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Behavioral Sciences
Volume 7
Issue 2
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Behav. Sci., Volume 7, Issue 2 (June 2017) – 23 articles

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242 KiB  
Article
Insights into the Experiences of Treatment for An Eating Disorder in Men: A Qualitative Study of Autobiographies
by Priyanka Thapliyal, Deborah Mitchison and Phillipa Hay
Behav. Sci. 2017, 7(2), 38; https://doi.org/10.3390/bs7020038 - 16 Jun 2017
Cited by 19 | Viewed by 7586
Abstract
Eating disorders are increasingly recognized as a problem for men but help-seeking is low and little is known about their treatment experiences. This paper sought to determine the treatment experiences of men who have suffered from an eating disorder using autobiographical data. Inclusion [...] Read more.
Eating disorders are increasingly recognized as a problem for men but help-seeking is low and little is known about their treatment experiences. This paper sought to determine the treatment experiences of men who have suffered from an eating disorder using autobiographical data. Inclusion criteria were autobiographies of men who had experienced an eating disorder and sought any form of treatment for this, written in the English language, published between 1995 and 2015, and available for purchase in 2016. The search resulted in six books that were thematically analyzed. Analysis of data resulted in two broad themes (1. Positive experiences; 2. Negative experiences) with sub-themes. With regards to the first theme, factors such as concern of staff members, therapist’s expertise (in treating eating disorders in men), and a collaborative treatment approach were considered favorable for treatment. In contrast to the first theme, apathy of staff members, the authors’ own negative preconceptions, treatment providers being perceived as prioritizing financial concerns, perceived as incompetent and judgmental behavior of therapist(s), and time limitations of sessions were considered unfavorable treatment experiences. In this study, the perceived success of treatment depended on therapist’s features and the form of treatment provided. Further research examining these is indicated. Full article
(This article belongs to the Special Issue Advances in the Prevention and Management of Obesity and Eating Disorders)
952 KiB  
Article
NADA Ear Acupuncture: An Adjunctive Therapy to Improve and Maintain Positive Outcomes in Substance Abuse Treatment
by Kenneth Carter, Michelle Olshan-Perlmutter, Jonathan Marx, Janet F. Martini and Simon B. Cairns
Behav. Sci. 2017, 7(2), 37; https://doi.org/10.3390/bs7020037 - 16 Jun 2017
Cited by 15 | Viewed by 15278
Abstract
The National Acupuncture Detoxification Association protocol (NADA) is an adjunctive therapy using 1 to 5 invariant ear acupuncture/acupressure points. This is a randomized prospective study to determine if NADA plus traditional treatment enhance outcomes: quality of life, depression, anxiety and abstinence from substance [...] Read more.
The National Acupuncture Detoxification Association protocol (NADA) is an adjunctive therapy using 1 to 5 invariant ear acupuncture/acupressure points. This is a randomized prospective study to determine if NADA plus traditional treatment enhance outcomes: quality of life, depression, anxiety and abstinence from substance abuse. There were 100 patients enrolled in the Keystone Substance Abuse Services-Winthrop University Department of Sociology and Anthropology NADA study. All patients completed Generalized Anxiety Disorder scale (GAD-7), Patient Health Questionnaire (PHQ-9), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES) prior to starting the program and at program completion. Patients self-reported alcohol, tobacco, and drug use prior to starting the program at program completion and at 3 and 6 month follow- up. Patient characteristics are predictive of completion versus non-completion when race, criminal history and initial drug test is considered. Those identified as nonwhite, (p < 0.05) and patients with positive initial drug test, (p < 0.01) were more likely to complete treatment in the NADA group. Also, among patients with criminal history a higher percentage failed to complete the program in the control group (p < 0.05). Participation in NADA positively associated with Q-LES score (p < 0.05), feeling better about oneself and improved energy (p < 0.05), likelihood of employment upon discharge (p < 0.05), and decreased alcohol use at 3 month follow up (p < 0.05) and 6-month follow-up (p < 0.01). NADA group reported less tobacco use at 6 months (p < 0.05). Full article
(This article belongs to the Special Issue Race, Ethnicity, and Drug Addiction)
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Article
Family Communication about End-of-Life Decisions and the Enactment of the Decision-Maker Role
by April R. Trees, Jennifer E. Ohs and Meghan C. Murray
Behav. Sci. 2017, 7(2), 36; https://doi.org/10.3390/bs7020036 - 7 Jun 2017
Cited by 24 | Viewed by 8315
Abstract
End-of-life (EOL) decisions in families are complex and emotional sites of family interaction necessitating family members coordinate roles in the EOL decision-making process. How family members in the United States enact the decision-maker role in EOL decision situations was examined through in-depth interviews [...] Read more.
