Health psychology : official journal of the Division of Health Psychology, American Psychological Association
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Prior research has shown that people mispredict their own behavior and preferences across affective states. When people are in an affectively "cold" state, they fail to fully appreciate how "hot" states will affect their own preferences and behavior. ⋯ The same biases apply interpersonally; for example, people who are not affectively aroused underappreciate the impact of hot states on other people's behavior. After reviewing research documenting such intrapersonal and interpersonal hot-cold empathy gaps, this article examines their consequences for medical, and specifically cancer-related, decision making, showing, for example, that hot-cold empathy gaps can lead healthy persons to expose themselves excessively to health risks and can cause health care providers to undertreat patients for pain.
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Seriously ill individuals, including those seriously ill with cancer, are frequently encouraged to complete instructional advance directives (i.e., living wills) to ensure that their wishes about the use of life-sustaining treatment are honored if they should lose the ability to make decisions for themselves. The authors present a social psychological analysis making explicit a series of steps that must necessarily take place if living wills are to honor the wishes of incapacitated patients. ⋯ In each case, this research raises serious questions about the psychological assumptions underlying the effective use of living wills in end-of-life decision making. Discussion focuses on the need for policy and law guiding the use of advance directives to be informed by both basic and applied research on judgment and decision making.
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The authors interviewed adult patients presenting to 4 Boston emergency departments (EDs) about their smoking, quit attempts, and interest in an outpatient referral. Of the 539 patients enrolled, 26% were current smokers. ⋯ The findings of this study reinforce the potential benefit of routine screening for smoking and interest in quitting in the ED. Because many underinsured Americans use the ED as a source of regular health care, the public health implications of increasing screening, counseling, and referral for smokers are substantial.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effectiveness of a primary care exercise referral intervention for changing physical self-perceptions over 9 months.
This study investigated the effectiveness of a 10-week primary care exercise referral intervention on the physical self-perceptions of 40-70 year olds. Participants (N=142) were assessed, randomized to an exercise or control group, and reassessed at 16 and 37 weeks. The Physical Self-Perception Profile (PSPP; K. ⋯ Fox, 1990), fitness, physical activity, body mass index, body fat (skinfolds), and hip and waist circumference were assessed. A multivariate analysis of variance revealed significant Group X Time interactions, with the exercise group showing greater physical self-worth, physical condition, and physical health at 16 and 37 weeks. Changes in all PSPP scales at baseline and 37 weeks were related to changes in anthropometric measures and adherence to the 10-week exercise program but not to changes in submaximal fitness parameters.
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Randomized Controlled Trial Clinical Trial
Evidence that implementation intentions reduce dietary fat intake: a randomized trial.
This study evaluates the effectiveness of an intervention based on the concept of implementation intentions for reducing dietary fat intake. Participants (n=264) completed questionnaires on their motivation to eat a low-fat diet before being randomized to either an experimental condition, which required them to form an implementation intention, or a control condition. ⋯ This difference could not be explained by differences in motivation between the 2 groups. The findings are discussed in relation to the use of implementation intentions instead of tailored interventions to change behavior in general populations.