Health beliefs - what role do they play in outcomes research?

Lay beliefs about health and illness are individual and social, influenced by prevailing social and medical ideologies. Health beliefs clearly influence self-care motivation and have an effect on health-promoting behaviour (e.g. attendance at a screening program, food choices, adherence to prescribed medication). Further, the beliefs and attributions that people hold can directly affect physiological systems (e.g. the immune system). Health beliefs have been shown to influence a variety of patient-reported outcomes, including medication adherence, satisfaction and health-related quality of life. It is widely acknowledged that when the patient's beliefs are acknowledged and incorporated, rather than ignored, optimal biomedical patient-reported outcomes are more likely to be achieved. Several psychological models have been developed to predict health behaviours and may be utilised to identify the beliefs that inform such behaviours. These models consider the social milieu, personality, demographic, political and economic predictors of health beliefs. They demonstrate the impact of beliefs such as the causes of illness, effectiveness of healthcare and acceptability of health services, and how manipulating these can result in actual or intended behaviour change. This workshop will introduce health beliefs and discuss the psychological models that underpin the translation of belief into behaviour. The session is interactive, with participants defining health beliefs and their impact on behaviour. Participants will be invited to critique the models and apply their chosen model to a health indication of their choice.

Managing depression in patients with vision impairment : a descriptive study of practitioners' beliefs and confidence

Aim: Depression is common in older adults with vision impairment yet it often remains unidentified and untreated.
Eye health professionals (EHPs) and rehabilitation workers (RWs) may be able to assist in detecting depression. This study identified EHPs’ and RWs’ beliefs about depression and confidence in working with patients with vision
impairment and depression.
Methods: A self-administered cross-sectional survey of 94 EHPs and RWs assessed beliefs about the symptoms and treatment for depression, and confidence in working with depressed people with vision impairment.
Results: Participants showed awareness of both the symptoms and treatment options for depression. However,
some important misconceptions were identified and many symptoms of depression were commonly attributed to
vision loss. Participants lacked confidence in communicating about depression with patients and their families.
Conclusions: Training programs are needed to enable EHPs and RWs to confidently identify depression and
discuss appropriate treatment and referral options with their patients.

Pierre Hadot (1922-2010)

Pierre Hadot, classical philosopher and historian of philosophy, is best known for his conception of ancient philosophy as a bios or way of life (manière de vivre). His work has been widely influential in classical studies and on thinkers, including Michel Foucault. According to Hadot, twentieth- and twenty-first-century academic philosophy has largely lost sight of its ancient origin in a set of spiritual practices that range from forms of dialogue, via species of meditative reflection, to theoretical contemplation. These philosophical practices, as well as the philosophical discourses the different ancient schools developed in conjunction with them, aimed primarily to form, rather than only to inform, the philosophical student. The goal of the ancient philosophies, Hadot argued, was to cultivate a specific, constant attitude toward existence, by way of the rational comprehension of the nature of humanity and its place in the cosmos. This cultivation required, specifically, that students learn to combat their passions and the illusory evaluative beliefs instilled by their passions, habits, and upbringing. To cultivate philosophical discourse or writing without connection to such a transformed ethical comportment was, for the ancients, to be as a rhetorician or a sophist, not a philosopher. However, according to Hadot, with the advent of the Christian era and the eventual outlawing, in 529 C.E., of the ancient philosophical schools, philosophy conceived of as a bios largely disappeared from the West. Its spiritual practices were integrated into, and adapted by, forms of Christian monasticism. The philosophers’ dialectical techniques and metaphysical views were integrated into, and subordinated, first to revealed theology and then, later, to the modern natural sciences. However, Hadot maintained that the conception of philosophy as a bios has never completely disappeared from the West, resurfacing in Montaigne, Rousseau, Goethe, Thoreau, Nietzsche, and Schopenhauer, and even in the works of Descartes, Spinoza, Kant, and Heidegger.

