Background: A cognitive approach to chronic illness management proposes that biased information processing distorts symptom perception and undermines recovery. Accordingly, a biased memory for health- and illness-related information may lead to negative illness cognitions, maladaptive coping and prolonged symptom suffering. Methods: Web-based study investigated autobiographic recall in CFS/ME (N = 87), Asthma (N = 56), and healthy (N = 60) participants of events when they experienced pain, fatigue, physical activity, and happiness. Participants were also assessed on illness cognitions, activity, and mood. Findings: CFS/ME and asthma participants recalled more specific memories of activity, while controls recalled more overgeneral memories. The specificity of health-related (pain, fatigue, activity) memories predicted more active coping and adaptive cognitions in illness groups. Discussion: The results indicate the importance of memory processing in relation to health- and illness-related information, suggesting overgeneral memories of health-related information may undermine people’s ability to cope in the context of a chronic condition.

Background: This study explored Eastern European immigrants’ stressful experiences regarding immigration to the UK and the coping strategies they applied to reduce such stress. Methods: Eight Eastern European (e.g., Russia, Latvia and Lithuania) participants took part in semi-structured interviews. Thematic analysis was employed in analysing the data. Findings: Four themes were identified: ‘Pre-immigration factors and life quality in the UK’, ‘Post-immigration stress’, ‘Resources for coping’ and ‘Coping strategy’. Participants were dissatisfied with their lives in the UK and experienced loneliness, depressive feelings, discriminatory behaviour of the host society, language difficulties and work-related stress. Pre-immigration factors such as reasons to immigrate, expectations and preparation contributed to the stressful experiences and the possession of resources for coping with stress. Discussions: Coming from the Post-Soviet countries, participants’ mentality differed greatly from the one in the UK. They had poor psychological preparation and high expectations of the host country, which subsequently influenced their experiences of stress and coping strategies applied.

Background: Stop-Signal Task (SST) training to improve inhibitory control can improve eating behaviour in the laboratory. However, these findings have not been replicated using externally valid measures, nor has the longevity of these effects been assessed. Methods: Seventy-one participants completed baseline, post-intervention and follow-up measures of inhibitory control, fat intake and body-mass index (BMI). Participants were randomly assigned to complete one of three SST daily for ten days: In group one participants inhibited their response to unhealthy food stimuli only, in group two participants inhibited their responses regardless of the stimuli. Group three was the control. Results: Neither fat intake nor BMI decreased post-intervention or at follow-up. Inhibitory control improved in both training conditions post-intervention (p < .01; partial eta2 = .427) but these effects were not maintained at follow-up. Discussion: It appears that SST training does not generalise to everyday eating behaviour and improvements in inhibitory control may not be long lasting. SST training may not be sufficient as a stand-alone behaviour change technique to change eating behaviour.

Background: Partners are a significant influence on health. This review aimed to determine the effectiveness of couple-based interventions in improving health relative to control conditions, and identify factors contributing to their effectiveness. Methods: A systematic review using standardised search methods identified RCTs or quasi-randomised trials for health behaviour change (HBC) in couples with at least one member at risk of chronic illness (excluding HIV), published from 1990-2014. Findings: The 19 included studies targeted cancer prevention, obesity, diet, smoking in pregnancy, mental health postpartum, breastfeeding, physical activity, and cardiovascular risk. Results suggested that adherence was better in couples than individuals, and couple-based interventions were more effective than usual care. Only one RCT demonstrated enhanced benefit for including couples relative to individuals alone, although gender differences were identified. Discussion: Couple-based interventions are at least as effective as individual interventions. RCTs comparing couple-based and individual interventions for HBC are needed to determine any added benefit of targeting the couple.

Background. In comparison to EU countries, the number of road traffic deaths in Lithuania is one of the most highest. 260 deaths occured in 2013, while 3654 persons were injured (Lithaunian Road Administration, 2014). Scientists have found that risky driving and emotions are important factors that affect the occurrence of traffic accidents (Begg 2009; Falk, 2010). However, the fear of driving has not received a lot of attention in scientific research so far (Taylor, 2002). Thus, this research aims to find links between the fear of driving and risky driving intentions. Methods. The DCQ (Taylor et al., 2007) is used to evaluate fear of driving that stems from the fear of car accidents and unexpected situations. It also evaluates a social fear of driving and is an instrument to assess expression of risky driving intentions (Parker et al., 1992). Subjects. 240 learner drivers from Lithuania. Findings. Learner drivers’ intention of speeding increases when the fear of driving that stems from the fear of car accidents increases as well. The same applies to the fear of driving that stems from unexpected situations and social driving fear. In addition, when the fear of driving that stems from the fear of car accidents increases, intentions not to maintain a safe distance and dangerous overtaking increase as well. Discussion. The research shows that fear is not a preventive measure to reduce risky driving behaviour.

Background: The study examines the impact of trauma on subjective age and on its relationship with health. Methods: Israeli veterans of the 1973 Yom Kippur War (mean age 57), including 111 ex-prisoners of war (ex-POWs) and 167 matched controls were assessed in 2008 for subjective age, war-related PTSD, and health (physical symptoms; somatization; health-risk behaviors; and self-rated health). Findings: Controlling for age, ANCOVAs showed that ex-POWs had higher subjective age than controls (F1, 275 = 24.55, p < .001) and that ex-POWs with PTSD had higher subjective age than controls and ex-POWs without PTSD (F2, 267 = 19.55, p < .001). Linear regression models using standardized variables revealed that PTSD and self-rated health (but not other health measures) predicted subjective age. Significant interactions were found between PTSD and each health measure (Bs ranged between .06, p < .05 and .12, p < .001). Health only predicts subjective age for those reporting high levels of PTSD symptoms. Discussion: PTSD symptoms appear to have implications on the links between health and subjective age in later life, pointing to the long-term effect of captivity and wartime stress on aging.

Background: As part of a WHO programme to improve child health across Europe, we conducted a study to evaluate the prevalence of exposure to adverse childhood experiences (ACE), and examine relationships between ACE exposure and harming health behaviours and health status in young adults. Methods: The sample consisted from 2088 Romanian university students, aged 18-25. ACE Survey measures emotional, physical and sexual abuse, as well as family dysfunction (e.g., an incarcerated or substance-abusing family member). Individuals were categorised according to number of ACEs experienced. Findings: Modelling identified proportions of health harming behaviours and health complains independently associated with ACEs. The odds of engaging in alcohol and drug consumption, as well sexual risk behaviors were higher as the number of ACEs increased. Increasing of exposure to ACEs has increased significantly the odds for experiencing depression, suicidal behavior, insomnia, as well as digestive symptoms, headaches, low back pain. Discussion: Considering the high prevalence of ACEs, several preventive and health promotion recommendations are presented.

Background: Until recently, smoking cessation guidelines only recommended abrupt quitting. Yet, almost half of smokers interested in quitting plan to quit gradually. This study examined predictors of gradual quitting among treatment-seeking smokers. Methods: We examined quit attempts of 28156 adult smokers who attended French cessation services nationwide in 2007-2010. Predictors of gradual quitting were determined with multivariate regression models. Findings: Only 4.4% quit gradually while 48.7% quit abruptly. Gradual quitting was associated with: older age, heavy smoking at baseline, no previous quit attempts, low self-efficacy, baseline intake of anxiolytics, symptoms of depression and history of depressive episodes. Gradual quitters had a similar anxio-depressive profile than continued smokers. Gradual quitters were twice more likely to be prescribed oral nicotine replacement therapy than abrupt quitters. Odds of gradual quitting vs. continued smoking improved with the number of follow-up visits. Discussion. Hard-to-treat smokers may be more likely to quit gradually than abruptly. However, intense follow-up with adapted treatment seems crucial to achieve cessation gradually.

Background: Excessive alcohol consumption places individuals at risk of acquiring harm from alcohol-related disease and injury (Jennison, 2004). A number of studies have reduced alcohol consumption by manipulating the neurocognitive processes underlying self-control ability and specifically, by training response inhibition (Houben, Havermans, Nederkoorn, & Jansen, 2012; Houben, Nederkoorn, Wiers, & Jansen, 2011; Jones & Field, 2013). The rationale for this approach is that response inhibition training leads to an increase in self-control strength, which allows individuals to control the urge to drink alcohol excessively and stay within moderate levels of consumption. The aim of the present study was to clarify if non-specific response inhibition training could improve response inhibition and reduce alcohol consumption. Method: Sixty first-year students were randomly assigned to one of two conditions (inhibition, disinhibition) in which they completed one stop-signal task a day, for four consecutive days. Participants in the inhibition condition completed a stop-signal task with a high target density (50% stop-signals) and were instructed to inhibit their response at the sound of a stop-signal. Participants in the disinhibition condition completed a stop-signal task with a lower target density (25% stop-signals) and were instructed to never inhibit their response. Before and after the intervention, participants completed measures of response inhibition (stop-signal task, stroop task), and alcohol consumption (timeline follow-back questionnaire). Additionally, alcohol consumption was measured after one month and all parts of the study were completed online. Findings and Discussion: Contrary to the hypotheses, the intervention had no significant effect on response inhibition or alcohol consumption. Future studies could test the effect of the intervention among a population of only binge drinkers and explore the role of factors such as intention and motivation.

Background: France has one of the highest rates of adolescent smokers in Europe. Effective predictors of smoking onset are necessary both for evaluating interventions and identifying at-risk individuals. This study examined the effectiveness of the smoking susceptibility measure (at 11yrs) in predicting having ever tried smoking 3 years later (at 14yrs), in French schoolchildren of different socio-economic status (SES). Methods: A 3-item smoking susceptibility measure was administered to 404 (235 female) French schoolchildren, along with demographic measures. Self-reported smoking behaviour was recorded 3 years later. Findings: Sex, SES, and parental smoking at 11 years did not significantly predict having ever tried smoking at 14 years, however smoking susceptibility did, b = 0.77, p < .001, such that the odds of a child whose scores designated them “susceptible” of having tried smoking 3 years later were 3.24 times higher than a child who was not susceptible. Susceptibility did not significantly interact with SES. Discussion: The smoking susceptibility measure represents an important and effective means of predicting smoking experimentation, and is robust across SES groups.

Artificial sweeteners offer a variety of health benefits compared to conventional sugar in terms of energy density, nutritive value or tooth decay prophylaxis. However, many people hesitate to consume artificially sweetened products due to their perception of potential health risks. Thus, the goal of this study was twofold: to investigate people’s health risk and benefit perceptions and to identify important predictors for avoiding or using artificial sweeteners. A mixed method design was applied. Firstly, in-depth qualitative interviews were conducted with 6 experts and 17 consumers. Secondly, a quantitative survey was conducted (N = 487, 45% male, Mage = 56). The following variables were included in the questionnaire: risk and benefit perceptions, avoidance, trust in regulators, and knowledge of the risk assessment process. Based on the survey data, a model predicting risk and benefit perceptions and avoidance was subjected to path analysis, identifying knowledge and trust as important predictors. The study offers insights into people’s risk and benefit perceptions and reasons for avoiding artificial sweeteners, despite their health benefits.

Background A multi-module mobile phone self-management system for hypertension was developed. System components were derived in interviews with patients and providers and included modules for 1) wellbeing, blood pressure (BP)/pulse, lifestyle, medication and side effect self-reports; 2) reminders/encouragements; 3) feedback of relationships between self-report variables; 4) home-based BP device. We report on evaluations of self-report variables in relation to each other and on effectiveness of the system in reducing BP. Methods 50 primary care hypertensives (m=60 yrs, 48% female) self-reported daily during 8 weeks. Patients were interviewed about their experiences during and at the end of study. Findings A mean decrease in systolic BP of 4.9mmHg was observed between the first and last week. Patients regarded the self-management system usable and felt they had gained insight into relationships of wellbeing, BP, symptoms, medication, physical activity and stress, and a feeling of control over their BP in daily life. Discussion Seeing relationships between BP and self-report variables and feeling own control over the BP may have motivated patients to follow treatment recommendations.

Background: Epilepsy is an example of a concealable stigmatised identity. Yet, little is known about the disclosure experiences of families living with epilepsy. This study sought to address this gap in epilepsy literature. This paper will focus on children’s epilepsy disclosure to others. Method: Phase one, of this two-phased mixed method study, consisted of qualitative interviews with 29 children (6-16 years) with epilepsy and 30 parents to investigate epilepsy disclosure experiences for children (self- and proxy-reported). Data were thematically analysed. Findings: Specific challenges to epilepsy disclosure for children were; 1) fear of the reactions of others; 2) feelings of differentness; 3) invisibility of the condition; and 4) difficulty to understand and explain the condition to others. Discussion: This qualitative data provides insight into factors that promote or prevent epilepsy disclosure in children; and subsequently highlight areas for appropriate psychological interventions to improve openness about epilepsy. Such openness could assist in tackling epilepsy-related stigma and consequently enhance life quality and wellbeing for children living with epilepsy.

Background: To assess changes in pain levels, self-rated health (SRH) and identity of a pain patient in adults with chronic pain from referral to implantation of a spinal cord stimulation (SCS) device to ~6 weeks following implantation. Methods: Patients with chronic pain (N=148) filled in questionnaires at referral to SCS (T1) and ~8 months later (T2; n=119), including ratings of pain and general health (SRH), acceptance of pain (indicating identification with being a pain patient), and the IPQ-R. Findings: 20% did not undergo SCS (no SCS=nSCS), 29% underwent only temporary implantation of a SCS device and discontinued ("disappointed"=dSCS), and 51% continued to permanent SCS (pSCS). Repeated measures ANOVA showed that pain levels significantly decreased in the dSCS and much more so in the pSCS but remained the same in the nSCS. SRH and pain perceptions improved only for the pSCS whereas stronger pain identity was reported only by the dSCS. Discussion: Continuous use of SCS relieves pain and leads to improved SRH yet pain still dominates these patients' lives and thoughts. Failing treatment leads to even stronger pain identity and intrusion, despite some improvement in pain level.

Background: The aim of this study was to examine exercise and relaxation in cardiac rehabilitation patients with the Theory of Planned Behaviour (Ajzen, 1991) and Temporal Self-Regulation Theory (Hall and Fong, 2007). Methods: Design: longitudinal; 6 months follow-up. Participants: cardiac rehabilitation inpatients with acute ischemic heart disease aged 65 or below. N=302, 278 (75%) males, mean age 55.61 (SD=7.31). Measures: self-report questionnaire about the variables of the theories. Three versions of TPB and two versions of TST were tested using path analyses. Findings: TPB explained 4–9% of variance in exercise and 14–15% in relaxation. TST explained 9–10% and 19–21% respectively. Model fits (exercise/relaxation): TPB complete model CFI .62/.82, RMSEA .18/.13; basic model: CFI .97/1.00, RMSEA .11/.00, third model CFI .99/.99, RMSEA .09/.05. TST original version CFI .94/.97, RMSEA .12/.09, TST modified model CFI .98/.99, RMSEA .09/.04. Discussion: The predictive powers of the models were low. TST had higher predictive power than TPB; relaxation was better predicted than exercise. The modified TST showed the best model fits. TST is a promising recent model.

Background: The purpose of the study was to investigate the relative importance of adolescent pathways to subjective satisfaction with life and happiness. Methods: Data were drawn from a 2 wave (3 year) longitudinal study of the health and development of around 2000 Romanian, nationally representative sample of adolescent and young adults. In the first wave, a series of risk behaviors and positive resources were assessed by an online questionnaire that including aspects of social support and socioeconomic status. Findings: Romanian adolescents reported average risk factors close to European averages satisfactory levels of resources and social support. Levels of subjective happiness and life satisfaction were lower compared to European averages. Discussions: Inequalities in happiness and life satisfaction were mostly related to low socio-economic situation, lack of appropriate social cohesion and presence of risk factors

Background. Burnout is usually defined as a combination of emotional exhaustion, depersonalization, and reduced personal accomplishment (RPA). Our aim was to examine the intertwining of burnout with anxiety and depression. Methods. This study included 5575 teachers. The Maslach Burnout Inventory was used to assess burnout. Depression was assessed with the 9-item depression-dedicated module of the Patient Health Questionnaire and anxiety with the 7-item Generalized Anxiety Disorder scale. Findings. Emotional exhaustion, the core of burnout, was more strongly associated with (job-unrelated) anxiety (r = .68) and depression (r = .72) than with (job-related) depersonalization (r = .53) and RPA (r = .35), all ps < .001. When combining emotional exhaustion and depression into a single scale (18 items), a Cronbach’s alpha of .91 was reached (mean between-item correlation (MBIC): .39). When combining emotional exhaustion, depersonalization, and RPA into a single scale (22 items), a Cronbach’s alpha of .72 was reached (MBIC: .11). Discussion. This study confirms the ambiguous conceptual status of burnout and questions the dimensions that have been selected to define it as a syndrome.

Background: The study aims at evaluating a proposed model of self-regulation of recovery from work. Three variables, “recovery related awareness”, “recovery motivation” and “ability to detach from work” are assumed to affect self-regulation and consequently recovery outcome. Methods: In two cross-sectional studies (n=308/383; study 1&2) the association of these recovery related variables with fatigue, exhaustion and sleep were investigated in employed individuals. In one longitudinal study (n=103; study 3), the impact of these variables on the change of well-being during a 12 hour day-shift in nurses was addressed. Data was analyzed using correlational and/or regression analyses. Findings: In study 1&2, awareness, motivation and detachment were negatively associated with prolonged fatigue and emotional exhaustion and positively with quality of sleep. In study 3, recovery motivation dampened the increase of distress and the decrease of vigor observed during the day. Discussion: The results provide first evidence for the validity of the model of recovery self-regulation from work. The model provides a theoretical underpinning for the assessment and training of recovery from work.

Background: Mindfulness based interventions have been shown to effectively reduce anxiety, depression and pain in patients with chronic physical illnesses. The aim of this study is to assess the effectiveness of an easy to access mindfulness based intervention, which aims to reduce distress for people affected by primary and secondary progressive MS. Methods: Forty participants were randomly assigned to the 8week intervention (n=19) or a waitlist control group (n=21). One-hour sessions were delivered to groups of 3-5 people using SKYPE videoconferencing. Participants completed standardized questionnaires to measure mood, impact of MS and symptom severity at baseline, post-therapy and 3 months follow-up. Findings: Health related distress scores were lower in the intervention group compared to control group at post-therapy and follow-up (p<0.05), effect size -.64 post-therapy and -.94 at follow-up. Mean scores for pain, fatigue, anxiety, depression, impact of MS were reduced for the mindfulness group compared to control group at post-therapy and follow-up; effect sizes, -.27- -.99 post-therapy and -.29 - -1.12 at follow-up. Discussion: Accessibility and feasibility of distance-delivered mindfulness interventions and the challenges of adapting a mindfulness course for people with progressive MS will be discuss.

Background: Hard-core smokers are smokers who have smoked for a considerable number of years and show little to no intention to quit. They might differ in their perceived pros and cons of smoking and quitting, which influence their intention to quit. Identifying distinct subgroups (profiles) based on these pros and cons could help to tailor information and improve approach and treatment efforts. Methods: 510 hard-core smokers completed an online survey on the perceived pros and cons of smoking and quitting. To identify possible profiles of hard-core smokers, we performed a latent profile analysis on these pros and cons. Results: We found three profiles among hard-core smokers. ‘Receptive’ hard-core smokers (36%) perceived many cons of smoking and saw many benefits of quitting. ‘Ambivalent’ hard-core smokers (59%) were rather ambiguous towards quitting. ‘Persistent’ hard-core smokers (5%) saw few pros of quitting, but many pros of smoking. Discussion: Hard-core smokers are not homogeneous in their perceived pros and cons of quitting and smoking. Results from this study may help to develop individualized tobacco-control messages for this hard-to-reach group of smokers.

Background: Comprehensive reporting of group interventions is important for comparing effectiveness, identifying ‘active ingredients’ and replicating interventions. Since group interventions are often inadequately described we developed a checklist for improving reporting. Methods: Based on a review of group-based interventions, and using pre-specified criteria, we identified elements that constitute the minimum content of a good description. Two authors independently coded 55 reports of different types of group interventions, and reliability statistics were calculated. A coding manual was developed to facilitate using the checklist. Findings: The checklist comprises 26 reporting elements related to intervention design, content, participants and facilitators. Inter-rater reliability was acceptable (91% agreement, Kappa=0.82). The frequency and quality of reporting varied considerably, and examples of comprehensive and insufficient reporting will be presented. Discussion: Our checklist can be used alongside other reporting guidelines to ensure comprehensive reporting of group-based health interventions. It can be also used to assess reporting quality.

Background: Multiple-perspective designs can aid researchers to develop a more multifaceted account of that phenomenon, and also as a form of triangulation of data. Oral anticoagulation reduces stroke risk in patients with atrial fibrillation however it is underutilized and sometimes refused by patients. Two inter-linking studies aimed to explore patients’ and physicians’ experiences of AF and OAC. Methods: Study 1: Three AF patient sub-groups were interviewed (n=11); accepted, refused, or discontinued OAC. Study 2: Four physician sub-groups (n=16) were interviewed: consultant cardiologists, general physicians, general practitioners and cardiology registrars. Data was analysed using IPA. Results: Three main themes comprised patients’ experiences: the initial consultation, life after the consultation, and patients’ reflections. Two main themes emerged from physicians’ experiences: communicating information and challenges with OAC prescription for AF. Discussion: By engaging in an ‘intra-study’ triangulation and at the same time, an ‘inter-study’ triangulation, a more thorough understanding of patients’ and physicians’ experiences of AF and OAC therapy was obtained

Background: According to health behavior models, significant others determine behavior, e.g. by providing norms. Especially adolescents tend to conform to peers (social contagion effect). Multilevel analysis can assess the impact of a health behavior’s prevalence of a group on the individual behavior. The purpose of this study is to determine the influence of proportions of problematic alcohol users per country on individual alcohol use. Methods: Self-reported data from 47.790 12 to 16 year olds from 25 European countries was analyzed within a two-level logistic regression. Findings: An individual’s chance to be a problematic alcohol user instead of not is higher if the prevalence rate of problematic alcohol use in a country increases (OR=1.08, p<.001). Thus, in countries like Germany where the proportion of problematic users is high (21%) a student has a higher chance to be a problematic user regardless of any other risk or protective factors than in countries with lower proportions (France, 6.6%). Discussion: In addition to specific risk/protective factors, preventive efforts targeting individual alcohol use should respect the drinking norms within the respective social context.

Background: Chronic pain is a major healthcare issue. As a multifactorial issue, chronic pain includes four key components, namely sensory, cognitive, behavioural and emotional aspects. Considering the use of EMDR (Eye Movement Desensitization and Reprocessing) therapy is an innovative approach in chronic pain management, the main focus of this research was to compare the use of EMDR therapy versus eclectic healthcare in a hospital unit specialized in the management of chronic pain. Methods: Forty-five patients divided into three groups were treated by standard protocol of EMDR therapy, pain protocol of EMDR therapy and eclectic therapy. Findings: Results show the effectiveness of EMDR therapy on sensory, cognitive, behavioural and emotional but also traumatic components of pain. Discussion: EMDR standard protocol being most efficient after five sessions, and a reduction of pain extending one month after therapy has been discontinued. While painkillers have been proven effective in treating acute pain, their long-term use has negative side-effects. But psychotherapeutic schemes like EMDR therapy can improved quality of life of chronic pain patients.

Quality of life (QoL) deceases in very old age & is related to negative health outcomes and mortality. Little is understood of the predictors of QoL change. This study investigated the correlates of QoL change in nonagenarians using a longitudinal cohort design. Participants (n=129, 39% male) were members of the Lothian Birth Cohort 1921. All completed assessments at approx age 79 & 90. Measures included QoL (WHOQOL-BREF), current anxiety & depression, objective health & functional status, self-rated health, sociodemographics & personality. QoL decreased significantly over time for the physical, psychological & environment domains & two general QoL items. Decline in psychological QoL was significantly associated (all p<.001) with decline in grip strength (r=.357) & Townsend functional ability (.270) & lower current self-rated health (.243), and decline in physical QoL with decline in functional ability (r=-.424) and increased depression (.419). There were no significant associations with baseline personality, disease history or living alone. The findings suggest that declining functional ability, mood & QoL are correlated in the 9th decade, implying potential intervention targets.

Background: Fatigue after myocardial infarction has been described as an unpleasant and incomprehensible symptom that is difficult to cope with because it is unpredictable and not related to effort. The aim of the present study was to identify how post-myocardial infarction fatigue is related to stress, coping strategies and sleep quality. Methods: The sample consisted of 140 persons who, two months earlier, had been treated for myocardial infarction at a coronary care unit. They completed questionnaires with items on fatigue, perceived stress, copings strategies, and sleep quality. Findings: Fatigue was correlated with stress, sleep quality and coping strategies. Further, stress was the strongest predictor (p<0.001) of post-myocardial infarction fatigue after two months. Moreover, reevaluation (p<0.01), isolation (p<0.05), and minimization (p<0.05) of coping strategies were predictors associated with fatigue. Discussion: Ordinary heart disease rehabilitation programmes include advice about diet, smoking, physical activity and emotions. Thus, for all those who are limited in their daily activities by fatigue, standard care does not provide adequate support.

Background Being family caregiver poses risks for physical, mental and social health. The health capability paradigm (Ruger, 2010) explores the capacity to achieve one’s optimal health. Family caregivers’ health capability partly consists of 8 dimensions: physical and psychological functioning, lifestyle value, self-efficacy, family support, social capital, socio-economic conditions and access to health services. Which relations exist between these dimensions, and which ones contribute the most to health capability? Methods Home-based structured interviews were led among 62 family caregivers living in Luxembourg 2 years after their relatives’ stroke. Twenty items measured the 8 dimensions of health capability. Using a Bayesian approach, a structural equation modelling was applied. Findings Socio-economic conditions were positively correlated with all the other dimensions. Family caregivers’ fatigue and feeling abandoned by their families impeded their health capability the most. Discussion Enhancing family caregivers’ well-being involves finding interventions relieving them physically and fostering family networking around the ill, giving priority to the socially disadvantaged.

Background: Cervical cancer is a considerable public-health problem. A broad range of perceived barriers is related to cervical cancer screening (CCS; Tanner-Smith & Brown, 2010). It is important to conduct a summary of research on individual perceived barriers related to CCS uptake. Methods: The systematic literature review using the Cochrane Group methodology was conducted (Higgins i Green 2008). The following key words was used: cervical cancer, screening, pap, barriers, pros, cons, decisional balance and the combinations and consequently searched articles published in scientific journals between 1979 and 2011. Findings: Use the TREND criteria (Kmet, Lee i Cook, 2004) 6 systematic reviews, 7 experimental design studies, 52 cross-sectional and 2 longitudinal design studies were found. It was identified 54 different kind of barriers related to CCS uptake. Discussion: Most studies did not examine the role of age as a moderator for the content barriers. The cultural and ethnic differences should be investigated more as well.

Background: Patient rated health status may be a useful risk stratification tool to effectively target secondary prevention behavioural programmes to patients with coronary heart disease (CHD). Methods: We examined the relationship between baseline patient rated health status (SF-12) and health outcomes (mortality (n 748); hospital admissions (n 588)) at 6 year follow up among primary care patients with CHD, using multivariate analysis and controlling for confounding variables. At 6 years, outcome data were collected from practice records and postal questionnaire. Findings: At follow-up, the odds ratio (OR) for a one point improvement in baseline SF-12 mental component score for mortality was 0.97 (95% CI 0.95-0.99; p 0.03) and for hospital admissions was 0.98 (95% CI 0.96-0.99; p 0.04). The OR for a one point improvement in the SF-12 physical component score for mortality was 0.97 (95% CI 0.95-0.99; p 0.04); for hospital admissions the OR was 0.99 (95% CI 0.98-1.01; p 0.06).Discussion: SF-12 scores independently predicted significant health outcomes at 6 years and may help in targeting secondary prevention interventions effectively.

Background: Parents caring for children with disabilities have poorer physical health. As yet however, the role of mastery and self-esteem as determinants of physical health in these caring parents has not been really tested. Methods: 108 parents of children with disabilities and a control sample of 58 parents of normally developing children completed validated measures of physical health, self-esteem and mastery. Findings: Parent of children with disabilities had poorer physical health, lower self-esteem and mastery. Moreover, both self-esteem and mastery were significant predictors of physical health with the model predicting 25% of the variance. Discussion: findings from this study emphasise the protective role of self-esteem and mastery for physical health in parents of children with disabilities. When designing supports and intervention protocols for families with children with disabilities methods of increasing these factors in parents should be included.

Background: Pasos Adelante is a theory-based chronic disease preventive intervention integrating walking groups (to promote social support and activity) as well as nutrition and physical activity education delivered by community health workers. While prior work has shown significant improvements in health outcomes (e.g., BMI, blood pressure, lipids; Staten et al., 2012; depression, quality of life; Cutshaw et al, 2012) and health behaviors (Carvajal et al., 2013), it is not known which psychosocial and behavioral factors are most responsible for participants’ improved outcomes. METHODS: Questionnaires (e.g., psychosocial factors, diet, IPAQ-physical activity), anthropometric measures and laboratory tests were collected three times over 6 months on 221 adults. FINDINGS: Cross-lagged SEM models showed earlier levels of activity and social support (p < .05) preceded improved BMI. DISCUSSION: Improved activity more so than nutrition appears to be the most critical behavioral factor linked to improved outcomes in this evidence-based intervention. Further, increased social support is an important mechanism contributing to participants’ well-being at 6 months and perhaps longer.

Background: Building on Honneth’s “Theory of recognition”, we identified strong associations between lack of recognition in the work place and several health indicators. In this study we tested the hypothesis that these associations vary as a function of job uncertainty level which we suppose to modify the recognition processes. Methods: Longitudinal and cross-sectional data from BELSTRESS III study (N=2876) were analyzed by way of logistic regressions. 4 recognition dimensions (social esteem, rights, existential recognition from colleagues, and supervisors) were included as factors. Absenteeism, presenteeism, SPH, back pain and depression were included as outcomes. Stratifications for job insecurity and globalization were applied. Findings: All 4 recognition dimensions were strongly associated with all health indicators (ORs between 1.21 and 3.93) but, contrary to our hypothesis, no variation in associations’ strength was observed for stratified data. Discussion: More research is needed for better grasp the specificities of the link between recognition in the workplace and health when these dynamics are embedded within the novel work forms in the post-taylorist labor market.

Medical advances contribute to raise life expectancy of people living with HIV/AIDS (PLWHA) and quality of life (QoL) became a priority. However, PLWHA still face challenges related to the disease, having to adjust to different situations and adapt their goals. Tenacious Goal Pursuit (TGP) means the pursuit of goals with determination. Flexible Goal Adjustment (FGA), on the other hand, means seeking them with flexibility, disengaging if necessary. Illness perceptions (IP) are the beliefs and cognitions people have of a disease. This study aims to measure the effects of TGP, FGA and IP in the QoL of PLWHA. Data was collected from 140 French HIV positive patients. It was used the WHOQOL-HIV Bref, the Brief-IPQ and the FGA and TGP Scales. Results showed a correlation between FGA, IP and General QoL. Hierarchical multiple regression analysis indicates that the effects of FGA on the General QoL became non significant when IP is included. A Sobel test confirms that the effects of FGA in QoL is fully mediated by IP. PLWHA have to adjust in a daily basis, for that reason, FGA seems important to improve QoL. Goal oriented interventions should focus in the HIV/AIDS perception of PLWHA.

Background: Action planning (AP) was shown to foster exercise habit formation (de Bruijn et al, 2011). However, coping planning (CP) may be more directly involved in this process given its critical focus on relapse prevention during maintenance (Prochaska et al, 2009). Methods: S1- 309 undergraduates were surveyed once on exercise habit, frequency, motivation, intention, self-regulatory tensions, AP and CP. S2- 531 runners completed those measures twice over 2 months. AP&CP were measured retrospectively at T2. S3- 208 adults in the action stage, randomized to AP only, AP&CP or control conditions, completed similar measures twice over 2 months. Findings: In studies 1&2, CP supplanted AP as a predictor of habit after controlling for all variables. In study 3, experimental effects on habit were observable only among low-habit participants of the AP&CP condition. Discussion: CP appears more typical of habitual exercisers than AP, and seems instrumental in achieving habit once the behaviour is successfully initiated. Individuals should therefore resort to CP to address relapses on the long term only after having steadily adopted a viable routine with AP to get around initial obstacles.

Background: It is unclear as to whether online mindfulness or progressive muscular relaxation (PMR) or a combination of both result in the best outcomes for people with chronic headache (Tension, Migraine & Cluster Headaches) Method: An online study which randomised people to one of three treatment groups; PMR, Mindfulness or combined PMR & Mindfulness (approximately 30 in each group). Groups were compared pre- post across 6 weeks of treatment & at one month follow-up across a number of pain, QOL & mental health measures. Findings: Both mindfulness and combined mindfulness with PMR performed significantly better than PMR alone. This effect was repeated across pain interference, medication usage, perceived illness threat and levels of pain catastrophisation. PMR alone was more successful at lowering levels of anxiety than Mindfulness or the combined treatment. Discussion: These initial results suggest that mindfulness alone might be a parsimonious intervention to help chronic headache sufferers to improve their level of pain interference, illness threat, catastrophisation and levels of medication usage. Replications of this study are now needed.

Background: People with high trait self-control (TSC) are not only more successful but also happier: how does regulatory focus (promotion vs. prevention) explain this relationship? Responding to this unexplored research question, the current study examines the relationship between self-control, regulatory focus, and happiness. Methods: 545 participants completed questionnaires on TSC, regulatory focus, and happiness. Findings: Mediation analyses using bootstrapping revealed that TSC positively predicts happiness and significant mediation effects for both promotion and prevention focus were found. TSC was positively associated with promotion focus, which in turn was positively associated with happiness. Contrastingly, TSC was negatively associated with prevention focus, which in turn was negatively associated with happiness. Discussion: Greater TSC leads to happiness as regulatory focus mediates this relationship. People with higher TSC are happier possibly because they are more concerned with potential positive outcomes. Counterintuitive to the traditional conceptualization that TSC involves more vigilance in line with a prevention focus, novel findings in this study posit that more TSC leads to greater happiness through a lower prevention focus. Findings have relevant implications for topical scientific debates about the underlying mechanisms of self-control.

Background Cardiovascular disease (CVD) screening occurs in primary care settings in the UK. People with psoriasis may particularly benefit from screening because unhealthy lifestyle behaviours in this group are high. This study explored psoriasis patients’ experiences of discussing CVD risk with primary care practitioners. Method Semi-structured interviews explored views and experiences of 29 people with psoriasis who had taken part in an audio-recorded CVD risk assessment. ‘Tape-assisted-recall’ informed questioning and data were analysed using Framework Analysis principles. Findings Patients reported: 1) learning little new or personally meaningful knowledge and understanding about CVD risk; 2) strong emotional reactions to risk discussions; and 3) minimal risk discussion with practitioners during consultations. Conclusions Risk discussions with people with psoriasis during CVD screening may be limited because practitioners do not assess patients’ pre-existing understanding of risk, address associated emotional reactions, or tailor discussions to patients’ concerns. Facilitating practitioners to address these issues could improve effectiveness of such screenings.

Background: According to WHO (2003), infants should be exclusively breastfed for the first six months of life to achieve optimal health. Still, many mothers opt for formula-feeding and early introduction of solid foods. Understanding mother’s views on the factors that facilitate or hinder breastfeeding becomes crucial for intervention planning. Methods: We gathered mothers’ opinions from 24 online discussion forums (17196 messages). Thematic analysis was used to categorize messages into themes. Findings: Maternal factors that would impede breastfeeding were: misinformation regarding lactation, poor latching on to the breast, low breastfeeding self-efficacy, and (mis)interpretation of baby crying as hunger cue. Mothers voiced their anxieties regarding the insufficient milk flow in direct relationship with baby’s slow weight gain or breast refusal. However, correct information regarding proper latching, avoiding mixed feeding or tight feeding schedules, were key ingredients for success. Discussion: Based on these insights, educational interventions should focus on providing technical information regarding lactation and breastfeeding as well as increasing maternal self-efficacy.

Background: To test the effects of an online-tailored step advice, based on the Theory of Planned Behavior and the Transtheoretical Model, in adults. Methods: A cluster-randomized controlled trial was conducted among 274 participants recruited from eight Flemish workplaces. Intervention participants received an Internet link to request the online-tailored step advice. Self-reported (IPAQ) and pedometer-based physical activity (PA) were assessed at baseline (T0), and one (T1) and three (T2) months post baseline. Repeated measures ANCOVA’s were used to examine intervention effects for both the total sample and the sample at risk. Findings: Between T0 and T1, significant intervention effects were found for step counts in the total sample (p = .004), and the at-risk sample (p = .001), and for time spent walking in the at-risk sample (p = .02). Between T0 and T2, intervention effects were still significant for step counts in the total sample (p = .03) and the at-risk sample (p = .02); however, self-reported PA differences were no longer significant. Discussion: The online-tailored step advice has the potential to enhance daily step counts, as well as time spent walking in adults.

Diarrhoea, a leading cause of death in children under the age of five years, is best prevented by handwashing (HW). Standard education compared to theory-based approaches are rarely effective to promote HW, and their change mechanisms are often unknown. We therefore aimed to test the change mechanisms of two HW interventions based on social cognitive theory (SCT), extended by forgetting. The two interventions, a public commitment and an infrastructure promotion, were combined with education and compared to education only in a nonrandomized trial in Ethiopia. Data were collected before and after the interventions by interviewing 408 randomly selected households’ primary caregivers. Mediation analyses were conducted. In comparison to the education intervention, the SCT interventions were more successful in changing handwashing, because they successfully changed SCT-factors and forgetting (total indirect effects [CI]: 0.08 [0.01, 0.14] to 0.14 [0.07, 0.21]). The study emphasizes not only the relevance of SCT in informing health interventions, but also highlights the importance of forgetting. The results confirmed the relevance of testing interventions’ underlying change processes.

Background: Bullying behaviors have a high prevalence in schools worldwide. The short and long term consequences vary from high levels of delinquency, antisocial behaviors, low school achievement to emotional problems for bullies. For perpetration victims, the negative effects vary from somatic complaints, low school achievement and high school drop-out rates to emotional problems. The mechanisms accounting for the high rates of emotional problems in children involved in bullying behaviors are still to be identified. Methods: By using a longitudinal approach, the present study aims to explore one possible mechanism involved in this relationship for school aged children: the use of dysfunctional cognitive emotion regulation strategies (N=154, age range 11-15 years old). The instruments used: Olweus Bullying Questionnaire, Cognitive Emotion Regulation Strategies, Youth Self Report. The measures were made at a 6 months’ time interval. Findings: By controlling for initial emotional problems, the use of dysfunctional emotion regulation strategies (e.g. catastrophizing) partially mediated the relationship between bullying victimization (T1) and emotional problems (T3). Discussion: Several recommendations for future research, as well intervention strategies are presented. mechanism involved in this relationship for school aged children: the use of dysfunctional cognitive emotion regulation strategies (N=154). Findings: By controlling for initial emotional problems, the use of dysfunctional emotion regulation strategies (e.g. catastrophizing) partially mediated the relationship between bullying victimization (T1) and emotional problems (T3). Discussion: Several recommendations for future research, as well intervention strategies are presented.

Background Researchers have stalked an elusive bear, a modifiable connection between negative emotion and morbidity and mortality. What is initially thought to be a bear in the woods (modifiable risk factor) turns out to be mere scat (uninformative risk marker). Discoveries are proclaimed, only to prove eventually false. Method. Narrative review of succession of variables deemed risk factors that went into decline, replaced by others. Results. Negative affect has been related to numerous morbidities and mortality. Discoveries often fail independent replication. Most candidates are statistically indistinguishable. Initial enthusiasm is due to artificial distinctions; capitalization on chance; flexibility in analysis and interpretation of data; and significance chasing. Conclusions. Each new false discovery scrambles research and clinical priorities and squanders resources. Future false alarms can be avoided with greater appreciation of the historical record. Preventive measures include recognizing false distinctions among concepts and appreciating the role of residual confounding and the inadequacy of statistical control for resolving causal issues in observational studies.

Background: Growing old in precarious times, defined by work and pension insecurity, makes it difficult to see aging as positive. The study explores positive meanings of old age from the perspectives of middle-aged persons and health professionals. Methods: Episodic interviews were conducted with middle-aged persons with secure (N=10) and insecure (N=10) pension plans and 7 expert interviews with professionals. Thematic coding was used for analyzing the data. Findings: Participants find it difficult to identify positive meanings for old age and tend to value staying young. Middle-aged consider wisdom a source of positive meaning in old age, whereas professionals promote social engagement and productivity. While professionals value personal responsibility for positive aging, precarious individuals believe it depends on luck. Secure individuals consider productivity and generativity attribute positive meaning to aging. Discussion: The positive meanings that professionals promote for old age may not be suitable for precarious individuals creating the risk for social inequalities in old age. The challenge for health psychology is to find new positive meanings for aging.

Background: Commercial paediatric weight management apps are deficient in theory and behaviour change techniques (BCTs) and have ignored parent’s role in children’s weight related behaviours. Aim: Select appropriate BCTs for a paediatric weight management app targeting parents Methods: The Behaviour Change Wheel(BCW): A Guide to Designing behaviour change Interventions, guided consultations with experts, and focus groups with case workers and parents of overweight children. Focus groups were audio-recorded and transcribed to facilitate thematic coding of statements using the COM-B model. A literature review and the taxonomy of BCTs provided effective BCTs which were refined in interactive sessions with parents in regards to engagement and acceptability. Findings: Results indicated the need for balancing BCTs (e.g. goal setting, information on health consequences) with user engagement techniques (e.g. gamification, customisation, novelty) in the context of a digital environment. Discussion: This study demonstrates broader considerations health psychologists must consider in applying systematic approaches to developing effective mHealth interventions.

Background: This systematic review tested the associations between meaning in life and health indicators. Methods: Using systematic review methodology we identified 49 studies testing associations between meaning and indicators of objectively and subjectively measured health (including perceived general health measures, symptoms frequency and intensity, health and risk behavior and mortality). Original trials included data from a total of 43 078 participants, including 39 939 healthy respondents and 3 139 participants with a diagnosed illness (1963 with cancer). Results: Following positive associations between finding or searching for meaning and health were found: 37/40 for perceived general health indices, 9/10 for risk or health behavior, 2/2 for mortality, 3/3 for symptoms. Discussion: Across populations, higher levels of meaning in life are related to better health measured with subjective and objective indicators.

Psychological capital is one of Positive Organizational Behaviors (POB) that argued affected job performance, however the empirical evidences are still less if comparing with others POB investigated. This study was aimed to find empirical evidence from psychological capital role as a mediator between manager leadership style named transformational leadership and adaptive selling of insurance agents. Data were collected from 205 “door to door” insurance agents and accounted by using correlation and regression techniques. The result showed that psychological capital was proved as a full mediator between transformational leadership style of managers and adaptive selling of insurance agents. The finding suggest that psychological capital is more powerful in influencing adaptive selling than transformational leadership style. Consequently, personality variable such as psychological capital need to be noticed not just in selection process but also in developing skill for insurance agent better performance.

Background: Coronary artery bypass graft (CABG) surgery is considered the optimal revascularization strategy for patients with complex coronary artery disease (CAD), whereas in patients with less severe CAD percutaneous coronary intervention (PCI) is recommended. As a more invasive procedure may be associated with increased psychopharmaca use, we compared antidepressant and anxiolytic use between CABG and PCI patients. Methods: Patients treated with CABG or PCI between 1999 and 2012 were identified from the Danish Heart Registry. Psychopharmaca use was determined by claimed prescriptions up to 12 months. Results: We identified 62.912 patients: 10.347 CABG and 52.565 PCI patients. After propensity-score matching, antidepressant use was significantly higher in CABG patients at 6 and 12 months, although no difference was found on anxiolytic use. Absolute risk differences (ARD’s) ranged between 1.0-1.8% and risk ratios (RR’s) between 1.1 - 1.2. Conclusion: CABG patients were more often than PCI patients prescribed antidepressants. Given the small ARD’s and RR’s, these differences did not seem clinically relevant, possibly reflecting comparable underlying psychological distress levels.

Background: More needs to be understood regarding the extent to which risk of bias exists and how this may affect intervention effects reported in reviews of health behaviour interventions. This paper examines risk of bias in HIV medication adherence (MA) intervention trials. Methods: Databases were systematically searched for RCTs published between 1996 and 2012. Data was abstracted for study characteristics, quality of study methodology to assess risk of bias, and intervention effect estimates for adherence and viral load. A meta-analysis was conducted to assess the relationship between these variables. Results: 80 RCTs were obtained and coded. There was substantial risk of bias due to use of subjective behavioural measures, and inadequate and inaccurate reporting of random sequence generation, allocation concealment, and the intent-to-treat analysis. Risk of bias did not impact intervention effect estimates for HIV viral load, but did influence effect sizes for adherence behaviours. Conclusions: Improving the design of HIV MA trials and the comprehensiveness of trial design reports is needed to improve the quality of the evidence in MA trials.

Background: The objective of the study was (1) to compare patients diagnosed with Chronic Fatigue Syndrome (CFS) to a (gender and age) matched sample of people suffering from prolonged fatigue (PF) with respect to fatigue severity, somatic complaints, psychological distress, physical functioning and use of health care resources, and (2) to examine to what extent cognitive, behavioral and social factors contributed to fatigue severity and physical functioning in each group. Methods: Sample size was 192 for each group (mean age = 40; 88% were female). Data were collected with self-report questionnaires; the study was a case-control cross-sectional study. Findings: The two groups differed from each other on each of the dimensions except psychological distress. For both groups, illness perceptions were the strongest determinants of fatigue and physical functioning. Activity avoidance contributed to fatigue severity in PF, whereas all-or-nothing behaviour contributed to fatigue severity in CFS. Adequate social support was associated with less fatigue in CFS only. Activity avoidance was associated with worse physical functioning in both groups. Discussion: Our findings suggest that activity avoidance leads to the development of chronic fatigue and ultimately CFS, whereas all-or-nothing behaviour maintains CFS.

Background: The World Health Organization recommend that for optimal growth and development all infants worldwide should be exclusively breastfed for the first six months of life. Previous studies have identified that psychosocial factors are important for the maintenance of exclusive breastfeeding. This study aimed to examine the psychosocial factors associated with exclusive breastfeeding duration to six months postpartum. Method: 125 women completed questionnaires at three time points; 32 weeks gestation, two and six months postpartum. Self-efficacy, body attitude, psychological adjustment, attitude, intention, confidence, motivation and importance of exclusive breastfeeding and breastfeeding status were measured. Findings: At 32 weeks gestation a woman’s confidence to achieve exclusive breastfeeding was a predictor of exclusive breastfeeding to six months postpartum. At two months postpartum, psychological adjustment and self-efficacy were predictive of exclusive breastfeeding duration. At six months postpartum, psychological adjustment, self-efficacy, confidence to maintain and feeling fat were predictive of exclusive breastfeeding duration. Conclusion: Self-efficacy, psychological adjustment, body image, motivation and confidence are important for the maintenance of exclusive breastfeeding to six months. This has clinical application for health psychology as antenatal breastfeeding education and postpartum support may be strengthened by strategies that build a woman’s confidence to exclusively breastfeed.

Background: South Africa is experiencing an epidemic of gender-based violence (GBV), rendering women and girls vulnerable. In some communities health workers have positioned themselves at the forefront of addressing GBV. We frame the visual participatory work of a group of female community health workers as ‘cultural production’ (Bourdieu & Jackson, 1993) - shifting the subordination of women and girls and disrupting automatic transmission of cultural form across generations. We pose the question: How can community health workers create a space for social transformation in addressing GBV in a rural community? Method: This qualitative participatory study is positioned as critical research. Five female community health workers were conveniently selected from a clinic a rural district. We used photovoice and production of media posters to generate data. We offer a close reading of the visual data. Findings: Three themes: community health workers with insider cultural knowledge; community health workers as cultural producers; community health workers taking action. Discussion: Implications for health psychology in places where health issues are related to cultural reproduction.

Purpose of this research was to gain insight in the effectiveness of Benzies & Batchies (B&B), a school-based program aimed at prevention of sexual harassment behavior (SHB) at Dutch schools for preparatory secondary vocational education (girls and boys; 12-16 years). B&B consisted of a peer-performed theatre play followed by a group discussion and a training aimed at skills and resilience based on the prototype willingness model. Cluster randomized control trial (EG = 14 schools/431 students; CG = 11 schools/384 students); baseline (T0), post-test (T1), 6 month follow-up (T2)). Students filled out questionnaires on SHB and behavioral determinants. Multilevel analysis were conducted. Significant effect on social norm at T1 and T2 in the EG with regard to rejecting SHB (?=.26 en ?=.28; p<.05 resp.); significant effect on self-efficacy in succeeding to reject SHB and less intention to commit SHB at T1 (?=.23; p<.05 and ?=.29; p<.01 resp.). At T2 students in the EG showed a significantly higher sexual self-esteem (?=.34; p<.001). No significant effects on behavior at T2. Students and teachers appreciated the program. Further promotion and implementation of B&B is recommended.

Background: We tested two computer tailored lifestyle programs, one inviting people to change unhealthy behavior one at a time (sequentially), and the other inviting people to change all unhealthy behaviors (simultaneously). We compared the results with those from a comparison group receiving only lifestyle feedback. Methods: In a 2-year RCT, all respondents (N=5055) received feedback about their compliance with the guidelines for physical activity, vegetable and fruit consumption, alcohol intake and smoking. The experimental groups also received motivational feedback–based on the I-Change Model to change during via 4 steps. Mixed model, cost-effectiveness and cost-utility analyses were performed. Findings: After 1 year, the sequential condition was most effective (ES=0.28). After 2 years, the simultaneous condition was most effective (ES=0.18). Both interventions were cost-effective for changing lifestyles. Discussion: Nation-wide implementation of both interventions is recommended given their effectiveness and cost-effectiveness. A combination of both tailoring strategies may be most suitable for multiple behavior change.

Background: Food marketing is ubiquitous in the current food environment and young people’s exposure to snack and soft drink advertising may increase consumption. We test if awareness of persuasive intent and use of self-regulation strategies attenuate the impact of advertising. Methods: Children and adolescents (N = 2,764 Mean age = 13.2; 49.1% girls) from The Netherlands, Poland, Portugal and the United Kingdom completed self-reports of snack and soft drink consumption, exposure to snack and soft drink advertising, awareness of persuasive intent of advertising, and eating-related self-regulation. Findings: Participants on average consumed two snacks and two glasses of soft drink per day. Snack and soft drink consumption was higher among those more exposed to advertising. Awareness of persuasive intent moderated the association between exposure to advertising and consumption, as did eating-related self-regulation. Discussion: Young people’s exposure to snack and soft drink advertising may affect consumption, but the effect size of this association was found to be small. The impact of advertising can be attenuated by awareness of its intent and use of self-regulation strategies.

Background: ‘In the heat of the moment’ and ‘keeping a cool head’ are common sayings that suggest a direct effect of temperature on risk behavior. We aim to show that higher temperatures, compared to lower temperatures, generally result in riskier behavior. Methods: In four studies, we tested the effect of temperature on sexual risk decisions and eating behavior, and found support for the predicted relation. We manipulated temperature by giving participants a warm or cold drink (Experiment 1), by manipulating room temperature (Experiments 2 and 4), or by using warm or cold packs (Experiment 3). Findings: Higher temperatures, compared to lower temperatures, resulted in riskier sexual decisions and higher food intake, when confronted with a temptation. Discussion: It thus seems that higher temperatures tip the decision-making scale towards temptations. People make more risky decisions ‘in the heat of the moment’ and ‘cooling down’ could literally help in the defense against temptations.

Background. The Intervention Mapping Protocol (IMP) is a planning tool to design theory- and evidence-based health interventions. This approach was used to design a serious game against cyberbullying among young adolescents. Methods. Data-collection procedures included focus groups (61 adolescents, Step 1), school-based survey (1750 adolescents, Step 1), online survey (437 teachers, Step 1), pen-and-paper survey (105 parents), pen-and-paper survey (530 adolescents, Step 4), focus groups (69 adolescents, Step 4). Collected evidence was combined with behavior change theories (Step 2, 3) to design the intervention. Results. Literature suggested high potential for a focus on bystanders. Main determinants of positive bystander behavior were moral disengagement attitudes, outcome expectations, subjective norm and self-efficacy. Behavior change methods (e.g. reinforcement) had to be translated into game principles (e.g. extra resources, accessorize). Concept testing showed positive evaluations of the narrative and characters. Conclusions. Intervention Mapping Protocol can be useful for serious game design, but its behavioral change methods need fine-tuning to fit with game mechanics.

Symptoms of depression are among the most common problems in older persons, and may occur in relation to various risk factors, such as health conditions and psychosocial factors. The aim of this study was to determine the possible associations between psychosocial factors, biochemical factors and depression in old people, and age changes in these associations. Participants were 391 retirement homes’ residents in Zagreb, Croatia, 28% men, 72% women, aged 56-96 years (average 79) at baseline, ambulatory and not diagnosed with dementia. Variables were measured, at baseline and at 2 years follow-up: sociodemographic, depression, self-perceived health, functional ability, cognitive function, social participation, individually, by trained interviewers. Biochemical variables were measured from the vein blood sample, collected at baseline. Psychosocial factors were stronger predictors of age changes in depression than biochemical factors. These findings are interesting in terms of intervention and better identification of groups particularly susceptible to depression that has been shown prospectively to predict disability, morbidity and mortality in old age.

Hand hygiene is vital for the prevention of nosocomial infections. We argue that empathy fosters hand hygiene behavior, since an orientation towards others’ fortunes should highlight the costs/ benefits of insufficient/ adequate hand hygiene for others. We tested this prediction in three studies. In Study 1, we assessed empathy using a short version of Mehrabian & Epstein’s measure of affective empathy and hand hygiene behavior with a self-report measure inspired by Kahneman and colleagues’ Day Reconstruction Method. In Study 2, we experimentally manipulated empathy according to a procedure by Batson and colleagues and assessed actual hand hygiene behavior during a food preparation task, simulating work processes in a retirement home. In Study 3, an empathy-intervention was tested in a German hospital, where an empathy induction was implemented in a hospital unit and disinfectant usage frequency was assessed during a baseline and an intervention period in the intervention and a control hospital unit. Results of all three studies indicate that empathy fosters hand hygiene behavior. This effect emerged in correlational as well as experimental studies in the lab and in the field.

Background. The effects of persuasive health communications are influenced by activated self-regulatory processes. In the present study, the method of eye movement desensitization and reprocessing (EMDR) is studied to understand these processes. It is hypothesized that EMDR disturbs these processes that take place in the working memory. Methods: Participants from a university sample (N=124) were asked to listen to the persuasive message in a randomized laboratory experiment. In the EMDR condition, they were also instructed to follow with their eyes a dot on the computer screen. Findings: The effects of EMDR on actual fruit and vegetable consumption after two weeks dependend on pretest scores on Cognitive Self-affirmation Inclination (CSAI): In people who scored high on CSAI, EMDR significantly lowered the consumption, but in people who scored low on CSAI, EMDR significantly increased the consumption. Discussion: The results suggest that EMDR disturbed defensive processes that lower persuasion in people with low CSAI, and self-affirming processes that support persuasion in people with high CSAI.

Background: The number of young women living with HIV is significant worldwide. Developing effective adherence support interventions requires an understanding of gender-specific challenges. Among these, the transition to motherhood may change adherence patterns as women adjust to new life routines. We conducted a cross-sectional adherence (ADH) survey among Romanian women with HIV with and without children. Methods: Self-reports of ADH behaviors and barriers were obtained from 139 women aged 18 to 40 (61 mothers). Viral load (VL) and socio-demographic data were collected from medical files. We examined differences between the two groups on VL, ADH, and ADH-related barriers. Findings: More mothers had detectable VL than childless women (? 2(1)=7.2; p<.01), although self-reported ADH levels did not differ. Perceived side effects and satisfaction with treatment were related only to mothers’ adherence (? =.59 and .34; p<.01), while perceived treatment effectiveness was relevant only for childless women (? =.36; p<.01). ADH scores correlated significantly with VL (? =-.25 to -.30; p<.01). Mothers had shorter treatment duration, less education, and more lived in rural areas and independent families. Discussion: Mothers in this group may be at higher risk of disease progression , despite similar levels of reported ADH. More research is needed into modifiable predictors of health status in this setting.

Background: To perceive the prototypical unhealthy eater more negative (prototype-distancing) represents a relevant target in the promotion of healthy eating. What, however, if adolescents perceive high similarity to the unhealthy eater? Two intervention studies were conducted to test how and when prototype-distancing can be reached. Methode: Study 1 (n=211) conveyed a negative unhealthy eater image via feedback of pilotstudy results. Study 2 (n=93) used imaginary Facebook-profiles with an instruction to contrast from the profile person. The control groups received no feedback or healthy eater profiles with an instruction to identify with the profile person. Perceived prototype similarity was tested as moderator of intervention effects. Findings: In adolescents perceiving high similarity to the unhealthy eater, the perception of the unhealthy eater did not became more negative after receiving negative image information only (Study 1) but if contrasting was initiated (Study 2). Discussion: Prototype-distancing can be reached in adolescents perceiving high similarity to the unhealthy eater prototype by presenting a negative prototype and initiating adequate comparison processes.

Background: Behavioural interventions produce weight loss, but weight loss maintenance is elusive. The correspondence between behaviour change techniques (BCTs) used to initiate and maintain weight loss and the effect of theory use on weight loss maintenance is currently unknown. Methods: Systematic review of interventions inducing weight loss (?5% body weight) in obese adults followed by randomisation to different maintenance treatments reporting weight outcomes ?12 months. BCTs were compared for weight loss vs. maintenance phases, and associations between theory and weight maintenance effects were examined. Findings: 45 RCTs met inclusion criteria, including 9451 participants (BMI=35.2). Most studies employed the same BCTs targeting initiation and maintenance. Instruction provision, self-monitoring and problem solving were the most frequently employed BCTs. Theory based interventions were more effective compared to non-theory based ones [-2.3kg 95%CI -3.2 to -1.5 vs. -0.1 95%CI -1.2 to 0.9, P<.001). Discussion: There is a lack of differentiation between BCTs used for initiation and maintenance of weight loss. Theory based maintenance interventions were found to be more effective.

Background: Meningococcal disease is a life-threatening infection that can lead to death or significant disability, including multiple limb loss. Although no previous research has specifically investigating the experiences of those with multiple amputations, anecdotal evidence suggests that the care and support received is variable. The aim of the study was to explore these experiences and investigate the key physical, emotional and social issues. Methods: Ab exploratory phenomenological study using semi-structured telephone and face-to-face interviews. Sixteen participants were interviewed, eight had multiple amputations and eight were parents or guardians of those who had multiple amputations. Findings: Key themes were: continuity and integration of care, specific prosthetic and rehabilitation needs for multiple limb loss, timing of psychosocial support and a lack of information. Discussion: Although multiple limb loss following meningococcal disease is rare, this study starts to explore the specific care and support needs of this specialist group and will be used as an important starting point for a future body of work in this field.

Over the past five years there has been a growing body of literature that examines meaning in work and career. Calling, defined as a deep-seated passion and meaning for a particular line of work is essential for professionals’wellbeing, career success and adaptability. Taking into account the above mentioned, the aim of this study was to explore the relationship between the perceived calling and life satisfaction on a sample of 460 Romanian undergraduate students (326 female and 134 male). Life goals - one potential moderator of the calling-life satisfaction relation was tested. The regression analysis have revealed a strong positive impact of all three types of measured calling (Transcendent Summons; Purposeful Work; Prosocial Orientation) on life satisfaction. Moreover, the data revealed that the participants more likely to perceive their career as a calling were more satisfied in life than the others. Also, the relation of calling and life satisfaction was different based on types of life goals, with the strongest relation for self-transcendent goals. Implications for career development programs and vocational counseling are discussed.

Background: Smartphone-based applications (apps) become increasingly popular when it comes to individual health. A link between these apps and occupational health can be seen as an innovative approach to raise motivation and participation in occupational health projects. The aim of our study is to investigate, how apps can be implemented in an occupational health project. Method: Two studies were conducted: First, 438 Austrian and German leaders were asked about their opinion of using apps in occupational health. Second, a pilot study was conducted in a medium-sized enterprise, where the process of including an app in an occupational health project was constantly evaluated. Findings: Among other results, study I shows that 33% of German and Austrian leaders would like to use an app in occupational health programs and see its main benefits in getting an instant feedback or advice. Study II shows the effects of the app in different phases of the project. Discussion: Our study can be seen as a first step in the direction of creating innovative occupational health projects with apps.

Background: We aimed to identify the impact of the patient’s and partner’s anxiety and depression on her/his own subjective experience of the disease and on her/his partner’s subjective experience, as well as the links between their experiences. Methods: 112 couples in which the woman had a non-metastatic breast cancer completed a self-administered questionnaire assessing 1) the perceived impact of the disease and treatments (Vanlemmens et al., 2013), 2) anxiety (STAI) and 3) depression (CESD). Findings: Patient’s subjective experience in terms of management of children and of daily life, feeling of couple cohesion, and body image and sexual life is predicted by her own emotional distress and by her partner’s experience on these dimensions. Similar results are found in partner except for his feeling of couple cohesion, predicted only by the patient’s experience of cohesion. Also, the support from close relatives he perceives is predicted only by the patient’s anxiety. Discussion: Partner’s experience seems to be more influenced by the patient’s experience than reverse. This suggests paying more attention to him –and to the couple– in support care.

Self-other associations between children’s self-reports of health behaviours and ratings from their parents and their classmates were analyzed. Children’s health protective behaviours (road safety, sun safety, dental hygiene) and eating behaviours (unhealthy eating, healthy eating, bringing with school lunch) were assessed. Methods: In Study I for 305 children (45 % girls, class levels 3-5) self-report data and their parents’ ratings were assessed, in Study II for 84 pupils (45 % girls, class levels 5-6) self-report data were validated with their classmates’ ratings. In Study III for 487 children (49 % girls, class levels 3-6) self-reports as well as ratings from their parents and their classmates were included. Findings: The self-other correlations between the corresponding subscales were modest to high, ranging from r = .30 for dental hygiene to r = .69 for road safety and bringing with school lunch. Even if controlled for gender and age the ratings from parents and classmates remained significant predictors for all self-reported health behaviour subscales. Self-other consistencies and the implications for the assessment of health behaviours in children will be discussed.

Background Adaptive emotion regulation strategies such as cognitive reappraisal have the capacity to ‘cool down’ negative feelings. The present research investigates the hypothesis that the cooling down capacity of reappraisal transcends to other ‘hot’ domains as well, such as the domain of eating palatable foods. Methods In two experiments anger was induced and participants reappraised their anger by viewing it from a third person perspective (reappraisal) or from their own perspective (control condition). Cognitive accessibility of eating enjoyment was assessed by a lexical decision task (Study 1) or caloric intake was assessed by a taste test (Study 2). Findings Results showed that relative to the control condition, reappraisal decreased cognitive accessibility of eating enjoyment and decreased caloric intake. Anger experience was not responsible for these findings. Discussion These findings imply that emotion regulation strategies with cooling down properties go beyond cooling down the affective domain, by dampening other ‘hot’ constructs as well.

B This paper examined the association of mothers’ and children’s posttraumatic stress reactions in the long-term aftermath of the 2004 Tsunami in South India. M 106 mothers gave answers for their 221 tsunami-affected children to the Traumatic Events Screening Inventory and the Parent Report of Child’s Reaction to Stress. The Impact of Event Scale and the General Health Questionnaire were used to gain information about mothers’ health status. The children (aged 8 to 17) were single and double orphans either living with their biological parent or in an out-of-home care organisation. The impact of mothers’ health, children’s prior trauma history and pre-existing characteristics on children’s stress reactions were analysed with hierarchial multiple regression analysis. F The results showed that general health of the mothers (ß=.46, p<.001) significantly predicted the amount of trauma symptoms in children, as does the context in which the children lived (ß=-.18, p<.05). D The findings were discussed in the light of that mothers’ health need to be secured in order to enable children’s well-being. This study is part of the project Post-tsunami which was funded by the European Commission.

Background: The majority of the literature on stress and blood pressure (BP) is concerned with increased risk of morbidity or mortality from cardiac events. As the sympathetic nervous system is also critical to the maintenance of orthostatic BP, we hypothesise that exposure to life stressors may alter BP regulation such that older adults who have experienced more stressful life events (SLEs) are more likely to show impaired recovery of BP in response to orthostatic stress. Methods: Data were collected during the first wave of The Irish Longitudinal Study on Ageing (TILDA), which took place between 2009 and 2011. Exposure to SLEs was ascertained via self-completion questionnaire. Orthostatic BP was measured using beat-to-beat digital plethysmography. 3,765 participants aged 50 and over completed both measures and thus were included in the current analysis. Findings: Adjusting for confounders, there was a dose-response relationship between the number of SLEs reported and the odds of impaired systolic BP recovery after standing (1 event: OR= 1.22, p <.05; 2 events: OR = 1.32, p <.05; 3 or more events: 1.61, p < .001). Discussion: This study is unique in being the first of its size to investigate the relationship between stress and orthostatic BP behaviour using beat-to-beat measurement. Follow-up is required to determine the clinical prognostic value of the observed association.

This study aimed to analyse the direct relationship between socio-economic status (SES) and eating behaviours, as well as the indirect relationship via impulsive, reflective, inhibitory control and environmental variables. 262 adolescents aged 12-13 years old were assessed on their intention to eat (reflective measure), temptation (impulsive measure) and the availability at their home of fruit/vegetables (FV) and sweet/savoury (SS) snacks, as well as their inhibitory control. Immediate food choices were assessed through a Behavioural Choice Task and a 24h recall was used to assess frequency of FV and SS. SES was assessed via wage and ownership of home and car. Immediate food choices (whether FV or SS or both) were directly predicted by SES and indirectly predicted by temptation and inhibitory control. The only (direct) predictor of frequency of FV consumption was SES. There was no predictor of the frequency of SS. Results seem to indicate that social inequalities can determine FV consumption. Public health interventions aiming at FV consumption need to take this into account when designing interventions. Aim should be to decrease the health inequality gap.

Minimal research has measured well-being and assets that could enhance well-being, particularly during adolescence. The current study had two aims (1) conceptualise and assess an adolescent resilience and well-being model; (2) evaluate a School-Based program guided by the variables within the model. A total of 250 participants aged between 13-16 years completed a questionnaire assessing a wide range of individual and environmental predictors of adolescent resilience. For participants who completed the program, the questionnaire was administered at three stages (n=180; pre-test, post-test, 6 month follow-up). Significant pathways within the model were found for numerous assets. Quantitative and qualitative findings were obtained during the evaluation of the program. Individual factors (i.e. self-esteem and specific coping skills) increased significantly for participants completing the program. Findings from this study have identified factors that could assist in the development of adolescent resilience to stressful life events and enhance well-being. Furthermore, participant feedback has provided guidance on improving the program, which could guide future intervention developments.

Background: Cardiac patients hold beliefs about their illness that can be misconceived and negatively affect adjustment. This study tested the efficacy of an intervention aimed at dispelling cardiac misconceptions in myocardial infarction (MI) patients. Methods: 86 first-MI patients were randomized to control or intervention group. The intervention consisted of 1 in-hospital session followed by 4 phone calls after discharge. Patients were assessed at baseline and 4 months later. The main outcomes were cardiac misconceptions, illness perceptions, perceived health-related quality of life, anxiety, depression and health behaviours. Findings: At the 4-month follow-up, patients in the control group had significantly higher misconceptions, more negative illness perceptions, and higher levels of depression than patients in the intervention group. Also, a significantly higher proportion of participants reported doing exercise in the intervention group than in the control group. Discussion: A cardiac misconception intervention can be effective in altering MI patients’ erroneous beliefs and negative illness perceptions, with beneficial effects over depression levels and exercise behaviours.

