Opposition to voluntary and mandated COVID-19 vaccination as a dynamic process: Evidence and policy implications of changing beliefs.

SignificanceThe challenge of securing adherence to public health policies is compounded when an emerging threat and a set of unprecedented remedies are not fully understood among the general public. The evolution of citizens' attitudes toward vaccination during the COVID-19 pandemic offers psychologically and sociologically grounded insights that enrich the conventional incentives- and constraints-based approach to policy design. We thus contribute to a behavioral science of policy compliance during public health emergencies of the kind that we may increasingly face in the future. From early in the pandemic, we have tracked the same individuals, providing a lens into the conditions under which people's attitudes toward voluntary and mandated vaccinations change, providing essential information for COVID-19 policy not available from cross-section data.

Does effort increase or decrease reward valuation? Considerations from cognitive dissonance theory.

The present research tested the effect of manipulated perceived control (over obtaining the outcomes) and effort on reward valuation using the event-related potential known as the Reward Positivity (RewP). This test was conducted in an attempt to integrate two research literatures with opposite findings: Effort justification occurs when high effort leads to high reward valuation, whereas effort discounting occurs when high effort leads to low reward valuation. Based on an examination of past methods used in these literatures, we predicted that perceived control and effort would interactively influence RewP. Consistent with the effort justification literature (cognitive dissonance theory), when individuals have high perceived control, high effort should lead to more reward valuation than low effort should. Consistent with the effort discounting literature, when individuals have low perceived control, low effort should lead to more reward valuation than high effort should. Results supported these interactive and integrative predictions.

Task shifting eating disorders prevention: A pilot study of selective interventions adapted for teacher-led universal delivery in secondary schools.

OBJECTIVE: Increasing effectiveness and sustainability of universal school-based eating disorder prevention is needed. This study adapted two existing selective prevention programmes for universal delivery, investigating feasibility, acceptability, and preliminary effects when delivered by trained teachers to classes of mixed-gender adolescents. METHOD: A three-arm controlled pilot study with Year 9 students (N = 288; Mage = 13.61 SDage = .50). Three schools in south Wales and south-west England were allocated to mindfulness-based intervention (MBI), dissonance-based intervention (DBI), or classes-as-usual (CAU) control. Self-reported eating disorder risk factors were collected at baseline, 6-week post-intervention, and 2-month follow-up. Focus groups were conducted post-intervention. RESULTS: Delivery and evaluation were feasible, allowing for flexibility in scheduling, with good retention. Student and teacher ratings indicated moderate acceptability of both interventions, with recommendations for refinement. Mixed model analyses, controlling for baseline, showed significant effects of condition across post-intervention and follow-up for body esteem (DBI > CAU; Cohen's d = .34) and positive affect (MBI > CAU, d = .58). For girls only, both MBI and DBI improved body satisfaction and internalization, and the MBI additionally resulted in improved weight and shape concerns, negative affect, and life disengagement (d's = .39-1.12), across post-intervention and follow-up. DISCUSSION: Selective eating disorder prevention programmes based on cognitive dissonance and mindfulness can be delivered universally in schools, by teachers, allowing for appropriate flexibility necessary for real world implementation. Moderate acceptability indicates areas for improving content and delivery; positive effects on key outcomes are encouraging. These findings provide support for further robust evaluation. PUBLIC SIGNIFICANCE: Existing universal eating disorder prevention is limited by small effects and reliance on highly trained facilitators. This study is the first to adapt mindfulness- and dissonance-based interventions for delivery by teachers, to adolescents of all genders in a classroom setting. Delivery was largely feasible and acceptable, and both interventions showed significant effects across key risk factors for eating disorders, with larger effect sizes than found previously. This underpins further robust evaluation.

Moral disengagement in the media discourses on meat and dairy production systems.

