Cross-cultural invariance of the Academic Expectations Stress Inventory: Adolescent samples from Canada and Singapore

We provide further evidence for the two-factor structure of the 9-item Academic Expectations Stress Inventory (AESI) using confirmatory factor analysis on a sample of 289 Canadian adolescents and 310 Singaporean adolescents. Examination of measurement invariance tests the assumption that the model underlying a set of scores is directly comparable across groups. This study also examined the cross-cultural validity of the AESI using multigroup confirmatory factor analysis across both the Canadian and Singaporean adolescent samples. The results suggested cross-cultural invariance of form, factor loadings, and factor variances and covariances of the AESI across both samples. Evidence of AESI's convergent and discriminant validity was also reported. Findings from t-tests revealed that Singaporean adolescents reported a significantly higher level of academic stress arising from self expectations, other expectations, and overall academic stress, compared to Canadian adolescents. Also, a larger cross-cultural effect was associated with academic stress arising from other expectations compared with academic stress arising from self expectations.     

Patients' Expectations of Asthma Treatment

A multicomponent model has been developed to explain patients' unmet expectations of medical care. The model proposes that expectations are related to patients' personal experiences with illness, perceived vulnerability to disease, transmitted knowledge, and perceived severity of disease. The objective of this cross-sectional study was to determine whether this model can be applied to patients' unrealistic expectations of treatment outcomes, specifically expecting to be cured of asthma. In total, 230 patients observed in a primary care practice in New York City were interviewed in person with open-ended questions about their expectations of asthma treatment. Responses were analyzed with qualitative techniques to generate categories of expectations. Patients had a mean age of 41 ± 11 years, 21% were white, 30% African American, 42% Latino, and 7% other groups. Major categories of expectations were generated from patients' responses and included symptom relief (expected by 52%), cure (36%), improved physical function (21%), and improved psychological well-being (15%). The category of expecting a cure was assessed with patients' responses to the following items representing components of the model: 1) resource utilization and medication requirements for asthma (representing severity of disease); 2) perceived quality of asthma care and satisfaction with care (representing past asthma experiences); 3) the Asthma Self-Efficacy Scale (representing perceived vulnerability to exacerbations); and 4) experiences of social network contacts with asthma and the Check Your Asthma IQ survey (representing transmitted knowledge). In bivariate analysis, patients who expected a cure were more likely to be Latino or Native American or Asian (p = 0.02), to have never required oral corticosteroids (p = 0.004), to be dissatisfied with the status of their asthma (p = 0.008), to know others who were limited by asthma (p = 0.03), to have worse Asthma Self-Efficacy Scale scores (p = 0.002), to have worse Check Your Asthma IQ scores (p = 0.04), and to currently be taking inhaled corticosteroids (p = 0.03). In multivariate analysis, worse asthma self-efficacy (p = 0.008), never having required oral corticosteroids (p = 0.005), and currently taking inhaled corticosteroids (p = 0.05) remained associated with expecting a cure. As a result of this study, we found that patients have multiple expectations of asthma treatment, including realistic expectations such as symptom relief and improved function, as well as unrealistic expectations, specifically to be cured of asthma. A multicomponent model of patient and disease characteristics was associated with this unrealistic expectation. These findings indicate that clinicians can intervene in diverse areas to foster realistic expectations of treatment outcomes among asthma patients.     

The rheumatic patient''s early needs and expectations

During the last few years, studies have revealed that the need for psychosocial support and concrete social services are great in the early stages of the treatment of rheumatic diseases. The ability to keep a job, to do household chores, to participate in leisure activities and to maintain social relations is clearly impaired. Anxiety and depression are not unusual and often associated with weak support from relatives, loneliness and disturbed family relations. Nevertheless, the patients report resilience and determination to cope with the impacts of illness. Crisis intervention, vocational guidance and counselling about problems concerning the disease should be available and offered to the patients. As the patients seem to be unaccustomed to talking about their psychosocial problems, an empathetic and information-seeking attitude on the part of the health care staff is essential.     

Social cognitive correlates of device-measured and self-reported physical activity in Black and White individuals with multiple sclerosis

BackgroundThere is increasing research interest regarding physical activity behavior among persons with multiple sclerosis (MS), yet there is little known about physical activity and its correlates in Black persons with MS.ObjectiveThis cross-sectional study assessed associations among social cognitive theory (SCT) variables and device-measured and self-reported physical activity in samples of Black and White persons with MS.MethodsParticipants included 67 Black and 141 White persons with MS who wore an ActiGraph accelerometer on a belt around the waist measuring moderate-to-vigorous physical activity (MVPA) for seven days and completed a battery of questionnaires. Questionnaires included demographic and clinical characteristics, leisure-time exercise, exercise self-efficacy, overcoming barriers self-efficacy, function, social support, exercise outcome expectations, and goal setting and planning.ResultsBlack participants with MS engaged in significantly less MVPA, but not sedentary behavior or light physical activity, than the White participants with MS. Black participants further had significantly lower levels of exercise self-efficacy and outcome expectations than the White sample. All SCT correlates were significantly correlated with self-reported physical activity, but only exercise and barriers self-efficacy, perceived function, and exercise goal setting were associated with device-measured MVPA. The difference in physical activity between Black and White participants with MS was accounted for by differences in exercise self-efficacy and outcome expectations.ConclusionsResearchers should consider developing behavioral interventions that target exercise self-efficacy and outcome expectations as SCT variables for increasing physical activity in Black persons with MS.     

