Matthew Hankins
Research interests
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Interestscondition.ConclusionsDispersed dot displays, chronic clinical wounds, psychometrics health psychology
Publications
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2.68Impact points
Distinct work-related, clinical and psychological factors predict return to work following treatment in four different cancer types.
Psycho-oncology. 03/2012;
OBJECTIVE: Many factors influence return to work (RTW) following cancer treatment. However specific factors affecting RTW across different cancer types are unclear. This study examined the role of clinical, sociodemographic, work and psychological factors in RTW following treatment for breast, gynae... [more] OBJECTIVE: Many factors influence return to work (RTW) following cancer treatment. However specific factors affecting RTW across different cancer types are unclear. This study examined the role of clinical, sociodemographic, work and psychological factors in RTW following treatment for breast, gynaecological, head and neck, and urological cancer. METHODS: A 12-month prospective questionnaire study was conducted with 290 patients. Cox regression analyses were conducted to calculate hazard ratios (HR) for time to RTW. RESULTS: Between 89-94% of cancer survivors returned to work. Breast cancer survivors took the longest to return (median 30 weeks), and urology cancer survivors returned the soonest (median 5 weeks). Earlier return among breast cancer survivors was predicted by a greater sense of control over their cancer at work (HR 1.2; 95% CI: 1.09-1.37) and by full-time work (HR 2.1; CI: 1.24-3.4). Predictive of a longer return among gynaecological cancer survivors was a belief that cancer treatment may impair ability to work (HR 0.75; CI: 0.62-0.91). Among urological cancer survivors constipation was predictive of longer RTW (HR 0.99; CI: 0.97-1.00), whereas undertaking flexible working was predictive of returning sooner (HR 1.70; CI: 1.07-2.7). Head and neck cancer survivors who perceived greater negative consequences of their cancer took longer to return (HR 0.27; CI: 0.11-0.68). Those reporting better physical functioning returned sooner (HR1.04; CI: 1.01-1.08). CONCLUSION: A different profile of predictive factors emerged for the four cancer types. In addition to optimal symptom management and workplace adaptations, the findings suggest that eliciting and challenging specific cancer and treatment-related perceptions may facilitate RTW. Copyright © 2012 John Wiley & Sons, Ltd.
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2.13Impact points
A pilot clinical trial to evaluate a novel time-to-positivity assay to measure the effectiveness of antibiotic therapy for septic patients in intensive care.
Journal of critical care. 08/2011;
PURPOSE: The purpose of the study was to investigate whether a novel assay of antibiotic efficacy could predict clinical outcome measures in septic patients in the intensive care unit (ICU). METHODS: A prospective, noninterventional clinical study was performed involving 48 adult patients with sepsi... [more] PURPOSE: The purpose of the study was to investigate whether a novel assay of antibiotic efficacy could predict clinical outcome measures in septic patients in the intensive care unit (ICU). METHODS: A prospective, noninterventional clinical study was performed involving 48 adult patients with sepsis in a single adult general ICU, with measurement of the time-to-positivity (Tpos) at 2 time points (Tpos1, Tpos2). RESULTS: The mean length of stay for all patients was 14.1 days (range, 2-98; median, 10 days). There was no significant difference between the Tpos1-adequate and the Tpos1-inadequate patients in day 1 Sequential Organ Failure Assessment or Acute Physiology and Chronic Health Evaluation II scores. However, there were a significant difference for the length of stay in ICU, with median stay in the Tpos1-adequate group of 7.8 days compared with 14.4 days in the Tpos1-inadequate group (Mann-Whitney U test, P = .028), and a significant difference in the length of stay in hospital, with a median stay in the Tpos1-adequate group of 13 days compared with 31 days in the Tpos1-inadequate group (P = .001). There was no statistical association between Tpos1 and 28-day survival (P > .05). The Tpos2 data added no further information. CONCLUSIONS: This pilot study provides preliminary evidence that measurement of Tpos1 24 hours after the initiation of antibiotic therapy is associated with ICU length of stay and might be of value as a surrogate marker of antibiotic activity.
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1.49Impact points
Why does genetic causal information alter perceived treatment effectiveness? An analogue study.