Most studies on work-family balance focus on time-related strains and resources. Employees in human service organizations are also confronted with emotional and social strains which could be still present at home with consequences for the family life. 1140 employees, working in human service organizations (education, youth care, nursing etc.) were asked for strains at work (time-related, emotional client work, social climate), organizational (overtime, shift) and social resources, psychological detachment of work and work-family conflict. Regarding the different parts of influences, a multiple hierarchical regression was used. There are high correlations between reduced psychological detachment of work and the emotional, social and time-related strains (r=.37-.42) and work-family conflict (r=.53). The full model explains 49% of the variance. Time-related strain, reduced psychological detachment of work and shift work are the highest predictors for work-family conflict. Besides the influence of time-related strains, the psychological detachment of work has an additional important impact on work-family conflict, especially for employees from the human services organizations.

Background: This intensive longitudinal study examined effects of health behaviors on affect experience and academic performance, indicators of mental health and cognitive functioning. Methods: Over the freshman year, 282 university students answered 65 online-assessments about sleep quality, eating behavior, physical activity, affect, learning behavior, and exam grades. Findings: Multilevel structural equation models over the first year, showed that subjects with on average better sleep quality and regular eating behavior but not physical activity predicted better learning behavior, which in turn was associated with passing exams Relations of all health behaviors with learning behavior were mediated by affect. In terms of day-to-day dynamics, on days with better sleep quality and eating behavior but not physical activity, participants reported better learning behavior. Daily affect mediated the relations of all health behaviors with learning behavior. Discussion: Results provide a first understanding of between- and within-person variations in health behaviors, affect and academic performance. They could inform health prevention or intervention programs for university students.

Background: Self-affirmation, the process of reflecting on important self-attributes, such as core values, has been found to reduce resistance to personally relevant health-risk information. However, little is known about whether it interacts with different types of health information to affect outcomes. The current study examined whether the effects of self-affirmation differed according to whether health information was presented as (a) a narrative account or (b) non-narrative data. Methods: In an online study, females (N = 132) were randomly allocated to condition resulting in a 2 x 2 design (Affirmation, No Affirmation x Narrative, Non-Narrative). Participants then completed measures assessing indicators of message acceptance and motivation. Alcohol consumption was assessed at 7-day follow up. Findings: Self-affirmation (vs. no-affirmation) reduced message derogation and counter-arguing to the narrative but not the non-narrative information. Self-affirmation increased message acceptance, while narrative information increased negative affect. Discussion: This study has implications for understanding how the effects of self-affirmation may be influenced by information type.

Background. Advertisements for alcoholic drinks televised in the UK must abide by the BCAP Code, which aims to prevent such adverts implying, condoning or encouraging immoderate, irresponsible or anti-social drinking. The present study examines whether the general public perceive alcohol advertisements as complying with this Code. Methods. A quota sample of 373 adults who were representative of the UK adult population viewed one of seven alcohol advertisements shown on television over a two-week period, and completed a questionnaire assessing whether that advertisement complied with each of the BCAP Code guidelines. Findings. Overall, 75% of the participants rated the advertisements as breaching at least one guideline from the BCAP Code. Over 50% of participants saw breaches in guidelines regarding alcohol being presented as contributing to popularity, and implying that alcohol is capable of changing mood, physical condition, behaviour, or as nourishment. Discussion The UK general public perceives alcohol advertisements shown on television as breaching the BCAP guidance. The present analysis indicates the inadequacy of the current regulatory system.

Introduction. Changing risk perception through providing actual risk feedback is a central topic in health intervention. Extending previous research, in the present study (1) multiple risk factors are assessed and, (2) a dynamic perspective is taken, examining trajectories in risk perception and protective behavior from pre-feedback to immediate responses after feedback and 6 month later. Methods: Dynamic change in risk perception in the context of a longitudinal public health was assessed before, immediately after and 6 month after receiving actual feedback about individual risk factors for coronary heart disease. Results: Participants (N=607) showed a relative accuracy in risk perception in relation to their actual risk feedback. Variations in post-feedback risk perception emerged due to both actual risk feedback and protective health behavior changes after receiving risk feedback. Importantly, the different risk status groups did not differ in the perceived peer-related risk, indicating an adaptive rather than defensive integration of risk information. Conclusions: Theoretical implications for and modulating factors of the processing of health risk information are discussed.

Background: Medication adherence rates after coronary artery bypass graft surgery (CABG) are low. There is a lack of studies looking into intentional (deliberate or reflective) and unintentional (forgetting to take medication) non-adherence in CABG patients. Methods: In a sample of N=197 post-CABG surgery patients followed from discharge over one year, it was hypothesized that motivation, action planning and coping planning are independently predictive of medication adherence. Moreover, interaction effects were tested. Findings: Motivation (B=.30, p<.01), action planning (B=.19, p<.01), and coping planning (B=.16, p<.01) were independently related to adherence. Beyond that, action planning×motivation (B=.06, p<.05) and coping planning×motivation (B=.07, p<.01) interaction terms were significant. Discussion: As theoretically predicted, planning was more predictive in those patients who reported higher motivation towards medication adherence, reflecting the idea of planning being a factor to overcome unintentional non-adherence. Implications for intervention development were discussed.

Scoring high on volitional competency should protect against ego-depletion. This buffering role and the interplay between broader personality traits and state self-control have not been largely examined yet. Thus, we tested the moderating role of different volitional competencies (as assessed by VCC-4 and NEO-FFI) on ego-depletion. We hypothesized that scoring high on impulse control and on conscientiousness protects against ego-depletion. Furthermore, overburdening the self-control muscle should result in more ego-depletion. Participants (n=64) completed an emotion-suppression task and had to suppress all emotions to videos or not. Afterwards they completed the Stroop-task to measure ego-depletion. As hypothesized, we found that scoring high on conscientiousness and impulse control protects against ego-depletion and that scoring low on these variables increases ego-depletion. Overcontrol increased vulnerability towards ego-depletion. These findings show that different volitional competencies have divergent effects and that overburdening the self-control muscle can backfire. These findings have clear practical implications for self-control interventions.

Background: In schools, perceived behavior or attitudes of classmates can facilitate but also inhibit unhealthy food intake of children and adolescents. The present study examined the association between actual attitudes of classmates and food intake. In addition, such normative effects may be facilitated by matching food preferences of the individual and class as well as a positive social self-concept indicating perceived group inclusion. Methods: 2118 Finnish, German, and Romanian children and adolescents (aged 8-19) of 127 school classes were asked to indicate their food preference, social self-concept, and snack intake. Findings: Multilevel-analyses indicated that class members share 14.7% snacking variance. Moreover, unhealthy food class preference is associated with classes’ snacking (?²(1) = 54.67, p < .000, pseudo-?R² = .35). This effect was facilitated by individual unhealthy food preferences (?²(1) = 17.67, p < .000, pseudo-R² = .55) and a positive social self-concept (?²(1) = 4.97, p = .025, pseudo-R² = .17). Discussion: Overall, while actual class norms are important for children’s and adolescents’ food intake, individual differences moderate the effect of social norms.

Background: Exercise referral schemes are increasingly used in primary care to promote mental health and wellbeing. This study explored the often overlooked psychological outcomes that patients experience from taking part. Methods: A pre- post design was used. Changes in potential mediators of change (motivation and self-efficacy), and quality of life (QoL) were recorded for 117 consecutive patients referred to a 12-week physical activity referral scheme in south west England. Outcomes were assessed at 3, 6, and 12 months after enrolment. Findings: Intrinsic motivation for exercise increased over 3 and 6 months (p<.05), but there was no change in self-efficacy or extrinsic motivation. Improvements in QoL were reported at all time points (p<.005). Improved QoL was positively predicted by improved self-efficacy at both 3 (R2=0.2) and 6 months (R2=0.4). Changes in motivation were not independently predictive of the observed improvements in QoL, but were significantly associated. Discussion: Exercise referral schemes can enhance intrinsic motivation for physical activity and QoL. The inclusion of strategies to promote self-efficacy may further enhance psychological outcomes.

Rising rates of childhood obesity worldwide highlight the need to address issues of diet and exercise in the early years. Little is known about children’s conceptualisations of factors associated with the maintenance of normal bodyweight. This study investigated children’s knowledge of food intake and exercise in relation to changes in weight. 72 children age 5-12 years (m= 36; f=34) participated in a vignette-based semi-structured interview around topics such as food composition, food intake and exercise. The data was analysed using content analysis. The findings indicate a developmental progression, with greater understanding of biological causal mechanisms from age 9 onwards. Under nines provided mainly mechanical explanations and endorsed a hereditary component to obesity. The conceptualization of foods as ‘good’ or ‘bad’ was seen across all ages. Information-based interventions to target childhood obesity need to be tailored to the developmental level of the child. The majority of participants demonstrated awareness of health education concepts, however conceptualisations at some ages may be counterproductive in encouraging health-related behaviours.

Background: We aimed to assess a) the effectiveness of ‘real-world' diabetes prevention programmes, and b) whether adherence to guideline recommendations on supporting behaviour change is associated with increased effectiveness. Methods: We systematic searched bibliographic databases and assessed study quality for ‘real world’ diabetes prevention programmes targeting change in diet and/or physical activity, with relevant outcome data for 12 months or more of follow up. We conducted a) random effects meta-analysis and b) meta-regression to associate intervention effectiveness with adherence to guideline recommendations on intervention content. Findings: A meta-analysis of 22 studies found a mean weight loss of 2.12kg (95% CI: 2.61 to 1.63; I2=91.4%), compared with 4.2 to 6.7Kg for ‘gold standard' clinical efficacy trials. Adherence to guidelines was significantly associated with greater weight loss, with an increase of 0.3Kg per point increase on an 11-point guideline-adherence scale. Discussion: The effectiveness of pragmatic diabetes prevention programmes varies substantially, but is higher for programmes that adhere to guideline recommendations on supporting behaviour change.

BACKGROUND: Depression is common in hemodialysis patients but little is known about the course of distress over time. This study set up to map the course of anxiety and depression and to identify factors associated with different trajectories. METHODS: 159 hemodialysis patients completed the HADS and measures of social support on two occasions 12 months apart. Clinical cut-offs were used to identify patterns of change and general linear models were applied to identify correlates of these trajectories. FINDINGS: Mean anxiety and depression remained unchanged with over 50% above cut-offs. While most patients had either persistent symptoms (39.6% depression; 31.8% Anxiety) or no/low symptoms (32.1% depression; 36.9% anxiety), 12.7% to 14.5% either had new-onset or recovered. Patients with persisting or new-onset symptoms of distress reported worsening in social support and quality of social interaction compared to patients with no/low symptoms (p<.01). DISCUSSION: Different patterns of symptoms reflect heterogeneity in patients’ emotional adjustment. More research is needed to identify patients at risk for emotional distress and to explore social support in the context of dialysis

Background: Diagnosis and treatment of breast cancer can pose significant adjustment challenges but some patients can also experience positive changes, although it is yet unclear whether these confer adaptive psychological consequences. This study (i) identifies predictors of both positive and negative adjustment and (ii) tracks how benefit finding relates to adjustment across an 18 month time period. Method: Data was collected from 167 women at 4, 12 and 18 months post diagnosis. They completed standardized questionnaires assessing stress, coping, optimism, social support, emotional adjustment (depression, anxiety, positive and negative affect) and benefit finding. Findings: Hierarchical regression analyses, controlling for medical variables and previous adjustment showed that while stress appraisal explained a third of variance in concurrent emotional status it was only baseline coping and optimism that predicted mood over time( 5% ). A random effects SEM model showed that low distress and high optimism predicted benefit finding at various time points. Discussion: These results support a positive relationship between perceived benefit and positive well-being.

Along with the technological developments, today’s life conditions make people more ponderous. Calories taken more than consumption and hypo-active living cause the increases in both body-fat and obesity. This global danger has become an important threat particularly for university students. This study was planned and conducted to reveal the possible relations between obesity and internet dependence in students living in university dormitories. Results from 290 students with an age range of 18-35 years showed that students’ body-mass-indexes become higher as their internet dependence levels increased. While 82,1% of the students stated that they used internet by their mobile phones, 50,3% of the students have been using internet for more than 7 years. Internet dependence levels were found significantly higher among the students who did not employ a regular nutrition regime, skipped meals, had a family member with obesity, did not practice regular physical exercise, and did not have sufficient social support of their families. Students and their families should be well informed about potential harms of internet dependence on health, particularly on obesity, and social life.

Background: physical and verbal violence by patients is now widely recognized as a major occupational health hazard. Based on the Job Demand-Resources Model, our study investigates if and how certain individual resources and socio-organizational resources contribute to buffering the negative impact of verbal aggression on burnout and to boost emotional well-being. Methods: 442 healthcare workers working in 4 departments (ED, psychiatry, midwifery and paediatrics and outpatient clinic ) were invited to complete a self-report questionnaire. Findings: a series of moderated stepwise regression analyses were conducted. Aggressive behaviours are important predictors of burnout and emotional well-being . Although healthcare workers in different departments differ neither in terms of perceived patient aggression nor of burnout and well-being, the study identifies differences in the patterns of resources that protect them against social stressors tied to the interaction with patients. Discussion: The different role played by different kinds of resources to buffer the effects of patient aggressive behaviours is also discussed.

Background: Behaviour change, prior to intervention but post diagnosis may affect engagement in lifestyle interventions. This study examines associations between stages of change, psychological factors and physical activity (PA) in Type II diabetes patients in a lifestyle intervention trial. Methods: Patients (N= 537) with newly-diagnosed type 2 diabetes took part in Early ACTID, a randomised controlled trial of physical activity and dietary change. Stage of change (SoC), self-efficacy, outcome expectations, social support and objective PA were measured at baseline and 6 months. Linear regression was used to determine if SoC and psychological factors predicted PA at 6 months. Findings: 58.3% patients were in the action/maintenance stage at baseline. Being at these stages at baseline and 6 months was associated with increased objectively measured PA. Only baseline stage of change predicted total PA and MVPA at 6 months (total PA: ?=0.47; P=0.000; MVPA: ?=0.49; P=0.000). Discussion: In predicting objective PA, the other psychological factors showed no association, suggesting readiness for change may override determinants previously specified as supporting self-reported PA change.

Backgrounds: This presentation is based on the assumption that religiosity, and spirituality can with other salutoprotective factors influence physical and psychological health (well-being). Methods: The sample consisted of 278 adults (104 men and 174 women, average age 41,9 years). Mental health was assessed via WHOQoL-Bref, SWLS, PANAS; independent variables were measured via scales: SOC, PSSS, GQ, LOC and lifestyle inventory. R/S were assessed via PCBS, SIBS and DSES. Results: R/S were in some models the specific predictors of subjective quality of life (QoL). Significant linear relations were found between the construct of R/S and life satisfaction. A nonlinear relation was found between R/S and the QoL. The persons with the highest and the lowest extent of R/S had higher QoL than those with the middle extent of R/S. We found connection between the QoL and meaningfulness. We proved significant differences between other variables as to lifestyle indicators, social support, gratitudes, LOC, stress etc. of the persons with higher and lower R/S. Discussion: The relation between R/S and psychosocial variables appears to be a lot more complex even if specific impact of different variables remains unclear. In a sample of Czech population we aimed to find which facets of R/S can lead to well-being improvement. R/S variables are presumed to have small but significant impact on overall well-being.

Background. Excessive alcohol consumption is linked to maladaptive outcomes. This experiment examined the effectiveness of mental simulation and self-control training in reducing alcohol consumption. Method. Undergraduates (N=78) were randomised to one of 4 conditions in a 2(mental simulation: mental simulation vs. irrelevant imagery) x 2(self-control training: challenging vs. easy Stroop task) experimental design. For the mental simulation manipulation, participants received either a mental simulation task requiring visualisation of steps required to reduce alcohol intake or an irrelevant imagery task. For the self-control training manipulation, participants completed either incongruent (challenging) or incongruent (easy) Stroop-colour naming tasks twice daily on their smartphone. Findings. Self-control training predicted alcohol consumption (partial eta squared=.022) but not mental simulation. No interaction effect for the manipulations on alcohol consumption was found. Discussion. Results support an effect of self-control training on alcohol consumption, but not the hypothesis that training is more effective for individuals whose motivation is enhanced through mental simulation.

This research performed with goal of comparison of five main factors of personality and basic incompatible plan at celiac patients and normal people. Research design was comparison–casual type and 108 patients (65 women and 43 men) and the same number of normal person from 4 universities of Nursing, Psychology, Literature and Accounting of Islamic Azad university of Karaj have been selected as a sample size. Both groups answered the brief five factors questionnaire about personality, Yang’s incompatible plan, and General health questionnaire. Results showed that from five main factors of personality, score of the psycho-lesion of the patient affected by the celiac was more than normal people. Also, patient’s scores at the basic incompatible plan (emotional baffling, lack of trust, fault, shame, social recluse, strangeness, attachment, inefficiency, vulnerability toward loss or sickness, not self-maturing, engaged, failure, fitness, modesty, self-denial, insufficient self-discipline, servitude, self–sacrifice, aggressive criteria, extreme criticize and emotional inhibition) in comparison with normal people were higher. Regarding the effect of the celiac sickness from basic incompatible plan for recovering the patients can use the psychological and educational courses and therapy plan at the recovering cognitive and emotional pattern of this patient.

Background: Motherhood may be associated with psychopathological manifestations. Recent studies have found a link between a traumatic experience of childbirth and Posttraumatic Stress Disorder (PTSD) (Olde et al, 2006; Denis et al, 2009). According to international literature, 2% of women are at risk to develop postpartum PTSD. The aim of this study is (1) to evaluate the prevalence of PTSD in a French/Tunisian populations and(2) to determine the role of coping strategies. Methods: French and Tunisian participants (n =164) were recruited during the last trimester of pregnancy (T0) and at 2 months postpartum (T1). They had completed measures of perinatal PTSD (PPQ) and coping (brief COPE). Findings: 34.4% of French women and 47.5% of Tunisian women have symptoms of PTSD at 2 months postpartum. Concerning the impact of coping strategies, women using more denial, blame and less positive reinterpretation and expression of feelings presented greather risk of developing PTSD following childbirth. Discussion: In the context of postpartum PTSD, the role of psychological adaptation must be exploser further in order to better understand its development and possibilities of prevention.

Background: Child Vaccine Providers (CVP) work at Child Welfare Centers (CWC), administer vaccines and communicate with parents about the National Immunization Programme (NIP). We performed this quantitative study to get more insight in CVPs attitude, their need for information and education, and their experience with educating (critical) parents who visit the CWC. Methods: We conducted a cross-sectional on-line self-report questionnaire. In total, 1427 CVPs received, and 432 CVPs completed the questionnaire (response rate = 30.3%). Findings: Half of the CVPs (52.2%) indicated that they sometimes avoid discussion with parents. CVPs give 1-2 minutes education during a consult about the NIP to parents, but prefer 2-5 minutes, while 11.8% of the CVPs do not give education at all. Discussion: CVPs indicated not having enough time to fulfill the information need of parents, we think that CWCs should schedule an extra consult, or information meeting when parents have many questions. CVPs have a need for education in how to communicate with parents, therefore Public Health Institutes should develop training for CVPs about how to communicate with parents.

Background: Albeit oral hygiene is a widespread health behavior prevalence of diseases due to insufficient oral hygiene is high. Deficits in oral hygiene skills might be responsible. Skills have been rarely included in health behavior modelling. This interventional study focusses on skills and how they are associated with psychological variables. Methods: 70 participants were randomized to a standardized training of one of two tooth brushing techniques (Fones, Bass) or of basics of tooth brushing alone (control group). Skills (plaque after thorough hygiene) and gingivitis were assessed 6, 12 and 28 weeks after the training. Self-efficacy, decisional balance and adherence were assessed and brushing behavior was video recorded after 28 weeks. Findings: Fones group differed significantly from the control group after 6 (p=0.030) and 12 weeks (p=0.006) with respect to skills. The control group showed less gingivitis. Groups did not differ with respect to self-reported adherence. Multiple associations were observed with psychological parameters and observed brushing behavior. Discussion: Data indicate complex relationships between behavior complexity, behavioral skills and maintenance.

Self-affirmation (eg induced by reflecting upon important values) may reduce defensive resistance to information and increase readiness for change. However, these effects have yet to be subjected to quantitative review. We report a meta-analysis of the impact of self-affirmation on outcomes at 3 key points in the process of health-behavior change: message acceptance, intentions to change, and subsequent behavior. Methods. The literature search identified 144 tests of the effects of self-affirmation on outcomes. Effect sizes were extracted and meta-analyzed. Findings. Random effects models indicated small but reliable +ve effects of self-affirmation on each outcome: acceptance, d=.17 (CI=.03 to.31), intentions, d=.14 (CI=.05 to .23), behavior, d=.32 (CI=.19 to .44). Findings held across a range of health problems and behaviors. Discussion. Deploying self-affirmation inductions alongside persuasive health information has +ve effects, with effect sizes comparable to ones obtained in meta-analyses of other health-behavior change interventions. The findings are relevant to those working to understand why people resist beneficial information and how such resistance can be reduced.

Background: Although policy of large-scale vaccination brought undeniable positive results, recent media attention on negative side-effects posed difficult decision-making dilemma to many parents. It leads to question which resources parents employ when making vaccination decisions. Method: In literature review, 15 most relevant quantitative and qualitative studies found via Ebsco and Science Direct were analyzed. Findings: Vaccination decision-making could be complex, posing cognitive and emotional strain and need to defend one's choice. Both vaccinating and non-vaccinating groups were found to lack relevant knowledge on the subject, describing the situation as “more question than answers”. Discussion: The topic of trust and disappointment seems to surface repeatedly. Health-care system is seen as neglecting individual specifics, and not capable of providing adequate answers to questions of vaccination safety. There appears a pressing need to seek more comprehensible and trustworthy ways of communicating benefits and risks of vaccination, and rebuilding trust. Data collection project in Slovakia would be designed based on this literature review. (VEGA Grant 2/0154/13)

It has been noted that people can show resilience when facing a kind of adversity but not with others, and also show it in different degrees. Still, there is no measure of adult resilience in different contexts. Previous research with teenagers indicates the adequacy of a contextual model – thus, we aim to validate a subjective contextual resilience test for adults. In our correlational study, we developed a 20 item scale with five problem areas: work, close persons relationships, own health, close person health and economy. It was completed along with CDRISC10 by 416 adults. We conducted a confirmatory factor analysis of a “5 specific x 1 general” factor model using AMOS, and reliability and correlation analyses. Results show that the 5x1 factor structure is well defined (X2/df=2.06; GFI=.93; CFI=.95; RMSEA=.05). The general scale (GS) has an excellent reliability (?=.90) as well as the subscales (ranging from ?=.71 to .83). The GS-CDRISC10 correlation is good (r=.45). Important implications for research and intervention are derived, such as the vital need of assessing resilience in different contexts and researching the resilience-promoting processes most adequate for each one.

Background: Although the CSM-related literature is advanced, there is a lack of research concerning illness and treatment perceptions of children and adolescents, and still less concerning dyadic approaches considering perceptions of both chronically ill patients and their parents. Methods: We conducted focus groups with N=30 adolescents with asthma and telephone interviews with N=15 mothers. The interviews were transcribed and analyzed in a dyad-focused qualitative content analysis procedure using the computer program Atlas.ti. Findings: Adolescents’ and parents’ statements were categorized using 74 codes assigned to 10 dimensions of illness and treatment perceptions. The results demonstrated large inter-individual variability in the perceptions among adolescents and parents and pointed to both issues of high congruence in parent-adolescent dyads and issues entailing distinctive discrepancies in perceptions. Discussion: For their high inter-individual variability, paying more attention to individual and dyadic illness and treatment perceptions in adolescent care could be worthwhile, not least because of their particular importance for patients’ adherence and illness management.

Background: Psychological problems are common post-stroke, including emotional distress, behavioural change and cognitive impairment. Stroke rehabilitation typically focuses on restoration of physical and language function. Methods: The ASPIRE-S (Action on Secondary Prevention Interventions and Rehabilitation in Stroke) study assessed secondary prevention, rehabilitation and stroke outcomes in a cohort of patients admitted with acute ischaemic stroke over one year from October 2011. Assessments were conducted at six months post stroke, including assessments of psychological distress and cognition. Results: 302 patients (58% male) participated. Mean age was 69 years (range 22-95). Over half (52%) of patients reported being emotionally distressed by the stroke. Over half (57%) also scored below the cut-off for cognitive impairment. Of those needing support from psychological services, a majority (63%) did not receive any. Conclusion: Significant levels of emotional challenges and cognitive impairment post-stroke were evident from the ASPIRE-S cohort. Provision of psychological services post-stroke is identified as a significant unmet rehabilitative need.

Numerous studies have attempted to explain the destructive results of interpersonal conflicts in the context of work for health-related variables. If poorly managed, conflicts can have negative effects on employees' well-being, such as burnout and psychosomatic complaints, particularly in the case of relationship conflicts (De Dreu & Weingart, 2003a). According to Dual Concern Model, an individual's style in handling conflicts can be categorized along two basic dimensions: the first pertains to the concern for self, while the second the concern of others. Using 402 public employees in Malaysia we explored the relationship of conflict styles with stress and job satisfaction. Results indicated obliging, a conflict style that have low concern for self while high for others influence stress. Employees that are unquestioningly oblige to others’ requests adversely impact their stress by creating a sense of frustration. Interestingly, dominators, who have the opposite concern of self and others than the obligers, also experience high level of stress. This is because that those who focus on their own concerns will act in a way that ensures that conflicts are resolved by presenting their interests and making sure that their needs are addressed. Contrarily, integrating that is associated with effective decision making, is positively related to job satisfaction. Furthermore, based on Social Exchange Theory interactional justice might be able to buffer the negative effects of conflict management styles. As expected, interactional justice moderates the relationship between avoiding and job satisfaction. As avoiders fail to satisfy their conflict goals by evading the conflict issues, supervisors’ assistance in exhibiting high interactional justice, can buffer their job satisfaction for those who hesitate to campaign for themselves. Ultimately, these employees will perform productively and make greater contribution to the organization.

Background: Health coaching (HC) has been widely used as a tool to promote behavior change to improve health outcomes, yet the effectiveness of HC interventions is unclear. We aimed to systematically review HC interventions regarding: effectiveness of HC for specific outcomes; optimal intervention approaches; identification of specific techniques associated with effectiveness. Method: We searched health/medical/psychological databases for randomized controlled trials that assessed the efficacy of HC interventions. For each study we assessed aims, participants, approach, behavior change techniques (BCTs) and findings. Findings: Fifteen of 16 eligible studies reported a positive HC effect on at least one outcome. The number of intervention sessions provided ranged from 2-48; in three studies, one or more intervention details were unclear. Studies used 3-15 BCTs and these varied widely. It was hence difficult to synthesize the studies to adequately address our aims. Discussion: HC is a promising strategy for health improvement. Future research should ensure clarity in reporting intervention details, consistency in reporting BCTs, and efforts to achieve high treatment fidelity.

Background: The aim of this study was to investigate the association between self-rated health (SRH) and risk of functional decline among community-dwelling older Japanese. Methods: A 3-year prospective study was conducted among 653 residents aged 65 years and older without disability in carrying out basic activities of daily living (BADL) at baseline. SRH was assessed using a 100-mm visual analogue scale (worst=0 to best=100). Information on functional ability, sociodemographic factors, depression, quality of life and medical conditions, was obtained using a self-administered questionnaire. Logistic regression was used to examine the association between baseline SRH and functional ability 3 years later. Findings: A total of 108 (16.5%) participants reported a decline in BADL at the 3-year follow up. Low SRH was significantly associated with a higher risk of functional decline, even after controlling for potential confounding factors (OR: 2.2, 95% CI: 1.2-3.9). Discussion: The results suggest that SRH is a strong predictor of subsequent loss or maintenance of functional ability in community-dwelling older adults.

Background Driving is a sedentary behaviour and car emissions a respiratory health issue. Consequently, promoting non-car travel mode choices has potential to enhance population health. Social cognition models, involving attitudes have been important to psychological research in personal travel. This review appraises transportation research and questions the adequacy of conceptualisations of “attitude”. Method This study systematically and critically reviews current models, synthesising both, qualitative and quantitative research. A two-stage systematic search structured by the PICO framework was undertaken and accessed EBSCO, Web-of-Science and ScienceDirect. Finding A critical perspective on attitude constructs and their measurement integrated goal and control theory into understanding travel mode choice. We question the assumption that travel mode attitudes are stable across contexts and propose that they are shaped by goal priorities. Discussion Development of a more context-sensitive conceptualisation of travel-mode of modifiable determinants of transport-choice cognitions has implications for the design of interventions to reduce car use and the promotion of healthier travel.

Background. To evaluate the (short and long-term) effects and program use of the revised Long Live Love program (LLL), a comprehensive sex education program for secondary schools. Method. Two experimental versions of LLL (with and without teacher e-coaching) were tested against regular sexual health education. Evaluation focused on behavioral determinants related to condom use, contraceptive use, relational and sexual desires and boundaries, and attitudes towards homosexuality. A cluster-RCT was used with a 1-month and 8-month follow-up. A total of 53 schools (4623 students) participated. Multilevel analyses with multiple imputation were used. Findings: Compared to the control group, the combined LLL groups reported exposure to a larger variety of sexual health themes, and use of active modes of delivery: Short-term changes were found for sexual health knowledge, STD vulnerability, and various social-cognitive determinants of condom use and contraceptive use. The effect on intended condom use was maintained at 8-months. Discussion. LLL does change determinants of sexual health. The teacher e-coach seems to improve program experience and participation of students.

Question-behaviour effect (QBE) refers to the finding that answering questions about behaviour can increase behaviour itself. We investigated the QBE and motivation as methods to increase bowel cancer screening. Participants (N= 10693) were randomized into four conditions and received a Theory of Planned Behaviour questionnaire only or combined with the offer of a £5 incentive for returning the questionnaire. Two control groups received either a demographic questionnaire or no contact. Behaviour was objectively measured by whether a bowel screening test kit was returned within 19 weeks. Total attendance was highest (61.5%) in the no contact control condition which was marginally significantly higher than the QBE condition (58.9%). Significantly more questionnaire returners in the QBE condition (97.3%) attended than the demographic control (94.5%). The incentive did not affect motivation and all questionnaire returners had high levels of motivation. These findings suggest the QBE cannot be applied as a population-wide intervention to increase bowel cancer screening, but for some individuals , simply completing a questionnaire can increase their likelihood of carrying out screening.

Mental health problems tend to have impact on the social reality of the affected individual. Depressive symptoms are associated with worsened couple satisfaction. The aim of this study is to explore the role positive sharing within the couple. Possibly, the decrease of this positive couple process in the context of depression is mediating the link with couple satisfaction. In an online study, 211 couples filled in questionnaires regarding the sharing or disclosure of positive experiences with the partner, depressive symptoms, and couple satisfaction. Structural equation based Actor Partner Interdependence Models reveal the expected intrapersonal associations between depression and couple satisfaction which is partially mediated by positive sharing. The weak associations between the partner’s depressive symptoms and own couple satisfaction are mediated by decreased positive sharing. Positive sharing in the couple might be an important way of interpersonal emotion regulation which suffers in depressive states and in turn affects relationship quality. This implicates that fostering positive couple processes may prevent possible adverse social correlates of mental health problems.

Background Limited is known about the daily life processes in the association between health promotion and outcomes in cancer patients. This study aimed to examine the nature of associations among cancer-specific health engagement control strategies, savoring, and psychological and physical symptoms in Chinese people with colorectal cancer (CRC). Methods and Findings A total of 157 newly diagnosed CRC patients were recruited and administered (1) back-translated items on control strategies (active processes counteracting physical health problems) (Wrosch et al., 2003), (2) back-translated Savoring Belief Inventory (enjoyment of pleasant experiences in the moment), and (3) the Chinese version of Hospital Anxiety and Depression Scale and Memorial Symptom Assessment Scale (psychological and physical symptoms). Structural equation modeling revealed that savoring mediated the association between control strategies and both depressive and physical symptoms. Discussion To maximize holistic health in cancer patients, symptom management and health behavior change intervention should be integrated with well-being intervention that targets daily life psychological functioning.

Background: Screens, in particular mobile devices, are the centrepiece of young people’s lives. Is the recommendation that parents limit children’s screen time to < 2 hours per day a realistic objective? Primary Objective: To determine Australian 8-16 year olds screen use, particularly in the context of the < 2 hours recommendation. Research Questions: To what extent are Australian children/adolescents exceeding the 2 hour recommendation? Method: On line survey of screen use on “a typical weekday” with 2,553 8-16 year olds from 26 schools. A new Youth Orientation to Screen Use Scale (YOSUS) was developed. Results: Two factors (Salience [S] & Mood Management [MM]) (CFI=.98, NFI=.98, RMSEA=.048)emerged. Hierarchical linear models revealed increasing gender disparity with main effects of Gaming, Social Networking, Web Use, and TV; different significant predictors for males/females evident. Screen use (0-2 hours, 2.1-4 hours, 4.1-6 hours, over 6.1 hours) revealed main effects for S & MM. Discussion: Young people exceed 2 hours by varying degrees on different activities (with differing associated effects). Findings are important for promoting healthy screen time habits.

Background: Breaking bad news produces negative emotional, cognitive and behavioral reactions on patients, has consequences on their quality of life, but a traumatic event could caused positive outcomes in the patient’s life. This study is focused on multiple sclerosis patient’s real-life experience of breaking bad news and on the posttraumatic growth dimension. Methods: participants: 15 patients; data collection: semi-directive interviews (based on exploratory interviews and on the Posttraumatic Growth Inventory); data analysis: IPA and clinical analysis (qualitative approach). Findings: themes developed: real-life experience when breaking bad news; evaluation of the doctor-patient communication; consequences of the announcement on their quality of life; change in their priorities and new identity; strategies to cope with multiple sclerosis; psychic resistances in non-adherence with treatment… Discussion: Psychic traumatism when breaking bad news, feeling of powerlessness due to the evolving and progressively crippling character of MS and relative effectiveness of treatment explain the difficulty for patients to cope with MS and the fragility of their relation to their doctor.

Background: Poor outpatient clinic attendance is common among young adults with Type 1 diabetes mellitus (DM). The aim of this qualitative study is to develop a theory, using Grounded Theory, of clinic attendance among young adults with Type 1 DM. Methods:Semi-structured interviews have been carried out with 18 young people with type 1 DM and 7 members of staff. Findings:Many young adults are motivated to attend the diabetes clinic in order to gain reassurance through contact with familiar, supportive staff, and testing and screening. Barriers to attendance include fear of deterioration of diabetes, work demands, and a lack of value associated with attending. Barriers prevent the development of Alliance, the core category in this theory. A collaborative relationship or Alliance between young adults and staff is developed through experience of attendance and major events (structured education programme or crisis of diabetes) and facilitates further attendance. Discussion:This substantive theory provides new insight into experiences of diabetes care which will inform the development of behavioural interventions to improve clinic attendance as well as improvements to services.

Background: Earlier reviews on school-based physical activity (PA) and sedentary behaviour (SB) interventions among adolescents have not characterised intervention content in sufficient detail to draw conclusions about the effective ingredients. This systematic review evaluates 1) the effectiveness of school-based interventions for PA and SB, and 2) whether content (i.e., behaviour change techniques, BCTs) influences intervention effectiveness. Methods: Five databases were searched. Two researchers independently screened publications to check eligibility, assessed risk of bias, and coded intervention content using BCT Taxonomy v1. Results: Ten studies were included. Six out of 10 studies reported significant increases in PA and two out of 4 reported reductions in SB. Effects were generally small and short-term. Interventions effective in increasing PA included BCTs related to self-regulation, e.g, goal setting and self-monitoring. Discussion: School-based interventions can increase PA in the short term, and use of self-regulatory BCTs seems promising. Researchers need to improve the quality of intervention descriptions to be able to identify which BCTs were actually implemented.

Background: A behavioural-educational pilot intervention was designed to prevent paediatric asthma emergency admissions to promote behaviour change towards effective self-management. The self-regulatory model, self-efficacy theory and intervention mapping were used. Methods: 15 participants (aged 2-16) with asthma were recruited from out-patient clinics (Birmingham Children´s Hospital). Survey, self-report and feedback data was collected (7 children and 15 participants´ parents) at baseline, 3months and 6months follow-ups. Findings: There were significant differences in ACT scores for parents ((2,n=15)=12.26, p=.002)) and children, ((2,n=7)=10.33, p=.006), and in parent PACQLQ scores ((2,n=15)=12.25, p=.002)). However there were non-significant differences in children´s miniPAQLQ scores ((2, n=7)=3.71, p=.156), Parent Asthma Self-Efficacy scores ((2,n=15)=5.22, p=.074)) and Child Asthma Self-Efficacy scores ((2,n=7)=2.55, p=.280)). Discussion: This theory-based intervention successfully tackled self-management behaviours. Feasibility, fidelity and quality of the pilot were good. Participants appreciated the extra contact; however a better tool for self-reporting is needed

Background: Aim of the study was to determine whether parental alcohol specific rules and communication have a beneficial effect on alcohol use in 16 to 18 year old Dutch adolescents, who were at the time of measurement legally allowed to buy soft alcoholic beverages. We furthermore assessed whether effects of rules and communication vary in drinking situations with and without parents. Methods: 499 Dutch parents and their 16 to 18 year old child responded to a questionnaire assessing alcohol consumption and binge drinking of adolescents, alcohol consumption of parents, alcohol specific rules and communication. Structural equation modeling was used to test the relationships between these variables. Findings: Stricter rules were associated with less adolescent alcohol use. Communication was positively related to alcohol use indicating that more communication was associated with more alcohol use. These effects were equally strong in situations with and without parents. Discussion: Contrary to parents’ perception, their influence on adolescent alcohol use persists, even in situations where they are not present. Parents should be encouraged to continue setting rules about alcohol use.

Background: Reports of interventions, including behavioural interventions, frequently omit essential information, thus preventing intervention uptake. One analysis reported only 29% of non-pharmacological interventions were adequate. We aimed to develop a guide for reporting minimum data across all interventions (drug, surgery, rehabilitation, psychotherapy, behaviour change). Methods: EQUATOR stages for reporting guideline development were followed: 1. item generation 2. two-round international Delphi survey with 74 inter-disciplinary experts; 3. consensus meeting of 13 experts; 4. follow-up iterations and piloting. Results: The resulting checklist identified 12 items: brief name, why (rationale), what materials, what procedure, who provided, how, where, when and how much, tailoring, modifications, how well planned (fidelity assessment), how well delivered (fidelity outcomes). Each item has a brief explanation and inter-disciplinary examples. Conclusions: The TIDieR (Template for Intervention Description and Replication) checklist and guide can be applied to all interventions, as well as control interventions, used by authors to guide intervention report writing and journal editors and reviewers to ensure adequate published intervention descriptions.

Background: Cardiac rehabilitation (CR) is highly effective in promoting physical and psychological recovery following acute cardiac syndrome (ACS). Despite this in the UK, only 42% of eligible patients take part. This study examines determinants of “perceived necessity” of Phase 3 CR in a cohort of ACS patients followed from discharge until the start of CR. Methods: Of 488 eligible ACS patients (March 2012 to July 2013), 214 consented. Consecutive patients completed a computerised weekly diary using shortened standardised questionnaires targeting illness and treatment-related beliefs, mood and “perceived necessity” of CR. Findings: 184 participants provided 5weeks of diary entries. “Perceived necessity” was independently predicted by illness perceptions (“treatment control” (B=0.07, p<.002); “emotional representation” (B= -0.13, p<.001)), treatment perceptions (“concerns regarding exercise” (z=-0.12, p<.001)) and positive affect (z=0.31, p<.001). Discussion: Perceptions of high controllability, negative emotional consequences of ACS, low concern regarding exercise were strong predictors of “perceived necessity”. Targeting these processes could increase attendance at CR.

Background: Visual attention to unhealthy food triggers the urge to eat and thereby creates self-control conflicts in people trying to eat healthily. Avoiding visual attention to unhealthy food can thus be considered a self-regulatory strategy. Self-regulatory capacity has been shown to develop throughout childhood and adolescence suggesting that adults self regulate better than children. Methods: Using a novel eye-tracking paradigm children's and adults' initial fixation (bottom-up) and retained dwell time (top-down), were measured upon exposure to healthy and unhealthy food pictures. Findings: Results revealed increased initial attention to unhealthy food in children and adults. For retained attention however, adults self-regulated their visual attention away from the unhealthy towards the healthy food, while children did not self-regulate visual attention away from unhealthy food despite their self-reported attempts to eat healthily. Discussion: These findings emphasize the necessity of improving children's self-regulatory skills to support healthy eating in an obesogenic environment and promote a novel technique of examining self-regulatory capacity.

Creating health promoting conditions for students is regarded an important duty of universities. Questionnaire surveys are the standard means for collecting data on students’ health. Yet, the cognitive and communicative processes impacting the answers in self-reports as described in the influential paper “How the questions shape the answers” by Norbert Schwarz [1999, American Psychologist, 54(2), 93-105] are not always considered sufficiently. The present paper describes the results of a replication of this work conducted within a research methods course (N = 16 students). The course aimed at sensitizing the students for context effects and promoting their research self-efficacy. Study subjects (N = 72) were randomly assigned to two experimental conditions, namely two versions of a questionnaire on student health. Results were significantly impacted by response alternatives (high vs. low frequency), question form (open vs. closed-ended) and question order. It was demonstrated that context effects shape the answers we receive in student health surveys. Besides, the students involved in conducting the present study reported a substantial perceived increase in research self-efficacy.

There are evidences in the literature supporting the relation between clinical communication and patients’ satisfaction. The aim of the present longitudinal study was to explore whether nurses’ self-regulation skills contributes to patients’ satisfaction. 338 nurses (mean age 38.8, SD = 8.8) from Public Hospitals participated in the study. 89 from the 338 nurses participated in a six month intervention programme for the purpose to develop self-regulation skills. The participants filled the following self-reported questionnaires : A goal elicitation procedure (Little, 1983); SRSB(Maes, De Gucht, Heiser, Karoly, & Ruehlman, 2005); Long-Form Patient Satisfaction Questionnaire (PSQ-III) (Marshall & Hays,1987) Structural Equation Analyses showed that nurses’ self- regulation has significant positive relation with patients’ satisfaction and negative significant relation with patients’ dissatisfaction. The present results underline the important contribution of nurse’s self-regulation to patient’s satisfaction.

Previous studies have found that specific sources of perceived social support may play different roles in health risk behaviour and sexual risk behaviour as well. The aim of this study is to explore the associations between three types of perceived social support from family, friends and others and sexual risk behaviour among young adults in Hungary, Lithuania and Slovakia. An online questionnaire concerning health behaviour,perceived social support and sexual behaviour was distributed to first year university students from Slovakia (N=807,75% females, mean age 20.8), Lithuania (N=928, 70% females, mean age 20,0), and Hungary (N=819, 66% females, mean age 21,4). Binary logistic regression was performed in SPSS 16. Young adults from all countries reported the same pattern of associations between social support and sexual risk behaviour. Higher levels of support from family and others was associated with lower rates of sexual risk behaviour. Students with a higher level of support from friends were more likely to report multiple partners, sex under the influence of alcohol and inconsistent condom use. Young adults are sensitive regarding the source of social support as their behaviour differs depending on the source. The identification of students with their peers and friends in addition to perceived social norms may explain this.

The degree an individual is prepared for a potential threatening event impacts on their ability to be resilient during and after the event. As such, predicting the factors that influence the level of preparation can provide useful recommendations in increasing the level of resilience. The current study sought to extend the applicability of the Extended Parallel Process Model to predicting preparation in a disaster prone community. A total of 279 participants from a cyclone prone community in Northern Australia completed the questionnaire about their experience with extreme weather events, preparation, concern, perceived threat, self-efficacy, social capital and resilience. It was found that self-efficacy predicted preparation (p=.01) and this was mediated by social connectedness (p=.00). Also, the perceived severity of a future weather event was found to predict concern (p=.00) and this was mediated by trust (p=.00). Findings from this study suggest that the adapted EPPM is an acceptable model for making predictions about preparation within a disaster prone community. The results suggest that increasing self-efficacy and social connectedness will increase preparation.

Background: The aim of this study was to examine whether the relation of general maladaptive health beliefs (as a set of biases in understanding general health issues) to patients’ coping behaviours is mediated by illness representations (as a set of beliefs about an illness). A further aim was to examine whether these relations are moderated by the amount of illness-related information provided by physicians. Methods: Patients with cardiovascular diseases (N=119) participated in the study. Coping behaviours were assessed 2 months later than general maladaptive beliefs, illness representations and information provided by physicians. Findings: Personal control and illness coherence mediated the relation of maladaptive beliefs to coping behaviour. The amount of information provided by physicians moderated the relation of maladaptive beliefs to illness representations and coping behaviour (it was not significant at the higher levels of the moderator). Discussion: General maladaptive health beliefs seem to conduce to a more negative perception of illness, which in turn impacts health behaviour. However, this effect is conditional on the quality of the patient–physician communication.

Background: The introduction of the HPV vaccine constitutes a shift in health policy and health promotion practice. The aim of this study is to investigate knowledge, attitudes and communication preferences of the Greek public in relation to cervical cancer and the HPV vaccine. Methods: 9 focus groups (6-8 participants each) were conducted with teenage girls, parents of vaccine eligible girls and young women. Pre-focus group questionnaires consisted of: socio-demographics, knowledge (adapted from Gerend & Sheperd, 2011), BMQ - General & Specific to the HPV vaccine (adapted from Horne et al, 1999). The discussion guide was based on issues raised by (Kang & Kim, 2011; Flynn & Ogden, 2004) i.e. risk perception, illness severity. Thematic analysis was used for analysis of qualitative data. SPSS will be used for correlation and comparative analysis. Findings: Preliminary quantitative findings indicate that participants had a moderate level of knowledge and strong concerns beliefs about medicines and the HPV vaccine. Emerging themes are: lack of faith in the healthcare industry, over- medicalization of life, poor health information communication, ambivalence of health professionals, negative emotions springing from the vaccine dilemma. Discussion: Findings will contribute to our understanding of health behavior decision making and provide recommendations for health policy adjustments.

Background: Prostate cancer patients can benefit from changes in their diet because they are at risk of developing other conditions. This study investigated the relationship between psychosocial factors, participants’ demographics and changes in prostate cancer patients’ diet. Methods: A cross sectional study using an online and paper survey in the UK. Prostate cancer patients (N = 95) were recruited through self-help groups and charities. The questionnaire consisted of information on dietary change, sociodemographic factors, the EORTC QLQ C-30 and PR25, Cancer Locus of Control and General Self Efficacy Scales. Findings: Lower cognitive functioning (CF), lower external locus of control (doctors), more severe symptoms of dyspnea and higher education were found to predict dietary changes after diagnosis but only lower cognitive functioning after therapy started. Discussion: Our study proposed an association between HRQOL, perceived behavioural control, self-efficacy and personal characteristics on the variability of dietary changed after diagnosis but not after therapy has stared. Cognitive functioning can determine the changes both after diagnosis and after therapy.

Background: Various studies on the wives of the veterans with PTSD show that these wives, after some time of joint life with these veterans, experience a lot of psychological problems. The object of the present study has been evaluating the effectiveness of mindfulness based cognitive therapy in changing the cognitive emotion regulation strategies among veterans’ wives with chronic PTSD. Methods: In this study, semi-experimental design pretest-post test was done with the control group. The statistical sample included 40 of veterans’ wives with chronic PTSD who had the criteria for entering into this study and was selected by an objective-based sampling method. These participants were randomly put in 2 groups of 20 individuals including the experimental group and the control group. The experimental group was trained in 8 sessions of 2 hours and 30 minutes. The measurement tool was CERQ scale. The results were analyzed using T-Test method. Findings: The results showed that the eight training sessions were effective in changing the experimental group’s cognitive emotion regulation strategies (P<0.01). Discussion: The obtained results suggest that the therapeutic sessions based on mindfulness strategies were effective in changing the cognitive emotion regulation strategies among veteran’s wives with chronic PTSD. In other words, these strategies increased the use of positive strategies (positive refocus and programming, positive evaluation, acceptance) and decreased the use of negative strategies (self-blame, blaming others, rumination, catastrophizing).

Background. Traditionally, research into health behaviours and well-being has adopted a self-report, explicit approach. More recently, implicit, impulsive processes have been measured. Recent research into health behaviours, relationships, and body dysmorphia and well-being in general will be presented. Methods. Several studies (n = 76 - 200) were conducted investigating the predictive validity of implicitly measured motivation and explicit measures across a number of health behaviours and well-being (e.g., eating, exercising, gym attendance, body dysmorphia). Findings. Analyses support the significant role of implicit motivation across a range of health behaviours and well-being in general. For several categories, implicit measures of motivation were a stronger predictor of behaviour than explicit measures of motivation, personality, and attachment. Discussion. There is growing support for the predictive validity of implicit measures of motivation and attitudes in research. However, there is a growing trend in the literature and current findings suggesting that implicit measures predict spontaneous, unplanned behaviours better.

Responding to the call for health interventions that address multiple health behaviors, we developed a transfer-oriented health curriculum for secondary schools. This curriculum explicitly addressed smoking, but it included principles from transfer-oriented learning theory, meaning that it aimed to transfer the skills and knowledge learned in the domain of smoking to other – unaddressed – health behavioral domains. An experimental study among 1107 thirteen and fourteen year old students indicated that the curriculum favorably impacted behavior in the unaddressed domain of alcohol consumption, but the mechanism through which those effects were achieved were unknown. Using regression analyses, the present article shows that the transfer-oriented curriculum strengthened the relationship between smoking determinants and alcohol consumption, allowing alcohol consumption to co-vary with positive changes in the addressed smoking determinants. By strengthening relationships between health behaviors, transfer-oriented health interventions can impact multiple health behaviors, and by doing so they have the potential to fulfill the need for more efficiency in health promotion practices.

Background: Although fear appeals can cause defensive reactions, traffic campaigns frequently use threat with the goal to promote safe driving. This study investigates possible defensive reactions (i.e. more risky driving) of threat information on billboards. Adding coping information with advices for safe driving might reduce defensive reactions and increase safe driving. Methods: 71 Participants completed a 25 km test-drive in a driving simulator showing four billboards (photo and text) related to safe driving. The levels of coping (yes or no) and threat (yes or no) on the billboards were varied as between-subjects factors. Eleven measures of risky driving were used including velocity and speeding. Findings: Univariate analyses showed main effects of threat on velocity (p = .007) and speeding (p = .019). Billboards with threat led to higher velocity and more speeding than billboards without threat. No effects of coping were found. Discussion: While threat information led to more risky driving, combining fear and coping showed no increase in safe driving. Cautiousness is advised when using fear appeals on billboards and more effective methods have to be developed.

Background:Psoriasis is associated with cardiovascular disease risk thereby making lifestyle behaviour change (LBC) key to its management. Environmental cues can nudge people into healthier lifestyle choices. If and how signposting and health information displays within health care centres is using this knowledge is unknown. We systematically examined LBC signposting in health centre waiting areas for general and specific health messages for patients with psoriasis. Methods:We analysed the quantity and quality of messages in health leaflets, posters and signposting to LBC. Findings:Across 24 health centres 262 sources of LBC information were recorded (median per site = 10, range= 0-40). These were mainly: generic posters/displays of LBC support (n = 113); and generic materials in waiting areas (n = 98). Information quality was poor and badly displayed, with no high quality psoriasis-specific patient materials. Discussion: Evidence about using environmental cues to prompt LBC does not currently inform the design and display of LBC information in standard health centre settings. Future research should test the impact of good quality information on psoriasis and other health outcomes.

Background: Because of increasing demand and access issues, there is an urgent need to evaluate alternative genetic service delivery models. Methods: In a randomized clinical trial we tested the equivalency and noninferiority of telephone counseling to remote in-person counseling for hereditary breast and ovarian cancer. Women (n=901), 25-74 years of age, with a personal or family history of breast and/or ovarian cancer completed BRCA1/2 counseling and follow-up assessments 1 week after pre-test and post-test counseling and at 6 months. Findings: Uptake of BRCA1/2 testing was lower following telephone (21.8%) than in-person counseling (31.8%; cluster bootstrap estimate of 95% confidence interval (CI)=3.9%-16.3%; intent-to-treat: 9.2%, CI=-0.1%-24.6%). Telephone counseling was noninferior to in-person counseling in terms of decisional conflict (linear model estimate of between group difference [D] = 0.42; noninferiority one-sided 97.5% CI=1.86), decision regret (D = 2.03; one-sided 97.5% CI=4.66) and patient-centered communication measures. Discussion: Telephone counseling can effectively increase the clinical reach of and access to genetic counseling services.

Commitment is the most important predictor of the maintenance of romantic relationships. Recently, Frank & Brandstattar (2002) and Strachman & Gable (2006) proposed that commitment can be divided into approach and avoidance commitment. The present study examines the influence of approach-avoidance commitment on mental health and subjective happiness. Sixty-nine romantic pairs completed a questionnaire about approach-avoidance commitment, positive and negative affect, subjective happiness and GHQ. The actor-partner interdependence model showed that for both men and women, own approach commitment was positively associated with positive affect; own avoidance commitment was positively associated with own negative affect. Additionally, a man’s approach commitment is negatively associated with a woman’s negative affect. Finally, whereas men’s negative affect is positively associated with GHQ score, women’s positive affect is positively associated with subjective happiness. These results suggest that the process by which approach-avoidance commitment influences mental health and happiness differs between men and women.

Chronic pain such as migraine is associated with emotional impairments and the use of maladaptive ER. We studied if migraineurs compared to pain-free controls can reduce negative emotions by employing the adaptive ER strategies reappraisal or distraction during experimental pain stimulation. To do so, 66 women (33 migraineurs, 33 controls) were randomized to one of three conditions (reappraisal, distraction, control) and exposed to 20 electric pain stimulation trials. After each trial participants rated their anticipatory anxiety and pain perception. Additionally, physiological parameters (skin conductance, heart rate) were recorded throughout the experiment. Compared to the control condition, reappraisal and distraction led to strong reductions in anticipatory anxiety and pain perception that were equivalent in migraineurs and controls. Physiological parameters are analyzed at present. When following instructions how to adaptively regulate emotions while anticipating and receiving pain, migraineurs are as capable as controls to reduce anxiety and pain perception. Thus, migraineurs could benefit from promoting reappraisal and distraction to regulate emotions and pain.

Background: Associating popularity with certain food items is a technique used in advertising. This raises the question (1) whether children associate unhealthy foods with a peer’s popularity status and, (2) whether this is related to their own preferences and consumption behavior. Methods: Snack preferences and consumption of 2.837 children and adolescents from Finland, Germany and Romania were assessed. In a forced-choice vignettes format, they indicated the preferred snack choices (e.g., muffin vs. apple) for a popular and an unpopular peer. Findings: Path models showed a significant association between the perceived snack preference ascribed to popular and unpopular peers and their own snack preference, indicating a symbolic preference effect: the more popularity was associated with unhealthy snacking the more children preferred unhealthy snacks themselves (?s > |.136|, p < .001) which in turn was associated with greater snack consumption (? = .441, p < .001). Discussion: The results suggest an implicit mode for triggering food preferences through social incentives: cool kids can make food more socially rewarding. Practical implications for interventions will be discussed.

Background: There is a need for better understanding on the factors predicting long-term weight outcomes after bariatric surgery. This study examined whether psychological eating behaviors (cognitive restraint, disinhibition, hunger) were prospectively related to short- and long-term weight changes after surgical treatment for severe obesity. Methods: Participants were bariatric surgery patients (n=2010) from the Swedish Obese Subjects study, which is an ongoing, matched (non-randomized), prospective intervention trial. Physical measurements (weight, height) and questionnaires (Three-Factor Eating Questionnaire) were completed prior to surgery and 0.5, 1, 2, 3, 4, 6, 8, 10 and 15 years after the treatment. Findings: Pre-treatment eating behaviors were unrelated to subsequent weight changes, while lower 6-month and 1-year levels of disinhibition and hunger were associated with greater 2-,10- and 15-y weight loss (B=0.19–0.36 in men, B=0.09–0.28 in women, all p<0.05). Discussion: Problems in the regulation of eating shortly after bariatric surgery predicted poorer long-term weight outcomes, making post-operative overeating tendencies an important indicator of targeted interventions.

Background: Although there is much evidenced of the social support effects on health, there is limited information about to what extent social support can be provided online and the conditions under which such support can have positive outcomes for chronic pain patients. The aim of this study is to examine the impact of an online social support tool on patients’ health outcomes and to identify the determinants that impact the usage and the efficiency of such a tool. Methods: we used a mixed approach and at the first stage we conducted an experimental quantitative study with 160 ---- (RA) patients interacting on a web site that we developed previously using an online questionnaire. At the second stage we conducted 20 in-depth interviews with RA patients evaluating what determined the usage and the impact of the site. Findings: Online support improved more concrete outcomes related to the daily management of the disease, but was less successful at deeper self-perceptions such as empowerment and acceptance. These results are explained by some determinants like the characteristics of the web source; the internal and external experience with the disease; illness dimensions and personality type. Discussion: defining the factors that determine patients’ usage of online support lead to recommendations for designing future tools in order to maximize the effectiveness in delivering online support.

Background A large proportion of young adults between the ages of 18 to 25 have been found to skip breakfast on a regular basis – the predictors of consumption within this population are not yet well understood. The aim of this study is to evaluate the extent to which Temporal Self-Regulation Theory (TST) can be meaningfully applied to breakfast consumption behaviour. Methods Australian young adults (18-25 years) were administered a web-based survey containing measures of habit and intention and two computerised measures of self-regulation. Breakfast consumption was measured at 1 week. Findings TST constructs predicted 66.2% of variance in breakfast consumption. Although intention was significantly correlated with behaviour, only habit was a significant predictor of breakfast consumption in the final model. Discussion This is the first study to evaluate TST in the context of breakfast consumption behaviour. The findings suggest a central role of habit in determining young adults’ breakfast consumption behaviours. Future research in this domain should explore the potential for interventions that target the habitual consumption breakfast in order to improve dietary behaviour.

Objectives: Studies of coping and quality of life (QOL) mostly consist of one assessment of patients in different phases. The goal was to assess the level and effects of specific copings on specific QOL domains in cancer patients in the month around diagnosis and 10-12 months later. Methods: The participants were 52 cancer patients with different diagnoses. They were administered the Multidimensional Inventory of Coping and the QOL Questionnaire two weeks after diagnosis and two weeks after treatment termination. Findings: Coping strategies and quality of life levels differed in the two phases of the study: Denial and fighting spirit in coping and work, negative emotions, and physical needs in QOL were higher in the first phase; and in the second phase stoic acceptance and changing life style in coping and social functioning and meaningfulnesss inQOL. The coping strategy with the strongest impact on QOL in the first phase was positive emotions and in the second phase focusing on oneself. Conclusions: Coping strategies and affected domains of QOL change in the course of the illness and the treatments as well as their interactions.

Background: The aim of the study was to explore how satisfaction of the communication with the physician impacts anxiety, depression, illness concern and comprehension in a dyadic setting. Methods: We compared 73 dyads of patients’ and caregivers’ on three scales assessing the satisfaction with communication (MCCS ; IV), illness concern and comprehension (BIPQ ; DV) and psychological distress (HADS ; DV). Data were analyzed using the Actor Partner Interdependence Model (APIM). Findings: Greater satisfaction with communication for patients was associated with greater patients’ coherence and illness concern and with more anxiety for caregivers. This last link was mediated by caregivers illness concern. Caregivers’ communication was not associated with caregivers’ outcomes. Conclusion: This study showed the importance of patients’ satisfaction about communication with the physician on both patients’ and caregivers’ distress and illness perceptions.

Background: Intra-individual change trajectories of depression symptoms and their covariates including coping process variables in myocardial infarction (MI) survivors, were examined in 6-year follow-up period. Methods: Two hundred cardiac patients (age 53.73±7.26 years) were assessed four times: a few days after first MI, one month, six months, and six years later. Demographic and medical characteristics, cognitive appraisal, coping, emotions, depression symptoms, as well as resources and critical life events (both only in the 4th stage) were measured. Findings: Three latent trajectories based on growth mixture modeling (GMM) were identified for depression symptoms: chronic (N=49), rising (N=121), and low (N=30). Belonging to the chronic group were associated with higher emotion-focused coping, negative affect and critical life events number, also lower problem-focused coping, hope, resources number and worse somatic health. Discussion: The findings shed light on the intra-individual change trajectories of depression symptoms after MI and related coping process variables: protective function of resources and instrumental coping, opposite of negative states and palliative coping.

Background: Procrastination is a prevalent and problematic phenomenon that has mostly been studied in the domain of academic behavior. The current study highlights another domain in which procrastination may lead to harmful outcomes, introducing bedtime procrastination as an important factor related to getting insufficient sleep and consequently affecting individual well-being. Methods: A community sample (N = 177) filled out an online questionnaire assessing self-regulation, bedtime procrastination and sleep outcomes (hours of sleep, experienced insufficient sleep, daytime fatigue). Findings: As predicted, bedtime procrastination was negatively associated with self-regulation. Moreover, bedtime procrastination was related to getting insufficient sleep above and beyond demographics and self-regulation. Discussion: Introducing a novel domain in which procrastinators experience problems, bedtime procrastination appears to be a prevalent and relevant issue that is associated with getting insufficient sleep. The current study suggests that procrastination may be an important but as of yet neglected factor in the health behavior domain.

Background: Chronic pain is common in many patients, sometimes without a clear cause. However, pain is not a medical specialty in the Netherlands. It is therefore of interest to see what care these patients receive and how they perceive the care received. Methods: Mixed methods using focus group discussions and IPA method for analyses in developing a structured Consumer Quality Index questionnaire (CQI). Findings: 23 chronic pain patients took part in four focus groups, 886 completed the survey (RR=40%; 73% women). Patients reported lack of continuity in care and poor coordination between healthcare providers. Though most reported fairly good doctor-patient communication, about 25% reported limited shared decision-making and 35% limited information sharing about treatment possibilities. Many made use of complementary medical care, due to restricted health care insurance coverage of standard care. Discussion: Chronic pain patients would benefit of health-care providers being more proactive and some central healthcare-professional coordinating the chronic pain care, e.g. a case manager. Complementary care was found useful, though standard care was believed to be most beneficial.

Background: This study aimed to advance understanding of explanatory variables associated with weight loss maintenance (WLM). Methods: We used a series of n-of-1 studies and McKnight bootstrapping approach to explore WLM in 12 people who in the previous year lost over 5% of their body weight. For two months we used ecologic momentary assessment to gather daily data on motivation, self-regulation, resources, habits and environmental and social influences (predictive variables) and weight, physical activity and ability to follow a WLM plan (outcome variables). Results: For all 12 participants, daily fluctuations of each of the 3 outcomes were significantly predicted by explanatory variables. Patterns of variables contributing to the prediction, amount of variability accounted for and autoregression differed between participants. Discussion: Divergent maintenance-related variables showed differential impact on ability to maintain weight, engage in physical activity and to follow a WLM plan for different individuals. The n-of-1 design offers useful tool for developing and testing theory of behaviour change maintenance.

Bacground: The aim of the study was to examine whether optimism and social support moderate within-day associations between pain intensity, pain coping and negative and positive emotions. Methods: 53 women completed an initial questionnaire assessing LOT-R and a 7-day daily diary assessing pain (10- point visual analogue-scale), negative and positive emotions (PANAS) and pain coping strategies (Daily Coping Inventory adapted for chronic pain coping). Findings: Multilevel analyses examining within- and between person variability showed a greater increases in positive emotion on less painful days and increases in relaxation on more painful days; whereas pessimistic patients showed a greater decline in seeking for social and professional support in more painful days. Furthermore, results revealed that effect of social support was non-significant. Discussion: Findings support the positive role of optimism defined as coping resource in psychological functioning in rheumatoid arthritis.

Background Limited information has reported about types of changes in quality of life (QOL) in advanced lung cancer patients (pts). The aims of this study were to (1) explore the types of QOL trajectories, and (2) identify factors related to each QOL pattern in advanced lung cancer pts during the first 6 months of being diagnosed as lung cancer. Methods A prospective longitudinal study was conducted in a medical center in Taiwan. Patients were assessed 4 times: pre-treatment (tx) and 1, 3, 6 months from first tx (T1-4, respectively). QOL pattern was measured by the overall QOL item from the EORTC QLQ-C30. Physical and psychological distress and self-efficacy were analyzed as potential factors for each QOL pattern. The Latent Class Growth Analysis (LCGA) was applied to analyze the patterns of QOL changes. Finding A total of 170 pts were recruited and three QOL patterns were identified. The first type of QOL (41.8% of pts) was “changing but moderate level of QOL“. The second type of QOL (19.6% of pts) was “moderate to lower levels of QOL”. The third type of QOL (39.6% of pts) was “steadily moderate level of QOL”. Generally, physical function, pain, poor appetite, uncertainty, and self efficacy (the most robust one) were related to patients’ QOL. Discussion The timely and tailoring interventions, including symptom and psychological supports, should be developed to enhance cancer patients’ QOL.

Fostering positive emotions and sense of life are central aims of Positive Psychology (PP). These variables are also important for psychological health (PH). It is suggestive therefore to combine both approaches and to use methods of PP to promote PH. In the paper the conception and evaluation of a PP-seminar to foster PH is presented. The seminar consists of seven elements: Psycho-education, happiness-diaries, cognitive restructuring, individual strengths and resources, mindfulness, enjoyment-training, and work-life-balance. 42 subjects participated in the training and were compared with a randomized control group (n=54) in following outcomes: positive emotions, well-being, depression, anxiety, self-esteem, personal and social resources. Effects of the training show medium effect sizes in average. Highest effects were found in raising positive emotions, self-esteem, and perceived personal resources, and in reducing depression and anxiety. Most outcomes are stable over a four to six-months period. Results are promising and show that PP interventions are able to promote well-being and happiness and to reduce distress in people without apparent mental problems.

Background: Social embeddedness is connected with well-being but little is known if experiencing MI, age and gender moderate this relation. Methods: MI-survivors (n=780) and MI-free participants (n=44820) in HUNT Study were followed-up after 10 years. Social embeddedness at HUNT2 (1995-1997) was used as a main predictor. Three positive (self-rated health, positive affect, general life satisfaction) and 3 negative (everyday life impairment, anxiety, depression) well-being indicators at HUNT2 and HUNT3 (2006-2008) were outcomes. Findings: Hierarchical regression revealed that higher social embeddedness predicted higher positive and lower negative well-being indicators both in cross-sectional and prospective analyses. Age moderated some of the relations: a negative relation between social embeddedness and current everyday life impairment and a positive relation between social embeddedness and future positive affect were stronger in older age, while a positive relation between social embeddedness and current self-rated health was stronger in younger age. Discussion: Social embeddedness should be an issue of interventions aimed at well-being improvement both in older and younger adults.

Background: To prevent the transmission of influenza to patients, influenza vaccination of healthcare personnel (HCP) is recommended but vaccination rates are low. The aim of this study was to identify social cognitive variables that explain the motivation to obtain vaccination and to test whether intention is a good predictor of actual vaccination behavior. Methods: Dutch HCP (N=1370) were invited to participate in a cross-sectional survey (baseline). To link intention to behavior, participants who completed the first questionnaire (N=556) were sent a second questionnaire after vaccinations were offered (follow-up). Findings: Multinominal regression analyses showed that HCP with a negative attitude, high autonomy, preference of inaction over vaccination, low moral norms, and high self-protection motives are more likely to report no intention to get vaccinated vs being unsure. A positive attitude and believing that vaccination is effective increase the probability of reporting high intention vs being unsure. 80% of the variance in intention was explained. Intention in turn explained 58% of the variance in behavior. Discussion: Social cognitive variables were identified that explain the intention to get vaccinated against influenza of HCP, which proved to be a good predictor of behavior. Future interventions should focus on these variables to increase vaccination coverage rates.

Work engagement has been proven to be a viable indicator of physical and mental well-being at work. Research findings have shown a link between work engagement and both individual and organizational resources. The aim of the present study is to test the hypothesized relationships between personal traits (Big-5), the quality of the social work environment (social capital) and work engagement among hospital (n = 35) physicians (n = 387) in North-Rhine Westphalia, Germany. Structural equation modeling (SEM), combining confirmatory factor analysis (CFA) and path analysis, was employed to conduct the statistical analyses. The results of the SEM indicated that social capital was positively associated with work engagement. The personal trait variable neuroticism was negatively related to work engagement. The relationship between agreeableness and work engagement was fully mediated by social capital. Findings suggest that social capital plays a key role in promoting work engagement of physicians.

