DigitalCommons@PCOM

Comparing the Effects of Myristic Acid- and TAT-conjugated Peptides to Their Native Counterparts Targeting Intracellular Pathways Mediating Myocardial Ischemia/Reperfusion Injury and Neutrophil Superoxide Release

Lindon H. Young et al. — Fri, 07 Jul 2017 08:26:56 PDT

Two commonly used modifications of native peptides to increase peptide permeability through the cell membrane to target intracellular substrates are myristic acid conjugated peptides (MYR) and transactivating conjugated peptides (TAT). However, there is limited literature comparing the effects of these two types of modified peptides in the same bioassay. The objective of this mini-review is to compare the effects of MYR- and TAT-conjugated peptides in two bioassays: 1) Myocardial ischemiareperfusion injury (I/R) in isolated perfused rat hearts using a mitochondrial fission peptide inhibitor, P110; 2) N-Formyl-L-Methionyl-L-Leucyl-LPhenylalanine (fMLP)-induced superoxide (SO) release from isolated rat neutrophils using a nicotinamide adenine dinucleotide phosphate (NADPH) oxidase peptide assembly inhibitor, Nox2ds. MYR-conjugated P110 (1 μM) exerted sustained improvement in post-reperfused cardiac function combined with reduced infarct size compared to TAT-conjugated P110 (1 μM) or native P110 peptide (1 μM) in hearts subjected to I(30 min)/ R(90 min). Nox2ds data suggested that MYRconjugated Nox2ds peptide exerted more potent effects and better permeability through the cell membrane to attenuate fMLP-induced SO release from rat neutrophils when compared to TAT-conjugated Nox2ds peptide. However, further metabolism studies are needed to determine peptide half-life between the MYR- and TAT-conjugated peptides to corroborate the pharmacodynamics studies.

Attitudes of Physician Assistant Educators Toward Interprofessional Education and Collaborative Care

Laura A. Levy et al. — Thu, 06 Jul 2017 12:12:02 PDT

PURPOSE: Interprofessional education (IPE) has been shown to improve collaboration in the workforce, ultimately improving patient care. The purpose of this study was to evaluate physician assistant (PA) educators' attitudes toward IPE and interprofessional (IP) health care teams.

METHODS: An online survey was sent to 1198 PA educators. The survey assessed 3 domains: attitudes toward IPE, attitudes toward IP health care teams, and attitudes toward IP learning in the academic setting.

RESULTS: Most participants were involved in some form of IPE. Faculty attitudes were positive in all 3 domains but were more favorable toward IPE.

CONCLUSIONS: The positive attitudes held by PA faculty members may change the way in which curricula are conceived and delivered, influencing IP collaboration of future health care providers.

Measuring Clinically Relevant Endpoints in a Serum-Free, Three-Dimensional, Primary Cell Culture System of Human Osteoarthritic Articular Chondrocytes

Grace Bundens et al. — Thu, 06 Jul 2017 08:47:42 PDT

Osteoarthritis (OA) is characterized by degeneration of articular cartilage within the joint, inflammation and pain. The purpose of this study was to develop a primary, serum free cell culture system of human osteoarthritic articular chondrocytes (HOACs) with which to study manifestations of the disease process. Joint tissues were obtained from OA patients undergoing total knee arthroplasty (TKA). HOACs isolated from the femoral condyles and tibial plateau of the same side were combined, plated in three-dimensional, alginate beads and cultured for five days in serum, hormone and protein free medium. More living cells were obtained from the femoral condyles than the tibial plateau. The optimal plating density was 2.5 × 10(6) cells/ml of alginate. The amounts of DNA, RNA, proteoglycans and total collagen were similar in cultures prepared from the sides of least and greatest pathology. More type 1 than type 2 collagen was detected in the medium on days 2 and 5. A greater percentage of type 1 than type 2 collagen was degraded. The inflammatory cytokine interleukin-1 beta was present in the medium and alginate associated matrix. Although variation in the metabolic profiles between subjects was observed, HOACs from all patients continued to reflect the OA phenotype for five days in culture. This serum free, three-dimensional primary culture system of HOACs provides a platform with which to measure clinically relevant endpoints of OA and screen potential disease modifying OA therapeutics.

