BackgroundHealth-related quality of life is known to be impaired in individuals with coronary artery disease, especially in those after a recent acute coronary syndrome. Heart failure is a common burden in this population that significantly contributes to worsening HRQoL. To accurately measure the level of HRQoL in individuals with CAD after ACS, disease-specific scales, such as the Minnesota living with heart failure questionnaire, are recommended. Nevertheless, to date, there has not been a study that would comprehensively evaluate the psychometric (...) properties of the MLHFQ in a large sample of individuals with CAD after ACS. The debate regarding the internal structure of MLHFQ is also still present. Hence, this study aimed to translate the MLHFQ and evaluate its internal structure, reliability/precision, and validity in individuals with CAD following ACS in Lithuania.MethodsIn the cross-sectional study, 1,083 participants were evaluated for sociodemographic and clinical characteristics. HRQoL was measured using the MLHFQ and the Short Form-36 health survey. In addition, exercise capacity was also evaluated in the study patients, using a standardized computer-driven bicycle ergometer.ResultsThe internal consistency of the MLHFQ subscales was found to be good. Confirmatory factor analysis provided the support for the three-factor model of the MLHFQ and showed acceptable fit [comparative fit indices = 0.894; goodness-of-fit = 0.898; non-normal fit index = 0.879, and root mean square error of approximation = 0.073]. Regarding convergent evidence, significant associations were found between the MLHFQ domains and the SF-36 domains and EC.ConclusionThe current study completed cultural validation and provided further information on the psychometric characteristics of the MLHFQ in Lithuania, suggesting MLHFQ as a valid and reliable instrument to measure HRQoL. The Lithuanian version of MLHFQ is best described by a three-factor solution, measuring physical, social, and emotional dimensions of HRQoL among individuals with CAD following ACS. (shrink)

Objectives: To evaluate the effects of an 8-week DNS training program on pain, EMG activity, and quality of life in individuals with CLBP. Design: Semi-experimental study. Participants: Thirty male participants with non-specific CLBP, divided into DNS (n=15) and control (n=15) groups. Main Outcome Measures: Pain levels (Quebec Back Pain Disability Scale), lumbar muscle EMG activity (MegaWin EMG device), and quality of life (SF-36 questionnaire). Results: The DNS group showed significant pain reduction (P=0.00), increased EMG activity in rectus abdominis (P=0.000), (...) erector spinae (P=0.002), and gluteus maximus (P=0.002), and improved quality of life (P=0.02). Conclusions: DNS exercises significantly reduce pain, enhance muscle activity, and improve quality of life in CLBP patients. (shrink)

Due to advances in medicine, a malignant neoplasm is a chronic disease that can be treated for a lot of patients for many years. It may lead to profound changes in everyday life and may induce fear of life. The ability to adjust to a new situation may depend on temperamental traits and stress coping strategies. The research presented in this paper explores the relationships between quality of life, PTSD symptoms, temperamental traits, and stress coping in a sample of patients (...) diagnosed with cancer. One hundred and twenty nine participants aged 24–81 years, 69 females diagnosed with breast cancer and 60 males diagnosed with lung cancer completed Formal Characteristics of Behavior – Temperament Inventory, Coping Inventory for Stressful Situations, PTSD Inventory, and Quality of life SF-36 questionnaire. Higher level of emotional reactivity and higher level of perseveration was associated with lower emotional quality of life. Higher level of emotion oriented-coping and higher level of avoidant-distracted coping was associated with higher level of PTSD symptoms. Emotion-oriented coping and avoidant-distracted coping are ineffective in dealing with stress in the case of patients diagnosed with cancer, because they are associated with a higher level of PTSD symptoms. The significance of temperamental traits for quality of life in the situation of the patients is marginal. Control of specific factors concerned with current health and treatment status is needed the future research. (shrink)

Medical, scientific and societal progress has been such that, in a universalist humanist perspective such as the WHO’s, it has become an ethical imperative for the primary endpoints in evidence based health care research to be expressed in e.g. Quality Adjusted Life Years (QALYs). The classical endpoints of discrete health‐related functions and duration of survival are increasingly perceived as unacceptably reductionistic. The major problem in ‘felicitometrics’ is the measurement of the ‘quality’ term in QALYs. That the mental, physical and social (...) domains, each containing many dimensions and items, all contribute to QOL is uncontroversial. What is controversial, is the weight of the different dimensions in overall QOL. It has been shown to be very different between different patient populations. In human individuals, assuredly complex systems, the many dimensions and items of QOL observably interact, probably sometimes also in chaotic ways. In these conditions, the weights of isolated items in individuals become for all practical purposes meaningless. Therefore, the much used multi‐item questionnaires at best describe, but do not evaluate QOL, neither in individuals, nor in populations. For example, allergic patients treated with cetirizine scored better than those a placebo on all dimensions of the SF‐36, a standard QOL questionnaire. Here there is no serious doubt that the treatment improved QOL, because it is highly unlikely that any important dimension on which the patient groups would have scored otherwise is missing in the SF‐36. However, whether piracetam treatment of acute stroke, which improved the surrogate endpoints neurological and functional scores, also improved QOL is plausible, but will be proven only when comprehensive QOL measurement will have been done. And suppose in randomised populations of end‐stage metastatic solid cancer patients, one would compare palliative last‐line chemotherapy with only palliative care, and one would, as can be expected, find no significant differences in average survival, and chemotherapy superior for the mental domain, but inferior for the physical comfort domain: we would not know which treatment, on aggregate, would be the better. The problem is that QOL is an individual and emergent construct, the resultant of a great many intractions, and of a different order than its contributing components. Overall QOL can therefore best be captured only as the Gestalt of a global self‐assessment. Just as people in everyday life, while acting under uncertainty, make global assessments all the time, so they can seriously answer the serious question: ‘How have you been?’ A solemn, practical, non peer‐relativistic, non‐cultural, experiential, and well tolerated way to obtain such responses is Anamnestic Comparative Self Assessment (ACSA), in which the subjects' memories of the best and the worst times in their life experience define their individual scale of QOL. ACSA is thus both exquisitely idiosyncratic, and yet can in a universalist humanistic perspective be considered generic. Using both a multi‐item questionnaire and a global assessment allows by one logistic regression, to estimate the weights of the dimensions and items in populations, and thus identify those whose improvement would most contribute to the QOL of the greatest number. A combined approach to measurement of QOL is necessary to maximise the utility of QOL interventions. (shrink)

ObjectivesAs the largest cohort of healthcare workers and nurses can practice as psychotherapists to integrate the psychotherapeutic interventions as part of routine care. The present study aims to evaluate the effectiveness of supportive psychotherapy on patients who had been scheduled to undergo a fiberoptic bronchoscopy procedure.MethodsThis study retrospectively analyzed 92 patients who underwent FOB, which was divided into the SPT group and usual-care group based on whether patients were given SPT interventions or not. The Patient Health Questionnaire-9 and Hospital (...) Anxiety and Depression Scale were used to determine the severity of depression and anxiety, as well as the 36-Item Short-Form Health Survey questionnaire to evaluate the health-related quality of life. Moreover, the patients' satisfaction was assessed based on the Likert 5-Point Scale.ResultsThe baseline status of anxiety, depression, and HRQoL in patients was similar in the SPT group and the usual-care group with no significant difference. Both PHQ-9 score and HADS-D score in the SPT group after intervention were lower than that in the usual-care group, accompanied by the deceased HADS-A subscale. Moreover, the improved HRQoL was found in the patients undergoing FOB after SPT interventions as compared to those receiving conventional nursing care using the SF-36 score. Additionally, the patient satisfaction in the SPT group was higher than in the usual-care group.ConclusionsThe study demonstrated that anxiety and depression, as negative emotions, can be reduced by supportive psychotherapy in patients receiving FOB with improved mental health and satisfaction with nursing care. (shrink)

