Examining the influence of personal goal interference and attainability on psychological distress in non-metastatic breast cancer patients.

The present study investigated the relationship between two goal-related appraisals - perceived cancer-related interference and perceived attainability of important personal goals - and psychological distress among non-metastatic breast cancer patients across the short-term treatment and recovery period. Forty-five women completed self-report questionnaires at approximately 1 and 6 months following surgery. A mixed idiographic-nomothetic goal methodology assessed perceived cancer-related interference and attainability of self-generated important personal goals. Psychological distress symptoms were assessed with the Depression Anxiety Stress Scales short form. Correlation analyses and general linear modelling were used to evaluate the hypothesised relationships over time. Average cancer-related interference and attainability of important personal goals were significantly associated with concurrent depression, anxiety and stress symptoms at 6 months following surgery. Perceived attainability of highly important goals at 6 months post-surgery uniquely predicted change in psychological distress symptoms over time. The findings suggest that low perceived attainability of important personal goals may be an important predictor of elevated distress symptoms across the short-term following surgery. Further insight into the relationship between these negative goal appraisals and psychological functioning among different groups of cancer patients could inform the provision of targeted psychosocial support across the cancer continuum.

The Theory of Planned Behaviour and dietary patterns: A systematic review and meta-analysis.

OBJECTIVE: Promoting adherence to healthy dietary patterns is a critical public health issue. Models of behaviour, such as the Theory of Planned Behaviour (TPB) allow programme designers to identify antecedents of dietary patterns and design effective interventions. The primary aim of this study was to examine the association between TPB variables and dietary patterns. METHODS: A systematic literature search was conducted to identify relevant studies. Random-effects meta-analysis was used to calculate average correlations. Meta-regression was used to test the impact of moderator variables. RESULTS: In total, 22 reports met the inclusion criteria. Attitudes had the strongest association with intention (r+=0.61) followed by perceived behavioural control (PBC, r+=0.46) and subjective norm (r+=0.35). The association between intention and behaviour was r+=0.47, and between PBC and behaviour r+=0.32. Moderator analyses revealed that younger participants had stronger PBC-behaviour associations than older participants had, and studies recording participants' perceptions of behaviour reported significantly higher intention-behaviour associations than did those using less subjective measures. CONCLUSIONS: TPB variables were found to have medium to large associations with both intention and behaviour that were robust to the influence of key moderators. Recommendations for future research include further examination of the moderation of TPB variables by age and gender and the use of more valid measures of eating behaviour.

Identification of distinct body mass index trajectories in Australian children.

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: Recent studies have identified distinct trajectories of obesity development in children, but more research is required to further explore these trajectories. Several socio-demographic variables such as parental education and obesity are associated with these trajectories. WHAT THIS STUDY ADDS: This study further demonstrates that there are distinct trajectories of body mass index in children. The use of raw body mass index values is more sensitive to changes in body composition compared with body mass index categories (e.g. lean vs. overweight). Hence the present results provide a more detailed insight into development patterns of obesity. The socio-demographic predictors of the trajectories offer potential avenues for future obesity interventions. BACKGROUND: A limited number of studies have demonstrated that there may be distinct developmental trajectories of obesity during childhood. OBJECTIVE: To identify distinct trajectories of body mass index (BMI) in a large sample of Australian children. METHODS: Participants included 4601 children aged 4-5 years at baseline, who were followed up at ages 6-7 years, 8-9 years and 10-11 years. Height and weight were measured at each of these time points, and used to calculate BMI. Growth Mixture Modelling was used to identify the presence of distinct BMI trajectories. RESULTS: Four distinct trajectories were identified (i) High Risk Overweight; (ii) Early Onset Overweight; (iii) Later Onset Overweight and (iv) Healthy Weight. Further analyses indicated that factors such as parental overweight, parent education, parent smoking and child birth weight were significant predictors of these trajectories. CONCLUSION: These findings indicate that different patterns of BMI development exist in children, which may require tailored interventions.

Asthma and ageing: an end user's perspective--the perception and problems with the management of asthma in the elderly.

Despite the high prevalence of asthma in the elderly, its development, diagnosis, and treatment are under-researched. This paper provides a comprehensive review of the current state of knowledge in relation to management of asthma in the elderly - focusing on barriers to diagnosis and treatment and the central role of self-management. Asthma prevalence increases with age, as does the risk of dying from asthma, and with the ageing of the population and increasing life expectancy, the prevalence of (diagnosed and undiagnosed) asthma in older adults is expected to increase drastically, placing an increasing burden on sufferers, the community and health budgets. Asthma sufferers are more likely to be psychologically distressed and at a higher risk of anxiety and depression, more likely to experience a sense of lack of control over their health and to have lower self-reported quality of life. Asthma is under-diagnosed, and under-treated, in the elderly, further exacerbating these negative consequences. The review concludes, among other things, that there is a need to better understand the development and impact of asthma in the elderly, to increase community awareness of asthma in the elderly, to improve both 'medical management' and 'self-management' in this population and to develop more effective tools for diagnosis and treatment of asthma in the elderly. The paper concludes with key recommendations for future research and practice in this area.

A link between chronic sleep restriction and obesity: methodological considerations.

