Yes / Illness representations shape responses to illness experienced by the self or by others. The illness representations held by family members of those with long-term conditions such as dementia influence their understanding of what is happening to the person and how they respond and provide support. The aim of this study is to explore components of illness representations (label, cause, control and timeline) in caregivers of people with dementia. This was an exploratory study; the data reported came from the Memory Impairment and Dementia Awareness Study (MIDAS). Data from semi-structured interviews with 50 caregivers of people with dementia were analysed using content analysis. The majority of caregivers gave accounts that appeared to endorse a medical/diagnostic label, although many used different terms interchangeably. Caregivers differentiated between direct causes and contributory factors, but the predominant explanation was that dementia had a biological cause. Other perceived causes were hereditary factors, ageing, lifestyle, life events and environmental factors. A limited number of caregivers were able to identify things that people with dementia could do to help manage the condition, while others thought nothing could be done. There were varying views about the efficacy of medication. In terms of timeline, there was considerable uncertainty about how dementia would progress over time. The extent of uncertainty about the cause, timeline and controllability of dementia indicated that caregivers need information on these areas. Tailored information and support taking account of caregivers' existing representations may be most beneficial.

Yes / Informal caregivers of people with dementia develop their own beliefs about the condition, referred to as Dementia Representations (DRs), as they try to make sense of the changes they are observing. The first aim of this study was to provide a profile of the types of DRs held by caregivers. The second aim was to examine the impact of caregivers’ DRs on their well-being, satisfaction with life (SwL) and caregiving stress. Methods: Participants were 1264 informal caregivers of people in the mild-to-moderate stages of dementia from time-point 1 of the IDEAL cohort study. Measures: DRs were measured using questionnaire items covering: Identity, Cause, Control, and Timeline. Results: Almost half (49.2%) of caregivers used a diagnostic term to describe the person’s condition, although 93.4% of caregivers stated they were aware of the diagnosis. Higher well-being, SwL, and lower caregiving stress were associated with the use of an identity term relating to specific symptoms of dementia, attributing the cause to ageing or not knowing the cause, and believing the condition would stay the same. Lower well-being, SwL, and higher caregiving stress were associated with believing there was little that could be done to control the effects of the condition. Conclusion: Healthcare professionals should assess and gain an understanding of caregivers’ DRs in order to provide more tailored information and support. / Economic and Social Research Council (UK) and the National Institute for Health Research (UK) grant ES/L001853/2

