Background. Lung cancer is the leading cause of cancer deaths worldwide. Low survival rates have been attributed to delays to diagnosis, and some patients report having symptoms for several months before presenting to health services. Strategies are needed to encourage timely help-seeking. The Web is increasingly used as a health information source. Aim. The aim of this thesis is to explore whether the Web plays a role in help-seeking behaviour of people with lung cancer prior to diagnosis, and how the Web can be utilised to encourage earlier presentation to health services for symptomatic people. Systematic review. To begin, I carried out a systematic review of the literature (N=34), which highlighted a scarcity of research on Web use for symptom appraisal among cancer populations. Mixed-methods study. I conducted a survey with recently diagnosed (6 months or less) lung cancer patients (N=113). Based on survey responses, I purposively selected a sub-sample of patients and their family/friends ("proxies") for semi-structured interviews (N=33). In the survey, 20.4% of participants reported they or proxies had researched their condition online before the diagnosis. Interview results suggest perceived impacts of online information on symptom appraisal, forming the decision to seek help, and on interactions with healthcare professionals. Intervention development and evaluation. Based on my findings, I developed a Web-based intervention. The intervention provides tailored information about lung cancer, and uses components based on the Theory of Planned Behaviour ("TPB-components") to encourage earlier help-seeking. This intervention was tested in an online feasibility study (N=130), and subsequently in an online randomised controlled trial (N=212) with a factorial design to test main and interaction effects of tailoring and TPB-components. The feasibility study and first trial helped identify methodological issues which were addressed in a second trial with a mixed factorial design. This trial (N=253) indicated that the self-reported likelihood of visiting a doctor increased significantly by 11.8% from before to after viewing study information (p < 0.001), but no effects of tailoring or TPB-components were found. When examining only those aged ≥50 years, who are at highest risk of lung cancer, those receiving tailored information reported an increase of 13.2% in likelihood of seeking help, compared to 3.2% in the untailored group (p=0.01). Participants aged 50+ receiving the TPB-component reported a larger increase (13.8%) than those who did not receive the TPB-component (5.2%), but this did not meet the significance criterion (p=0.054). Conclusions. According to patients' perceptions, the Web can impact on processes in the appraisal, help-seeking and diagnostic interval leading up to diagnosis. Presentation of information about symptoms and risk factors online can produce significant effects on self-reported likelihood of seeking help. These findings indicate that there is potential for the Web to be utlised in the endeavour to educate the public about symptoms and to promote earlier presentation to health services, but due to small effects and differential dropout in this study, further research is required.

Sammanfattning  Bakgrund: Hjärtsvikt är en folksjukdom och ca 250 000 människor i Sverige är diagnostiserade med sjukdomen. Hur drabbade personer upplever sjukdomen i vardagslivet är viktigt för att kunna hjälpa dem så mycket som möjligt. Syfte: Syftet var att beskriva personers upplevelser av att leva med hjärtsvikt. Metod: En litteraturöversikt med kvalitativ och induktiv ansats är genomförd av 13 resultatartiklar. Resultat: Två kategorier framkom vid analysarbetet, känslomässiga och kroppsliga förändringar. Upplevelser som kunde utläsas i resultatet var hopplöshet, frustration och depression, men också glädje över det friska livet de hunnit leva, trygghet i att ha någon nära och viljan att fortsätta trots begränsningar. Slutsatser: Hjärtsvikt genererar många blandade känslor. Fynden visar att det är viktigt för vården att kunna identifiera utmaningarna med att leva med hjärtsvikt. Detta för att kunna stötta och utbilda de drabbade personerna. Kunskap om symptom är en bemästringsstrategi som skapar trygghet.  Nyckelord: Hjärtsvikt, trygghet och otrygghet, begränsningar, Teori om planerat beteende. / Summary  Title: Peoples experiences of living with heart failure - a literature review.   Background: Heart failure is a public disease and about 250 000 people in Sweden are diagnosed with the disease. How affected people experience the disease in everyday life is important in order to be able to help them as much as possible. Aim: The aim was to describe persons experiences of living with heart failure Method: A qualitative literature review with an inductive approach. 13 articles was used for the result. Result: Two categories emerged during the analysis work, emotional and physical changes. Experiences that could be learned in the result were hopelessness, frustration and depression, but also joy for the healthy life that has been, security in having people close and the will to keep going despite of the limitations. Conclusion: Heart failure generate a lot of mixed feelings. The findings show that it is of great importance for the health care system to be able to recognize the challenges of living with heart failure. This is to be able to support and educate the affected people. Knowledge of the symptoms is a coping strategy that creates security.  Keywords: Heart failure, security and insecurity, limitations, Theory of Planned Behaviour.