Resveratrol Enhances Polyubiquitination-Mediated ARV-7 Degradation in Prostate Cancer Cells

Sara Wilson Reece et al. — Thu, 06 Jul 2017 08:08:32 PDT

Although androgen deprivation therapy (ADT) serves as the primary treatment option for localized or metastatic prostate cancer, most cases eventually develop into castration-resistant prostate cancer (CRPC). However, androgen receptor (AR) continues to be functional in CRPC through various mechanisms, including the development of AR splicing variants, especially ARV7. Since it lacks the ligand binding domain but retains the intact DNA binding domain, ARV7 is constitutively active, which makes ARV7-positive prostate cancer responsive to neither abiraterone nor enzalutamide. In this study, we explored the effect of resveratrol on ARV7 transcriptional activity and the potential for development of resveratrol as a treatment for ARV7-positive prostate cancer. First, we ectopically expressed ARV7 in PC3 cells, an AR-negative prostate cancer cell line, and demonstrated that resveratrol is capable of inhibiting ARV7 transcriptional activity by downregulating ARV7 protein levels. Of note, resveratrol does not affect the mRNA levels of ARV7 nor its nuclear translocation. Next, we demonstrated that resveratrol is capable of downregulating the levels of the endogenously expressed ARV7 as well as AR target gene mRNAs in 22RV1 prostate cancer cells. Mechanistically, resveratrol downregulates ARV7 by enhancing ARV7 polyubiquitination and subsequent proteasome-mediated degradation. These findings suggest that resveratrol could be a potential treatment for ARV7-positive CPRC.

Therapist Knowledge, Attitudes Toward, and Experiences with Social Media Use in Treating Adolescent Females

Kristin Hess — Fri, 30 Jun 2017 06:55:30 PDT

Recent research on social media use suggest that over 90% of adolescents aged 13 to 17 years use the Internet and 73% spend time on social networking sites (Cingel, Lauricella, Wartella, & Conway, 2013). This makes it increasingly important for therapists to be aware of the current social media applications, as well as the risks and benefits that may accompany use. Although there is much literature on the possible benefits and risks to social media use, there is minimal research on how therapists use this information to treat an adolescent population effectively. The present study utilized a cross-sectional web-survey design to gain insight into current knowledge and attitudes of therapists regarding social media use in adolescent girls. The survey was completed by psychology clinicians and psychology practicum students (n = 98), and assessed therapist attitudes, knowledge, and experiences with social media. The survey addressed personal use of social media as well as use for adolescent clients. Results found that over 75% of participants reported they access social media profiles at least one time per day. A large majority of participants (96.8%) reported they have encountered clients with problems associated with social networking and 88.9% believed there is a need for interventions targeting social media addiction in adolescent girls. Results found that personal experiences with social media applications significantly predicted therapists’ overall attitude about social media for adolescents. Results also found that therapists’ social media use frequency significantly predicted therapists’ comfort in targeting social media topics in therapy. Results suggest therapists’ personal experiences may impact their use of interventions in therapy. Future research should look for other variables that impact therapists’ ability to discuss social media topics effectively in therapy and use social media interventions.

The Impact of Treatment Beliefs, Caregiver Participation, and Treatment Adherence on Treatment Outcome in Childhood Mental Illness