Background The present study examined which factors mediate the association between parental educational level (PEL) and children’s fruit and (FV) intake in ten European countries. Methods In total, 8159 11-year-old children (response rate 72%) and their parents, in ten European countries, participated in the PRO GREENS project in 2009. Children completed a validated food frequency questionnaire about their daily FV intake and a validated questionnaire about availability of FV at home, parental facilitation of FV intake, liking for FV, self-efficacy to eat FV and knowledge of the FV intake recommendations. PEL was reported by parents. Associations were examined with mediation analyses with Mplus. Findings Higher PEL was associated with more frequent daily fruit intake among children in five of the ten countries. This association was mediated mainly by knowledge. Positive association between PEL and children’s daily vegetable intake, found in seven countries, was mediated mainly by availability and knowledge. Discussion Future intervention studies, which aim to decrease PEL differences in FV intake, should target the country-specific determinants of FV intake.

Background: This study aims at exploring the factors that contribute the most to PRPE in advanced cancer patients. Investigated factors were: physician-reported empathy, patients’ unmet supportive care needs, concordance between patients and physicians on patients’ unmet needs, and patients’ satisfaction with care on various dimensions. Methods: 201 metastatic cancer patients and 28 oncologists participated in the study filling out validated questionnaires. Durations of consultations were also recorded. Multilevel analyses were carried out. Findings: Patients’ psychological unmet needs, physician-reported empathy and concordance were not related to PRPE. Conversely, patients’ unmet needs for more support and information by medical staff strongly lessened PRPE, while the patients’ satisfaction with interpersonal skills and the duration of consultations strongly improved PRPE. Discussion: According to these results, it would not be necessary for oncologists to develop an accurate perception of their patients’ situation or to focus too much on their psychological concerns, as long as they pay attention to provide them with clear information and explicit expression of their support.

Background: Periodontal diseases and dental caries are the most prevalent dental diseases affecting people worldwide. According to the health action process approach (HAPA), participants should first be informed about the risks and benefits to be encouraged to form a behavioral intention to adopt better oral self-care.Then should be guided to generate plans and control their behavior. However, research has not addressed the validity of this putative sequence. Thus, this study evaluates the effectiveness of two subsequent dental flossing interventions (Motivational vs. Self-regulatory), placed in different order to test the superiority of a sequence. Methods: Young adults(N=205, aged 18–26 years) were allocated to two treatment groups (Sequence 1 vs. Sequence 2) at three assessment points, 34 days apart in Spring 2013. Sequence 1 received a motivational intervention followed by a self-regulatory intervention. Sequence 2 group received the same treatments, but in the opposite order. ANOVAs and ANCOVAs were conducted with dental flossing, self-efficacy, planning, and action control as dependent variables and sequence conditions as within subject factor. Results: Both treatment sequences yielded gains in terms of all variables. However, the motivational treatment was found to have a negligible effect, i.e., the overall gains were attained even without it. At Time 2, those who had received the self-regulatory treatment first, were superior to their counterparts who had received the motivational treatment first. At T 3, differences vanished as everyone had then received both treatments. Conclusions: This research has explored in a unique way the sequencing of different health behavior interventions. Findings highlight the advantage of a self-regulatory intervention over a motivational dental flossing intervention. Keywords: self-regulation, intervention, oral self-care, self-efficacy, planning, action control, young adults.

Background: People with a limited future-time perception (FTP) are likely to engage more in emotionally meaningful goals but less in healthy behaviors. In view of the potential conflict between health and social goals, this study tested whether FTP affected goal prioritization and intentions to be physically and socially active. Methods: Participants (n=262) elicited 3 health and 3 social goals, ranked the goals on importance, and reported exercise and social engagement intentions. They were randomly assigned to receive open-ended, limited, or unchanged FTP manipulations. Afterward, participants ranked the goals and reported the intentions again. Findings: Both open-ended and limited FTP conditions led to a shift toward social over health goals as compared with unchanged condition. People in the limited FTP condition intended to exercise less than those in the control condition. Discussion: Both open-ended and limited FTP manipulations might make time constraints salient and shifted people’s attention toward social goals. No such pattern was observed in exercise intention, suggesting the existence of temporal mechanisms other than the socioemotional selectivity theory.

Background: Research suggests that gain- or loss-framed messages may be an effective way to manipulate attitudes toward health behaviour. However, the majority of this research has focused on the influence of message framing on explicit attitudes. The current study aimed to examine whether alcohol-related implicit attitudes could be altered by exposing participants to different message frames. Methods: Participants (N=196) completed an alcohol-related Implicit Association Test (IAT) before being exposed to either gain- or loss-framed social or health-based messages aimed at making implicit attitudes toward alcohol more negative. Participants then completed another IAT after reading the message. Findings: Messages targeting the social aspects of drinking produced a significant negative shift in implicit attitudes from pre- to post-test, while health-based messages had no influence. Gain- or loss-framed messages showed no significant differences in influencing implicit attitudes. Discussion: Results suggest that attempts to make alcohol-related implicit attitudes more negative should focus on highlighting the negative social outcomes that result from consuming alcohol.

Non-communicable diseases caused 65.5 % deaths worldwide in 2010. These are the results of lifestyle and established chronic disease management. So new preventive concepts have to be found. Lifestyle interventions based on the findings of function diagnosis of the autonomous nervous system promise to enable health-conscious behaviour to any population group. In healthy people, the heart continuously reacts to stimuli with finely tuned “variations” of the heart beat. This so-called heart rate variability (HRV) is a measure of an organism’s general adaptability and therefore a measure of disease and health as well. Transforming the data of a 24 hour measurement into a color prism, it visualizes numerical values in a “fire-like” spectrographic illustration – an intruiging, self-explanatory, easy-to- understand, engaging and emotional way of bio-psycho-socio-emotional feedback. Intuitively and rationally noticeable results of one’s personal physiological “fingerprint” establish understanding between therapist and client. As a screening-and evaluation-tool for disease and predisease states HRV is a reliable tool to proof and democratize the evidence of disease and health management.

This clinical trial evaluates the effectiveness of the 6-week program “Parenting the Strong Willed Child-Group Curriculum” (PSWC-GC) to improve the wellbeing of 58 Greek Cypriot parents of children with various disruptive behaviors (2-8 years old). Parenting stress is the constellation of aversive stress reactions that arise from the demands of the parent role. Parents were recruited from the community following bioethics approval and assigned to the PSWC-GC condition. The Greek adaptation (Aerostata) maintained all key elements of the original curriculum in 5 parenting skills. T1=Baseline and T2=post-intervention at 7 weeks. Cronbach’s alphas were high. A paired sampled t-test showed a significant decrease at T2 in Parental Distress of the Greek PSI-Short Form. Child behavior problems decreased significantly at T2, as measured by the Greek ECBI. Higher PSI-SF scores negatively correlated with ECBI. Parents reported high satisfaction with the program at T2 and a global improvement in functioning. Effective parent training programs, such as the Greek adaptation of the PSWC-GC, seem to have significant benefits for the well-being of the parents and the behavior of the child.

Background: Individuals with alexithymia tend to exhibit a deficit in emotional processing and poorer emotional regulation which can then lead to poorer mental health and somatic disorders. We investigated the moderating impact of alexithymia on the ability of adults to control the recall of negative and neutral material, using the directed forgetting paradigm. Methods: Participants studied negative (Experiment 1, N = 60) and neutral (Experiment 2, N = 60) words. They were instructed to forget the first half and remember the second half of an entire list of words. Findings: Alexithymia impaired the recall of wanted negative material and impairs the ability to prevent the recall of unwanted negative material and the ability to exhibit cognitive control over memory for neutral material. The "externally oriented thinking" factor of alexithymia may play a pivotal role in this inability. Discussion: These results suggest that the deficits associated with alexithymia represent a global decline in cognitive control. They will help guide the future treatment of primary and comorbid alexithymia, giving special consideration to its effects on both emotional and cognitive processing.

During pregnancy expectant parents develop an attachment relation with their unborn child (Condon, 1993). The aim of our study was to compare the influence of Adult Attachment dimensions and Gender on Antenatal Attachment. 76 participants completed questionnaires on their 3rd trimester of pregnancy: ECR (Experiences in Close Relationships-Adult Attachment: Brennan et al.,1998) and MAAS/PAAS (Maternal/Paternal Antenatal Attachment: Condon, 1993). In our study, expectant parents presented good levels of parental-foetal attachment (M=57.07; SD=8.27; min=30; max=70). Linear regression showed that gender had an important effect on antenatal attachment (?=.58, p=.001). Avoidance of intimacy dimension-ECR was also relevant for antenatal attachment (?=-.35, p=.001). This result was significant for both expectant fathers (?=-.42, p=.012) and mothers (?=-.47, p=.004). Anxiety of abandonment dimension-ECR had no effect on Antenatal Attachment. Our results showed adult attachment had an important impact in the way expectant parents related to their unborn child. Understanding factors underlying Antenatal Attachment would allow preventing perinatal negative outcomes and promoting family health.

Background: This study investigated to what extent demographics, traumatic occupational events, occurrence of physical occupational hazards, violence and situations that can cause burnout as well as social support of by colleagues and supervisor contributed to post traumatic stress, psychological distress, subjective fatigue, somatic complaints and sleep problems in emergency physicians (EP). Methods: 346 questionnaires, measuring the above concepts by means of mainly validated instruments, were distributed to EP at two emergency medicine conferences. This resulted in 150 usable questionnaires. Hierarchical regression analyses were conducted to explore the contribution of the independent variables on the dependent variables. Findings: High clinical levels were found for all outcome variables. For post-traumatic stress and psychological distress occurrence of burnout situations was the most important predictor. For subjective fatigue occurrence of violence, burnout situations and lack of social support by colleagues were significant predictors. For somatic complaints gender, occurrence of burnout situations, lack of social support by the supervisor and lack of social support by colleagues explained most variance. Sleep problems were mainly predicted by traumatic events. Discussion: There is a lack of research on occupational stress in physicians. These data suggest that EP do not only experience a lot of occupational stress, but that some determinants are more important than others and can be important intervention targets.

Background. The aims of the present study were: a) to construct nonlinear integrated subjective well-being (SWB) model based on bottom-up approach and experimental data on several personality variables: inner directedness, time competence, sociotropy, perfectionism, locus of control, body dissatisfaction, neuroticism, and alexithymia; b) to use SWB model for evaluating the effectiveness of rhythmic movement therapy (RMT) in the increasing of SWB level. Methods. A total of 273 subjects (54 males and 219 females, mean age was 37.3±10.5 years) were selected at random in nonclinical population and assessed with the appropriate surveys and questionnaires. The obtained data were used to construct the SWB model, evaluation of its parameters and validation. The RMT program was proposed to the 105 subjects (24 males, 81 females, mean age 37.6±11.7 years) with very low, low and medium SWB level. Control group was included. Findings. Results revealed that: a) the SWB model not only predicts the level of SWB satisfactorily but also allows obtaining the partial response functions of psychological predictors of SWB directly as a result of estimation of model’s parameters; b) the efficacy of RMT intervention for increasing SWB level was confirmed; c) SWB model predicts the changes in SWB after RMT intervention satisfactorily and can help to identify the reliable predictors of success.

Background: Hedonic priming can lead to increased food intake. We propose that when unconsciously triggered indulgence violates a person’s dieting standards, it may lead to negative affect and a tendency to confabulate (to make up a plausible, but erroneous reason for the indulgent behaviour). Methods: A study with a 2 (Dieting Standard: high vs. low) x 2 (Condition: Neutral vs. Hedonic Prime) between subjects design was conducted. Dieting standards and negative affect were assessed in questionnaires. Condition was experimentally manipulated in a lexical decision task. After the lexical decision task, a taste test was administered. An excuse for indulgence was then subtly provided. Then, negative affect and the tendency to use the excuse was assessed. Findings: Results were indicative of moderated mediation: dieters, but not non-dieters, who indulged as a result of the prime, experienced increased negative affect which caused them to misattribute their behaviour using the provided excuse. Discussion: These findings suggest that hedonic priming has relevant down-stream psychological consequences that extend beyond the primed behaviour itself and that may affect future behaviour.

Background: This meta-analysis examined (1) the effects of behavioral and psychological interventions containing a graded physical activity component in chronic fatigue management, and (2) potential moderator effects of trial characteristics. Methods: Studies were identified through electronic database searches. Studies reporting on randomized controlled trials (RCT’s) were eligible if they: a) targeted adults with chronic fatigue, and b) presented data on any of the following: fatigue, physical functioning, physical activity, and psychological distress; assessed at baseline, post treatment and/or follow-up. Methodological quality and content of studies were extracted. Meta-analysis software was used to calculate effect sizes of intervention effects and to conduct moderator analyses. Findings: Sixteen RCT’s were included. Significant effect sizes were found for all outcomes. Subgroup analyses revealed that interventions providing minimal direct contact with patients had additional effects upon fatigue and depression. Discussion: Treatments with an activity component have beneficial effects upon chronic fatigue management. Identifying key factors of success can improve future interventions’ design and effectiveness.

Objective. To assess if training parents as distraction coaches would increase the amount of distraction used by parents and reduce child pain and anxiety during venipuncture procedures. Method. 44 participants were assigned to either distraction training condition (using a training booklet sent prior to the procedure and an electronic tablet to distract their child during the procedure) or a control group. Results. Parents used significantly more distraction in the experimental group compared with the controls. Although no significant differences for child distress or pain were observed between groups, significantly higher levels of coping behaviours were found in the experimental group. Significant correlations between higher rates of parental use of distraction and lower reports of child pain and distress. Significant correlations were found between parent distress-promoting behaviours and child distress. Conclusions. Distraction training was successful in training parents to use higher rates of distraction although expected reductions in pain and distress were not found for the experimental group. The intervention significantly increased child coping behaviour.

Background: It is unclear to what extent health-related decision-making in adolescence is influenced across a range of measures and illnesses by earlier parental reactions to illness behaviour in the child. Methods: 247 Participants, M = 16.8 years (SD = 0.5). Illness decision measures included visits to GPs, reported levels of illness disruption and vulnerability, and treatment-seeking scenarios for rash, urinary problems, and anxiety. Parental Reactions to Childhood Illness Behaviour (PRCIB) were assessed as in Crane and Martin (P&ID, 2002). Findings: Higher levels of PRCIB led to increased levels of GP visits, illness disruption and vulnerability. Examining levels of treatment-seeking, regression analysis showed PRCIB to be significant even after HADS depression and anxiety, sex and age had been extracted; compared to NHS guidelines, mean responses under-reacted to rash and urinary problems and over-reacted to anxiety. Discussion: Adolescents differed systematically in health-related decision-making as a function of childhood experience, with normative levels both exceeded and fallen short of in different areas, suggesting the need for targeted health education.

We investigated the effectiveness of an intervention to promote informed decision-making on primary renal replacement therapy (RRT) among patients with ESRD and members of their social network (attendees). In a multicentre randomised controlled trial 40 patients received home-based group education and 40 patients received standard education. 310 attendees participated. TPB concepts were measured in a pre-post design: knowledge, communication, attitude, self-efficacy, anticipated negative affect, and subjective and moral norm. In the intervention group significant increases were observed in knowledge (d=1.1; p<.001), communication (d=0.2; p=.13), attitude toward haemodialysis (d=0.5; p=.01), and subjective and moral norm (d=0.5; p=.02) while no changes were observed in the control group. In the intervention group no change was found in anticipated affect (d=-0.1; p=.65) while the controls showed a significant decrease (d=0.6; p=.003). There were also significant increases among attendees in knowledge (p<.001) and communication (p<.001). Early, out-reaching, group education supports informed decision-making regarding primary treatment for ESRD and may facilitate PKT.

Background: Indigenous Australian men’s life expectancy is substantially shorter than that of non-Indigenous Australian men. This study is designed to examine the health behaviors, as well as the enablers and barriers to these health behaviors. Method: One hundred and fifty Indigenous Australian men from three different locations (rural, regional, urban) were interviewed about their health behaviors, particularly in relation to eating and physical activity. Findings: The analyses from the perspective of the Ecological Model of Human Development, revealed several themes of importance to men in terms of their current health and/or their ability to improve their health: 1) Community, 2) Discrimination/racism, 3) Partner and family, 4) Broader relationships, 5) Lack of appropriate healthcare facilities 6) Role of the Indigenous man, 7) Employment. Discussion: These findings are discussed within the context of a participatory action research framework, and highlight the importance of broad community-based (rather than individualistic) approaches to promoting health behavior in Indigenous men.

Background: The purpose of this study was to determine whether self-monitoring interval exercise, compared to other-monitored intervals, produced ego-depletion effects assessed in terms of subjective vitality and post-exercise choice of healthy snacks (e.g., fruit), 100 calorie snack treats, or full size snack treats (e.g., chips, chocolate). Methods: Eighty-one university students were randomized to a self-monitored or other-monitored interval cycling exercise bout. Subjective vitality was assessed before and after the 25 minute exercise bout in half the sample. On completion of the exercise, a snack selection was offered to all participants, whose choices were surreptitiously recorded. Findings: A significant time x group interaction for subjective vitality (eta2=.165, p<.05) was observed. There were no significant effects of exercise monitoring group, or activity level on snack selection. Overall, participants were least likely to choose the 100kcal treats. Discussion: Self-monitoring interval cycling exercise did produce ego-depletion effects evidenced by subjective vitality, but not snack choice. Possible explanations including affective effects of exercise are suggested.

Background: Momentary confabulations are false recollections produced in response to questioning, often arising in clinicians’ interviews with patients. Here we examine the interactional elements of such interviews. Methods: Using discourse analysis, we analysed talk from clinical interviews with confabulating patients. Analysis focused on how both parties oriented to patients’ descriptions of remembered events and on the design and consequential relevance of interactional turns. Findings: Patients’ descriptions show interaction of memory deficits with preserved interactional skills. Interviewers agree with rather than challenge problematic descriptions resulting in further confabulation. Thus, patients’ false recollections arise in part out of the interviews themselves rather than neuropsychological impairment. Discussion: These features mark the clinical interviews out as different from other interactions. Ironically, interviews based on use of confabulation questionnaires can provide settings that are especially conducive to generation of momentary confabulations. Clinical and health researchers require to be alert to the interactional aspects of such encounters.

Increased population knowledge of stroke warning signs has been reported in Ireland following widespread advertisement of the stroke awareness message ‘Act FAST’. This study aimed to examine the change in incidence of pre-hospital delay in an acute ischaemic stroke population and to examine if the Act FAST message influenced individual behaviour when stroke occurred. The incidence rate of pre-hospital delay was examined by assessing delayed stroke presentations in 2010/2011 and 2012/2013 to two Dublin hospitals. A cross-sectional prospective design was employed to examine behaviour during stroke onset. The primary outcome was pre-hospital delay, as defined by Onset-to-Door time (OTD) greater than 3.5 hours The incidence rate of pre-hospital delay significantly reduced from 2010/2011 to 2012/2013. Adjusted Cox regression modelling indicated shorter OTD time if the patients decision-making during symptom onset was affected by prior exposure to the FAST campaign (OR=1.8, 95% CI 1.01-3.24). Pre-hospital delay evidenced a significant reduction since the introduction of FAST. There was evidence that demonstrated population knowledge increases successfully affected behavioural response.

Background: The aim of this study was to examine attributions that may influence the willingness to provide social support to a patient diagnosed with skin cancer. Methods: In an experimental design, N=485 participants received written fictional scenarios in which the onset controllability of the cancer (non-self- vs. self-inflicted), the controllability of the course of the cancer (treatable vs. terminal), and the patient's coping behavior (norm-conforming vs. norm-violating) were systematically varied. Emotional reactions towards the patient (empathy, blame, anger) and the willingness to provide social support were measured. Findings: Results of an ANOVA showed that more support would be provided when onset controllability was attributed as non-self-inflicted (F(1,477)=11.24, p = .001, ?p2 = .023). Mediation analysis showed significant indirect effects from onset controllability, course controllability and coping behavior on support through empathy. Discussion: Attributions explain variance in the willingness to provide social support. Findings suggest that patients who may benefit most from support have a reduced chance to receiving it. Practical implications will be discussed.

Background Psychosocial stress and adiposity are public health threats that have been associated with each other. Longitudinal studies are needed to reveal the directionality and underlying behavioral or hormonal factors. Methods In 312 Belgian children (5-12y), the longitudinal stress-lifestyle-adiposity relation was tested. Stress data, lifestyle and adiposity (BMI,fat%,waist) were measured in 2010,2011,2012. Salivary cortisol was sampled in 2010. Findings Children with a high stress score reported more sweet food consumption, psychological eating behaviour and physical activity. Stress increased adiposity in children with high sweet food consumption or high cortisol awakening response. Stress decreased adiposity in children with high physical activity. In the other direction, adiposity also increased stress. High cortisol was associated with an unhealthy diet, supporting the cortisol-induced comfort food preference. Conclusions Children’s stress deteriorates their diet which stimulates adiposity. Stress can also enhance physical activity which inhibits adiposity. This creates a perspective for multi-factorial obesity prevention, targeting stress and lifestyle in parallel.

Background: The oral contraceptive pill (OCP) is the most popular form of hormonal contraceptive and its use continues to increase internationally. In this analysis we aim to identify key determinants of OCP use in an existing population dataset. Method: In this cross-sectional survey 1,562 women were interviewed and asked about their views and experiences of contraceptive use. Logistic regression analyses were used to identify associations between predictor variables and OCP use. Findings: Thirty-five percent had used the OCP in the previous year. Younger, unmarried women, with free medical care were more likely to be OCP users. Sixty-eight percent agreed that taking a break from long term use of the OCP is a good idea. Thirty-seven percent agreed with the statement that the OCP had dangerous side effects and this belief was the strongest predictor variable of non-use of the OCP (Adjusted odds ratio: 0.52, 95% CI: 0.41, 0.66). Age dependent associations between beliefs and OCP use were observed in interaction analysis. Discussion: Concerns about the safety of the OCP are prevalent and may be important and modifiable determinants of contraceptive related behaviour.

Background. Recent research supports the role of prototype perceptions in predicting a range of health behaviours. The current study adopts the prototype willingness (PW) model as a framework for examining a range of sun-related behaviours including sunbathing, sun protection, and incidental sun exposure. Method. Community participants (N=218) from North Queensland, Australia completed an online survey measuring the PW model variables and their sun-related behaviour. Findings. Results indicated that those who sunbathed rated all three prototypes (protector, incidental, deliberate) to be of similar favourability; in addition, the incidental prototype was perceived to be most similar to themselves. Those who abstained from sunbathing perceived the protector and incidental exposer prototypes to be significantly more favourable than the deliberate tanner. Prototype perceptions also predicted sunbathing and incidental sun exposure. Discussion. This research suggests that prototype perceptions can predict sun-related behaviours. The PW model could inform future interventions to reduce incidental sun exposure in high-risk regions.

Background: Healthcare should address the needs of individual patients. This feasibility study develops and implements a needs assessment within routine clinical oncology practice. Methods: Our previous work resulted in the CancerCAN-22, a multi-domain needs assessment tool. 43 outpatients were recruited (IG) to complete the CancerCAN-22 and the HADS and PHQ-9 (mood). On-referrals and service/advice provision were compared with a matched control group (CG). Findings: 66 unmet needs were reported by the IG. Females, older participants (66-80 yrs), and those with gynaecological or liver cancer reported the most unmet needs. Time since diagnosis (0-3m; 4-12m; 13+m) did not affect total unmet needs however those diagnosed within 4-12 months experienced significantly higher HADS-distress and HADS-anxiety compared to the 13+m group. Whilst total on-referrals did not vary between IG and CG, the IG were more often referred to community or complementary services. Discussion: Findings reveal individual variability in unmet needs and the feasibility of completing an individual needs assessment in a clinical setting and making on-referrals as appropriate to identified unmet needs.

Background: Given the very limited data, this study aimed to determine the applicability of the Theory of Planned Behaviour (TPB: Ajzen, 1991) in the study of high-fat snacking in Greek high-school students, whilst taking into consideration gender and culture-relevant factors. Methods: Predictor variables were measured at Time 1 (N=147), and actual high-fat snacking a week later (N=129). Additionally, three focus groups (N=28) were conducted to elucidate culture-relevant factors influencing high-fat snacking. Findings: The TPB variables predicted 19.6% of intended high-fat snacking, with attitudes being the strongest predictor (? =.40, p< .001). Moreover, the model predicted 35% of subsequent high-fat snacking. Gender did not influence intended or subsequent high-fat snacking. Of the culture-relevant influences, the involvement of grandmothers and the 24-hour easy access to snacks at kiosks were particularly salient. Discussion: The TPB can be used to study high-fat snacking among Greek students, whilst accounting for culture-relevant influences.

Given that immigrant children are a vulnerable group regarding health (Javier et al., 2009), it is important to promote their adherence to Child Health Surveillance Services (CHSS). Evidence suggests lower rates of adherence to CHSS among immigrant children (vs. non-immigrants, Javier et al., 2009), but little is known about the determinants of this behavior. Therefore, this study aimed to develop a Grounded Theory (GT) on the determinants of adherence to CHSS, of Cape Verdean and Brazilian immigrants in Portugal. 5 Focus Groups (n=19 immigrants) and 15 in-depth interviews were conducted; with Cape Verdean, Brazilian and Portuguese child caregivers, from different socioeconomic conditions. Data was analyzed using a grounded-theory methodology (Strauss & Corbin, 1990). Adherence to CHSS is a nuclear and multidimensional concept with several determinants at different levels of analysis. Some of the main determinants are: the degree of similarity between consults/health-care providers of origin and host countries; caregivers’ and health-care providers’ practices and socioeconomic conditions. These findings may contribute to improve immigrant’s adherence to CHSS.

Background: HIV serostatus disclosure is most often construed as a transmission reduction strategy by health professionals. We explored the lived experience of disclosure to sex partners among HIV-positive gay men. Methods: 15 in-depth interviews were conducted with HIV-positive gay men, and were analysed using grounded theory. Findings: The following themes were elaborated: (1) Protective non-disclosure: Discourses portrayed seropositivity as a moral failure rather than the result of viral exposure, and non-disclosure protected a discreditable identity. (2) Rejective non-disclosure: Interviewees refused association with other HIV-positive gay men, characterised as damaged and dysfunctional, and rejected disclosure as allowing oneself to be defined by an illness. (3) Moral non-disclosure: Personal infection was presented as a temporary moral lapse, which when contrasted with a renewed morality and responsibility, made non-disclosure to partners ethical. Discussion: The findings highlight the role of disclosure in identity management, in contrast with usual conceptions of disclosure, and the need for a more nuanced approach in the design of transmission reduction interventions.

Background. The positive effects of exercise training in cardiovascular diseases are well known and used widely in cardiac rehabilitation. Evidences indicate that exercise improves physical activity and overall cardiorespiratory fitness. However, less is known about the relations of exercise training to psychological factors, like vital exhaustion and chronic fatigue as highly predictive risk-factors of myocardial infarction and sudden cardiac death. The pathophysiological mechanisms are not yet well understood but fatigue might be partly related to disrupted cardiorespiratory values. Methods. Patients with ischemic cardiovascular diseases entered the study (n=227; mean age=63.30±9.89). All patients underwent both standard ergometric and psychological test procedures. In addition, 72 of these patients (mean age= 64.88±5.59) entered an exercise-based cardiac rehabilitation program and were followed for three months. Results and Conclusions. Our results indicate the positive effects of rehabilitation on both cardiovascular and psychological fitness. In addition, we found strong associations between the ergometric and psychological factors. More specifically, the fatigue related psychological parameters were found to show significant associations with maximum systolic blood pressure during exercise, metabolic equivalent and maximum heart rate.

Background: The main objective of this study was to explore South African adolescents’ perceived risk and protective mechanisms for HIV infection in their communities. Methods: The study used a qualitative design with Focus Group Discussions (FGDs) for data collection. FGDs were conducted among 12 to 17 year old participants receiving mental health services at either one of two clinics in Cape Town. Thematic content analysis was used to generate the core themes that emerged. Findings: Themes associated with risky behaviours for HIV infection were: Alcohol and illicit drug use; Non-condom use; Prostitution and risky sexual activity with multiple partners; and Non-disclosure of HIV status. Themes associated with protective mechanisms were: HIV knowledge and appropriate risk- reducing behaviour; and Proactive parental attitudes and behaviour. Discussion: The findings highlight the importance of ascertaining the perceptions of adolescents regarding how knowledge, attitudes and practices of the members of their social network influence young individuals’ vulnerability to HIV infection. The findings also help to shape future targeted adolescent programs for HIV prevention.

Background: Aim: to estimate the initiation rate among pregnant smokers of a tailored SMS text message smoking cessation intervention (MiQuit) when promoted in antenatal care without health professional endorsement. Methods: Pregnant women (N=1,750) accessing a UK maternity hospital received a single-sheet A5 leaflet describing MiQuit in their maternity notes folder over a 6-month period. Similar materials were left on clinic desks and noticeboards. Activation requests for the SMS system and system interaction were recorded over a 9-month period. Historical hospital smoking rates were used to estimate the number of pregnant smokers exposed to the materials. Findings: 25 activation requests were received, estimated to represent 3.7% (95% CI 2.3-5.2%) of all pregnant smokers accessing care over the 9-month period. Only 11 (44%) sent the sign up request SMS message in the correct format. Among those activating support, there was relatively high interaction with the system. Discussion: A low intensity and low cost promotion of a low cost intervention resulted in an engagement rate which would confer a significant public health benefit if effectiveness was demonstrated

Background: Psoriasis is associated with unhealthy behaviours known to trigger onset/flares of the condition and to increase the risk for cardiovascular disease. Whether health-care practitioners managing people with psoriasis are confident to incorporate lifestyle behaviour change (LBC) techniques into routine consultations is unknown. Methods: In-depth, qualitative interviews were carried out with 23 practitioners managing psoriasis patients in the UK stratified by discipline. Interviews explored practitioners’ knowledge, skills and attitudes in relation to LBC, including perceived barriers. Data were analysed using Framework Analysis to identify key issues. Findings: Practitioners viewed LBC as important in managing psoriasis but believed such work was outside their role, citing organisational constraints and prioritisation of other goals as barriers. Limited knowledge and skills about lifestyle factors in psoriasis underpinned these beliefs, resulting in LBC being addressed only rarely in consultations. Discussion: Low levels of knowledge, skills and confidence among professionals about addressing lifestyle issues in psoriasis patients and a lack of structured support for LBC were identified. Findings will inform the development of training for staff and support materials to improve lifestyle in people with psoriasis.

Background: Recent findings in risk perception highlight the importance of the affective component in predicting intentions and behaviors (Dillard, Ubel, Ferrer, & Fagerlin, 2012; Janssen et al., 2011). The present study replicated the design and measures in sun-screening and extended it to use of cellular phones.Methods: 116 participants filled an online cross-sectional survey, tapping knowledge , affective and cognitive risk perception, worry, behavioral intentions and actual behaviors with respect to using sun-screen and using cellular phones. Demographic variables were also recorded. Results: Finding on sun-screen use were replicated, but were different in the case of using a cellular phone: thought knowledge about the negative effects of radiation was unrelated to reported behavior, the cognitive component of risk perception was significantly associated (r=.18, p<.05) with behavior while the affective component and worry were unrelated. Moreover, cognitive risk perception was the only predictor of behavior in a multivariate analysis. Conclusions: The results are discussed in terms of dual-process models and the possibility of the singularity and centrality of cell phones.

Background: To test within an n-of-1 design whether brief interventions (1) increase physical activity (PA)and (2) reduce sedentary activity (SA) in people with Type 2 Diabetes; and to examine whether effects are mediated by psychological process measures taken on a daily basis. Methods: Six participants wore an accelerometer device for 6 months that deliver different instructions on alternate days (either to improve PA, reduce SA or no instruction) while measuring physical activity levels. Participants recorded levels of confidence, self-efficacy, stress, pain, happiness and motivation on a daily basis. Results of the n–of-1 study were analysed by bootstrapped time series analyses. Findings: Participants varied in response to the PA and SA interventions with some being more responsive to PA whereas others were more responsive to SA. Self-efficacy and happiness were routinely predictive of physical activity levels Discussion: The n-of-1 design highlighted how participants respond differentially to interventions targeting PA as opposed to SA and that level of response to an intervention was mediated by psychological processes.

It is known that mother’s emotional reaction maturity is the main factor of the child’s psychological health. After birth, most children in Russia are given one or another diagnosis. By the end of the child’s first 2 years of life these earlier diagnoses are dismissed by specialists. The purpose of the research was to analyze, which parameters of mother’s emotional reaction influence on the child’s diagnoses dismissing. Overall 100 mother-child pairs with the child in the first 2 years of life were participants. To analyze the heart rate variability of mothers in emotional situation, we recorded heart rate variability. Two consecutive recordings of 300 R-R intervals (a fixed number, making it possible to successfully evaluate the high and low frequency waves of the heart rate) were made. The first record was made in the rest situation and during the second records mothers were asked about their children health. We have analyzed some additional characteristics: the number of children in families, mother’s level of education and her age. Regression analysis showed that the more mother’s level of education and her age is the more probability of her child’s diagnose dismissing. The less her heart rhythm rigidity during both the rest and emotional situation is the better her child’s health.The research was supported by the grant RGNF N14-16-48005 and 14-06-00195

Background: Autonomous motivation and self-regulatory techniques, e.g. self-monitoring, action planning and coping planning, are known to predict physical activity (PA). We studied whether the use of self-regulatory techniques affects the motivation-behaviour relationship. Methods: Finnish adolescents (N =411, aged 16-19) took an electronic survey including validated measures of self-determined motivation, self-regulatory techniques, and PA, and a one-month follow-up. A subsample used an accelerometer to objectively measure PA (n=69). Findings: Intrinsic motivation was positively related (?=.47, p<.001) and extrinsic motivation unrelated (? =-.03, p=.612) to self-regulation technique use. Autonomous PA motivation (?=.29, p<.001) and the use of self-regulation techniques (?=.39, p<.001) prospectively predicted PA. Self-regulation techniques mediated the effects of motivation on PA but did not influence the strength or direction of the relationship between any type of motivation and PA. Discussion: Teaching self-regulation techniques use and supporting autonomous PA motivation may be equally important and have additive effects in interventions aiming to increase adolescents’ PA.

Background: This study tested whether asking people to rate their anticipated feeling regret (AR) for not registering as a posthumous organ donor increases subsequent verified organ donor registration. Method: 14,509 members of the UK general public were randomly allocated to 1 of 4 arms. Participants in the no-questionnaire control (NQC) arm were asked if they were registered as an organ donor. Participants in the questionnaire control (QC) arm answered the same questions plus questions regarding their affective attitudes towards donation and their intention to register as an organ donor. Those in the TPB arm received the same items as the QC arm, plus items measuring their attitudes towards organ donation, subjective norm and perceived control. Those in the AR arm received the same items as the TPB arm, plus two items measuring AR for not registering as an organ donor. 6 months later, the UK transplant register was searched. Findings: People in the NQC condition were more likely to register as an organ donor (6.39%) than participants in the QC (5.27%), TPB (5.40%), and AR (4.51%) arms. Discussion: A brief AR intervention did not lead to an increase on organ donor registration.

Background: Positive psychology activities (PPAs) have empirically shown to increase wellbeing. However, the role of positive social relationships is yet to be examined in this research. This study aimed to test whether kindness and gratitude PPAs enhance existing social relationships. Methods: Using a mixed repeated measures design, 212 participants were randomised to one of four intervention conditions (or control) and completed measures of social support and wellbeing at three time points (baseline, post intervention and one month). The experimental conditions involved positive interactions with others whereas the control did not. Findings: As evidenced by a significant interaction, those who completed kindness or gratitude PPAs to people in their social network had greater increases in relationship satisfaction than the control group post intervention. Further, only those in the experimental conditions felt their existing relationships had improved at trial cessation. Discussion: PPAs significantly enhanced social relationships. Given its integral relationship to health and wellbeing, health researchers are advised to value the role of social relationships in the PPA framework.

Background Conscientiousness predicts longevity and better health outcomes. Health behaviours have been found to account, in part, for these positive relationships. However, little or no research has explored the effects of conscientiousness on sleep and sleep quality. This study, using a daily diary design, investigated the effects of conscientiousness on sleep outcome measures. Method Two hundred and forty-five participants completed a baseline measure of conscientiousness followed by a 7 day daily diary, providing daily reports of stressors experienced as well as hours slept, sleep quality and efficiency and mood. Findings As predicted, hierarchical linear modelling found cross-level interactions indicating that higher levels of conscientiousness were associated with better daily sleep quality measures, though, not number of hours slept. At baseline, conscientiousness and its facets were also associated with better sleep efficiency and overall sleep quality. Discussion These findings indicate that conscientiousness, and its facets, may influence health status directly by influencing sleep quality and efficiency.

Background: The associations between mental disorders and cancer is unclear. It is also unknown whether associations vary according to life course stage or gender. Methods: The World Health Organization Composite International Diagnostic Interview retrospectively assessed lifetime prevalence of 16 DSM-IV mental disorders in face-to-face household population surveys in 19 countries (n=52,095). Cancer was indicated by self-report of diagnosis. Survival analyses estimated associations between first onset of mental disorders and subsequent cancer. Results: Following adjustment for mental disorder comorbidity, panic disorder, specific phobia and alcohol abuse were associated with cancer (OR 1.3-1.5). The risk of cancer rose with the number of disorders. Depression was more strongly associated with cancers diagnosed early in life (OR 1.7) and not late onset (OR 1.2) and cancer among women (OR 1.5). PTSD also has an association with early cancers. Discussion: This study reveals the magnitude and patterns of the associations between mental disorders and cancer. The findings suggest a link between the two types of conditions and support arguments for early identification and treatment of mental disorders.

Background: Much attention has been directed at behavior change techniques (BCTs) in interventions. Little attention, however, is being paid to the BCTs in control groups receiving usual care, yet studies suggest usual care content can vary between study sites and impact outcomes. This study explored a method of assessing the active content of usual care provided to control groups. Methods: HIV-nurses (n=21) completed an open-ended questionnaire about nine domains in adherence counseling. The content was coded by two coders based on a medication adherence BCT taxonomy. We examined intercoder reliability (kappa), internal consistency of a standard care quality (SCQ) scale, and variability in SCQ scores. Findings: Responses could be reliably coded with the taxonomy. The mean kappa was .79. 19 of the 22 BCTs coded produced a kappa >.6. The SCQ scores displayed substantial variability (range=7-19 BCTs), and showed good internal consistency (?=.74). Discussion: The BCT taxonomy could be reliably applied to responses to open questions on adherence counseling. Moreover, adherence counseling can be compiled in one quality score. The tool may be useful for exploring control group content.

Background: Unhealthy eating habits are difficult to change by intention to diet. Habitual behavior sometimes operates automatically, inconsistent with conscious intention. The study examined the effect of diet priming that changes habits and reduces unhealthy eating behavior unconsciously. Method: 139 female undergraduates participated in the field experiment. For about half of participants, the goal of dieting was primed by giving a picture of a slender female (priming condition). For the others, an animal picture that was unrelated with diet was used (control condition). The study measured diet intention, habits, and subsequent snacking behavior two weeks after the manipulation. Findings: The results showed that the consumption of snacks was reduced in the priming condition more than in the control condition. Intention to diet had no effect on the subsequent behavior. Moreover, diet priming moderated the effect of habits on behavior. Discussion: Diet intention cannot always control unhealthy eating habits. However, the introduction of diet priming can reduce habits and can change behavior. These findings are discussed in the context of intervention for unhealthy habits.

Background: We aim to study whether working and non-working caregivers differ in their quality of life (QoL), and what the underlying factors of these differences are. Methods: The study population consists of informal caregivers in the LifeLines Cohort Study (aiming to include 165.000 participants in total), who participate in an additional informal care questionnaire. Within 7 months of recruitment, 582 caregivers completed the questionnaire. We aim to include 1000 caregivers. The following constructs were measured: QoL (EQ-5D VAS), caregiver burden (Caregiver Reaction Assessment), work, informal care situation, and support. (Preliminary) findings: 403 caregivers (70%) are employed (77% female, mean age 50 yrs), and 179 (30%) are unemployed (73% female, mean age 60 yrs). The mean QoL of working caregivers (78.3) is significantly higher than of non working caregivers (73.6) (mean difference 4.7; 95%CI .78-8.56). Multivariate regression analyses will examine possible underlying factors of this difference. Discussion: Working and non-working informal caregivers differ in their QoL, and should be targeted differently in interventions when aiming to improve their QoL.

Background: Although many people know that an active lifestyle contributes to health they fail to translate their intention into action. This has been explained by deficits in health literacy such as enabling social support, planning and self-regulation in the face of barriers. The present study examines the role of received social support, planning and self-regulation in facilitating physical activity. Methods: In a prospective online study (N = 1660), intention was assessed at baseline, planning and social support at 4-week follow-up, self-regulation and physical activity at 6-month follow-up. A path analysis was conducted including intention, received support, planning and self-regulation to predict physical activity. Findings: Received support, planning and self-regulation mediated the link from intention to physical activity, the total indirect effect was significant (b = 5.38, CI 95% [2.76; 9.29]). Discussion: In the present sample received social support, planning and self-regulation bridged the intention-behavior gap. To support behavior change and maintenance health literacy should be enhanced in vulnerable individuals (cf. www.irohla.eu)

Background: Experimental studies have systematically shown that the benefits associated with physical activity (PA) are stronger after exercise in natural, compared with built, environments. This research explores whether these results apply beyond experimental settings. Methods: Nationally representative Finnish survey data (n=2072) on outdoor recreation was analysed using structural regression modeling. Weekly frequencies of PA indoors, built outdoor settings, and in nature were regressed on perceived general health and emotional well-being (RAND-36). Covariates included general situation in life and socioeconomic factors. Findings: Frequent PA in nature, but not in built environments, was related to improved emotional well-being (?=0.069, p=0.003). General health was positively connected to PA in natural (?=0.046, p=0.028) and built (?=0.046, p=0.032) outdoor environments. Discussion: The results suggest that PA in natural environments is related to enhanced well-being more specifically than PA in built settings. Green areas could provide a cost-effective, preventative tool for stress- and self-regulation, and thus, promote individual well-being and public health.

Background: Previous research has shown a positive correlation between impulsivity and high-calorie snack consumption. The current study examined whether highlighting immediate (vs. long-term) consequences of high-calorie snack consumption reduced impulsive participants’ snacking behaviour. Methods: Participants (N=109) completed a questionnaire including measures of impulsivity and snack consumption, completed either an impulsivity priming task or neutral task, and read a health message highlighting either the short-term or long-term health consequences of consuming high-calorie snacks. One week later, participants were asked to record their snack consumption over the previous seven days. Findings: Participants with higher individual levels of impulsivity, and participants experimentally primed with impulsivity, consumed fewer high-calorie snacks when the immediate (vs. long-term) consequences of snacking were highlighted. Discussion: Findings suggest that health promotion messages advocating the avoidance of high-calorie snacks may be more effective for impulsive individuals if immediate health consequences are highlighted.

Background: Moderate level of stress is a normal phenomenon for students. Students who reported higher levels of stress were linked with poor health behaviors, increased depression, anxiety, reduced learning achievements. Thus, physical, psychological, behavioral, and academic difficulties were the cost of stress for students. When academic stress is perceived negatively, it may decrease academic performance and health. The study aimed at assessing the potential of relaxation training in reducing academic stress. Methods: Subjects of the study were 29 undergraduate university students aged between 19 and 27. The participants were randomly assigned to 3 different groups. Two groups received 4 progressive muscle relaxation (9, 32.3%) and skin-conductance relaxation (23, 41.9%) training sessions once a week between two measurements of their perceived stress (Perceived Stress Scale, (Cohn, 1983) and academic stress (Student Academic Stress Scale, (Busari, 2011). Results: The results of the study showed that perceived stress and academic stress decreased after skin-conductance relaxation training, while no such changes were observed in the progressive relaxation and control groups.

Health Psychologists using questionnaires rely heavily on Cronbach’s alpha as indicator of scale reliability and internal consistency. Cronbach’s alpha is often viewed as some kind of quality label: high values certify scale quality, low values prompt removal of one or several items. Unfortunately, this approach suffers two fundamental problems. First, Cronbach’s alpha is both unrelated to a scale's internal consistency and a fatally flawed estimate of its reliability. Second, the approach itself assumes that scale items are repeated measurements, an assumption that is often violated and rarely desirable. The problems with Cronbach’s alpha are easily solved by computing readily available alternatives, such as the Greatest Lower Bound or Omega. Solving the second problem, however, is less straightforward. This requires foregoing the appealing comfort of a quantitative, seemingly objective indicator of scale quality altogether, instead acknowledging the relationship between reliability and validity and the distinction between scales and indices. In this contribution, I will explore these issues, and provide recommendations for scale inspection that takes these dynamics into account.

Background. In accordance with the Effort - Recovery model(Meijaman & Mulder, 1998), recovery is a process of psychological unwinding that is the opposite of the activation of psychophysiological systems during effort expenditure, particularly under stressful conditions. In the present study we examined the mediator role of three recovery dimensions (spillover, recovery self efficacy and sleep disorders) in the relationships between psychosocial job dimensions and psychological distress/well being variables. Methods. Three hundred and forty nine workers (69% females, mean age = 44.8 years; SD = 9.6 ) employed in helping professions (37% teachers; 28% civil servants, 18% health care workers, 16% social workers) filled out the Leiden Quality of Work Life Questionnaire (van der Doef & Maes, 1997); the recovery self efficacy scale (Kodja, 2003); the sleep disorders questionnaire (Violani,et al., 2000); and the Maslach Burnout Inventory-Human Service Survey (Maslach & Jackson, 1997). Findings. The recovery self efficacy showed only direct associations. Moreover, spillover and insomnia impact partially mediated the association between job demands and emotional exhaustion. Finally, spillower partially mediated the association between job control and emotional exhaustion. The indexes of the final model were: ChiSquare = 35.3; GDL = 28; CFI = .99; RMSEA= ,03; (.00 - .05). Discussion. The processes of recovery were not univocal. Future research would benefit from the use of longitudinal designs and focus on changes of working conditions.

Background: The prevalence of chronic diseases has increased during the past decades, suggesting that primary prevention about health behaviour may be important. The general practitioner (GP) can positively affect patients’ behavioural choices. But often GP’s report a lack of time which makes it difficult to provide preventive counselling. The objective in this study is to develop a programme delivered by GP’s that empowers adults (18 to 65 years old) to make changes in physical activity and dietary behaviours. Methods: The Intervention Mapping Protocol (IMP) was used for the systematic development of this programme. By the elaboration of the six steps of the IMP, theoretical and empirical methods were used and programme objectives (PO’s), theoretical methods and practical applications were stated. Findings: The systematic development resulted in a tablet based eHealth programme existing of three parts, based on the self-regulation theory: goal selection (1), active goal pursuit (2) and goal attainment (3). The PO for patients is to develop their own action plan that states which behaviour they will perform, when, where and how they will deal with difficult situations. Methods used are self-regulation, computer-tailoring, planning coping responses, goal setting, implementation intentions and selfmonitoring of behaviour. For GP’s the most important PO is to motivate their patients to use the programme. Discussion: The IMP resulted in the development of a flexible eHealth programme, used for developing action plans by patients to achieve health goals. This programme will be delivered in general practice by the use of tablets. It is expected that this programme solves the problem of time burden because it provides tailored information and empowers patients to change their behaviour themselves. To ensure the feasibility, focus group research have to be conducted in general practice. Also a pilot test to evaluate the acceptability, feasibility and efficacy of this programme will be performed.

Background: In an experimental online study we compared the effects of different types of risk information on mothers’ perceived vulnerability towards HPV and cervical cancer of their daughter . Methods: 375 mothers of girls-to-be invited to the HPV vaccination round of 2014 were derived from the National Immunization Register and were randomly assigned to one of four conditions in a 2 (statistical information: yes or no) x 2 (narrative information: yes or no) factorial between-subjects design. Narrative information was expected to increase perceived susceptibility to both HPV and cervical cancer, while statistical information was only expected to increase perceived susceptibility towards HPV due to difference in prevalence rates between HPV (high) and cervical cancer (low). Findings: Mothers who received statistical information felt their daughter was more susceptible towards HPV than mothers who received no statistical information. No effects of narrative information were found. Discussion: Among mothers, statistical information seems most effective in increasing perceived vulnerability of their daughters towards HPV and may thus motivate decision making towards HPV vaccination.

Background: Use of cognitive emotion regulation strategies (CERS) in response to stressful life events varies by country, though research has been limited to Americans and Asians. We aimed to compare six European countries to investigate cross-cultural differences in the use of CERS and test if the relationship between specific strategies and psychopathology varies across countries. Methods: Participants were recruited from the Netherlands, Hungary, Spain, Italy, Portugal and Germany (N=1553) and completed cross-cultural measures of cognitive emotion regulation using the Cognitive Emotion Regulation Questionnaire (CERQ), depression and anxiety. Results: We found significant differences on all the subscales of the CERQ: northern European countries made less use of strategies related to maladjustment than southern European countries. The direction of the relationships between specific strategies and symptoms of psychopathology was consistent across countries. Discussion: Although there were culture-related differences in the use of CERS, the consistent relationship between strategies and psychopathology supports the idea of a transdiagnostic approach to treating psychopathology.

Background: Immuno-virological data have highlighted the particular situation of people living with HIV (PLHIV) who are called “HIV controllers”. Infected for more than 10 years and having never received antiretroviral treatment, the level of the virus in their blood remains undetectable despite the presence of antibodies indicating HIV infection. Methods: We implemented a study aimed at understanding the life experience of these PLHIV. The present analysis focuses on qualitative data. Thematic analyses were performed. Findings : 14 PLHIV HIV Controllers were interviewed for the qualitative study. These PLHIV brought up persistent representations about HIV before their identification as HIV Controllers. With regard to their status, moral and mental strength were frequently mentioned, this psychological aspect helping them make sense of the immuno-virological data in order to justify their situation. Lifestyle, healthy living and religious beliefs/spirituality were less frequently mentioned to justify their situation. Discussion: These data, unprecedented in PLHIV HIV Controllers, highlight the complex nature of this sub-group’s experience with HIV.

Background: A 2012 Lancet review identified 142 trials of interventions for quality improvement (QI) for people with diabetes, and classified interventions using broad QI categories, making analysis and replication difficult. We examined which behaviour change techniques (BCT) could be identified within these QI interventions. Methods: Three psychologists independently coded a random sample of 23 trials for healthcare professional (HCP) and/or patient behaviour, using the v1 BCT taxonomy. Rules were developed to supplement use of the framework for this literature. Findings: Only 26/93 BCTs were identified targeting HCP and 22/93 targeting patient behaviours: median=6 BCTs per trial for HCPs and 3 for patients. Interventions mainly used prompts/cues, goal setting, feedback and monitoring, social support, instruction on how to perform the behaviour, credible source, and/or add objects to the environment. Discussion: BCTs provide detailed description of QI interventions’ active ingredients, which may enable identification of effective components and help replication efforts. Many BCTs are rarely incorporated in QI interventions and may present a useful focus for future research.

Background: This meta-analysis assessed the efficacy of psychological interventions to reduce distress in patients undergoing cardiac procedures and explored the impact of intervention features. Methods: Random effects models assessed changes in depression and anxiety at post-test (earliest after baseline) and follow-up (after three months), with moderator analyses for type of usual care, cardiac procedure undertaken, intervention duration, risk of bias, and facilitator type. Findings: Twenty studies met the inclusion criteria (2181 participants), 16 reported depression and 12 reported anxiety. Relative to controls, interventions reduced depression and anxiety at post-treatment (SMD = -0.66, 95% CI: -1.14 to -0.19, and SMD = -0.40, 95% CI: -0.71 to -0.09, respectively), and anxiety at follow-up (SMD = -0.29, 95% CI: -0.47 to -0.10). Type of usual care, type of cardiac procedure, and intervention duration significantly moderated depression outcomes, whereas facilitator characteristics significantly moderated anxiety outcomes. Discussion: Psychological interventions can reduce distress in cardiac patients. Future research could investigate how intervention features impact outcomes.

Background: Although the health benefits of traditional social support have been largely documented (e.g. Uchino, 2006), less is known about its virtual form. Some of the benefits include increased social capital, potential for egalitarianism and the cathartic function of writing (e.g. White and Dorman, 2006). Notwithstanding, there is a risk of over-extending our virtual time at the expense of traditional interactions (Burrows et al., 2000). Moreover, spending long hours online is associated with higher risk of Compulsive Internet Use (CIU), a maladaptive use that results in damaged family relationships (Meerkerk et al, 2010). In this study, we explore the extent to which using online channels to interact with the main source of social support contributes to the development of CIU. Furthermore, to address the lack of reference to macro-variables in the study of social support and health, we collected data in three countries with different freedom in their internet access. Methods: We used a cross-sectional, survey-based design (NUK=277, NUSA=268, NUAE=270). The survey was made of validated scales (i.e. CIU, Meerkerk et al, 2010), Social Support (Rena et al, 1999) and new items that we developed to assess main source and main channel of social support. Findings: Those that mostly used online channels to interact with their main source of social support were at a higher risk of CIU. UK and UAE used online channels in higher proportion than face to face, whereas the USA used all channels (face to face and online) in a similar way. UAE reported higher levels of CIU than UK and USA, even though they also were the country that spent the lowest time online. Discussion: Our study highlights the dangers of relying on online channels for social support. The study also supports previous studies regarding the health benefits of using a variety of social support sources (Cohen et al,1997) and expands these to incorporate the channel of interaction(virtual vs non virtual).

Background: Associations between parent’s Sense of Coherence (SOC) and schoolchildren’s energy-balance related eating habits have been found. This study examines if parent’s SOC is associated with other energy-balance related behaviors; screen time, sleep duration, and physical activity, and whether parent’s SOC predicts the change in behaviors. Methods: Finnish schoolchildren (n=1268, RR 79%), aged 10-11, reported their screen time, sleep duration, and physical activity (PA) in autumn 2006. Simultaneously, one parent filled-in a questionnaire comprising SOC-13. In spring 2008, a follow-up was conducted among schoolchildren. Parent-child dyads were 747 in 2006 and 475 in 2008. Linear regression was used in the analyses. Findings: A stronger parent’s SOC in 2006 was associated with schoolchildren’s less screen time, and longer sleep duration. A stronger parent’s SOC did not predict the change in energy-related behaviors in 2008. Discussion: The associations found were energy-related behaviors conducted at home, sleep duration and screen time, but not for out of home activities as PA. A stronger parent’s SOC might not be a preventing factor for children’s behavior.

Health state reflects the degree of well-being of an individual on the physiological, psychic and social levels. By considering a disease as adaptation disturbance and the nervous system as a major regulator of the functional equilibrium of all organism systems it is logical to conclude on indirect connection between intelligence and health. To study plasticity of functional neuronal networks determining human adaptability we analysed the relationship between IQ and SF-36 scales in patients with brain tumours vs. control subjects. Significant positive correlations between scores in solving figural tasks and ‘Physical function’ and ‘Vitality’ scales in control group were found. Patients with brain tumour were characterized by positive relation between general IQ and ‘Role of interactions due to emotional problem’ scale as well as between efficiency of solving verbal tasks and ‘Role of interactions due to physical problem’. The variable relationships between intellectual abilities and SF-36 scores can be ascribed to flexible strategies of information selection and potential adaptability in individuals with brain damage due to compensatory reconstructions in neuronal systems.

Background: Informed choice in mammography screening has long been an ethical requirement with poor implementation. The objective of this study was (1) to develop a questionnaire to assess informed choice in the German mammography screening programme (MSP) and (2) to determine whether women invited to the MSP for the first time make informed choices. Methods: This study was designed as a cross-sectional study with 3-month follow-up on self-reported behaviour. 2084 women from Westfalen-Lippe aged 50 answered the questionnaire in 2013/2014. The primary outcome was informed choice. Secondary outcomes were the components of informed choice (intention, knowledge, attitude) and components of the reasoned action approach. Findings: 23.7% made an informed, 58.0% a partly uninformed and 18.3% a completely uninformed choice. Accordingly, knowledge was low (M=2.8 SD=1.4, possible scores 0 to 8). Attitude was favourable (M=1.1, SD=0.7, possible scores -2 to 2) reflected in 71.1% having a positive intention. Discussion: This study showed that the majority of women in our study did not make an informed choice. Developing tools to improve informed choice in the MSP is therefore imperative.

Background: Based on Berry's acculturation theory and on concepts of social support, we tested the assumption that sponsorships by laypeople would moderate acculturative stress by reducing psychological and physical strain and by enhancing psychological and socio-cultural adaptation in refugees. Methods: N = 63 Chechnyan and Afghan refugees (N = 27 female, mean age of 33.08 years, s = 10.3) were randomized to a sponsorship group, which was granted support for six months and a control group with no support. Questionnaires assessing well-being by life satisfaction, self-esteem, interpersonal contact and assistance and by the absence of marked clinical symptoms were administered at pre, post, and follow-up occasions. Findings: Sponsorships had distinct palliative effects on traumatized participants only. As compared to the control group, their well-being improved significantly and persistently as indicated by the absence of severe clinical symptoms. There were no significant instrumental effects (e.g. improvement of living conditions). Discussion: The results advocate sponsorships as a means of improving well-being in refugees suffering from acculturative and post-traumatic stress.

Background : This study examined the effects of TPB-based interventions using the taxonomy of behaviour change techniques (BCTs) in improving balanced diet in French children aged 12-14 yrs. Methods : Allocation to intervention group (intervention vs. control) was randomised at the school-level, the intervention group received 2 hour-long interventions containing BCTs to improve attitudes and perceived behavioural control. Self-reported diet was assessed pre- and post-interventions. The resulting data were coded by a nutritionist and transformed into a novel measure representing the extent to which the participant achieved a balanced diet. Findings : Multi-level modelling indicated that there was a significant interaction effect between intervention group and balanced diet over time, b = 1.54, t(1836) = 2.13, p = .03. Separate models for each intervention group revealed that balanced diet decreased over time in the control group, b = -1.20, t(1200) = -2.34, p = .02, but did not in the intervention group, b = .04, t(636) = 0.86, p = 0.39, suggesting a buffering effect of the interventions. Discussion : Theory-based interventions can prevent the worsening of diet over time.

Background: The study examined whether a self-regulatory intervention increases exercise levels via action planning. Planning strategies might be especially important in people with low levels of exercise in order to initiate with a new behaviour. Methods: a randomized controlled trial was conducted to compare an intervention on exercise with an active control condition in young adults (N = 486, mean age = 18.74, SD = 2.83). Exercise levels were measured at pre-test and post-test and action planning at post-test. To evaluate intervention effects and change mechanisms involved, repeated measures ANOVA and mediation analysis were conducted. Findings: Intervention had an effect on exercise (p < .05). When the overall sample was divided into participants with high and low levels of activity at T1, the effect remains only for the less active subsample (p < .05). Planning mediated the effect of the intervention on exercise. Discussion: Planning is a useful self-regulatory strategy for low active persons, who benefit from it when adopting a new behaviour. Initial levels of activity should be taken into account when designing self-regulatory interventions on exercise.

The aim of this population based study was to examine the relationship between war experiences and health, measured by poor general health and longstanding health problems. Methods: The data source is the South-East European Social Survey Project (SEESSP) based on a representative survey in Bosnia-Herzegovina (n=3313) and in Kosovo (n=1000). The data collection with face-to-face interviews was fielded in the winter of 2003/2004, that means 8-9 years after the end of the war (1995) in Bosnia-Herzegovina, compared to 4-5 years after the war ended (1999) in Kosovo. The finding showed that individuals with more severe war experiences, reported poorer general health in both countries, while for longstanding health problems this was the case only for Kosovo. Individuals in Kosovo who fought in the war had highest probability of poor health, while longstanding health problems were reported in both countries. The expected relationship between the time since the war, and general health and longstanding health problems showed up in Kosovo, where those who fought in the war seemed to have higher probability of poor health than those who fought in the war in Bosnia-Herzegovina.

Background: Men suffer more severe chronic health conditions and have higher mortality for leading causes of death. Research suggests that men who endorse more traditional constructions of masculinity are less likely to engage in health protective behaviour. However, less attention has been paid to non-Western societies. Methods: The present study used a quantitative approach to examine the influence of age on health behaviours and masculinity, among Chinese men in Hong Kong. A total of 200 Chinese males are used in the present study, for the purpose of examining age-related differences, participants were split into two groups: younger (?25yrs) and older (?50yrs) age groups. Findings: Older men were significantly less likely to engage in preventive care and healthy dietary behaviour compared to their younger counterparts. Diet and social support were significant in their prediction of engagement in preventive care. Playboy behaviour, heterosexual presentation, and the primacy of work were all predictive of power over women. Discussion: Findings are discussed in relation to the influence of culture. The implications of the findings for future research are discussed.

Background: The idea of coping with barriers to enhance exercise adherence has been well addressed, yet little is known about differences between men’s and women’s confidence for overcoming specific barriers, and how this might change with exercise experience among initiates. Methods: A sample of 63 previously sedentary adults (nmen=23; nwomen=40) completed assessments of confidence for overcoming 9 exercise barriers at baseline and after 3 months of exercise. Exercise frequency was objectively assessed. Findings: RMANOVA revealed significant main effects of time (Eta2p=.049, p<.1), and barrier Eta2p=.663, p<.001, and a multivariate sex x time x barrier interaction (Eta2p=.313, p<.006) such that women’s confidence decreased more than men on 8 of 9 barriers over 3 months. Discussion: Women seem to lose confidence for motivational barriers (e.g., I don’t feel like it) faster than men. Barrier specific intervention strategies could be developed for men and women separately.

Research on parental psychological outcomes related to a child’s critical illness has focused on the assessment of distress and psychopathology, but resilience has been overlooked. So, this research studies: 1) the evolution of resilience after child’s discharge from a Pediatric Intensive Care Unit (PICU), and 2) whether resilience predicts anxiety, depression and post-traumatic stress. We used a prospective longitudinal cohort design. A total of 130 parents were assessed within 48 h after the discharge of their child from PICU, and 3 and 6 months later. We measured resilience (CDRISC10), stress (PSS), stress related to PICU (PSS: PICU), emotions (DES), posttraumatic stress (DTS), anxiety and depression (HADS). Repeated Measures ANOVA, and confirmatory factor analyses were carried out. Resilience remains stable in the lower resilience group, but decreases between the discharge and the 3 months assessment in the higher resilience group. Parents with lower initial resilience show poorer outcomes than high resilience parents. The level of positive emotions, negative emotions and stress experienced during admission mediates the relationship between resilience and poor outcome (X2/df =1.72; GFI= 0,84; CFI= 0,90; RMSEA=0,075). Mental health in parents after a child’s PICU admission can be predicted by resilience, so this measure can be used to detect high risk parents for intervention.

Bicultural stress arises from intercultural conflicts in norms, language, values, or fair treatment. Grounded in theories of risk and resilience, the present study tests a mediational model of bicultural stress, coping strategies, and mental well-being. METHODS: 268 college students aged 18-23 participated (62% were European American; 38% Mexican American) in an IRB-approved online survey at a large US university. The Bicultural Stress Scale (Romero & Roberts, 2003) measured proximate everyday life stressors that occur within a bicultural environment; other measures included the Responses to Stress Questionnaire, the Rosenberg Self-Esteem scale, and the CES-D. FINDINGS: Models tested (MPlus) evidenced equivalent parameters across groups. Indirect effects (estimates from bootstrapping) showed involuntary engagement and voluntary disengagement significantly (p<.05) mediated relations between stress and well-being. DISCUSSION: Ignoring cultural stressors may have negative effects on majority and ethnic minority students’ well-being. Mindfulness strategies and others directed at reducing involuntary responses (e.g., rumination) may be applicable to promoting their college adjustments.

Background: Psychological distress is reported to be highly prevalent in women with early breast cancer. Consistent with the conceptualization of anxiety as a future oriented mood-state reflecting uncertainty and anticipation of negative outcomes, we approach a gradual decrease in anxiety as a proxy of overall psychological adjustment to breast cancer. The aim of the present study is to identify patterns of trajectories of anxiety to assess the course of adjustment from acute to extended survival in breast cancer. Methods: Data on Hospital Anxiety and Depression Scale acquired from a longitudinal prospective cohort study of women with breast cancer (n =750) were subjected to Mixture Growth Modeling. Results: 94% of the group divided into 3 classes displayed varying initial levels, but significant decrease in anxiety within a year, followed by a non-significant slope from a year to 2 years. A 4th class (6%), however, displayed the highest intercept and non-significant slopes throughout the time frame of the study. Discussion: The results suggest that the main adjustment occurs within the first year following the surgery for most of the women. However, a small subgroup displays abiding levels of anxiety indicating a lack of psychological adjustment 2 years after the surgery. The need for intervention for this group may be extended beyond the first year following the initial treatment.

Background: Over the last decades the interface between work and family life and its influence on health has received increasing attention. Work-family-conflict (WFC) and Family-work-conflict (FWC) have been identified as two crucial constructs, with women seeming to perceive more conflict. Past research has identified some external variables (e.g., work stressors) that impact WFC and FWC, but less is known about person-related variables and resources. Methods: 284 women in two-earner families filled in questionnaires assessing WFC, FWC, work and family characteristics, personality (big five, self-esteem) and resources (individual/family coping, social support). Findings: Personality variables accounted for a significant rise in explained variance on both WFC (r2corr=.24) and FWC (r2corr=.21); emotional stability showed the highest significant correlations (beta =-.44/-.24). Resources explained further 5%/4% of variance. Social support mediates the relation between extraversion and WFC, while adaptive family coping mediates the relation between emotional stability and WFC. Discussion: Personality and coping should be considered as important variables with regard to WFC and FWC.

Existing sex education programs have failed in involving people with intellectual disabilities (ID) in the development of these programs, which decreases the likelihood that the sex education program will be effective. This study was conducted to assess the perspectives of people with ID on several sexuality-related topics. Semi-structured interviews were held with 20 people with an ID. The reported frequency of sex education the participants receive is low. Their knowledge regarding sex education is mainly limited to topics such as safe sex, contraception and STI’s and tends to be superficial. Additionally, knowledge on safe sex does not always translate to safe sex behavior. Finally, relationships are important for most participants; mainly because they don’t want to be alone. There is a need for high quality sex education. Sex education should be lengthier and taught more frequently, focusing on a variety of sexuality-related topics. Furthermore, sex education should include the improvement of sexuality-related skills as well. To increase the likelihood of a program to be effective it is advisable that a theory- and evidence-based framework is used for its development.

Background: The aim was to quantify the relationship between behavioural determinants and dental health behaviour among 9-18 year old children. Methods: Searches were conducted in PsycINFO, PubMed, CINAHL and EMBASE. In total 25 studies were included, which addressed 16 variables. A weighted average effect size correlation (WAES r) was calculated per determinant and dental health behaviour. According to Cohen (1988) effect sizes can be considered as small (r = 0.10), medium (r = 0.30) and large (r = 0.50). Findings: All WAES r’s were significant and revealed a positive relation between determinant and dental health behaviour. Large effects were found for coping planning and self-efficacy. Medium-to-large effects were found for the determinants: intention, affective attitude, and action planning. The WAES r was small-to-medium effects were found for: social norms, cognitive attitude, knowledge, parental oral health behaviour and parental cognitions. Discussion: Although the number of studies focusing on volitional factors are limited, the overall findings highlight the importance of volitional factors, rather than knowledge or motivational factors in explaining dental health behaviour.

Background: Body image is defined as one‘s body-related self-perceptions and self-attitudes, including thoughts, beliefs, feelings, and behaviours. Experiences and conditions of embodiment may have far-reaching effects on physical and emotional well-being. In patients with severe somatic diseases body image disturbances have been confirmed and are associated with lower quality of life. However, the association between body image, mental health, and quality of life is still unclear. Methods: The present study investigated the association between body image and quality of life in 267 patients with a wide range of mental health problems. Body image was measured by the Dresden Body Image Questionnaire (DBIQ), a 35 items self-report instrument measuring five dimensions of body image: vitality, body-acceptance, self-aggrandizement, physical contact, and sexual fulfillment. Quality of life was measured with the Manchester Short Assessment of Quality of Life (MANSA). Findings: Body image was significantly lower for all subscales in the clinical sample compared with healthy controls. Correlations between DBIQ-35 and MANSA were strong for mean total score and moderate for body acceptance, vitality and sexual fulfillment. Discussion: Enhancing body image may be beneficial for people with mental health problems.

