Hypertension is defined as an asymptomatic disease which means that the disease is not related to the experience of physical symptoms. This illness is mainly managed by means of oral drug therapies, but research shows that many patients fail to take their medication as they should. Non-compliance is the main problem associated with drug-related treatments, specifically amongst patients diagnosed with chronic conditions, such as hypertension. Past research has focused on many different factors accounting for the high occurrence of non-compliance. Psychological factors relate to patients’ beliefs about their diagnosed illness and their prescribed treatment regimen. These beliefs are conceptualized in terms of the self-regulation model as constituting 5 main dimensions: identity or symptoms of their illness, the consequences of their illness, timeline or specifically referring to the course of the illness (chronic or acute), causes of the illness and controllability. Compliance is vital in the treatment and management of hypertension and research attempting to understand the relation between compliance and patients’ illness cognitions are thus important. The already high prevalence of this condition coupled with an increase in the number of people reporting low compliance suggests the need for intervention. The research question informing the present study was based on the role that psychological factors play in impacting patients’ medication-taking patterns. The medication adherence model describes medication compliance in terms of purposeful action, patterned behaviour and feedback. Purposeful action concerns patients’ intentional decisions to take their medication while patterned behaviour relates to the medication-taking patterns that patients develop. The feedback dimension guides the medication-taking patterns, providing feedback about blood pressure for example. The theory informing the present study involved social cognitive theory, which highlights the role of self-efficacy and outcome expectancies. Self-efficacy is linked with feelings of personal control and specifically refers to people’s belief in their ability to perform certain actions that will produce desired outcomes. Outcome expectancies are described as people’s ability to consider the consequences of their actions and using this information to direct their behaviour. Bearing in mind these two aspects of social cognitive theory, patients’ belief in their ability to conform to their medication instructions together with their expectations that it will improve their health will direct their medication-taking behaviour (i.e. their compliance). The illness-perception questionnaire-revised and the medication-taking questionnaire were used to obtain information about patients’ illness cognitions and their medication compliance. The correlational findings as well as the results produced by regression analysis revealed that, although illness cognitions can play a determining role in patients’ compliance, the present findings found no relation between how patients take their medication and psychological factors, defined in terms of the self-regulation model. Only one of the factors used during factor analysis revealed to significantly predict medication. Limitations associated with the present study might account for this finding and it is recommended that future research should focus on a larger sample and also use supplementary assessment measures in conjunction with self-report measures. Copyright / Dissertation (MA)--University of Pretoria, 2012. / Psychology / unrestricted

The purpose of this study was to examine the relationship between keeping a daily leisure-time physical activity record and adolescent (a) feelings of competence toward leisure-time physical activity, (b) motivational profiles toward leisure-time physical activity, and (c) leisure-time physical activity behaviors. Participants were 124 junior high and high school physical education (PE) students. Students completed the Behavioural Regulation in Exercise Questionnaire–2, the Godin Leisure–Time Exercise Questionnaire, the Perceived Competence Scale, and were assigned to keep an online leisure-time physical activity record for three weeks as part of their regular PE class. A 2 (gender) x 4 (trials) repeated measures ANCOVA was used to examine the relationships between recording compliance and the variables of perceived competence, motivation, and physical activity. Results showed a significant interaction between recording compliance and leisure-time physical activity. As students kept the leisure-time physical activity record, boys' leisure-time physical activity levels significantly increased and girls' leisure-time physical activity levels significantly decreased. Also, a significant interaction between recording compliance and introjected regulation was found. The more students recorded the less motivated they were by guilt and obligation to exercise in their leisure time. Lastly a significant interaction was found between recording compliance and intrinsic regulation, showing that the more students recorded the more intrinsically motivated they were to exercise in their leisure time. Implications and suggestions are set forth for PE professionals.

