LSE has developed LSE Research Online so that users may access research output of the School. Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. Users may download and/or print one copy of any article(s) in LSE Research Online to facilitate their private study or for non-commercial research. You may not engage in further distribution of the material or use it for any profit-making activities or any commercial gain. You may freely distribute the URL (http://eprints.lse.ac.uk) of the LSE Research Online website. This document is the author's submitted version of the journal article, before the peer review process. There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it. For more research by LSE authors go to LSE Divergences of Perspective Between People With Aphasia and their Family CaregiversBackground: Studies of the relation between family caregivers and care-receivers have identified large divergences between their perspectives. It has been suggested that these divergences may adversely affect the care relationship. However, there has been little research examining the source of these divergences. Aims:The reported mixed-method study aimed to examine the relationship between people with aphasia and their family caregivers in order to identify the sources of observed divergences of perspective. Methods & Procedures:Twenty people with aphasia and their main family caregivers, living in the UK, completed an adapted version of the Interpersonal Perception Method questionnaire, which yielded both rating data and qualitative data. Participants rated themselves, each other, and how they thought the other would rate them, on issues regarding communication ability and identity. Outcomes & Results:As expected on the basis of existing research, divergences clustered around the provision of communication support and issues of confidence, independence, embarrassment and overprotection. A qualitative analysis of the participants' talk during the rating task suggested that a source of these discrepancies is in the conflicting demands which characterise the care relationship, specifically, caregivers' desire to support independence on the one hand but feeling compelled to be protective on the other hand. In response to these demands, caregivers try to create the impression that the disability has less impact than it has and that they are more in control than they feel they are. Conclusions:We conclude by suggesting that some divergences of perspective may not be adverse overall, but rather, may be a result of caregivers' creative adaptations to seemingly irreconcilable demands.Keywords: Aphasia, UK, family care, role, identity, disagreement, misunderstanding 2 AcknowledgementsThe authors would like to acknowledge the support of a research grant from the Economic and Social Research Council, UK (RES-000-22-2473). 3 Divergences of Perspective Between People ...
Interpersonal relationships are a missing dimension in models of delay. We need to know more about how to use relationships, in addition to traditional routes, to harness health promotion messages. Interpersonal relationship, including partners and social networks, may be powerful conduits and may prove effective mechanisms to identify and access men most at risk of prostate cancer.
The Consultation and Relational Empathy (CARE) Measure (Mercer et al., 2004) is a patient-rated experience measure of practitioner empathy, developed and validated within adult health services. This study reports the feasibility, acceptability, reliability and validity of three adapted versions of the original CARE measure for the paediatric setting, namely the Visual CARE Measure 5Q, 10Q and 10Q Parent (also known as the Paediatric CARE Measure). Three hundred and sixty-nine participants (N = 149 children (40%) and N = 220 parents (60%)) completed the measure following consultation with an Allied Health Professional (AHP). AHPs felt it was feasible to use the measure in routine practice and the majority of children and parents found the measure easy to understand (98%) and complete (98%). Internal reliability (Cronbach's α) was .746 for the 5Q, .926 for the 10Q and .963 for the 10Q parent. Few participants used the 'not applicable' response (N = 28 (8%)), suggesting high content validity. AHPs found the measures relevant (95%) and useful (90%) and reported that they were likely to use them again (96%). The Visual CARE Measure shows promise as a useful tool to enable children and their parents to give their views. Further research on the tool's reliability and validity is required.
• Prostate cancer has three known clinical risk factors: age, ethnicity and family history. Men's knowledge of prostate cancer is low.• This study demonstrates that men rely on family and friends to learn about prostate cancer and help them interpret their risk. The findings suggest the need for tailored prostate cancer education, through social networks, to encourage risk-stratified PSA testing, which will lead to earlier diagnosis for those most at risk. Objectives• To determine men's perceptions of their risk of developing prostate cancer.• To consider the implications for PSA testing based on individual risk perceptions. Patients and Methods• The research adopted an embedded mixed-method design, using clinical records and a retrospective postal survey.• Patients (N = 474) diagnosed with prostate cancer in a two-year period (2008)(2009) in Greater Glasgow were identified from pathology records.• In all, 458 men received a postal survey (16 deceased patients were excluded); 320 men responded (70%).
Introduction Early diagnosis is critical in reducing mortality in prostate cancer. The extant literature identifies a range of variables which impact on when men present in primary care. For example, recent evidence suggests that men from high deprivation areas are significantly more likely to present with advanced disease and have lower survival rates. Psychosocial theories provide a framework for understanding patterns in the timing of diagnoses, for example, the role of social context and relationships in help-seeking behaviour. Aim To identify how men account for the timing of their presentation and subsequent diagnosis with advanced disease. Methods Embedded mixed-method design involving a postal survey (N=320) and semi-structured interviews with a purposive sub-sample of men and partners (N=30). Analysis drew primarily on χ2 and spearman's correlation, alongside framework analysis of the qualitative data, informed by Anderson's (1995) model of Total Patient Delay. Results Data indicate that relationships and experiential knowledge play significant roles in gaining a diagnosis. Notably friends/relatives are key sources of information on prostate cancer and often prompt help-seeking behaviour. Indeed, men's perceptions of risk are not informed by clinical risk factors such as age and family history, but by their own and friends/relatives' experiential knowledge. Conclusion Health promotion interventions should draw on relational theories, to be cognisant of the important role of relationships in help-seeking behaviour. Adopting a systemic approach has the potential to reach men at higher risk of prostate cancer and contribute to earlier diagnosis.
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