No / Nonadherence to antihypertensive medicines limits their effectiveness, increases the risk of adverse health outcome, and is associated with significant health care costs. The multiple causes of nonadherence differ both within and between patients and are influenced by patients’ care settings. Objectives The objective of this article was to identify determinants of patient nonadherence to antihypertensive medicines, drawing from psychosocial and economic models of behavior. Methods Outpatients with hypertension from Austria, Belgium, England, Germany, Greece, Hungary, The Netherlands, Poland, and Wales were recruited to a cross-sectional online survey. Nonadherence to medicines was assessed using the Morisky Medication Adherence Scale (primary outcome) and the Medication Adherence Rating Scale. Associations with adherence and nonadherence were tested for demographic, clinical, and psychosocial factors. Results A total of 2595 patients completed the questionnaire. The percentage of patients classed as nonadherent ranged from 24% in The Netherlands to 70% in Hungary. Low age, low self-efficacy, and respondents’ perceptions of their illness and cost-related barriers were associated with nonadherence measured on the Morisky Medication Adherence Scale across several countries. In multilevel, multivariate analysis, low self-efficacy (odds ratio = 0.73; 95% confidence interval 0.70–0.77) and a high number of perceived barriers to taking medicines (odds ratio = 1.70; 95% confidence interval 1.38–2.09) were the main significant determinants of nonadherence. Country differences explained 11% of the variance in nonadherence. Conclusions Among the variables measured, patients’ adherence to antihypertensive medicines is influenced primarily by their self-efficacy, illness beliefs, and perceived barriers. These should be targets for interventions for improving adherence, as should an appreciation of differences among the countries in which they are being delivered.

Chronic pain sufferers are frequently misunderstood and stigmatised. The aim of this investigation was to provide a description of the lifewor1d of people with chronic low back pain, using the phenomenological method. Themes which emerged were that the persistent nature of chronic pain makes it particularly difficult to endure, arousing a profound fear of the future. It causes a disruption in the relationship between the person and the body, in which the person is forced to function within the constraints of pain. Sufferers are unable to fulfil social roles as expected and are forced to revise their goals and activities. The distress of their experience is mediated by the ability to make sense of their condition, finding meaning in the pain itself. The study highlights the value of the phenomenological method in health psychology. Recommendations are made which may be of benefit to people with chronic pain and their families. / Psychology / M. Sc. (Psychology)

<p> The purpose of this policy analysis is to critically review the Welfare and Institutions Code&sect; 369.5, which regulates the authorization of psychotropic medication to treat mental disorders among California's dependent children. While these medications have been proven effective forms of treatment, there is a growing concern about their life threatening side effects.</p><p> Research has concluded that children exposed to chronic child abuse and neglect often present with behaviors indicative of trauma. The <i>Diagnostic and Statistical Manual of Mental Disorders</i> 5th Edition has included criteria for Post-Traumatic Stress Disorder (P.T.S.D.) in children. However, the Welfare and Institutions Code&sect; 369.5 does not mandate psychiatrists and pediatricians to first rule out trauma prior to diagnosing foster children with one or more behavior, mood, or psychotic disorders.</p><p> Results support amending child welfare legislation and policies to reflect a shift toward trauma-focused services, thereby reducing the reliance on potentially dangerous pharmaceutical drugs.</p>

Chronic pain sufferers are frequently misunderstood and stigmatised. The aim of this investigation was to provide a description of the lifewor1d of people with chronic low back pain, using the phenomenological method. Themes which emerged were that the persistent nature of chronic pain makes it particularly difficult to endure, arousing a profound fear of the future. It causes a disruption in the relationship between the person and the body, in which the person is forced to function within the constraints of pain. Sufferers are unable to fulfil social roles as expected and are forced to revise their goals and activities. The distress of their experience is mediated by the ability to make sense of their condition, finding meaning in the pain itself. The study highlights the value of the phenomenological method in health psychology. Recommendations are made which may be of benefit to people with chronic pain and their families. / Psychology / M. Sc. (Psychology)

Although self-efficacy has long been established as an important variable for psychological wellbeing across a range of contexts, coping self-efficacy, a subtype of self-efficacy specific to the function of coping, has only recently begun to receive research attention. In addition, despite support from both self-efficacy theory and coping theory, the relationship between coping self-efficacy and coping behaviour in the face of stressful events has not previously been considered. This thesis explores the importance of coping self-efficacy for psychological wellbeing in a new context, recovery after stroke, and investigates the relationship between coping self-efficacy and coping behaviour in the face of this stressor. Stroke was selected as a suitable context for this exploration given its high incidence, lengthy recovery period and the prevalence of significant post stroke psychological distress. The thesis explores four key questions: (i) is coping self-efficacy related to psychological wellbeing for people recovering from stroke, (ii) what types of coping behaviours are related to coping self-efficacy during recovery, (iii) does coping behaviour mediate the relationship between coping self-efficacy and psychological outcomes, and (iv) what is the role of individual dispositional traits (optimism and trait anxiety) in these relations. The implications of these relationships for clinical intervention were a secondary focus of the project.

