Search

This commentary describes the methodological shortcomings and the misleading presentation of the 'think-aloud' Brief Illness Perception Questionnaire (IPQ) paper by . We highlight that this paper uses a confusing Dutch translation of the scale, fabricates incorrect instructions, and employs a sample in which the majority of patients do not have established illness diagnoses. We believe these problematic methodological issues are the likely cause of the results presented in the paper. We argue that the conclusions of the paper are inaccurate, unsupported, and overstated given the limitations of the study. Furthermore, the think-aloud method cannot be a substitute for the established psychometric methods for assessing reliability and validity. [ABSTRACT FROM AUTHOR]

In this reply to Broadbent, Kaptein, and Petrie's commentary, we agree that our 'think aloud' study has limitations. However, we consider that the commentary goes too far in claiming these invalidate our findings. The authors of this commentary cite as a major limitation our use of a Dutch translation of the Brief IPQ. However, their reservations about this translation were not sufficient to prevent them from attempting to publish a paper describing the extended process behind its translation and validation. In contrast to the claims made, we consider that the Brief IPQ has poor concurrent validity, content validity is neglected, and no evidence is provided regarding discriminant validity. Our conclusions are described as 'overstated'-but we consider that calling into question the content validity of the Brief IPQ is fairly temperate, given the lack of attention it has received. Further, we cannot see how anyone could reasonably disagree with 'further developmental work with this questionnaire may be needed to better quantify and resolve the problems identified'-to do so it is to claim that the Brief IPQ is perfect! In sum, we think a more constructive response from the authors of this critique would be to engage with our observations, to improve the Brief IPQ. [ABSTRACT FROM AUTHOR]

Objectives: The Demand-Control (DC) and Effort-Reward Imbalance (ERI) models predict health in a work context. Self-report measures of the four key constructs (demand, control, effort, and reward) have been developed and it is important that these measures have good content validity uncontaminated by content from other constructs. We assessed relevance (whether items reflect the constructs) and representativeness (whether all aspects of the construct are assessed, and all items contribute to that assessment) across the instruments and items.Methods: Two studies examined fourteen demand/control items from the Job Content Questionnaire and seventeen effort/reward items from the Effort-Reward Imbalance measure using discriminant content validation and a third study developed new methods to assess instrument representativeness. Both methods use judges' ratings and construct definitions to get transparent quantitative estimates of construct validity. Study 1 used dictionary definitions while studies 2 and 3 used published phrases to define constructs.Results: Overall, 3/5 demand items, 4/9 control items, 1/6 effort items, and 7/11 reward items were uniquely classified to the appropriate theoretical construct and were therefore 'pure' items with discriminant content validity (DCV). All pure items measured a defining phrase. However, both the DC and ERI assessment instruments failed to assess all defining aspects.Conclusions: Finding good discriminant content validity for demand and reward measures means these measures are usable and our quantitative results can guide item selection. By contrast, effort and control measures had limitations (in relevance and representativeness) presenting a challenge to the implementation of the theories. Statement of contribution What is already known on this subject? While the reliability and construct validity of Demand-Control and Effort-Reward-Imbalance (DC and ERI) work stress measures are routinely reported, there has not been adequate investigation of their content validity. This paper investigates their content validity in terms of both relevance and representativeness and provides a model for the investigation of content validity of measures in health psychology more generally. What does this study add? A new application of an existing method, discriminant content validity, and a new method of assessing instrument representativeness. 'Pure' DC and ERI items are identified, as are constructs that are not fully represented by their assessment instruments. The findings are important for studies attempting to distinguish between the main DC and ERI work stress constructs. The quantitative results can be used to guide item selection for future studies. [ABSTRACT FROM AUTHOR]