Meat and dairy production and consumption are the subject of ongoing public debates that touch on various sustainability issues such as biodiversity loss, climate change, animal welfare, and social and health aspects. Despite extensive discussions specifically relating to the environmental impacts of livestock farming in conjunction with animal welfare aspects, there have been no substantial changes in production or consumption patterns. Moreover, the focus of extant research is usually on consumers' responses to public concerns around livestock production. In this study, we shed light on the discrepancy between the normative discourse and action of relevant value chain actors with the help of Bandura's theory of moral disengagement, which allows us to identify mechanisms that contribute to the perpetuation of unsustainable production and consumption patterns. In particular, we focus on the shifting of responsibility between actors in the normatively charged field of sustainable livestock production. We collected 109 media interviews on meat and dairy production and consumption from the years 2020-2022, including interviews with actors from agriculture, processing industries, and food retail. Using qualitative content analysis, we investigated the role of moral disengagement in the media discourse on meat and dairy production and explored differences between actors in terms of moral disengagement. We found that shifting of responsibility shows a quasi-circular dynamic of being shifted from all actors to all, in our case most frequently to consumers, politics, and (diffuse) economic forces. In addition, our analysis showed the use of social justifications, beneficial comparisons, and euphemistic labelling to be common mechanisms of moral disengagement, constituting a collective problem within agri-food systems.

Support for the 'Pets as Ambassadors' hypothesis in men: Higher animal empathy in Australian pet-owners vs non-owners and farmers.

Human empathy towards non-human animals (Animal Empathy; AE) has shown a strong gender bias, with women demonstrating higher levels than men. This study aimed to investigate the influence of animal experiences on AE in a male-only sample. It was hypothesised that there would be different levels of AE between men with experiences caring for pets, men with experience in animal agriculture, and men with limited animal experiences. Ninety-one Australian men (18yrs+) completed an online survey evaluating their level of AE using the Animal Empathy Scale (AES). Additionally, they were asked what in their experience they think has influenced their beliefs about how animals think and feel. As expected, AE levels differed significantly between groups, with those in the pet ownership experience group demonstrating higher AE levels than the other two groups. All three groups displayed high endorsement for direct interactions with animals in adulthood as being most influential in shaping their beliefs about how animals think and feel. However, our quantitative results support the idea that not all experiences are worth the same, with the responsibility and sacrifice involved in pet caring appearing to be most influential to the development of AE. These findings have implications for the importance of human-animal interactions in understanding animal sentience and the development of AE in males.

Role-Related Value Conflicts: A Qualitative Study of the Experiences of Perianesthesia Nurse Managers.

PURPOSE: Value conflicts with the potential to elicit moral distress are among the factors that contribute to burnout and threaten nurse manager retention. Little is known about the value conflicts faced by nurse managers working in the perianesthesia environment. Using the process model of managerial dissonance and responsibility attribution as a framework of inquiry, this study explored the types of value conflicts experienced by perianesthesia nurse managers and how they worked to reduce the accompanying distress. DESIGN: Qualitative, descriptive design. METHODS: Data were collected by means of semi-structured interviews from 14 participants meeting inclusion criteria. Thematic analysis was used to analyze data. FINDINGS: Eleven subthemes were identified and mapped onto the four phases of process model of managerial dissonance: Phase 1 Harm Doing Event: (1) Operational management strategies, (2) Patient care management strategies, (3) Standardized organizational practices; Phase 2 Dissonance: (4) Questioning my leadership, (5) Altered well-being, (6) Just do something; Phase 3 Attribution, (7) Consider organizational viewpoint, (8) Consider role and responsibilities, and Phase 4 Outcomes, (9) Commit to act, (10) Value the organization, and (11) Forgotten by leadership. CONCLUSIONS: Perianesthesia nurse managers experience similar types of value conflicts as inpatient nurse managers; however, some aspects of their experiences reflect the uniqueness of their practice environment. The process model of managerial dissonance and responsibility attribution serves as a useful framework for understanding the psychological difficulties and processes by which nurse managers seek to resolve the distress associated with mandated actions likely to induce harm in employees. Executive leaders must act to implement strategies to mitigate the associated psychological difficulties and prevent the increased potential in nurse managers for work-role disengagement and potential exit from the organization.

The cost-effectiveness of a virtual intervention to prevent eating disorders in young women in Sweden.