Current empirical evidence suggests that true recovery from eating disorders is not possible without a corresponding improvement in body image and self-esteem. Ten studies in current literature evaluate this relationship between self-esteem and clinical eating disorders during inpatient treatment or during follow-up studies but do not provide both pre- (baseline) and post-treatment self-esteem scores. As a result, many questions about the nature of the relationship between eating disorders and self-esteem remain unanswered. The purpose of this study was to empirically investigate whether a comprehensive measure of self-esteem, given to women at the beginning of inpatient treatment for eating disorders, reliably predicted treatment outcome. Specific and global levels of self-esteem were determined by the Multidimensional Self-Esteem Inventory (MSEI). Pearson Product Moment Correlations run on SPSS 10 were used to determine significant results. Participants in this study included 246 women experiencing anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified who received inpatient treatment at the Center for Change (CFC), in Orem, Utah, during the years 1996 to 2003. For the purposes of this study, outcome was measured upon termination of treatment at the Center for Change. CFC discharge was based on clinical judgment of progression through the treatment program, medical stability, reduction of purging behaviors, body weight, as well as attainment of additional treatment goals designed by the therapist. The results of the current study replicate earlier research that reports that positive treatment outcome is nearly always associated with high self-esteem at discharge. These findings extend earlier research by suggesting that high levels of self-esteem at admission are associated with positive treatment outcome. This investigation, which is the first to examine self-esteem change scores between admission and discharge, found that women who experience the greatest decrease in eating disorder symptomatology are those who presented at admission with low self-esteem. Further, a significant association was found between improvements in self-esteem and decreases in eating disorder symptomatology. These findings suggest that the women who report high self-esteem at admission, or women who have low self-esteem but make dramatic improvements by discharge, are likely to experience significant reductions in disordered eating behaviors.

Because of the lasting impact that traumatic family events can have on psychological well-being, students who present for services at college counseling centers may be experiencing problems and symptoms associated with earlier trauma. Many college counseling centers utilize the Counseling Concerns Survey developed by the Research Consortium of Counseling and Psychological Services in Higher Education (1991) and the Outcome Questionnaire-45 (OQ-45; Lambert et al., 1996) as intake instruments to assess students who present for counseling. The major components of the Counseling Concerns Survey are the 18-item Family Experiences Questionnaire, which identifies history of family trauma, and the 42-item Presenting Problems List, which assesses students' major areas of distress. The OQ-45 measures symptom severity. While it is generally assumed that family trauma during childhood and adolescence can negatively impact future mental health and well-being, it has been unclear how specific traumatic family experiences reported on the Family Experiences Questionnaire are related to specific presenting problems as listed on the Presenting Problems List or symptom severity as measured by the OQ-45. The purpose of this study was to examine this relationship and to ascertain discernible patterns. Data from the intake instruments of 20,495 students who sought counseling services at a large western U.S. university from 1997 to 2007 was analyzed. Logistic regression of each of the 18 traumatic family history experiences was performed, using the initial OQ-45 score, the 42 Presenting Problems List items, and five Presenting Problems List factors (Draper, Jennings, & Baron, 2003) as "predictors" of the types of trauma the students might have experienced. Results showed that although family trauma of a variety of types was associated with symptom severity and various presenting problems, there did not seem to be an overall discernible pattern. The results suggest that trauma seems to have a diffuse association with presenting problems and symptom severity. However, some family traumas are associated with a greater number of presenting problems, and these traumas were identified.

Mental health problems are associated with significant losses in work productivity and, consequently, have significant ramifications for business entities and the general economy. Several instruments have been developed to measure productivity-related constructs such as absenteeism and presenteeism. The current study examines the utility of the Outcome Questionnaire-45 (OQ), a commonly used mental health questionnaire, in predicting work productivity. This relationship is explored as a preliminary step in assessing the degree to which changes in mental health brought about by psychotherapy will improve work productivity. Forty-nine participants were recruited from a call center in a small market research firm based in the Western United States. Work productivity was measured using four subscales of the Work Productivity and Activity Impairment (WPAI) questionnaire as well as an objective measure. The OQ and WPAI were administered on a weekly basis over the course of five weeks. Participant characteristic variables and work-time variables were also measured. A mixed models analysis of covariance (ANCOVA) with repeated measures showed that the Social Role (SR) Scale, a subscale of the OQ, was a significant predictor of Presenteeism, Overall Work Impairment, and Activity Impairment subscales. Latent growth modeling (LGM) was used to examine the relationship between the variables while accounting for individual trajectory differences. Although the results suggested that an unconditional model of Overall Work Impairment with SR as a time-varying covariate provided a good fit for the data, standardized regression weights between the variables were not significant. Implications of findings, limitations, and recommendations for future research are discussed.

