Self-management associated with fatigue in patients with advanced cancer : a prospective longitudinal study

Cancer-related fatigue is one of the most distressing symptoms experienced by patients with advanced cancer. This doctoral study identified that patients with advanced cancer commonly use a number of self-management strategies in response to fatigue, although these strategies had varying levels of effectiveness in reducing the symptom. The study identified that enhancing self-efficacy and managing depressive symptoms are important factors to consider in the design of future interventions to support fatigue self-management.

Teacher organizational citizenship behaviours and job efficacy : implications for student quality of school life

The present study investigated the impact of teachers' organizational citizenship behaviours (OCBs) on student quality of school life (SQSL) via the indirect effect of job efficacy. A measure of teacher OCBs was developed, tapping one dimension of individual-focused OCB (OCBI – student-directed behaviour) and two dimensions of organization-focused OCB (OCBO – civic virtue and professional development). In line with previous research suggesting that OCBs may enhance job efficacy, as well as studies demonstrating the positive effects of teacher efficacy on student outcomes, we expected an indirect relationship between teachers OCBs and SQSL via teachers' job efficacy. Hypotheses were tested in a multi-level design in which 170 teachers and their students (N=3,057) completed questionnaires. A significant proportion of variance in SQSL was attributable to classroom factors. Analyses revealed that the civic virtue and professional development behaviours of teachers were positively related to their job efficacy. The job efficacy of teachers also had a positive impact on all five indicators of SQSL. In regards to professional development, job efficacy acted as an indirect variable in the prediction of four student outcomes (i.e., general satisfaction, student–teacher relations, achievement, and opportunity) and fully mediated the direct negative effect on psychological distress.

Three social car visions to improve driver behaviour

The social cost of road injury and fatalities is still unacceptable. The driver is often mainly responsible for road crashes, therefore changing the driver behaviour is one of the most important and most challenging priority in road transport. This paper presents three innovative visions that articulate the potential of using Vehicle to Vehicle (V2V) communication for supporting the exchange of social information amongst drivers. We argue that there could be tremendous benefits in socialising cars to influence human driving behaviours for the better and that this aspect is still relevant in the age of looming autonomous cars. Our visions provide theoretical grounding how V2V infrastructure and emerging human–machine interfaces (HMI) could persuade drivers to: (i) adopt better (e.g. greener) driving practices, (ii) reduce drivers aggressiveness towards pro-social driving behaviours, and (iii) reduce risk-taking behaviour in young, particularly male, adults. The visions present simple but powerful concepts that reveal ‘good’ aspects of the driver behaviour to other drivers and make them contagious. The use of self-efficacy, social norms, gamification theories and social cues could then increase the likelihood of a widespread adoption of such ‘good’ driving behaviours.

Exploring potential factors leading to effective training : an exclusive study on commercial banks in Cambodia

Purpose A previous study found that the quality of education in Cambodia is poor compared to other developing countries. However, the working performance of commercial banks in Cambodia is high. It was speculated that effective training was the main factor underlying this contradiction. Therefore, the main purpose of this article is to explore the elements of training conducted by commercial banks in Cambodia and to examine their relationship with training effectiveness. Design/methodology/approach The research focuses on six factors: training needs assessment; training program; flexibility of training; self-efficacy; social support; and transfer of knowledge. The data came in the form of questionnaires and desk research. A descriptive analytical approach is then used to describe these six factors. Findings The banking industry in Cambodia offers very effective training to its employees. It is also worth noting that more than 80 percent of employees are satisfied with the training, despite few attempts on the part of management to elicit opinions from employees on what training methods should be employed. Research limitations/implications As research studies involving Cambodia are relatively rare, it was difficult for to gather primary data. Because of this limitation and the purpose of this study, descriptive data interpretation was employed. Practical implications – Even though training can make up for poor education, it is only a short-term solution. In the long term, education needs to be enhanced to increase working performance. Originality/value This research provides a good framework for commercial banks in other developing countries to compare. A cross-cultural study is also proposed for future research.

The Australian general public's perceptions of having a personally controlled electronic health record (PCEHR)