End-of-life (EOL) decisions in families are complex and emotional sites of family interaction necessitating family members coordinate roles in the EOL decision-making process. How family members in the United States enact the decision-maker role in EOL decision situations was examined through in-depth interviews with 22 individuals who participated in EOL decision-making for a family member. A number of themes emerged from the data with regard to the enactment of the decision-maker role. Families varied in how decision makers enacted the role in relation to collective family input, with consulting, informing and collaborating as different patterns of behavior. Formal family roles along with gender- and age-based roles shaped who took on the decision-maker role. Additionally, both family members and medical professionals facilitated or undermined the decision-maker’s role enactment. Understanding the structure and enactment of the decision-maker role in family interaction provides insight into how individuals and/or family members perform the decision-making role within a cultural context that values autonomy and self-determination in combination with collective family action in EOL decision-making. Full article
(This article belongs to the Special Issue Family Communication at the End of Life)
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Article
Adventure Behavior Seeking Scale
by Piotr Próchniak
Behav. Sci. 2017, 7(2), 35; https://doi.org/10.3390/bs7020035 - 27 May 2017
Cited by 8 | Viewed by 7507
Abstract
This article presents a new tool—the Adventure Behavior Seeking Scale (ABSS). The Adventure Behavior Seeking Scale was developed to assess individuals’ highly stimulating behaviors in natural environments. An exploratory factor analysis was conducted with 466 participants and resulted in one factor. The internal [...] Read more.
This article presents a new tool—the Adventure Behavior Seeking Scale (ABSS). The Adventure Behavior Seeking Scale was developed to assess individuals’ highly stimulating behaviors in natural environments. An exploratory factor analysis was conducted with 466 participants and resulted in one factor. The internal consistency was 0.80. A confirmatory factor analysis was performed using another sample of 406 participants, and results verified the one-factor structure. The findings indicate that people with a lot of experience in outdoor adventure have a higher score on the ABSS scale than control groups without such experience. The results also suggest that the 8-item ABSS scores were highly related to sensation seeking. The author discusses findings in regard to the ABSS as an instrument to measure outdoor adventure. However, further studies need to be carried out in other sample groups to further validate the scale. Full article
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Article
Social Support, Religious Involvement and Alcohol Use among Students at a Conservative Religious University
by Wendy E. Thompson
Behav. Sci. 2017, 7(2), 34; https://doi.org/10.3390/bs7020034 - 24 May 2017
Cited by 14 | Viewed by 5957
Abstract
The misuse of alcohol among college students remains a significant public health concern in the United States. Excessive drinking among college students has been linked to numerous negative consequences, including rape, impaired academic performance, absenteeism from work and school and damaged social relations. [...] Read more.
The misuse of alcohol among college students remains a significant public health concern in the United States. Excessive drinking among college students has been linked to numerous negative consequences, including rape, impaired academic performance, absenteeism from work and school and damaged social relations. This study examined whether religious involvement and social support played a role in reducing the frequency of alcohol use. A non-random convenience sample of 364 students from a larger study of 760 college students—18 years old and older—were recruited over a 2 month period. The survey used in this study consisted of 124 items and collected information on areas such as substance misuse, sexual activity, use of pornography, relationships, personal religious practices, and social support. A descriptive analysis and chi-square were performed to determine if there was a relationship between frequency of alcohol use and gender, marital status, student class, GPA, religion, ethnicity and age. Linear regression was conducted to determine if social support and religious involvement were predictors of frequency of alcohol misuse. Multivariate regression analysis was used for predicting religious involvement when including social support while controlling for gender, age, ethnicity and grade. The present study revealed that religious involvement was a predictor for reduced frequency of alcohol use, while social support was not a predictor of lower frequency of alcohol use. Full article
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Article
Communicatively Constructing the Bright and Dark Sides of Hope: Family Caregivers’ Experiences during End of Life Cancer Care
by Jody Koenig Kellas, Katherine M. Castle, Alexis Johnson and Marlene Z. Cohen
Behav. Sci. 2017, 7(2), 33; https://doi.org/10.3390/bs7020033 - 15 May 2017
Cited by 25 | Viewed by 7846
Abstract
(1) Background: The communication of hope is complicated, particularly for family caregivers in the context of cancer who struggle to maintain hope for themselves and their loved ones in the face of terminality. In order to understand these complexities, the current study examines [...] Read more.