Background: As diabetes requires extensive self-care, self-management education is widely recommended to enhance the effectiveness and reduce the costs of treatment. While a variety of diabetes self-management (DSM) programs are available, the conditions for their effective implementation are not well documented. This paper reviews the literature on implementation fidelity (IF) as a factor influencing the effectiveness of diabetes education. Methods: Medical, psychological and educational research databases were searched to identify published studies on diabetes education describing the implementation process. Studies detailing the intervention adherence/fidelity/integrity were included to assess the way key elements of IF were addressed. Findings: From an initial 418 abstracts, 20 published papers were retained for an in-depth analysis focusing on the components of IF. Intervention content was mainly assessed through observation, whereas intervention dose was more often assessed through self-report measures. Only one study addressed the relationship between IF and intervention effectiveness. Discussion: Despite the importance of IF to achieve program outcomes, IF of DSM programs remains largely under-investigated. The results of this review suggest that reports on DSM education should systematically describe how the program was implemented.

In Europe, the smoking prevalence of 15- and 16-year-olds is high (30 days prevalence: 28%). School-based tobacco use prevention programs might be fostered by the use of videotapes in which the students give a statement about their attitude toward smoking. 12 to 16-year-old students in 35 classes were randomly assigned into an intervention (in which statements of students were videotaped) and a control group. Students were asked about their smoking, their intention to smoke, their commitment not to smoke, their knowledge about smok-ing, and about side effects, such as negative peer pressure and stigmatisation of smokers. 619 students participated and 467 returned the questionnaire (75%). 211 (46%) of the students have ever tried smoking and 90 students declared themselves as current smokers. Almost two out of three students intend to reduce or quit smoking. However, this did not differ between the intervention and the control group. Videotaping students' commitment not to smoke may reinforce the non-smoking students in their behaviour. Smoking students, however, do not change their smoking due to the videotaping in the class and the possible side effects should be considered.

Background: A parent-teacher consultation was introduced to empower parents to decide what kind of secondary school their children should go to. Effects of the shift from an obligatory secondary school recommendation to a parent-teacher consultation on children’s stress levels and well-being were examined. Method: Within 7 schools a first group of primary school children with an obligatory school recommendation (Group I, grade 4, assessed in 2011, n=120; age: M=9.7 ys.) as well as a second group with a parent-teacher consultation (Group II, grade 4, assessed in 2012, n=164; age: M=9.5 ys.) were examined. Stress and well-being were assessed using a self-report. Children’s well-being was assessed by parents’ reports as well. Findings: Stress varied as a function of a school by group interaction; F(6,223)=2.86, p<.05, showing a positive effect of paradigm shift only for children attending certain schools. In addition, only girls showed a benefit in self- and parent-reported well-being from the annulment of the obligatory school recommendation; F(1,220)=4.83, p<.05. Discussion: Findings are discussed with regard to gender-specific social consequences of the new arrangement.

Background: In order to optimize reach of Internet-delivered lifestyle interventions it is important to invest in proactive dissemination strategies. The present study used a proactive dissemination strategy by embedding an Internet-delivered lifestyle intervention in an existing online health monitoring system. Methods: Dutch adults were invited to participate in the Adult Health Monitor (N = 96,388). A prospective design was used to determine levels of reach. Furthermore, adequacy of reach was assessed by composing detailed profiles of intervention users. Findings: A total of 16.940 people participated, of which more than half indicated their interest (n=54%) and 5.168 actually participated in the Internet-delivered lifestyle intervention. Males, older respondents and higher educated respondents were significantly more likely to participate in the intervention. Furthermore, results indicated that especially participants with a relatively healthier lifestyle and a healthy BMI were likely to participate. Discussion: Even though high levels of reach were ensured, reach among at-risk individuals remained modest. It is essential to further optimize reach among these subgroups.

Background: Many smokers are dissatisfied with their tobacco consumption. 61% of current tobacco users who live in the EU have undertaken at least one attempt to quit smoking. Various assumptions and perhaps reasons exist why smoking cessation attempts aren’t followed through with more vigor, enthusiasm and success. The high anticipation of psychological distress expected throughout a cessation process, the fear of an unbearably strong desire to smoke, as well as the increased stress and weight gain are identified barrier. Methods: This is a longitudinal study based on case reports of 270 participants (55.6 % men) who completed an in-patient smoking cessation program in Austria. Treatment effects such as health complaints, sense of well-being, and changes in sleep pattern were analyzed. Findings: At 12 months post-therapy follow up, 42.6% of participants were identified (via CO values) as non-smokers. Along with the expected health benefits of quitting smoking, non-smokers reported significant changes to their quality of life such a better sense of well-being and sleep habits, increased level of physical activity, and lower drug prescriptions. Discussion: The many successes that can be gained through smoking cessation - particularly in terms of increased quality of life - should be motivation for current smokers struggling with this addiction.

Background: Despite of high motivation, compliance with home exercise is low in patients receiving physiotherapy. Predictions based on the strength model of self- control (Baumeister et al., 2007) were tested by investigating whether high self-control demands at work lead to difficulties to begin with home exercise and to low actual exercise behavior (ego-depletion). It was also tested whether relaxation can counteract the effects of ego-depletion. Methods: 40 patients who should do home exercise every after work day took part in a RCT with 2 groups over a period of 5 working days. One group conducted a standardized relaxation (15 minutes) before starting the exercises; the other group conducted the exercises straight after work. Self-control demands at work, the perceived difficulty and actual exercise behavior were assessed by a daily survey. Findings: ANOVAs revealed no significant group effect. Self-control demands at work were positively associated with perceived difficulty (r= .50; p < .01) and negatively associated with actual exercise behavior (r= -.25; p = .17). Perceived difficulty was also negatively associated with actual exercise behavior (r= -.55; p < .001). Discussion: Results suggest that high self-control demands at work lead to a state of ego-depletion which consequently reduces compliance with home exercise. The missing group effect can be due to methodological issues.

Background: Due to the positive effect on the treatment of cancer patients, physical activity schemes should be implemented alongside hospital care. The level of demand for "treatment-associated sports schemes" has been examined in an implementation and acceptance study. Following questions were investigated: 1. How should offers and communication be designed? 2. Which barriers do the patients face? 3. What are patients’ opinions and how high is the readiness to participate? Method: A questionnaire was used to collect data, specifying personal details, medical history, physical activity, attitude towards an exercise programme, readiness to participate, social support and structural conditions of an exercise programme. The survey was conducted at an oncology clinic, 120 patients took part in answering the questionnaire. Findings: Above all, patients desire an exercise programme with participants of a similar age. Women would prefer to be in exclusively female groups. Longer journeys (> 2 km), rather than physical fitness, prevent patients from participating, but a positive attitude increases the willingness to travel a further distance. Discussion: The implementation of concomitant therapy for physical activity is generally welcomed. To overcome barriers, a strengthening of the personal resources and the improvement of structural conditions ought to be considered.

Background: The purpose was to examine whether very brief paper-pencil interventions can have an effect in various domains of health behaviour change.Theoretical basis was the health action process approach (HAPA) that makes a distinction between motivational and volitional phases. Methods: A series of leaflet-based interventions were conducted in Poland, India, Iran, and Costa Rica with more than 1,000 participants. Repeated measures analyses of variance were applied to test time by treatment effects, observing treatment and control groups over several weeks. Findings: Modest intervention effects were found for diet, exercise, hand hygiene, and dental flossing. Moreover, mediation and moderation analyses identified the role of social-cognitive variables (intentions, planning, self-efficacy, action control). Discussion: A case has been made in favor of very parsimonious interventions that provide either a starting point for the adoption of health behaviors, or a cue to action that helps to maintain on-going behaviors.

In exacerbating epistemological oppositions between « post-positivist » and «constructivist » paradigms, the « Paradigm war » has entailed a focus on one of the two methods, rather than thinking about the phenomenon under investigation. This presentation aims to raise the value of combining these two methods. Through our research, we illustrate the mismatch between patients and gynaecologists facing the integration of sexuality during consultation. We conducted semi-structured interviews (N=21), 3 focus groups and a questionnaire based on the qualitative findings (N=421) in a sequential design. Qualitative methods allow the discovery of new outcomes. Indeed, our analysis highlights important gaps between gynaecologists’ and patients’ perceptions regarding for exemple the definition of sexuality. Gynaecologists reduce it to medical aspects, whilst patients would expect to discuss their sexuality at the embodied, relational and psychological levels. The questionnaire adds an additional value in confirming qualitative findings and provide further information. In our use of mixed methods, we emphasize the need for reflexive adjustements by the researcher at each stage of the research.

Background: The study deals with the influence of physical activity on personality of seniors. Methods: From 2007 to 2013 we conducted an individual examination of seniors over the age of 75 using the NEO FFI method. The study group consisted of 117 seniors, who were not diagnosed with dementia. The group was divided: 1. Members of the Czech Sokol Community. 2. People who regularly perform physical activity. 3. People who do not regularly perform physical activity. Findings and Discussion: Male participants of „Sokol“ (Czech sport club) had lower levels of neuroticism and openness and higher level of friendliness and knowledge. The degree of extroversion was comparable. In this group, we found a tendency for a high level of active management and live their lives according to their own ideas, which were confirmed. Regarding Sokol women, we found lower levels of extroversion, openness, and slightly higher neuroticism, agreeableness and consciousness. The measured values were similar group of women who regularly participate in any organized activities and do not exercise regularly. We believe that despite their age, women from these groups are actively involved in their lives.

This paper aims to examine the role of personal and contextual resources in buffering the effect of chronic disease and disability on quality of life (QoL) in older people. We used data from the Irish Longitudinal Study of Ageing (TILDA), a population sample of adults aged 50+ (n=4454). QoL was measured with the two dimensions of the CASP-R12 – control/autonomy and self-realisation/pleasure. Regression was used to test the effect of newly diagnosed chronic conditions and increased disability on change in QoL over two years, with interaction terms to examine moderating effects of socioeconomic status, social support, personality and religiosity. Two effects were statistically significant. Living as married, regardless of marital quality, reduced the negative effect of disabling chronic disease on control/autonomy. Religiosity reduced the effect of a disabling diagnosis on self-realisation/pleasure. Both contextual and personal resources matter for maintaining QoL in poor health. Living as married may provide key instrumental support, allowing older people to maintain independence, while religiosity may make physical health less important for living a fulfilling and enjoyable life.

Background: Health behavior theories predominantly focus on conscious, reflective precursors of health behaviors and eschew the possibility of implicit influence. Four studies examined whether behavior priming influences decisions and actions related to diet, exercise, alcohol consumption, and condom use. A fifth study explored whether self-control training moderates the impact of priming on eating behavior. Method: Participants were university staff and students (Ns = 50, 151, 31, 24, and 173 in Studies 1-5, respectively) who were randomly assigned to conditions. Decisions were measured using questionnaires and behavior was measured objectively. Findings: Priming stereotypes, exemplars, or goals had reliable effects on exercise and condom use decisions, mental readiness to drink alcohol, and food intake. Self-control training did not moderate the impact of priming on food intake. Discussion: This research obtained evidence of priming effects on health cognitions and behaviors, but found that self-control training not attenuate priming effects. Implications for dual-process theories of health behavior and for interventions to promote behavior change will be discussed.

Background. Increasing life expectancies, burgeoning healthcare costs, and an emphasis on the management of multiple health-risk behaviours points to a need to identify health-related lifestyles in older adults. The aim of this study was to delineate health lifestyles of older adults, and to examine the association of these lifestyles with biological and psychological states, and socioeconomic indices. Methods. Cluster Analysis was applied to data derived from the 45 and Up cohort study of Australians over 45 years. Participants (N=96,276) completed measures of exercise, smoking, alcohol consumption, diet, cancer screening, and physical functioning, quality of life and psychological distress. Findings. Six lifestyle clusters emerged characterised by smoking, screening and physical activity levels. Individuals within health-risk dominant clusters were more likely to be male, living alone, low income earners, living in a deprived neighbourhood, psychologically distressed and experiencing low quality of life. Discussion. Health lifestyle cluster membership can be used to identify older adults at greatest risk for physical and psychological health morbidity.

Background: The emotional, cognitive and behavioral effects on patients caused by watching the monitor screen during cardiac catheterization were investigated, including potential mediators (illness perceptions) and moderators (individual differences in monitoring coping style). Methods: An experiment was conducted, comparing patients instructed to watch the monitor screen during the procedure with those that were not. Questionnaires measuring illness perceptions, monitoring coping style, emotional, cognitive and behavioral variables associated with cardiac health were collected one day and one month after the procedure. Results: watching the angiography screen during the procedure increased cardiac patients’ personal and treatment control perceptions, which in turn increased their functional self-efficacy and outcome expectancies regarding lifestyle changes, improved their self-assessed health, and decreased negative affect. Behavior-related benefits of watching the screen were moderated by monitoring coping style, which was correlated positively with the benefits of watching the screen. Conclusions: these findings illustrate the significance of illness perceptions, perceived control and monitoring coping style in achieving desirable outcomes, and open new opportunities for psychological interventions using medical imaging technologies.

Migration may be seen as a critical life event. Moving to foreign country requires an individual to face a completely new life situation. Our previous research brought up the following questions: 1) are there any differences in perceived stress among immigrants regarding country of destination; 2) what are psychosocial predictors of stress in immigrants. Research group: 239 Polish immigrants to England, Scotland and Ireland. Participants were asked to fill out several questionnaires: COPE, BMS, SE, DI. Analyses have shown that load of stress among immigrants is different in every country in this research (F=29,768**; eta2=0,20). Moreover, stress predictors are different in every country of immigrants’ destination. For immigrants psychosocial factors explain: in case of England 28% of stress variability (R2=0,28;F= 9,101**), Ireland 20% of stress (R2=0,20;F=11,262**), Scotland 34% of stress (R2=0,34;F=11,892**). Our results demonstrated that countries differ essentially in demands of immigration. Most likely distinctive features of immigrants destination countries are source of high stress. We anticipated that reasons for obtained results lay in cultural differences immigrants are exposed to.

Effectiveness of self-help groups was investigated in a study on female Turkish migrants with recurrent depressive disorder. Self-help groups were guided by group leaders of Turkish decent, providing a platform for exchange and social support. Analysis of qualitative data on effects of participation in groups was done, though no alleviation of symptoms was found. 43 female Turkish migrants participated in groups over a period of 4 months. Qualitative data contained interviews with participants, group protocols and supervision protocols of group leaders. Analysis of data was done with the qualitative content analysis (Mayring). Findings revealed that women reported feelings of being neglected and violated by their husbands, pointing towards a functional value of the illness. During participation in self-help groups women also reported emancipating from their husbands and gaining strength. Self-help groups were seen as social resource and support for change in their lives. Interventions to improve well-being and social functioning in female Turkish migrants should consider the functional value of depressive symptoms and focus on social support systems as well as social networks.

Background: This study investigated the impact of work-family conflict in Portuguese nurses’ stress responses, the quality of their marital adjustment and their attitudes toward work. Methods: The sample consists of 310 female hospital nurses (Age: M = 33.83; SD = 8.70). Measures were the Portuguese versions of the General Health Questionnaire (GHQ-12) and the Brief Personal Survey-Revised, to measure stress responses; the Organizational Climate Questionnaire, to measure job attitudes; the Work-Family Conflict Scales, to evaluate work-to-family conflict (WFC) and family-to-work conflict (FWC); and the Revised Dyadic Adjustment Scale, to assess marital adjustment. Findings: WFC was higher than FWC, being a significant predictor of all outcomes. Higher WFC was associated with more stress responses (deltaR2= [psychological distress: .132; pressure overload: .140]), reduced marital adjustment (deltaR2= [consensus: .022; satisfaction: .033]), and increased negative attitudes toward work (deltaR2= [global assessment of organizational climate: .120]). FWC predicted guilt feelings (deltaR2= .037) and lowered dyadic consensus (deltaR2= .018) but did not predict job attitudes. Discussion: Findings show that WFC and FWC affect both the work and marital domains. The interface of family and work demands must be considered in occupational health promotion programs, targeting female nurses.

BACKGROUND The HAPA model and HAPA-like approaches (incorporating self-efficacy plus multiple motivational and volitional components) are increasingly applied in intervention studies. This review: 1) describes how HAPA-based approaches have been used to design or evaluate interventions to change behaviours for preventing/managing chronic disease; 2) examines the effectiveness of HAPA-based interventions. METHODS Relevant studies were identified, selected and synthesised as per our protocol: www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42013003596 FINDINGS 402 of 669 potentially relevant papers initially identified were selected for full text review, with 54 studies included. Over half were published in the last 2 years and half were European. Apart from self-efficacy, intention/goal-setting was the most used, and risk perception the least used component. Most studies were trials and targeted exercise, diet and/or weight loss. Detailed data extraction is ongoing. DISCUSSION This review assesses the use and effectiveness of HAPA-based approaches in interventions, suggesting there is scope for their application to a wide range of preventative and disease management behaviours.

Background: Intention behaviour relationships are often studied in between-subject designs looking at an individual behaviour. It has been suggested that failure to implement intentions reflect poor self-regulatory capacity and has psychological costs. Methods: N=126 participants completed measures of 51 different intentions, demographics, behaviour, crystallized intelligence, executive function and quality of life. Participants were followed up one week later with a 49 self-reported and two objective behaviour measures. Results: The number of intentions participants reported was not related to the percentage of intentions implemented. Crystallized intelligence and executive function measures showed higher associations with the number of intentions formed and implemented than with those failed. Participants with more intentions reported higher well being. Failed intentions were not related to lower well being. Discussion: People may form more intentions than they can translate because they are more prone to be happy about their achievement than disappointed about intentions which are not translated.

Background: Patients anticipating surgery experience significant anxiety. The prevalence of anxiety prior to surgical procedures has been reported to range from 11% to 80% among adult patient populations. The objective of the study is to explore preoperative anxiety dynamics in patients. Methods: Two samples of patients (N1=60, M1=57.5, SD1=16.8; N2=50, M2=44.3, SD2=13.7) were assessed by nurses using the rating scale Anxiety Level-12 and at the same time self-report state anxiety measures HADS-A (Hospital Anxiety and Depression Scale) and STAI (State Trait Anxiety Inventory) were administered. Time remaining to surgery ranged from 10 minutes to 48 hours. Findings: Results showed significantly higher anxiety closer to surgery. Several other variables show influence on the relationship: age, premedication, sex, anesthesia. Discussion: In accordance with previous findings the results show that preoperative anxiety changes with time remaining to surgery and the relationship is influenced by various factors, e.g. age, sex, previous surgery, type of anesthesia. Future research could uncover the influence of personality factors on preoperative anxiety dynamics.

Background: A severely ill person has to cope with medical proce¬dures, declines in socio-economic status, and the direct threat to his/her life. If this person is a parent, the consequences of these stressor factors may result in a lasting distortion of the children's social and emotional development. The purpose of this study of families where a parent has an acute brain injury was to present an in-depth, idiographic study of the coping strategies used by children. Methods: Thirty-two counseling sessions (8 children) were analyzed and the resultant transcripts subjected to interpretative phenomenological analysis. Findings: Several themes emerged in the analysis and are discussed here: “closeness strategies”, “avoidance strategies”, “gender and age specific differences”. Discussion: The results points to the importance of developing counselling possibilities focused on facilitating factual as well as emotional communication within the family, empowering the parenting function of the healthy parent, and helping children in sharing their worries and thoughts.

Background: The demands associated with the diagnosis and treatment of serious illness can substantially interfere with personal goal pursuit. Adaptive goal-related coping is necessary to maintain psychological well-being in response to goal interference. This prospective study sought to gain insight into the nature of goal-related coping in the context of early-stage breast cancer. Methods: Personal goal interference and goal-related coping were examined in a sample of female breast cancer patients (n=33) at two, four and six months post-surgery using a novel mixed-method goal-specific assessment and multi-phase thematic analysis. Findings: Participants widely varied in their experiences of goal interference and subsequent coping responses across different goals and over time. Four clusters of participants were identified on the basis of patterns of adaptive (vs. maladaptive) goal-related coping over time. Discussion: Findings suggest that early-stage breast cancer patients widely vary in their experience of goal-related coping across time and provide support for a situation-specific approach to investigating goal-related coping in early-stage breast cancer patients. Further empirical studies are needed to examine the utility of this approach in larger samples of breast cancer patients. Such research may inform person-centred psychosocial support in this population.

Unhealthy eating behaviour is a health issue among adolescent Turkish migrants in Germany and among adolescents in Turkey. To develop effective interventions, it is important to identify relevant social-cognitive determinants of eating behaviour for both groups and to find out how the migration experience affects these social-cognitive factors. The present study combined research on migration with the prototype-willingness model (PWM) for the explanation of eating behaviour. PMW-variables were assessed via questionnaire and compared cross-sectionally across adolescent Turkish migrants (n = 102) and adolescent Turks (n = 270) using multiple-group SEM. Latent mean differences and associations of variables were analysed. Levels of PWM-variables were more favourable in Turkish migrants than in Turks. Turkish migrants’ eating behaviour was predicated via the reasoned action pathway, whereas Turks’ eating behaviour was predicted via both the social-reaction pathway and the reasoned action pathway. Migration seems to affect both levels of PWM-variables and which PWM-variables are relevant for the prediction of eating behaviour. Implications for theory and interventions are discussed.

Background: Despite the increasing incidences of the publication of assessment frameworks intending to establish the "standards" of the quality of qualitative research, the research conducted using such empirical methods are still facing difficulties in being published or recognised by funding agencies. Methods: We conducted a thematic content analysis of eight frameworks from psychology/psychiatry and general medicine. The frameworks and their criteria are then compared against each other. Findings: The results illustrated the difficulties in reaching consensus on the definition of quality criteria. This showed the differences between the frameworks from the point of views of the underlying epistemology and the criteria suggested. Discussion: The aforementioned differences reflect the diversity of paradigms implicitly referred to by the authors of the frameworks, although rarely explicitly mentioned in text. We conclude that the increase in qualitative research and publications has failed to overcome the difficulties in establishing shared criteria and the great heterogeneity of concepts raises methodological and epistemological problems.

Background: Social norms influence eating behavior. Research has shown that communicating social norms does not always promote healthy eating, but may sometimes backfire. We investigated if a suggested norm is more successful in curbing unhealthy behavior than a restrictive norm. Methods: Participants (n = 79) completed a creativity task while M&M’s were within reach, consumption of which was forbidden (restrictive norm), discouraged (suggested norm) or allowed (control). Reactance was then assessed, after which a taste test was administered where all participants could eat M&M’s. Findings: Consumption during the creativity task did not differ between the experimental conditions, but reactance after the creativity task was higher in restricted participants. In the free-eating taste test phase, restricted participants consumed more than suggested participants. Indications of mediation via reactance were found. Discussion: There are more and less effective ways of delivering social norms. A restrictive as compared to suggested norm induced psychological reactance and higher unhealthy consumption. It is important to pay attention to the way in which norms are communicated.

Background: Apps to increase physical activity (PA) are popular, but hardly include theory-based features. This study will examine how behavior change techniques (BCTs) and technological features can be used to target important determinants as social support and self-efficacy (SE). Additionally, the preferences and the intentions to use such features will be assessed. Method: Young adults (n~100) will complete an online questionnaire assessing constructs of PA, social influences, SE, their preferences, acceptance and usage of BCTs (e.g. monitoring, goal setting)using validated questionnaires. Associations of PA, social determinants and SE with the preferences will be estimated by regression analyses. Results: Results (available in May/June 2014) will describe the behavioral and technological preferences of young adults, e.g. proportions of participants that prefer SE promoting features in an app. Regression coefficients will describe the strength of PA, social determinants and SE with the specific preferences. Conclusion: Results will directly be used in the development of a new theory-based mobile intervention, aiming to empower young adults to be more physically active.

Background: Healthcare providers don't seem to be taking the issue of obesity as seriously as they should. Quantitative studies are criticized for insufficient comprehension of this phenomenon. This qualitative study aimed to understand the beliefs, attitudes, practices and treatment role about obesity of Portuguese general practitioners, nurses and dietitians in primary care setting. Method: Semi-structured interviews were conducted and data was analyzed according to Thematic analysis procedures. Findings: The main themes indicate that all groups hold negative beliefs and attitudes towards obese. General practitioners lack successes, feel frustrated, have low expectations of efficacy and are negative about their role in the treatment. Nutritionists and nurses demonstrate an active role and perceived themselves as being able to positively modify obese motivation. However, the change process is described as a constant struggle with the patients. There seems to exist communication problems between the three groups. Discussion: Knowledge about treatment options and communications skills should be improved and a bigger emphasis should be put on a multidisciplinary approach to obesity.

Background| Obesity has become a growing problem, where not only metabolic health, but also psychological wellbeing is decreased. A long-term effective program should focus on both one’s biological and psychological strengths. For overweight people, strength exercises might be the answer. From a biological perspective, there is a consensus that strength training results in long term positive effects on metabolic and cardiovascular health. What are the psychological consequences of these biological insights? Methods| A systematic review using Pubmed and Psychinfo. Findings and discussion| Resistance exercises might trigger the intrinsic motivation and self-efficacy that is lacking in aerobic exercise programs. Overweight people notice that 1) resistance exercises are relatively easier than aerobic exercises; 2) their performance will be better than the performance of their normal weight counterparts, and 3) their performance will improve more compared to both aerobic exercises and compared to the normal weight. We assume that to make overweight and obese people healthier, stronger, more confident (and feeling better in general), this is the answer.

Background This study describes the development of a habit-formation intervention of low-level physical activities for sedentary older adults, to achieve long-term activity gains and reduce sedentary behaviour. Method An intervention leaflet was developed in four stages: 1) a multidisciplinary expert panel generated physical activity tips; 2) a focus group of ten adults aged 60-75 discussed the tips; 3) a panel of 21 adults aged 63-85 rated tips and a motivational text for readability, difficulty, motivation and performance likelihood (1=least, 4=most positive); 4) acceptability is currently (Dec 13-Apr 14) being tested among 30 sedentary adults aged 60+. Findings Stage 1 generated 18 tips covering walking, stretching, strength, balance and limiting sitting. Removing tips viewed unfavourably (Stage 2) reduced the tips to ten, which were judged (stage 3) to be readable (mean=3.38), easy (2.95), motivating (2.82), and likely to be performed (2.95). Photos were added to the leaflet for clarity. So far, stage 4 data suggest older adults are motivated and able to incorporate the tips into everyday routines. Discussion Effects on behaviour and health are to be tested in a pilot RCT.

Background In order to optimize screening and support of living kidney donors, we examined which factors predict changes in donors’ mental health after living kidney donation. Methods Living kidney donors (N=137) completed validated questionnaires and participated in interviews a median of 2 months before and 3 months after donation. Using multilevel linear models we examined whether psychological complaints and wellbeing were predicted by sociodemographic characteristics, medical outcomes for donor and recipient, and psychological factors based on stress models of Lazarus (1999) and Ursin & Eriksen (2004). Findings There was no main effect of time on psychological complaints while wellbeing increased over time (p<.01). Donors’ home situation, greater stress, appraising donation as an uncontrollable or negative event, expectations of negative personal consequences, coping, social support, and more negative life events predicted negative changes in donors’ mental health. Medical outcomes were not related to changes in donors’ mental health. Discussion We recommend negative appraisals of donation and individual resources as targets for improved donor screening and support.

The lack of adequate sanitation is a major threat for health and well-being of people, particularly for those living in urban slums in developing countries. Affordable solutions to the problem are available and new technologies in development but, still, will be relatively expensive. We investigated how slum dwellers in Kampala (Uganda) decide to rent a new sanitation service, in order to improve the design and promotion of the service. 1050 participants were randomly selected for personal interviews that covered a wide range of qualitative and quantitative questions. A logistic regression explains the decision to rent the service with psychological evaluations on 4 dimensions: (1) affective (liking the toilet), (2) instrumental (advantages for health), (3) normative (compliance with cultural norms, being proud or ashamed, and expected opposition or support), and (4) expected difficulties when using the toilet. All dimensions significantly (p < 0.01) affect the decision with the exception of affective liking (p = 0.846). To conclude, the promotion of the toilet should address advantages, difficulties, and normative aspects with arguments favouring systematic information processing.

Background: Inflammation is a possible aetiological mechanism through which depression increases incident diabetes risk however there are few longitudinal studies. Methods: A cohort of 1,110 men aged 35 years or older underwent venous withdrawal for cardiometabolic risk factors, IL-6, CRP, and e-selectin at baseline and 5 year follow-up. Depression symptoms were assessed by CES-D or BDI-I, respondents were categorized into chronic or remitting depression. Logistic regression determined whether diabetes mellitus was associated with depression chronicity, inflammation, ? inflammation, and their interaction terms. Findings: There were 158 cases of incident diabetes (14.2%). The chronic depression and ? IL-6 interaction term was associated with greater diabetes risk (OR 2.36; 95% CI 1.28 – 4.36, p =.006). Chronic depression and ? e-selectin interaction term also significantly increased diabetes risk (OR 1.08; 95% CI 1.00 – 1.16, p =.05). Conclusions: These data provide support for inflammation as a biological mechanisms through which chronic depression increases diabetes risk.

The study examined if a Health Action Process Approach (HAPA) based exercise counseling increases physical activity of cancer patients who are motivated but insufficiently active and leads to a progress in HAPA stages. 72 cancer patients (54 % female; M = 56 years) participated in the MOTIVACTION study consisting of a 4 week intervention (1 hour personal counseling and weekly phone calls) with pre- (T1) and post-test (T2). Participants were randomized either to exercise counseling or stress management training (control). The exercise counseling included volitional behavior change techniques and a meeting with a role model. Physical exercise was assessed with the SQUASH. Patients of the exercise counseling group increased their weekly exercise from 52 minutes (T1) to 150 minutes (T2). They spend significantly more minutes on exercise at T2 than patients of the control group (M = 150.4 vs. M = 65.0, p < .05). Looking at HAPA stages, 47% could proceed in stages between T1 and T2 in the exercise group, whereas only 24% in the control group. The MOTIVACTION exercise intervention turned out to be helpful to increase the exercise of insufficiently active cancer patients.

Background: To decrease social inequalities in colorectal cancer screening participation, Screening Navigation Programs (SNPs) focusing on a global view of individual barriers (transportation, cultural difficulties, knowledge) have shown to be effective. However, psychological mechanisms of SNP efficacy are not well known. We hypothesized that SNP should change health beliefs about screening and reduce social inequalities on them. Methods: From a French SNP protocol, the study included two independent variables: SNP Intervention (Screening Navigation vs. Usual Screening) x Socioeconomic Status of the living place (Townsend Index). We measured health beliefs following the Protection Motivation Theory by a mailed questionnaire, in 261 non-compliant persons regarding screening and targeted to participate to screening. Findings: We found significant interactions between SNP Intervention and Socioeconomic Status on several health beliefs. More specifically, our results show that social inequalities on perceived efficacy of the screening and on perceived facility were reduced by the SNP. Discussion: Health beliefs are a way to understand SNP efficacy to reduce social inequalities.

Background. Research on eHealth applications is growing fast, but little is known about people’s experiences with internet-based weight loss interventions. The current study explored experiences with these interventions to provide a better understanding of the facilitators and barriers to adherence. Method. Semi-structured recorded interviews were conducted with 20 primary care patients who were offered lifestyle advice and access to three free internet-based weight loss programmes. The interviews focused on experiences with the interventions during a 4-week period. Transcripts were analysed by two separate coders using Thematic Analysis. Findings. The accessibility and novelty of using the internet for weight loss was the initial motivation of engagement. Barriers to adherence included time, effort and excessive reminders. Ongoing engagement was facilitated by face to face contact and perceived success of changes. Discussion. This study identified facilitators and barriers to adherence that can inform the development of new eHealth behaviour change interventions and highlights the potential for use of eHealth alongside weight management advice within primary care settings.

Introduction We study whether previous findings in studies on blood donation behaviour that were labelled question behaviour effect (QBE) could actually reflect a non-response bias (NRB) instead. Higher response rates have also been associated with finding QBE. Methods Blood donors (N=1,395) were randomly allocated to one of six experimental questionnaire conditions or to a control group. The questionnaire conditions either included intention items to trigger a QBE, general health items, both items, and handwritten post-its to increase response rate or not. The outcome variable was the % of donors that donated after receiving a standard invitation. Results The questionnaire conditions did not influence the odds of donation compared to the control group (OR’s ranged from 0.70 to 1.01). Non-responders showed significantly lower odds of donating than controls (ORresponders: 1.05, 95%CI: .77-1.45; ORnon-responders: .63, 95%CI: .45-.88). Discussion Regardless of the content or response rate, receiving or filling in questionnaires does not seem to increase blood donation. However, non-responders donate less than responders. These findings support the NRB hypothesis over the QBE hypothesis.

Background Current self-management support (SMS) programmes pay little attention to patients’ age and related life context. The aim of is study is to examine age-related differences in SMS needs by applying the stress-coping theory. We explore the role of three concepts that relate to patients’ age and that may impact on their SMS needs: burden of illness, social roles and resources. Methods Logistic regression analyses were conducted using data on SMS needs, burden of illness (e.g. type of illness, physical functioning), social roles and resources (educational level, health literacy) of 1,782 patients with chronic disease(s) who participated in a nationwide Dutch panel-study. Findings Age is positively related to the need for SMS regarding medical management, coping with the consequences of having an chronic illness and communicating with healthcare providers. SMS needs regarding making lifestyle changes are not related to age. Age-related differences in SMS needs can be explained by patients’ social roles and especially by their burden of illness. Discussion This study shows that there is a an urge for tailored interventions, which take the life context of patients into account.

Background: Fast track surgery or Enhanced Recovery Programs (ERP) have been shown to improve patient outcomes, speed patient recovery post-operatively and increase cost-effectiveness for patients undergoing cancer surgery. ERPs are based on improving patient education, explaining the expected milestones in the recovery period and discharge planning. The effectiveness of ERP has been assessed by clinical outcome measures. The patient experience is often neglected. Methods: The current qualitative study was designed alongside a Randomised Control Trial for patients enrolled in an ERP for liver cancer. The aim of the qualitative study was to conduct a process evaluation. 30 patients were interviewed pre-operatively and 6 week post surgery. Transcripts were analysed using Thematic Content Analysis (Braun & Clarke, 2006) Findings: The patient experience of preparing and recovering from surgery for ERP was different for “Avoiders” (patients who distance themselves from negative feelings) and “Sensitizers” (patients who acknowledge negative emotions). Leventhal’s Self-Regulatory Model was used as a theoretical framework to explain the patient experience and ways in which patient education and psychological support may accentuate the effect of ERP. Discussion: The potential for using a psychometric tool for assessing “readiness for fast track surgery” are discussed.

The happiness indicator is a combination of a self-help website and a long-term follow-up study. Participants get an e-mail every month wit a link to a webpage on which they rate how happy they feel right now and during the last month. They get instant feedback on difference with the happiness of comparable people and change in their happiness over time. Participants can also complete the Happiness Diary' on which they record their activities of the previous day and rate how happy they have felt during each of these. They get instant feedback on how their time use and experience differs from comparable people. The happiness indicator is developed in the Netherlands as a joint project of health insurance company VGZ and Erasmus University Rotterdam. To date the site has attracted some 75000 participants of which about half on a regular basis. An English language Beta version is available at www.happinessindicator.com Uses for health promotion and follow-up research are discussed. Participation from colleagues in other countries is welcomed.

Introduction: A growing body of literature shows that psychological flexibility (PF) is associated with higher psychological well-being (PWB). Studies on this issue conducted in patients with cancer are however few and limited by the cross-sectional nature of the methodological designs. The objective of this study was to explore whether PF longitudinally predicts PWB in patients with cancer. Method: A total of 87 females with cancer (Mean age = 50 years, SD=9.6, range = 23-68) participated in the study. Patients completed the Acceptance and Action Questionnaire II (AAQ-II) and the Psychological Well-Being Scale (PWB) at Time 1 (T1) and at Time 2 (T2), that is 16 months later. Findings: Results from hierarchical regression analyses – controlling for socio-demographic, clinical, and dependent variables at T1 – showed that PF at T1 significantly and positively predicted both Positive Relations and Personal Growth scores of the PWB as well as the PWB total score at T2. Conclusion: Findings in this study support PF as a temporal antecedent of two important PWB dimensions. Psychological interventions designed to increase PF may be effective to improve PWB in patients with cancer.

Background To explore if action planning improves the uptake of guidelines for smoking cessation care by general practitioners (GPs). Methods During a training GPs (n=25) formulated action plans on asking about smoking and advising to quit and coping plans for encountering smokers who are (un)motivated to quit. GPs’ plans were rated on the degree of specificity and GP-reported goal attainment. Patients reported smoking cessation activities of GPs after consultation during a three-week period prior (n=1002) and following (n=630) the training. Findings We found an effect of high GP plan specificity (OR 1.52, 95% CI 1.29-1.92) and high GP goal attainment (OR 2.83, 95% CI 2.18-3.68) on the number of patients being asked about smoking compared to baseline. Patients were most likely to be asked about smoking when GPs formulated a highly specific plan ánd reported a high goal attainment (OR 3.35, 95% CI 2.50-4.47). No effects were found on other smoking cessation activities. Discussion Incorporating action planning in a training for GPs may improve the frequency at which smokers are identified, especially when GPs describe their plan highly specific.

Background: Implementation intentions effectively change unhealthy snacking habits by creating an association between a detailed situation and alternative. Yet such plans are rather inflexible. We tested whether if-then plans can be taught as a metacognitive strategy (MCS) teaching people to use and adapt this strategy independently. Methods: After keeping a 7-day snack diary, participants (N=73; community sample) received a planning strategy (implementation intentions, MCS, control). MCS instructions involved three steps: planning, monitoring, evaluating, and participants learned to adapt plans accordingly. Caloric intake was assessed with a diary after one and two months. Findings: Results showed main effects of condition and time (p’s<.05) and a marginally significant interaction (p=.07). The MCS was found most effective in reducing unhealthy snacking. Discussion: Providing the instructions just once, implementation intentions can be taught as a MCS. People learn to adapt plans to changing situations resulting in behaviour change maintenance. Boundaries regarding the use of if-then plans are addressed and an effective and applicable strategy for interventions is demonstrated.

Background: This study tested the effect of social comparative norms on fruit intake intentions in students. We expected negative comparative information to increase intention and positive comparative information to increase or decrease intention (boosting or boomerang effect). Methods: Participants were 172 Dutch students (22% males, Mage: 21.9) who reported intention, attitude, self-efficacy and self-identity towards fruit intake. Fruit intake was reported during 3 days. Hereafter, they received a message that they either consumed more fruit than the average student (pos experimental group, n=46), consumed less fruit (neg experimental group, n=46), or received no message (pos and neg control groups, both n=40). Intention was then again assessed. Findings: Intention decreased among the neg experimental group (t=2.38, p=.02), while it stayed stable among the neg control group (t=-.15, p=.88). In the pos groups, the controls showed a decrease in intention (t=2.45, p=.02) while the experimental group stayed stable (t=-.15, p=.88). Discussion: Contrary to expectations, a negative comparative norm message demotivated participants to consume fruit, while a positive norm message seemed to boost intention. Hence, positive comparative norms seem most fruitful.

Background: The Quality of Life after Brain Injury (QOLIBRI) scale is a recently developed instrument that provides a profile of health-related quality of life (HRQoL) in domains typically affected by traumatic brain injury (TBI). However, for some purposes (e.g. when time is costly or the concentration of respondents limited) it is desirable to have a brief summary measure. This study examined a six-item QOLIBRI Overall Scale (QOLIBRI-OS), and considered whether it could provide an index of HRQOL after TBI. Methods: The properties of the QOLIBRI-OS were studied in a sample of 792 participants after TBI recruited from centres in nine countries covering six languages. An examination of construct validity was undertaken on a sub-sample of 153 participants recruited in Germany who had been assessed on two relevant brief quality of life measures: the Satisfaction With Life Scale and the Quality of Life Visual Analogue Scale. Results: The reliability of the QOLIBRI-OS was good (Cronbach’s ? =0.86, test-retest reliability=0.81), and similar in participants with higher and lower cognitive performance. Factor analyses indicated that the scale is unidimensional. Rasch analysis also showed a satisfactory fit with this model. The QOLIBRI-OS correlates highly with the total score from the full QOLIBRI scale (r=0.87). Moderate to strong relationships were found between the QOLIBRI-OS and the GOSE, SF-36, and Hospital Anxiety and Depression scale (r=0.54 to - 0.76). The QOLIBRI-OS showed good construct validity in the TBI group. Conclusion: The QOLIBRI-OS assesses a similar construct to the QOLIBRI total score and can be used internationally as a brief index and screening instrument of HRQoL for TBI. Key words: Traumatic brain injury, outcome, health-related quality of life, short index.

Background:Digital interventions are increasingly used for changing alcohol and tobacco use in young people. This review aims to assess the efficacy of digital interventions targeting alcohol and tobacco use in young people, to update existing evidence and to expand the range of digital components reviewed. Methods:Electronic databases were searched for randomised and quasi-randomised trials targeting individuals aged 15-24, which reported either alcohol or tobacco outcomes, and which involved a direct interface between the participants and the digital intervention components. Findings:2259 unique articles were found. 94 studies from abstract and reference searching were retained for full text screening. Data extraction includes the effect of digital interventions on alcohol and tobacco consumption outcomes and the duration and use of digital interfaces in the delivery of the intervention. Discussion:Digital interventions in young people might provide a promising intervention channel for alcohol and tobacco use behaviours. The results will inform a pilot trial for a digital intervention tackling alcohol and tobacco use in adolescents and young adults in Estonia.

Background:The distinct impact of physical trauma is currently not considered in any measures of post traumatic growth (PTG). The main aims of this study were to develop a measure of PTG following physical trauma; assess dimensionality and psychometric properties using exploratory and confirmatory factor analysis. Methods:Men at least 1yr post prostate cancer treatment were recruited via clinics, online and local support groups (n = 452). The physical PTG questionnaire items were distributed to participants. Participants were randomly split into two independent samples: Data Set A (n = 226) and Data Set B (n = 226) for EFA and CFA respectively. Findings:Two factors emerged following EFA of Data Set A:Health Autonomy and Health Awareness. CFA was conducted on a 2nd sample (Data Set B). These factors were deemed a good fit: ?2 (164) 284.13, p< .0005; Q= 1.73; RMSEA= .057 (90% CI: .05-.07);CFI= .95 and AIC: 376.13. This supports our initial qualitative findings on the unique role of physical trauma in PTG. Discussion:This novel measure of physical PTG addresses major limitations in current PTG measures and facilitates a more comprehensive understanding of adjustment and survivorship.

Background: Volunteering is presumed to confer health benefits, but interventions to encourage older adults to volunteer are sparse. Methods: An RCT with n = 280 community-dwelling older adults was conducted to test a theory-based social-cognitive intervention for volunteering (VIG) against a passive control group (PCG) and an active control group for physical activity (ACG). Self-reports of weekly volunteering were assessed at baseline (T1), two (T2) and six weeks (T3) after the intervention. Controls were age, gender, education, partner status and number of illnesses. Findings: The latent change model fitted well, ?2(2) = 4.41, p = .11, RMSEA = 0.07, CFI = 0.99, SRMR = 0.02. All groups developed similarly from T1 to T2. Volunteering change from T2 to T3 was associated with assignment to the ACG versus VIG (? = -.23, p = .02) and PCG versus VIG (? = -.26, p = .01), indicating a steeper increase of volunteering from T2 to T3 in the VIG as compared to both other groups. Discussion: A single face-to-face group session can increase volunteering among older community-dwelling adults. The effects, however, need time to unfold, as changes in volunteering were apparent at T3 but not T2.

Background:Self-determination theory (SDT) posits satisfaction of psychological needs is key to development of self-determined regulation (Deci & Ryan, 2002). These relationships were prospectively examined in exercise initiates. Methods: 97adults (Mean age 43.43, SD=10.71) participated in 6 months of exercise. The psychological need satisfaction in exercise scale (PNSE), and behaviour regulation in exercise questionnaire (BREQ) were completed at 0, 3, and 6 months. Findings: Positive significant correlations (r) were observed between PNSE and self-determined regulations (rs from .247 to .548) but not controlled regulations (rs from -.140 to .045), except a positive r between relatedness and introjection at 3 months (r .305). Repeated measures MANOVAs revealed interactions of PNSE subscales over time, Eta2 =.37, with increased autonomy and competence and decreased relatedness; and BREQ subscales over time, Eta2 =.63, which mostly increased except external. Discussion: Results provide novel evidence of declining relatedness in an individual exercise program, and support for the role of needs satisfaction in the development of self-determined regulations.

This paper combines two bodies of literature - Service Dominant Logic (S?D Logic) and Self-Determination Theory (SDT). It is argued that each has much to offer the other in respect to health care provision and management. Service Dominant Logic (S?D Logic) is described as the ‘logic of interactivity’ and involves participating agents co-creating value through an exchange of operant resources such as skills, knowledge and competencies. In effect, S-D Logic exemplifies the ecological process of symbiosis where two (or more) participating agents benefit from a mutual sharing of operant resources. In brief, S-D Logic builds on the idea that exchange is about agents doing things for and with each other. The coexistence that occurs in S?D Logic highlights the interactional role of agents in a process of mutual value co-creation (i.e., health care provision and wellbeing). Self-determination theory (SDT) proposes that behaviour and subsequent wellbeing are shaped among others by the satisfaction of three basic human psychological needs: autonomy, competence and relatedness. The need for autonomy reflects a social need for volitional decision-making, perhaps in respect to health-related behaviours such as those concerned with self-care maintenance programs. The need for competence reflects a desire for mastery in the physical and social worlds. The need for relatedness reflects among others a desire to care for others and to feel cared for. When these needs are supported, empirical evidence suggests that behaviour is more likely to be sustained longer than under controlled conditions; an important goal in respect to many healthcare programs. This paper argues that successful service-oriented health-care providers can support their patient/client partners by facilitating opportunities that advance the fulfillment of the other’s specific health care needs in respect to autonomy, competence and relatedness. Furthermore, this paper introduces several SDL principles, including that of co-creation, as important in this respect. In doing so, this conceptual paper lays a foundation for the development of research that builds on these arguably related bodies of literature.

Background: Inter-professional teamwork is essential to provide safe patient care, which is a central indicator of hospitals’ organizational performance. Reduction of care providers’ work stress is another important organizational focus. However, little is known about the complex interrelations between these constructs. This study examined if the effect of teamwork on patient safety was mediated by clinician burnout. Method: Participants were 1453 nurses and physicians working on intensive care units. Data on different teamwork aspects, burnout, and patient safety was collected via an online questionnaire. Multiple mediation analysis was used to test whether burnout mediated the relationship between teamwork and patient safety. Findings: All teamwork aspects correlated positively with burnout and negatively with patient safety. In addition, the association between teamwork and patient safety was mediated by emotional exhaustion. The effects varied depending on individual and organizational factors. Discussion: Teamwork is associated both with clinician burnout and patient safety. Team-based interventions could contribute to improving both clinician and patient outcomes.

Habit formation is thought to lead to long-term maintenance of fruit and vegetable consumption (FVC). Habits develop through context-dependent repetition, but additional variables such as intrinsic reward of behaviour may influence habit strength. Drawing upon the Associative-Cybernetic Model, this study tested pathways by which intrinsic reward may influence FVC habit strength. In a threewave study of FVC in the general population (N = 127 adults), intrinsic reward, intention, and self-efficacy were assessed at baseline, FVC and intrinsic reward 2 weeks later, and habit strength another 2 weeks later. Direct, indirect, and moderation effects of intrinsic reward on habit were tested simultaneously in a moderated mediation model. Intrinsic reward had positive indirect effects on habit through its influence on FVC frequency. Further, the relationship between FVC and habit was stronger where consumption was considered more intrinsically rewarding. Findings highlight the potential relevance of intrinsic reward to habit. Intrinsic rewards from behaviour may not only facilitate habit via behaviour frequency, but also reinforce the behavioural repetition and habit strength relationship.

Background: Subjective age seems to have an impact on forming intentions as well as on physical activity itself. However, it is unclear if subjective age has a greater impact on the intention or the action phase of health behaviors. This will be addressed in the current study by analyzing data from an online-survey. Methods: Cross-sectional data (N = 615) were analyzed using multinomial regression to investigate the influence of subjective physical age on three phases of the Health Action Process Approach with a stage algorithm as the dependent categorical variable. Findings: The model led to a significant decrease of unexplained variance (?² = 213.31, p < .001). When intenders are the reference group, significant differences for subjective physical age arise for the actors group (b = -0.4, Wald?²(1) = 6.05, p = .01, OR = .963), but not for non-intenders. Discussion: The findings suggest that individuals who feel physically older are more likely to be intenders, whereas individuals who feel younger are more likely to be actors. These results contribute to a better understanding of the differential effects of subjective age on health behavior stages of physical activity.

Background: Previous research has demonstrated TPB variables as consistent predictors of physical activity intentions and behaviour. Yet studies have shown that TPB variables do not predict objectively measured behaviour, but these studies had sample and method limitations. This study aimed to assess which TPB variables predicted objective walking behaviour, and behaviour change, in a general practice sample. Methods:N=315 general practice patients were recruited as part of a randomised controlled trial. Patients completed a TPB questionnaire, and wore a NL-1000 pedometer. Multiple hierarchical regression analyses were conducted. Findings: TPB variables explained 42%-51% of the variance in intentions. Intention and PBC predicted walking behaviour at 6 weeks and 6 months, with 5.8%-5.9% unique variance explained. When past behaviour was controlled for TPB variables failed to predict change in walking behaviour. Discussion: TPB variables are predictive of intentions and objective walking behaviour, but not behaviour change, in the current sample. Past behaviour was the most important predictor of future behaviour, suggesting walking is a habitual behaviour.

The perinatal period is a critical phase for the biopsychosocial health of mothers and infants. A study investigates the psychosocial factors influencing childbirth methods and women’s mental states. The representative survey was carried out 4 days postpartum among 1,829 women in 7 hospitals administered by the City of Vienna by means of a questionnaire provided in 8 languages, as well as a follow-up analysis among 99 women 4 to 6 months later. Psychosocial risk factors, delivery methods, information levels, subjective motives for the particular childbirth method and emotional and social situations were recorded. Fear of childbirth correlates with an increased C-section rate. There were significant differences in the emotional state depending on childbirth method. 24% of women electing to undergo a Caesarean said they would recommend their chosen childbirth method. 1.5% of the women had a C-section without medical indication. A C-section is a relevant perinatal stress factor. Childbirth classes and effective multidisciplinary cooperation are key protective factors. A block of measures have been drawn up aimed at counteracting and preventing later psychosocial crisis situations.

Background: Between-meal snacking is a key risk factor for overweight. The aim of this study is to validate momentary energy intake as measured by the Snackimpuls app, a smartphone application based on the Experience Sampling Method. Methods: In a counterbalanced design participants (n=46; age 20-50) reported snack intake during four days with Snackimpuls and during four days with an estimated snack diary. To investigate whether Snackimpuls and the snack diary were comparable on momentary energy intake (Kcal) a multilevel regression analysis was conducted. A mixed Anova Latin square analysis was used to assess differential transfer. Findings: Results showed no significant differences between the app and the snack diary (? = 11.84, SE = 8.03, p > 0.05). A mixed design Anova Latin square analysis showed no differential transfer (F(1,44) = 3.29, p =.077). Discussion: This study demonstrates satisfactory validity of the Snackimpuls app to assess momentary energy intake. The Snackimpuls app is a suitable instrument to assess dynamic psychological processes related to between-meal snacking behavior.

Background: To adapt an existing intervention, based on the Theory of Planned Behaviour (TPB) extended to include planning, to increase walking for stroke survivors, we tested the TPB’s ability to predict intentions for, and actual, walking more in this group. We also tested if planning predicts/moderates the effect of intentions on walking Method: Longitudinal survey. At t1, 70 South London Stroke Register participants, able to walk outdoors, completed measures of walking, intentions, attitudes, subjective norms (SN), PBC and spontaneous planning for walking more. c7 days later, weekly time walked was assessed Results: SN (?=0.41, p<0.001) and PBC (?=0.38, p=0.01) significantly predicted intentions, while attitudes’ effect (?=0.20, p=0.08) was only marginally significant, R2 = 0.50. Neither intentions (OR=1.09, p=0.20), PBC (OR=0.99, p=0.99), planning (OR=0.93, p=0.33) nor the plans x intentions interaction (OR=1.02, p=0.11) significantly predicted walking more at t2 Discussion: PBC and SN are key predictors of intentions to walk more among stroke survivors and could be targeted by interventions. Interventions will also need strategies to turn this positive motivation into action

Background: The theoretical base of researches is Helena Wrona-Polanska’s Functional Model of Health (FMH Wrona-Pola?ska 2003), in which health is a function of creative coping with stress. Psychological predictors of health and well-being were: level of stress and personal resources. 141 patients after BMT - 80 males and 61 females – at the Hematology Clinic of Jagiellonian University of Collegium Medicum, were studied clinically. Methods: Examined methods were the questionnaires: Spielberger `s STAI , Endler`s , Parker`s CISS and CHIP, Antonovsky`s SOC-29 , Rosenberg`s self-esteem scales,10-point rating scales of sense of health and sense of calm. Objective health was examined by physician on the 10-point rating scale. Findings: Health and well-being depended on styles and effective coping strategies with stress, personal resources and temporal factor since transplantation. Discussion: The basis of health promotion of persons after BMT is development effective coping with stress and increase personal resources.

Background: Existing fruit and vegetable promotion campaigns are often based on the assumption that acceptance of the value and importance of healthy eating (i.e., known as identified regulation) will lead to behavior change. However, intrinsic regulation (i.e., engaging in the target behavior out of a sense of enjoyment), another autonomous motivational dimension proposed in the Self-Determination Theory, has not received much attention in the domain of healthy eating. we examined the possibility that intrinsic versus identified regulation may be more or less strongly associated with consumption of vegetables. Methods: A two-wave online survey of main household food preparers was conducted (N=610). Findings: intrinsic regulation was more strongly associated with the frequency of preparing and serving both classes of vegetables than identified regulation. Furthermore, the association between intrinsic regulation and cruciferous vegetables was mediated by self-efficacy of preparing vegetables in challenging situations. Discussion: Our findings suggest that new marketing campaigns for vegetables are needed that focus on enhanced sensory attributes of vegetable-rich meals.

Background: Significant health benefits can be obtained by incorporating moderate physical activity into daily life. Since stair climbing is an easily attainable activity, researchers have conducted stair climbing interventions in a range of settings. This systematic review was conducted to investigate the effectiveness of a range of stair climbing interventions. Methods: A search strategy using electronic databases was undertaken to identify relevant articles that involved stair climbing interventions. The search strategy returned 5697 articles that yielded 43 eligible studies in 38 articles. Studies were coded independently by two investigators. Findings: Papers included studies at workplaces (11), public transportation stations (11), shopping malls (8), and academic buildings (6). Two papers included multiple intervention settings. Interventions using point-of-decision prompts were more effective than environmental change or education. Most of studies demonstrated an increase in stair use, although only two studies compared individual change of stair climbing. Discussion: Follow-up measures of stair use are needed to evaluate long-term intervention effects. There is a need for evaluation at the individual level and improved external validity is required.

Even though young traffic offenders contribute to high number of traffic violations and accidents in most countries including Lithuania, they may not be homogenous in their motivational features. This study was aimed to find out if two groups of young male traffic offenders (drunk drivers and overspeeders) differ in their motives for risky driving and attitudes towards traffic safety; and how these two psychological characteristics can predict their risky driving indicators. A cross-sectional survey using self-report questionnaire (with Motives for dangerous driving scale, Attitudes towards traffic safety, and DBQ) was carried out in 2013. The total sample included 268 young male traffic offenders (151 – drunk drivers, 117 – overspeeders; mean age 23.4). The results showed that drunk drivers and overspeeders do not differ in their risky driving indicators or attitudes towards traffic safety, but overspeeders had stronger motive for driving fast/risk taking and stronger motive of disrespect for traffic laws. Regression analysis also revealed that motive for driving fast/risk taking is the strongest predictor of self rated risky driving indicators in both groups of traffic offenders.

Background: Lithuania is a small European country marked with history of significant social changes during last two decades, including restoration of independence in 1990, and joining EU. We assume that social cognitions related with social changes can be significantly related with health. Our main goal of this study was to examine relationship between acceptance of social changes and perceived health in a Lithuanian general population sample. Research was funded by a grant (No. SIN-01/2012) from the Research Council of Lithuania. Methods: 626 participants, mean age about 39 on average (from 18 to 89 years) participated in our study. Self-report measures of perceived health and acceptance of social changes were used. Acceptance of social changes was measured using Social Changes Inventory (SOCHI) developed by the authors of this study. Findings: Results supported our prediction, that acceptance of social changes is significantly related with health. More positive attitude towards social changes was significantly related with better perceived health. Discussion: Present study contributes to better understanding of social cognitive factors of health in the context of society changes.

Background Obesity is a risk factor for lifestyle diseases. Effect of obesity levels on lifestyles and QOL were investigated. Methods Participants were middle and old aged women (N=900) in Body Mass Index (BMI) Standard class, Class?, and above Class? (n=300 in each class). An Internet survey was conducted. One-way analysis of variance was used to examine differences in lifestyles, among others, between BMI classes. Results Participants’ mean age was 51.8 (SD=10.23), mean BMI values were: Standard=21.2 (SD=1.74), Class I =26.7 (SD=1.23), and Class?=33.8 (SD=5.66). Significant between-group differences were shown in lifestyles, stress responses, and QOL: lifestyles: F (2,897) =8.788, stress responses: F (2,897) =4.799, and QOL: F (2,897) =11.297, p< .001. Furthermore, multiple comparison (5% level) using the Tukey’s method for lifestyles, QOL and stress responses indicated that the Standard BMI class was optimal (standard> Class?> Class?). Discussion Lifestyles, stress responses, and QOL were different among three BMI classes. To prevent and improve problems caused by overweight, intervention measures for changing behaviors of overweight people are needed based on their obesity level.

Children with high abilities could have emotional and behavioral instability. This can cause problems while adapting at transitional conditions or disadaptation in middle school. The aim of the research is to find out relationships between school anxiety features and high abilities. Abilities were measured by Raven's Progressive Matrices, and school anxiety was assessed by R. Philips's school anxiety test. Participants were divided into two groups: children with high abilities- G1 and children with average abilities - G2. T-test was used for statistics. 34 students(age- 11-13) from middle school were enrolled. G1 had high school anxiety level (75% and higher by R. Philips's test), especially at the scale of "Experiences of social stress", "Fear of self expression" and "The fear of situation of knowledge testing". G2 had an average and lower levels of school anxiety(low that 50% by R. Philips's test). G1 had higher level of school anxiety, than G2. (p<0.05). Study shows the relationship between high abilities and school anxiety. The main contribution for school organization is the plan for individual education for high developed children and educational program for teachers.

Background: In the recent years a construct of Health Sense of Responsibility (HSR) has been identified and empirically verified, which helped to provide a new perspective on analyzed issues. It is defined as individualized and multidimensional subjective-personal construct, which plays an important role in regulating choices, decisions and human activities in the aspect of health behaviours. HRS constitutes a concept of an individualized character and bears a cognitive-emotional aspect. The development of an individual as well as their level of maturity appears to play a significant part in developing one’s sense of responsibility for health. These two factors constitute individual character structures, which are displayed in behaviour, choices and decisions of an individual. The concept of responsibility for health within the scope of health psychology and promotion of health behaviours represents an important innovative and innovatory approach, being complementary to the research approach explaining complex mechanisms of undertaking health behaviours in different age groups. The aim of undertaken research was to elaborate an accurate and reliable tool enabling the measurement of the HRS in adolescents. For the purpose of achieving the main objective the following detailed objectives were formulated: 1) Elaborating items, which will relate to HSR in adolescents and establish an initial version of Health Sense of Responsibility Scale (SPO-Z). 2) Evaluation of the psychometric properties of the elaborated SPO-Z scale. 3) Evaluation of relationships between the level of social approval against results obtained in SPO-Z scale. Methods: The research was conducted among 103 respondents aged 16-19 years. The research adopted two research tools: 1) author’s Health Sense of Responsibility Scale initially consisting of 19 items, which were subject to standardization among adolescents. 2) KAS Questionnaire elaborated by Wilczy?ska and Drwal, aimed at evaluating social approval level. Cronbach's alpha coefficient for this questionnaire is 0.82-0.79 depending on a researched group. The evaluation of the psychometric features of elaborated questionnaire encompassed the analysis of SPO-Z accuracy and reliability. Test accuracy provides information on how precise the measurement of an examined characteristic was in a presented questionnaire. Due to the strategy of construing this diagnostic test, the evaluation of accuracy was performed by measuring the intensification of hypothetical characteristic in an examined individual (so called theoretical accuracy). The evaluation of accuracy was performed by employing factor analysis method, which enables identifying the factors responsible for covariance of tests’ results correlated with each other. The research also encompassed measuring the KMO coefficient and Bartlett's test. KMO coefficient indicates whether the chosen sample of items is adequate. KMO coefficient value should be higher than 0.5. This determines the validity of employing the Principal Component Analysis. Bartlett's test of sphericity verifies zero hypothesis, which assumes that „ Correlation matrix of variables is an identity matrix, with 1 on the diagonal and 0 on the off-diagonal”. The reliability was evaluated by the means of analysis of test items characteristics. This method compares variances of questions. Variances were calculated for each question and relativised to total variance, following Kuder-Richardson formula. In the research the level of item-difficulty index was also defined; it indicates the proportion of persons giving the answers in accordance with previously generated answer key. The answers considered diagnostic were “often” and “very often”. Discriminative power of each test item was also calculated. Discriminative power constitutes a coefficient informing us on how a given test item differentiates given population with respect to a characteristic, measured throughout the whole test. Spearman correlation coefficient was employed to evaluate discriminative power. The evaluation of the relationship between the level of social support and the level of sense of responsibility for health was also conducted. An adequate Spearman correlation coefficient was employed to evaluate the power of relationship between social approval level and the answers given to particular items of the elaborated questionnaire. Statistical analyses were performed employing SPSS 18 statistical software. Findings: Obtained results were subject to the analysis of anti-image correlation matrix in order to eliminate variables which will lower the psychometric values of elaborated questionnaire. Two items had value below 0.5 in anti-image matrix and were excluded from further analyses. In the given study the value of elaborated test was Chi2= 416.210 while significance level was close to zero (p=0.0001). Due to this fact, the zero hypothesis, which assumes that „ Correlation matrix of variables is an identity matrix, with 1 on the diagonal and 0 on the off-diagonal”, was rejected. Consequently, it has been considered that in the case of analyzed data the factor analysis can be conducted. KMO coefficient value was 0.721 and was considered satisfactory. The number of factors in the scale was specified based on eigenvalue criterion (Kaisser criterion), scree test criterion, as well as variance explained criteria. The analysis taking into account the total explained variance and with the employment of SSPS statistical software identified only these factors, which have eigenvalue above 1. Consequently, the conducted statistical analysis suggested including two main factors into the analysis. In order to thoroughly evaluate the number of distinguished variables, the scree diagram was used, on the basis of which two main factors were incorporated into further analyses. For the purpose of defining the factors’ structure Varimax rotation was employed; the rotated component matrix was also evaluated. While performing the evaluation of factor loadings, 4 out of 16 analyzed items have been observed, which belong to two or more factors. They have been excluded from further analyses. A model matrix that consisted of 2 factors has been identified. SPO-Z in its final version consists of 12 statements and enables the measurement of the total Health Sense of Responsibility level (OOZ). Within the scale two subscales were distinguished: 1) the first of them relates to responsible (mature) involvement (OZ) – 7 items. This factor explained 27.357% of variances 2) the second of them relates to adequate responsible behaviours (A) – 5 items. This factor explained 15.720% of variances Both subscales of the sense of responsibility for health explained 43.078% of cumulated variance. Cronbach's alpha coefficient for the first of subscales (OZ) was 0.73 and for the second one (A) – 0.70. For the whole questionnaire the discussed coefficient has a 0.74 value. Discriminative power index for the whole test is 0.632. In the case of A factor the discriminative power index placed itself within the range of 0.617 – 0.742. In the case of OZ factor discriminative power index was between 0.529 – 0.682. Total scale difficulty is 0.37. For subscale A the test items difficulty is between 0.80 and 0.92. For subscale OZ the test items difficulty is between 0.25 and 0.46. None of the items included in the questionnaire displays the relationship with the level of social approval. Discussion: The innovatory character of the elaborated Health Sense of Responsibility Scale results from a more profound and detailed literature research as well as already undertaken empirical work of the authors. This scale represents, beyond doubt, a new research method. An important advantage of the proposed SPO-Z scale is its multidisciplinary character which joins together, and at the same time is complementary to, the achievements of health psychology, developmental psychology as well as prevention and promotion of health behaviours. Therefore, this scale is aimed at adolescents.

Background: Health related quality of life (HRQoL) maybe differently related to usage of alcohol, tobacco and other addictive substances (ATA). The aim of this study is to disclose the relationship between the physical functioning of HRQoL and usage of ATA. Methods: The data of participants in Kaunas regional health project 913 males and 1317 females investigated by WHO HRQoL-100 scales of physical functioning, self-rated health (SRH) and items for evaluation ATA were analyzed using ?² and Spearman correlational tests by SPSS.16 software. Cronbach's alpha coefficients 0.8-0.9. Findings: Better physical functioning is related with better general health and younger. Better physical functioning in males and females was related to higher involvement in ATA (p<0.001) (including more positive attitude towards usage of ATA), better SRH and less willingness to consult psychologists (p<0.001). Discussion: The findings about the level of physical functioning are of value for health psychologists planning health promotive and preventive activities for chronic diseases and untimely deaths.

Background: This study examines the relationship between family environment (FE), including relationship, personal growth, and system maintenance dimensions with resilience and high risk behaviors (HRB) in adolescents, in Tehran, Iran. Method: In this correlation study, 83 adolescents (age mean = 16.3) were recruited through a cluster sampling method in Tehran. Family Environment (Moos & Moos, 1994), CD-RIS (Persian version, Joukaar, 2007), and Youth Risk Behavior Surveillance System (1999) were respectively utilized to evaluate FE, resilience, and HRB. The data were collected after getting the required permissions. Findings: Pearson correlation and regression analysis revealed a significant relationship between the variables. A significant relationship was also observed between FE dimensions and resilience and HRBs. Discussion: Accordingly, we can conclude that FE has relationship with resilience, HRBs and can predict health relationships and a positive condition in the family.

Background: Athletes’ psycho/physiological stress problems have become the critical issues in the world. The purpose of this study was to examine time variation in psychological stress responses. Methods: The participants in this study were 372 athletes. They were given a questionnaire on Athletes Stress Response Scale (Amemiya, 2013). To examine time variation in psychological stress responses, a cross-lagged effects model and synchronous effects model were examined between times 1 and 2 to monitor stress response progression. Findings: The results of the cross-lagged effects model and synchronous effects model had good fit indices and showed that athletes’ stress responses in Time1 significantly affected stress responses in Time2. Moreover, stress responses in Time 2 significantly interacted with the stress responses cycle in Time 2. Discussion: The results of this study showed athletes’ stress responses progress and change through time variation. These findings suggested that athletes who have psychological problems need professional psychological support not only improve their performance but also improve their mental health as soon as possible.

Background: The purpose of the current study was to investigate the effect of training behavior modification methods to mothers of children with Attention Deficit Disorder (ADHD) on enhancing the behavioral performance and decreasing parenting stress. Method: The research method was quasi-experimental with pre-test and post-test design and cotrol group. To do so, 30 mothers of children with ADHD were selected using at-hand sampling and divided into control and experimental groups. Both groups filled out Parenting Stress Index and children behavioral performance questionnaire. In the next step, the experimental group was instructed behavior modification methods in 9 ninety-minute sessions while the mothers in control group went on their normal procedures. At the end of the instructional session, both groups filled out the mentioned questioners as the post-test. Covariance analysis was used for analyzing data. Findings: The results of the analysis of covariance showed that instructing behavior modification methods improved behavioral performance in children (P<0/05) and also decreased parenting stress (P<0/05) among mothers in experimental group, in comparison with the control group. Conclusion: Findings generally showed that instructing behavior modification methods to mothers, reduces behavioral problems of children and prevents stress in child-parent relationship.

