenkins, Jennifer M.

2009-01-01

Use of metacognitive language by child care center staff in classrooms that serve preschool-aged children was examined. Staff's use of mental-state talk, perspective-taking talk, and activity-relevant questioning with children were coded in a series of 20-s snapshots taken over the course of one full morning per classroom. A total of 3401…

Provider awareness alone does not improve transition readiness skills in adolescent patients with inflammatory bowel disease.

PubMed

Fishman, Laurie N; Ziniel, Sonja I; Adrichem, Max E; Fernandes, Susan M; Arnold, Janis

2014-08-01

Adolescent patients with chronic health conditions must gradually assume responsibility for their health. Self-management skills are needed for a successful transfer from adolescent to adult health care, but the development of these skills could be resource intensive. Pediatric providers are already instrumental in teaching patients about their health and may improve these skills. The aim of the study was to evaluate whether informal education of pediatric providers regarding transition improves inflammatory bowel disease (IBD) patient self-management skills. Consecutive patients with IBD older than 10 years who presented to the outpatient setting were administered a survey regarding self-management behaviors in 2008 and 2011. During this time, several conferences on transition were presented to the providers. In 2008, 294 patients completed the survey (82%) compared with 121 patients (89%) in 2011. The patient groups were comparable with respect to sex (boys 50% vs 42%), mean age (16.7 vs 16.2 years), and type of IBD (Crohn 68% vs 66%). The 13- to 15-year-olds reported calling in refills (11%, 8%, respectively), scheduling clinic appointment (0, 1%), preparing questions (13%, 5%), and taking the main role in talking during clinic visits (15%, 24%). The 16- to 18-year-olds reported calling in refills (13%, 27%), scheduling clinic appointments (9%, 6%), preparing questions (9%, 16%), and taking the main role in talking in clinic visits (36%, 45%). Responsibility for behaviors gradually increases with age, but did not differ significantly between 2008 and 2011. Increasing awareness around transition readiness for pediatric providers had an insignificant effect on the self-management skills of patients with IBD. A more formal or structured approach is likely required to improve transition skills in adolescent patients.

Nurse and Patient Characteristics Associated with Duration of Nurse Talk During Patient Encounters in ICU

PubMed Central

Nilsen, Marci Lee; Sereika, Susan; Happ, Mary Beth

2012-01-01

Background Communication interactions between nurses and mechanically ventilated patients in the intensive care unit (ICU) are typically brief. Factors associated with length of nurses’ communication have not been explored. Objective To examine the association between nurse and patient characteristics and duration of nurse talk. Methods In this secondary analysis, we calculated duration of nurse talk in the first 3-minutes of video-recorded communication observation sessions for each nurse-patient dyad (n=89) in the SPEACS study (4 observation sessions/dyad, n=356). In addition, we explored the association between nurses’ characteristics (age, gender, credentials, nursing experience, and critical care experience) and patients’ characteristics (age, gender, race, education, delirium, agitation-sedation, severity of illness, level of consciousness, prior intubation history, days intubated prior to study enrollment, and type of intubation) on duration of nurse talk during the 3-minute interaction observation. Results Duration of nurse talk ranged from 0–123 seconds and varied significantly over the 4 observation sessions (p=.007). Averaging the duration of nurse talk over the observation sessions, differences in talk time between the units varied significantly by study group (p<.001). Talk duration was negatively associated with a Glasgow Coma Scale ≤ 14 (p=.008). Length of intubation prior to study enrollment had a curvilinear relationship with talking duration (linear p=.002, quadratic p=.013); the point of inflection was at 23 days. Nurse characteristics were not significantly related to duration of nurse talk. Conclusion Length of time the patient is intubated, and the patient’s level of consciousness may influence duration of nurse communication in ICU. PMID:23305914

Neglected Diseases

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Learning to "Talk the Talk": The Relationship of Psychopathic Traits to Deficits in Empathy across Childhood

ERIC Educational Resources Information Center

Dadds, Mark R.; Hawes, David J.; Frost, Aaron D. J.; Vassallo, Shane; Bunn, Paul; Hunter, Kirsten; Merz, Sabine

2009-01-01

Background: Psychopathy is characterised by profound deficits in the human tendency to feel and care about what other people feel, often known as "affective empathy". On the other hand, the psychopath often has intact "cognitive" empathy skills, that is, he is able to describe what and why other people feel, even if he does not share or care about…

Building Self-Esteem.

ERIC Educational Resources Information Center

Gover, Jill

Self-esteem lies at the core of psychological health. This paper presents several strategies individuals might use for stopping negative self-criticism, overcoming self-rejection, and developing greater acceptance and compassion for themselves and others. The first step involves identifying any negative self-talk and then writing these thoughts…

Self-Advocacy. Feature Issue.

ERIC Educational Resources Information Center

Hayden, Mary F., Ed.; Ward, Nancy, Ed.

1994-01-01

This feature issue newsletter looks at issues the self-advocacy movement is raising and the contributions it is making to the lives of people with developmental disabilities. Articles by self-advocates and advisors to self-advocacy organizations talk about their self-advocacy experiences, barriers to self-advocacy, and ways to support it. Primary…

Learning about Cystic Fibrosis

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Learning about Retinitis Pigmentosa

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Learning about Breast Cancer

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Learning about Klinefelter Syndrome

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Learning about Skin Cancer

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Learning about Holoprosencephaly (HPE)

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Learning about Hereditary Hemochromatosis

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Learning about Dercum Disease

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Learning about Duane Syndrome

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Conversation map: an educational strategy in the care of elderly people with diabetes mellitus.

PubMed

Carvalho, Silvana Linhares de; Ferreira, Marília Araripe; Medeiros, Juliana Mineu Pereira; Queiroga, Anne Caroline Ferreira; Moreira, Tatiana Rebouças; Negreiros, Francisca Diana da Silva

2018-01-01

To report the experience of using diabetes conversation maps as an educational strategy for diabetic elderly people. Experience report, conducted from July to December 2016 in a specialized outpatient clinic for diabetics, in Fortaleza, Ceará, Brazil. A total of 72 users participated, between diabetics and those accompanying them. The participants talked about issues that were not addressed in personal consultations, and could see themselves through the stories of others, thus realizing they were not alone and that others also experienced the same difficulties as them. Through empathy and the accounts of others, participants built knowledge and practices for their own daily lives. Final Considerations: The conversation map enables professionals to empower patients with diabetes, promoting self-care and ensuring better control over the disease, in order to prevent or delay the onset of related complications.

Barriers and facilitators to epilepsy self-management for patients with physical and psychological co-morbidity.

PubMed

Perzynski, Adam T; Ramsey, Riane K; Colón-Zimmermann, Kari; Cage, Jamie; Welter, Elisabeth; Sajatovic, Martha

2017-09-01

Objectives This exploratory study identifies barriers and facilitators to self-management to inform future epilepsy self-management interventions for persons who have epilepsy complicated by co-morbid mental health conditions and serious medical events. Methods Focus group methods were used in a series of community advisory board meetings. Analysis was conducted using a thematic, constant comparative approach aiming to describe the range of barriers and facilitators salient to participants. There were a total of 22 participants, including 8 health professionals, 9 patients with epilepsy, and 5 care partners. Mean age was 49.1 (SD = 11.0, range 32-69), 11 (50%) were female, and 11 (50%) were male. For those with epilepsy, mean years having epilepsy was 24.7 (SD = 19.9, range 1-58 years). Results Individual psychological barriers (mental illness, fatigue, and psychological distress) prominently interfered with health behaviors. Community and family barriers included stigma, lack of epilepsy knowledge, and poor social support. Facilitators included planning for seizures, learning about medications, stress management, socializing with others, and talking with other epilepsy patients. Discussion Qualitative evidence in this study suggests a linkage between social integration and positive health behaviors. Future efforts to embed patients with epilepsy and their caregivers into clinical care processes could offset barriers and enhance facilitators.

18-24 Months: Your Child's Development

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... t do it all for him. Spotlight on Language Development Between 18 and 24 Months Learning to talk ... speak. (If you have questions about your child’s language development, talk with your health care provider or other ...

Learning about Tay-Sachs Disease

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Frequently Asked Questions about Rare Diseases

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Frequently Asked Questions about Genetic Disorders

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Learning about Cri du Chat Syndrome

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Learning about Duchenne Muscular Dystrophy

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Comparison of the Educational Needs of Neonatologists and Neonatal Nurses Regarding Palliative Care in Taiwan.

PubMed

Lee, Min-Chun; Chen, Yong-Chuan; Chen, Chao-Huei; Lu, Frank Leigh; Hsiao, Chien-Chou; Peng, Niang-Huei

2016-04-01

Education and training are very critical to development of high-quality neonatal palliative care. However, little investigation has been done into Taiwanese neonatal clinicians' educational needs regarding neonatal palliative care. The purposes of this study were to characterize and identify neonatal clinicians' educational needs regarding neonatal palliative care. A cross-sectional descriptive surveyed method via a self administered questionnaire was used in this research. Thirty neonatologists were recruited by a convenience sampling and 30 nurses were recruited by a randomized sampling. Out of sixty neonatal clinicians' survey, few had received the education in neonatal palliative care. Most reported minimal training in, experience with, and knowledge of neonatal palliative care. For neonatologists, two of twelve most strongly-felt educational needs were "discussing palliative care and ethical decision-making with parents" (70%) and "informing parents the poor progress in neonates" (63.3%). In contrast, neonatal nurses wanted more training regarding pain control (50%). Communication skills, including the discussing poor prognosis, bad news, and code status and talking with neonates about end-of-life care, were the educational need most commonly felt by both neonatologists and nurses. Survey data from neonatologists and neonatal nurses in Taiwan indicate a need for further training on a range of neonatal palliative care competencies. © The Author(s) 2014.

Personality Tests: Self-Disclosures or Self-Presentations?

ERIC Educational Resources Information Center

Johnson, John A.

When people talk about themselves, psychologists have noted that their verbal reports can be categorized as simple factual communications about the self, i.e., self-disclosure, or as ways to instruct others about how one is to be regarded, i.e., self-presentation. Responses to items on objective self-report measures of personality similarly can be…

Mental Health Nurses as therapists in a rehabilitation setting: A phenomenological study.

PubMed

Browne, Graeme; Hurley, John

2018-06-01

Mental Health Nurses have a long tradition of delivering talk-based interventions across a range of clinical settings. Despite this, Mental Health Nurses receive limited recognition of this contribution. This paper presents findings from a study that explored Mental Health Nurses' experience of delivering talk-based therapies in an inpatient rehabilitation setting. This study uses semistructured interviews and a phenomenological approach to explore eight Mental Health Nurses' experience. Themes emerging included that: mental health nursing is a talk-based therapy in its own right, talk-based therapy was part of everyday nursing care on the floor and integrated talk-based therapy enhanced recovery opportunities for consumers. However, a further theme was that there were tensions around providing talk-based therapy conflicted with other roles including unit management and the role of nurses in controlling challenging behaviours. This study found that Mental Health Nurses, in this setting, are offering talk-based therapy to the people they care for. The findings of this study have implications for research: there needs to be a larger study investigating nurses' use of talk-based therapy in inpatient settings. If, as the authors expect that, it is found that mental health nurses are offering these therapies generally in inpatient settings, this has serious implications for postgraduate education in Mental Health Nursing policy in terms of recognition that this is happening and finding ways to support nurses to do this well. There also needs to be further research in the best ways to offer talk-based therapy in these settings. © 2017 Australian College of Mental Health Nurses Inc.

Time to Talk: 5 Things You Should Know about Yoga

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... issues you have, and ask about the physical demands of yoga. Talk to your health care providers ... Personnel and Veterans 5 Myths About Popular Natural Products Marketed for Disease Prevention and Wellness See all ...

Patients’ Engagement With “Sweet Talk” – A Text Messaging Support System for Young People With Diabetes

PubMed Central

Franklin, Victoria Louise; Greene, Alexandra; Waller, Annalu; Greene, Stephen Alan

2008-01-01

Background Guidelines for optimizing type 1 diabetes in young people advocate intensive insulin therapy coupled with personal support from the health care team. “Sweet Talk” is a novel intervention designed to support patients between clinic visits using text messages sent to a mobile phone. Scheduled messages are tailored to patient profiles and diabetes self-management goals, and generic messages include topical “newsletters” and anonymized tips from other participants. The system also allows patients to submit data and questions to the diabetes care team. Objectives The aim was to explore how patients with type 1 diabetes interact with the Sweet Talk system in order to understand its utility to this user group. Methods Subjects were 64 young people with diabetes who were participating in the intervention arms of a randomized controlled trial. All text messages submitted to Sweet Talk during a 12-month period were recorded. Messaging patterns and content were analyzed using mixed quantitative and qualitative methods. Results Patients submitted 1180 messages during the observation period (mean 18.4, median 6). Messaging frequency ranged widely between participants (0-240) with a subset of 5 high users contributing 52% of the total. Patients’ clinical and sociodemographic characteristics were not associated with total messaging frequency, although girls sent significantly more messages unrelated to diabetes than did boys (P = .002). The content of patients’ messages fell into 8 main categories: blood glucose readings, diabetes questions, diabetes information, personal health administration, social messages, technical messages, message errors, and message responses. Unprompted submission of blood glucose values was the most frequent incoming message type (35% of total). Responses to requests for personal experiences and tips generated 40% of all the incoming messages, while topical news items also generated good responses. Patients also used the service to ask questions, submit information about their self-management, and order supplies. No patients nominated supporters to receive text messages about their self-management goals. Another option that was not used was the birthday reminder service. Conclusions Automated, scheduled text messaging successfully engaged young people with diabetes. While the system was primarily designed to provide “push” support to patients, submission of clinical data and queries illustrates that it was seen as a trusted medium for communicating with care providers. Responses to the newsletters and submission of personal experiences and tips for circulation to other participants also illustrate the potential value of such interventions for establishing a sense of community. Although participants submitted relatively few messages, positive responses to the system suggest that most derived passive support from reading the messages. The Sweet Talk system could be readily adapted to suit other chronic disease models and age groups, and the results of this study may help to inform the design of future text message support interventions. PMID:18653444

Danish general practitioners' self-reported competences in end-of-life care.

PubMed

Winthereik, Anna; Neergaard, Mette; Vedsted, Peter; Jensen, Anders

2016-12-01

General practitioners (GPs) are pivotal in end-of-life (EOL) care. This study aimed to assess GP-reported provision of EOL care and to assess associations with GP characteristics. Population-based questionnaire study. Central Denmark Region with approximately 1.3 million inhabitants. All 843 active GPs in the Central Denmark Region were sent a questionnaire by mail. Responses to 18 items concerning four aspects: provision of EOL care to patients with different diagnosis, confidence with being a key worker, organisation of EOL care and EOL skills (medical and psychosocial). In total, 573 (68%) GPs responded. Of these, 85% often/always offered EOL care to cancer patients, which was twice as often as to patients with non-malignancies (34-40%). Moreover, 76% felt confident about being a key worker, 60% had a proactive approach, and 58% talked to their patients about dying. Only 9% kept a register of patients with EOL needs, and 19% had specific EOL procedures. GP confidence with own EOL skills varied; from 55% feeling confident using terminal medications to 90% feeling confident treating nausea/vomiting. Increasing GP age was associated with increased confidence about being a key worker and provision of EOL care to patients with non-malignancies. In rural areas, GPs were more confident about administering medicine subcutaneously than in urban areas. We found considerable diversity in self-reported EOL care competences. Interventions should focus on increasing GPs' provision of EOL care to patients with non-malignancies, promoting better EOL care concerning organisation and symptom management. KEY POINTS GPs are pivotal in end-of-life (EOL) care, but their involvement has been questioned. Hence, GPs' perceived competencies were explored. GPs were twice as likely to provide EOL care for patients with cancer than for patients with non-malignancies. EOL care was lacking clear organisation in general practice in terms of registering palliative patients and having specific EOL procedures. GPs were generally least confident with their skills in terminal medical treatment, for example, using medicine administered subcutaneously.

A randomized controlled multimodal behavioral intervention trial for improving antiepileptic drug adherence.

PubMed

Pakpour, Amir H; Gholami, Maryam; Esmaeili, Ravanbakhsh; Naghibi, Seyed Abolhasan; Updegraff, John A; Molloy, Gerard J; Dombrowski, Stephan U

2015-11-01

Medication nonadherence is one of the most important reasons for treatment failure in patients with epilepsy. The present study investigated the effectiveness of a multicomponent intervention to improve adherence to antiepileptic drug (AED) medication in patients with epilepsy. In a prospective, randomized multicenter trial, three sessions of face-to-face motivational interviewing (MI) in combination with complementary behavior change techniques were compared with standard care. Motivational interviewing prompted change talk and self-motivated statements from the patients, planning their own medication intake regimen and also identifying and overcoming barriers that may prevent adherence. Participants were provided with calendars to self-monitor their medication taking behavior. A family member and the health-care team were invited to attend the last session of MI in order to improve the collaboration and communication between patients, their caregiver or family member, and their health-care provider. At baseline and 6-month follow-up, psychosocial variables and medical adherence were assessed. In total, 275 participants were included in the study. Compared with the active control group, patients in the intervention group reported significantly higher medication adherence, as well as stronger intention and perceptions of control for taking medication regularly. The intervention group also reported higher levels of action planning, coping planning, self-monitoring, and lower medication concerns. This study shows that MI can be effective in clinical practice to improve medication adherence in patients with epilepsy. It also provides evidence that combining volitional interventions, including action planning, coping planning, and self-monitoring with motivational interviewing can promote the effectiveness of the medical treatments for epilepsy by improving adherence. Copyright © 2015 Elsevier Inc. All rights reserved.

Implementation of Health Information Technology in Routine Care for Fibromyalgia: Pilot Study.

PubMed

Sparks, Toni; Kawi, Jennifer; Menzel, Nancy Nivison; Hartley, Kendall

2016-02-01

Fibromyalgia management remains complicated and challenging. Health information technology is an evidence-based, nonpharmacological self and symptom management strategy, but few studies have evaluated its feasibility for managing fibromyalgia patients in clinical practice. FibroGuide is an example of an evidence-based, interactive, and computer-based program comprised of 10 educational modules on fibromyalgia. Study aims were to: (1) develop a process for implementing FibroGuide into the routine care of patients with fibromyalgia, (2) evaluate the overall impact on fibromyalgia before and after a 12-week implementation, and (3) assess patient perspectives on using FibroGuide health information technology to assist in self-management. In this pilot study, 35 participants with fibromyalgia were recruited from an Advanced Practice Registered Nurse's outpatient clinic. Using a descriptive design, quantitative data analysis was employed to address study aims. Based on data collection pre- and post-intervention using paired samples testing, a statistically significant change (p = .017) was observed in overall fibromyalgia impact (improved symptom severity, activity, and function). Majority felt that FibroGuide was helpful as part of their routine care, and nearly half reported that it assisted in their self-management. Although 65% noted that technology was an effective and efficient way to receive education for fibromyalgia management, 57% preferred talking to healthcare providers. Larger longitudinal studies are needed on the use of health information technology in fibromyalgia, evaluating both statistical and clinical significance, while decreasing barriers to participant use for this promising adjunct to clinical management. Providers need to be well educated on supporting self-management strategies and health information technology. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Developing patient-centred care: an ethnographic study of patient perceptions and influence on quality improvement.

PubMed

Renedo, Alicia; Marston, Cicely

2015-04-23

Understanding quality improvement from a patient perspective is important for delivering patient-centred care. Yet the ways patients define quality improvement remains unexplored with patients often excluded from improvement work. We examine how patients construct ideas of 'quality improvement' when collaborating with healthcare professionals in improvement work, and how they use these understandings when attempting to improve the quality of their local services. We used in-depth interviews with 23 'patient participants' (patients involved in quality improvement work) and observations in several sites in London as part of a four-year ethnographic study of patient and public involvement (PPI) activities run by Collaborations for Leadership in Applied Health Research and Care for Northwest London. We took an iterative, thematic and discursive analytical approach. When patient participants tried to influence quality improvement or discussed different dimensions of quality improvement their accounts and actions frequently started with talk about improvement as dependent on collective action (e.g. multidisciplinary healthcare professionals and the public), but usually quickly shifted away from that towards a neoliberal discourse emphasising the role of individual patients. Neoliberal ideals about individual responsibility were taken up in their accounts moving them away from the idea of state and healthcare providers being held accountable for upholding patients' rights to quality care, and towards the idea of citizens needing to work on self-improvement. Participants portrayed themselves as governed by self-discipline and personal effort in their PPI work, and in doing so provided examples of how neoliberal appeals for self-regulation and self-determination also permeated their own identity positions. When including patient voices in measuring and defining 'quality', governments and public health practitioners should be aware of how neoliberal rationalities at the heart of policy and services may discourage consumers from claiming rights to quality care by contributing to public unwillingness to challenge the status quo in service provision. If the democratic potential of patient and public involvement initiatives is to be realised, it will be crucial to help citizens to engage critically with how neoliberal rationalities can undermine their abilities to demand quality care.

Walking the Talk: Fostering Self-Regulated Learning in the Classroom.

ERIC Educational Resources Information Center

Ridley, D. Scott; And Others

1994-01-01

Describes how teachers can transform self-regulated learning theory and research into classroom practice. Defines the concept and discusses the costs of encouraging student dependency, the benefits of nurturing student self-regulation, and implementation recommendations. Teachers should model self-regulatory attitudes and behaviors, incorporate…

In pursuit of leanness: the management of appearance, affect and masculinities within a men's weight loss forum.

PubMed

Bennett, Eleanor; Gough, Brendan

2013-05-01

In a somatic society which promotes visible, idealized forms of embodiment, men are increasingly being interpellated as image-conscious body-subjects. Some research suggests that men negotiate appearance issues in complex and varied ways, partly because image concerns are conventionally feminized. However, little research has considered how overweight men construct body projects in the context of weight loss, or how men talk to each other about weight management efforts. Since sources of information and support for overweight men are now provided online, including dedicated weight loss discussion forums, our analysis focuses on one such forum, linked to a popular male-targeted magazine. We conducted a thematic analysis of selected extracts from seven threads on the forum. Our analysis suggests a widespread focus on appearance, as well as the use of emotion categories when describing difficult bodily experiences. Invariably, however, such talk was carefully constructed and constrained by hegemonic masculinities founded on discipline, work-orientation, pragmatism and self-reliance. The findings are discussed in relation to magazine masculinities and aesthetics, as well as literature on male embodiment.

Masculinity and urogenital cancer: sensitive issues in health care.

PubMed

Nobis, Regina; Sand, Inger; Elofsson, Kristina

2007-02-01

The aim of this literature review was to analyse the approaches adopted by patients, health professionals, spouses and other care-givers towards sensitive issues related to male urogenital cancer, and to describe how these findings can be applied in health care practice. The findings revealed five identifiable domains, namely 'the barrier to talking', 'the barrier of sensitivity', 'the barrier of masculinity', 'the barrier to seeking health care' and 'the communicative barrier'. The conclusion was that the phenomenon of a barrier is strongly connected with hegemonic masculinity. The review of literature confirmed that, for many men, talking about genitally-related health problems is not easy and that health care professionals need to learn more about gender and masculinity in order to address urogenitally sensitive issues.

Depression, negative emotionality, and self-referential language: A multi-lab, multi-measure, and multi-language-task research synthesis.

PubMed

Tackman, Allison M; Sbarra, David A; Carey, Angela L; Donnellan, M Brent; Horn, Andrea B; Holtzman, Nicholas S; Edwards, To'Meisha S; Pennebaker, James W; Mehl, Matthias R

2018-03-05

Depressive symptomatology is manifested in greater first-person singular pronoun use (i.e., I-talk), but when and for whom this effect is most apparent, and the extent to which it is specific to depression or part of a broader association between negative emotionality and I-talk, remains unclear. Using pooled data from N = 4,754 participants from 6 labs across 2 countries, we examined, in a preregistered analysis, how the depression-I-talk effect varied by (a) first-person singular pronoun type (i.e., subjective, objective, and possessive), (b) the communication context in which language was generated (i.e., personal, momentary thought, identity-related, and impersonal), and (c) gender. Overall, there was a small but reliable positive correlation between depression and I-talk (r = .10, 95% CI [.07, .13]). The effect was present for all first-person singular pronouns except the possessive type, in all communication contexts except the impersonal one, and for both females and males with little evidence of gender differences. Importantly, a similar pattern of results emerged for negative emotionality. Further, the depression-I-talk effect was substantially reduced when controlled for negative emotionality but this was not the case when the negative emotionality-I-talk effect was controlled for depression. These results suggest that the robust empirical link between depression and I-talk largely reflects a broader association between negative emotionality and I-talk. Self-referential language using first-person singular pronouns may therefore be better construed as a linguistic marker of general distress proneness or negative emotionality rather than as a specific marker of depression. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Teacher Talk in General and Special Education Elementary Classrooms

ERIC Educational Resources Information Center

Hollo, Alexandra; Wehby, Joseph H.

2017-01-01

Teachers' oral language use may be an important factor in student achievement, particularly for students who struggle with language, learning, and behavior. This study examined features of teacher talk during whole-class instruction in 14 general education (GE) and 14 self-contained special education (SE) elementary classrooms that included…

Tobacco Talk: Educating Young Children about Tobacco. Suggestions for Teachers, Parents, and Other Care Providers of Children to Age 10.

ERIC Educational Resources Information Center

D'Onofrio, Carol

This book provides adults with specific suggestions and advice for talking with children about the health and social hazards of tobacco use. The first two chapters provide background information and general principles for talking about tobacco with children up to the age of 10. Each of the following five chapters focuses on one topic about tobacco…

Reliability and validity enhancement: a treatment package for increasing fidelity of self-report.

PubMed

Bornstein, P H; Hamilton, S B; Miller, R K; Quevillon, R P; Spitzform, M

1977-07-01

This study investigated the effects of reliability and validity "enhancers" on fidelity of self-report data in an analogue therapy situation. Under the guise of a Concentration Skills Training Program, 57 Ss were assigned randomly to one of the following conditions: (a) Reliability Enhancement; (b) Truth Talk; (c) No Comment Control. Results indicated significant differences among groups (p less than .05). In addition, tests of multiple comparisons revealed that Reliability Enhancement was significantly different from Truth Talk in occurrences of unreliability (p less than .05). These findings are discussed in light of the increased reliance on self-report data in behavioral intervention, and recommendations are made for future research.

Vacation health care

MedlinePlus

... page: //medlineplus.gov/ency/article/001937.htm Vacation health care To use the sharing features on this page, ... and help you avoid problems. Talk to your health care provider or visit a travel clinic 4 to ...

Talking the Talk, Not Walking the Walk: Expressions from Underrepresented Students about Their Counselor Education Doctoral Programs

ERIC Educational Resources Information Center

Baker, Caroline Ann

2010-01-01

This qualitative study explored the perceptions of self-identified racial or ethnic minorities about their counselor education doctoral programs in relation to multicultural competence. More specifically, semi-structured interview questions were used to obtain information about their doctoral experiences related to faculty and peer relationships,…

Floating on a Sea of Talk: Reading Comprehension through Speaking and Listening

ERIC Educational Resources Information Center

Mills, Kathy A.

2009-01-01

Talk is the foundation for thought and understanding and the key to literacy learning. Research demonstrates that powerful metacognitive strategies can be taught to help students self-monitor their comprehension when reading print and digital texts. This article provides a repertoire of speaking and listening strategies to develop the…

Identity Constructions and Transition to Adulthood for Young People with Mild Intellectual Disabilities

ERIC Educational Resources Information Center

Midjo, Turid; Aune, Karin Ellingsen

2018-01-01

This article explores the self-constructions of young adults with mild intellectual disabilities in talk about their everyday living and how parents and professionals construct young adults with disabilities in talk about their involvement in transition processes. The analysis is related to an interpretive tradition and conducted based on…

Rational Emotive Behavior Therapy Successes and Failures: Eight Personal Perspectives.

ERIC Educational Resources Information Center

Weinrach, Stephen G.; Ellis, Albert; MacLaren, Catharine; DiGiuseppe, Raymond; Vernon, Ann; Wolfe, Janet; Malkinson, Ruth; Backx, Wouter

2001-01-01

Eight experts in Rational Emotive Behavior Therapy (REBT) provide personal examples of their own successes and failures in applying REBT to themselves. The experts actively talked to themselves both rationally and irrationally. Rational self-talk was more prevalent in the examples of how REBT was successfully used by the experts. (GCP)

Two-year-olds' understanding of self-symbols.

PubMed

Herold, Katherine; Akhtar, Nameera

2014-09-01

This study investigated 48 2.5-year-olds' ability to map from their own body to a two-dimensional self-representation and also examined relations between parents' talk about body representations and their children's understanding of self-symbols. Children participated in two dual-representation tasks in which they were asked to match body parts between a symbol and its referent. In one task, they used a self-symbol and in the other they used a symbol for a doll. Participants were also read a book about body parts by a parent. As a group, children found the self-symbol task more difficult than the doll-task; however, those whose parents explicitly pointed out the relation between their children's bodies and the symbols in the book performed better on the self-symbol task. The findings demonstrate that 2-year-old children have difficulty comprehending a self-symbol, even when it is two-dimensional and approximately the same size as them, and suggest that parents' talk about self-symbols may facilitate their understanding. © 2014 The British Psychological Society.

The air's got to be far cleaner here: a discursive analysis of place-identity threat.

PubMed

Hugh-Jones, Siobhan; Madill, Anna

2009-12-01

That talk is never disinterested complicates the relationship between the environment and the claims people make about it. Talk about place, and one's self in it, is particularly complex when the environment poses risk or is otherwise problematized. This study, a secondary analysis of interview data, seeks to extend discursive work on place-identity by examining the ways in which 14 residents of a small English village talk about themselves and their locale. The locale accommodates an active quarry, and many residents had lodged complaints to the quarry about dust, noise and vibrations from blasting. Attention to the interactional context of the interviews illustrates the ways in which (simply) interviewing people about their locale can threaten self- and place-identity. When asked about life in the village, interviewees oriented to two main dilemmas in protecting self- and place-identity: (1) how to justify continued residence in a challenging environment and (2) how to complain about the locale whilst maintaining positive place-identity. Discursive responses to these dilemmas drew upon typical identity processes, such as self- and place distinctiveness and the formulation of out-groups, as well as upon constructions of localized power-sharing and morally obligated tolerance of risk. We suggest that research on problematical places, and of environmental risk, needs to be sensitized to how it may constitute a threat to self- and place-identity, and how this may mediate formulations self and place, as well as of environmental risk.

Self-determination and empowerment: a feminist standpoint analysis of talk about disability.

PubMed

Sprague, J; Hayes, J

2000-10-01

In this paper we offer a feminist analysis of talk about self-determination and empowerment in the context of disability, focusing on the case of developmental disabilities. We find strains of the same patterns feminist epistemologists have argued shape the organization of formal knowledge from the standpoint of the privileged. At the extreme, people with developmental disabilities appear as objects without selves, outside of the context of interpersonal and social structural relationships that constrain who they can be by defining them as other, often in multiple and interacting ways. Empowerment, from the dominant standpoint, becomes an abstract attribute or condition; something a person has or does not have. Taking the standpoint of women and other marginalized people offers a view of self-determination as a person's development of his or her self. Empowerment becomes a potential characteristic of a social relationship, one that facilitates the development of someone's self. The most empowering relationships are mutual, recognizing and building on the diverse contributions and needs of participants in ways that seek to minimize inequalities over time. The reason some of us are self-determining is that we are in interpersonal and social structural relationships that empower us. To construct interpersonal and social structural relationships that empower people with developmental disabilities requires challenging the way dominant conceptualizations of independence and productivity also express the standpoint of the privileged. The standpoint of women allows all of us to talk more of how we connect with and facilitate one another's developing selves within communities.

Function in context: why American and Trinidadian young and older adults remember the personal past.

PubMed

Alea, Nicole; Bluck, Susan; Ali, Sideeka

2015-01-01

Multiple and interacting contextual (culture, life phase) and person-specific predictors (i.e., personality, tendency to think-talk about the past) of the functions of autobiographical memory were examined using the Thinking about Life Experiences Scale. American (N = 174) and Trinidadian (N = 182) young and older adults self-reported how frequently they remembered the personal past to serve self, social and directive functions, how often they thought and talked about their past overall, and completed a measure of trait personality. Independent contextual and person-specific predictors were found for using memory to serve a social-bonding function: Americans, young adults, those higher in extraversion, lower in conscientiousness and individuals who frequently think and talk about the past more often use autobiographical memory for social bonding. Across cultures, younger adults report more frequently using memory to serve all three functions, whereas Trinidadians who think more often about the past compared with those who reflect less often are more likely to use it for self and directive functions. Findings are discussed in terms of the individual's embeddedness in cultural and life phase contexts when remembering.

Inadequate vocal hygiene habits associated with the presence of self-reported voice symptoms in telemarketers.

PubMed

Fuentes-López, Eduardo; Fuente, Adrian; Contreras, Karem V

2017-12-18

The aim of this study is to determine possible associations between vocal hygiene habits and self-reported vocal symptoms in telemarketers. A cross-sectional study that included 79 operators from call centres in Chile was carried out. Their vocal hygiene habits and self-reported symptoms were investigated using a validated and reliable questionnaire created for the purposes of this study. Forty-five percent of telemarketers reported having one or more vocal symptoms. Among them, 16.46% reported that their voices tense up when talking and 10.13% needed to clear their throat to make their voices clearer. Five percent mentioned that they always talk without taking a break and 40.51% reported using their voices in noisy environments. The number of working hours per day and inadequate vocal hygiene habits were associated with the presence of self-reported symptoms. Additionally, an interaction between the use of the voice in noisy environments and not taking breaks during the day was observed. Finally, the frequency of inadequate vocal hygiene habits was associated with the number of symptoms reported. Using the voice in noisy environments and talking without taking breaks were both associated with the presence of specific vocal symptoms. This study provides some evidence about the interaction between these two inadequate vocal hygiene habits that potentiates vocal symptoms.

Peer pressure to "Fat talk": Does audience type influence how women portray their body image?

PubMed

Craig, Ashley B; Martz, Denise M; Bazzini, Doris G

2007-04-01

"Fat talk" describes women discussing their bodies disparangingly for impression management while interacting with one another. This study examined whether college females deliberately alter their self-reported body image according to characteristics of their prospective audience. This study was a mixed experimental design with four audience conditions (private, public, female audience, male audience) as the between-subjects factor and time across trials as the within-subjects factor using college females as participants (N=100). Pre versus posttest changes on the Body Esteem Scale (BES) and the Body Weight Figure Assessment (BWFA) served as the dependent variables. It was hypothesized that body image would decrease to indicate self-derogation (fat talk) in the public audience and female audience conditions, whereas body image would increase in the male audience condition. These hypotheses were not supported using repeated measures ANOVA. Strengths and weaknesses of the study are discussed.

Medicare and Advance Planning: The Importance of Context.

PubMed

Dresser, Rebecca

2016-05-01

In January 2016, a long-delayed Medicare change took effect. The Medicare program will now reimburse doctors for time they spend talking with patients about end-of-life care. This is the move that Sarah Palin and other Affordable Care Act critics said would authorize government "death panels" to decide whether older Americans should live or die. Today virtually no one buys into Palin's death panel rhetoric. But many people do think the Medicare change is a big deal. Representative Earl Blumenauer, a Democrat from Oregon who sponsored the original ACA reimbursement proposal, lauded the Medicare provision as "a turning point in end-of-life care." Others are not so sure about that. After all, laws promoting advance care planning have existed for decades. The federal Patient Self-Determination Act of 1990 and the many court decisions and state laws supporting advance care planning have had relatively little impact. Similarly, legal recognition of physician orders for life-sustaining treatment as advance planning instruments have not produced the improvements that were predicted. And from a broad perspective, advance care planning is a small piece of the puzzle. The effort to improve end-of-life care must take into account the limitations of advance decision-making, as well as the overriding importance of the general standard of care for terminally ill patients. © 2016 The Hastings Center.

Changing Hearts and Minds: The Quest for Open Talk about Race in Educational Leadership

ERIC Educational Resources Information Center

Rusch, Edith A.; Horsford, Sonya Douglass

2009-01-01

Purpose: The purpose of this paper is to seek to conceptualize a theory of self-contribution as a framework for understanding and demonstrating the dispositions and skills academics and educational leaders need to break the silence and engage in constructive talk about race across color lines. Design/methodology/approach: Brian Fay's framework for…

Interrupting Gendered Discursive Practices in Classroom Talk About Texts: Easy To Think About, Difficult To Do.

ERIC Educational Resources Information Center

Alvermann, Donna E.; Commeyras, Michelle; Young, Josephine P.; Randall, Sally; Hinson, David

1997-01-01

Focuses on university- and school-based teacher researchers attempting to alter or interrupt certain gendered discursive practices that threatened to reproduce some of the same inequities in classroom talk about texts that were noted in the past, but were not challenged. Finds four types of interactions: self-deprecating, discriminatory, and…

What We Talk About When We Talk About Art Therapy: An Outsider's Guide to Identity Crisis

ERIC Educational Resources Information Center

Lentz, Rob

2008-01-01

The author discusses Randy Vick's analysis of studio-based programs in the United States and Europe for artists with disabilities. The disability studio, advocates the writer, is generally a grassroots, ad-hoc creation, staffed by self-taught practitioners who operate seemingly unaware that the operation of studio programs for artists with…

Talk-Aloud Protocols during Conditional Discrimination Training and Equivalence Class Formation

ERIC Educational Resources Information Center

Vie, Aleksander; Arntzen, Erik

2017-01-01

The primary focus of the present experiment was to study participants' self-talk during conditional discrimination training and test for the emergence of conditional relations consistent with equivalence. Eighteen adult participants were exposed to either a Many-to-One (MTO) or a One-to-Many (OTM) training structure arranged as a 6-s delayed…

Assessing the knowledge to practice gap: The asthma practices of community pharmacists

PubMed Central

Guirguis, Lisa M.

2017-01-01

Background: Community pharmacists are well positioned to identify patients with poorly controlled asthma and trained to optimize asthma therapy. Yet, over 90% of patients with asthma live with uncontrolled disease. We sought to understand the current state of asthma management in practice in Alberta and explore the potential use of the Chat, Check and Chart (CCC) model to enhance pharmacists’ care for patients with asthma. Methods: An 18-question survey was used to examine pharmacists’ monitoring of asthma control and prior use of the CCC tools. Descriptive statistics were used to characterize the response rate, sample demographics, asthma management and CCC use. Survey validity and reliability were established. Results: One hundred randomly selected pharmacists completed the online survey with a 40% (100/250) response rate. A third of responding pharmacists reported talking to most patients about asthma symptoms and medication, with a greater focus on talking with patients on new prescriptions over those with ongoing therapies. Fewer than 1 in 10 pharmacists routinely talked to most patients about asthma action plans (AAPs). The majority of pharmacists (76%) were familiar with the CCC model, and 83% of those reported that the CCC model influenced their practice anywhere from somewhat (45%) to a great deal (38%). Both scales had good reliability, and factor analysis provided support for scale validity. Conclusions: There was considerable variability in pharmacists’ activities in monitoring asthma. Pharmacists rarely used AAPs. The CCC model had a high level of self-reported familiarity, use and influence among pharmacists. PMID:29317938

Talking about depression: an analogue study of physician gender and communication style on patient disclosures.

PubMed

Roter, Debra L; Erby, Lori H; Adams, Ann; Buckingham, Christopher D; Vail, Laura; Realpe, Alba; Larson, Susan; Hall, Judith A

2014-09-01

To disentangle the effects of physician gender and patient-centered communication style on patients' oral engagement in depression care. Physician gender, physician race and communication style (high patient-centered (HPC) and low patient-centered (LPC)) were manipulated and presented as videotaped actors within a computer simulated medical visit to assess effects on analogue patient (AP) verbal responsiveness and care ratings. 307 APs (56% female; 70% African American) were randomly assigned to conditions and instructed to verbally respond to depression-related questions and indicate willingness to continue care. Disclosures were coded using Roter Interaction Analysis System (RIAS). Both male and female APs talked more overall and conveyed more psychosocial and emotional talk to HPC gender discordant doctors (all p<.05). APs were more willing to continue treatment with gender-discordant HPC physicians (p<.05). No effects were evident in the LPC condition. Findings highlight a role for physician gender when considering active patient engagement in patient-centered depression care. This pattern suggests that there may be largely under-appreciated and consequential effects associated with patient expectations in regard to physician gender that these differ by patient gender. High patient-centeredness increases active patient engagement in depression care especially in gender discordant dyads. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Mothers' experiences of a Touch and Talk nursing intervention to optimise pain management in the PICU: a qualitative descriptive study.

PubMed

Rennick, Janet E; Lambert, Sylvie; Childerhose, Janet; Campbell-Yeo, Marsha; Filion, Françoise; Johnston, C Celeste

2011-06-01

Parents consistently express a desire to support their child and retain a care-giving role in the paediatric intensive care unit (PICU). Qualitative data gathered as part of a PICU intervention study were analysed to explore mothers' experiences using a Touch and Talk intervention to comfort their children during invasive procedures. To describe how mothers experienced involvement in their children's care through a Touch and Talk intervention and whether they would participate in a similar intervention again. RESEARCH METHODOLOGY AND SETTING: A qualitative descriptive design was used and semi-structured interviews conducted with 65 mothers in three Canadian PICUs. Data were subjected to thematic analysis. The overarching theme centred on the importance of comforting the critically ill child. This included being there for the child (the importance of parental presence); making a difference in the child's pain experience; and feeling comfortable and confident about participating in care. All but two mothers would participate in the intervention again and all would recommend it to others. Giving parents the choice of being involved in their child's care using touch and distraction techniques during painful procedures can provide an invaluable opportunity to foster parenting and support the child during a difficult PICU experience. Copyright © 2011 Elsevier Ltd. All rights reserved.

Nurses' care practices at the end of life in intensive care units in Bahrain.

PubMed

O'Neill, Catherine S; Yaqoob, Maryam; Faraj, Sumaya; O'Neill, Carla L

2017-12-01

The process of dying in intensive care units is complex as the technological environment shapes clinical decisions. Decisions at the end of life require the involvement of patient, families and healthcare professionals. The degree of involvement can vary depending on the professional and social culture of the unit. Nurses have an important role to play in caring for dying patients and their families; however, their knowledge is not always sought. This study explored nurses' care practices at the end of life, with the objective of describing and identifying end of life care practices that nurses contribute to, with an emphasis on culture, religious experiences and professional identity. Research Design and context: Grounded theory was used. In all, 10 nurses from intensive care unit in two large hospitals in Bahrain were participated. Ethical Considerations: Approval to carry out the research was given by the Research Ethics Committee of the host institution, and the two hospitals. A core category, Death Avoidance Talk, was emerged. This was supported by two major categories: (1) order-oriented care and (2) signalling death and care shifting. Death talk was avoided by the nurses, doctors and family members. When a decision was made by the medical team that a patient was not to be resuscitated, the nurses took this as a sign that death was imminent. This led to a process of signalling death to family and of shifting care to family members. Despite the avoidance of death talk and nurses' lack of professional autonomy, they created awareness that death was imminent to family members and ensured that end of life care was given in a culturally sensitive manner and aligned to Islamic values.

Communication and support from health-care professionals to families, with dependent children, following the diagnosis of parental life-limiting illness: A systematic review.

PubMed

Fearnley, Rachel; Boland, Jason W

2017-03-01

Communication between parents and their children about parental life-limiting illness is stressful. Parents want support from health-care professionals; however, the extent of this support is not known. Awareness of family's needs would help ensure appropriate support. To find the current literature exploring (1) how parents with a life-limiting illness, who have dependent children, perceive health-care professionals' communication with them about the illness, diagnosis and treatments, including how social, practical and emotional support is offered to them and (2) how this contributes to the parents' feelings of supporting their children. A systematic literature review and narrative synthesis. Embase, MEDLINE, PsycINFO, CINAHL and ASSIA ProQuest were searched in November 2015 for studies assessing communication between health-care professionals and parents about how to talk with their children about the parent's illness. There were 1342 records identified, five qualitative studies met the inclusion criteria (55 ill parents, 11 spouses/carers, 26 children and 16 health-care professionals). Parents wanted information from health-care professionals about how to talk to their children about the illness; this was not routinely offered. Children also want to talk with a health-care professional about their parents' illness. Health-care professionals are concerned that conversations with parents and their children will be too difficult and time-consuming. Parents with a life-limiting illness want support from their health-care professionals about how to communicate with their children about the illness. Their children look to health-care professionals for information about their parent's illness. Health-care professionals, have an important role but appear reluctant to address these concerns because of fears of insufficient time and expertise.

Communication and support from health-care professionals to families, with dependent children, following the diagnosis of parental life-limiting illness: A systematic review

PubMed Central

Fearnley, Rachel; Boland, Jason W.