(1) Background: The communication of hope is complicated, particularly for family caregivers in the context of cancer who struggle to maintain hope for themselves and their loved ones in the face of terminality. In order to understand these complexities, the current study examines the bright and dark sides of how hope is communicated across the cancer journey from the vantage point of bereaved family caregivers; (2) Methods: We analyzed interviews with bereaved family caregivers using qualitative thematic and case oriented strategies to identify patterns in the positive and negative lived experiences when communicating about hope at the end of life; (3) Results: Two overarching patterns of hope emerged. Those who experienced hope as particularized (focused on cure) cited communication about false hope, performing (faking it), and avoidance. Those who transitioned from particularized to generalized hope (hope for a good death) reported acceptance, the communication of hope as social support, prioritizing family, and balancing hope and honesty; (4) Conclusion: Family caregivers face myriad complexities in managing the bright and dark sides of hope. Interventions should encourage concurrent oncological and palliative care, increased perspective-taking among family members, and encourage the transition from particularized to generalized hope. Full article
(This article belongs to the Special Issue Family Communication at the End of Life)
240 KiB  
Article
The Link between Mastery and Depression among Black Adolescents; Ethnic and Gender Differences
by Shervin Assari and Cleopatra Howard Caldwell
Behav. Sci. 2017, 7(2), 32; https://doi.org/10.3390/bs7020032 - 12 May 2017
Cited by 14 | Viewed by 7379
Abstract
Purpose: Although the link between depression and lower levels of mastery is well established, limited information exists on ethnic and gender differences in the association between the two. The current study investigated ethnic, gender, and ethnic by gender differences in the link between [...] Read more.
Purpose: Although the link between depression and lower levels of mastery is well established, limited information exists on ethnic and gender differences in the association between the two. The current study investigated ethnic, gender, and ethnic by gender differences in the link between major depressive disorder (MDD) and low mastery in the United States. Methods: We used data from the National Survey of American Life-Adolescent supplement (NSAL-A), 2003–2004. In total, 1170 Black adolescents entered the study. This number was composed of 810 African-American and 360 Caribbean Black youth (age 13 to 17). Demographic factors, socioeconomic status (family income), mastery (sense of control over life), and MDD (Composite International Diagnostic Interview, CIDI) were measured. Logistic regressions were used to test the association between mastery and MDD in the pooled sample, as well as based on ethnicity and gender. Results: In the pooled sample, a higher sense of mastery was associated with a lower risk of MDD. This association, however, was significant for African Americans but not Caribbean Blacks. Similarly, among African American males and females, higher mastery was associated with lower risk of MDD. Such association could not be found for Caribbean Black males or females. Conclusion: Findings indicate ethnic rather than gender differences in the association between depression and mastery among Black youth. Further research is needed to understand how cultural values and life experiences may alter the link between depression and mastery among ethnically diverse Black youth. Full article
(This article belongs to the Special Issue Socioeconomic Adversity, Associated Risks, and Resilience across Neurocognitive, Emotional, and Behavioral Development)
206 KiB  
Opinion
The Role of the Orbitofrontal and Dorsolateral Prefrontal Cortices in Aesthetic Preference for Art
by Luca F. Ticini
Behav. Sci. 2017, 7(2), 31; https://doi.org/10.3390/bs7020031 - 11 May 2017
Cited by 12 | Viewed by 8206
Abstract
The search for the underlying neural activation that occurs during subjective aesthetic experiences of artwork has been enhanced through neuroimaging techniques. Recently, the dorsolateral prefrontal cortex, alongside the orbitofrontal cortex, have been implicated in aesthetic appreciation, and this is the focus of the [...] Read more.
The search for the underlying neural activation that occurs during subjective aesthetic experiences of artwork has been enhanced through neuroimaging techniques. Recently, the dorsolateral prefrontal cortex, alongside the orbitofrontal cortex, have been implicated in aesthetic appreciation, and this is the focus of the present paper. Here, the validity of this conclusion is examined through the discussion of its neuroanatomical connections and functional properties. It is proposed that the experimental evidence challenges the view that this area could hold a privileged position in a brain network involved in aesthetic preference. Full article
(This article belongs to the Special Issue Neuroscience of Art)
191 KiB  
Article
Physicians’ Religious Topic Avoidance during Clinical Interactions
by Melinda M. Villagran, Brenda L. MacArthur, Lauren E. Lee, Christy J. W. Ledford and Mollie R. Canzona
Behav. Sci. 2017, 7(2), 30; https://doi.org/10.3390/bs7020030 - 8 May 2017
Cited by 4 | Viewed by 5748
Abstract
Religious and spiritual (R/S) conversations at the end-of-life function to help patients and their families find comfort in difficult circumstances. Physicians who feel uncertain about how to discuss topics related to religious beliefs may seek to avoid R/S conversations with their patients. This [...] Read more.
