Purposes/Aims: The purpose of this study is to examine the role of self-transcendence along with illness perception and selected demographic factors in the experience of depression in Taiwanese men who have oral cancer. There are three main research questions: 1) What are the relationships among the following variables: demographic variables (age, education level, marital status, income, and work class), illness perception, self-transcendence, and depression? 2) How does self-transcendence relate to depression–directly or as a mediator between illness perception and depression? 3) What set of variables best explain the variance in depression? Significance and Conceptual Framework Oral cancer is the fourth leading cause of cancer deaths among men in Taiwan since 2003. Depression is common in oral cancer patients and is associated with poor quality of life and negative health outcomes, such as morbidity and mortality. Illness perception is the person’s understanding of his/her health threat based upon previous experiences and how perceptions affect an individual’s coping. Self-transcendence is an inner resource of which research evidence suggests that it promotes well-being and decreases level of depression in the context of significant life-altering health events. It is proposed then that during the crisis of diagnosis and treatment of oral cancer, self-transcendence may be an independent contributor to well-being, or function as a mediator in alleviating depression. Method: This is a cross-sectional, descriptive design. A convenience sample of men who have a confirmed diagnosis of oral cancer was recruited from the department of Oral and Maxillofacial Surgery and Oncology, which is located at two medical centers in the same county in Taiwan. The inclusion criteria are male, ages 18 or older, ability to communicate in Mandarin or Taiwanese, and agreeing to participate in this study. Participants completed a Demographic and Health Related Questionnaire, a Chinese version of the Self- Transcendence Scale, Chinese versions of the Revised Illness Perception Questionnaire, and a Chinese version of Beck’s Depression Inventory. Data analysis included use of descriptive statistics, correlation coefficients, and multiple regression. Results and Implications The results of this study support a clinical focus on facilitating self-transcendence to improve healing outcomes during this stressful event. Obtaining information about the role of self-transcendence in Taiwanese men with oral cancer may be particularly helpful in designing interventions or support programs to prevent or minimize depressive symptoms. Self-transcendence practices may help mediate the impact of negative illness perceptions on the emotional distress of men with oral cancer. Continued research and evaluation of practice applications of the theory will contribute to nursing knowledge concerning the relationships of illness perception, self-transcendence and demographic and health-related factors in depression among Taiwanese men with oral cancer.

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Yes / The Self-Regulation Model (SRM) identifies that the beliefs people hold about an illness can influence their responses to that illness. Although there are generic measures of illness representations, there is a need for a brief tailored measure to use with people with dementia. The aim of this study was to develop and validate a brief measure called the Representations and Adjustment to Dementia Index (RADIX). The RADIX contains questions on the SRM elements: Identity, Cause, Timeline, Control, and Consequences. The RADIX validation was conducted with a sample of 385 community-dwelling people with mild to moderate dementia who were taking part in the IDEAL cohort study. Test-retest reliability was conducted over a 4-week period with a separate sample of 20 people with dementia. The validation process resulted in a reduction in the number of items in the Timeline, Control, and Consequences items. The resulting RADIX demonstrated good acceptability, internal reliability, and test-retest reliability. All the RADIX items had low missing data, indicating good acceptability. The factor analysis confirmed that the Consequences items formed two subscales (practical and emotional consequences) that had Cronbach's α of 8 and 0.91 respectively. Test-retest reliability indicated that the Identity, Timeline, and Control items had moderate reliability and the practical and emotional consequences scales had good reliability. The RADIX demonstrates acceptable psychometric properties, proves to be a useful measure for exploring people's beliefs about dementia, and could aid the provision of tailored information and support to people with dementia.