OBJECTIVE: To determine the cost-effectiveness of a virtual version of the Body Project (vBP), a cognitive dissonance-based program, to prevent eating disorders (ED) among young women with a subjective sense of body dissatisfaction in the Swedish context. METHOD: A decision tree combined with a Markov model was developed to estimate the cost-effectiveness of the vBP in a clinical trial population of 149 young women (mean age 17 years) with body image concerns. Treatment effect was modeled using data from a trial investigating the effects of vBP compared to expressive writing (EW) and a do-nothing alternative. Population characteristics and intervention costs were sourced from the trial. Other parameters, including utilities, treatment costs for ED, and mortality were sourced from the literature. The model predicted the costs and quality-adjusted life years (QALYs) related to the prevention of incidence of ED in the modeled population until they reached 25 years of age. The study used both a cost-utility and return on investment (ROI) framework. RESULTS: In total, vBP yielded lower costs and larger QALYs than the alternatives. The ROI analysis denoted a return of US $152 for every USD invested in vBP over 8 years against the do-nothing alternative and US $105 against EW. DISCUSSION: vBP is likely to be cost-effective compared to both EW and a do-nothing alternative. The ROI from vBP is substantial and could be attractive information for decision makers for implementation of this intervention for young females at risk of developing ED. PUBLIC SIGNIFICANCE: This study estimates that the vBP is cost-effective for the prevention of eating disorders among young women in the Swedish setting, and thus is a good investment of public resources.

A randomized controlled trial to evaluate the acceptability and effectiveness of two eating disorders prevention interventions: the HEIDI BP-HW project.

BACKGROUND: Eating disorders (ED) are common in Switzerland, as in other Western countries, with a prevalence of any ED of 3.5%. However, no specific prevention intervention has been evaluated in the French-speaking part of the country. In this study, we assessed the acceptability and effectiveness of two well-validated eating disorders prevention interventions: the Body Project intervention (BP), based on cognitive dissonance techniques, and the Healthy Weight intervention (HW), based on the implementation of a healthy lifestyle. METHODS: Forty female students, aged 18-28, with body dissatisfaction, were randomized into three arms: a BP group, an HW group, and a waiting-list control group (WLCG). The primary outcome measure was body dissatisfaction. Secondary outcomes were thin-ideal internalization, dietary restraint, negative affect, and ED psychopathology. Thirty-three participants completed the assessments before and after the one-month interventions or waiting period. A follow-up measurement was conducted one month after the interventions to assess the stability of the results. RESULTS: Both interventions, delivered via a virtual web platform, were considered acceptable. The reduction in body dissatisfaction was greater in the BP group (r = 0.7; p < 0.01) or the HW group (r = 0.6; p < 0.01) than in the WLCG, with large effect sizes. Dietary restraint and shape concern were also significantly reduced in the BP group (r = 0.6 and r = 0.7, respectively; p < 0.01) and HW group (r = 0.5 and r = 0.5, respectively; p < 0.05) compared to the WLCG, with moderate to large effect sizes. The results obtained in each intervention group were stable at the one-month follow-up. CONCLUSIONS: This study showed encouraging results in young women with body dissatisfaction, arguing in favor of the French adaptations of the BP and HW interventions. However, the feasibility of recruitment was difficult, partly due to the pandemic situation at the time of the study, and should be further considered to improve dissemination. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04558073, 22/09/2020 and Swiss National Clinical Trial Portal (SNCTP000003978).

The cheese paradox: How do vegetarians justify consuming non-meat animal products?

Researchers interested in animal ethics have proposed the 'meat paradox' - psychological discomfort arising from people's affinity for animals and conflicting desire to consume their flesh. Yet what can be said about the psychology of consuming an animal's non-meat products, in an age where most beings in these industries are harmed, and ultimately killed? Non-meat animal products (NMAPs) such as eggs and dairy entail the same, and perhaps even worse ethical issues as meat yet receive disproportionately less critical attention. Therefore, unlike meat, very little is known about the psychology of egg and dairy consumption. This study looks at vegetarians to address this gap, because they are more likely to show empathetic concern for animals than meat-eaters, yet actively choose to include these products in their diet, a conflict ripe for exploration. Interview data were analysed via thematic analysis, finding that vegetarians perceive robust ethical issues with NMAPs but give various justifications pertaining to personal benefits and social norms. Cognitive dissonance was evident and participants used various strategies to resolve it. This paper expands research on food psychology and animal ethics and may also be used to inform NMAP reduction strategies, an important pursuit in the quest for a more sustainable and compassionate world.

Feeling morally troubled about meat, dairy, egg, and fish consumption: Dissonance reduction strategies among different dietary groups.