Religious and spiritual (R/S) conversations at the end-of-life function to help patients and their families find comfort in difficult circumstances. Physicians who feel uncertain about how to discuss topics related to religious beliefs may seek to avoid R/S conversations with their patients. This study utilized a two-group objective structured clinical examination with a standardized patient to explore differences in physicians’ use of R/S topic avoidance tactics during a clinical interaction. Results indicated that physicians used more topic avoidance tactics in response to patients’ R/S inquiries than patients’ R/S disclosures; however, the use of topic avoidance tactics did not eliminate the need to engage in patient-initiated R/S interactions. Full article
(This article belongs to the Special Issue Family Communication at the End of Life)
1658 KiB  
Review
Universal Connection through Art: Role of Mirror Neurons in Art Production and Reception
by Bartlomiej Piechowski-Jozwiak, François Boller and Julien Bogousslavsky
Behav. Sci. 2017, 7(2), 29; https://doi.org/10.3390/bs7020029 - 5 May 2017
Cited by 13 | Viewed by 9298
Abstract
Art is defined as expression or application of human creative skill and imagination producing works to be appreciated primarily for their aesthetic value or emotional power. This definition encompasses two very important elements—the creation and reception of art—and by doing so it establishes [...] Read more.
Art is defined as expression or application of human creative skill and imagination producing works to be appreciated primarily for their aesthetic value or emotional power. This definition encompasses two very important elements—the creation and reception of art—and by doing so it establishes a link, a dialogue between the artist and spectator. From the evolutionary biological perspective, activities need to have an immediate or remote effect on the population through improving survival, gene selection, and environmental adjustment, and this includes art. It may serve as a universal means of communication bypassing time, cultural, ethnic, and social differences. The neurological mechanisms of both art production and appreciation are researched by neuroscientists and discussed both in terms of healthy brain biology and complex neuronal networking perspectives. In this paper, we describe folk art and the issue of symbolic archetypes in psychoanalytic thought as well as offer neuronal mechanisms for art by emphasizing mirror/neurons and the role they play in it. Full article
(This article belongs to the Special Issue Neuroscience of Art)
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2360 KiB  
Article
Failure to CAPTCHA Attention: Null Results from an Honesty Priming Experiment in Guatemala
by Stewart Kettle, Marco Hernandez, Michael Sanders, Oliver Hauser and Simon Ruda
Behav. Sci. 2017, 7(2), 28; https://doi.org/10.3390/bs7020028 - 28 Apr 2017
Cited by 29 | Viewed by 13490
Abstract
We report results from a large online randomised tax experiment in Guatemala. The trial involves short messages and choices presented to taxpayers as part of a CAPTCHA pop-up window immediately before they file a tax return, with the aim of priming honest declarations. [...] Read more.
We report results from a large online randomised tax experiment in Guatemala. The trial involves short messages and choices presented to taxpayers as part of a CAPTCHA pop-up window immediately before they file a tax return, with the aim of priming honest declarations. In total our sample includes 627,242 taxpayers and 3,232,430 tax declarations made over four months. Treatments include: honesty declaration; information about public goods; information about penalties for dishonesty, questions allowing a taxpayer to choose which public good they think tax money should be spent on; or questions allowing a taxpayer to state a view on the penalty for not declaring honestly. We find no impact of any of these treatments on the average amount of tax declared. We discuss potential causes for this null effect and implications for ‘online nudges’ around honesty priming. Full article
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193 KiB  
Editorial
Advances in Psychiatric Diagnosis: Past, Present, and Future
by Carol S. North and Alina M. Surís
Behav. Sci. 2017, 7(2), 27; https://doi.org/10.3390/bs7020027 - 26 Apr 2017
Cited by 8 | Viewed by 7555
Abstract
This editorial examines controversies identified by the articles in this special issue, which explore psychopathology in the broad history of the classification of selected psychiatric disorders and syndromes over time through current American criteria. Psychiatric diagnosis has a long history of scientific investigation [...] Read more.
This editorial examines controversies identified by the articles in this special issue, which explore psychopathology in the broad history of the classification of selected psychiatric disorders and syndromes over time through current American criteria. Psychiatric diagnosis has a long history of scientific investigation and application, with periods of rapid change, instability, and heated controversy associated with it. The articles in this issue examine the history of psychiatric nomenclature and explore current and future directions in psychiatric diagnosis through the various versions of accepted diagnostic criteria and accompanying research literature addressing the criteria. The articles seek to guide readers in appreciating the complexities of psychiatric diagnosis as the field of psychiatry pushes forward toward future advancements in diagnosis. Despite efforts of many scientists to advance a diagnostic classification system that incorporates neuroscience and genetics, it has been argued that it may be premature to attempt to move to a biologically-based classification system, because psychiatric disorders cannot yet be fully distinguished by any specific biological markers. For now, the symptom-based criteria that the field has been using continue to serve many essential purposes, including selection of the most effective treatment, communication about disease with colleagues, education about psychiatric illness, and support for ongoing research. Full article
(This article belongs to the Special Issue Advances in Psychiatric Diagnosis Past, Present and Future)
220 KiB  
Article
Death Cafés: Death Doulas and Family Communication
by Paula K. Baldwin
Behav. Sci. 2017, 7(2), 26; https://doi.org/10.3390/bs7020026 - 26 Apr 2017
Cited by 24 | Viewed by 10181
Abstract
The Death Café is part of the Death Positive movement, and as such, is uniquely positioned to bring the dialogue about death and dying to the public. Participants in a Death Café typically have two different perspectives. Some participants have not experienced death [...] Read more.
