This study provides initial evidence that the specific process of legacy creation is able to positively affect sense of generativity, meaning, and acceptance near end of life. High acceptability and satisfaction rates for both DT and LR and positive impacts on families/carers of DT participants provide additional support for clinical utility of these interventions. Further evaluation of specific mechanisms of change post-intervention is required given DT's uncertain efficacy on other primary outcomes.
Atopic dermatitis (AD) is a chronic, debilitating skin disorder that accounts for up to 20% of dermatological diagnoses. A 6-week psychoeducational stress management program was developed, implemented, and evaluated as an adjunctive treatment for AD. The participants (n = 17) were randomly assigned to a treatment or waiting-list control group. Participants in both the intervention and waiting-list control groups were assessed for dermatitis severity by a blind rater both pre and posttreatment and at a follow-up conducted 8 weeks after the conclusion of the program. At posttest the intervention group had significantly reduced pruritus and global severity of atopic dermatitis, and reduced levels of social anxiety and private self-consciousness. At an 8-week follow-up, pruritus was entirely absent and global severity was continuing to decrease, as were levels of social anxiety and private self-consciousness. The psychoeducational stress-management program provided a short effective treatment that resulted in reduction of symptoms and provided long-term management strategies to sufferers of atopic dermatitis.
Systemic lupus erythematosus (SLE) is a chronic illness that usually follows a fluctuating course and, therefore, can be difficult to diagnose. Consequently, individuals with SLE often hold beliefs about the nature and course of the illness that are at odds with medical opinion. Clearly, a shared understanding of the illness would be beneficial to illness management. In this study, the authors used semistructured interviews and interpretative phenomenological analysis to explore the content of the illness representations held by 36 individuals diagnosed with SLE. They also identified the ways in which these illness representations were generated initially and attempted to determine whether changes occurred over time in these illness representations, as predicted by the self-regulatory model.
Fruit and vegetable intake is insufficient in industrialized nations and long-haul heavy goods vehicle (HGV) drivers are considered a particularly at-risk group. The aim of the current study was to test the effectiveness of a multi-theory, dual-phase model to predict fruit and vegetable consumption in Australian long-haul HGV drivers. A secondary aim was to examine the effect of past fruit and vegetable consumption on model paths. A prospective design with two waves of data collection spaced one week apart was adopted. Long-haul HGV drivers (N = 212) completed an initial survey containing theory-based measures of motivation (autonomous motivation, intention), social cognition (attitudes, subjective norms, perceived behavioural control), and volition (action planning, coping planning) for fruit and vegetable consumption. One week later, participants (n = 84) completed a self-report measure of fruit and vegetable intake over the previous week. A structural equation model revealed that autonomous motivation predicted intentions, mediated through attitudes and perceived behavioural control. It further revealed that perceived behavioural control, action planning, and intentions predicted fruit and vegetable intake, whereby the intention-behaviour relationship was moderated by coping planning. Inclusion of past behaviour attenuated the effects of these variables. The model identified the relative contribution of motivation, social cognition, and volitional components in predicting fruit and vegetable intake of HGV drivers. Consistent with previous research, inclusion of past fruit and vegetable consumption led to an attenuation of model effects, particularly the intention-behaviour relationship. Further investigation is needed to determine which elements of past behaviour exert most influence on future action.
Aims To identify the facilitators of and barriers to nurses’ adherence to evidence‐based wound care clinical practice guidelines (CPGs) in preventing surgical site infections (SSIs) in an Australian tertiary hospital. Background Current research suggests that up to 50% of nurses are unaware of the evidence‐based recommendations to prevent SSIs and that adherence to evidence‐based CPGs is suboptimal. However, little is known regarding the facilitators and barriers to adherence to evidence‐based CPGs. Design A qualitative study incorporating ethnographic data collection techniques. Methods Data collection included semi‐structured individual interviews and focus groups (N = 20), and examination of existing hospital policy and procedure documents. Thematic analysis using inductive and deductive approaches was conducted. This manuscript adheres to the COnsolidated criteria for REporting Qualitative research (COREQ) guidelines. Findings Data analysis revealed four themes: adhering to aseptic technique, knowledge and information seeking, documenting wound care and educating and involving patients in wound care. Facilitators and barriers within each theme were identified. Facilitators included participants’ active information‐seeking behaviour, a clear understanding of the importance of aseptic technique, and patient participation in wound care. Barriers included participants’ knowledge and skills deficits regarding application of aseptic technique principles in practice, the availability of the hospital's wound care procedure document, suboptimal wound care documentation and the timing of patient education. Conclusions There is a need to develop interventions to improve nurses’ adherence to recommended CPGs including following aseptic technique principles, hand hygiene, documentation and patient education. Hospital procedure documents that outline wound care need to reflect current recommended CPGs. Relevance to clinical practice Adhering to evidence‐based CPGs has been found to be effective in reducing and preventing SSIs. Our study provides an in‐depth understanding of the barriers and facilitators to nurses’ adherence to recommended CPGs. The findings may inform future practice improvements in wound care.
There is evidence to suggest that illness representations are associated with chronic illness outcomes. Accordingly, several authors have recommended that interventions aimed at improving illness outcomes should include an illness-representations component. While a few researchers have attempted to develop such interventions for chronic illness and chronic pain, no such intervention has been developed for individuals with systemic lupus erythematosus (SLE), a chronic auto-immune illness which results in a variety of negative physical and psychological symptoms. This article reports on a pilot program that investigated the feasibility of a cognitive and behavioural—based intervention for treating SLE which included an illness-representations-change component. The effectiveness of the intervention compared to usual treatment for SLE was evaluated. Also investigated was whether changed illness representations had a beneficial effect on physical health and psychological wellbeing. It was found that the intervention did change participants' treatment control and emotional representations, and that perceived stress was reduced following the intervention. The importance of these findings is discussed, two rival hypotheses for the findings obtained are explored and directions for future research are suggested.
This study provides further insight into what palliative care patients consider to be most important and meaningful to them when taking part in DT and LR. Creating legacy documents is likely to result in session content that is different in several key areas compared with LR, even when controlling for interview questions, therapist influences, and session length. Consideration of the above is essential in optimizing psychotherapeutic outcomes near end of life.
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