A largescale shift towards plant-based diets is considered a critical requirement for tackling ethical, environmental, and global health issues associated with animal food production and consumption. Although previous research has identified psychological strategies that enable meat-eaters to justify and continue meat consumption and feel less morally conflicted about it, research on the psychological strategies that enable consumers to continue dairy, egg, and fish consumption is scarce. We conducted an online survey study using an adjusted version of the Meat-Eating Justification Scale to investigate the use of psychological strategies to cope with cognitive dissonance related to meat, dairy, egg, and fish consumption in omnivores (n = 186), pescatarians (n = 106), vegetarians (n = 143), vegans (n = 203), and flexitarians (n = 63). Results indicated greater use of meat-related dissonance reduction strategies among omnivores as compared to other dietary groups, greater use of fish-related dissonance reduction strategies among fish consumers (omnivores, flexitarians and pescatarians) compared to vegetarians and vegans, and greater use of dairy and egg-related dissonance reduction strategies among dairy and egg consumers (omnivores, flexitarians, pescatarians, and vegetarians) as compared to vegans. This pattern was particularly clear for justifications used to defend animal product consumption, denial of animal suffering, and use of dichotomization when considering meat and fish consumption. These findings highlight the importance of extending the research on dissonance reduction strategies beyond meat consumption and studying the consumption of a range of animal products. This can help in identifying the psychological barriers to adopting a plant-based diet and informing interventions for behaviour change.

Effects of a healthcare students' prevention intervention for school children on their own substance use: a before-after study.

BACKGROUND: Cognitive dissonance theory and research has suggested that engaging in prevention interventions for other students may be a means of reducing one's own problematic behaviors in order to reduce potential cognitive dissonance. This study assessed the effects of a new mandatory prevention intervention program for healthcare students in France. The aim was to measure the effects of engaging in a prevention program in schools on the usual increase in substance use in student populations. METHODS: Healthcare students were trained in a French university to develop psychosocial competences as a health promotion means (FEPS training) or more specifically to prevent substance use in teenagers (Unplugged program training). The students (n = 314) who accepted to take part in the study from both groups completed questionnaires before their interventions in schools, and at the end of the year, measuring their representations and behaviors regarding psychoactive substances. RESULTS: The results indicated a significant reduction in alcohol consumption in terms of quantity, but no significant reduction in tobacco and marijuana consumption. CONCLUSIONS: This study showed that, contrary to the usual increase in substance use in students as they advance in their year, the students who took part in this study showed reduced self-reported consumption of alcohol after they had performed the prevention intervention in schools regardless of the type of training they had received (general health promotion vs. specific substance use prevention program). Limitations and future perspectives are discussed.

Behavioral Responses to Losses Disguised as Wins: A Field Study of Slot Machine Players.

We present the results of a field study examining the effect of losses disguised as wins (LDWs) on subsequent slot machine gambler betting behavior. An LDW occurs when the amount won is less than the amount bet. Using non-experimental, individual transaction gambling data, we examine post LDW betting behavior in a panel of 42,669 gamblers and 17 million slot machine plays. The primary empirical findings include: (1) streaks of three LDWs greater than 75% of the original amount bet lead slot gamblers to increase the amount bet on the next spin; (2) streaks of three LDWs less than 25% of the original amount bet results in gamblers decreasing their bet size on the next spin; (3) slot machine gamblers play faster following streaks of three LDWs compared to losses. We interpret these behavioral findings of differing outcomes associated with small versus large LDWs as consistent with a cognitive dissonance effect (Festinger, 1957). Specifically, the disconnect between the amount "won" (actually lost) and the audio and video stimulus produced by the slot machine highlighting the LDW, produces a dissonance-related arousal that players seek to avoid or reduce leading to changes in betting behavior. Our results complement the experimental findings on LDWs and suggest that the size of the LDW matters in examining the impact on gambling behavior.

[Discrepancy between behavioral-indicated and perceived candidacy for HIV pre-exposure prophylaxis among men who have sex with men in Chengdu, China].