The purpose of this study was to evaluate Chinese Americans’ perceptions and knowledge about cardiovascular disease (CVD) risk factors and to determine if acculturation has systematic effects on perception of illness. Perception about the cause, seriousness, curability, and controllability of CVD were investigated. Relationships between the demographic characteristics of the participants and cardiovascular knowledge and perception were examined. The conceptual framework for this study was based on Leventhal’s (1970, 1984) Common Sense Model of Illness Representation. The influence of Kleinman’s Explanatory Model about the cultural and social consideration of illness representation was incorporated. A cross-sectional design was selected for this descriptive study with a convenience sampling technique. The target population was community-based Chinese Americans who live in the United States. Data collection was conducted using the Internet to access a population. The sample of the study was comprised of 124 adults with 68% being female. The majority of participants retained a high Asian identity. Participants identified Chinese over English for speaking, reading, writing preferences. Instruments included the Illness Perception Questionnaire-Revised (IPQ-R), Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA) and the Healthy Heart IQ. Findings included the following: the IPQ-R subscales were intercorrelated in a logical manner. Illness perceptions correlated positively with each other but were negatively correlated with optimistic perceptions like personal and treatment control. No difference was observed in the IPQ-R based on age, gender or educational level. Knowledge of CVD among Chinese Americans was lower than the general population. The level of acculturation had an impact on the illness perception. Acculturation level was significantly related to all seven illness perception dimensions of illness representation on the IPQ-R. There were significant relationships between acculturation level and knowledge of CVD. However, due to the low acculturation level presented by majority of participants, caution must be exercised in the interpretation of the study findings. The findings of this study have important implications for nursing practice, education, and theory. These results also provide directions for future research. Suggestions for health care professionals who care for patients with ethnic cultural backgrounds were given. / text

Tyrimo tikslas – nustatyti sergančių onkologine liga asmenų, vyrų ir moterų, ligos suvokimo sąsajas su gyvenimo prasme ir ligos įveikos strategijomis. Tyrimui atlikti naudota: Ligos suvokimo klausimynas (Weinman, Petrie, Moss-Morris, Horne, 1996; Weinman, Petrie, 1997) (angl. The Revised-Illness Perception Questionnaire, IPQ–R), siekiant nustatyti vėžiu sergančių asmenų ligos suvokimą; Gyvenimo prasmės skalė (Jim et al., 2006) (angl. Meaning in Life Scale, MiLS), skirta tiriamųjų gyvenimo prasmės įvertinimui; COPE streso įveikimo strategijų klausimynas Carver, Scheier, Weintraub, 1989) (angl. Coping Orientation of Problem Experience Inventory, COPE), siekiant nustatyti tiriamųjų pasirinktas ligos įveikos strategijas. Gauti duomenys apdoroti naudojant statistinį SPSS 16,0 versijos programinį paketą. Statistiškai patikimais rezultatais laikytini atvejai, kai p < 0,05, P = 95 proc. Tyrime dalyvavo 142 (22–74 metų) onkologinėmis ligomis sergantys vyrai ir moterys. Tyrimo rezultatai parodė, kad onkologine liga sergančių asmenų, vyrų ir moterų, stipresnis ligos suvokimas siejasi su dažniau naudojama adaptyvia, į problemas nukreipta ligos įveika; onkologine liga sergančių asmenų, vyrų ir moterų, stipresnis ligos suvokimas siejasi su aukštesne gyvenimo prasme; onkologine liga sergantiems asmenims, vyrams ir moterims, pasižymintiems stipresniu ligos suvokimu ir adaptyvia, į emocijas nukreipta ligos įveika, būdinga žemesnė gyvenimo prasmė. / The aim of the research is to identify oncology patients’, men and women, relation of illness perception to the meaning in life, the coping strategies of illness. References for research: The Revised-Illness Perception Questionnaire, IPQ–R (Weinman, Petrie, Moss-Morris, Horne, 1996; Weinman, Petrie, 1997) in order to identify oncology patients’ illness perception; Meaning in Life Scale, MiLS (Jim et al., 2006) for evaluation of research participants’ meaning in life; Coping Orientation of Problem Experience Inventory, COPE (Carver, Scheier, Weintraub, 1989) in order to identify the coping strategies of illness chosen by research participants. The received data was processed while using a statistical SPSS software package. Statistically reliable cases werw considered when p < 0,05, P = 95%. 142 people (22-74years old), men and women with oncologic illnesses participated in the research. The research results have revealed that a stronger illness perception of men and women with oncologic illness is associated with a more frequently used adaptive, problem-focused coping of illness; a stronger illness perception of men and women with oncologic illness is associated with a higher meaning in life; a lower meaning in life is typical for those oncology patients, men and women, who have a stronger illness perception and adaptive, emotion - focused illness coping.