British journal of health psychology. 07/2011;
Objectives. When a health problem is perceived as having a genetic cause, this appears to increase the perceived effectiveness of pharmacological treatments and reduce perceived effectiveness of non-pharmacological treatments. Potential mediators of this effect include causal attributions, perceive... [more] Objectives. When a health problem is perceived as having a genetic cause, this appears to increase the perceived effectiveness of pharmacological treatments and reduce perceived effectiveness of non-pharmacological treatments. Potential mediators of this effect include causal attributions, perceived severity, and perceived control over the health problem. This study aimed to use experimental methods to establish which beliefs mediate the effect of genetic causal information on perceived effectiveness of treatments. Design. A 4(cause: environmental, family history, genetic test, family history & genetic test)×2(severity: higher or low) between-subjects design using vignettes about heart disease risk, obesity or depression. Methods. A total of 647 adults, randomly assigned to read one of the experimental vignettes, were interviewed. Key outcomes were perceived effectiveness of medication and of non-pharmacological treatments. Potential mediators of perceived severity, perceived controllability, and causal attributions were also assessed. Results. For heart disease risk, genetic causes reduced perceived effectiveness of non-pharmacological treatments (an effect mediated by causal attributions and perceived control) but did not influence perceived medication effectiveness. For obesity, neither severity nor cause influenced the perceived effectiveness of either treatment. For depression, genetic causes only increased perceived effectiveness of medication for more severe depression, an effect mediated by perceived control. Conclusions. The impact of genetic causal information on perceived effectiveness of treatments varies with type of health problem. When genetic causal information influences perceived treatment effectiveness, it does so by altering causal attributions and perceived controllability. However, these effects are small and unlikely to translate into clinically meaningful differences in health-enhancing behaviours.
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High adherence and concordance within a clinical trial of antihypertensives.
Chronic illness. 12/2010; 6(4):243-51.
To explore hypertensive patients' beliefs about their condition and its treatment and their adherence within the context of a clinical trial. To assess the degree of concordance between patients' beliefs about hypertension and the medical model of the condition. This was a questionnaire-base... [more] To explore hypertensive patients' beliefs about their condition and its treatment and their adherence within the context of a clinical trial. To assess the degree of concordance between patients' beliefs about hypertension and the medical model of the condition. This was a questionnaire-based study, involving 230 patients participating in the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT), a randomized controlled trial comparing two pharmaceutical approaches to the management of hypertension. A comparison group of 106 hypertensive patients who were screened for ASCOT but did not meet the entry criteria was also recruited. Outcome measures were beliefs about hypertension and antihypertensive medication, and adherence to medication (self-report and tablet count). Adherence to medication was higher than anticipated, with 45% participants reporting complete adherence over the 18-month study and a further 40% only rare non-adherence. Patients' beliefs about their condition and treatment were generally concordant with the medical model of hypertension. High concordance was associated with high medication adherence (p<0.001). Clinical trial volunteers may have beliefs that are unusually concordant with the medical model of hypertension and may demonstrate atypically high adherence. This has implications for the transferability of trial findings to the general hypertensive population.
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6.38Impact points
Measuring asthma-specific quality of life: structured review.
Allergy. 11/2010; 66(4):439-57.
Measuring quality of life (QoL) has become an increasingly important dimension of assessing patient well-being and drug efficacy. As there are now several asthma QoL questionnaires to choose from, it is important to appreciate their strengths and weaknesses. To assist in this choice, we have reviewe... [more] Measuring quality of life (QoL) has become an increasingly important dimension of assessing patient well-being and drug efficacy. As there are now several asthma QoL questionnaires to choose from, it is important to appreciate their strengths and weaknesses. To assist in this choice, we have reviewed the existing questionnaires in a structured way. Information relating to the conceptual and measurement model, reliability, validity, interpretability, burden, administration format and translations was extracted from the published literature. The instruments differ in almost all criteria considered, and therefore it cannot be assumed that they measure the same thing. We recommend the selection of questionnaires that are designed only for asthma and that do not assess symptoms as part of QoL. Only two of the questionnaires reviewed fulfill these requirements: the Sydney Asthma QoL Questionnaire (AQLQ-S) and the Living with Asthma Questionnaire (LWAQ). However, for multinational studies, it may be convenient or practical to use questionnaires that have been linguistically validated in many languages (AQLQ-J, SGRQ). It remains unclear which of these questionnaires best reflects patient perceptions of QoL. Our review did not involve patients, so for the time being choosing from existing questionnaires requires a compromise based on the rigor of the development process and the target patient group.