Objectives: Several studies have shown that perseverative, worrisome thoughts are prospectively related to subjective health complaints (SHC) and that a short worry postponement intervention can decrease these complaints. As SHC and worry are prevalent and costly, we tested whether the intervention can be offered online to reduce these complaints in the general population.Design: A randomized parallel-group trial was conducted with self-selected participants from the general population.Methods: Via the research website, 996 participants were instructed to register their worrying for 6 consecutive days. The intervention group was instructed to postpone worry to a special 30-min period in the early evening. The Subjective Health Complaints inventory, as administered before and after the intervention, and daily worry frequency and duration were considered the primary outcomes.Results: Three hundred and sixty-one participants completed the study. Contrary to our expectation, the registration group (n = 188) did not differ from the intervention group (n = 163) in SHC (ηp² = .000, CI [0.000-0.003]), or in worry frequency or duration. Nevertheless, the different worry parameters were moderately related to SHC (r between .238 and .340, p ≤ .001).Conclusions: In contrast to previous studies using pen-and-pencil versions of the worry postponement intervention, this study suggests that a direct online implementation was not effective in reducing SHC and worry. Overall, participants had high trait worry levels and reported difficulty with postponing worrying. Reducing SHC and worries via the Internet might require more elaborate interventions that better incorporate the advantages of delivering interventions online.Statement Of Contribution: What is already known on this subject? The perseverative cognition hypothesis argues that perseverative cognition, such as worry and rumination, acts as a mediator by which psychosocial stress may produce negative health effects. Prior research has indeed shown that worry and subjective health complaints (SHC) are prospectively related, but causality studies - that is, showing that changes in worry induce changes in health outcomes - are scarce and have mainly been conducted in young samples. These studies showed that reducing worry, using a worry postponement intervention, can reduce daily worrying and SHC. What does this study add? Trait and daily worrying are associated with SHC. An online worry postponement intervention is ineffective in reducing worry and SHC. Paper-and-pencil interventions cannot directly be used as online interventions. [ABSTRACT FROM AUTHOR]

Objectives In studies involving theoretical constructs, it is important that measures have good content validity and that there is not contamination of measures by content from other constructs. While reliability and construct validity are routinely reported, to date, there has not been a satisfactory, transparent, and systematic method of assessing and reporting content validity. In this paper, we describe a methodology of discriminant content validity ( DCV) and illustrate its application in three studies. Methods Discriminant content validity involves six steps: construct definition, item selection, judge identification, judgement format, single-sample test of content validity, and assessment of discriminant items. In three studies, these steps were applied to a measure of illness perceptions ( IPQ- R) and control cognitions. Results The IPQ- R performed well with most items being purely related to their target construct, although timeline and consequences had small problems. By contrast, the study of control cognitions identified problems in measuring constructs independently. In the final study, direct estimation response formats for theory of planned behaviour constructs were found to have as good DCV as Likert format. Conclusions The DCV method allowed quantitative assessment of each item and can therefore inform the content validity of the measures assessed. The methods can be applied to assess content validity before or after collecting data to select the appropriate items to measure theoretical constructs. Further, the data reported for each item in Appendix S1 can be used in item or measure selection. [ABSTRACT FROM AUTHOR]

Introduction. Weinman, Petrie, Sharpe, and Walker (2000) showed that the causal attributions of a sample of first-time myocardial infarction (MI) patients and their spouses from Auckland, New Zealand, were associated with changes in health-related behaviour over the first 6 months post-MI. However, their analyses did not control for pre-MI health-related behaviour. Method. This paper reports a re-analyses of the Auckland data, and a replication study conducted with 155 first-time MI patients in Brighton, United Kingdom (UK), to investigate whether baseline attributions for MI were related to health-related behaviour change at 6 months (N = 132). Spouses (N = 85) also completed the attribution questionnaire at baseline. Results. There was no consistent relationship between the causal attributions of patients and subsequent behaviour change in Auckland and Brighton. For both samples, causal attributions were associated with pre-MI behaviour. Conclusions. The data from both samples suggest that the causal attributions of MI patients and their spouses may be realistic, but not predictive of subsequent changes in behaviour. [ABSTRACT FROM AUTHOR]