Alexandra Gallagher — Fri, 30 Jun 2017 06:55:22 PDT

One in five children in the United States is diagnosed with a mental health disorder; however, not all of them receive the appropriate services (NAMI, 2015). When services are accessible, lack of engagement in treatment can contribute to high dropout and to limited treatment success (Staudt, 2007). In literature on adults, one well studied factor that contributes to participation and engagement in treatment is an individual’s treatment beliefs and expectations. In the case of children, however, it is important to consider not only their treatment beliefs and expectations, but also the beliefs and expectations of their primary caregivers, because they play a large role in the children’s lives. This study expands on the research that exists regarding both caregiver and children’s treatment beliefs and expectations and the impact of these on caregiver participation, adherence, and change in children’s mental health symptoms. The present study used archival data collected from a community mental health agency to understand children and caregiver treatment beliefs about outpatient therapy. A total of 85 participants (one participant = a child and primary caregiver) were assessed at time of intake on their initial treatment beliefs and expectations, and on children’s initial mental health symptoms. They were then assessed again after 6 months of treatment for their treatment beliefs and expectations and children’s mental health symptoms. In addition, the children’s clinicians completed a rating scale to determine caregiver treatment participation and adherence. Due to a small sample size and high initial treatment beliefs and expectations from both caregiver and children, there were no significant results found in the study. Future research should use a larger sample size to elucidate the relationship between children and caregiver beliefs and expectations and treatment.

Mental Health Attitudes and Stigma among Medical Students: An Evaluation of the Student Mental Health Initiative

Jennifer Hess Kengeter — Fri, 30 Jun 2017 06:55:14 PDT

There is a plethora of literature on the formation and prevalence on mental health stigma; however, literature on anti-stigma programs is scarce. The current mixed method study evaluated an anti-stigma program for medical students that contained a peer testimony component. A total of 25 participants were included in the quantitative component of the study. Data were collected over 3 consecutive years. All participants attended the Student Mental Health Initiative (SMHI) and completed a pre- and post-survey examining stigmatizing beliefs and negative attitudes toward mental illness. The qualitative portion of the study was a focus group with two participants who examined the strengths and weaknesses of the event. Results indicated there was a significant difference in negative attitudes across mental illnesses. Results approached significance for attitude change. These results are likely due to low sample size, which lacked statistical power. Limitations and future directions are discussed.

Exploring the Relationships Between Pornography Consumption, Relationship Satisfaction, Relationship Beliefs, and Masculinity

Benjamin Ryan Barnes Jr. — Fri, 30 Jun 2017 06:55:05 PDT

Pornography is widely available and consumed in the United States and worldwide. Despite pornography’s wide spread use and expansions since the advent of the Internet, the psychosocial problems related to its use are not fully delineated. Previous studies have explored the relationship between pornography consumption and psychosocial variables such as sexual and physical violence against women, misogynistic beliefs, sexual callousness, acceptance of rape myths, and other problematic sexual beliefs and behaviors. Fewer studies have explored pornography use and its impact on relationship variables such as relationship satisfaction and beliefs about relational constructs such as intimacy, passion, and equality/independence. Furthermore, there are limited studies on how pornography consumption relates to constructs such as masculinity and body satisfaction among male users. The current study aimed to explore the relationship between these constructs, as well as further delineate pornography consumption by examining frequency, duration, method, subgenre, and perceived harm. One hundred fifty-six males were recruited from various northeastern universities and through online advertisements. Results demonstrated a significant negative relationship between pornography consumption and relationship satisfaction. Alternatively, body dissatisfaction and masculinity did not relate to pornography use or relationship satisfaction. Exploratory analysis indicated that pornography consumption was not related to perceived harm or opinions about intimacy, passion, or equality/independence. Research and clinical implications of the findings and future directions are discussed.

Stress, Coping, and Academic Self-Efficacy in First-Generation College Students

Samantha Fitz-Gerald — Fri, 30 Jun 2017 06:54:55 PDT

This qualitative research was conducted with first-generation college students who were enrolled in one of two university settings in northeastern Pennsylvania. The purpose of the study was to explore the unique stressors and coping mechanisms first-generation college students experience and how these impact their academic self-efficacy beliefs. A total of 10 participants were interviewed for the study using a demographic questionnaire, self-report stress scale, and semi-structured interview. Grounded theory of analysis provided the theoretical framework for the study, allowing the researcher to code the data to discover four emerging themes. The themes found included (a) the first-generation college students’ motivation to attend college and their positive experience in applying, (b) emotional coping as a first-generation college student, (c) difficulty adapting to college due to unrealistic expectations, and (d) the importance of a positive support system during the first year of college to cope with unique stressors.