Hadot’s conception of ancient philosophy and his historical narrative of its disappearance in the West have provoked both praise and criticism. Hadot received a host of letters from students around the world telling him that his works had changed their lives, perhaps the most fitting tribute given the nature of Hadot’s meta-philosophical claims. Unlike many of his European contemporaries, Hadot’s work is characterized by lucid, restrained prose; clarity of argument; the near-complete absence of recondite jargon; and a gentle, if sometimes self-depreciating, humor. While Hadot was an admirer of Nietzsche and Heidegger, and committed to a kind of philosophical recasting of the history of Western ideas, Hadot’s work lacks any eschatological sense of the end of philosophy, humanism, or the West. Late in life, Hadot would report that this was because he was animated by the sense that philosophy, as conceived and practiced in the ancient schools, remains possible for men and women of his era: “from 1970 on, I have felt very strongly that it was Epicureanism and Stoicism which could nourish the spiritual life of men and women of our times, as well as my own” (PWL 280).

Exploring negativity bias in brand beliefs and stated brand switching propensity

Negativity bias has been well studied by psychologists but limited research has been conducted on it in a marketing context. Given previous research, this exploratory study aims to examine whether there are any negativity bias effects in brand beliefs and whether there is any influence on stated brand switching propensity amongst current users of a brand. The results suggest that there is a negativity bias evident in brand image data.

‘On the influence of the scientific societies of New Zealand on the character of the nation’ - Collecting and identity at the Hawke’s Bay Philosophical Institute museum, 1874–1899

This paper explores the collection and collecting activity of the Hawke’s Bay Ph ilosophical Institute of Napier, New Zealand. It examines the development of the Institute’s museum and considers the motivations, intentions and interests of the collectors and their activity within the broader scientific and museum context. The work of two significant collectors is examined in detail: William Colenso, FLS, FRS, missionary, explorer and enthusiastic botanist, who engaged in over fifty years of correspondence and botanical exchange with Sir Joseph Hooker at Kew Gardens; and Augustus Hamilton, the curator of the museum who later became Director of New Zealand’s national collection at the Colonial Museum in Wellington. Through consideration of the Institute’s activities during the period 1874 to 1899, it is proposed that within the collection, the emergence of a distinct local identity can be discerned, during the early colonial period of Hawke’s Bay.

The invincible summer : on Albert Camus’ philosophical neoclassicism

What follows is a work of critical reconstruction of Camus' thought. It aims to answer to the wish Camus expressed in his later notebooks, that he at least be read closely. Specifically, I hope to do three things. In Part I, we will show how Camus' famous philosophy of the absurd represents a systematic scepticism whose closest philosophical predecessor is Descartes' method of doubt, and whose consequence, as in Descartes, is the discovery of a single, orienting certainty, on the basis of which Camus would proceed to pass beyond the 'nihilism' that conservative critics continued to level against him (MS 34). Part II will unfold the central tenets of Camus' mature thought of rebellion, and show how Camus' central political claims follow from his para-Cartesian claim to have found an irreducible or 'invincible' basis for a post-metaphysical ethics, consistent with the most thoroughgoing epistemic scepticism. Part III then undertakes to show that the neoclassical rhetoric and positioning Camus claimed for his postwar thought—as a thought of moderation or mesure, and a renewed Greek or Mediterranean naturalism—is more than a stylistic pretension. It represents, so I argue, a singular amalgam of modern and philosophical classical motifs which makes Camus' voice nearly unique in twentieth century ideas, and all the more worth reconsidering today. So let us proceed.

Do health beliefs and behaviors differ according to severity of obesity? A qualitative study of Australian adults

Public responses to obesity have focused on providing standardized messages and supports to all obese individuals, but there is limited understanding of the impact of these messages on obese adults. This descriptive qualitative study using in-depth interviews and a thematic method of analysis, compares the health beliefs and behaviors of 141 Australian adults with mild to moderate (BMI 30−39.9) and severe (BMI ≥ 40) obesity. Mildly obese individuals felt little need to change their health behaviors or to lose weight for health reasons. Most believed they could “lose weight” if they needed to, distanced themselves from the word obesity, and stigmatized those “fatter” than themselves. Severely obese individuals felt an urgent need to change their health behaviors, but felt powerless to do so. They blamed themselves for their weight, used stereotypical language to describe their health behaviors, and described being “at war” with their bodies. Further research, particularly about the role of stigma and stereotyping, is needed to fully understand the impact of obesity messaging on the health beliefs, behaviors, and wellbeing of obese and severely obese adults.