2016-01-01

Background: Communication between parents and their children about parental life-limiting illness is stressful. Parents want support from health-care professionals; however, the extent of this support is not known. Awareness of family’s needs would help ensure appropriate support. Aim: To find the current literature exploring (1) how parents with a life-limiting illness, who have dependent children, perceive health-care professionals’ communication with them about the illness, diagnosis and treatments, including how social, practical and emotional support is offered to them and (2) how this contributes to the parents’ feelings of supporting their children. Design: A systematic literature review and narrative synthesis. Data sources: Embase, MEDLINE, PsycINFO, CINAHL and ASSIA ProQuest were searched in November 2015 for studies assessing communication between health-care professionals and parents about how to talk with their children about the parent’s illness. Results: There were 1342 records identified, five qualitative studies met the inclusion criteria (55 ill parents, 11 spouses/carers, 26 children and 16 health-care professionals). Parents wanted information from health-care professionals about how to talk to their children about the illness; this was not routinely offered. Children also want to talk with a health-care professional about their parents’ illness. Health-care professionals are concerned that conversations with parents and their children will be too difficult and time-consuming. Conclusion: Parents with a life-limiting illness want support from their health-care professionals about how to communicate with their children about the illness. Their children look to health-care professionals for information about their parent’s illness. Health-care professionals, have an important role but appear reluctant to address these concerns because of fears of insufficient time and expertise. PMID:27383635

Patient-Provider Discussions About Strategies to Limit Air Pollution Exposures.

PubMed

Mirabelli, Maria C; Damon, Scott A; Beavers, Suzanne F; Sircar, Kanta D

2018-06-11

Exposure to air pollution negatively affects respiratory and cardiovascular health. The objective of this study was to describe the extent to which health professionals report talking about how to limit exposure to air pollution during periods of poor air quality with their at-risk patients. In 2015, a total of 1,751 health professionals completed an online survey and reported whether they talk with their patients about limiting their exposure to air pollution. In 2017, these data were analyzed to assess the frequency that health professionals in primary care, pediatrics, obstetrics/gynecology, and nursing reported talking about limiting air pollution exposure with patients who have respiratory or cardiovascular diseases, were aged ≤18 years, were aged ≥65 years, or were pregnant women. Frequencies of positive responses were assessed across categories of provider- and practice-level characteristics. Overall, 714 (41%) respondents reported ever talking with their patients about limiting their exposure to air pollution. Thirty-four percent and 16% of providers specifically reported talking with their patients with respiratory or cardiovascular disease diagnoses, respectively. Percentages of health professionals who reported talking with their patients about limiting air pollution exposure were highest among respondents in pediatrics (56%) and lowest among respondents in obstetrics/gynecology (0%). Despite the well-described health effects of exposure to air pollution, the majority of respondents did not report talking with their patients about limiting their exposure to air pollution. These findings reveal clear opportunities to improve awareness about strategies to limit air pollution exposure among sensitive groups of patients and their health care providers. Published by Elsevier Inc.

Australians with osteoarthritis: satisfaction with health care providers and the perceived helpfulness of treatments and information sources.

PubMed

Basedow, Martin; Hibbert, Peter; Hooper, Tamara; Runciman, William; Esterman, Adrian

2016-01-01

The aim of this study was to evaluate the satisfaction of Australian patients who suffer from osteoarthritis (OA) with their health care providers and the perceived helpfulness of treatments and information sources. A self-administered questionnaire was conducted with a sample of 560 Australian patients who suffer from OA with questions about satisfaction with health care providers and the helpfulness of different treatment options and information sources. Logistic regression models were used to assess potential predictors of satisfaction. Thematic analysis was undertaken for attitudinal factors associated with satisfaction. A total of 435 participants returned questionnaires (response rate 78%). Most respondents were highly satisfied with the care provided by their general practitioner (GP) (84%), communication with their GP (88%), time spent with their GP (84%), and their ability to talk freely with their GP about their medical problem (93%), but less satisfied with their ability to talk freely about associated emotional problems (77%). Satisfaction with pharmacists (80%), rheumatologists (76%), and orthopedic surgeons (72%) was high. Joint replacement surgery (91%), prescription anti-inflammatory medications (66%), aids and assistive devices (65%), intra-articular injections (63%), and prescription painkiller medications (62%) were perceived as effective treatments. Less highly rated treatments were exercise (48%), physiotherapy (43%), and complementary medicines (29%). A majority of patients were satisfied with the information to manage their OA (65%). From the multivariable logistic regression analysis, four GP satisfaction factors were found to be predictors of overall satisfaction with GP care: the amount of time that the GP spends with the patient (P=0.005), the information the GP provides about what to expect (P<0.001), the communication between patient and GP (P=0.001), and the information that the GP provides about medications (P=0.042). The study showed that although patients with OA were generally satisfied with their health care providers, there was notable variation in the perceived helpfulness of therapeutic options. The importance to patients of having access to good quality information about their condition was emphasized.

Preparation for birth and beyond: caring for our baby.

PubMed

Nolan, Mary

2012-09-01

A baby's earliest relationships with the mother and father are critical in terms of the way in which their highly plastic brain develops. It is through 'mutual gaze'-that is looking at the parents'faces - that s/he learns about the range of emotions which humans experience. As a result of being talked to, touched and responded to when distressed, s/he develops social skills and emotional intelligence. Preparation for birth and beyond looks at how parents can interact with their babies both through physical care and through talking and playing.

Communication nonaccommodation in family conversations about end-of-life health decisions.

PubMed

Scott, Allison M; Caughlin, John P

2015-01-01

Furthering our understanding of how communication can improve end-of-life decision making requires a shift in focus from whether people talk to how people talk about end-of-life health decisions. This study used communication accommodation theory to examine the extent to which communication nonaccommodation distinguished more from less successful end-of-life conversations among family members. We analyzed elicited conversations about end-of-life health decisions from 121 older parent/adult child dyads using outside ratings of communication over- and underaccommodation and self-reported conversational outcomes. Results of multilevel linear modeling revealed that outside ratings of underaccommodation predicted self-reported and partner-reported uncertainty, and ratings of overaccommodation predicted self-reported decision-making efficacy and change in concordance accuracy. We discuss the methodological, theoretical, and practical implications of these findings.

Straight talk. New approaches in healthcare.

PubMed

Lanier, Jack; Loudermilk, Kerry; Skogsbergh, Jim; Clark, Reatha; Friz, Robert; Lopez, Fawn

2005-11-07

Not-for-profit health systems are under the public microscope. Sen. Charles Grassley, (D-Iowa) chairman of the Senate Finance Committee, has been critical of the charity care and billing practices of not-for-profit health systems, and vows to introduce legislation to correct abuses throughout the tax-exempt sector. The House has studied the issue as well. Not-for-profit health systems also have been accused in hundreds of lawsuits of overcharging uninsured patients and aggressively pursuing debt collection. In this installment of Straight Talk, we explore the issues surrounding tax-exempt status and how health systems should publicize their charitable work. Modern Healthcare and PricewaterhouseCoopers present Straight Talk. The session on charity care and tax-exempt status was held on October 4, 2005 at Modern Healthcare's Chicago headquarters. Fawn Lopez, publisher of Modern Healthcare, was the moderator.

Sexual Health (Women)

MedlinePlus

... health care team about your options. Hormones & Menstrual Cycle Some women find it hard to keep their ... blood glucose levels on target during your monthly cycles. Talk with your health care team about hormone ...

[A nursing experience with a child with rape trauma by using therapeutic play in an emergency room].

PubMed

Kao, Ying-Fen; Liu, Shu-Hua

2005-02-01

This article conceptualized a therapeutic game theory to discuss the pickings process of a preschool sexually violated victim with respect to nursing care delivery in our department of emergency medicine. In cooperation with the victim, we offered support to prevent her from fearing loss of her capacity for self-defense when facing a similar scenario. The overall exercise included observation time, a return outpatient visit and a follow-up phone interview. By using observation, role-play, leading drawing and interviews, we used Piaget's Cognitive Child Development model and game therapy theory to reduce the victim's sense of fear and shame, inducing the victim to eliminate her confusion by talking and to complete the whole pickings process.

ShopTalk: a pilot study of the feasibility and utility of a therapeutic board game for youth living with cancer

PubMed Central

Wiener, Lori; Battles, Haven; Mamalian, Cynthia; Zadeh, Sima

2016-01-01

Purpose ShopTalk is a therapeutic game, created to help youth living with cancer talk about their illness in a non-threatening way. The aim of this study is to learn how the game is being used in clinical settings and to gather information regarding the usefulness of ShopTalk in establishing a therapeutic relationship and in assessing key psychosocial issues in the child’s life. Methods ShopTalk was distributed at a social work pediatric oncology conference and to 70 sites. Game holders were asked to complete a survey regarding their clinical experience using ShopTalk. Results Responses came from 110 professionals. ShopTalk has been found to be as an effective tool in identifying coping skills and psychological adjustment, as well as issues related to family relationships, depression/sadness, stress, prognosis, peer relationships, and self-esteem. Respondents found ShopTalk useful from diagnosis to end of life. Qualitative feedback suggested therapeutic value along with discomfort with specific questions. Conclusion ShopTalk appears to be a beneficial therapeutic tool in building rapport and identifying and discussing difficult issues with medically ill children. Areas for future versions of the game and research exploring patient/therapist outcomes are discussed PMID:21451945

A Vygotskian Perspective on Parent-Child Talk During iPad Story Sharing

ERIC Educational Resources Information Center

Kucirkova, Natalia; Sheehy, Kieron; Messer, David

2015-01-01

This study explores the themes in the talk of two mothers and daughters as they share a self-created story with an iPad app. Vygotsky's theory of learning is applied to inform a thematic analysis and help interpret the learning potential within the observed parent-child exchanges. A deductive-inductive thematic analysis identified three recurring…

Are International Students Quiet in Class? The Influence of Teacher Confirmation on Classroom Apprehension and Willingness to Talk in Class

ERIC Educational Resources Information Center

Hsu, Chia-Fang; Huang, I-Ting

2017-01-01

This study investigated the influence of teacher confirmation (TC) on classroom apprehension (CCA) and willingness to talk in class (WTT) among international students in the United States. The participants (N = 121) completed a battery of self-report instruments online. Results confirmed a path model that TC positively predicts classroom…

Talk with Teens about Self and Stress: 50 Guided Discussions for School and Counseling Groups.

ERIC Educational Resources Information Center

Peterson, Jean Sunde; Espeland, Pamela, Ed.

Written to meet the affective need of adolescent students to share their feelings and concerns with supportive listeners, this document contains 50 guided discussions on various topics relating to three focus areas: the self, the self and others, and stress. Under the focus of the self topics include: personal strengths and limitations; behind the…

Patterns of Co-Occurring Non-Verbal Behaviour and Self-Directed Speech; a Comparison of Three Methodological Approaches

ERIC Educational Resources Information Center

Kuvalja, Martina; Verma, Mohini; Whitebread, David

2014-01-01

"Self-directed speech"--the audible or partially whispered self-talk that children engage in during their daily activities, was proposed by Vygotsky to have a mediating role in the emerging self-regulatory behaviour of young children. Studies with correlational findings tend to lend support to this hypothesis but fail to delineate the…

Danish general practitioners’ self-reported competences in end-of-life care

PubMed Central

Winthereik, Anna; Neergaard, Mette; Vedsted, Peter; Jensen, Anders

2016-01-01

Objective General practitioners (GPs) are pivotal in end-of-life (EOL) care. This study aimed to assess GP-reported provision of EOL care and to assess associations with GP characteristics. Design Population-based questionnaire study. Setting Central Denmark Region with approximately 1.3 million inhabitants. Subjects All 843 active GPs in the Central Denmark Region were sent a questionnaire by mail. Main outcome measures Responses to 18 items concerning four aspects: provision of EOL care to patients with different diagnosis, confidence with being a key worker, organisation of EOL care and EOL skills (medical and psychosocial). Results In total, 573 (68%) GPs responded. Of these, 85% often/always offered EOL care to cancer patients, which was twice as often as to patients with non-malignancies (34–40%). Moreover, 76% felt confident about being a key worker, 60% had a proactive approach, and 58% talked to their patients about dying. Only 9% kept a register of patients with EOL needs, and 19% had specific EOL procedures. GP confidence with own EOL skills varied; from 55% feeling confident using terminal medications to 90% feeling confident treating nausea/vomiting. Increasing GP age was associated with increased confidence about being a key worker and provision of EOL care to patients with non-malignancies. In rural areas, GPs were more confident about administering medicine subcutaneously than in urban areas. Conclusion We found considerable diversity in self-reported EOL care competences. Interventions should focus on increasing GPs’ provision of EOL care to patients with non-malignancies, promoting better EOL care concerning organisation and symptom management. KEY POINTSGPs are pivotal in end-of-life (EOL) care, but their involvement has been questioned. Hence, GPs’ perceived competencies were explored.GPs were twice as likely to provide EOL care for patients with cancer than for patients with non-malignancies.EOL care was lacking clear organisation in general practice in terms of registering palliative patients and having specific EOL procedures.GPs were generally least confident with their skills in terminal medical treatment, for example, using medicine administered subcutaneously. PMID:27822976

Dialogic Struggles and Pedagogic Innovation

ERIC Educational Resources Information Center

Moate, Josephine

2014-01-01

The aim of this research was to explore the way in which talk is used in teacher focus group discussions. The data from these discussions belong to a wider study on the challenges teachers face when introducing foreign-language mediated education. The research presented here provides a careful analysis of the talk between teachers drawing on…

What Do I Say Next? Using The Third Turn to Build Productive Instructional Discussions

ERIC Educational Resources Information Center

Ford-Connors, Evelyn; Robertson, Dana A.

2017-01-01

Research has strongly supported the role of classroom talk as a valuable teaching and learning tool. Carefully crafted teacher-student discussions that encourage broad student participation and knowledge building correlate with increased knowledge generation and higher academic achievement. To better understand classroom talk as an instructional…

Improving sexual health communication between older women and their providers: how the integrative model of behavioral prediction can help.

PubMed

Hughes, Anne K; Rostant, Ola S; Curran, Paul G

2014-07-01

Talking about sexual health can be a challenge for some older women. This project was initiated to identify key factors that improve communication between aging women and their primary care providers. A sample of women (aged 60+) completed an online survey regarding their intent to communicate with a provider about sexual health. Using the integrative model of behavioral prediction as a guide, the survey instrument captured data on attitudes, perceived norms, self-efficacy, and intent to communicate with a provider about sexual health. Data were analyzed using structural equation modeling. Self-efficacy and perceived norms were the most important factors predicting intent to communicate for this sample of women. Intent did not vary with race, but mean scores of the predictors of intent varied for African American and White women. Results can guide practice and intervention with ethnically diverse older women who may be struggling to communicate about their sexual health concerns. © The Author(s) 2013.

Providing therapy to children and families in foster care: a systemic-relational approach.

PubMed

Lewis, Catherine

2011-12-01

Foster care is a system created to protect children from an unsafe home environment yet multiple foster home placements, conflictual or nonexistent relationships between foster parents and birth parents, long, drawn out court battles, and living in an on-going state of not knowing when or if they will be going home are just some of the challenges many children in care are expected to manage. This paper presents a guide for therapists working with families involved in foster care. Utilizing ideas from the postmodern therapies and structural family therapy, suggestions will be provided about who needs to talk to whom about what, when to have these necessary conversations, and how to talk to people in a way that mobilizes adults to take action for the children, with the goal of minimizing postplacement trauma, strengthening and repairing relational bonds, and moving children out of foster care and into permanent homes as quickly as possible.

Identifying and Assessing Self-Images in Drawings by Delinquent Adolescents (in 2 Parts).

ERIC Educational Resources Information Center

Silver, Rawley; Ellison, JoAnne

1995-01-01

Examines assumption that art therapists can objectively identify self-images in drawings by troubled adolescents without talking to these youth. Findings suggest that discussion, though preferable, is not required for identifying self-images. Analysis of adolescents' drawings indicates that structured art assessment can be useful in evaluating…

Effects of voice style, noise level, and acoustic feedback on objective and subjective voice evaluations

PubMed Central

Bottalico, Pasquale; Graetzer, Simone; Hunter, Eric J.

2015-01-01

Speakers adjust their vocal effort when communicating in different room acoustic and noise conditions and when instructed to speak at different volumes. The present paper reports on the effects of voice style, noise level, and acoustic feedback on vocal effort, evaluated as sound pressure level, and self-reported vocal fatigue, comfort, and control. Speakers increased their level in the presence of babble and when instructed to talk in a loud style, and lowered it when acoustic feedback was increased and when talking in a soft style. Self-reported responses indicated a preference for the normal style without babble noise. PMID:26723357

Function in context: Why American and Trinidadian young and older adults remember the personal past

PubMed Central

Bluck, Susan; Ali, Sideeka

2014-01-01

Multiple and interacting contextual (culture, life phase) and person-specific predictors (i.e., personality, tendency to think-talk about the past) of the functions of autobiographical memory were examined using the Thinking about Life Experiences scale. American (N = 174) and Trinidadian (N = 182) young and older adults self-reported how frequently they remembered the personal past to serve self, social, and directive functions, how often they thought and talked about their past overall, and completed a measure of trait personality. Independent contextual and person-specific predictors were found for using memory to serve a social-bonding function: Americans, young adults, those higher in extraversion, lower in conscientiousness, and individuals who frequently think and talk about the past more often use autobiographical memory for social-bonding. Across cultures, younger adults report more frequently using memory to serve all three functions, whereas Trinidadians who think more often about the past compared with those who reflect less often, are more likely to use it for self and directive functions. Findings are discussed in terms of the individual’s embeddedness in cultural and life phase contexts when remembering. PMID:24992649

Does cardiovascular reactivity during speech reflect self-construction processes?

PubMed

Lyons, A C; Spicer, J; Tuffin, K; Chamberlain, K

2000-11-01

Abstract Substantial empirical research has been undertaken on cardiovascular reactivity (CVR). however interpretation of this research is hampered by a lack of theoretical frameworks. This paper develops a framework initially stimulated by evidence demonstrating that the cardiovascular system increases in activity during communication, and that the extent of this activation depends upon numerous and diverse psychosocial factors. We attempt to account for this phenomenon using merit post-structuralist ideas concerning the constructive nature of language and its centrality to an individual's sense of self. Our theoretical framework proposes that the CVR exhibited during language use is explicable in terms of self-construction - From this analysis we hypothesised that CVR would differ across conversations about private self. public self and non-self topics, and that these differences would depend upon people's speaking histories. We found that the blood pressure and heart rate of 102 women was most reactive when they talked in a laboratory with a stranger about aspects of their private self, and least reactive during non-self talk, whilst their heart rate was most reactive during talk about their public self. Overall the results highlight the inextricable link between our inherent socialness and our cardiovascular systems. SUMMARY The explanatory scheme outlined here is an attempt to provide a social reconceptualisation of a phenomenon that is typically interpreted in individualistic psychophysiological terms, and which is consistent with the notion that repeated exposure to situations which provoke large haemodynamic changes may lead to CHD disease progression. The explanation draws heavily on post-structuralist ideas regarding language, and the social constructionist notion that engaging in language use is central to constructing and maintaining a sense of self. This sense of self is a central theoretical entity in our everyday lives, produced and maintained in our interactions with others. We argue that it is this centrality of self-construction that helps to explain the extraordinary consistency of elevated CVR in conversation. Further, we have noted the striking parallels between those features of conversations that make the self salient, and those that have been associated with elevated CVR. To examine it more explicitly, it needs to be tested empirically with new data, using explicitly derived operationalisations and hypotheses.

Frequency and Efficacy of Talk-Related Tasks in Primary Science

NASA Astrophysics Data System (ADS)

Braund, Martin; Leigh, Joanne

2013-04-01

Pupil talk and discussion are seen as having important social and cognitive outcomes. In science classes, pupils' collaborative talk supports the construction of meaning and helps examine the status of evidence, theory and knowledge. However, pupil interactive talk in groups is rare in science lessons. The research reported is part of a project to increase the amount of pupil-pupil talk in primary schools through a programme of teaching and professional development. Pupils' self-reports of the frequency and learning efficacies of talk related activities in science lessons were collected before and after a programme of teaching in 24 schools in one of the most socially and educationally deprived areas of England. Findings showed pupils valued talking about their ideas over listening to those of other pupils. Science talk frequency (STF) was closely correlated with science talk efficacy (STE) and both were positively correlated with pupils' attitudes to school science. Analysis of covariance (ANCOVA) of the correlation of STF with STE showed values were independent of gender and ability but that school experience was a significant factor. After the teaching programme and, contrary to expectations, the frequency of talk activities in science lessons appeared to have decreased but varied according to class grades. The degree of correlation between STF and STE was stronger after the teaching in over half of the schools. Schools where STF/STE strengthened most as a result of teaching were those involved in an additional initiative to use modelled talk related to industrial contexts.

Brief Online Training Enhances Competitive Performance: Findings of the BBC Lab UK Psychological Skills Intervention Study

PubMed Central

Lane, Andrew M.; Totterdell, Peter; MacDonald, Ian; Devonport, Tracey J.; Friesen, Andrew P.; Beedie, Christopher J.; Stanley, Damian; Nevill, Alan

2016-01-01

In conjunction with BBC Lab UK, the present study developed 12 brief psychological skill interventions for online delivery. A protocol was designed that captured data via self-report measures, used video recordings to deliver interventions, involved a competitive concentration task against an individually matched computer opponent, and provided feedback on the effects of the interventions. Three psychological skills were used; imagery, self-talk, and if-then planning, with each skill directed to one of four different foci: outcome goal, process goal, instruction, or arousal-control. This resulted in 12 different intervention participant groups (randomly assigned) with a 13th group acting as a control. Participants (n = 44,742) completed a competitive task four times—practice, baseline, following an intervention, and again after repeating the intervention. Results revealed performance improved following practice with incremental effects for imagery-outcome, imagery-process, and self-talk-outcome and self-talk-process over the control group, with the same interventions increasing the intensity of effort invested, arousal and pleasant emotion. Arousal-control interventions associated with pleasant emotions, low arousal, and low effort invested in performance. Instructional interventions were not effective. Results offer support for the utility of online interventions in teaching psychological skills and suggest brief interventions that focus on increasing motivation, increased arousal, effort invested, and pleasant emotions were the most effective. PMID:27065904

Self construction in schizophrenia: a discourse analysis.

PubMed

Meehan, Trudy; MacLachlan, Malcolm

2008-06-01

Lysaker and Lysaker (Theory and Psychology, 12(2), 207-220, 2002) employ a dialogical theory of self in their writings on self disruption in schizophrenia. It is argued here that this theory could be enriched by incorporating a discursive and social constructionist model of self. Harr's model enables researchers to use subject positions to identify self construction in people with a diagnosis of schizophrenia that the dialogical model, using analysis of narrative, does not as easily recognize. The paper presents a discourse analysis of self construction in eight participants with a diagnosis of schizophrenia. Transcripts from semi-structured interviews are analysed, wherein focus falls on how participants construct self in talk through the use of subject positioning. The findings indicate that Harr's theory of self and the implied method of discourse analysis enables more subtle and nuanced constructions of self to be identified than those highlighted by Lysaker and Lysaker (Theory and Psychology, 12(2), 207-220, 2002). The analysis of subject positions revealed that participants constructed self in the form of Harr's (The singular self: An introduction to the psychology of personhood, 1998, London: Sage) self1, self2, and self3. The findings suggest that there may be constructions of self used by people diagnosed with schizophrenia that are not recognized by the current research methods focusing on narrative. The paper argues for the recognition of these constructions and by implication a model of self that takes into account different levels of visibility of self construction in talk.

A pragmatist approach to the hope discourse in health care research.

PubMed

Herrestad, Henning; Biong, Stian; McCormack, Brendan; Borg, Marit; Karlsson, Bengt

2014-07-01

Hope is a central concept in nursing and other fields of health care. However, there is no consensus about the concept of hope. We argue that seeking consensus is futile given the multifaceted and multidimensional nature of the concept, but instead we encourage in-depth studies of the assumptions behind talk about hope in specific contexts. Our approach to the 'science of hope' is inspired by philosophical pragmatism. We argue that hope is a concept that opens different rooms for action in different contexts and that accordingly, all hope interventions are contextually sensitive. Careful attention to how the relative positions and power of nurses and patients influence what can be inferred from their different ways of talking about hope may make hopeful conversations more meaningful in health care relationships. © 2014 John Wiley & Sons Ltd.

[Ictal Speech Manifesting as Sleep Talking: A Case Report].

PubMed

Suzuki, Takehiro; Kakisaka, Yosuke; Kitazawa, Yu; Jin, Kazutaka; Sato, Shiho; Iwasaki, Masaki; Fujikawa, Mayu; Nishio, Yoshiyuki; Kanno, Akitake; Nakasato, Nobukazu

2017-02-01

We present a 28-year-old female patient whose epilepsy started at the age of 19. MRI showed right perisylvian polymicrogyria. She exhibited various seizure symptoms, such as somatosensory aura involving the left leg, dyscognitive seizures, and amnesic seizures. Her mother indicated that the patient sometimes had "sleep talking", which was associated with presence of epileptic seizures of the next day. Long-term video electroencephalography (EEG) revealed that her episodes of "sleep talking" were epileptic events, specifically ictal speech, originating in the right hemisphere. The present case demonstrates the importance of considering "sleep talk" as an epileptic symptom. Careful history taking is fundamental to carry patients with possibly pathological "sleep talk" to the long-term video EEG, which will contribute correct diagnosis and treatment. (Received August 16, 2016; Accepted September 9, 2016; Published February 1, 2017).

Assessing Women's Negative Commentary on Their Own Bodies: A Psychometric Investigation of the Negative Body Talk Scale

ERIC Educational Resources Information Center

Engeln-Maddox, Renee; Salk, Rachel H.; Miller, Steven A.

2012-01-01

Our article details the development of the self-report Negative Body Talk (NBT) scale and five studies (all conducted with samples of U.S. undergraduate women) supporting the psychometric soundness of scores on this measure. The NBT scale measures women's tendency to engage in negatively valenced commentary about the weight and shape of their own…

Effectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trial.

PubMed

Mash, Bob; Levitt, Naomi; Steyn, Krisela; Zwarenstein, Merrick; Rollnick, Stephen

2012-12-24

Diabetes is an important contributor to the burden of disease in South Africa and prevalence rates as high as 33% have been recorded in Cape Town. Previous studies show that quality of care and health outcomes are poor. The development of an effective education programme should impact on self-care, lifestyle change and adherence to medication; and lead to better control of diabetes, fewer complications and better quality of life. Pragmatic cluster randomized controlled trialParticipants: Type 2 diabetic patients attending 45 public sector community health centres in Cape TownInterventions: The intervention group will receive 4 sessions of group diabetes education delivered by a health promotion officer in a guiding style. The control group will receive usual care which consists of ad hoc advice during consultations and occasional educational talks in the waiting room. To evaluate the effectiveness of the group diabetes education programmeOutcomes: diabetes self-care activities, 5% weight loss, 1% reduction in HbA1c. self-efficacy, locus of control, mean blood pressure, mean weight loss, mean waist circumference, mean HbA1c, mean total cholesterol, quality of lifeRandomisation: Computer generated random numbersBlinding: Patients, health promoters and research assistants could not be blinded to the health centre's allocationNumbers randomized: Seventeen health centres (34 in total) will be randomly assigned to either control or intervention groups. A sample size of 1360 patients in 34 clusters of 40 patients will give a power of 80% to detect the primary outcomes with 5% precision. Altogether 720 patients were recruited in the intervention arm and 850 in the control arm giving a total of 1570. The study will inform policy makers and managers of the district health system, particularly in low to middle income countries, if this programme can be implemented more widely. Pan African Clinical Trial Registry PACTR201205000380384.

Communication in Cancer Care (PDQ®)—Health Professional Version

Cancer.gov

Effective communication in cancer care between the health care team, cancer patients, and their family is important. Learn about communication skills that support a patient-centered practice and how to talk with adults and children about their diagnosis, prognosis, and transition to end-of-life care in this expert-reviewed summary.

Infant-Mother Attachment and Children's Friendship Quality: Maternal Mental-State Talk as an Intervening Mechanism

ERIC Educational Resources Information Center

McElwain, Nancy L.; Booth-Laforce, Cathryn; Wu, Xiaoying

2011-01-01

Utilizing data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development's Study of Early Child Care and Youth Development, we investigated mothers' talk about mental states during play with their 24-month-old children as a mechanism though which infant-mother attachment was associated with children's later…

Kids Talk: Strategic Language Use in Later Childhood. Oxford Studies in Sociolinguistics.

ERIC Educational Resources Information Center

Hoyle, Susan M., Ed.; Adger, Carolyn Temple, Ed.

Attention to the language practices of school-age children and teenagers is essential for a complete understanding of how language use can vary in the social construction of everyday activity across the life span. This book examines a wide variety of language practices using data from naturally occurring recorded talk and careful observation of…

Talking Pictures: Exploiting the Potential of Visual Sources to Generate Productive Pupil Talk

ERIC Educational Resources Information Center

Card, Jane

2012-01-01

Jane Card has long been fascinated by the power of visual sources to stimulate pupil thought and discussion. In previous articles she has shared insights from her own expert practice, fusing deep subject knowledge with careful planning to generate highly skilful questioning. Here she presents another rich example of classroom practice, carefully…

Talking about Internal States in Mother-Child Reminiscing Influences Children's Self-Representations: A Cross-Cultural Study

ERIC Educational Resources Information Center

Wang, Qi; Doan, Stacey N.; Song, Qingfang

2010-01-01

This study examined the relation of mother-child discussions of internal states during reminiscing to the development of trait and evaluative self-representations in 131 European American and Chinese immigrant 3-year olds. Mothers and children discussed one positive and one negative event, and children were interviewed for self-descriptions.…

Exploring the Influence of a Smartphone App (Young with Diabetes) on Young People’s Self-Management: Qualitative Study

PubMed Central

Husted, Gitte Reventlov; Weis, Janne; Teilmann, Grete

2018-01-01

Background Adequate self-management is the cornerstone of preventing type 1 diabetes mellitus (T1DM) complications. However, T1DM self-management is challenging for young people, who often struggle during the transition from childhood to adulthood. The mobile health (mHealth) app Young with Diabetes (YWD) was developed in collaboration with young people to enhance their T1DM self-management during this transition. Objective The purpose of this study was to explore the influence of YWD on young people’s self-management during a 12-month period. Methods A qualitative explorative approach was used, comprising a purposive sample of 20 young people (11 females and 9 males, ages 15 to 23 years, with app use of 3 to 64 days) from 3 pediatric and 3 adult departments. Participants were interviewed individually using a semistructured interview guide. Data were collected from January to March 2017 and analyzed using thematic analysis. Results A total of 5 themes were identified: (1) not feeling alone anymore (“we are in this together”); (2) gaining competence by sharing experiences and practical knowledge (“they know what they are talking about”); (3) feeling safer (“it’s just a click away”); (4) breaking the ice by starting to share thoughts and feelings and asking for help (“it is an outstretched hand”); and (5) lack of motivating factors (“done with the app”). Young people reported that YWD promoted self-management by peer-to-peer social support, exchanging messages with health care providers, and sharing YWD with parents. Participants recommended YWD as a supplement to self-management for newly diagnosed young people with T1DM and suggested improvements in app content and functionality. Conclusions The mHealth app YWD has the potential to support self-management. In particular, peer-to-peer support reduced feelings of loneliness and helped young people to gain knowledge and skills for managing T1DM. A need exists for alternative ways to train health care providers in using YWD and to support collaboration between young people and their parents to further improve young people’s self-management of T1DM. PMID:29490897

[Vulnerabilities and humanity of care, the ethical compass].

PubMed

Vallejo, Marie-Claude

2018-04-01

Talking about care refers us directly to the values which shape it. At a time when these values are under threat, it is the very idea of caring which is in danger. Its moral and ethical foundations must be reasserted. Copyright © 2018. Published by Elsevier Masson SAS.

Planning the Transition to End-of-Life Care in Advanced Cancer (PDQ®)—Patient Version

Cancer.gov

Planning the transition to end-of-life care in advanced cancer involves talking about patient wishes and preferences. Learn more about common topics and how preparation for transition to end-of-life care can help ease the stress in patients and their families.

Think It Through: Managing the Benefits and Risks of Medicines

MedlinePlus

... full benefits of medicines: Talk With Your Doctor, Pharmacist, or Other Health Care Professionals Keep an up- ... the label and the directions from your doctor, pharmacist, or other health care professional. If you stop ...

Talking with Kids about AIDS: A Program for Parents and Other Adults Who Care. Teaching Guide [and] Resource Manual.

ERIC Educational Resources Information Center

Tiffany, Jennifer; Tobias, Donald; Raqub, Arzeymah; Ziegler, Jerome

The teaching guide and resource manual present information to help parents and other adults talk to children and adolescents about AIDS. The teaching guide is a resource for conducting parent AIDS education programs. It presents step-by-step instructions for facilitators that explain the activities and objectives and the teaching techniques for…

Talking with Children and Teens about Alzheimer's Disease: A Question and Answer Guidebook for Parents, Teachers and Caregivers.

ERIC Educational Resources Information Center

McCrea, James M.

Professionals in the fields of nursing, education, health care, recreation, and social work, who specialize in dealing with Alzheimer's disease, wrote answers to questions collected from discussion sessions held at four Pennsylvania elder facilities and made suggestions for talking to young people about the disease and its impact. This guidebook…

Beyond "I'm Sorry": The Educator's Role in Preschoolers' Emergence of Conscience

ERIC Educational Resources Information Center

Smith, Charles A.

2013-01-01

People are not born with a conscience. Conscience does not appear because of "message" books with moral lessons or a grade school campaign for character or a high school course on ethics. Just as children are born to talk and walk, seeking positive social engagement is part of the fabric of humanity. Talking, walking, and caring, however, must…

The need to nurse the nurse: emotional labor in neonatal intensive care.

PubMed

Cricco-Lizza, Roberta

2014-05-01

In this 14-month ethnographic study, I examined the emotional labor and coping strategies of 114, level-4, neonatal intensive care unit (NICU) nurses. Emotional labor was an underrecognized component in the care of vulnerable infants and families. The nature of this labor was contextualized within complex personal, professional, and organizational layers of demand on the emotions of NICU nurses. Coping strategies included talking with the sisterhood of nurses, being a super nurse, using social talk and humor, taking breaks, offering flexible aid, withdrawing from emotional pain, transferring out of the NICU, attending memorial services, and reframing loss to find meaning in work. The organization had strong staffing, but emotional labor was not recognized, supported, or rewarded. The findings can contribute to the development of interventions to nurse the nurse, and to ultimately facilitate NICU nurses' nurturance of stressed families. These have implications for staff retention, job satisfaction, and delivery of care.

Fleshing out vulnerability.

PubMed

Tavaglione, Nicolas; Martin, Angela K; Mezger, Nathalie; Durieux-Paillard, Sophie; François, Anne; Jackson, Yves; Hurst, Samia A

2015-02-01

In the literature on medical ethics, it is generally admitted that vulnerable persons or groups deserve special attention, care or protection. One can define vulnerable persons as those having a greater likelihood of being wronged - that is, of being denied adequate satisfaction of certain legitimate claims. The conjunction of these two points entails what we call the Special Protection Thesis. It asserts that persons with a greater likelihood of being denied adequate satisfaction of their legitimate claims deserve special attention, care or protection. Such a thesis remains vague, however, as long as we do not know what legitimate claims are. This article aims at dispelling this vagueness by exploring what claims we have in relation to health care - thus fleshing out a claim-based conception of vulnerability. We argue that the Special Protection Thesis must be enriched as follows: If individual or group X has a greater likelihood of being denied adequate satisfaction of some of their legitimate claims to (i) physical integrity, (ii) autonomy, (iii) freedom, (iv) social provision, (v) impartial quality of government, (vi) social bases of self-respect or (vii) communal belonging, then X deserves special attention, care or protection. With this improved understanding of vulnerability, vulnerability talk in healthcare ethics can escape vagueness and serve as an adequate basis for practice. © 2013 John Wiley & Sons Ltd.

Religiosity, spirituality, and cancer fatalism beliefs on delay in breast cancer diagnosis in African American women.

PubMed

Gullatte, Mary Magee; Brawley, Otis; Kinney, Anita; Powe, Barbara; Mooney, Kathi

2010-03-01

African American women are more likely than any other racial or ethnic group to present with a later stage of breast cancer at initial diagnosis. Delay in breast cancer detection is a critical factor in diagnosis at a later stage. Available data indicate a delay of 3 months or more is a significant factor in breast cancer mortalty. Numerous factors have been reported as contributing to delay in time to seek medical care including religiosity, spirituality, and fatalistic beliefs. This study examined the influence of religiosity, spirituality, and cancer fatalism on delay in diagnosis and breast cancer stage in African American women with self-detected breast symptoms. A descriptive correlation, retrospective methodology using an open-ended questionnaire and three validated measurement scales were used: the Religious Problem Solving Scale (RPSS), the Religious Coping Activity Scale (RCAS) subscale measuring spiritually based coping, and the modified Powe Fatalism Inventory (mPFI). A convenience sample of 129 women ages between 30 and 84 years who self-reported detecting a breast symptom before diagnosis of breast cancer within the preceding 12 months were included in the study. Outcome variables were time to seek medical care and breast cancer stage. Other variables of interest included marital status, income, education, insurance status, and to whom the women spoke about their breast symptoms. Data were analyzed using descriptive statistics, logistic regression analysis, Pearson r correlations, Mann-Whitney U analysis, and Chi Square analysis. Participants were found to be highly religious and spiritual but not fatalistic. While most women delayed more than 3 months in seeking medical care, no associations were found between the three predictor variables and time to seek medical care. The median delay in time from self detection of a breast symptom to seeking medical care was 5.5 months. Women who were less educated, unmarried, and talked to God only about their breast change were significantly more likely to delay seeking medical care. An association was found between disclosing a breast symptom to God only and delay in seeking medical care. In contrast, women who had told a person about their breast symptom were more likely to seek medical care sooner. African American women who delayed seeking medical care for longer than 3 months were more likely to present with a later stage of breast cancer than women who sought care within 3 months of symptom discovery.

The impact of the SAGE & THYME foundation level workshop on factors influencing communication skills in health care professionals.

PubMed

Connolly, Michael; Thomas, Joanne M; Orford, Julie A; Schofield, Nicola; Whiteside, Sigrid; Morris, Julie; Heaven, Cathy

2014-01-01

The "SAGE & THYME Foundation Level Workshop" delivers evidence-based communication skills training to 30 health care workers in 3 hours. It teaches a structured approach (the SAGE & THYME model) to discuss patient/carer concerns. The aim of this study was to determine whether the workshop had a positive outcome on factors that influence communication skills. The study had a pragmatic, mixed methods design. Workshops were run in an acute hospital. One hundred seventy health care workers completed questionnaires pre- and post-workshop; 141 were sent follow-up questionnaires at 2 weeks and 2 months; and 9 were filmed talking to a simulated patient pre- and post-workshop. From pre- to post-workshop, there was a significant increase in knowledge (p < 0.001), self-efficacy (p < 0.001), and outcome expectancy (p < 0.001). An expert's rating of behavior with the simulated patient also significantly increased after the training (p = 0.011). Motivation to use the training, and the perceived usefulness of the SAGE & THYME model, were high post-workshop. There was a poor response rate in the follow-up period; hence, the quantitative data are not reported. The qualitative data are described, however, as they give an insight into the impact of the training on staff and their patients. The SAGE & THYME Foundation Level Workshop significantly increases communication skills knowledge, self-efficacy, and outcome expectancy of hospital health care workers who are predominantly white, female, nursing, or nonclinical staff. This suggests that the workshop may have a positive impact on some factors influencing communication skills in this group. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

Nursing students' spiritual talks with patients - evaluation of a partnership learning programme in clinical practice.

PubMed

Strand, Kari; Carlsen, Liv B; Tveit, Bodil

2017-07-01

To evaluate the impact of a partnership learning programme designed to support undergraduate nursing students' competence in speaking with patients about spiritual issues. Spiritual care is an oft-neglected and underexposed area of nursing practice. Despite the increasing amount of research on spiritual care in educational programmes, little is known about nursing students' experiences with existential/spiritual talks and the process of learning about spiritual care in the clinical placement. The project used a qualitative evaluation design to evaluate the impact of a partnership-initiated intervention focusing on student learning of spiritual care in a hospital ward. Data were collected through three focus group interviews with bachelor of nursing students from one Norwegian university college and supplemented with notes. Data were analysed by means of qualitative interpretative content analysis. The intervention was found to enhance students' competence in spiritual talks. The students developed an extended understanding of spirituality, became more confident in speaking with patients about spiritual issues and more active in grasping opportunities to provide spiritual care. Participating nurses significantly contributed to the students' learning process by being role models, mentoring the students and challenging them to overcome barriers in speaking with patients about spiritual issues. The partnership learning programme proved to be a useful model in terms of enhancing students' confidence in speaking with patients about spiritual concerns. Collaboration between nursing university colleges and clinical placements could help nursing students and clinical nurses to develop competencies in spiritual care and bridge the gap between academic education and clinical education, to the benefit of both. © 2016 John Wiley & Sons Ltd.

Health consequences of adverse childhood experiences: a systematic review.

PubMed

Kalmakis, Karen A; Chandler, Genevieve E

2015-08-01

Adverse childhood experiences (ACEs) have been associated with negative health outcomes, but the evidence has had limited application in primary care practice. The purpose of this study was to systematically review the research on associations between ACEs and adult health outcomes to inform nurse practitioners (NPs) in primary care practice. The databases PubMed, CINAHL, PsycINFO, and Social Abstracts were searched for articles published in English between 2008 and 2013 using the search term "adverse childhood experiences." Forty-two research articles were included in the synthesis. The evidence was synthesized and is reported following the preferred reporting items for systematic reviews and meta-analysis procedure (PRISMA). ACEs have been associated with health consequences including physical and psychological conditions, risk behaviors, developmental disruption, and increased healthcare utilization. Generalization of the results is limited by a majority of studies (41/42) measuring childhood adversity using self-report measures. NPs are encouraged to incorporate assessment of patients' childhood history in routine primary care and to consider the evidence that supports a relationship between ACEs and health. Although difficult, talking about patient's childhood experiences may positively influence health outcomes. ©2015 American Association of Nurse Practitioners.

Promoting organ donation to Hispanics: the role of the media and medicine.

PubMed

Frates, Janice; Bohrer, Gloria Garcia; Thomas, David

2006-01-01

This study assesses the impact of a paid media advertising campaign employing Spanish language, culturally sensitive television and radio spots airing on major Hispanic stations in southern California. An advertising tracking study with a baseline and three postintervention telephone surveys was conducted from 2001 through 2003 among 500 randomly selected self-identified, primarily Spanish language dominant adult Hispanics. Measures of organ donation attitudes and behaviors (decision and declared intent to donate organs) improved significantly (P < .05) in 2001 and 2002, then leveled off or declined in 2003. Among the reasons given for not making a decision to donate was fear that medical personnel might withhold care from identified organ donors, suggesting lack of knowledge and distrust of the health care system. Few respondents talked to health care professionals or contacted the organ procurement agency for information either before or after the campaign. Findings from this study indicate a need for ongoing public education in the Hispanic community about organ transplantation and donation. Health professionals need to become more engaged in encouraging Hispanic patients to learn about organ transplantation and donation, and to inform their families that they have made the personal decision to donate.

Pastoral Care Use among Post-9/11 Veterans who Screen Positive for Mental Health Problems

PubMed Central

Nieuwsma, Jason A.; Fortune-Greeley, Alice K.; Jackson, George L.; Meador, Keith G.; Beckham, Jean C.; Elbogen, Eric B.

2014-01-01

As a result of their military experience, veterans with mental health problems may have unique motivations for seeking help from clergy. Patterns and correlates of seeking pastoral care were examined using a nationwide representative survey that was conducted among veterans of post-9/11 conflicts (adjusted N = 1,068; 56% response rate). Separate multivariate logistic regression models were used to examine veteran characteristics associated with seeking pastoral care and seeking mental health services. Among post-9/11 veterans with a probable mental disorder (n = 461) – defined as a positive screen for posttraumatic stress disorder, major depressive disorder, or alcohol misuse – 20.2% reported talking to a “pastoral counselor” in the preceding year, 44.7% reported talking to a mental health professional, and 46.6% reported talking to neither. In a multivariate analysis for veterans with a probable mental disorder, seeing a pastoral counselor was associated with an increased likelihood of seeing a mental health professional in the past year (OR: 2.16; 95% CI: [1.28, 3.65]). In a separate bivariate analysis, pastoral counselors were more likely to be seen by veterans who indicated concerns about stigma or distrust of mental health care. These results suggest that pastoral and mental health care services may complement one another and underscore the importance of enhancing understanding and collaboration between these disciplines so as to meet the needs of the veterans they serve. PMID:24933105

Risks of hip and knee replacement

MedlinePlus

... can help lower your chances of risks from surgery by planning ahead. Choose a doctor and a hospital that provide high-quality care. Talk with your health care provider long before your surgery. Find out what you can do to help ...

