• 【宫颈细胞学筛查-城市周围地区的知识,态度和实践。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Bailie R,Pick W,Cooper D
    BACKGROUND & AIMS: AIM:To determine the knowledge, attitudes and practice of women living in peri-urban settlements with regard to screening for cervical cancer. METHOD:A community-based questionnaire survey of 165 women living in a defined area of Khayelitsha, a peri-urban settlement on the outskirts of Cape Town. RESULTS:Two hundred households were visited, with a response rate of 84%. Median age of respondents was 27.5 years. The majority of interviewees were married (53.3%), unemployed (61.5%), had an educational status of standard 4 or less (58.1%) and had been living in Cape Town for 4 years or more (64.3%). The median parity was 2 (range 0-11). Most interviewees were currently using contraception (52.4%). One-third (35.4%; 95% CI 28.1-42.7%) of interviewees had heard of the Pap smear. Of these women, most had obtained their information from the midwife obstetric unit (MOU), and this was the most commonly reported facility where Pap tests were known to be done. The majority of interviewees did not regard the test (or the prospect thereof) as embarrassing (88.4%), painful (89.1%) or harmful (90.9%), and indicated that they would have the test done (89.1%). The most important reason for choice of where the test should be done was proximity to place of residence (83.9%). More than one-third of interviewees reported having had a Pap test (37.2%; 95% CI 28.8-44.8%). The most common reason for not having had a test was that the interviewee had never heard of it (81.3%). Most had undergone the test at a MOU (65.6%), where it had been part of an antenatal work-up (80.3%). Fewer than half of the interviewees who had undergone a test knew the result of their test. CONCLUSION:The antenatal, obstetric and family planning services in the area have been effective, to a limited extent, in providing information and conducting screening. However, these services are missing many opportunities to fulfill this function, and knowledge and practice of cervical cytology screening in this community are poor. With the implementation of a rational policy for screening in this area there is the potential to achieve good coverage.
    背景与目标:
  • 【[在甲型H1N1 2009流感大流行期间,媒体对西班牙医护人员的信仰、态度和影响]。】 复制标题 收藏 收藏
    DOI:10.1016/j.eimc.2012.09.013 复制DOI
    作者列表:Tuells J,Caballero P,Nolasco A
    BACKGROUND & AIMS: INTRODUCTION:The aim of this article is to report, from their own perspective, the attitudes and believes towards vaccination, with special emphasis on the influence of sources of information to make the decision to get vaccinated, of health care workers (HCWs), considered as a specific risk group for immunization strategy against A (H1N1) influenza. METHODS:Cross-sectional observational study focused on active health workers in the province of Alicante. Made by face to face questionnaires to a stratified random sample based on occupational categories in hospitals and health care centres. RESULTS:The sources of information differ between subgroups; physicians used journals and/or conferences, nurses obtained information through the Ministry of Health and other nurses, and the remaining workers opted for television and/or the family physician. Of the three studied groups, physicians felt minor concern about the influenza A (H1N1) pandemic (59.4%), had the most confidence in the vaccine (42.3%), were the ones who recommended the vaccine the most (44.4%), who best followed the recommendations to avoid infection (93%), and were the most vaccinated (18.3%). Around three-quarters (75.5%) of the HCWs assessed the provided information as fair, poor or very poor. All HCWs admitted that a social alarm was created. DISCUSSION:The success of future immunization campaigns against influenza in HCWs could increase if information activities were designed to focus on each subgroup of HCWs, by adapting the strategy and improving the quality of information.