Aim: The overall aim of this thesis was to explore and describe patients’ and healthcare providers’ experiences of the causes, management and interaction in the care of rheumatoid arthritis (RA). Method: The thesis is based on four studies. Studies I and II contain data from an epidemiologic project involving patients who were recently diagnosed with RA. The patients answered an open-ended question about their conception of the cause of their RA (Study I). Qualitative data from 38 patients were analysed using the phenomenographic approach in order to identify variation in conceptions. The results of Study I formed the basis for categorizing the conceptions of 785 patients in the search for patterns of background factors (Study II). Study III aimed to explore how patients experienced their management of RA in everyday life. Data were collected by interviews with 16 patients and analysed according to Grounded Theory (GT). In study IV, the aim was to explore healthcare providers’ experiences of their interaction with patients’ management of RA. Data were collected by interviews with 18 providers representing different professions and analysed using GT. Findings:  Patients’ conceptions of the cause of their RA revealed new aspects from the patient perspective that can complement pathogenetic models. Two descriptive categories emerged: consequences beyond personal control and overloaded circumstances, which included six categories of conceptions (Study I). The most common conceptions of the cause of RA were unexpected effects of events followed by work and family-related stress (Study II). Background factors that influenced the conceptions of the cause were age, sex and educational level. Patient management of RA involved using personal resources together with grasping for support from others in their striving for a good life. When linking these aspects together, four ways of management emerged: mastering, struggling, relying and being resigned (Study III). Healthcare providers’ experiences of their interaction with patients’ management shed light upon the important issue of delivering knowledge and advice. The providers’ attitudes constituted one cornerstone and patients’ responses the other. The providers reported that the interaction led to different outcomes: completed delivery, adjusted delivery and failed delivery. Conclusions: The findings contribute new knowledge from both patients’ and healthcare providers’ perspectives, which could be used to develop a more person-centred approach in rheumatology care. Person-centred care involves taking patients’ beliefs and values into account in addition to creating a trusting relationship between patient and provider. A successful person-centred approach requires an organisation that supports the person-centred framework.

abstract: Nationally, African Americans suffer disproportionately from diabetes; with 13.2% of African Americans diagnosed with diabetes compared to 7.6% of non-Hispanic whites (CDC, 2014). Nearly one-half of all people with diabetes are non-adherent to their oral medications; adherence to insulin therapy was 60%-80% (Brunton et al., 2011; Cramer, 2004; Rubin, 2005). This study explored the question, "What mechanisms are associated with adherence to diabetes medication, including insulin, for African Americans in the Southwest?" Twenty-three people participated in the study; 17 participated in interviews and six participated in gendered focus groups. A community-based participatory research (CBPR) approach engaged the African American community as partners in research. Major themes emerging from the data included illness perception, support, and the process of medication adherence. Acceptance of the diabetes diagnosis was imperative for medication adherence. Stigmatization of diabetes was salient in the recruitment process and as it related to mechanisms for adherence. Furthermore, many informants were not aware of a family history of diabetes before their own diagnosis. Four gendered emerging typologies were identified, which further illuminated major themes. Moreover, an eight-step process of medication adherence model is discussed. The researcher was able to identify culturally compatible strategies that may be extended to those struggling with medication adherence. The implications section suggests a set of strategies that healthcare providers can present to people with diabetes in order to increase medication adherence. / Dissertation/Thesis / Doctoral Dissertation Social Work 2015