No description available.

No description available.

No description available.

Background: Dietary salt intake in the South African population exceeds the physiological need. Excessive salt intake is associated with elevated blood pressure levels which may lead to hypertension and cardiovascular accidents. A lifestyle modification such as dietary salt restriction is an inexpensive, effective disease prevention option. Objective: The overall main objectives of this investigation was to: 1) compare salt intake, estimated from a short salt frequency intake questionnaire, with the 24-hour urinary salt excretion and blood pressure of young normotensive healthy white and black South Africans; and 2) compare 24-hour salt excretion and 24-hour blood pressure profiles of normotensive white and black individuals in terms of their knowledge, attitude and behaviour towards dietary salt intake. Study design: The study design was cross-sectional and nested in the baseline phase of the African Prospective Study on the Early Detection and Identification of Cardiovascular Disease and Hypertension in South Africa (African-PREDICT) study. Methods: Multiple methods of data collection were used including anthropometry, biochemical analyses, dietary intakes and cardiovascular measurements. Participants in the study completed the short salt frequency intake questionnaire, describing and quantifying habitual salt intake, and a questionnaire describing knowledge, attitude and behaviour regarding salt intake. Responses to the questionnaires were compared with actual salt intakes estimated from a single 24-hour urine sample and with the 24-hour blood pressure measurements. Results: There was no significant correlation between salt intake based on the questionnaire and 24-h urinary excretion in the white (r=0.07; p=0.40) and black (r=-0.53; p=0.56) participants before and after adjustment for covariates. Estimated salt intake from the questionnaire significantly correlated with systolic blood pressure in white participants (r=0.22, p=0.005) before adjustment for covariates and was no longer significant after adjustment. None of the correlations (unadjusted or adjusted) were significant for the black participants (all p>0.05). The Bland-Altman plots for salt intake showed that the mean difference between the methods used to determine salt intake for the white group is 0.5 g/day, and for the black group is -1.9 g/day. The urinary salt excretion may estimate salt intake to be 9.6 g/day above or 11.1 g/day below the questionnaire’s estimation in the white, and 10.8 g/day above and 18.4 g/day below in the black groups. The level of agreement (Cohen’s Kappa analyses) between the salt frequency questionnaire and the 24-hour urinary salt excretion were determined by categorising the participants in groups who meet the target of <5 grams salt per day or do not. The value of Kappa for the white participants was 0.17 (slight agreement) and for the black participant it was -0.06 (no agreement). In the white participants were a significant increase in both SBP and DBP with increasing tertiles of salt intake according to the questionnaire (p<0.006 and p<0.02 respectively). In the black participants there were no significant difference in BP levels (all p>0.05). The five foods/food groups that contributed most to dietary salt intake in both ethnic groups were discretionary salt, bread, gravy made with stock or gravy powder, soup and biltong. There were no differences in the BP levels between those who answered questions about their knowledge and attitude towards salt intake in both ethnic groups (all p>0.05). Also, there were no differences in their urinary salt excretion (all p>0.05). Only certain behaviours mentioned in the questionnaire were reflected in the salt intake levels and blood pressure. Conclusions: The short salt frequency intake questionnaire can be used to identify food items that contribute to total salt intake. However, the questionnaire considerably underestimates the dietary salt intake. The application of this questionnaire may be helpful in epidemiological studies that evaluate foods which contribute to the total salt intake in order to monitor the average salt intake of a population and to assess the proportion of the population that does not meet the target of less than 5 grams of salt intake per day. It cannot, however, be used to assess the salt intake of an individual. The knowledge, attitude and behaviour of women and men of both ethnic groups are poorly reflected in their actual salt intake and blood pressure, especially among the black participants. The majority of the participants in both ethnic groups consume dietary salt in much higher quantities than the recommended less than 5 grams per day. The current public awareness campaign to decrease salt intake to the target level of less than 5 grams per day by the South African National Department of Health and the Heart and Stroke Foundation is commendable. / MSc (Nutrition), North-West University, Potchefstroom Campus, 2015