The Death Café is part of the Death Positive movement, and as such, is uniquely positioned to bring the dialogue about death and dying to the public. Participants in a Death Café typically have two different perspectives. Some participants have not experienced death in their family and friends’ circle and wish to converse with others about their beliefs on death and dying. Others are those who have experienced death somewhere in their circle of friends and families. One of goals of the Death Café facilitators is to help attendees reconcile their family narratives regarding death using the broader lens of the Death Café. Using the insights provided by interviews from 15 Death Café facilitators, this manuscript discusses the role of the Death Café facilitators as the death doulas of family communication. Full article
(This article belongs to the Special Issue Family Communication at the End of Life)
679 KiB  
Review
Still Searching: A Meta-Synthesis of a Good Death from the Bereaved Family Member Perspective
by Kelly E. Tenzek and Rachel Depner
Behav. Sci. 2017, 7(2), 25; https://doi.org/10.3390/bs7020025 - 25 Apr 2017
Cited by 39 | Viewed by 8771
Abstract
The concept of a good death continues to receive attention in end-of-life (EOL) scholarship. We sought to continue this line of inquiry related to a good death by conducting a meta-synthesis of published qualitative research studies that examined a good death from the [...] Read more.
The concept of a good death continues to receive attention in end-of-life (EOL) scholarship. We sought to continue this line of inquiry related to a good death by conducting a meta-synthesis of published qualitative research studies that examined a good death from the bereaved family member’s perspective. Results of the meta-synthesis included 14 articles with 368 participants. Based on analysis, we present a conceptual model called The Opportunity Model for Presence during the EOL Process. The model is framed in socio-cultural factors, and major themes include EOL process engagement with categories of healthcare participants, communication and practical issues. The second theme, (dis)continuity of care, includes categories of place of care, knowledge of family member dying and moment of death. Both of these themes lead to perceptions of either a good or bad death, which influences the bereavement process. We argue the main contribution of the model is the ability to identify moments throughout the interaction where family members can be present to the EOL process. Recommendations for healthcare participants, including patients, family members and clinical care providers are offered to improve the quality of experience throughout the EOL process and limitations of the study are discussed. Full article
(This article belongs to the Special Issue Family Communication at the End of Life)
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Article
Contradictions and Promise for End-of-Life Communication among Family and Friends: Death over Dinner Conversations
by Andrea Lambert South and Jessica Elton
Behav. Sci. 2017, 7(2), 24; https://doi.org/10.3390/bs7020024 - 20 Apr 2017
Cited by 29 | Viewed by 7440
Abstract
The free, open-access website called “Let’s Get Together and Talk about Death”, or Death over Dinner (DoD), provides resources for initiating end-of-life conversations with family and friends by taking the frightening—talking about death—and transforming it into the familiar—a conversation over dinner. This qualitative, [...] Read more.
The free, open-access website called “Let’s Get Together and Talk about Death”, or Death over Dinner (DoD), provides resources for initiating end-of-life conversations with family and friends by taking the frightening—talking about death—and transforming it into the familiar—a conversation over dinner. This qualitative, descriptive study uses grounded theory and thematic analysis to answer the following research question: How do friend and family groups communicate about death and dying in DoD conversations? To answer this question, 52 dinner groups were recruited and conversations were conducted, which consisted of a facilitator and volunteers. The facilitators were the researchers or research assistants who allowed dinner participants to control the conversation and identify topics of interest, and participants were free to share as much or as little as they wanted. Our analysis revealed that family and friend groups communicated similarly in that they talked about similar topics and used similar communication strategies to discuss those topics. Three major themes emerged: Desire for a good death, which juxtaposed people’s perceptions of a “dreaded” death with those of a “desirable” death; tactics for coping, which consisted of the subthemes of humour to diffuse tension or deflect discomfort, spiritual reassurance, and topic avoidance; and topics that elicit fear or uncertainty, which consisted of the subthemes of organ and whole-body donation, hospice and palliative care, wills and advance directives. Ultimately, however, participants felt their experiences were positive and DoD shows promise as a tool for families to engage in end-of-life conversations. Full article
(This article belongs to the Special Issue Family Communication at the End of Life)
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Article
Cognitive Remediation Therapy for Adolescents with Anorexia Nervosa—Treatment Satisfaction and the Perception of Change
by Camilla Lindvall Dahlgren and Kristin Stedal
Behav. Sci. 2017, 7(2), 23; https://doi.org/10.3390/bs7020023 - 18 Apr 2017
Cited by 11 | Viewed by 8548
Abstract
Cognitive remediation therapy (CRT) has recently been developed for children and adolescents with anorexia nervosa (AN). It focuses on decreasing rigid cognitions and behaviors, as well as increasing central coherence. Overall, CRT has been proven feasible for young individuals with AN, but little [...] Read more.