    背景与目标:
  • 【晚期癌症患者对肿瘤基因组分析中次级种系发现的兴趣和态度。】 复制标题 收藏 收藏
    DOI:10.1200/JOP.2016.020057 复制DOI
    作者列表:Hamilton JG,Shuk E,Genoff MC,Rodríguez VM,Hay JL,Offit K,Robson ME
    BACKGROUND & AIMS: PURPOSE:Tumor genomic profiling (TGP) can reveal secondary findings about inherited disease risks in a patient with cancer. Little is known about how patients with advanced cancer, currently the primary users of TGP, perceive the benefits and harms of secondary germline findings. METHODS:We conducted semistructured interviews with 40 patients with advanced breast, bladder, colorectal, or lung cancer who had TGP. Qualitative interview data were evaluated by using a thematic content analysis approach. RESULTS:Most participants expressed interest in the prospect of learning their secondary germline findings (57%), although a minority was equivocal (29%) or disinterested (14%). Reasons for these preferences varied but were influenced by participants' perceptions of diverse benefits and harms of this information, which they regarded as relevant to themselves; their families; and other patients with cancer, medical science, and society. These attitudes were uniquely shaped by participants' personal disease experiences and health status. CONCLUSION:Many patients with advanced cancer are interested in learning secondary germline findings and hold optimistic and perhaps unrealistic beliefs about the potential health benefits. Patients also have important concerns about clinical and emotional implications of this information. These perceptions are necessary to address to ensure that patients make informed decisions about learning secondary germline findings.
    背景与目标:
  • 【来源可信度和电子烟态度: 对烟草传播的影响。】 复制标题 收藏 收藏
    DOI:10.1080/10410236.2017.1331190 复制DOI
    作者列表:Case KR,Lazard AJ,Mackert MS,Perry CL
    BACKGROUND & AIMS: :As there are many conflicting sources of e-cigarette information, research is needed to determine the impact of these sources on e-cigarette attitudes to inform future communication campaigns. Source credibility is important in shaping attitudes toward other health topics; however, no study has examined its role in influencing e-cigarette attitudes. Data from the 2015 Health Information National Trends Survey-FDA (HINTS-FDA) were utilized to assess differences in trust in different sources by e-cigarette user status and to investigate the associations between trust in sources and e-cigarette attitudes (n = 3,738). Differences in trust in sources were examined using weighted linear regression. Associations between trust in sources of e-cigarette health effects and attitudes toward e-cigarettes were assessed using weighted logistic regression. Overall, e-cigarette ever users reported significantly lower trust in governmental agencies as compared to never users. Trust in e-cigarette companies was negatively associated with perceived addictiveness of e-cigarettes (AOR = 0.76, 95% CI = 0.58, 1.00), while trust in doctors/pharmacists/healthcare providers was negatively associated with harm perceptions of e-cigarettes relative to conventional cigarettes (AOR = 0.72, 95% CI = 0.55, 0.95). Trust in tobacco companies and trust in e-cigarette companies were negatively associated with absolute perceived harm of e-cigarettes (AOR = 0.70, 95% CI = 0.51, 0.95; AOR = 0.60, 95% CI = 0.46, 0.79, respectively). Results from this study indicate that the associations between trust in sources of e-cigarette health effects and e-cigarette attitudes differ both by source and specific attitude assessed. Ultimately, future campaigns should incorporate messaging to discredit industry sources of information and utilize non-governmental sources to effectively influence e-cigarette attitudes.
