This study examines the impact of 2 classes of psychological variables--expectancies for the future and self-efficacy--on recovery of function and reduction in symptomatology among individuals seeking total knee replacement surgery (TKR). The authors collected outcome measures (SF-36, WOMAC, Clinician assessments) prior to surgery, 4-6 weeks after surgery, and 6 months postsurgery for surgery patients and controls. Linear trend analyses by group gauged the impact of the surgical intervention on recovery, revealing significant improvements over time on physical health outcomes for the surgery patients not attained by controls. In addition, two classes of psychosocial variables--expectancies and efficacy beliefs--predicted the extent of gains in physical and mental health outcomes among those patients who elected to have surgery. When initial status was controlled, between 9 and 13 percent of the variance in TKR outcomes was due to expectations and efficacy. These results point to the importance of psychosocial variables in recovery of function and reduced symptoms after knee surgery.

sleep, psychological well-being, depression, anxiety,

Objective To compare the effectiveness of touch screen system with information leaflet for providing women with information on prenatal tests. Design Randomised controlled trial; participants allocated to intervention group (given access to touch screen and leaflet information) or control group (leaflet information only). Setting Antenatal clinic in university teaching hospital. Subjects 875 women booking antenatal care. Interventions All participants received a leaflet providing information on prenatal tests. Women in the intervention arm also had access to touch screen information system in antenatal clinic. Main outcome measures Women's informed decision making on prenatal testing as measured by their uptake of and understanding of the purpose of specific tests; their satisfaction with information provided; and their levels of anxiety. Results All women in the trial had a good baseline knowledge of prenatal tests. Women in the intervention group did not show any greater understanding of the purpose of the tests than control women. However, uptake of detailed anomaly scans was significantly higher in intervention group than the control group (94% (351/375) v 87% (310/358), P = 0.0014). Levels of anxiety among nulliparous women in intervention group declined significantly over time (P < 0.001). Conclusions The touch screen seemed to convey no benefit over well prepared leaflets in improving understanding of prenatal tests among the pregnant women. It did, however, seem to reduce levels of anxiety and may be most effective for providing information to selected women who have a relevant adverse history or abnormal results from tests in their current pregnancy.

These results are consistent with a model in which good-quality sleep acts as a biobehavioral resource that minimizes allostatic load.

These results lend support to the hypothesis that sleep is a component of allostatic load and has an upstream role in daily functioning.

No abstract

Hope has been correlated with greater pain tolerance and thresholds and less reported pain severity. The present study investigated the effectiveness of a brief hope-based intervention involving guided imagery and skills instruction aimed at enhancing pain coping skills among university students performing the cold pressor task. The intervention resulted in increased hope among females and increased pain tolerance in all participants. The intervention did not affect pain threshold and resulted in marginally increased pain severity. Thus, this intervention facilitates better pain tolerance without necessarily changing the experience of the pain. Implications for practice and future research are discussed.

Most Americans have occasional problems with insomnia. The relationship of insomnia to illness is well known. However, insomnia may also relate to lower levels of well-being. Although there are various definitions of well-being, one of the most clearly articulated and comprehensive models identifies 2 overarching constructs, psychological well-being and subjective well-being. The purpose in the present study was to assess the relationship between insomnia symptoms and the dimensions of psychological and subjective well-being, adjusting for the potential confound of comorbid physical and psychological illness. The data for the present study came from the National Survey of Midlife Development in the United States, a survey of community-dwelling adults. After adjustment for demographic characteristics and a wide range of chronic mental and physical health conditions, insomnia symptoms were found to have a significant relationship with both psychological and subjective well-being but a stronger relationship to subjective well-being. These data suggest that insomnia symptoms have a stronger relationship to enjoying life than to the perception that one has a meaningful life.