OBJECTIVE: To explore the discrepancy between behavioral-indicated candidacy and perceived candidacy (behavioral-perceived gap) and its associated factors of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM), so as to identify the focus population of PrEP interventions and to design and implement targeted interventions. METHODS: We recruited a sample of 622 HIV-negative MSM who were regular clients of a community-based organization located in Chengdu, China, from November to December 2021. A cross-sectional questionnaire was used to collect the participants' information on social demographics, PrEP-related knowledge and cognitions, and risk behaviors. In this study, behaviorally eligible for PrEP was defined as performing at least one type of high-risk behavior in the past six months, including inconsistent condom use, sex with an HIV-positive partner, confirmed sexual transmitted infections (STI) diagnosis, substance use, and post-exposure prophylaxis (PEP) experience. Logistic regression models were fitted, and multivariate analyses were adjusted for social demographics. RESULTS: Among the 622 eligible participants, 52.6% (327/622) were classified as behaviorally eligible for PrEP. Only 37.9% (124/327) of the participants perceived themselves as appropriate candidates for PrEP and 62.1% (203/207) had discrepancy between behavioral-indicated and perceived candidacy. 85.9% (281/327) had heard of PrEP, and 14.2% (40/281) accessed PrEP information through health care providers. Of the 327 participants eligible for behavior-indicated PrEP use, about half (47.1%) knew how to obtain PrEP medication and 33.0% had a professional PrEP counseling experience. The majority (93.3%) had no or few friends using PrEP. 54.1% scored eight or above in PrEP knowledge level. 66.7% reported having two or more sexual partners in the past six months. After adjusting for age and recruitment channel, we found six factors that were associated with perceived candidacy for PrEP, including PEP use [adjusted odds ratio (ORA)=2.20; 95% confidence interval (CI): 1.33-3.63], PrEP availability (ORA=1.69; 95%CI: 1.06-2.68), a greater number of PrEP-using friends (ORA=4.92; 95%CI: 1.77-13.65), PrEP know-ledge (ORA=2.21; 95%CI: 1.38-3.56), multiple sexual partnership (ORA=1.77; 95%CI: 1.07-2.94), and perceiving a higher risk of HIV infection (ORA=4.02; 95%CI: 1.73-9.32). Substance use during sex and PrEP information channel were not statistically associated with this beha-vioral-perceived gap. CONCLUSION: We observed a high discrepancy between behavioral-indicated and perceived candidacy for PrEP among Chengdu MSM in China. Future PrEP implementation efforts should be made in skills training in assessing HIV infection risk, increasing PrEP knowledge, providing professional PrEP counselling, and fostering PrEP support environment.

A Complexity Science Account of Humor.

A common assumption of psychological theories of humor is that experienced funniness results from an incongruity between stimuli provided by a verbal joke or visual pun, followed by a sudden, surprising resolution of incongruity. In the perspective of complexity science, this characteristic incongruity-resolution sequence is modeled by a phase transition, where an initial attractor-like script, suggested by the initial joke information, is suddenly destructed, and in the course of resolution replaced by a less probable novel script. The transition from the initial to the enforced final script was modeled as a succession of two attractors with different minimum potentials, during which free energy becomes available to the joke recipient. Hypotheses derived from the model were tested in an empirical study where participants rated the funniness of visual puns. It was found, consistent with the model, that the extent of incongruity and the abruptness of resolution were associated with reported funniness, and with social factors, such as disparagement (Schadenfreude) added to humor responses. The model suggests explanations as to why bistable puns and phase transitions in conventional problem solving, albeit also based on phase transitions, are generally less funny. We proposed that findings from the model can be transferred to decision processes and mental change dynamics in psychotherapy.

Feasibility and acceptability of video-based microinterventions for eating disorder prevention among adolescents in secondary schools.

OBJECTIVE: Eating disorders (EDs) often emerge in late adolescence. Schools are ideal settings for prevention programs; however, cost and time limit implementation. Microinterventions may overcome these challenges. This study adapted two microinterventions (cognitive dissonance, self-compassion) and assessed feasibility and acceptability among mid-adolescents to provide proof-of-concept for further investigation. METHOD: Feedback from staff (n = 5) and student (n = 15) focus groups contributed iteratively to the adaptation of intervention materials. Students in Grade 10 and 11 (N = 101, Mage  = 15.80, SD = 0.68) were then randomly allocated by class to a 20-min video-based cognitive-dissonance or self-compassion intervention, accessed on their school devices. ED risk and protective factors were assessed at baseline, immediate postintervention (state outcomes), and 1-week follow-up (trait outcomes). Acceptability items were included at both timepoints. RESULTS: Implementation was deemed feasible. Girls generally reported greater acceptability than boys. Among girls, the self-compassion intervention demonstrated greater acceptability. Among boys, some aspects of acceptability (e.g., lesson endorsement, utilization of techniques) were rated higher in the cognitive dissonance group whereas other aspects (e.g., understanding, interest) were greater in the self-compassion group. All groups exhibited favorable changes in most state outcomes, however trait outcome change was varied. DISCUSSION: Microinterventions provide a feasible way of implementing prevention strategies in a time-poor educational context. Future large-scale evaluation is warranted to determine efficacy, following modifications based on current findings. PUBLIC SIGNIFICANCE: This study shows promising feasibility and acceptability of two brief, self-guided video-based lessons (microinterventions) for adolescents in school classrooms, that use psychological techniques to target appearance pressures as a key risk factor for eating disorders. Such interventions are easier to implement in school settings than longer, facilitator-led interventions, to encourage greater uptake and ongoing use. Findings support further research to evaluate effectiveness, to ultimately provide accessible and gender-inclusive tools for busy schools.