Cognitive remediation therapy (CRT) has recently been developed for children and adolescents with anorexia nervosa (AN). It focuses on decreasing rigid cognitions and behaviors, as well as increasing central coherence. Overall, CRT has been proven feasible for young individuals with AN, but little is known regarding the specifics of its feasibility, and the perception of change associated with the intervention. Consequently, the aim of the current study was to explore service users’ perspective on CRT with a specific focus on treatment delivery, treatment content, and perceived change. Twenty adolescents (age 13–18) with AN participated in a 10-session course of CRT. A 20-item treatment evaluation questionnaire was administered at the end of treatment, focusing on four aspects of the intervention: (1) general attitudes towards treatment, (2) treatment specifics, (3) the perception of change and (4) the patient-therapist relation. The main findings suggest high levels of treatment satisfaction, but somewhat limited perceptions of change. The current study is one of the most detailed accounts of adolescents’ perspective on CRT published on eating disorders, and highlights several important aspects of the treatment viewed through the eye of the receiver. Full article
(This article belongs to the Special Issue Advances in the Prevention and Management of Obesity and Eating Disorders)
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Article
Designing Effective Interactions for Concordance around End-of-Life Care Decisions: Lessons from Hospice Admission Nurses
by Carey Candrian, Channing Tate, Kirsten Broadfoot, Alexandra Tsantes, Daniel Matlock and Jean Kutner
Behav. Sci. 2017, 7(2), 22; https://doi.org/10.3390/bs7020022 - 18 Apr 2017
Cited by 10 | Viewed by 7739
Abstract
Near the end of life, hospice care reduces symptom-related distress and hospitalizations while improving caregiving outcomes. However, it takes time for a person to gain a sufficient understanding of hospice and decide to enroll. This decision is influenced by knowledge of hospice and [...] Read more.
Near the end of life, hospice care reduces symptom-related distress and hospitalizations while improving caregiving outcomes. However, it takes time for a person to gain a sufficient understanding of hospice and decide to enroll. This decision is influenced by knowledge of hospice and its services, emotion and fear, cultural and religious beliefs, and an individual’s acceptance of diagnosis. Hospice admission interactions, a key influence in shaping decisions regarding hospice care, happen particularly late in the illness trajectory and are often complex, unpredictable, and highly variable. One goal of these interactions is ensuring patients and families have accurate and clear information about hospice care to facilitate informed decisions. So inconsistent are practices across hospices in consenting patients that a 2016 report from the Office of Inspector General (OIG) entitled “Hospices should improve their election statements and certifications of terminal illness” called for complete and accurate election statements to ensure that hospice patients and their caregivers can make informed decisions and understand the costs and benefits of choosing hospice care. Whether complete and accurate information at initial admission visits improves interactions and outcomes is unknown. Our recent qualitative work investigating interactions between patients, caregivers, and hospice nurses has uncovered diverse and often diverging stakeholder-specific expectations and perceptions which if not addressed can create discordance and inhibit decision-making. This paper focuses on better understanding the communication dynamics and practices involved in hospice admission interactions in order to design more effective interactions and support the mandate from the OIG to provide hospice patients and their caregivers with accurate and complete information. This clarity is particularly important when discussing the non-curative nature of hospice care, and the choice patients make to forego aggressive treatment measures when they enroll in hospice. In a literal sense, to enroll in hospice means to bring in support for end-of-life care. It means to identify the need for expertise around symptom management at end-of-life, and agree to having a care team come and manage someone’s physical, psychosocial, and/or spiritual needs. As with all care, hospice can be stopped if it is no longer considered appropriate. To uncover the communication tensions undergirding a hospice admission interaction, we use Street’s ecological theory of patient-centered communication to analyze a case exemplar of a hospice admission interaction. This analysis reveals diverse points of struggle within hospice decision-making processes around hospice care and the need for communication techniques that promote trust and acceptance of end-of-life care. Lessons learned from talking about hospice care can inform other quality initiatives around communication and informed decision-making in the context of advance care planning, palliative care, and end-of-life care. Full article
(This article belongs to the Special Issue Family Communication at the End of Life)
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Article
How Older Adults and Their Families Perceive Family Talk about Aging-Related EOL Issues: A Dialectical Analysis
by Nichole Egbert, Jeffrey T. Child, Mei-Chen Lin, Carol Savery and Tammy Bosley
Behav. Sci. 2017, 7(2), 21; https://doi.org/10.3390/bs7020021 - 17 Apr 2017
Cited by 11 | Viewed by 6750
Abstract
For older adults, approaching end-of-life (EOL) brings unique transitions related to family relationships. Unfortunately, most families greatly underestimate the need to discuss these difficult issues. For example, parents approaching EOL issues often struggle with receiving assistance from others, avoiding family conflict, and maintaining [...] Read more.