The Attitudes, Level of Interest, and Knowledge Held by Physicians and Psychologists Toward Integrated Healthcare Practices and the Patient-Centered Medical Home Model

Mark Cassano — Fri, 30 Jun 2017 06:54:47 PDT

As the healthcare system continues to evolve, issues related to cost and access to care continue to persist. In response to this concern, integrated models of healthcare, like the Patient-Centered Medical Home (PCMH), have been developed to work toward reducing cost for both patients and providers, increasing patient access to quality care, and improving patients’ overall satisfaction with the care that they are provided. However, despite the overwhelming evidence found in the literature supporting the efficacy and benefit of these treatment models, it is unclear why more providers do not choose to practice in and support collaborative forms of healthcare provision. In order to understand how providers view and understand this approach to providing care, this study was developed to examine the current attitudes, levels of interest and knowledge that licensed practicing physicians and psychologists have toward integrated healthcare practices and the PCMH model. Participants completed an online questionnaire that was developed for this study to help illuminate a provider’s understanding and perceptions about integrated forms of care based on three primary constructs: attitudes, interest, and knowledge. Multivariate Analyses of Variance and a Pearson’s Correlation were used to analyze the data. The first independent variable had three levels that described whether the participant was a licensed and practicing psychologist, Doctor of Medicine, or Doctor of Osteopathy. The second independent variable had two levels that included the years of post-licensure experience time frames of fewer than 1 to 10 years, and more than 10 years of clinical practice in an integrated healthcare environment. The third independent variable had two levels: experience versus no experience in working or having worked in an integrated care setting. The three dependent variables were the attitudes, levels of interest and knowledge that a provider holds about integrated healthcare models. Findings suggested that psychologists held more positive attitudes, and a higher level of interest and knowledge about integrated models of healthcare than did physicians. Additionally, a provider’s amount of post-licensure experience did not significantly impact his or her rating on the dependent variables. It was also shown that a positive relationship exists between the three dependent variables. Finally, providers who had previous experience working in an integrated healthcare environment held more positive attitudes toward, more interest in, and more knowledge about integrated healthcare practices and PCMH model than those who had no prior experience.

Differences Between Trauma Experience, Perceived Stress, and Effort Testing in Patients with Psychogenic Nonepileptic Seizures and Epilepsy

Anthony Fatzinger Jr. — Fri, 30 Jun 2017 06:54:39 PDT

The present study attempted to identify predictors that would differentiate psychogenic non-epileptic seizures (PNES) from epilepsy, examine individual strength of predictors, and, in a separate analysis, examine the relationship between perceived stress and effort testing. A common experience that differentiates PNES patients from epilepsy patients is a traumatic experience, specifically childhood sexual abuse. The Adverse Childhood Experiences (ACE) scale has never been used to see if it differentiates PNES and epilepsy samples, despite its focus on abuse, neglect, and household dysfunction. The ACE was combined with other previously researched predictors. Results of the logistical regression were insignificant and the model was not able to accurately predict the two groups. A second analysis conducted through means of a point-biserial correlation failed to identify a relationship between perceived stress and performance on effort testing in a PNES sample. Both analyses were likely impacted by a lower than anticipated sample size. Future research should attempt to examine other possible predictors, such as the presence of functional somatic syndromes (fibromyalgia), substance abuse, and other measures of stress and worry.

Factors Affecting Athlete Adherence After Disqualificaiton from Competitive Sports

Aaron Myers — Fri, 30 Jun 2017 06:54:32 PDT

The purpose of the current study is to examine the relationship between athletic identity, social problem-solving ability, cognitive distortions, depression, and locus of control in predicting adherence to medical advice after athletes have been instructed to stop participating in sports for a cardiac condition. The measures included the Athletic Identity Measurement Scale (AIMS), the Social Problem-Solving Inventory, Revised, Short Form (SPSI-R:S), the Inventory of Cognitive Distortions (ICD), the Patient Health Questionnaire (PHQ-9), the Multidimensional Health Locus of Control scale, Form C (MHLC-C), an adherence measure, and demographic questionnaire. Results revealed significant findings. The internal locus of control, social problem-solving ability, and cognitive distortions predicted a significant amount of the variance, with a large effect (F(3,16) = 9.20, p = .001). The adjusted R squared is .56 meaning that 56% of the variance in adherence can be predicted from the Internal LOC, ICD total score, and SPSIR: S total scores. Future research should include a larger sample size to ensure the findings are representative of the larger population.