The Potential Perils of Praise in a Democratic Interactive Classroom.

ERIC Educational Resources Information Center

Larrivee, Barbara

2002-01-01

Teacher praise can undermine the development of fundamental democratic values. This article presents styles of teacher talk in line with the principles and goals of democratic leadership and interactive teaching. Advocated discourse patterns encourage self-evaluation and self-reflection, enabling students to develop standards for judging their own…

The right to life

PubMed Central

Boyd, Kenneth M

1981-01-01

For much of human history the idea of a right to life has not seemed self-evident. The credibility of the idea appears to depend on a particular kind of intuition concerning the nature of the world. In this paper, the kind of intuition involved is related to the idea of a covenant, illustrated by that of marriage. The paper concludes by suggesting that talk about responsibilities may be more fruitful than talk about rights. PMID:7277408

Neighborhood Child Care: Family, Friends, and Neighbors Talk about Caring for Other People's Children.

ERIC Educational Resources Information Center

Porter, Toni

This report details a qualitative study undertaken to add to the knowledge base about care provided by relatives, friends, and neighbors. Focus group discussions were organized with African American, Puerto Rican, and Dominican women who care for other people's children in three low-income communities in New York City. There were a total of 45…

"Does AIDS Hurt?": Educating Young Children about AIDS. Suggestions for Parents, Teachers, and Other Care Providers of Children to Age 10.

ERIC Educational Resources Information Center

Quackenbush, Marcia; Villarreal, Sylvia

This document gives parents, teachers, and others basic information and suggested guidelines for teaching children aged 10 and younger about Acquired Immune Deficiency Syndrome (AIDS). These topics concerning AIDS and young children are discussed: (1) talking with young children about AIDS; (2) things to keep in mind when talking with children,…

Healthy Business and Creative Partnerships Strengthen Quality Early Care and Education

ERIC Educational Resources Information Center

Schlueter, Heidi H.

2010-01-01

First Children's Finance is a national nonprofit organization located in Minneapolis, Minnesota, whose work strives to break the cycle of poverty, starting with those who care for and educate the nation's youngest citizens--child care businesses. First Children's Finance asks the question: How do Americans talk about providing quality child care…

Using motivational interviewing to facilitate death talk in end-of-life care: an ethical analysis.

PubMed

Black, Isra; Helgason, Ásgeir Rúnar

2018-03-21

Morbidity arising from unprepared bereavement is a problem that affects close personal relations of individuals at the end-of-life. The bereavement studies literature demonstrates that a lack of preparedness for a loved one's death is a risk factor for secondary psychological morbidity among survivors. Short awareness time of death negatively correlates to preparedness for bereavement. The absence of disclosure of end-of-life diagnosis and prognosis to close personal relations ('death talk') between patients and loved ones, or health professionals and loved ones, may contribute to short awareness time of death. To increase awareness time of death, we might attempt to increase patient first-personal disclosure of end-of-life diagnosis and prognosis to loved-ones, and/or patient consent to health professional disclosure of the same. Interventions based on motivational interviewing in end-of-life care whose aim is to facilitate death talk, either by the patient directly, or by a health professional with the patient's consent, may offer a part solution to the problem of unprepared bereavement. This paper evaluates the ethical permissibility of such interventions. We consider two ethical objections to using motivational interviewing in this way: first, that it is inappropriate for practitioners to seek disclosure as an outcome in this setting; second, that aiming at disclosure risks manipulating individuals into death talk. While it need not be impermissible to direct individuals toward disclosure of end-of-life diagnosis/prognosis, the objection from manipulation implies that it is pro tanto ethically preferable to use motivational interviewing in a non-directive mode in death talk conversations. However, insofar as non-directive motivational interviewing requires more advanced skills, and thus may be more difficult to learn and to practise, we advance that it may be ethically permissible, all things considered, to employ directional, or specific outcome-oriented, motivational interviewing. Motivational interviewing interventions in end-of-life care whose aim is to facilitate death talk, either by the patient directly, or by a health professional with the patient's consent may be ethically permissible, all things considered.

Verbal and social interaction patterns among elementary students during self-guided "I Wonder Projects"

NASA Astrophysics Data System (ADS)

Huziak, Tracy Lynn

National standards for science teaching stress the use of inquiry teaching methods. One example of inquiry teaching is the I Wonder Project, which has been used in the Madison, WI Metropolitan School District for over ten years. The purpose of the I Wonder Project is to promote scientific discourse among elementary students through the publication of their research in a journal, similar in some ways to the scientific discourse within a community of scientists. This research study utilizes the I Wonder Project method to encourage student communication and self-guided project work. Approximately fifteen students ages 6--12 participated in a six-week self-guided inquiry project called I Wonder. Students worked as a cohort to learn science process skills and to build a scientific community. During this time, each student designed and carried out a self-guided inquiry project and wrote an article about their findings, which was presented on the last day of summer camp. A mixed method approach was used conduct this study. Participants were given a pretest and a posttest to determine the changes in scientific process skills as a result of participation in the project. The students were interviewed to determine their ideas about science and how those ideas changed over the time of participation in summer camp. Also the students were observed by the researchers, as well as audio- and video-taped to capture the verbal conversations and debates that take place as a result of discussion of ideas during the program. Students participated in this study as individuals and group members. Teacher and student interactions were noted to follow three main interaction styles: structured, guided and open-ended. These interactions work much like the inquiry levels described in the literature. Students also interacted with each other in three different ways: independently, dependently, and multifunctioning. Some students wished to work alone, while others preferred others to contribute to their work as well. Finally, there were five main types of science talk described by this study based on Gee's (1997) four types of science talk: design and debate, anomaly talk, everyday speculation talk, and explanation talk. What was also noted was an overwhelming amount of prior experience talk. Because students were given free choice in their topics of study, many chose to study topics that they had some interest or prior experience with. This led to a comparison of current findings to those they had already anticipated or expected. This study shows that self-guided inquiry projects require a range of interaction styles between students and also teachers. Many students need differing levels of support in order to be successful. In addition, it is important that students have an opportunity to select a topic of choice so that they have the opportunity to build on their scientific knowledge from their prior experiences.

The Last Word: An Interview with Frank Pajares--God, the Devil, William James, the Little Prince, and Self-Efficacy

ERIC Educational Resources Information Center

Bembenutty, Hefer

2007-01-01

This article presents an interview with Frank Pajares, an internationally recognized scholar in the field of motivation and self-efficacy. During the interview, Pajares talked about William James, what he learned from reading "The Little Prince," his self-efficacy beliefs, and his famous speech wherein he spoke of God, the Devil, and solving the…

When You and Your Family Differ on Treatment Choices

MedlinePlus

... care team that can guide you through the decision-making process. Attorneys and legal-aid clinics can also be helpful in addressing legal concerns. More Information Advanced Cancer Care Planning Making Decisions About Cancer Treatment Talking with Family and Friends ...

All about Blood Glucose

MedlinePlus

... diabetes.Most of the steps needed to take care of diabetes are things you do yourself. • Use a meal ... several times a day.Talk with your health care American Diabetes Association    1–800–DIABETES (342–2383)    www. diabetes. ...

Talk to the virtual hands: self-animated avatars improve communication in head-mounted display virtual environments.

PubMed

Dodds, Trevor J; Mohler, Betty J; Bülthoff, Heinrich H

2011-01-01

When we talk to one another face-to-face, body gestures accompany our speech. Motion tracking technology enables us to include body gestures in avatar-mediated communication, by mapping one's movements onto one's own 3D avatar in real time, so the avatar is self-animated. We conducted two experiments to investigate (a) whether head-mounted display virtual reality is useful for researching the influence of body gestures in communication; and (b) whether body gestures are used to help in communicating the meaning of a word. Participants worked in pairs and played a communication game, where one person had to describe the meanings of words to the other. In experiment 1, participants used significantly more hand gestures and successfully described significantly more words when nonverbal communication was available to both participants (i.e. both describing and guessing avatars were self-animated, compared with both avatars in a static neutral pose). Participants 'passed' (gave up describing) significantly more words when they were talking to a static avatar (no nonverbal feedback available). In experiment 2, participants' performance was significantly worse when they were talking to an avatar with a prerecorded listening animation, compared with an avatar animated by their partners' real movements. In both experiments participants used significantly more hand gestures when they played the game in the real world. Taken together, the studies show how (a) virtual reality can be used to systematically study the influence of body gestures; (b) it is important that nonverbal communication is bidirectional (real nonverbal feedback in addition to nonverbal communication from the describing participant); and (c) there are differences in the amount of body gestures that participants use with and without the head-mounted display, and we discuss possible explanations for this and ideas for future investigation.

Ethnic inequalities in doctor-patient communication regarding personal care plans: the mediating effects of positive mental wellbeing.

PubMed

Umeh, Kanayo F

2017-04-06

There is limited understanding of ethnic inequalities in doctor-patient communication regarding personal care plans (PCPs). This study investigated the mediating effects of positive mental wellbeing on differences in PCP-related doctor-patient communication amongst South Asian and Caucasian UK residents. Data from 10,980 respondents to the 2013 Health Survey for England was analysed using bootstrapping methods. Constructs from the WEMWBS (Warwick and Edinburgh Mental Wellbeing Scale) (Stewart-Brown, S., and K. Janmohamed. 2008. Warwick, UK) were assessed as mediators of relations between ethnicity and several doctor-patient communication variables, including PCP-related interactions; (a) had a PCP-related discussion about a long-term condition with a doctor/nurse, and (b) had this conversation within the past year, (c) agreed to a PCP with a health professional; and (d) talked to a doctor in the past 2 weeks. Bootstrapped mediation analysis (Hayes, A. F. 2013. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-based Approach. New York, NY: The Guilford Press) showed that three positive mind-sets mediated associations between ethnicity and doctor-patient contact, including PCP-related communication. Being able to make up one's mind (ab = -0.05; BC a CI [-0.14, 0.01]) mediated the effect of ethnicity on agreeing to a PCP, while having energy to spare (ab = 0.07; BC a CI [-0.04, 0.12]), and feeling good about oneself (ab = 0.03; BC a CI [0.01, 0.07]), mediated ethnic effects on talking to a doctor during the past fortnight. The mediating effect of reported energy persisted after controlling for medical history, perceived health, and other covariates. Ethnic disparities in doctor-patient interaction, including PCP-related communication, are partly explained by positive mental wellbeing. Gauging positive psychological moods in patients, particularly self-worth, self-perceived vigour and decisiveness, are relevant to addressing ethnic inequalities in doctor-patient communication. As PCPs may have direct implications for patient health it is important for health professionals to address deficits in psychological functioning that may precipitate ethnic inequalities in setting up PCPs.

GMAG PhD Dissertation Research Award Talk: Dynamic Magnetic Traps for Particle Self-Assembly and Lab-on-Chip Applications

NASA Astrophysics Data System (ADS)

Chen, Aaron

2013-03-01

Micro-patterned Permalloy thin films serve as an excellent means to architect the spatial profile of magnetic fields with the tunable, high gradients required to manipulate objects with weak induced magnetic moments. In this presentation, I will highlight two projects carried out during my PhD studies. These findings demonstrate the functionalities achieved through carefully designed patterns of different sizes and shapes (e.g. circular, triangular, octagonal profiles): (i) By tuning a precessing magnetic field in conjunction with such Permalloy patterns, microsphere (i.e. dipole) cluster structures ranging from closely packed to frustrated and to plum-pudding-like planar lattices are stabilized. Such self-assembly of components at the micro to nanometer range not only support a rich variety of physical phenomena, but also have applications, for example, as filters or force probes and field-tunable photonic crystals. (ii) Mobile magnetic trap arrays consisting of Permalloy disks have enabled rapid transport of magnetic beads or immunomagnetically labeled cells across surfaces. Integration of these arrays with microfluidic droplet technology allows separation of labeled cells and their subsequent encapsulation into picoliter-sized droplets. The droplets serve as isolated containers for individual cells to be probed without cross-contamination. The separation-encapsulation function could become a critical component in point-of-care single-cell analysis platforms.

Walk and Talk: an intervention for behaviorally challenged youths.

PubMed

Doucette, Patricia A

2004-01-01

This qualitative research explored the question: Do preadolescent and adolescent youths with behavioral challenges benefit from a multimodal intervention of walking outdoors while engaging in counseling? The objective of the Walk and Talk intervention is to help the youth feel better, explore alternative behavioral choices, and learn new coping strategies and life skills by engaging in a counseling process that includes the benefits of mild aerobic exercise, and that nurtures a connection to the outdoors. The intervention utilizes a strong therapeutic alliance based on the Rogerian technique of unconditional positive regard, which is grounded and guided by the principles of attachment theory. For eight weeks, eight students (aged 9 to 13 years) from a middle school in Alberta, Canada, participated weekly in the Walk and Talk intervention. Students' self-reports indicated that they benefited from the intervention. Research triangulation with involved adults supported findings that indicated the students were making prosocial choices in behavior, and were experiencing more feelings of self-efficacy and well-being. Limitations, new research directions, and subsequent longitudinal research possibilities are discussed.

Measuring Motivation: Change Talk and Counter-Change Talk in Cognitive Behavioral Therapy for Generalized Anxiety

PubMed Central

Lombardi, Diana R.; Button, Melissa

2013-01-01

How clients talk about change early in treatment has been found to be a potent predictor of their subsequent treatment success. Studies examining such client motivational language (arguments for and against change) have typically been conducted in the context of motivational interviewing for addictions. The present study examined the capacity of client motivational language to predict treatment outcomes in the context of cognitive behavioral therapy (CBT) for generalized anxiety. Client early in-session statements against change (counter-change talk) were found to be robust predictors of post-treatment worry scores and differentiated treatment responders from nonresponders. Moreover, client motivational language predicted outcomes beyond initial symptom severity and self-report measures of motivation. These results strongly support the relevance of client motivational language outcomes in CBT and provide a foundation for advancing research on motivation for change in a CBT context. PMID:24134594

Measuring motivation: change talk and counter-change talk in cognitive behavioral therapy for generalized anxiety.

PubMed

Lombardi, Diana R; Button, Melissa L; Westra, Henny A

2014-01-01

How clients talk about change early in treatment has been found to be a potent predictor of their subsequent treatment success. Studies examining such client motivational language (arguments for and against change) have typically been conducted in the context of motivational interviewing for addictions. This study examined the capacity of client motivational language to predict treatment outcomes in the context of cognitive behavioral therapy (CBT) for generalized anxiety. Client early in-session statements against change (counter-change talk) were found to be robust predictors of post-treatment worry scores and differentiated treatment responders from nonresponders. Moreover, client motivational language predicted outcomes beyond initial symptom severity and self-report measures of motivation. These results strongly support the relevance of client motivational language outcomes in CBT and provide a foundation for advancing research on motivation for change in a CBT context.

Parent-adolescent communication about sexual intercourse: an analysis of maternal reluctance to communicate.

PubMed

Guilamo-Ramos, Vincent; Jaccard, James; Dittus, Patricia; Collins, Sarah

2008-11-01

A unified theory of behavior was applied to parent-adolescent communication about sexual intercourse to understand why some mothers speak less often with their children about not having sexual intercourse. According to the theory, parental decisions or intentions to engage in such conversations are a function of expectancies, social norms, self-concept, emotions, and self-efficacy. Data were collected from a random sample of 668 mother-adolescent dyads recruited from middle schools located in the Bronx community of New York City. Data were collected via self-administered surveys. Mother and adolescent reports on the frequency of parent-adolescent communication about sexual intercourse were obtained. Adolescents and mothers reported how often the mother had discussed 21 topics related to sexual behavior. Results supported the utility of the framework for understanding parent-adolescent communication about sexual intercourse. Significant maternal correlates included (a) expectancies about lacking knowledge, being embarrassed and encouraging children to think maturely and focus on school; (b) self-concept and perceiving that mothers who didn't talk with their children about sex were irresponsible; (c) emotions about feeling relaxed and comfortable; and (d) self-efficacy about the ease of talking with one's child. Implications for family based prevention programs are discussed.

Pedometer Ownership, Motivation, and Walking: Do People Walk the Talk?

ERIC Educational Resources Information Center

Berry, Tanya R.; Fraser, Shawn N.; Spence, John C.; Bengoechea, Enrique Garcia

2007-01-01

The purpose of this research was to examine whether pedometer ownership and source of pedometer (i.e., self-purchased, a gift, a promotion) was related to physical activity self-efficacy and outcome expectations in relation to physical activity. Further, the authors examined whether there was a relationship between pedometer ownership and…

Mothers' Attributions in Reminiscing Conversations about Children's Successes and Failures: Connections with Children's Self-Evaluations

ERIC Educational Resources Information Center

Goodvin, Rebecca; Rolfson, Jacqueline

2014-01-01

Effects of feedback on children's self-evaluations are well established, yet little is known about how parents talk with children about everyday successes and failures, despite the importance of parent-child reminiscing in children's psychological understanding. We examine mothers' attributions and performance evaluations in conversations about…

Overcoming Personal and Academic Challenges: Perspectives from Latina/o College Students

ERIC Educational Resources Information Center

Cavazos, Javier, Jr.; Johnson, Michael B.; Sparrow, Gregory Scott

2010-01-01

Eleven Latina/o college students were interviewed to provide insight into what kind of coping responses they used to overcome challenges and when such responses were employed. The following responses emerged: positive reframing, acceptance, self-talk, maintaining focus on final goals, using low expectations as motivation, self-reflection, taking…

Stress Can Be a Friend: Approaches to Producing Good Stresses That Reduce and Control Bad Stresses.

ERIC Educational Resources Information Center

Demery, Marie

Individuals can produce good stresses that will inhibit or eliminate the bad stresses of anxiety, depression, resentment, and hopelessness. This can be accomplished as individuals learn to include in their lifestyles these nine approaches: self-talk, commitment, self-control, challenge, interpersonal relations, time management, relaxation,…

Training Preschoolers' Prospective Abilities through Conversation about the Extended Self

ERIC Educational Resources Information Center

Chernyak, Nadia; Leech, Kathryn A.; Rowe, Meredith L.

2017-01-01

The ability to act on behalf of one's future self is related to uniquely human abilities such as planning, delay of gratification, and goal attainment. Although prospection develops rapidly during early childhood, little is known about the mechanisms that support its development. Here we explored whether encouraging children to talk about their…

Chilean Family Reminiscing about Emotions and Its Relation to Children's Self-Regulation Skills

ERIC Educational Resources Information Center

Leyva, Diana; Nolivos, Virginia

2015-01-01

Research Findings: This study examined the relation between Chilean parents' narrative participatory styles (i.e., the way in which parents scaffold children's participation in conversations) and children's self-regulation skills. A total of 210 low-income Chilean parent-child dyads participated in the study. Dyads were videotaped talking about a…

Promoting and supporting self-management for adults living in the community with physical chronic illness: A systematic review of the effectiveness and meaningfulness of the patient-practitioner encounter.

PubMed

Rees, Sally; Williams, Anne

There has been a reported rise in the number of people with chronic illness (also referred to as long-term disease) in the Western world. One hundred million people in the United States have at least one chronic condition and in the United Kingdom (UK) as many as 17.5 million adults may be living with chronic disease. New models of care have been developed which recognise the complexities of managing care where there is overlap between the wider community, the health care system and provider organisations, for example, the Chronic Care Model and the Expert Patient Programme. These new models herald a shift away from the idea of chronically ill patients as passive recipients of care towards active engagement, in partnership with health professionals, in managing their own care.Partnership, ideally, involves collaborative care and self-management education. This may support self-care alongside medical, preventative and health maintenance interventions. In this context the nature of the patient-practitioner consultation in promoting self-care takes on a new importance. The overall objective of the review was to determine the best available evidence regarding the promotion and support of self-care management for adults living in the community with chronic illness during the patient-practitioner encounter. Specifically the review sought to determine: What is the effectiveness of the patient-practitioner encounter in promoting and supporting self-care management of people with chronic illness? What are the individual and organisational factors which help or hinder recognition, promotion and support of chronic disease self-care management strategies? What are the similarities and differences between how 'effectiveness' is defined in this context by patients and different practitioners? The review focussed on self-caring adults aged nineteen years and older living in the community, with a physical chronic illness, and not currently being treated as an in-patient. For example, people with diabetes, asthma, arthritis, coronary disease, lung disease, heart failure, epilepsy, kidney disease and inflammatory bowel disease. Since patients meet various professionals in a variety of community settings regarding their care, a practitioner in this review included doctors (physicians and General Practitioners), nurses, nurse specialists, dieticians, podiatrists and community health workers.A variety of outcomes measures was used to evaluate effective self-care management. These included physiological measurements such as: HbA1c, blood pressure, body weight, lipids; lifestyle measurements, for example physical activity; and self-care determinants such as knowledge, attitude; and self-care behaviours regarding, for example, diet and physical exercise, and medication. The outcome measures used to explore the meaningfulness of the patient-practitioner encounter, concerned patients', physicians' and nurses' views and perceptions of self-care management and support.The review considered all types of quantitative and qualitative evidence regarding the patient-practitioner encounter where self-care in chronic illness was the focus. The quantitative studies reviewed included systematic reviews, randomised controlled trials (RCTs), quasi-experimental studies, and survey studies.Qualitative studies reviewed included interview designs, vignette technique, qualitative evaluation, grounded theory, and exploratory descriptive design. The search sought to find both published and unpublished studies between 1990 and 2005. The year 1990 was deemed appropriate since it precedes the development of the Chronic Care Model in which self-management support for people living with chronic illness is heralded as an important part of care-management. An initial search of CINAHL and MEDLINE databases was undertaken to identify appropriate search terms regarding self-care and chronic illness. A search strategy was then developed using all identified MeSH headings and key words and the following databases were searched: - Ovid CINAHL; Ovid MEDLINE (R); Ovid EMBASE; Ovid EBM Reviews (CDSR, ACP Journal Club, DARE, CCTR); ASSIA; SIGLE; Digital Dissertations; and British Library's Zetoc Services. Thirty-two papers were considered applicable to the review topic from the title and abstract. Two reviewers used the appropriate critical appraisal instruments designed by the Joanna Briggs Institute (JBI) to assess methodological quality of papers retrieved for review, and agreed on the papers for inclusion. A total of 18 papers reporting 16 studies were included in the review (3 papers reported from the same study): 12 quantitative studies, 5 qualitative studies and 1 study using mixed methods. These papers were heterogeneous in nature, diverse in subject matter and considered a wide range of physiological, psychological, sociological and behavioural self-care outcome measures. Data were extracted by the two independent reviewers using a variety of data extraction instruments developed by JBI. The heterogeneous nature of the quantitative studies prevented meta-analysis and so these studies are presented in narrative summary. Meta-synthesis of the qualitative data was performed for the six qualitative pieces following the process of meta-synthesis set out in the JBI-QARI software package. The process of meta-synthesis embodied in this programme involves the aggregation or synthesis of findings. Seven syntheses were produced from fifty findings. For effective patient-centeredness to be established patients should be able to discuss their own ideas about self-care actions, including lifestyle management in an unhurried fashion and with a practitioner who has the time and who is willing to listen. Patient-centred interventions aimed at providers such as patient-centred training and patient-centred materials were shown to have a positive effect on the patient-centeredness of an encounter, but their effect on self-care outcomes was not clear. Interventions directed at enhancing patient participation in the encounter were shown to effect diabetes self-care and self-behaviour.Nurses were shown to have an effective role in educating patients and facilitating adherence to treatment. Patients found nurses approachable and some studies showed that when given the choice, patients were more likely to contact a nurse (than a doctor) regarding their care.Professional interventions such as education, and organisational interventions such as management of regular review and follow up, were shown to improve process outcomes in the management of a patient-practitioner encounter. When patient-orientated interventions were added to professional and organisational interventions, in which patient education and / or the role of the nurse was enhanced, patient health outcomes were improved.The different patient-orientated interventions reviewed highlighted some of the elements that can effectively support self-care management during a patient-practitioner encounter. These are information giving, including the use of a guidebook, the use of care plans, the structure of treatment using checklists, and education and support for staff in 'collaboratives'.Comprehensive, well-paced, user-friendly information is effective in supporting and promoting self-care management in a variety of ways. It informs and reassures patients and their families. It can be used during a doctor/patient consultation to assist communication between doctors and patients, and may help patients feel more involved in their care.For information to effect self-care management, it is important that it is given at diagnosis and from then onwards so that the implications of good self-care management in relation to long term health outcomes are established.Care plans and self-management plans can be useful in facilitating patients' discussion of self-care actions and lifestyle management.Organisational factors affect opportunities for professionals to support patient self-care management. These include time, resources, the existing configuration and expectations of a consultation, the opportunity for open access to appointments, the ability to see the same doctor and early referral to other professional groups.Correlational design studies indicated that individual psychological factors, such as attachment style and autonomy support given to a patient during a patient-practitioner encounter, have a relationship to self-care behaviours and outcomes.Correlational design studies indicated that both general communication and diabetic specific communication used during a patient-practitioner encounter have a positive effect on patient self-care management and outcomes for patients with diabetes.Consultations about self-care for patients with chronic illness tend to be medically focussed and do not always include discussion of patients' views of the routines and self-care actions. This can lead to tension and unresolved issues between the patient and professional.Studies in the context of diabetes self-management reveal that professionals can effectively support patients in a number of ways. These include assisting the orientation of patients towards skills and competencies needed for self-care; sharing knowledge and information; endorsing the patient's view that he or she is the most reliable and accurate source of information about his or her physiological function; trusting the patients' interpretations of their physiological function, and modifying advice in response to patients in accordance with their bodily cues and experiences. The nature of the patient-practitioner encounter is multifaceted involving patient, professional and organisational factors. Patient-orientated interventions are the most effective in effecting positive self-care behavioural and health outcomes. Patient participation in the patient-practitioner encounter is a key factor in influencing self-care outcomes. Patients' self-care management involves social as well as medical management. Professionals need to recognise and value patients' views and experiences in order to support their self-care management. Patients need information at diagnosis and from then onwards to enable good self-care management. It is important to enable patient participation during the patient-practitioner encounter.For patients' self-care needs to be addressed opportunities for patients to talk about their diet, routines and lifestyle management need to be incorporated into the encounter. Extra time in consultations may be required. Care plans can help to facilitate this discussion.To support patients with their self-care management, both sharing of medical and nursing knowledge, and recognition of the value of patient's knowledge and experiences are vital.Nurses relate well to patients who want to discuss self-care management.Professional interventions and organisational interventions can improve the management of a patient-practitioner encounter. Patient-orientated interventions in addition to good management of the encounter can improve health care outcomes. Patient focussed interventions have a positive effect on patient self-care outcomes. Further research regarding patients' self-care and health outcomes and behaviours is needed to establish which patient focussed interventions in particular are effective.Qualitative research has proved to be important in understanding the different ways that professionals and patients approach self-care management during an encounter. More qualitative research would assist an understanding of the processes that inspire effective partnership between patients and professionals to support the establishment of self-care management of chronic illness.

Communication in Cancer Care (PDQ®)—Patient Version

Cancer.gov

Good communication in cancer care between patients, families, caregivers and doctors is important. Talk to your doctor about your cancer diagnosis, goals of treatment, plan of care, and what to expect over time. Learn how good communication between the healthcare team, cancer patients, and family can improve the patient's quality of life in this expert-reviewed summary.

Straighttalk. The ideal master facility plan begins with business strategy and integrates operational improvement.

PubMed

Powder, Scott; Brown, Richard E; Haupert, John M; Smith, Ryder

2007-04-02

Given the scarcity of capital to meet ever-growing demands for healthcare services, master facility planning has become more important than ever. Executives must align their master facility plans with their overall business strategy, incorporating the best in care- and service-delivery models. In this installment of Straight Talk, executives from two health systems--Advocate Health Care in Oak Brook, Ill. and Parkland Health & Hospital System in Dallas--discuss master facility planning. Modern Healthcare and PricewaterhouseCoopers present Straight Talk. The session on master facility planning was held on March 8, 2007 at Modern Healthcare's Chicago Headquarters. Charles Lauer, former vice president of publishing and editorial director at Modern Healthcare, was the moderator.

A task analysis of the shift from teacher instructions to self-instructions in performing an in-common task.

PubMed

Grote, I; Rosales, J; Baer, D M

1996-11-01

Three preschool children repeatedly did four kinds of sorts with a deck of stimulus cards: a difficult, untaught target sort and three other sorts considered analytic of self-instructing the target performance. The untaught target sort was to find in a deck of cards those matching what two sample cards had in common. Most preschool children must be taught to mediate this problem. The three other kinds of sorts taught skills involved in the target performance or its mediation. As correct self-instructive talk emerged in the target sorts, it was confirmed. The untaught target sorts were interspersed infrequently among the three alternating directly taught skill sorts, to see if accurate target sorts, and accurate self-instructive talk about the target sorts, would emerge as the three skill sorts were mastered. As all the sorts progressed, increasing accuracy was seen first in the skill sorts and then in the untaught target sorts. All three subjects showed subsequent generalization to new target sorts involving other stimulus sets. Correct spontaneous self-instructions about the target sorts increased from near zero at the beginning of the experiment to consistency at its end. Thus the three skill sorts appeared sufficient for the emergence of a self-instructed solution to the previously insoluble target performance.

Cross-Talk Limits of Highly Segmented Semiconductor Detectors

NASA Astrophysics Data System (ADS)

Pullia, Alberto; Weisshaar, Dirk; Zocca, Francesca; Bazzacco, Dino

2011-06-01

Cross-talk limits of monolithic highly-segmented semiconductor detectors for high-resolution X-gamma spectrometry are investigated. Cross-talk causes false signal components yielding amplitude losses and fold-dependent shifts of the spectral lines, which partially spoil the spectroscopic performance of the detector. Two complementary electrical models are developed, which describe quantitatively the inter-channel cross-talk of monolithic segmented detectors whose electrodes are read out by charge-sensitive preamplifiers. The first is here designated as Cross-Capacitance (CC) model, the second as Split-Charge (SC) model. The CC model builds around the parasitic capacitances Cij linking the preamplifier outputs and the neighbor channel inputs. The SC model builds around the finite-value of the decoupling capacitance CC used to read out the high-voltage detector electrode. The key parameters of the models are individuated and ideas are shown to minimize their impact. Using a quasi-coaxial germanium segmented detector it is found that the SC cross-talk becomes negligible for decoupling capacitances larger than 1 nF, where instead the CC cross-talk tends to dominate. The residual cross-talk may be reduced by minimization of stray capacitances Cij, through a careful design of the layout of the Printed Circuit Board (PCB) where the input transistors are mounted. Cij can be made as low as 5 fF, but it is shown that even in such case the impact of the CC cross-talk on the detector performance is not negligible. Finally, an algorithm for cross-talk correction is presented and elaborated.

'It's quite hard to grasp the enormity of it': perceived needs of people upon diagnosis of rheumatoid arthritis.

PubMed

Radford, S; Carr, M; Hehir, M; Davis, B; Robertson, L; Cockshott, Z; Tipler, S; Hewlett, S

2008-09-01

The diagnosis of rheumatoid arthritis (RA) brings rapid pharmacological and multidisciplinary team interventions to address inflammatory processes and symptom management. However, people may also need support on the journey to self-management. The aim of this study was to explore what professional support patients feel they receive upon diagnosis, and what support they feel would be most helpful. Two focus groups comprised patients with at least five years'; disease duration (n = 7), and patients more recently diagnosed (5-18 months, n = 5). The latter had attended at least two appointments in a rheumatology nurse specialist clinic during the previous year, aimed at providing support upon diagnosis. Transcripts were subjected to thematic analysis to identify common issues regarding support needs, which were then grouped into themes. Interviewing and analysis was performed by researchers not involved in clinical care. Four overarching themes emerged. 'Information' was needed about the symptoms of RA, its management and personal outcome, while 'Support' related to emotional needs ('It's quite hard to grasp the enormity of it'). Information and Support overlapped, in that patients wanted someone to talk to, and to be listened to. These two themes were underpinned by issues of service delivery: 'Choice' (patient or professional to talk to, groups, one-to-one) and 'Involvement' (holistic care, partnership), which overlapped in terms of the opportunity to decide when and which interventions to access. People with RA report not only informational, but also emotional support needs at diagnosis. The potential for delivering emotional support to patients around the time of diagnosis warrants further exploration. (c) 2008 John Wiley & Sons, Ltd.

Motivation, justification, normalization: talk strategies used by Canadian medical tourists regarding their choices to go abroad for hip and knee surgeries.

PubMed

Cameron, Keri; Crooks, Valorie A; Chouinard, Vera; Snyder, Jeremy; Johnston, Rory; Casey, Victoria

2014-04-01

Contributing to health geography scholarship on the topic, the objective of this paper is to reveal Canadian medical tourists' perspectives regarding their choices to seek knee replacement or hip replacement or resurfacing (KRHRR) at medical tourism facilities abroad rather than domestically. We address this objective by examining the 'talk strategies' used by these patients in discussing their choices and the ways in which such talk is co-constructed by others. Fourteen interviews were conducted with Canadians aged 42-77 who had gone abroad for KRHRR. Three types of talk strategies emerged through thematic analysis of their narratives: motivation, justification, and normalization talk. Motivation talk referenced participants' desires to maintain or resume physical activity, employment, and participation in daily life. Justification talk emerged when participants described how limitations in the domestic system drove them abroad. Finally, being a medical tourist was talked about as being normal on several bases. Among other findings, the use of these three talk strategies in patients' narratives surrounding medical tourism for KRHRR offers new insight into the language-health-place interconnection. Specifically, they reveal the complex ways in which medical tourists use talk strategies to assert the soundness of their choice to shift the site of their own medical care on a global scale while also anticipating, if not even guarding against, criticism of what ultimately is their own patient mobility. These talk strategies provide valuable insight into why international patients are opting to engage in the spatially explicit practice of medical tourism and who and what are informing their choices. Copyright © 2014 Elsevier Ltd. All rights reserved.

Antenatal Training with Music and Maternal Talk Concurrently May Reduce Autistic-Like Behaviors at around 3 Years of Age

PubMed Central

Ruan, Zeng-Liang; Liu, Li; Strodl, Esben; Fan, Li-Jun; Yin, Xiao-Na; Wen, Guo-Min; Sun, Deng-Li; Xian, Dan-Xia; Jiang, Hui; Jing, Jin; Jin, Yu; Wu, Chuan-An; Chen, Wei-Qing

2018-01-01

Antenatal training through music and maternal talk to the unborn fetus is a topic of general interest for parents-to-be in China, but we still lack a comprehensive assessment of their effects on the development of autistic-like behaviors during early childhood. During 2014–2016, 34,749 parents of children around the age of 3 years who were enrolled at kindergarten in the Longhua district of Shenzhen participated in this study. Self-administered questionnaires regarding demographics, antenatal music training, and maternal talk to the fetus during pregnancy were completed by the children’s primary caregivers. Autistic-like behaviors were assessed using the Autism Behavioral Checklist. Tobit regression analyses revealed that antenatal music training and maternal talk to the fetus was associated with a reduction in autistic-like behaviors in children, with a dose-dependent relationship. Furthermore, factorial analysis of covariance indicated a significant interaction effect between antenatal music training and maternal talk to the fetus on the autistic-like behaviors and found that children who often experienced antenatal music training and maternal talk concurrently had the lowest risk of autistic-like behaviors, while children who were never exposed to maternal talk and only sometimes experienced antenatal music training had the highest risk. Our results suggest that antenatal training through both music and maternal talk to the unborn fetus might reduce the risk of children’s autistic-like behaviors at around 3 years of age. PMID:29375407

Antenatal Training with Music and Maternal Talk Concurrently May Reduce Autistic-Like Behaviors at around 3 Years of Age.

PubMed

Ruan, Zeng-Liang; Liu, Li; Strodl, Esben; Fan, Li-Jun; Yin, Xiao-Na; Wen, Guo-Min; Sun, Deng-Li; Xian, Dan-Xia; Jiang, Hui; Jing, Jin; Jin, Yu; Wu, Chuan-An; Chen, Wei-Qing

2017-01-01

Antenatal training through music and maternal talk to the unborn fetus is a topic of general interest for parents-to-be in China, but we still lack a comprehensive assessment of their effects on the development of autistic-like behaviors during early childhood. During 2014-2016, 34,749 parents of children around the age of 3 years who were enrolled at kindergarten in the Longhua district of Shenzhen participated in this study. Self-administered questionnaires regarding demographics, antenatal music training, and maternal talk to the fetus during pregnancy were completed by the children's primary caregivers. Autistic-like behaviors were assessed using the Autism Behavioral Checklist. Tobit regression analyses revealed that antenatal music training and maternal talk to the fetus was associated with a reduction in autistic-like behaviors in children, with a dose-dependent relationship. Furthermore, factorial analysis of covariance indicated a significant interaction effect between antenatal music training and maternal talk to the fetus on the autistic-like behaviors and found that children who often experienced antenatal music training and maternal talk concurrently had the lowest risk of autistic-like behaviors, while children who were never exposed to maternal talk and only sometimes experienced antenatal music training had the highest risk. Our results suggest that antenatal training through both music and maternal talk to the unborn fetus might reduce the risk of children's autistic-like behaviors at around 3 years of age.

Is self-disclosure in couples coping with cancer associated with improvement in depressive symptoms?

PubMed

Hagedoorn, Mariët; Puterman, Eli; Sanderman, Robbert; Wiggers, Theo; Baas, Peter C; van Haastert, Michiel; DeLongis, Anita

2011-11-01

This study examined associations between the degree of self-disclosure and changes in depressive symptoms in couples coping with colorectal cancer. Sixty-four newly diagnosed patients and their partners completed a measure of depressive symptoms (Center of Epidemiologic Studies Depression Scale) 3 and 9 months postdiagnosis. Furthermore, approximately 2 months after the first assessment, they engaged in a cancer-related conversation in which the patient was asked to introduce a concern. Each partner's verbalizations of emotions, thoughts, and wishes (i.e., self-disclosures) were coded by independent observers. Patients who reported more depressive symptoms at baseline showed more self-disclosures. Mutual self-disclosure was not associated with lower levels of depressive symptoms in patients and partners as compared with one-sided self-disclosure or low disclosure in both patients and partners. It is important to note that decreases in depressive symptoms over time were least prominent in couples in which the partner disclosed a lot whereas the patient disclosed little. These results suggest that mere disclosure of emotions and thoughts to one's intimate partner is not beneficial in reducing distress. Partners' self-disclosure toward patients who disclose few emotions and concerns even appears to be harmful both for patients and partners, given that it reduces the decrease of depressive symptoms over time. If there is a mismatch in the need for self-disclosure within couples, partners with a strong need to talk about their emotions and concerns may be recommended to confide in someone else in their social network or to consult a health care professional. PsycINFO Database Record (c) 2011 APA, all rights reserved.

The Higgs and All That: How the Universe Works and Why We Should Care

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hinchliffe, Ian

2013-10-31

Berkeley Lab's Ian Hinchliffe discusses "The Higgs and all that. How the universe works and why we should care" in this Oct. 28, 2013 talk, which is part of a Science at the Theater event entitled Eight Big Ideas.

The Higgs and All That: How the Universe Works and Why We Should Care

ScienceCinema

Hinchliffe, Ian

2018-01-16

Berkeley Lab's Ian Hinchliffe discusses "The Higgs and all that. How the universe works and why we should care" in this Oct. 28, 2013 talk, which is part of a Science at the Theater event entitled Eight Big Ideas.

A comparison of perceptions of quality of life among adults with spinal cord injury in the United States versus the United Kingdom.

PubMed

Palimaru, Alina; Cunningham, William E; Dillistone, Marcus; Vargas-Bustamante, Arturo; Liu, Honghu; Hays, Ron D

2017-11-01

To identify which aspects of life are most important to adults with spinal cord injury (SCI) and compare perspectives in the United States and the United Kingdom. We conducted 20 in-depth interviews with adults with SCI (ten in the US and ten in the UK). Verbatim transcriptions were independently analyzed line-by-line by two coders using an inductive approach. Codes were grouped into themes about factors that constitute and affect quality of life (QOL). Five overarching themes emerged: describing QOL in the context of SCI; functional adjustment; medical care; financial resources; and socio-political issues. Twenty subthemes emerged on factors that affect QOL. Participants in both samples identified medical care as a key influence on QOL. The US group talked about a predominantly negative influence (e.g., fragmented primary and specialist care, insurance constraints, bureaucracy), whereas UK interviewees mentioned a predominantly positive influence (e.g., universal provision, including free and continuous care, free wheelchairs and home care, and length of rehabilitation commensurate with level of injury). Functional adjustment, such as physical and mental adjustment post-discharge and aging with SCI, was another important contributor to QOL, and varied by country. Most US interviewees reported poor knowledge about self-care post-discharge and poor quality of home adaptations compared to the UK group. For adults living with SCI, good QOL is essential for successful rehabilitation. Differences between interviewees from the two countries in perceived medical care and functional adjustment suggest that factors affecting QOL may relate to broader health system characteristics.

"Teens Talk Healthy Weight": the impact of a motivational digital video disc on parental knowledge of obesity-related diseases in an adolescent clinic.

PubMed

Windham, Meghan E; Hastings, Elisabeth S; Anding, Roberta; Hergenroeder, Albert C; Escobar-Chaves, Soledad Liliana; Wiemann, Constance M

2014-10-01

The purpose of the study was to investigate the impact of a 7-minute educational and motivational weight-management digital video disc (DVD) that uses real patient/parent testimonials and provider-patient interactions, on adolescent and parent knowledge of obesity-related diseases; readiness, motivation, and self-efficacy to lose weight; connectedness to care provider; and likelihood of return to clinic for follow-up care. A randomized controlled trial was conducted among 40 overweight/obese adolescent participants (22.5% male, 77.5% female, mean age=15.43 years) and their parents (n=38) who visited a referral-only adolescent clinic for the first time from October 2009 to March 2010. Adolescents were randomly assigned by a research assistant to standard care alone or standard care plus DVD. Standard care (protocol-driven medical and nutritional assessment and counseling) was provided to all adolescents by a registered dietitian nutritionist and physician or nurse practitioner. Adolescents in the intervention group also viewed the DVD. Adolescents and parents completed assessments pre- and post-clinic visit. Repeated measures analysis of covariance was used to evaluate group differences, while controlling for race/ethnicity and age. Parents who viewed the DVD experienced greater improvements in obesity-related disease knowledge than parents who did not view the DVD. Adolescents in both groups improved on measures of motivation to lose weight and dieting self-efficacy, based on pre and post-test questionnaires. A 7-minute educational and motivational DVD helped improve parent knowledge, but was not more powerful than standard care alone in changing other weight-related outcomes in this adolescent clinic. Because it led to increased parental knowledge, incorporating the DVD into clinical practice could also allow more time for health providers to focus on specific obesity-related treatment/education. Future research might examine whether the DVD has more utility in different settings, such as primary care. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Youth Suicidal Behavior

MedlinePlus

... ii Risk Factors* Mental illness Substance abuse iv Firearms in the household vi Previous suicide attempts viii ... connectedness iii Safe schools v Reduced access to firearms vii Academic achievement ix Self-esteem xi Talking ...

The Proud Story of Military Child Care: An Exchange Trend Report

ERIC Educational Resources Information Center

Neugebauer, Roger

2011-01-01

This article presents an interview with Barbara Thompson, the Director of the Office of Family Policy/Children and Youth in the Office of the Secretary of Defense. In the interview, Thompson talks about trends in military child care in the United States. She shares when the military got into the business of providing child care. She also talks…

Effects of a Self-Management Educational Program for the Control of Childhood Asthma.

ERIC Educational Resources Information Center

Perez, Maria Gabriela; Feldman, Lya; Caballero, Fernan

1999-01-01

Evaluates the effects of a self-management educational program on 29 children and their parents. Program consists of six sessions of information giving and cognitive-behavioral strategies for the children, and two talks and a brochure for the parents. Results indicate a significant effect on children's asthma knowledge and practice of…

The Self in Art Education. Research Monograph 5.

ERIC Educational Resources Information Center

Mattil, Edward L.

The major purpose of this paper, based on a talk given at the National Art Education Association Conference in Dallas, April, 1971, is to review literature in art education concerning the concept of self in order to get a better perspective on present thought in art education and to determine new directions, priorities, and purposes. Some of the…

A New Movement in an Old Bureaucracy: The Development of Self-Advocacy in the Czech Republic

ERIC Educational Resources Information Center

Siska, Jan

2006-01-01

In this paper I describe how self-advocacy has grown in the Czech Republic. First, I talk about how services for people with learning disabilities have begun to change in the last few years. This is because voluntary groups have lobbied and campaigned for change. I learned about self-advocacy during a visit to the UK in the 1990s. I went back to…

British-Pakistani women's perspectives of diabetes self-management: the role of identity.