Following Bernheim,1 we examine aspects of 'felicitometrics,'2 the measurement of the 'quality' term in Quality of Life (QOL). Bernheim argued that overall QOL is best captured as the Gestalt3 of a global self-assessment and suggested that the Anamnestic Comparative Self Assessment (ACSA) approach, in which subjects' memories of the best and worst times of their lives are used to anchor a Visual Analog Scale (VAS), provided a serious answer to the serious question, 'How have you been?' Bernheim compares and contrasts (...) the ACSA to multi-item questionnaire QOL instruments, such as the SF-36, concluding that the ACSA has a number of advantages. His discussion assumes that the use of QOL outcomes in clinical trials is both relevant and appropriate. In the present paper, we document the reasonableness of this latter assumption,4 contribute to the characterization of the similarities and differences between multi-item and individualized QOL instruments, and point to some other individualized instruments that may be used in clinical trial contexts. These 'other individualized instruments' differ from the ACSA in fundamental ways; but they are individualized in that the subject defines those areas in his/her life that are most important, and these may vary from subject-to-subject. (shrink)

The present study examined the psychometric properties of the Chinese version of the Trait Emotional Intelligence Questionnaire Short Form (TEIQue-SF). Analyses were performed using a sample of undergraduates (N = 585) recruited from four universities across China. Confirmatory factor analysis of the Chinese TEIQue-SF supported the one-factor structure of trait emotional intelligence. Measurement invariance analyses were conducted across the Chinese sample and a sample of Canadian undergraduate students (N = 638). Although the two samples demonstrated configural and partial metric (...) invariance, scalar invariance was not found. Cross-cultural implications and explanations of the present findings, as well as suggestions for future research are discussed. (shrink)

This paper presents a validation study of a new questionnaire of self-control as an individual trait. The questionnaire has two parallel versions, one based on self-reports and another one based on informant reports. Each version consists of three subscales, called Inhibition, Switching, and Goal Monitoring. Eight samples of participants took part in the validation study. Both versions obtained satisfactory indices of internal consistency, assessed with Cronbach’s alpha and split-half coefficients. Selfcontrol assessed with this scale proved to be entirely (...) independent of general intelligence. However, AS-36 and AS-36-3 scores tended to correlate with other self-report measures of trait self control, such as Tangney, Baumeister, and Boone’s self-control scale. We conclude that AS-36 is a valid and reliable tool, suitable for assessment of self-control in both research and diagnostic settings. (shrink)

The study was aimed at validating the Polish version of the Trait Emotional Intelligence Questionnaire-Short Form. Our findings confirm the reliability and validity of the scale. With respect to reliability, internal consistency coefficients of the TEIQue-SF were comparable to those obtained using the original English version. The evidence of the validity of the TEIQue-SF came from the pattern of relations with the other self-report measure of EI, personality measures, as well as affective and social correlates. We demonstrated that the (...) TEIQue-SF score correlated positively with scores on the Emotional Intelligence Questionnaire. The TEIQue- SF score correlated negatively with Neuroticism and positively with Extraversion, Openness, Agreeableness, and Conscientiousness. In addition, scores on the TEIQue-SF were related to dispositional affect, i.e., correlated positively with positive affectivity and negatively with negative affectivity. The TEIQue-SF score correlated positively with social competencies as measured with the Social Competencies Questionnaire. We also found that trait EI, as measured with the TEIQue-SF, was positively related to the richness of one’s supportive social network and this relationship remained statistically significant even after controlling for Big Five variance. We also demonstrated that scoring on the TEIQue-SF was positively related to satisfaction with life and negatively related to perceived stress and these relationships remained significant, even after controlling for positive and negative affectivity. Taken together, these findings suggest that the Polish version of the TEIQue-SF is a reliable and valid measure that inherits the network of associations both from the original version of the TEIQue-SF and the full form of the Polish TEIQue. (shrink)

Advance care planning is a voluntary process whereby individual preferences, values and beliefs are used to aid a person in planning for end-of-life care. Currently, there is no local instrument to assess an individual’s awareness and attitude towards advance care planning. This study aimed to develop an Advance Care Planning Questionnaire and to determine its validity and reliability among older people in Malaysia. The Advance Care Planning Questionnaire was developed based on literature review. Face and content validity was (...) verified by an expert panel, and piloted among 15 participants. Our study was conducted from October 2013 to February 2014, at an urban primary care clinic in Malaysia. Included were those aged >50 years, who could understand English. A retest was conducted 2 weeks after the first administration. Participants from the pilot study did not encounter any problems in answering the Advance Care Planning Questionnaire. Hence, no further modifications were made. Flesch reading ease was 71. The final version of the Advance Care Planning Questionnaire consists of 66 items: 30 items were measured on a nominal scale, whilst 36 items were measured on a Likert-like scale; of which we were only able to validate 22 items, as the remaining 14 items were descriptive in nature. A total of 245 eligible participants were approached; of which 230 agreed to participate. Factor analysis on the 22 items measured on a Likert-scale revealed four domains: “feelings regarding advance care planning”, “justifications for advance care planning”, “justifications for not having advance care planning: fate and religion”, and “justifications for not having advance care planning: avoid thinking about death”. The Cronbach’s alpha values for items each domain ranged from 0.637–0.915. In test-retest, kappa values ranged from 0.738–0.947. The final Advance Care Planning Questionnaire consisted of 63 items and 4 domains. It was found to be a valid and reliable instrument to assess the awareness and attitude of older people in Malaysia towards advance care planning. (shrink)

BackgroundWhereas the majority of bereaved persons recover from their grief without professional assistance, a minority develops pathological grief reactions. Etiological models postulate that dysfunctional cognitions may perpetuate such reactions. The Grief Cognitions Questionnaire assesses thoughts after bereavement in nine interrelated domains. A short form with four domains is often used. However, an evaluation of the psychometric properties of the GCQ-SF and its utility compared to the GCQ is lacking and these instruments have not been validated in German.MethodGerman bereaved persons (...) responded to an online survey containing the GCQ, measures of grief severity, grief rumination, symptoms of depression and anxiety, and optimism and pessimism. 585 participants were included. Item analyses and confirmatory factor analyses were conducted. Correlations between the GCQ and GCQ-SF and grief rumination, optimism and pessimism assessed construct validity. Criterion-related validity was assessed by comparing whether the correlation of the GCQ with grief severity was higher than with anxious and depressive symptoms. Logistic regression and receiver-operator characteristics compared the questionnaires on their ability to predict probable prolonged grief ‘caseness’.ResultsInternal consistencies for both questionnaires were identical and excellent. Confirmatory factor analyses obtained a satisfactory fit for models with nine and four correlated subscales and respective higher-order factor models. The GCQ and the GCQ-SF correlated higher with grief severity than with other measures of psychopathology. The logistic regression showed a significant association between the GCQ-SF and prolonged grief ‘caseness’. Of the remaining subscales of the GCQ, only one subscale contributed to the prediction. The ROC analyses showed nearly identical areas under the curve.ConclusionThe translated GCQ and GCQ-SF demonstrated very good psychometric properties. The correlations with grief severity highlight the questionnaires’ clinical relevance. The questionnaires possessed identical diagnostic specificity and sensitivity. Whenever a timesaving assessment of the most typical grief-specific cognitions is important, the GCQ-SF represents an alternative to the GCQ. The original GCQ may still be superior when a more detailed description of a bereaved person’s cognitions is desirable. (shrink)

