Health psychology : official journal of the Division of Health Psychology, American Psychological Association
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Randomized Controlled Trial Clinical Trial
Reducing infant immunization distress through distraction.
Infant procedural distress is largely understudied, and there is a dearth of empirically supported interventions in the child health psychology literature. This study examined nurse-directed distraction for reducing infant immunization distress. ⋯ Results indicated that infants engaged in distraction and that distraction reduced their behavioral distress; however, ratings and heart rate were inconclusive. Analyses of procedural phases indicated that infants exhibited elevated distress immediately prior to and during an injection, but this distress was fleeting.
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To honor the wishes of an incapacitated patient, surrogate decision makers must predict the treatment decisions patients would make for themselves if able. Social psychological research, however, suggests that surrogates' own treatment preferences may influence their predictions of others' preferences. ⋯ Although the majority of prediction errors reflected inaccurate use of surrogates' own treatment preferences, projection was also found to result in accurate prediction more often than counterprojective predictions. The rationality and accuracy of projection in surrogate decision making is discussed.
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Randomized Controlled Trial Clinical Trial
Follow-up of coping skills training in adults with sickle cell disease: analysis of daily pain and coping practice diaries.
This study examined the 3-month follow-up effects of a pain coping skills intervention in African American adults with sickle cell disease. Sixty-seven participants were randomly assigned to either a coping skills condition or a disease-education control condition. Multivariate analyses applied to summary measures of coping, laboratory pain perception, and clinical measures indicated that participants in the coping intervention reported significantly lower laboratory pain and significantly higher coping attempts at 3-month follow-up in comparison with the control condition. Multilevel random effects models applied to prospective daily diaries of daily pain, health care contacts, and coping practice indicated that on pain days when participants practiced their strategies, they had less major health care contacts in comparison with days when they did not use strategies.
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This study examined whether the relative reinforcing value of physical activity (RRVPA) measured in the laboratory predicted physical activity measured in the natural environment in 32 6-11-year-old children. RRVPA correlated with physical activity level (r = .42, p < .05), and contributed to the prediction of physical activity level along with child obesity. RRVPA was related to the number of moderate to vigorous physical activity exercise bouts (r = .35, p < .05), not to the duration of those bouts. These results suggest that RRVPA is a determinant of child physical activity level, and that it may be naturally more reinforcing for children to engage in multiple, short exercise bouts than fewer, more extended bouts.
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The process of psychological adjustment to breast cancer was examined at diagnosis and at 3- and 6-month follow-ups in a sample of 80 women with Stage I-Stage IV breast cancer. At diagnosis, symptoms of anxiety/depression were predicted by low dispositional optimism, and this path was partially mediated by use of emotion-focused disengagement coping. Younger age also was predictive of anxiety/depression symptoms at time of diagnosis, and this relationship was fully mediated by magnitude of intrusive thoughts. ⋯ At 6 months, low dispositional optimism reemerged as a significant predictor of changes in anxiety/depression and again was partially mediated by the use of emotion-focused disengagement coping. Independent effects for problem-focused engagement and disengagement and emotion-focused engagement coping were also found at 6 months. Implications of these data for psychosocial interventions with breast cancer patients are highlighted.