Diss. (sammanfattning) Stockholm : Karolinska institutet, 2001. / Härtill 5 uppsatser.

Thesis (M.S.)--Ohio University, 2002. / Title from PDF t.p.

The purpose of this study was to test the relationships between and among the concepts of severity of illness, dependency, uncertainty, functional status and the mediators of self-esteem and mastery relative to the outcome of wellbeing. The conceptual framework was adapted from various sources in the literature which support the concept of wellbeing as an important outcome in arthritis. Evidence also supports self-esteem and mastery as mediators of the chronic illness experience. Dependency, uncertainty and functional status have been shown to be predictors of wellbeing but have never been tested as a complete paradigm. The sample for the study was 128 patients with either rheumatoid arthritis or osteoarthritis. Subjects completed 7 questionnaires which measured the 7 variables under study. Descriptive statistics were used to examine the demographic characteristics of the sample. Multiple regression technique was used to empirically test the predicted theoretical concepts and to estimate predictive validity for the theoretical concepts. The results demonstrated that when self-esteem was used in the causal model, 58% of the variance in wellbeing was explained by self-esteem and uncertainty. When mastery was included instead of self-esteem 52% of the variance of wellbeing was explained by mastery and uncertainty. When tested as mediators, both self-esteem and mastery emerged as significant mediators of dependency, uncertainty and functional status relative to wellbeing. These results are of clinical use to nurses who, by virtue of working with these patients on a daily basis, are in a position to intervene with actions which encourage positive self-esteem and maintain mastery over the environment. If these actions are successful, then wellbeing can be maintained for those patients diagnosed with arthritis.

Although medical advances have improved prognosis for children with cystic fibrosis (CF) and congenital heart disease (CHD), these youth experience poor psycho - social health. Embedded within the Medical Research Council’s framework, the purpose of this Dissertation was to a) examine how CF and CHD children experience physical activity, b) explore parents’ perceptions toward their child’s activity, c) develop a theory of physical activity in childhood chronic diseases, d) develop a physical activity counselling program for youth with CF and their parents, and e) evaluate the program impact on quality of life and physical activity. Study One explored how 14 CF youth experience physical activity. Active and inactive youth were characterized by different experiences, such as a sense of hope or despair. Given the burden of treatment and the fatal nature of the disease, youth negotiated temporal barriers to activity. Study Two explored perceptions toward activity among 29 CF and CHD parents. Parents discussed the benefits and barriers associated with physical activity for both child and self, and underscored the importance of role modeling. By adopting a Grounded Theory approach, the theoretical constructs from Study One and Two were crystallized to develop a theory of physical activity in youth with CF and CHD. This theory was used to develop “CF Chatters:” A Six Week Physical Activity Counselling Program for Youth with CF and their Parents, and the intervention employed behavioural self regulation ii skills. In Study Three, four case families in the CF clinic at the Hospital for Sick Children participated in CF Chatters. Improvements were noted in quality of life and physical activity, and participants described the program as convenient and relevant to their activity concerns. CF Chatters afforded therapeutic benefits to participants. By employing an eclectic qualitative approach, this Doctoral Program has made theoretical and practical contributions toward our understanding of how physical activity is experienced among children living with CF/CHD. The findings support the use of behavioural counselling as an effective and feasible modality for enhancing quality of life and physical activity. This Dissertation calls on clinicians to attend to the activity needs of chronically ill Canadian youth.

Although medical advances have improved prognosis for children with cystic fibrosis (CF) and congenital heart disease (CHD), these youth experience poor psycho - social health. Embedded within the Medical Research Council’s framework, the purpose of this Dissertation was to a) examine how CF and CHD children experience physical activity, b) explore parents’ perceptions toward their child’s activity, c) develop a theory of physical activity in childhood chronic diseases, d) develop a physical activity counselling program for youth with CF and their parents, and e) evaluate the program impact on quality of life and physical activity. Study One explored how 14 CF youth experience physical activity. Active and inactive youth were characterized by different experiences, such as a sense of hope or despair. Given the burden of treatment and the fatal nature of the disease, youth negotiated temporal barriers to activity. Study Two explored perceptions toward activity among 29 CF and CHD parents. Parents discussed the benefits and barriers associated with physical activity for both child and self, and underscored the importance of role modeling. By adopting a Grounded Theory approach, the theoretical constructs from Study One and Two were crystallized to develop a theory of physical activity in youth with CF and CHD. This theory was used to develop “CF Chatters:” A Six Week Physical Activity Counselling Program for Youth with CF and their Parents, and the intervention employed behavioural self regulation ii skills. In Study Three, four case families in the CF clinic at the Hospital for Sick Children participated in CF Chatters. Improvements were noted in quality of life and physical activity, and participants described the program as convenient and relevant to their activity concerns. CF Chatters afforded therapeutic benefits to participants. By employing an eclectic qualitative approach, this Doctoral Program has made theoretical and practical contributions toward our understanding of how physical activity is experienced among children living with CF/CHD. The findings support the use of behavioural counselling as an effective and feasible modality for enhancing quality of life and physical activity. This Dissertation calls on clinicians to attend to the activity needs of chronically ill Canadian youth.