PubMed

Majeed-Ariss, Rabiya; Jackson, Cath; Knapp, Peter; Cheater, Francine M

2015-09-01

To explore the effects of type 2 diabetes on British-Pakistani women's identity and its relationship with self-management. Type 2 diabetes is more prevalent and has worse outcomes among some ethnic minority groups. This may be due to poorer self-management and an inadequate match of health services to patient needs. The influence that type 2 diabetes has on British-Pakistani women's identity and subsequent self-management has received limited attention. An explorative qualitative study. Face-to-face semi-structured English and Urdu language interviews were conducted with a purposively selected heterogeneous sample of 15 British-Pakistani women with type 2 diabetes. Transcripts were analysed thematically. Four themes emerged: Perceived change in self emphasised how British-Pakistani women underwent a conscious adaptation of identity following diagnosis; Familiarity with ill health reflected women's adjustment to their changed identity over time; Diagnosis improves social support enabled women to accept changes within themselves and Supporting family is a barrier to self-management demonstrated how family roles were an aspect of women's identities that was resilient to change. The over-arching theme Role re-alignment enables successful self-management encapsulated how self-management was a continuous process where achievements needed to be sustained. Inter-generational differences were also noted: first generation women talked about challenges associated with ageing and co-morbidities; second generation women talked about familial and work roles competing with self-management. The complex nature of British-Pakistani women's self-identification requires consideration when planning and delivering healthcare. Culturally competent practice should recognise how generational status influences self-identity and diabetes self-management in ethnically diverse women. Health professionals should remain mindful of effective self-management occurring alongside, and being influenced by, other aspects of life. © 2015 John Wiley & Sons Ltd.

Postherpetic neuralgia - aftercare

MedlinePlus

... such as: Meditation Deep-breathing exercises Biofeedback Self-hypnosis Muscle-relaxing techniques A common type of talk therapy for people with chronic pain is called cognitive behavioral therapy. It may help you learn how to ...

A Randomized Controlled Trial of a Group Motivational Interviewing Intervention for Adolescents with a First Time Alcohol or Drug Offense

PubMed Central

D’Amico, Elizabeth J.; Hunter, Sarah B.; Miles, Jeremy N.V.; Ewing, Brett A.; Osilla, Karen Chan

2013-01-01

Group Motivational Interviewing (MI) interventions that target youth at-risk for alcohol and other drug (AOD) use may prevent future negative consequences. Youth in a teen court setting (n=193; 67% male, 45% Hispanic; mean age 16.6 (SD = 1.05) were randomized to receive either a group MI intervention, Free Talk, or usual care (UC). We examined client acceptance, intervention feasibility and conducted a preliminary outcome evaluation. Free Talk teens reported higher quality and satisfaction ratings, and MI integrity scores were higher for Free Talk groups. AOD use and delinquency decreased for both groups at three months, and 12-month recidivism rates were lower but not significantly different for the Free Talk group compared to UC. Results contribute to emerging literature on MI in a group setting. A longer term follow-up is warranted. PMID:23891459

Improving health care professionals' feedback on communication skills: development of an on-line resource.

PubMed

Harrison, Gill; Hayden, Sheila; Cook, Viv; Cushing, Annie

2012-09-01

This project aimed to develop an open-access on-line resource to assist health care professionals in providing effective feedback on patient-centered clinical and communication skills. The collaborative nature of the development of this learning resource is outlined and evaluation of its use is discussed. An inter-professional team of teaching staff from two London Universities employed a researcher to interview experienced clinical and academic health care professionals and gather examples of difficult feedback situations. Material was used to develop short video clips illustrating some common challenges in giving feedback on clinical and communication skills. Initial evaluation following use of the scenarios in workshops was undertaken by means of a "talking wall" technique. Evaluation indicated that the resource enhanced the learning experience by providing realistic and challenging scenarios to focus discussion. Inter-professional working and piloting the use of the video scenarios in workshops enabled the improvement and refinement of an on-line staff development resource on feedback. The on-line resource is now available as an open access learning tool, with eight scenarios and guidelines for providing effective feedback in the academic or clinical setting. It can be used for self-study or as part of a group training session. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Communication about palliative care: A phenomenological study exploring patient views and responses to its discussion.

PubMed

Collins, Anna; McLachlan, Sue-Anne; Philip, Jennifer

2018-01-01

Communication about palliative care is a complex task frequently delayed until otherwise unavoidable. There is a need for discussion of palliative care to be viewed as a distinct communication task that is guided by empirical data. However, little is known of patient views and responses to these encounters. To explore patient views surrounding communication about palliative care and their responses to its discussion. Cross-sectional, prospective, exploratory qualitative design, involving narrative-style interviews and underpinned by an interpretative phenomenological framework. Purposively sampled, English-speaking, adult patients with advanced cancer ( n = 30) recruited from cancer services at a tertiary metropolitan hospital in Melbourne, Australia. Three major themes evolved. (1) Death as unspeakable: death was expressed using only implicit, ambiguous or technical terms and perceived to be outside the parameters of medical interactions. (2) Palliative care as a euphemism for death: the term 'palliative care' was perceived to be used by health professionals as a tool to talk about dying and understood by patients as a euphemism for death. (3) Palliative care as unspeakable: 'palliative care' was personified by patients to mean not just death, but my death, in turn, also becoming unspeakable. This study provides important new patient insights and responses to the discussion of palliative care. Results demonstrate that the task of discussing palliative care remains complex, difficult and limited by our language. Greater consistency, sensitivity and sophistication are required when talking about palliative care to patients who may benefit from this care.

Cancer-specific Relationship Awareness, Relationship Communication, and Intimacy Among Couples Coping with Early Stage Breast Cancer

PubMed Central

Manne, Sharon L.; Siegel, Scott; Kashy, Deborah; Heckman, Carolyn J.

2013-01-01

If couples can maintain normalcy and quality in their relationship during the cancer experience, they may experience greater relational intimacy. Cancer-specific relationship awareness, which is an attitude defined as partners focusing on the relationship and thinking about how they might maintain normalcy and cope with cancer as a couple or “team”, is one factor that may help couples achieve this goal. The main aim of this study was to evaluate the associations between cancer-specific relationship awareness, cancer-specific communication (i.e., talking about cancer’s impact on the relationship, disclosure, and responsiveness to partner disclosure), and relationship intimacy and evaluate whether relationship communication mediated the association between relationship awareness and intimacy. Two hundred fifty four women diagnosed with early stage breast cancer and their partners completed measures of cancer-specific relationship awareness, relationship talk, self-and perceived partner disclosure, perceived partner responsiveness, and relationship intimacy. Results indicated that patients and spouses who were higher in cancer-specific relationship awareness engaged in more relationship talk, reported higher levels of self-disclosure, and perceived that their partner disclosed more. Their partners reported that they were more responsive to disclosures. Relationship talk and perceived partner responsiveness mediated the association between cancer–specific relationship awareness and intimacy. Helping couples consider ways they can maintain normalcy and quality during the cancer experience and framing coping with cancer as a “team” effort may facilitate better communication and ultimately enhance relationship intimacy. PMID:25242854

20 strategies for marketing your managed care plan.

PubMed

Firshein, J

1996-01-01

In today's fiercely competitive managed care marketplace, healthcare executives must find a way to set their plans apart from the competition and build a sufficient customer base. At the same time, they must confront a growing anti-managed care backlash among a wary and confused public. Healthcare executive magazine talked with managed care experts to gather their views on key strategies to help executives meet both of these challenges. Here's what they suggest.

Pilot undergraduate course teaches students about chronic illness in children: an educational intervention study.

PubMed

Montenegro, Roberto E; Birnie, Krista D; Fisher, Paul Graham; Dahl, Gary V; Binkley, John; Schiffman, Joshua D

2014-01-01

Recent data question whether medical education adequately prepares physicians to care for the growing number of children with chronic medical conditions. We describe a 10-week course designed to provide undergraduate students with the knowledge and skills required to understand and care for children with chronic or catastrophic illnesses. The course presented the illness experience from the child's perspective and thus presented information in a manner that was efficient, conducive, and memorable. The curriculum was designed like a graduate-level seminar that included workshops, lectures, readings, writing, and lively discussions. This is an educational intervention study that used survey data to assess changes in attitudes among and between participants completing this course versus students not exposed to this course. We used Somers' D test and Fisher's z-transformation to perform both pre- and post-nonparametric comparisons. Course participants were more likely to change their attitudes and agree that chronically ill children "feel comfortable talking with their peers about their condition" (P=0.003) and less likely to agree that these children "want to be treated differently," "want more sympathy," or "care less about romantic relationships" (P = 0.003, 0.002 and 0.02, respectively). Controls were more likely to continue to agree that chronically ill children "want to be treated differently" (P = 0.009) and "care less about romantic relationships" (P = 0.02), and less likely to agree that these children "talk openly" or "feel comfortable talking with their peers about their condition" (P = 0.04). This classroom-based course serves as a feasible and cost-effective model for universities and medical schools to aid in improving student attitudes toward treating chronically ill children. The course provides the unique opportunity to learn directly from those who care for and those who have lived with chronic illness.

Self-Care in Palliative Care Nursing and Medical Professionals: A Cross-Sectional Survey.

PubMed

Mills, Jason; Wand, Timothy; Fraser, Jennifer A

2017-06-01

Self-care is an important consideration for palliative care professionals. To date, few details have been recorded about the nature or uptake of self-care practices in the palliative care workforce. As part of a broader mixed methods study, this article reports findings from a national survey of nurses and doctors. The objective of this study was to examine perceptions, education, and practices relating to self-care among palliative care nursing and medical professionals. A cross-sectional survey using REDCap software was conducted between April and May 2015. Perceived importance of self-care, self-care education and planning, and self-care strategies most utilized were explored. Descriptive statistics were calculated and content analysis used to identify domains of self-care. Three hundred seventy-two palliative care nursing and medical professionals practicing in Australia. Most respondents regarded self-care as very important (86%). Some rarely practised self-care and less than half (39%) had received training in self-care. Physical self-care strategies were most commonly reported, followed closely by social self-care and inner self-care. Self-care plans had been used by a small proportion of respondents (6%) and over two-thirds (70%) would consider using self-care plans if training could be provided. Self-care is practised across multiple health related domains, with physical self-care strategies used most frequently. Australian palliative care nurses and doctors recognize the importance of self-care practice, but further education and training are needed to increase their understanding of, and consistency in, using effective self-care strategies. These findings carry implications for professional practice and future research.

Home visit patients and family with cleft lip and palate.

PubMed

Augsornwan, Darawan; Pradubwong, Suteera; Prathumwiwattana, Pornpen; Sucontaman, Duangjai; Surakunprapha, Palakorn

2011-12-01

The operating process for cleft care, requires continuity of care involving a multidisciplinary team. When the patient goes to hospital to receive surgery, parents and family feel nervous about their children and need to know how to take care of their children afterwards. Some patients will have operations into their teenage years. The scar on their face will give them low self esteem and feelings of isolation. Patients and family need information and encouragement. Home visit should be a good process to convey information and encourage patients and family. Of this project were to convey information and encourage patients and family and to evaluate patients/family problems and needs as well as to promote networking. A team meeting took place to decide about the families to be visited. After selection the family nurse coordinator contacted them by telephone, as well as contacting the primary care unit near to the family and then travelled to visit the family. The collected data was by questionnaire, observation and in-depth interview. 2 families were visited before and after operation, 8 families were visited 2-3 days after operation. The families have better knowledge, more confidence and can take better care of their children. Unfortunately health care professionals in primary care unit were too busy to join with the team. Home visit is a good process to convey information and find patients and family problems/needs because they are more relaxed than in hospital, so can better understand and talk more easily. The families are happy to see the home visit team and are more confident to take care of their children after visit.

Chronic Pain

MedlinePlus

... of mainstream medical care. Acupuncture and massage are examples of these treatments. Talk to your doctor before trying any CAM procedures. Severe cases of chronic pain could require more invasive treatment. ...

Ambivalence and alliance ruptures in cognitive behavioral therapy for generalized anxiety.

PubMed

Hunter, Jennifer A; Button, Melissa L; Westra, Henny A

2014-01-01

Client ambivalence about change (or motivation) is regarded as central to outcomes in cognitive behavioral therapy (CBT). However, little research has been conducted to examine the impact of client ambivalence about change on therapy process variables such as the therapeutic alliance. Given the demonstrated limitations of self-report measures of key constructs such as ambivalence and motivation, the present study instead employed a newly adapted observational measure of client ambivalence. Client statements regarding change (change talk (CT) and counter-change talk (CCT)) were coded in early (session 1 or 2) therapy sessions of CBT for generalized anxiety disorder. The frequency of CT and CCT was then compared between clients who later experienced an alliance rupture with their therapist, and clients who did not. The results showed that clients in dyads who later experienced an alliance rupture expressed significantly more CCT at the outset of therapy than clients who did not later experience an alliance rupture. However, CT utterances did not significantly differ between alliance rupture and no-rupture groups. CCT may strain the alliance because clients expressing higher levels of CCT early in therapy may be less receptive to therapist direction in CBT. Consequently, it is recommended that clients and therapists work together to carefully address these key moments in therapy so as to prevent alliance rupture and preserve client engagement in therapy.

Straight Talk. Communicating in Health Care Settings. An Offering of Step Ahead: A Partnership for Improved Health Care Communication.

ERIC Educational Resources Information Center

Dutson-Mallory, Cate; And Others

This coursebook provides materials for a course to improve the oral communication skills of workers in health care settings. The course is designed to be delivered in eight sessions over a 4-week period. Stated objectives for the participants are as follows: feel more comfortable with communication in the hospital, avoid becoming defensive or…

An Examination of Possible Explanations for Differential Weight Changes Associated with Pregnancy

DTIC Science & Technology

1986-01-21

talk to about oneself), self - esteem support (perceived potential of a positive comparison of oneself with others), and belong- ing ~uppo~t (perceived...support; ISEL2, belonging support; ISEL3, tangible support; and ISEL4, self - esteem support). People high in one type of social support were likely...tangible support subscale score ISEL4- self - esteem support scale score STUNKT-total scale score for Stunkard eating scale STU~~l-cognitive restraint

Brief Report: "I Can't Talk about It"--Sexuality and Self-Silencing as Interactive Predictors of Depressive Symptoms in Adolescent Dating Couples

ERIC Educational Resources Information Center

Little, Katherine C.; Welsh, Deborah P.; Darling, Nancy; Holmes, Rachel M.

2011-01-01

This longitudinal study examined sexual intercourse within adolescent romantic relationships as a couple-level moderator of the association between adolescent individual characteristics and depressive symptoms. Two hundred nine middle- and older-adolescent dating couples (aged 14-17 and 17-21, respectively) reported on their own self-silencing,…

A Beautiful Myth? The Gendering of Being/Doing "Good at Maths"

ERIC Educational Resources Information Center

Mendick, Heather

2005-01-01

This paper draws on a research study into why more boys than girls choose to study mathematics. My starting point is that only four of the 43 young participants, and all of them male, self-identified as "good at maths". By reading these interviews as narratives of self, I explore the "identity work" accomplished within their talk and within the…

Patient experience and attitudes toward addressing the cost of breast cancer care.

PubMed

Irwin, Blair; Kimmick, Gretchen; Altomare, Ivy; Marcom, P Kelly; Houck, Kevin; Zafar, S Yousuf; Peppercorn, Jeffrey

2014-11-01

The American Society of Clinical Oncology views patient-physician discussion of costs as a component of high-quality care. Few data exist on patients' views regarding how cost should be addressed in the clinic. We distributed a self-administered, anonymous, paper survey to consecutive patients with breast cancer presenting for a routine visit within 5 years of diagnosis at an academic cancer center. Survey questions addressed experience and preferences concerning discussions of cost and views on cost control. Results are primarily descriptive, with comparison among participants on the basis of disease stage, using chi-square and Fisher's exact tests. All p values are two-sided. We surveyed 134 participants (response rate 86%). Median age was 61 years, and 28% had stage IV disease. Although 44% of participants reported at least a moderate level of financial distress, only 14% discussed costs with their doctor; 94% agreed doctors should talk to patients about costs of care. Regarding the impact of costs on decision making, 53% felt doctors should consider direct costs to the patient, but only 38% felt doctors should consider costs to society. Moreover, 88% reported concern about costs of care, but there was no consensus on how to control costs. Most breast cancer patients want to discuss costs of care, but there is little consensus on the desired content or goal of these discussions. Further research is needed to define the role of cost discussions at the bedside and how they will contribute to the goal of high-quality and sustainable cancer care. ©AlphaMed Press.

Talk to the Virtual Hands: Self-Animated Avatars Improve Communication in Head-Mounted Display Virtual Environments

PubMed Central

Dodds, Trevor J.; Mohler, Betty J.; Bülthoff, Heinrich H.

2011-01-01

Background When we talk to one another face-to-face, body gestures accompany our speech. Motion tracking technology enables us to include body gestures in avatar-mediated communication, by mapping one's movements onto one's own 3D avatar in real time, so the avatar is self-animated. We conducted two experiments to investigate (a) whether head-mounted display virtual reality is useful for researching the influence of body gestures in communication; and (b) whether body gestures are used to help in communicating the meaning of a word. Participants worked in pairs and played a communication game, where one person had to describe the meanings of words to the other. Principal Findings In experiment 1, participants used significantly more hand gestures and successfully described significantly more words when nonverbal communication was available to both participants (i.e. both describing and guessing avatars were self-animated, compared with both avatars in a static neutral pose). Participants ‘passed’ (gave up describing) significantly more words when they were talking to a static avatar (no nonverbal feedback available). In experiment 2, participants' performance was significantly worse when they were talking to an avatar with a prerecorded listening animation, compared with an avatar animated by their partners' real movements. In both experiments participants used significantly more hand gestures when they played the game in the real world. Conclusions Taken together, the studies show how (a) virtual reality can be used to systematically study the influence of body gestures; (b) it is important that nonverbal communication is bidirectional (real nonverbal feedback in addition to nonverbal communication from the describing participant); and (c) there are differences in the amount of body gestures that participants use with and without the head-mounted display, and we discuss possible explanations for this and ideas for future investigation. PMID:22022442

Motivating women and men to take protective action against rape: examining direct and indirect persuasive fear appeals.

PubMed

Morrison, Kelly

2005-01-01

This article examines the effectiveness of persuasive fear appeals in motivating women to enroll in self-defense classes to take protective action against rape. Witte's extended parallel process model is used as a framework to examine the relations between perceived invulnerability, perceived fear, and fear control processes. Because women may perceive invulnerability to rape, persuasive fear appeals targeted toward them may be ineffective in achieving attitude, intention, and behavioral change toward protecting themselves. One possible solution is to persuade men to talk with women about whom they care. Results indicated that women did not perceive invulnerability to rape, and although there was no differential impact between high- and low-threat messages, women did report positive intention and behaviors in response to direct fear appeals. Moreover, men reported positive intention and behaviors in response to indirect fear appeals.

Clinical and socio-demographic determinants of self-care behaviours in patients with heart failure and diabetes mellitus: A multicentre cross-sectional study.

PubMed

Ausili, Davide; Rebora, Paola; Di Mauro, Stefania; Riegel, Barbara; Valsecchi, Maria Grazia; Paturzo, Marco; Alvaro, Rosaria; Vellone, Ercole

2016-11-01

Self-care is vital for patients with heart failure to maintain health and quality of life, and it is even more vital for those who are also affected by diabetes mellitus, since they are at higher risk of worse outcomes. The literature is unclear on the influence of diabetes on heart failure self-care as well as on the influence of socio-demographic and clinical factors on self-care. (1) To compare self-care maintenance, self-care management and self-care confidence of patients with heart failure and diabetes versus those heart failure patients without diabetes; (2) to estimate if the presence of diabetes influences self-care maintenance, self-care management and self-care confidence of heart failure patients; (3) to identify socio-demographic and clinical determinants of self-care maintenance, self-care management and self-care confidence in patients with heart failure and diabetes. Secondary analysis of data from a multicentre cross-sectional study. Outpatient clinics from 29 Italian provinces. 1192 adults with confirmed diagnosis of heart failure. Socio-demographic and clinical data were abstracted from patients' medical records. Self-care maintenance, self-care management and self-care confidence were measured with the Self-Care of Heart Failure Index Version 6.2; each scale has a standardized score from 0 to 100, where a score <70 indicates inadequate self-care. Multiple linear regression analyses were performed. Of 1192 heart failure patients, 379 (31.8%) had diabetes. In these 379, heart failure self-care behaviours were suboptimal (means range from 53.2 to 55.6). No statistically significant differences were found in any of the three self-care measures in heart failure patients with and without diabetes. The presence of diabetes did not influence self-care maintenance (p=0.12), self-care management (p=0.21) or self-care confidence (p=0.51). Age (p=0.04), number of medications (p=0.01), presence of a caregiver (p=0.04), family income (p=0.009) and self-care confidence (p<0.001) were determinants of self-care maintenance. Gender (p=0.01), number of medications (p=0.004) and self-care confidence (p<0.001) were significant determinants of self-care management. Number of medications (p=0.002) and cognitive function (p<0.001) were determinants of self-care confidence. Self-care was poor in heart failure patients with diabetes mellitus. This population needs more intensive interventions to improve self-care. Determinants of self-care in heart failure patients with diabetes mellitus should be systematically assessed by clinicians to identify patients at risk of inadequate self-care. Copyright © 2016 Elsevier Ltd. All rights reserved.

Teaching Quantum Mechanics through Project-based Learning

NASA Astrophysics Data System (ADS)

Duda, Gintaras

2013-04-01

Project/Problem-based learning (PBL) is an active area of research within the physics education research (PER) community, however, work done to date has focused on introductory courses. This talk will explore research on upper division quantum mechanics, a junior/senior level course at Creighton, which was taught using PBL pedagogy with no in-class lectures. The talk will explore: 1. student learning in light of the new pedagogy and embedded meta-cognitive self-monitoring and reflective exercises and 2. the effect of the PBL curriculum on student attitudes students’ epistemologies.

Pathway cross-talk network analysis identifies critical pathways in neonatal sepsis.

PubMed

Meng, Yu-Xiu; Liu, Quan-Hong; Chen, Deng-Hong; Meng, Ying

2017-06-01

Despite advances in neonatal care, sepsis remains a major cause of morbidity and mortality in neonates worldwide. Pathway cross-talk analysis might contribute to the inference of the driving forces in bacterial sepsis and facilitate a better understanding of underlying pathogenesis of neonatal sepsis. This study aimed to explore the critical pathways associated with the progression of neonatal sepsis by the pathway cross-talk analysis. By integrating neonatal transcriptome data with known pathway data and protein-protein interaction data, we systematically uncovered the disease pathway cross-talks and constructed a disease pathway cross-talk network for neonatal sepsis. Then, attract method was employed to explore the dysregulated pathways associated with neonatal sepsis. To determine the critical pathways in neonatal sepsis, rank product (RP) algorithm, centrality analysis and impact factor (IF) were introduced sequentially, which synthetically considered the differential expression of genes and pathways, pathways cross-talks and pathway parameters in the network. The dysregulated pathways with the highest IF values as well as RP<0.01 were defined as critical pathways in neonatal sepsis. By integrating three kinds of data, only 6919 common genes were included to perform the pathway cross-talk analysis. By statistic analysis, a total of 1249 significant pathway cross-talks were selected to construct the pathway cross-talk network. Moreover, 47 dys-regulated pathways were identified via attract method, 20 pathways were identified under RP<0.01, and the top 10 pathways with the highest IF were also screened from the pathway cross-talk network. Among them, we selected 8 common pathways, i.e. critical pathways. In this study, we systematically tracked 8 critical pathways involved in neonatal sepsis by integrating attract method and pathway cross-talk network. These pathways might be responsible for the host response in infection, and of great value for advancing diagnosis and therapy of neonatal sepsis. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Day Child Care Was the Talk of the White House.

ERIC Educational Resources Information Center

Neugebauer, Bonnie

1998-01-01

Reports on the White House Conference on Child Care held in October, 1997. Includes excerpts from remarks by President Clinton, Vice President Al Gore, Hillary Clinton, legislators, federal and state government officials, and representatives from the Families and Work Institute, National Institute on Out-of-School Time, the Kellogg Foundation, and…

Embracing Powerlessness in Pursuit of Digital Resilience: Managing Cyber-Literacy in Professional Talk

ERIC Educational Resources Information Center

Hammond, Simon P.; Cooper, Neil J.

2015-01-01

The use of digital media by adolescents living in out-of-home care raises safeguarding and risk-management concerns, creating challenges for practitioners in how to control risk while promoting independence. This article explores how professionals working in residential care negotiated their own and adolescents' use of ubiquitous digital…

Not all are desired: providers' views on interpreters' emotional support for patients.

PubMed

Hsieh, Elaine; Hong, Soo Jung

2010-11-01

This study examines (a) providers' expectations and concerns for interpreters' emotional support, and (b) the complexity and dilemma for interpreters to offer emotional support in health care settings. We recruited 39 providers from 5 specialties to participate in in-depth interviews or focus groups. Grounded theory was used for data analysis to identify providers' expectations and concerns for interpreters' emotional support. From the providers' perspective, interpreters' emotional support: (a) is embodied through their physical presence, (b) is to be both a human being but also a professional, (c) represents the extension of the providers' care, and (d) imposes potential risks to quality of care. Emotional support in bilingual health care is accomplished through the alliance of providers and interpreters, complementing each other to support patients' emotional needs. Interpreters should be vigilant about how their emotional support may impact the provider-patient relationship and the providers' therapeutic objectives. Interpreters should be aware that providers also rely on them to provide emotional support, which highlights the importance of giving medical talk and rapport-building talk equal attention in medical encounters. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Telemedicine

MedlinePlus

... making health care delivery easier and more efficient. Electronic medical records are replacing paper charts. Digital devices ... 2016 More on this topic for: Parents Teens Electronic Health Records Talking to Your Child's Doctor How ...

Empagliflozin

MedlinePlus

... prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. ... empagliflozin without talking to your doctor.Ask your pharmacist or doctor for a copy of the manufacturer's ...

Dapagliflozin

MedlinePlus

... prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. ... without talking to your doctor.Your doctor or pharmacist will give you the manufacturer's patient information sheet ( ...

Ertugliflozin

MedlinePlus

... prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. ... without talking to your doctor.Your doctor or pharmacist will give you the manufacturer's patient information sheet ( ...

Response practices in multilingual interaction with an older Persian woman in a Swedish residential home.

PubMed

Plejert, Charlotta; Jansson, Gunilla; Yazdanpanah, Maziar

2014-03-01

In the present case study, a care encounter between an older multilingual (Farsi/Swedish/English) Persian woman and staff in an ordinary, Swedish residential home is investigated. The woman is perceived as suffering from dementia symptoms, but has not received any formal diagnosis of the disease. More specifically, the study focuses on how the woman's contributions in her mother tongue, Farsi, are responded to by a carer, who is also multilingual and speaks Swedish as a second language (L2), but has a very limited knowledge of Farsi. The data consists of recorded material from a mundane morning activity in the residential home, as the woman is undressed and prepared to go to the shower. The method employed is conversation analysis, and the study addresses the interactional outcome of this type of multilingual encounters, highlighting the way the establishment of mutual understanding is negatively affected by the fact that the participants do not or only to a limited extent share a common language. Analysis of the data shows that most of the woman's contributions in Farsi are responded to in L2-Swedish by the carer, primarily by means of seven different response practices: soothing talk, instrumental talk, minimal responses, explicit expressions of understanding, mitigating talk, questions, and appraisal. The findings are discussed in light of new demands on Swedish (and Western) care- and health care systems to adapt to the increasing number of multilingual, older people, who will become residents in care facilities and attend day centers within the coming years.

Preschool children's mathematical knowledge: The effect of teacher "math talk.".

PubMed

Klibanoff, Raquel S; Levine, Susan C; Huttenlocher, Janellen; Vasilyeva, Marina; Hedges, Larry V

2006-01-01

This study examined the relation between the amount of mathematical input in the speech of preschool or day-care teachers and the growth of children's conventional mathematical knowledge over the school year. Three main findings emerged. First, there were marked individual differences in children's conventional mathematical knowledge by 4 years of age that were associated with socioeconomic status. Second, there were dramatic differences in the amount of math-related talk teachers provided. Third, and most important, the amount of teachers' math-related talk was significantly related to the growth of preschoolers' conventional mathematical knowledge over the school year but was unrelated to their math knowledge at the start of the school year. Copyright 2006 APA, all rights reserved.

Stress Management: Positive Thinking

MedlinePlus

Healthy Lifestyle Stress management Positive thinking helps with stress management and can even improve your health. Practice overcoming negative self-talk ... with optimism is a key part of effective stress management. And effective stress management is associated with ...

Building Social Bonds: Connections That Promote Well-Being

MedlinePlus

... bonds help children and teens develop trust and self-esteem. They can then venture out of the family ... Kids Mental Health and Relationships (HHS) Parents:Healthy Communication and Relationships (HHS) Talking with Teens About Peer ...

Soft and Bio Nanomaterials Group at Brookhaven’s Center for Functional Nanomaterials

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gang, Oleg

2016-12-07

Group leader Oleg Gang talks about the methods his group develops to direct the self-assembly of nanoscale systems from organic and inorganic components into functional materials with desired properties.

Genital herpes - self-care

MedlinePlus

Herpes - genital - self-care; Herpes simplex - genital - self-care; Herpesvirus 2 - self-care; HSV-2 - self-care ... Call your health care provider if you have any of the following: Symptoms of an outbreak that worsen despite medicine and self-care ...

Considering the alternatives.

PubMed

Byrne, J

1999-01-01

Health care providers frequently talk about values and community care, and their mission statements often espouse a commitment to cooperative relationships with their patients. Good intentions aside, the reality is that some health care providers may be unable to accommodate patients who are unable to pay for services. Distrust is guaranteed when an industry's words and deeds don't match, but several caregivers are thinking outside the lines to find solutions to their patients' payment problems.

Training Providers and Patients to Talk about End-of-Life Care

Cancer.gov

Failing to discuss the transition from active cancer treatment to end-of-life care can leave doctors unsure of what a patient truly wants. Failing to receive end-of-life care in line with their values and wishes can cause patients and their families great distress. Researchers have developed innovative, evidence-based programs to help doctors and patients improve their communication skills and grow comfortable with these discussions.

Teen Development

MedlinePlus

... you might notice include Increased independence from your parents More concerns about body image and clothes More ... problem. If you need help, talk to your parents, school counselor, or health care provider. Centers for ...

Helping your teen with depression

MedlinePlus

Teen depression - helping; Teen depression - talk therapy; Teen depression - medicine ... You, your teen, and your health care provider should discuss what might help your teen the most. The most effective treatments ...

LAM (Lymphangioleiomyomatosis)

MedlinePlus

... Take steps to care for your lungs. For example, talk with your doctor about getting a pneumococcal pneumonia vaccine and a yearly influenza or flu shot. Visit the Centers for Disease Control and Prevention ( ...

The Experience of Native Peer Facilitators in the Campaign Against Type 2 Diabetes

PubMed Central

Struthers, Roxanne; Hodge, Felicia Schanche; De Cora, Lorelei; Geishirt-Cantrell, Betty

2011-01-01

Context The use of peer facilitators in health-programs has great potential. One important application is prevention and control of type 2 diabetes among American Indians. Purpose To explore the experience of American Indian facilitators in a culturally appropriate intervention (Talking Circles) on 2 Northern Plains reservations. The Talking Circles offered a forum for educational dialogue on diabetes risk factors and the management of type 2 diabetes. Methods Phenomenology, a qualitative research approach, was used to answer the research question: “What did Native Talking Circle facilitators-experience?” Participants were 4 lay health workers from the intervention reservations who had been trained to present a diabetes curriculum while coordinating and guiding the group discussion. During open-ended, taped interviews, the facilitators shared their experiences conducting the Talking Circles. Analysis categorized the experiences into common themes to explain the phenomena and cultural construction of oral discussions (Talking Circles) of diabetes. Findings Themes included the concept of “a calling” to do the work, which included a self-growth process, a blending of 2 worldviews as a diabetes intervention strategy, the importance of translating educational materials in a liaison role, and commitment to tribal people and communities. Conclusions The experience of the facilitators was positive because they were knowledgeable about American Indian culture arid worldview arid were trained in both Talking Circle facilitation and type 2 diabetes. PMID:12696854

Kidney stones - self-care

MedlinePlus

... self-care; Nephrolithiasis and self-care; Stones and kidney - self-care; Calcium stones and self-care; Oxalate ... provider or the hospital because you have a kidney stone. You will need to take self-care ...

Factors contributing to nursing task incompletion as perceived by nurses working in Kuwait general hospitals.

PubMed

Al-Kandari, Fatimah; Thomas, Deepa

2009-12-01

Unfinished care has a strong relationship with quality of nursing care. Most issues related to tasks incompletion arise from staffing and workload. This study was conducted to assess the workload of nurses, the nursing activities (tasks) nurses commonly performed on medical and surgical wards, elements of nursing care activities left incomplete by nurses during a shift, factors contributing to task incompletion and the relationship between staffing, demographic variables and task incompletion. Exploratory survey using a self-administered questionnaire developed from IHOC survey, USA. All full time registered nurses working on the general medical and surgical wards of five government general hospitals in Kuwait. Research assistants distributed and collected back the questionnaires. Four working days were given to participants to complete and return the questionnaires. A total of 820 questionnaires were distributed and 95% were returned. Descriptive and inferential analysis using SPSS-11. The five most frequently performed nursing activities were: administration of medications, assessing patient condition, preparing/updating nursing care plans, close patient monitoring and client health teaching. The most common nursing activities nurses were unable to complete were: comfort talk with patient and family, adequate documentation of nursing care, oral hygiene, routine catheter care and starting or changing IV fluid on time. Tasks were more complete when the nurse-patient load was less than 5. Nurses' age and educational background influenced task completion while nurses' gender had no influence on it. Increased patient loads, resulting in increased frequency of nursing tasks and non-nursing tasks, were positively correlated to incompletion of nursing activities during the shift. Emphasis should be given to maintaining the optimum nurse-patient load and decreasing the non-nursing workload of nurses to enhance the quality of nursing care.

[Substance related disorder in emergency services: Which attitudes?

PubMed

Rica, M; Principe, A; Le Reste, J-Y; Guillou Landreat, M

2017-02-01

Substance related disorders are more prevalent in emergency services than in the general population, about 20% of individuals in emergency care test positive for alcohol. Emergency services are strategic places to identify alcohol misuse. Attitudes to individuals presenting substance related disorders are important in developing therapeutic relationships and applying interventions. This study explores the attitudes of an emergency staff to these individuals across a range of roles, and evolution in face of an addictology care improvement. Data were gathered from an emergency service sample from the emergency department of a general hospital in Morlaix (France). We used a short questionnaire, adapted from previous similar French studies. Twenty-five persons answered the first questionnaire and 18 the second. A self-administrated attitudes questionnaire showed its interest in our study and helped us to identify attitudes and to initiate a reflection on behaviours in emergency care. Moreover, it helped to change attitudes towards individuals presenting substance related disorders. The daily setting of an addictive disorders specialized unit in emergency changed the point of view on addictive disorders of both physicians and nurses. We showed differences in addictive related disorders prevalence perception among patients attending emergency care between the two evaluations. But we also showed that physicians and nurses stressed that it was more difficult to ask patients in emergency care on the second evaluation, after and despite a daily addictive disorders specialized setting. We showed several limits in emergency staff care relationship with patients with substance related disorders. They identified difficulties to talk about addictive disorders, especially in younger and older patients. Regarding literature, we discuss our study limits and different ways of improving addictology care in emergency services. Copyright © 2015 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries.

PubMed

Evans-Lacko, S; Brohan, E; Mojtabai, R; Thornicroft, G

2012-08-01

Little is known about how the views of the public are related to self-stigma among people with mental health problems. Despite increasing activity aimed at reducing mental illness stigma, there is little evidence to guide and inform specific anti-stigma campaign development and messages to be used in mass campaigns. A better understanding of the association between public knowledge, attitudes and behaviours and the internalization of stigma among people with mental health problems is needed. This study links two large, international datasets to explore the association between public stigma in 14 European countries (Eurobarometer survey) and individual reports of self-stigma, perceived discrimination and empowerment among persons with mental illness (n=1835) residing in those countries [the Global Alliance of Mental Illness Advocacy Networks (GAMIAN) study]. Individuals with mental illness living in countries with less stigmatizing attitudes, higher rates of help-seeking and treatment utilization and better perceived access to information had lower rates of self-stigma and perceived discrimination and those living in countries where the public felt more comfortable talking to people with mental illness had less self-stigma and felt more empowered. Targeting the general public through mass anti-stigma interventions may lead to a virtuous cycle by disrupting the negative feedback engendered by public stigma, thereby reducing self-stigma among people with mental health problems. A combined approach involving knowledge, attitudes and behaviour is needed; mass interventions that facilitate disclosure and positive social contact may be the most effective. Improving availability of information about mental health issues and facilitating access to care and help-seeking also show promise with regard to stigma.

Independence as a practice issue in occupational therapy: the safety clause.

PubMed

Russell, Cherry; Fitzgerald, Maureen H; Williamson, Peter; Manor, Debra; Whybrow, Samantha

2002-01-01

This article reports findings from interviews that explored the meanings occupational therapists attach to independence as a value and a therapeutic goal in interactions with elderly clients. Through a historical review of the literature, we trace the changing use of this term and identify two analytically distinct concepts associated with it: independence as self-reliance in activity and independence as autonomy, self-determination, or choice. We show how the latter has emerged in contemporary service contexts to represent an ideal of client-centered practice for persons with chronic disabilities, such as frail elderly clients. Using a "critical incident" interview approach with 12 Australian occupational therapists, we identified the therapists' explicit and implicit understandings of independence as a value concept and practice issue. Our findings suggest that a mismatch often exists between idealized and practice-based talk about independence and that therapists narrativize this opposition around what we call "the safety clause." That is, therapists invoke concerns about safety and duty of care as a caveat to implementing their independence ideals and justifying the retention of professional control. We identify key issues that therapists need to address if the rhetoric of independence-related client-centered practice is to be achieved in reality.

Conceptual Change and Science Achievement Related to a Lesson Sequence on Acids and Bases Among African American Alternative High School Students: A Teacher's Practical Arguments and the Voice of the "Other"

NASA Astrophysics Data System (ADS)

Wood, Lynda Charese

The study of teaching and learning during the period of translating ideals of reform into classroom practice enables us to understand student-teacher-researcher symbiotic learning. In line with this assumption, the purpose of this study is threefold:(1) observe effects of the Common Knowledge Construction Model (CKCM), a conceptual change inquiry model of teaching and learning, on African American students' conceptual change and achievement; (2) observe the shift in teacher's practical arguments; and (3) narrate the voice of "the Other" about teacher professional learning. This study uses retrospective data from a mixed-method approach consisting of Phenomenography, practical arguments and story-telling. Data sources include audio-recordings of a chemistry teacher's individual interviews of her students' prior- and post-intervention conceptions of acids and bases; results of Acid-Base Achievement Test (ABA-T); video-recordings of a chemistry teacher's enactment of CKCM acid-base lesson sequence; audio-recordings of teacher-researcher reflective discourse using classroom video-clips; teacher interviews; and teacher and researcher personal reflective journals. Students' conceptual changes reflect change in the number of categories of description; shift in language use from everyday talk to chemical talk; and development of a hierarchy of chemical knowledge. ABA-T results indicated 17 students in the experimental group achieved significantly higher scores than 22 students in the control group taught by traditional teaching methods. The teacher-researcher reflective discourse about enactment of the CKCM acid-base lesson sequence reveals three major shifts in teacher practical arguments: teacher inadequate preparedness to adequate preparedness; lack of confidence to gain in confidence; and surface learning to deep learning. The developing story uncovers several aspects about teaching and learning of African American students: teacher caring for the uncared; cultivating student and teacher confidence; converting dependence on teacher and self to peer interdependence. The study outlines six implications: caring conceptual change inquiry model for the often unreached mind; developing simple chemical talk into coherent chemical explanation; using CKCM for alternative high school students' conceptual change and achievement; engaging teachers in elicitation and appraisal of practical arguments for reconstruction of beliefs; overcoming challenges in teacher practical argument research; and "storytelling" as a way of unpacking teacher transformation amidst complexities of classroom teaching and learning.

Time, timing, talking and training: findings from an exploratory action research study to improve quality of end of life care for minority ethnic kidney patients.

PubMed

Wilkinson, Emma; Randhawa, Gurch; Brown, Edwina; Da Silva Gane, Maria; Stoves, John; Warwick, Graham; Mir, Tahira; Magee, Regina; Sharman, Sue; Farrington, Ken

2017-06-01

Background. With an ageing and increasingly diverse population at risk from rising levels of obesity, diabetes and cardiovascular disease, including kidney complications, there is a need to provide quality care at all stages in the care pathway including at the end of life and to all patients. Aim . This study purposively explored South Asian patients' experiences of kidney end of life care to understand how services can be delivered in a way that meets diverse patient needs. Methods. Within an action research design 14 focus groups (45 care providers) of kidney care providers discussed the recruitment and analysis of individual interviews with 16 South Asian kidney patients (eight men, eight women). Emergent themes from the focus groups were analysed thematically. The research took place at four UK centres providing kidney care to diverse populations: West London, Luton, Leicester and Bradford. Results. Key themes related to time and the timing of discussions about end of life care and the factors that place limitations on patients and providers in talking about end of life care. Lack of time and confidence of nurses in areas of kidney care, individual attitudes and workforce composition influence whether and how patients have access to end of life care through kidney services. Conclusion. Training, team work and time to discuss overarching issues (including timing and communication about end of life) with colleagues could support service providers to facilitate access and delivery of end of life care to this group of patients.

The Struggle for Self-Sufficiency: Participants in the Self-Sufficiency Project Talk about Work, Welfare, and Their Futures.

ERIC Educational Resources Information Center

Bancroft, Wendy; Vernon, Sheila Currie

This report recounts experiences of 99 single parents in British Columbia and New Brunswick who were offered the opportunity to receive cash payments in addition to their earnings if they left the income assistance (IA) rolls and took full-time jobs. The experiences are from participants of focus groups who were mostly female single parents, about…

The "Silent Dog" Method: Analyzing the Impact of Self-Generated Rules when Teaching Different Computer Chains to Boys with Autism

ERIC Educational Resources Information Center

Arntzen, Erik; Halstadtro, Lill-Beathe; Halstadtro, Monica

2009-01-01

The purpose of the study was to extend the literature on verbal self-regulation by using the "silent dog" method to evaluate the role of verbal regulation over nonverbal behavior in 2 individuals with autism. Participants were required to talk-aloud while performing functional computer tasks.Then the effects of distracters with increasing demands…

The Effect of Vocal Hygiene and Behavior Modification Instruction on the Self-Reported Vocal Health Habits of Public School Music Teachers

ERIC Educational Resources Information Center

Hackworth, Rhonda S.

2007-01-01

This study examined the effects of vocal hygiene and behavior modification instruction on self-reported behaviors of music teachers. Subjects (N = 76) reported daily behaviors for eight weeks: water consumption, warm-up, talking over music/noise, vocal rest, nonverbal commands, and vocal problems. Subjects were in experimental group 1 or 2, or the…

Self-Management as a Class-Wide Intervention: An Evaluation of the "Self & Match" System Embedded within a Dependent Group Contingency

ERIC Educational Resources Information Center

Bulla, Andrew J.; Frieder, Jessica E.

2018-01-01

Teachers are responsible for providing an education to students of all ability levels. Recent data suggest that roughly 95% of students with a disability are receiving some form of education in their general education setting. Individuals with disabilities tend to engage in higher levels of disruptive behaviors (e.g., talking out in class,…

Précis of Talking to Our Selves: Reflection, Ignorance, and Agency.

PubMed

Doris, John M

2016-11-29

Does it make sense for people to hold one another responsible for what they do, as happens in countless social interactions every day? One of the most unsettling lessons from recent psychological research is that people are routinely mistaken about the origins of their behavior. Yet philosophical orthodoxy holds that the exercise of morally responsible agency typically requires accurate self-awareness. If the orthodoxy is right, and the psychology is to be believed, people characteristically fail to meet the standards of morally responsible agency, and we are faced with the possibility of skepticism about agency. Unlike many philosophers, I accept the unsettling lesson from psychology. I insist, however, that we are not driven to skepticism. Instead, we should reject the requirement of accurate self-awareness for morally responsible agency. In Talking to Our Selves I develop a dialogic theory, where the exercise of morally responsible agency emerges through a collaborative conversational process by which human beings, although afflicted with a remarkable degree of self-ignorance, are able to realize their values in their lives.