Background Licensed nurses working in long-term care facilities experience ethical challenges if not resolved can lead to moral distress. There is a lack of an English-language validated tool to adequately measure moral distress in the long-term care setting. Aims To describe the modification and psychometric evaluation of the Moral Distress Questionnaire. Methods Instrument development and psychometric evaluation. Internal consistency using Cronbach’s α to establish reliability was conducted using SPSS version 27.0 while SPSS Amos version 27.0 was used to perform (...) a confirmatory factor analysis of the Moral Distress Questionnaire Participants A national sample of US-licensed nurses who provided direct resident care in long-term care settings were recruited via a targeted sampling method using Facebook from 7 December 2020 to 7 March 2021. Ethical Consideration The study was approved by the university’s human research protection program. Informed consent was provided to all participants. Results A total of 215 participants completed the surveys. Confirmatory analysis indicated that the 21-item scale with a 4-factor structure for the Moral Distress Questionnaire model met the established criteria and demonstrates an acceptable model fit (CMIN/DF = 2.0, CFI = 0.82, TLI = 0.77, RMSEA = 0.07). Factor loadings for each item depict a moderate to a strong relationship (range 0.36–0.70) with the given underlying construct. Cronbach’s α coefficient was 0.87 for the overall scale and 0.60–0.74 for its subscales which demonstrate good reliabilities. Discussion This is the first English-language validated tool to adequately measure moral distress in the long-term care setting experienced by US long-term care nurses. This reliable and well-validated tool will help identify moral distress situations experienced by US long-term care nurses. Conclusion The modified 21-item English version of the Moral Distress Questionnaire is reliable tool that demonstrates good psychometric properties to validly measure sources of moral distress among direct resident care nurses. (shrink)

The Multifactor Leadership Questionnaire is the most frequently used leadership measure in scholarship and organizational practice. However, so far it has not been validated in the Polish context. Therefore, the present study aimed to validate and shorten the MLQ in the Polish organizational setting. A total sample of 1,065 employees from different organizations took part in two sessions of an online study. Respondents were between 18 and 70 years old with an average job tenure of 17.00 years. In subsample (...) 1, using exploratory factor analysis, a three-factor structure of the MLQ full form was established, comprising transformational-supportive, inspirational goal-oriented, and passive-avoidant leadership. Based on qualitative and quantitative criteria, we constructed an 18-item MLQ short form. Both forms were supported by the confirmatory factor analysis in subsample 2. The MLQ-FF and MLQ-SF factors displayed acceptable to high levels of item-related parameters, as well as scale-related reliability. Both forms indicated high convergent and predictive validity examined by correlations with authentic leadership and employee's work outcomes. Our study provided the full and the short form of the MLQ as reliable and valid instruments, potentially suitable to measure leadership styles in academic research and organizational practice. (shrink)

Breaking bad news (BBN) to parents whose newborn has a major disease is an ethical dilemma. In Saudi Arabia, BBN about newborns is performed according to the parental preferences that have been reported from non-Arabic/non-Islamic countries. Saudi mothers' preferences about BBN have not yet been studied. Therefore, we aimed to elicit the preferences of Saudi mothers about BBN concerning newborns. We selected a convenience sample of 402 Saudi mothers, aged 18-50 years, who had no previous experience with BBN. We selected (...) them via a simple number-randomization scheme from the premises of a level III Saudi hospital between October of 2009 and January of 2011. We used a hypothetical situation (BBN about trisomy 21) to elicit their preferences about BBN concerning newborns via a structured verbal questionnaire composed of 12 multiple-choice questions. We expressed their preferences as percentages (95% confidence interval), and we used the Kendall's W test (W) to assess the degree of agreement in preferences. The Saudi mothers preferred that BBN be conducted with both parents together (64% [60-69]), albeit with weak levels of agreement (W = 0.29). They showed moderate agreement in their preferences that BBN should be conducted early (79% [75-83], W = 0.48), in detail (81% [77-85], W = 0.52), in person (88% [85-91], W = 0.58), and in a quiet setting (86% [83-90], W = 0.53). With extremely weak agreement, they preferred to have a known person present for support during BBN (56% [51-61], W = 0.01), to have close bodily contact with their babies (66% [61-70], W = 0.10), and to have no another patients present (64% [59-68], W = 0.08). They showed moderate levels of agreement in their desires to detail, in advance, their preferences about process of BBN by giving a reversible, written informed consent that could be utilized for guidance, if needed (80% [76-84], W = 0.36). In our experience, Saudi mothers' preferences about BBN concerning newborns are varied, suggesting that a "one-size-fits-all" approach is inappropriate. A reversible, written informed consent detailing their preferences about BBN that would be kept in their medical records and utilized for guidance, if needed, may be the best solution, given this level of diversity. These findings merit further study. (shrink)

BackgroundDrawing from Erikson’s theory, Domino and Affonso constructed the Inventory of Psychosocial Balance, a scale with satisfactory reliability and validity. However, the lack of a credible Chinese version of the scale may hinder research on ego development in Taiwan. The aim of the present study was to construct a short form Chinese IPB. In addition, factor analysis was employed to shorten the original 120-item scale to make it suitable for application in the older adults in the future.MethodsThe study involved three (...) steps: The first step was to establish the 120-items of the Chinese Inventory of Psychosocial Balance, and we conducted translation, back-translation, expert validity, and reliability of pilot study for this step. Following the first step was to construct the short-form C-IPB in the second step, and the CIPB-SF was developed via item analysis and factor analysis. Finally, we assessed the reliability and validity of the CIPB-SF via structural equation model in the third step.ResultsThree hundred eight older adults without cognitive disorder completed the IPB. The 40-item CIPB-SF was completed through item analysis and factor analysis. The internal consistency test of CIPB-SF and the eight stages were good. The CIPB-SF had acceptable validity, except in the intimacy and identity stages, in which validity was only fair. Compared with the IPB, the CIPB-SF had good reliability and acceptable validity. However, because of its conciseness, the 40-item CIPB-SF was more suited for application among the Chinese elderly population because its application avoids physical overload.ConclusionThe CIPB-SF served as a concise scale for assessing ego development in our study. This scale can also serve as a useful tool for convenient screening in the future. (shrink)

The concept of quality of life is the basis for a new paradigm of clinical medicine. Its assessment is considered to be an important instrument in determining disease severity and effectiveness of different treatment modalities. Our studies are devoted to the problem of diabetes complications especially anemia in patients with diabetic kidney disease. Anemia in subjects with diabetic nephropathy may result from various pathogenic factors including erythropoietin deficiency, iron deficiency, vitamin B12 and/or folate deficiencies, the effects of proinflammatory cytokines etc. (...) Diabetic patients with anemia are at increased risk of cardiovascular accidents and death. The aim of this study was to assess the influence of anemia on the quality of life of patients with early stages of diabetic nephropathy. We investigated 127 patients with type 2 diabetes mellitus and early diabetic nephropathy. Anemia was defined according to the World Health Organization criteria. Anemic patients were divided into three groups according to the stage of chronic kidney disease. Patients’ quality of life was assessed with SF-36 health survey. Anemic patients had lower scores of physical role functioning and emotional role functioning as compared to the patients with normal hemoglobin level, irrespective of the stage of chronic kidney disease. Patients with anemia and chronic kidney disease stage 3 had lower scores of general health perceptions, physical functioning, bodily pain, vitality and mental health than patients in the non-anemic group. Social role functioning was similar in anemic and non-anemic patients. The possible mechanisms and implications of the above mentioned findings are discussed with a medical and humanitarian perspective. The directions of further studies are proposed. (shrink)