General medical practitioners’ knowledge and beliefs about osteoporosis and its investigation and management

Summary This qualitative study explored beliefs and attitudes regarding osteoporosis and its management. General medical practitioners (GPs) were ambivalent about osteoporosis due to concern about financial barriers for patients and their own beliefs about the salience of osteoporosis. GPs considered investigation and treatment in the context of patients' whole lives.

Purpose We aimed to investigate barriers, enablers, and other factors influencing the investigation and management of osteoporosis using a qualitative approach. This paper analyses data from discussions with general medical practitioners (GPs) about their beliefs and attitudes regarding osteoporosis and its management.

Methods Fourteen GPs and two practice nurses aged 27–89 years participated in four focus groups, from June 2010 to March 2011. Each group comprised 3–5 participants, and discussions were semi-structured, according to the protocol developed for the main study. Discussion points ranged from the circumstances under which GPs would initiate investigation for osteoporosis and their subsequent actions to their views about treatment efficacy and patient adherence to prescribed treatment. Audio recordings were transcribed and coded for analysis using analytic comparison to identify the major themes.

Results The GPs were not particularly concerned about osteoporosis in their patients or the general population, ranking diabetes, osteoarthritis, cardiovascular disease, and hypertension higher than concern about osteoporosis. They expressed confidence in the efficacy of anti-fracture medications but were concerned about the potential financial burden on patients with limited incomes. The GPs were unsure about guidelines for investigation and management of osteoporosis in men and the appropriate duration of treatment, particularly for the bisphosphonates in all patients.

Conclusions The GPs' ambivalence about osteoporosis appeared to stem from structural factors such as financial barriers for patients and their own beliefs about the salience of osteoporosis. GPs considered the impact of investigating and prescribing treatment in the context of patients' whole lives.

An examination of the mediating role of salt knowledge and beliefs on the relationship between socio-demographic factors and discretionary salt use: a cross-sectional study

Background Discretionary salt use varies according to socio-demographic factors. However, it is unknown whether salt knowledge and beliefs mediate this relationship. This study examined the direct and indirect effect of socio-demographic factors on salt knowledge and discretionary salt use in a sample of 530 Australian adults.

Methods An internet based cross-sectional survey was used to collect data for this study. Participants completed an online questionnaire which assessed their salt knowledge, beliefs and salt use behaviour. Mplus was used to conduct structural equation modelling to estimate direct and indirect effects.

Results The mean age of the participants was 49.2 years, and about a third had tertiary education. Discretionary salt use was inversely related to age (r=-0.11; p<0.05), and declarative salt knowledge (knowledge of factual information) scores (r = -0.17; p<0.01), but was positively correlated with misconceptions about salt (r = 0.09; p<0.05) and beliefs about the taste of salt (r = 0.51; p<0.001). Structural equation modelling showed age, education and gender were indirectly associated with the use of discretionary salt through three mediating pathways; declarative salt knowledge, misconceptions about salt and salt taste beliefs.

Conclusions Inequalities observed between socio-demographic groups in their use of discretionary salt use can potentially be reduced through targeted salt knowledge and awareness campaigns.

Moral antecedents of smoking behavior and risk beliefs among overseas Asian students

Instead of focusing on the misconduct of multinational cigarette manufacturers, this research project broadens the discussion of cigarette consumption by focusing on the moral antecedent variables that shape young adults' smoking behavior and risk beliefs. It especially challenges current wisdom among anti-smoking advocates that by increasing consumer knowledge of the medical risks associated with smoking will lead to significant reductions in young adult smoking prevalence rates. Empirical results of this study suggest that although increasing smoking risk knowledge does not significantly reduce Asian students' smoking behavior, increasing their risk assessment beliefs does produce the desirable public policy effect of reducing current smoking. Furthermore, only among rules-driven individuals does an increase in no harm scores significantly reduce student smoking risk assessment beliefs. Thus, current anti-smoking advertising campaigns among overseas Asian students may be more effective if they attempt to change these students' smoking risks assessment beliefs especially if they are targeted to rules-driven student market segments.