Dieting and Gallstones

MedlinePlus

... weight very quickly may raise your chances of forming gallstones, however. Talk with your health care professional ... as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of ...

Insulin

MedlinePlus

... physical health. Work with your health care team to keep your feet, eyes, heart, and teeth healthy. This page should not be used in place of talking to your doctor or reading the label on your ...

Pregnancy - health risks

MedlinePlus

... drugs, stop drinking alcohol, and limit caffeine and coffee. Talk to your health care provider about any ... problems with the unborn baby. Smoking, alcohol, and marijuana use have also been shown to lower sperm ...

Involving women.

PubMed

Agbo, J

1994-01-01

I am a primary health care (PHC) coordinator working with the May Day Rural project, a local NGO involved in integrated approaches and programs with rural communities in the Ga District of the Greater-Accra region in Ghana. When we talk about the community development approach we must first and foremost recognize that we are talking about women, because in the developing world frequent childbirths mean that her burden of mortality is higher than a man's; her workload is extremely heavy--whether in gardening, farming, other household duties, caring for the sick, or the rearing of children; she has a key role in PHC and community development, because men are always looking for greener pastures elsewhere, leaving the women behind. Women's concerns are critical in most health care projects and women and children are their main beneficiaries. Why not include women in the management team, project design, implementation and evaluation processes? That is what the May Day Rural project is practicing, encouraging women's participation and creating a relationship of trust. full text

A Cooperative Communication System for the Advancement of Safe, Effective, and Efficient Patient Care

DTIC Science & Technology

2014-09-01

information technology to improve decision making and, thus, improve patient care . The daily work of the clinician requires knowledge representations ... palliative care . The resident pulls up the patient’s integrated view that shows key trend information, including: a. Vital signs over last 48 hours b...to talk to the family about transitioning the patient to palliative care . W81XWH-12-C-0126 Page 37 of 132 For the other patient, the burn surgeon

The Postmodernism of David Antin's "Tuning."

ERIC Educational Resources Information Center

Altieri, Charles

1986-01-01

Shows that Antin's talk poems satisfy basic needs. Discusses Antin's view on an art that addresses the concerns of "common life" and concentrates on feelings that do not depend on elaborate and evasively self-sustaining formal constructs. (EL)

Soft and Bio Nanomaterials Group at Brookhaven’s Center for Functional Nanomaterials

ScienceCinema

Gang, Oleg

2018-06-13

Group leader Oleg Gang talks about the methods his group develops to direct the self-assembly of nanoscale systems from organic and inorganic components into functional materials with desired properties.

Programmable Self-assembly of Hydrocarbon-capped Nanoparticles: Role of Chain Conformations

NASA Astrophysics Data System (ADS)

Waltmann, Curt; Horst, Nathan; Travesset, Alex

Nanoparticle superlattices (NPS), i.e. crystalline arrangements of nanoparticles, are materials with fascinating structures, which in many cases are not possible to attain from simple atoms or molecules. They also span a wide range of possible applications such as metamaterials, new energy sources, catalysis, and many others. In this talk, we present a theoretical and computational description of the self-assembly of nanoparticles with hydrocarbons as capping ligands. Usually, these systems have been described with hard sphere packing models. In this talk, we show that the conformations of the hydrocarbon chains play a fundamental role in determining the equilibrium phases, including and especially in binary systems. The work of CW was supported by a DOE-SULI internship from May-December 2016, and by NSF, DMR-CMMT 1606336 CDS&E: Design Principles for Ordering Nanoparticles into Super-crystals after January 1st.

THE EFFECT OF A CULTURALLY TAILORED SUBSTANCE ABUSE PREVENTION INTERVENTION WITH PLAINS INDIAN ADOLESCENTS.

PubMed

Patchell, Beverly A; Robbins, Leslie K; Lowe, John A; Hoke, Mary M

2015-01-01

To examine the effects of incorporating tribal specific cultural beliefs into a tailored substance abuse prevention intervention for at risk rural Oklahoma Native American Indian (NAI) Plains adolescents. The 10 hour Native American Talking Circle Intervention, a school-based, group substance abuse prevention program, was implemented over a 8.5 week period and evaluated using a one group, pretest-posttest design. Measurements were from the Native Self-Reliance Questionnaire and the Substance Problems Scale from Global Appraisal of Individual Needs-Quick (GAIN-Q). One-tailed, paired sample t-tests demonstrated significant increase in self-reliance, from 86.227 to 92.204 (t (43) = -2.580, p = .007) and a decrease in substance abuse/use, from 2.265 to 1.265 (t (33) = 1.844, p = .007). The Native Talking Circle Intervention based on tribal-specific values and beliefs was shown to be effective with substance abuse/use at-risk NAI Plains tribal adolescents.

Self-care confidence may be the key: A cross-sectional study on the association between cognition and self-care behaviors in adults with heart failure.

PubMed

Vellone, Ercole; Fida, Roberta; D'Agostino, Fabio; Mottola, Antonella; Juarez-Vela, Raul; Alvaro, Rosaria; Riegel, Barbara

2015-11-01

Self-care, a key element of heart failure care, is challenging for patients with impaired cognition. Mechanisms through which cognitive impairment affects self-care are not currently well defined but evidence from other patient populations suggests that self-efficacy, or task-specific confidence, mediates the relationship between cognitive functioning and patient behaviors such as self-care. The aim of this study was to test the mediating role of self-care confidence in the relationship between cognition and self-care behaviors. A secondary analysis of data from a cross-sectional study. Outpatient heart failure clinics in 28 Italian provinces. 628 Italian heart failure patients. We used the Self-Care of Heart Failure Index v.6.2 to measure self-care maintenance, self-care management, and self-care confidence. Cognition was assessed with the Mini Mental State Examination. Structural equation modeling was used to analyze the data. Participants were 73 years old on average (SD=11), mostly (58%) male and mostly (77%) in New York Heart Association functional classes II and III. The mediation model showed excellent fit (comparative fit index=1.0; root mean square error of approximation=0.02): Self-care confidence totally mediated the relationship between cognition and self-care maintenance and management. Cognition affects self-care behaviors indirectly, through self-care confidence. Interventions aimed at improving self-care confidence may improve self-care, even in heart failure patients with impaired cognition. Copyright © 2015 Elsevier Ltd. All rights reserved.

Menopause Symptoms | NIH MedlinePlus the Magazine

MedlinePlus

... have your blood pressure and levels of triglycerides, fasting blood glucose, and LDL, HDL, and total cholesterol checked regularly. Talk to your health care provider to find out what you should ...

Brain Development

MedlinePlus

... All Early Learning Child Care Early Literacy Early Math and Science Language and Communication Play School Readiness ... Brain Development from Birth Series Let's Talk About Math: Early Math Video Series Resource | Disponible en español ...

Reaching out to people struggling with their lives: a discourse analysis of answers from Internet-based services in Norway and Sweden

PubMed Central

Andersen, Anders Johan W; Svensson, Tommy

2012-01-01

The Internet has enlarged the scope of human communication, opening new avenues for connecting with people who are struggling with their lives. This article presents a discourse analysis of 101 responses to 98 questions that were posted on 14 different Internet-based mental health services in Norway and Sweden. We aimed to examine and describe the dominant understandings and favored recommendations in the services’ answers, and we reflected upon the social consequences of those answers. The services generally understood life struggles as an abnormal state of mind, life rhythms, or self-reinforcing loops. Internet-based mental health services primarily counsel service users to seek help, talk to health care professionals face-to-face, and discuss their life struggles openly and honestly. They also urge service users to take better care of themselves and socialize with other people. However, such answers might enhance the individualization of life problems, masking social origin and construction. Consequently, the services are challenged to include social explanations in their answers and strengthen their responsibility to amplify peoples’ messages at a societal level. Potentially, such answers could strengthen democratic structures and put pressure on social equity. PMID:23049282

Caring About Kids: Talking to Children About Death.

ERIC Educational Resources Information Center

National Inst. of Mental Health (DHEW), Rockville, MD. Div. of Scientific and Public Information.

This pamphlet is designed to help parents care for their children and themselves in ways that foster good mental health. The subject matter presented, death, may also be useful for relatives, school teachers, and babysitters who play important roles in the lives of children. Emphasis is placed on the following areas: (1) awareness of death; (2)…

My "Cancion"

ERIC Educational Resources Information Center

Herrera-Pazmino, Alma

2011-01-01

The author moved from Guatemala to California with her mom. In this article, she talks about the challenges of learning English. She needs to learn English to take care of her mom until her "papa" comes to take care of them. If she knows English she can help her mother with the groceries and answering the phone. She can also teach her…

Getting Medical Directors Out of the C-Suite and Closer to Points of Care.

PubMed

Schlosser, Michael

2016-11-01

Physicians, more than anyone else, can influence peers when it comes to talking about evidence-based care, even when it runs counter to customary, but costly, practice patterns. The timing couldn't be better to put physicians in this leadership role because of the growing use of value-based payment models.

Socio-demographic and clinical determinants of self-care in adults with type 2 diabetes: a multicentre observational study.

PubMed

Ausili, Davide; Rossi, Emanuela; Rebora, Paola; Luciani, Michela; Tonoli, Luca; Ballerini, Enrico; Androni, Silvia; Vellone, Ercole; Riegel, Barbara; Di Mauro, Stefania

2018-04-05

To describe self-care as defined by the Middle Range Theory of Self-Care of Chronic Illness and to identify clinical and socio-demographic determinants in a T2DM population. A multicentre observational cross-sectional study was conducted involving 540 adults with a confirmed diagnosis of T2DM from six outpatient diabetes services in Italy. Socio-demographic and clinical data were collected from medical records. The Self-Care of Diabetes Inventory (SCODI) was used to measure self-care maintenance, monitoring, management, and confidence dimensions. For each separate scale, scores were standardized 0-100 with higher SCODI scores indicating better self-care; a score ≥ 70 is adequate. Multiple quantile regression models were performed to identify determinants of each self-care dimension. Self-care maintenance (median = 81.3) and self-care confidence (median = 79.5) were adequate in most of the subjects. Self-care monitoring was adequate in only half of the sample (median = 70.6). Self-care management was poor (median = 59.4). Lower self-care maintenance was associated with lower self-care confidence (p < 0.001). Lower self-care monitoring was associated with being male (p < 0.001), having lower self-care confidence (p < 001), and having diabetes for < 10 years (p < 0.001). Lower self-care management was associated with being male (p = 0.002), being older (p = 0.005), having a low income (p = 0.030), being employed (p = 0.008), having missed diabetes education in the last year (p = 0.002), and lower self-care confidence (p < 0.0001). Lower self-care confidence was associated with having diabetes for < 10 years (p = 0.008), and having at least one comorbid condition (p = 0.006). Determinants of self-care maintenance, monitoring, management and confidence include both clinical and socio-demographic variables. Modifiable determinants such as self-care confidence and diabetes self-care management education could be used to tailor interventions to improve diabetes self-care.

Ethical practice in internet research involving vulnerable people: lessons from a self-harm discussion forum study (SharpTalk).

PubMed

Sharkey, Siobhan; Jones, Ray; Smithson, Janet; Hewis, Elaine; Emmens, Tobit; Ford, Tamsin; Owens, Christabel

2011-12-01

The internet is widely used for health information and support, often by vulnerable people. Internet-based research raises both familiar and new ethical problems for researchers and ethics committees. While guidelines for internet-based research are available, it is unclear to what extent ethics committees use these. Experience of gaining research ethics approval for a UK study (SharpTalk), involving internet-based discussion groups with young people who self-harm and health professionals is described. During ethical review, unsurprisingly, concerns were raised about the vulnerability of potential participants. These were dominated by the issue of anonymity, which also affected participant safety and consent. These ethical problems are discussed, and our solutions, which included: participant usernames specific to the study, a closed website, private messaging facilities, a direct contact email to researchers, information about forum rules displayed on the website, a 'report' button for participants, links to online support, and a discussion room for forum moderators. This experience with SharpTalk suggests that an approach to ethics, which recognises the relational aspects of research with vulnerable people, is particularly useful for internet-based health research. The solutions presented here can act as guidance for researchers developing proposals and for ethics committees reviewing them.

Bilingual health literacy assessment using the Talking Touchscreen/la Pantalla Parlanchina: Development and pilot testing.

PubMed

Yost, Kathleen J; Webster, Kimberly; Baker, David W; Choi, Seung W; Bode, Rita K; Hahn, Elizabeth A

2009-06-01

Current health literacy measures are too long, imprecise, or have questionable equivalence of English and Spanish versions. The purpose of this paper is to describe the development and pilot testing of a new bilingual computer-based health literacy assessment tool. We analyzed literacy data from three large studies. Using a working definition of health literacy, we developed new prose, document and quantitative items in English and Spanish. Items were pilot tested on 97 English- and 134 Spanish-speaking participants to assess item difficulty. Items covered topics relevant to primary care patients and providers. English- and Spanish-speaking participants understood the tasks involved in answering each type of question. The English Talking Touchscreen was easy to use and the English and Spanish items provided good coverage of the difficulty continuum. Qualitative and quantitative results provided useful information on computer acceptability and initial item difficulty. After the items have been administered on the Talking Touchscreen (la Pantalla Parlanchina) to 600 English-speaking (and 600 Spanish-speaking) primary care patients, we will develop a computer adaptive test. This health literacy tool will enable clinicians and researchers to more precisely determine the level at which low health literacy adversely affects health and healthcare utilization.

Ontological Security in Nursing Homes for Older Persons – Person-Centred Care is the Power of Balance

PubMed Central

James, Inger; Ardeman-Merten, Rebecka; Kihlgren, Annica

2014-01-01

Introduction: The Swedish national guidelines for elderly care describe how older persons should be able to trust that their care is permeated with security. Different theoretical perspectives can be found that describe what creates security. Many studies have been done about security. However, few studies have explicitly asked older persons what security in nursing homes means to them. Aim: The aim of the study was to describe how older persons in nursing homes talked and reflected about security in their daily lives. Method: Nine older persons were interviewed in, in-depth interviews one to three times and the resulting data was analysed using content analysis. Results: The older persons adapted to having their own needs and those of the other older persons met and to the staff routines which created a sense of security. At the same time, they longed for security in which they could trust themselves and create their own daily life. Further to have a sense of belonging and of being liked for created an internal, interpersonal and external security. This can be linked to an ontological security which means having a sense of confidence in the continuity of self-identity and order in events, a being in the world. Conclusion: Person-centred instead of institution- centred care can provide the balance of power that allows the older person to obtain ontological security in which the staff's ability to create a relationship with the older persons becomes crucial. PMID:25852785

Managing tension headaches at home

MedlinePlus

Tension-type headache - self-care; Muscle contraction headache - self-care; Headache - benign - self-care; Headache - tension- self-care; Chronic headaches - tension - self-care; Rebound headaches - ...

ASK Talks with W. Scott Cameron

NASA Technical Reports Server (NTRS)

Cameron, W. Scott

2002-01-01

This paper presents an interview with Scott Cameron who is the Capital Systems Manager for the Food and Beverage Global Business Unit of Procter and Gamble. He has been managing capital projects and mentoring other project managers for the past 20 years at Procter and Gamble within its Beauty Care, Health Care, Food and Beverage, and Fabric and Home Care Businesses. Scott also has been an Academy Sharing Knowledge (ASK) feature writer since Volume One.

Someone To Talk to and Someone To Listen. The Development of a Support and Learning Network for Palliative Care Workers in the Country Area of the Barossa Valley in South Australia.

ERIC Educational Resources Information Center

Elsey, Barry

A palliative care support and training network was developed in a relatively isolated country area of the Barossa Valley in South Australia. The project was intended to help palliative care workers, volunteers, home carers, and others work collaboratively as a team (holistic model) for the purposes of mutually supporting, sharing information and…

MedTalks: developing teaching abilities and experience in undergraduate medical students.

PubMed

Bandeali, Suhair; Chiang, Albert; Ramnanan, Christopher J

2017-01-01

According to the CanMEDS' Scholar competency, physicians are expected to facilitate the learning of colleagues, patients and other health professionals. However, most medical students are not provided with formal opportunities to gain teaching experience with objective feedback. To address this, the University's Medical Education Interest Group (MEIG) created a pilot teaching program in January 2015 entitled 'MedTalks'. Four 3-hour sessions were held at the University Faculty of Medicine, where first and second year medical students taught clinically oriented topics to undergraduate university students. Each extracurricular session included three 30-minute content lectures, and a 90-minute small group session on physical examination skills. Each medical student-teacher received formal feedback from undergraduate students and from faculty educators regarding teaching style, communication abilities, and professionalism. In addition, medical student-teachers self-evaluated their own teaching experience. Over 50 medical students from the University participated as medical student-teachers. Based on quantitative and qualitative evaluation surveys, 100% of medical students agreed that MedTalks was a useful way to develop teaching skills and 92% gained a greater confidence in individual teaching capabilities, based largely on the opportunity to gain experience (with feedback) in teaching roles. A program designed to give medical students multi-source teaching experience (lecture- and small group-based) and feedback on their teaching (from learners and Faculty observers, in addition to their own self-reflection) can improve medical student confidence and enthusiasm towards teaching. Future studies will clarify if medical student self-perceived enhancements in teaching ability can be corroborated by independent (Faculty, learner) observations of future teaching activity.

How Christian nurses converse with patients about spirituality.

PubMed

Pfeiffer, Jane Bacon; Gober, Carla; Taylor, Elizabeth Johnston

2014-10-01

To describe the experience of conversing with clients to provide spiritual care from the perspective of Christian nurses identified as exemplary spiritual caregivers. More specifically, findings presented here describe the goals and strategies of these nurses when conversing with patients about spirituality. Although verbal communication is pivotal to most spiritual care interventions recognised in the nursing literature, there is scant empirical evidence to inform such spiritual care. There is evidence, however, that many nurses have discomfort and difficulty with conversations about spirituality. Cross-sectional, descriptive, qualitative design framed by phenomenology. Semi-structured interviews were conducted with 14 southern California registered nurses working in varied clinical settings. Data were coded and thematically analysed by three researchers who established equivalency. Methods to support the trustworthiness of the findings were employed. Themes providing structure to the description of how nurses converse with patients about spirituality included assessing and establishing connection, overt introductions of spirituality, finding spiritual commonality, self-disclosure, spiritual encouragement, spiritual advice or religious teaching, and prayer. Requisite to any spiritual care conversation, however, was 'allowing them (patients) to talk'. Informants tread 'gently and softly' in approaching spiritual discourse, assessing for any patient resistance, and not pushing further if any was met. Findings illustrate compassionate nursing with specifiable goals and strategies for conversations about spirituality; they also raise questions about how nurse religious beliefs are to ethically inform these conversations. The Invitation, Connection, Attentive care, Reciprocity mnemonic is offered as a means for nurses to remember essentials for communication with patients about spirituality. © 2014 John Wiley & Sons Ltd.

Self-Care for the Prevention and Management of Cardiovascular Disease and Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association.

PubMed

Riegel, Barbara; Moser, Debra K; Buck, Harleah G; Dickson, Victoria Vaughan; Dunbar, Sandra B; Lee, Christopher S; Lennie, Terry A; Lindenfeld, JoAnn; Mitchell, Judith E; Treat-Jacobson, Diane J; Webber, David E

2017-08-31

Self-care is defined as a naturalistic decision-making process addressing both the prevention and management of chronic illness, with core elements of self-care maintenance, self-care monitoring, and self-care management. In this scientific statement, we describe the importance of self-care in the American Heart Association mission and vision of building healthier lives, free of cardiovascular diseases and stroke. The evidence supporting specific self-care behaviors such as diet and exercise, barriers to self-care, and the effectiveness of self-care in improving outcomes is reviewed, as is the evidence supporting various individual, family-based, and community-based approaches to improving self-care. Although there are many nuances to the relationships between self-care and outcomes, there is strong evidence that self-care is effective in achieving the goals of the treatment plan and cannot be ignored. As such, greater emphasis should be placed on self-care in evidence-based guidelines. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Deciding to quit drinking alcohol

MedlinePlus

... how to stay away from alcohol Provide a space where you can talk with others who have ... Association, 2013. Moyer VA; US Preventive Services Task Force. Screening and behavioral counseling interventions in primary care ...

Straight Talk For Good Health

MedlinePlus

... care provider about what's wrong and how to cure it is one of the most important aspects ... you use, such as herbs or supplements. Any allergies you may have, especially to medications. A description ...

Talking to Your Child's Doctor

MedlinePlus

... doctor is unrealistic expectations or an unwillingness to trust a doctor's diagnosis or treatment of a minor ... communication by letting the doctor know that you trust him or her to care for your child. ...

Self-care confidence may be more important than cognition to influence self-care behaviors in adults with heart failure: Testing a mediation model.

PubMed

Vellone, Ercole; Pancani, Luca; Greco, Andrea; Steca, Patrizia; Riegel, Barbara

2016-08-01

Cognitive impairment can reduce the self-care abilities of heart failure patients. Theory and preliminary evidence suggest that self-care confidence may mediate the relationship between cognition and self-care, but further study is needed to validate this finding. The aim of this study was to test the mediating role of self-care confidence between specific cognitive domains and heart failure self-care. Secondary analysis of data from a descriptive study. Three out-patient sites in Pennsylvania and Delaware, USA. A sample of 280 adults with chronic heart failure, 62 years old on average and mostly male (64.3%). Data on heart failure self-care and self-care confidence were collected with the Self-Care of Heart Failure Index 6.2. Data on cognition were collected by trained research assistants using a neuropsychological test battery measuring simple and complex attention, processing speed, working memory, and short-term memory. Sociodemographic data were collected by self-report. Clinical information was abstracted from the medical record. Mediation analysis was performed with structural equation modeling and indirect effects were evaluated with bootstrapping. Most participants had at least 1 impaired cognitive domain. In mediation models, self-care confidence consistently influenced self-care and totally mediated the relationship between simple attention and self-care and between working memory and self-care (comparative fit index range: .929-.968; root mean squared error of approximation range: .032-.052). Except for short-term memory, which had a direct effect on self-care maintenance, the other cognitive domains were unrelated to self-care. Self-care confidence appears to be an important factor influencing heart failure self-care even in patients with impaired cognition. As few studies have successfully improved cognition, interventions addressing confidence should be considered as a way to improve self-care in this population. Copyright © 2016 Elsevier Ltd. All rights reserved.

Construct validity of the Chinese version of the Self-care of Heart Failure Index determined using structural equation modeling.

PubMed

Kang, Xiaofeng; Dennison Himmelfarb, Cheryl R; Li, Zheng; Zhang, Jian; Lv, Rong; Guo, Jinyu

2015-01-01

The Self-care of Heart Failure Index (SCHFI) is an empirically tested instrument for measuring the self-care of patients with heart failure. The aim of this study was to develop a simplified Chinese version of the SCHFI and provide evidence for its construct validity. A total of 182 Chinese with heart failure were surveyed. A 2-step structural equation modeling procedure was applied to test construct validity. Factor analysis showed 3 factors explaining 43% of the variance. Structural equation model confirmed that self-care maintenance, self-care management, and self-care confidence are indeed indicators of self-care, and self-care confidence was a positive and equally strong predictor of self-care maintenance and self-care management. Moreover, self-care scores were correlated with the Partners in Health Scale, indicating satisfactory concurrent validity. The Chinese version of the SCHFI is a theory-based instrument for assessing self-care of Chinese patients with heart failure.

Gender differences in and factors related to self-care behaviors: a cross-sectional, correlational study of patients with heart failure.

PubMed

Heo, Seongkum; Moser, Debra K; Lennie, Terry A; Riegel, Barbara; Chung, Misook L

2008-12-01

Although self-care may reduce exacerbations of heart failure, reported rates of effective self-care in patients with heart failure are low. Modifiable factors, including psychosocial status, knowledge, and physical factors, are thought to influence heart failure self-care, but little is known about their combined impact on self-care. The objective of this study was to identify factors related to self-care behaviors in patients with heart failure. A cross-sectional, correlational study design was used. One hundred twenty-two patients (77 men and 45 women, mean age 60+/-12 years old, 66% New York Heart Association functional class III/IV) were recruited from the outpatient clinics of an academic medical center and two community hospitals. Data on self-care behaviors (Self-Care of Heart Failure Index), depressive symptoms, perceived control, self-care confidence, knowledge, functional status, and social support were collected. Factors related to self-care were examined using hierarchical multiple regression. Mean self-care behavior scores were less than 70 indicating the majority of men and women with HF did not consistently engage in self-care behaviors. Higher self-care confidence and perceived control and better heart failure management knowledge were associated with better self-care (r2=.25, p<.001). Higher perceived control and better knowledge were related to better self-care behaviors in men (r2=.18, p=.001), while higher self-care confidence and poorer functional status were related to better self-care behaviors in women (r2=.35, p<.001). This study demonstrates the substantial impact of modifiable factors such as confidence in one's self-care abilities, perceived control, and knowledge on self-care behaviors. This study demonstrates that there are gender differences in factors affecting self-care, even though at baseline men and women have similar knowledge levels, physical, psychological, and behavioral status. Effective interventions focusing on modifiable factors and the unique characteristics of men and women should be provided to improve self-care behaviors in patients with heart failure.

Beyond the Biology: A Systematic Investigation of Noncontent Instructor Talk in an Introductory Biology Course

PubMed Central

Seidel, Shannon B.; Reggi, Amanda L.; Schinske, Jeffrey N.; Burrus, Laura W.; Tanner, Kimberly D.

2015-01-01

Instructors create classroom environments that have the potential to impact learning by affecting student motivation, resistance, and self-efficacy. However, despite the critical importance of the learning environment in increasing conceptual understanding, little research has investigated what instructors say and do to create learning environments in college biology classrooms. We systematically investigated the language used by instructors that does not directly relate to course content and defined the construct of Instructor Talk. Transcripts were generated from a semester-long, cotaught introductory biology course (n = 270 students). Transcripts were analyzed using a grounded theory approach to identify emergent categories of Instructor Talk. The five emergent categories from analysis of more than 600 quotes were, in order of prevalence, 1) Building the Instructor/Student Relationship, 2) Establishing Classroom Culture, 3) Explaining Pedagogical Choices, 4) Sharing Personal Experiences, and 5) Unmasking Science. Instances of Instructor Talk were present in every class session analyzed and ranged from six to 68 quotes per session. The Instructor Talk framework is a novel research variable that could yield insights into instructor effectiveness, origins of student resistance, and methods for overcoming stereotype threat. Additionally, it holds promise in professional development settings to assist instructors in reflecting on the learning environments they create. PMID:26582237

Physician gender and patient-centered communication: a critical review of empirical research.

PubMed

Roter, Debra L; Hall, Judith A

2004-01-01

Physician gender has stimulated a good deal of interest as a possible source of variation in the interpersonal aspects of medical practice, with speculation that female physicians are more patient-centered in their communication with patients. Our objective is to synthesize the results of two meta-analytic reviews the effects of physician gender on communication in medical visits within a communication framework that reflects patient-centeredness and the functions of the medical visit. We performed online database searches of English-language abstracts for the years 1967 to 2001 (MEDLINE, AIDSLINE, PsycINFO, and BIOETHICS), and a hand search was conducted of reprint files and the reference sections of review articles and other publications. Studies using a communication data source such as audiotape, videotape, or direct observation were identified through bibliographic and computerized searches. Medical visits with female physicians were, on average, two minutes (10%) longer than those of male physicians. During this time, female physicians engaged in significantly more communication that can be considered patient-centered. They engaged in more active partnership behaviors, positive talk, psychosocial counseling, psychosocial question asking, and emotionally focused talk. Moreover, the patients of female physicians spoke more overall, disclosed more biomedical and psychosocial information, and made more positive statements to their physicians than did the patients of male physicians. Obstetrics and gynecology may present a pattern different from that of primary care: Male physicians demonstrated higher levels of emotionally focused talk than their female colleagues. Female primary care physicians and their patients engaged in more communication that can be considered patient-centered and had longer visits than did their male colleagues. Limited studies exist outside of primary care, and gender-related practice patterns might differ in some subspecialties from those evident in primary care.

Metformin and Pregnancy

MedlinePlus

... fed. Be sure to talk to your health care provider about all your breastfeeding questions. For information on a related topic see the MotherToBaby fact sheet for Diabetes and Pregnancy at https: / / mothertobaby. org/ fact- sheets/ ...

CDC Vital Signs: Alcohol Poisoning Deaths

MedlinePlus

... role of alcohol in injuries and deaths. Doctors, nurses, and other providers can Screen all adult patients ... signs of alcohol poisoning. Talk to your doctor, nurse, or other health care provider if you think ...

Timothy Ley, M.D., Advocates for Personalized Medicine in AML - TCGA

Cancer.gov

Oncologist Dr. Timothy Ley talks about how repurposing of existing drugs based on better understanding of the genetic basis of acute myeloid leukemia (AML) can help patients receive personalized care.

Pyruvate kinase blood test

MedlinePlus

... Some labs use different measurements or test different samples. Talk to your health care provider about the meaning of your ... Veins and arteries vary in size from one person to another and from one side of ...

Normal birth, magical birth: the role of the 36-week birth talk in caseload midwifery practice.

PubMed

Kemp, Joy; Sandall, Jane

2010-04-01

to obtain a detailed description of the 36-week birth talk, and how it is delivered to and perceived by women and their birth partners. two qualitative methods: ethnography and interpretative phenomenological analysis. Non-participant observation of five birth talks and in-depth semi-structured interviews with midwives, women and their birth partners. two caseload midwifery practices in an inner city area of England, and women's homes. five birth talks, five case-loading midwives, five childbearing women and five birth partners. a rich description of the content and conduct of the birth talk emerged from the data. In addition, three master themes were identified: a new philosophy for birth ('don't forget the magic'); the construction of authoritative midwifery knowledge ('they make you believe that you can have what you want'); and achieving a sense of coherence ('making sense of the birth'). IMPLICATIONS FOR PRACTICE, POLICY, EDUCATION AND RESEARCH: the majority of data from this study suggest that the effectiveness of a birth talk cannot be separated from the philosophy and continuity associated with caseload midwifery practice. The birth talk is therefore probably not transferable per se into different models of care in order to achieve higher rates of normal birth. Further evaluation of the effectiveness of the birth talk in clinical practice, and further research into alternative birth philosophies in different settings is now required. Caseload midwifery practice has been shown to benefit women and midwives. This study would seem to concur with these previous findings. The sense of coherence concept could prove to be a useful tool to measure outcomes in future midwifery research. Copyright 2008 Elsevier Ltd. All rights reserved.

More reliable data for diarrhoeal intervention programmes: rethinking on knowledge, attitude and practice studies.

PubMed

Antia, B E; Omotara, B A; Rabasa, A I; Addy, E O; Tomfafi, O A A; Anaso, C C

2003-06-01

The aim of this study was to propose an alternative approach to traditional knowledge, attitude and practice (KAP) studies to enhance the quality of data on which educational health programmes are based. The methodology proposed and illustrated involved a triangulation of approaches derived from linguistics, cognitive science, and medical laboratory sciences. Three diarrhoeal health talks (educational messages) as given to mothers in three primary-care facilities in Borno State (Northeast Nigeria) were subjected to a linguistics analysis. Relationships were then sought between the ontology of knowledge in the health talks as revealed by the text analysis and two other kinds of data, namely: (a) mothers' answers to a set of ecologically-sensitive reasoning questions that test how much relevant inferential knowledge the health talks allow for and (b) results of microbiological and biochemical analyses of salt-sugar rehydration solutions prepared by mothers participating in the study. The findings of the study show a relationship between contents/formatting of the health talks and the extent to which relevant inferential competence was supported or demonstrated by mothers. It was also evident that the laboratory analyses could be related either directly to the health talks or indirectly in terms of what the health talks need to emphasize on. The conclusion shows how the methodology proposed addresses shortcomings of traditional KAP studies in respect of the gap between health knowledge and practice.

Living Arrangements Modify the Relationship Between Depressive Symptoms and Self-care in Patients With Heart Failure.

PubMed

Lee, Kyoung Suk; Lennie, Terry A; Yoon, Ju Young; Wu, Jia-Rong; Moser, Debra K

Depressive symptoms hinder heart failure patients' engagement in self-care. As social support helps improve self-care and decrease depressive symptoms, it is possible that social support buffers the negative impact of depressive symptoms on self-care. The purpose of this study is to examine the effect of living arrangements as an indicator of social support on the relationship between depressive symptoms and self-care in heart failure patients. Stable heart failure patients (N = 206) completed the Patient Health Questionnaire-9 to measure depressive symptoms. Self-care (maintenance, management, and confidence) was measured with the Self-Care of Heart Failure Index. Path analyses were used to examine associations among depressive symptoms and the self-care constructs by living arrangements. Depressive symptoms had a direct effect on self-care maintenance and management (standardized β = -0.362 and -0.351, respectively), but not on self-care confidence in patients living alone. Depressive symptoms had no direct or indirect effect on any of the 3 self-care constructs in patients living with someone. Depressive symptoms had negative effects on self-care in patients living alone, but were not related to self-care in patients living with someone. Our results suggest that negative effects of depressive symptoms on self-care are buffered by social support.

Exposed and embedded corrections in aphasia therapy: issues of voice and identity.

PubMed

Simmons-Mackie, Nina; Damico, Jack S

2008-01-01

Because communication after the onset of aphasia can be fraught with errors, therapist corrections are pervasive in therapy for aphasia. Although corrections are designed to improve the accuracy of communication, some corrections can have social and emotional consequences during interactions. That is, exposure of errors can potentially silence the 'voice' of a speaker by orienting to an utterance as unacceptable. Although corrections can marginalize speakers with aphasia, the practice has not been widely investigated. A qualitative study of corrections during aphasia therapy was undertaken to describe corrections in therapy, identify patterns of occurrence, and develop hypotheses regarding the potential effects of corrections. Videotapes of six individual and five group aphasia therapy sessions were analysed. Sequences consistent with a definition of a therapist 'correction' were identified. Corrections were defined as instances when the therapist offered a 'fix' for a perceived error in the client's talk even though the intent was apparent. Two categories of correction were identified and were consistent with Jefferson's (1987) descriptions of exposed and embedded corrections. Exposed corrections involved explicit correcting by the therapist, while embedded corrections occurred implicitly within the ongoing talk. Patterns of occurrence appeared consistent with philosophical orientations of therapy sessions. Exposed corrections were more prevalent in sessions focusing on repairing deficits, while embedded corrections were prevalent in sessions focusing on natural communication events (e.g. conversation). In addition, exposed corrections were sometimes used when client offerings were plausible or appropriate, but were inconsistent with therapist expectations. The observation that some instances of exposed corrections effectively silenced the voice or self-expression of the person with aphasia has significant implications for outcomes from aphasia therapy. By focusing on accurate productions versus communicative intents, therapy runs the risk of reducing self-esteem and communicative confidence, as well as reinforcing a sense of 'helplessness' and disempowerment among people with aphasia. The results suggest that clinicians should carefully calibrate the use of exposed and embedded corrections to balance linguistic and psychosocial goals.

How to Structure University/Industry Cooperation for Maximum Mutual Benefit

NASA Astrophysics Data System (ADS)

Sommer, Klaus H.

2000-03-01

Research in the technical industries has changed dramatically in the past twenty years. As part of the change, many companies have shifted their long-term research from within company labs to university labs using a variety of mechanisms for such "cooperations." This talk focuses on how Bayer Corporation uses contract research, unrestricted funds, consortia, and government contracts to supplement in-house research programs. The talk emphasizes the importance of careful tailoring of these mechanisms in order to achieve maximum success for both the company and its university partners.

[Quality evaluation of the orthodontic practice for certification by ISO 9001. A procedure beneficial for medical, medico-dental or hospital service].

PubMed

Becker, G

2001-01-01

The accreditation of the ISO 9001 certification (ISO = International Standard Organization) is an external evaluation procedure carried out by independent experts, whose object is the analysis of the operational methods and practices of a medical care facility (e.g. hospital, private clinic, general practitioner's or dentist's practice) which decided to assume the concept, implementation and control of its own quality policy. The whole accreditation procedure represents the basic structure of a continuous dynamic progressiveness within a cabinet eager to offer outstanding quality. Moreover, it guarantees active and voluntary participation of every single member of the medical administration or technical team involved in the realization of this primary objective. In other words, we are talking about a very strong dynamic innovation leading to a change of views and the improvement of communication means, while simultaneously enhancing the security and quality aspects of medical care. The continuous guarantee of high quality medical care calls for precise planning and systematization of actions. First of all, these actions are defined, analyzed and listed in precise work procedures. As they are defined with the agreement of the whole team, they implicate respect and self control. This requires of course transparency of the treatment methods, whose different steps and procedures are described in detail in a logogramm set up in common.

Examining Self-Care Behaviors and Their Associated Factors Among Adolescent Girls With Dysmenorrhea: An Application of Orem's Self-Care Deficit Nursing Theory.

PubMed

Wong, Cho Lee; Ip, Wan Yim; Choi, Kai Chow; Lam, Lai Wah

2015-05-01

To test a hypothesized model that examines the relationship between selected basic conditioning factors, self-care agency, and self-care behaviors among adolescent girls with dysmenorrhea using Orem's self-care deficit nursing theory as a framework. This was a predictive correlational study conducted with a total of 531 secondary school girls. Self-care agency, self-care behaviors, and 11 variables that have been theoretically or empirically justified in previous studies as relevant to basic conditioning factors were selected and collected by means of structured questionnaires. Path analyses were performed to test the hypothesized linkages among variables. Path analysis revealed that age and received menstrual education had both direct and indirect effects through self-care agency on self-care behaviors. Mother's and father's educational level, pain intensity, and self-medication used when experiencing dysmenorrhea only affected the self-care behaviors directly. This is the first study that provided information about the relationship between basic conditioning factors, self-care agency, and self-care behaviors among adolescent girls with dysmenorrhea. Knowledge of the factors influencing self-care behaviors in these adolescent girls will assist healthcare professionals in developing effective interventions to promote self-care and ameliorate the adverse impact of this condition. Interventional strategies that aim at promoting self-care behaviors among adolescent girls with dysmenorrhea should strengthen girls' self-care agency and should target those with a younger age, higher pain intensity, mother with a higher educational level, father with a lower educational level, and those who do not take self-medication for dysmenorrhea. © 2015 Sigma Theta Tau International.

Slavery and jouissance: analysing complaints of suffering in UK and Australian nurses' talk about their work.

PubMed

Traynor, Michael; Evans, Alicia

2014-07-01

Nursing has a gendered and religious history where ideas of duty and servitude are present and shape its professional identity. The profession also promotes idealized notions of relationships with patients and of professional autonomy both of which are, in practice, highly constrained or even impossible. This paper draws on psychoanalytic concepts in order to reconsider nursing's professional identity. It does this by presenting an analysis of data from two focus group studies involving nurses in England and Australia held between 2010 and 2012. The studies gave rise to data where extremely negative talk about nursing work seemed to produce, or to be expressed with, a high degree of energy, and a particular kind of enjoyment. In our analysis, we focus on the nurses' apparent enjoyment derived from their expression of a position of powerlessness in which they describe themselves as 'slaves' or 'martyrs' in the health care system. We interpret this as jouissance and suggest that the positions of slave or martyr provide a possible response to what we argue is the impossibility of the nurse's role. We argue that a remnant of a quasi-religious ethic within the profession makes it acceptable for nurses to talk about self-sacrifice and powerlessness as part of their working subjectivity. We further argue that this analysis offers a new consideration of the issue of power and professional identity in nursing that goes beyond seeing nurses as simply overpowered by, or engaged in, a gendered power struggle with other professional groups. We suggest that powerlessness and victimhood hold particular attractions and advantages for nurses and are positions that are more available to nurses than to other occupational groups. This research shows how psychoanalytic theory can help produce new insights into the problems and complexity of nursing and extend existing study of the professions. © 2014 John Wiley & Sons Ltd.

Self-care and HIV/AIDS patients: nursing care systematization.

PubMed

Caetano, Joselany Afio; Pagliuca, Lorita Marlena Freitag

2006-01-01

This research aimed at systematizing nursing care to HIV/aids patients in view of Orem's Self-care Deficit Nursing Theory, using the convergent-care method and the Self-Care Nursing Process. Subjects were thirteen HIV/AIDS patients attended at a non-governmental organization in Fortaleza/CE, Brazil. We used interview techniques, physical examination, observation and information records, with a structured instrument, addressing requisites related to universal self-care, development and health alterations. Self-care deficits corresponded to nineteen nursing diagnoses, named according to NANDA's Taxonomy II, ten of which were based on the requisites for universal self-care, five on the requisites for self-care related to development and four on the requisites for self-care related to health deviations. In care planning, goals were established and the system and health methods were selected, prioritizing support-education actions in order to engage HIV/aids patients in self-care.

Training to use motivational interviewing techniques for depression: a cluster randomized trial.

PubMed

Keeley, Robert D; Burke, Brian L; Brody, David; Dimidjian, Sona; Engel, Matthew; Emsermann, Caroline; deGruy, Frank; Thomas, Marshall; Moralez, Ernesto; Koester, Steve; Kaplan, Jessica

2014-01-01

The goal of this study was to assess the effects of training primary care providers (PCPs) to use Motivational Interviewing (MI) when treating depressed patients on providers' MI performance and patients' expressions of interest in depression treatment ("change talk") and short-term treatment adherence. This was a cluster randomized trial in urban primary care clinics (3 intervention, 4 control). We recruited 21 PCPs (10 intervention, 11 control) and 171 English-speaking patients with newly diagnosed depression (85 intervention, 86 control). MI training included a baseline and up to 2 refresher classroom trainings, along with feedback on audiotaped patient encounters. We report summary measures of technical (rate of MI-consistent statements per 10 minutes during encounters) and relational (global rating of "MI Spirit") MI performance, the association between MI performance and number of MI trainings attended (0, 1, 2, or 3), and rates of patient change talk regarding depression treatments (physical activity, antidepressant medication). We report PCP use of physical activity recommendations and antidepressant prescriptions and patients' short-term physical activity level and prescription fill rates. Use of MI-consistent statements was 26% higher for MI-trained versus control PCPs (P = .005). PCPs attending all 3 MI trainings (n = 6) had 38% higher use of MI-consistent statements (P < .001) and were over 5 times more likely to show beginning proficiency in MI Spirit (P = .036) relative to control PCPs. Although PCPs' use of physical activity recommendations and antidepressant prescriptions was not significantly different by randomization arm, patients seen by MI-trained PCPs had more frequent change talk (P = .001). Patients of MI-trained PCPs also expressed change talk about physical activity 3 times more frequently (P = .01) and reported more physical activity (3.05 vs 1.84 days in the week after the visit; P = .007) than their counterparts visiting untrained PCPs. Change talk about antidepressant medication and fill rates were similar by randomization arm (P > .05 for both). MI training resulted in improved MI performance, more depression-related patient change talk, and better short-term adherence. © Copyright 2014 by the American Board of Family Medicine.

Summer Doldrums.

ERIC Educational Resources Information Center

Muchnick, Bruce

2002-01-01

For camp staff, factors that contribute to the summer doldrums are weather, level of general fatigue, unsatisfied expectations, sensory overload, accumulation of negative "self-talk," and an underlying sense of hurry. Strategies for overcoming summer doldrums involve novelty and stress management, and include promoting health, challenging…

Hospital staff corridor conversations: work in passing.

PubMed

González-Martínez, Esther; Bangerter, Adrian; Lê Van, Kim; Navarro, Cécile

2016-03-01

First, to document the prevalence of corridor occupations and conversations among the staff of a hospital clinic, and their main features. Second, to examine the activities accomplished through corridor conversations and their interactional organization. Despite extensive research on mobility in hospital work, we still know fairly little about the prevalence and features of hospital staff corridor conversations and how they are organized. We conducted a study combining descriptive statistical analysis and multimodal conversation analysis of video recordings of staff corridor practices in a hospital outpatient clinic in Switzerland. In 2012, we collected 59 hours of video recordings in a corridor of a hospital clinic. We coded and statistically analysed the footage that showed the clinic staff exclusively. We also performed qualitative multimodal conversation analysis on a selection of the recorded staff conversations. Corridor occupations by the clinic staff are frequent and brief and rarely involve stops. Talk events (which include self-talk, face-to-face conversations and telephone conversations) during occupations are also brief and mobile, overwhelmingly focus on professional topics and are particularly frequent when two or more staff members occupy the corridor. The conversations present several interactional configurations and comprise an array of activities consequential to the provision of care and work organization. These practices are related to the fluid work organization of a spatially distributed team in a fast-paced, multitasking environment and should be taken into consideration in any undertaking aimed at improving hospital units' functioning. © 2015 John Wiley & Sons Ltd.