O presente estudo teve como objetivo verificar a relação entre o estado nutricional e a autopercepção de saúde de professores que atuam em escolas da rede pública em um município da região norte do PR/Brasil. O estudo foi de natureza aplicada, analítica e transversal.O estado nutricional foi avaliado pelo índice de massa corporal e a obesidade abdominal pela circunferência da cintura. O Medical Outcomes Short-Form Health Survey-SF-36 determinou a autopercepção de saúde e o Beck Depression Inventory -BDI,a saúde mental. Participaram (...) do estudo 100 professores, desses 60% estavam acima do peso e 66% apresentaram obesidade abdominal. O domínio de SF – 36 que apresentou menor escore foi vitalidade (65,55) e estado geral de saúde (70,02), os domínios com maiores escores foram capacidade funcional (83,00) e aspectos sociais (78,50). Pode-se constatar que os educadores necessitam de estratégias e programas voltados para a promoção da saúde no local de trabalho. (shrink)

Objective: We aimed to analyze the characteristics and psychological mechanism of depressive symptoms in elderly patients with alcohol dependence under the COVID-19 epidemic and to observe the effect of acupuncture combined with emotional therapy of Chinese medicine treatment on depressive symptoms in elderly patients with alcohol dependence.Methods: Sixty patients were randomly divided into two groups. One group was treated by a set of emotional therapy of Chinese medicine treatment for 12 weeks. One group was treated by a set of acupuncture (...) combined with emotional therapy of Chinese medicine treatment for 12 weeks. We compared the curative effect between the control group and the treatment group, the mean alcohol consumption, the SF-36 scores before and after treatment, and the scores of Hamilton Depression Scale before and after treatment of 3, 6, and 9 weeks.Results: Based on the cognitive behavior model, the characteristics and psychological mechanism of depression in elderly patients with alcohol dependence under the COVID-19 epidemic situation were summarized. The total effective rate of the control group was 60%, and that of the treatment group was 100%. After 12 weeks of treatment, there were significant differences in PF, RF, physical pain, general health status, energy, and mental health between the treatment group and the control group. Before and after treatment, there were significant differences in PF, RF, physical pain, general health, energy, emotional function, and mental health of the treatment group. The PF, energy, and mental health of the control group were significantly different before and after treatment. There was no significant difference between the treatment group and the control group in the scores of Hamilton Depression Scale before treatment. There was significant difference between the treatment group and the control group in the scores of Hamilton Depression Scale at 3, 6, and 9 weeks after treatment.Conclusion: Attention, cognition, emotion, behavior, and physical response reinforce each other, creating a vicious cycle that reinforces and sustains the depressive symptoms of elderly alcohol dependence under the COVID-19 epidemic, and acupuncture combined with emotional therapy of Chinese medicine treatment for improving the depressive symptoms of elderly alcohol dependence during the epidemic period of COVID-19 has a brilliant therapeutic effect. (shrink)

Rare neuromuscular diseases are a group of pathologies characterized by a progressive loss of muscular strength, atrophy, fatigue, and other muscle-related symptoms, which affect quality of life levels. The low prevalence, high geographical dispersion and disability of these individuals involve difficulties in accessing health and social care services. Teleassistance is presented as a useful tool to perform psychosocial interventions in these situations. The main aim of this research is to assess the effects of a teleassistance psychosocial program on the QoL (...) levels of people with RNMDs who have different levels of disability. A sample of 73 participants was divided into an experimental group, which participated in the intervention, and a control wait list group. QoL was evaluated through the SIP and the SF-36, and disability through the WHO-DAS II. The participants with a moderate to severe level of disability were those who most benefited from the intervention. The results also revealed that the psychosocial teleassistance program was suitable to improve physical and psychosocial aspects of people suffering from a rare neuromuscular disease with a moderate level of disability, but just psychosocial aspects in those with a severe level of disability. (shrink)

Under other circumstances, I would have written an academic paper rehearsing the arguments for and against legalization of physician-assisted suicide: autonomy and the avoidance of pain and suffering on the pro side, the wrongness of killing, the integrity of the medical profession, and the risk of abuse, the “slippery slope,” on the con side. I’ve always supported the pro side. What this paper is, however, is a highly personal account of the challenges to my thinking about right-to-die issues. In November (...) 2008, my husband suffered a C2/C3 spinal cord injury in a bicycle collision, leaving him ventilator-dependent, almost completely paralyzed, and in the hospital—but fully alert and profoundly self-reflective. What if he wanted to die? This paper draws from two multimedia presentations—file:///Users/margaretbattin/Documents/BROOKE’S%20ACCIDENT/The%20Salt%20Lake%20Tribune %20%7C%20Multimedia:%20Metamorphosis.webarchive and file:///Users/margaretbattin/Documents/BROOKE’S%20ACCIDENT/The%20Salt%20Lake%20Tribune%20%7C%20Multi media:%20Learning%20to%20live%20again.webarchive—and personal material concerning quality of life (he’d rank at the bottom on the SF-36 and similar scales) and concerning autonomy (his own accounts, verbatim). This is a detailed portrait of a man whose life involves extraordinary suffering but also luminous experience some of the time. It only makes the question harder: What if he wanted to die? (shrink)

Background The Regional Committee for Africa of the World Health Organization (WHO) in 2001 expressed concern that some health-related studies undertaken in the Region were not subjected to any form of ethics review. In 2003, the study reported in this paper was conducted to determine which Member country did not have a national research ethics committee (REC) with a view to guiding the WHO Regional Office in developing practical strategies for supporting those countries. Methods This is a descriptive study. The (...) questionnaire was prepared and sent by diplomatic pouch to all the 46 Member States in the WHO African Region, through the WHO country representatives, for facilitation and follow up. The data were entered in Excel spreadsheet and subsequently exported to STATA for analysis. A Chi-Squared test (χ 2) for independence was undertaken to test the relationship between presence/absence of Research Ethics Committee (REC) and selected individual socioeconomic and health variables. Results The main findings were as follows: the response rate was 61% (28/46); 64% (18/28) confirmed the existence of RECs; 36% (10/28) of the respondent countries did not have a REC (although 80% of them reported that they had in place an ad hoc ethical review mechanism); 85% (22/26) of the countries that responded to this question indicated that ethical approval of research proposals was, in principle, required; and although 59% of the countries that had a REC expected it to meet every month, only 44% of them reported that the REC actually met on a monthly basis. In the Chi-Squared test, only the average population in the group of countries with a REC was statistically different (at 5% level of significance) from that of the group of countries without a REC. Conclusion In the current era of globalized biomedical research, good ethics stewardship demands that every country, irrespective of its level of economic development, should have in place a functional research ethics review system in order to protect the dignity, integrity and safety of its citizens who participate in research. (shrink)