Objectives. Treatment transitions are frequent in end-stage renal disease (ESRD) but little is known about cognitive responses pre- to post-transplantation or after transplant failure. The purpose of this study was to examine changes in illness cognitions across treatment transitions between dialysis and transplantation and their impact on quality of life (QOL). Methods. In this longitudinal study, ESRD patients ( N= 262) patients were followed up across treatment transitions over a 7-year observation window using the Illness Perceptions Questionnaire, the Illness Effects Questionnaire, and measures of QOL. Study sample comprised the patients from this cohort who switched treatment modality ( N= 60 post-transplantation; N= 28 transplant failure). Data were collected while on dialysis or transplantation and at 6 months post-treatment change. Results. Significant changes in QOL and illness perceptions were found in treatment transitions with opposite patterns of either improvement or deterioration following transplantation or transplantation failure. Pre- to post-transplantation, QOL improves and patients report less symptoms, lower consequences, and illness intrusiveness, more acute timeline and stronger control beliefs ( ps < .01). QOL is diminished following transplant failure and patients report more symptoms, consequences, illness disruptiveness, more chronic timeline, and lower control. Changes in cognitions are associated with changes in QOL ( R2= .469-.789). Conclusions. Treatment transitions marked significant changes in illness perceptions that were associated with changes in QOL. Interventions to prepare patients for treatment transitions and prevent increasingly negative patterns of illness perceptions with transplant failure may serve towards maintaining or improving adjustment outcomes. Statement of contribution What is already known on this subject? Illness cognitions have been shown to predict health outcomes and to change in response to changes in health status. Treatment transitions between dialysis and transplantation are frequent in end stage renal disease but their effect on illness representations has not been explored. What does this study add? The paper described results of the first study to prospectively explore changes in illness cognitions across treatment transitions between dialysis and transplantation and their impact on QOL outcomes. The paper documents dynamic changes in illness cognitions when treatment modality is changed in line with the predictions of a dynamic reassessment of illness perceptions and coping behaviour as described in Leventhal's Common Sense Model of Illness Behaviour. [ABSTRACT FROM AUTHOR]

Objectives: Tamoxifen non-adherence is apparent in up to half of breast cancer survivors and is associated with increased risk of recurrence and reduced quality of life. However, factors contributing to non-adherence in this population are currently poorly understood. This study explored the relationship between key components of the Common Sense Model of Illness Representations (CSM)/the Theory of Planned Behaviour (TPB) and intentional and unintentional non-adherence in a large sample of women prescribed tamoxifen following primary breast cancer.Design: Cross-sectional questionnaire study (n = 777).Methods: Women were eligible if they were over 18, had been diagnosed with primary breast cancer, and had been prescribed tamoxifen. Participants were recruited in clinic or online and completed questionnaires assessing illness perceptions, treatment beliefs, adherence, quality of life, social support, distress, and the key TPB components. Logistic regressions were conducted to test elements from each model and to identify correlates of intentional and unintentional non-adherence.Results: Patients were classified as non-adherent based on Medication Adherence Rating Scale scores; 44% of the population were non-adherent; 41% reported unintentional non-adherence, and 9% reported intentional non-adherence. Study variables accounted for more variance in intentional (Nagelkerke R2  = 46%) than unintentional non-adherence (Nagelkerke R2  = 17%). Intentional non-adherence was best explained by a combination of TPB and CSM variables, but these variables did not contribute significantly to unintentional non-adherence.Conclusions: The TPB and the CSM provide a useful framework for understanding intentional tamoxifen non-adherence. Elements from both models should be considered when designing interventions to increase adherence rates. Statement of contribution What is already known about this subject? Non-adherence to tamoxifen is common and is associated with poor clinical outcomes. Few modifiable predictors of tamoxifen non-adherence have been identified. What does this study add? Unintentional non-adherence is reported much more frequently than intentional non-adherence. Elements from the CSM and TPB provide a useful framework for understanding non-adherence to tamoxifen. Unique correlates were found for intentional and unintentional non-adherence. [ABSTRACT FROM AUTHOR]