Background:The aim of the study was to evaluate the effectiveness of the Mitchell Method Relaxation Technique (MMRT) for reducing symptoms of fibromyalgia. Method: A three arm randomised controlled trial was used to compare effectiveness of a self-applied MMRT (n= 67) to an unspecified attention (n = 66) and a usual care (n = 56). Health outcomes were fatigue, pain sleep, daily functioning, quality of life, depression, anxiety, coping and perceived stress. Assessment was done at baseline, post intervention and one month after intervention. Findings: MANCOVA, followed up with discriminant function analysis identified improvement on outcomes in the MMRT group (p<.005) with small effects for sleep problems (d=0.29, p<.05), sleep inadequacy (d=0.20, p<.05), and significant medium effects on fatigue (d=0.47, p<.05). The one-month follow-up fatigue score was not different to the post-intervention score (p=.246) indicating short-term sustainability of the treatment effect. Pre-post change in pain levels did not vary across three groups, (p=.59).Discussion: MMRT is an effective treatment for pain, sleep problems, and fatigue. The MMRT is proposed as an adjuvant treatment for fibromyalgia.

ObjectiveUnderstanding and assessing health care personnel’s work culture in palliative care is important, due to the conflict between “high tech” and “high touch”. The aim of this study was to explore the work culture at a palliative medicine unit (PMU).MethodHealthcare personnel (N = 26) at a PMU in Norway filled in a questionnaire. The Systematizing Person-Group Relations (SPGR) method was used for gathering data and for the analyses. The method seeks to explore which aspects dominate the particular work culture. ResultsThe healthcare personnel working at the PMU had significantly higher scores than the “Norwegian Norm (NN)” in vectors in the “Withdrawal” dimension and significant lower scores in vectors in the “Synergy,” “Control,” and “Dependence” dimensions.Discussion Healthcare personnel at the PMU have a significantly different perception of their work culture than NN in several dimensions. The low score in the “Synergy” and “Control” dimensions indicate lack of engagement and constructive goal orientation, and not being in a position to change their behavior. The conflict between “high tech” and “high touch” at a PMU seems to be an obstacle when implementing changes.

Background: People having strong sense of community are in general happier, mentally healthier, they trouble and worry less and perceive themselves as more competent to influence their lives (Cochrun, 1994). The aim of the research was to measure influence of the SPT on the psychological sense of community with respect to duration of the training. Methods: Social-psychological training (SPT) was pursued with tutors (N1=67, duration of SPT 40 hours) and with social workers (N2=69, duration of SPT 80 hours). The measurement of the psychological sense of community was carried out before and after SPT using the Perceived Sense of Community Scale (Bishop, Chertok, Jason, 1997). Findings: We´ve identified a significant increase of the sense of community after taking part in SPT in both groups. Having compared the groups with respect to the duration of the SPT, the sense of community of the group taking part in 80 hour SPT grew more significantly. Discussion: As SPT has increased the sense of community, it is considered to be a suitable tool for the care of quality mental life of workers occupying helping professions.

Background. The significance of self-concept is controversially interpreted in personality research both as predictive of other psychological outcomes (Marsh, 2008) and as having only a “seductive pleasure” (Baumeister et al., 2005). The objective of this research was to demonstrate the causal effect of the multidimensional self- concept on psychological well-being of the individuals, their future orientations and personality traits. Method. A sample of 180 university undergraduates was clustered (K-means algorithm) on the variables of the complexity and clarity of their domain-specific self-concept (Campbell et al., 1996). The findings revealed significant inter-cluster differences on the psychological well-being measures (Ryff, 1989), with t-varying from 3.04 to 6,52; on the future -orientation measures (Malmberg, 1998) in professional self-actualization, further education, family life (t=3.74, 2.56 and 1.97 respectively) and on the Big-five trait measures: openness to experience (t=2.86), agreeableness (t=3.09), conscientiousness (t=3.52). Discussion. The results suggest that the multidimensional self-concept is an important personality facet, thoroughly predicting the individual's well-being.

Background: Research shows that parental influence on adolescents‘ alcohol use remains important after entering college. This study explores whether this is true also for other health risk behaviours (HRB) of college students. Methods: As a part of international SLICE study data were collected among 243 college students (mean age 20.8, 79% females). Students completed questionnaires on Perception of Parents, family support, type of living during a school year (with parents, other) and HRB (amount of alcohol used, frequency of smoking and marihuana use). Stepwise linear regression was used in three models. Findings: Interestingly, living without parents (students dormitories, shared rented flat) was associated only with higher frequency of smoking (?=0.17; p?.05), not alcohol or marihuana use. Both low positive (?=-0.23; p?.05) and high negative (?=0.25; p?.05) perception of mother were connected to greater amount of alcohol use. All the other associations between perception of parents, family support and type of living with students’ HRB were insignificant. Discussion: Parental influences explored within the study affected students’ HRB only to a small extent.

Aim:. The purpose of current research is the study of the role of spiritual intelligence as the predictors of subjective well-being in University students. Method: the research method was correlation. The statistical population of research were students in Mazanadarn university and the sample consisted 220 students which randomly were selected. They were asked to respond to self-report measure of the spiritual intelligence (king ,2008) and subjective well-being (Keyes and coworkers, 2003). Data were analyzed using Pearson correlation coefficient and multiple regression analysis. Results: Results showed that personal meaning production predict 22 percent of the variance related to subjective well-being , 17 percent of the variance related to psychological well-being and 18 percent of the variance related to social well-being. Transcendental awareness 7 percent of the variance related to emotional well-being. Conclusion: Based on results, spiritual intelligence can be well predictive for subjective well-being. So it was suggested that spiritual intelligence and subjective well-being training and workshop are required to improve spiritual intelligence and subjective well-being by university. Keywords: subjective well-being, spiritual intelligence, University students

Background: Trait Emotional Intelligence – considered different from ability emotional intelligence – was being conceptualized as a constellation of emotional self perceptions and behavioural dispositions. The study of the relationship between trait emotional intelligence (TEI) and stress and two consequences of stress, anxiety and depression, has revealed contradicting results. Method Objective: the analysis of the relationship between TEI and perceived stress, anxiety and depression in the students' environment. Subjects: N = 115 students. Age - M = 19,41 S.D. = 0,45 Measures: Trait emotional intelligence questionnaire – TEIque-SF - measures a global score of TEI and its factors; Perceived stress scale – PSS - explores the subjective feeling of stress; Anxiety and depression scale – HAD - measures scores for anxiety and depression. Results and discussion: The correlational analysis shows significant negative relationship between TEI and perceived stress (r between -.36 and -.60) as well as between TEI and anxiety and depression. Emotionality and sociability components of the TEI structure seem to have the highest influence in resistance to stress. The results suggests that individuals with highly developed TEI withstand stress better than those with lower scores. We consider that TEI is a useful construct to capture interindividual differences in the case of stress, anxiety and depression.

Companies expect their employees would develop coping skills to manage stress. Earlier research asserts we cope with stress at different levels. Strategies can be classified as more or less adaptive. We investigated the relationship between cognitive emotion regulation and stress appraisal in the workplace. Our goal was determining the workplace dynamics driven by this relationship. We used a non-experimental design and data came from 260 respondents (M age= 34.1, gender reported by 178 males and 69 females). Cognitive Emotion Regulation Questionnaire (N. Garnefski et al., 2001) displayed the frequency of cognitive strategy use and we assessed stress appraisal by Perceived Stress Scale (Cohen et al., 1983). Refocus on planning was the most used strategy, while catastrophizing was the least preferred. Only 6% frequently used less adaptive strategies. When they evaluated the last month of their experiences, one third of employees perceived high level of stress. There was small, yet significant correlation (r=0.17, p=0.01) between less adaptive strategy use and stress appraisal. Our study implies that HR professionals should use more measures to lead better intervention processes.

Former studies have pointed out that usually mental health is not so good in musicians. To promote their mental health, cognitive strategies (e.g., an optimistic view) might be played an important role. The purpose of this study was to investigate the states of mental health and the cognitive tendencies for music major college students. Subjects were 186 music major college students (MS group), and 139 college students (CS group) who majored the other studies (e.g., economics, etc.) (mean age; 20.6 ± 2.6 years). Center for epidemic studies depression scale (CES-D; Shima et al., 1985) and Optimism and Pessimism Scale (Toyama, 2013) were measured by questionnaire method. Independent t-tests showed that in the MS group, the mean of CES-D scores was significantly higher and the mean of optimism scores was significantly lower than those of the CS group. Multiple-?regression analysis indicated that the pessimism scores were positively associated with the CES-D scores in both two groups. These results suggested that music major college students experienced more stressful events than the other college students. Therefore, an optimistic view might be needed for them.

Introduction: International guidelines suggest special attention to the management of the personal needs and psychological problems of patients with serious oncological diseases, for example the psychological “distress”, the onset of a new psychiatric illness or the worsening of a pre-existing one. Our protocol provides the specific procedure in the management of psychiatric consultation for in-patients and Day-Hospital patients in oncology, hematology, breast surgery and otorhinoloaryngology wards in our Hospital. Methods: With the aim to improve the traditional “liason” activity and to create a structured and shared contribution from the different services involved, different employers (medical doctors, residents, psychologists, nurses) coming from different wards of AOU UD attended, an internal structured training, through which emerged the importance of dealing with the problems related to the assistance of the oncological patients. The training has led to the organization of a ‘psychoncology microteam’ and a specific protocol has also been activated, in order to give concrete answers to the needs of the patients. Results: Procedure includes the compilation, by the requesting wards, of the NICE Distress misure Scale and the assessment of the characteristics of the patient as described in the document DIS A and DIS-B of the scale. The consultant, after visiting the patient, also fills in a “Needs Survey Scale” and, if it is needed, can make other assessments like the “Mini-MAC Test”. Interventions suggested includes: reports with psychopharmacological prescription, psychotherapy, referring to social and religious services. In addition to the use of these measures, other instruments and other initiatives can be chosen in order to make an integrated intervention that meets, highlights and underlines the specific needs of the patient and also the demands of the requesting wards. Particularly, for most complex situations, the patient can refer to our psychoncological microteam, which will meet regularly and will be composed by some doctors, psychologists and nurses from the wards involved in the protocol. Conclusions: The aim of our work has been to define an integrated procedure in order to improve the quality of the liason activity and ameliorate our respond to the patients’ needs. We also look forward to the possibility to discuss and exchange impressions and suggestions with colleagues from others countries who are concerned with this kind of problems.

Beckground: The great progress that has been made in application of dialysis lets the patients with end-stage renal disease live in satisfactory somatic state for many years. It was investigated whether eudaimonic intervention can influence on cognitive appraisal of illness and treatment. Methods: The study was a randomized controlled trial using a convenience sample of 88 (44 women, 44 men, age M =49; SD =14,07) fully informed and consenting patients with the end-stage renal disease who were assigned to experimental (eudaimonic intervention) or control (usual care) groups. Participants in the experimental group participated in psychological intervention once a week during 5 weeks. The instrument was the Cognitive Appraisal Inventory. Findings: After the application of a eudaimonic intervention, the experimental group had a weaker intensity of cognitive appraisal of the situation as a harm/loss F(2,60)=3.01; p < .05 and a stronger intensity of cognitive appraisal of the situation as a challenge F(1,24)=5.65; p < .05 Discussion: The results make it possible to identify the opportunity of changing patients' psychological state in a positive way.

Background: Although job satisfaction is widely analyzed, it has received limited attention in the literature on cultural diversity. The aim of this paper was to analyze how a multicultural environment of multinational corporations (MNCs) impacts on job satisfaction of employees, who interact with representatives of different cultures. Methods: The narrative review of theoretical and empirical studies was used. Results: The theoretical conceptualization of job satisfaction showed that job satisfaction includes both cognitive and affective components. The narrative review revealed that the effect of cultural diversity on job satisfaction was inconsistent. A positive organizational scholarship (POS) lens, including subjective well-being and positivity, was applied. Cultural diversity in a working environment was positively related to the cognitive component of job satisfaction, however, it was negatively associated with the affective component. Discussion: Having implemented the POS lens, it has been indicated that job satisfaction and positivity appear to be associated with a multicultural setting of MNCs in different ways. The recommendations for future research are presented.

Background:Teachers are among the occupational groups most severely affected by psychological strain. Therefore the prevention of stress should start as early as during teacher training. Referring to the Transactional Model of Stress and Coping (Lazarus, 1966) the current study explores the degree of psychosocial resources of German student teachers and their level of psychological strain to identify starting points for early prevention.Methods:The cross-sectional study was conducted using an anonymous online survey. It comprised of well-established questionnaires assessing on the one hand psychosocial resources (social skills, self-efficacy, uncertainty tolerance and mindfulness) and on the other hand psychological strain (Irritation Scale by Mohr, 2007). N = 805 student teachers completed the survey.Findings & Discussion:Student teachers already perceive a higher-than-average degree of psychological strain (Irritation) that correlates significantly with the level of reported psychosocial resources.Uncertainty tolerance and self-efficacy of the participants are significantly below the norm. Multivariate analyses are planned to obtain a more differentiated basis for prevention.

Background:Even though 85% of those who have been severely injured in an accident in Germany survive, complex and serious long-term consequences are still a major problem and the victims´ quality of life is affected permanently. Therefore the aim of the current study is to identify factors that correlate significantly with the quality of life after a severe traumatic injury and to investigate whether the support by a reintegration service has a positive effect.Methods:The sample consists of severely injured accident victims who were supported by a reintegration service. The data collection comprises three data points: T1 (N = 108), T2 (N = 67) and T3 (N = 47). At every data point the German version of the SF-36 questionnaire (Bullinger & Kirchberger, 1998) was used to assess the participants’ quality of life. Findings & Discussion:The results indicate that an individual medical-vocational support by a reintegration service has the potential to significantly and stably improve the physical but not the psychological aspects of quality of life, even if the accident dates back several years. The treatment of psychological consequences after severe accidents needs more attention.

Background: While the relationship between decision-making styles and other cognitive characteristics has often been investigated, little attention has been given to the connection with health. The main aim of the present research is to examine the association of decision-making styles with risk behaviour in terms of alcohol use, smoking and drug use. Methods: University students from Slovakia (N = 218) filled in the General decision-making styles questionnaire (Scott & Bruce, 1995) identifying five decision-making styles as part of the SLICE study. AUDIT (Babor et al., 2001) was used to assess alcohol use. Smoking was assessed by five items and drug use by ten. Findings: Dependent and spontaneous decision-making styles were positively associated with some aspects of alcohol use and smoking. The relationship of drug use with decision-making styles was not found to be significant. Discussion: Certain decision-making styles are associated with risk behaviour which highlights the importance of the way decisions are made in relation to keeping healthy.

Our assumption was that to the number of the professionally important traits that characterize the individual-psychological characteristics of a surgeon are attributed the thinking style and typological characteristics of the person associated with the temperament. The role of the thinking is determined by the specifics of the professional activity involving the need to solve a variety of professional tasks, development of skills and strategies of practical thinking. In order to study the features of surgeons’ personality types accentuations we have carried out a study in the City Hospital ? 1, Rostov-on-Don (Russia), which included 60 surgeons. For the diagnosis of the intelligent characteristics was used the author's technique "Thinking style", to study individual-typological characteristics - Eysenck Personality Inventory. Analysis of the study results showed the differences in the individual-psychological characteristics. There are differences in the surgeons’ thinking style and in the dominance of the extraversion and emotional instability.

Background Self-management support tools, facilitating patients' understanding of relationships between wellbeing, blood pressure and lifestyle may help to improve adherence to hypertension treatment. We report on the development of a multi-module mobile phone self-management system and on evaluations of the self-report module regarding content validity and reliability. Methods Domains and items were derived from focus group interviews with patients and providers. Items and response formats were designed to fit all mobile phones. Content validity was iteratively assessed in 21 cognitive interviews in four rounds. Reliability was examined by test-retest. Findings The focus groups resulted in six domains covered by 16 items. The cognitive interviews showed good item comprehension, relevance and coverage. Reliability was satisfactory. Discussion The self-report module appears relevant to the self-management of hypertension. The system, also including modules for reminders/encouragements, blood pressure measurements and feedback of self-reports in relation to blood pressure, will be evaluated in clinical practice as a tool to support patients in self-managing their hypertension.

Background: This study used the Self-determination theory to explore whether basic psychological needs satisfaction (BPN) has a protective role against unhealthy internet use. Methods: The sample of 237 (75% women) first year university students completed questionnaires on generalized problematic internet use (GPIU), perceived stress (PS) and BPN (autonomy, competence, relatedness) on two occasions over a one year period. Linear regression models were built to explore the relationship between PS, BPN and GPIU as well as to test the potential moderating role of BPN. Findings: The BPN relatedness at T2 was negatively associated with GPIU (?=-0.156; p?0.05). Further, PS at the baseline and its increase during the year served as significant predictors of GPIU at T2 (?=0.310 p?0.001; ?=0.153 p?0.05). However, evidence for the moderating effect of BSN was not detected. Discussion: In line with the assumptions, PS and low satisfaction with relationships was found to be directly related to GPIU although further research is needed to identify moderating protective factors.

Background: Psychological distress is of increasing human and financial cost in a variety of healthcare settings. This study aimed to investigate the efficacy of traditional Chinese acupuncture in the treatment of somatised and general psychological distress in a diverse sample. Methods: The study was a double blind, randomised, placebo controlled trial, utilising a sham acupuncture device. Forty two participants were allocated into either genuine or placebo acupuncture groups. Measures included the eight subscales of the Bradford Somatic Inventory(BSI) and the General Health Questionnaire(GHQ-12). Measurements were taken before and after a five weekly treatments. Findings: Current findings are part of a larger randomised trial of the effects of acupuncture on psychological distress. Significant post-treatment differences were observed between genuine and placebo treatment on all primary outcomes (p<.001). Discussion: Findings suggested that traditional Chinese acupuncture had a significant positive effect on somatised and general psychological distress beyond placebo and may have implications for the treatment of psychologically distressed clients in various health care settings.

Background Epilepsy is unique as it is only visible when symptoms manifest. During periods of seizure freedom, there may be no evidence that the person has epilepsy. This poster aims to relay the impact that the invisibility of epilepsy may have on family communication and disclosure strategies adopted by families living with epilepsy. Methods Data in this presentation emerged from the qualitative phases of two mixed method studies exploring disclosure practices and family communication surrounding epilepsy. Sixty interviews were conducted with children with epilepsy and their parents. Data were thematically analysed. Findings Analysis of the data revealed that the invisible nature of epilepsy: a) poses significant challenges for parent-child communication about the condition; and b) can result in families adopting concealment disclosure strategies. Discussion Silence around epilepsy contributes to epilepsy related-stigma. Acknowledging the impact that the invisibility of epilepsy can have on family communication and disclosure practices can promote more openness about epilepsy within a family context and in the public domain; thereby enhancing the wellbeing of individuals with epilepsy.

Background: the aim of the study was to investigate the stimulating or deteriorating influence of core task characteristics and intrinsic motivation on employees’ engagement. Methods: participants were 95 physicians. Work engagement was assessed by UWES; motivational aspects were measured by Hackman & Oldham’s JDS and Ritchie & Martins’ Motivational profile. To answer the research questions we used regression analysis as our analytical model to explore the relationship between task characteristics and motivational factors (independent variables) on engagement (dependent variables). Findings: work engagement among practicing doctors and teachers of medical secondary school has different motivational determination. Growth Satisfaction, Skill Variety and Growth Need Strength have statistically reliable influence on work engagement among practicing doctors (R2=0,67). Skill Variety, Knowledge of Results of the Work Activities and Recognition have statistically reliable influence on work engagement among teachers of medical secondary school (R2=0,51). Discussion. The significance of focus on motivational aspects for occupational health prevention will be discussed.

Background: Religion can affect health by providing health promoting norms of behavior. The aim of this study was to examine how much of the variance in alcohol use can be explained by normative beliefs about alcohol consumption and the importance of religious belief among men and women. Methods: The research sample: 802 Slovak university students (females: 75.7%) who participated in the international study SliCE. The Alcohol Use Disorders Identification Test, scale measuring alcohol related normative beliefs and single item measure of the importance of religious belief were used. Data were analyzed with the Mann-Whitney U-test and linear regression. Findings: Gender differences were found in alcohol use (U=25830, p<0.01). Normative beliefs (0.309, p<0.01) and the importance of religious belief (T1) (-0.131, p<0.05) among women and normative beliefs (0.259, p<0.05) among men contributed to the variance of alcohol use. Conclusion: The findings contribute to the knowledge about gender differences in alcohol use. The implementation of a social influence strategy with emphasis on the correction of normative beliefs is an important part of prevention in men and women

Background: The aim of this study was to examine factors of exercise and relaxation behaviour in cardiac patients six months after their rehabilitation with the Theory of Planned Behaviour (Ajzen, 1991) and Temporal Self-Regulation Theory (Hall and Fong, 2007). Methods: Design: longitudinal; 6 months follow-up. Participants: cardiac rehabilitation inpatients with acute ischemic heart disease aged 65 or below. N=302, 278 (75%) males, mean age 55.61 (SD=7.31). Measures: CDS, SVS, self-report questionnaire about the variables of the theories. Linear regression models and path analyses were used. Findings: 212 participants (71%) did exercise and 45 (15%) did relaxation 6 months after the rehabilitation. Positive temporal evaluation was expected after one month of regular exercise or relaxation. Predictors of exercise behaviour were intention, descriptive (but not injunctive) subjective norm, self-efficacy, past behaviour, temporal proximity of positive consequences, and state vitality. Predictors of relaxation were intention and past behaviour. Discussion: Relaxation is less accepted than exercise by cardiac patients. Different factors contribute to these behaviours.

Background: Although nurses are in an ideal position to offer smoking cessation interventions during hospitalization, they perceive challenges in providing this care. The Ask-Advise-Refer (AAR) strategy may be a feasible approach since the actual counseling delivered at the outpatient setting. This study identified determinants of cardiac nurses' intentions towards providing the AAR strategy. Methods: A cross-sectional survey was conducted among randomly selected nurses in all Dutch cardiac wards, of whom 165 (35%) responded. Regression analyses were used to determine correlates of the intention towards providing the AAR strategy. Current provision of smoking cessation care was also assessed. Findings: The current delivery of smoking cessation care was low, though the majority of the cardiac nurses had a strong intention to work with the AAR strategy. Familiarity with smoking cessation guidelines, positive attitudes, high self-efficacy expectancies, social modeling, and social support by cardiologists were significantly associated with increased intentions to apply the AAR strategy. These factors explained 65% of the intentions. Discussion: The AAR strategy may improve smoking cessation care for cardiac patients. Nurses should be familiarized and be encouraged towards working with this strategy, and be able to practice its delivery to enhance their attitudes and self-efficacy.

Background: The objective of this study was to explore whether scores on the Activity Engagement (AE) and Pain Willingness subscales of the Chronic Pain Acceptance Questionnaire (CPAQ) may be useful to identify clinical significant subgroups of females with endometriosis. Methods: A total of 296 females with endometriosis completed the CPAQ, measures of positive and negative affectivity, anxiety and depression. Exploratory cluster and ANCOVA’s analyses were conducted. Findings: Analyses yielded three clusters on the basis of the CPAQ scores: females with high or low scores in both CPAQ dimensions, and participants with high AE but low PW scores (discordant scores). The cluster with low scores showed a poorer adjustment than the other two clusters, and the Discordant group showed a poorer adjustment than the group with high scores. Discussion: Findings support the validity of the CPAQ scores to identify females with endometriosis at risk of poorer adjustment to illness. Further, results support that PW is sufficient but not necessary to AE.

Background: The health belief model (HBM) guided an examination of relationships between leisure-time physical activity (LTPA) and fruit and vegetable consumption and the HBM constructs of susceptibility, seriousness, fear, risk reduction, control, family history and media exposure related to heart disease (HD). Methods: Data were collected using an internet survey of adults (813 men, 1635 women). LTPA and fruit and vegetable consumption were regressed onto the HBM constructs and demographic variables. Separate models were conducted for each behavior and for men and women. Findings: Susceptibility, media exposure, education and income predicted LTPA in men. Susceptibility, risk reduction, family history, media, and income predicted LTPA in women. Fruit and vegetable consumption in men was predicted by susceptibility, risk reduction, control over HD, media, age, education and income. In women, significant predictors were susceptibility, risk reduction, family history, media, having HD, age, education, and income. Discussion: The differences and similarities between the models have gender-based implications for targeted communications regarding health behaviours.

Background: In the context of clinical assessment of memory complaints (MCs), the process of disclosing a diagnosis is of major importance since it is known to influence disease acceptance of patients and their next of kin. Based on the Common Sense Model (CSM, Leventhal et al. 1997), this study aims to prospectively examine memory problem perceptions of patients with memory complaints and their next of kin during the diagnostic process, namely before and after diagnosis disclosure. Methods: We plan to recruit 125 patients with MCs who are seen for the first time at the Research and Resources Memory Center in Nancy, France. This study includes 4 visits during which patients and their next of kin are evaluated for memory problem perceptions (French adaptation of the Illness Perception Questionnaire-Memory IPQ-M, Hurt et al. 2010), anxiety, depression, quality of life and coping strategies. Findings: Results from the pilot study show that the CSM is applicable in MCs and early stage dementia and reveal a typical profile for first-visit patients at a memory center. Discussion: We anticipate that the use of IPQ-M will help gain insight into how patients and their next of kin cope with memory problems.

Nature and daylight can enhance health in many ways, for instance by reducing stress and improving mood, self-regulation, and health. Since exposure to daylight and nature often co-occur, both phenomena were investigated simultaneously. To investigate benefits of both phenomena in daily life an experience sampling methodology was employed. Previous experience sampling studies have found vitalizing effects of nature and mood enhancing effects of daylight. Two experience sampling studies were conducted. Participants filled in a questionnaire 8 times per day for 6 consecutive days. Pseudo-objective checklists and subjective assessments of naturalness and daylight characteristics were used to assess naturalness and amount of daylight. Dependent variables were indicators of mental and physical health. Hierarchical linear models indicated a significant positive correlation (p < .05) between amount of daylight or nature and several aspects of health (e.g., mood, self-regulation). Results stress the importance of nature and daylight for micro-restorative experiences in daily life and can be used to design individualized health-promoting interventions using experience sampling technology.

The nature of the associations between interpersonal relationships and mental health is not clear yet. The aim of this study was to explore the correlations between social skills and neuroticism. The subjects that participated in this survey study were 1.031 college students of both genders (mean age=24,5; standard deviation=6,9) who self-evaluated their social behaviour and neuroticism. Results show significative and negative correlations between social skills and neuroticism (rs=-0,078 to rs=-0,416). Social skills of Conversation and social fluency appear as the stronger correlation with neuroticism (rs=-0,354, p<0,001), and Depression was the subscale of neuroticism that more closely had correlated with the social repertoire (rs=-0,416, p<0,001). It was concluded that the deficit of social skills tends to be accompanied by psychological suffering. The theorical and practical implications for psychological work in mental health were discussed.

Background Lifestyle modifications can prevent diabetes in people at high risk. This study investigated factors underlying behaviour change in adults with pre-diabetes taking part in an intervention based on the Health Action Process Approach (HAPA). Methods Semi-structured interviews with 21 participants (13 m, 8 f; 47-80 years; mean BMI=31kg/m2) probed lifestyle changes made; motivations/barriers; understanding of the HAPA-based model. Interviews were audio recorded, transcribed verbatim and analysed in NVivo using Framework Analysis. Findings Many participants were surprised by the pre-diabetes diagnosis but indicated this increased their motivation to change, suggesting the HAPA risk perception component was important. Social influences and enjoyment of food were common barriers to dietary change; barriers to physical activity included age/illness/injury and low motivation. Discussion Qualitative research on use of the HAPA is rare, as is literature on the determinants of behaviour change in adults at diagnosed risk of chronic disease. These findings tend to support the motivational phase of the HAPA but imply the addition of social support as a motivating factor.

BACKGROUND: Medical decisions should be based on patient needs. Objectives were to (a) develop treatment goal items for a questionnaire on needs and benefit in nail psoriasis treatment, (b) determine goal importance and (c) determine the association between goal importance and quality of life (QoL). METHODS: The study comprised 4 steps: qualitative patient survey on needs and burdens due to nail psoriasis (n=120); development of pilot items in expert group; empirical item testing (n=55); assessment in 6 countries (n=203). The percentage of patients rating goals as important was compared between different subgroups. Overall goal importance was correlated with disease-specific QoL. FINDINGS: The final NAPPA-PBI contained 24 treatment goals. Outcomes of particular importance related to manual dexterity and social interaction. Importance of many goals increased with disease severity, but not with age or disease duration. Goal importance and quality of life were associated (r=.61, p<.001), but patients with high QoL differed widely in goal importance, whereas most patients with low QoL stated high goal importance. DISCUSSION: Goal importance is not determined by subjective impairment only.

Background: Oral anticoagulation (OAC) reduces stroke risk in patients with atrial fibrillation (AF) however it is often underutilized and sometimes refused by patients. Two inter-linking studies aimed to explore patients’ and physicians’ experiences of AF and OAC. Methods: Study 1: Three AF patient sub-groups were interviewed (n=11); accepted, refused, or discontinued OAC. Study 2: Four physician sub-groups (n=16) were interviewed: consultant cardiologists, general physicians, general practitioners and cardiology registrars. Data was analysed using IPA. Results: Three main themes comprised patients’ experiences: the initial consultation, life after the consultation, and patients’ reflections. Two main themes emerged from physicians’ experiences: communicating information and challenges with OAC prescription for AF. Discussion: This programme of work has illustrated the benefit of taking an in depth phenomenological approach to understanding the lived experience of the physician- patient consultation. This work has strengthened the evidence base and demonstrated that there is a need to target patients' and physicians' ability to communicate with each other in a comprehensible way.

Background: Action planning has been postulated to bridge the intention-behaviour gap; however, some studies have shown that the mediating role of action planning between intention and PA behaviour may be contingent to specific conditions. We hypothesized that the indirect effect of intention (the independent variable) on PA behaviour (the dependent variable), through planning (a mediator), will be moderated by the relative autonomy index (RAI). Methods: A total of 122 people with type 2 diabetes (T2D), selected randomly, completed the baseline questionnaire measuring the theoretical constructs. The Godin Leisure-Time Questionnaire was used to measure the PA behaviour one month later. Moderated mediation analysis was conducted. Findings: Controlling for the effect of baseline PA, action planning mediated the effect of intention on PA at the mean and low (-1 SD) levels of RAI, but not when the RAI was high (+1 SD). Discussion: The findings suggest that people with T2D, characterized with a high intention and using an action planning strategy, are more likely to practice PA; however, this action planning strategy seems useless for those with high autonomous regulation.

Previous research found that exercise had positive impact on body image perception. However, few studies examine the relationship between body image dissatisfaction and readiness to engage in regular physical activities across gender. The main goal of this study was to examine the role of gender in the relationship between body image dissatisfaction and stages of behavioral change for exercise in adults. The sample consisted of 272 employed adults (48.5% females) in Serbia, with a mean age of 39.46 years. The participants completed the measures of body image dissatisfaction (Body Shape Questionnaire) and readiness to exercise (Exercise: Stages of Change-short form). Analysis showed that females reported, on average, greater body image dissatisfaction than males. The results also indicated that perception of body image was significantly associated with the stages of exercise change behavior, with females in the stage of contemplation having greater odds for body image dissatisfaction when compared with females in the stage of maintenance. On the other hand, males reported similar levels of body image dissatisfaction across all stages of exercise change behavior.

Background: The aim of this research was to challenge the use of EMDR - Eye Movement Desensitization and Reprocessing - therapy in the treatment of the phantom breast syndrome. Methods: Thirteen patients agreed to participate in this study and were treated by EMDR therapy, focusing on two target types: traumatic events related to disease experience and phantom breast sensation. Quantitative evaluations were conducted before the first session, just after the last session and as a follow-up three and six months after. Intensity of the pain and intensity of the sensation were measured, as well as Post-Traumatic Stress Disorder, anxiety and depression. Findings: Results show significant effectiveness of EMDR therapy on all quantitative measures, but also show that EMDR approach can be an encouraging, non-invasive and relatively short strategy. Discussion: While these results need to be completed by other studies covering a larger population and the use of a control group, they are still encouraging because they suggest that a psychological treatment based on EMDR techniques and adapted to the specificity of phantom breast syndrome could be effective in bringing relief to patients.

Background: The aim of the study is to investigate the contributions of normative beliefs (NB) and self-determination (awareness of self and perceived choice) (SD) on Slovak university students' alcohol use (AU). Methods: The data were collected online from 814 university students (75.22% females; M=19.61; SD=1.42), who filled in the AUDIT-C, items of NB and self-determination scale. T-tests and linear regression were used for data analysis. Findings: Gender differences were found in AU. Males had a higher level of AU. Further analyses were conducted separately by gender. Linear models were statistically significant and explained 14.1% and 14.3% of the variance in males' and females' AU respectively. A higher level of AU was associated with (1) a higher level of NB for males and females and (2) lower awareness for males. Discussion: The findings showed gender differences in the contribution of variables to AU. The results are relevant for improving intervention effectiveness by focusing on (1) the development of awareness of self (it is a precursor of additional competences which closely relate to AU) and (2) correcting normative beliefs regarding the prevalence of AU.

Many young people are involved in risky behaviors which are related to immediate or long term negative health consequences and can have adverse effect on the overall development and well-being of youth (Boyer, 2006; Gruber, 2000). In order to prevent risky behavior we have to know the factors that increase the likelihood of this behavior. One psychological variable that might explain and predict risky behavior is time perspective (Adams,Nettle, 2009; Crocket, Weinman, 2009;Zimbardo, Boyd,1999). The aim of our study - to investigate association between various forms of risky behaviors and time perspective in University students. 664 university students from 8 Universities in Lithuania participated in the survey. Students’ mean age was 20,4 years (SD = 2,2). 76% female, 24% - male. We used specially designed questionnaire and Time Perspective Inventory (Zimbardo, 1988). The results revealed, that drug use, 6 drinks per one time, smoking, driving under the influence of alcohol, not using seat belts, writing SMS while driving, risky sports, sex without condom were related to hedonic present time perspective. Our research demonstrates, that time perspective is an important factor in understanding risky behavior and can be explored in the prevention and intervention context.

This paper presents findings from a larger study of the psychosocial implications of living with a chronic food sensitivity. Participants were targeted through membership of food related illness support groups, and parent reports were gathered for 1316 Australian children aged 0-18 (M= 7.3 years). Almost half (46%,n=¬594) were reported to have a food sensitivity (food allergy or food intolerance), with 80% (n=450) having received a professional medical diagnosis. A significantly higher proportion of those children also had a diagnosed psychological condition compared to the children without food sensitivities, and at rates much higher than Australian prevalence data. This indicates that a child with a food sensitivity is more likely to also have significant psychological needs. Children with a medically diagnosed food sensitivity were 4 times more likely to have Asperger Syndrome, 4 times more likely to have Dyslexia, 3 times more likely to have Depression or Anxiety, and 4 times more likely to have ADHD. Acknowledgement of the potential complexity of these conditions will promote more effective management of the psychosocial health of these children and their families.

The goal of this research was to determine the effect of the system of reward and punishment used in the family on the child through the study of their heart rate variability. 119 children from two schools in Saint-Petersburg took part in this experiment. The children’s heart rates were monitored while they were sitting and answering questions about punishment and reward in their families. After comparing the results, we discovered the following pattern: the children’s experiences associated with the system of punishment, had almost no reflection in their cardio, on the contrary the experiences of reward significantly affected their cardio. Thus we came to the conclusion that the reward system used in the family has a significant impact on the characteristics of cardio children under punishment. In all cases, the evidence suggests that the maximum variation of cardio while rewarding was marked in cases when a child reports tactile encouragement, and the minimum - in case where a child failed to answer. At the same time in punishing the opposite is true: if the child is encouraged to be tactile, there will be more pronounced effect on the sympathetic pacemaker in the punishment. Therefore, the closer a child is with a parent, the more painfully he will experience the punishment. But if the child receives no encouragement, we can see stronger sympathetic influence in connection with encouragement and parasympathetic influence with punishment. Consequently, the reward system is reflected with the cardio activity when a child recalls reward and punishment situation.

The contribution presents the main sources of potential stress in the teaching profession and discusses the elimination of these factors in favour of improving the experience of subjective well-being of teachers. Research data are derived from structured interviews with teachers and from the answers on the questionnaire focused on situations that could be described as stressful and dealt by a teacher on a daily basis. Respondents were 27 teachers. The answers in the interviews and questionnaires were processed by qualitative analysis. Research has found that a major source of stress is in our group referred to psychological stress, which is mainly due to troublesome pupils, unappreciated work of teachers and parents' attitude towards school. In coping with stressful situations, the most frequently used are positive strategies for finding social support.

Background: While several studies have identified psychological predictors of sleep, most of the available body of work is lacking a strong theoretical basis. The present study explored the association between the satisfaction of the basic psychological needs for autonomy, competence and relatedness, as defined within the Self-Determination Theory, and subjective measures of sleep in a non-clinical population. Secondly, we explored whether need satisfaction would account for the relation between mindfulness and financial strain and sleep outcomes. Methods: Adult participants (N = 215, 61% female; Mean age = 31) completed a questionnaire assessing psychological need satisfaction, mindfulness, financial strain and sleep outcomes. Findings: The results indicated that psychological need satisfaction related to better sleep quality and more adaptive daytime functioning but was only minimally associated with sleep quantity. Finally, mindfulness and financial strain related, respectively, positively and negatively to sleep quality through need satisfaction, suggesting that need satisfaction represents a critical explanatory mechanism. Discussion: These results suggest that the satisfaction of one’s psychological needs is implicated in the adequate regulation and satisfaction of the physiological need for sleep.

Background: Domestic violence is frequently studied, yet, questions concerning its causes and consequences still remain to be elucidated. Previous findings suggest that the degree to which women are willing to forgive their abuser plays a significant role in their intention to remain in a relationship. This study employed the Functional Theory of Cognition to address this matter. Methods: 100 female victims expressed their willingness to forgive an abuser while judging 48 scenarios. Six between-subject factors were studied: couple commitment, aggression context, type of abuse, the abused woman’s response, recurrence of the abuse and presence of apologies. Results: factorial ANOVAS evidenced a significant effect of four factors: type of abuse, the abused woman’s reaction, recurrence of the abuse and presence of apologies. A cluster analysis evidenced three groups of participants: those that never forgive, those that always forgive and those that forgive while considering the same factors as the total sample. Discussion: Findings contribute to the understanding of domestic violence victims’ decision making processes which can be crucial for their health and well-being.

Background: Studies on chronic diseases have underlined the need for personalized healthcare, taking into account patients’ characteristics and needs to support proactive health management. Our study aimed to explore the priorities and the correlates of information needs among patients with coronaropathy. Method: 357patients with acute myocardial infarction or acute coronary syndrome completed an assessment questionnaire. Descriptive analyses were conducted to identify information needs; path analysis were conducted to explore the relationship between needs and psychological factors. Findings: The key information need was for a full understanding of the disease. Positive coping strategies were positively associated with need for information on pharmacological treatment and pathology while negative association were found with information on distress management; non adaptive coping strategies were positively related to distress management information. Anxiety was positively associated with information on distress management and risks and complications. Discussion: The comprehension of patients’ information needs and correlates could strongly improve the quality of disease management.

The HIV infection impacts the quality of life of affected people, who can sometimes present negatives feelings. Some psychosocial aspects can influence it. In this research, we had attempted to see the impact of social support on their quality of life and their emotional distress, with a comparative study between HIV positive persons and HIV negative. A questionnaire (composed by the WHOQOL-HIV Bref/WHOQOL Bref, the HADS and the SQQ6) was completed by a sample of 119 persons (67 HIV-positive persons and 52 HIV-negative). The results show that social support had mainly an influence on the social relationship quality of life of our participants, but not on the emotional distress. It also point out a difference regarding physical, psychological, independent and social relationship quality of life and the presence of anxiety and depression disadvantaging HIV-positive persons when compared to healthy people. These results suggest the development of interventions with relatives could improve the quality of life of people living with HIV and as well as researches on the impact of social support.

Higher levels of negative cognition and emotions, and indications of poor effort will have poorer outcomes in contrast to those who are able to mobilize their “resources” at the beginning of treatment.Over 100 individuals who suffered motor vehicle traumas or industrial accidents were examined at the onset and the end of psychological treatment. Salmon Rehabilitation Checklist was used to identify priority of the social roles along with Resourcefulness for Recovery Inventory-Revised. As an outcome measure the Rehabilitation Survey of problems and Coping was used to assess self-reported changes in the level of disability and improvement in coping. Effort measures included Test of Memory Malingering, Computerized Assessment of Response Bias and Psycho-assistant.Binary logistic regression revealed that better coping and lower social disability were strongly associated with an initial focus on personal resourcefulness and indications of adequate effort.In conclusion,it is essential in order to maximize psycho-social outcomes in recovery from trauma that both resourcefulness and effort be initially assessed and addressed in treatment.

Our research aim was the exploration of relation between life-satisfaction and resilience. We worked with specific definition of life-satisfaction by Fahrenberg et al. (2001) and the Concept of resilience which is the subject of interest of various authors (e.g. Conner, 1993; Grotberg, 1996; Goldstein, Brooks, 2005). Our research methods were Resilience Scale (Wagnild, Young, 1993) and Life Satisfaction Questionnaire (Fahrenberg, Myrtek, Schumacher, Brähler, 2001) which consists of ten sub-scales: health, job and occupation, financial situation, free time, marriage and partnership, relation to own children, satisfaction with oneself, sexuality, friends and acquaintances, living. The research sample consisted of 200 university students with average age of 22.2 years, male-female ratio of 34:166. In the first analysis stage we created two groups characteristic by different resilience levels – one having high level of resilience and the other one having a low level of resilience. We subsequently analysed the life-satisfaction in these two groups. We discovered that students with high level of resilience possess significantly higher life-satisfaction (??0.05), satisfaction with hobbies (??0.01), with school (??0.01) and with health (??0.05). We haven't discovered significant differences in other life-satisfaction variables. The results show that courage and hope in difficult life situations (which are the bases of resilience) are the sources aiding to life-satisfaction in subjectively important areas.

Background: This study, using a quasi-experimental design, examined the effect of teachers’ autonomy support on students’ motivation and intention of wearing facemasks during an H1N1 pandemic situation. Methods: Participants (705 university students from China) were randomly divided into two groups before receiving hypothetical scenarios about an H1N1 pandemic. In the scenario, the teachers asked them to wear facemasks in the classroom, by an autonomy supportive manner (e.g., care, support, and the rationale) for group 1 and by a controlling style (e.g., punishment) for group 2. All participants responded to the items of autonomy support from the teacher, motivation and intention of wearing facemasks in the classroom according to the given scenario. Findings: The autonomy-supportive group reported higher perceived autonomy support and self-determined motivation of facemask wearing in the classroom than the controlling group. Self-determined motivation was a positive predictor of behavioural intention. Discussion: For the prevention of infectious diseases, health messages presented in an autonomy supportive style might be more effective than using controlling or punitive methods.

Background:It is proposed that for each population a culturally appropriate cut-off point should be defined when using scales or questionnaires in quantitative cross-cultural research.The purpose of this study was to identify the best cut-off point of the Children’s Eating Attitudes Test (ChEAT) in a Taiwanese prepubertal population. Methods. A two-stage design for the recruitment of the participants was used. During the first stage, fifth- and sixth-graders from three elementary schools in Taiwan were purposively selected, and a total of 1,195 valid questionnaires were obtained using the ChEAT. During the second stage, 280 students were chosen using a stratified random sampling method; among them, 205 students received a diagnostic interview for any eating disorder. The differences between the clinical diagnoses and the ChEAT scores of all study samples were compared to determine the best cut-off point. Results. Using the psychiatrist’s clinical diagnosis as the golden standard, it was found that when the cut-off point was set at 21.5, the ChEAT yielded the highest discriminant value with the area under the curve (AUC-ROC) of 0.723, showing good sensitivity and specificity. Conclusions. The optimal cut-off point for the ChEAT among prepubertal students in Taiwan was 21.5. Limitations of this present study and suggestions for future research were also addressed.

Background Psoriasis is a long-term condition associated with significant psychological and physical disability. Illness beliefs or ‘personal models’ underpin patients’ mood, self-management, and healthcare seeking behaviours but little is known about health professionals’ understanding of psoriasis and how this informs clinical decision making. We examined health professionals’ personal models about psoriasis. Method In-depth interviews were conducted with 23 practitioners managing people with psoriasis. Analysis was informed by the Common Sense Model, and principles of Framework Analysis. Findings Practitioners often held incongruent personal models about psoriasis; while commonly aware of the condition’s complexity and long-term nature, they described more linear and narrowly focused approaches to management and acute skin-focused management strategies. Conclusions Practitioners’ understanding of psoriasis conflicts with their reported management of the condition. Addressing practitioners’ personal models of psoriasis may address the current mismatch between understanding and practice.

Without professional help only every 10th smoker, who wants to stop smoking, reaches long term – sucession in beeing smoke free. Beside therapeutical treatement programms, variuos self help materials and SMS support services, applications for smart phones are a new and promising way to offer support in stop smoking. Especially target groups, who do not want to attend face to face programms might be adressed by cost free applications. The „Rauchfrei App“, 2014 developed by psychologists of the „Rauchfrei Telefon“ and „Co;des“ offers well grounded support to get smoke free. The programm is developed on evidence based therapy programs. Experiences and evaluations of existing applications for tobacco cessations were taken into consideration. The application emphasises the preparation, the implementation and the maintenance of tobacco abstinence as well as the relapse prevention. It considers the personal motivation to stop smoking as well as high risk situations and offers personalised tipps and messages in the process of changing the smoking behaviour into the non smoking behaviour. The „Rauchfrei App“ works in close cooperation with the „Rauchfrei Telefon“ and the homepage www.rauchfrei.at, but can be used independently from the phone counselling.

Background: Messages framing outcomes of healthy behaviours as occurring ‘every day’ vs. ‘every year’ can influence the temporal proximity and perceived likelihood of these outcomes. However, it is not known how pre-existing beliefs such as confidence in one’s ability to perform health-related behaviour interacts with such messages. Objectives: The purpose of this research was to investigate whether eating self-efficacy moderates the effect of temporal framing (day-frame vs. year-frame) on snacking behaviour. Methods: Participants (N = 95) completed the short-form of the Weight Efficacy Lifestyle Questionnaire (WEL-SF) and read either a day-framed or year-framed message about the health benefits associated with avoiding snacking. Consumption of snacks was reported 7-days later. Results: For those with low levels of eating self-efficacy (WEL-SF score < 4.3 on a 7-point response scale), the year-framed message was associated with lower levels of snacking than the day-framed message. Conclusions: The current research identifies a key role for eating self-efficacy in shaping recipients’ responses to temporally framed messages about the health benefits associated with the avoidance of snacking.

Background: The aim of the study was to determine the prevalence of risk-health behaviors among students of University of Zadar in order to identify potential student risk groups for educational health programs. Methods: Survey comprised a sample of 500 students of University of Zadar aged 18-35. A questionnaire was designed to examine five areas of risk-health behaviors: eating habits, physical activity, cigarette smoking, drinking alcohol and risk sexual behaviors. Findings: 48% of female and 23% of male students do not participate in any physical activity and in the same time 35% of females and 21% of males spend 4 and more hours a day in front of the computer. 60% of students are smoking cigarettes and 80% of them have drunk alcohol at least once in the last 30 days. 75% percent of females have entered into sexual relationships, but 41% of them have never visited gynecologist. Discussion: The findings of the present study suggest the need for health promotion programs with special emphasis on importance of regular physical activity and taking care of reproductive health.

Background: Family caregivers of patients in a vegetative state (VS) can experience high levels of distress and difficulty in facing grief. Our aim was to explore how the health status of VS caregivers changed in relation to the different coping strategies they used. Methods: The Anxiety and Depression Short Scale, the Prolonged Grief 12, Family Strain Questionnaire, and the Coping Orientations to Problem Experiences were used with 61 caregivers of VS patients hospitalized in specialized units in Italy. A hierarchical cluster analysis was carried out to group the data. Findings: Two groups of caregivers were found. The first group was characterized by lower levels of anxiety, depression, family strain, and prolonged grief. The main coping strategies used by this group were Social Support, Positive Attitude, and Problem Oriented. The second group showed higher levels of anxiety, depression, family strain, and prolonged grief, and used the Avoidance strategy more than the first group. Discussion: The health status of family caregivers of VS patients changes according to the different coping strategies adopted. Helping these caregivers to adopt more effective coping strategies may increase their well-being.

In the near future, many western nations will be confronted with specific challenges regarding ageing populations and their physical and psychological well-being. Ageing parents might experience a greater need for intergenerational support and solidarity, especially in the context of migration. The acculturation process may, however, entail an increased intergenerational gap possibly leading to conflicts and ambivalences between parents and adult children. This might in turn diminish their well-being. Here, a cross-cultural comparison is envisaged between Luxemburgish and Portuguese triads of adult children and their older parents living in Luxembourg (N = 120). Participants will report on their mutual relationship quality and subjective well-being by using a standardized questionnaire. Similarities and differences in mutual expectations of family members as well as the effects of an intergenerational gap in ideas about intergenerational solidarity on relationship quality and on subjective well-being (SWB) will be examined. Results will be discussed regarding the relevance of intergenerational family relations for subjective well-being in the light of migration and ageing.

There is evidence to suggest that psychosocial interventions may be effective in reducing fatigue during active treatment in cancer patients.It is still unclear how effective such interventions may be post-treatment. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL PsycINFO, Web of Science and CancerLit were searched. RCTs were included which evaluated psychosocial interventions for fatigue in adults post cancer-treatment. One author screened titles. Two authors independently screened the remaining abstracts for their eligibility for inclusion. The search returned 6,380 papers. Following an assessment of the abstracts approximately 24 papers remained. Two authors independently extracted data from studies using a standard data extraction form and assessed the risk of bias of the selected studies. Education and CBT were the most commonly used psychosocial interventions for this group. This review is the first to evaluate the effectiveness of psychosocial interventions for cancer-related fatigue following cancer treatment. Findings will inform the literature, as well as policy makers & stake-holders, to ameliorate fatigue in this group.

Background: To explore the role of coping in the Leventhal self regulatory model by testing whether coping styles mediate the relationship between illness representation and metabolic control (HbA1c). Specifically, we aim to establish which of the five dimensions of illness representation are most highly associated with coping strategies used by adolescents with type 1 diabetes in order to explain metabolic control. Methods: Seventy adolescents between 13 and 16 years of age were asked to complete the Diabetes Illness Representations Questionnaire (DIRQ) and the Kidcope. Measures of metabolic control (hemoglobin A1c) were taken from medical records. Findings: Perceived impact, identity, and cognitive restructuring were significant independent predictors for coping styles. Active coping predicted lower A1C levels. Multiple regression analyses indicated that coping did not mediate the association between illness representations and HbA1c. Discussion: Understanding the relationship between illness representation and coping styles should enhance efforts to improve diabetes outcomes in terms of metabolic control.

Background: Internet-delivered interventions have proved efficacious in changing people’s behaviours, but the actual use of these interventions by the target group is often very low. The aim of this paper is to investigate whether arousing interest and enjoyment results in increased intervention use in an online context. Methods: Invitations to visit a website about Hepatitis A, B, and C virus infections (Studies 1 and 3) and the website itself (Studies 2 and 3) were manipulated to arouse interest and enjoyment. Subsequently, intention to visit the website (Study 1), clicking on the link to visit the website (Studies 2 and 3), and pages visited on the website (Study 3) were assessed. Findings: Arousing interest in an invitation resulted in a higher intention to visit the website (Study 1) and a higher likelihood of clicking on the link to visit the website in comparison with arousing enjoyment (Study 2). The percentage of pages visited increased when interest was aroused on the website (Study 3). Discussion: Arousing interest is a promising strategy to increase use of Internet-delivered interventions and potentially increase the public health impact of these interventions.

Abstract The Functional Assessment of Chronic Illness Therapy - Treatment Satisfaction Background:patient Satisfaction (FACIT-TS-PS) is a measure for assessing the quality of care and satisfaction in chronically ill patients. Methods: validity of the multi-dimensional structure and reliability of the FACIT-TS-PS were investigated in a sample of 431 chronically ill patients, using Confirmative Factor Analysis (CFA) and CUB models. Results:integrated use of CUB models and CFA resulted in an satisfactory structure, leading to confirmation of the original, reliable, six-factor structure, even with a reduction in items from 25 to 15. Discussion: the FACIT-TS-PS appears to be a practical instrument that is reliable and has good construct validity.

Background and aims: We present preliminary findings from a quality assurance project at an outpatient pain clinic at the University Hospital of North Norway, identifying key factors associated with mental distress. Methods: Patients admitted 2010 - 2012 (n= 300) completed measures of pain (Numerical Rating Scale NRS), number of pain locations, sleep disturbance, mental distress (Hopkins Symptom Checklist HSCL-25), catastrophizing (Coping Strategies Questionnaire CSQ) and demographics. Results: Mean age was 45 (15-87), 59 % female, 70 % not working. Mean pain intensity 8.49 (SD = 5.89), 68% > 5 locations of pain, and 37% >10 years of pain. Mean HSCL was 1.99 (SD = 0.59), 62% > cut-off (1.75). 34% reported severe sleep problems. 47% reported that personal economy was inflicted by their health. The mean of the CSQ items was 3.8 (SD 1.4). In a stepwise regression analysis, mental distress was predicted by catastrophizing, sleep disturbance, personal economy inflicted by health, and number of pain locations (F (291) = 42.3, p=.000). The model explained 37% of the variance. Conclusion: Mental distress is frequent among patients with chronic pain, and associated with a range of psychosocial factors. The effect of pain intensity was mediated by the other factors in the regression model. The results support a multidisciplinary treatment of chronic pain, including an awareness of psychosocial issues.

Previous findings highlight that health self-perception depends directly on the subjective evaluation that individuals gives to their experience of illness, as well as of their living experiences (Tap & Vasconcelos, 2004). In this field, psychosocial adjustment indicators as social integration, self-esteem and stress may assume special relevance on individual’s health and illness self-evaluation. The purpose of this work is to examine the relationship between health self-perception and age, gender and psychological adjustment indicators. This is a quantitative study conducted in 448 patients, from 18 to 85 years old, recruited from fourteen Portuguese health-care centers. For data gathering it was applied a questionnaire to access background variables, health self-perception (measured by a scale from 1 to 20), and psychosocial adjustment indicators (e.g. social integration, self-esteem and stress). Findings suggest that the score of health self-perception decreases with age and tends to be lower in women. Results also show that health self-perception is positively associated with social integration and self-esteem, and negatively associated stress. Globally, this study indicates that adjustment feelings play a role in the way that patients experience and cope with their own state of health.

Several authors in critical health psychology have underlined the need to develop models of psychological life within qualitative research that are not limited to mere descriptions of health or illness. This communication presents methodological basis in order to overcome such descriptive level by proposing a socio-cultural approach. First, we analyse the dominant tendency in psychology consisting on defining the constructivist paradigm and qualitative research as impressionist, vague and subjective, that is, “non scientific”. We claim that qualitative research may be objective, clear and precise while succeeding to consider psychological processes within their socio-cultural context. We make “indirect methods” a major focus, as able to capture psychological processes at stake in health and illness by interpretating their “traces”. Moreover, we illustrate a variety of methods used in psychology to study the structuring role of culture in this process. We conclude by discussing the possibility to build complex psychological concepts regardless immediate experience.

Background: MSM are a high-risk group, and therefore target of much research investigating risk factors related to having STI/HIV. Our primary objective was to compare findings of three data sources regarding differences in demographics, risk factors, STI/HIV and their relations. Methods: Dutch data available in 2010 from EMIS, an international internet survey, Schorer Monitor , a Dutch internet survey, as well as data from 3800 STI-clinic visits were combined into one dataset. Findings: Risk factors were similar in the databases, with besides some actual differences, some differences caused by question phrasing. We analyzed three outcomes, having STI or HIV, and having never tested for HIV. Risk factors include drug use (e.g., combinations of drugs increased the risk), age, residence, and number of partners. Notably, ethnicity had no effect. Data from STI-clinics differed, possibly as it involves diagnosed instead of self-reported STI/HIV. Discussion: This research sheds light on the comparability of different initiatives investigating MSM, consequences of phrasing questions differently, and ultimately differences in conclusions drawn based on these initiatives.

Background: Breaking bad news to patients with hematologic malignancy produce a traumatic outcome on the patient’s quality of life. This study focused on the announcement of allogeneic bone marrow transplant (ABMT) and on the real-life experience of patients and haematologists about this event in order to reduce the psychic impact of this medical care. Methods: participants: 5 patients and 4 haematologists; data collection: semi-directive interviews; data analysis: Grounded Theory and clinical analysis (qualitative approach). Find.: themes developed: 1.Patients: Patients’ real-life experience when receiving the diagnosis, hearing the possibility of a transplant and the risk of recurrences; Perception of its relationship with the doctor, communication elements and content of the announcements; Beliefs, psychic resistances, coping strategies and anguishes about ABMT /2.Haematologists: announcement of hematologic malignancies diagnosis and recurrences; presentation of the ABTM;… Discuss.: Haematologists must explore patients’ beliefs and anguishes about the transplant and patients’ use of defence mechanisms and coping strategies, to reduce their anxiety before and after the surgery.

Background. Multilevel programs (containing individual and environmental influences) are often documented as most effective in health promotion. This study examines whether serious games which are part of a multilevel program are more effective than games focusing only on the individual. Methods. A meta-analysis was conducted of serious games for health promotion published before Aug 2013. Random effects model analyses were performed (Hedges’ g). Results. Sixty-seven studies were included, of which a minority (29%) were multilevel games. Both single level (g=.391) and multilevel games (g=.215) were effective, but surprisingly, single level games were more effective than multilevel games. However, when examining behavioral determinants separately, only for attitudes (Q(1)=10.553, p<.01 -note: small sample) single level games were significantly more effective than multilevel programs. No long-term differences were significant. Conclusions. Both single level and multilevel serious games are effective for health promotion. When targeting attitudes, single level games may be preferred. However, few multilevel serious games to date exist and more research on multilevel games is needed.

Background: The objective of the study was to asses the presence of depressive symptoms at patients with peripheral arterial disease (PAD) and to identify potential psychosocial factors (such as social support and coping mechanisms) that may help these patients to deal with the disease. Methods: The design of the study was transversal and included 37 patients with PAD with critical ischemia (32 men, 5 women, mean age= 62,41). They were administered Center for Epidemiologic Studies Depression Scale, Duke-UNC Functional Social Support Questionnaire and COPE inventory. Findings: Depressive symptoms were found at 21,6 % of the patients. There were low scores of perceived social support at 32,4% of the patients. Depression correlated (p<.001) positively with mental disengagement (r=.791), denial (r=.672), behavioral disengagement (r=.760), restraint (r=.0753) and negatively with social support (r= -.879) and positive reinterpretation (r=-.844), active coping (r=-.776), use of emotional support (r=-.624). Discussion: Recognition and evaluation for depression in patients with PAD followed by identifying psychosocial interventions may be useful in improving outcomes of these patients.

Background: Obesity is a global problem, however, behaviour change to counter this problem is not well understood. This study sought to explore this in a group of NHS patients who were obese or who had been obese but who had lost a substantial amount of weight within the last 3 years (even if they had regained). Method: After receiving NHS ethical approval this study recruited 11 participants, data was collected by means of semi-structure interviews and a 7-day daily diary. Thematic analysis was used to analyse the data. Findings: Of the 11 participants, 3 had not been successful at losing weight and 8 had been successful (5 regained). Themes developed from the analysis included ‘what was helpful’ (the doctor’s approach, e.g. a ‘shock tactic’), weight loss techniques (e.g. motivation and knowledge), the successful state of mind (e.g. perception of body size), and the support (positive and negative) received from friends and family. Discussion: The results have implications for health professionals in identifying factors important for this group for interventions. The results suggest that tackling knowledge and social norms and using ‘shock tactics’ may be effective.

The aim of this study was to investigate body satissfaction and readiness to accept Western standards of beauty (thin-ideal) among Muslim female adolescents with different religious beliefs, manifested in different dress preferences (Western or non-Western). The sample consisted of 150 high school students. All students were Muslim, but half of them accept Western dress preferences, and other half follow traditional way of dressing wearing non-Western clothing and a head veil (hijab). The instruments were: Contour Drawing Rating Scale for measuring body satissfaction and SATAQ-3 for measuring sociocultural attitudes towards body appearance. We also collect data on Body Mass Index and existance of diet regime. Muslim adolescents wearing non-Western clothing and a head veil were significantly less likely to express drive for thinness or pressure to attain a thin-ideal standard of beauty than adolescents wearing Western dress style (t = -5,761; p<0,001). They are also more satisfied with their body shape, than adolescents accepting Western dress standards. (t = 3,029; p<0,005). The results suggest the significance of Western cultural pressures in existence of body dissatisfaction and drive for thinness in adolescents. It is well known that such pressures could be the important risk factor for developing of eating disorders. Key words: Muslim religion, body image, dress preferences

Background: The study aimed to compare somatic symptoms between patients undergoing hemodialysis and a healthy control group and to investigate the relationship of psychological variables (i.e. anxiety, depression, social support, self-efficacy, coping strategies) with the severity of these complaints. Method: Forty-six patients and 30 matched healthy controls participated. Data analysis was based on multiple regression models. Findings: Patients reported markedly elevated somatic symptoms, especially immunological, cardiovascular, gastrointestinal and allergic complaints. Anxiety turned out to be the main predictor of most symptom categories, explaining up to 24.9% of variance in symptom severity. Depression, worry and passive coping strategies (helplessness, fatalisms) were furthermore associated with higher symptom levels. Active coping strategies, self-efficacy and social support were associated with lower symptom severity. Discussion: The results suggest that emotional factors explain some of the symptoms without clear etiology in the renal patient and may help developing psychological interventions aiming to reduce somatic symptoms in patients undergoing chronic dialysis.

Background: Reducing the time between the onset of the first symptoms of cancer and the first consultation with a doctor (patient delay) is essential to improve the vital prognosis and quality of life of patients. Understanding which factors mostly determine the patient delay seems to be essential for optimization of preventive messages in public health. The main objective of this qualitative study is to assess whether, in head and neck cancer, patient delay is linked to socio-cognitive and emotional factors, in addition to previously known factors. Methods: 15 semi-directive interviews of head and neck patient’s cancers were conducted to identify subjective perceptions concerning the symptoms and the medical appointment, and subjective perceptions of health, the disease and treatments. Findings: Several themes were obtained such as: symptoms interpretation; health habits; relatives support; and coping strategies. For instance, we found quite pro-active approach to health (“I do not wait to consult”) and more passive visions (“we’ll see later”). Discussion: The identification of these different factors could be useful to offer some interventions and prevention campaigns strategies.

Background: Quality management programmes were implemented at the CF centre Innsbruck more than ten years ago, including regular ISO 9001:2000 certificates. To account for the patients' opinion on our services, we prospectively evaluated the experience and satisfaction of parents, CF adults, and adolescents and used the results for quality improvement. Methods: In 2009, we participated in a pilot study to develop a CF specific patient's experience and satisfaction questionnaire. Two years later, a nationwide survey was performed in Germany using the same instrument. Our centre also took part in that survey. Findings: In 2009 and 2011, 63 and 76 (78%) participants from IBK (both parents and adult patients) responded to the surveys. Ideal problem scores of 0%, indicating no problems for the respective topic, were reported in 2009 for 15% and 19% of all items by adults and parents, respectively. The thirteen adolescents reported more problems. After quality improvement measures had been implemented, the percentage of ideal scores increased to 32% and 48% (adults and parents) in 2011, also for adolescents better follow-up results were achieved. Conclusion: The CF specific questionnaire identified strengths and weaknesses of patient care " through the patients' eyes." After improving procedures, lower problem scores in the 2011 IBK survey indicated the success of certain measures.

Background Prior research has suggested that parental involvement is needed for alcohol prevention program. In this research, we focus on how much knowledge dose parents has about alcohol and clarify what kinds of knowledge should be incorporated into alcohol prevention program. Methods 348 parents who have child aged 6 or younger completed questionnaire about knowledge related to alcohol, genetic constitution, experience to offer alcohol for their child, and ideas about the contents of alcohol prevention program. Findings The highest item that participants answered correctly was knowledge about acute alcohol intoxication is consequence of drinking alcohol excessively in short time, and the lowest one was about drinking alcohol causes pancreatitis and diabetes. 1.1 % of participants answered that they have ever offered alcohol to their child, and the main ideas they expects for alcohol prevention program for children was to teach bad influence of alcohol on children body. Discussion This result indicated that many parents has insufficiency knowledge about the effects of alcohol on human health and alcohol prevention program should be include this type of knowledge for the parents.

Background: To investigate the influence of a number of psychosocial and biological variables related to the quality of life in MS patients. Methods: The sample consisted of 49 MS patients (30.6 % men, mean age 39.5, SD 9.6), who were being treated in two hospitals in Girona (Spain) and agreed to take part in an 18 month long prospective cohort study. The number of relapses and pseudo-relapses, the degree of disability, the level of anxiety and depression, perceived stress, social support and controllability were measured at baseline and every 6 months. Demographic variables, the number of new brain lesions and quality of life were measured at the beginning and at the end of the study. Findings: Gender, the level of anxiety and depression and the number of pseudo-relapses were the variables most able to predict a reduction in the perceived quality of life after 18 months (R2 = 0.80 and p < 0.05). Being female, having had more pseudo-relapses and higher levels of anxiety and depression predicted a lower perceived quality of life. Discussion: These results identify the role a psychologist may play in improving patients’ perceived quality of life of, since three of the four significant factors were psychological. The results also highlight the specific needs of female MS patients.

Background: We studied to what degree psychosocial resources, demographic variables and situational aspects are related with patients’ emotional distress and self-rated health at emergency department (ED). Methods: This is an observational cohort study including 101 medical ED patients (M = 68.7 years, males 67.07%) from a Swiss tertiary care hospital. Emotional distress was assessed using a short form of the Positive and Negative Affect Schedule (PANAS). Self-rated health was measured with a visual analogue scale. Further variables assessed with standardized questionnaires were personality (BFI-10), resilience (RS-11) and self-efficacy (ASKU). Findings: Results from regression analysis showed that emotional distress was significantly correlated with patients’ knowledge of diagnosis (rs = .21, p <. 05) and neuroticism (rs = .27, p < .05). In turn, conscientiousness (rs = .29, p = .01), resilience (rs = .29, p < .05), age (rs = -.22, p < .05) and gender (rs = .31, p < .01) were related with self-rated health. Discussion: Results are discussed referring to a resource-oriented model of distress-management, and in view of designing prevention and intervention strategies.

Background: According to attachment theory, romantic and sexual involvement and commitment to a steady partner mark the transition to adulthood aimed at procreation and transfer of well-being to next generation. The paper explores how quality of relationships with parents - in terms of attachment to parents, stressful childhood experiences and family ties - influences satisfaction in romantic dyads and social loneliness in adolescence - measured in terms of relationships with friends. Methods: From the online Outcome of Adolescence Survey, completed by Romanian students on the XIIth grade in 2012-13, only respondents with a romantic partner and who lived with parents until their 15 were selected. Two logistic regression models were applied to 1259 students, controlling for gender, age-group and economic status of family. Findings: According to first logistic regression, relationships with parents in childhood appeared unrelated with satisfaction in romantic dyad in adolescence. However, males reported significantly less satisfaction in partnership than females. Instead, the second regression model proved that low attachment to parents and material deprivation almost halved the chance to avoid loneliness. In addition, high level of stress in family significantly increased the chance of relying on the social network of friends. Younger adolescents were more likely to rely on friends. Family ties during childhood seemed unrelated with the quality of romantic relationship or with the level of social loneliness in adolescence. Discussion: This study is valuable as our trial to capture a clearer picture of the contribution of family experiences in childhood on the quality of romantic dyads and of friendship networks among nowadays adolescents is a novelty in the Romanian literature on adolescents.