Objective: The aim of this research was to study the mediation of body dissatisfaction, physical self-concept, and body mass index (BMI) on the relationship between physical activity and self-concept in adolescents. Materials and Methods: A sample of 652 Spanish students between 12 and 17 years participated in a cross-sectional study. Physical self-concept and general self-concept were assessed with the Physical Self-Concept Questionnaire (CAF), body dissatisfaction with the Body Shape Questionnaire (BSQ), and physical activity was estimated with the International (...) Physical Activity Questionnaire (IPAQ-SF). BMI was utilized as a measurement of body composition. Structural equation modeling was used to assess the results. Results: The resulting models showed good fit indexes. Physical activity had a positive and indirect effect on self-concept (β = 0.29, p < 0.01) and direct effects on dissatisfaction (β = -0.26, p < 0.01) and physical self-concept (β = 0.20, p < 0.01). BMI had a direct effect on dissatisfaction (β = 0.31, p < 0.01) and on physical self-concept (β = -0.10, p < 0.01) and an indirect effect on general self-concept (β = -0.24, p < 0.01). However, it was only associated with physical activity in males, playing a mediating role between physical activity and body dissatisfaction. Conclusion: Physical activity can help individuals to achieve a positive self-concept and promote psychological well-being in adolescents through the improvement of physical perceptions and body satisfaction. The importance of BMI, body dissatisfaction, and physical self-concept on the configuration of the self-concept are also emphasized. Educational policymakers and Physical Education teachers should implement strategies to promote physical activity in the schools and provide a Quality Physical Education programs to increase physical activity during adolescence. (shrink)

Brief submaximal actions are important for wide range of functional movements. Until now, rate of force development and relaxation scaling factor have been used for neuromuscular assessment using 100–120 isometric pulses which requires a high level of attention from the participant and may be influenced by physiological and/or psychological fatigue. All previous studies have been conducted on a smaller number of participants which calls into question the eligibility of some of the outcome measures reported to date. Our aims were: to (...) find the smallest number of rapid isometric force pulses at different force amplitudes is still valid and reliable for RFD-SF slope and RFR-SF slope calculation, to introduce a new outcome measure – theoretical peak of rate of force development/relaxation and to investigate differences and associations between kRFD–SF and kRFR–SF. A cross-sectional study was conducted on a group of young healthy participants; 40 in the reliability study and 336 in the comparison/association study. We investigated the smallest number of rapid isometric pulses for knee extensors that still provides excellent reliability of the calculated kRFD–SF and kRFR–SF. Our results showed excellent reliability of the reduced protocol when 36 pulses were used for the calculations of kRFD–SF and kRFR–SF. We confirmed the negligibility of the y-intercepts and confirmed the reliability of the newly introduced TPRFD and TPRFR. Large negative associations were found between kRFD–SF and kRFR–SF, while comparison of the absolute values showed a significantly higher kRFD–SF compared to kRFR–SF. The advantage of the reduced protocol is the shorter assessment time and the reduction of possible influence of fatigue. In addition, the introduction of TPRFD and TPRFR as an outcome measure provides valuable information about the participant’s maximal theoretical RFD/RFR capacity. This can be useful for the assessment of maximal capacity in people with various impairments or pain problems. (shrink)

Background: Nurses’ ethical competence has been identified as a significant factor governing high quality of care. However, nurses lack support in dealing with ethical problems, and therefore managerial support for nurses’ ethical competence is needed. Research questions: This study aimed to analyse, from the perspective of nurse and nurse leaders, the level of nurses’ and nurse leaders’ ethical competence, perceptions of support for nurses’ ethical competence at the organisational and individual levels and background factors associated with this support. Research design: (...) A descriptive, cross-sectional study design was employed. The Ethical Competence and Ethical Competence Support questionnaires were used to measure the main components. Descriptive statistics and multifactor analysis of variance were used for data analysis. Participants: The participants were 298 nurses and 193 nurse leaders working in specialised (48%/52%), primary (43%/36%) or private healthcare (5%/7%) in Finland. Ethical considerations: Ethical approval was obtained from the university ethics committee. Results: Nurses estimated their own ethical competence to be at an average level, whereas nurse leaders estimated their own competence at a high level. Nurses’ and nurse leaders’ perceptions of provided support for nurses’ ethical competence was not at a high level. The positive agreement percentage related to organisational support was 44% among nurses and 51% among nurse leaders. The positive agreement percentage related to individual support was lower, that is, 38% among nurses and 61% among nurse leaders. University education had a positive association with some items of individual support. Conclusion: Despite the findings that ethical competence was estimated at a high level among nurse leaders, perceptions of support for nurses’ ethical competence were not at a satisfactory level. At the organisational level, nurse leaders need to inform of ethical procedures and practices in orientation; encourage multidisciplinary ethics discussions and collaboration; and support nurses at an individual level to participate in ethics education, multidisciplinary ethics discussions and in solving ethical problems. (shrink)

Background There is a dearth of information on the prevalence of scientific misconduct from Nigeria. Objectives This study aimed at determining the prevalence of scientific misconduct in a group of researchers in Nigeria. Factors associated with the prevalence were ascertained. Method A descriptive study of researchers who attended a scientific conference in 2010 was conducted using the adapted Scientific Misconduct Questionnaire-Revised (SMQ-R). Results Ninety-one researchers (68.9%) admitted having committed at least one of the eight listed forms of scientific misconduct. (...) Disagreement about authorship was the most common form of misconduct committed (36.4%) while plagiarism was the least (9.2%). About 42% of researchers had committed falsification of data or plagiarism. Analysis of specific acts of misconduct showed that committing plagiarism was inversely associated with years in research (Fisher exact p-value = 0.02); falsifying data was related to perceived low effectiveness of the institution's rules and procedures for reducing scientific misconduct (X2 = 6.44, p-value = 0.01); and succumbing to pressure from study sponsor to engage in unethical practice was related to sex of researcher (Fisher exact p-value = 0.02). Conclusions The emergent data from this study is a cause for serious concern and calls for prompt intervention. The best response to reducing scientific misconduct will proceed from measures that contain both elements of prevention and enforcement. Training on research ethics has to be integrated into the curriculum of undergraduate and postgraduate students while provision should be made for in-service training of researchers. Penalties against acts of scientific misconduct should be enforced at institutional and national levels. (shrink)

ObjectiveTo investigate the influence of quality of life on unhealthy emotions as well as relevant factors among patients with endometriosis for supporting relevant clinical care.MethodsA convenience sampling method was used to administer questionnaires to 139 patients with endometriosis, using the Hamilton Anxiety Inventory, the Depression Anxiety Scale, and the SF-12 Health Survey Short Form, and the results were analyzed. The SPSS20.0 software was used for statistical analysis on relevant data. If P < 0.05, there was statistical significance.ResultsTwelve-Item Short Form for (...) health survey covered two comprehensive indexes, i.e., physical component summary and mental component summary scores. MCS score was the main factor influencing anxiety and depression in patients with endometriosis; the higher the MCS score, the lower the anxiety and depression degrees in patients with endometriosis. PCS score was a factor influencing anxiety degree; the higher the PCS score, the lower the anxiety degree.ConclusionThe QOL of patients with endometriosis is negatively correlated with anxiety and depression. Therefore, improvement in QOL may help relevant patients to relieve their unhealthy emotions. (shrink)

Objective—To demonstrate Japanese doctors' and nurses' attitudes towards and practices of voluntary euthanasia (VE) and to compare their attitudes and practices in this regard. Design—Postal survey, conducted between October and December 1999, using a self-administered questionnaire. Participants—All doctor members and nurse members of the Japanese Association of Palliative Medicine. Main outcome measure—Doctors' and nurses' attitude towards and practices of VE. Results—We received 366 completed questionnaires from 642 doctors surveyed (response rate, 58%) and 145 from 217 nurses surveyed (68%). A (...) total of 54% (95% confidence interval (CI): 49-59) of the responding doctors and 53% (CI: 45-61) of the responding nurses had been asked by patients to hasten death, of whom 5% (CI: 2-8) of the former and none of the latter had taken active steps to bring about death. Although 88% (CI: 83-92) of the doctors and 85% (CI: 77-93) of the nurses answered that a patient's request to hasten death can sometimes be rational, only 33% (CI: 28-38) and 23% (CI: 16-30) respectively regarded VE as ethically right and 22% (CI: 18-36) and 15% (CI: 8-20) respectively would practise VE if it were legal. Logistic regression model analysis showed that the respondents' profession was not a statistically independent factor predicting his or her response to any question regarding attitudes towards VE. Conclusions—A minority of responding doctors and nurses thought VE was ethically or legally acceptable. There seems no significant difference in attitudes towards VE between the doctors and nurses. However, only doctors had practised VE. (shrink)