Background: Dietary salt intake in the South African population exceeds the physiological need. Excessive salt intake is associated with elevated blood pressure levels which may lead to hypertension and cardiovascular accidents. A lifestyle modification such as dietary salt restriction is an inexpensive, effective disease prevention option. Objective: The overall main objectives of this investigation was to: 1) compare salt intake, estimated from a short salt frequency intake questionnaire, with the 24-hour urinary salt excretion and blood pressure of young normotensive healthy white and black South Africans; and 2) compare 24-hour salt excretion and 24-hour blood pressure profiles of normotensive white and black individuals in terms of their knowledge, attitude and behaviour towards dietary salt intake. Study design: The study design was cross-sectional and nested in the baseline phase of the African Prospective Study on the Early Detection and Identification of Cardiovascular Disease and Hypertension in South Africa (African-PREDICT) study. Methods: Multiple methods of data collection were used including anthropometry, biochemical analyses, dietary intakes and cardiovascular measurements. Participants in the study completed the short salt frequency intake questionnaire, describing and quantifying habitual salt intake, and a questionnaire describing knowledge, attitude and behaviour regarding salt intake. Responses to the questionnaires were compared with actual salt intakes estimated from a single 24-hour urine sample and with the 24-hour blood pressure measurements. Results: There was no significant correlation between salt intake based on the questionnaire and 24-h urinary excretion in the white (r=0.07; p=0.40) and black (r=-0.53; p=0.56) participants before and after adjustment for covariates. Estimated salt intake from the questionnaire significantly correlated with systolic blood pressure in white participants (r=0.22, p=0.005) before adjustment for covariates and was no longer significant after adjustment. None of the correlations (unadjusted or adjusted) were significant for the black participants (all p>0.05). The Bland-Altman plots for salt intake showed that the mean difference between the methods used to determine salt intake for the white group is 0.5 g/day, and for the black group is -1.9 g/day. The urinary salt excretion may estimate salt intake to be 9.6 g/day above or 11.1 g/day below the questionnaire’s estimation in the white, and 10.8 g/day above and 18.4 g/day below in the black groups. The level of agreement (Cohen’s Kappa analyses) between the salt frequency questionnaire and the 24-hour urinary salt excretion were determined by categorising the participants in groups who meet the target of <5 grams salt per day or do not. The value of Kappa for the white participants was 0.17 (slight agreement) and for the black participant it was -0.06 (no agreement). In the white participants were a significant increase in both SBP and DBP with increasing tertiles of salt intake according to the questionnaire (p<0.006 and p<0.02 respectively). In the black participants there were no significant difference in BP levels (all p>0.05). The five foods/food groups that contributed most to dietary salt intake in both ethnic groups were discretionary salt, bread, gravy made with stock or gravy powder, soup and biltong. There were no differences in the BP levels between those who answered questions about their knowledge and attitude towards salt intake in both ethnic groups (all p>0.05). Also, there were no differences in their urinary salt excretion (all p>0.05). Only certain behaviours mentioned in the questionnaire were reflected in the salt intake levels and blood pressure. Conclusions: The short salt frequency intake questionnaire can be used to identify food items that contribute to total salt intake. However, the questionnaire considerably underestimates the dietary salt intake. The application of this questionnaire may be helpful in epidemiological studies that evaluate foods which contribute to the total salt intake in order to monitor the average salt intake of a population and to assess the proportion of the population that does not meet the target of less than 5 grams of salt intake per day. It cannot, however, be used to assess the salt intake of an individual. The knowledge, attitude and behaviour of women and men of both ethnic groups are poorly reflected in their actual salt intake and blood pressure, especially among the black participants. The majority of the participants in both ethnic groups consume dietary salt in much higher quantities than the recommended less than 5 grams per day. The current public awareness campaign to decrease salt intake to the target level of less than 5 grams per day by the South African National Department of Health and the Heart and Stroke Foundation is commendable. / MSc (Nutrition), North-West University, Potchefstroom Campus, 2015