Four studies were conducted to investigate the impact of self-enhancement motivation on the temporal comparisons of victims of stressful life events. Study 1 revealed that (a) victims were more likely than acquaintances of victims to report greater improvement in their personal attributes after traumatic life events than after mild negative life events and (b) victims perceived improvement by derogating their pre-event attributes. In Studies 2 and 3, an experimental approach was used to study the impact of threatening experiences on perceptions of personal growth, and similar findings were obtained. Study 4 confirmed that threatening self-relevant feelings play a causal role in prompting self-enhancing temporal comparisons. Taken together, the findings of these studies support the view that perceptions of personal improvement reflect, at least in part, motivated illusions that are designed to help people cope with threatening life experiences.

BackgroundHealth systems face challenges in using research evidence to improve policy and practice. These challenges are particularly evident in small and poorly resourced health systems, which are often in locations (in Canada and globally) with poorer health status. Although organizational resources have been acknowledged as important in understanding research use resource theories have not been a focus of knowledge translation (KT) research. What resources, broadly defined, are required for KT and how does their presence or absence influence research use?In this paper, we consider conservation of resources (COR) theory as a theoretical basis for understanding the capacity to use research evidence in health systems. Three components of COR theory are examined in the context of KT. First, resources are required for research uptake. Second, threat of resource loss fosters resistance to research use. Third, resources can be optimized, even in resource-challenged environments, to build capacity for KT.MethodsA scan of the KT literature examined organizational resources needed for research use. A multiple case study approach examined the three components of COR theory outlined above. The multiple case study consisted of a document review and key informant interviews with research team members, including government decision-makers and health practitioners through a retrospective analysis of four previously conducted applied health research studies in a resource-challenged region.ResultsThe literature scan identified organizational resources that influence research use. The multiple case study supported these findings, contributed to the development of a taxonomy of organizational resources, and revealed how fears concerning resource loss can affect research use. Some resources were found to compensate for other resource deficits. Resource needs differed at various stages in the research use process.ConclusionsCOR theory contributes to understanding the role of resources in research use, resistance to research use, and potential strategies to enhance research use. Resources (and a lack of them) may account for the observed disparities in research uptake across health systems. This paper offers a theoretical foundation to guide further examination of the COR-KT ideas and necessary supports for research use in resource-challenged environments.

This paper explores why Canadian government policies, particularly those related to obesity, are ‘stuck’ at promoting individual lifestyle change. Key concepts within complexity and critical theories are considered a basis for understanding the continued emphasis on lifestyle factors in spite of strong evidence indicating that a change in the environment and conditions of poverty isare needed to tackle obesity. Opportunities to get ‘unstuck’ from individual-level lifestyle interventions are also suggested by critical concepts found within these two theories, although getting ‘unstuck’ will also require cross-sectoral collective action. Our discussion focuses on the Canadian context but will undoubtedly be relevant to other countries, where health promoters and others engage in similar struggles for fundamental government policy change.

ObjectiveThis study investigated what is important in care delivery from the perspective of hospital inpatients with complex chronic disease, a currently understudied population.Participants and SettingOne‐on‐one semi‐structured interviews were conducted with inpatients at a continuing care/rehabilitation hospital (n = 116) in Canada between February and July 2011.DesignThe study design was mixed methods and reports on patient characteristics and care delivery experiences. Basic descriptive statistics were run using SPSS version 17, and thematic analysis on the transcripts was conducted using NVivo9 software.ResultsPatients had an average of 5 morbidities and several illness symptoms including activity of daily living impairments, physical pain and emotional disturbance. Three broad themes (each with one or more subthemes) were generated from the data representing important components of care delivery: components of the care plan (a comprehensive assessment, supported transitions and a bio‐psycho‐social care package); care capacity and quality (optimal staff to patient ratios, quicker response times, better patient–provider communication and consistency between providers) and the patient–provider relationships (characterized by respect and dignity).ConclusionsAs health systems throughout the industrialized world move to sustain health budgets while optimizing quality of care, it is critical to better understand this population, so that appropriate metrics, services and policies can be developed. The study has generated a body of evidence on the important components of care delivery from the perspectives of a diverse group of chronically ill individuals who have spent a considerable amount of time in the health‐care system. Moving forward, exploration around the appropriate funding models and skill mix is needed to move the evidence into changed practice.

This research program examined how self-focused attention to feelings affects the relation between mood negativity and self-enhancing thought. The primary hypothesis was that the particular manner in which people focus on their moods (reflective vs. ruminative) determines whether they reveal positive (i.e., mood-incongruent) or negative (i.e., mood-congruent) self-relevant thoughts in response to negative moods. Studies 1-4 revealed that social comparisons, temporal comparisons, and other self-enhancing cognitions (i.e., attributions, disidentification, relationship evaluations) are more likely to be mood incongruent when people adopt a reflective orientation to their negative feelings and more likely to be mood congruent when they adopt a ruminative orientation. Additionally, moods and mood orientations affected self-enhancing thoughts through the mediating influence of mood regulation goals and intentions (Studies 5 and 6).

Beyond the value of assessing the impact of the design intentions on outcomes, the approach used in this study would benefit evaluation strategies across a diversity of health and other public and large-scale buildings.

A growing number of individuals require health services to manage multiple chronic conditions (i.e., complex chronic disease), yet little is known about their experience. The purpose of this study was to investigate the impact of *The authors thank the Bridgepoint Health Hospital Foundation for funding the study and to Great-West Life, London Life, Canada Life New Scientist Fund for providing salary support for the lead author.

Purpose - The purpose of this paper is to develop a psychometrically validated survey to assess satisfaction in complex continuing care (CCC)/rehabilitation patients. Design/methodology/approach - A paper or computer-based survey was administered to 252 CCC/rehabilitation patients (i.e. post-acute hospital care setting for people who require ongoing care before returning home) across two hospitals in Toronto, Ontario, Canada. Findings - Using factor analysis, five domains were identified with loadings above 0.4 for all but one item. Behavioral intention and information/communication showed the lowest patient satisfaction, while patient centredness the highest. Each domain correlated positively and significantly predicted overall satisfaction, with quality and safety showing the strongest predictive power and the healing environment the weakest. Gender made a significant contribution to predicting overall satisfaction, but age did not. Research limitations/implications - Results provide evidence of the survey's psychometric properties. Owing to a small sample, supplemental testing with a larger patient group is required to confirm the five-factor structure and to assess test-retest reliability. Originality/value - Improving the health system requires integrating patient perspectives. The patient experience, however, will vary depending on the population being served. This is the first psychometrically validated survey specific to a smaller specialty patient group receiving care at a CCC/rehabilitation facility in Canada.