In occupational health psychology, perception of health is studied mainly through single time data collection. However, perception of health is a psychological developmental experience linked to the unpredictable professional context that may be revealed by longitudinal methods. Semi-structured interviews conducted with 7 female nurses from 28 to 50 years old in a 2-steps design explore the evolution of health perception connected to occupational health. Using phenomenological psychology data analysis (Giorgi), results from thematic content analysis of the second interviews evidence that participants debrief their health perception evolution between T1 and T2 as a positive experience influencing their life in a healthy way. Self-awareness of endangering situations and development of systematic safer work behaviours, disclosure of unknown resources, collective team supporting strategies or decision/possibility of professional change are themes connected positively with a perception of better health and motivation. In terms of prevention of occupational disease and clinical interventions, these results advocate in favour of longitudinal approaches in occupational health psychology.

Background: With aging, impairments in cardiovascular and autonomic nervous system function render older adults more vulnerable to orthostatic hypotension, increasing the risk of cerebral hypoperfusion which may potentially accelerate cognitive decline. The current study investigated the relationship between orthostatic blood pressure (BP) and cognitive decline in a large sample of older adults.Methods: Data were collected during the first and second waves of The Irish Longitudinal Study on Ageing (TILDA), which took place in 2009-2011 and 2012-2013 respectively. 4,134 adults aged 50 and older were included in the current analysis. Orthostatic BP was measured by beat-to-beat digital plethysmography. Cognitive function was assessed using the Mini Mental State Exam (MMSE) at baseline and follow-up. A multivariate regression model was fitted, adjusting for demographics, depression, health behaviours, exercise, BMI, cholesterol, and medications. Findings: Delayed systolic BP recovery from orthostasis at baseline with associated with a decrease in MMSE score at follow-up (coeff: 0.53, p <.01). Discussion: The failure to return BP to baseline rapidly after standing may impair cerebral blood flow and adversely affect cognition. Further longitudinal study will determine whether these individuals have a greater risk of transitioning to mild cognitive impairment/dementia.

Background: There is evidence to suggest that childhood environmental factors play an important role in the development of eating pathology and emotional eating. Few studies have addressed protective factors against emotional eating. The current study aimed to elucidate some of the processes involved. Method: 573 participants completed measures including BMI, emotional eating, remembered parenting style, attachment, attitudes towards emotional expression in childhood, and ability to observe oneself in the moment. Findings: An SEM revealed age, gender, and the ability to observe oneself in the moment as having significant direct effects on BMI and emotional eating. Attachment and remembered parenting style had indirect effects which were mediated by attitudes towards emotional expression in childhood. Discussion: Childhood environmental factors, particularly attitudes towards emotional expression, have a role in the development of emotional eating in adults. The preventative role of mindfulness-based skills, particularly those focusing on observing oneself in the moment need to be further investigated.

Background: Literature and clinical practice evidence that some patients who complain about allergic symptoms do not result positive from diagnostic tests. The study aims to investigate the possible psychological variables involved. Methods: The project involved 208 subjects of the Allergology Department of San Raffaele Hospital in Milan (Italy), who filled out three questionnaires,WHOQOL (World Heath Organization Quality of Life), SCL -90- R (Symptom Checklist -90 -Revised),TAS- 20 (20 -Item Toronto Alexithymia Scale). Findings: The true allergic patients represent the 78% of the sample and non-allergic 22%,while manifesting the symptoms. The non-allergic patients have more compromised scores in the scales of quality of life (F(1)=4.91; p?0.05) (WHOQOL). They have higher values in hostility (F(1)=16.33; p?0.001), somatization (F(1)=4.64; p?0.005), obsessive- compulsive (F(1)=6.05; p?0.05), interpersonal sensitivity (F(1)=8.76; p?0.005) and depression (F(1)=5.42. p?0.05) (SCL -90- R ). Discussion: specific psychological features may influence the symptomatology reported by patients with negative allergologic test results

Background: This study focused on the validation of the Italian version of the Parental Attitude Scale (PAD). This is a 46-item questionnaire that was developed to measure parental attitudes on the basis of three dimensions: Pleasure-Displeasure, Arousal-Non arousal, Dominance-Submissiveness. Methods: 495 parents (241 males; mean age= 40.6±5.7 years) participated in the study. Dimensionality was explored using Principal Component Analysis. Findings: The three-factor solution accounted for 19.98% of the variance, and yielded poor indices for about one-third of the items. Moreover, it was largely inconsistent with the original proposed structure and difficult to interpret, suggesting the removal of 17 items. A four-factor solution for the resulting 29-item version was identified (Parenting Pleasure, Parenting Load, Parental Permissiveness, Educational Rules), explaining 30.63% of the variance. Discussion: The 29-item version of the PAD seems a more psychometrically sound measure than the original 46-item version. However, more studies are needed to achieve a comprehensive investigation of its psychometric characteristics in Italian contexts.

Backgroung : The aim of this study was to overview scale used to evaluate the burden experienced by caregivers and their clinimetric properties from 2002 to 2012. Methods : A review of the literature was conducted to examine burden scales with regard to setting, caregiver population, sample size, reliability, validity, feasibility and subscales. Findings : The literature search resulted in 95 studies measures of caregiver outcomes, including 39 different measures of caregiver burden. While, most of the instruments measure various aspects of burden (negative personal impact, activity limitation, social strain, emotional burden, physical burden, economic aspects, etc. ). Also, little is known about the reliability, validity and subscales of these measures. While five studies evaluate the burden of caregiver in the field of children, there is only one English study aiming to explore caregiving among ASD children parent’s. Discussion : While there is a lot of scales evaluating burden of caregivers, to our knowledge, there is no French scale adapted for ASD children. It seems of primary importance to create and validate a french scale in order to better targeting burden experienced by ASD children parent’s.

Background: Prototype perception is an important determinant of behaviour. Intervention studies show that prototype information successfully influence behaviour or related constructs. This was found for drinking and unprotected sex. Further, evidence suggests this method to be promising in improving eating behaviour as well. The aim was thus to develop and evaluate a theory- and evidence-based intervention targeting eater prototypes. Methods: An RCT-study was conducted with 108 adolescents. The intervention consisted of specific information on healthy and unhealthy eater prototypes and the initiation of directed social comparison processes. Prototype information was given via Facebook profiles. Social comparison was initiated by asking participants to identify with or contrast from the healthy and unhealthy eater respectively. Results: The intervention was well received and could be carried out as planned. Further, it effectively changed prototype perception and eating behaviour directly and four weeks later. Discussion: The developed intervention proved to be feasible and effective in improving adolescents eating behaviour. It can be provided alone or integrated in larger programmes.

Mindfulness is defined as intentional and non-judgmental observation of all experiences in the present moment. Metacognition is similar to mindfulness. Thoughts, emotions and behavior are observed from a meta-perspective. Thus, the metacognitive subject is separated from the observed object (e.g., one’s thoughts). Thoughts and emotions are attenuated by detached observation. Although the influence of dysfunctional cognitions and emotions are reduced through mindfulness-based interventions, from a metaregulative perspective it should be possible to affect one’s thoughts, emotions and behavior. Thus, mindfulness-based metaregulative intervention goes one step further: thoughts, emotions and behavior should not only be observed from a meta-perspective, but also directly influenced, regulated and controlled. In addition to mindfulness-based and metacognitive techniques, people will learn to influence and modify positive cognitions and emotions. It is assumed that the mindfulness-based metaregulative intervention has positive effects on well-being and reduces depression and anxiety. The discussion is based on psychoanalytic assumptions and cognitive behavioral therapeutic approaches.

Background: Women with no physical defect request cosmetic surgery to increase self-confidence and quality of life(QoL). The aim of study is to identify relationship between body image(BI) and QoL as impacted by surgery. Methods: BI was assessed by Multidimensional Body-Self Relations Questionnaire (MBSRQ), QoL by SF-36 scale. 80 women were divided into: Control Group (CG)-was satisfied with BI, Experimental Group1 (EG1)-was operated, ExperimentalGroup2 (EG2)-planning surgery. Pierson correlation coefficient was used for statistics. Findings: QoL is highest in CG, EG1 higher than EG2. The most significant differences in QoL indicate in 3 groups: EG1/EG2/CG: Emotional well-being (EWB) 52.6/41.65/73.3, Social functioning (SF) – 60/45.2/81. Significant results for MBSRQ: Appearance orientation(AO) is above norm in EG1, EG2.Body areas satisfaction(BAS) is higher in EG1 than in EG2 but lower than average coefficient. Significant correlations are between: EG1-SF and AO(r=-0.6), EG2-BAS and EWB(r=0.8), (p<0.5) Discussion: BI and self-esteem issues persist after cosmetic surgery. The poor QoL correlates with negative BI and impacts negatively on emotions, social activity and well being.

Background: This study aimed to explore the associations between personality factors, autonomy, religion and risk behaviours (RBs) among students. Methods: Six separate binary logistic regression models were built to explore associations of problematic internet use (PIU), binge drinking and smoking for boys and girls (807 students, 75% females, 19.6 mean age) with personality variables (Plasticity, Stability), autonomy (awareness of self), religion (importance & attendance). Findings: The individual models revealed that PIU was associated with Plasticity and autonomy for both genders and with Stability for boys. Binge drinking was associated with Plasticity for both genders, with importance of religion for boys and attendance for girls. Smoking was associated with Plasticity for both genders, with autonomy for boys and Stability and religious attendance for girls. Discussion: A higher level of Plasticity seems to be generally associated with RBs while Stability, autonomy and religion, although differently for each gender, is protective. This distinction may be an important aspect of prevention programs.

Background: Intermittent claudication (IC) is a debilitating leg pain caused by peripheral arterial disease. It is improved with walking exercise, but activity levels are low. An understanding of people’s experience of their condition and of walking exercise may inform management strategies. Methods: Data from semi-structured interviews were explored using Framework analysis. Findings: A semi-purposive sample of 16 people (4 female) with IC was included. Three themes (subthemes) emerged: 1) Purposeful exercise is challenging (desire for clearer instructions, barriers/facilitators to walking, beliefs do not translate to behaviour); 2) Walking is an overlooked self-management opportunity (uncertainty about IC cause and treatment, walking is secondary to medical/surgical options); 3) Perceived consequences of IC are not addressed by walking (IC is benign and leg pain can be overcome, IC is serious and medical management is required). Discussion: People report uncertainty about IC and walking. Clear instructions and information on benefits of walking for general health and for IC are required. A better understanding of IC could help translate positive walking beliefs to behaviour.

Background: Providing social support has been found to improve psychological well-being. However, little is known about the physiological consequences of providing support or whether it varies with relationship intimacy or types of social support. We investigated whether relationship intimacy (friend vs stranger) would interact with support type (active vs passive) to influence cardiovascular responses of support providers. Methods: Participants were randomly allocated to one of four conditions (stranger/active support, stranger/passive support, friend/active support and friend/passive support), and then completed a standard stress testing protocol (baseline, task) and had their blood pressure and heart rate monitored while they watched someone to a stress task. Findings: Thus far, there are no interactions between relationship intimacy or support type for psychological or cardiovascular responses. However, those providing passive, and not active, support had the greatest reductions in diastolic blood pressure while watching someone do a stress task Discussion: This suggests that it is passive support that will bring the most health benefits to the social support provider.

Background: The aim was to provide a systematic examination of the associations between self-efficacy and health outcomes among people with cardiovascular diseases. Methods: Five databases were searched to retrieve published literature over the period of June 1988 and October 2013. Using methodology of systematic review 209 studies were identified and 28 met the inclusion criteria. Original trials included 5710 participants. Findings: Self-efficacy was positively associated with subjective and objective health outcomes, such as physcial activity, diet, BMI, blood pressure, total cholesterol ratio, quality of life, self-care management behaviours, social functioning, positive emotions, and indicators of psychological well-being. Twelve out of thirteen self-efficacy enhancing interventions significantly affected health outcomes. Disscusion: Higher levels of self-efficacy are related with better health status of patients with cardiovascular diseases.

Objective : Students in last year of psychology could have lot of stress, anxiety, rumination and reduced quality of life. Many research studies showed that CBSM (cognitive behavioral stress management) reduce stress, rumination and also enhance quality of life. This research developps CBSM technique for students. Method : A 2-days group cognitive-behavioral stress management intervention has been tested among 25 students, following them for 4 months after recruitment. This group has been compared to a control group (25 students also). Quality of life has been evaluated by questionnaire and we have also assessed change in stress (PSS) since trial enrollment, anxiety (HADS) and rumination (Mini-CERTS). Results : CBSM intervention learns to patients what is stress, coping, cognitive distorsions and rational thought replacement, social support and assertiveness. Results show that intervention group has less stress, anxiety and rumination than control group. Conclusion : This intervention reduce stress, anxiety and rumination for students. We would like to developp this technique in France to other population.

Background: Depression is prevalent in patients with epilepsy, which is associated with low health-related quality of life (HRQOL). Our aim was to study the relationship between depression and HRQOL in epilepsy. Methods: We enrolled 140 epilepsy patients. Depression was assessed by Hamilton depression scale (HAMD), and HRQOL by SF-36 scale. We divided patients into 2 groups: G1- mild/no depression (HAMD 0-16, n=89, mean age-32), and G2 - patients with moderate/severe depression (HAMD>16, n=51, mean age - 39.4). T-test was used for statistics. Findings: Results for each SF-36 domain (D) in the groups (G1/G2): D1 Physical functioning - 77.3/39.3, D2 Role limitations due to physical health - 48.9/10.6, D3 Role limitations due to emotional health - 52.6/8.1, D4 Fatigue - 59.4/31.6, D5 Emotional well-being - 60.2/34.8, D6 Social functioning - 75.5/36.7, D7 Pain - 76.1/36.3, D8 General health – 53.8/29.9. Our results show that means of all SF-36 domains in G2 were significantly higher than in G1 (p<0.001). Discussion: We found that the higher depression rates are in epilepsy the lower HRQOL is. Depression influences not only emotional domains, but also physical and social functioning.

Background: Social-cognitive determinants have been studied to explain and predict the adoption and maintenance of regular physical activity. This review aims to synthesize the outcomes of published studies that have investigated the 21 associations among such constructs and with physical activity on the basis of the Health Action Process Approach (HAPA). Method: A systematic literature search has been conducted for HAPA-based articles that report associations between social-cognitive constructs and physical activity including cross-sectional, longitudinal, and experimental research designs. Findings: Among the 32 studies initially identified, 11 were included in the meta-analyses with a total sample size of 2677 participants. Their age ranged from 12 to 93 years (mean 43.91 years). The majority (63%) were women, 36.75% were patients, and countries of origin were the U.S., South Korea, Germany, and France. The summary effect sizes for all model associations, except for paths involving risk perception, were positive and significant (all p<.001) but they remained heterogeneous. Moderator search yielded no evidence that moderators (i.e., country, age, gender, study design, and sample type) had systematic effects on the associations. Conclusions: Meta-analyses on the 21 paths in the HAPA resulted in high associations among social-cognitive constructs and with physical activity. To identify more homogeneous subsets of associations, another meta-analysis with a larger sample of studies is needed that allows to test a multitude of putative moderators.

Background: Medical care are developed to combat obesity such as bariatric surgery. In spite of the existence of many therapeutic education programs, a significant number of therapeutic failures are observed with patients, because of presence of psychic resistances that prevent them for adopting behaviors in favor of the loss of weight. This research is focused on the psychic resistances in the loss of weight and attempts to highlight the emotional, cognitive and behavioral processes which explained the origin of these resistances. Methods: Population : Four patients with obesity (average : 40,5 years). Methodology: qualitative approach. Data collection: semi-structured interviews. Data analysis : using IPA and clinical analysis. Finding: - Most of patients lived traumatic experiences. To defend themselves against the psychic tensions, they adopt a compulsive consumption of food ; - The patients associate their eating habits with the family model ; - Their feeling to exist become intensified by consuming food ; - Submit to a conflict in the Ego, these patients are urged to adopt behaviors sometimes in favour, sometimes against a loss of weight. Discussion : This research allow us to consider that these defensive and identity functions are at the origin of the psychic resistances in the loss of weight. A therapeutic education, which would consider these elements related to the subjectivity of patients, could constitute an interesting way for the care of patients in preparation for a bariatric surgery and to decrease the incidence of therapeutic failures.

Background: Active school travel (AST) (walking/cycling to school) can augment youth’s physical activity but 50% of UK children travel to school by car or bus. Evidence suggests that incentive schemes may be effective at promoting AST. Aim: To test the feasibility of an incentive scheme to promote AST in year 5 children. Methods: Using a cluster randomised design, schools will be invited to take part and two will be selected by a match of features (e.g. area, free meals). An information pack and parent questionnaire will be sent home. Participation may be complete or limited to baseline assessment, intervention phase or semi-structured interviews about taking part in the study. Both intervention and control groups will report their daily travel mode to school via parental forms and wear an accelerometer, to help validate the reports. The procedure will last seven days at baseline and one school term during the intervention. Once a week, the researcher will visit the intervention classroom, collect the forms and accelerometers, download the data and count the “points”: the number of parent-reported AST days. Each point is a ticket with the child’s name on entering a weekly £5 voucher draw. Similar contact will be kept with the control school (no incentive scheme). Interviews will be conducted throughout the intervention. Findings: Data on barriers and facilitators will inform a future trial.

This review explored the role of technical condom use skills development techniques in improving consistent, correct and complete condom use, and reducing sexually transmitted infection (STI) incidence. The optimal mode of delivery for specific techniques was explored. Electronic databases, reference lists and citations search located 18 relevant studies (21 conditions). Supplemental materials were acquired. Narrative synthesis was chosen to analyse the findings. Demonstration, practice, and self-monitoring were amongst components of interventions reporting increased condom use frequency and consistency and improved correct condom use. Together with home practice and behavioural experiment they contributed to reducing condom use errors and problems and improving condom use experience. No links were found between specific techniques and condom use self-efficacy or STIs incidence. Guided individual practice was superior to practice in a group setting. The review findings help to elucidate the factors and processes responsible for behaviour change. They may guide evaluation and design of interventions aiming to improve consistent, complete, and correct condom use.

Health messages congruently framed with peoples´ motivational orientation are more effective in promoting health behavior change, but inconsistencies have been found in the literature. This study aimed to test whether the perceived quality of a health message may moderate the congruency effect. Participants (N = 109) were exposed to a health message promoting fruit and vegetable (FV) intake that was either congruent or incongruent with their motivational orientation. Perceived message quality and intention to increase FV intake were assessed after message exposure, and actual FV intake one week later. Main effects for congruency were not found, but significant interactions of congruency and perceived message quality were found for intention and FV intake. When messages were congruent, higher intention and FV intake were found when perceived message quality was high, and lower when perceived message quality was low. Smaller or no differences were found between levels of perceived message quality in incongruent conditions. Matching the frame to the recipient´s motivational orientation is only effective when the message is perceived has having good quality.

Background Participant observation refers here to a specific health psychology research methodology in which the researcher takes on a role of participant observer in the practice of health care under observation into natural situation of daily work of diabetes therapy. The researcher immerses him/herself in the institutional context and into the health care setting in order to experience with the other(s) professional(s) the daily routine of the treatment and prevention with patients on carrier of this illness. Method Studying the reality of doctor patient communication in the field of diabetes mellitus the researcher try to comprehend the motives and meanings of the subject´s actions from the viewpoint of those involved. On everyday lives questions may be propose: How this health care practice is been occurring? How the accompaniment of the therapeutic and prevention process is been working? This accompaniment is been working successfulness? How the relationship between professionals and patients take place? There is a dialogical communication in this interaction? Which events seem to be relevant in this context? To register the observations and data collection the researcher generally use techniques resources as field notes, self-analyses notes, reflexivity journal, interviews. Findings and Discussion The assemblage of those registered informations is organized and analysed according to health psychology theoretical reference on treatment and prevention in diabetes mellitus, type II. The results of this study must be discussed with the group where the participant observation takes place. Nevertheless, the results are relative to local and institutional micro-analyse. The research results are compared with the others been realised in similar organisational context and methodology and will be transformed in the education of patient - doctor communication in Brazil.

Participant observation in this context refers to a specific health psychology research methodology in which the researcher takes on a role as participant observer in the daily routine of the health care in a natural situation of everyday work. The researcher immerses himself/herself in the institutional context and into the diabetes mellitus health care setting in order to experience the daily routine of treatment and prevention. To register the observations and data collection he/she uses technical resources: field notes, self-analyses notes, reflective journals and interviews. This set of collected data is organized and analyzed in a critical movement between the experience of the participant researcher and the health psychology theoretical reference on the treatment and prevention of diabetes mellitus. The results are relative to local and institutional micro-analyses and must be compared with other researches carried out in similar organizational contexts and methodologies.

The study’s main objective was to analyze and evaluate the effectiveness of a Virtual Reality Program (VRP) in the prevention of risk factors in eating disorders. The nonrandom sample of 30 adolescent girls (M = 13.4 years old, SD = 1.13), were selected from a greater sample of girls (130) who had chosen a thin ideal figure and had dieted in the past six months. The research adjusted to a pretest and posttest design. Once the informed consent was obtained, a baseline was established using a self-report questionnaire (alpha = .90). The results were statistically significant in the expected direction, some of these were: ideal figure t(27) = 4.42, p =.0001; Mpre = 1.99 SD= .60; Mpost = 2.64, SD =.49 body image dissatisfaction t(27) = 4.67, p = .0001, Mpre = 2, 21, SD = 2, 1; Mpost = .50 SD= 1.3; Restrained diet, t(27) = 1.25 p = .001, Mpre = 2.49, SD= .70; Mpost = 1.61; SD = .52. The posttest was estimated a month after the pretest.The clinical significance test showed that a significant percentage of participants (48% - 70%) were in the out of risk category after the intervention. Although these results are preliminary, as it is necessary to evaluate their effects over time, they are encouraging because they showed not only a decrease in the risk factors, but also a congruent relationship between variables related to body image and eating behavior. KeyWords. An intervention program of virtual reality, a prevention program of risk factors, body image variables, disordered eating behavior, adolescent girls.

Encounters involving patients with Medically Unexplained Symptoms (MUS) are challenging for general practitioners (GPs) and patients who have different views on the origin of pain and divergent expectations, which can weaken the doctor-patient relationship. The study aims to highlight GPs’ abilities to preserve the doctor-patient relationship and their job satisfaction and investigate if they match patients’ expectations. 15 semi-structured interviews were conducted with GPs to explore their perceptions and reported practices about these encounters. Then online forums for MUS were analysed to highlight the patients’ experiences and expectations. Qualitative data were analysed with computer-assisted thematic analysis. Results show that the use by GPs’ of various sources of knowledge to give explanations to patients and the involvement in reflective practice groups improve their job satisfaction and understanding of patients’ condition. At once these GPs’ abilities tend to match the patients’ expectations about medical encounters. The findings could open ways to increase GPs’ and patients’ satisfaction about medical follow-up by improving GPs’ communication and reflective skills.

Delirium is the most frequent complication of hospitalization in elders. Delirium is treatable with anti-psychotic drugs but, due to their iatrogenic effect and worse prognosis after delirium onset, screening for risk factors and prevention are most efficient management of it. The innovative, interdisciplinary, multifactorial, volunteers-based non-pharmacological delirium prevention was founded on internal geriatric ward. Aim of the speech is to present the programme that is still in process of design and initial results of evidence-based evaluation research on its efficiency. Details of research design, advantages and difficulties of cunducting study in highly contextualized hospital environment will be discussed. The efficiency and cost-effectiveness of delirium prevention on the ward is evaluated retrospectively. Medical documentation of every patient introduced to the programme (patients being in logical contact and over the age of 70). Initial results will be available in spring after completing the first phase of the research. Randomized clinical trial is also planned in future phases of programme evaluation. Details of the design will be discussed during the presentation.

Background: The usage of alcohol, tobacco and other addictive substances (ATA) is a well known risk factor for chronic diseases and premature mortality (WHO, 2013) depending on complex biopsychosocial obstacles. The aim of study was to disclose the relationship between health related psychological quality of life (HRPQoL, SRH) and usage of ATA. Methods: The sample for this analysis was extracted from Kaunas regional health project, including 859 male and 1035 female investigated by scales of psychological domain of WHO HR QoL -100, SRH scale and selected items for ATA evaluation. Findings: Males and females of worse psychological functioning tend to cut usage of alcohol but generally use it more often. They are more willing to seek consultation of psychologist. Similar linkages were found with SRH (p<0,001) and spirituality evaluation. No linkages were found between psychological functioning and usage of tobacco and other drugs in males and females (p>0,05). Discussion: The findings disclosed complex relationship between indicators of psychological functioning SRH and ATA in adult population. It may be useful for health psychologists working in the area of prevention.

Background: Men are often portrayed as poor at managing their emotional health, but research is starting to explore ways in which men constructively engage with their wellbeing. This study aimed to explore men’s narratives of coping across the life course as part of a larger project looking at successful ageing. Methods: In-depth interviews were conducted with 40 older men (50-90 yrs), purposively sampled from Australia and the UK. Data was analysed using thematic analysis. Findings: Men’s strategies of coping across the life course were characterised by action and control. In childhood, coping tended to be passive as men lacked the agency to confront difficulties or find effective solutions. By adulthood men predominately described ‘taking action’ to cope with struggle and distress. Conversely, ‘go with the flow’ reflected a shift away from notions of taking control, with more men adopting this attitude in older age. Men’s accounts of ’positivity’ also appeared to privilege attitude above action. There were tendencies towards community (voluntary work) and constructive physical practices (yoga) in later life. Discussion: These findings highlight ways in which men's wellbeing is organised through age-relations and particularly sense of control. With age, some men shifted away from action-orientated approaches whilst others sustained control through a variety of strategies.

Background: We aimed to develop a home-based self-care support programme to improve quality of life in people with Heart Failure (HF). Methods: Intervention Mapping methods included 1) Needs Assessment: Interviews with patients, service providers and caregivers; systematic reviews of quantitative and qualitative evidence; consultation with experts and a 9-member patient group. 2) Construction of ‘mapping matrices’ of intervention objectives and determinants 3) Selection of intervention strategies using existing theory, a taxonomy of change technique and expert opinion. Findings: We produced a written ‘Heart Failure Manual’ and a training programme for intervention providers (who provide 4-6 contacts). There are 4 main self-care objectives (maximise physical fitness, manage stress/anxiety, manage medications, manage fluid balance) and 19 secondary objectives. The intervention is individually tailored and aims to increase understanding of HF and mastery of self-care through practice, self-monitoring and facilitated problem-solving. Discussion: Our self-care support intervention is grounded in theory, evidence and patient perspectives. A feasibility study and RCT are in progress.

Introduction: Assisted Peritoneal Dialysis (PD) involving family members allows more patients to get started on home-based dialysis with good clinical outcomes. The impact of assisted PD on patient and caregiver is not well understood. This study aimed to compare assisted-PD vs. self-care PD on adjustment outcomes for patients and caregivers. Methods: N=231 PD patients (89/142 assisted PD/self-care) completed measures of QOL and emotional distress. Caregivers (N=112) completed the Lay Care-Giving for Adults Receiving Dialysis questionnaire and Zarit Burden Interview. Findings: Casemix adjusted comparisons indicated comparable QOL between assisted-PD and self-care PD in all dimensions with the exception of the SF-12 physical component score) and the KDQOL- effects of kidney disease in favor of the self-care group (<.01). Levels of anxiety and depression were equivalent. Caregiver of assisted-PD patients reported more task orientated-duties (p < .01) yet levels of perceived burden were equal to family members of self-care PD. Discussion: Our findings of equivalent caregiver and patient outcomes in assisted-PD and self-care PD support the expansion of assisted PD utilization.

Background: According to Fredrickson and Losada, positivity ratio (PR) is the proportion between positive and negative emotions. Relationship between PR and well-being seems to be non-linear with a curve point around 3 for PR. The aim of our study was to examine the effect of positivity on burnout and work engagement. Methods: A group of white-collar workers (n=139) was evaluated with JAWS (PR), OLBI (burnout: disengagement and exhaustion) and UWES (work engagement: vigor, dedication, absorption). Results: The relation between PR and burnout subscales had a curvilinear pattern with a curve point around 2. A curvilinear relation was also found for PR and vigor, whereas for dedication and absorption it was linear. After the adjustment for the relation between burnout and work engagement, only vigor and dedication were associated linearly with PR. Discussion: The results confirm that in the work context the moderate positivity ratio is associated with the lowest burnout level. However, the relationship with work engagement is more complicated, suggesting a rather beneficial effect of PR increase on vigor and dedication. The mechanism underlying these relations needs further research.

Background: This study aggregates insights of three studies evaluating manager’s and employee’s view on workplace health promotion (WHP) in Switzerland. The studies' objectives were to analyze requirements and measures taken by companies and their appraisal from involved parties. Methods: Based on the findings of a quantitative study, inquiring 190 HR managers, two qualitative studies were conducted to evolve the manager’s role and the employee’s needs. Findings: Data show that managers are highly responsive to WHP issues. A wide range of activities are reported, however, activities are not embedded in a holistic concept. The employee’s interest in WHP activities is moderate. Employee’s participation in activities is low, ranging between 12 and 16 percent. Both, employees and managers rate infrastructure and workplace organization as their first priorities. Psychological dimensions, such as decision-making, responsibility, task fulfillment, are not perceived as important. Discussion: It is argued that WHP has become a growing issue among Swiss managers and employees. However, WHP is much linked to an understanding of health in a core sense, disregarding psychological dimensions.

Despite the fact that the prolongation in life span is considered as a positive progress, the preparedness of communities for this process is not satisfactory. World Health Organisation (WHO) defines the life quality as individuals’ perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. This study was conducted to evaluate the life quality and effecting factors among elderlies taking home-care. WHOQOL-OLD was used to collect data from (49 female, 51 male) elderlies who accepted to participate in the study. Mean score was 72,91±1,15. Participants who are female, with relatively high educational status, have more frequent contact with their children, and think that their life quality increased after receiving home-care have higher life quality score. Health promoting behaviours have become important in maintaining the functional independence and life quality. Since elderlies’ contact with their people affects the quality of home-care positively, a special attention should be given to develop home-care and to improve the communication skills of home-care providers.

Delirium is frequent complication of hospitalization in elders. Symptoms include cognitive and mood disturbances. Risk factors are: coexisting medical conditions, dementia, sensory impairment and many factors connected with treatment and hospital environment. Anty-psychotic drugs are treatment of choice but it might be iatrogenic: past delirium episode increases the mortality, morbidity and necessity of institutional care. Therefore, prevention of delirium plays a significant role. Literature review on methods used for delirium prevention will be presented. Delirium prevention divides into pharmacological and non-pharmacological methods. Pharmacological methods base on administering preventive anti-psychotic drugs' dose every hospitalized patient. Non–pharmacological methods include medical staff education, supportive care, information- and care-giving. Special attention will be given to second group of methods due to their additional benefits for patients. Because they avoid the implementation of additional drugs they protect patients form side effects and hospital from additional costs, what is a reason for further development of non-pharmacological delirium prevention.

The subject of the research is connection between psychosocial factors like: anxiety, life satisfaction, stress and selfesteem problems with voice production among the primary school teachers. 113 teachers have been examined. The group was examined by questionnaire methods (for measuring psychosocial factors) and Sheet of the Voice Emission Diagnosis (SVED) for measuring principle problems with voice production: breathing (respiration), phonation, articulation, efficiency of articulatory apparatus and resonators. It has been proved that there is correlation between psychological factors like: stress, anxiety and life satisfaction and problems voice production among teachers. Research can help with preparing for prophylactic programs for teachers in context of counteraction problems with voice production.

Background: Working parents experiencing time scarcity use food coping strategies to manage balance between work and family roles, potentially making more poor nutritional choices for their families. This study aimed to determine associations between working parents' time demands, parents' food coping strategies and their children's eating behaviour. Methods: A cross-sectional design; 53 parents of children aged 0-11 years completed measures on time demands, food coping strategies, their own and their child's food choices and meal patterns. Correlation and regression analyses were used to determine contributions to eating behaviour. Results: Mothers' time demands were associated with lower child fruit (r=-.30, p<0.05)and child vegetable intake (r=-.34, p<0.05), reduced child healthy eating (r=-.52, p<0.01), and mothers' higher missing of meals (r=.38, p=0.05) and poor meal planning (r=-.34, p=0.05), while mothers' food coping strategies contributed to children eating on their own (?=-0.37; p=0.01). Discussion: Working parents' perceptions of time scarcity and demands likely contribute to poorer family eating behaviour choices and meal patterns, suggesting perceptions of time scarcity may be an important factor counterbalancing more positive determinants of change and may need to be considered when applying current coping and behaviour change models to intervening with eating patterns and food choices.

This research was casual – comparative and The purpose of this study was to compare the components of family Functioning in family of patients with Tension-type headaches and patients without Tension type headache. The sample size in this study was 120 patients (including two groups with and without tension headache) who referred to headache clinic and public center of Baghiat Allah in 1392. The first group was selected by Convenience sampling method and the second group was selected randomly. For data collecting we used family functioning device (FAD) and for data analysis t-test and MANOVA analysis was performed. The results showed that there is a significant difference between family functioning in patients with tension-type headache and patients without tension headache totally. Also results showed that there is significantly difference between two groups in factors of problem solving, Communication, affective responsiveness, affective involvement, behavior control, and general functioning. we can conclude that one of the factors that causing or maintaining family functioning is tension-type headaches.

BACKGROUND: Melanoma of the skin is the third most commonly diagnosed cancer in Australia. Given the high incidence of sunburn in children and level of sun protection provided by parents is often infrequent and/or insufficient, this research employed qualitative methodology to examine parents’ beliefs about their young child’s sun safe behaviours. METHODS: Parents (N= 23; n=14 mothers, n=9 fathers) of children aged 2-5 years participated in focus groups to identify commonly held beliefs about their decisions to sun protect their child. Data were analysed using thematic content analysis. FINDINGS: A range of advantages (e.g., reducing the risk of skin cancer, developing good habits early in life, parental peace of mind), disadvantages (e.g., false sense of safety, prevent vitamin D absorption), barriers (e.g., inaccessibility, child refusal), and facilitators (e.g., routine, accessibility) to performing sun safe practices were identified. Normative pressures and expectations also affected parents’ motivation to be sun safe with their child. DISCUSSION: These identified beliefs can be used to inform strategies and interventions to improve sun safe behaviours in young children.

Background: The problems associated with substance misuse pervade the lives of the family as well as the individual drinker or drug user. As a result of being concerned about a person with an alcohol or drug problem, it has been estimated that approximately one hundred million people worldwide experience considerable daily dilemmas and stress. Treatments for substance misuse problems have, historically, tended to focus on the individual substance misuser only. Methods: An evaluation of a training program promote a whole organisation shift towards greater involvement of affected family members within one UK addiction treatment service. A two-phase mixed-methods quasi-experimental design, integrating action research, is described. Findings: Staff receiving training reported significant increases in positive attitudes towards family-focused practice; and increases in the proportion of family-focused practice in their daily routine work. Improvements in attitudes were also evident in the absence of the training package in the comparison group. Discussion: Supports an organisational platform to implement change towards more family-focused addiction treatment.

Aim: The aim of the project was to reveal the relation between the existential and psychological models of well-being and to examine its influence on the paradox of well-being. Method: The Existential Quality of Life Questionnaire (Görtz) measuring existential well-being on the basis of the Existential Fundamental Motivations (Längle), the Psychological Well-Being-Scales (Ryff) capturing psychological well-being, the Satisfaction with Life Scale (Diener et al.) eliciting subjective life satisfaction and the European Quality of Life Questionnaire (EuroQualgroup)measuring health status, were given to 65 elderly people. Findings: Existential well-being was highly correlated with psychological well-being and life satisfaction. When taking existential well-being into account, the correlation between health ratings and satisfaction with life disappears. Discussion: The high correlation of existential well-being with other forms of well-being displays its convergent validity and highlights its central role in surveying well-being. Furthermore, existential well-being might be seen as a factor of resilience protecting a person’s life satisfaction in spite of low self-reported health status.

Coping assessment has focused on coping as a general trait and has overlooked the context effect, although it has been noted that considering the situation could improve the explanatory power of tests. Therefore, we aim to develop a contextual coping questionnaire for adults (CCQA). After reviewing previous coping studies and measures for our correlational study, we developed a 40 item scale related to five problem areas – work, close person relationships, own health, close person health and economy. It was completed by 416 adults. Confirmatory factor analyses were carried out with AMOS to compare a basic model which did not consider the context to a nested model that considered it. Reliability analyses were also conducted. The analyses yielded good reliability indexes (?=.78 for the complete scale; from ?=.71 to .88 for the coping strategies subscales). The nested model fit was acceptable (X2/df=2.49; GFI=.82; CFI=.86; RMSEA=.06), and better than that of the basic model (X2/df=3.24; GFI=.77; CFI=.77; RMSEA=.07). These results emphasise the importance of considering the different contexts when assessing coping strategies for designing interventions to improve health and well-being.

Childsmile Support Workers facilitate parents with child dental registration and attendance. Their approach is tailored to families’ needs. However the specific actions or strategies involved in tailoring are unclear. This study explores how tailoring is defined, why it is thought to be important and how it is implemented. Focus groups/interviews were conducted with Childsmile stakeholders and service users. Thematic analysis was conducted using the Framework approach in NVivo. Themes relating to the meaning and implementation of tailoring were; ‘taking account of delivery environment’, ‘responding to differing needs’, ‘empowering parents’, ‘considering preparedness for change’, ‘utilising flexible communication strategies’ and ‘developing a relationship’. Tailoring was thought to be important ‘because it is more likely to be effective’, ‘there is flexibility to address specific barriers’ and ‘tailoring promotes engagement’. Understanding if and how tailored support can be implemented lays the foundations for later phases of this project which, ultimately, will lead to a better understanding of how lay health worker interventions can be tailored in order to optimise effectiveness.

Background: Current thinking suggests measuring social progress and national wellbeing requires something more than GDP. Method: We employed a novel approach to the design of a national wellbeing index by experts, citizens, and politicians. Participants first generated a list of strategic objectives to guide efforts to enhance the wellbeing of the Irish public. A systems science methodology, Interactive Management, which optimises deliberation and co-design in group settings and graphically represents inter-relations between ideas generated, was later employed. This facilitated participants in further developing strategic objectives within each domain. Findings: Domains for which strategic objectives were developed included Education, Business and Employment, Community, Health, Democracy, Environment, Sustainability, Governance, Lifestyle and Equality. An influence structure highlighted governance involving community participation as the primary driver. Discussion: Different countries have focused more or less on citizen consultation in the design of wellbeing measures and policies. We believe involving citizens to be crucial and have developed an effective way of doing so.

Background: This study focuses on aspects related to osteoarthritis, emphasizing how persistent pain and complications occurring can lead to impaired quality of life, psycho-behavioral disturbances such as inability to engage in activity, psychological complaints / somatic and affective disorders and sleep disorders. Methods: The study included a number 72 patients with osteoarthritis, aged between 19-78. Data collection was performed using SF-36, SCL-90 and VAS scale. Findings and Results: The evaluation of results on the whole group revealed as the most affected domain the pain one, in which 78,3% of osteoarthritis patients declare problems. Evaluation on age groups reveales that osteoarthritis patients aged 30-40 have the highest score in D6 and D7 domains and patients in age group 55-78 declare severe pain and interrupted sleep. Conclusions: Patients with osteoarthritis tend to report that they are hampered severely in their capacity to perform their day-to-day physical and social activities, and those with severe disease have the worst SF-36.

Background: The aim of the study was to assess quality of life in patients with chronic haemophilia arthropathy (CHA), and evidence of correlation between chronic pain and life quality domains. Methods: The study included a number of 46 patients with CHA, aged between 16-45 in the period 2012-2013. For this study we used quality of life questionnaire WHOQOL and VAS to measure joint pain. Findings: The statistical analysis has revealed a significant correlation between chronic pain and quality of life (p <.01). Our results revealed that haemophilia severity had influence on physical and psychological domain, independence level and the general state of health. We observed significant differences in social relationships, personal beliefs and pain related to socio-professional status (p <.05 and p<.01). Discussion: Limitation of articular mobility and pain leads to a decrease in life quality of haemophilia patients. WHOQOL data may impact on care options and therapeutic process.

Methods: 200 parent-child dyads participated in this longitudinal study (with a baseline measurement and 6-month follow-up). Self-report measures, such as Comprehensive Feeding Practices Questionnaire (Musher-Eizenman i Holub, 2007) were applied, along with objective measures of body weight and fat tissue. Findings: High levels of restrictive practices reported by parents (parental control the child’s food intake and limiting sweets and fatty food intake) were predictive of children’s report of their hiding behavior (hiding eating unhealthy snacks, eating more than allow parents), which in turn was related to unfavorable changes in fat tissue among children. Discussion: Parental who strongly rely on practices aiming at a restriction of specific types of food may promote fat tissue increase, with hiding behavior playing the mediating role.

Due to the demographic change the health care sector faces a particularly intense shortage of skilled staff as well as a situation of increasing work-related strains. To support employees’ health and to reduce their strains organizational characteristics are of importance. The presented study investigates the effects of organizational characteristics on employees’ health and organizational performance. Data was collected in 28 nursing homes, surveying the head of management, supervisors and employees (n = 1.017). Employees’ health, commitment and work satisfaction as well as organizational characteristics were measured by questionnaire. First results show significant correlations between employees’ health, commitment and organizational characteristics. Moreover multivariate analysis was calculated, identifying organizational characteristics, in particular the care for employees, as significant predictors of employees’ health and commitment. The findings underline the importance of organizational characteristics for employees’ health. Putting employees’ needs in the center of attention reduces not only their strains but leads to greater employee engagement.

Background: Considering the burden of widespread mental disorders posing on societies and the urgent need to enhance General Health, the aim of this article is to "Evaluate the effect of Tai Chi(TC)on enhancing General Health and Mood”.TC is a mental-physical exercise which can enhance mental health.It is also known as “Meditation in motion” with mindful breathing.Our aim was to determine the effect of TC on enhancing General Health and Mood. Methods: This design is pre-test and post-test design with a control group. A total of 20 men and 20 women practicing TC(beginners)in Tehran gyms, participated in the present study.Materials used in this study were Positive and Negative Affect Schedule(PANAS) and General Health questionnaire(GHQ-28). Findings: Wilks Lambda test showed that General Health trend in pre-test and post-test was significant. TC’s effect on enhancing General Health was 38.3%.Co variance analysis showed that TC's effect on changing Negative Affect was 24.6%.TC's effect on Positive Affect change was 2.4%. Discussion:considering the urgent need for inexpensive and effective strategies to improve General Health,TC was proven in our study to be a beneficial alternative.

The present study examined the effectiveness of mindfulness-based stress reduction, stress reduction training psychology students PNU done. To this end, 30 students were randomly assigned to two groups. Stress levels were determined in all subjects and 8 sessions of mindfulness-based stress reduction training method. Assigned to the control group after group training sessions. The complete 8-session stress levels in both groups were tested again. Results were analyzed using ANCOVA results suggest that reducing stress in the experimental group. Keywords: stress, mindfulness based stress reduction

The purpose of this study is to investigate the effect of schema-focused-group therapy on increasing marital adjustment in Womens with Multiple Sclerosis. The data was gathered by giving the Dyadic Adjustment Scale )DAS( to 30 individuals were selected through accessible sampling method in Iran MS Association.These females were randomly assigned to the experimental and control groups. After random selection of the groups a pre-test was given to the both groups. The experiment group received the treatment (SFT) and finally both groups were given a post-test. Data was analyzed using ANCOVA. The findings of this study indicated the significant differences between two groups after intervention . Key Words: Schema-Focused-Group Therapy, Marital Adjustment, Multiple Sclerosis. Faculty of psychology of karaj slamic Azad University, Moazen Blvd.,end of Gohardasht Ave.

The aim of this research is to study the relationship between the attachment style with affective self regulation. The sample of 117 individuals, was drawn through the accessibility mode from a larger statistical population consisted of female patients with Multiple Sclerosis . Adult attachment style and affective self regulation were also administered. in addition to methods of descriptive statistics, pearson correlation test have been to analyse the data. Results indicated that secure attachment style was negatively, significantly correlated with the negative affective self regulation. Key Words:Attachment Style, Affective Self Regulation , Multiple Sclerosis

Background This study aimed to examine the role of affective and interpersonal processes in the relationship between trait resilience and psychiatric symptoms. Methods A total of 284 Chinese university students were recruited and administered questionnaires that assessed trait resilience (Resiliency Scale), positive rumination (Responses to Positive Affect), negative rumination (Response Style Questionnaire), adult attachment styles (Relationship Structures questionnaire), relationship satisfaction (Relationship Assessment Scale), anxiety symptoms (State-Trait Anxiety Inventory), and depressive symptoms (Beck Depression Inventory II). Findings Latent-variable structural equation modeling revealed that affective and interpersonal processes mediated the association between trait resilience and psychiatric symptoms. The inverse association between trait resilience and psychiatric symptoms became positive in the mediation model, suggesting that the associations between trait resilience and psychiatric symptoms could be observed only after considering the impact of the two processes. Discussion This study provided evidence on specific underlying affective and interpersonal processes of resilience and possible direction for intervening resilience.

Background : This study is focused on neurologists’ real-life experience of breaking bad news in multiple sclerosis, their perception of their patients’ relationships and their perception of patients’ emotional, cognitive and behavioral reactions during this announcement in order to improving communication with multiple sclerosis patients. Methods: population : 15 neurologists ; data collection : semi-directive interviews ; data analysis : IPA and clinical analysis (qualitative approach). Findings: Themes with IPA : neurologist’s real-life experience of breaking bad news ; communications aspects and content of the diagnosis announcement ; complexity of the doctor-patient relationship in multiple sclerosis ; medical training and specificities of their profession… /Clinical analysis approaches: micro-traumatic impact on the doctor when he breaks bad news ; defence mechanisms mobilized ; empathy ; doctor’s anguish… Discussion : Psychic elements that we analysed, management of nonverbal communication and neurologist’s analysis of the patient’s reactions have an influence on the quality of the doctor-patient relationship, on the treatment adhesion and on the patient’s well-being.

Background: Self-medication behavior, promote by the successive health policies and by many pharmaceutical groups, tends to become generalized. The fast development of self-medication has to ask us questions about the factors that underlies it and on the potential negative consequences that can infer on people’s health. That’s why this study is focus on the self-medication behavior by young adults and on the psychic mechanisms that induce them. Methods: Population: 11 young adults; Data collection: semi-structured interviews. Data analysis: Grounded Theory and clinical analysis. Finding: themes developed: representation of the medicine and the self-medication behaviour; self-medication and feeling of autonomy; patient’s expectations and complexity in the general practioner-patient relationship; self-medication, relationship with the body and health capital; psychic mechanisms underlying self-medication behaviour; incorrect use of medical prescriptions. Discussion: Young adults have new representations of medicine and they express their difficulty to conciliate medical recommendations and the feeling of having to manage alone their heath capital (autonomy and responsibility).

Background: There are numerous studies exploring eating disorders (ED) in association with substance use. However, few studies have focused on the associations between ED and problematic internet use (PIU). Aims: (1) to explore the differences in PIU between female students at risk and those not at risk of ED and (2) to specify which ED indicators are the most important in relation to PIU. Methods: The sample size consisted of 453 Slovak female university students (average age 19.68, SD=1.56). The respondents completed a screening tool for detecting ED (SCOFF) and the PIU questionnaire (GPIUS 2) online. Mann-Whitney U tests were used for data analysis. Findings: The results revealed (1) significant differences in PIU between those at risk and those not at risk of ED, with more PIU for those at risk and (2) an analysis on the level of individual indicators showed that a higher PIU was found if these indicators were present: control over eating, body image distortion and impact of food on life. Discussion: The results support and contribute to previous studies and can be applied to prevention strategies of ED and PIU.

Background: In process at becoming a childcare worker can bring lots of unnecessary stress. Examining the stress of childcare training could help eliminate much of the stress that comes with being a childcare worker. A survey was done to help improve the technical college childcare worker training program. Methods: In the survey, 41students were asked the following 5 questions (Ex. What drove you to this training? What do you want to take from it? What did you find difficult about the training? ). Findings: The source of stress during training often varies. Upon completing the training, many students expressed an interest in learning how to better handle their children. Many trainees expressed that one difficulty in the training was the poor communication between training trainees, causing the trainees to lose confidence. Finally, a request from the trainees on how to better record the things they learned in a training journal. Discussion: Our school, as a technical school for childcare, reconfirmed the importance of nursing the character of the students. Therefore helping them cultivate strong children as a childcare worker.

Background:This study examines a stress-related growth model in Japanese 3rd year junior high school students facing an entrance examination, based on the conceptual model of Schaefer and Moos (1992). Methods:The participants were 191 students (96 male, 87 female, and 8 unspecified), who answered a socio-demographic questionnaire comprising the following: perceived social support (Hosoda et al., 2009); personality (Oshio et al., 2012); positive acceptance of adversity (Hatori et al., 2012); proactive coping (Iimura et al., in press); and stress-related growth (Iimura et al., 2012). We performed model process estimation through statistical analysis using structural equation modeling. Results:Structural equation modeling confirmed that perceived social support and personality correlated positively with stress-related growth (R2 = .67) via positive acceptance of adversity (R2 = .48) and proactive coping (R2 = .90). The fit indices of the model were CFI = .90, RMSEA = .06, and AIC = 1153.00. Discussion:These findings suggest that environmental and personal systems affect cognitive appraisal and coping response; therefore, examination stress stimulates students’ psychological growth.

Background:The purpose of this study was to examine the efficacy of a tailored education program based on behavioral and psychological factor. Methods:Caregivers of asthmatic children were randomly assigned to the tailored education or non-tailored education groups. The former underwent a tailored program using a touch-screen computer, in which they received tailored messages generated by a computer program. A research nurse and clinical psychologist used computer-based resources to tailor the education messages and provided counseling to the caregivers, using motivational interviewing. The second group received only a booklet on asthma. Participants were asked about their asthma knowledge, self-efficacy on self-management, asthmatic parents’ quality of life scale (QOLCA). Findings:A total of 65 caregivers were randomly assigned to each groups. The results of general linear mixed models, the tailored education group was observed to have increasing at asthma knowledge scores and QOLCA scores over time, as compared to the non-tailored education group. Discussion:The current educational intervention was thus shown to significantly improve the quality of life of the caregivers.

Background: Children involved in sport or physical activity related to their body image more adequate than children not practicing physical activity. Coach usually plays an important role in the formation of body image of children involved in sport. Methods: Participants were 125 adolescents, 9-12 years: 110 athletes (55 girls, 55 boys) and 115 non-athletes (60 girls, 55 boys). The "Questionnaire measuring body image and dissatisfaction" was used. Findings: The images of the real and the ideal body in the group of athletes were almost identical. Sports protect athletes from dissatisfaction with their body. But athletes are more critical for their bodies. Girls more than boys are worried about their weight, and girls-athletes more than non athletes. In sports environment children are less teased by their peers than in the school. The formation of body image is greatly affected by parents and peers, and among athletes - by coaches. Discussion: Sport and physical activity facilitate the formation of an adequate image of the body in childhood. Regular practice of physical activity may be a method to overcome personal complexes associated with the perception of their body.

The present study describes the development and validation of an indigenous scale for Pakistani population to assess their resilience against terrorism. An extensive exercise and effort was put in to identify resilience related constructs particularly in Pakistani cultural context along with considering its theoretical and literature background. Initially, a fairly large pool of 120 items, ultimately reduced to 74, was generated out of 3 focus groups and in-depth interviews with experts, university students, teachers, police, army and rescue personnel, common public witnessing terrorist attack or being victim to it. Empirical evaluation was done on 435 men and 324 women from all walks of life throughout country. Principle component factor analysis with was computed to determine construct validity that provided four factors solution with 52 items (loading ?.40) labeled as Pessimism, Self efficacy, Optimism, and Religiosity/Education; all four sub-scales showed significantly high reliability and for total RATS. Hence, the resilience construct for Pakistani public fighting against war on terror were discussed in the international as well as national context particularly.

The present study aimed to explore the Psychosocial Factors and Common Mental Disorders in men who were seeking treatment for Erectile Dysfunction from different health professionals. A Structured Interview was devised by the researcher to look into demographics, interpersonal, marital/sexual, health and treatment related areas of the participants. The International Index of Erectile Function (IIEF-15) and General Health Questionnaire (GHQ-28) were used to assess erectile functioning, depression, anxiety, somatic complaints and social dysfunctioning in the sample. From March to June 2012, a total of 109 men from outpatient clinics of different health professionals were recruited who fulfilled the ICD 10 and DSM IV criteria of Erectile Dysfunction. The results of this study showed that most of the men were seeking herbal treatment, had a mean age of 33 years, educated up to matriculation, were married and living in joint family system. The correlates were found to be relationship with father, relationship with wife/partner, effects of Erectile Dysfunction on life, interest in sex, frequency of sex, satisfaction with sexual life, anxiety, and depression. The strongest predictors of Erectile Functioning were relationship with wife/partner, interest in sex, relationship with father, drug abuse before Erectile Dysfunction and satisfaction with sexual life. The men reported substantial implications of this dysfunction on their psychological well-being so there is a need to cater the Psychosocial Factors in devising a complete treatment plan for men having this problem. Key Words: Erectile Dysfunction, Psychosocial Factors

Background: The purpose of this study was to examine the effect of giving and receiving support on self-efficacy and health behaviors. Methods: Participants: 50 healthy college students. Measures:Giving and Receiving Emotional / Instrumental support Scale. Generalized Self-Efficacy Scale. General Health Questionnaire. Life Style Questionnaire Procedures: Participants were randomly assigned to two groups (the providing support group and the receiving group).Participants of providing support group were instructed to make a program for improvement of their peer’s health behavior and to act as a peer coach (60min-5sessions). The receiving group had 5 traditional health education. Results and Discussion: The result showed that the improvement of health behavior in the providing support group were superior to the receiving group. And the providing support group demonstrated significantly higher scores on Generalized Self-Efficacy. They suggest that providing support could increase not only their knowledge in their life style problem but also positive motivation for health behavior.

Background: Different research showed that Machiavellianism highly correlates with manipulative behavior and also based on the self-regulation deficiency. The problem becomes dramatic in case of high suicidal risk of borderline patients, vulnerable to disorganization as a consequence of experiences of abandonment and stress because of brittle mental representations of self and others named by P.Fonagy "mentalization deficit". Methods: Mach-IV scale, Cognitive Scale for level of abstraction qualification, Rosenzweig Picture-Frustration Study. In our research took part 40 patients with suicidal attempt passing the therapy in hospital and 40 people without suicidal attempt (control group). Findings: Experimental group has statistically higher level of Machiavellianism than control one. Moreover, patients with high Mach have multiple suicide attempts and severe thinking and mentalization disturbances. Discussion: understanding special manipulative style including cognitive and mentalization deficits of such patients will help to establish productive relations with them and, in general to increase the effectiveness of psychotherapy and decrease suicidal risk.

Background: The Internet Addiction Scale (ISS), developed in the field of health psychology, is a German questionnaire consisting of 20 items. It is used to screen for Internet addiction. The study aims to replicate the factor structure of the ISS. Methods: Exploratory (EFA) and confirmatory (CFA) factor analyses were used to replicated the factor structure of the ISS in a sample of 1123 German adolescents and young adults (M=22, SD=3 years, 52% female). Results: EFA with default on 5 factors yielded no satisfactory solution; the results spoke for a one-factor solution. CFA of the original factor structure (5 scales and total value) showed insufficient model fit criteria (?2=1504.3, df=165, p<0.001, RMSEA=.09, CFI=.86, TLI=.83). Based on these results, items were eliminated. CFA showed acceptable model fit criteria (?2=985.2, df=125, p<0.001, RMSEA=.08, CFI=. 90, TLI=.87). Discussion: The proposed scale structure of the ISS could be replicated neither using EFA nor using CFA in the present sample. The results indicate that some items should be eliminated and others reworded. Further conceptual and psychometric research on the dimensionality of Internet addiction is needed.

Background: Distress and resources of healthy siblings of chronically ill or disabled children have been investigated only in a few studies. Findings point to a reduced quality of life and increased prevalence of behavioral problems, but they’re hardly any approaches to primary prevention. Aim of the study was to carry out expert interviews to detect the need for support from an expert point of view. Methods: 10 experts, people who work with chronically ill or disabled children or with their siblings in the medical, educational and or social area, were studied with semi-structured interviews concentrated on help and support requirements. Interviews were analyzed according to qualitative content analysis. Findings: The results showed that the experts consider the relief of the parents and the child-oriented teaching of coping strategies, social skills training and resource activation as very important elements of support. Discussion: Apart from the results of the expert interviews, interviews with siblings should be carried out to take account of their needs when developing a primary intervention for siblings of chronically ill or disabled children.

Background: The aim of this study was to explore the role of social support, emotional well-being and personality traits in changes of alcohol consumption among university students. Methods: 190 Slovak university students participated in a longitudinal online study. We compared the data collected in the first and second year of their university studies using Wilcoxon tests and regression analysis. We modelled the change in the alcohol consumption score for each individual as a function of changes in their social support, emotional well-being, personality traits and intimate relationships.Findings: We observed a significant decrease in social support and a significant increase in emotional well-being and alcohol consumption. The increase in alcohol consumption can be explained by the decrease in social support, by changes in emotional well-being, by having no intimate relationships, by higher levels of agreeableness and by lower levels of extroversion.Discussion: The results point to several important variables which could explain the increase in alcohol consumption among university students and which may prove useful for precise targeting in health-related prevention programmes.

The aim of the present study was to evaluate the association between accessibility of healthy und unhealthy foods, the use of self-regulatory strategies, nutrition and body weight of children and adolescents. The questionnaire study was attended by 1,170 pupils aged 12 -17 (M = 14.09, SD = 1.63). There is a significant association between the accessibility of unhealthy foods at home and outside of home and snacks eating, but the relationship wasn't significant if the level of the use of self-regulatory strategies based on controlling and avoiding temptations was high. Similarly, there is a significant association between the accessibility of unhealthy foods at home and the consumption of sweetened beverages but the relationship wasn't significant if the level of the use of self-regulatory strategies based on avoiding temptations was high. In summary self-regulation was a moderator of the relationship between the accessibility of the unhealthy foods and nutrition. The relationship between the foods accessibility and body weight were not significant.

The aim of the study was to evaluate emotional and psychophysiological reactivity to cognitive stressor of individuals having type A behavior pattern. 100 undergraduate students (50 type A and 50 type B) participated in a study. Attention concentration ABQ test was used as a stressor. The participants were asked to perform ABQ test while given 3 different situations: when giving basic instructions, when giving the instructions with time limitations and stimulus to compete and when criticizing while doing the task. Psychophysiological reactivity to stressors was measured using biofeedback device Nexus-10 by Mind Media. Emotional reactivity during the performances of the tasks was evaluated using Emotional Assessment Scale. The results of the study showed that type A individuals had higher psychophysiological reactivity to cognitive stressor than individuals having type B behavior pattern and they felt more negative emotions during the task. The findings explain one of the possible mechanisms why type A individuals are more likely to suffer from coronary heart disease.

Background: Our knowledge about illness perceptions among persons treated for colorectal cancer (CRC) and their partners is incomplete, as is our knowledge about how the context of cancer care environments affects illness perceptions. The aim of the present study was to explore illness perception in relation to cancer care settings and healthcare information among CRC survivors and their partners. Methods: Nine survivors and nine partners were interviewed, and grounded theory was undertaken, using the method presented by Katy Charmaz. Findings: The results were presented in the core category Outlook on the cancer diagnosis in a ‘quick-fix’ environment, which illustrated how the illness perceptions of survivors and partners were influenced in various ways by environment and healthcare semantics as well as personal approaches and lay beliefs described in the conceptual categories outlook on the cancer diagnosis, experiencing a ‘quick-fix’ environment, approaching information and interpreting healthcare language. Discussion: Healthcare professionals should pay attention to illness perceptions among survivors and partners and adjust the information provided to different perceptions. The commonsense model of illness representations offers the practical guidance needed to recognize the potential of illness perceptions and to achieve the goals of contemporary cancer care.

The main goal of the present study was to examine the protective function of subjective well-being against the negative effects of stressful life events among adolescents. The sample consisted of 317 Serbian adolescents (52% females, mean age = 17 years). The following scales were used: Life Events Checklist-Adolescent version, Satisfaction with Life Scale, Positive and Negative Affect Schedule and the Stress subscale of the Depression, Anxiety and Stress Scale. Moderation effects of affective well-being and life satisfaction in the relations between negative life events and symptoms of stress were tested with multiple regression analysis. The results did not support the buffering hypothesis regarding the protective role of subjective well-being. Neither affective component nor cognitive component of subjective well-being moderated the negative life events-stress relationship. The findings of the presents study suggest that high subjective well-being does not protect adolescents from adverse effects of stressful events.

Background: The use of motivational interviewing (MI) for changing unhealthy behaviour of ischemic heart disease patients forces us to find methods for its effectiveness evaluation. One of the solutions could be the transtheoretical model (TTM). It is a stage-based theory of behaviour changes. Movement through the stages is hypothesized to be caused by the processes of change, decisional balance and temptation. The objective of this study is to find out how TTM can show health behaviour changes for ischemic heart disease patients. Methods: One to three MI sessions has been successfully applied for 12 cardiac patients during their rehabilitation treatment period. TTM’s Readiness to Change Questionnaire was used to evaluate behaviour changes at the beginning and at the end of MI treatment. Findings: There were 7 patients at precontemplation, 5 at contemplation and none at action stages at the begining of MI sessions. Results showed that 5 patients stayed at contemplation stage but 4 patients moved from precontemplation to contemplation and 3 from precontemplation to action stages after MI interventions. Discussion: TTM evaluates health behaviour changes even after brief intervention.

Current challenges of the healthcare system call for interdisciplinary cooperation of health professionals. The university is responsible for disposing students accordingly. Social representations theory was used as a framework for studying the social representations of health of allied health professional students and faculty. Study 1: Students (N = 465) completed a pile sorting task (sorting 142 health terms according to perceived similarity). Non-parametric multidimensional scaling yielded three essential dimensions: individual vs. system, therapy vs. prevention, and health threats vs. controllability (Kada et al., 2013). Study 2: Leading items from each dimension were presented to 131 lecturers in pairwise comparisons of health terms’ importance for education (N = 8724 completed paired comparisons). Conditional logistic regression models were applied for analysis. Judged importance was highest for terms covering specific duties of lecturers own professions (McFadden's LRI = 0.127). Thus, interdisciplinarity was not regarded a key element of education. Results call for and may support the creation of learning environments enabling students to think outside the box of their own professions.

Background: Smoking put nurses’ health in danger and it can become a serious obstacle for taking tobacco use prevention initiatives at their work. Methods: A cross-sectional study was conducted to estimate the prevalence of smoking among nurses and to identify restructuring related psychosocial risk factors associated with this health damaging behavior. The sample consisted of 775 nurses (age: X=38.8, SD=8.8; response rate was 91.25%) from 13 randomly selected hospitals that undergo restructuring in Lithuania. The questionnaire was designed according to European Model Questionnaire of European Monitoring Centre for Drugs and Drug Addiction, special scales were developed to measure restructuring related psychosocial risks at work. Binary logistic regression with bootstrap was used to analyze the data. Findings: In the studied group, 20.1% of nurses reported smoking in last 12 months what was quite similar to the corresponding prevalence rates among 35-64 year old Lithuanian woman (21.9%). Procedural justice of hospital restructuring implementation, working hours per week and hospital level predicted smoking behavior of nurses. Discussion: The results suggest that it is important to reduce the smoking behavior risk for nurses by creating health promoting psychosocial work environment particularly in the period of intensive changes at work such as hospital restructuring. Key words: smoking, nurses, hospital restructuring, psychosocial risk factors

Background: The more sensitive parents are to their children’s developmental and emotional needs, or the better the parents are to mentalize, the more successful the child’s socioemotional and cognitive development. The aim of the present project is to enhance parental mentalization capacity through a new group intervention for first-time parents. Generally, the aim is to support well-functioning models of parenting, prevent transmission of negative parenting models over generations and thus promote child development and overall family health. Methods: The intervention is a renewed format of a 12-session group intervention originally developed at Yale University. Parents are trained to reflect on their child’s experiences, feelings and needs in relation to child behavior. A web-based research evaluation (200 intervention families, 1000 control families) is performed evaluating mentalization capacity, parental stress, marital satisfaction and overall child development. Evaluations are performed for baseline data, at pre-intervention (3-4 months), post-intervention (1-year) and a follow-up (2-years). The intervention, research design and preliminary data will be presented.

Volunteers-based non-pharmacological delirium prevention was founded on internal geriatric ward. Volunteers' saily assistance is known to improve patients’ well-being and are proved to be effective in delirium prevention and outcomes improvement. Qualitative study was conducted to explore variety and dynamics of experience of voluntary work on geriatric ward. The special interest was given to volunteers’ motivation, values, believes concerning work and attitudes toward elders and the change of those aspects in process of care-giving. 20 volunteers were interviewed about their lived experience of voluntary. Transcribed data were submitted to IPA. Great emotional burden connected with the care-giving in geriatric ward and confrontation with corporeity, severe illness, difficult aging, death and traumatizing hospital environment lead to decreased motivation and frequent drop-outs. The necessary need for supervision and psychological support for volunteers were identified. Context-dependent findings have significant implications for proper management and safe environment for volunteers on geriatric ward with respect to individual differences of motivation, values and attitudes.

Many children in Europe live in families that have migrated to other countries. Yet little is known how their parent’s migration decisions and their subjective well-being impacts subjective well-being of these children. This paper examines subjective well-being of Latvian immigrant children in the UK using a sample of 50 families who have children who were born in Latvia but have moved with their families to the UK and have lived there for at least five years. A questionnaire developed for the purpose of this study was used to measure cognitive and affective components of subjective well-being, as well as parent's migration intentions and children’s migration preferences. We found that there was a strong positive correlation between children’s and their parents’ subjective well-being levels; intentions to stay in the UK also were positively link to subjective well-being of children and parents. This research has been funded by the EU project “The emigrant communities of Latvia: National identity, transnational relations, and diaspora politics” No. 2013/0055/1DP/1.1.1.2.0/13/APIA/VIAA/040.

Although rumination is an important factor of meaning making to overcome stressful experiences, this relationship has not been clarified in detail. This study used a retrospective method to examine how intrusive rumination and deliberate rumination influence meaning making and clarify the mechanisms underlying meaning making. First, 97 participants completed a questionnaire assessing executive function, self-rumination, and self-reflection. Next, they answered questions about stressful events to ascertain aspect of subjective evaluation, intrusive rumination, deliberate rumination, the contents of meaning making, and posttraumatic growth (PTG). Results showed that self-reflection promoted deliberate rumination, which also facilitated positive meaning making, and subsequently, positive meaning enhanced PTG. Further, when both intrusive and deliberate rumination immediately following the event were low, the content of meaning making was more negative. These findings indicate the importance of having time to deliberately consider the event for adaptive meaning making, and avoiding trying to inhibit rumination immediately after the event to prevent maladaptive meaning making.

The current study is based on the hypothesis that cyberchondria leads to poor well-being. We also hypothesise that certain personality traits are prerequisites for unfounded concerns about personal health following online information search. For the purposes of the study, in which 615 respondents took part, we applied a battery of questionnaires measuring: anxiety aroused by online health information seeking, cyberchondria, satisfaction with life, psychological well-being, eudaimonic well-being, depression, and personality traits. After carrying out regression and mediation analyses with the data, we registered that Neuroticism predicts anxiety aroused by online health information seeking, escalation and persistence of concerns. Negative associations were registered between Consciousness and escalation of concerns, and between Openness and health anxiety. Furthermore, the assumption that cyberchondria leads to decreased well-being was justified. The current study is the first of its kind in Bulgarian context and the results enrich research achievements in the field by bringing out new characteristics about cyberchondria which should be considered in addressing the problem.