Smoking-related psychosocial beliefs and justifications among smokers in India: Findings from Tobacco Control Policy (TCP) India Surveys.

BACKGROUND: Previous research in high-income countries (HICs) has shown that smokers reduce their cognitive dissonance through two types of justifications over time: risk minimizing and functional beliefs. To date, however, the relationship between these justifications and smoking behaviors over time has limited evidence from low- and middle-income countries. This study examines these of justifications and their relation to quitting behavior and intentions among smoking tobacco users in India. METHODS: The data are from the Tobacco Control Policy (TCP) India Survey, a prospective cohort of nationally representative sample of tobacco users. The respondents include smoked tobacco (cigarettes and bidi) users (n = 1112) who participated in both Wave 1 (W1; 2010-2011) and Wave 2 (W2; 2012-2013) surveys. Key measures include questions about psychosocial beliefs such as functional beliefs (e.g., smoking calms you down when you are stressed or upset) and risk-minimizing beliefs (e.g., the medical evidence that smoking is harmful is exaggerated) and quitting behavior and intentions at Wave 2. FINDINGS: Of the 1112 smokers at W1, 78 (7.0%) had quit and 86 (7.8%) had intentions to quit at W2. Compared to W1, there was a significant increase in functional beliefs at W2 among smokers who transitioned to mixed use (using both smoking and smokeless tobacco) and a significant decrease among those who quit. At W2, smokers who quit held significantly lower levels of functional beliefs, than continuing smokers, and mixed users ((M = 2.96, 3.30, and 3.93, respectively, p < .05). In contrast, risk-minimizing beliefs did not change significantly between the two waves. Additionally, higher income and lower functional beliefs were significant predictors of quitting behavior at W2. CONCLUSION: These results suggest that smokers in India exhibit similar patterns of dissonance reduction as reported in studies from HICs: smokers who quit reduced their smoking justifications in the form of functional beliefs, not risk-minimizing beliefs. Smokers' beliefs change in concordance with their smoking behavior and functional beliefs tend to play a significant role as compared to risk-minimizing beliefs. Tobacco control messaging and interventions can be framed to target these functional beliefs to facilitate quitting.

Animal rights, environment, or health? Effects of argument type and dissonance on the attitudes toward the consumption of animals.

The scientific literature and advocacy organisations highlight three harm-related arguments as paramount reasons for the reduction and cessation of the consumption of animal-derived products (ADP) - violence toward animals, damage to the environment, and human health. However, research on their comparative effects is scarce and there is no clear definition of which type of argument is the most effective in restricting ADP consumption. Based on cognitive dissonance theory, this study aimed to investigate the effects of these types of arguments on meat-eaters' attitudes and beliefs toward the propositions of reducing and ceasing ADP consumption. The study sample comprised 545 Brazilian adults. We adopted an experimental between-subjects design based on the presentation of vignettes. Each participant responded to one of the vignettes (animal rights, environmental, or health arguments) or a control condition. Results showed that greater levels of ADP-related dissonance provoked greater positive attitudes toward the reduction and cessation of ADP consumption. Compared to baseline, the animal rights and environmental messages significantly increased dissonance and positive attitudes toward ADP restriction, but not the health argument. Participants most frequently adopted the dissonance-management strategies of denial of responsibility, denial of harm, and the articulation of beliefs favourable to change. The discussion highlights that the different effects of social influence contexts and argument types depend on their capacity to reveal ADP consumption as morally problematic behaviour. To our knowledge, this is the first study to experimentally compare the effects of animal rights, environmental and health-related arguments in generating ADP-related dissonance and attitude change.