Adipositas gilt seit einigen Jahren als eine der häufigsten chronischen Erkrankungen des Kindes- und Jugendalters. Welche Faktoren zu einer erfolgreichen Behandlung der Adipositas im Kindes- und Jugendalter führen, sind jedoch noch immer nicht ausreichend geklärt. Ein wichtiger – bisher jedoch weitgehend unbeachteter – Faktor, welcher möglicherweise wegweisend für den Therapieverlauf sein kann, ist das subjektive Krankheitskonzept der betroffenen Kinder. Das bedeutsamste theoretische Modell, welches den Einfluss der individuellen Krankheitsvorstellungen auf den Regulationsprozess eines Menschen im Umgang mit Erkrankungen beschreibt, ist das Common Sense Model of Illness Representation (CSM) von Howard Leventhal. Ziel der vorliegenden Arbeit war es die subjektiven Krankheitskonzepte adipöser Kinder zu erfassen und ihren Einfluss auf den Regulationsprozess zu analysieren. In einer ersten Untersuchung wurde mittels Daten von 168 adipösen Kindern im Alter von 8 bis 12 Jahren zunächst ein Fragebogen zur Erfassung der subjektiven Krankheitskonzepte entwickelt. Die Ergebnisse weisen darauf hin, dass der Fragebogen als reliabel und valide eingeschätzt werden kann. Mit Hilfe dieses Fragebogens konnte nachgewiesen werden, dass adipöse Kinder Konstrukte über ihre Erkrankung haben, welche in eigenständigen Dimensionen gespeichert werden. Die gefundenen initialen Krankheitskonzepte adipöser Kinder ergeben ein homogenes erwartungskonformes Bild. In einer zweiten Untersuchung wurden anschließend die subjektiven Krankheitskonzepte adipöser Kinder, die Bewältigungsstrategien sowie gesundheits- und krankheitsrelevante Kriteriumsvariablen untersucht. Die Befragungen erfolgten vor Beginn einer stationären Reha (T1), am Ende der Reha (T2) sowie sechs Monate nach Reha-Ende (T3). Von 107 Kindern liegen Daten zu allen drei Messzeitpunkten vor. Es konnte ein Zusammenhang zwischen Krankheitskonzepten, Bewältigungsstrategien und spezifischen Kriteriumsvariablen bei adipösen Kindern nachgewiesen werden. Die Analyse der Wirkzusammenhänge konnte zeigen, dass die kindlichen Krankheitskonzepte – neben den indirekten Einflüssen über die Bewältigungsstrategien – die Kriteriumsvariablen vor allem auch direkt beeinflussen können. Der Einfluss der initialen Krankheitskonzepte adipöser Kinder konnte hierbei sowohl im querschnittlichen als auch im längsschnittlichen Design bestätigt werden. Zudem konnten vielfältige Einflüsse der Veränderung der subjektiven Krankheitskonzepte während der Therapie gefunden werden. Die Veränderungen der Krankheitskonzepte wirken sowohl mittelfristig auf die individuellen Bewältigungsstrategien am Ende der Reha als auch längerfristig auf die adipositasspezifischen Kriteriumsvariablen Gewicht, Ernährung, Bewegung und Lebensqualität. Die Befunde stärken die Relevanz und das Potential der zielgerichteten Modifikation adaptiver bzw. maladaptiver Krankheitskonzepte innerhalb der stationären Therapie der kindlichen Adipositas. Zudem konnte bestätigt werden, dass subjektive Krankheitskonzepte und ihre Veränderung innerhalb der Therapie einen relevanten Beitrag zur Vorhersage des kindlichen Therapieerfolgs über einen längerfristigen Zeitraum leisten können. / Obesity has been considered one of the most common chronic illnesses in children and adolescents for some years. The factors that contribute to a successful treatment of obesity in children and adolescents have however yet to be adequately identified. One important – but so far largely neglected – factor which could be crucial to the therapeutic process is the subjective concept of illness in the children affected. The most significant theoretical model to describe the influence of the individual notions of illness on a person’s regulatory process in dealing with illnesses is the Common Sense Model of Illness Representation (CSM) developed by Howard Leventhal. The aim of this thesis was to record the subjective concepts of illness in obese children and to analyse their influence on the regulatory process. In a first study, a survey was developed to collect data on the subjective concepts of illness in 168 obese children between the ages of 8 and 12 years. The results indicate that the survey can be considered reliable and valid. With the aid of this survey, it could be proven that obese children have constructs of their illness that are stored in independent dimensions. The initial concepts of illness found in obese children give a homogeneous picture that conforms to expectations. A second study analysed the subjective concepts of illness in obese children, as well as coping strategies and health and illness-relevant criterion variables. Surveys were carried out before the start of in-patient rehab (T1), at the end of rehab (T2) and six months after the end of rehab (T3). The data of 107 children is available from all three instances of measurement. It was possible to prove a connection between concepts of illness, coping strategies and specific criterion variables in obese children. An analysis of cause-and-effect relationships was able to demonstrate that – as well as indirectly influencing the coping strategies – the children’s concepts of illness had above all a direct influence on the criterion variables. The influence of the initial concepts of illness in obese children could thus be confirmed both in a cross-sectional and in a longitudinal design. In addition, multiple influences were found of changes to the subjective concepts of illness in the course of therapy. Changes to concepts of illness have both a medium-term effect on individual coping strategies at the end of rehab and a longer-term effect on the obesity-specific criterion variables weight, diet, movement and quality of life. The findings reinforce the relevance and potential of the goal-orientated modification of adaptive or maladaptive concepts of illness within the in-patient treatment of childhood obesity. In addition, it was confirmed that subjective concepts of illness and the changes they undergo during therapy can provide a relevant contribution to predicting the success of a child’s therapy over a longer period of time.