The Role of Cognitive Distortions in Predicting Mental Toughness in Athletes

Courtney Dougherty — Fri, 30 Jun 2017 06:54:23 PDT

Mental toughness is one of the most commonly applied concepts in sports but also one of the least understood terms used by individuals in the athletic community (Jones, Hanton, & Connaughton, 2002). Mental toughness in sports is also characterized as the ability to be more consistent and better than opponents in remaining determined, focused, and confident under pressure (Jones et al., 2007). Despite the advancements in the cognitive understanding of mental toughness, little research has focused on evaluating the basis or rationality as to why or how mentally tough athletes possess the tendency to have an unshakeable confidence and belief in their abilities in the face of uncertainty. The purpose of the current study was to examine the possibility that mental toughness is related to the presence of specific cognitive distortions (e.g., minimization, magnification, all-or-nothing thinking, comparisons to others, emotional reasoning and decision making, should statements, and, particularly, perfectionism) after accounting for the factors already known to be related to mental toughness (i.e., age, gender, total years of playing experience). Results demonstrated that magnifications and comparisons to others were significantly, negatively correlated to mental toughness. Apparently, the less frequently athletes engage in blowing bad situations out of proportion to reality and comparing themselves unfavorably to others, the more mentally tough they are likely to be. These findings lend support to the integration of cognitive-behavioral interventions aimed at reducing athletes’ engagement in these specific types of distortions in order to improve mental toughness and, potentially, athletic performance.

Mismatch of School Desks and Chairs by Ethnicity and Grade Level in Middle School

Lance M Cotton et al. — Mon, 26 Jun 2017 11:43:24 PDT

OBJECTIVE: The purpose of this study was to compare anthropometric measurements of children/adolescent (6th grade - 8th grade) and use these measurements to determine fit by ethnicity and grade level across three common classroom desks and chairs.

STUDY DESIGN: Eighty-eight Caucasian-American (CA), 65 Mexican-American (MA), and 58 African-American (AA) 6th, 7th, and 8th graders participated in the study (n = 211 students). Students were seated (shoeless) on a horizontal seating surface with an adjustable footrest to obtain 90 degrees angles at the hips, knees, and ankles. Standing height and five seated measurements were obtained using a stadiometer. Desk measurements were obtained from the most common desks used for each grade level. Six measurements (seat height, seat depth, seat slope, desk height, desk clearance, desk slope) were obtained with a tape measure and angle finder. Mismatch was operationalized apriori to determine fit of student dimensions and desks.

RESULTS: Multivariate analysis (SPSS 10.1) revealed significant differences in anthropometric dimensions at each grade level for ethnicity and gender (p < 0.05). Only one 6th grade MA male fit both seat height and depth criteria. One-way ANOVA's and Scheffe post hoc tests revealed significant differences between fit by ethnicity for chair 1 and chair 2. No students experienced knee/desk clearance problems. Only one student was able to find a desk surface that did not exceed their maximum functional elbow height.

CONCLUSIONS: AA's had longer lower extremity lengths versus their ethnic counterparts at all grade levels. Subjects did not fit chairs and desks regardless of age or ethnicity. Ethnicity played a significant role in seat height fit for two of the three chairs. These disparities may create a generation with an increased incidence of musculoskeletal problems carrying over to adulthood and the adult workplace.

The Efficacy of Participation in a Survivorship Program on Functional Abilities and Quality of Life in Cancer Survivors: A Descriptive, Retrospective Study

Phillip B. Palmer et al. — Mon, 26 Jun 2017 11:43:16 PDT

Background: Cancer survival rates are increasing and survivors are living with the negative effects of cancer and its treatments resulting in decreased quality of life (QOL).

Objective: The purpose of this study was to assess the effectiveness of participation in a survivorship program on QOL.

Design: This study was a case series.