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 Mariana Dornelles Vargas (marianadv) on 2015-05-29T17:36:45Z No. of bitstreams: 1 percepcao_sobre.pdf: 624117 bytes, checksum: 32c35c4fe3164fc8bd6f5aca246544df (MD5) / Made available in DSpace on 2015-05-29T17:36:45Z (GMT). No. of bitstreams: 1 percepcao_sobre.pdf: 624117 bytes, checksum: 32c35c4fe3164fc8bd6f5aca246544df (MD5) Previous issue date: 2012-05 / Nenhuma / Esta dissertação é composta por dois artigos, o primeiro deles de revisão sistemática da literatura e o segundo um artigo empírico. No estudo 1, buscou-se realizar uma revisão sistemática da literatura internacional sobre percepção da doença e o câncer. Foram encontrados 11 artigos. Os resultados mostraram que os estudos são diversos e o foco das pesquisas é abrangente, relacionando a percepção sobre a doença e o câncer em diversas situações, especialmente na qualidade de vida. No estudo 2, o objetivo foi avaliar e comparar as percepções sobre o câncer do colo do útero em três grupos de mulheres: 1) mulheres com diagnóstico de câncer do colo do útero e em tratamento para a doença; 2) mulheres com lesões precursoras de câncer uterino ou contaminadas pelo HPV; e 3) mulheres sem a doença e sem lesão precursora. Participaram da pesquisa 150 mulheres adultas em atendimento ambulatorial de ginecologia e ambulatório de oncologia em dois hospitais de Porto Alegre (RS). Foram utilizadas como instrumentos a ficha de Dados Sociodemográficos e Clínicos, o Questionário de percepção sobre a doença Revised Illness Perception Questionnaire (IPQ-R) e Revised Illness Perception Questionnaire for Healthy People (IPQ-RH). Os resultados mostraram diferenças na percepção entre os grupos nas dimensões identidade (F=11,654, p<0,001), duração cíclica da doença (F=4,416, p<0,05) e causas da doença (F=15,941; p<0,001), o que mostra que as mulheres saudáveis apresentaram percepções positivas em relação à doença, diferente das mulheres com lesão e com câncer. As percepções entre os três grupos se assemelharam nas seguintes dimensões: duração da doença (aguda/crônica), consequência da doença, controle pessoal e do tratamento, coerência da doença e representações emocionais. / This dissertation consists of two articles, the first one being a systematic review of the literature and the second an empirical study. In study 1, it sought to conduct a systematic review of international literature regarding the perception of the disease and the cancer itself. 11 articles were found. The results showed that the studies are diverse and the focus of research is comprehensive, listing the perception about the disease and the cancer in various situations, especially in terms of quality of life. In study 2, the objective was to evaluate and compare the perceptions about cervical cancer found in three groups of women: 1) women diagnosed with cervical cancer and undergoing treatment for the disease; 2) women with uterine early stage cancer lesions or with HPV infections; and 3) women not having the disease nor the early stage cancer lesions. 150 adult women participated in the study at clinical gynecology and oncology outpatient clinics in two hospitals in Porto Alegre (RS). as instruments, the Demographic and clinical data sheet, the Questionnaire of perception about the disease Revised Illness Perception Questionnaire (IPQ-R) and Revised Illness Perception Questionnaire for Healthy People (IPQ-RH) were used. The results showed differences in perception between the groups in the identity dimensions (F = p < 0.001 11.654,), cyclic duration of disease (F = 4.416, p < 0.05) and causes of disease (F = 15.941, p < 0.001), which shows that healthy women showed positive perceptions in relation to disease, different from women with cancer and lesions. Perceptions among the three groups resembled each other in the following dimensions: length of the disease (acute/chronic), as a result of illness, personal control and consistency of treatment, disease and emotional representations.