Polycystic ovary syndrome (PCOS) is a chronic illness that affects approximately five million premenopausal women in the United States and is associated with significant cosmetic, reproductive, metabolic, and psychological consequences. Despite its prevalence, few studies have explored the lived experiences and illness perceptions of women living with PCOS. Identifying illness perceptions of women living with (WLW) PCOS is important, because mounting research suggests that a person's perceptions of their chronic illness and its management determine that person's coping behaviors (e.g., adherence, self-management) and, consequently, illness outcomes. In this dissertation, the Common Sense Model (CSM) is used as a framework to identify the illness perceptions of PCOS held by WLW the syndrome. As such, this dissertation is the first to test the ecological validity of the CSM in a population of women diagnosed with PCOS. In addition, the relationship between illness perceptions and (1) infertility, a common symptom of the syndrome, and (2) health-related quality of life (HRQoL) is explored. Lastly, this study makes a novel contribution to the literature by describing one of the first samples of WLW PCOS recruited through a social networking site. This includes a discussion of the participant's demographic information, fertility experiences, and HRQoL. This is a two-phase mixed methods study. Phase one consisted of an online quantitative survey capturing data on 376 participants' demographic information and medical history. Data were also collected on each participant's HRQoL using the SF-36, a generic, well-validated measure of the phenomenon. Of the 376 survey participants, 34 were interviewed via phone or video chat in the fall 2013 and spring 2014 semesters. Quantitative data were downloaded from Qualtrics® and analyzed using SAS statistical software version 9.3. In this analysis, descriptive statistics were generated to describe sample characteristics and SF-36 domain scores were calculated for each participant. In the qualitative analysis, data were analyzed through a series of sorting techniques and transcripts were imported into NVivo 10 and subjected to content analysis. The mean age of survey participants was 31.8 years (SD=5.8). Respondents were primarily non-Hispanic (92.5%), white (88.3%), straight (94.4%), and married (73.4%) with a college education (64.1%). On average, participants reported living with PCOS for 7.6 years (SD=6.1). Approximately half of the sample reported having biological children (47.9%) and currently trying to conceive (42.1%), and most participants reported a history of infertility (70.7%). In addition, almost half of the total sample reported heights and weights that placed them in the morbidly obese category (BMI>35). Lastly, a history of depression (63.6%) and anxiety (68.6%) was common among participants. Few survey participants reported their general health as being excellent (2.6%) or very good (27.4%). Similarly, women reported the lowest levels of functioning on the dimension of vitality, meaning that, in general, women reported feeling tired and being low in energy. Conversely, women reported the highest scores on the dimensions of physical functioning and role limitations due to physical health, meaning that, in general, women did not report that their health limited their physical abilities or caused problems with work or other daily activities. Interview findings suggest that WLW PCOS generally have illness perceptions of the syndrome that are consistent with the domains identified in the CSM. In addition, it was found that, in relation to their illness cognitions, WLW PCOS described the extent to which they felt they had a comprehensive understanding of the syndrome, a phenomenon labeled illness coherence. Similarly, participants identified PCOS as a common condition (i.e. labeled perceived prevalence). Lastly, a number of relationships were identified between illness perceptions and (1) infertility status and (2) HRQoL scores. Overall, this dissertation identifies a number of implications for patient education, provider education, clinical practice, and policy improvements. Examples include addressing (1) unmet information needs, (2) significant psychological morbidity and unmet mental health needs, (3) breastfeeding challenges and need for breastfeeding support, (4) poor quality of care and low patient satisfaction, and (5) limited access to care - all among women living with PCOS.

This preliminary investigation utilized both a top-down theory (Banduras Self-Efficacy Theory: SET, 1997) and a bottom-up theory (Leventhals Common Sense Model: CSM, 1980) to examine the cognitions and exercise behavior of novice cardiac rehabilitation (CR) participants engaged in 3 months of standard CR treatment. The primary purpose of this study was to investigate if the Illness Perception Questionnaire (IPQ,) as a reflection of the CSM, could classify CR novices relative to the strength of their illness perceptions. A further objective was to detect differences at baseline between the illness perception groups when evaluating SET variables and health-related outcomes that have been identified as important correlates of CR adherence. Additionally, the study proposed to determine differences between illness perception groups on adherence to recommended exercise therapy in CR. Lastly, differences between the groups on the assessed variables over the 3 month-rehabilitation period was examined. Forty-nine CR initiates were recruited. Participants were measured at 4 different time points over the 3-month initiation phase of CR. The IPQ, SF-36 (assessing health-related quality of life; HRQL,) and other social cognitive measures, including self-regulatory efficacy and positive and negative outcome expectations, were used to examine individuals. Participants completed measures at initiation of CR, after 2 weeks in CR, 6 weeks in CR and at the end of the 3-month initiate phase of CR. At onset of the program, cluster analysis successfully classified participants to weaker and stronger symptom-identity groups (i.e., illness perception groups). These groups were shown to be significantly different on the illness perceptions of identity, consequences and emotion. Upon initiation of CR, the classified groups were also significantly different on likelihood and value of negative outcome expectations, as well as physical and mental HRQL. At baseline, the group with stronger identity, consequences and emotion had higher negative outcome expectations and lower HRQL. In regards to adherence at the end of 3-months of CR, significant differences were found between the groups such that the group with stronger identity, consequences and emotion were less adherent to CR. This study was an initial exploration of the effectiveness of using the CSM along with SET. The findings offer insight into complementary use of top-down and bottom-up theoretical constructs to study psychological beliefs and adherence to exercise therapy in this rehabilitation setting.