Recently, aggression has been paid attention as a risk factor of mental health in college students in Japan, and then to cope and prevent an expression of aggression have been an important issue. To reduce aggression, improving life skills and increasing perceived social supports are considered to be effective. The purpose of the present study was to investigate the relationships among aggression, life skills, social support, and mental health. Subjects were 545 college students (222 males, 323 females, mean age: 19.8±1.2 years). Japanese Version of the Buss-Perry Aggression Questionnaire (Ando et al., 1999), Daily Life Skills Scale for College Students (Shimamoto et al., 2006), Japanese Version of Social Support Scale (Iwasa et al., 2007), and Japanese Version of the 12-Item General Health Questionnaire (GHQ12; Nakasugi, 1987) were measured by questionnaire method. Covariance structure analysis showed that the life skills scores were positively related to the social support scores directly, and then, social support scores were negatively related to the GHQ12 scores directly, and negatively related to the GHQ12 scores via the aggression scores (GFI=.998, AGFI=.992, RMSEA=.000). These results suggest that improving life skills contributes to promote mental health and to reduce aggression via increasing perceived social support from “Family”, “Friends”, and “Significant other”.

Background: Biological recovery function after mental stress has to date been proposed for the mediation process of stress into physical health. Methods: We continuously measured blood pressure of 142 young men before, during, and after mental stress tasks. Recovery function was calculated by our newly developed index, mean recovery rate (MRR) that is the recovery time-averaged area under the curve (AUC) divided by the task-induced reactivity. Before this experiment, we evaluated their state of depression and optimism by CES-D and LOT-R questionnaire, respectively. Moderation analysis was done using Johnson-Neyman technique. Findings: We found a significant association between the MRR and optimism above the 21.4 score of depressive symptom. Discussion: The MRR offers an advantage independent of the effect of the initial level of stress reactivity. The recovery function after stress is likely to be adequately associated with positive affective state at the high level of depression.

Background: The present examined relationship between protective factors, drug use and depression and meditational role of drug use in relationship between protective factors and depression. Methods: Sample comprised of 200 male drug users recruited from different hospitals and clinics in Lahore, Pakistan. The Communities that care youth Survey, Drug Abuse Questionnaire and Depression Scale were used for assessment. Findings: The results revealed that protective factors had negative relationship with drug use and depression while drug use had positive relationship with depression. Self controlling coping and interaction with pro social peer were the significant predictors of drug use and family rewards and drug use were the significant predictors of depression. Drug use mediated the relationship between protective factors and depression. Discussion: The findings have important implications for drug rehabilitation services, drug users, their families and communities who can play an important role as protective factors against drug use.

Background: The present study was conducted to investigate Optimism, Affect and Posttraumatic growth in the victims of domestic violence living in Shelter Homes in Pakistan. It was hypothesized that optimism, positive affect are likely predictors of posttraumatic growth in the victims of domestic violence. Method: The sample of (N=100) women was recruited from Darulaman, Dastak, Social Welfare Center, Lahore, Darulaman Bahawalpur and Darulaman Lodhran, Pakistan. Life Orientation Test, Positive and Negative Affect Schedule and Posttraumatic Growth Inventory were used for assessment. Results: Hierarchical regression analysis showed that Positive Affect significantly predicted posttraumatic growth but optimism did not predict posttraumatic growth in the victims of domestic violence living in Shelter homes. Conclusion: Findings have important implications for destitute women who find respite in shelter homes in Pakistan.

Background: Recently, a growing trend of suicide has been seen in children and adolescents in Pakistan, therefore the present research explored psychosocial risk factors of suicidal ideation such as personality, parental and teacher acceptance-rejection, anger impulsivity, depression, interpersonal relations, academic stress and intolerance in adolescents in Pakistan. Methods: Sample included 180 adolescents with equal number of suicide ideators and non ideators who were recruited from public and private schools and colleges in Lahore. The Big Five Personality Inventory, Parental acceptance rejection questionnaire, teacher acceptance and control-teacher acceptance-rejection/ control questionnaire, Inventory of Parent and Peer Attachment, Educational Stress Scale for Adolescents, Frustration Discomfort Scale were used for assessment. Findings: Class marks percentages; father’s monthly income, depression, anger impulsivity and worry about grades were significant predictors of suicidal ideation in adolescents. Discussion: the findings highlight the role of counseling and support for adolescents to help vulnerable adolescents cope effectively with stress.

Background: The present research was designed to investigate social support, coping strategies and perceived stigmatization in drug addict patients. It was hypothesized that perceived social support and coping strategies are likely to predict perceived stigmatization in drug addict patients. Methods: Sample comprised of 100 males drug addicts ranging in ages between 20 – 45 years and were recruited from different rehabilitation services based in Lahore, Pakistan. Perceived Stigma of Substance Abuse Scale (PSAS), Multidimensional Perceived Social Support Scale (MSPSS) and Coping Strategies Questionnaire (CSQ) were used for assessment. Findings: Perceived social support, use of active practical coping, religious focused coping had negative relationship with perceived stigmatization. Friends and significant others’ support and use of religious focused coping were significant predictors of perceived stigmatization.

Type D (the distressed) personality is associated with various noncommunicable diseases, their outcomes. Distressed personality is related with both physical as well as mental health (Molls, Denollet, 2010). Despite that the association between type D personality and cardiovascular diseases and their outcomes has been confirmed by scientific evidence (Denollet, 2005; Martens et al, 2010), the mechanisms accounting for these associations is still unrevealed (Kupper et al., 2013). One of the possible mechanism – Type D personality and stress reactivity (Habra, Linden, Anderson, Weinberg, 2003; Molloy et al., 2008). The objective was to review literature concerning Type D (distressed) personality disease-promoting mechanism - stress reactivity. The controversial results of the systematic literature review confirmes stress - reactivity of the Type D personality being one of possible mechanism revealing association between Type D personality and diseasest. Better understanding of possible mechanism is an important impact for the prevention and intervention, especially, talking about cardiovascular diseases.Implications for the future research are discussed.

Background:The aim of this study is to evaluate mood alteration and physical condition through a One-year Healthy Hill-walking Program for retired elderly in Kaminoyama, Japan. This program was designed as health promotion for retired elderly. Methods:Quantitative and follow up study was used for the study. Twenty-three retired elderly (range=59-70) participated in this program as subjects. Mood alteration was measured with MCL-S.2. Physical condition was measured with some questions, constructed by authors. Data were collected on 12-days hill-walking from 2012 to 2013. Participants answered the questionnaire before and after walking, and on the following day. Findings:Pleasantness and Relaxation scores in MCL-S.2 significantly increased after 9 and 6 times of walking, respectively (p<0.05). Anxiety score decreased after 4 times of walking (p<0.05). Waist and knee pain decreased after 6 times of walking (P<0.05). Some elderly commented positive relation between their sleep condition and this walking. Discussion:The elderly was able to promote perception of their mental and physical conditions and motivation for healthy custom.

Background: The hardiness is one of the personality characteristics which include the ability to have a right understanding from the environment and also the ability to make decisions for the individual, and the happiness is the positive individual’s idea toward themselves and their lives. The object of the present study is to evaluate the relationship between the hardiness and happiness among university students. Methods: In this study the correlation design was used. The sample consisted of 300 students which were randomly chosen. The measurement tools consisted of Kobassa and oxford scales were used. Data were analyzed via correlation coefficient of Pierson. Findings: The research findings stated that there is a direct and meaningful relation between the hardiness and happiness rate (r=0.80). Other results stated that there are also relations between happiness and the variables depending on hardiness such as commitment (r=0.44), control (r=0.26) and the challenge (r=0.33). Discussion: The results stated that there is a relationship between the hardiness and the variables depending on happiness, i.e. individuals, who consider stressful events of life as instructive, challenging and flexible events, and are prosperous with getting involved, influencing and open to challenges, and consider the changes as the common and unavoidable parts of the life, gain more happiness feelings.

Background: Recent studies on e-health web-based solutions show promising results. The main goal of this study was to facilitate change and increase daily life functioning for people who experienced traumatic stressors. Methods: 10 women aged from 20 to 61 years, who experienced at least one traumatic event, participated in this study. 8 session internet-based stress management program developed by the authors of this study included writing task once in a week, with a response from a professional psychologist. Functioning and health measures were made online. Research was funded by a grant (No. MIP-011/2012) from the Research Council of Lithuania. Findings: Stress management program had significant positive effects on health and daily functioning of participants. Discussion: This study demonstrated promising results of web-based e-health solutions for trauma exposed persons, and indicates perspectives of cost-effective stress management programs for prevention of health related problems.

Background. Excessive alcohol drinking, and binge drinking in particular, have direct negative outcomes in terms of economic, social, and health consequences. Investigating how to overcome binge drinking is an important area. One proposal is to raise the minimum price per unit/standard drink of alcohol beverages. Methods. Focus groups (28 UK; 14 WA) were conducted to gain insight into participants' views towards price policies. Transcribed focus-group discussions were analysed for emergent themes using inductive thematic content analysis. Findings. Analyses indicated that participants in the UK and WA showed 3 main themes: dislike, skepticism, and concern the policy may exacerbate problems. However, participants did outline several ways in which the policy may be made more acceptable. Discussion. UK focus groups agreed cost and availability was more of an issue than WA groups – which focused more on social and cultural influences. There is some support for minimum price policies only under certain conditions. The current research is important for policy makers attempting to raise the price of any product as a means of controlling its use.

Background: The project aims for exploring the paths to optimal development using empirical data of the longitudinal studies following individuals since 1956 (Prague) and 1961 (Brno). Methods: The sample of 88 Czech adults (49 women, 39 men) was examined besides the set of psychological methods also by somato-physiological measures (weight, height, BMI, WHR, systolic and diastolic blood pressure), selected biochemical measures (total cholesterol, triacylglycerides, glycaemia) as well as using the health questionnaire, and measures focused on selected behavioural aspects of health. Findings: As regards results of the linear regression analysis, BMI should be predicted in our study by NEO-C (Conscientiousness), interpersonal sensitivity, anxiety and self-concept, WHR by discipline, social competence, life satisfaction and self-concept, systolic blood pressure by optimism, discipline, favorable memories of home and social competence.Discussion: There is a higher number of participants with over-limited values of blood pressure – nearly in 40% of systolic, and in 25 % of diastolic blood pressure. There are no gender differences in this trend.

Background: The basic data concerning social influences on equity in health in Czech districts (2002, 2005, 2008, 2011) are in our study compared with results from 18 European countries, and the EU data. Methods: A representative sample of Czech citizens obtained by random quota sampling completed data on self-reported health, income, and level of education in conjunction with Czech national, statistical data on sick leave, unemployment, income and Gini coef. in respective districts of the Czech Republic. Findings: The poorer Czech districts report a higher morbidity and higher unemployment rate. The similarities and differences in social influences related to health inequalities within the EU will be demonstrated using the comparison of national and European statistical data. Discussion: One of the most important problem of European integration are social influences on equity in health, and its psychological reflection at both individual and social levels. Health Psychology should focus on the closing this gap.

Telehealth technology advancements have renewed interest in its potential to provide more home-based care by extending human resources, improving access to services and minimizing costs of the provision and receipt of specialist care (Herbert, Korabek, & Scott, 2006). The aim of this study was to explore how medical professionals perceive telehealth and what psychological factors contribute to the formation of these opinions. A qualitative design was employed using semi-structured interviews to obtain the views of medical professionals (N=8) who carried out a range of roles involved in palliative care. An inductive thematic analysis was conducted on verbatim transcriptions. Three themes were recurrent across the interviews; a changing culture within society and organizations, elements of the patient-professional relationship which included trust and the importance of human touch. The final theme identified was perceived technological competence. Increased knowledge of the psychological constructs of medical professionals’ perceptions of telehealth will benefit healthcare managers responsible for making decisions about implementing and training for telehealth in care delivery.

Family organization (FO) has a significant effect on the well-being and healthy status of the family members, as well as we can often recognize dysfuntional FO in psychosomatic families (PF). The aim of my study was to explore the characteristics of the family structure in two illnesses with heavy breathing: (1) asthma bronchiale (AB, the classic psychosomatic disorder) and (2) panic disorder (PD that is already said to be a partly somatization disorder). It is remarkable that the preceding disorders are comorbid with one another, but at least PD is the most frequent mental problem in AB. In this way, I supposed if there is some kind of symptom-changing by patients linking to the psychosocial background. My theory was tested with Gehring's Family System Test (FAST) that was used both in static- and dynamic forms. There were 5-5-5 families in my research with a healthy, AB- and PD-people. The demonstrations of the families' dynamic representations were recorded on video for later analysis. My results confirmed particular patterns of the perceived family structures and behaviors in PF. In this way, more rigid family system, the family members' peculiar influence on the FO and role in the system were found linking to the (psycho)somatic disorders. Although further studies are needed to understand better the interactions of the individual factors.

The number of road collision deaths for those under the age of 25 has reached a global crisis point. A recent approach to improving outcomes has been the introduction of Phone App’ Driver Monitors (PADMs). These smartphone apps provide real-time, in-vehicle feedback and summary reports. They also enable the generation of personal, subsidised insurance rates. This study is the first to examine the impact of PADM use on young driver behaviour (in this case, speeding violations and mean speed). 125 licensed, insured, smartphone-using drivers (aged 18-24) were recruited. All participants completed an initial demographics questionnaire, simulated 20km drive and were then split into groups. Group 1 (control) completed the 20km drive as before, while Group 2 (monitoring) were informed their driving would also be monitored. Group 3 (monitoring + alerts) could also receive smartphone audio alerts for unsafe driving. Group 4 (monitoring + financial incentive) could earn up to €5 for safe driving while monitored. Group 5 (monitoring + alerts + financial incentive) could receive payment and alerts for unsafe driving. Following a data collection period of three months, the time I and II simulator data was processed and within-between ANOVAs with interactions conducted. The results identify the optimal medium for successfully moderating young driver speeding, and the potential roles of PADM feedback and financial incentives in improving this risky health behaviour are discussed.

Background: Psoriasis is associated with risk of cardiovascular disease thus lifestyle behaviour change (LBC) is key to patient management. Healthcare professionals, well placed to support LBC, lack the skills to do so. We examined the extent of training received by specialist and general healthcare staff to manage LBC. Methods: Training documents from UK professional accrediting groups were content analysed to examine: a) health promotion and LBC as part of the professional role; and/or b) health promotion and LBC as explicit training competencies. Findings: References to health promotion and LBC appeared mostly in the General Practitioner (GP) curriculum (n=42), followed by the Dermatology Specialist Nurse curriculum (n=14) and Dermatologist curriculum (n=11). None were found in the GP with a Special Interest in Dermatology curriculum. There was no evidence of clearly specified LBC knowledge, skills and attitudes; only basic level competencies were described. Discussion: Given the evidence linking unhealthy lifestyles with psoriasis outcomes, the training of specialist healthcare professionals should include LBC competencies to support psoriasis patients.

Several studies showed that the attitudes of deprecating dietary moods in dairy life were associated with mental health among college students in Japan. Additionally, inner strength has been paid attention as a personal resource that promotes mental health. However, the relationships among these factors have not been studied. The purpose of this study was to investigate the relationships among dietary moods, inner strength, and mental health in Japanese college students. Subjects were 187 college students (112 males, 75 females, mean age: 19.2±1.3 years). Dietary Life Style Scale for Japanese College Students (Takano et al., 2009), Japanese versions of Inner Strength Scale (ISS-J; Endo et al., 2013) and General Health Questionnaire (GHQ28 Nakagawa & Daibo, 1985) were measured by questionnaire method. Covariance structure analysis showed that the deprecating dietary moods scores were positively related to the ISS-J scores directly, and negatively related to the scores of GHQ28 via the ISS-J scores (?2(1)=1.74 (p=.19), GFI=.994, AGFI=.963, RMSEA=.063). These results suggested that dietary moods were important factor to improve inner strength and mental health in college students.

Aims: The purpose of this study was to clarify the awareness of Japanese nurse in relation to the children of female cancer patients. Method: Data were collected 7 Japanese nurses through semi-structured interviews and content analysis was performed. Findings: The following 7 categories were extracted: "background of nurses who are practicing family nursing”, "cooperation between medical teams that support the children and the families”, "patients who are mothers as well", "Nurse consideration for children", "families who support children affected by the mother's cancer treatment", "family functions", "connection between families with children and the local community" Discussion: The nurse had taken into account the fact that the female cancer patients had children, so they were aware that their work also extended to patient's family.

Background: Everyday life with a child with behavioral problems is associated with stressors for women. Multi-family-therapy (MFT) stimulates a therapeutic process for developing coping strategies. Considering own and child-related bonding experiences and personal and social resources the study examines the developmental processes of women in relation to coping strategies and SOC. Methods: 16 women were interviewed pre-/post-therapy using semi-structured interviews. The interviews were transcribed and analysed by using a grounded theory approach. Results: Preliminary results of the study show positive change of perceived self-efficacy and sense of meaningfulness. The confidence factor changed from “hope in the success of the experts” (pre) to “trust in their own abilities” (post). By the solution-oriented approach of the MFT, positive bonding experiences are recalled and changed the relationship between mother and child. Discussion: MFT seems to enhance sense of coherence and coping skills in mothers of children with behavioral problems.

Background: People experience a range of stressors related to the decline of health in mind and body. This research seeks to explore how the elderly deploy resilience to recover their health in the face of stressful life events, in particular, how they experience moments of growth away from adverse events, and what the turning points are for that growth. ?Methods: In this study, a two-hour interview was conducted with an 85-year-old Japanese man with four diagnosed illnesses such as multiple brain infarction, living alone in public housing in a suburban area. Based on Modified Grounded Theory Approach (M-GTA), a word-to-word record was fractionated and categorized, and the relationship was analyzed. We obtained consent from the Research Ethics Committee at J. F. Oberlin University. Findings: The process took place over three stages: Stage 1, where the subject faced difficulty and he deployed both positive and negative interpretations; Stage 2, where the subject ascertained the benefits and disadvantages of available social resources, and he used the good aspects of them to move into actions. They were undergirded by psychological momentum and energy; and Stage 3, where the subject took measures to change his lifestyle towards a healthier one. ?Discussion: Through this research, we learned how resilience is deployed as an elderly person with illnesses living alone improves his QOL.

Background:From 2010-2011 Dutch primary care psychologists offered insured care programs of 8 meetings per year for their clients. Due to cutbacks, this amount was lowered to 5 meetings in 2012-2013. Our aim is to study the assumption that efficient care programs of 5 meetings are as effective as care programs of 8 meetings. Methods:Socio-demographics & psychological complaints were assessed at baseline and after the intervention in 2 selfregulation intervention groups (int-5:N=400 & int-8:N=924). MANOVA was used to analyze data. Results:A larger decrease in psychological complaints was observed in the int-8 group, but there was no significant difference (P>.05) between the 2 groups. We also found that a larger group of clients (P<.05), who initially started with 5 meetings 1) used additional insurance or 2) were willing to pay themselves for extra meetings or 3) were more often referred to secondary psychological care. Discussion:Based on the results we conclude that the length and intensity of care should be adjusted to clients specific situation and complaints. Cutting back on insurance does not ensure lower costs, because other forms of compensation or counseling will be found.

Background: Is the fear of being-laughed at (i.e., gelotophobia) a problem for adolescents with overweight and obesity? Methods: In two online interviews with gelotophobic adults (Study I: 102 English-speaking participants, Study II: 22 German-speaking participants) assumed reasons for the personal development of gelotophobia were asked for. Experiences of teasing and ridicule related to physical appearance (including weight-related topics) were reported quite often. In Study III (participants: 75 Zurich adolescents) associations between objective weight status, weight perceptions (e.g., “much too big”), experience of weight-related teasing and ridicule, and gelotophobia were analysed. Findings: Whereas weight perceptions were unrelated to the psychological variables, objective weight status was linked with the experience of teasing and ridicule and thereby indirectly to the fear of being laughed at. Discussion: Given the debate on overweight and health risks, implications of the study are discussed within the context of an increasing tendency to stigmatize overweight individuals (Funding: SNF International Short Visit).

Background:Post-stroke patients tend to reduce their social activity, which engenders decreased quality of life. This study was conducted to clarify the intention–behavior relationship of social activity of post-stroke patients. Methods:The study was approved by the hospital’s medical ethics committee. As participants, 45 people were included (29 men; mean age:64.2±12.1). Intention was assessed using the Intention of Social Activity Scale.Social activity was measured using the Social Activity Scale before discharge(T1), at 3 months after discharge(T2), and at 6 months after discharge(T3). Changes in intention and social activity were tested with ANOVA. The intention–behavior relationship analysis, using multiple regression analysis, was based on the assumption that intentions are the proximal predictors of subsequent behavior. Findings:Intention showed no change over T3 from T1. However, social activity was reduced over T3 from T2. At T2,intention was a predictor of behavior. However,at T3,intention was not a predictor of behavior. Discussion:At 6 months after discharge,an intention–behavior gap was found. The moderators or mediators in this intention–behavior gap must be examined.

Background:Motives for physical activity are very important determinants for being physically active.The aim of this study was to investigate the test-retest reliability of motives for physical activity items from the HBSC questionnaire among adolescents and differences by gender, age group and country.Methods:We obtained data from male and female students aged 11or15 years old who participated in a test and retest study with a four-week interval in 2013 via the HBSC pilot study in the Czech Republic and Slovakia (n=580, 51.2% boys).We estimated the test-retest reliability of all 13 dichotomised motives by using Cohen’s Kappa statistic in the whole sample and stratified by gender, age group and country.Findings:We mainly observed strong or moderate correlations between test and retest for most motives.Weak correlations (0.1–0.3) were observed in two items (“to make new friends” and “to enjoy the feeling of using my body”) and a trivial correlation in the item “to improve my health” in the whole sample and also stratified by gender, age group and country.Discussion:The HBSC questionnaire seems to be a reliable instrument for measuring motives for physical activity among adolescents.

Objectives: Physical activity (PA) can reduce cigarette cravings and aid quitting but little is known about its promotion during smoking cessation counselling. This study aimed to determine the extent to which smoking cessation advisors promote PA. Methods: Self-report surveys assessing PA promotion within the Transtheoretical Model (TTM) framework, advisors’ own PA levels and demographics were completed by 122 German speaking advisors. Results: 95.9% of advisors reported promoting PA to most smokers and were in the maintenance phase (TTM). Advisors spent an average of 6.4 mins and 11.8 mins per session promoting PA during the longer (7 weekly sessions) and shorter clinics (3 weekly sessions), respectively. Advisors delivering shorter clinics rated PA as more important for smoking cessation. A positive correlation was found between self-reported physical activity and minutes spent promoting PA in advisors using the short form, but no other factors predicted PA promotion. Conclusions: In this study nearly all smoking cessation advisors promoted PA. Advisors using a short-form seem to be aware of the importance of promoting PA despite the limited time-frame of this approach.

Background: The aim of this study was to determine whether implementation intentions could increase breakfast consumption in Australian young adults aged 18-25. The moderating effect of intention on the relationship between implementation intentions and breakfast consumption was also examined. Method: Participants (n=71) responded to a baseline questionnaire measuring intentions and breakfast consumption, and were randomized to either the implementation intention or control group. A similar survey was then completed one to two weeks from baseline to determine whether breakfast consumption had increased. Findings: It was found that participants in the implementation intentions did not significantly increase breakfast consumption compared to the control group. Intention moderated this effect, such that the intervention was effective for those participants with weaker intentions to consume breakfast at baseline. Discussion: By building on further research in the area, this study supports the endeavour to increase breakfast consumption through the use of implementation intentions. However, such research must account for the impact of baseline intention on intervention efficacy.

In a review of 50 systematic reviews we found that information levels have been considered frequently as predictors of screening uptake. The evidence from the literature suggests that increasing information offers limited benefits to Pap test attendance. In addition, thematic analysis of data from 4 semi-structured focus groups (N = 15) indicates that women attending for Pap tests, though feeling informed, objectively lack knowledge about cervical screening. Cross-sectional findings from a survey of 256 women corroborate this conclusion: information levels correlate positively with intention, but failed to predict intention in multiple regression or attendance (logistic regression). How much information is necessary? This presentation discusses the difference between being informed and feeling informed. Successful intervention may need to focus on practical information to create a sense of mastery. Ethical approval was obtained before data collection.

Background: The purpose of the research was to study the relationship between the quality of life satisfaction and such characteristics of communicative competence as emotional intelligence, perceptive and interactive competence in Russian and Belarusian university students trained to become specialists of helping professions. Methods: The sample consisted of 93 Russian psychology students and 92 Belarusian student-teachers, aged at 18-20. The students completed Quality of Life Index Scale (R. Eliot, adapted by N. Vodopianova), Emotional Intelligence Scale (G. Rezapkina’s version) and Communicative Competence Questionnaire (N. Fetiskin). Findings: The results of correlation, multiple regression and comparative analyses revealed two different models of communicative predictors of quality of life index in Russian and Belarusian students. For Russians the main predictors are self-motivation and mutual understanding, while for Belarusians they are emotional intelligence, self-regulation and mutual understanding. At the same time for Russian students such quality of life indicator as state of health depends on mutual understanding competence, while for Belarusians it is predicted by self-regulation. Discussion: We consider the received data to specify the influence of communicative competence on quality of life index due to cultural differences.

Background: The purpose of the research was to study the relationship between the quality of life satisfaction and such characteristics of communicative competence as emotional intelligence, perceptive and interactive competence in Russian and Belarusian university students trained to become specialists of helping professions. Methods: The sample consisted of 93 Russian psychology students and 92 Belarusian student-teachers, aged at 18-20. The students completed Quality of Life Index Scale (R. Eliot, adapted by N. Vodopianova), Emotional Intelligence Scale (G. Rezapkina’s version) and Communicative Competence Questionnaire (N. Fetiskin). Findings: The results of correlation, multiple regression and comparative analyses revealed two different models of communicative predictors of quality of life index in Russian and Belarusian students. For Russians the main predictors are self-motivation and mutual understanding, while for Belarusians they are emotional intelligence, self-regulation and mutual understanding. At the same time for Russian students such quality of life indicator as state of health depends on mutual understanding competence, while for Belarusians it is predicted by self-regulation. Discussion: We consider the received data to specify the influence of communicative competence on quality of life index due to cultural differences.

Background: Recent technology development, miniaturisation and simplification of electronic equipment have made health psychology research more feasible. The aim of this study was to assess usability, practicality and user-friendliness of novel technology aided research using the Technology Acceptance Model (TAM3) as a framework. Methods: We undertook in depth interviews with 12 study participants (Mean age 50.58, SD=9.92; 3M,9F) who had all taken part in research which used mobile-phone/touch-pad aided ecologic momentary assessment, on-line supported activity monitoring and real time on-line administered weight assessment. Qualitative data was analysed using the Framework method. Results: Employing technology in research was seen as useful, practical and accessible. TAM3 variables were often referred to, particularly ‘perceived usefulness’ and ‘perceived ease of use’. Technology was reported as easy to become accustomed to, including among older participants. Discussion: Technology-aided research is seen as valuable and easily embedded in everyday life. TAM3 provides a starting point for conceptualising technology acceptance in health-related behaviour research.

Acute exercise in natural environments increases affective responses compared to indoor exercise in adults. This intervention study aimed to compare the long term effects of outdoor and indoor training environments on psychological well-being and exercise adherence in postmenopausal women. In a 12-week randomized trial, 24 healthy overweight (BMI 22 to 29 kg/m2) postmenopausal women (52 to 69 years old) were assigned to either: 1) Outdoor training, 2) Indoor training, consisting in three weekly 1h-session of identical aerobic and resistance training. Main outcomes were affective valence (Feeling Scale), measured before and during every mid-week session, and affective states (Exercise-Induced Feeling Inventory), which were measured at weeks 1, 6 and 12 of the intervention. Depression symptoms (Beck Depression Inventory) were assessed before and after the training. After 12 weeks of training, exercise-induced changes in affective valence was higher for the outdoor training group (p?0.05). Positive engagement and tranquility decreased only in the indoor group (p?0.05). Adherence to exercise was also higher (p?0.01) and depression symptoms decreased (p?0.01) for the outdoor group. As a conclusion, outdoor training enhanced affective responses to exercise and improved psychological well-being in postmenopausal women to a greater extent than indoor training.

Background: The potential for brief interventions (BIs) to promote physical activity (PA) is increasingly recognised. It is timely to examine the evidence from reviews to determine what is known about BIs that could be delivered in primary care consultations. Methods:Databases were searched for systematic reviews of individual level BIs promoting PA in adults, reporting a PA outcome. Findings:Ten reviews were included. Three provided definitions, one specifying a maximum duration of 30 minutes. BIs increased short-term self-reported PA. Providing intervention supplements may increase effectiveness. It was unclear if BIs were more or less effective when targeting patients with certain characteristics. Many factors may influence their feasibility and acceptability e.g. time constraints. Discussion:Definitions include interventions that are too long for routine consultations. Practitioners and commissioners should be aware of this when interpreting the evidence. Intervention effects on objectively measured and self-reported PA in the long-term need further investigation. Future research should develop and evaluate very brief interventions that could fit into a routine consultation.

Background: We investigated the effects of an acute exercise bout (AEB) on urges to consume sweets, affect and responses to stress and a sweet cue. Potential long-term effects on physical activity (PA) were assessed 12 months later. Methods: Following 3 days of chocolate-abstinence 47 overweight, sweet consumers were assessed, on separate days, in 2 randomly ordered conditions, in a within-subject design: 15-min brisk walk or passive control. Following each, participants completed 2 tasks: Stroop color–word interference task, and handling sweets. Urges for sweets, affective activation and valence were assessed. 30 of the 47 participants completed questionnaires about their exercise behaviour 12 months later. Findings: ANOVAs revealed sig. condition x time interaction effects for: urges for sweets (p<0.01, eta2 =0,245), valence (p<0.01, eta2 =0,183), and activation (p<0.01, eta2 =0,130). 65.6 percent of those surveyed reported more PA since study participation. Discussion: Obtained data show a potential of AEB in reducing food craving in overweight people; participating in an AEB study may increase PA – levels. The potential of AEB in weight reduction programs should be explored.

The study explored heterogeneous patterns of academic procrastination behavior within college students who came to the student counseling center for academic issues. Latent profile analysis was conducted to differentiate the types of procrastination behavior among undergraduates. Participants were 323 undergraduates who visited the student counseling center for academic difficulties. Academic procrastination and professional efficacy were the class indicators to determine the number and types of procrastination behavior. The results identified 4 classes, the optimal solution that best represented the sample. Additional analyses revealed how the groups differ in using coping strategies. Non-procrastinators engaged in more problem-focused and social support seeking coping while procrastinators tended to engage in more emotion-focused and wishful thinking. Procrastinators with low-efficacy used less coping strategies in general. Findings have significant implications for interventions designed to overcome procrastination and help their academic adjustment. Specific needs of distinct procrastination types should be considered to customize the right intervention to each individual.

Background: This study aimed to develop a scale measuring playfulness of schoolchildren in active play context. Methods: The playfulness scale was developed on the basis of literature review, focus group interview, and experts review. A sample of 526 elementary school children responded to the playfulness scale and children’s perceived stress scale. Factor analysis, reliability analysis and validity analysis were conducted to establish structure of the scale, and to obtain evidence for validity and reliability of the scale. Findings: The scale consisted 19 items with a five-factors structure: Engrossed, self-determine, self-efficacy, team rule, and socialization. Cronbach’s ? were from .788 to .876. The scale had high internal reliability (r = .903) by using the split-half method. Results of the regression indicated that playfulness significantly predicted the number of perceived stress (? = -.325, p < .01, R square = .106, p < .01). Discussion: The playfulness scale in active play context demonstrated acceptable reliability and validity, which could be applied for assessing playfulness in school-aged children.

In health psychology research, insufficient attention is being paid to non-medical/non-nursing health professionals. This investigation examines the subjective well-being of physiotherapists, psychologists, and social workers and the interplay with job demands and job satisfaction. An employee survey was conducted in 2010/11 in certified breast cancer centers in the state of North-Rhine-Westphalia, Germany. In the heterogeneous sample of the non-medical/non-nursing hospital staff, physiotherapists, psychologists and social workers were the largest vocational groups. First, subgroup analyses and descriptive statistics were performed. Second, relationships between well-being scores, job demands and satisfaction for the three subgroups were analyzed. The mean scores of subjective well-being were significantly different between subgroups (F = 5.43, p < .01). On average, physiotherapists and psychologists perceived decent to high well-being scores. Social workers’ mean well-being score was lower than in the later professional groups. Job satisfaction and specific kinds of job demands did not play a decisive role for the professionals' well-being in each of the subgroups.

Background: We investigated effects of an acute exercise bout (AEB) on psychological well-being in depressive in-patients during psychiatric treatment. Methods: 23 patients with a total beck depression inventory score ? 18 were assessed on separate days in 2 randomly ordered conditions in a within-subject design: 30-min brisk walk or passive control (sitting and reading). Mood, psychological well being, affective activation and valence were assessed pre- and post- treatment, using mood survey scale (MSS), Activation Deactivation Adjective Check List (ADACL), Feeling Scale (FS) and Felt Arousal Scale (FAS). Findings: ANOVAs revealed sigificant condition x time interaction effects for MSS dimensions “lack of energy” (p=0,035), “activation” (p=0,017), “psychological agitation” (p=0,028) and “worry” (p=0,030) as well as for ADACL dimension “energetic arousal” (p=0,012). Discussion: Obtained data show positive effects of AEB on psychological well- being in depressive patients during inpatient treatment. Further trials should explore whether moderate physical activity at the beginning of psychiatric treatment improves the therapeutic outcome or not.

Quantitative evidence supports the effectiveness of acceptance based cognitive behavioural therapies (CBT) for chronic pain. Qualitative research has explored the experiences of chronic pain sufferers. However, there is an absence of literature examining the processes through which improvements are made. This study sought to qualitatively analyse the experiences of 6 adult patients who completed an acceptance based CBT pain management programme (PMP). Semi-structured interviews were carried out and verbatim transcripts were subjected to Interpretative Phenomenological Analysis. Three superordinate themes were identified: acceptance of a renewed sense of self; feelings of insecurity in the context of healthcare; and sustained motivation for change. These results add to the evidence base regarding a loss of sense of self. However, in addition, a renewed sense of self was found amongst patients’ reports of their subjective experiences of participation in the PMP. The findings also highlight the processes by which the renewed sense of self was reached and these are discussed in relation to chronic pain literature. Potential areas for improvement in clinical practice are identified.

Background: Illness representations are an important determinant of health outcomes. The cognitive representation includes personal ideas about causes of the illness. This study aimed at analyzing causal representations of patients with mental disorders. Methods: The open-ended response item on causal representation from the IPQ-R was answered by 648 patients (73% female, mean age 47 years, 52% diagnosed with depression) receiving psychotherapy. According to qualitative content analysis, 2 raters agreed on 9 main categories and coded 1771 responses (kappa= .88). Findings: Most frequently, respondents referred to “problems on the job” (47%) and “problems in the social environment” (44%) as causes for their mental disorder. Further relevant causes were “person-centered” (35%), “threatening life events” (29%), and “stress” (21%). Correlations were found between causal representation and demographic and clinical factors. Discussion: The analysis demonstrates the multifaceted causes patients attribute to their mental disorders. Demographic and clinical variables affect patients’ causal representations. Further analyses will be conducted related to causal representations and psychotherapy outcome.

Background: Whilst research has documented the physical and psychological burden of advanced prostate cancer, there has been limited exploration of approaches to well-being. This study explored men with advanced prostate cancers’ practices for promoting and maintaining emotional well-being. Methods: Semi-structured, in-depth interviews with five men with advanced prostate cancer from around the UK. Transcripts were analysed using Interpretative Phenomenological Analysis. Findings: Within narratives of lost and regained well-being, two super-ordinate themes emerged: ‘living with an imminent and uncertain death' and ‘strategies to manage living with death and uncertainty.' Well-being was threatened by reduced sense of the future, isolation and uncertainty. Yet the men pursued well-being by managing their emotions, striving for the future whilst enjoying life in the present, taking care of their families and renegotiating purpose. Discussion: Practitioners could encourage men with advanced prostate cancer to explore their own existing resilience and coping strategies. In particular, sense of purpose, social connectedness and life-engagement were revealed as concepts central to improving well-being. Additionally participants sought to take action and problem-solve, pointing to the relevance of CBT-based interventions for this population.

Self-Determination Theory (SDT) has been used successfully as a model for health behaviour change in weight loss programs. However, the effectiveness of SDT for promoting physical activity (PA) behaviour change in an elderly population at elevated risk of colon cancer is unknown. This study investigated the feasibility of implementing an SDT approach in this population and provides preliminary evidence of its efficacy for modifying motivational regulation. Methods: Patients (n=27) with bowel polyps were randomised to a usual care (UC) (n=12) or an active lifestyle group (AL) (=-15) in a 6-month randomised-controlled feasibility study. Motivational regulation was the main outcome assessed at 3 time-points. Other measures included body composition, PA, and fitness. Results: Significant changes between the groups were seen in amotivation (P<.05), identified (P<.05), intrinsic regulation (P<.01) and relative autonomy index (P<.01) at 6-months in favour for the AL group. Total leisure time activity was higher in AL at 6 months compared to UC (P<.05). Discussion: The findings suggest that SDT could be an effective strategy for promoting long-term PA behaviour change in this population. A larger randomised controlled trial is needed to further explore the utility of SDT in this context.

Background: With the age-related changes in future-time perception (FTP), individuals may differentially prioritize health and social goals. This study examined whether FTP mediated the age effects on goal prioritization and intentions to be physically and socially active. Methods: Older and younger adults (n=262) elicited 3 health and 3 social goals, ranked the goals on importance, and reported their FTP and intentions to exercise and engage in social activities. A goal priority index and the 2 intentions were regressed on age groups in 3 models. The mediating effects of FTP were also tested. Findings: Older adults more often prioritized health over social goals, and had stronger exercise and social engagement intentions than younger adults. FTP did not predict prioritization but mediated the age effects on intentions. Discussion: The age-related preference toward health goals might be attributed to the concerns over the age-related physical decline. FTP did not predict prioritization, as health goals might become emotionally meaningful with age. The suppression effects of FTP on age suggested the importance of an extended FTP in physical and social engagement.

Background?The purposes of the research were to construct a “family therapy assessment model for the drop-out students in the middle way school” , and to evaluate the effects of the model. Method?The qualitative research method was adopted and the systemic theory was used to analyze the data. The family therapy assessment model was applied to 10 dropouts’ families, including home visit, 1.5 hours family interview, and 30 minutes family negotiation. All of the interview and negotiation were recorded and analyzed to provide the school staff the intervention maps. After one year’s intervention, the improvement of the dropouts’ behaviors as well as the family functions and relationships were evaluated. Findings? 1. The family therapy assessment showed (1) Parenting monitoring function badly. (2) Families had insecure attachment issues. (3) Rigid family interaction patterns reflected ineffective family communications and the parenting authorities failed. 2. The dropouts’ behaviors and the family function and relationship improved. Discussion? The assessment model for the high school dropouts was well built to improve the family health and the adolescents’ behaviors. It could be a potential model for other schools to use it. The rigid family interaction patterns, insecure attachment, and lack of parents’ monitoring in the dropouts’ families found implied a clinical intervention map.

Background: Attitudinal ambivalence can arise when individuals endorse both positive and negative attitudes toward a target object. Ambivalent attitudes are relevant for health behaviours, as they may have both positive and negative evaluations. By assessing ambivalence toward health behaviours, the underlying structure of attitudes toward them can be realised. Furthermore, attitudinal ambivalence toward health behaviours was assessed across different cultures. Methods: All participants (257 Australians, 105 Singaporeans) completed ambivalence measures and self-report assessments for five health behaviours: drinking alcohol, exercising, increasing fruit and vegetable intake and smoking. Findings: Singaporeans and Australians had similar levels of ambivalence toward health-risk behaviour but not health protective behaviours. Singaporeans reported being significantly more ambivalent toward health protective behaviour than Australians. Discussion: As ambivalence toward health protective behaviour was found to be high in Singaporeans, interventions aiming to increase these behaviours may need to be more explicit in highlighting the positives of such behaviour.

Background: The aim of the study was to determine the relationship between the Parental Feeding Practices and healthy, unhealthy diet, body weight and fat tissue among children. Methods: Parental Practices were assessed with measures by Food Parenting Practices Scale (Vereecken, 2004), Comprehensive Feeding Practices Questionnaire (Musher-Eizenman, Holub, 2007), Child Feeding Questionnaire (Birch i in., 2001). The participants were 250 dyads of child (6-11 years) - parent. Data were collected with standardized interviews, questionnaires, and using certified body weight and fat scales. It was a longitudinal 6-monts follow-up study Findings: After controlling for parental body weight, child’s adipose tissue, body mass index and diet relate to following parental practices, reported by both parents e.g. involvement in meal planning/preparation, pressure to consume more food at meals, restriction for weight control , monitoring, stimulation healthy intake, restriction unhealthy intake, encouragement through material reward, permissiveness, and making healthy foods available. Discussion: Accessibility, meals planning and rewarding were the key factors related with body fat tissue.

This study investigated inter-correlations between the Comprehensive Assessment of Psychopathic Personality (CAPP) and popular measures of the Dark Triad of Personality as the CAPP has not yet been applied in this context. The Dark Triad was measured using the Mach-IV (Machiavellianism), NPI (Narcissism), LSRP (Psychopathy) and the CAPP. Participants were 100 adults (aged 18-65) currently in leadership roles. The LSRP measures primary (P1; interpersonal/affective variant) and secondary (P2; behavioural variant) psychopathy, while the CAPP measures six domains of psychopathic personality: Self, Attachment, Behavioural, Dominance, Emotional and Cognitive. Correlational analysis revealed significant correlations between all four measures, but divergences were also found. Total CAPP scores were significantly correlated with both P1 and P2 of the LSRP. When controlling for the LSRP the CAPP was significantly correlated with the Mach-IV, but not with the NPI. Findings suggest that the CAPP may tap the same underlying construct as the LSRP and Mach-IV. As the CAPP is a relatively new measure of psychopathic personality, validating its use in different populations is of high importance.

Background: Physical exercise and psychological intervention are evidence-based practices in Fibromyalgia. Our aims are to identify the prevalence of walking and psychological treatment in fibromyalgia, and their characteristics related to walking. Methods: 920 women belonging to Fibromyalgia patients´ associations returned a mailed questionnaire (41.31%). Results: Of the sample, 59.2% reported walking but 48.07% under the minimum recommended by experts. 50.2% attended psychological treatment mainly due to depression (35.8%). These women scored higher (p?.001) in pain, fatigue, sleep and cognitive problems. Prevalence of medical advice to walk was 79% and was not associated with psychological treatment. However, women in psychological treatment perceived more interference of chronic problem in walking (?2=29.1, p?.0001) and 63% perceived interference of their psychological problems in this behavior. Discussion: Psychological problems are relevant both to symptom perceptions and recommended health behaviors. The adherence to walking is a main objective for psychological intervention from a Health Psychology perspective. Supported by Spanish Ministry of Economy and Competitiveness

Background: Walking is recommended by experts to improve health outcomes in fibromyalgia. Our aim is to identify the predictors of walking intention in patients with fibromyalgia using the Theory of Planned Behavior and considering other fibromyalgia variables. Methods: 274 Fibromyalgia women of several patients´ associations completed a self-reported questionnaire based on the theory of Planned Behavior, pain-related fear, distress, pain intensity and fibromyalgia impact. Multiple regression analyses were conducted. Findings: Intention was predicted by Attitude (?= .29, p?.001), perceived behavioral control (?=.14, p?.05) and subjective norm (?=.13, p?.05) (24% of explained variance). Discussion: Only TPB constructs were relevant in the motivation of walking, mainly the attitude. Other emotional, symptom and impact variables were not relevant. Results are coherent with previous research except in the main predictor which was attitude and not perceived behavioral control. Supported by Spanish Ministry of Economy and Competitiveness (Grant: PSI 2011-25132).

Background: Attention deficit hyperactivity disorder is one of the most common childhood behavioral disorders causing hyperactivity, attention deficit and education decline among children. Regarding the importance of medication treatment, this study was performed to compare the effect of two methods (Direct and Indirect) of education of parents of children with ADHD on their attitudes about medication, treatment satisfaction and medication compliance. Methods: In this quasi- experimental study, sixty one parents of children with ADHD who referred the child and adolescent psychiatry clinic in Shahrekord were randomly assigned to direct and indirect education groups. The first group (direct group) was attended in groups four sessions. The second group was given education booklet with the same content. Participants were evaluated before and one month after education in terms of their attitudes to medication, treatment satisfaction and treatment compliance. Results: After intervention, the mean scores of attitudes about medication and satisfaction with treatment were care significantly improved in the direct education groups. There was significant difference in the direct education group .whereas in indirect education group, significant difference was not statistically observed. Both groups had significantly increased treatment compliance one month after education, change of mean score attitudes to medication consumption at the end of the periods was significantly different in direct group comparing indirect education group. Conclusion: Direct or conventional education was more effective in treatment rather than indirect education on improvement of attitudes towards medication and increase in treatment satisfaction, this study suggests and significant influence on disorder children in family and school environment.

Background: Quality of life in elders is often considered to be lower due to the risk of disease and disability that clearly increase as people grow older, but poor health might not be an inevitable consequence of aging. Methods: We investigated the directionality of the dynamic relationship between quality of life in elders and their attitudes towards aging and we hypothesized that negative attitudes toward aging might be linked to poor physical health and functioning outcomes in late life. Participants in this study were elders from urban areas (N=154) over the age of 65 with no prior history of dementia. Findings: As hypothesized, when aging attitudes were less favorable, the quality of life of elders was reported as being lower. Discussion: Although previous research has identified a strong association between quality of life and attitudes towards aging the present study highlights the direction of this relationship which can give practitioners insights when designing interventions aimed to improve the quality of life in elders.

Background: This study aims to identify factors that motivate people to continue hill-walking to promote their psychological and physical health. Methods: Three males and 20 females participated in a one-year health promotion program, including 12 hill-walkings in 2012 - 2013. Questionnaires were given each time, in which we asked, using 4-point-scale, degrees of expectation for motivational factors such as enjoying scenery, exercising in nature, interaction with people and refreshing their mind before walking and degree of satisfaction with them after walking. Findings: Expectation for factors such as scenery varied each time (mean value ranged 3.07-3.71). Its post-walking satisfaction was significantly lower than pre-walking expectation one day (p<0.05). Expectation for improving physical condition remained low (overall mean value 3.11). However, the satisfaction with interaction with people was consistently high (mean value 3.44 to 3.80), and significantly greater than the pre-walking expectation twice (p<0.05 and p<0.01). Discussion: While environmental and physical factors are unstable as motivation, social factors may play a key role for people to continue hill walking.

Objective: To evaluate the perception of quality of life, nutritional status and level of physical activity of the academic community.Methods: The perception of quality of life, we used the WHOQOL-bref instrument of the World Health Organization (WHO). The nutritional status was assessed using the body mass index (BMI). The level of physical activity was measured using the International Physical Activity Questionnaire (IPAQ).The instruments composed of computerized data collection system with voluntary participation.The data analysis considered comparisons by the Kruskall Wallis test. Results: Among the 1966 volunteers, the women are the majority (61.6%). The nutritional status, 32.3% of individuals are over the ideal body weight and 65.5% practice physical activities regularly, in about quality of life, respondents ranked the environment in 63.85%; social relationships 67.96%; psychological aspect 68.04%; physical condition 73.03% and general aspect 68.46%.Discussion: The results corroborate the idea of the need for the implementation of specific actions to promote health and quality of life for the maintenance of good life habits during aging

Background The purpose of this study was to explore the predictive utility of the Health Action Process Approach (HAPA), and test a brief HAPA based healthy eating intervention, in adults with Type 2 Diabetes (T2D). Methods Seventy-seven participants took part in a prospective RCT. Outcome measures collected prior to the intervention and four months later included; BMI, blood pressure and blood glucose levels as well as HAPA variables (e.g. risk awareness and planning). Findings HAPA predicted BMI (16.6%) with risk awareness and recovery self-efficacy significant independent predictors. Risk awareness, intentions and self-efficacy were also independent predictors of health outcomes such as diabetes distress, HbA1c, diastolic blood pressure and HDL cholesterol; however, the HAPA did not predict healthy eating. The intervention did not result in changes in diet (p=.84) or HAPA outcome measures compared to the control group. Discussion HAPA may be of some utility in predicting and explaining but not changing behaviour for people with T2D. Other health models may be more effective, and alternative brief-low cost health interventions for those with T2D should be explored.

Background Physical activity has many bene?ts for health. The aim of this study was to investigate the relationships between students’ physical activity status and their academic performance, academic stress, general self-efficacy and satisfaction with life. Theory of planned behavior was the main theoretical approach. Methods A cross-sectional study was undertaken among 96 psychology students (73.2% female). In this study, the Concise Physical Activity Questionnaire, the Academic Stress subscale of the School Perception Scale, the General Self-Efficacy Scale and Life Satisfaction Scale have been used. Previous semester average was considered as a measure of student performance. Findings The results show that physical activity reported by students positively and significantly correlates with their satisfaction with life and negatively with perceived academic stress. General self-efficacy mediates the relationship between physical activity and student performance. Discussion The results from this study are potentially relevant to the development of physical activity programs in university helping students to reduce academic stress and improve their satisfaction with life.

Background: The literature has found that obese patients usually report less depression and anxiety than normal weight individuals. However, not many investigations have studied the relationship between obesity and quality of life from a Positive Psychology approach. Methods: A total of 221 participants were selected to conduct the study. Participants were obese outpatients from the Valme Hospital (Seville) and a control group comprised of students from the Spanish Open University. The Spanish versions of the Ryff’s Scales of Psychological Well-Being and the SF-36 were used to measure psychological well-being and mental health respectively. Findings: Obese participants showed less psychological well-being than normal weight individuals but there were not statistically significant differences in the case of mental health measured with the SF-36. Discussion: According to the results, it could be concluded that reports of psychological well-being problems are much more common in participants with weight problems than in the control group.

Child Abuse Scale (CAS, Malik & Shah, 2007) was revised and standardized. Separate forms for mother and father were developed; 17 new items were generated for sexual abuse. A sample of 700 children (356 boys and 344 girls) of 8-12 years (M = 10.31, SD = 1.14) was drawn from five cities in Pakistan. Principal component factor analysis revealed 3 factors structure for CAS-Revised comprising of 38 items with factor loadings ? 3.50 which was supported by item analysis. Factors were labeled as Physical and Emotional Abuse, Physical and Emotional Neglect and Sexual Abuse. Child Abuse Scale-Revised showed significantly high alpha coefficients for Mother and Father Forms as well as its three sub-scales. There were significant inter-correlations among all sub-scales and with total CAS-R score. Levels of abuse were determined by computing percentile scores for mild, moderate, moderately severe and severe for the total sample as well as clinical and non-clinical samples separately. Age and gender norms were computed for CAS-R. The results are discussed in the light of cultural context of Pakistan

Self-leadership is a self-influencing process through which people achieve the effectiveness necessary to reach their own goals. Goal attainment leads to a sense of achievement, thus influencing our personal well-being, while failing to achieve personal goals leads to feelings of helplessness associated with depression and withdrawal. Considering the influence of self leadership on one person’s expectations about his/her own effectiveness the authors examined the relationship between self-leadership skills and their impact on personal happiness and depressiveness. A sample of 448 students completed an online questionnaire, consisting of the German version of the Revised Self-leadership Questionnaire, the Optimism Pessimism Scale, the Oxford Happiness Inventory and the Health Questionnaire for Patients. The results showed both a positive relationship between self-leadership and happiness, and a negative relation between self-leadership and depressiveness. In addition regression analysis with self-leadership as predictor confirmed the described relationships among variables. The authors discuss the role of goal attainment by self-leadership skills as a path to increased happiness.

Background: Previous studies indicate that older people are not well aware of dietary recommendations according fruit and vegetable consumption. Further, older people are not aware of risks about food safety and those who are still living at home might be a vulnerable group when it comes to obtain relevant health information. Methods: A questionnaire was responded by 317 respondents (73% women, n=232; and 22% men, n=70 men; 5%, n=15 excluded) in central part of Sweden. Confirmatory Factor Analysis were used as a statistical method (SAS 9.3). Finding: Few respondents reported a daily intake of fruit and vegetables of exactly 5 portions. There was a significant association between knowing the recommended amount of fruit and vegetables to be eaten per day and the amount actually eaten. The results also show a significant association between fruit and vegetable consumption showing that women consume more than men and that responders living together eat more than those living alone. Positive correlations imply that answering that it is harmful to taste raw minced meat will raise the probability of actually not tasting raw minced meat. One reason not to taste raw minced meat is that it might contain Verotoxin-producing Escherichia coli, a dangerous of bacteria. Regarding refrigerator temperature, the study indicates that it was common to think that 8 °C, since this is the temperature often written on food products. A negative correlation is indicating that the respondents do not know the recommended temperature for the refrigerator which should be < 5°C. Discussion: The present results are in line with earlier studies performed in this group. Knowledge regarding daily consumption of fruit and vegetables as well as an awareness of the risks of tasting raw minced meat might have an impact on behavior. Further research should focus on relevant channels for health communication targeting older people. One limitation of this study might be that the larger proportion was women. Thus, further studies should include a larger proportion of men.

Background: Dementia is a worldwide health issue. The need for an effective dementia workforce has been stated at national, European and international level (WHO, 2012). The multi-lateral project “Positive About Dementia” is dedicated to the development of an interdisciplinary Masters Programme. Methods: One work package deals with Quality Assurance and Evaluation(QA&E). The QA&E concept applies Mixed Methods (Plano Clark & Creswell, 2008) by combining qualitative and quantitative methods. Formative and summative evaluation is realized. For example, the project’s progress is evaluated continuously; an external expert group reviews the developed Curriculum. Findings: The survey of the project´s meeting (N=16) shows that getting to know the partners, the various expectations and the different work packages were liked most (n=11). On the other hand, the meeting´s time frame was rated as too short (n=11). Discussion: An interdisciplinary approach, combining health psychology, management, neuroscience and nursing is a promising way for the development of high-quality dementia education. For a sustainable implementation close collaboration must be realized.

Background: Economics of Happiness (EoH) examines the relationship between individual satisfaction and economic issues: what factors increase or decrease human well-being and quality of life. In our research we looked at prevalence of ideas of EoH among various socio-demographic groups of Latvian and Lithuanian population. Methods: Using anonymous survey, 15 questions in 5-level Likert scale, we determined 292 respondents' attitude towards concepts of EoH and implementation of them in work, family, education, health care, public administration. Findings: People with higher education, high income, residents of the capital, and employees aged 36-55 had the most positive attitudes towards the EoH. Men’s responses tended to be on extremes: either positive or negative, while women’s attitudes clustered around the middle of the scale. The most negative attitudes were observed among individuals with primary or secondary education, living in rural areas. Discussion: Our finding contribute to the understanding of who and to what extent supports the ideas of EoH.

This study was designed to investigate the effects of emotional self-perceptions and stress coping strategies on marital satisfaction. We tested whether married couples who were high on emotional intelligence had different coping strategies and high marital satisfaction than those with low emotional intelligence. Eighty heterosexual couples (N=160, Mean of age=39.87, SD=12.61) were administered with the Trait Emotional Intelligence Questionnaire (TEIQue) (Petrides, K. 2009); the short demographic questionnaire and the COPE Inventory (Carver, C., Scheier, M., & Weintraub, J. 1989) along with ENRICH Marital Satisfaction Scale (Fowers, B. & Olson, D. 1993). The results indicate that trait Emotional Intelligence strongly correlates with and therefore has high predictive value for individual’s marital satisfaction. Couples emotional self-efficacy is highly related to their reports of marital satisfaction as well as to their coping strategies. Stress coping strategies are related to marital satisfaction. The results have implications for health psychology as high marital satisfaction may contribute to individuals’ physical or psychological health and well-being and protect them from certain diseases.

The aim was to investigate the role of illness perceptions, treatment beliefs and goal cognitions in predicting medication adherence after kidney transplantation. Consecutive patients were invited to participate in an interview 6 weeks (T1: n=113), 6 months (T2: n=104) and 18 months (T3: n=87) after transplantation. The following concepts were measured: adherence (BAASIS©); illness perceptions (Brief IPQ); treatment beliefs (BMQ); goal cognitions (adapted from Pomaki); and socio-demographic and medical characteristics. Nonadherence significantly increased from 17%, 27%, to 31%. Controlling for T1 adherence, logistic regression showed that lower age and an increase in perceived graft longevity were related to nonadherence 6 months post-transplant (p<.05). Controlling for T1 and T2 adherence, a decrease in self-efficacy between T2 and T3 was significantly related to nonadherence 18 months post-transplant (p < .05). Various psychological factors were found to pertinent at different stages in the post-transplant period. Unrealistic beliefs and self-efficacy are potential targets for interventions aimed at reducing nonadherence after kidney transplant.

Background: The stress-relieving effects of methods including physical activity and/or relaxation were investigated. It was examined whether participants with an initial high vs. low stress level showed a different relaxation response. Methods: Participants took part in four methods: (1) physical activity combined with resting, (2) physical activity combined with balneotherapy, (3) combined relaxation (resting and balneotherapy) or (4) resting only. Blood pressure, saliva cortisol, state of mood and the status of relaxation were measured pre- and post-intervention. Groups with a high vs. low stress level were determined by validated questionnaires. Findings: 81 healthy participants were analysed (31% in the high stress group). Both groups showed significant and similar relaxation responses. The high stress group felt more awake after methods including balneotherapy (2 and 3). In this group saliva cortisol increased after physical activity combined with resting (1), while in all other groups it decreased significantly. Discussion: Results indicate that the development of personalized strategies for stress reduction that take into account the initial stress level could be beneficial.

Background Multimorbidity, the co-occurrence of multiple conditions, is particularly prevalent in older populations. Developing effective interventions requires an awareness of how multimorbidity impacts patients’ lives. The aim of this review is to develop a conceptual framework of older adults’ experiences and management of multimorbidity through a systematic review and meta-synthesis of qualitative studies. Methods Electronic databases were searched using multiple condition and qualitative methodology search terms. Included papers were synthesised using the meta-ethnographic approach described by Noblit and Hare. Findings The use of meta-ethnography allowed for the development of a higher order interpretation of older adults' experiences of managing multiple conditions. Preliminary analysis indicates that multiple-medication issues are a key challenge across studies. Discussion This review will contribute to the development of a patient-focused evidence base to inform intervention development, clinical care and policy. The review findings will also be used to explore how existing health psychology concepts may need modification for use with older multimorbid populations.

Background: Older adults living independently often require cooking and nutritional support. Our aim was to explore cooking and eating patterns among Irish older adults, as well as exploring the recommendations of geriatric healthcare professionals, in order to inform future design of mealtime support for older adults. Methods: User and expert consultations in the form of interviews and focus groups were held with 7 users and 25 experts from relevant professions. All data were recorded, transcribed, and analysed using content analysis by two independent researchers. Findings: Overall a need for cooking support for older adults living independently was evident. The data revealed 14 recommendations including: dyadic peer-based partnership; active, person-centred, additive, multi-componential intervention; prioritising energy intake; and the mealtime as occasion, and as an opportunity to evaluate improvement. Discussion: Implications for supporting cooking and mealtimes in a social cognitive framework are discussed. We also describe the development of our own novel peer-led intervention arising from this research, entitled “RelAte”.

Background: Healthy ageing is an international policy priority. This paper reviews research on psychosocial factors in healthy ageing, and considers how Health Psychology can best contribute. Method. A structured review of the scientific literature from 2000–2013, building on a previous review in 2010. The search term ‘healthy ageing/aging’ was combined with ‘older people’, also using conceptually overlapping terms. Following a review of identified abstracts, full articles on the central topic of the review were obtained and evaluated. Results. Three main factors contributing to healthy ageing were: physical exercise, social engagement, and diet; other important factors included perceived control and potentially important but neglected factors included sleep quality. Few studies considered the interactive effects of contributing factors, there were few intervention studies, and little model-testing. Conclusions. Contributing factors to healthy ageing contain a substantial behavioural component, indicating the relevance of a Health Psychology perspective. More model-testing and intervention studies are needed –to which Health Psychology is well-suited to respond.

Smoking is a major avoidable risk factor for developing diverse diseases which are caused by tobacco use. Changing the smoking behaviour into non smoking behaviour therefore is a big challenge for the health care system. Health psychologists are those who can take care of this topic in a well grounded way. Behavioural therapeutical modells of treatement have proven to be efficient and effective for nicotine dependence, a chronical addiction disorder. The treatement is not only efficient in the single or group face to face setting. Psychological tobacco cessation is also efficient when it is performed on the phone. The characteristics of the communication medium telephone – anonymous accessible anytime from everywhere - are practical for tobacco cessation. It is a low – threshold service. It therefore helps to provide tobacco cessation for a very broad and divers range of smokers and exsmokers. One important aspect of the effectiveness is the proactive element of the counselling calls. The austrian „Rauchfrei Telefon - 0800 810 013“ is offering tobacco cessation since 2006 through a team of clinical and health psychologists. The treatement emphasises the preparation, the implementation and the maintenance of tobacco abstinence as well as the relapse prevention. In addition to counselling, information on tobacco and on cessation services all over the country is offered. Treatement, experiences with different target groups, support by homepage, self help materials and supporting online - programms will be presented and discussed .

Background: With technological development and innovation in medical resources, there has become a growing number of lawsuits sued against medical profesionals in Brazil, and consequently, an increase in the number of cases of medical malpractice. Medical malpractice can be understood as the damage caused to the patient by act or omission of practitioners in the medical profession, through incompetence, imprudence or negligence. We have analyzed this situation, within the Brazilian context, and looked at how psychological treatment could be instated to act in an attempt to minimize the suffering of victims and their families. Methods: Studies were identified through electronic database searches. Findings: It was found that the Brazilian and international medical literature does not mention the psychological suffering of these victims, this leaves them vulnerable and lacking resources to fight for their rights or report incidences of malpractice. Discussion: The Brazilian Psychology community need to accept the reality of the psychological suffering of victims of medical malpractice, their sufferings and anxieties need to be worked on clinically. Families of victims could also benefit from psychological treatment to help deal with issues such as attachment and death.

the aim of study is comparison of patterns personality based on the Million Clinical Multiaxial Inventory III (MCMI-III) had two groups of males with chronic pain and normal. Methodology: to this end 202 participants , including 119 patients and 83 group control using randomly selected . primarily people with chronic pain by medical expert groups evaluated for diagnosing chronic pain .Then both groups of participants were completed MCMI-III. Results: data from the study were analyzed by one-way analysis of variance .The results showed that among groups with various types of chronic pain with each other and with the control group in some of the clinical patterns of personality subscales there was statically significant difference. Conclusion: people with chronic pain usually deal adjustment problems such in personality disorders. therefore further study could be focused on types of pain ,separation and their differential and their relation with abnormal psychology. Key Word: chronic pain-clinical patterns of personality-MCMI-III Inventory

Background: Patients’ sub-optimal medication taking behavior with respect to their therapeutic regimen leads to poorer clinical outcomes and quality of life, and generates economic loss. The implementation which explains where, when and how to act in a situation encountered, could be a solution to this problem. Method: In a randomized control study, we will test the effect of the implementation intention on medication adherence problems in 50 patients with heart failure. After choosing the daily barriers they encounter among a list of the barriers to medication adherence, participants in the experimental group will form an implementation intention by finding their own solution, which takes the form of "if I encounter the situation X, then I will do Y". Medication adherence will be measure with self-report questionnaires. Findings: The result show that medication adherence of the participants in the intervention group will be improved 1 month after the implementation intention. Discussion: Thus, it could be an effective mean to improve treatment compliance. It could be easy to administer by the psychologists or health care professionals, as part of the educational monitoring.

Psychiatric patients present high rates of interpersonal victimization. Studies fail to examine a large set of victimization experiences, not considering victimization through lifetime. The purpose is to describe the rates of a large set of victimization experiences in a sample of psychiatric patients. 96 psychiatric patients (51% female, 49% male, mean age 46.23, SD: 13.46), answered to the Life Trauma and Victimization History, and the Structured Clinical Interview for DSM-IV. Psychiatric disorders included Depression (44.8%), Schizophrenia (15.6%), Anxiety (11.5%), Bipolar Disorder (10.4%) and Alcohol Dependence (10.4%). Victimization experiences varied between 0 and 7 for childhood, 0 and 8 for adolescence, 0 and 8 for adulthood and 0 and 9 for lifetime. Verbal abuse (76%), physical violence (54.2%), threaten of physical violence (53.1%), discrimination (50%), and witnessing victimization (42.7%) were the most prevalent.Data show that psychiatric patients do experience a wide range of victimization experiences, through lifetime. Mental health care practitioners should evaluate all possible victimization experiences, in order to ensure the best suitable intervention.

Background: Eveningness preference (“late chronotypes”) and night eating syndrome are associated with higher nocturnal food intake and higher body-mass-index (BMI). Beyond consuming large portions of food in the evening, diet quality in late eaters might also be a factor contributing to weight gain. Methods: Female students (N = 133) completed the Night Eating Questionnaire (NEQ) and the Food Frequency List (FFL). Height, weight, and body composition were measured. Findings: The total score of the NEQ, and particularly its subscale evening hyperphagia, was negatively correlated with the Diet Quality Index of the FFL, indicating eating a more unhealthy diet with increasing night eating scores. When looking at the specific food categories, higher NEQ scores were associated with more frequent intake of chocolate, cakes and cookies, candy, cheese, fruit juice and sugary soft drinks. Higher scores were also associated with less frequent intake of fresh fruits and mineral water. However, neither NEQ scores nor the Diet Quality Index were associated with BMI or body fat. Discussion: Habitual late eating is marked by poor diet quality, which may be a risk factor for future weight gain.

Background: Physical activity (PA) level decreases during the transition from adolescence into adulthood, especially in women. It is well known that social and personal factors influence PA, but little is known about how and why these factors change over time. The aim of this study is to get a better understanding of how social support and personal/cognitive factors relate to PA in women aged 18-30 by exploring changes over time and identifying pathways. Methods: Survey data provided by the READI cohort will be analysed for healthy women(n~521) aged 18-30 years living in socioeconomically disadvantaged neighbourhoods in Victoria, Australia. Mediation analysis will be conducted on longitudinal data: T1 (2007/08), T2 (2010/11) and T3 (2012/13). Findings: Analyses will be conducted in March 2014. Means, standard deviations and proportions will be calculated for all variables included in the study. Mediation effects and proportions mediated will be calculated. All regression models will be adjusted for possible confounders. Discussion: Results will contribute by identifying modifiable risk factors for PA and future interventions targeting PA among women will benefit.

Background. Insufficient physical activity (PA) in patients with diabetes raise concern. The aim of the study was to examine integration of Self-determination theory (SDT) and Theory of planned behavior (TPB) to explain PA behavior in people with diabetes. Methods. It is a descriptive survey based on the TPB and SDT integrative model. Sixty patients with T1 diabetes participated in the study (Mage = 29.16). PA was measured with scale from the SDSCA, Autonomy by TSRQ for Diabetes Management, Autonomy support (AS) by Modified HCCQ For Diabetes Management. Scales to measure TPB variables were self-designed. Findings. Regression analysis confirmed association between perceived behavioral control (PBC) and autonomy (? = .50; p < .01), but not AS (p > .05), however latter predicted subjective norms (SN) (? = .46; p < .01). Intentions to be physically active were predicted by SN (? = .52; p < .01) and PBC (? = .45; p < .01), but not attitude (p > .05). Finally, controlling all other variables from SDT and TPB, intentions failed to predict PA (? = -.01; p > .05) while PBC (? = .34; p < .05) and AS (? = .36; p < .01) did. Discussion. Results did not confirm all hypothetical relationships within integrated model.

Background: Current study examined the relationship between adolescents’ coping strategies and emotional problems across different types of chronic conditions (cancer, asthma, diabetes type I and chronic renal failure). Methods: One hundred-nineteen (65 boys, 54 girls) chronically ill adolescents aged between 12-16 years-old (M = 14.18; SD = 1.39) recruited from Polish hospitals filled in measures for coping strategies and anxiety and depression symptoms. Findings: Type of diseases had direct effect on coping strategies and emotional problems. Adolescents with cancer used significantly less self-blame, planning and putting into perspective than adolescents with other chronic diseases. Also, having cancer predicted significantly more anxiety than having asthma, respectively more depression than having diabetes. Among the coping strategies used, only planning mediated the relationship between type of disease and anxiety. Discussion: Findings suggest that a categorical approach is useful in understanding the coping strategies used by chronically ill adolescents. Still, the relationships between coping strategies and emotional problems are consistent across categories of disease.