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5.15Impact points
Cognitive impairment and 7-year mortality in dialysis patients.
American journal of kidney diseases : the official journal of the National Kidney Foundation. 10/2010; 56(4):693-703.
Although dementia has predicted mortality in large dialysis cohorts, little is known about the relationship between less pronounced cognitive deficits and mortality in patients with end-stage renal disease. This study assessed whether cognitive impairment without dementia was an independent predicto... [more] Although dementia has predicted mortality in large dialysis cohorts, little is known about the relationship between less pronounced cognitive deficits and mortality in patients with end-stage renal disease. This study assessed whether cognitive impairment without dementia was an independent predictor of 7-year survival in dialysis patients after controlling for other risk factors. Prospective single-cohort study. 145 prevalent dialysis patients from 2 units in London, UK, were followed up for 64.3 ± 27.4 months and censored at the time of change to a different treatment. Cognitive impairment, defined as performance 1 standard deviation less than normative values on 2 or more cognitive tests within a neurocognitive battery assessing attention/concentration, memory, and psychomotor function domains. Depression, quality-of-life, and clinical measures also were obtained. All-cause mortality was the primary outcome. Cox proportional hazard models were used to assess the contribution of demographics and clinical and psychological measures and cognitive impairment to mortality. 98 (67.6%) patients were cognitively impaired at baseline. At follow-up, 56 (38.6%) patients had died, 29 of cardiac causes. Unadjusted Kaplan-Meier analysis showed higher mortality in cognitively impaired patients, in whom 7-year survival was 49% versus 83.2% in those with no cognitive impairment (P < 0.001). Mortality risk associated with cognitive impairment remained significant in adjusted analysis controlling for sociodemographic, clinical, and psychological factors (adjusted HR, 2.53; 95% CI, 1.03-6.22; P = 0.04). Small sample size and number of events. Cognitive impairment is an independent predictor of mortality in dialysis patients. Although the implications of early recognition and treatment of cognitive impairment for clinical outcomes are unclear, these results suggest that patient management protocols should attempt to ensure prevention of cognitive decline in addition to managing coexisting medical conditions.
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Impact of informed-choice invitations on diabetes screening knowledge, attitude and intentions: an analogue study
BMC Public Health. 01/2010;
Abstract Background Despite concerns that facilitating informed choice would decrease diabetes screening uptake, 'informed choice' invitations that increased knowledge did not affect attendance (the DICISION trial). We explored possible reasons using data from an experimental analo... [more] Abstract Background Despite concerns that facilitating informed choice would decrease diabetes screening uptake, 'informed choice' invitations that increased knowledge did not affect attendance (the DICISION trial). We explored possible reasons using data from an experimental analogue study undertaken to develop the invitations. We tested a model of the impact on knowledge, attitude and intentions of a diabetes screening invitation designed to facilitate informed choices. Methods 417 men and women aged 40-69 recruited from town centres in the UK were randomised to receive either an invitation for diabetes screening designed to facilitate informed choice or a standard type of invitation. Knowledge of the invitation, attitude towards diabetes screening, and intention to attend for diabetes screening were assessed two weeks later. Results Attitude was a strong predictor of screening intentions (β = .64, p = .001). Knowledge added to the model but was a weak predictor of intentions (β = .13, p = .005). However, invitation type did not predict attitudes towards screening but did predict knowledge (β = -.45, p = .001), which mediated a small effect of invitation type on intention (indirect β = -.06, p = .017). Conclusions These findings may explain why information about the benefits and harms of screening did not reduce diabetes screening attendance in the DICISION trial.
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2.22Impact points
Impact of informed-choice invitations on diabetes screening knowledge, attitude and intentions: an analogue study.
BMC public health. 01/2010; 10:768.