Objectives: The cognitive-behavioural model of functional somatic syndromes (FSS) proposes a multifactorial aetiology consisting of predisposing, precipitating and perpetuating factors. In this study, we sought to investigate three questions that can be drawn from this model: (1) Do patients with FSS show high levels of neuroticism? (2) Does neuroticism affect physical health and social functioning, either directly or indirectly through maladaptive coping? (3) Does more adaptive coping mediate the effect of cognitive-behavioural therapy (CBT) on outcome?Design: Secondary analysis of a randomized controlled trial (RCT) using additional data.Method: We used yet unpublished data on neuroticism (measured with Temperament and Character Inventory, Revised) and coping (measured with Coping Strategies Questionnaire) together with already reported outcomes (physical health and social functioning measured with SF-36) from an RCT comparing group CBT with enhanced usual care in 120 patients with a range of FSS. Neuroticism was measured at referral, while coping and outcomes were measured at referral, baseline, 4 and 16 months after randomization. Our hypotheses were explored through a series of cross-sectional (linear regression and structural equation models) and longitudinal (mediation) analyses.Results: Patients with FSS showed higher levels of neuroticism than two healthy comparison groups. At referral, symptom catastrophizing partly mediated the negative association between neuroticism and outcome. Reduction in symptom catastrophizing during group CBT partially mediated its long-term effect.Conclusions: The results give support to a generic cognitive-behavioural model of FSS. Targeting symptom catastrophizing may be an essential component in CBT for patients with FSS, regardless of their specific diagnosis. Statement of contribution What is already known on this subject? Previous studies have found support for single components of the cognitive-behavioural model such as dysfunctional illness beliefs or avoidant coping. Most studies have investigated single functional somatic syndromes (FSS) such as fibromyalgia or irritable bowel syndrome. What does this study add? Predisposing neuroticism was linked to poor physical health through symptom catastrophizing across a range of FSS. Reduced symptom catastrophizing during group cognitive-behavioural therapy partially mediated its long-term effect. Addressing symptom catastrophizing may be a key element of the management of patients with FSS. [ABSTRACT FROM AUTHOR]

Objective: The present research aimed to test the efficacy of affective and instrumental text messages compared with a no-message control as a strategy to increase fruit and vegetable intake (FVI) in adolescents.Design: A randomized controlled trial was used test impact of different text messages compared with no message on FVI over a 2-week period.Method: A total of 1,065 adolescents (14-19 years) from a high school of the South of Italy completed the baseline questionnaire and were randomly allocated to one of three conditions: instrumental messages (N = 238), affective messages (N = 300), and no messages (N = 521). Students in the message conditions received one message each day over a 2-week period. The messages targeted affective (affective benefits) or instrumental (instrumental benefits) information about FVI. Self-reported FVI at 2 weeks was the key dependent variable. Analyses were based on the N = 634 who completed all aspects of the study.Results: Findings showed that messages significantly increased FVI, particularly in the affective condition and this effect was partially mediated by changes in affective attitude and intentions towards FVI.Conclusion: Text messages can be used to increase FVI in adolescents. Text messages based on affective benefits are more effective than text messages based on instrumental benefits. Statement of contribution What is already known on this subject? Text messages have been shown to promote positive change in health behaviours. However, the most appropriate target for such text messages is less clear although targeting attitudes may be effective. What does this study add? This randomized controlled study shows that text messages targeting instrumental or affective attitudes produce changes in fruit and vegetable intake (FVI) in adolescents. Text messages targeting affective attitudes are shown to be more effective than text messages targeting instrumental attitudes. The effect of affective text messages on FVI was partially mediated by changes in affective attitudes. [ABSTRACT FROM AUTHOR]