Perceptions of North Dakota Registered Nurses Regarding Advance Directives

DTIC Science & Technology

2005-05-01

directives. As one of the largest and most accessible members of the health care team, nurses are in an ideal position to serve as advocates and... nurses will advocate for patient participation in end-of-life care planning, and assumes that both groups possess the knowledge and comfort levels...that time, 72% of respondents felt that it was a nursing responsibility to suggest to patients that they talk with family or friends about what care

WHERE HAS THE COMPASSION GONE FROM THE RESIDENTIAL AGED CARE ENVIRONMENT?

PubMed

Oliver, Kim

2017-02-01

Would working in residential aged care be your dream job as a newly qualified nurse, probably not, but why not? Montayre (2015) suggests that although nurses don't like to talk about it, or even less, what the real problem is perceived to be with this practice area, residential aged care nursing is thought to be less exciting, monotonous, and requiring less skill than other areas such as emergency nursing, or medical nursing.

Self-care and quality of life of heart failure patients at a multidisciplinary heart function clinic.

PubMed

Seto, Emily; Leonard, Kevin J; Cafazzo, Joseph A; Masino, Caterina; Barnsley, Jan; Ross, Heather J

2011-01-01

Multidisciplinary heart function clinics aim to improve self-care through patient education and to provide clinical management. The objectives of the present study were to investigate the self-care and quality of life of patients attending a multidisciplinary heart function clinic and to explore the relationship between self-care and quality of life. One hundred outpatients attending a multidisciplinary heart function clinic were asked to complete a questionnaire. The questionnaire included the Self-care of Heart Failure Index (SCHFI) and the Minnesota Living With Heart Failure Questionnaire, which were used to assess self-care behavior and quality of life, respectively. Self-care practices and perceived barriers were also assessed through semistructured interviews with each patient. : The returned questionnaires (n = 94) were used to compute the following SCHFI maintenance, management, and confidence scores: 60.8 (SD, 19.3), 62.0 (SD, 20.7), and 55.9 (SD, 19.7), respectively. Higher SCHFI scores indicate better self-care. None of the self-care dimensions reached the self-care adequacy cut point of 70. The average score on the Minnesota Living With Heart Failure Questionnaire was 49.9 (SD, 25.4), indicating a moderate health-related quality of life. Lower ejection fraction, older age, and better quality of life were associated with better self-care. Determinants of better quality of life were older age, better functional capacity, higher self-care confidence, and fewer comorbidities. The patient interviews revealed that better quality of life is associated with higher self-care confidence and barriers to self-care caused anxiety to the patients. The self-care barriers were found to include lack of self-care education, financial constraints, lack of perceived benefit, and low self-efficacy. Patients attending a large multidisciplinary Canadian heart failure clinic do not perform adequate self-care as measured with the SCHFI and report only a moderate quality of life. Increasing self-care through education and tools that target self-care barriers are required and may help improve quality of life.

Supporting self-care in general practice

PubMed Central

Greaves, Colin J; Campbell, John L

2007-01-01

There is both a clear need and a political will to improve self-care in long-term conditions: demand for self-care support interventions is rising. This article discusses current approaches to supporting self-care in primary care, evidence in favour of self-care support, and issues for GPs to consider in planning self-care support systems. In planning care pathways, important choices need to be made about whether to use individual or group-based approaches and what intensity of intervention is appropriate to match patient needs. Investment may also be needed in both health professional competences and practice systems to optimise their ability to support patient self-care. Self-care support is a key approach for the future of UK health care. Practices that are well trained and well organised to support self-care will respond better to the complex challenges of achieving improvements in the outcomes of long-term conditions. PMID:17925140

Touch massage, a rewarding experience.

PubMed

Lindgren, Lenita; Jacobsson, Maritha; Lämås, Kristina

2014-12-01

This study aims to describe and analyze healthy individuals' expressed experiences of touch massage (TM). Fifteen healthy participants received whole body touch massage during 60 minutes for two separate occasions. Interviews were analyzed by narrative analysis. Four identifiable storyline was found, Touch massage as an essential need, in this storyline the participants talked about a desire and need for human touch and TM. Another storyline was about, Touch massage as a pleasurable experience and the participants talked about the pleasure of having had TM. In the third storyline Touch massage as a dynamic experience, the informants talked about things that could modulate the experience of receiving TM. In the last storyline, Touch massage influences self-awareness, the participants described how TM affected some of their psychological and physical experiences. Experiences of touch massage was in general described as pleasant sensations and the different storylines could be seen in the light of rewarding experiences. © The Author(s) 2014.

How do adolescents talk about self-harm: a qualitative study of disclosure in an ethnically diverse urban population in England

PubMed Central

2013-01-01

Background Self-harm is prevalent in adolescence. It is often a behaviour without verbal expression, seeking relief from a distressed state of mind. As most adolescents who self-harm do not seek help, the nature of adolescent self-harm and reasons for not disclosing it are a public health concern. This study aims to increase understanding about how adolescents in the community speak about self-harm; exploring their attitudes towards and experiences of disclosure and help-seeking. Methods This study involved 30 qualitative individual interviews with ethnically diverse adolescents aged 15–16 years (24 females, 6 males), investigating their views on coping with stress, self-harm and help-seeking, within their own social context in multicultural East London. Ten participants had never self-harmed, nine had self-harmed on one occasion and 11 had self-harmed repeatedly. Verbatim accounts were transcribed and subjected to content and thematic analysis using a framework approach. Results Self-harm was described as a complex and varied behaviour. Most participants who had self-harmed expressed reluctance to talk about it and many had difficulty understanding self-harm in others. Some participants normalised self-harm and did not wish to accept offers of help, particularly if their self-harm had been secretive and ‘discovered’, leading to their referral to more formal help from others. Disclosure was viewed more positively with hindsight by some participants who had received help. If help was sought, adolescents desired respect, and for their problems, feelings and opinions to be noticed and considered alongside receiving treatment for injuries. Mixed responses to disclosure from peers, family and initial sources of help may influence subsequent behaviour and deter presentation to services. Conclusions This study provides insight into the subjective experience of self-harm, disclosure and help-seeking from a young, ethnically diverse community sample. Accounts highlighted the value of examining self-harm in the context of each adolescent’s day-to-day life. These accounts emphasised the need for support from others and increasing awareness about appropriate responses to adolescent self-harm and accessible sources of help for adolescents. PMID:23758739

A prospective study of adjustment to hemodialysis.

PubMed

Lev, E L; Owen, S V

1998-10-01

To examine (a) changes in subjects' self-care self-efficacy over time and (b) the relationship of subjects' self-care self-efficacy with adjustment to hemodialysis. A longitudinal design was used to study changes in self-care self-efficacy and associations between self-care self-efficacy and measures of adjustment: health status, mood distress, symptom distress, dialysis stress, and perceived adherence to fluid restriction. Subjects were recruited from 8 settings in the Northeast where outpatient hemodialysis treatment was administered. Sixty-four subjects were recruited to the study. Twenty-eight subjects completed 3 occasions of data collection. Data were collected on three occasions: (a) baseline-within 100 days of beginning treatment; (b) 4 months after beginning treatment; and (c) 8 months after beginning treatment. Eta-squared, a measure of practical significance, is reported for four factors of the self-care self-efficacy measure on each of the three occasions. Associations between self-care self-efficacy and measures of adjustment were examined by means of Pearson correlations. Eta-squared estimates showed generally positive changes occurring over time in subjects' self-care self-efficacy, health status, mood distress, symptom distress, dialysis stress, and perceived adherence to fluid restriction. Changes were more positive at 4-months than at 8-months after enrollment. Significant correlations (p < .05) occurred between self-care self-efficacy and mood states, health status, symptom distress, and perceived adherence to fluid restrictions. Correlations occurred more frequently between self-care self-efficacy and mood states than between self-care self-efficacy and other measures of adjustment. The study provided pilot data suggesting that hemodialysis patients' self-care self-efficacy and measures of adjustment change over time. Patients who had increased confidence in self-care strategies (self-efficacy) were associated with having more positive mood states, health status, and perceived adherence to fluid restrictions and less symptom distress. Interventions designed to increase patients' self-care self-efficacy may yield positive results. Nurses are in an excellent position to give efficacy enhancing feedback that may promote patients' adjustment.

Coccidioides complement fixation

MedlinePlus

... antibodies are detected in the blood sample. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your health care provider about the meaning of your specific test results.

End-of-Life Care for People Who Have Cancer

MedlinePlus

... people often have episodes of confusion or waking dreams. They may get confused about time, place, and ... They can let them share their visions and dreams, not trying to talk them out of what ...

Understanding Motherhood and Mood - Baby Blues and Beyond

MedlinePlus

... this site from a secured browser on the server. Please enable scripts and reload this page. Turn ... requires immediate help. Talk to a Health Care Professional Screening for depression during and after pregnancy should ...

Developmental milestones record - 4 years

MedlinePlus

... little differently. If you are concerned about your child's development, talk to your child's health care provider. PHYSICAL ... and the A.D.A.M. Editorial team. Child Development Read more NIH MedlinePlus Magazine Read more Health ...

Snacks and sweetened drinks - children

MedlinePlus

... ingredients are not healthy snack choices. Avoid fried foods like French fries, onion rings, and other fried snacks. Talk to a nutritionist or your family's health care provider if you need ideas for healthy foods for your family.

Smooth School Transitions: Tips for Military Families

MedlinePlus

... family separation, and transition. Additional Information from HealthyChildren.org: Deployment and Children Military Families: Child Care Support ... CNN.com) Coming Together Around Military Families (zerotothree.org) FOCUS (Families OverComing Under Stress™) FOX News Talks ...

Oral Appliances Therapy

MedlinePlus

... for travel Easy to care for How a Dentist Can Help: The First Visit Dentists work closely with physicians to treat snoring and sleep apnea. At your first visit, your dentist will talk to you about the benefits of ...

Can it be harmful for parents to talk to their child about their weight? A meta-analysis.

PubMed

Gillison, Fiona B; Lorenc, Ava B; Sleddens, Ester F C; Williams, Stefanie L; Atkinson, Lou

2016-12-01

Many parents express concern that raising the issue of weight risks harming their child's physical self-perceptions and wellbeing. Such concerns can deter families from engaging with weight management services. This systematic review aimed to investigate the evidence behind these concerns by analysing the association between parent-child weight-talk and child wellbeing. A systematic search of eight databases identified four intervention studies and 38 associative studies. Meta-analysis was only possible for the associative studies; to facilitate more meaningful comparisons, weight-talk was categorized into four communication types and effect size estimates for the association between these and wellbeing indicators were calculated through a random effects model. Encouraging children to lose weight and criticizing weight were associated with poorer physical self-perceptions and greater dieting and dysfunctional eating (effect sizes: 0.20 to 0.47). Conversely, parental encouragement of healthy lifestyles without explicit reference to weight was associated with better wellbeing, but this was only measured in two studies. Of the four intervention studies, only one isolated the effects of parents' communication on wellbeing outcomes, reporting a positive effect. There was no effect of age on the strength of associations, but dysfunctional eating was more strongly associated with parent communication for girls than boys. The findings indicate that some forms of parent-child weight-talk are associated with poor wellbeing, but suggest that this is not inevitable. Encouraging healthy behaviours without reference to weight-control, and positive parental involvement in acknowledging and addressing weight-concern may avoid such outcomes. More longitudinal research is needed to analyse the direction of these effects. Copyright © 2016 Elsevier Inc. All rights reserved.

Engaging Terminally Ill Patients in End of Life Talk: How Experienced Palliative Medicine Doctors Navigate the Dilemma of Promoting Discussions about Dying.

PubMed

Pino, Marco; Parry, Ruth; Land, Victoria; Faull, Christina; Feathers, Luke; Seymour, Jane

2016-01-01

To examine how palliative medicine doctors engage patients in end-of-life (hereon, EoL) talk. To examine whether the practice of "eliciting and responding to cues", which has been widely advocated in the EoL care literature, promotes EoL talk. Conversation analysis of video- and audio-recorded consultations. Unselected terminally ill patients and their companions in consultation with experienced palliative medicine doctors. Outpatient clinic, day therapy clinic, and inpatient unit of a single English hospice. Doctors most commonly promoted EoL talk through open elaboration solicitations; these created opportunities for patients to introduce-then later further articulate-EoL considerations in such a way that doctors did not overtly ask about EoL matters. Importantly, the wording of elaboration solicitations avoided assuming that patients had EoL concerns. If a patient responded to open elaboration solicitations without introducing EoL considerations, doctors sometimes pursued EoL talk by switching to a less participatory and more presumptive type of solicitation, which suggested the patient might have EoL concerns. These more overt solicitations were used only later in consultations, which indicates that doctors give precedence to patients volunteering EoL considerations, and offer them opportunities to take the lead in initiating EoL talk. There is evidence that doctors treat elaboration of patients' talk as a resource for engaging them in EoL conversations. However, there are limitations associated with labelling that talk as "cues" as is common in EoL communication contexts. We examine these limitations and propose "possible EoL considerations" as a descriptively more accurate term. Through communicating-via open elaboration solicitations-in ways that create opportunities for patients to volunteer EoL considerations, doctors navigate a core dilemma in promoting EoL talk: giving patients opportunities to choose whether to engage in conversations about EoL whilst being sensitive to their communication needs, preferences and state of readiness for such dialogue.

Self-management support in primary care: enactments, disruptions, and conversational consequences.

PubMed

Thille, Patricia; Ward, Natalie; Russell, Grant

2014-05-01

A common refrain in chronic disease management is that patients and clinicians need to enact new roles: patients as their own caregivers; clinicians as professional supporters of patient self-management activities. These roles are central to self-management support (SMS), an approach that emphasizes a clinical partnership, and promotes patient identification and achievement of realistic and short-term behavioral goals. With SMS, behavior change is the desired end, not the means to a desired biomedical end. Shifting SMS concepts into clinical practice has proven to be difficult and inconsistent, creating potential, unknown risks or harms to patients. We completed a discourse analysis of 16 clinical dialogues between diabetic patients and clinicians, collected during a study of six Ontario Family Health Teams, to explore the questions of risks and harms relating to SMS implementation. We observed varying degrees of incomplete implementation of SMS, as well as interactions that actively negated the core principles. Contrary to SMS principles, clinicians tended to emphasize behavioral changes as means to achieve biomedical ends, though to varying degrees. We present two appointments in detail, highlighting how linking behavior change closely with biomedical measures often elicited face-saving defenses from patients. The subsequent dialogue shifted attention away from problem solving and behavior change into active negotiation of responsibility and identity. Interactions that oriented more to SMS concepts elicited fewer defensive maneuvers from patients. Our analysis helps explicate one additional mechanism by which self-management talk threatens the clinical relationship, and highlights a promising method to mitigate this threat. Copyright © 2014 Elsevier Ltd. All rights reserved.

Using simulation pedagogy to teach clinical education skills: A randomized trial.

PubMed

Holdsworth, Clare; Skinner, Elizabeth H; Delany, Clare M

2016-05-01

Supervision of students is a key role of senior physiotherapy clinicians in teaching hospitals. The objective of this study was to test the effect of simulated learning environments (SLE) on educators' self-efficacy in student supervision skills. A pilot prospective randomized controlled trial with concealed allocation was conducted. Clinical educators were randomized to intervention (SLE) or control groups. SLE participants completed two 3-hour workshops, which included simulated clinical teaching scenarios, and facilitated debrief. Standard Education (StEd) participants completed two online learning modules. Change in educator clinical supervision self-efficacy (SE) and student perceptions of supervisor skill were calculated. Between-group comparisons of SE change scores were analyzed with independent t-tests to account for potential baseline differences in education experience. Eighteen educators (n = 18) were recruited (SLE [n = 10], StEd [n = 8]). Significant improvements in SE change scores were seen in SLE participants compared to control participants in three domains of self-efficacy: (1) talking to students about supervision and learning styles (p = 0.01); (2) adapting teaching styles for students' individual needs (p = 0.02); and (3) identifying strategies for future practice while supervising students (p = 0.02). This is the first study investigating SLE for teaching skills of clinical education. SLE improved educators' self-efficacy in three domains of clinical education. Sample size limited the interpretation of student ratings of educator supervision skills. Future studies using SLE would benefit from future large multicenter trials evaluating its effect on educators' teaching skills, student learning outcomes, and subsequent effects on patient care and health outcomes.

Patient participation in medical consultations: why some patients are more involved than others.

PubMed

Street, Richard L; Gordon, Howard S; Ward, Michael M; Krupat, Edward; Kravitz, Richard L

2005-10-01

Patients vary in their willingness and ability to actively participate in medical consultations. Because more active patient participation contributes to improved health outcomes and quality of care, it is important to understand factors affecting the way patients communicate with healthcare providers. The objectives of this study were to examine the extent to which patient participation in medical interactions is influenced by 1) the patient's personal characteristics (age, gender, education, ethnicity); 2) the physician's communication style (eg, use of partnership-building and supportive talk); and 3) the clinical setting (eg, the health condition, medical specialty). The authors conducted a post hoc cross-sectional analysis of 279 physician-patient interactions from 3 clinical sites: 1) primary care patients in Sacramento, California, 2) patients with systemic lupus erythematosus (SLE) from the San Francisco Bay area, and 3) patients with lung cancer from a VA hospital in Texas. The outcome measures included the degree to which patients asked questions, were assertive, and expressed concerns and the degree to which physicians used partnership-building and supportive talk (praise, reassurance, empathy) in their consultations. The majority of active participation behaviors were patient-initiated (84%) rather than prompted by physician partnership-building or supportive talk. Patients who were more active participants received more facilitative communication from physicians, were more educated, and were more likely to be white than of another ethnicity. Women more willingly expressed negative feelings and concerns. There was considerable variability in patient participation across the 3 clinical settings. Female physicians were more likely to use supportive talk than males, and physicians generally used less supportive talk with nonwhite compared with white patients. Patient participation in medical encounters depends on a complex interplay of personal, physician, and contextual factors. Although more educated and white patients tended to be more active participants than their counterparts, the strongest predictors of patient participation were situation-specific, namely the clinical setting and the physician's communicative style. Physicians could more effectively facilitate patient involvement by more frequently using partnership-building and supportive communication. Future research should investigate how the nuances of individual clinical settings (eg, the health condition, time allotted for the visit) impose constraints or opportunities for more effective patient involvement in care.

Feasibility and effectiveness of a telephone-based social support intervention for informal caregivers of people with dementia: Study protocol of the TALKING TIME project.

PubMed

Berwig, Martin; Dichter, Martin Nikolaus; Albers, Bernd; Wermke, Katharina; Trutschel, Diana; Seismann-Petersen, Swantje; Halek, Margareta

2017-04-17

Caring for people with dementia at home requires a significant amount of time, organization, and commitment. Therefore, informal caregivers, mainly relatives, of people with dementia often feel a high burden. Although on-site support groups are known to have positive effects on the subjective well-being (SWB) and perceived social support of informal caregivers, there are cases in which relatives have either no time or no opportunity to leave the person alone or in which there are no support groups nearby. The TALKING TIME project aims to close this supply gap by providing structured telephone-based support groups in Germany for the first time. International studies have shown benefits for informal caregivers. The TALKING TIME study is a randomized controlled trial. The effects of the 3-month TALKING TIME intervention will be compared with those of a control group without intervention at two time points (baseline = T 0 , after 3 months = T 1 ). The control group will receive the TALKING TIME intervention after T 1 . With a planned sample size of 88 participants, the study is powered to detect an estimated effect size of 0.70 for psychological quality of life, considering an α of 0.05 (two-sided), a power of 80%. Caregivers are informal caregivers who are eligible if they are 18 years of age or older and have cared for a person with diagnosed dementia for at least four hours, four days per week, in the past six months. The exclusion criteria are psychiatric disorders of the informal caregiver. The primary outcome is the mental component summary of the SF-12 rated by informal caregivers. The secondary outcomes for informal caregivers are the physical component summary of the SF-12, the Perceived Social Support Caregiver Scale (SSCS) score, and the Caregiver Reaction Scale (CRS) score. The secondary outcome for care recipients is the Neuropsychiatric Inventory (NPI-Q). For the process evaluation, different quantitative and qualitative data sources will be collected to address reach, fidelity, dosage and context. The results will provide further information on the effectiveness and optimization of telephone-based support groups for informal caregivers of people with dementia, which can help guide the further development of effective telephone-based social support group interventions. Clinical Trials: NCT02806583 , June 9, 2016.

Predictors of heart failure self-care in patients who screened positive for mild cognitive impairment.

PubMed

Davis, Karen K; Himmelfarb, Cheryl R Dennison; Szanton, Sarah L; Hayat, Matthew J; Allen, Jerilyn K

2015-01-01

Heart failure (HF) is associated with cognitive impairment, which could negatively affect a patient's abilities to carry out self-care, potentially resulting in higher hospital readmission rates. Factors associated with self-care in patients experiencing mild cognitive impairment (MCI) are not known. This descriptive correlation study aimed to assess levels of HF self-care and knowledge and to determine the predictors of self-care in HF patients who screen positive for MCI. The Montreal Cognitive Assessment was used to screen for MCI. In 125 patients with MCI hospitalized with HF, self-care (Self-care of Heart Failure Index) and HF knowledge (Dutch Heart Failure Knowledge Scale) were assessed. We used multiple regression analysis to test a model of variables hypothesized to predict self-care maintenance, management, and confidence. Mean (SD) HF knowledge scores (11.24 [1.84]) were above the level considered to be adequate (defined as >10). Mean (SD) scores for self-care maintenance (63.57 [19.12]), management (68.35 [20.24]), and confidence (64.99 [16.06]) were consistent with inadequate self-care (defined as scores <70). In multivariate analysis, HF knowledge, race, greater disease severity, and social support explained 22% of the variance in self-care maintenance (P < .001); age, education level, and greater disease severity explained 19% of the variance in self-care management (P < .001); and younger age and higher social support explained 20% of the variance in self-care confidence scores (P < .001). Blacks, on average, scored significantly lower in self-care maintenance (P = .03). In this sample, patients who screened positive for MCI, on average, had adequate HF knowledge yet inadequate self-care scores. These models show the influence of modifiable and nonmodifiable predictors for patients who screened positive for MCI across the domains of self-care. Health professionals should consider screening for MCI and identifying interventions that address HF knowledge and social support. Further research is needed to explain the racial differences in self-care.

Coaching behaviors associated with changes in fear of failure: changes in self-talk and need satisfaction as potential mechanisms.

PubMed

Conroy, David E; Coatsworth, J Douglas

2007-04-01

Cognitive-interpersonal and motivational mechanisms may regulate relations between youth perceptions of interpersonal aspects of the social ecology and their fear-of-failure (FF) levels. Youth (N=165) registered for a summer swim league rated their fear of failure at the beginning, middle, and end of the season. Extensive model comparisons indicated that youths' end-of-season ratings of coach behaviors could be reduced to three factors (affiliation, control, blame). Perceived control and blame from coaches predicted residualized change in corresponding aspects of youths' self-talk, but only changes in self-blame positively predicted changes in FF levels during the season. Perceived affiliation from coaches predicted autonomy need satisfaction which, in turn, negatively predicted the rate of change in FF levels during the season. These findings indicate that (a) youth perceptions of coaches were directly and indirectly related to acute socialization of FF and (b) both cognitive-interpersonal and motivational mechanisms contributed to this socialization process. Further research is needed to test for developmental differences in these mechanisms to determine whether findings generalize to more heterogeneous and at-risk populations and to investigate other potential social-ecological influences on socialization.

Self-organization of neural patterns and structures in 3D culture of stem cells

NASA Astrophysics Data System (ADS)

Sasai, Yoshiki

2013-05-01

Over the last several years, much progress has been made for in vitro culture of mouse and human ES cells. Our laboratory focuses on the molecular and cellular mechanisms of neural differentiation from pluripotent cells. Pluripotent cells first become committed to the ectodermal fate and subsequently differentiate into uncommitted neuroectodermal cells. Both previous mammalian and amphibian studies on pluripotent cells have indicated that the neural fate is a sort of the basal direction of the differentiation of these cells while mesoendodermal differentiation requires extrinsic inductive signals. ES cells differentiate into neuroectodermal cells with a rostral-most character (telencephalon and hypothalamus) when they are cultured in the absence of strong patterning signals. In this talk, I first discuss this issue by referring to our recent data on the mechanism of spontaneous neural differentiation in serum-free culture of mouse ES cells. Then, I will talk about self-organization phenomena observed in 3D culture of ES cells, which lead to tissue-autonomous formation of regional structures such as layered cortical tissues. I also discuss our new attempt to monitor these in vitro morphogenetic processes by live imaging, in particular, self-organizing morphogenesis of the optic cup in three-dimensional cultures.

The effects of self-efficacy enhancing program on foot self-care behaviour of older adults with diabetes: A randomised controlled trial in elderly care facility, Peninsular Malaysia.

PubMed

Ahmad Sharoni, Siti Khuzaimah; Abdul Rahman, Hejar; Minhat, Halimatus Sakdiah; Shariff-Ghazali, Sazlina; Azman Ong, Mohd Hanafi

2018-01-01

Self-care behaviour is essential in preventing diabetes foot problems. This study aimed to evaluate the effectiveness of health education programs based on the self-efficacy theory on foot self-care behaviour for older adults with diabetes. A randomised controlled trial was conducted for 12 weeks among older adults with diabetes in elderly care facility in Peninsular Malaysia. Six elderly care facility were randomly allocated by an independent person into two groups (intervention and control). The intervention group (three elderly care facility) received a health education program on foot self-care behaviour while the control group (three elderly care facility) received standard care. Participants were assessed at baseline, and at week-4 and week-12 follow-ups. The primary outcome was foot-self-care behaviour. Foot care self-efficacy (efficacy expectation), foot care outcome expectation, knowledge of foot care and quality of life were the secondary outcomes. Data were analysed with Mixed Design Analysis of Variance using the Statistical Package for the Social Sciences version 22.0. 184 respondents were recruited but only 76 met the selection criteria and were included in the analysis. Foot self-care behaviour, foot care self-efficacy (efficacy expectation), foot care outcome expectation and knowledge of foot care improved in the intervention group compared to the control group (p < 0.05). However, some of these improvements did not significantly differ compared to the control group for QoL physical symptoms and QoL psychosocial functioning (p > 0.05). The self-efficacy enhancing program improved foot self-care behaviour with respect to the delivered program. It is expected that in the future, the self-efficacy theory can be incorporated into diabetes education to enhance foot self-care behaviour for elderly with diabetes living in other institutional care facilities. Australian New Zealand Clinical Trial Registry ACTRN12616000210471.

The effects of self-efficacy enhancing program on foot self-care behaviour of older adults with diabetes: A randomised controlled trial in elderly care facility, Peninsular Malaysia

PubMed Central

Abdul Rahman, Hejar; Minhat, Halimatus Sakdiah; Shariff-Ghazali, Sazlina; Azman Ong, Mohd Hanafi

2018-01-01

Background Self-care behaviour is essential in preventing diabetes foot problems. This study aimed to evaluate the effectiveness of health education programs based on the self-efficacy theory on foot self-care behaviour for older adults with diabetes. Methods A randomised controlled trial was conducted for 12 weeks among older adults with diabetes in elderly care facility in Peninsular Malaysia. Six elderly care facility were randomly allocated by an independent person into two groups (intervention and control). The intervention group (three elderly care facility) received a health education program on foot self-care behaviour while the control group (three elderly care facility) received standard care. Participants were assessed at baseline, and at week-4 and week-12 follow-ups. The primary outcome was foot-self-care behaviour. Foot care self-efficacy (efficacy expectation), foot care outcome expectation, knowledge of foot care and quality of life were the secondary outcomes. Data were analysed with Mixed Design Analysis of Variance using the Statistical Package for the Social Sciences version 22.0. Results 184 respondents were recruited but only 76 met the selection criteria and were included in the analysis. Foot self-care behaviour, foot care self-efficacy (efficacy expectation), foot care outcome expectation and knowledge of foot care improved in the intervention group compared to the control group (p < 0.05). However, some of these improvements did not significantly differ compared to the control group for QoL physical symptoms and QoL psychosocial functioning (p > 0.05). Conclusion The self-efficacy enhancing program improved foot self-care behaviour with respect to the delivered program. It is expected that in the future, the self-efficacy theory can be incorporated into diabetes education to enhance foot self-care behaviour for elderly with diabetes living in other institutional care facilities. Trial registration Australian New Zealand Clinical Trial Registry ACTRN12616000210471 PMID:29534070

A literature review on self-care of chronic illness: definition, assessment and related outcomes.

PubMed

Ausili, Davide; Masotto, Matteo; Dall'Ora, Chiara; Salvini, Lorena; Di Mauro, Stefania

2014-01-01

Chronic illnesses care represents a challenging issue for people well-being and future health systems' sustainability. Promotion of self-care is considered a key point for chronically ill patients' care. The aim of this literature was to explore: how self-care of chronic illness has been theoretically defined; how self-care can be assessed in clinical and research settings; what associations exist between self-care and health outcomes of chronically ill patients. A wide range of definitions and terminologies related to self-care of chronic illness has been found in the literature. Although some common elements useful to explain the concept of self-care have been identified, the physical, cognitive, emotional and social processes underlying self-care remain controversial and poorly defined. Valid and reliable disease-specific assessment tools have been developed and used in a growing number of studies; however, the lack of utilization of standardized instruments in clinical practice has been referred by many authors. Significant correlations between self-care of chronic illness and outcome measures e.g. general health status, quality of life and healthcare costs, are reported by a limited number of studies. Supporting patient self-care is recognized as a crucial factor in chronic illness care. A deeper analysis of variables and processes influencing self-care could help for a full description of the phenomenon. A systematic evaluation of self-care in health professionals' everyday clinical practice is strongly recommended. The development of general non-disease-specific assessment tools could facilitate the evaluation of complex patients, especially those with multiple co-morbidities. Although self-care has been recognized as a vital intermediate outcome, further large-scale studies clarifying the association between self-care and patients' and health systems' outcomes are needed.

Making self-care a priority for women at risk of breast cancer-related lymphedema.

PubMed

Radina, M Elise; Armer, Jane M; Stewart, Bob R

2014-05-01

Estimates suggest that between 41% and 94% of breast cancer survivors may develop the chronic condition of secondary lymphedema at some point during their lifetimes. Self-care is critical for effective lymphedema management and risk-reduction. At the same time, women in general have been characterized as engaging in self-sacrificing behaviors in which they choose other-care over self-care. This study explored the self-care experiences of women with breast cancer within the contexts of complex and demanding familial and work-related responsibilities. Participants (N=14) were enrolled in a behavioral-educational intervention aimed at lymphedema risk-reduction. This feminist family theory-informed secondary analysis of qualitative data focused on women's familial roles and the balance or lack of balance between self-sacrifice and self-care. Findings included participants' struggles with time management and prioritizing self-care over care of others as well as making a commitment to self-care. Findings have implications for patient and family-level education and research with regard to gender role-based barriers to self-care and self-care within complex social contexts.

Tuning the entropic spring to dictate order and functionality in polymer conjugated peptide biomaterials

NASA Astrophysics Data System (ADS)

Keten, Sinan

Hybrid peptide-polymer conjugates have the potential to combine the advantages of natural proteins and synthetic polymers, resulting in biomaterials with improved stability, controlled assembly, and tailored functionalities. However, the effect of polymer conjugation on peptide structural organization and functionality, along with the behavior of polymers at the interface with biomolecules remain to be fully understood. This talk will summarize our recent efforts towards establishing a modeling framework to design entropic forces in helix-polymer conjugates and polymer-conjugated peptide nanotubes to achieve hierarchical self-assembling systems with predictable order. The first part of the talk will discuss how self-assembly principles found in biology, combined with polymer physics concepts can be used to create artificial membranes that mimic certain features of ion channels. Thermodynamics and kinetics aspects of self-assembly and how it governs the growth and stacking sequences of peptide nanotubes will be discussed, along with its implications for nanoscale transport. The second part of the talk will review advances related to modeling polymer conjugated coiled coils at relevant length and time scales. Atomistic simulations combined with sampling techniques will be presented to discuss the energy landscapes governing coiled-coil stability, revealing cascades of events governing disassembly. This will be followed by a discussion of mechanisms through which polymers can stabilize small proteins, such as shielding of solvents, and how specific peptide sequences can reciprocate by altering polymer conformations. Correlations between mechanical and thermal stability of peptides will be discussed. Finally, coarse-grained simulations will provide insight into how the location of polymer attachment changes entropic forces and higher-level organization in helix bundle assemblies. Our findings set the stage for a materials-by-design capability towards dictating complex topologies of polymer-peptide conjugate systems.

Social modulation of facial pain display in high-catastrophizing children: an observational study in schoolchildren and their parents.

PubMed

Vervoort, Tine; Caes, Line; Trost, Zina; Sullivan, Michael; Vangronsveld, Karoline; Goubert, Liesbet

2011-07-01

The present study examined existing communal and operant accounts of children's pain behavior by looking at the impact of parental presence and parental attention upon children's pain expression as a function of child pain catastrophizing. Participants were 38 school children and 1 of their parents. Children completed a cold pressor pain task (CPT) twice, first when told that no one was observing (alone condition) and subsequently when told that they were being observed by their parent (parent-present condition). A 3-minute parent-child interaction occurred between the 2 CPT immersions, allowing measurement of parental attention to their child's pain (ie, parental pain-attending talk vs non-pain-attending talk). Findings showed that child pain catastrophizing moderated the impact of parental presence upon facial displays of pain. Specifically, low-catastrophizing children expressed more pain in the presence of their parent, whereas high-catastrophizing children showed equally pronounced pain expression when alone or in the presence of a parent. Furthermore, children's catastrophizing moderated the impact of parental attention upon facial displays and self-reports of pain; higher levels of parental nonpain talk were associated with increased facial expression and self-reports of pain among high-catastrophizing children; for low-catastrophizing children, facial and self-report of pain was independent of parental attention to pain. The findings are discussed in terms of possible mechanisms that may drive and maintain pain expression in high-catastrophizing children, as well as potential limitations of traditional theories in explaining pediatric pain expression. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Self-care in older adults with heart failure: an integrative review.

PubMed

Zavertnik, Jean Ellen

2014-01-01

The aims of this integrative review were to examine the evidence specific to self-care in older adults, 65 years or older, with heart failure and to indicate best nursing practice interventions for use in this population. Self-care is a complex set of activities involving self-care maintenance and self-care management. Age-related and psychosocial factors impact older patients' ability to engage effectively in self-care practices. Although self-care processes are the focus of the investigation, few studies provide implications specific for the older adult population. Limited research on heart failure self-care in the older adult meets the age criterion of 65 years or older. A comprehensive search of the literature was performed using Medline, CINAHL, and the Cochrane Library, as well as an ancestry approach of reference lists of selected studies. Eligible studies were randomized controlled trial, qualitative, quantitative, and mixed-method design studies on older adults with heart failure related to self-care for the years 2002-2012. Three themes of self-care were noted in the selected studies: patient-related factors, patient education, and telemonitoring. The patient-related factors identified were barriers to self-care such as age-related symptoms, cognitive factors, and social issues. The interventions promoting self-care were patient education (self-care knowledge) and telemonitoring (augmenting symptom recognition). Patient education tailored to older adults may be beneficial. Telemonitoring is an appropriate self-care enhancement tool for selected older adults. More emphasis needs to be placed on interventions to assist older adults with heart failure in symptom recognition and early notification of healthcare providers. As the population ages, a need for evidence-based care for older adults with heart failure is warranted. Heart failure self-care interventions do not address the special considerations of the older heart failure patient. To determine the best approaches for promoting effective self-care, older adults with heart failure need to be studied as a cohort. Older adults with heart failure face many challenges engaging in self-care practices. These older adults need individualized self-care instructions and home care follow-up. Identifying special needs of the patient, such as sensory or cognitive impairment, is necessary when providing instructions and follow-up care for the older adult.

Broken toe - self-care

MedlinePlus

Fractured toe - self-care; Broken bone - toe - self-care; Fracture - toe - self-care; Fracture phalanx - toe ... often treated without surgery and can be taken care of at home. Severe injuries include: Breaks that ...

Masturbation

MedlinePlus

... of behavioral or emotional difficulty, including social isolation, aggression, destructiveness, sadness, withdrawal, bed-wetting, or soiling (encopresis). Inappropriate sexual talk or other sexual activity. Last Updated 11/3/2009 Source Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 ...

Hoarding: Issues for the Fire Service

MedlinePlus

... Keep in mind that people with compulsive hoarding behavior are intelligent and care deeply about their possessions. The following suggestions have been adapted from The Hoarding Handbook: A Guide for Human Service Professionals (Oxford University Press). When talking to ...

Military Families: Child Care Support During Deployments

MedlinePlus

... us what to do.” Additional Information from HealthyChildren.org: Deployment and Children Smooth School Transitions: Tips for ... CNN.com) Coming Together Around Military Families (zerotothree.org) FOCUS (Families OverComing Under Stress™) FOX News Talks ...

Self-care coping strategies in people with diabetes: a qualitative exploratory study

PubMed Central

Collins, Margaret M; Bradley, Colin P; O'Sullivan, Tony; Perry, Ivan J

2009-01-01

Background The management of diabetes self-care is largely the responsibility of the patient. With more emphasis on the prevention of complications, adherence to diabetes self-care regimens can be difficult. Diabetes self-care requires the patient to make many dietary and lifestyle changes. This study will explore patient perceptions of diabetes self-care, with particular reference to the burden of self-care and coping strategies among patients. Methods A maximum variation sample of 17 patients was selected from GP practices and diabetes clinics in Ireland to include patients with types 1 and 2 diabetes, various self-care regimens, and a range of diabetes complications. Data were collected by in-depth interviews; which were tape-recorded and transcribed. The transcripts were analysed using open and axial coding procedures to identify main categories, and were reviewed by an independent corroborator. Discussion of the results is made in the theoretical context of the health belief, health value, self-efficacy, and locus of control frameworks. Results Patients' perceptions of their self-care varied on a spectrum, displaying differences in self-care responsibilities such as competence with dietary planning, testing blood sugar and regular exercise. Three patient types could be distinguished, which were labeled: "proactive manager," a patient who independently monitors blood glucose and adjusts his/her self-care regime to maintain metabolic control; "passive follower," a patient who follows his/her prescribed self-care regime, but does not react autonomously to changes in metabolic control; and "nonconformist," a patient who does not follow most of his/her prescribed self-care regimen. Conclusion Patients have different diabetes self-care coping strategies which are influenced by their self-care health value and consequently may affect their diet and exercise choices, frequency of blood glucose monitoring, and compliance with prescribed medication regimens. Particular attention should be paid to the patient's self-care coping strategy, and self-care protocols should be tailored to complement the different patient types. PMID:19232113

Dilemmas of talking about lifestyle changes among couples coping with a cardiac event.

PubMed

Goldsmith, Daena J; Lindholm, Kristin A; Bute, Jennifer J

2006-10-01

Persons who have experienced a myocardial infarction (MI) and/or coronary artery bypass graft (CABG) surgery may benefit from a low-fat diet, regular exercise, smoking cessation, and stress management. Yet many patients do not make these changes. A spouse or partner's attempts at support may facilitate or interfere with patient behavior change. The present study explores dilemmas that may arise when couples talk about lifestyle changes following one person's MI or CABG. In interviews carried out in Urbana-Champaign, Illinois, and surrounding communities with 25 patients and 16 partners we found communicating support for lifestyle change may be interpreted as undesired control or criticism. The caring conveyed by talking may be viewed positively but can also threaten patient autonomy and entrap partners in unwanted expectations and obligations. Finally, lifestyle change conversations may reflect empowered patients collaborating with partners to take control of health but can also serve as potent reminders of loss. These multiple, potentially conflicting meanings give an account for why talking with a partner does not always facilitate patient lifestyle change. Understanding these dilemmas also suggests practical implications for helping patients and partners.

Health Care Professionals' Understandings of Cross-Cultural Interaction in End-of-Life Care: A Focus Group Study.

PubMed

Milberg, Anna; Torres, Sandra; Ågård, Pernilla

2016-01-01

The academic debate on cross-cultural interaction within the context of end-of-life care takes for granted that this interaction is challenging. However, few empirical studies have actually focused on what health care professionals think about this interaction. This study aimed to explore health care professionals' understandings of cross-cultural interaction during end-of-life care. Sixty end-of-life care professionals were recruited from eleven care units in Sweden to take part in focus group interviews. These interviews were analyzed using qualitative content analysis. The health care professionals interviewed talked about cross-cultural interaction in end-of-life care as interaction that brings about uncertainty, stress and frustration even though they had limited experience of this type of interaction. The focus group discussions brought attention to four specific challenges that they expected to meet when they care for patients with migrant backgrounds since they took for granted that they would have an ethno-cultural background that is different to their own. These challenges had to do with communication barriers, 'unusual' emotional and pain expressions, the expectation that these patients' families would be 'different' and the anticipation that these patients and their families lack knowledge. At the core of the challenges in question is the idea that cross-cultural interaction means meeting "the unknown". In addition, the end-of-life care professionals interviewed talked about patients whose backgrounds they did not share in homogenizing terms. It is against this backdrop that they worried about their ability to provide end-of-life care that is individualized enough to meet the needs of these patients. The study suggests that end-of-life care professionals who regard cross-cultural interaction in this manner could face actual challenges when caring for patients whose backgrounds they regard as "the unknown" since they anticipate a variety of challenges and do not seem confident enough that they can provide good quality care when cross-cultural interaction is at stake.

The Situation-Specific Theory of Heart Failure Self-Care: Revised and Updated.

PubMed

Riegel, Barbara; Dickson, Victoria Vaughan; Faulkner, Kenneth M

2016-01-01

Since the situation-specific theory of heart failure (HF) self-care was published in 2008, we have learned much about how and why patients with HF take care of themselves. This knowledge was used to revise and update the theory. The purpose of this article was to describe the revised, updated situation-specific theory of HF self-care. Three major revisions were made to the existing theory: (1) a new theoretical concept reflecting the process of symptom perception was added; (2) each self-care process now involves both autonomous and consultative elements; and (3) a closer link between the self-care processes and the naturalistic decision-making process is described. In the revised theory, HF self-care is defined as a naturalistic decision-making process with person, problem, and environmental factors that influence the everyday decisions made by patients and the self-care actions taken. The first self-care process, maintenance, captures those behaviors typically referred to as treatment adherence. The second self-care process, symptom perception, involves body listening, monitoring signs, as well as recognition, interpretation, and labeling of symptoms. The third self-care process, management, is the response to symptoms when they occur. A total of 5 assumptions and 8 testable propositions are specified in this revised theory. Prior research illustrates that all 3 self-care processes (ie, maintenance, symptom perception, and management) are integral to self-care. Further research is greatly needed to identify how best to help patients become experts in HF self-care.

Evaluating the Emotion Ontology through use in the self-reporting of emotional responses at an academic conference.

PubMed

Hastings, Janna; Brass, Andy; Caine, Colin; Jay, Caroline; Stevens, Robert

2014-01-01

We evaluate the application of the Emotion Ontology (EM) to the task of self-reporting of emotional experience in the context of audience response to academic presentations at the International Conference on Biomedical Ontology (ICBO). Ontology evaluation is regarded as a difficult task. Types of ontology evaluation range from gauging adherence to some philosophical principles, following some engineering method, to assessing fitness for purpose. The Emotion Ontology (EM) represents emotions and all related affective phenomena, and should enable self-reporting or articulation of emotional states and responses; how do we know if this is the case? Here we use the EM 'in the wild' in order to evaluate the EM's ability to capture people's self-reported emotional responses to a situation through use of the vocabulary provided by the EM. To achieve this evaluation we developed a tool, EmOntoTag, in which audience members were able to capture their self-reported emotional responses to scientific presentations using the vocabulary offered by the EM. We furthermore asked participants using the tool to rate the appropriateness of an EM vocabulary term for capturing their self-assessed emotional response. Participants were also able to suggest improvements to the EM using a free-text feedback facility. Here, we present the data captured and analyse the EM's fitness for purpose in reporting emotional responses to conference talks. Based on our analysis of this data set, our primary finding is that the audience are able to articulate their emotional response to a talk via the EM, and reporting via the EM ontology is able to draw distinctions between the audience's response to a speaker and between the speakers (or talks) themselves. Thus we can conclude that the vocabulary provided at the leaves of the EM are fit for purpose in this setting. We additionally obtained interesting observations from the experiment as a whole, such as that the majority of emotions captured had positive valence, and the free-form feedback supplied new terms for the EM. EmOntoTag can be seen at http://www.bioontology.ch/emontotag; source code can be downloaded from http://emotion-ontology.googlecode.com/svn/trunk/apps/emontotag/and the ontology is available at http://purl.obolibrary.org/obo/MFOEM.owl.

