Randomized controlled trial of an intervention to change cardiac misconceptions in myocardial infarction patients

There is converging evidence that changing beliefs about an illness leads to positive recovery outcomes. However, cardiac misconceptions interventions have been investigated mainly in Angina or Coronary Heart Disease patients, and less in patients following Myocardial Infarction (MI). In these patients, cardiac misconceptions may play a role in the adjustment or lifestyle changes. This article reports a randomized controlled trial of an intervention designed to reduce the strength of misconceptions in patients after a first MI. The primary outcome was the degree of change in misconceptions and the secondary outcomes were: exercise, smoking status, return to work and mood (anxiety and depression). Patients in the intervention condition (n = 60) were compared with a control group (n = 67) receiving usual care. Both groups were evaluated at baseline and 4, 8 and 12 months after hospital discharge. There was a significant time-by-group interaction for the total score of cardiac misconceptions. Patients in the intervention group significantly decreased their total score of cardiac misconceptions at 4 months compared with the control group and this difference was sustained over time. Patients in the intervention group were also more likely to exercise at the follow-up period after MI than the control group. This intervention was effective in reducing the strength of cardiac misconceptions in MI patients and had a positive impact on health behaviour outcomes. These results support the importance of misconceptions in health behaviours and the utility of belief change interventions in promoting health in patients with Myocardial Infarction.

The old and the oldest-old: Do they have different perspectives on adjustment to aging?

Background: Older adults experience varying challenges in old age. This study aims to explore the indicators of adjustment to aging (AtA) and to examine the potential explanatory mechanisms of a correlational model for AtA for the old and oldest-old adults. Methods: This qualitative study comprised demographics and semistructured interviews. Complete information on 152 older adults aged between 75 years and 102 years (mean ¼ 83.76 years; standard deviation ¼ 6.458). Data was subjected to content analysis. The correlational model of indicators of AtA was analyzed using a multiple correspondence analysis. Results: “Occupation and achievement” was the most mentioned indicator of AtA by the old participants (17.7%), whereas “existential meaning and spirituality” was the most verbalized indicator of AtA for the oldest-old participants (16.9%). AtA was explained by a three-factor model for each age group. For the old participants, the largest factor “occupational and social focus” accounted for 33.6% of total variance, whereas for the oldest-old participants, “spirituality and health focus” represented 33.5% of total variance. Conclusion: The outcomes presented in this paper stressed the varied perspectives concerning AtA, contoured in two different models, and the need of considering these when designing and implementing programs in health care for the old and the oldest-old.

A film director’s challenge : To manage – to manage? – The creative process in a film project

The aim of this text is to discuss how it is possible to manage the art creating process in a film project, where the circumstances are often turbulent. In normative project management literature one proceeds from the idea that a project is realised in a stable world from a clear goal. In a film project there is often a need to change your plans, to improvise both in front of the camera as well as behind the camera. In the theoretical cinematic literature the responsibility for the final film text is more and more being viewed as a product of not only the director, but of the whole team’s work. Consequently, the narrative of leadership/management in a film team can be viewed from a relational perspective where the director and those s/he interacts with, are responsible for the action, relations and social situations they construe jointly in the process of filmmaking. The organization of a film project is a temporary one. The members of a team are seldom the same from one production to another, as well as the creative process always being unique. According to process thinking, organizing can be seen as the ongoing creative activity where we structure and stabilize the chaotic, moving reality. As concerns a film project, the process of becoming of the filmic expression; careful plans, on the one hand, and improvisation and flexibility in action, on the other hand, are a precondition for its realisation. The director when setting a linguistic formulation to what is to be done, can be considered as a practical author.