BACKGROUND: Pain intensity, functional status and beliefs and attitudes towards pain are dynamic elements involved in the experience of chronic pain. Lidocaine infusion (LI) is a therapeutic intervention used to relieve pain. OBJECTIVES: The primary objective of this study was to determine if people with chronic pain who received LI and reported a decrease in pain intensity at 4 days post-infusion differed from those who did not report a decrease in pain intensity with respect to the following: a) baseline beliefs and attitudes towards pain; b) changes in belief and attitudes towards pain; c) and changes in functional status. This study also investigated if these differences were associated with being a novel or repeat LI user. A secondary objective was to estimate the sample size required for a larger study. METHODS: This project was an exploratory study. Thirty-three subjects were monitored for pain intensity using the Visual Analogue Scale (VAS) just before the infusion, and then at four days, two weeks, and three weeks after the infusion. The subjects were separated into groups depending on the criteria of whether or not they had: a) criterion-based pain intensity decrease or not on the fourth day post infusion, and b) received a previous LI or not. Since no subjects who received their first LI reported pain intensity decrease four days later, three groups emerged from this classification: first time LI users with no pain decrease, repeat LI users with no pain decrease, and repeat LI users with pain decrease. The subjects completed two self-administered questionnaires the Survey of Pain Attitudes (SOPA-32) and the Short Musculoskeletal Function Assessment (SMFA) - before the infusion, and at two and three weeks post-infusion. The most important change at two or three weeks post-infusion was used for comparison purposes. RESULTS: No significant changes in function (SMFA) were found. However, changes in specific beliefs and attitudes towards pain (SOPA-32) were associated with the group variable as follows: 1) All three groups showed a significantly stronger belief that 'others, especially family members, should be solicitous in response to their experience of pain' after the infusion. 2) Those who received their first LI and did not report pain intensity decrease also showed a significantly stronger belief that 'medications are an appropriate treatment for chronic pain' after the infusion. 3) Subjects who had previous LI and did not report pain intensity decrease were the only ones to believe significantly less that 'medications are an appropriate treatment for chronic pain' and more 'in a medical cure for their pain problem' after the infusion. 4) Subjects who had previous LI and did report pain intensity decrease had a significantly stronger belief in the appropriateness of medications and that 'that they should avoid exercise' after the infusion. 5) Finally, subjects who believed more that 'medications are an appropriate treatment for chronic pain' and less 'that they should avoid exercise' at baseline, had significantly higher chances of experiencing decrease in pain intensity 4 days after a LI. CONCLUSION: The impact of a LI on the individuals' beliefs and attitudes towards pain differs depending if their pain intensity decreased or not four days after the infusion, and if they had previous LI or not. By contrast, their pre-infusion beliefs and attitudes profile impacts on the efficacy of this intervention. Because of the small sample size, the heterogeneity of the subjects in terms of the localization of their pain, and our choice of measurement tool, it is not possible to determine if LI impacts on function. Nevertheless, this exploratory study generated some novel observations and questions that are of great interest for future research. A particular question of interest would be to determine if repeated LI fosters a more passive attitude towards pain management. It was also determined that a sample size of 70 subjects per group would be necessary for future research on this question. / Keywords: Chronic pain, lidocaine, beliefs and attitudes towards pain, function, pain intensity.

Given the presumed importance of cardiovascular reactivity and the role of anger in the development of hypertension and coronary heart disease, this study is the first to jointly examine three related areas (i.e. gender effects, anger direction preference, and opportunity/no opportunity to aggress following an anger Inducing situation). The present study tested the following hypotheses: a) that cardiovascular reactivity would vary as a function of subjects' gender and direction preference; b) that the rate of cardiovascular recovery would vary as a function of anger direction preference and opportunity/no opportunity to aggress; c) that the subjective feelings of anger after harassment would vary as a function of gender, anger direction preference, and opportunity/no opportunity to aggress; and d) that the evaluation of experimenter's competency and performance would vary as a function of anger preference. 56 females and 49 males executed a math task while being harassed for "poor performance". Next, they were randomly assigned to either write a negative evaluation of the frustrator or to copy a neutral paragraph and then to circle some letters in another paragraph. Heart rate and blood pressure were measured intermittently throughout. Subjects' preferred mode of anger expression (i.e. anger-in versus anger-out) had been previously assessed and cross validated by self as well as peer evaluations. Results indicated that gender was a better predictor than anger direction preference for cardiovascular reactivity to harassment. Complex patterns of recovery were detected with Intriguing sex differences. Results on male diastolic recovery were consistent with a matching hypothesis of anger direction preference but only for anger-out males. In addition, subjective anger for males was related to opportunity/no opportunity conditions, whereas females did not show such a relationship. Female anger-ln's showed quicker systolic recovery than anger-out's. Lastly, the evaluation of experimenter's competency and performance did not vary as a function of anger preference. Therapeutic implications of the findings within the context of anger control as well as trends for future research are discussed. / Arts, Faculty of / Psychology, Department of / Graduate

No description available.