"You Worry, 'cause You Want to Give a Reasonable Account of Yourself": Gender, Identity Management, and the Discursive Positioning of "Risk" in Men's and Women's Talk About Heterosexual Casual Sex.

PubMed

Farvid, Panteá; Braun, Virginia

2018-07-01

Heterosexual casual sex is routinely depicted as a physically, socially, and psychologically "risky" practice. This is the case in media accounts, psychological research, and other academic work. In this article, we examine 15 men's and 15 women's talk about casual sex from a discursive psychological stance to achieve two objectives. Firstly, we confirm the categories of risk typically associated with casual sex but expand these to include a domain of risks related to (gendered) identities and representation. Men's talk of risk centered on concerns about sexual performance, whereas women's talk centered on keeping safe from violence and sexual coercion. The notion of a sexual reputation was also identified as a risk and again manifested differently for men and women. While women were concerned about being deemed promiscuous, men displayed concern about the quality of their sexual performance. Secondly, within this talk about risks of casual sex, the participants' identities were identified as "at risk" and requiring careful management within the interview context. This was demonstrated by instances of: keeping masculinity intact in accounts of no erection, negotiating a responsible subject position, and crafting agency in accounts of sexual coercion-in the participants' talk. We argue that casual sex, as situated within dominant discourses of gendered heterosexuality, is a fraught practice for both men and women and subject to the demands of identity representation within co-present interactions.

Discrepancies between HIV prevention communication attitudes and actual conversations about HIV testing within social and sexual networks of African American men who have sex with men.

PubMed

Tobin, Karin Elizabeth; Yang, Cui; Sun, Christina; Spikes, Pilgrim; Latkin, Carl Asher

2014-04-01

Promoting communication among African American men who have sex with men (AA MSM) and their social networks about HIV testing is an avenue for altering HIV prevention social norms. This study examined the attitudes of AA MSM on talking with peers about HIV testing and characteristics of their network members with whom they have these conversations. Data came from a cross-sectional survey of 226 AA MSM who were 18 years or older and self-reported sex with another male in the prior 90 days. Participants completed an inventory to characterize network members with whom they had conversations about HIV testing and HIV status. Most of the sample reported that it was important/very important to talk to male friends about HIV (85%) and that they were comfortable/very comfortable talking with their friends about sexual behaviors (84%). However, a small proportion of the social network had been talked to by the participant about HIV testing (14%). Among sexual networks, 58% had been talked to about their HIV status, and this was positively associated with main and casual partner type compared with partners with whom money or drugs were exchanged. Findings suggest that positive attitudes about communication may be necessary but not sufficient for actual conversations to occur. Designing interventions that increase communication with social networks is warranted.

Listening to Girls Talk about Their Bodies.

ERIC Educational Resources Information Center

Nichter, Mimi

2000-01-01

This article, written by an anthropologist who has studied the culture of teenage girls, explores influences on their sense of self, including those of peers, parents, and the media. Educators and parents can play important roles in helping young people navigate successfully through adolescence. (Author/MKA)

The Power of Talk: Who Gets Heard and Why.

ERIC Educational Resources Information Center

Tannen, Deborah

1995-01-01

Conversational style often overrides what is said, affecting who gets heard and what gets done. Women's linguistic styles often make them seem less competent and self-assured than they are. Better understanding of speech styles will make managers better listeners and communicators. (SK)

An Internet-based self-help treatment for fear of public speaking: a controlled trial.

PubMed

Botella, C; Gallego, M J; Garcia-Palacios, A; Guillen, V; Baños, R M; Quero, S; Alcañiz, M

2010-08-01

This study offers data about the efficacy of "Talk to Me," an Internet-based telepsychology program for the treatment of fear of public speaking that includes the most active components in cognitive-behavior therapy (CBT) for social phobia (exposure and cognitive therapies). One hundred twenty-seven participants with social phobia were randomly assigned to three experimental conditions: (a) an Internet-based self-administered program; (b) the same program applied by a therapist; (c) a waiting-list control group. Results showed that both treatment conditions were equally efficacious. In addition, Talk to Me and the same treatment applied by a therapist were more efficacious than the waiting-list condition. Treatment gains were maintained at 1-year follow-up. The results from this study support the utility of Internet-delivered CBT programs in order to reach a higher number of people who could benefit from CBT. Internet-delivered CBT programs could also play a valuable role in the dissemination of CBT.

Antecedents of self-care in adults with congenital heart defects.

PubMed

McCabe, Nancy; Dunbar, Sandra B; Butler, Javed; Higgins, Melinda; Book, Wendy; Reilly, Carolyn

2015-12-15

Adults with congenital heart defects (ACHD) face long-term complications related to prior surgery, abnormal anatomy, and acquired cardiovascular conditions. Although self-care is an important part of chronic illness management, few studies have explored self-care in the ACHD population. The purpose of this study is to describe self-care and its antecedents in the ACHD population. Persons with moderate or severe ACHD (N=132) were recruited from a single ACHD center. Self-care (health maintenance behaviors, monitoring and management of symptoms), and potential antecedents including sociodemographic and clinical characteristics, ACHD knowledge, behavioral characteristics (depressive symptoms and self-efficacy), and family-related factors (parental overprotection and perceived family support) were collected via self-report and chart review. Multiple regression was used to identify antecedents of self-care maintenance, monitoring, and management. Only 44.7%, 27.3%, and 23.3% of participants performed adequate levels of self-care maintenance, monitoring and management, respectively. In multiple regression analysis, self-efficacy, education, gender, perceived family support, and comorbidities explained 25% of the variance in self-care maintenance (R(2)=.248, F(5, 123)=9.44, p<.001). Age, depressive symptoms, self-efficacy, and NYHA Class explained 23% of the variance in self-care monitoring (R(2)=.232, F(2, 124)=10.66, p<.001). Self-efficacy and NYHA Class explained 9% of the variance in self-care management (R(2)=.094, F(2, 80)=5.27, p=.007). Low levels of self-care are common among persons with ACHD. Multiple factors, including modifiable factors of self-efficacy, depressive symptoms, and perceived family support, are associated with self-care and should be considered in designing future interventions to improve outcomes in the ACHD population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Antecedents of Self-Care in Adults with Congenital Heart Defects

PubMed Central

McCabe, Nancy; Dunbar, Sandra B.; Butler, Javed; Higgins, Melinda; Book, Wendy; Reilly, Carolyn

2015-01-01

Background Adults with congenital heart defects (ACHD) face long-term complications related to prior surgery, abnormal anatomy, and acquired cardiovascular conditions. Although self-care is an important part of chronic illness management, few studies have explored self-care in the ACHD population. The purpose of this study is to describe self-care and its antecedents in the ACHD population. Methods Persons with moderate or severe ACHD (N=132) were recruited from a single ACHD center. Self-care (health maintenance behaviors, monitoring and management of symptoms), and potential antecedents including sociodemographic and clinical characteristics, ACHD knowledge, behavioral characteristics (depressive symptoms and self-efficacy), and family-related factors (parental overprotection and perceived family support) were collected via self-report and chart review. Multiple regression was used to identify antecedents of self-care maintenance, monitoring, and management. Results Only 44.7%, 27.3%, and 23.3% of participants performed adequate levels of self-care maintenance, monitoring and management, respectively. In multiple regression analysis, self-efficacy, education, gender, perceived family support, and comorbidities explained 25% of the variance in self-care maintenance (R2=.248, F(5, 123)=9.44, p<.001). Age, depressive symptoms, self-efficacy, and NYHA Class explained 23% of the variance in self-care monitoring (R2=.232, F(2, 124)=10.66, p<.001). Self-efficacy and NYHA Class explained 9% of the variance in self-care management (R2=.094, F(2, 80)=5.27, p=.007). Conclusions Low levels of self-care are common among persons with ACHD. Multiple factors, including modifiable factors of self-efficacy, depressive symptoms, and perceived family support, are associated with self-care and should be considered in designing future interventions to improve outcomes in the ACHD population. PMID:26340127

Skin flaps and grafts - self-care

MedlinePlus

... Free flap - self-care; Skin autografting - self-care; Pressure ulcer skin flap self-care; Burns skin flap self- ... skin infection Surgery for skin cancer Venous ulcers , pressure ulcers , or diabetic ulcers that DO NOT heal After ...

Applications of and Barriers to Holistic Self-Care in a Low-Income, High-Risk Obstetric Population.

PubMed

Rhoades, Katherine; Telliard, Sarah; Thomas, Tiffany Stanfill; Barkin, Jennifer L

We examined 1) women's perceptions regarding self-care, 2) applications of self-care, and 3) barriers to practicing effective self-care. Four focus groups were conducted in a low-income, pregnant population. Focus group recruitment and discussions took place at a large medical center in a medically underserved area of central Georgia. Thirty-two adult pregnant women attending a high-risk obstetric clinic were included. Data related to holistic self-care were identified and grouped into one of three categories: women's valuations of self-care, applications of self-care, and barriers to self-care. The results were synthesized and compared to results from a study of postpartum women in which the same analytic framework for examining self-care practice was applied. Although women tended to understand the importance of self-care, they had difficulty practicing all forms of self-care on a regular basis owing to financial constraints, limited family support, health complications due to their high-risk obstetric status, external commitments, and childcare and household responsibilities. Applications of self-care were typically inexpensive and mainly required time rather than money. Socioeconomic status seems to influence the specific applications of and barriers to self-care. Health care providers should be aware of existing low-cost resources in the community that may assist prospective and new mothers in tending to their own emotional and physical needs. Providers should also discuss the importance of self-care with women during the perinatal period. Efforts should be made to educate school administrators regarding the impact of spontaneous requests for money for school activities, supplies, and field trips on the family budget. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Taking Legal Histories in Psychiatric Assessments.

PubMed

Morris, Nathaniel P

2018-05-25

People with mental illness are often disproportionately affected by the U.S. justice system, yet psychiatrists and other mental health professionals may avoid or feel uncomfortable talking with patients about legal history. This column examines why legal history is relevant to psychiatric assessments and provides guidance for talking with patients about these issues. Key aspects of taking a legal history are reviewed, including suggested questions, the role of collateral information, and considerations for medicolegal documentation. Developing skills in taking patients' legal histories may equip clinicians to better understand their patients' stories and to provide more effective psychiatric care.

Activation and Self-Efficacy in a Randomized Trial of a Depression Self-Care Intervention.

PubMed

McCusker, Jane; Lambert, Sylvie D; Cole, Martin G; Ciampi, Antonio; Strumpf, Erin; Freeman, Ellen E; Belzile, Eric

2016-12-01

In a sample of primary care participants with chronic physical conditions and comorbid depressive symptoms: to describe the cross-sectional and longitudinal associations of activation and self-efficacy with demographic, physical and mental health status, health behaviors, depression self-care, health care utilization, and use of self-care tools; and to examine the effects of a depression self-care coaching intervention on these two outcomes. Design/Study Setting. A secondary analysis of activation and self-efficacy data collected as part of a randomized trial to compare the effects of a telephone-based coached depression self-care intervention with a noncoached intervention. Activation (Patient Activation Measure) was measured at baseline and 6 months. Depression self-care self-efficacy was assessed at baseline, at 3 months, and at 6 months. In multivariable cross-sectional analyses (n = 215), activation and/or self-efficacy were associated with language, birthplace, better physical and mental health, individual exercise, specialist visits, and antidepressant nonuse. In longitudinal analyses (n = 158), an increase in activation was associated with increased medication adherence; an increase in self-efficacy was associated with use of cognitive self-care strategies and increases in social and solitary activities. There were significant improvements from baseline to 6 months in activation and self-efficacy scores both among coached and noncoached groups. The self-care coaching intervention did not affect 6-month activation or self-efficacy but was associated with quicker improvement in self-efficacy. Overall, the results for activation and self-efficacy were similar, although self-efficacy correlated more consistently than activation with depression-specific behaviors and was responsive to a depression self-care coaching intervention. © 2016 Society for Public Health Education.

A study on the information-motivation-behavioural skills model among Chinese adults with peritoneal dialysis.

PubMed

Chang, Tian-Ying; Zhang, Yi-Lin; Shan, Yan; Liu, Sai-Sai; Song, Xiao-Yue; Li, Zheng-Yan; Du, Li-Ping; Li, Yan-Yan; Gao, Douqing

2018-05-01

To examine whether the information-motivation-behavioural skills model could predict self-care behaviour among Chinese peritoneal dialysis patients. Peritoneal dialysis is a treatment performed by patients or their caregivers in their own home. It is important to implement theory-based projects to increase the self-care of patients with peritoneal dialysis. The information-motivation-behavioural model has been verified in diverse populations as a comprehensive, effective model to guide the design, implementation and evaluation of self-care programmes. A cross-sectional, observational study. A total of 201 adults with peritoneal dialysis were recruited at a 3A grade hospital in China. Participant data were collected on demographics, self-care information (knowledge), social support (social motivation), self-care attitude (personal motivation), self-efficacy (behaviour skills) and self-care behaviour. We also collected data on whether the recruited patients had peritoneal dialysis-associated peritonitis from electronic medical records. Measured variable path analysis was performed using mplus 7.4 to identify the information-motivation-behavioural model. Self-efficacy, information and social motivation predict peritoneal dialysis self-care behaviour directly. Information and personal support affect self-care behaviour through self-efficacy, whereas peritoneal dialysis self-care behaviour has a direct effect on the prevention of peritoneal dialysis-associated peritonitis. The information-motivation-behavioural model is an appropriate and applicable model to explain and predict the self-care behaviour of Chinese peritoneal dialysis patients. Poor self-care behaviour among peritoneal dialysis patients results in peritoneal dialysis-associated peritonitis. The findings suggest that self-care education programmes for peritoneal dialysis patients should include strategies based on the information-motivation-behavioural model to enhance knowledge, motivation and behaviour skills to change or maintain self-care behaviour. © 2018 John Wiley & Sons Ltd.

[Heart failure in primary care: Attitudes, knowledge and self-care].

PubMed

Salvadó-Hernández, Cristina; Cosculluela-Torres, Pilar; Blanes-Monllor, Carmen; Parellada-Esquius, Neus; Méndez-Galeano, Carmen; Maroto-Villanova, Neus; García-Cerdán, Rosa Maria; Núñez-Manrique, M Pilar; Barrio-Ruiz, Carmen; Salvador-González, Betlem

2018-04-01

To determine the attitudes, knowledge, and self-care practices in patients with heart failure (HF) in Primary Care, as well as to identify factors associated with better self-care. Cross-sectional and multicentre study. Primary Care. Subjects over 18 years old with HF diagnosis, attended in 10 Primary Health Care Centres in the Metropolitan Area of Barcelona. Self-care was measured using the European Heart Failure Self-Care Behaviour Scale. Sociodemographic and clinical characteristics, tests on attitudes (Self-efficacy Managing Chronic Disease Scale), knowledge (Patient Knowledge Questionnaire), level of autonomy (Barthel), and anxiety and depression screening (Goldberg Test), were also gathered in an interview. A multivariate mixed model stratified by centre was used to analyse the adjusted association of covariates with self-care. A total of 295 subjects (77.6%) agreed to participate, with a mean age of 75.6 years (SD: 11), 56.6% women, and 62% with no primary education. The mean self-care score was 28.65 (SD: 8.22), with 25% of patients scoring lower than 21 points. In the final stratified multivariate model (n=282; R 2 conditional=0.3382), better self-care was associated with higher knowledge (coefficient, 95% confidence interval: -1.37; -1.85 to -0.90), and coronary heart disease diagnosis (-2.41; -4.36: -0.46). Self-care was moderate. The correlation of better self-care with higher knowledge highlights the opportunity to implement strategies to improve self-care, which should consider the characteristics of heart failure patients attended in Primary Care. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Perspectives on Self-Care

ERIC Educational Resources Information Center

Williams, Isha D.; Richardson, Tenille A.; Moore, Darren D.; Gambrel, Laura Eubanks; Keeling, Margaret L.

2010-01-01

Self-care for clinicians is much needed. To discover ways to implement self-care into our lives, we (four therapists) tried different self-care methods over a span of one to two weeks. After using practices that explored self-care through mindfulness meditation, autohypnosis, music, and spirituality, we wrote about the outcome of these experiences…

Designing Networks that are Capable of Self-Healing and Adapting

DTIC Science & Technology

2017-04-01

Undergrad. Res. Fellowship, visiting from Caltech. Undergraduate Eugene Park Math Duke Models of self-healing networks (undergrad. senior thesis...Graduate student Anastasia Deckard Math Duke 3rd/4th year PhD. Wrote software for simulation. Undergraduate Nick Day Math LIMS Summer project at...Harer gave a talk on this DTRA grant to undergraduate math majors at Duke. 11 Q UA D C HA R T Uploaded to the DTRA Basic and Fundamental Research

Factors associated with self-care agency in patients after percutaneous coronary intervention.

PubMed

Saeidzadeh, Seyedehtanaz; Darvishpoor Kakhki, Ali; Abed Saeedi, Jila

2016-11-01

The aim of this study is to assess the factors associated with self-care agency in postpercutaneous coronary intervention patients. Patients after percutaneous coronary intervention need to perform self-care to reduce the side effects and increase the quality of life. Self-care agency is considered to be an important factor in guaranteeing self-care actions. In this descriptive study a total number of 300 postpercutaneous coronary intervention patients participated. Data were collected from the four hospitals affiliated with Shahid Beheshti University of Medical Sciences in Iran between February-May 2015. The data were gathered using demographic and basic conditioning factors questionnaire and appraisal of self-care agency scale. Data analysis was performed by anova and t-test. The mean age of the participants was 62·10 ± (8·14), which included 52·7% men and 47·3% women. Most patients (72%) had good level of self-care agency. Self-care agency had higher level in married and higher income patients. Self-care agency is influenced by economic and marital situation. Identifying factors associated with self-care agency can help healthcare professionals to consider these factors in self-care planning. © 2016 John Wiley & Sons Ltd.

Family Caregiver Contribution to Self-care of Heart Failure: An Application of the Information-Motivation-Behavioral Skills Model.

PubMed

Chen, Yuxia; Zou, Huijing; Zhang, Yanting; Fang, Wenjie; Fan, Xiuzhen

Adherence to self-care behaviors improves outcomes of patients with heart failure (HF). Caregivers play an important role in contributing to self-care. We aimed to explore the relationships among HF knowledge, perceived control, social support, and family caregiver contribution to self-care of HF, based on the Information-Motivation-Behavioral Skills Model. Two hundred forty-seven dyads of eligible patients with HF and family caregivers were recruited from a general hospital in China. Structural equation modeling was used to analyze the data obtained with the Caregiver Contribution to Self-care of Heart Failure Index, the Heart Failure Knowledge Test, the Control Attitudes Scale, and the Social Support Rating Scale. In this model, caregiver contribution to self-care maintenance was positively affected by perceived control (β = .148, P = .015) and caregiver confidence in contribution to self-care (β = .293, P < .001). Caregiver contribution to self-care management was positively affected by HF knowledge (β = .270, P < .001), perceived control (β = .140, P = .007), social support (β = .123, P = .019), caregiver confidence in contribution to self-care (β = .328, P < .001), and caregiver contribution to self-care maintenance (β = .148, P = .006). Caregiver confidence in contribution to self-care was positively affected by HF knowledge (β = .334, P < .001). Heart failure knowledge, perceived control, and social support facilitated family caregiver contribution to self-care of HF. Targeted interventions that consider these variables may effectively improve family caregiver contributions to self-care.

Phenomenological perspectives on self-care in aging.

PubMed

Söderhamn, Olle

2013-01-01

Self-care is a central concept in health care and may be considered as a means to maintain, restore, and improve one's health and well-being. When performed effectively, self-care contributes not only to human functioning but also to human structural integrity and human development (ie, to a dynamic and holistic state of health). Self-care as a clinical concept is relevant for health care professionals, and it should be meaningful to investigate it at a philosophical level and to further elaborate upon this concept. The aim of this article is to discuss and elaborate upon a phenomenological perspective on self-care in aging that is relevant for the health sciences. Self-care may be preliminarily regarded as a fundamental perspective for the conscious older individual, and as a way of being in the world with both the objective body and with the lived body. The lived body is the personal center of perception and the field of action, and it is also the center of self-care. The potentiality or ability for self-care activity and self-care activity itself are structures given to perception, with self-care ability as an integral part of the lived body. The actualization of self-care ability comes about through a certain meaning, which can be regarded as an important driving force. It is constituted by communication, a healthy lifestyle, and by building meaning and socializing. Successful self-care involves having contacts with the health care system, being conscious of a sound lifestyle, being physically and mentally active, being engaged, having social contacts with family and others, as well as being satisfied, positive, and being able to look forward. One fundamental cornerstone is serenity on behalf of the individual. Self-care can facilitate transitions, and it may also be an outcome of transitions.

Phenomenological perspectives on self-care in aging

PubMed Central

Söderhamn, Olle

2013-01-01

Self-care is a central concept in health care and may be considered as a means to maintain, restore, and improve one’s health and well-being. When performed effectively, self-care contributes not only to human functioning but also to human structural integrity and human development (ie, to a dynamic and holistic state of health). Self-care as a clinical concept is relevant for health care professionals, and it should be meaningful to investigate it at a philosophical level and to further elaborate upon this concept. The aim of this article is to discuss and elaborate upon a phenomenological perspective on self-care in aging that is relevant for the health sciences. Self-care may be preliminarily regarded as a fundamental perspective for the conscious older individual, and as a way of being in the world with both the objective body and with the lived body. The lived body is the personal center of perception and the field of action, and it is also the center of self-care. The potentiality or ability for self-care activity and self-care activity itself are structures given to perception, with self-care ability as an integral part of the lived body. The actualization of self-care ability comes about through a certain meaning, which can be regarded as an important driving force. It is constituted by communication, a healthy lifestyle, and by building meaning and socializing. Successful self-care involves having contacts with the health care system, being conscious of a sound lifestyle, being physically and mentally active, being engaged, having social contacts with family and others, as well as being satisfied, positive, and being able to look forward. One fundamental cornerstone is serenity on behalf of the individual. Self-care can facilitate transitions, and it may also be an outcome of transitions. PMID:23807842

Unraveling triadic communication in hospital consultations with adolescents with chronic conditions: the added value of mixed methods research.

PubMed

van Staa, Anneloes

2011-03-01

To integrate findings of a mixed methods research (MMR) into adolescents' preferences and competencies for communication during consultations, in order to demonstrate the added value of MMR for health communication research. Sequential MMR with adolescents (12-19 years) with various chronic conditions in a university hospital. Methods comprised: (1) 31 face-to-face interviews; (2) Q-methodology; (3) 39 observations of outpatient consultations; (4) three focus groups with 27 healthcare providers; (5) web-based questionnaire in 960 adolescents. Adolescents had different preferences regarding health communication, but all wished to be involved as partners. Yet, their actual participation during consultations was low. They often acted as bystanders rather than main characters because their participation was neither requested nor encouraged. Parents filled the gap, to healthcare providers' frustration. The questionnaire confirmed the discrepancy between self-efficacy and self-reported independent behavior during consultations. Triadic communication was all but multi-party-talk and adolescents did not act and were not considered as main partners. MMR was of pivotal importance for our understanding. As chronically ill adolescents need to prepare themselves for transition to adult care, healthcare providers should encourage them to take the lead in communication by initiating independent visits and changing the parents' roles. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Interacting factors associated with Low antibiotic prescribing for respiratory tract infections in primary health care - a mixed methods study in Sweden.

PubMed

Strandberg, Eva Lena; Brorsson, Annika; André, Malin; Gröndal, Hedvig; Mölstad, Sigvard; Hedin, Katarina

2016-07-18

Prescribing of antibiotics for common infections varies widely, and there is no medical explanation. Systematic reviews have highlighted factors that may influence antibiotic prescribing and that this is a complex process. It is unclear how factors interact and how the primary care organization affects diagnostic procedures and antibiotic prescribing. Therefore, we sought to explore and understand interactions between factors influencing antibiotic prescribing for respiratory tract infections in primary care. Our mixed methods design was guided by the Triangulation Design Model according to Creswell. Quantitative and qualitative data were collected in parallel. Quantitative data were collected by prescription statistics, questionnaires to patients, and general practitioners' audit registrations. Qualitative data were collected through observations and semi-structured interviews. From the analysis of the data from the different sources an overall theme emerged: A common practice in the primary health care centre is crucial for low antibiotic prescribing in line with guidelines. Several factors contribute to a common practice, such as promoting management and leadership, internalized guidelines including inter-professional discussions, the general practitioner's diagnostic process, nurse triage, and patient expectation. These factors were closely related and influenced each other. The results showed that knowledge must be internalized and guidelines need to be normative for the group as well as for every individual. Low prescribing is associated with adapted and transformed guidelines within all staff, not only general practitioners. Nurses' triage and self-care advice played an important role. Encouragement from the management level stimulated inter-professional discussions about antibiotic prescribing. Informal opinion moulders talking about antibiotic prescribing was supported by the managers. Finally, continuous professional development activities were encouraged for up-to-date knowledge.

Accuracy and congruence of patient and physician weight-related discussions: from Project CHAT (Communicating Health: Analyzing Talk)

PubMed Central

Bodner, Michael E.; Dolor, Rowena J.; Óstbye, Truls; Lyna, Pauline; Alexander, Stewart C.; Tulsky, James A.; Pollak, Kathryn I.

2014-01-01

Objective Primary care providers should counsel overweight patients to lose weight. Rates of self-reported weight-related counseling vary, perhaps due to self-report bias. We assessed accuracy and congruence of weight-related discussions among patients, physicians, and audio-recorded encounters. Methods We audio recorded encounters between physicians (n=40) and their overweight/obese patients (n=461) at five community-based practices. We coded weight-related content and surveyed patients and physicians immediately after the visit. Generalized linear mixed models assessed factors associated with accuracy. Results Overall, accuracy was moderate: patient (67%), physician (70%), and congruence (62%). When encounters contained weight-related content were analyzed, patients (98%) and physicians (97%) were highly accurate and congruent (95%) but when weight was not discussed patients and physicians were more inaccurate and incongruent (patient 36%; physician 44%; 28% congruence). Physicians less comfortable discussing weight were more likely to misreport that weight was discussed [OR = 4.5 (95% CI=1.88–10.75, p<0.001)]. White physicians with African-American patients were more likely to report accurately no discussion about weight than White physicians with White patients OR=0.30 (95% CI=0.13–0.69, p<0.01). Conclusion Physician and patient self-report of weight-related discussions were highly accurate and congruent when audio-recordings indicated weight was discussed, but not when recordings indicated no weight discussions. Physician overestimation of weight discussions when weight is not discussed constitutes missed opportunities for health interventions. PMID:24390888

Motivational Interviewing: moving from why to how with autonomy support

PubMed Central

2012-01-01

Motivational Interviewing (MI), a counseling style initially used to treat addictions, increasingly has been used in health care and public health settings. This manuscript provides an overview of MI, including its theoretical origins and core clinical strategies. We also address similarities and differences with Self-Determination Theory. MI has been defined as person-centered method of guiding to elicit and strengthen personal motivation for change. Core clinical strategies include, e.g., reflective listening and eliciting change talk. MI encourages individuals to work through their ambivalence about behavior change and to explore discrepancy between their current behavior and broader life goals and values. A key challenge for MI practitioners is deciding when and how to transition from building motivation to the goal setting and planning phases of counseling. To address this, we present a new three-phase model that provides a framework for moving from WHY to HOW; from building motivation to more action oriented counseling, within a patient centered framework. PMID:22385702

"No justice, no peace" and the right to self-determination: an interview with Gary Grant and Naeema Muhammed of the North Carolina Environmental Justice Network.

PubMed

Grant, Gary; Muhammed, Naeema; Slatin, Craig; Scammell, Madeleine Kangsen

2014-01-01

This is an interview with Gary Grant and Naeema Muhammed, leaders of the North Carolina Environmental Justice Network. Each of them talks about where they grew up, their politicization, how their paths crossed, their work together after Hurricane Floyd, and the unique challenges of organizing for social justice for black communities in the South. We learn of their fight against concentrated animal feeding operations (CAFOs), primarily for the hog trade, and they take us up to North Carolina's Moral Monday protests of 2013 against legislation that threatens voting rights, public education, access to medical services, unemployment benefits, workers rights, occupational and environmental health, and women's access to reproductive health care. We are grateful to these two friends of New Solutions for their contribution to the journal, and we hope that their insights regarding struggles for social and environmental justice can serve as guides for us all.

Diabetes - eye care

MedlinePlus

... having too much sugar and water in the lens of the eye, which is in front of the retina. Control ... your medicines. Always read labels with a magnifying lens. Use a ... are unsure of your doses, talk with your doctor, nurse, or pharmacist. Keep ...

Realizing the competitive advantage of the Internet.

PubMed

Kolesar, M S

1997-12-01

Everyone's talking about the Internet; everyone's getting on the Internet, either with a home page or to gather information. How has this type of technology become so prevalent--and what if home care providers lag behind in jumping aboard?

Sharing her passion with others.

PubMed

Henze, Tonja Marie

2013-10-22

Tonja Marie Henze, MS, CMAR, RLATg, Facilities Coordinator, Division of Animal Resources, University of Illinois, Urbana, IL. Ms. Henze talks about the joys and challenges of her job and realizing the importance of speaking out about her passion for laboratory animal care.

Special Section: Complementary and Alternative Medicine (CAM): Time to Talk

MedlinePlus

... with your health care providers any complementary and alternative medicines you take or are thinking about starting. Photo: ... and older use some form of complementary and alternative medicine (CAM). But less than one-third who use ...

How Do I Get Rid of Extra Skin After Weight Loss?

MedlinePlus

... addition to talking to your doctor, continue taking good care of yourself: Eating right, getting exercise, and moisturizing your skin daily can help you look and feel good. *Names have been changed to protect user privacy. ...

Talking with Your Doctor: Make the Most of Your Appointment

MedlinePlus

... health information. Many health care providers now use electronic health records. Ask your doctor how to access your records, ... on Facebook RSS Home Past Issues About Us Privacy Accessibility Freedom of Information Act No Fear Act ...

From MIPS to Vicsek: A comprehensive phase diagram for self-propelled rods

NASA Astrophysics Data System (ADS)

Shi, Xiaqing

Self-propelled rods interacting by volume exclusion is one of the simplest active matter systems. Despite years of effort, no comprehensive picture of their phase diagram is available. Furthermore, results on explicit rods are so far largely disconnected from those obtained on the relatively better understood cases of motility induced phase separation (MIPS) of (usually) isotropic active particles, and from our current knowledge of Vicsek-style aligning point particles. In this talk, I will present a complete phase diagram of a generic model of self-propelled rods and show how it is connected to both MIPS and Vicsek worlds.

Translation and validation of the Self-care of Heart Failure Index into Persian.

PubMed

Siabani, Soraya; Leeder, Stephen R; Davidson, Patricia M; Najafi, Farid; Hamzeh, Behrooz; Solimani, Akram; Siahbani, Sara; Driscoll, Tim

2014-01-01

Chronic heart failure (CHF) is a common burdensome health problem worldwide. Self-care improves outcomes in patients with CHF. The Self-care of Heart Failure Index (SCHFI) is a well-known scale for assessing self-care. A reliable, valid, and culturally acceptable instrument is needed to develop and test self-care interventions in Iran. We sought to translate and validate the Persian version of SCHFI v 6.2 (pSCHFI). We translated the SCHFI into Persian (pSCHFI) using standardized methods. The reliability was evaluated by assessing Cronbach's α coefficient. Expert opinion, discussion with patients, and confirmatory factor analysis were used to assess face validity, content validity, and construct validity, respectively. The analysis, using 184 participants, showed acceptable internal consistency and construct validity for the 3 subscales of pSCHFI-self-care maintenance, self-care management, and self-care self-confidence. The pSCHFI is a valid instrument with an acceptable reliability for evaluating self-care in Persian patients with heart failure.

Shin splints - self-care

MedlinePlus

... self-care; Tibial periostitis - self-care; Posterior tibial shin splints - self-care ... Shin splints are an exercise problem. You get shin splints from overloading your leg muscles, tendons or shin ...

Illness beliefs predict self-care behaviours in patients with diabetic foot ulcers: a prospective study.

PubMed

Vedhara, Kavita; Dawe, Karen; Wetherell, Mark A; Miles, Jeremy N V; Cullum, Nicky; Dayan, Colin; Drake, Nicola; Price, Patricia; Tarlton, John; Weinman, John; Day, Andrew; Campbell, Rona

2014-10-01

Patients' illness beliefs are known to be influential determinants of self-care behaviours in many chronic conditions. In a prospective observational study we examined their role in predicting foot self-care behaviours in patients with diabetic foot ulcers. Patients (n=169) were recruited from outpatient podiatry clinics. Clinical and demographic factors, illness beliefs and foot self-care behaviours were assessed as baseline (week 0). Foot self-care behaviours were assessed again 6, 12 and 24 weeks later. Linear regressions examined the contribution of beliefs at baseline to subsequent foot self-care behaviours, controlling for past behaviour (i.e., foot self-care at baseline) and clinical and demographic factors that may affect foot self-care (i.e., age and ulcer size). Our models accounted for between 42 and 58% of the variance in foot self-care behaviours. Even after controlling for past foot-care behaviours, age and ulcer size; patients' beliefs regarding the symptoms associated with ulceration, their understanding of ulceration and their perceived personal control over ulceration emerged as independent determinants of foot self-care. Patients' beliefs are important determinants of foot-care practices. They may, therefore, also be influential in determining ulcer outcomes. Interventions aimed at modifying illness beliefs may offer a means for promoting self-care and improving ulcer outcomes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Corrigendum.

PubMed

2018-01-01

Gelo, F. (2018). TED Talks: Learning Through Podcasts. Journal of Pastoral Care & Counselling, 72, 76-76. In the first line of the above-mentioned article, there is a reference to the article Gelo, F. (2018) On Being: Podcasts to Explore, Journal of Pastoral Care & Counselling 72, 75-75, as being in a previous issue of the Journal of Pastoral Care & Counselling. This is incorrect, and the article "On Being: Podcasts to Explore", appeared in the same issue of the Journal of Pastoral Care & Counselling. This line should read: "This issue of JPC&C also highlights a public radio conversation and podcast website On Being."

Depression, self-esteem, diabetes care and self-care behaviors among middle-aged and older Mexicans.

PubMed

Rivera-Hernandez, Maricruz

2014-07-01

Examine the associations of depression and self-esteem on self-care activities and care received among Mexicans with diabetes. Using data from the Mexican Nutrition and Health Survey 2012, logistic regression models were fit to test the associations between each self-care activity and diabetes care, and self-esteem and depression. People with low self-esteem were less likely to follow a diet, but no other associations were found. Contrary to what was expected, there were no relationships between depression and quality of care received or self-care behaviors. Current findings support the importance of looking at mental health and emotional state among older adults with diabetes. Future studies should explore the relationship between different psychological barriers to proper diabetes management. Published by Elsevier Ireland Ltd.

Depression, self-esteem, diabetes care and self-care behaviors among middle-aged and older Mexicans☆

PubMed Central

Rivera-Hernandez, Maricruz

2016-01-01

Aims Examine the associations of depression and self-esteem on self-care activities and care received among Mexicans with diabetes. Methods Using data from the Mexican Nutrition and Health Survey 2012, logistic regression models were fit to test the associations between each self-care activity and diabetes care, and self-esteem and depression. Results People with low self-esteem were less likely to follow a diet, but no other associations were found. Contrary to what was expected, there were no relationships between depression and quality of care received or self-care behaviors. Conclusion Current findings support the importance of looking at mental health and emotional state among older adults with diabetes. Future studies should explore the relationship between different psychological barriers to proper diabetes management. PMID:24846446

Stress and Coping Activity: Reframing Negative Thoughts

ERIC Educational Resources Information Center

Hughes, Jamie S.; Gourley, Mary K.; Madson, Laura; Le Blanc, Katya

2011-01-01

Stress management and coping techniques are not only relevant in many psychology courses but also personally relevant for undergraduate students. In this article, the authors describe an activity designed to provide students with practice evaluating and challenging negative self-talk. Students responded to scenarios individually, were paired with…

Cutting and Self-Harm

MedlinePlus

... can contact a helpline . Remember, you have a right to be safe and happy! If you are hurting yourself, please get help. It is possible to get past the urge to hurt yourself. There are other ways to deal with your feelings. You can talk to your parents, your doctor, ...

Your Child's Development: 3-5 Days

MedlinePlus

... calms self when upset has periods of alertness Cognitive Skills (Thinking and Learning) looks at and follows faces when quiet and alert stares briefly at bright objects placed in front of the face When to Talk to Your Doctor Every child develops at his or her own pace, but ...

Mindful Self-Care and Secondary Traumatic Stress Mediate a Relationship Between Compassion Satisfaction and Burnout Risk Among Hospice Care Professionals.

PubMed

Hotchkiss, Jason T

2018-01-01

Effective self-care in hospice is anecdotally proclaimed to reduce burnout risk. Yet, the topic has received little empirical attention. This study developed a model for predicting burnout risk from compassion satisfaction (CS), secondary traumatic stress (STS), and mindful self-care. Hospice care professionals (n = 324). Cross-sectional self-report survey. Mindful self-care was correlated with CS ( r = 0.497, p < .01), Burnout ( r = -0.726, p < .01), and STS ( r = -0.276, p < .01). A multiple regression model indicated that the combined effect of CS, STS, and mindful self-care explained 73.7% of the variance in Burnout. Mindful self-care and STS mediated a relationship between CS and Burnout. Each self-care category was statistically significant protective factors against burnout risk ( p < .01). Associations with Burnout in order of strength were self-compassion and purpose (SC; r = -0.673), supportive structure (SS; r = -0.650), mindful self-awareness (MS; r = -0.642), mindful relaxation (MR; r = -0.531), supportive relationships (SR; r = -0.503), and physical care (PC; r = -0.435). However, for STS, only SS ( r = -0.407, p < .01) and MR ( r = -0.285, p < .05) were statistically significant protective factors. Hospice care professional had higher self-care, CS, lower STS, and Burnout compared to published norms. Those who engaged in multiple and frequent self-care strategies experienced higher professional quality of life. Implications for hospice providers and suggestions for future research are discussed.

Self-care among healthcare social workers: An exploratory study.

PubMed

Miller, J Jay; Lianekhammy, Joann; Pope, Natalie; Lee, Jacquelyn; Grise-Owens, Erlene

2017-01-01

Despite growing interest in self-care, few studies have explicitly examined the self-care practices of healthcare social workers. This exploratory study investigated self-care among practitioners (N = 138) in one southeastern state. Overall, data suggest that healthcare social workers only moderately engaged in self-care. Additionally, analyses revealed significant differences in self-care practices by financial stability, overall health, and licensure status, respectively. Interestingly, perceived health status and current financial situation were significant predictors for overall self-care practices. After a brief review of the literature, this narrative will explicate findings, elucidate discussion points, identify salient implications, and conclude with areas for future research.

Informing the development of services supporting self-care for severe, long term mental health conditions: a mixed method study of community based mental health initiatives in England

PubMed Central

2012-01-01

Background Supporting self-care is being explored across health care systems internationally as an approach to improving care for long term conditions in the context of ageing populations and economic constraint. UK health policy advocates a range of approaches to supporting self-care, including the application of generic self-management type programmes across conditions. Within mental health, the scope of self-care remains poorly conceptualised and the existing evidence base for supporting self-care is correspondingly disparate. This paper aims to inform the development of support for self-care in mental health by considering how generic self-care policy guidance is implemented in the context of services supporting people with severe, long term mental health problems. Methods A mixed method study was undertaken comprising standardised psychosocial measures, questionnaires about health service use and qualitative interviews with 120 new referrals to three contrasting community based initiatives supporting self-care for severe, long term mental health problems, repeated nine months later. A framework approach was taken to qualitative analysis, an exploratory statistical analysis sought to identify possible associations between a range of independent variables and self-care outcomes, and a narrative synthesis brought these analyses together. Results Participants reported improvement in self-care outcomes (e.g. greater empowerment; less use of Accident and Emergency services). These changes were not associated with level of engagement with self-care support. Level of engagement was associated with positive collaboration with support staff. Qualitative data described the value of different models of supporting self-care and considered challenges. Synthesis of analyses suggested that timing support for self-care, giving service users control over when and how they accessed support, quality of service user-staff relationships and decision making around medication are important issues in supporting self-care in mental health. Conclusions Service delivery components – e.g. peer support groups, personal planning – advocated in generic self-care policy have value when implemented in a mental health context. Support for self-care in mental health should focus on core, mental health specific qualities; issues of control, enabling staff-service user relationships and shared decision making. The broad empirical basis of our research indicates the wider relevance of our findings across mental health settings. PMID:22769593

Urinary tract infection in women - self-care

MedlinePlus

UTI - self-care; Cystitis - self-care; Bladder infection - self-care ... BATHING AND HYGIENE To prevent future urinary tract infections, you ... make infections more likely. Change your pad each time you ...

1996 outlook: systems, for-profit chains, medical groups, religious healthcare, managed care, post-acute care, finance, purchasing, info systems, labor, legal, construction.

PubMed

Greene, J; Lutz, S; Jaklevic, M C; Japsen, B; Kertesz, L; Shriver, K; Pallarito, K; Scott, L; Morrissey, J; Moore, J D; Burda, D; Fitzgerald, J

1996-01-01

It's put-up-or-shut-up time for healthcare providers in 1996. Two years ago, everyone talked about fixing the healthcare system. Not much happened. Last year, providers and politicians concentrated on squeezing medical costs. According to some of Modern Healthcare's key beat reports, this year it's back to the basics of running a business.

'Talking of Sex': developing and piloting a sexual health communication tool for use in primary care.

PubMed

Macdowall, Wendy; Parker, Rachael; Nanchahal, Kiran; Ford, Chris; Lowbury, Ruth; Robinson, Angela; Sherrard, Jackie; Martins, Helen; Fasey, Nicky; Wellings, Kaye

2010-12-01

To develop and pilot a communication aid aimed at increasing the frequency with which sexual health issues are raised proactively with young people in primary care. Group interviews among primary health care professionals to guide development of the tool, simulated consultations to pre-test it, and a pilot study to assess effectiveness. We developed an electronic consultation aid: Talking of Sex and piloted it in eight general practices across the UK. 188 patients and 58 practitioners completed questionnaires pre-intervention, and 92 patients and 45 practitioners post-intervention. There was a modest increase in the proportion of consultations in which sexual health was raised, from 28.1% pre-intervention to 32.6% post-intervention. In consultations with nurses the rise was more marked. More patients reported discussing preventive practices such as condom use post-intervention. Patients unanimously welcomed the opportunity to discuss sexual health matters with their practitioner. The tool has capacity to increase the frequency with which sexual health is raised in primary care, particularly by nurses, to influence the topics discussed, and to improve patient satisfaction. The tool has potential in increasing the proportion of young people whose sexual health needs are addressed in general practice. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Pathways of empowerment perceptions, health literacy, self-efficacy, and self-care behaviors to glycemic control in patients with type 2 diabetes mellitus.

PubMed

Lee, Yau-Jiunn; Shin, Shyi-Jang; Wang, Ruey-Hsia; Lin, Kun-Der; Lee, Yu-Li; Wang, Yi-Hsien

2016-02-01

To validate a hypothesized model exploring the influencing pathways of empowerment perceptions, health literacy, self-efficacy, and self-care behaviors to glycosylated hemoglobin (HbA1c) levels in patients with type 2 diabetes (T2DM). Overall, 295 patients with T2DM were recruited from five endocrine clinics in Taiwan through convenience sampling. Data regarding personal characteristics, empowerment perceptions, health literacy, self-efficacy, self-care behaviors, and HbA1c levels were collected. A structural equation modeling was used to validate the hypothesized model. Significant direct pathways were determined from empowerment perceptions to health literacy, from health literacy to self-efficacy, from self-efficacy to self-care behaviors, and from self-care behaviors to HbA1c levels. The empowerment perceptions and health literacy relatively influenced self-efficacy and self-care behaviors. Self-efficacy and self-care behaviors relatively influenced glycemic control in patients with T2DM. Modifying self-care behaviors have been demonstrated to be the most essential for improving glycemic control. To improve self-care behaviors, healthcare providers should target improving self-efficacy, and enhancing health literacy can be considered to be a potential strategy for improving self-efficacy. To enhance health literacy, healthcare providers could use an empowerment approach rather than an authoritative approach that emphasizes patient compliance in managing patients with T2DM. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

What level of self-care agency in mental illness? The factors affecting self-care agency and self-care agency in patients with mental illness.