Books Reviewed in this Article: Transforming Bible Study. By Walter Wink. Pp.175, London, SCM Press, 1981, £3.50. Isaiah 1–39. By R.E. Clements. Pp.xvi. 301, London, Marshall, Morgan and Scott, 1980, £3.95. Isaiah 40–66. By R.N. Whybray. Pp.301, London, Marshall, Morgan and Scott, 1975, Reprinted 1981, £3.95. Die Gestalt Jesu in den synoptischen Evangelien. By Heinrich Kahlefeld. Pp.264, Frankfurt, Verlag Josef Knecht, 1981, no price given. Following Jesus: Discipleship in the Gospel of Mark. By Ernest Best. Pp.283, Sheffield, JSOT Press, 1981, (...) £15.00, £5.95. The Origin of Paul's Gospel. By Seyoon Kim. Pp.xii, 391, Tübingen, J.C.B. Mohr, 1981, 78 DM. An die Römer. By Ernst Käsemann. Pp.xvi, 411, Tübingen, J.C.B. Mohr, 1980, 48 DM. Les Récits de Resurrection des Morts dans le Nouveau Testament. By Gerard Rochais. Pp.xv, 252, Cambridge, Cambridge University Press, 1981, £15.00. Prêtres Anciens, Prétre Nouveau selon le Nouveau Testament. By Albert Vanhoye. Pp.366, Paris Editions du Seuil, 1980, no price given. Woman in the World of Jesus. By Evelyn and Frank Stagg. Pp.292, Edinburgh, The St Andrew Press, 1981, no price given. Jesus, Man and the Church. By Karl Rahner. Pp.260, London, Darton Longman & Todd, 1981, £14.50. Jesus Lord and Savior: A Theopathic Christology and Soteriology. By William M. Thompson. Pp.ix, 287, Leominster, Fowler Wright, 1981, £7.45. God and World in Schleiermacher's ‘Dialektik’ and ‘Glaubenslehre’. Criticism and the Methodology of Dogmatics. By John E. Thiel. Pp.xiv, 239, Bern, Frankfurt and Las Vegas, Peter Lang, 1981, SF 49.50. Ministry: A Case for Change. By Edward Schillebeeckx. Pp.ix, 165, London, SCM Press, 1981, £4.95. The Sacraments: Readings in Contemporary Sacramental Theology. Edited by Michael J. Taylor. Pp.274, New York, Alba House, 1981, $7.95. Believing in the Church: The Corporate Nature of Faith. A Report by the Doctrine Commission of the Church of England. Pp.ix, 310, London, SPCK, 1981, £8.50. Confessing the Faith in the Church of England Today. By R.T. Beckwith. Pp.36, Oxford, La timer House, 1981, £1.00. A Kind of Noah's Ark? The Anglican Commitment to Comprehensiveness. By J.I. Packer. Pp.39, Oxford, Latimer House, 1981, £1.00. Reasonable Belief: A Survey of the Christian Faith. By Anthony Hanson and Richard Hanson. Pp.xii, 283, Oxford University Press, 1981, £8.50. Doctrine in the Church of England. The 1938 Report with a new introduction by G.W.H. Lampe. Pp.lx, 242, London, SPCK, 1982, £8.50. The Divine Right of the Papacy in Recent Ecumenical Theology. By J. Michael Miller. Pp.xvi, 322, Rome, Università Gregoriana Editrice, 1980, 18,000 Lire. Der heilige Geist in der Theologie von Heribert Mühlen: Versucheiner Darstellung und Würdigung. By John B. Banawiratma. Pp.ix, 310, Frankfurt and Bern: Peter D. Lang, 1981, SFr. 60.00. Standing Before God: Studies on Prayer in Scriptures and Tradition with Essays in Honor of John M. Oesterreicher. Edited by Asher Frinkel and Lawrence Frizzell. Pp.410, New York, Ktav Publishing House, 1981, $29.50. Judaism and Healing. By J. David Bleich. Pp.xiii, 199, New York, Ktav, 1981, $15.00. The Diversity of Moral Thinking. By Neil Cooper. Pp.x, 303, Oxford, Clarendon Press: Oxford University Press, 1981, £15.00. L'Homme: Sujet ou Objet? By Jacques Croteau. Pp.260, Montreal, Bellarmin: Tournai, Desclée et Cie, 1981, $15.00. The Texture of Knowledge: An Essay on Religion and Science. By James W. Jones. Pp.97, Washington, University Press of America, 1981, no price given. Cosmos and Creator. By Stanley L. Jaki. Pp.xii, 168, Edinburgh, Scottish Academic Press, 1980, £6.75. Dante, Philomythes and Philosopher: Man in the Cosmos. By Patrick Boyde. Pp.vii, 408, Cambridge, Cambridge University Press, 1981, £30.00. Dissidence et Philosophie au Mayen Âge. By E.L. Fortin. Pp.201, Montreal, Bellarmin, 1981, $12.00. The Philosophy of John Norris of Bemerton. By Richard Acworth. Pp.x, 388, Hildesheim, Georg Olms, 1979, 74 DM. Philosophy and Ideology in Hume's Political Thought. By David Miller. Pp.xii, 218, Oxford, Clarendon Press, 1981, £15.00. Hegelianism. By John Edward Toews. Pp.x, 450, Cambridge, Cambridge University Press, 1980, £25.00. One Hundred Years of Thomism. Edited by V.B. Brezik. Pp.210, Houston, Centre for Thomistic Studies, 1981, no price given. Gramsci's Political Thought: Hegemony, Consciousness and the Revolutionary Process. By J.V. Femia. Pp.xiii, 303, Oxford, Clarendon Press, 1981, £17.50. Greek and Roman Slavery. By Thomas Wiedemann. Pp.xvi, 284, London, Croom Helm, 1981, £10.95, £5.95. Prophecy and Millenarianism. Essays in Honour of Marjorie Reeves. Edited by Ann Williams. Pp.x, 355, London, Longman, 1980, £25.00. Of Prelates and Princes: A Study of the Economic and Social Position of the Tudor Episcopate. By Felicity Heal. Pp.xv, 353, Cambridge, Cambridge University Press, 1980, £17.50. Radical Religious Movements in Early Modern Europe. By Michael Mullett. Pp.xxiv, 193, London, George Allen & Unwin, 1980, £10.50. The Jesuits. By J.C.H. Aveling. Pp.390, London, Blond and Briggs, 1981, £16.95. The Beginnings of Ideology. By Donald R. Kelley. Pp.xv, 351, Cambridge, Cambridge University Press, 1981, £24.00. Utopia and the Ideal Society: A Study of English Utopian Writing 1516–1700. By J.C. Davis. Pp.x, 427, Cambridge, Cambridge University Press, 1981, £25.00. Eastern Politics of the Vatican 1917–1979. By Hansjakob Stehle. Pp.466, Athens, Ohio University Press, 1981, £16.20, £8.10. Structuralism or Criticism? By Geoffrey Strickland. Pp.viii, 209, Cambridge, Cambridge University Press, 1981, £17.50. The Call of God: The Theme of Vocation in the Poetry of Donne and Herbert. By Robert B. Shaw. Pp.xiii, 123, Cambridge, Mass., Cowley Publications, 1981, $5.00. John and Charles Wesley: Selected Prayers, Hymns, Journal Notes, Sermons, Letters and Treatises. Edited by Frank Whaling. Pp.xx, 412, London, SPCK, 1981, £8.95. The Trickster in West Africa: A Study of Mythic Irony and Sacred Delight. By Robert D. Pelton. Pp.312, Berkeley, University of California Press, 1980, £15.00. (shrink)