Objective The move internationally by Governments and other health providers to encourage patients to have their own electronic personal health record (e-PHRs) is growing exponentially. In Australia the initiative for a personally controlled electronic health record (known as PCEHR) is directed towards the public at large. The first objective of this study then, is to examine how individuals in the general population perceive the promoted idea of having a PCEHR. The second objective is to extend research on applying a theoretically derived consumer technology acceptance model to guide the research. Method An online survey was conducted to capture the perceptions and beliefs about having a PCEHR identified from technology acceptance models and extant literature. The survey was completed by 750 Queensland respondents, 97% of whom did not have a PCEHR at that time. The model was examined using exploratory factor analysis, regressions and mediation tests. Results Findings support eight of the 11 hypothesised relationships in the model. Perceived value and perceived risk were the two most important variables explaining attitude, with perceived usefulness and compatibility being weak but significant. The perception of risk was reduced through partial mediation from trust and privacy concerns. Additionally, web-self efficacy and ease of use partially mediate the relationship between attitude and intentions. Conclusions The findings represent a snapshot of the early stages of implementing this Australian initiative and captures the perceptions of Queenslanders who at present do not have a PCEHR. Findings show that while individuals appreciate the value of having this record, they do not appear to regard it as particularly useful at present, nor is it particularly compatible with their current engagement with e-services. Moreover, they will need to have any concerns about the risks alleviated, particularly through an increased sense of trust and reduction of privacy concerns. It is noted that although the respondents are non-adopters, they do not feel that they lack the necessary web skills to set up and use a PCEHR. To the best of our knowledge this is one of a very limited number of studies that examines a national level implementation of an e-PHR system, where take-up of the PCEHR is optional rather than a centralised, mandated requirement.

Emergence and artistic visualisation

This research draws on theories of emergence to inform the creation of an artistic and direct visualization. This is an interactive artwork and drawing tool for creative participant experiences. As is discussed, emergence is characteristically creative. It is also debated across and within disciplines, resulting in a range of understandings as well as models. This paper shows how one field’s understanding of emergence (complexity theory) can be used to facilitate emergence in another domain (design research) and, importantly provide the opportunity for someone to act creatively. This paper begins with a brief review of some theories of emergence to show how they interrelate and can effect the perception of emergent structures in an observer, and, correspondingly, the design for creative experience. This is subsequently demonstrated in the second section of the paper where an interactive artwork and drawing application, Of me with me, is presented. This artwork by the author was created during collaboration with community artists from Cerebral Palsy League. The discussion covers the application of emergence theories to create this visualization in order facilitate the perception of structures and creative behaviours in a participant and to facilitate self-efficacy in the community artist user group.

Psychological health of medical and dental students in Saudi Arabia : a longitudinal study

Introduction: Many studies have indicated the poor psychological health of medical and dental students. However, few studies have assessed the longitudinal trajectory of that psychological health at different times in an academic year. Aim: To evaluate the positive and negative aspects of psychological health among preclinical medical and dental students in Saudi Arabia prospectively. Methods: A total of 317 preclinical medical and dental students were recruited for a longitudinal study design from second and third-year students at Umm Al-Qura University in the 2012-2013 academic year. The students were assessed at the middle of the first term and followed up after 3-monthes at the beginning of the second term. Questionnaires included assessment of depression, anxiety, stress, self-efficacy, and satisfaction with life. Results: Depression, anxiety, stress, and satisfaction with life were improved significantly at the beginning of the second term, whereas self-efficacy did not change significantly. The medical, female, and third-year student subgroups had the most significant changes. Depression and stress were significantly changed at the beginning of the second term in most demographic subgroups. Conclusion: Preclinical medical and dental students have different psychological health levels at different times of the same academic year. It is recommended to consider time of data collection when analyzing the results of such studies.

The quik fix study : a randomised controlled trial of brief interventions for young people with alcohol-related injuries and illnesses accessing emergency department and crisis support care

Background: Alcohol is a major preventable cause of injury, disability and death in young people. Large numbers of young people with alcohol-related injuries and medical conditions present to hospital emergency departments (EDs). Access to brief, efficacious, accessible and cost effective treatment is an international health priority within this age group. While there is growing evidence for the efficacy of brief motivational interviewing (MI) for reducing alcohol use in young people, there is significant scope to increase its impact, and determine if it is the most efficacious and cost effective type of brief intervention available. The efficacy of personality-targeted interventions (PIs) for alcohol misuse delivered individually to young people is yet to be determined or compared to MI, despite growing evidence for school-based PIs. This study protocol describes a randomized controlled trial comparing the efficacy and cost-effectiveness of telephone-delivered MI, PI and an Assessment Feedback/Information (AF/I) only control for reducing alcohol use and related harm in young people. Methods/design: Participants will be 390 young people aged 16 to 25 years presenting to a crisis support service or ED with alcohol-related injuries and illnesses (including severe alcohol intoxication). This single blinded superiority trial randomized young people to (i) 2 sessions of MI; (ii) 2 sessions of a new PI or (iii) a 1 session AF/I only control. Participants are reassessed at 1, 3, 6 and 12 months on the primary outcomes of alcohol use and related problems and secondary outcomes of mental health symptoms, functioning, severity of problematic alcohol use, alcohol injuries, alcohol-related knowledge, coping self-efficacy to resist using alcohol, and cost effectiveness. Discussion: This study will identify the most efficacious and cost-effective telephone-delivered brief intervention for reducing alcohol misuse and related problems in young people presenting to crisis support services or EDs. We expect efficacy will be greatest for PI, followed by MI, and then AF/I at 1, 3, 6 and 12 months on the primary and secondary outcome variables. Telephone-delivered brief interventions could provide a youth-friendly, accessible, efficacious, cost-effective and easily disseminated treatment for addressing the significant public health issue of alcohol misuse and related harm in young people. Trial registration: This trial is registered with the Australian and New Zealand Clinical Trials Registry ACTRN12613000108718.