Strategies to manage cognitive dissonance when experiencing resistiveness to care in people living with dementia: A qualitative study.

AIMS: To explore the experiences of healthcare personnel when they face resistiveness to care in people living with dementia in nursing homes. DESIGN: The study has a qualitative explorative design. METHODS: Three focus group interviews were conducted in June 2019. A total of 16 nurses and other healthcare personnel employed in three different nursing homes participated. A semi-structured interview guide was used during the focus group interviews. Data were transcribed verbatim and analysed using an inductive qualitative content analysis. RESULTS: The analysis generated one overarching category-'Tension when facing resistiveness to care', which describes the discomfort healthcare personnel experienced when confronted with resistiveness to care in people with dementia-and two other categories: 'Attitude change' and 'Changing behaviour', which describes their strategies to reduce and/or manage the discomfort. Four subcategories-'Changing the mindset', Conceptual shift', Stepping back' and 'Not giving up'-described the actions taken by healthcare personnel to manage or reduce their cognitive dissonance. CONCLUSION: The strategies used to manage or reduce cognitive dissonance provide a new understanding of how healthcare personnel choose to approach resistiveness to care in people living with dementia. IMPACT: This study addresses cognitive dissonance, a discomfort experienced by healthcare personnel when facing resistiveness to care from people living with dementia. To reduce their dissonance, the participants employed several strategies, including coercive measures, when providing care. The theory of cognitive dissonance may help explain why healthcare personnel sometimes choose to employ coercive measures while providing care.

Experience of mental health nurses regarding mechanical restraint in patients with psychomotor agitation: A qualitative study.

AIM: To explore mental health nurses' experiences whilst managing a patient with psychomotor agitation, and the factors that influence the decision to use mechanical restraints. BACKGROUND: Psychomotor agitation is considered a potentially violent psychiatric emergency. The management of disruptive behaviours includes mechanical restraints as the last resort although its use has consequences for patients, professionals and the therapeutic relationship. DESIGN: A qualitative study design with a hermeneutical approach was developed. METHODS: A total of 31 nurses were purposively sampled from six short- and medium-stay mental health inpatient units. Data were obtained from semi-structured interviews. A thematic content analysis following the seven steps of Colaizzi's method was performed. Three researchers independently conducted an inductive analysis within a perspective of a hermeneutic paradigm. The COREQ checklist was followed in carrying out this research. RESULTS: Four themes emerged from the analysis: 1) Nurses' perceptions of restraint methods, 2) Factors influencing decision-making, 3) Consequences for professionals of the use of mechanical restraint and 4) Alternatives to mechanical restraint. CONCLUSIONS: Aspects such as the importance of teamwork, the issue of cognitive dissonance, ethical conflict and barriers to effecting the withdrawal of these measures affect the mental health nurse's decision-making process. The understanding of these aspects is crucial to further reducing its incidence and negative consequences and achieving the elimination of mechanical restraints. RELEVANCE FOR CLINICAL PRACTICE: Knowing how nurses feel during the patient's episode of psychomotor agitation and which factors influence the decision on whether to apply coercive methods can guide us on the quality of care offered.

Exploring cognitive dissonance in the correctional nursing experience.

OBJECTIVE: Correctional nurses navigate conflict between custody and caring. Balance is needed between healthcare and security priorities. This study explores the unique nature of nursing practice within correctional settings to inform interventions reducing stress, enhancing coping and mitigating cognitive dissonance among these nurses. DESIGN: Qualitative, semi-structured interviews. SAMPLE: Purposive sampling of nurses practicing in a correctional facility in the Southwestern United States. RESULTS: Thematic analyses identified six themes describing the experiences of nurses in the correctional facility. The themes, "We have a sense of purpose," "We don't trust each other," "We want respect," "We experience unique stress," "It changes who you are," and "We try to leave it all there," describe the need for interventions providing debriefing opportunities, strengthening of relationships with corrections personnel, reflection and stress reduction to ameliorate the potential for cognitive dissonance. CONCLUSIONS: Correctional nurses in this study perceived a strong sense of purpose and a desire for respect. They are challenged by relationships with both correctional staff and inmates and perceived a change in who they are due to practice in this challenging environment. Measurable, evidence-based stress relief interventions such as mindfulness practices, reflection interventions, physical activity, prayer and meditation are indicated to address these challenges.