    背景与目标: : 由于存在许多相互矛盾的电子烟信息来源,因此需要进行研究以确定这些来源对电子烟态度的影响,以为未来的交流活动提供信息。来源可信度对于塑造对其他健康主题的态度很重要; 但是,没有研究检查其在影响电子烟态度中的作用。来自2015健康信息国家趋势调查-FDA (HINTS-FDA) 的数据被用来评估电子烟用户状况对不同来源信任的差异,并调查来源信任与电子烟态度之间的关联 (n = 3,738)。使用加权线性回归检查来源信任的差异。使用加权逻辑回归评估了对电子烟健康影响来源的信任与对电子烟的态度之间的关联。总体而言,与从未使用过的电子烟用户相比,曾经使用过的电子烟用户对政府机构的信任度明显降低。对电子烟公司的信任与电子烟的感知成瘾性负相关 (AOR = 0.76,95% CI = 0.58,1.00),而对医生/药剂师/医疗保健提供者的信任与电子烟相对于传统香烟的危害感知负相关 (AOR = 0.72,95% CI = 0.55,0.95)。对烟草公司的信任和对电子烟公司的信任与电子烟的绝对感知危害呈负相关 (AOR = 0.70,95% CI = 0.51,0.95; AOR = 0.60,95% CI = 0.46,0.79)。这项研究的结果表明,对电子烟健康影响来源的信任与电子烟态度之间的关联因来源和评估的特定态度而异。最终,未来的运动应纳入信息传递,以抹黑行业的信息来源,并利用非政府来源有效地影响电子烟的态度。
  • 【佛兰德消费者对更可持续的食品选择的态度。】 复制标题 收藏 收藏
    DOI:10.1016/j.appet.2012.11.003 复制DOI
    作者列表:Vanhonacker F,Van Loo EJ,Gellynck X,Verbeke W
    BACKGROUND & AIMS: :Intensive agricultural practices and current western consumption patterns are associated with increased ecological pressure. One way to reduce the ecological impact could be a shift to more sustainable food choices. This study investigates consumer opinions towards a series of food choices with a lower ecological impact. The investigated food choices range from well-known meat substitutes to alternatives which are more radical or innovative and that require an adaptation of food habits and cultural patterns. Results are obtained through a survey among 221 Flemish respondents in Spring 2011. Many consumers underestimate the ecological impact of animal production. Well-known alternatives such as organic meat, moderation of meat consumption and sustainable fish are accepted, although willingness to pay is clearly lower than willingness to consume. Consumers are more reluctant to alternatives that (partly) ban or replace meat in the meal. Opportunities of introducing insects currently appear to be non-existent. Five consumer segments were identified based on self-evaluated ecological footprint and personal relevance of the ecological footprint. The segments were termed Conscious, Active, Unwilling, Ignorant and Uncertain. A profile in terms of demographics, attitudinal and behavioral characteristics is developed for each segments, and conclusions with respect to opportunities for sustainable food choices are discussed.
    背景与目标: : 集约化农业实践和当前的西方消费模式与生态压力增加有关。减少生态影响的一种方法可能是转向更可持续的食物选择。这项研究调查了消费者对一系列生态影响较低的食物选择的看法。所调查的食物选择范围从著名的肉类替代品到更激进或创新的替代品,需要适应饮食习惯和文化模式。结果是通过对2011年春季的221名佛兰德受访者的调查获得的。许多消费者低估了动物生产对生态的影响。众所周知的替代品,例如有机肉,适度的肉类消费和可持续的鱼类被接受,尽管支付意愿明显低于消费意愿。消费者更不愿选择 (部分) 禁止或替换餐食中的肉类的替代品。目前似乎不存在引入昆虫的机会。根据自我评估的生态足迹和生态足迹的个人相关性,确定了五个消费者细分市场。这些部分被称为有意识的,积极的,不愿意的,无知的和不确定的。针对每个细分市场制定了人口统计,态度和行为特征的概况,并讨论了有关可持续食物选择机会的结论。
  • 【中年妇女对基于网络的促进体育锻炼干预措施的态度。】 复制标题 收藏 收藏
    DOI:10.1258/jtt.2012.120514 复制DOI
    作者列表:Im EO,Chang SJ,Chee W,Chee E
    BACKGROUND & AIMS: :We explored the attitudes of women at midlife to web-based interventions for promoting physical activity. 145 women volunteered to participate in one of four online forums. The forums were for four major racial/ethnic groups. 90 volunteers were recruited for the online forums (29 Whites, 23 Hispanics, 21 African Americans, and 17 Asians). Two sets of topics on attitudes to physical activity and racial/ethnic contexts were used. Each topic had some introductory questions and related prompts, and these were posted on the online forum sites in a serial fashion during the six-month period. We used a thematic analysis. Four major themes emerged: (1) 'a matter of the source of the information'; (2) 'I can pace myself'; (3) 'lack of interpersonal interactions'; and (4) 'culture-specificity and low cost.' The women in all ethnic groups thought that the source of the information was much more important than the medium of the information (e.g. web-based, booklet or face-to-face). They liked the self-controllability in web-based interventions. They preferred web-based interventions to other types of interventions because of easy accessibility, but they were concerned about lack of interpersonal interaction. None of the White or African American women indicated the need for culture-specificity in web-based interventions, but Hispanic and Asian women indicated that culture-specific interventions should be provided. Web-based interventions appear to have several advantages over conventional approaches to promoting physical activity.