This study examined variables related to the doctor-patient interaction that can predict college students’ trust in their physicians. Specifically, I examined if five personality variables, ethnicity, and gender were associated with attitudes toward physicians. A second aim of the study was to determine if there was a difference in the level of trust in physicians between pre-medical and non-pre-medical students. Surveys were administered to UCF students containing a series of questions compiled from the Interpersonal Physician Trust Scale, Interpersonal Trust Scale, Illness Attitude Scale, Big Five Inventory, Martin-Larsen Approval Motivation Scale-Short Form, Almost Perfect Scale-Revised and Marlowe-Crowne Social Desirability Scale-Short Form, as well as 13 original questions that I developed. The sample consisted of 211 UCF students. It was hypothesized that lower levels of mistrust of others, symptoms of hypochondria, introversion, need for approval, and perfectionism would correlate significantly with trust in medical doctors. It was also hypothesized that there would be a difference in the level of trust in physicians between pre-medical and non-premedical students. Results indicated that on average, most participants across ethnicity and gender expressed uncertainty about their level of trust in their physicians. Ethnicity was not associated significantly with trust in physician. Gender was also not associated significantly with trust in physician. For Hispanic participants, only introversion predicted trust in physician. For male participants, only hypochondria predicted trust in physician. Finally, pre-medical status was not associated significantly with a difference in physician trust.

"The emergence of rehabilitation as a social movement may be a significant contribution of the twentieth century to human development. Each step toward freeing human potentiality from the limitations of disability contributes to the dignity and growth of all mankind." (14:1) Through accident or disease. thousands each year are faced with the problems of physical disability. While the major concern in the rehabilitation of these people is the restoration or improvement of physical function. the social and psychological effects of disability are now being recognized as weighing heavily in the total adjustment to the problems of coping with life in normal society.

Sex education in Britain is poorly practised, in schools as well as in the home. British so called ‘Puritanism’ has been seen as one of the reasons. At a time and age when teenage pregnancy, Sexual Transmitted Infections (STIs) and viruses (AIDS/HIV) are on the increase more attention to the education of sexual behaviour is needed. Government initiatives are leading in that direction for schools as well as families, but it is unclear how these are materialised. Especially, how families discuss sexual matters is underresearched and poorly understood. Therefore, the aims of this study were to explore the potential facilitators and barriers of the communication of sexual topics, with and without the use of a Sex and Relationship Education (SRE) multimedia program, and to explore the impact of this program on the knowledge of sexual issues and concerns. A mixed-method design was employed by using Strauss and Corbin’s (1998) modified grounded theory to develop a model reflecting the findings. Knowledge was assessed on data gathered from twenty British families over a ten-month period. Using semi-structured interviews, observational field notes and quantitative measures, it was found that trust, respect, spending (leisure) time together and children’s perception of their parents’ sexual knowledge were facilitators for sexual communications. Older siblings and other family members who were regarded as role models also facilitated the discussion of sexual matters. The barriers for discussing sexual issues openly within families included authoritative parenting, lack of parental sexual knowledge, presence of younger siblings and parents’ direct questioning of children’s personal relationships. In light of this, the multimedia program could be beneficial in many more families when initiating and communicating sexual matters.

Health and wellness programs are being utilized by organizations at growing rates. Research on health and wellness programs is typically confined to the program of a single organization and the employees participating in that specific program. Typically, this research examines the outcomes of health and wellness programs in organizations, such as return on investment in terms of medical costs, as well as improvements in the health of the employees. However, little information is known about those who choose to participate in health and wellness programs and the characteristics that may influence their participation. This study examined the relationship between demographic characteristics and likelihood of participation in health and wellness programs, as well as the relationship between program characteristics and likelihood of participation. Differences in likelihood of participation were found between different program types. Women were found to be more likely to participate than men, in most cases. Likelihood of participation increased as the incentive amount increased and decreased if the program incentive had a loss frame. Likelihood of participation was also higher for participation-based incentives compared to outcome-based incentives.

Psychosocial functioning is a key component of screening and treatment of Temporomandibular Disorders (TMD) in adults; however, psychosocial functioning in adolescents with TMD has received little empirical attention. The present study aims to examine group difference between adolescents and adults with TMD on pain and prominent psychosocial factors, such as anxiety, depression, and somatization, as well as to explore additional developmentally sensitive psychosocial factors that may be associated more with the adolescent TMD pain. Participants included 35 adolescents aged 12-17 (M=14.89 years, SD=1.84) with TMD muscle pain who completed pain questionnaires and a comprehensive dental examination. Patients and their primary caregivers completed behavioral questionnaires to examine psychosocial functioning. Thirty-five adults matched on gender, diagnosis, and duration of pain were selected from a large pre-existing database of previous orofacial pain patients. Adolescents and adults reported descriptively similar TMD pain and equivalent rates of anxiety, depression, and somatization; however, the relationship between these psychosocial factors and TMD pain appear to be more salient for adults compared to adolescents. In adolescents, increased pain-related interference was significantly associated with positive attitudes toward school, better anger control, and deficits in functional communication; whereas, more frequent TMD pain was significantly associated with sense of inadequacy and parent-reported withdrawal, though not in the expected direction. Screening for TMD in adults typically focuses on anxiety, depression, and somatization; however, these psychosocial factors overall did not appear as salient in adolescents as attitude toward school, anger control, sense of inadequacy, withdrawal, and functional communication, suggesting that adult psychosocial screen may need to be revised to include developmentally sensitive targets that may be particularly important for screening of TMD in adolescents.