Psychosocial factors and excessive gestational weight gain: the effect of parity in an Australian cohort

OBJECTIVES: psychosocial variables can be protective or risk factors for excessive gestational weight gain (GWG). Parity has also been associated with GWG; however, its effect on psychosocial risk factors for GWG is yet to be determined. The aim of this study was to investigate if, and how, psychosocial factors vary in their impact on the GWG of primiparous and multiparous women. DESIGN/PARTICIPANTS: pregnant women were recruited in 2011 via study advertisements placed in hospitals, online, in parenting magazines, and at baby and children's markets, resulting in a sample of 256 women (113 primiparous, 143 multiparous). Participants completed questionnaires at 16-18 weeks' gestation and their pregravid BMI was recorded. Final weight before delivery was measured and used to calculate GWG. FINDINGS: the findings revealed that primiparous women had significantly higher feelings of attractiveness (a facet of body attitude; p=0.01) than multiparous women. Hierarchical regressions revealed that in the overall sample, increased GWG was associated significantly with lower pre-pregnancy BMI (standardised coefficient β=-0.39, p<0.001), higher anxiety symptoms (β=0.25, p=0.004), and reduced self-efficacy to eat a healthy diet (β=-0.20, p=0.02). Although higher GWG was predicted significantly by decreased feelings of strength and fitness for primiparous women (β=-0.25, p=0.04) and higher anxiety was related significantly to greater GWG for multiparous women (β=0.43, p<0.001), statistical comparison of the model across the two groups suggested the magnitude of these effects did not differ across groups (p>0.05). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: the findings suggest that psychosocial screening and interventions by healthcare professionals may help to identify women who are at risk of excessive GWG, and there may be specific psychosocial factors that are more relevant for each parity group.

How does microfinance enhance entrepreneurial outcomes in emerging economies? The mediating mechanisms of psychological and social capital

In this article, a conceptual framework and research propositions are developed to explain how microfinance provision can translate into new venture creation and existing venture growth in an emerging economy context by engendering higher levels of psychological and social capital in clients. In doing this, the extent to which microfinance institutions provide business support and opportunities for social interaction are identified as factors which may strengthen the impact of microfinance provision on psychological and social capital, especially for poor entrepreneurs in resource-constrained settings. The conceptual framework and research propositions developed will be of use to academics in designing an agenda for future empirical research. In addition, they will help policymakers and microfinance providers to better design microfinance initiatives that enhance the well-being of clients and maximise their entrepreneurial outcomes. © The Author(s) 2013.

Psychological capital: A review and synthesis

The concept of psychological capital (PsyCap) has attracted a great deal of interest from both academics and practitioners and has been linked to employee attitudes, behavior and performance at different levels of analysis. Yet, the nature of the concept, its measurement, the factors that influence its development, and when and how it influences individual-level, team-level and organizational-level outcomes are the subject of continued debate in the literature. This article offers a detailed and focused review of the existing literature on PsyCap, with the aim of developing an agenda for future research. In particular, we call for researchers to pay greater attention to possible multi-level applications of PsyCap research, examine the underlying mechanisms by which PsyCap influences individual-level, team-level and organizational-level outcomes, and identify possible factors that may moderate the relationship between PsyCap and its outcomes. In doing this, we provide a roadmap for scholars to progress the development of the field. © 2014 John Wiley & Sons, Ltd.

Do pain-related beliefs influence adherence to multidisciplinary rehabilitation? A systematic review

OBJECTIVES: To understand how pain-related cognitions predict and influence treatment retention and adherence during and after a multidisciplinary rehabilitation program.

METHODS: Electronic databases including Medline, CINAHL, PsycINFO, Academic Search Complete, and Scopus were used to search three combinations of keywords: chronic pain, beliefs, and treatment adherence.

RESULTS: The search strategy yielded 591 results, with an additional 12 studies identified through reference screening. 81 full-text papers were assessed for eligibility and 10 papers met the inclusion and exclusion criteria for this review. The pain-related beliefs that have been measured in relation to treatment adherence include: pain-specific self-efficacy, perceived disability, catastrophizing, control beliefs, fear-avoidance beliefs, perceived benefits and barriers, as well as other less commonly measured beliefs. The most common pain-related belief investigated in relation to treatment adherence was pain-related self-efficacy. Findings for the pain-related beliefs investigated among the studies were mixed. Collectively, all of the aforementioned pain-related beliefs, excluding control beliefs, were found to influence treatment adherence behaviours.