    背景与目标: : 我们探讨了中年妇女对基于网络的干预措施以促进体育锻炼的态度。145妇女自愿参加四个在线论坛之一。论坛面向四个主要种族/族裔群体。在线论坛招募了90名志愿者 (29名白人,23名西班牙裔,21名非裔美国人和17名亚洲人)。使用了两套关于体育活动态度和种族/族裔背景的主题。每个主题都有一些介绍性问题和相关提示,这些问题在六个月内以连续方式发布在在线论坛网站上。我们使用了主题分析。出现了四个主要主题 :( 1) “信息来源问题”; (2) “我可以调整自己”; (3) “缺乏人际互动”; (4) “文化特殊性和低成本”。所有种族的妇女都认为信息的来源比信息的媒介 (例如基于网络的,小册子或面对面的) 重要得多。他们喜欢基于网络的干预中的自我控制性。由于易于访问,他们更喜欢基于网络的干预措施,而不是其他类型的干预措施,但他们担心缺乏人际互动。在基于网络的干预措施中,没有白人或非洲裔美国妇女表示需要文化特异性,但是西班牙裔和亚裔妇女表示应提供针对文化的干预措施。与传统的促进体育锻炼的方法相比,基于网络的干预似乎具有几个优势。
  • 【发展脑血管态度和信念量表 (CABS): 中风相关健康信念的量度。】 复制标题 收藏 收藏
    DOI:10.1310/tsr1403-41 复制DOI
    作者列表:Sullivan K,Waugh D
    BACKGROUND & AIMS: PURPOSE:To develop a measure of stroke-related health beliefs, derived from the Health Belief Model (HBM) and a measure of stroke risk factor behavior change. METHOD:The Cerebrovascular Attitudes and Beliefs Scale (CABS) was devised to assess survivors' beliefs and attitudes about their susceptibility to future stroke, the perceived seriousness of stroke, and the likely benefits and barriers associated with undertaking behaviors to reduce stroke risk. A second measure, the Stroke Behavior Change Inventory (SBCI), as well as a version developed for relatives (SBCI-R), was devised to assess participants' pre- and poststroke risk factor behavior. RESULTS:Forty-two stroke/transient ischemic attack (TIA) survivors accurately described behavior changes they had undertaken poststroke, when compared to relatives' reports of such behavior (n = 7). Most survivors changed at least some behaviors poststroke to reduce their stroke risk. Further analysis to determine the role of health beliefs in predicting behavior change poststroke was undertaken, focusing on those behaviors that were changed in a large enough proportion of the sample. The beliefs most predictive of behavior change related to perceived stroke seriousness and severity, but the combination of beliefs from the HBM was not predictive of behavior change. CONCLUSION:After stroke or TIA, most survivors change their behavior in ways that would contribute to stroke risk reduction. Such effects can be demonstrated using survivor self-report or relatives' report of survivors' behaviors. Using the CABS, partial support for health belief variables as predictors of such behavior change was also identified, suggesting that further investigation of these variables is warranted.
    背景与目标:
  • 【对艾滋病毒/艾滋病患者的医疗保健提供者和预约出勤的态度。】 复制标题 收藏 收藏
    DOI:10.1016/j.jana.2007.03.002 复制DOI
    作者列表:Bodenlos JS,Grothe KB,Whitehead D,Konkle-Parker DJ,Jones GN,Brantley PJ
    BACKGROUND & AIMS: :Patients with HIV/AIDS are likely to have numerous interactions with health care providers (HCPs) during the course of their disease. Research has shown that satisfaction with one's HCP is related to better medication adherence in patients with HIV/AIDS. Although a patient's attitude toward his or her HCP is important, little has been done to assess how it relates to appointment attendance. The current study assessed how attitudes toward HCPs as well as social support and depression relate to outpatient appointment attendance. Further, this study used a newly developed, psychometrically valid scale to assess specific patient attitudes toward HCPs including those related to disease stigma. Participants were predominantly low-income African American men (N = 109) recruited from a public southern HIV clinic. Analyses indicated that attitudes toward HIV HCPs, social support, and medication status but not depression or satisfaction with social support were associated with appointment attendance.