Methods: Medical records of 8 individuals were reviewed. Data collected included type of cancer, date of diagnosis, reasons for referral, medical treatment, description of the rehabilitation program, results of the initial and final examinations, and demographic data. Outcomes included the Functional Assessment of Chronic Illness Therapy ‐ Fatigue (FACIT‐F), Numeric Rating Scales for pain and fatigue, Eastern Cooperative Oncology Group's (ECOG) Performance Status Scale, Six‐Minute Walk Test (6MWT), Timed Up and Go (TUG), and the Tinetti Performance Oriented Mobility Assessment (POMA).

Data Analysis: Only subjects who had values for initial and follow‐up tests for the outcomes were included in the analysis. Differences between the initial and follow‐up values were calculated and categorized. Change scores were compared with the minimal clinically important difference (MCID) or the minimal detectable change (MDC) reported in the literature.

Results: On 4 of the variables (Tinetti, FACIT‐F, TUG, 6MWT ‐ distance), 60% or more of the subjects improved. Two of 4 individuals had values that exceeded the MCID on the 6MWT‐D.

Conclusions: The results suggest that survivorship programs may have a positive impact on QOL. More research should be done.

Limitations: The small sample size and missing data made drawing definitive conclusions difficult.

The Ability of the Brain to Adapt to Temporal Lobe Epilepsy in the Context of Hemispheric Dominance for Language

Kathleen A. Breslin — Mon, 26 Jun 2017 09:27:02 PDT

The potential for the brain to adapt to insult or injury is demonstrated in the preservation of language functions when there is damage to the language areas (Lidzba, Staudt, Wilke, Grodd, & Krageloh-Mann, 2006). Although atypical hemispheric dominance for language is rare in the general population, rates are higher in epilepsy patients (Araujo, Schwarze, & White, 2009; Drane et al., 2012; Lidzba, Staudt, Wilke, Grodd, et al., 2006; Powell, Kemp, & Garcia-Finana, 2012; Spreer et al., 2001). Understanding this relationship and factors affecting atypicality is important for neuropsychologists in making treatment recommendations and for pre-operative planning. This study sought to understand the relationship of hemispheric dominance to the crowding hypothesis, cognitive reserve theory, and patterns on neuropsychological test data. The current literature is reviewed. Archival data from an urban hospital in southeastern Pennsylvanian was used. After accounting for inclusion and exclusion criteria, 185 participants were included in this study. Hemispheric dominance for language was not related to crowding or cognitive reserve independently. The interaction between crowding and cognitive reserve was found to be related to hemispheric dominance for language, with cognitive reserve accounting for the bulk of the effect. Nevertheless, this effect vanishes when right temporal lobe epilepsy (RTLE) versus left temporal lobe epilepsy (LTLE) patients are separated into individual samples. Hemispheric dominance was not related to discrete neuropsychological profiles. Potential explanations, implications, and limitations are discussed.

Cognitive Distortions: Predictors of Medical Adherence and Health Behaviors Among Women at Risk for Breast Cancer

Amanda Viner — Mon, 26 Jun 2017 09:26:57 PDT

This study examined the relationship between cognitive distortions and health behaviors among women at risk for breast cancer. Sixty-eight participants completed an online survey consisting of demographic information, the Inventory of Cognitive Distortions (ICD), and the Health Adherence Behavior Inventory (HABIT). Results of the study indicate that health behaviors decrease as thinking becomes more distorted. The data also suggest that various cognitive distortions predict worse adherence, including fortune telling, minimization, and magnification. These findings have implications for the role of clinical psychologists in healthcare settings, and for the utility and implementation of cognitive behavioral interventions to increase early detection and promote prevention strategies among women at risk for breast cancer.

