How Do People with Intellectual Disabilities and Diabetes Experience and Perceive their Illness?

Introduction Diabetes is a significant health problem amongst people with intellectual disabilities, yet there is a lack of qualitative literature looking specifically at their experiences and perceptions of living with this chronic illness. Method Using Interpretative Phenomenological Analysis, this study explored the experiences and perceptions of four people with intellectual disabilities and diabetes. Results Results showed that participants demonstrated some knowledge of the language surrounding diabetes, but considerable confusion and uncertainty about their illness. The impact of diabetes was described in terms of physical, emotional and social consequences, and participants spoke of diabetes in the context of co‐existing health problems. Conclusions People with intellectual disabilities and diabetes face many challenges when perceiving and coping with their illness. Gaining insight into these challenges could help health professionals work together more effectively and provide appropriate support to people with intellectual disabilities and diabetes.     

How Do Nursing Students Perceive Substance Abusing Nurses?

Substance abuse among nurses was recognized by nurse leaders and professional nursing organizations as a growing threat to patient safety and to the health of the abusing nurse more than 30 years ago. Although numerous studies on nurse impairment were published in the 1980s and 1990s, there was minimal focus on student nurses' perceptions about impaired nurses and less research has been published more recently, despite a growing rate of substance abuse. A quasi-experimental study to explore the perceptions of student nurses toward nurses who are chemically dependent was conducted using a two-group, pretest–posttest design. The Perception of Nurse Impairment Inventory (PNII) was completed by student nurses at the beginning of their junior course work, prior to formal education about substance abuse. The PNII was repeated after the students received substance abuse education. The PNII was also completed by a control group of sophomore student nurses who did not receive the formal substance abuse education. A repeated measures analysis of variance was used to measure the differences between the two groups of students. Students who received the education chose more compassionate responses on the PNII and were more likely to respond that an impaired nurse's supervisor is responsible for supporting and guiding the impaired nurse to access professional care. Discrepancies in study findings about the efficacy of education for effecting positive attitudes of student nurses toward impaired nurses may be related to the length and type of the education.     

How Do the Dimensions of Perfectionism Relate to Mental Health?

The present study examined the relationship between the two central dimensions of perfectionism, Pure Personal Standards (PPS) and Maladaptive Evaluative Concerns (MEC), and psychological distress as well as positive affect. The study also explored two potential mediators, self-concealment (SC) and contingent self-worth (CSW), of the relationship between these perfectionism dimensions and various mental health measures. Participants completed questionnaires assessing perfectionism, the two mediator variables, and a number of measures of mental health, including depression, fear of negative evaluation, positive affectivity, and eating disorder symptomatology. Analyses revealed that extracting out the MEC from PPS perfectionism scores using partial correlations removed the one significant correlation of PPS with psychopathology, and strengthened its positive correlation with well-being. In contrast, the MEC dimension of perfectionism was positively related to psychopathology and negatively related to well-being, even when controlling for PPS scores using partial correlations. Mediational analyses indicated that CSW significantly mediated the relationships between PPS and mental health, including fully mediating the relationship between PPS and each measure of psychopathology. Multiple mediational analyses revealed that SC and/or CSW mediated the relationships between MEC and mental health indices. These findings suggest that the central aspect of perfectionism related to psychopathology is the MEC dimension whereas PPS is more closely associated with positive features of mental health. Findings also suggest that future investigations of the relationship between perfectionism and psychopathology take into consideration the mediating effects of SC and CSW.

Efficacy and Effectiveness of Colonoscopy: How Do We Bridge the Gap?

Colonoscopy is sometimes considered the preferred colorectal cancer screening modality, yet this modality may be subject to variation in operator performance more than any other screening test. Failures of colonoscopy to consistently detect precancerous lesions threaten the effectiveness of this technique for the prevention of colorectal cancer. Studies on high-level adenoma detectors under optimal conditions have begun to establish the true efficacy of colonoscopy and further widen the gap between efficacy and effectiveness. Research is required to establish the component skills, attitudes, and behaviors for high-level mucosal inspection competence necessary for training and assessment. Interventions to bridge the gap between efficacy and effectiveness are lacking, yet they should emphasize quality measurement and operate at various levels within the health system to motivate change in endoscopist behavior.     

Why Are People Afraid of the Dentist? Observations and Explanations

Objective

The aim of this review was to explore the peer-reviewed literature to answer the question: ‘Why are people afraid of the dentist?’

Method

Relevant literature was identified by searching the following on-line databases: PubMed, PsycInfo, the Cochrane Library and Google Scholar. Publications were extracted if they explored the causes and consequences of dental fear, dental anxiety or dental phobia.

Results

The research evidence suggests that the causes of dental fear, dental anxiety or dental phobia are related to exogenous factors such as direct learning from traumatic experiences, vicarious learning through significant others and the media, and endogenous factors such as inheritance and personality traits. Each individual aetiological factor is supported by the evidence provided.

Conclusions

The evidence suggests that the aetiology of dental fear, anxiety or phobia is complex and multifactorial. The findings show that there are clear practical implications indicated by the existing research in this area: a better understanding of dental fear, anxiety and phobia may prevent treatment avoidance.Key Words: Dental anxiety, Dental phobia, Aetiology     

Do organizational factors explain the quality of care?

This study investigated the perceptions of patients, nurses, physicians, and managers of the quality of care. While they all evaluated the quality of care to be good, the evaluations of patients and staff were different from each other's. Organizational factors such as values and work explained the quality of care evaluated by nursing staff and physicians compared to work and leadership by managers. No obvious relationship between quality and leadership could be found.