Social science & medicine
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Social science & medicine · Aug 2006
Randomized Controlled TrialPredictors of improvement in social support: Five-year effects of a structured intervention for caregivers of spouses with Alzheimer's disease.
Those who provide care at home for a spouse with Alzheimer's disease (AD) endure considerable challenges, including social isolation and increasing caregiving responsibilities. We examine the extent to which an intervention that helps spouse-caregivers mobilize their social support network, helps them better adapt to the caregiving role. ⋯ Higher levels of emotional support, more visits, and having more network members to whom they felt close were all individually predictive of longitudinal changes in social support network satisfaction. We conclude with a discussion of the importance of having psychological respite when caregivers spend their days in the home and are isolated.
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Social science & medicine · Aug 2006
Predicting intended use of voluntary HIV counselling and testing services among Tanzanian teachers using the theory of planned behaviour.
The theory of planned behaviour (TPB) provides a conceptual model for understanding individual cognitions that influence behavioural intentions and enactment of the actual behaviours. This study examined the applicability of the TPB and the additional predictive role of perceived risk in predicting intended use of voluntary HIV counselling and testing (VCT) services. We conducted a cross-sectional questionnaire survey among 918 primary school teachers in the Mwanza region, Tanzania between September 2003 and November 2003. ⋯ Socio-economic status did not moderate the predictive value of the TPB components. The present study demonstrates that the TPB is a useful conceptual framework for predicting intended use of HIV counselling and testing services among Tanzanian teachers. A theory-based VCT intervention programme among Tanzanian teachers should mainly focus on reducing social and psychological barriers related to the use of VCT services.
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Social science & medicine · Aug 2006
Parent communication and child pain and distress during painful pediatric cancer treatments.
Children with cancer often consider treatment procedures to be more traumatic and painful than cancer itself. Previous research indicates that parents' behavior before and during painful medical procedures influences children's distress level. Understanding parents' naturally occurring communication patterns is essential to identifying families in need of an intervention to enhance coping and emotional well-being. ⋯ Six children (19.4%) experienced invalidation during at least one clinic visit phase. Analyses indicated that invalidated children experienced significantly more pain and distress than children whose parents used other communication patterns. This typology provides a theoretical approach to understanding previous research and offers a framework for the continuing investigation of the influence of parents' communication during potentially painful pediatric oncology procedures.
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Social science & medicine · Aug 2006
Determinants of physicians' patient-centred behaviour in the medical specialist encounter.
It has been suggested that patient-centred communication does not necessarily translate into a 'one-size fits all' approach, but rather that physicians should use a flexible style and adapt to the particular needs of their patients. This paper examines variability in physicians' patient-centred behaviour in medical specialist encounters, and determines whether patient, visit, and physician characteristics influence this variability. Participants were 30 residents and specialists in internal medicine at an academic teaching hospital in The Netherlands, and 323 patients having a (videotaped) outpatient follow-up appointment. ⋯ Apparently, sicker patients were targets of both greater facilitation and greater inhibition. Variability in physicians' facilitating and inhibiting behaviour was explained by patient characteristics, i.e. patients' age and health condition, and-with the exception of physician gender-not by physician or visit characteristics. This indicates that physician patient-centred behaviour is related to the type of patient visiting, especially in relation to the seriousness of symptoms.