This preliminary investigation utilized both a top-down theory (Banduras Self-Efficacy Theory: SET, 1997) and a bottom-up theory (Leventhals Common Sense Model: CSM, 1980) to examine the cognitions and exercise behavior of novice cardiac rehabilitation (CR) participants engaged in 3 months of standard CR treatment. The primary purpose of this study was to investigate if the Illness Perception Questionnaire (IPQ,) as a reflection of the CSM, could classify CR novices relative to the strength of their illness perceptions. A further objective was to detect differences at baseline between the illness perception groups when evaluating SET variables and health-related outcomes that have been identified as important correlates of CR adherence. Additionally, the study proposed to determine differences between illness perception groups on adherence to recommended exercise therapy in CR. Lastly, differences between the groups on the assessed variables over the 3 month-rehabilitation period was examined. Forty-nine CR initiates were recruited. Participants were measured at 4 different time points over the 3-month initiation phase of CR. The IPQ, SF-36 (assessing health-related quality of life; HRQL,) and other social cognitive measures, including self-regulatory efficacy and positive and negative outcome expectations, were used to examine individuals. Participants completed measures at initiation of CR, after 2 weeks in CR, 6 weeks in CR and at the end of the 3-month initiate phase of CR. At onset of the program, cluster analysis successfully classified participants to weaker and stronger symptom-identity groups (i.e., illness perception groups). These groups were shown to be significantly different on the illness perceptions of identity, consequences and emotion. Upon initiation of CR, the classified groups were also significantly different on likelihood and value of negative outcome expectations, as well as physical and mental HRQL. At baseline, the group with stronger identity, consequences and emotion had higher negative outcome expectations and lower HRQL. In regards to adherence at the end of 3-months of CR, significant differences were found between the groups such that the group with stronger identity, consequences and emotion were less adherent to CR. This study was an initial exploration of the effectiveness of using the CSM along with SET. The findings offer insight into complementary use of top-down and bottom-up theoretical constructs to study psychological beliefs and adherence to exercise therapy in this rehabilitation setting.

Introducción: Desde el registro de los primeros casos de COVID-19 en México, se han derivado una serie de respuestas emocionales caracterizadas por miedo y estrés. Dicho impacto emocional se debe en gran medida a la inundación de información paralela a las fases de la pandemia y la transición entre ellas y la percepción que los individuos tienen de la enfermedad. El objetivo del presente trabajo fue comparar la percepción del COVID-19 entre la fase 1 y 2 de la pandemia y entre los medios de información usados para informarse en población mexicana. Métodos: Considerando un muestreo en cadena, se realizó un estudio comparativo en el que se diseminó por medio de correo electrónico y redes sociales una batería de evaluación que respondieron 1560 participantes. Resultados: La preocupación por las consecuencias del COVID-19 y su impacto emocional incrementaron al pasar de la fase 1 a la fase 2 de la pandemia. Además, se identificó que el impacto emocional fue mayor en quienes se informaron a través de Facebook® y televisión. Conclusiones: La pandemia tendrá un impacto emocional progresivo en medida en que avancen sus fases y en la importancia de informarse en medios adecuados para prevenir consecuencias emocionales.

Submitted by William Justo Figueiro (williamjf) on 2015-07-17T21:35:41Z No. of bitstreams: 1 28c.pdf: 1664499 bytes, checksum: e38ac91534a8d10f05977f5835c56e81 (MD5) / Made available in DSpace on 2015-07-17T21:35:41Z (GMT). No. of bitstreams: 1 28c.pdf: 1664499 bytes, checksum: e38ac91534a8d10f05977f5835c56e81 (MD5) Previous issue date: 2014 / Nenhuma / Esta dissertação é composta por dois artigos, um artigo de revisão sistemática da literatura e um artigo empírico. No primeiro estudo, buscou-se realizar uma revisão sistemática da literatura internacional sobre intervenções clínicas que utilizam o modelo do senso comum. Foram selecionados cinco artigos de um total de 170 encontrados. Os resultados mostraram que os estudos são de intervenções psicológicas diversas e com foco em portadores de doenças crônicas e na prevenção delas em indivíduos saudáveis. No segundo estudo buscouse desenvolver, aplicar e avaliar um protocolo de intervenção utilizando a psicoeducação e o Modelo do Senso Comum no intuito de aumentar o conhecimento em mulheres saudáveis quanto ao câncer de colo de útero, ajustar a percepção de risco, promover e fortalecer condutas de autocuidado e ajustar a percepção da doença. Método: delineamento misto, quase experimental, com a avaliação pré e pós-intervenção com mulheres usuárias de uma Unidade Básica de Saúde de uma capital do sul do Brasil. Os instrumentos utilizados foram: Questionário sociodemográfico, Escala de Avaliação das Capacidades de Autocuidado (ASAA), Brief Illness Perception Questionaire (Brief IPQ), Questionário Percepção de Risco, Folder sobre o câncer de colo de útero. Resultados: a intervenção possibilitou que as mulheres ajustassem a percepção sobre a doença, aumentando a percepção de risco e, com isso, diminuindo a percepção de ameaça da doença. / This essay is divided in two articles. One is based on a systematic literature review and the other is an empirical article. The aim of the first study was to conduct a systematic review of the international literature about psychological interventions based on the Common Sense Model. Five arcticles were selected from a total of 170 found. The results have shown that most of the studies are about psychological interventions focused on the the management of patients with chronical diseases and on the prevention of those diseases in healthy individuals. The second study aims to develop, apply and evaluate an intervention protocol using psychoeducation based on the Common Sense Model, with the purpose to acquire knowledge on cervical cancer, adjust risk perception, promote and enhance selfcare and change illness perception. Method: quasi-experimental design, with evaluation pre and post-intervention with women that use a health care center. The instruments were: Sociodemographic questionnaire, Self-Care Evaluation Scale (ASA-A), Brief Illness Perception Questionnaire (Brief IPQ), Risk Perception Questionnaire, Leaflet about cervical cancer. Results: The intervention allowed women to adjust their perception about the disease, increasing risk perception and reducing the perceived threat of the disease.