Use of physical activity self-management strategies by high school students

Teaching adolescents to use self-management strategies (SMS's) may be an effective approach to promoting lifelong physical activity (PA). However, the extent to which adolescents use SMS's and their impact on current PA have not been studied previously. The aims of this study were: 1) describe the prevalence of SMS use in adolescents; and 2) determine relationships between SMS use, PA self-efficacy, and PA participation. 197 students completed questionnaires measuring use of SMS's, self-efficacy, and PA behavior. The most prevalent SMS's (>30%) were thinking about the benefits of PA, making PA more enjoyable, choosing activities that are convenient, setting aside time to do PA, and setting goals to do PA. Less than 10% reported rewarding oneself for PA, writing planned activities in a book or calendar, and keeping charts of PA. SMS use was associated with increased self-efficacy (r = 0.47, P < .001) and higher levels of PA (r = 0.34 P < .001). A one unit difference in SMS scores was associated with a ~ 4-fold increase in the probability of being active (OR = 3.7, 95% CI = 1.8-7.4). Although strongly associated with PA, a relatively small percentage of adolescents routinely use SMS's.

The OnTrack Diabetes web-based program for type 2 diabetes and dysphoria self-management: A randomized controlled trial protocol

Background: The prevalence of type 2 diabetes is rising with the majority of patients practicing inadequate disease self-management. Depression, anxiety, and diabetes-specific distress present motivational challenges to adequate self-care. Health systems globally struggle to deliver routine services that are accessible to the entire population, in particular in rural areas. Web-based diabetes self-management interventions can provide frequent, accessible support regardless of time and location Objective: This paper describes the protocol of an Australian national randomized controlled trial (RCT) of the OnTrack Diabetes program, an automated, interactive, self-guided Web program aimed to improve glycemic control, diabetes self-care, and dysphoria symptoms in type 2 diabetes patients. Methods: A small pilot trial is conducted that primarily tests program functionality, efficacy, and user acceptability and satisfaction. This is followed by the main RCT, which compares 3 treatments: (1) delayed program access: usual diabetes care for 3 months postbaseline followed by access to the full OnTrack Diabetes program; (2) immediate program: full access to the self-guided program from baseline onward; and (3) immediate program plus therapist support via Functional Imagery Training (FIT). Measures are administered at baseline and at 3, 6, and 12 months postbaseline. Primary outcomes are diabetes self-care behaviors (physical activity participation, diet, medication adherence, and blood glucose monitoring), glycated hemoglobin A1c (HbA1c) level, and diabetes-specific distress. Secondary outcomes are depression, anxiety, self-efficacy and adherence, and quality of life. Exposure data in terms of program uptake, use, time on each page, and program completion, as well as implementation feasibility will be conducted. Results: This trial is currently underway with funding support from the Wesley Research Institute in Brisbane, Australia. Conclusions: This is the first known trial of an automated, self-guided, Web-based support program that uses a holistic approach in targeting both type 2 diabetes self-management and dysphoria. Findings will inform the feasibility of implementing such a program on an ongoing basis, including in rural and regional locations.

Psychometric validation of the Dysexecutive Questionnaire (DEX)

This study reported on the validation of the psychometric properties, the factorability, validity, and sensitivity of the Dysexecutive Questionnaire (DEX) in 3 clinical and nonclinical samples. A mixed sample of 997 participants—community (n = 663), psychiatric (depressed [n = 92] and anxious [n = 122]), and neurologically impaired (n = 120)—completed self-report questionnaires assessing executive dysfunction, depression, anxiety, stress, general self-efficacy, and satisfaction with life. Before analyses the data were randomly split into 2 subsets (A and B). Exploratory factor analysis performed on Subset A produced a 3-factor model (Factor 1: Inhibition, Factor 2: Volition, and Factor 3: Social Regulation) in which 15 of the original 20 items provided a revised factor structure that was superior to all other structures. A series of confirmatory factor analyses performed on Subset B confirmed that this revised factor structure was valid and reliable. The revised structure, labeled the DEX-R, was found to be a reliable and valid tool for assessing behavioral symptoms of dysexecutive functioning in mixed community, psychiatric, and neurological samples.