In recent years, one of the most significant pieces of environmental legislation in New Zealand has been the Resource Management Act (New Zealand Government 1991) that has empowered local government agencies to manage the use of natural resources in their regions. Three Government Departments have been responsible for developing policies directly relating to the use of natural resources in New Zealand. The Department of Conservation has been mainly concerned with the management of natural resources on public land. The Ministry for the Environment has particularly addressed environmental policy issues of national significance. The Ministry of Agriculture and Forestry has worked with New Zealand's agricultural, horticultural and forestry industries to encourage sustainable resource use and development for the benefit of all New Zealanders. In general, local and central government agencies carrying out policy analyses have drawn upon highly goal driven theories such as Rational Choice or Incremental Policy Theories or alternatively they have applied more loosely framed theories such as Systems Policy Thinking or Garbage Can Theory. Policy formulation and instrument selection may have been based upon instrumentalist, proceduralist, contingentist or constitutivist selection criteria, depending upon the assumed influence of peoples' behavioural and social contexts in addition to the technical characteristics of the tools themselves. However, there has been a limited range of policy theories to guide the integration of policy analysis, and formulation and operational planning into a management strategy for effective policy delivery. Such theories would have assisted policy agencies to identify the human and social behaviours most closely related to policy issues and to better match policies to differences in the political and social context of each of the issues that they were dealing with. In academic articles a number of behaviour models from social psychology have been used to explain and predict human behaviour. One of those, the Theory of Reasoned Action (TRA) has a long history of use in research and application. It has been adapted to suit the needs of policy makers in human health, marketing, and education. Applications of the TRA have been reported to have achieved coefficients of determination for behaviour of on average, 53% in one study and 71% in another. Some of the modified models based upon the Theory such as the Theory of Planned Behaviour, have in themselves been able to make additional contributions to peoples' understanding of how to explain and predict human behaviour in more complex situations. In this report, unless otherwise stated, references to the TRA are inclusive of all associated models, such as the Theory of Planned Behaviour. This thesis has examined the application of the Theory of Reasoned Action in the formulation of environmental policy. Five research questions were considered. 1. Could a human behaviour model based upon the Theory of Reasoned Action be developed sufficiently for environmental policy makers to explain landowner behaviour associated with managing indigenous vegetation? 2. How well could the social psychology model of human behaviour based upon the TRA have predicted public responses to a policy programme? 3. How well could the social psychology model of human behaviour based upon the TRA have distinguished between the policy-intervention needs of different stakeholder groups? 4. How much have peoples' values, attitudes and beliefs affected their behaviour? 5. What would be the immediate antecedents to peoples' behaviour and how have they led to behaviour change? This has been a quantitative study to develop and test models of human behaviour specific to the preservation of indigenous vegetation. Three data sets were compared from surveys of peoples' bush protection behaviour, the establishment of indigenous woodlots and the protection and planting of riparian areas with indigenous vegetation. The results from the analyses have shown that accounting for peoples' intentions could have been used to improve the estimates of peoples' use of policy-desired practices. The coefficients of determination in multivariate equations to predict peoples' natural resource behaviour based upon non-specific (external) variables, varied between 3 - 10%. By including intentions in the models, the level of explanation increased to 10 - 17%. The results may have been lower than expected from other examples in the literature due to poorly specified measures of behaviour relative to the measures used for intentions. When it came to estimating intentions (rather than the actual behaviours), the TRA variables in regression equations achieved coefficients of determination of 55 - 75% and these provided a measure of how well the underlying values, attitudes and beliefs could have given policy makers an understanding of peoples' behaviour. Comparing the beliefs of people with high and low intentions to perform the behaviours, clear differences have been identified that could have been the basis of policy strategies for behaviour change. After analysing and considering these examples, this thesis has argued that the TRA could be used in the future to provide policy agencies with an increased level of understanding of human behaviour and so enable them to formulate policy interventions for achieving predictable levels of behaviour change.