Expectations and limitations due to brachial plexus injury: a qualitative study

Purpose

This study described physical and psychosocial limitations associated with adult brachial plexus injuries (BPI) and patients’ expectations of BPI surgery.

Methods

During in-person interviews, preoperative patients were asked about expectations of surgery and preoperative and postoperative patients were asked about limitations due to BPI. Postoperative patients also rated improvement in condition after surgery. Data were analyzed with qualitative and quantitative techniques.

Results

Ten preoperative and 13 postoperative patients were interviewed; mean age was 37 years, 19 were men, all were employed/students, and most injuries were due to trauma. Preoperative patients cited several main expectations, including pain-related issues, and improvement in arm movement, self-care, family interactions, and global life function. Work-related expectations were tailored to employment type. Preoperative and postoperative patients reported that pain, altered sensation, difficulty managing self-care, becoming physically and financially dependent, and disability in work/school were major issues. All patients reported making major compensations, particularly using the uninjured arm. Most reported multiple mental health effects, were distressed with long recovery times, were self-conscious about appearance, and avoided public situations. Additional stresses were finding and paying for BPI surgery. Some reported BPI impacted overall physical health, life priorities, and decision-making processes. Four postoperative patients reported hardly any improvement, four reported some/a good deal, and five reported a great deal of improvement.

Conclusions

BPI is a life-altering event affecting physical function, mental well-being, financial situation, relationships, self-image, and plans for the future. This study contributes to clinical practice by highlighting topics to address to provide comprehensive BPI patient-centered care.     

不同类别军医大学生学习认识和期望的比较

目的调查不同类别军医大学生对于学习的认识和期望。方法应用自制问卷,比较不同类别军医大学生对于学习的认识和期望情况。结果无军籍学员对待学习的认识和期望较高;其次是联合培养学员、战士学员(χ2=33.933,97.079;P均0.001)。结论针对不同类别军医大学生对待学习的认识和期望情况,采取有针对性的教育措施保持和提高其水平。     

History of food acceptance research in the US Army

The history of food acceptance research by the US Army in Chicago and Natick is reviewed. The review covers the staff of the two research centers, the research programs, and the significant accomplishments of the Army laboratories from the 1940s to the present. Accomplishments begin with the development of the nine-point hedonic scale, and the development of the first Food Acceptance Laboratory. Further accomplishments include studies of sensory psychophysics, food preferences, food choice and food intake. The laboratories designed methods and conducted research on the role of consumer variables in the acceptance of food products and food service systems. Recent work has focused on new scaling approaches, the role of contextual factors and the importance of product expectations. Throughout the period of the review, the Army research has examined the relationship of laboratory acceptance to field acceptance, and the relationship of acceptance to intake.     

Evaluating medication-related services in a hospital setting using the disconfirmation of expectations model of satisfaction

BACKGROUND: Patient satisfaction is considered an important outcome measure of services and associated with behavioral intentions. The appraisal process commonly used in satisfaction models is the disconfirmation of expectations. A patient compares his or her experience to preexisting expectations. The resulting satisfaction from this comparison is dependent on whether the patient's expectations are superior, inferior, or just as expected. OBJECTIVES: The aims of this study were to (1) determine the relationship between disconfirmation of expectations with medication-related services and patient satisfaction with medical care; and (2) determine if patient satisfaction is related to the likelihood to say good things about the medical care provided at the hospital to family and friends. METHODS: A cross-sectional, nonexperimental study design was implemented to test the disconfirmation of expectations model. Patients on warfarin therapy and recently discharged from an acute care hospital to their homes were surveyed by mail. The survey asked about how well the hospital services related to medication therapy met patient expectations. Satisfaction with medical care and the likelihood of positive word of mouth regarding the medical care were also measured. Structural equation modeling (SEM) was used to test the model. RESULTS: The survey response rate was 34% (n=187). Factor analysis of the 7 disconfirmation of expectation items resulted in a 2-factor solution: (1) medication counseling and (2) discharge medication services. The SEM demonstrated that the model was significant; however, the disconfirmation of expectation items did not significantly relate to the 1-item satisfaction measure. Patient satisfaction and the behavioral intentions measures were significantly related. A post hoc analysis using SEM demonstrated that the disconfirmation of expectations factors did significantly relate to a higher-order latent construct. This construct also related to patient satisfaction. CONCLUSION: The disconfirmation of expectations has a role in a postservice experience response expressed by the patient, but not as a direct antecedent to patient satisfaction. Opportunities to improve the model are the use of a multi-item satisfaction measure and the inclusion of patient affect.