Emerging evidence suggests that chronic sleep restriction contributes to obesity. Targeting short sleep duration may therefore offer a novel and effective method of preventing and treating obesity. However, this area of research is only in its infancy, and a complete understanding of how chronic sleep restriction and obesity are linked is currently lacking. The aim of this paper is to briefly review epidemiological evidence for an association between chronic sleep restriction and obesity in adults, and outline the key methodological limitations of these studies. Particular attention is paid to the methods used to measure sleep and obesity, as well as the need to control for potential confounding variables. Methodological recommendations are provided for future studies that will facilitate a more complete understanding of how chronic sleep restriction and obesity are linked in the general population. This has implications for the development of public health programmes that target sleep as a modifiable risk factor for obesity.

Association between socioeconomic status, weight, age and gender, and the body image and weight control practices of 6- to 19-year-old children and adolescents.

The aim of the study was to examine the effect of socioeconomic status (SES), age, weight and gender on the body image and weight control practices of children and adolescents, and to investigate whether health education about weight issues should target low socioeconomic groups. The study participants were a randomly selected group of school children who completed a questionnaire, and had their height and weight measured. Participants (n = 1131) were aged 6-19 years from 12 schools in New South Wales. SES, age, gender, body weight, body image, skipping breakfast, physical self-esteem, attempts to lose or gain weight, and dietary and weight control advice received from others were examined. Log-linear, chi 2 and MANOVA analyses were used to determine interactions between variables. Low SES children were more likely to be overweight, to skip breakfast, to perceive themselves as 'too thin', to be trying to gain weight and less likely to receive dietary or weight control advice. Physical self-esteem was lowest among overweight girls of middle/upper SES and greatest among boys of low SES, despite the latter being more likely to be overweight. Being overweight does not appear to adversely affect the physical self-esteem of children of low SES, particularly boys. Health educators should examine these issues with young people to help make health education and nutrition education most relevant and appropriate.

The relationship between emotions and stress among mental health nurses.

This paper presents findings from an exploratory correlational study that examined the relationships between Emotional Competency, Trait Affectivity, Stress and Experienced Emotions among 43 mental health nurses in Australian regional hospitals. A significant relationship was found between Emotional Competency and Personal Self-doubt in male nurses only; however, no association was found between Emotional Competency and Experienced Emotions. Trait Affectivity was found to be associated with Experienced Emotions but not Stress. Gender differences were found in Trait Affectivity and Experienced Emotions. The results of the study have implications for the retention of mental health nurses in their profession.

Exploring the relationship between work stress, years of experience and emotional competency using a sample of Australian mental health nurses.

This paper reports an exploratory study examining the relationship between emotional competency and work stress, and the association between the length of time in mental health nursing and emotional competency and stress. A significant relationship was found between emotional competency and years of experience. Nurses with six years and more experience had higher levels of emotional competency. This relationship was stronger for female than male nurses. Nurses with less than two years in the nursing profession were found to experience significantly more personal self-doubt than nurses with greater nursing experience.

Interrater reliability of the Camberwell Assessment of Need Short Appraisal Schedule.

OBJECTIVE: Australian mental health policy aims to introduce evidence-based practice within a community care approach. This aim requires reliable measures that can be used by a wide variety of professionals. The interrater reliability of the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) was assessed under routine conditions. METHOD: Three interviewer-observer dyads assessed the needs of 14 inpatients and 18 day patients of a psychiatric rehabilitation unit in New South Wales, Australia. RESULTS: Agreement on the identification of an area of need was high. However, agreement was higher on patient ratings than on staff ratings. Correlations on staff ratings of met needs were also moderate (r = 0.53), suggesting discrepancies in rating the level of need. CONCLUSION: Differences in staff ratings may be attributed to ambiguity in the definition of need and levels of need and/or the sources of information used by the rater making the assessment. An approach to establishing an operational definition of need is suggested, and an increase in the number of levels of need is recommended. Implications for Australian mental health policy are noted.

Computer attitude and computer anxiety in nursing. Validation of an instrument using an Australian sample.

The purpose of this study was to refine the instrument, Nurses' Computer Attitudes Inventory (NCATT), which was developed to measure nurses' attitudes toward computers in an Australian setting. The study was designed to test the reliability and validity (concurrent and discriminant) of the instrument. The NCATT was administered to 170 subjects: 71 first-year nursing students and 99 nurses employed in a local hospital. On the basis of factor and item analysis the 40-item NCATT was reduced to 22 items. Three factors for the revised NCATT were identified: (1) Computers and Patient Care, (2) Computer Anxiety, and (3) Patient Confidentiality and Computers. These three factors accounted for 90.0% of the variance (factor 1, 56.6%; factor 2, 24.8%; and factor 3, 8.6%). The factors demonstrated good internal consistency with the Cronbach alpha coefficients for each factor ranging from 0.72 to 0.90. The revised NCATT provided evidence of concurrent validity on the student sample when related to Dambrodt's scale for Computer Attitudes. Some evidence of discriminant validity was demonstrated as the internal consistency reliabilities were much higher in all factors than their intercorrelations. The authors propose that the revised NCATT is a practical instrument that is useful to assess nurses' attitudes before computer implementation and training.