The aim of the present study was to examine both the individual and organizational level factors contributing to the safety related behaviours of nurses. Effects of the individual level factors on safety behaviour of nurses were analyzed within the theoretical framework of Ajzen&rsquo / s (1991) Theory of Planned Behaviour (TPB) and effects of the organizational level factors were analyzed through safety climate perceptions of the nurses. Data were collected from nurses (N=274) of two different private hospitals located in Ankara and their first line supervisors (N=34).Participants filled out the questionnaires including scales of TPB (i.e., subjective norm, attitude toward the behaviour, perceived behavioural control, and intention), safety climate perceptions and compliance to Standard Safety Precautions. The outcome variable was the compliance to the Standard Safety Precautions as rated by the first line supervisors of the nurses. Subjective norm was found to be the only significant predictor of the nurses&rsquo / intention to adhere to the Standard Safety Precautions. Contrary to the hypothesized relationships, intention and perceived behavioural control did not contribute significantly to the prediction of safety behaviour rated by the first line supervisors. Furthermore, teamwork dimension of safety climate perceptions was found to be the only significant predictor of compliance to the Standard Safety Precautions. The results are discussed with practical implications of the findings.Contributions of the study are presented followed by the limitations and some future research suggestions.

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BACKGROUND: Anxiety and pain are prevalent symptoms experienced by inpatients in acute, long-term and rehabilitation care settings. There is a need for effective relief from these symptoms without increasing the risks as a result of the intervention. Empirical evidence supports the use of music as a complementary therapy for the management of anxiety and pain. However, there is limited knowledge of nurses’ awareness of and intention to use music therapy in clinical practice. AIMS: This study examined nurses’ awareness of and intention to use music therapy for the management of anxiety and pain, and factors that influenced nurses’ intention to implement music therapy in practice. A conceptual framework incorporating elements of the Theory of Planned Behaviour and Triandis’ Theory of Interpersonal Behaviour guided the study. METHOD: A correlational, survey-type design was used. The sample consisted of 161 Registered Nurses who were currently providing direct care to patients in acute, rehabilitation and long-term care settings in Ontario. Data were collected using adapted instruments that were pilot tested. RESULTS: Attitudes, subjective norms, perceived behavioural control, moral norms, and awareness were positively and moderately (all β > 0.20, p < .05) associated with nurses’ intention to use music therapy for the management of anxiety and pain. Role beliefs, selected demographic and professional characteristics were not significantly related to nurses’ intention to use music therapy for either anxiety or pain management. Nurse, client and unit factors were additional factors reported by nurses as affecting their use of music therapy in practice. IMPLICATIONS: The findings suggested the need for strategies to educate nurses about music therapy to facilitate its implementation in clinical practice. Research exploring why nurses are unaware of music therapy as an intervention and revisions to the current conceptual framework to incorporate additional factors influencing intervention use are required.

BACKGROUND: Anxiety and pain are prevalent symptoms experienced by inpatients in acute, long-term and rehabilitation care settings. There is a need for effective relief from these symptoms without increasing the risks as a result of the intervention. Empirical evidence supports the use of music as a complementary therapy for the management of anxiety and pain. However, there is limited knowledge of nurses’ awareness of and intention to use music therapy in clinical practice. AIMS: This study examined nurses’ awareness of and intention to use music therapy for the management of anxiety and pain, and factors that influenced nurses’ intention to implement music therapy in practice. A conceptual framework incorporating elements of the Theory of Planned Behaviour and Triandis’ Theory of Interpersonal Behaviour guided the study. METHOD: A correlational, survey-type design was used. The sample consisted of 161 Registered Nurses who were currently providing direct care to patients in acute, rehabilitation and long-term care settings in Ontario. Data were collected using adapted instruments that were pilot tested. RESULTS: Attitudes, subjective norms, perceived behavioural control, moral norms, and awareness were positively and moderately (all β > 0.20, p < .05) associated with nurses’ intention to use music therapy for the management of anxiety and pain. Role beliefs, selected demographic and professional characteristics were not significantly related to nurses’ intention to use music therapy for either anxiety or pain management. Nurse, client and unit factors were additional factors reported by nurses as affecting their use of music therapy in practice. IMPLICATIONS: The findings suggested the need for strategies to educate nurses about music therapy to facilitate its implementation in clinical practice. Research exploring why nurses are unaware of music therapy as an intervention and revisions to the current conceptual framework to incorporate additional factors influencing intervention use are required.

No description available.

No description available.

影響俄國民眾購買有機食品的因素之研究 / The aim of this paper is to explore consumers’ attitudes and identify factors influencing willingness to pay within the context of Russian organic food market. The Theory of Planned Behavior informs the research framework and the hypotheses are tested via hierarchical multiple regression analysis. The survey was distributed online and a total sample of 231 questionnaires was used for this study. The findings indicate that health concerns, knowledge of organic food and trust in organic food claims are all important predictors of consumers’ attitudes, as well as willingness to pay a premium price for organic food, while environment-consciousness appears to be unimportant in contrast to findings from previous research. Additionally, subjective norms are also found to have a strong influence on willingness to pay premium price for organic products.