Despite concerns that facilitating informed choice would decrease diabetes screening uptake, 'informed choice' invitations that increased knowledge did not affect attendance (the DICISION trial). We explored possible reasons using data from an experimental analogue study undertaken to develo... [more] Despite concerns that facilitating informed choice would decrease diabetes screening uptake, 'informed choice' invitations that increased knowledge did not affect attendance (the DICISION trial). We explored possible reasons using data from an experimental analogue study undertaken to develop the invitations. We tested a model of the impact on knowledge, attitude and intentions of a diabetes screening invitation designed to facilitate informed choices. 417 men and women aged 40-69 recruited from town centres in the UK were randomised to receive either an invitation for diabetes screening designed to facilitate informed choice or a standard type of invitation. Knowledge of the invitation, attitude towards diabetes screening, and intention to attend for diabetes screening were assessed two weeks later. Attitude was a strong predictor of screening intentions (β = .64, p = .001). Knowledge added to the model but was a weak predictor of intentions (β = .13, p = .005). However, invitation type did not predict attitudes towards screening but did predict knowledge (β = -.45, p = .001), which mediated a small effect of invitation type on intention (indirect β = -.06, p = .017). These findings may explain why information about the benefits and harms of screening did not reduce diabetes screening attendance in the DICISION trial.
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5.65Impact points
Visual feedback of individuals' medical imaging results for changing health behaviour.
Cochrane database of systematic reviews (Online). 01/2010;
Feedback of medical imaging results can reveal visual evidence of actual bodily harm attributable to a given behaviour. This may offer a particularly promising approach to motivating changes in health behaviour to decrease risk. Applicable behaviours include smoking cessation, skin self-examination,... [more] Feedback of medical imaging results can reveal visual evidence of actual bodily harm attributable to a given behaviour. This may offer a particularly promising approach to motivating changes in health behaviour to decrease risk. Applicable behaviours include smoking cessation, skin self-examination, sun protection behaviour, dietary intake, physical activity and medication usage. The current review assembles and evaluates the evidence concerning the behavioural impact of showing and explaining images, in order to determine whether their communication is an effective intervention approach. To assess the extent to which feedback to individuals of images of their own bodies created during medical imaging procedures increases or decreases a range of health behaviours. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 3 2009), MEDLINE (1950 to 14 September 2009), EMBASE (1980 to 14 September 2009), CINAHL (1982 to 9 October 2009), PsycINFO (1806 to 14 September 2009) and reference lists of articles. We also contacted authors of selected papers, and searched the ProQuest Dissertations and Theses database on 1 October 2009 for grey literature. Randomised or quasi-randomised controlled trials involving adult (18 years and over) non-pregnant individuals undergoing medical imaging procedures assessing risk of disease or of an existing condition, for which personal risk may be reduced by modification of behaviour. The sole or principal component of included interventions is visual feedback of individuals' medical imaging results, defined as individuals being shown, and having explained, source images (still or moving images) of their bodies generated by the procedure. Two authors searched for studies and independently extracted data from included studies, with disagreements resolved by consensus and a third author acting as arbiter. The risk of bias of included studies was assessed and reported in accordance with the guidelines in the Cochrane Handbook for Systematic Reviews of Interventions. We conducted a narrative synthesis of the included studies, dividing them into clinical and non-clinical population groups and presenting major characteristics and results. Where the studies were sufficiently similar in terms of population, inclusion criteria, interventions and/or outcomes, we pooled the data statistically. We included nine trials involving 1371 participants. Overall, results were mixed. Regarding five trials in clinical populations, three assessed smoking cessation behaviours, all featuring arterial scanning procedures to assess cardiovascular risk, and reported a statistically significant effect favouring the intervention, producing a pooled odds ratio (OR) of 2.81 (95% confidence interval (CI) 1.23 to 6.41, P = 0.01). One of these trials also measured physical activity and reported no statistically significant difference between the groups. A further trial measured skin examination behaviour following a skin photography procedure for assessing moles, and reported a statistically significant increase in favour of the intervention, with an OR of 4.86 (95% CI 1.95 to 12.10, P = 0.0007). The final clinical population trial measured a range of dietary intake and medication usage behaviours and featured an arterial scanning procedure assessing cardiovascular risk, and reported no statistically significant effects.Among the four trials in non-clinical populations, all featuring ultraviolet (UV) photography to highlight UV-related skin damage, a statistically significant result favouring the intervention was found in one trial for reducing tanning booth use, producing a mean difference (MD) of -1.10 (95% CI -1.90 to -0.30, P = .007) and one trial reported an outcome on which the control condition was favoured, with an MD of 0.45 (95% CI 0.04 to 0.86, P = 0.03) on intentional hours spent in the sun. In two further trials, no statistically significant behavioral effects were reported regarding time spent in the sun or sun protection behaviours.There was no evidence of significant adverse effects in the included trials, although this was not well reported. Due to the limited nature of the available evidence and the mixed results that were found, no strong statements can be made about the effectiveness of communicating medical imaging results to change health behaviour. Only three trials in clinical populations were similar enough in term of setting, intervention and outcome to allow meta-analysis. We suggest, however, that targeted interventions using medical imaging technologies may be effective in certain contexts, or as applied to certain behaviours, but that this should be considered on an intervention by intervention basis, and not assumed as a general principle.