Submitted by Silvana Teresinha Dornelles Studzinski (sstudzinski) on 2015-10-27T15:18:35Z No. of bitstreams: 1 Viviane Altenhofen_.pdf: 761664 bytes, checksum: a05ecd5634ac3306aaadce42d85d6387 (MD5) / Made available in DSpace on 2015-10-27T15:18:35Z (GMT). No. of bitstreams: 1 Viviane Altenhofen_.pdf: 761664 bytes, checksum: a05ecd5634ac3306aaadce42d85d6387 (MD5) Previous issue date: 2015-08-28 / Nenhuma / Esta dissertação é composta por dois artigos, um de revisão sistemática e um empírico. No primeiro artigo, o objetivo foi realizar uma revisão sistemática da literatura que investigou a percepção da doença cardíaca a partir do Modelo Teórico do Senso Comum (MSC). Dezesseis estudos corresponderam aos critérios de busca. Os resultados mostraram que as percepções e/ou crenças do paciente a respeito da doença cardíaca exercem um papel importante nas medidas de enfrentamento. Pode-se concluir que, em geral, a maioria dos estudos mostrou que a percepção da doença cardíaca é associada a consequências graves à vida do paciente com causas atribuídas a fatores independentes dos comportamentos do indivíduo (causas psicológicas, hereditariedade, vírus, má sorte etc.). Além disso, os resultados indicaram que a maior parte dos pacientes cardíacos atribui maior peso ao tratamento para o controle da doença do que ao seu controle pessoal. No segundo artigo, o objetivo foi avaliar a percepção da doença em indivíduos cardíacos e sua relação com a percepção das sete dimensões do Modelo de Senso Comum (MSC) identificadas na comunicação do seu diagnóstico. Foram utilizados os instrumentos: Questionário Sociodemográfico; Revised Illness Perception Questionnaire (IPQ-R) e Questionário das Percepções das Informações Fornecidas no Diagnóstico. Os resultados mostraram que as percepções sobre a doença do paciente cardíaco não se relacionaram com as informações transmitidas pelo médico no momento da comunicação do diagnóstico. / This thesis consists of two articles; one of them is a systematic review, and the other one, an empirical article. The first one aimed at conducting a systematic literature review that investigated the perception of heart disease based on the theory of the Common-Sense Model (MSC). Sixteen studies matched the search criteria. The results showed that the perceptions and /or the patient's beliefs about heart disease play an important role in coping measures. It has been concluded that, in general, most studies showed that the perception of heart disease is associated with serious consequences to the patient's life, with causes connected to factors regardless of individuals´ behavior (psychological causes, heredity, viruses, bad luck etc.). In addition to that, results indicated that most cardiac patients assign greater relevance to treatment for disease control than to their personal control. In the second article, we attempted to assess the perception of the disease in cardiac patients and their relationship to communicating the seven disease perception dimensions, identified by the patient when communicating the diagnosis. The instruments used were: sociodemographic questionnaire; Revised Illness Perception Questionnaire (IPQ-R) and Survey of Perceptions of Information Provided in diagnosis. The results showed that perceptions of the illness by the heart patient are not related to the information provided by the doctor at the time of communicating the diagnosis.

No description available.