Objectives: Preschool-aged children spend substantial amounts of time engaged in screen-based activities. As parents have considerable control over their child's health behaviours during the younger years, it is important to understand those influences that guide parents' decisions about their child's screen time behaviours.Design: A prospective design with two waves of data collection, 1 week apart, was adopted.Methods: Parents (n = 207) completed a Theory of Planned Behaviour (TPB)-based questionnaire, with the addition of parental role construction (i.e., parents' expectations and beliefs of responsibility for their child's behaviour) and past behaviour. A number of underlying beliefs identified in a prior pilot study were also assessed.Results: The model explained 77% (with past behaviour accounting for 5%) of the variance in intention and 50% (with past behaviour accounting for 3%) of the variance in parental decisions to limit child screen time. Attitude, subjective norms, perceived behavioural control, parental role construction, and past behaviour predicted intentions, and intentions and past behaviour predicted follow-up behaviour. Underlying screen time beliefs (e.g., increased parental distress, pressure from friends, inconvenience) were also identified as guiding parents' decisions.Conclusion: Results support the TPB and highlight the importance of beliefs for understanding parental decisions for children's screen time behaviours, as well as the addition of parental role construction. This formative research provides necessary depth of understanding of sedentary lifestyle behaviours in young children which can be adopted in future interventions to test the efficacy of the TPB mechanisms in changing parental behaviour for their child's health.Statement Of Contribution: What is already known on this subject? Identifying determinants of child screen time behaviour is vital to the health of young people. Social-cognitive and parental role constructions are key influences of parental decision-making. Little is known about the processes guiding parents' decisions to limit their child's screen time. What does this study add? Parental role construction and TPB social-cognitive factors influence parental decisions. The beliefs of parents for their child's behaviour were identified. A range of beliefs guide parents' decisions for their child's screen time viewing. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this longitudinal investigation was to examine the association between emotion regulation and future insomnia (incidence and persistence).Design: A longitudinal study in the general population.Methods: A survey was sent out to 5,000 individuals in the community. To those who returned the baseline questionnaire (n = 2,333), two follow-up surveys, 6 and 18 months later, were sent out and then completed by 1,887 and 1,795 individuals, respectively. The survey contained information about demographic factors, insomnia symptomatology, the Difficulties in Emotion Regulation Scale, anxiety, and depression.Results: The findings suggested that emotion regulation at baseline was not associated with the incidence or persistence of insomnia. Overall, the effect sizes were very small to medium. When examining changes in emotion regulation over time, a different pattern emerged. Partial support was established for the notion that decreases in emotion regulation were related to incident and persistent insomnia, as a decrease in emotion regulation was associated with a higher likelihood of future insomnia. Yet, the effect sizes were very small to small.Conclusion: This study does partly point towards a longitudinal association between emotion dysregulation and insomnia. This might have implications for the conceptualization and management of insomnia as well as for future research.Statement Of Contribution: What is already known on this subject? Previous research has indicated that emotion dysregulation might be enhanced in patients with insomnia. A number of limitations have however hindered progress in understanding how emotion dysregulation is related to insomnia, such as limited research on the topic and relying solely on cross-sectional data. What does this study add? The current investigation showed that emotion dysregulation is a risk factor for the development of incident and persistent insomnia. This study also shows that increased emotion dysregulation over time heightens the risk of incident and persistent insomnia. [ABSTRACT FROM AUTHOR]

Objectives Post-traumatic stress disorder ( PTSD) can be a consequence of acute medical events and has been associated with non-adherence to medications. We tested whether increased concerns about medications could explain the association between PTSD and non-adherence to medication in stroke survivors. Design We surveyed 535 participants aged 40 years or older who had at least one stroke or transient ischaemic attack in the previous 5 years. Methods We assessed PTSD using the PTSD checklist-specific for stroke, medication adherence with the Morisky Medication Adherence Questionnaire, and beliefs about medications with the Beliefs about Medicines Questionnaire. We used logistic regression to test whether concerns about medications mediated the association between stroke-induced PTSD and non-adherence to medication. Covariates for adjusted analyses included age, sex, race, comorbid medical conditions, stroke-related disability, years since last stroke/ TIA, and depression. Results Symptoms of PTSD were correlated with greater concerns about medications ( r = 0.45; p < .001), and both were associated with medication non-adherence. Adjustment for concerns about medications attenuated the relationship between PTSD and non-adherence to medication, from an odds ratio [ OR] of 1.04 (95% confidence interval [ CI], 1.01-1.06; OR, 1.63 per 1 SD) to an OR of 1.02 (95% CI, 1.00-1.05; OR, 1.32 per 1 SD), and increased concerns about medications remained associated with increased odds of non-adherence to medication ( OR, 1.17; 95% CI, 1.10-1.25; OR, 1.72 per 1 SD) in this fully adjusted model. A bootstrap mediation test suggested that the indirect effect was statistically significant and explained 38% of the association of PTSD to medication non-adherence, and the direct effect of PTSD symptoms on medication non-adherence was no longer significant. Conclusion Increased concerns about medications explain a significant proportion of the association between PTSD symptoms and non-adherence to medication in stroke survivors. Statement of contribution What is already known on this subject? Posttraumatic stress disorder ( PTSD) is common after cardiovascular events, including stroke and transient ischemic attack. PTSD due to non-stroke cardiovascular events is associated with increased risk of cardiovascular disease recurrence and mortality. PTSD due to stroke is associated with increased risk for medication nonadherence in stroke survivors. What does this study add? While PTSD has been associated with medication nonadherence in stroke survivors and acute coronary syndrome survivors, no mechanism for that association has been tested. This is the first study to provide evidence for a mediator of the PTSD-nonadherence association, increased concerns about medications, and point to potential interventions to improve adherence in stroke survivors. [ABSTRACT FROM AUTHOR]