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1.52Impact points
Conducting oral examinations for cancer in general practice: what are the barriers?
Family practice. 10/2009;
BACKGROUND: The incidence of oral (mouth) cancer in the UK is continuing to rise. Individuals who are at greatest risk rarely visit a dentist but do consult general medical practitioners (GMPs). Therefore, GMPs could have an important role in the early detection of oral cancer. Research has shown th... [more] BACKGROUND: The incidence of oral (mouth) cancer in the UK is continuing to rise. Individuals who are at greatest risk rarely visit a dentist but do consult general medical practitioners (GMPs). Therefore, GMPs could have an important role in the early detection of oral cancer. Research has shown that GMPs do not opportunistically screen high-risk individuals; however, the barriers to screening are poorly understood. OBJECTIVES: To understand the reasons why GMPs may not screen for oral cancer. METHODS: A questionnaire was developed, using the Theory of Planned Behaviour (TPB), to measure GMPs attitudes to and screening for oral cancer. The questionnaire was designed using all the key theoretical constructs of the TPB and incorporating the themes identified in a qualitative elicitation study. The questionnaire was posted to 499 GPs in Surrey Primary Care trust. RESULTS: Two hundred and twenty-eight completed questionnaires were returned (46%). Two TPB constructs [subjective norm (e.g. peer pressure) and perceived external control factors (e.g. adequate equipment, time constraints)] were identified as significant predictors of 'intention' to perform oral screening. Intention and perceived internal control factors (e.g. self-efficacy) were predictive of actually performing oral screening with patients. CONCLUSIONS: The results of the study suggest that there is considerable potential for improving intention to perform oral cancer screening in general practice. Theory-based interventions could include further training to enhance confidence, expertise, knowledge and ease of examination, the provision of adequate equipment in the surgery and increasing the motivation to comply with significant others by introducing guidelines on opportunistic screening.
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2.91Impact points
Psychological stress and wound healing in humans: a systematic review and meta-analysis.
Journal of psychosomatic research. 09/2009; 67(3):253-71.
OBJECTIVE: The current review aims to synthesize existing knowledge about the relationship between psychological stress and wound healing. METHODS: A systematic search strategy was conducted using electronic databases to search for published articles up to the end of October 2007. The reference list... [more] OBJECTIVE: The current review aims to synthesize existing knowledge about the relationship between psychological stress and wound healing. METHODS: A systematic search strategy was conducted using electronic databases to search for published articles up to the end of October 2007. The reference lists of retrieved articles were inspected for further studies and citation searches were conducted. In addition, a meta-analysis of a subset of studies was conducted to provide a quantitative estimation of the influence of stress on wound healing. RESULTS: Twenty-two papers met the inclusion criteria of the systematic review and a subsample of 11 was included in a meta-analysis. The studies assessed the impact of stress on the healing of a variety of wound types in different contexts, including acute and chronic clinical wounds, experimentally created punch biopsy and blister wounds, and minor damage to the skin caused by tape stripping. Seventeen studies in the systematic review reported that stress was associated with impaired healing or dysregulation of a biomarker related to wound healing. The relationship between stress and wound healing estimated by the meta-analysis was r=-0.42 (95% CI=-0.51 to -0.32) (P<.01). CONCLUSION: Attention now needs to be directed towards investigating potential moderators of the relationship, mediating mechanisms underpinning the association, as well as the demonstration of a causal link by the development of experimental interventions in healthy populations.