DISCUSSION: The findings suggest that treatment adherence is determined by a combination of pain-related beliefs either supporting or inhibiting chronic pain patients' ability to adhere to treatment recommendations over time. In the studies reviewed, self-efficacy appears to be the most commonly researched predictor of treatment adherence, its effects also influencing other pain-related beliefs. More refined and standardised methodologies, consistent descriptions of pain-related beliefs and methods of measurement will improve our understanding of adherence behaviours.

Autobiographical memory and depression: identity-continuity and problem-solving functions indirectly predict symptoms over time through psychological well-being

The aim of this study was to assess the longitudinal associations between adaptive autobiographical memory functions and depressive symptoms. Consistent with the proposed mechanisms of change underpinning cognitive-reminiscence therapy (CRT), it was hypothesised that more frequent adaptive reminiscence would lead to increases in psychological resources over time and indirectly affect depressive symptoms through this pathway. A sample of 171 young adults (mean age=25.9years, SD=3.5) completed measures of how frequently they utilised autobiographical memory for identity-continuity and problem-solving purposes, depressive symptoms and personal resources (self-esteem, self-efficacy, meaning in life and optimism) at two time-points. The results of structural equation modelling supported the model of indirect influence between reminiscence functions and depression through these psychological resources. These findings clarify the effects of adaptive autobiographical memory on depressive symptoms in young adults and indicate potential benefits of interventions such as CRT.

Single session web-based counselling: a thematic analysis of content from the perspective of the client

Despite the exponential growth of non-appointment-based web counselling, there is limited information on what happens in a single session intervention. This exploratory study, involving a thematic analysis of 85 counselling transcripts of people seeking help for problem gambling, aimed to describe the presentation and content of online conversations. Observed from the perspective of the client, we found that presentations were related to immediate help with a crisis and non-urgent assistance in developing strategies and skills. Almost all clients spent a great deal of time telling their story (i.e., the pattern, context, progression and impact of the problem, motivation for continuing and previous attempts to change) with less time spent exploring opportunities, readiness or self-efficacy related to change or relevant options and strategies. These findings provide important information that informs the application of traditional counselling approaches within web-based environments.

Organizational factors related to the confidence of workers in working with residents with dementia or depression in aged care facilities

OBJECTIVES: There has been limited research examining how organizational factors are associated with the level of confidence of residential aged care staff in managing both residents' depression and the behavioural and psychological symptoms of residents with dementia (BPSD). This study investigated this issue. METHOD: A cross-sectional study design was employed. In total, 255 aged care staff (131 senior staff, 124 junior staff) from 21 residential care facilities participated in the study. All staff completed measures of self-efficacy in managing BPSD as well as confidence in working with older people with depression. They also completed measures of organizational climate (autonomy, cohesion, trust, pressure, support, recognition, fairness and encouragement of innovation) and measures of workplace experience (job role, number of years working in aged care facilities), job stress and satisfaction, and knowledge of depression. RESULTS: The results demonstrated that autonomy, trust, support, and job stress were associated with confidence in managing BPSD, while the factors related to confidence in managing depression were autonomy, support, job stress, job satisfaction, and knowledge of depression. CONCLUSION: These findings highlight that organizational climate factors need to be addressed in order to increase staff confidence in managing BPSD and depression. In particular, the findings demonstrate the importance of fostering organizational environments in which autonomy is promoted and there is support and cooperation among aged care staff. Attention to these factors is likely to increase the confidence of staff as they carry out their carer role.

A path model of psychosocial and health behaviour change predictors of excessive gestational weight gain