Objectives. The aim of this study was to examine if changes in motivations to care, familism, illness perceptions, caregiver tasks, coping, and social support were related to caregiver reported gains (subjective feelings of satisfaction and rewards as a result of the care role). Design. A longitudinal design was employed whereby 123 caregivers completed a questionnaire at three time points: baseline, 3 months, and 9 months from baseline. Method. Independent variables were converted into residual change scores (between time 1 and time 2) and their influence on caregiver gains at time 2 and time 3 was examined. Results. Caregiver reported gains remained stable over time. Hierarchical regression analysis found that an increase in illness coherence was a strong predictor of caregiver gains at time 2, whereas predictors of time 3 gains included ethnicity, number of hours caregiving, and an increase in self-distraction and denial as coping methods. Conclusion. The study has implications for the development of time-specific interventions to increase caregiver gains and also for service development. [ABSTRACT FROM AUTHOR]

Objectives. Physical activity has been associated with positive health outcomes. The objective of the study was to investigate the relationship between knowledge of physical activity, social support, self-efficacy, perceived barriers to physical activity, and level of physical activity among healthcare employees and students in a National Health Service (NHS) Trust. Design. This study was secondary analysis of questionnaire data on the health and well-being of staff and students within the NHS. Method. A total of 325 student nurses and 1,452 NHS employees completed the questionnaire. The data were analysed using descriptive statistics, zero-order correlations, and structural equation modelling. Results. Self-efficacy fully mediated the relationship between social support, perceived barriers, and level of physical activity in the student sample and partially mediated the relationship between social support, perceived barriers, and level of physical activity in the healthcare staff sample. Knowledge of physical activity had no significant effect on physical activity. Conclusion. Findings suggest that instead of instilling knowledge, interventions to promote physical activity among healthcare staff and students should enhance social support and self-efficacy and also to remove perceived barriers to physical activity. [ABSTRACT FROM AUTHOR]

Objectives. The Brief Illness Perception Questionnaire (Brief IPQ) is a commonly used questionnaire that aims to assess patients' illness beliefs. There is, however, no direct information on how people interpret and respond to this questionnaire, nor on the nature and extent of problems people have when completing it. The present study describes the problems that patients encounter when completing the Brief IPQ. Design. Cross-sectional observational study. Methods. A 'think-aloud' method was employed with two samples: 6 patients attending a preoperative exercise programme in secondary care, and 11 patients receiving physiotherapy in primary care. Results. In total, 88 problems were identified, mostly ( N= 45) consisted of participants rereading a question or stumbling in reading it. In 8 cases, participants misinterpreted a question. The pattern of findings was striking similar across the two samples. The questions about identity, personal control, illness coherence, and causal attributions yielded most difficulties (18, 16, 16, and 11 problems, respectively). Conclusions. Given that the Brief IPQ assesses each construct with a single item, the number of problems people have with completing it is particularly problematic, and calls into question the content validity of this measure. Further developmental work with this questionnaire may be needed to better quantify and resolve the problems identified. [ABSTRACT FROM AUTHOR]