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2.86Impact points
The effect of the European Clinical Trials Directive on published drug research in anaesthesia.
Anaesthesia. 09/2009; 64(9):984-9.
The clinical indications for anaesthetic drugs are developed through peer-reviewed publication of clinical trials. We performed a bibliometric analysis of all human research papers reported in nine general anaesthesia journals over 6 years (n = 6489), to determine any effects of the 2004 European Cl... [more] The clinical indications for anaesthetic drugs are developed through peer-reviewed publication of clinical trials. We performed a bibliometric analysis of all human research papers reported in nine general anaesthesia journals over 6 years (n = 6489), to determine any effects of the 2004 European Clinical Trials Directive on reported drug research in anaesthesia originating from Europe and the United Kingdom. We found 89% studies involved patients and 11% volunteers. Of 3234 (50%) drug studies, 96% were phase IV (post-marketing) trials. Worldwide, the number of research papers fell by 3.6% (p < 0.004) in the 3 years following introduction of the European Clinical Trials Directive (5% Europe, 18% United Kingdom), and drug research papers fell by 12% (p < 0.001; 15% Europe, 29% United Kingdom). The introduction of the Clinical Trials Directive has therefore coincided with a decline in European drug research, particularly that originating from the United Kingdom. We suggest a number of measures researchers could take in response, and we propose a simplification of the application process for phase IV clinical trials, emphasising patient risk assessment.
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3.47Impact points
Measuring the adherence to medication of elderly patients with heart failure: Is there a gold standard?
International journal of cardiology. 08/2009;
ACE inhibitors and loop diuretics are treatments of first choice for heart failure, but patients must take their medications regularly to achieve maximum benefit. Adherence is commonly assessed using pill counts, self-report or electronic monitoring, with the latter widely considered the 'gold s... [more] ACE inhibitors and loop diuretics are treatments of first choice for heart failure, but patients must take their medications regularly to achieve maximum benefit. Adherence is commonly assessed using pill counts, self-report or electronic monitoring, with the latter widely considered the 'gold standard'. We assessed the concordance of these three methods in a sample of 52 elderly patients with heart failure over a six-week period. Substantial differences in adherence were found between the three methods. Adherence by self-report was very high for both ACE-I and diuretic, with little between-person variation. This was, however, uncorroborated by pill count and electronic monitoring. Closer examination of the electronic record suggested that the mean level of adherence overlooked patterns of openings more consistent with adherent behaviour. There seems to be no gold standard for measurement of adherence in this population.
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1.44Impact points
Development of a tracheostomy scoring system to guide airway management after major head and neck surgery.
International journal of oral and maxillofacial surgery. 06/2009;
The use of elective tracheostomy in major head and neck surgery is well established, although practice varies between units. There is no published method that reliably predicts the need for tracheostomy. This paper describes the development of a surgical scoring system designed to achieve that aim. ... [more] The use of elective tracheostomy in major head and neck surgery is well established, although practice varies between units. There is no published method that reliably predicts the need for tracheostomy. This paper describes the development of a surgical scoring system designed to achieve that aim. The system was devised using data obtained retrospectively from 148 consecutive major head and neck procedures. These procedures were grouped according to the airway management plan in place at the end of the procedure: elective extubation (group E, 52 procedures, 50 patients); elective overnight ventilation via an endotracheal tube (group ETT, 55 procedures, 52 patients); and elective overnight ventilation via a tracheostomy (group T, 41 procedures, 41 patients). 8 patients from group ETT required a late tracheostomy for either medical or surgical indications. Using statistical methods, a threshold score was defined above which the high risk of upper airway obstruction should prompt consideration of an elective tracheostomy.
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4.26Impact points
Comments on 'Validity and responsiveness of the Osnabrück Hand Eczema Severity Index (OHSI): a methodological study'
The British journal of dermatology. 06/2009;
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3.46Impact points
Evaluating three theory-based interventions to increase physicians' recommendations of smoking cessation services.