The Effects of Online Social Networking on Social Connectedness and Friendship Quality Among Adolescents

Christine Klinkhoff — Mon, 26 Jun 2017 09:26:52 PDT

The emergence of social networking sites (SNSs) has led to marked shifts in the ways that individuals communicate, share, and acquire information. Present-day adolescents are the first generation to grow up with these technologies and are among the most frequent users (Shapiro & Margolin, 2014). Although the technological landscape continues to evolve, the impact it has on aspects of adolescent development remains poorly understood. This study examined the possible relationship between SNS use and perceptions of social connectedness and friendship quality in a sample of Canadian and American adolescents. A self-report questionnaire developed by the author was utilized to examine the ways participants use SNSs. The Social Connectedness Scale (Lee, Draper, & Lee, 2001) and a modified version of this scale were used to measure offline and online social connectedness. The Friendship Quality Scale (FQS; Bukowski, Hoza, & Boivin, 1994) and a modified version of this scale were used to measure aspects of offline and online friendship quality. The results showed a nonsignificant relationship between the amount of time adolescents spent on SNSs for both friendship quality and social connectedness. The ways that adolescents used SNSs (e.g., for communication or non-communication purposes) were also found to be nonsignificant in their relation to friendship quality and social connectedness. These results are likely due to the variability in the ways that participants spent their time online as well as the overlap between offline and online domains. The finding that using SNSs for communication purposes did not impact friendship quality or social connectedness is likely due to the changing nature of SNSs, which facilitates visually-based information sharing and can result in superficial communication. Limitations of the study and future directions are discussed.

The Influence of Patient-Practitioner Orientation on Practitioners’ Self-Perception of Adhering to a Motivational Interviewing Style of Communication in Medical Settings

Brian Ashenfelter — Mon, 26 Jun 2017 09:26:47 PDT

As of 2012, approximately 117 million adults have experienced at least one chronic illness (CDC; 2014). Healthy lifestyle choices can reduce the probability of developing particular chronic conditions, such as diabetes, heart disease, and specific forms of cancer (CDC; 2014). Individuals with chronic conditions may continue engaging in unhealthy lifestyle choices, despite having knowledge of the adverse ramifications. This includes nicotine use, dieting, and a sedentary lifestyle with limited physical activity. There are various manners in which primary care practitioners can address lifestyle choices with their patients. Motivational interviewing (MI) is a patientcentered approach, which is used to facilitate readiness to make behavioral changes. Although research has demonstrated the efficacy of MI in medical settings, it is not a commonly utilized approach by medical practitioners. The purpose of the current study was to investigate whether or not practitioner orientation (disease-centered or patientcentered) influences a practitioners’ self-perceived adherence to an MI style of communication. Participants for the study included physicians and non-physicians (nurse practitioners and physician assistants) who were practicing in a primary care setting. The findings indicate a relationship between practitioner orientation and perceived adherence to an MI style of communication. Practitioners generally endorsed a perceived MI style of communication, suggesting that practitioners in medical settings believe they are utilizing MI when addressing lifestyle choices. Additional research is warranted to determine whether or not a perceived MI style of communication translates to actual clinical practice in primary care settings.

The Effects of Coping Styles and Perceived Stress on Clinical Outcomes in Individuals with Moderate to Severe Brain Injury in a Post-Acute Rehabilitation Program

Leslie Perez — Mon, 26 Jun 2017 09:26:41 PDT

The present study investigated the effects of different coping styles used by individuals with moderate to severe brain injury on their clinical outcomes. Specifically, using self-report measures, this study evaluated the use of task-oriented, avoidance, and emotion-oriented coping and how these different styles influenced patients’ perceived stress and depression levels. In addition, task-oriented coping style has previously been deemed as a more adaptive way of dealing with life challenges. Hence, through a retrospective examination of archival records, this study also evaluated patients’ adjustment (i.e., observed mood lability and social contact), participation (i.e., observed ability to initiate tasks, interact with others, and manage life responsibilities), and executive functioning (i.e., decision-making and abstract reasoning skills) abilities to determine if individuals with a greater number of intact abilities in these areas were in fact relying more on task-oriented coping. Multiple regression analyses of the data from 32 participants revealed that the use of task-oriented coping was significantly correlated with lower levels of depression and stress. The use of task-oriented coping, however, was not predicted by more intact participation, adjustment, or executive functioning abilities. Last, it was found that adjustment and participation made significant contributions to the prediction of perceived stress.