The objective of this study—a substudy to a phase I bioequivalence study—was to compare the effect of standard and concise consent forms on research volunteers’ comprehension of and satisfaction with consent forms, as well as to assess the effect of select volunteer characteristics, such as financial motivations to participate in research, on their comprehension. A 36-item questionnaire measured volunteers’ comprehension, satisfaction, and motivations for participation. Volunteers were randomized to the standard Pfizer consent form or a concise, easier-to-read form. We (...) approached 139 volunteers to participate, and 138 completed the questionnaire . The cohorts did not differ in sociodemographic characteristics. We found that the average comprehension scores for the standard consent form cohort and the concise consent cohort were about the same, and that satisfaction with the consent form was high in both cohorts. Surprisingly, volunteers with a financial motivation had significantly greater comprehension of the study. (shrink)

Emotional creativity refers to a set of cognitive abilities and personality traits related to the originality of emotional experience and expression. Previous studies have found that emotional creativity can positively predict posttraumatic growth and mental health. The outbreak of coronavirus disease 2019 (COVID-19) has posed great challenges to people’s daily lives and their mental health status. Therefore, this study aims to address the following two questions: whether emotional creativity can improve posttraumatic growth and mental health during the COVID-19 pandemic and (...) how it works. To do this, a multiple mediation model has been proposed, which supposes that emotional creativity is associated with posttraumatic growth and mental health through perceived social support and regulatory emotional self-efficacy. The study involved 423 participants from multiple regions with different COVID-19 involvement levels. Participants were asked to complete a questionnaire with six parts, which included Emotional Creativity Inventory (ECI), Regulatory Emotional Self-Efficacy Scale (RES), Stress-Related Growth Scale-Short Form (SRGS-SF), Multidimensional Scale of Perceived Social Support scale (MSPSS), Brief Symptom Inventory-18 scale (BSI-18), and COVID-19-related life events questionnaire. Path analysis used to examine the mediation model indicated that under the control of COVID-19-related life events and age, perceived social support mediated a positive association between emotional creativity and posttraumatic growth as well as a negative association between emotional creativity and all mental health problems, including somatization, depression, and anxiety. Regulatory emotional self-efficacy mediates the association between emotional creativity and posttraumatic growth, emotional creativity and anxiety, and emotional creativity and depression. The results suggest that emotional creativity plays an important role in coping with stressful events related to COVID-19. Furthermore, these results might provide a better understanding of the possible paths through which emotional creativity is related to psychological outcomes, such as mental health and posttraumatic growth. (shrink)

A recent surge of research has begun to examine music participation and well-being; however, a particular challenge with this work concerns theorizing around the associated well-being benefits of musical participation. Thus, the current research used Self-Determination Theory to consider the potential associations between basic psychological needs (competence, relatedness, and autonomy), self-determined autonomous motivation, and the perceived benefits to well-being controlling for demographic variables and the musical activity parameters. A sample of 192 Australian residents (17-85, Mage = 36.95), who were currently (...) participating in a musical activity at the time, completed an online questionnaire. Results indicated that females were more likely to perceive benefits to their well-being; and that how important an individual considers music in their life was positively related to perceived well-being. Importantly, the analyses also revealed that the basic needs of competency and relatedness were related to overall perceived well-being as well as specifically social, cognitive, and esteem dimensions of well-being. Autonomous motivation demonstrated significant associations with both an overall well-being score as well as four of five specific well-being subscales measured. Collectively, the findings indicate that Self-Determination Theory offers a useful theoretical framework to understanding the relationship between musical participation and well-being. Further, the pattern of findings reiterates the positive associations between musical participation and one’s psychosocial well-being, with broad implications for people involved in the facilitation of musical activity. (shrink)

Objective:The purpose of this study was to describe the current situation of moral distress and to explore its influencing factors among Chinese nurses.Methods:This is an exploratory, descriptive design study. A total of 465 clinical nurses from different departments in three Grade-III, Level-A hospitals in Jinan, Shandong Province, completed the questionnaires, including demographics questionnaire, Chinese version of Moral Distress Scale–Revised, and Job Diagnostic Survey.Ethical considerations:The study was approved by the university ethics board and the local health service director.Results:The total score (...) of Moral Distress Scale–Revised was 36.01 ± 24.02 points. The mean frequency and intensity scores of moral distress were 1.13 ± 0.49 and 1.09 ± 0.58, respectively. The level of moral distress among Chinese clinical nurses was low, and the frequency and intensity of moral distress were on low to moderate level. The level of moral distress experienced by clinical nurses is associated with demographics features and job characteristics, including age, education degree, department, task significance, autonomy, and dealing with others.Conclusion:Our conclusion suggests that hospital and organizational administrations should attach much importance to the moral distress experienced by clinical nurses in China. Further studies should focus on interventions about how to reduce the levels of the frequency and intensity of moral distress among clinical nurses. (shrink)

Background: Fear of cancer recurrence or progression is a common challenge experienced by people living with and beyond cancer and is frequently endorsed as the highest unmet psychosocial need amongst survivors. This has prompted many cancer organizations to develop self-help resources for survivors to better manage these fears through psychoeducation, but little is known about whether they help reduce FCR/P.Method: We recruited 62 women with ovarian cancer. Women reported on their medical history and demographic characteristics and completed the Fear of (...) Progression Questionnaire-Short Form. They then read a booklet on FCR specifically created for Ovarian Cancer Australia by two of the authors. One week after reading the booklet, 50/62 women completed the FoP-Q-SF and answered questions about their satisfaction with the booklet.Results: More than half of the women scored in the clinical range for FCR/P at baseline. Of the completers, 93% said that they would recommend the booklet to other women. Satisfaction with the booklet was relatively high and more than two-thirds of women rated it as moderately helpful or better. However, FCR/P did not change significantly over the week following reading the booklet [t = 1.71, p = 0.09]. There was also no difference in change in FCR/P between women in the clinical vs. non-clinical range on the FoP-Q. Women high in FCR/P rated the booklet as less helpful in managing FCR/P, but overall satisfaction with the booklet was not associated with degree of FCR/P.Conclusions: These results suggest that a simple online FCR booklet is acceptable to women with ovarian cancer and they are satisfied with the booklet, but, it was insufficient to change in FCR/P levels. These results suggest that such resources are valued by women with ovarian cancer, but more potent interventions are necessary to reduce FCR in this population. (shrink)

Background Many studies have investigated the adherence to professional codes of ethics by nurses. However, no study has explicitly examined the relationship between workload and adherence to professional codes of ethics among Iranian nurses. Objective This study aimed to explore the relationships between workload and adherence to professional codes of ethics among a sample of Iranian nurses. Materials and Methods A cross-sectional descriptive study was conducted on 213 nurses who were randomly selected from the different wards of Shahid Beheshti Hospital (...) of Kashan, Iran. Data collection instruments included a personal characteristics questionnaire, the Nursing Ethics Questionnaire, and the National Aeronautics and Space Administration Task Load Index. The Chi-square, the Spearman correlation coefficient, the Kruskal–Wallis, and Mann–Whitney U tests were used to analyze the data. Results A majority of nurses were females, married, and permanently employed. The mean of the overall perceived workload and adherence to professional codes of ethics were 76.36 ± 13.64 and 13.98 ± 2.58, that were at high and moderated level, respectively. Spearman correlation test showed no significant correlation between perceived workload and adherence to professional codes of ethics. A significant difference was found between the mean scores of adherence to professional codes of ethics in nurses working in different departments. Conclusion Participating nurses perceived high levels of workload but their mean adherence to professional codes of ethics was at a moderate level. The perceived workload was indirectly correlated with adherence to professional codes of ethics. (shrink)