Health psychology : official journal of the Division of Health Psychology, American Psychological Association. 04/2009; 28(2):174-82.
Objective: To evaluate three theory-based interventions aimed at increasing the rate at which primary care physicians recommend smoking cessation services to smokers. Design: Primary care physicians (n = 251) were randomized to one of four conditions: (a) information based on social cognitive theory... [more] Objective: To evaluate three theory-based interventions aimed at increasing the rate at which primary care physicians recommend smoking cessation services to smokers. Design: Primary care physicians (n = 251) were randomized to one of four conditions: (a) information based on social cognitive theory (SCT) targeting outcome expectations, (b) information based on SCT + elaboration likelihood model, (c) feedback based on self-perception theory, or (d) control. Main Outcome Measures: Intentions to recommend and self-reported recommendations of smoking cessation services 1 week postintervention. Results: Data were analyzed using covariance and mean structure analysis. Compared with the control group, only the SCT group reported more frequently recommending services (mean difference = 1.1 recommendations per week, Cohen's d = 0.46) and higher intentions. Mediation analysis was consistent with increased intentions resulting from changes in outcome expectations. There was no evidence that changes in intentions explained self-reported behavior change. Conclusion: The study provides preliminary "proof of principle" for further studies incorporating more robust outcome measures. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
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1.68Impact points
The influence of symptom experiences and attributions on adherence to highly active anti-retroviral therapy (HAART): a six-month prospective, follow-up study.
AIDS care. 04/2009; 21(4):520-8.
OBJECTIVE: To examine changes in individuals' experiences of symptoms over the first six months of taking highly active anti-retroviral therapy (HAART) and to assess the impact of symptom experiences and attributions on adherence to HAART. METHODS: A prospective study where consecutive HIV posit... [more] OBJECTIVE: To examine changes in individuals' experiences of symptoms over the first six months of taking highly active anti-retroviral therapy (HAART) and to assess the impact of symptom experiences and attributions on adherence to HAART. METHODS: A prospective study where consecutive HIV positive individuals initiating HAART completed validated questionnaires assessing their experiences of symptoms, depression, beliefs about HAART and adherence, before starting treatment and after one, three and six months of treatment. RESULTS: Rates of low (<95%) adherence to HAART increased over time (p<0.001). Overall, the number of HIV or HAART-related symptoms reported did not change significantly over follow-up. However, symptom experiences differed between those reporting high (> or =95%) adherence and those reporting low adherence. Individuals reporting high adherence experienced a decrease in symptoms they attributed to HIV (p<0.05), and a decrease in the symptoms they attributed to HAART-side effects (p<0.05) over time. This decrease in symptoms over time was not seen among individuals reporting low adherence. A lack of symptomatic improvement was associated with increasing doubts about the continued necessity for HAART (p<0.05). CONCLUSIONS: The findings suggest that adherence to HAART is influenced by individuals' experiences of both HIV and HAART-related symptoms. Patients who experience persistent symptoms while on HAART may begin to doubt their continued need for treatment and respond by missing doses. These findings have implications for the development of evidence-based interventions to increase adherence.
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1.69Impact points
Time orientation and health-related behaviour: measurement in general population samples.
Psychology & health. 03/2009; 24(3):333-50.
Research on health behaviour and time orientation has been hindered by a lack of consensus about appropriate measurement. Study 1 assessed the reliability of the Consideration of Future Consequences Scale (CFC) and the Zimbardo Time Perspective Inventory (ZTPI) in a general population sample (n = 30... [more] Research on health behaviour and time orientation has been hindered by a lack of consensus about appropriate measurement. Study 1 assessed the reliability of the Consideration of Future Consequences Scale (CFC) and the Zimbardo Time Perspective Inventory (ZTPI) in a general population sample (n = 300). Although more reliable, the CFC was less readable. Study 2 assessed the validity of a shortened ZTPI, measuring future and present orientation, and the full CFC. The measures had good discrimination to distinguish interpersonal differences. Construct validity of present, but not future, orientation as measured by the ZTPI, was evidenced by its mediation of the association between socioeconomic status and expectations of participating in diabetes screening. The CFC mediated this relationship more weakly. Further investigation of present orientation in understanding health-related behaviour is warranted.
