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Illness Representations (illness + representation)
Selected AbstractsDevelopment of a tool to assess fidelity to a psycho-educational interventionJOURNAL OF ADVANCED NURSING, Issue 3 2010Mi-Kyung Song song m.-k., happ m.b. & sandelowski m. (2010) Development of a tool to assess fidelity to a psycho-educational intervention. Journal of Advanced Nursing66(3), 673,682. Abstract Aim., This paper is a description of a method to develop and conduct a customized psycho-educational intervention fidelity assessment as part of pilot work for an efficacy study. A tool designed to assess treatment fidelity to a psycho-education intervention for patients with end-stage renal disease and their surrogate decision makers, Sharing the Patient's Illness Representations to Increase Trust, is presented as an illustration. Background., Despite the specificity and idiosyncrasy of individual interventions and the call to systematically evaluate treatment fidelity, how to accomplish this goal has not been clarified. Tools to adequately measure treatment fidelity are lacking. Methods., We developed the Sharing the Patient's Illness Representations to Increase Trust Treatment Fidelity Assessment tool by identifying elements that were idiosyncratic to the intervention and those that could be adapted from existing tools. The tool has four components: overall adherence to the intervention content elements; pacing of the intervention delivery; overall dyad responsiveness; and, overall quality index of intervention delivery. The study was undertaken between 2006 and 2008. Results., Inter-rater reliability ranged from 0·80 to 0·87 for the four components. The tool showed utility in training and monitoring, such as detecting unplanned content elements delivered and the use of proscribed communication behaviours. Conclusion., Psycho-educational interventions are one of the most common types of nursing interventions worldwide. Use of fidelity assessment tools customized to the individual interventions may enhance systematic evaluation of training and monitoring treatment fidelity. [source] Illness Representations According to Age and Effects on Health Behaviors Following Coronary Artery Bypass Graft SurgeryJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2001Brooks B. Gump PhD OBJECTIVES: To determine if illness representations differ as a function of age and how these representations, in conjunction with age, predict postoperative health behaviors. DESIGN: Prospective study of patients undergoing coronary artery bypass graft (CABG) surgery. SETTING: A large metropolitan hospital providing regional cardiac care for patients in a tri-state area, located in Pittsburgh, Pennsylvania. PARTICIPANTS: All consenting patients (N = 309) from a consecutive series of patients scheduled for CABG surgery between January 1992 and January 1994. To be eligible for participation, patients could not be scheduled for any other coincidental surgery (e.g., valve replacement), and could not be in cardiac intensive care or experiencing angina at the time of the referral. Participants were predominantly male (70%) and married (80%), and averaged 62.8 years of age. MEASUREMENTS: Postoperative self-reported health behaviors. RESULTS: Older participants awaiting CABG surgery were significantly more likely to believe old age to be the cause of their coronary heart disease (CHD) and significantly less likely to believe genetics, health-damaging behaviors, health protective behaviors, and emotions to be the cause of their CHD than were younger participants awaiting surgery. Furthermore, the older participants were significantly more likely to believe they had no control over the disease and that the disease would be gone after surgery, and reported fewer postoperative health behavior changes than did younger participants. CONCLUSION: These findings demonstrate significant differences in illness representations as a function of age. Furthermore, differences in postoperative health behaviors were consistent with differing illness representations. [source] Randomized controlled trial of SPIRIT: An effective approach to preparing African-American dialysis patients and families for end of life,RESEARCH IN NURSING & HEALTH, Issue 3 2009Mi-Kyung Song Abstract This randomized controlled trial tested an intervention, Sharing Patients' Illness Representations to Increase Trust (SPIRIT), designed to enhance communication regarding end-of-life care between African Americans with end-stage renal disease (ESRD) and their chosen surrogate decision makers (N,=,58 dyads). We used surveys and semi-structured interviews to determine the feasibility, acceptability, and preliminary effects of SPIRIT on patient and surrogate outcomes at 1 week and 3 months post-intervention. We also evaluated patients' deaths and surrogates' end-of-life decision making to assess surrogates' perceptions of benefits and limitations of the SPIRIT while facing end-of-life decisions. We found that SPIRIT promoted communication between patients and their surrogates and was effective and well received by the participants. © 2009 Wiley Periodicals, Inc. Res Nurs Health 32:260,273, 2009 [source] Promoting self-care through symptom management: A theory-based approach for nurse practitionersJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 5 2007ACNP (Acute Care Nurse Practitioner), Christopher Fowler RN, PhD(c) Abstract Purpose: To present a theory of illness representation useful in clinical practice along with two case studies as examples of theory implementation. Data sources: Literature review of relevant theory and associated literature, case studies from clinical practice. Conclusions: An individual asks several questions when experiencing a physical sensation: "Am I sick, stressed, or is this a sign of aging? If I'm sick, is the symptom connected with a disease label?" After asking these questions, the individual develops a cognitive and emotional illness representation that includes the dimensions of identity, cause, consequences, control, and timeline. This representation is guided by personal, cultural, and environmental contexts and determines coping strategies. By assessing the individual's cognitive and emotional representations of the illness, the nurse practitioner (NP) can use the common sense model of illness representation (CSM) to establish interventions and action plans helpful in decreasing distress in the management of symptoms. Implications for practice: NPs frequently care for patients who present with very severe symptoms related to their health problem. This becomes a major challenge in effective disease management. Leventhal's CSM can be used as a framework to identify the cognitive and emotional illness representations individuals develop when acute and chronic symptoms are presented. By