Introduction. Eating Disorders (EDs) are serious psychiatric disorders, impacting physical and psychosocial functioning, often with a chronic course and high mortality rates. The two continua model of mental health states that mental health is a complete state, that is not merely the absence of mental illness, but also the presence of mental health. This model was studied among ED patients by comparing the levels of well-being to the Dutch general population and by examining the of well-being and psychopathology. Method. A (...) total of 468 female ED patients participated in this study during application and intake at a specialized ED treatment centre in the Netherlands. They filled out questionnaires about well-being (MHC-SF), general psychopathology (OQ-45), and ED psychopathology (EDE-Q). Categorical and mean well-being levels were calculated. Also, the correlates of these variables were examined with Pearson correlation and multiple hierarchical regression analysis. Results. ED patients showed lower levels of emotional, psychological and social well-being on average compared to the general population. About 26% of the ED patients experienced low levels of well-being (languishing). However, also 13% experienced high levels of well-being (flourishing), varying between 9% in Anorexia Nervosa to 25% in Binge Eating Disorder. ED psychopathology and general well-being showed a moderate negative correlation. For patients with Bulimia Nervosa and Binge Eating Disorder however no such correlation was found. Lower general psychopathology, not having a history of hospitalization for the ED, and adaptive personal functioning were correlated with well-being among ED patients. Conclusion This study shows initial support for the two continua model of mental health among ED patients. Psychopathology and well-being should be considered as related, but distinct dimensions of mental health in ED patients. Further research should focus on the possible reciprocal relationships between psychopathology and well-being during recovery. It is recommended to monitor well-being during treatment and to implement interventions for well-being to realize complete recovery for those patients with inadequate levels of well-being. (shrink)

Objectives To investigate empirically the motivations for not consenting to DNA biobanking in a Swedish population-based study and to discuss the implications. Design Structured questionnaires and semistructured interviews. Setting A longitudinal epidemiological project (PART) ongoing since 1998 in Stockholm, Sweden. The DNA-collection wave took place during 2006–7. Participants 903 individuals completed the questionnaire (participation rate 36%) and 23 were interviewed. All individuals had participated in both non-genetic waves of the project, but refused to contribute saliva samples during the DNA-collection (...) wave. Main outcome measures Motivations behind refusing to consent to DNA biobanking, with subsequent focus on participants' explanations regarding this unwillingness. Results Public refusal to consent to DNA biobanking, as revealed by the questionnaire, was mainly explained by a lack of personal relevance of DNA contribution and feelings of discomfort related to the DNA being used for purposes other than the respective study. Interviews of individuals representing the second motivation, revealed a significant mistrust of DNA biobank studies. The underlying beliefs and attitudes were associated with concerns about integrity, privacy, suspiciousness and insecurity. However, most interviewees were supportive of genetic research per se and interpreted their mistrust in the light of distressing environmental influences. Conclusion The results suggest a need for guidelines on benefit sharing, as well as trustworthy and stable measures to maintain privacy, as a means for increasing personal relevance and trust among potential participants in genetic research. Measures taken from biobanks seem insufficient in maintaining and increasing trust, suggesting that broader societal measures should be taken. (shrink)

This research examines the current status of clinical ethics consultation (CEC) in Japan through a nationwide study conducted with chairs of ethics committees and clinical ethics committees among 1028 post-graduate clinical teaching hospitals. We also qualitatively analyzed their viewpoints of the CEC’s benefits and problems related to hospital consultation services to identify the critical points for CEC and inform the development of a correctly functioning system. The questionnaire included structured questions about hospital CEC organization and service purpose and operation (...) and open-ended questions about the benefits and problems of initiating CEC. The questionnaire comprised the presence/absence of an ethics committee, CEC services and membership when services were implemented, users, and the number of cases handled since inception. In addition, the respondents also provided their impressions of the CEC system’s impact on their hospital by describing (a) the benefits of CEC services and (b) the ineffectual or harmful aspects of the CEC system. Qualitative data were examined using qualitative content analysis to determine the impact of establishing a CEC and the difficulties of practice. One hundred twenty-five questionnaires were returned from either the chair of the ethics committee or clinical ethics committee in teaching hospitals. Of these, 90 (72%) reported they provided CEC services. Additionally, 36 respondents (34.6%) reported that their existing research and clinical ethics committees had conducted CEC services, and 35 (33.7%) reported having a newly established clinical ethics committee conducting CEC services. Three positive effects of establishing and four challenges in managing CEC were also identified. (shrink)

Background: Aggression is an important risk factor for delinquency and crime in adolescents. Previous studies have indicated that childhood maltreatment plays an important role in the development of aggression. However, whether the effect could be mediated by other factors is still unknown. Evidence suggests that callous-unemotional (CU) traits and self-control may be candidate mediators in the relationship between childhood maltreatment and aggression.Methods: A total of 585 male juvenile delinquents from China were recruited for the present study. We measured self-reported childhood (...) maltreatment, CU traits, self-control, and aggression with the short form of the Childhood Trauma Questionnaire (CTQ-SF), the Inventory of Callous-Unemotional Traits (ICU), the Self-Control Scale (SCS), and the Aggression Questionnaire (AQ), respectively. Furthermore, we constructed multiple mediation models to investigate the mediating effects of CU traits and self-control on the relationship between childhood maltreatment and aggression. Childhood maltreatment and aggression were entered into the model as the independent and dependent variables, respectively, and CU traits and self-control were treated as the mediating variables. In addition, the moderating role of self-control in the relationship between childhood maltreatment and aggression was tested by constructing a moderation model.Results: Correlation analysis showed significant positive correlations among childhood maltreatment, CU... (shrink)

Objectives To explore attitudes and reasoning among Swedish physicians and the general public regarding the withdrawal of life-sustaining treatment at a competent patient's request. Design A vignette-based postal questionnaire including 1202 randomly selected individuals in the county of Stockholm and 1200 randomly selected Swedish physicians with various specialities. The vignettes described patients requesting withdrawal of their life-sustaining treatment: (1) a 77-year-old woman on dialysis; (2) a 36-year-old man on dialysis; (3) a 34-year-old ventilator-dependent tetraplegic man. Responders were asked to (...) classify the act of terminating treatment and to prioritise arguments for/against. Results A majority in both groups prioritised arguments in favour of terminating treatment and classified the act as defensible in all vignettes. However, among the general public, 16% classified the act as euthanasia in all vignettes; among physicians this view was most expressed regarding ventilator treatment (26%). Some who classified the act as euthanasia prioritised arguments in favour of terminating treatment: among physicians 18% in vignette 1, 19% in vignette 2 and 34% in vignette 3; among the general public 35% in vignette 1, 20% in vignette 2 and 48% in vignette 3. Conclusion There is a widespread consensus regarding competent patients' right to abstain from life-sustaining treatment. An association between the hastening of death, caused by the withdrawal of life-sustaining treatment and the concept of euthanasia is proposed. The results also suggest that classifying the withdrawal of life-sustaining treatment as ‘euthanasia’ does not necessarily mean that the act is interpreted as ethically unacceptable. (shrink)