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2.79Impact points
A survey of the quality and accuracy of information leaflets about skin cancer and sun-protective behaviour available from UK general practices and community pharmacies.
Journal of the European Academy of Dermatology and Venereology : JEADV. 02/2009;
Abstract Background Better information promotes sun protection behaviour and is associated with earlier presentation and survival for malignant melanoma. Aim To assess the quality of patient information leaflets about skin cancer and sun-protective behaviour available from general practices and comm... [more] Abstract Background Better information promotes sun protection behaviour and is associated with earlier presentation and survival for malignant melanoma. Aim To assess the quality of patient information leaflets about skin cancer and sun-protective behaviour available from general practices and community pharmacies. Design of study A structured review of patient information leaflets. Setting All community pharmacies and general practices in one Primary Care Trust were invited to supply leaflets. Methods Readability was assessed using the SMOG scoring system. Presentation and content were reviewed using the Ensuring Quality Information for Patients (EQIP) guidelines. Three consultant dermatologists assessed each leaflet for accuracy. Results Thirty-one different patient information leaflets were returned. Thirteen (42%) were published in the previous 2 years, but 10 (32%) were over 5 years old. Nine (29%) leaflets were produced by the NHS or Health Education Authority, and 8 (27%) were linked to a commercial organization. One leaflet had readability in the primary education range (SMOG score = 6), and none with the recommended range for health education material (SMOG score </= 5). Two leaflets (6%) were in the highest quartile of EQIP score for presentation and content. Five leaflets (17%) had a major inaccuracy such as over-reliance on sun screen products instead of shade and clothing. Conclusions Leaflets were of variable quality in presentation and content. All required a reading age higher than recommended. All leaflets with major inaccuracies had links with commercial organizations. This study raises important issues about the potential conflict between marketing and health messages in the way sun creams are promoted. Conflicts of interest None declared.
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2.22Impact points
The reliability of the twelve item general health questionnaire (GHQ-12) under realistic assumptions.
BMC public health. 11/2008; 8(1):355.
ABSTRACT: BACKGROUND: The twelve-item General Health Questionnaire (GHQ-12) was developed to screen for non-specific psychiatric morbidity. It has been widely validated and found to be reliable. These validation studies have assumed that the GHQ-12 is one-dimensional and free of response bias, but r... [more] ABSTRACT: BACKGROUND: The twelve-item General Health Questionnaire (GHQ-12) was developed to screen for non-specific psychiatric morbidity. It has been widely validated and found to be reliable. These validation studies have assumed that the GHQ-12 is one-dimensional and free of response bias, but recent evidence suggests that neither of these assumptions may be correct, threatening its utility as a screening instrument. Further uncertainty arises because of the multiplicity of scoring methods of the GHQ-12. This study set out to establish the best fitting model for the GHQ-12 for three scoring methods (Likert, GHQ and C-GHQ) and to calculate the degree of measurement error under these more realistic assumptions. METHODS: GHQ-12 data were obtained from the Health Survey for England 2004 cohort (n=3705). Structural equation modelling was used to assess the fit of (1) the one-dimensional model (2) the current 'best fit' three-dimensional model and (3) a one-dimensional model with response bias. Three different scoring methods were assessed for each model. The best fitting model was assessed for reliability, standard error of measurement and discrimination. RESULTS: The best fitting model was one-dimensional with response bias on the negatively phrased items, suggesting that previous GHQ-12 factor structures were artifacts of the analysis method. The reliability of this model was over-estimated by Cronbach's Alpha for all scoring methods: 0.90 (Likert method), 0.90 (GHQ method) and 0.75 (C-GHQ). More realistic estimates of reliability were 0.73, 0.87 and 0.53 (C-GHQ), respectively. Discrimination (Delta) also varied according to scoring method: 0.94 (Likert method) , 0.63 (GHQ method) and 0.97 (C-GHQ method). CONCLUSIONS: Conventional psychometric assessments using factor analysis and reliability estimates have obscured substantial measurement error in the GHQ-12 due to response bias on the negative items, which limits its utility as a screening instrument for psychiatric morbidity.
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Bryan Lask
Univ of London