For older adults, approaching end-of-life (EOL) brings unique transitions related to family relationships. Unfortunately, most families greatly underestimate the need to discuss these difficult issues. For example, parents approaching EOL issues often struggle with receiving assistance from others, avoiding family conflict, and maintaining their sense of personhood. In addition, discussions of EOL issues force family members to face their parents’ mortality, which can be particularly difficult for adult children to process emotionally. This study explored aging issues identified by aging parents and their families as they traverse these impending EOL changes. Ten focus groups of seniors (n = 65) were conducted. Focus groups were organized according to race (African-American/European-American), gender, and whether the older adult was living independently or in an assisted care facility. When asked open-ended questions about discussing aging and EOL issues with family members, participants revealed tensions that led us to consider Relational Dialectics Theory as a framework for analysis. The predominant tension highlighted in this report was certainty versus uncertainty, with the two sub-themes of sustained life versus sustained personhood and confronting versus avoiding EOL issues. For these data, there were more similarities than differences as a result of gender, race, or living situation than one might expect, although culture and financial status were found to be influential in the avoidance of EOL discussions. The results of this study help to provide additional insight into relational dialectics related to aging, EOL, and the importance of communication in facilitating family coping. Full article
(This article belongs to the Special Issue Family Communication at the End of Life)
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Article
Development and Validation of a Questionnaire to Assess Knowledge, Threat and Coping Appraisal, and Intention to Practice Healthy Behaviors Related to Non-Communicable Diseases in the Thai Population
by Kanittha Chamroonsawasdi, Suthat Chottanapund, Pravich Tunyasitthisundhorn, Nawaphan Phokaewsuksa, Tassanee Ruksujarit and Pawarat Phasuksathaporn
Behav. Sci. 2017, 7(2), 20; https://doi.org/10.3390/bs7020020 - 14 Apr 2017
Cited by 15 | Viewed by 8367
Abstract
Non-communicable diseases (NCDs) are important issues in Thailand and health sectors are now focusing on modifiable risks that include cognitive, affective and behavioral factors. This study aimed to develop and validate a questionnaire to assess knowledge about NCDs, threat appraisal, coping appraisal and [...] Read more.
Non-communicable diseases (NCDs) are important issues in Thailand and health sectors are now focusing on modifiable risks that include cognitive, affective and behavioral factors. This study aimed to develop and validate a questionnaire to assess knowledge about NCDs, threat appraisal, coping appraisal and intention to practice based on protection motivation theory. Content validity was determined by the mean of the item content validity index (I-CVI) from five experts. The questionnaire was pilot tested for difficulty of knowledge items and reliability test using the Kuder-Richardson (KR)-20 and Cronbach’s alpha coefficient among 30 Thai adult subjects in the health office for two sub-districts. The mean I-CVI ranged from 0.90–1.00 and difficulty of knowledge ranged from 0.3–0.9. The reliability test of knowledge by KR-20 ranged from 0.648–0.799, while Cronbach’s alpha coefficients of threat and coping appraisal and intention to practice ranged from 0.70–0.843. We compared sociodemographic data, knowledge about NCDs, threat appraisal, coping appraisal and intention to practice between 50 diabetic type 2 cases and 50 controls. T2DM cases had higher age, knowledge scores on diabetes and hypertension, threat appraisal scores on hypertension and cardiovascular disease when compared with control (p < 0.05). The questionnaire was valid and sufficiently reliable to use for data collection. Full article
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185 KiB  
Concept Paper
Palliative Care and the Family Caregiver: Trading Mutual Pretense (Empathy) for a Sustained Gaze (Compassion)
by Joy Goldsmith and Sandra L. Ragan
Behav. Sci. 2017, 7(2), 19; https://doi.org/10.3390/bs7020019 - 13 Apr 2017
Cited by 10 | Viewed by 6690
Abstract
In this conceptual piece, we survey the progress of palliative care communication and reflect back on a chapter we wrote a decade ago, which featured the communication concept of mutual pretense, first described by Glaser and Strauss (1965). This work will include an [...] Read more.