    背景与目标: : 艾滋病毒/艾滋病患者在患病过程中可能会与医疗保健提供者 (hcp) 发生许多互动。研究表明,对HCP的满意度与HIV/AIDS患者更好的药物依从性有关。尽管患者对HCP的态度很重要,但几乎没有采取任何措施来评估其与预约出勤的关系。当前的研究评估了对hcp以及社会支持和抑郁的态度与门诊预约出勤之间的关系。此外,这项研究使用了新开发的,心理测量有效的量表来评估患者对hcp的特定态度,包括与疾病污名有关的态度。参与者主要是从南方公立HIV诊所招募的低收入非裔美国人 (N = 109)。分析表明,对HIV hcp的态度,社会支持和药物状况,但对抑郁或对社会支持的满意度与预约出勤有关。
  • 【长期的睡眠限制增加了对阿拉伯穆斯林的消极隐性态度。】 复制标题 收藏 收藏
    DOI:10.1038/s41598-017-04585-w 复制DOI
    作者列表:Alkozei A,Killgore WDS,Smith R,Dailey NS,Bajaj S,Haack M
    BACKGROUND & AIMS: :Chronic sleep restriction is a common experience; and while it has negative physiological effects, little is known about how it affects human behavior. To date, no study has investigated whether chronic sleep restriction can influence implicit attitudes (e.g., towards a race). Here, in a randomized, counterbalanced crossover design, we subjected participants to 3 weeks of chronic sleep restriction in the lab (i.e., 3 weekly cycles of 5 nights of 4 hours of sleep per night followed by 2 nights of 8 hours of sleep) and found evidence for an increased negative implicit bias towards Arab Muslims. No indicators of an implicit bias were found in these same individuals when they were rested (during a counterbalanced 3-week period of 8 hours time in bed per night). These findings suggest that chronic sleep restriction may "unmask" implicit racial or ethnic biases that are otherwise inhibited when in a rested state. Because chronic sleep restriction is prevalent among many occupations that routinely interact with ethnic minorities in potentially high-conflict situations (e.g., police officers), it is critical to consider the role that restricted sleep may play in exacerbating negative implicit attitudes and their potential for provoking unintentional and potentially harmful behavioral consequences.
    背景与目标: : 慢性睡眠限制是一种常见的体验; 尽管它具有负面的生理影响,但对它如何影响人类行为知之甚少。迄今为止,还没有研究研究慢性睡眠限制是否会影响内隐态度 (例如,对种族)。在这里,在随机,平衡交叉设计中,我们使参与者在实验室中接受了3周的慢性睡眠限制 (即,每周3个周期,每5个晚上,每晚4个小时的睡眠,然后是2个晚上8个小时的睡眠),并发现了对阿拉伯穆斯林的负面隐性偏见增加的证据。在这些人休息时 (在每晚卧床8小时的平衡3周内),没有发现隐性偏见的指标。这些发现表明,慢性睡眠限制可能会 “掩盖” 隐性的种族或种族偏见,而这些偏见在休息状态下会受到抑制。由于慢性睡眠限制在许多职业中普遍存在,这些职业在潜在的高冲突情况下经常与少数民族互动 (例如,警察),因此至关重要的是要考虑睡眠限制在加剧消极的内隐态度及其潜在的潜在影响中发挥的作用。引发无意的和潜在的有害行为后果。
  • 【自由意志信念可以预测对不道德行为和刑事处罚的态度。】 复制标题 收藏 收藏
    DOI:10.1073/pnas.1702119114 复制DOI
    作者列表:Martin ND,Rigoni D,Vohs KD
    BACKGROUND & AIMS: :Do free will beliefs influence moral judgments? Answers to this question from theoretical and empirical perspectives are controversial. This study attempted to replicate past research and offer theoretical insights by analyzing World Values Survey data from residents of 46 countries (n = 65,111 persons). Corroborating experimental findings, free will beliefs predicted intolerance of unethical behaviors and support for severe criminal punishment. Further, the link between free will beliefs and intolerance of unethical behavior was moderated by variations in countries' institutional integrity, defined as the degree to which countries had accountable, corruption-free public sectors. Free will beliefs predicted intolerance of unethical behaviors for residents of countries with high and moderate institutional integrity, but this correlation was not seen for countries with low institutional integrity. Free will beliefs predicted support for criminal punishment regardless of countries' institutional integrity. Results were robust across different operationalizations of institutional integrity and with or without statistical control variables.