Objective. We applied Antonovsky's salutogenic model to healthy ageing. Basically, salutogenic theory states that generalized resistance resources build-up the sense of coherence which in turn determines an individual's health level. Specifically, we explored the status of the sense of coherence as a mediator variable. Design and Method. We conducted a cross-sectional questionnaire study with 387 volunteering elders (73.4% women and 22.2% nursing home residents) at the mean age of 74 (SD = 7.58) years. We assessed 19 bio-psychosocial resources, the sense of coherence, and three subjective health measures - psychological health, symptom reporting, and physical health. As nursing home residents were generally inferior, our study controlled for dependent living. Results. Resources, sense of coherence, and subjective health were significantly inter-related. A regression showed that optimism, self-esteem, low depressive mood, self-efficacy, and social support predicted the sense of coherence significantly. Predicting psychological health and symptom reporting, the sense of coherence remained significant when resources were added in the final step of the regression. This pattern was not found for physical health. Mediator analyses using Preacher and Hayes' paradigm showed that every eligible resource influenced both psychological health and symptom reporting, but not physical health, indirectly via the sense of coherence. Conclusion. The sense of coherence is largely shaped by individual difference variables. As a mediator variable, it strongly accounts for the relation between resources and psychogenic aspects of health, whereas its relative significance for physical health is not corroborated. Our findings emphasize the importance of resource-oriented health care for elders. [ABSTRACT FROM AUTHOR]

Objectives. Obesity has been shown to be negatively related to physical health- related quality of life (HQOL) much more strongly than mental HQOL. This is remarkable given findings on obesity-related social stigmata and associations with depression. Considering obesity as a stressor, this study tests for a moderating role of social support for obesity/HQOL associations among women and men. Design. Data come from N = 2,732 participants aged 35-74 years in a 2004-2005 general population survey in the Augsburg region, Germany. Methods. Body weight and height were assessed by anthropometric measurements (classified by body mass index using WHO standards), social support by the Social Support Questionnaire 14-item Short-Form (F-SozU-K14) and HQOL by the 12-item Short-Form Health Survey (SF- 12). In multiple regression and general linear models, age, education, family status, health insurance, and place of residence were adjusted for. Results. Among both genders, obesity was associated with reduced physical but not mental HQOL Among men reporting strong social support, physical HQOL was impaired neither in the moderately nor the severely obese group (compared with normal weight), while it was given less social support. Among women, poor physical HQOL was associated with obesity regardless of social support. Conclusions. In this adult population sample, no association was found for obesity with mental HQOL. In contrast, a negative association with physical HQOL exists for all subgroups except men with strong social support, indicating that social support buffers obesity-related impairments in physical HQOL in men but not in women. This suggests that obese women and men with strong social support represent distinct populations, with possible implications for obesity care. [ABSTRACT FROM AUTHOR]

Objectives. Sense of Coherence is the core construct of Antonovsky's salutogenetic model. To measure Sense of Coherence, a 29-item-questionnaire (SOC-29), a shortened 13-item version, and a simplified measure of only three items (SOC-3) are available. In our study, the last was tested in terms of the psychometric properties and compared with an alternative short form derived from the SOC-29. Methods. Data with respect to the original SOC-29-scale, the SOC-3, and additional other health measures were collected in a representative general population survey, the German study 'Transitions in Alcohol Consumption and Smoking' (TACOS). Analyses of the factor structures, reliability and validity correlations are reported. Results. The reliability and validity results of the SOC-3 were not encouraging. Subsequent item analyses revealed that three items taken out of the SOC-29 outperformed the SOC-3 in measuring Sense of Coherence in a simplified way. This newly developed instrument is presented as the Brief Assessment of Sense of Coherence (BASOC). Conclusion. The BASOC is a superior short form compared with the SOC-3 and is recommended for large surveys with limited space for questions. [ABSTRACT FROM AUTHOR]

Presents a study that developed the Transplant Effects Questionnaire (TxEQ) for assessing the multidimensional outcome of organ transplantation. Issues covered in the questions; Instructions of the TxEQ; Test-retest reliability of the TxEQ.