This study aimed to evaluate a conceptual model of psychosocial, behaviour change, and behavioural predictors of excessive gestational weight gain (GWG). Background: Excessive GWG can place women and their babies at risk of poor health outcomes, including obesity. Models of psychosocial and behaviour change predictors of excessive GWG have not been extensively explored; understanding the mechanisms leading to excess GWG will provide crucial evidence towards the development of effective interventions. Method: Two hundred and eighty-eight pregnant women (≤18 weeks gestation) were recruited to a prospective study. Demographic, psychosocial, health behaviour change, and behavioural factors were assessed at 17 (Time 1, T1) and 33 weeks (Time 2, T2) gestation. Pre-pregnancy and final pregnancy weight were obtained and women were classified with/without excessive GWG. Logistic regressions refined the list of predictors of excessive GWG; variables with p < .1 were included in a path analysis. Results: Age, family income, T2 depression, T2 pregnancy-specific coping, T1 buttocks dissatisfaction, T2 GWG-specific self-efficacy, T1 dietary readiness, T1 dietary importance, and T1 vegetable intake predicted excessive GWG in the logistic regressions and were included in the path model. The baseline path model demonstrated poor fit. Once statistically and theoretically plausible paths were added, adequate model fit was achieved (χ² = 21.61(9), p < .05; RMSEA = .07; CFI = .93); this revised model explained 19.5% of the variance in excessive GWG. Women with high T1 buttocks dissatisfaction were more likely to exhibit low levels of dietary readiness. Women with low dietary readiness were more likely to have a lower vegetable intake, which predicted excessive GWG. Women with higher T2 depressive symptoms were more likely to report lower GWG self-efficacy and gain excessively. Conclusion: Future behavioural GWG trials should consider combining psychosocial and health behaviour change factors to optimise GWG.

HPV.edu study protocol: a cluster randomised controlled evaluation of education, decisional support and logistical strategies in school-based human papillomavirus (HPV) vaccination of adolescents

BACKGROUND: The National Human Papillomavirus (HPV) Vaccination Program in Australia commenced in 2007 for females and in 2013 for males, using the quadrivalent HPV vaccine (HPV 6,11,16,18). Thus far, we have demonstrated very substantial reductions in genital warts and in the prevalence of HPV among young Australian women, providing early evidence for the success of this public health initiative. Australia has a long history of school-based vaccination programs for adolescents, with comparatively high coverage. However, it is not clear what factors promote success in a school vaccination program. The HPV.edu study aims to examine: 1) student knowledge about HPV vaccination; 2) psycho-social outcomes and 3) vaccination uptake.

METHODS/DESIGN: HPV.edu is a cluster randomised trial of a complex intervention in schools aiming to recruit 40 schools with year-8 enrolments above 100 students (approximately 4400 students). The schools will be stratified by Government, Catholic, and Independent sectors and geographical location, with up to 20 schools recruited in each of two states, Western Australia (WA) and South Australia (SA), and randomly allocated to intervention or control (usual practice). Intervention schools will receive the complex intervention which includes an adolescent intervention (education and distraction); a decisional support tool for parents and adolescents and logistical strategies (consent form returns strategies, in-school mop-up vaccination and vaccination-day guidelines). Careful process evaluation including an embedded qualitative evaluation will be undertaken to explore in depth possible mechanisms for any observed effect of the intervention on primary and secondary outcomes.

DISCUSSION: This study is the first to evaluate the relative effectiveness of various strategies to promote best practice in school-based vaccination against HPV. The study aims to improve vaccination-related psychosocial outcomes, including adolescent knowledge and attitudes, decision-making involvement, self-efficacy, and to reduce fear and anxiety. The study also aims to improve school vaccination program logistics including reduction in time spent vaccinating adolescents and increased number of consent forms returned (regardless of decision). Less anxiety in adolescents will likely promote more efficient vaccination, which will be more acceptable to teachers, nurses and parents. Through these interventions, it is hoped that vaccination uptake will be increased.

How do postgraduate qualifications in medical education impact on health professionals?

Background and Purpose: The number of degree-awarding programmes in medical education is steadily increasing. Despite the popularity and extensive investment in these courses, there is little research into their impact. This study investigated the perceived impact of an internationally-renowned postgraduate programme in medical education on health professionals’ development as educators.

Methods: An online survey of the 2008–12 graduates from the Centre for Medical Education, University of Dundee was carried out. Their self-reported shifts in various educational competencies and scholarship activities were analysed using non-parametric statistics. Qualitative data were also collected and analysed to add depth to the quantitative findings.

Results: Of the 504 graduates who received the online questionnaire 224 responded. Participants reported that a qualification in medical education had significantly (p < 0.001) improved their professional educational practices and engagement in scholarly activities. Masters graduates reported greater impact compared to Certificate graduates on all items, including ability to facilitate curriculum reforms, and in assessment and feedback practices. Masters graduates also reported more engagement in scholarship activities, with significantly greater contributions to journals. These qualifications equally benefited all participants regardless of age. International graduates reported greater impact of the qualification than their UK counterparts.