    背景与目标: : 自由意志信仰会影响道德判断吗?从理论和实证的角度回答这个问题是有争议的。本研究试图通过分析来自46个国家 (n = 65,111人) 的居民的世界价值调查数据来复制过去的研究并提供理论见解。证实了实验结果,自由意志信念预测了对不道德行为的不容忍以及对严厉刑事处罚的支持。此外,自由意志信念与对不道德行为的不容忍之间的联系受到国家机构完整性差异的调节,机构完整性的定义是国家对公共部门负责的程度,无腐败。自由意志信念预测了机构完整性高和中等国家的居民对不道德行为的不容忍,但是对于机构完整性低的国家却没有这种相关性。自由意志信念预测,无论国家的机构完整性如何,都将支持刑事处罚。在机构完整性的不同操作中,无论有无统计控制变量,结果都是稳健的。
  • 【与自我报告的谷物食品消费趋势相关的消费者态度和误解: 西澳大利亚成年人的横断面研究,1995 2012年。】 复制标题 收藏 收藏
    DOI:10.1186/s12889-017-4511-5 复制DOI
    作者列表:Pollard CM,Pulker CE,Meng X,Scott JA,Denham FC,Solah VA,Kerr DA
    BACKGROUND & AIMS: BACKGROUND:The reasons for low adherence to cereal dietary guidelines are not well understood but may be related to knowledge, attitudes, beliefs and perceived barriers. This study aims to assess trends in cereal foods consumption, intention to change and factors associated with intake among Western Australian (WA) adults 18 to 64 years. METHOD:Cross-sectional data from the 1995, 1998, 2001, 2004, 2009, and 2012 Nutrition Monitoring Survey Series involving 7044 adults were pooled. OUTCOME VARIABLES:types and amount of cereals (bread, rice, pasta, and breakfast cereal) eaten the day prior. Attitudes, knowledge, intentions, weight status and sociodemographic characteristics were measured. Descriptive statistics, multiple binary logistic and multinomial logistic regressions assess factors associated with consumption. RESULTS:Bread (78%) was the most commonly consumed cereal food. The proportion eating bread decreased across survey years (Odds Ratio OR = 0.31; 95% Confidence Interval; 0.24-0.40 in 2012 versus 1995), as did the amount (4.1 slices of bread in 1995 to 2.4 in 2012). The odds of consuming whole-grain cereal foods increased since 2009 (OR = 1.27; 1.02-1.58 versus 1995 p < 0.05). The likelihood of trying to eat less cereal food in the past year was greater in 2012 compared to 1995 (Relative Risk Ratio RRR 10.88; 6.81-17.4). Knowledge of cereal recommendations decreased over time (OR = 0.20; 0.15-0.27 in 2012 versus 1995 p < 0.001). Overweight and obese respondents were more likely than healthy weight respondents to have tried to eat less cereals (RRR 1.65; 1.22-2.24 and 1.88; 1.35-2.63 respectively). 'I already eat enough' was the main barrier (75% in 1995 to 84% in 2012 (p < 0.001)). CONCLUSIONS:WA adults are actively reducing the amount of cereal foods they eat and intake is associated with a misperception of adequacy of intake. Nutrition intervention is needed to increase awareness of the health benefits of cereal foods, particularly whole-grains, and to address barriers to incorporating them daily. TRIAL REGISTRATION:Not applicable.