In this conceptual piece, we survey the progress of palliative care communication and reflect back on a chapter we wrote a decade ago, which featured the communication concept of mutual pretense, first described by Glaser and Strauss (1965). This work will include an update on family caregivers and their role in cancer caregiving as well as a review of current palliative care communication curriculum available for providers. And finally, we will spotlight the conversation and research going forward on the subject of health literacy for all stakeholders; patients, families, providers, and systems. We feature one family’s story of incurable cancer and end of life to revisit the needs we identified ten years ago, which are still present. Goals for going forward in chronic and terminal illness are suggested in a health care context still too void of palliative care communication resources for providers, patients, and especially family caregivers. Full article
(This article belongs to the Special Issue Family Communication at the End of Life)
190 KiB  
Article
Upstreaming and Normalizing Advance Care Planning Conversations—A Public Health Approach
by Maryjo Prince-Paul and Evelina DiFranco
Behav. Sci. 2017, 7(2), 18; https://doi.org/10.3390/bs7020018 - 12 Apr 2017
Cited by 41 | Viewed by 7941
Abstract
As a society, we simply don’t talk about this universal experience called dying and death; in fact, we ignore it until we have to face it. Thus, it is often in a crisis experience when we have to make decisions while we are [...] Read more.
As a society, we simply don’t talk about this universal experience called dying and death; in fact, we ignore it until we have to face it. Thus, it is often in a crisis experience when we have to make decisions while we are laden with uncertainty and intense emotions. Sixty percent of people say making sure their family is not burdened by tough decisions is extremely important, yet 56% of them have not held a conversation about its context. Instead of waiting to make end-of-life decisions, let us begin to think about what matters most while we are living, what we value most, and how we translate these values into conversations about what is important. As a public health concern, if we can upstream the advance care planning discussion into usual health promotion activities, perhaps, as a society, we can begin to normalize and reshape how we make decisions about the last chapters of our lives. Full article
(This article belongs to the Special Issue Family Communication at the End of Life)
191 KiB  
Article
Final Conversations: Overview and Practical Implications for Patients, Families, and Healthcare Workers
by Maureen P. Keeley and Mark A. Generous
Behav. Sci. 2017, 7(2), 17; https://doi.org/10.3390/bs7020017 - 5 Apr 2017
Cited by 21 | Viewed by 8331
Abstract
The current paper presents a summary of a 12-year body of research on final conversations, which will be useful for healthcare providers who work with patients and family nearing the end-of-life, as well as for patients and their family members. Final conversations encompass [...] Read more.
The current paper presents a summary of a 12-year body of research on final conversations, which will be useful for healthcare providers who work with patients and family nearing the end-of-life, as well as for patients and their family members. Final conversations encompass any and all conversations that occur between individuals with a terminal diagnosis and their family members (all participants are aware that their loved one is in the midst of the death journey). Final conversations take the family member’s perspective and highlights what are their memorable messages with the terminally ill loved one. In this paper the authors highlight the message themes present at the end-of-life for both adults and children, the functions each message theme serves for family members, and lastly, the communicative challenges of final conversations. Additionally, the authors discuss the current nature and future of final conversations research, with special attention paid to practical implications for healthcare providers, patients, and family members; also, scholarly challenges and future research endeavors are explored. Full article
(This article belongs to the Special Issue Family Communication at the End of Life)
188 KiB  
Essay
Death of an Ex-Spouse: Lessons in Family Communication about Disenfranchised Grief
by Jillian A. Tullis
Behav. Sci. 2017, 7(2), 16; https://doi.org/10.3390/bs7020016 - 24 Mar 2017
Cited by 7 | Viewed by 7294
Abstract
The death of a loved one is an emotional-laden experience, and while grief and mourning rituals are less formal today in many communities, there remain some social norms for individuals to process loss. The death of an ex-family member, such as a former [...] Read more.
The death of a loved one is an emotional-laden experience, and while grief and mourning rituals are less formal today in many communities, there remain some social norms for individuals to process loss. The death of an ex-family member, such as a former spouse, is more complicated and expectations for how to respond are fraught with uncertainty. While grief has been studied and is primarily understood as an individual cognitive process, scholars in sociology and communication are considering the ways in which grief and mourning are social and take place in dialogue with others. This manuscript explores Kenneth Doka’s concept of disenfranchised grief, which is “grief that is experienced when loss cannot be openly acknowledged, socially sanctioned, or publicly mourned” through the author’s experience of the death of her ex-husband. The narrative will recount how the author learned about her ex-husband’s death (via text message), and will challenge definitions of family and family communication about death and grief, particularly the communication strategies used to cope with this unique type of loss. Full article
(This article belongs to the Special Issue Family Communication at the End of Life)
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