Conclusion: A postgraduate medical education programme can significantly impact on the practices and behaviours of health professionals in education, improving self-efficacy and instilling an increased sense of belonging to the educational community.

Engaging patients, clinicians and health funders in weight management: the Counterweight Programme

Background. The Counterweight Programme provides an evidence based and effective approach for weight management in routine primary care. Uptake of the programme has been variable for practices and patients.

Aim. To explore key barriers and facilitators of practice and patient engagement in the Counterweight Programme and to describe key strategies used to address barriers in the wider implementation of this weight management programme in UK primary care.

Methods. All seven weight management advisers participated in a focus group. In-depth interviews were conducted with purposeful samples of GPs (n = 7) and practice nurses (n = 15) from 11 practices out of the 65 participating in the programme. A total of 37 patients participated through a mixture of in-depth interviews (n = 18) and three focus groups. Interviews and focus groups were analysed for key themes that emerged.

Results. Engagement of practice staff was influenced by clinicians’ beliefs and attitudes, factors relating to the way the programme was initiated and implemented, the programme content and organizational/contextual factors. Patient engagement was influenced by practice endorsement of the programme, clear understanding of programme goals, structured proactive follow-up and perception of positive outcomes.

Conclusions. Having a clear understanding of programme goals and expectations, enhancing self-efficacy in weight management and providing proactive follow-up is important for engaging both practices and patients. The widespread integration of weight management programmes into routine primary care is likely to require supportive public policy.

Vulnerabilidade situacional afetando a intenção comportamental: um estudo no setor de serviços automotivos

Considerando os avanços da pesquisa e teoria da psicologia do risco e, em particular, da perspectiva do risco como sentimentos, ressaltando a interação entre cognição e emoção na análise de ameaças, esta tese propõe e testa um modelo conceitual sobre o efeito da vulnerabilidade (risco como sentimento) em intenções comportamentais de serviços relacionados a automóveis. Este estudo teve como hipótese que a autoeficácia percebida pelo consumidor diminui ou elimina o efeito da vulnerabilidade nas intenções comportamentais de perpetuidade de relacionamento com a empresa de serviço. Estimularam o interesse de pesquisa tanto a carência de pesquisas sobre o papel da vulnerabilidade no consumo de serviços não relacionados à área da saúde ou ao corpo do consumidor, quanto a carência de pesquisas sobre a relação entre a vulnerabilidade e as intenções comportamentais. Testou-se em um único modelo, o impacto previsto pelos processos cognitivos e afetivos que envolvem a análise de ameaça (sentimentos de vulnerabilidade, risco e severidade das falhas) e de capacidade de enfrentamento (autoeficácia) na intenção comportamental, no contexto específico de consumo de serviços relativos a automóveis. O modelo de mensuração proposto foi avaliado quanto à dimensionalidade, validade e confiabilidade pelo uso de análise fatorial confirmatória; posteriormente, avaliou-se a relação causal proposta nas hipóteses pelo modelo completo de equações estruturais. O modelo de mensuração proposto foi avaliado quanto à dimensionalidade, validade e confiabilidade pelo uso de análise fatorial confirmatória; posteriormente, avaliou-se a relação proposta nas hipóteses pelo modelo completo de equações estruturais, usando-se o software Amos e a estimativa por máxima verossimilhança. O modelo foi estimado em uma amostra de 202 respondentes. Os dados foram coletados por meio de um levantamento eletrônico transversal e os achados da pesquisa apontam para a confirmação das hipóteses de que (1) o risco percebido cognitivamente, sentimentos de vulnerabilidade e a autoeficácia influenciam as intenções comportamentais. Não foi possível suportar a hipótese de que (2) a severidade das possíveis falhas de serviço tem relação com risco ou com sentimentos de vulnerabilidade. Esses achados ajudam a compreender a relação entre intenções comportamentais e sentimentos de vulnerabilidade. Implicações para o desenvolvimento teórico da pesquisa na área e implicações gerenciais são discutidas. Os resultados auxiliam a compreensão dos resultados de estudos realizados nos EUA nas últimas décadas. Os achados oferecem uma contribuição teórica ao entendimento do fenômeno da vulnerabilidade, a adaptação de uma escala de medida para o fenômeno no contexto brasileiro e aplicado a serviços que não sejam de saúde e cuidados com o corpo. Do ponto de vista gerencial, o estudo alerta para o fato de a vulnerabilidade exercer influência no desempenho comercial de empresas de serviços automotivos, visto que ela influência negativamente a recomendação positiva e a manutenção de relacionamentos de negócios. Os achados sugerem que os gestores de empresas de serviços devem empreender esforços para reduzir a vulnerabilidade do consumidor por meio de informações que o auxiliem na negociação e avaliação do serviço ao minimizar incertezas.