    背景与目标:
  • 【医院临床医生对缺乏心理能力的患者的法定倡导服务的态度: 实施的意义。】 复制标题 收藏 收藏
    DOI:10.1258/jhsrp.2007.007084 复制DOI
    作者列表:Luke L,Redley M,Clare I,Holland A
    BACKGROUND & AIMS: OBJECTIVES:To examine attitudes to the Mental Capacity Act's new statutory Independent Mental Capacity Advocate (IMCA) service in England and Wales and consider the implications for its delivery. METHODS:Quantitative data describing all referrals to the seven pilot IMCA services (January 2006-March 2007) and qualitative data from semi-structured interviews with 18 doctors, 21 senior nurses and one discharge planning manager in four general hospitals in England. RESULTS:Of 127 hospital-based referrals to the seven pilot IMCA services, 29 (23%) were for patients facing serious medical treatments, 52% of whom were judged to lack decision-making capacity due to a learning disability; ninety-eight (77%) were for patients facing a change of accommodation upon hospital discharge, 62% of whom were elderly and lacked capacity due to dementia. While aware of the potential benefits of the IMCA service, clinicians were generally negative about the contribution advocates could make to patients' medical care and thought they could only contribute usefully in a minority of ethically complicated decisions. In contrast, they were more positive about the involvement of advocates in hospital discharge decisions and hoped that they would improve current discharge practice. CONCLUSIONS:Clinicians held ambivalent attitudes towards the involvement of a statutory IMCA service in medical decisions, reflecting beliefs that the service was largely impractical and unnecessary given current procedures for making medical decisions in patients' 'best interests'. Conversely, clinicians were more likely to support advocacy in discharge decisions because they believed that non-medically qualified advocates could make a valuable contribution to decisions that were seen as predominantly social and where practice was frequently considered deficient. By holding these beliefs, clinicians are failing to have due regard for the IMCA service as a statutory measure for safeguarding patients' interests.
    背景与目标:
  • 【疗养院尸检。医师态度和执业模式调查。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Katz PR,Seidel G
    BACKGROUND & AIMS: :Autopsy rates remain disturbingly low in nursing homes despite the fact that 1 of 5 deaths occurs in this setting. To determine the autopsy rate for nursing homes, we analyzed all deaths occurring in New York State nursing homes from 1980 to 1984. Of 58,985 nursing home deaths, autopsies were performed in only 499 cases (0.8%). In comparison to the general nursing home population, autopsied residents were more likely to be male and never married and less likely to be widowed. Of 110 practicing nursing home physicians surveyed, 19% believed autopsies had little if any value in the nursing home population, whereas 71% saw autopsy as a valuable tool but rarely requested one. Fewer than 1 in 10 physicians routinely discussed autopsies with patients and/or families before death. Perceived obstacles included the emotional lability of patients and families and a lack of financial reimbursement. Concerns over religious objections, funeral delays, and unnecessary mutilation were cited by fewer than one third of respondents. Facilitation of consent, physician education, and cost sharing may all contribute to enhanced rates of autopsies in the future.