Thesis (MA)--Stellenbosch University, 2005. / ENGLISH ABSTRACT: HIV/AIDS places much stress on those living with the disease. An understanding of the processes of stress and coping and how these relate to people living with HIV/AIDS (PLWHA) can inform the nature of services we offer to PLWHAs. Social support has been shown to playa mediatory role in the stress response and is also considered to be a problem-focused coping strategy. This paper presents an overview of the literature on stress, coping and social support with the aim of assisting healthcare workers to understand how these issues relate to HIV/AIDS and to show how healthcare workers, and, specifically psychologists can use their unique competencies and skills to enhance the quality of life of PLWHAs. / AFRIKAANSE OPSOMMING: MIVNIGS plaas baie druk op mense wat met die siekte moet saamleef. Insig rakende die prosesse van spanning en hantering daarvan en hoe dit verband hou met mense wat met MIVNIGS moet saamleef, het die potensiaal om die aard van die dienste wat aan die spesifieke populasie gelewer word, in te lig. Sosiale ondersteuning blyk 'n bemiddelende rol te speel in spanningsresponse en word ook beskou as 'n probleemgefokusde hanteringsmeganisme. Die betrokke werkstuk bied 'n oorsig van die literatuur rakende spanning, hantering en sosiale ondersteuning. Dit is gefokus daarop om bystand te verleen aan gesondheidsorg werkers om hulle insig te gee hoe hierdie kwessies met MIVNIGS verband hou. Dit poog ook om aan te toon hoe gesondheidsorgwerkers en spesifiek sielkundiges, hul unieke bevoegdhede en vaardighede kan benut om die wat met MIVNIGS moet saamleef, se kwaliteit van lewe te verryk.

Objective: Chronic pain is a common condition worldwide that poses significant impact to society in terms of its health and economic costs. It has been found to be related to a number of emotional and cognitive factors that are amenable to psychological treatments. Traditional cognitive-behavioral therapy (CBT) for chronic pain has become the gold standard of psychological treatment with reported efficacy. However, recent meta-analyses have found its effect size to be only modest at most. Moreover, its specific mechanisms of action are not well elucidated. With recent advances in neuroscience on possible neurocognitive processes underlying chronic pain, alternative treatment models targeting these specific neurocognitive processes are worth exploring. The present study tested the effectiveness of the Four-step Mindfulness-based Therapy (FSMT) for chronic pain in a randomized-controlled trial. The FSMT was chosen because of its explicit emphasis on altering neurocognitive processes that appear to be highly relevant in treating chronic pain. Method: Ninety-nine chronic pain patients in a hospital cluster-based outpatient pain clinic were randomly allocated to either the FSMT treatment or wait-list control group. The FSMT was modified for use with chronic pain and incorporated mindfulness exercises, such as mindful breathing and mindful meditation. Treatment consisted of eight weekly two-hour group sessions conducted by a clinical psychologist experienced in the implementation of the FSMT protocol. Assessment took place at baseline and post-treatment for both the FSMT and wait-list control. For the FSMT, assessment also took place at mid-group and 3-month follow-up. Results: Findings showed that the FSMT produced superior outcomes in terms of activity interference (primary endpoint), pain unpleasantness, and depression when compared to the wait-list control group or over time. Improvements were also found in the process measures of pain catastrophizing and pain acceptance. All treatment effects were maintained at follow-up. Further, the effects have been shown to be clinically significant and reliable above and beyond measurement errors. Mediational analyses revealed that pain catastrophizing and pain acceptance mediated the effects of FSMT on the outcomes of activity interference and depression; pain catastrophizing also mediated the effect of FSMT on the outcome of pain unpleasantness. Conclusions: The present study was the first to establish statistical and clinical evidence of the FSMT for chronic pain. It also revealed possible processes and mechanisms that might have brought about the changes in outcome, namely reduction in pain catastrophizing and improvement in pain acceptance. How the FSMT led to the outcome changes via these two processes was discussed and enriched by neurocognitive perspectives. Future studies should seek to further compare the FSMT with other active psychological treatments for chronic pain and collect neuroimaging data to further illustrate the neurocognitive processes involved. / Wong, Chi Ming. / "October 2009." / Adviser: Freedom Leung. / Source: Dissertation Abstracts International, Volume: 72-01, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 139-175). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.