Evaluating a web-based self-management intervention in patients with heart failure: A pilot study

This pilot study aimed to evaluate the feasibility of a web-based self-management intervention in patients with heart failure. The study consisted of two phases including developing the web-based application and examining its feasibility in a group of heart failure patients. The results of this study were consistent with the current literature which has failed to show the benefits of web-based interventions for chronic disease self-management. In the current thesis, therefore, issues influencing the effectiveness of the web-based interventions were analysed. Recommendations for improving effectiveness of the web-based applications were also provided.

Identifying risk factors and protective factors for venous leg ulcer recurrence using a theoretical approach : a longitudinal study

Background The high recurrence rate of chronic venous leg ulcers has a significant impact on an individual’s quality of life and healthcare costs. Objectives This study aimed to identify risk and protective factors for recurrence of venous leg ulcers using a theoretical approach by applying a framework of self and family management of chronic conditions to underpin the study. Design Secondary analysis of combined data collected from three previous prospective longitudinal studies. Setting The contributing studies’ participants were recruited from two metropolitan hospital outpatient wound clinics and three community-based wound clinics. Participants Data were available on a sample of 250 adults, with a leg ulcer of primarily venous aetiology, who were followed after ulcer healing for a median follow-up time of 17 months after healing (range: 3 to 36 months). Methods Data from the three studies were combined. The original participant data were collected through medical records and self-reported questionnaires upon healing and every 3 months thereafter. A Cox proportion-hazards regression analysis was undertaken to determine the influential factors on leg ulcer recurrence based on the proposed conceptual framework. Results The median time to recurrence was 42 weeks (95% CI 31.9–52.0), with an incidence of 22% (54 of 250 participants) recurrence within three months of healing, 39% (91 of 235 participants) for those who were followed for six months, 57% (111 of 193) by 12 months, 73% (53 of 72) by two years and 78% (41 of 52) of those who were followed up for three years. A Cox proportional-hazards regression model revealed that the risk factors for recurrence included a history of deep vein thrombosis (HR 1.7, 95% CI 1.07–2.67, p=0.024), history of multiple previous leg ulcers (HR 4.4, 95% CI 1.84–10.5, p=0.001), and longer duration (in weeks) of previous ulcer (HR 1.01, 95% CI 1.003–1.01, p<0.001); while the protective factors were elevating legs for at least 30 minutes per day (HR 0.33, 95% CI 0.19–0.56, p<0.001), higher levels of self-efficacy (HR 0.95, 95% CI 0.92–0.99, p=0.016), and walking around for at least three hours/day (HR 0.66, 95% CI 0.44–0.98, p=0.040). Conclusions Results from this study provide a comprehensive examination of risk and protective factors associated with leg ulcer recurrence based on the chronic disease self and family management framework. These results in turn provide essential steps towards developing and testing interventions to promote optimal prevention strategies for venous leg ulcer recurrence.

Examining well-being, anxiety, and self-deception in university students

This study examined the combined influence of six positive psychology variables (optimism, hope, self-efficacy, grit, gratitude, and subjective life satisfaction), termed covitality, in relation to buffering individuals against anxiety symptoms. In addition, the influence of self-deception was examined to test whether this construct had an influence on the reporting of these positive psychology variables. A total of 268 individuals (203 females and 65 males) with a mean age of 22.2 years (SD = 7.4 years) from one Queensland university took part in the study. The participants completed an online questionnaire, which included a battery of positive psychological measures, plus a measure of anxiety and self-deception. The results indicated that the covitality constructs had a moderation effect on anxiety. In a regression analysis, the six covitality constructs explained an additional 24.5% of the variance in anxiety, after controlling for self-deception. Further analyses revealed that those higher in self-deception scored higher in self-efficacy and all positive covitality measures and lower in anxiety, than those lower in self-deception. These findings illustrate the importance of considering the role that self-deception might play in the reporting of positive psychology variables.

Emergence in interactive artistic visualization

This research draws on theories of emergence to inform the creation of an artistic and direct visualization. This is an interactive artwork and drawing tool for creative participant experiences. Emergence is characteristically creative and many different models of emergence exist. It is therefore possible to effect creativity through the application of emergence mechanisms from these different disciplines. A review of theories of emergence and examples of visualization in the arts, is provided. An art project led by the author is then discussed in this context. This project, Iterative Intersections, is a collaboration with community artists from Cerebral Palsy League. It has resulted in a number of creative outcomes including the interactive art application, Of me with me. Analytical discussion of this work shows how its construction draws on aspects of experience design, fractal and emergent theory to effect perceptual emergence and creative experience as well as to facilitate self-efficacy.