Síndrome de burnout e autoeficácia: um estudo com profissionais de enfermagem de hospitais privados de Natal/rn

This research verifies the influence of the self-efficacy level on burnout syndrome incidence in relation to nursing professionals from private hospitals located in the Municipality of Natal, State of Rio Grande do Norte. The nature of the research was descriptive, and the used data analysis method was quantitative which was developed through SPSS computational package, version 17.0. The used instrument for the investigation was Maslach-Burnout Inventory (MBI), and the General Perceived Self-efficacy Scale (GPSES) was applied to a sample formed from 230 nursing professionals. The statistic techniques to data analysis were: frequency analysis; factor analysis; Cronbach.s alpha; Kaiser-Meyer-Olkin test (KMO); Bartlett efericity test; percentual analysis; Spearman rank correlation analysis; and simple regression. The achieved factors from factor analysis of MBI were the same, taking into account the dimensions which Maslach initially suggested to the instrument (emotional exhaustion, lack of personal realization, and depersonalization). However, one highlights that the low internal consistence of the depersonalization dimension can occur from people.s difficulty (caused by cultural aspects) of assuming this attitude in their work environment. Through GSE, it was achieved a factor which confirmed the unidimensionality showed by the author of the instrument. In relation to the syndrome incidence, it was verified that about 50% of the researched sample presented burnout syndrome evidence. Referring to self-efficacy level, about 65% of the researched sample presented low level of self-efficacy, what can be explained by the work characteristics of these professionals. In relation to the self-efficacy influence on the Burnout syndrome, it was verified that self-efficacy can be one of the aspects which influences occupational stress chronification (burnout), mainly to the personal realization dimension. Therefore, the researched hospital organizations need reflect about their attitudes in respect to their professionals, since the numbers showed a dangerous tendency regarding a predisposition to burnout syndrome of their staff, what implies not only a significant amount of individuals who can present high levels of emotional exhaustion, lack of personal realization, and depersonalization, but also the fact that this group presents low level of self-efficacy

Auto-eficácia de alunos de administração: um estudo com concluintes do curso de graduação em Administração no Estado do Pará

The current study presents the characteristics of self-efficacy of students of Administration course, who work and do not work. The study was conducted through a field research, descriptive, addressed quantitatively using statistical procedures. Was studied a population composed of 394 students distributed in three Higher Education Institutions, in the metropolitan region of Belém, in the State of Pará. The sampling was not probabilistic by accessibility, with a sample of 254 subjects. The instrument for data collection was a questionnaire composed of a set of questions divided into three sections: the first related to sociodemographic data, the second section was built to identify the work situation of the respondent and the third section was built with issues related to General Perceived Self-Efficacy Scale proposed by Schwarzer and Jerusalem (1999). Sociodemographic data were processed using methods of descriptive statistics. This procedure allowed characterizing the subjects of the sample. To identify the work situation, the analysis of frequency and percentage was used, which allowed to classify in percentage, the respondents who worked and those that did not work, and the data related to the scale of self-efficacy were processed quantitatively by the method of multivariate statistics using the software of program Statistical Package for Social Sciences for Windows - SPSS, version 17 from the process of Exploratory Factor Analysis. This procedure allowed characterizing the students who worked and the students who did not worked. The results were discussed based on Social Cognitive Theory from the construct of self-efficacy of Albert Bandura (1977). The study results showed a young sample, composed the majority of single women with work experience, and indicated that the characteristics of self-efficacy of students who work and students who do not work are different. The self-efficacy beliefs of students who do not work are based on psychological expectations, whereas the students who work demonstrated that their efficacy beliefs are sustained by previous experiences. A student who does not work proved to be reliant in their abilities to achieve a successful performance in their activities, believing it to be easy to achieve your goals and to face difficult situations at work, simply by invest a necessary effort and trust in their abilities. One who has experience working proved to be reliant in their abilities to conduct courses of action, although know that it is not easy to achieve your goals, and in unexpected situations showed its ability to solve difficult problems