assessing the individual's cognitive and emotional representations of the illness, the NP will be able to use the CSM to establish interventions and action plans that will be helpful in decreasing the patient's distress in the management of symptoms. [source] Delay in seeking care for symptoms of acute myocardial infarction: Applying a theoretical model,RESEARCH IN NURSING & HEALTH, Issue 4 2005Jill R. Quinn Abstract Thirty percent of people who experience symptoms of acute myocardial infarction (AMI) do not seek care until more than 2,6 hours after onset of symptoms, increasing their risk for morbidity and mortality. Using a model based on two frameworks, the common sense model of illness representation (CSM) and goal expectancy, variables associated with delay were examined to identify the most salient predictors of delay in seeking care for AMI. Hierarchical regression analysis revealed that the set of illness representation components from the CSM was a significant predictor of time to seek care, but individually, only recognition of symptoms as being caused by the heart was significant. Providing accurate information on symptoms of AMI may lead to early recognition, reduced delay, and reduced morbidity and mortality. © Wiley Periodicals, Inc. Res Nurs Health 28:283,294, 2005 [source] Illness Representations According to Age and Effects on Health Behaviors Following Coronary Artery Bypass Graft SurgeryJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2001Brooks B. Gump PhD OBJECTIVES: To determine if illness representations differ as a function of age and how these representations, in conjunction with age, predict postoperative health behaviors. DESIGN: Prospective study of patients undergoing coronary artery bypass graft (CABG) surgery. SETTING: A large metropolitan hospital providing regional cardiac care for patients in a tri-state area, located in Pittsburgh, Pennsylvania. PARTICIPANTS: All consenting patients (N = 309) from a consecutive series of patients scheduled for CABG surgery between January 1992 and January 1994. To be eligible for participation, patients could not be scheduled for any other coincidental surgery (e.g., valve replacement), and could not be in cardiac intensive care or experiencing angina at the time of the referral. Participants were predominantly male (70%) and married (80%), and averaged 62.8 years of age. MEASUREMENTS: Postoperative self-reported health behaviors. RESULTS: Older participants awaiting CABG surgery were significantly more likely to believe old age to be the cause of their coronary heart disease (CHD) and significantly less likely to believe genetics, health-damaging behaviors, health protective behaviors, and emotions to be the cause of their CHD than were younger participants awaiting surgery. Furthermore, the older participants were significantly more likely to believe they had no control over the disease and that the disease would be gone after surgery, and reported fewer postoperative health behavior changes than did younger participants. CONCLUSION: These findings demonstrate significant differences in illness representations as a function of age. Furthermore, differences in postoperative health behaviors were consistent with differing illness representations. [source] A Representational Approach to Patient EducationJOURNAL OF NURSING SCHOLARSHIP, Issue 3 2001Heidi Scharf Donovan Purpose: To describe the theoretical basis for a representational approach to patient education and the application of this approach to the development, implementation, and preliminary evaluation of a representational intervention for pain management. Organizing Construct: Leventhal's common sense model (CSM) was a guide for this approach to patient education. The CSM is based on the idea that people have common sense beliefs, or representations, that guide how they cope with health problems. Theoretically based interventions derived from the CSM have not been reported. Methods: Steps included: (a) designing a general approach to educational interventions, centered on illness representations; (b) specifying an intervention (RIDPAIN) to facilitate coping with cancer pain; (c) pilot-testing and revising the intervention; and (d) testing feasibility and acceptability of the intervention with 61 patients in a Midwestern American city. Findings: The RIDPAIN intervention was useful in eliciting misconceptions of pain and pain management from patients experiencing cancer pain. Many patients found RIDPAIN to be meaningful and useful, and they perceived it to have an effect on pain-related beliefs and behaviors. Conclusions: This theory-driven approach should be effective and widely applicable because it includes patients as active participants in all phases of the learning continuum, from information acquisition to behavior change. [source] Beliefs about cancer causation and prevention as a function of personal and family history of cancer: a national, population-based studyPSYCHO-ONCOLOGY, Issue 10 2008Emily L. B. Lykins Abstract Objective: Research suggests individuals possess multifaceted cognitive representations of various diseases. These illness representations consist of various beliefs, including causal attributions for the disease, and are believed to motivate, guide, and shape health-related behavior. As little research has examined factors associated with beliefs about cancer causation, this study examined the relationship between personal and family history of cancer and beliefs about the causes and prevention of malignant disease. Methods: Data were obtained from 6369 adult respondents to the 2003 Health Information National Trends Survey, a national population-based survey. Information about personal and family history of cancer and beliefs regarding cancer causation and prevention was obtained. Results: Results showed both a personal and family history of cancer were associated with differences in beliefs about the causes of cancer. In general, a personal history of cancer was not significantly linked to causal attributions for cancer relative to those without a personal history. In contrast, a family history of cancer tended to increase the likelihood a respondent viewed a particular cause as increasing cancer risk. Thus, personal and vicarious experience with cancer had dramatically diverging influences on attributions of cancer causation, which may be due to differing self-protection motives. Conclusion: Results support the belief that illness representations, in this case the causal belief component, are influenced by both personal and vicarious experience with a disease and also suggest illness representations may influence receptivity to messages and interventions designed to increase appropriate cancer risk reduction behavior. Copyright © 2007 John Wiley & Sons, Ltd. 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