    背景与目标: : 尽管5例死亡中有1例发生在这种情况下,疗养院的尸检率仍然低得令人不安。为了确定疗养院的尸检率,我们分析了1984年1980年在纽约州疗养院发生的所有死亡。在58,985例疗养院死亡中,只有499例 (0.8% 例) 进行了尸检。与一般疗养院人口相比,经过尸检的居民更有可能是男性且从未结婚,也不太可能丧偶。在接受调查的110名执业疗养院医生中,19% 人认为尸检对疗养院人群几乎没有价值,而71% 人认为尸检是一种有价值的工具,但很少要求尸检。在死亡前,只有不到十分之一的医生与患者和/或家属进行常规尸检。感知到的障碍包括患者和家人的情绪不安和缺乏经济补偿。不到3分之1的受访者提到了对宗教异议,葬礼延误和不必要的肢解的担忧。同意的便利,医师教育和费用分担都可能有助于将来提高尸检率。
  • 【妇女对计划生育方法行动机制的态度: 西班牙潘普洛纳初级保健中心的调查。】 复制标题 收藏 收藏
    DOI:10.1186/1472-6874-7-10 复制DOI
    作者列表:de Irala J,Lopez del Burgo C,Lopez de Fez CM,Arredondo J,Mikolajczyk RT,Stanford JB
    BACKGROUND & AIMS: BACKGROUND:Informed consent in family planning includes knowledge of mechanism of action. Some methods of family planning occasionally work after fertilization. Knowing about postfertilization effects may be important to some women before choosing a certain family planning method. The objective of this survey is to explore women's attitudes towards postfertilization effects of family planning methods, and beliefs and characteristics possibly associated with those attitudes. METHODS:Cross-sectional survey in a sample of 755 potentially fertile women, aged 18-49, from Primary Care Health Centres in Pamplona, Spain. Participants were given a 30-item, self-administered, anonymous questionnaire about family planning methods and medical and surgical abortion. Logistic regression was used to identify variables associated with women's attitudes towards postfertilization effects. RESULTS:The response rate was 80%. The majority of women were married, held an academic degree and had no children. Forty percent of women would not consider using a method that may work after fertilization but before implantation and 57% would not consider using one that may work after implantation. While 35.3% of the sample would stop using a method if they learned that it sometimes works after fertilization, this percentage increased to 56.3% when referring to a method that sometimes works after implantation. Women who believe that human life begins at fertilization and those who consider it is important to distinguish between natural and induced embryo loss were less likely to consider the use of a method with postfertilization effects. CONCLUSION:Information about potential postfertilization effects of family planning methods may influence women's acceptance and choice of a particular family planning method. Additional studies in other populations are necessary to evaluate whether these beliefs are important to those populations.
    背景与目标:
  • 【体育运动中兴奋剂态度背后的心理机制: 动机和道德脱离。】 复制标题 收藏 收藏
    DOI:10.1123/jsep.35.4.419 复制DOI
    作者列表:Hodge K,Hargreaves EA,Gerrard D,Lonsdale C
    BACKGROUND & AIMS: :We examined whether constructs outlined in self-determination theory (Deci & Ryan, 2002), namely, autonomy-supportive and controlling motivational climates and autonomous and controlled motivation, were related to attitudes toward performance-enhancing drugs (PEDs) in sport and drug-taking susceptibility. We also investigated moral disengagement as a potential mediator. We surveyed a sample of 224 competitive athletes (59% female; M age = 20.3 years; M = 10.2 years of experience participating in their sport), including 81 elite athletes. Using structural equation modeling analyses, our hypothesis proposing positive relationships with controlling climates, controlled motivation, and PEDs attitudes and susceptibility was largely supported, whereas our hypothesis proposing negative relationships among autonomous climate, autonomous motivation, and PEDs attitudes and susceptibility was not supported. Moral disengagement was a strong predictor of positive attitudes toward PEDs, which, in turn, was a strong predictor of PEDs susceptibility. These findings are discussed from both motivational and moral disengagement viewpoints.
    背景与目标: : 我们研究了自我决定理论 (Deci & Ryan,2002) 中概述的结构,即自主支持和控制动机气候以及自主和控制动机,是否与运动和药物对提高表现药物 (ped) 的态度有关吸毒易感性。我们还调查了道德脱离作为潜在调解人的情况。我们调查了224名竞技运动员 (59% 名女性; M年龄 = 20.3岁; M = 10.2年参加运动的经验) 的样本,其中包括81名精英运动员。使用结构方程模型分析,我们的假设提出了与控制气候,受控动机以及PEDs态度和敏感性之间的正相关关系,而我们的假设提出了自主气候,自主动机以及PEDs态度和敏感性之间的负相关关系,则没有得到支持。道德脱离是对ped积极态度的有力预测因素,而这反过来又是ped易感性的有力预测因素。从动机和道德脱离的角度讨论了这些发现。

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