PubMed

Çiftçi, Bahar; Yıldırım, Naci; Şahin Altun, Özlem; Avşar, Gülçin

2015-12-01

The purpose of this study is to evaluate self-care agency and the factors affecting self-care agency in patients with psychiatric disorders. The population of the study comprised patients diagnosed with mental disorders at the clinics of psychiatry in Erzurum Regional Training and Research Hospital and Atatürk University Research Hospital. Patient information forms and the Self-Care Agency Scale were used to collect the study data. Psychiatric nurse collected the data from the patients face to face. This study determined that the average age of the patients was determined to be 32.19±1.11. The findings indicated that the mean self-care agency level of the patients was 79.3±23.2. It was also found that the differences between sex, educational status, socio-economic status, and self-care agency levels were statistically significant (p<0.05). In conclusion, the patients' self-care agency levels were determined to be mid-level. The findings suggest that people with mental disorders have difficulty identifying their need for self-care. Thus, periodic training programs are necessary to increase self-care levels and further research studies of this type should be done on larger groups. Copyright © 2015 Elsevier Inc. All rights reserved.

Effect of healing touch training on self-care awareness in nurses

NASA Astrophysics Data System (ADS)

Black, Pegi

Nursing focuses on supporting clients' health and health behaviors; however, they tend to exhibit unproductive behaviors when it comes to caring for themselves. As nurses' self-neglect can undermine client care, supporting nurses' self-care practices are expected to translate into clients' self-care. Healing Touch (HT) is one option for supporting nurses' self-care, as it is an accepted nursing practice and studies suggest that HT may have beneficial effects for those delivering it. This study examined the impact of a 2-day HT training on awareness of the need for self-care in nurses. HT training was offered as continuing education for 45 nurses at a Veteran's Administration hospital in Long Beach, CA. This mixed-methods study used a pre/post-test design to measure the effects of HT Level 1 training on nurses' self-care self-awareness. Independent samples t-tests and analyses of variance were used to detect whether any significant differences emerged based on participant demographic data. Data were analyzed using paired t-tests to determine whether participants' self-awareness changed over the study period. Effect size for any differences were calculated using Cohen's d. Open-ended responses were reviewed and common themes were identified related to what participants believed they learned and how it affected their care for themselves and their clients. Two increases were found to be significant and of sufficient power when comparing pre- to delayed post-test scores: physical self-care awareness (mean difference = 0.956, t(44) = 5.085, p = .000, r = .61) and professional self-care awareness (mean difference = .955, t(43) = 5.277, p = .000, r = .63). Qualitative findings suggested that changes in their awareness, self-directed practices, and patient care practices are anticipated, evident, and sustained based upon themes across the three tests. Nurses are advised to take a course that teaches specific self-care techniques and strategies and continue practicing, monitoring, and adapting the practice of self-care. Administrators are advised to recognize the importance of self-care for healthcare staff, institute programs that encourage such activities, and model their own self-care.

Partnering with consumers to develop and evaluate a Vietnamese Dementia Talking-Book to support low health literacy: a qualitative study incorporating codesign and participatory action research

PubMed Central

Goeman, Dianne; Michael, J; King, J; Luu, Huy; Emmanuel, Claire; Koch, S

2016-01-01

Objective The aim of the Vietnamese Dementia talking-book was to address low health literacy in older people of Vietnamese background living with dementia through the provision of an online resource to help individuals, their families and carers better understand and manage this condition and provide information about available dementia services. Design This qualitative study used codesign and participatory action research to develop and refine the talking-book in consultation with expert stakeholders, a consumer advocacy group and the Vietnamese community to assess its utility and ensure cultural and linguistic appropriateness and relevance. Participants 59 members of the Vietnamese community, 11 stakeholders from community health services and ethnic agencies, consumer advocacy groups and the research team participated in the codesign and refinement of the talking-book. 22 members of the Vietnamese community appraised the final product. Setting Vietnamese community planned activity groups in the Western, Northern and Southern suburbs of Melbourne, Australia. Results Our codesign study outlines the process required to develop a Vietnamese Dementia Talking-Book resource partnering with consumers and expert stakeholders to identify consumer need, selection of the content and appropriate language level, construction of the book, measuring acceptability of the talking-book, modification based on feedback and production and dissemination. Feedback on the final version of the talking-book revealed widespread consensus that the book enhanced the knowledge of members of the Vietnamese community in regard to understanding dementia and navigation and accessing of available services. Conclusions This free internationally available online Vietnamese Dementia Talking-Book facilitates improved dementia-related health literacy in the Vietnamese community. The book also serves as a tool to facilitate the provision of care to Vietnamese people living with memory loss by assisting health professional staff to develop relationships with Vietnamese clients, their families and carers in a culturally appropriate manner. PMID:27670516

New frontiers in couple-based interventions in cancer care: refining the prescription for spousal communication.

PubMed

Badr, Hoda

2017-02-01

The diagnosis and treatment of cancer is a life-altering experience that signals profound changes in a person's life. However, most people do not experience cancer in isolation or cope alone. Despite the fact that partners (i.e. spouses, significant others) provide emotional support and play a critical role in caregiving, cancer exacts a heavy toll on them and challenges their relationship with the patient by altering established communication patterns and roles. In recognition of this, a burgeoning literature involving couple-based interventions to improve patient and partner quality of life and adaptation has emerged. However, questions remain regarding how we can improve these interventions to exact greater impact on patient and partner outcomes. A narrative review of the literature on couples' communication processes in cancer was conducted in order to describe knowledge gaps and directions for future research. Most couple-based interventions have included a communication skills training component because communication is an important process through which couples make sense of cancer, engage in social support, negotiate role changes and coordinate coping responses. However, scholars still know very little about what they should instruct couples to talk about, how often they should talk and when talking (or not talking) is beneficial (and for whom - the patient, partner, or both). In order push this field forward, we need to develop a more nuanced view of couples' communication that acknowledges that there are multiple ways to talk, different aspects of the cancer experience to talk about, and preexisting communication patterns and preferences for different couples that may influence the utility of talk. Interventions that replace the unilateral and generic prescription to talk openly about cancer with targeted questions that prompt reflection on couples' unique strengths, preexisting communication patterns and support resources may thus help bolster the impact of couple-based interventions on patient and partner quality of life.

When Your Parent Has Cancer

Cancer.gov

Help for teens whose mom or dad has cancer. Learn how families cope and find support when a parent has cancer. Tips to help you talk with your friends, deal with stress, and take care of your mind and body are also shared.

When Your Brother or Sister Has Cancer

Cancer.gov

Help when a brother or sister has cancer. Learn how families cope and find support when a sibling has cancer. Tips to help you talk with your friends, deal with stress, and take care of your mind and body are also shared.

Talking about Complementary and Alternative Medicine with Your Health Care Providers: A Workbook and Tips

MedlinePlus

... therapy Omega-3 fatty acids Osteopathy Probiotics Pulsed electromagnetic fields Qigong Reflexology Reiki Relaxation therapy Selenium Soy ... types of energy therapies are biofield therapies and electromagnetic-based therapies. Biofield therapy: A type of energy ...

Care of self - care by other - care of other: the meaning of self-care from research, practice, policy and industry perspectives.

PubMed

Godfrey, Christina M; Harrison, Margaret B; Lysaght, Rosemary; Lamb, Marianne; Graham, Ian D; Oakley, Patricia

2011-03-01

Currently, no single definition of self-care is broadly accepted in the literature. Definitions vary as to (i) who engages in self-care behaviour; (ii) what motivates self-care behaviours; and (iii) the extent to which healthcare professionals are involved. Perspectives of self-care differ between healthcare professionals and the general public, and between healthcare professionals in different disciplines and different roles. As different professions view self-care within their own domain of practice, we are left with a multitude of explanations and descriptions. This variety of conceptualisations does impact and complicate research on self-care. As part of a larger enquiry focused on the clarification of this complex concept, this study provides a content analysis of documented definitions of self-care, and a summary of the evolution of the definition of self-care over time. To examine the diversity of definitions of self-care from the perspectives of research, practice, policy and industry, and to identify themes or trends in the evolution of the definition of self-care over time. The search strategy was designed in consultation with a library scientist to find both published and unpublished papers. A three-step search strategy was used to locate the literature. The databases searched included CINAHL, Medline, EMBASE, PsycINFO, AMED, Cochrane Library, Scirus and Mednar. The definition of self-care was extracted from each paper included in the study. Using an inductive process, a content analysis was performed identifying common terms and phrases from the definitions. The definitions were then divided into four decades, 1970s, 1980s, 1990s and 2000s, and the evolution of the definition of self-care was examined. In this study we sought to clarify the concept of self-care by examining in detail the definition of self-care. Content analysis of 139 definitions identified seven components of the definition and a range of terms that were applicable to each component. Evolution of the definition over time showed a more expansive definition by the end of the 2000s. Current and evolving definitions of self-care would benefit by being comprehensive and encompassing as many facets of the concept as possible. Healthcare professionals assess, guide, instruct and support individuals as they initiate or engage in self-care. Using a comprehensive definition of self-care would provide an anchor linking each discipline as they interact not only with the individual but also among themselves. The concept of self-care is a many-layered one. Identifying the components in the definition of the term delineates the different areas for potential research in this area. When planning a research project, the definition of the key concept guides the research and shapes the approach to the investigation. For researchers in this area, this study illustrates the wealth and diversity of the definitions of self-care. © 2011 The Authors. International Journal of Evidence-Based Healthcare © 2011 The Joanna Briggs Institute.

Health literacy and its association with diabetes knowledge, self-efficacy and disease self-management among African Americans with diabetes mellitus.

PubMed

McCleary-Jones, Voncella

2011-01-01

The purpose of this descriptive correlational study was to examine health literacy and its association with diabetes knowledge, perceived self-efficacy and disease self-management among African Americans with diabetes mellitus. Fifty English-speaking, adult African American participants with diabetes mellitus were recruited from a community health center and a church located in the Midwestern United States. Data were collected at a single point in time utilizing the Rapid Estimate of Adult Literacy in Medicine (REALM), Diabetes Knowledge Test (DKT), Diabetes Self-efficacy Scale, and Summary of Diabetes Self-care Activities (SDSCA) Questionnaire. Bivariate associations were identified for health literacy with diabetes knowledge level; diabetes knowledge level with dietary self-care activities; and self-efficacy with dietary, exercise, and foot care self-care activities. Diabetes knowledge level and self-efficacy were independent predictors for dietary self-care activities, while self efficacy was the sole independent predictor for foot self-care. Means for health literacy and diabetes self-care activities were influenced by demographic factors examined.

Perspectives on barriers and facilitators to self-care in Lebanese cardiac patients: A qualitative descriptive study.

PubMed

Dumit, Nuhad Yazbik; Noureddine, Samar Nayef; Magilvy, Joan Kathy

2016-08-01

Cardiovascular disease is the leading cause of mortality worldwide. Cardiac self-care practices are essential for managing cardiac illness and improving quality of life. However, these practices may be affected by factors that may hinder or facilitate self-care especially in countries that experience political and economic instabilities. The purpose of this study was to explore self-care practices among Lebanese cardiac patients. Another aim was to reveal factors that might influence these self-care practices. This is a qualitative descriptive study. Participants were recruited from a referral medical center in Beirut, Lebanon and interviews took place in their homes. Purposive sample of 15 adult participants, seven females and eight males, diagnosed with coronary artery disease at least a year ago and not in critical condition recruited from the cardiology clinics of the medical center. Data were collected through semi-structured audio-recorded interviews that took place in their places of residents. Three themes emerged from the data: I. The behaviors of cardiac patients demonstrated selected self-care practices; II. Patients identified barriers to self-care reflective of the Lebanese political and socio-economic situation; and, III. Patients described facilitators to self-care consistent with the Lebanese socio-cultural values and norms. The most common self-care practices included taking medications and eating properly. Participants emphasized avoiding stress and being upset as a self-protective measure for cardiac health. Health care costs, family responsibilities, psychological factors and the country's political situation impeded self-care practices whereas family support facilitated them. Lebanese patients reported select self-care practices in dealing with their cardiac illness. Barriers and facilitators to their self-care behaviors reflected the Lebanese context and culture. Thus health care providers must assess their patients' practices within their sociocultural context so that interventions to promote self-care are tailored accordingly. Copyright © 2016 Elsevier Ltd. All rights reserved.

Relationship between self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting.

PubMed

Tharek, Zahirah; Ramli, Anis Safura; Whitford, David Leonard; Ismail, Zaliha; Mohd Zulkifli, Maryam; Ahmad Sharoni, Siti Khuzaimah; Shafie, Asrul Akmal; Jayaraman, Thevaraajan

2018-03-09

Self-efficacy has been shown to be positively correlated with self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus. However, such evidence is lacking in the Malaysian primary care setting. The objectives of this study were to i) determine the levels of self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting ii) determine the relationship between self-efficacy, self-care behaviour and glycaemic control iii) determine the factors associated with glycaemic control. This was a cross-sectional study involving patients with type 2 diabetes mellitus from two public primary care clinics in Malaysia. Self-efficacy and self-care behaviour levels were measured using previously translated and validated DMSES and SDSCA questionnaires in Malay versions, respectively. Glycaemic control was measured using HbA 1c. RESULTS: A total of 340 patients with type 2 diabetes mellitus were recruited. The total mean (±SD) of self-efficacy and self-care behaviour scores were 7.33 (±2.25) and 3.76 (±1.87), respectively. A positive relationship was found between self-efficacy and self-care behaviour (r 0.538, P < 0.001). Higher self-efficacy score was shown to be correlated with lower HbA 1c (r - 0.41, P < 0.001). Multiple linear regression analysis demonstrated that higher self-efficacy scores (b - 0.398; 95% CI: -0.024, - 0.014; P < 0.001), shorter duration of diabetes (b 0.177; 95% CI: 0.002, 0.007; P < 0.001) and smaller waist circumference (b 0.135; 95% CI: 0.006, 0.035; P = 0.006), were significantly associated with good glycaemic control. This study demonstrated that higher self-efficacy was correlated with improved self-care behaviour and better glycaemic control. Findings of this study suggest the importance of including routine use of self-efficacy measures in the management of type 2 diabetes mellitus in primary care.

A comparison of self-oscillating phonation models

NASA Astrophysics Data System (ADS)

McPhail, Michael; Campo, Elizabeth; Walters, Gage; Krane, Michael

2017-11-01

This talk presents a comparison of self-oscillating models of phonation. The goal is to assess how well synthetic rubber vocal folds reproduce the gross behavior of phonation. Data from molded rubber folds and a variety of excised mammalian larynges were collected from the literature and from the authors' physical model. Gross trends are discussed and a simple scaling is presented that appears to collapse these data. Finally, comparisons between molded rubber folds and excised larynges are highlighted. Acknowledge support from NIH DC R01005642-11.

Exploring the meaning and practice of self-care among palliative care nurses and doctors: a qualitative study.

PubMed

Mills, Jason; Wand, Timothy; Fraser, Jennifer A

2018-04-18

Self-care practice within the palliative care workforce is often discussed, yet seemingly under-researched. While palliative care professionals are required to implement and maintain effective self-care strategies, there appears little evidence to guide them. Moreover, there is an apparent need to clarify the meaning of self-care in palliative care practice. This paper reports qualitative findings within the context of a broader mixed-methods study. The aim of the present study was to explore the meaning and practice of self-care as described by palliative care nurses and doctors. A purposive sample of 24 palliative care nurses and doctors across Australia participated in semi-structured, in-depth interviews. Interviews were digitally recorded and transcribed prior to inductive qualitative content analysis, supported by QSR NVivo data management software. Three overarching themes emerged from the analysis: (1) A proactive and holistic approach to promoting personal health and wellbeing to support professional care of others; (2) Personalised self-care strategies within professional and non-professional contexts; and (3) Barriers and enablers to self-care practice. The findings of this study provide a detailed account of the context and complexity of effective self-care practice previously lacking in the literature. Self-care is a proactive, holistic, and personalised approach to the promotion of health and wellbeing through a variety of strategies, in both personal and professional settings, to enhance capacity for compassionate care of patients and their families. This research adds an important qualitative perspective and serves to advance knowledge of both the context and effective practice of self-care in the palliative care workforce.

Patients understanding of depression associated with chronic physical illness: a qualitative study

PubMed Central

2014-01-01

Background Detection of depression can be difficult in primary care, particularly when associated with chronic illness. Patient beliefs may affect detection and subsequent engagement with management. We explored patient beliefs about the nature of depression associated with physical illness. Methods A qualitative interview study of patients registered with general practices in Leeds, UK. We invited patients with coronary heart disease or diabetes from primary care to participate in semi-structured interviews exploring their beliefs and experiences. We analysed transcripts using a thematic approach, extended to consider narratives as important contextual elements. Results We interviewed 26 patients, including 17 with personal experience of depression. We developed six themes: recognising a problem, complex causality, the role of the primary care, responsibility, resilience, and the role of their life story. Participants did not consistently talk about depression as an illness-like disorder. They described a change in their sense of self against the background of their life stories. Participants were unsure about seeking help from general practitioners (GPs) and felt a personal responsibility to overcome depression themselves. Chronic illness, as opposed to other life pressures, was seen as a justifiable cause of depression. Conclusions People with chronic illness do not necessarily regard depression as an easily defined illness, especially outside of the context of their life stories. Efforts to engage patients with chronic illness in the detection and management of depression may need further tailoring to accommodate beliefs about how people view themselves, responsibility and negative views of treatment. PMID:24555886

Is it safe? Talking to teens with HIV/AIDS about death and dying: a 3-month evaluation of Family Centered Advance Care (FACE) planning – anxiety, depression, quality of life

PubMed Central

Lyon, Maureen E; Garvie, Patricia A; Briggs, Linda; He, Jianping; Malow, Robert; D’Angelo, Lawrence J; McCarter, Robert

2010-01-01

Purpose To determine the safety of engaging HIV-positive (HIV+) adolescents in a Family Centered Advance Care (FACE) planning intervention. Patients and methods We conducted a 2-armed, randomized controlled clinical trial in 2 hospital-based outpatient clinics from 2006–2008 with HIV+ adolescents and their surrogates (n = 76). Three 60–90 minutes sessions were conducted weekly. FACE intervention groups received: Lyon FCACP Survey©, the Respecting Choices® interview, and completion of The Five Wishes©. The Healthy Living Control (HLC) received: Developmental History, Healthy Tips, Future Planning (vocational, school or vocational rehabilitation). Three-month post-intervention outcomes were: completion of advance directive (Five Wishes©); psychological adjustment (Beck Depression, Anxiety Inventories); quality of life (PedsQL™); and HIV symptoms (General Health Self-Assessment). Results Adolescents had a mean age, 16 years; 40% male; 92% African-American; 68% with perinatally acquired HIV, 29% had AIDS diagnosis. FACE participants completed advance directives more than controls, using time matched comparison (P < 0.001). Neither anxiety, nor depression, increased at clinically or statistically significant levels post-intervention. FACE adolescents maintained quality of life. FACE families perceived their adolescents as worsening in their school (P = 0.018) and emotional (P = 0.029) quality of life at 3 months, compared with controls. Conclusions Participating in advance care planning did not unduly distress HIV+ adolescents. PMID:22096382

Nursing on the medical ward.

PubMed

Parker, Judith M

2004-12-01

This paper considers some issues confronting contemporary medical nursing and draws upon psychoanalytic theories to investigate some seemingly straightforward and taken-for-granted areas of medical nursing work. I am arguing that the everyday work of medical nurses in caring for patients is concerned with bringing order to and placing boundaries around inherently unsettled and destabilized circumstances. I am also arguing that how nurses manage and organize their work in this regard stems from traditional practices that tend to be taken for granted and not explicitly thought about. It is therefore difficult for nurses to consider changing these practices that often have negative consequences for the nurses. I want to examine the impact upon nurses of the consequences of three taken-for-granted nursing practices: (i) the tendency of nurses to confine their reactions to what is going on so as to present a caring self; (ii) the tendency of nurses in their everyday talk to patients to confine, limit and minimize meaning; and (iii) the tensions and ambiguities that emerge for nurses in the policing function they perform in confining patients to the bed or the ward. Negative consequences on nurses of these practices potentially include stress and confusion regarding their ability to care for patients; an undervaluing of nursing skills; and a deterioration in the nurse-patient relationship. Clinical supervision for medical nurses is proposed as a means of facilitating greater understanding of the nature of nurses' relationships with patients and the complex dimensions of their medical nursing role.

A project in Zambia: talking to children about AIDS.

PubMed

Baker, K

1988-09-01

Early in 1987, it became clear to this individual that children were a high priority group for Acquired Immune Deficiency Syndrome (AIDS) education. Preparation for providing AIDS education in Zambia included reading as much as possible about AIDS and AIDS education in schools, contacting the Health Education Unit at the Ministry of Health for their permission and advice, and making posters and preparing a list of 10 basic questions about AIDS. The 1st talks were at a boys' technical school and a large girls' day school. Following an introduction of the subject, the format included: a 10-minute quiz with students writing down their answers; a 35-40 minute talk, using posters as visual aids; a 20-30 minute open question time; and a repeat of the same quiz as a form of "posttest." The students responded positively, and there was a substantial increase in the percentage of correct answers after each talk. Subsequently, talks were given in other Lusaka secondary schools. After the 1st few talks, the pretest and posttest was discontinued as it was considered preferable to spend more time answering the students' questions. The talks varied depending on the audience, but posters were always included as visual aids. Initially, this AIDS education effort was voluntary and unfunded. Subsequently, and as the work grew, NORAD funded the project, paying for duplicating and printing as well as a salary on an hourly basis. A booklet on AIDS for secondary schools has been written and duplicated and accepted by the Intersectorial Committee on AIDS Health Education with minor changes. Late in 1987, the booklet was rewritten totally and expanded, with numerous illustrations. Throughout the booklet, human immunodeficiency virus (HIV) is carefully differentiated from AIDS disease. Talks also have been initiated at the Upper Primary School level. The format has been altered somewhat for these younger children as they tend to be noisy and excited. The primary project planned for 1988 is to talk to teachers and health educators, individually and in groups, informally and formally. Thus far, 58 talks have been given in 22 secondary schools and 11 primary schools along with 29 talks to nonschool groups. Culturally, it is much easier as a medically trained non-Zambian to talk about AIDS and AIDS-related concerns, but the message needs to be given more than once. It must be discussed both in the classroom and at home until it becomes a part of life.

Role of community pharmacists in patients’ self-care and self-medication

PubMed Central

Rutter, Paul

2015-01-01

This review highlights the growing prominence of self-care and explores the contribution of community pharmacy. Firstly, background to self-care is discussed, followed by placing self-care in context with regard to the general public and accessing community pharmacy. From this perspective the contribution community pharmacy currently makes is assessed, paying particular attention to the factors that negatively impact on the ability of community pharmacy to facilitate self-care. PMID:29354520

Illness perception, diabetes knowledge and self-care practices among type-2 diabetes patients: a cross-sectional study.

PubMed

Kugbey, Nuworza; Oppong Asante, Kwaku; Adulai, Korkor

2017-08-10

Self-care practices among persons living with type-2 diabetes are very crucial in diabetes manages as poor self-care results in complications. However, little research exists within the Ghanaian context. This study examined whether type-2 diabetes patients' illness perception and diabetes knowledge significantly predict diabetes self-care practices. A cross-sectional survey design was employed and a total of 160 participants (45 males and 115 females) were sampled from a general hospital in Accra. A self-administered questionnaire measuring illness perception, diabetes knowledge and diabetes self-care practices as well as demographic checklist were used collect data. Results showed that illness perception and diabetes knowledge significantly predicted overall diabetes self-care practices. Analysis of domain specific self-care practices showed that patients' diet was significantly predicted by illness perception and diabetes knowledge. Exercise was significantly predicted by only illness perception while blood sugar testing and diabetes foot-care were significantly predicted by diabetes knowledge. Cognitive and emotional representation of diabetes and diabetes knowledge are key determinants of patients' diabetes self-care practices. It is therefore important that appropriate psychosocial interventions are developed to help patients' adherence to recommended self-care practices.

The Functions of Spanish in the School Lives of Mexicano Bilingual Children.

ERIC Educational Resources Information Center

Benjamin, Rebecca

1996-01-01

A study of the language usage of five Mexican American fifth-grade bilingual students in an all-English classroom revealed the functions that Spanish continued to serve: providing information and assistance with school work, seeking explanations, providing self-talk, establishing and maintaining social relationships, and negotiating and…

Talking Typewriter Training Program in a Rehabilitation Setting.

ERIC Educational Resources Information Center

Kupshunas, Sue

1984-01-01

As part of a state residential center's 16-week training program to assist blind adults, aged 16-65, in acquiring employability skills, clients receive hands-on training in mastering the IBM Memory 100 Audio Unit typewriter. Training includes assessing prerequisite secretarial skills, using self-instructional materials, and evaluating performance.…

Communication Systems. Supervising: Communication. The Choice Series #63. A Self Learning Opportunity.

ERIC Educational Resources Information Center

Carr, Linda

This student guide is intended to assist persons employed as supervisors in understanding and using communication equipment. Discussed in the first three sections are the following topics: producing and storing information (communicating, storing, and retrieving information and using word processors and talking machines); communicating information…

The Business Approach to Training.

ERIC Educational Resources Information Center

Williams, Teresa; Green, Adrian

This self-study book concentrates on enabling trainers to talk and think in a business-related way, use business concepts and terminology, and translate training and development ideas into a business setting. Each part contains activities to enable users to study their training and development function and organization and consider how to use the…

Applying Cognitive-Behavioral Techniques to Social Skills Instruction. ERIC/OSEP Digest.

ERIC Educational Resources Information Center

Smith, Stephen W.

This digest describes how teachers can use cognitive-behavioral interventions (CBI) to remediate behavioral deficits and excesses by providing students with the tools necessary to control their own behavior. CBIs involve teaching the use of inner speech ("self-talk" )to modify underlying cognitions that affect overt behavior. CBI…

The Challenge of Prejudice: Counsellors' Talk about Challenging Clients' Prejudices

ERIC Educational Resources Information Center

Spong, Sheila J.

2012-01-01

This paper considers the implications for training and practice of counsellors' responses to the notion of challenging clients' prejudices. It explores tensions in counselling discourse between social responsibility, responsibility to the client and responsibility for one's self as counsellor. Three focus groups of counsellors were asked whether a…

Parents in Reading: Parents' Booklet.

ERIC Educational Resources Information Center

Truby, Roy

Intended for parents, this booklet offers advice and suggestions for developing a child's self-expression and providing a supportive environment for reading experiences at home. Various sections of the book discuss the following: (1) giving love and warmth to your child, (2) reading with your child, (3) listening to your child, (4) talking with…

Tale of an Innocent

ERIC Educational Resources Information Center

Singer, Nicky

2006-01-01

The British novelist Nicky Singer talks about becoming a writer, the role of editors and about who decides what can--and what cannot--be published on either side of the Atlantic. Her three novels explore territory which can make publishers nervous: "Feather Boy" (initiation rites and domestic violence), "Doll" (self-harm) and…

Talking a Good Game.

ERIC Educational Resources Information Center

Journal of Physical Education, Recreation & Dance, 1982

1982-01-01

A collection of essays focuses on the need to integrate philosophy into sport and physical education. The function of sport philosophy is to examine beliefs and values as a basis for human behavior. Philosophical issues examined include: (1) cheating; (2) competition; (3) the development of self-reflection and responsibility; and (4) the…

Improving support for heart failure patients: a systematic review to understand patients' perspectives on self-care.

PubMed

Spaling, Melisa A; Currie, Kay; Strachan, Patricia H; Harkness, Karen; Clark, Alexander M

2015-11-01

This systematic review aimed to generate patient-focussed recommendations to enhance support of heart failure self-care by examining patients' experiences, perspectives and self-care behaviours. Despite increased recognition of the importance of heart failure self-care, patients' knowledge and practices around this self-care and interventions to improve it are inconsistent. Consequently, current guidelines focus on what the domains of heart failure self-care are, more so than the ways to improve this care. Systematic review and qualitative interpretive synthesis. A systematic, comprehensive and detailed search of 11 databases was conducted until March, 2012 for papers published 1995-2012: 37 studies were included (1343 patients, 75 caregivers, 63 health care professionals) that contained a qualitative research component and data on adult patients' heart failure self-care. This interpretive synthesis used a recognized approach consisting of a multi-stage analytic process; in addition, the included studies underwent quality appraisal. Findings indicate that while patients could often recall health professionals' self-care advice, they were unable to integrate this knowledge into daily life. Attempts to manage HF were based on how patients 'felt' rather than clinical indicators of worsening symptoms. Self-efficacy and learning from past management experiences facilitated favourable outcomes - these enabled patients and caregivers to adeptly apply self-care strategies into daily activities. Addressing common but basic knowledge misconceptions regarding the domains of HF self-care is insufficient to increase effective HF self-care; this should be supplemented with strategies with patients and family members to promote self-efficacy, learning and adaptation/application of recommendations to daily life. © 2015 John Wiley & Sons Ltd.

Examining the relationship between therapeutic self-care and adverse events for home care clients in Ontario, Canada: a retrospective cohort study.

PubMed

Sun, Winnie; Doran, Diane M; Wodchis, Walter P; Peter, Elizabeth

2017-03-14

In an era of a rapidly aging population who requires home care services, clients must possess or develop therapeutic self-care ability in order to manage their health conditions safely in their homes. Therapeutic self-care is the ability to take medications as prescribed and to recognize and manage symptoms that may be experienced, such as pain. The purpose of this research study was to investigate whether therapeutic self-care ability explained variation in the frequency and types of adverse events experienced by home care clients. A retrospective cohort design was used, utilizing secondary databases available for Ontario home care clients from the years 2010 to 2012. The data were derived from (1) Health Outcomes for Better Information and Care; (2) Resident Assessment Instrument-Home Care; (3) National Ambulatory Care Reporting System; and (4) Discharge Abstract Database. Descriptive analysis was used to identify the types and prevalence of adverse events experienced by home care clients. Logistic regression analysis was used to examine the association between therapeutic self-care ability and the occurrence of adverse events in home care. The results indicated that low therapeutic self-care ability was associated with an increase in adverse events. In particular, logistic regression results indicated that low therapeutic self-care ability was associated with an increase in clients experiencing: (1) unplanned hospital visits; (2) a decline in activities of daily living; (3) falls; (4) unintended weight loss, and (5) non-compliance with medication. This study advances the understanding about the role of therapeutic self-care ability in supporting the safety of home care clients. High levels of therapeutic self-care ability can be a protective factor against the occurrence of adverse events among home care clients. A clear understanding of the nature of the relationship between therapeutic self-care ability and adverse events helps to pinpoint the areas of home care service delivery required to improve clients' health and functioning. Such knowledge is vital for informing health care leaders about effective strategies that promote therapeutic self-care, as well as providing evidence for policy formulation in relation to risk mitigation in home care.

What are the combined effects of negative emotions and illness cognitions on self-care in people with type 2 diabetes? A longitudinal structural equation model.

PubMed

Hudson, Joanna L; Bundy, Christine; Coventry, Peter; Dickens, Chris; Wood, Alex; Reeves, David

2016-07-01

To explore whether negative emotions mediate the effect of diabetes cognitions on diabetes self-care and conversely whether diabetes cognitions mediate the effect of negative emotions on diabetes self-care. Longitudinal observational study in adults with type 2 diabetes. Self-reported depression and anxiety (Diabetes Wellbeing Questionnaire), cognitions (Illness Perceptions Questionnaire-Revised; Beliefs about Medicines Questionnaire), and diabetes self-care (Summary of Diabetes Self-Care Activities Scale) were completed at baseline and six months. Analyses used structural equation modelling. Baseline medication concerns were associated with elevated symptoms of depression and anxiety at follow-up, but emotions did not mediate medication concern's effect on diabetes self-care. Baseline depression and anxiety symptoms were associated with specific diabetes cognitions over time, but these cognition domains did not mediate emotion's effect on diabetes self-care. Personal control remained independent of emotions and was associated with diabetes self-care over time. Negative emotions did not act directly or alongside cognitions to influence diabetes self-care. The reciprocal relationship between diabetes cognitions and emotions suggests cognitive restructuring, in addition to other mood management intervention techniques would likely improve the emotional wellbeing of adults with type 2 diabetes. Likewise, personal control beliefs are likely important intervention targets for improving self-care.

Student Perceptions of and Confidence in Self-Care Course Concepts Using Team-based Learning.

PubMed

Frame, Tracy R; Gryka, Rebecca; Kiersma, Mary E; Todt, Abby L; Cailor, Stephanie M; Chen, Aleda M H

2016-04-25

Objective. To evaluate changes in student perceptions of and confidence in self-care concepts after completing a team-based learning (TBL) self-care course. Methods. Team-based learning was used at two universities in first professional year, semester-long self-care courses. Two instruments were created and administered before and after the semester. The instruments were designed to assess changes in student perceptions of self-care using the theory of planned behavior (TPB) domains and confidence in learning self-care concepts using Bandura's Social Cognitive Theory. Wilcoxon signed rank tests were used to evaluate pre/post changes, and Mann Whitney U tests were used to evaluate university differences. Results. Fifty-three Cedarville University and 58 Manchester University students completed both instruments (100% and 92% response rates, respectively). Student self-care perceptions with TPB decreased significantly on nine of 13 items for Cedarville and decreased for one of 13 items for Manchester. Student confidence in self-care concepts improved significantly on all questions for both universities. Conclusion. Data indicate TBL self-care courses were effective in improving student confidence about self-care concepts. Establishing students' skill sets prior to entering the profession is beneficial because pharmacists will use self-directed learning to expand their knowledge and adapt to problem-solving situations.

Student Perceptions of and Confidence in Self-Care Course Concepts Using Team-based Learning

PubMed Central

Gryka, Rebecca; Kiersma, Mary E.; Todt, Abby L.; Cailor, Stephanie M.; Chen, Aleda M. H.

2016-01-01

Objective. To evaluate changes in student perceptions of and confidence in self-care concepts after completing a team-based learning (TBL) self-care course. Methods. Team-based learning was used at two universities in first professional year, semester-long self-care courses. Two instruments were created and administered before and after the semester. The instruments were designed to assess changes in student perceptions of self-care using the theory of planned behavior (TPB) domains and confidence in learning self-care concepts using Bandura’s Social Cognitive Theory. Wilcoxon signed rank tests were used to evaluate pre/post changes, and Mann Whitney U tests were used to evaluate university differences. Results. Fifty-three Cedarville University and 58 Manchester University students completed both instruments (100% and 92% response rates, respectively). Student self-care perceptions with TPB decreased significantly on nine of 13 items for Cedarville and decreased for one of 13 items for Manchester. Student confidence in self-care concepts improved significantly on all questions for both universities. Conclusion. Data indicate TBL self-care courses were effective in improving student confidence about self-care concepts. Establishing students’ skill sets prior to entering the profession is beneficial because pharmacists will use self-directed learning to expand their knowledge and adapt to problem-solving situations. PMID:27170817

'I've put diabetes completely on the shelf till the mental stuff is in place'. How patients with doctor-assessed impaired self-care perceive disease, self-care, and support from general practitioners. A qualitative study.

PubMed

Kristensen, Mads Aage Toft; Guassora, Ann Dorrit; Arreskov, Anne Beiter; Waldorff, Frans Boch; Hølge-Hazelton, Bibi

2018-06-22

This paper investigated patients' experiences of disease and self-care as well as perceptions of the general practitioner's role in supporting patients with impaired self-care ability. Qualitative interviews with 13 patients with type 2 diabetes, concurrent chronic diseases, and impaired self-care ability assessed by a general practitioner. We analyzed our data using systematic text condensation. The shifting perspectives model of chronic illness formed the theoretical background for the study. Although most patients experienced challenges in adhering to recommended self-care activities, many had developed additional, personal self-care routines that increased wellbeing. Some patients were conscious of self-care trade-offs, including patients with concurrent mental disorders who were much more attentive to their mental disorder than their somatic diseases. Patients' perspectives on diseases could shift over time and were dominated by emotional considerations such as insisting on leading a normal life or struggling with limitations caused by disease. Most patients found support in the ongoing relationship with the same general practitioner, who was valued as a companion or appreciated as a trustworthy health informant. Patient experiences of self-care may collide with what general practitioners find appropriate in a medical regimen. Health professionals should be aware of patients' prominent and shifting considerations about the emotional aspects of disease. Patients valued the general practitioner's role in self-care support, primarily through the long-term doctor-patient relationship. Therefore, relational continuity should be prioritized in chronic care, especially for patients with impaired self-care ability who often have a highly complex disease burden and situational context. Key points   Little is known about the perspectives of disease and self-care in patients with a doctor-assessed impaired ability of self-care.   • Although patients knew the prescribed regimen they often prioritized self-care routines that increased well-being at the cost of medical recommendations.   • Shifting emotional aspects were prominent in patients' considerations of disease and sustained GPs' use of a patient-centred clinical method when discussing self-care.   • Relational continuity with general practitioners was a highly valued support and should be prioritized for patients with impaired self-care.

Engaging Terminally Ill Patients in End of Life Talk: How Experienced Palliative Medicine Doctors Navigate the Dilemma of Promoting Discussions about Dying

PubMed Central

Parry, Ruth; Land, Victoria; Faull, Christina; Feathers, Luke; Seymour, Jane

2016-01-01

Objective To examine how palliative medicine doctors engage patients in end-of-life (hereon, EoL) talk. To examine whether the practice of “eliciting and responding to cues”, which has been widely advocated in the EoL care literature, promotes EoL talk. Design Conversation analysis of video- and audio-recorded consultations. Participants Unselected terminally ill patients and their companions in consultation with experienced palliative medicine doctors. Setting Outpatient clinic, day therapy clinic, and inpatient unit of a single English hospice. Results Doctors most commonly promoted EoL talk through open elaboration solicitations; these created opportunities for patients to introduce–then later further articulate–EoL considerations in such a way that doctors did not overtly ask about EoL matters. Importantly, the wording of elaboration solicitations avoided assuming that patients had EoL concerns. If a patient responded to open elaboration solicitations without introducing EoL considerations, doctors sometimes pursued EoL talk by switching to a less participatory and more presumptive type of solicitation, which suggested the patient might have EoL concerns. These more overt solicitations were used only later in consultations, which indicates that doctors give precedence to patients volunteering EoL considerations, and offer them opportunities to take the lead in initiating EoL talk. There is evidence that doctors treat elaboration of patients’ talk as a resource for engaging them in EoL conversations. However, there are limitations associated with labelling that talk as “cues” as is common in EoL communication contexts. We examine these limitations and propose “possible EoL considerations” as a descriptively more accurate term. Conclusions Through communicating–via open elaboration solicitations–in ways that create opportunities for patients to volunteer EoL considerations, doctors navigate a core dilemma in promoting EoL talk: giving patients opportunities to choose whether to engage in conversations about EoL whilst being sensitive to their communication needs, preferences and state of readiness for such dialogue. PMID:27243630

Innovative tools help counselors discuss childhood obesity with parents.

PubMed

Herrera, Jennifer; Lockner, Donna; Kibbe, Debra; Marley, Scott C; Trowbridge, Frederick; Bailey, Angie

2013-04-01

Childhood overweight and obesity pose potential health risks for many children under the age of 5 years. Women, Infants, and Children (WIC) nutritionists are in a unique position to help reduce this problem because of their frequent counseling contacts with clients during certification visits. Therefore, four new tools to facilitate nutritional counseling of parents of overweight children during certifications were developed and systematically evaluated. The Nutrition and Activity Self-History (NASH) form, Report Card/Action Plan (ReCAP), Talking Tips, and Healthy Weight Poster were evaluated by WIC nutritionists via an online survey. Anchors on the Likert scale were 0 for Strongly Disagree to 6 for Strongly Agree. Four regional focus groups were also conducted. Data were analyzed descriptively. The response rate on the survey was 83% (n=63). Focus groups were comprised of staff that volunteered to participate (n=34). The NASH form, which replaces a food frequency questionnaire for identifying nutrition risk, had a mean rating of 5.20 as "Helpful when counseling about weight." The ReCAP, Talking Tips, and Healthy Weight Poster achieved mean ratings of 5.70, 4.75, and 5.30, respectively, in this category. Focus group responses were very positive about the usefulness of the ReCAP and Healthy Weight Poster to visually convey the concept of BMI percentile for age using a green, yellow, and red color-coded "traffic light" approach to showing healthy versus unhealthy BMI values. WIC programs and other pediatric health care settings may want to consider adopting these innovative tools to better serve their clients and address pediatric overweight in the populations they serve.

Beyond the realist turn: a socio-material analysis of heart failure self-care.

PubMed

McDougall, Allan; Kinsella, Elizabeth Anne; Goldszmidt, Mark; Harkness, Karen; Strachan, Patricia; Lingard, Lorelei

2018-01-01

For patients living with chronic illnesses, self-care has been linked with positive outcomes such as decreased hospitalisation, longer lifespan, and improved quality of life. However, despite calls for more and better self-care interventions, behaviour change trials have repeatedly fallen short on demonstrating effectiveness. The literature on heart failure (HF) stands as a case in point, and a growing body of HF studies advocate realist approaches to self-care research and policymaking. We label this trend the 'realist turn' in HF self-care. Realist evaluation and realist interventions emphasise that the relationship between self-care interventions and positive health outcomes is not fixed, but contingent on social context. This paper argues socio-materiality offers a productive framework to expand on the idea of social context in realist accounts of HF self-care. This study draws on 10 interviews as well as researcher reflections from a larger study exploring health care teams for patients with advanced HF. Leveraging insights from actor-network theory (ANT), this study provides two rich narratives about the contextual factors that influence HF self-care. These descriptions portray not self-care contexts but self-care assemblages, which we discuss in light of socio-materiality. © 2018 Foundation for the Sociology of Health & Illness.

Women's self-perception and self-care practice: implications for health care delivery.

PubMed

Mendias, E P; Clark, M C; Guevara, E B

2001-01-01

Mexican American women experience unique health care needs related to integration of Mexican and American cultures. To learn how to better promote self-care practices and service utilization in women of Mexican origin living in Texas, researchers used a qualitative approach to interview a convenience sample of 11 low-income women attending a health clinic. Researchers collected narrative data about the women's perceptions of health, wellness, and self-care. Using the matrix approach described by Miles and Huberman, we organized findings around women's roles, including participants' descriptions of themselves, their health and wellness awareness, self-care practices for health/illness and wellness/nonwellness, barriers to self-care, origin of self-care practices, and perceptions of life control. Implications for health planning and service delivery are presented.

Sexual Orientation Disclosure in Primary Care Settings by Gay, Bisexual, and Other Men Who Have Sex with Men in a Canadian City.

PubMed

Coleman, Todd A; Bauer, Greta R; Pugh, Daniel; Aykroyd, Gloria; Powell, Leanne; Newman, Rob

2017-02-01

Sexual orientation affects individuals' health histories and is fundamental to providers' understanding of patients as a whole. Gay, bisexual, and other men who have sex with men (GB-MSM) are vulnerable to certain health conditions, including HIV. The aim of this exploratory analysis was to examine factors associated with sexual orientation disclosure and communication with providers about GB-MSM health issues and to discuss implications. We conducted a cross-sectional internet survey of GB-MSM (n = 202) in London-Middlesex, Ontario, Canada; analyses were limited to those with a regular primary care provider (n = 173). Blockwise regression models explored demographic, psychosocial, and healthcare-related factors associated with sexual orientation disclosure and physician-patient communication about GB-MSM-related health. Just over seventy-one percent (71.1%) of participants reported that their primary care provider (PCP) knew their sexual orientation, and 44.5% had talked to them about GB-MSM health. Overt negative comments or being refused care based on sexual orientation occurred infrequently, although 26.6% reported their provider had assumed they were heterosexual. Being married to or living common-law with another man, more frequent experiences of homosexual prejudice, and higher quality assessment of provider's communication skills were associated with the PCP knowing respondents' sexual orientation. Greater internalized homonegativity was associated with not talking to a PCP about GB-MSM-related health issues. More frequent experiences of homosexual prejudice, higher assessment of provider communication, and having prior negative experiences with a PCP were significantly associated with talking to a PCP about GB-MSM health. The majority of our sample disclosed their sexual orientation; however, not all patients voluntarily disclose. Medical training and education in Canada, where specific rights protections exist for sexual orientation minority populations, should emphasize awareness of essential patient health information. Training should include information about GB-MSM health and building a foundation on how to speak with GB-MSM patients nonjudgmentally.

Subcritical Transition in Channel Flows

NASA Astrophysics Data System (ADS)

Maestri, Joseph; Hall, Philip

2014-11-01

Exact-coherent structures, or colloquially non-linear solutions to the Navier-Stokes equations, have been the subject of great interest over the past decade due to their relevance in understanding the process of transition to turbulence in shear flows. Over the past few years the relationship between high Reynolds number vortex-wave interaction theory and such states has been elucidated in a number of papers and has provided a solid asymptotic framework to understand the so-called self-sustaining process that maintains such structures. In this talk, we will discuss this relationship before talking about recent work on solving the vortex-wave interaction equations using numerical techniques in order to propose laminar-flow control techniques.