Background: Recent years have witnessed increased interest in adaptive functions of well-being to deal with stress. In our previous study, we observed the association between personal growth (PG: a sense of continued growth and development, the sub-construct in psychological well-being) and psychobiological stress responses. However, the effect of PG on psychobiological responses induced by acute stress is not clear. The aim of this study was to experimentally verify whether difference of levels of perceived PG reflects on stress reactivity or post-stress recovery process. Methods: Twenty healthy students (11 men and 9 women, mean age = 20.6 years) were recruited, and participants were classified into high (average + 0.5 SD) or low PG groups (average – 0.5 SD) screened according to levels of perceived PG among 203 participants. PG was measured by psychological well-being subscale. At the laboratory mental stress testing session, 12 high and 8 low PG participants were required to complete a 5 min speech task and a 5min arithmetic task preceded by a 10 min baseline period. Salivary free- 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG: the major metabolite of norepinephrine) and perceived stress was measured at baseline, immediately after task and recovery period. Heart rate and High-frequency heart rate variability (HF: index of parasympathetic activity) was monitored during the entire period. Findings: High PG group showed significantly lower psychobiological stress responses and quickly returned to a basal level during the recovery period (MHPG and HF) compared with low PG group, although a change in subjective and objective indicators during task period was observed in both groups. Discussion: These results suggest that perceived PG in younger adults may be related with adaptive responses which facilitate recovery from daily life stress.

Background Type D personality is associated with poorer health status and affects quality of life (QoL). The aim of this study is to explore whether different coping strategies mediate association between Type D personality and QoL in patients with multiple sclerosis (MS). Methods We collected 156 consecutive patients with MS (response rate: 72.9%; 75% women; mean age 39.95±9.97). Patients completed Type-D Scale-14 (DS14), Coping Self-Efficacy Scale (CSE) and Short-Form Health Survey (SF-36) measuring physical (PCS) and mental (MCS) component of QoL. The mediating effect of coping was analysed using the Sobel z test. Findings In PCS no mediation between studied variables was found. In MCS all three studied coping strategies mediated the association between Type D personality and QoL(z=-3.7 for problem focused coping, z=-3.37 for emotion focused coping and z=-4.11 for coping focused on stopping unpleasant emotions and thoughts). Discussion Our results can be implemented in educational programs, psychotherapies and counselling. Caregivers and physicians can teach patients to use various coping strategies in order to mitigate the adverse effects of Type D personality on patient´s QoL

BACKGROUND: Past research (Brickwell & Chatzisarantis, 2007) has shown that motivation can influence spontaneous action planning toward exercise. Using self-determination theory (Deci & Ryan, 2000), this study explores the motivational correlates of two measures of spontaneous planning within the context of physical activity (PA), namely action and coping planning, as well as how these two types of plans are related to PA practice. METHOD: A cross-sectional design was used and 352 adults (N= 291 women, mean age of 35.5 years), filled-in a web-based survey. FINDINGS: Results of a path analysis revealed that only identified regulation predicted AC while introjected regulation and intrinsic motivation both predicted CP. Indirect effects were tested using the bias-corrected bootstrap confidence limits. Results showed that: 1) AC mediates the relationship between identified regulation and PA frequency, 2) CP mediates the relationship between both intrinsic motivation or introjected regulation and PA frequency. DISCUSSION: Results are discussed with reference to SDT framework and the need for future research to examine the motivational consequences of spontaneous AP and CP.

Background: The concept of resilience as an individual characteristic has attracted recent attention. The clarification of the relationships between stress, resilience, and immune function may contribute to the prevention of psychosomatic disease. Therefore, we examined the effects of resilience on life stress through the measurement of psychological and physiological responses. Method: Subjects were 32 college students who complained of some stress during the experimental term (3 months). At the start of this study, participant resilience levels measured innate and acquired resilience. Stress level was additionally assessed with the Stress Response Scale-18 (SRS-18). Saliva was also collected so that levels of sIgA could be measured. Moreover, these parameters were evaluated again. Finding: The SRS-18 scores of the innate low resilience group were significantly higher than those of the high resilience group. The sIgA levels of the acquired high resilience group were significantly higher than those of the low resilience group. Discussion: These results suggest that high acquired resilience attenuates the subjective stress response and improves immune function.

Introduction The aim of this study was to explore the associations between the duration of physical activity (PA) , the kind of PA and the intensity of PA on the one hand and quality of life (QoL) on the other hand. Methods This cross-sectional study was based on a database which gradually expands. At the time of the analyses of which the results are presented here, the database comprised information about 825 Dutch primary school children aged 9 to 12 years. PA was measured with the modified Sport Monitor Questionnaire Youth 8-12 Years. The Kidscreen-10 was used to assess QoL. Results Children in the highest three quartiles of duration of PA had a better QoL than children in the lowest quartile. With respect to the kind of PA the research findings showed that participating in sports is also positively associated with QoL. The intensity of PA appeared to be not related to QoL. Discussion The observed positive effects of a longer duration of PA and participating in sports offer possibilities to develop preventive programs that promote the QoL of Children.

this study examined the effect of mindfullness in Gray`s behavioral activation system(BIS) and behavioral activation system(BAS) in patients with diabet. 55 patients were selected through accessible sampling method . the present research is a semi-experimental study with pre-test ,post-test and follow up .we measured BIS and BAS before and immediately after ,and then 3 months after an 8-week training program mindfulness meditation.data was analyzed using ANCOVA/reapeated Measure Design. the findings of this study indicated the significant differences between groups after intervention and the effect of therapy was permanent after follow-up period. these finding demonstrate that a short program in mindfulness meditation produces demonstrable effects on BIS and BAS system . keywords: mindfullness ,behavioral activation system(BIS) ,behavioral activation system(BAS) , diabet.

Background: Work is known to be a determinant of positive mental health, particularly for those with a mental health issue. This study explored the significance of paid work to the perceived wellbeing of people with bi-polar disorder & its impact in supporting their illness management. Methods: Semi-structured interviews were carried out with a purposive sample of 6 participants to elicit their experiences of paid employment. Transcripts were analysed using Interpretative Phenomenological Analysis. Findings: Seven themes emerged from the analyses which were subsequently conceptualised into three superordinate themes: “a desire to be part of the mainstream”, “being out of the ordinary” and “finding a fit”. Employment was of great value to participants in terms of their mental well-being & they drew on a range of practical and psychological strategies in order to reap the potential benefits of wellness and normality that employment presented. Discussion: Clinicians & employers should view the results as lending support to previous research that has stressed the significant benefits of work for well-being. It contributed to feelings of social inclusion, self-empowerment and wellbeing. Additionally it highlights the relevance of the latest government initiative Public Health Responsibility Deal which urges employers to ensure people with mental health conditions can remain in work.

Background: Many claims are made that humour enhances wellbeing and is a direct form of coping. Method: This paper evaluates the status of positive humour in research on wellbeing. There are numerous forms of humour presented in the literature. In research on wellbeing, humour is most commonly operationalised as either laughter or sense of humour. There are experimental methods to induce laughter, whereas sense of humour is measured as a dispositional trait. Findings: Induction of laughter increases pain thresholds; Endorphins are posited as the underlying mechanism explaining the effect of laughter on pain, but there is mixed evidence to support the claims. It is possible laughter works via distraction. In studies on infection, laughter is related to physiological changes, eg SIgA, but not necessarily better health, eg fewer respiratory infections. Sense of humour is associated with subjective reports of better health, positive mood, and ability to deal with stress. The effects are likely to be mediated by personality. Additionally, greater use of an affiliative style of humour is associated with social support and social networking, themselves important for wellbeing. Finally, some types of humour are harmful. Discussion: Humour has pleasant hedonic qualities and is related to wellbeing across a large array of studies. Such relationships may be mediated rather than direct. Inducing laughter may be easier than changing sense of humour to enhance wellbeing, but less permanent.

Background: While coordinated care has been associated with better outcomes in cancer patients, French studies on this topic are still sparse. Therefore, we set out to explore the factors that could impact on the continuity of care in cancer settings. Methods: 90 semi-structured interviews were carried out with various hospital practitioners (e.g. physicians, nurses, medical secretaries), general practitioners, cancer patients, and patients’ relatives. A thematic analysis was performed using N-Vivo 10 software. Findings: Contrasting themes emerged between the different interviewees. Healthcare professionals highlighted a lack of time and material resources, and of clear task assignments concerning the continuity of patients' care. On the other hand, patients and relatives focused on the quality of relations with healthcare professionals as a major determinant of healthcare coordination. Patients also pointed out the importance of their relatives’ help in the management of their care. Discussion: The links between various French cancer healthcare professionals should be reinforced, and the role of relatives more taken into account as facilitators of patients' care.

Background: The factors that contribute toward incidental sun exposure are relatively unexplored. Incidental sun exposure is neither planned nor deliberate, thus theoretical frameworks adopted for its exploration must account for this. The current study adopts the prototype willingness (PW) model as a framework for examining incidental exposure in an extreme ultra-violet radiation (UVR) environment. Method: An experimental 1-factor design with three levels aimed to manipulate the favourability of the incidental exposer prototype. Community participants (N=96) were exposed to positive or negative information about the prototypical incidental exposer. Participants responded to items assessing PW model variables and sun-related behaviour. Skin reflectance spectrophotometry was used to measure skin colour at T1 and T2 (1-month later). Findings: Preliminary findings after wave 1 recruitment suggest that the manipulation was effective with within-group differences detected for prototype favourability ratings. Discussion: Findings suggest that the PW model provides a useful framework for examining an underlying mechanism of incidental sun exposure behaviour.

Background: The progression of cardiovascular disease (CVD) is modifiable through health behaviours. Community pharmacists are ideally placed to facilitate CVD self-management however research demonstrates varying levels of pharmacist engagement in providing behaviour change advice (BCA). This study explored pharmacists’ experiences of providing BCA to patients with CVD. Methods: Semi-structured interviews were conducted with 15 pharmacists recruited from community pharmacies across the English Midlands. A thematic analysis was conducted using a Framework approach. Findings: Pharmacists categorised patients according to their perceptions of patients’ ability to benefit from advice; this influenced BCA provision. Self-efficacy to provide BCA varied. Professional identity was a key theme; beliefs concerning whether pharmacists should provide BCA varied. Professional identity and associated role conflict appeared to underpin many perceived barriers to providing BCA. Conclusions: Interventions designed to increase pharmacists’ self-efficacy to provide BCA, to integrate BCA into regular practice, and challenge pharmacists’ perceptions of patients’ receptiveness to BCA may be beneficial.

Background: This study investigated whether the effects of acute exercise are the result of a placebo effect, i.e. different expectations towards the exercise. Methods: 78 subjects were tested in a double-blinded, randomized controlled design. Expectations regarding the health effects of a subsequent 30 min bicycle ergometry were manipulated in four groups through different videos. In addition, we measured expectations towards mood and health changes following exercise that already existed in participants before the experiment. Mood, anxiety, blood pressure and EEG were measured before and after the exercise. Perceived exertion was quantified during the activity. Findings: Results show that positive expectations following the experimental manipulation resulted in reduced perceived exertion during the activity (p < .01). In addition, most of the health effects of the acute exercise (increased mood, reduced anxiety, reduced blood pressure and characteristic changes in EEG) were dependent on expectations that already existed before the experiment. Discussion: This study supports the hypothesis that health effects of acute exercise are at least in part result of a placebo effect.

Background: We aim to explore factors influencing the breaking bad news process in different medical contexts with irreversible conditions (others than cancer). Methods: 23 patients and 18 physicians concerned by different chronic diseases were interviewed by psychologists. They received/broke bad news in the few months preceding the interview. Findings: Thematic analysis of interviews allowed to identify higher-order themes, and more specific themes for both, patients and physicians. The main topics covered by physicians concerned the determinants of the strategies to communicate with patients, the encountered difficulties, the initial training, the information, interpersonal relationships, emotional reactions, perception of its role, the specifics of the disease. The discourse of patients referred to three stages including specifics topics: the communication of bad news, the health care pathways, and the life with disease. Discussion: Data analysis highlight importance of patient and physician’s profiles, and specifics of disease, in the breaking bad news process. Recommendations to build tailored intervention for physicians by using formative self-assessment will be exposed.

Background: Even with demand for transplant organs exceeding supply, registration of homosexuals remains controversial. While some theorists suggest positive experiences lead to prosocial behavior, others like Staub, posit group hardship leads to helping. We break ground by being the first to examine the prevalence and psychological correlates of this altruistic action in those with homosexual tendencies. Methods: In 13,856 individuals from Wave III of Add Health, we examined sexual orientation controlling for gender and education using decision trees and analyzed personality correlates. Findings: Homosexual tendencies, being female, and having higher education were associated with increased registered organ donor rates. In groups with at least a high school education, individuals with homosexual tendencies' rates were almost 14 percentage points higher. No differences in altruism existed, but those with homosexual tendencies were more liberal and less conservative. Discussion: Although individuals with homosexual tendencies were higher in registration, altruism measures did not underlie the relationship. Research is needed to understand the behavior's mediating factors.

Falls is a major health issue among the elderly. It instils fear of falling (FoF) and affects quality of life (QoL). However few studies have examined this issue in a multicultural population like that in Malaysia. Our aim is to evaluate the association between FoF and QoL among Malaysian older adults. Respondents aged 58 and above, able to give consent, were recruited from University Malaya Medical Centre and community centers (n=486). QoL and FoF were measured using CASP-19 and short Falls Efficacy Scale-International respectively. Questionnaires were administered face-to-face by trained interviewers. Participants were mostly female (66%). The ethnic distribution of participants was: Chinese (60%), Malay (24%), Indian (12%) and others (4%).Mean score for QoL is 43.8 ranging from 10-57 while FoF mean is 13.2 ranging from 7-28. QoL declined as FoF increased(r=-.47, p?.01) Malays have the highest QoL in Malaysia. QoL scores decrease with increased FoF. Further study is necessary to establish the role of economy or livelihoods as well as investigating are cultural practices of a particular ethnic influencing QoL in anyway

Background. There are a lot of difficulties in keeping chemically dependent young people in treatment programs. Researches show that a lot of them relapse because of the lack of motivation to maintain treatment changes. The aim of this study is to examine psychosocial factors which affect motivation to seek treatment and maintain those changes. Methods. A cross-sectional design was used to survey chemically dependent young people. Special scales were created to measure socio-demographic characteristics and features of substance abuse. Measures is being used: URICA Questionnaire and TCU Psychosocial Scales. Participants (N=58) were taken from the addiction treatment programs. Findings. Precontemplation, contemplation, action and maitenance stages of motivation to change were significantly related with different self-esteem, depression and anxiety levels and also with social factors (risk-taking behavior, social conformity and hostility). Discussion. In order to enhance motivation to change in substance abuse treatment it is important to evaluate comorbidity level and the role of social factors. It is essential for the improvement of the motivational programs for young drug abusers.

Background: Context aware smartphone apps for behaviour change have become a reality due to a rapidly growing smartphone market and the presence of sensors on smartphones as standard. Aim: to describe the development of a novel smartphone sensing smoking cessation app (QSense). Methods: The development of QSense has been informed by: a) a sparse literature on how smokers’ cravings are cued by contextual triggers, b) the tailored message libraries from two theory-guided tailored SMS text message support systems for smoking cessation (MiQuit and iQuit), c) early piloting work, d) a qualitative study using data assisted interviews of smokers who have tested out the app. Findings: This system has been designed to deliver real-time behavioural support triggered by a smoker’s proximity to a pre-identified high risk location for a cue-induced craving episode. However, there are many challenges to developing context-aware eHealth behaviour change interventions to avoid user disengagement. Discussion: New clinical and theoretical insight is required to inform the next generation of digital interventions which promise context awareness.

In this research we study the relationship between the level of stress and counterproductive behavior, moderated by negative affectivity. The main objectives are: the analysis of the stress, as a component of counterproductive behavior, the identification of the relationships between the occupational stress and counterproductive behavior, the identification of the relationship between the negative affectivity and counterproductive behavior, and the decrease of the occupational stress, by individual and organizational strategies. Subjects (N=94) are employees of an aeronautical organization. Statistical results show a positive and significant correlation between stress and counterproductive behavior (r=.357, p<.05). Regarding negative affectivity and counterproductive behavior, we measured a positive and significant correlation (r=.373, p=.011). The regression model for the moderator effect show that stress is a powerful predictor for the counterproductive behavior (p<.005), but the interaction between occupational stress and negative affectivity adds an increment of .04, compared to separate predictors, and this difference is statistically significant (p=.038).

Background: Few studies were conducted on the covariates of having breakfast among young adults. The present study examined the association of having breakfast with other health behaviors, alertness, mood, and achievement (=grades) among students. Methods: 213 students (mean age=25) filled an online cross-sectional survey. Having breakfast was the independent variable, and other health behaviors (not drinking sweet beverages, exercising, fruit and vegetables intake), alertness (10 items, ?=.90), mood (10 items, ? =.86), and mean grade were the dependent variables. Age and parental SES were recorded. Results: Students who ate breakfast engaged significantly more in other health behaviors, had better mood, and reported higher mean grades. There was no difference between the two groups in alertness. Conclusions: The study is first on reporting higher reported grades among students eating breakfast and joins other findings in the literature demonstrating the beneficial covariates of having breakfast among young adults, thus extending the findings from children and adolescents to adults.

The purpose of the research was to analyze the connection between conscious attitude to the health and cardiac rhythm regulation in emotional situation. Inner health picture – the term proposed by Yu. Nekrasova (1984) - is the system of the human representation about health, its value and understanding the methods of its support and forming. 83 pupils of the primary school were participants (9,1± 0,5 yr. old). Children answered on the questions about health using the questionnaire about inner health picture. Later they were asked about the methods of the punishment and the rewards in their families and variability of cardiac rhythm were registered during this conversation. SPSS program were used for the data analysis. Regression analysis shows that the higher level of the inner health picture the child has the better cardiac regulation is. The research was supported by RGNF grant N 14-06-00195 and 14-16-48005

Background: Colorectal cancer is among leading causes of cancer related deaths in men and women in many countries. This investigation was carried out to examine the contribution of pain to decreased social activity in colorectal cancer patients. Thirty two (32) patients were examined. The mean age of patients was 64.1 years (SD = 10.6), 56% were male, 52% did not know their cancer diagnosis which was related to colon (42%) and rectum (58%). The second research group consisted of twenty eight (28) patients with chronic low back pain. All patients were assessed based on clinical standards (physical examination, laboratory results, histological diagnosis and analysis of medical records). The methods used were Visual Analogue Scales (VAS), Cold pressure test, standardized interviews and self-questionnaires – Back Depression Inventory and State-Trait Anxiety Inventory for Adults. 29 patients experienced pronounced anxiety because of their pain and 23 patients expressed depressive pain-associated symptoms. We found significant differences between cancer and non-cancer groups in level of functional activity decreasing especially mental functioning and social activities.

Objectives: This study was designed to identify the relationship between positive and negative emotions and physical and psychological well-being. Methods: Japanese university students (N = 200) participated in a self-administered questionnaire survey by responding to the Positive and Negative Affect Schedule (PANAS), Subjective Well-Being Scale (SWBS), and certain items of the Cornell Medical Index (CMI). Results: There were significant positive correlations between positive emotions and physical and psychological well-being, as well as significant negative correlations between negative emotions and physical and psychological well-being. A stronger correlations was observed between psychological well-being and positive and negative emotions among women than men. Moreover, there was a significant difference in psychological well-being depending on positive and negative emotion scores, and their interaction. Discussion and Conclusions: Well-being was associated with both positive and negative emotions. Moreover, these emotions had a stronger influence on women than on men. Also, the results indicated that having high positive emotions was more important for psychological well-being than the absence of negative emotions. It is suggested that further investigations on populations with a wider age range should be conducted to replicate these results.

Present study investigated the effects of “Ibasho” on relational aggression such as bullying among schoolchildren. The purpose of this study was to prove that children with “Ibasho” would not be aggressive against others even if they had been under some stress. What is “Ibasho” in Japanese? According to the definition, it contains two keywords; sense of belonging and sense of authenticity. My first concern is to determine whether “Ibasho” is a mediator of the relation between stressors and relational aggression. My second concern is to determine whether there is a difference among schoolchildren who belong to two schools; one school (School A) which has many opportunities to interact with adults living in its local area and the other (School B) which has few opportunities to do so. The participants were 604 fourth and fifth grade students; 258 in School A, 346 in School B. The results indicate that children in School A have less achievement stressor, more “Ibasho” and better cooperation, and that the interaction with adults in the community may be a unique predictor to reduce problem behaviors among schoolchildren. Implications of these findings are discussed.

Background:Critical thinking (CT) involves successful analysis and evaluation of evidence and arguments as well as the inference of reasonable conclusions and is crucial in modern workplaces(Facione, 2013). According to dual-processing accounts, such reflective responses require the intervention of executive functioning (EF; Evans & Stanovich, 2013). One proposed way of enhancing EF is through mindfulness practice (Chiesa et al., 2011). This study investigated whether mindfulness facilitates CT and whether this relationship is mediated by EF. Method: The FFMQ (Baer et al., 2006), an EF battery (Miyake et al., 2000) and the Halpern Critical Thinking Assessment (Halpern, 1998) were administered to 196 undergraduates. Findings: Structural Equation Modelling showed relations between (1)mindfulness and CT performance;(2)each EF process (Updating, Inhibition and Shifting) and CT performance;(3) the Observing and Acting with Awareness facets and Updating;(4)the Observing and Acting with Awareness facets and Shifting; and (5) Non-reacting and Non-judging and Inhibition. Discussion: The possibility of enhancing CT through mindfulness practice is compelling as it would be synergistic with improved well-being outcomes.

The levels of self-efficacy, spiritual well-being and their relationship with treatment motivation in under treatment drug addicts were investigated in the current study. It was hypothesized that self-efficacy would mediate between spiritual well-being and treatment motivation. A sample of 60 under treatment drug addict volunteers was drawn from 4 drug rehabilitation centers in Lahore. The measures used included Urdu version of Spiritual Well-Being Scale (Booth & Martin, 1998), Treatment Motivation Questionnaire (Ryan, Plant, & O'Malley, 1995) and Generalized Self-Efficacy Scale (Jerusalem & Schwarzer, 1981).The results showed a significant positive association among spiritual well-being, self-efficacy and treatment motivation in drug addicts and self-efficacy and spiritual well-being both predicted treatment motivation. The meditational analyses depicted that self-efficacy significantly mediated between spiritual well-being and treatment motivation. The married participants showed more treatment motivation than unmarried participants. The results are discussed in the light of existing literature as well as in particular cultural context of Pakistan.

Background: The transition to university can be associated with a decrease in health-promoting behaviours (e.g., exercise) and an increase in health-risk behaviours (e.g., alcohol). An online intervention, combining self-affirmation, the theory of planned behaviour and implementation intentions, targeted fruit and vegetable intake, exercise, binge drinking and smoking during the transition to university. Methods: New students (N=2621) were randomly allocated to an online health-behaviour intervention (U@Uni: LifeGuide) or a measurement-only control condition one month before starting university. Participants were followed-up one month after starting university (N=1319). Findings: At one-month follow-up, participants in the intervention group reported eating more fruit and vegetables, F(1, 1280) = 4.19, p = .04, than participants in the control group. No significant differences were found between the two conditions on the other three health behaviours targeted in the intervention. Discussion: The findings suggest that a theory-based intervention targeting multiple health behaviours may have a modest impact on the health behaviours of students during their first month at university.

Background. An individual resorts to self-handicapping in the situations of the anticipated failure to protect one’s self-esteem (Feick & Rhodewalt, 1997). The objective of this research was to identify its personality precursors and outcomes for mental health. Method. On a sample of 120 university undergraduates, using the methods of factor and cluster analysis its intercorrelations with the likely personality precursors including coping strategies were assessed. Findings. The phenomenon appeared to have significant negative correlations with belief in self-efficacy, disposition to self-actualization, self-esteem and problem-focused coping, both reactive and proactive. It positively correlates with emotion-focused coping and neuroticism, all being the members of the same cluster. The cluster analysis revealed statistically significant differences between clusters with higher and lower self-handicapping tendencies on the subjective well-being (t= 2.97, p<.05) and mental-health continuum (Keyes, MCH-SF, 2009; t= 4.05, p<.01). Discussion. Self-handicapping can be claimed to merit the status of a maladaptive proactive coping strategy affecting mental health.

Background: Infertility is highly stressful for religious women. Based on the Self-regulation Model, we tested the associations between perceptions of infertility, coping, and psychological adjustment. Methods: 186 religious Israeli women undergoing infertility treatment filled in questionnaires assessing perceptions of infertility (based on the IPQ-R), religious coping (turning to God /the community /Rabbis), and psychological adjustment (distress and well-being). Findings: The full study model was tested by structural equations modeling. Perceptions of lower control and greater severity (chronicity and consequences) were related to poorer adjustment. Religious coping did not mediate these associations but had independent associations with adjustment: Seeking Rabbi support was associated with lower distress and seeking community support had both positive and negative associations with adjustment. Discussion: The data support the importance of illness perceptions and coping for adjustment to health threats yet suggest that coping is an independent factor, not a mediator. The findings highlight the importance of studying coping and adjustment within the socio-cultural context.

Background: Public health research, practice and policy focus on many health behaviors (HBs). Therefore, five studies were conducted to create the Health Behavior Taxonomy (HBT), a classification representing meaningful clusters of HBs, based on lay-perceptions. Methods: A comprehensive list of HBs was elicited from lay people and professionals (N=100), and their perceived importance was rated (N=266). A card sorting task and cluster analysis were applied (N=374), and replicated (N=510). Results: 66 HBs were reduced to the 45 most important ones. Hierarchical cluster analysis using similarity data revealed a taxonomy consisting of 4 main clusters (General well-being, Avoiding risk, Nutrition, and Physical health routines), representing the cognitive schema by which people process and integrate information regarding HBs. Clusters differed by importance judgments, and minor yet interpretable variations in clustering were associated with gender and age. Compared to the HBT, engagement reports formed a divergent structure. Discussion: The HBT can advance health promotion programs and cost-effectiveness of interventions by targeting clusters of meaningfully linked health behaviors.

Due to the relevance of attachment as predictor for maternal disorders and family functioning, this study’s aim is to validate the 19 items Maternal Postnatal Attachment Scale-MPAS (Condon & Corkindale, 1998) to Portuguese population. After back-translation process and a pre-test, MPAS was applied in a cross-sectional study to 219 women, aged from 18-47 (M=30.97; SD=5.49), mostly married (83.1%), with a 1-12 months child (M=7.01; SD=3.23). After item’s exclusion due to lack of variance or significant correlations, KMO (0.71) and Bartlett´s test (p<.001) enabled the PC Analysis -Varimax rotation. One item eliminated due to low factor loading. A two-factor solution emerged, explaining 30.45% of total: 1st factor-attachment quality (7 items; ? =.65); 2nd factor-maternity feelings (7 items; ?=.56). The final version (14 items; ?=.69), is adequate for future studies. Although relational and maternal experiencing dimensions are coherent with attachment theory, this structure doesn't support the original tri-factor model (Pleasure in proximity; Acceptance and tolerance; Competence). Cultural and social desirability factors may explain current results.

Background Stigmatising feelings are common among parents of children with epilepsy. Parents who harbour fear of their child with epilepsy being viewed differently may restrict the child’s social participation. This study aimed to explore issues related to the interpersonal processes and context surrounding parent child dialogue about epilepsy, including consequences of communicating, or not, about epilepsy related issues, such as the restriction of participation in social activities. Method Phase one of this mixed method study involved conducting qualitative interviews with 30 children (6–16 years) with epilepsy and their parents. Data were thematically analysed. Findings Findings revealed a core theme of parents’ restriction of social activities in response to their child’s epilepsy. Sub-themes included hyper-vigilance (a heightened sense of watchfulness) and avoidance of communication about epilepsy to minimise social restrictions. Discussion Parental over-protection can relay to children the limitations that their epilepsy imposes on them. The impact of these limitations can not only support a child’s negative attitude towards epilepsy but also promote child exclusivity and isolation.

Background: The relationship between the experience of pain and its emotional expression has been previously demonstrated. The present study explored the associations between the experience of pain, the social sharing of emotions (SSE) linked to the painful experience and personality. Methods: 230 laypersons (165 women and 65 men) with an average age of 31 years (20-65; SD = 11.5) were invited to recall a recent (within 3 months) painful experience. Questionnaires assessed quantitative and qualitative aspects of the SSE related to this experience, as well as personality factors. Findings: The quality of SSE showed significant correlations with the following personality factors: extraversion, agreeableness and neuroticism. In a multiple regression analysis these personality factors explain 11% of the variance concerning the interpersonal quality of the SSE F(3.226)=9.6; p < 0.001. Discussion: Along with previous research showing the crucial role of positive social interactions and well-being, these findings gather further information when it comes to the role played by personality in individuals’ perception of such interactions. Further research should examine this matter in chronic pain patients.

Body Perception Disturbance (BPD) is a part of CRPS, whereby sensory distortions occur. Visually altering the affected hand may normalise disturbed perceptions, encourage limb engagement (Lewis & McCabe, 2010) and improve rehabilitation outcomes. The MIRAGE device has been found to relieve pain and affect movement via digital manipulation of painful limbs (Preston & Newport, 2011). Mixed methodology with 6 patients. Data analysed with non-parametric tests using SPSS. Qualitative data analysed using Thematic Analysis. Participants’ hands within MIRAGE, performed movement tasks, rated statements on hand appearance, and answered questions on perceived and desired hand movement. Affected hand digitally altered to desired appearance and viewed for 1 minute before answering measures. Fear of movement and BPD measured at baseline and post intervention with BPD and TSK scales. Non-significant changes in response time and accuracy, significant changes in perceptual ratings. Themes identified: loss, self-evaluation, fear of movement, and overall effect of intervention. Results infer potential to normalise disturbed bodily perceptions, improving quality of life and rehabilitation outcomes.

Background: Amazons’ Mechanical Turk (MTurk) is fast becoming a key tool for conducting online cross-sectional and experimental health research. This study evaluated the feasibility of employing MTurk for a longitudinal randomised controlled trial (RCT) using simple positive psychology activities aimed at increasing wellbeing and social relationships. Methods: Using Unipark software, 465 MTurk participants were randomised to one of four intervention conditions (or control) and were assessed on psychosocial and wellbeing measures at three time points (baseline, post intervention and one month). Participants were given online instructions on how to complete their assigned positive psychological activity. Findings: Mturk was found to be an inexpensive and speedy resource for recruiting participants and testing a longitudinal RCT paradigm. Although compliance to the assigned wellbeing enhancing activities was good, attrition rate was high at final follow-up (>50%). Discussion: MTurk is identified as a cost and time effective mechanism for conducting ehealth intervention research. However caution is urged on several grounds regarding high attrition rates and generalizability of samples.

Background: Health psychology interventions are increasingly expected to improve subjective well-being (SWB), rather than health-related quality of life (HRQOL) only. However, little is known about how SWB relates to HRQOL and other quality of life (QOL) domains among HIV-patients. Methods: HIV-patients treated in the Netherlands completed a cross-sectional survey on SWB (Satisfaction With Life Scale); HRQOL (SF-12); social, financial, sexual, and environmental well-being (WHO-QOL), as well as demographic and clinical characteristics. Exploratory structural equation modeling was conducted in AMOS to predict SWB. Findings: The questionnaire was completed by 191 participants. In univariate analyses, all (HR)QOL domains were significantly related to SWB (range r=.17-.42). Physical health (?=.14; p<.05), mental health (?=.27; p<.01), and environmental well-being (?=.41; p<.01) directly predicted SWB, while financial and social well-being explained SWB indirectly. Discussion: Health psychology interventions among HIV-patients are mostly focused on mental and physical health. To further promote SWB, services should also focus on promoting environmental, financial, and social well-being.

Background: Camphor essential oil can sedate the autonomic nervous system. However, no study has been undertaken in the past to investigate its sedative effects using biological markers. The purpose of this study is to evaluate the sedative effect of camphor essential oil on the recovery process from the psychobiological stress responses induced by mental stress testing. Methods: Twenty healthy participants were recruited, and they were randomly classified into the aroma group and the control group. Salivary MHPG (the major metabolite of noradrenaline) and HF-component (index of parasympathetic activity) were measured at the baseline, immediately after speech & arithmetic tasks and the recovery period. Findings: The level of MHPG in the aroma group returned to the basal level during the recovery period more quickly than the control group, although an increase in MHPG during the task period was equally observed in both groups. HF-component increased in both groups during the recovery period, but these levels were significantly higher in the aroma group than in the control group. Discussion: These results indicate that camphor essential oil could produce sedative effects which promote the recovery process from the psychobiological stress responses.

Background: In Aged society, smooth exchange between generations is expected. In this study, relations of images and knowledge to the elderly, and feeling of consideration to grandparents and parents in developmental process were examined. Methods: Scores of image factors (integrity and tenderness, activeness, maturity and positiveness, extracted with a principal factor analysis) and knowledge of 183 university students were compared with two-way ANOVA at pre-post of lecture of Aging psychology and between groups according to recognition to grandparents and parents. Findings: Main effects of pre-post were significant in integrity and tenderness, positiveness, and knowledge (post >pre). Main effects of groups were significant in integrity and tenderness, maturity, and positiveness (to grandparents and parents > to grandparents or parents, or to neither). Discussion: Although knowledge was acquired through lecture regardless of recognition to grandparents and parents, change of images were different according to recognition. The affirmative recognition formed with consideration attitudes of grandparents and parents promotes understanding in various sides of the elderly.

We tested the hypothesis that decision made in intuitive mode tapped into non-declarative, affective-based motive system (implicit), while decision made in deliberative mode tapped into declarative, cognitively elaborated, socially influenced motive system (explicit). Mixed design study was used; motives and decisions measured within, while intuitive-deliberative manipulation was between. As decisions (dependent var.), scenarios with options corresponding to Achievement, Power, and Affiliation motives were used. Regression analysis (N=66) indicated no meaningful interaction when instruction followed standard means of inducing intuitive-deliberative modes. When focused on self vs. others were used instead, same analysis (N=80) showed the expected interaction effect, between explicit motives of affiliation and preference for affiliation options, only in deliberative (t=2.35, p=.02) and not in intuitive (t=-.20, p=.84) condition. Similar findings were found for explicit power motive on choice; high (t=4.42, p=.00) and low (t=-.26, p= .80) deliberation. Decisions congruent on implicit motives ensure affective satisfaction and enable automatic self-regulation, resulting in well-being and personal growth. Decision mode, however, is a mediator in choice-congruent motives. Results of the study showed that current decision making trend which focuses on deliberation and ill-defined intuition, goes contrary to the aim of well-being enhancement.

Background: The primary objective is to provide answers to research questions about the way in which teachers working in a deprived environment, experience and manage their challenges, and the characteristics they display. Methods: This was a qualitative investigation. The participants came from the schools of a disadvantaged township and were selected by means of purposive sampling, meeting a set of pre-determined criteria. The data were collected through drawings and narrations and then analysed into themes, according to the steps of Tesch. An independent researcher confirmed the findings via re-coding and consensus. Findings: The following themes emerged from this study: The teachers working in a deprived environment experience even more context-related challenges than other teachers. They display a specific approach to their teaching. The maintenance of their efforts is based on their personal strengths. They draw on their available assets and support. Discussion: When the findings are screened against the essential components of emotional intelligence, it becomes clear that the teachers, who work in this deprived environment, handle their specific teaching challenges in a mentally healthy way. This makes a comprehensible contribution to the existing theory on well-being, emotional intelligence and health psychology.

Background. To determine socioeconomic inequalities in opiates and cocaine related Fatal OverDose (FOD) cases and their implications in terms of prevention. Methods. Cross-examination of healthcare and forensic data in a nested case-control study design. FOD cases (272) were individually matched with 4 controls (1,056) according to sex, year of birth, drug administration route, duration of drug use and compared through conditional logistic regression. Findings. Employment [OR=0.662(95% CI 0.446–0.985)], salary as main income [OR=0.417(95% CI 0.258–0.674)] and educational attainment higher than primary school [OR=0.501(95% CI 0.344-0.729)] revealed to be protective, whereas parental professional status was not associated to FOD. Discussion. Among peers, drug users with lower socioeconomic profiles show increased odds of FOD. However, self-referred socioeconomic characteristics impacting on daily life quality such as education, employment and revenue, were more predictive of FOD than transgenerational factors (e.g. parental social status). Thus, motivational interventions fostering socio-professional integration should be given due attention in dedicated harm prevention policies.

Background: The main aims of this study were to explore (1) the associations between depression, perceived social support (PSS) and generalized problematic internet use (GPIU), (2) the mediating effect of PSS on the relationship between depression and GPIU within a longitudinal design (SliCE study, www.slice-study.eu). Methods: A total sample of 814 university freshmen (T1), and 237 students (after one year period T2, 29.1% students of T1, 73.5% females, SD=3.67) completed an on-line questionnaire measuring GPIU, depression and PSS. The analyses were carried out using Linear regression (changes in depression and PSS between T1 and T2 were entered as independent variables and changes in GPIU between T1 and T2 were entered as the dependent variable in the model) which was followed by the Sobel test. Findings: Increased depression was associated with increased GPIU (beta=0.216, p<0.01), decreased PSS was associated with increased GPIU (beta=-0.197, p<0.05). The PSS changes were found to mediate the effect of depression on GPIU changes (Sobel test=-1.75, p<0.05). Discussion: The results support the importance of social support in GPIU prevention.

The focus of the current work is integrating the theory of bounded rationality with decision-making regarding eating behaviour. Bounded rationality outlines how individuals make decisions while constrained to time, cognitive capability, and their environment. It proposes the use of heuristics, or simple mental tools, which show to be both fast and frugal. Bounded rationality's focus in on the interaction between cognition and the environment- that is, the selection of heuristics used will depend on both the environmental context and cognitive capacity. Bounded rationality’s emphasis on the environmental context as a major influence in the decision-making process complements present theories in food decision-making. Variance of cognitive capability in the selection of heuristics in food decision-making is less studied, and will be explored. Bounded rationality will be described, related to existing models, and reviewed through empirical evidence. This work has possible implications for designing heuristic-based weight management programs centered around food decision-making, which cater to both the environment and cognitive capabilities of the target group.

Background-Well being is an important outcome in health. The objective of the study is to identify psychosocial predictors of well being, after one year, in a group of persons with a stable chronic disease Methods –The study is longitudinal: Participants are a consecutive sample of 436 chronic patients with a diagnosis for over three years, age 18 - 65 years, 76.9% female, without cognitive limitations. Patients were assessed for psychosocial variables and one year later for well being. Well-being is a component of SF-36. The psychosocial predictors includes the big five personality inventory, severity of disease, time since diagnosis, adherence, optimism, spirituality, stigma, positive and negative affect, and social support. Regression analysis forward method, with well being variable as dependent variable was used. Results- show an (adj)R2 of .35; the order and importance of predictors are: Positive affect, stigma, neuroticism, severity of disease, extraversion, negative affect, adherence. Discussion- A combination of positive and negative variables act together to a better well being. The study helps the orientation for intervention to facilitate adjustment to chronic disease

The Health Action Process Approach (HAPA; Schwarzer, 1992) is one of the most widely used model to investigate the adoption and maintenance of health behaviors. The present study aimed to investigate whether the personality profile could affect the preintentional stage of the HAPA in a population of young daily smokers (N=287). The questionnaire was composed of the Big Five Adjectives Scale (BFA) and of scales to measure risk perception (RP), action self-efficacy (ASE), outcome expectancies (OE), and intention to change behavior. A cluster analysis was performed to identify personality profiles. Profiles were then set as cluster variable in a mixed model. Nine personality profiles were identified. The final mixed model included random effects for intercept, RP, and ASE. Results indicated that: resilient profiles had the largest positive effects of both RP and ASE on intention, whereas these constructs did not affect the intention to quit smoking for overcontrolled people; undercontrolled profile showed a positive effect of ASE but not of RP. Findings suggest the importance to consider personality traits in the HAPA in order to improve interventions to help people quit smoking.

Several individual difference risk factors, including the presence of external locus of control, psychopathology and gender have been linked with thalassemia patients’ diminished well-being. Experiential avoidance (EA) was found to moderate symptom presentation in chronic patients; however its relation to thalassemia and well-being has not yet been examined. The present study explored differences between 2 levels of locus of control (external vs. internal) on physical and mental well-being in 74 thalassemia patients. The SF-36, AAQ-II and the Multidimensional Health Locus of Control Scale (MHLC-C) questionnaires were used. Individuals with external locus of control had significantly lower mental quality of life compared to those with internal control. Individuals with high EA presented with significantly lower physical quality of life but did not differ in terms of locus of control. There was no significant interaction between gender and EA on well-being. EA was found to be a significant moderator only for internal locus of control on well-being. Implications of the results may aid in the design of individualised health care programs for thalassemia patients.

Background: Little is known about the pathways through which maladaptive beliefs impact adaptation to illness. In this regard, the aim of this study was to examine whether illness representations mediate the relation of maladaptive health beliefs to patients’ subjective health. There is considerable evidence that an adaptive representation of a curable/controllable illness is related to better health, whereas a less adaptive representation of a severe, troublesome and less controllable condition is associated with worse health outcomes. Methods: Patients suffering from cancer (N=125) participated in this cross-sectional study. Mean age of the sample was 58 years (sd =11.49), 78 were women and 47 men. Findings: Personal control and emotional representations mediated the relation of maladaptive beliefs to health. Also, personal control and illness coherence mediated the relation of maladaptive beliefs to coping behaviour. Discussion: It seems that maladaptive health beliefs, as deeply-rooted ways of processing health-related information, ‘urge’ patients to represent illness in a more negative way, which in turn impact adaptation to illness.

Background: Regular moderate-intensity walking is recommended for patients with Fibromyalgia. Our aim is to identify the predictors of walking in fibromyalgia patients, using intention and perceived behavioral control (Theory of Planned Behavior: TPB) and taking into account other variables related to the fibromyalgia condition. Methods: 274 Fibromyalgia women completed self-reported questionnaires for the assessment of TPB constructs, previous walking behavior, fear-avoidance, distress, pain intensity and FM impact variables (Time 1) and seven weeks later they repeated the walking behavior assessment (Time 2). Person correlation and multiple regression analyses were conducted. Findings: Intention, perceived behavioral control and fibromyalgia impact in T1 were significantly correlated to self-reported walking behavior in T2, but only perceived behavioral control was a significant predictor (?= .15, p=.03) accounting for 6% of the variance. Discussion: Participants did not act on their intentions in Time 2. To increase the control perception will be more helpful than strengthening intentions. Supported by Spanish Ministry of Economy and Competitiveness (Grant: PSI 2011-25132).

Background: We aimed to investigate the contribution of gender, country, perceived stress (PS) and perceived social support (PSS) to the risk of eating disorders (ED) among university students. Methods: 1687 freshmen university students (74.21% females, mean age 20.30, SD=3.78) from SK (n=607), LT (n=539) & HU (n=541) completed the SCOFF questionnaire, Cohen´s perceived stress scale and Multidimensional Scale of Perceived Social Support. Binary logistic regression was performed to calculate the odds of risk of ED as a full model with gender, country, PS and PSS as independent variables. Findings: The model was statistically significant and explained between 10.5% & 16.5% of the variance in the occurrence of ED indicators. Gender and country were significant with an odds ratio of 0.421, 95% CI: 0.301-0.589 (men vs. women) and 2.99, 95% CI: 2.20-4.05 (LT vs. SK) respectively. PS increased the likelihood that respondents would be in the ED risk group with an odds ratio of 1.14, 95% CI: 1.10-1.19 and PSS decreased it with an odds ratio of 0.985, 95% CI: 0.977-0.994. Discussion: Prevention strategies of ED should also be aimed at stress management and looking for social support sources.

Background: The aim of the study was to analyze the relationship among illness perception and self-efficacy and changes in quality of life in lung cancer, in the context of the mediation role of coping and posttraumatic growth. Methods: Data for the analysis were obtained from 102 patients. The measurement was conducted three times, 3-4 days after the surgery (Time 1), one month after the surgery (Time 2) and 4 months after the surgery (Time 3). Findings: Coping strategies based on emotion regulation (T1 and 2) serve as the main mediator between cognitive interpretations of disease (T1) and quality of life (T2 and 3). Coping strategies (T1 and 2) and factor of posttraumatic growth - a sense of personal power (T1 and 2) serve as the main mediator between the self-efficacy (T1) and quality of life (T2 and 3). The analyzed cognitions most frequently predicted such areas of quality of life as: physical functioning, functioning associated with symptoms, functioning associated with lung cancer symptoms and cognitive functioning. Discussion: The findings provide an insight into the key modifiable cognitions which may facilitate post-surgery adaptation and better quality of life.

Background: The aim of this study is to examine the interest for relation between quality of life (QOL) and well being of an implementation of a program of physical activity, with patients of Multiple Sclerosis (MS). Methods: This is a correlation study. The study includes 27 patients with MS, mean age 44 years, 58,3 % women, 37,5% currently married, 67% retired, mean school level of 12,5 years. We use the questionnaire and the Multiple Sclerosis Quality of Life scale (MSQol-54) and sub scale psychological well-being (PWB) of Mental Health Inventory The program consists of an intervention to promote physical activity (IPPA) in a group of eight people, in once a week sessions of 90 minutes, during seven weeks. We analyze the results through the Spearman correlation tests between the dimensions of MSQOL-54 and Well-being. Findings: The Results the correlations between PWB and the domains of MSQOL-54 before application of IPPA and the end of the implementation of IPPA, showed that there were statistically significant correlations between all variables. Discussion: In this study, suggests that IPPA can play an important in the relation between the QOL and PWB of these patients.

Background: Quality of life has multiple influences on behavioural risk factors of chronic diseases, which are important for carrying preventive activities. The aim of the study is to determine the links of environmental domain of WHO HR QoL 100, self-rated health (SRH) and usage of alcohol, tobacco and other drugs (ATA). Methods: The study involved 913 males and 1317 females, participants of Kaunas regional Health project investigated by environmental domain of questionnaire WHO HR QoL-100 with SRH scales and items for evaluation of ATA. Results: (1) Women who are more satisfied with their environment and value their health higher, consume alcohol once or more per month, and have never attempted to quit. Men who value their health higher, use alcohol more or less often and have never tried to quit. Men who are more satisfied with their environment, use alcohol once or more times per month. (2) Women, who value their health less, do not smoke and/or never have been smokers. (3) Men and women, who are more satisfied with their environment and value their health higher, are less tending to consult a psychologist compared to those who value their health less and are less satisfied with their environment. Discussion: Findings confirmed the importance of environmental quality of life and SRH for the usage of addictive substances.

BACKGROUND: The objective of this study is to observe how the motivational interviewing in groups can influence the quality of life and psychological health of people with disabilities. We are interested in knowing if motivational interviewing helps people to change their thinking. Our sample has initially responded to the pre-questionnaire before the motivational interviews and have responded at the same questionnaire after the procedure of motivational interviews METHOD: 59 people with motor disability and sensory were selected. We undertook an interwiew with each of them in order to collect sociodemographic informations. All the subjects were asked to complete questionnaires of accessibility, mobility, satisfaction urban development, depression and anxiety, motivation to engage in a process of behavior change. FINDINGS: Results show greater trust in the fact of increasing the output frequency. We note an evolution in the stages of behavior change between T1 and T2. Subjects show a positive and significant increase in their desire to increase their output. DISCUSSION : Subjects have a higher score in T2 in the scale of motivation on their mobility. The importance to increase mobility and self-confidence to want to get out more and the feeling of being willing to invest more public places have increased considerably.

The aim of the study is to explore the relationships between personality characteristics and risk taking in two areas: sexual behaviour and substance use. The participants are Bulgarian young adults (n=178). The Big Five personality dimensions, past sexual behaviour, protection motivation, maladaptive strategies to cope with HIV threat, and drug involvement are assessed with self-report instruments. Extraversion, agreeableness, neuroticism and sensation seeking are positively related to fear and threat appraisal of HIV. More openness to experience reveals less fear of HIV. Sensation seeking is strongly connected with riskier sexual behavior, drug involvement and maladaptive coping strategies. Results are useful for identifying risk-prone personality profile and designing health promotion and behavioral change programs.

Despite prevetion efforts, there has been no mortality rates changes in Brazil for the past two decades. Leventhal's Self-Regulation Theory proposes that actions related to health and how self-care is exercised can be guided by the nature and organization of illness representations. This study was conducted in order to compare illness perception, knowledge and self-care in women with and without cancer precursory lesions. In this cross-sectional study, 92 women (with a mean age of 36 years; SD= 11) were enrolled consecutively, from a primary care unit in southern Brazil. The sample was divided into two groups: women with premalignant lesion (n= 46) and without precursory lesions (n=46). The instruments used were the Revised Illness Perception Questionnaire for Healthy People, the Questionnaire on women's cervical cancer knowledge and the Rating Scale of Self-Care Skills. There was no statistically significant difference between groups about illness perceptions, knowledge and self-care.

Background: Personality disorders (PD’s) have been suggested to contribute to pathogenesis of alcohol dependence. The aim of the study was the investigation of maladaptive schemas assuming them to be of more relevance in addiction than axis II diagnosis. Methods: Clinical interviews (SCID I and II) were carried out to assess any psychiatric disorder that is prevalent in 60 patients. In 60 controls, Brief Symptom Inventory and SCID II were used. Maladaptive schemas were evaluated by Young Schema Questionnaire. Results: Schema analyses yielded significant higher scores in patients than in controls indicating that addicted persons are much more driven by dysfunctional core beliefs. Differences were less marked, however, when comparing patients with and without PD’s. In the whole patient group four schemas predominated: self sacrifice, insufficient self control, approval seeking, and unrelenting standards. Conclusions: Our findings point to the significance of maladaptive schemas as vulnerability markers for alcohol dependence whereas comorbid PD’s appeared to be of minor relevance. Thus, in the treatment of alcohol dependence early maladaptive schemas should be especially addressed.

Background: Activity becomes especially important by periods of personal choice. It was hypothesized that the positive stressful situation revaluation at the level of appraisal-behavioral activity component is associated with proactive coping, while passive behavior - with negative feelings. Methods: There were used the following Russian adapted diagnostic techniques: The Motive-enactment Test(J. Kuhl),Cognitive Orientation(J. Rotter),Indicator Strategies (D. Amirkhan), Motivation to Success ( T. Ehlers), Motivation to Avoid Failure (T. Ehlers), The Coping Strategies Inventory (R. Lazarus), Identification of Individual Coping Strategies (E. Heim), Picture Frustration Test (S. Rosenzweig). To study the personal activity 228 Russian students, 19-23 years old were engaged. For processing the empirical data there were used X2 Pearson, tt-test, correlation and factor analysis. Discussion: Presented study (Peoples' Friendship University of Russia, Moscow) shows: subjects actively cope with stress tend to solve the problem, motivated by the success of their own activities, can emotionally distance themselves from the source of stress, that lead to improved life quality and well-being.

Background. The prevention strategies of HIV infection has been reinforced by the extended access of condoms and the Post Exposure Prophylaxis (PEP) after sexual exposure to HIV. The study aimed to describe the perceptions of people with HIV/AIDS about the prevention of sexual transmission of HIV in the context of serodiscordance. Method: Study descriptive and exploratory. Two focus groups were conducted with the participation of 13 HIV-positives persons in serodiscordant relationships: one group (n=7) with people in a stable partnership and the other (n=6) in a partnership not stable. The reports were analyzed and categorized from its content. Results: A third percent of the participants were aware of PEP. It was a consensus that in non stable relationships it is easier to use prevention strategies then in stable relationships. Some advantages of the new policies were mentioned, as well as the fear that prevention strategies might be neglect. Discussion: Results pointed to positive aspects about the new strategies for prevention of HIV infection adopted by the Brazilian Ministry of Health, but still pose challenges to their implementation.

Background: This research aimed at understanding the subjective experience of patients in deceased donor ‘s (DD) first kidney transplantation (KTX). Methods: Interviews were conducted on 30 patients before until 24 months after KTX. Qualitative analysis was performed: results of 1/12 themes is presented. Findings: Themes evolve with time: 1. Information about brain death is needed (T1) and could help avoiding social stigma (T2-3). 2. The donor and his/her family are sensitive topics, and are present in the thoughts of the patients (T2-3) responsibility towards the graft/donor (T3) feelings of gratitude/sadness are described decreasing while learning to live with the donor (T4). 3. Acceptance of anonymity (T2-4) is part of a grieving process. 4. Taking a pragmatic perspective about the donor helps dealing with social pressure about donation (T2-T3). 5. Living donation might be considered if returning to dialysis (T4). Discussion: The subjective experience of patients waiting for a DD’s KTX evolves with time. Evaluating donation choices while waiting is important as the need to explain different donation contexts to the patient's significant ones and to the general public.

Background In lung transplantation most research focus on negative emotions, on specific personality traits in predictive/evaluative purposes. Few research has comprehensively explored the emotional experience of patients. Methods Interviews (N=15) were conducted after registration on the waiting list, fully transcribed and analysed with a thematic analysis focusing on emotional descriptions. Results I) Analysis of emotional descriptions First, the analysis was structured in positive, negative, neutral emotional descriptions. Secondly, these descriptions were grouped in primary, secondary emotions, evaluative processes, coping strategies, personal qualities. II) Situational and contextual analysis Emotional descriptions and personal characteristics could be situated in four contextual perspectives a) situational b) relational c) existential d) representational-conceptual. Discussion In these different levels of data analyses we tried to stay the closest possible from the discourse of the patients. This comprehensive account of their emotional descriptions provides a better understanding of how, when and on which aspects psychological support should be defined.

In the scope of attachment research, fathers are no longer excluded, assuming that father-baby relationship has an equivalent affective pattern as in mothers. Paternal Postnatal Attachment Scale PPAS, a 19 items – three factor scale was created to support this (Condon & Corkindale, 2008). Due to the relevance of attachment in family functioning, we intend to validate PPAS to Portuguese population. After the back-translation process, pre-test with 10 men, PPAS was applied to 220, 21-57 year old men (M=33.4; SD=6.11), mostly married (82.7%), newly fathers (M= 6.88 months; SD= 6.21). After KMO (0.79) and Bartlett’s test values confirmed (p <.001), a PC Analysis-varimax rotation was conducted. Two factors were extracted, explaining 32.4% of total variance: 1st factor - Attachment quality (11 items, ?=.77); 2nd - Patience and tolerance (5 items, ?=.64). Three items with lower factor loading (<.30) were excluded, resulting in 16 items with a good internal consistency (?=.80). The bi-factor structure doesn't support the original Condon and Corkindale’s model (Pleasure in interaction; Patience and tolerance; Affection and Pride), though it's consistent with attachment theory background.

Background: General practitioners (GP’s) can positively affect patients’ behavioural choices. But often GP’s report a lack of time and of standarized approaches which may hamper preventive counselling. Therefore a tablet based eHealth programme based on self regulation was developed for general practitioners (GP’s). In order to adjust this programme to the needs of GP’s, focus group interviews were conducted. Methods: Focus group interviews were conducted in which the determinants for the use of the proposed eHealth programme were discussed. Data were collected from a sample of eight local consultation groups of GP’s. In total, 50 GP’s participated in the focus group interviews. After the researcher gave a short presentation of the new programme, open-ended questions were used to address the opinion of the GP’s to the content and to the use of the proposed programme. The focus groups interviews were audio-taped and transcripted. These transcripts were thematically analysed via NVivo software. Findings: GP’s reported the need for a primary prevention method that people can use to effectively change their health behaviour. The majority of GP’s were positive about the use of self-regulation in a programme. However they also had some concerns about the delivery method in general practice. The majority of GP’s wanted different ways of delivery. The use of ehealth tools was considered as a good method, but not for all patients. According to the participating GP’s, the programme is not suitable for people with low education or for older people. Discussion: Self-regulation is a preferred method for ehealth programmes in general practice. The delivery method should exist of a combination of approaches (tablets, flyers and a website). In order to know if the intervention is also suitable for low SES and older people, a piloottest is needed.

Background: Most risk factors for Coronary Heart Disease are behaviour related and should be controlled i.e. by heart-healthy nutrition (NU) and physical activity (PA). To support patients to start with NU or PA brief activating health-psychological group interventions based on the Health-Action-Process-Approach (HAPA) were implemented on an acute cardiology ward. Methods: An intervention (IG) and a control group (CG) were assessed at baseline, two and six months including socio demographic variables, intentions and NU or PA behaviour prior to the hospital stay. Findings: In total 394 patients participated (NU: 63±10.8 years, IG: N=143/CG: N=58; PA: 63±9.2 years, IG: N=115/CG: N=78). From baseline to month 2 the NU-IG reported a significant increase in vegetable fat consumption (p<.05) and the PA-IG in general physical activity (p<.01), both compared to their respective CG. Six months after discharge the NU-IG consumed significantly more low fat food and fish (p<.05), the PA-IG and CG both increased their PA by nearly 50 min/week (p=ns). Discussion: The brief intervention was feasibly to be implemented in the acute care routine and is able to influence some lifestyle changing aspects.

Although it is well documented that adults are more willing to attend to, learn from and make use of negative information, adolescents’ behavior in this regard is less investigated. This tendency to preferentially process information encoded in negative stimuli (i.e., negativity bias) is known to play a major role in the development and maintenance of emotional disorders, both anxiety and depression being associated with it in adults. The aim of our study is to investigate the negativity bias displayed by adolescents in relation to their cognitive style and emotional symptomatology. Participants aged 13 to 16 years old (N=108) completed a performance-based measure which assessed their ability to learn both positive and negative outcomes associated with novel stimuli, and also filled in self-report measures of emotional symptomatology and cognitive style (YSR - ASEBA, Achenbach, 2001; PANAS-C, Laurent et al., 1999; CATS P/N, Hogendoorn et al., 2010). Poorer learning and greater asymmetry towards the negative stimuli were associated with greater vulnerability for internalizing symptomatology and a negative cognitive style. Even though previous research has identified a strong relation between negative cognitive styles and emotional disorders, the present study indicates that poor learning of positive stimuli might also be a risk factor for the development of emotional disorders.

Background. Implantation of integrative teaching methodology in pedagogical practice is based on the connecting and summarizing of knowledge from different subjects in order to promote the development of students’ personality. Methods. An Integrative Teaching Methodology was developed and used in 17 Latvia schools (14 general education and 3 special schools) during one study year. Questionnaire of 615 3-4, 5-7 and 8-12 grade students and 631 teachers was carried out before and after using of integrative teaching methodology. Findings. The results of investigation showed that different parameters of anxiety decreased and well-being increased in all age groups of general education school students after using of integrative teaching methodology. In schools of special education some parameters of anxiety decreased and well-being increased in all age groups. Changes in students’ mutual relations were observed as well after introduction of integrative teaching methodology: 3-4 grade students of special schools have become more open and supportive. Discussion. Using of integrative teaching methodology improve students well-being, decrease their anxiety and develop personality of students.

Background: This study aimed to explore the experiences of non-active users of an online Facebook support group for multiple sclerosis (MS). Emphasis was placed on the resources and the challenges that were associated with membership to this group. Method: A qualitative design was implemented in this study, whereby thematic analysis was utilized to examine the semi-structured interviews that were conducted with ten non-active members of the support group. Findings: Several resources were acquired through the online support group; namely knowledge, advice, empowerment, empathy, mental assistance and group reassurance. Several challenges also emerged; namely concern for quality of information, excessive posting, negative aspects of the disease and lack of responses. Discussion: This study demonstrates that the online support group is a vital source of resources for individuals with MS; however, these individuals also face several challenges, which could possibly be attributed to their non-active status and/or physical limitations. These findings will hopefully result in the modification of such forms of support to better accommodate the needs of their members.

Background: This study aimed to explore the experiences of caregivers who care for a family member who sustained a traumatic brain injury (TBI). Emphasis was placed on the challenges and the resources that were associated with the caregiving role. Method: A qualitative design was implemented in this study, whereby thematic analysis was utilised to examine the semi-structured interviews that were conducted with twelve family caregivers of TBI survivors. Findings: Several challenges emerged; namely trauma, consequences of a TBI, responsibilities, lack of support, unawareness, financial burden, emotional challenges and coping. Several resources were also identified; namely road to recovery, social support, financial resource and coping. Discussion: These findings suggest that although caregivers who care for a family member who sustained a TBI face several challenges through the caregiving task, these individuals have a number of resources that help them to cope. The findings of this study could be utilised to facilitate the effective implementation of caregiver interventions and help to provide better directed strategies for dealing with the care of TBI survivors.

The aim of the study was to examine the differences between 3 groups of patients in terms of severity of symptoms of depression, anxiety and stress and usage of affect regulation strategies, as well as to test the predictive power of affect regulation strategies for these symptoms. Study included 150 respondents (average age 49.7 years, 50% male) divided into 3 groups: healthy people, people with psychosomatic complaints and those suffering from hypertension and/or gastritis due to an organic disorder. They completed: ASQ (Hofmann & Kashdan, 2010), CERQ (Garnefski, Kraaij, & Spinhoven, 2001), and DASS-21 (Lovibond & Lovibond, 1995). The MANOVA analysis indicated that groups significantly differ in the severity of symptoms of anxiety and stress (people with psychosomatic complaints express the highest level of symptoms), but don't in the usage of affect regulation strategies, while ANOVA found differences in the usage of 3 strategies measured by CERQ questionnaire. The multiple regression analyses indicated that affect regulation strategies are good predictors of symptoms of depression, anxiety and stress. Theoretical and practical implications of these findings will be discussed.

Background: In literature there has been increasing evidence of Posttraumatic Growth (PTG) as a positive result from the breast cancer trauma experience. Psychosocial interventions are associated with increased values of PTG. This study presents the results of the efficacy of a socio-cognitive group intervention designed specifically to facilitate PTG. The effects of the intervention on other psychosocial variables were also explored. Method: Women with non-metastatic breast cancer diagnosis (stage 1-3) were randomly assigned to the control group (n= 60), or the intervention group (n= 43) who were offered 8 weekly sessions of group intervention. The psychosocial variables were assessed in 2 measurement points: baseline, after 6 months (post-intervention). Results: Intervention participants reported greater PTG after breast cancer experience, compared to women on the control condition. At the 6-month assessment, statistically significant differences were observed between the two groups over the PTG (F (1,103) = 12.519; p < .001). No significant results were found for the other psychosocial variables. Discussion: The intervention programme facilitated the development of PTG.

Background: The word burnout indicates a state of emotional exhaustion, depersonalization and feelings of low personal accomplishment resulting from workplace stress (Maslach, 1981). It occurs in individuals who are employed "people-oriented" as nurses. The aim of this observational study is to analyse the differences among burnout components (Maslach, 1981) based on different average age of nurses(N =142)working in four health facilities in Milan. Methods: The level of burnout was measured by the MaslachBurnout Inventory (Emotional exhaustion: ?=.89; Depersonalization: ?=7; Personal accomplishment: ?=.7). Findings: One-way ANOVA shows that the older (mean age) the nurses in the structure, the greater the: (A) Emotional exhaustion, F (1,141) =13,803, p <.001, and (B) Depersonalization, F (1,141) =13,736, p <.001, but not the(C)Personal accomplishment, p>.05, ns. Discussion: Results indicate that structures with a higher average age of nurses, show higher levels in two out of three components of the MBI. These results can be used for structuring prevention and intervention on burnout for the nursing staff, taking into consideration the age factor.

Background: Family-caregivers face high demands creating a need for professional support as well as hindering its utilization. Telephone support allows easier access than face-to-face support. The objectives of this study were (1) to test the implementation of a telephone-based cognitive-behavioural therapy (TCT) in established care provision structures, (2) to assess whether TCT improves outcomes compared to usual care, and (3) whether TCT is as effective as face-to-face therapy (FCT). Methods: This study was designed as a randomized controlled trial with three measurement points. 274 caregivers were randomized to TCT or usual care; 49 participated in FCT. Primary outcomes were subjective health, health complaints and problem solving ability. Findings: Burden of care was high (M=72.58, SD=18.99). WHOQOL-BREF was lower than for the norm population regarding social relations (M=48.61, SD=19.3). 198 (72.8%) had a physical illness and 56 (20.6%) had a mental illness. Discussion: This study showed that family-caregivers have a high burden of care and are willing to participate in TCT which potentially improves health outcomes and elevates the utilization rate of support structures.

Background Herbert Benson described the relaxation response technique as a mindfulness based breathing technique. Two studies aimed to evaluate the effectiveness of the method in terms of relaxation success and process variables. Method In two studies we proved the effects of a ten week/ ten group sessions learning programme of relaxation response technique and measured the effects pre - post and post two in an ranomized controlled design. The variables came from standardized stress and relaxation questionnaires and process measurments (TICS, SVF, KUSTA). Group sample size are Treatment Group n=30 and control group n=30. Results & Discussion The method shows clear positive relaxation results in effect measures and process-measures and develop the ability to relax of 80 % of the parcipants (VEV).The easy to teach and to learn method is recommanded for german health promotion programmes. The resluts

The concept of illness representations is of major interest in health psychology. It has been described as a predictor of health behaviour and patient’s subjective experience. This literature review has two main objectives: firstly to identify and to assess the available scales, and secondly to analyse their use in empirical studies with cancer patients. Our goal is to propose recommendations for future researches. Two consecutive reviews have been carried out through four databases. 7 measuring tools differing from their features and psychometric properties were identified. Only one of them is cancer specific and aims at assessing individual knowledge about cancer. 29 of the 33 included studies use one of the three IPQ versions. They give priority to specific subscales and adapt items to their objectives. Despite the fact that these tools are based on different theoretical frameworks, all of them focus on perceptions conceptualised as universally shared whatever the pathology. Consequently, none of the reviewed tools appear to be more appropriate to the cancer specific context. We highlight the interest of mixed methods to investigate in a more comprehensive way these issues.

Many cancer patients’ management decisions remain to be taken in a context of uncertainty. In this context, social representations theory allows considering that practitioners may refer to lay theories regarding the patient for decision making. The objectives of this study were to find out what therapeutic options were discussed in Multidisciplinary team (MDT) meetings and what nature of arguments was used by doctors to defend their propositions. Systematic data collection has been made using a pre-constructed observation grid during 32 MDT meetings dealing with patients records suffering from various cancers. Decisions discussed by doctors concern curative or palliative orientation of the treatment, patient’s eligibility to enter in a clinical trial and prescription of complementary tests. In the majority of these discussions, medical criterions such as comorbidities are put forward. Some subjective patient’s lifestyle or personal characteristics (e.g kindness) also appear in the discussions. These findings contribute to understand psychosocial factors and processes underlying medical decision making in oncology and aim at improving patient’s management quality.

Background: Action planning and coping planning are promising variables to bridge the intention-behaviour gap. More proximate variables to health behaviour have been studied, such as action control. The degree by which planning exerts its effect on behaviour through action control is studied. Methods: A longitudinal study was conducted in Costa Rica with 497 participants (mean age = 18.7 years, SD = 2.8) from humanities courses at the university. Structural Equation Modelling was used to test the model proposed. A 3 steps-mediation was specified where T1 intention and T1 action planning were expected to precede T2 coping planning, T2 action control and T2 exercise. Intention, action planning, coping planning were expected to exert their effects on exercise through action control. T1 exercise, sex and age were specified as covariates on T2 exercise. Findings: The model proposed showed a good fit to the data, which indicates that intention, action planning, coping planning have indirect effects on exercise via action control. Discussion: The effects of intentions and planning on exercise are explained via action control, which should be considered when designing interventions.

The purpose of this study was to determine the effectiveness of CBT on ODD symptoms and social problem solving skills among children and preadolescent students. The research method was a quasi-experimental one with Pre-Post design with a control group. The sample included 40 subjects who were divided into two experimental and control groups according to random assignment, including twenty ones in each. Two scales were used Behavioral Disorders Questionnaire (M.Rutter, teacher's form 1967) , and Social Problem Solving Skills Inventory (Dodge,Batez & Petit,1990), accompanied with the diagnostic interview according to DSM-IV-TR. the experimental group received ten individual CBT sessions ,three times a week , each one 45 minutes. the date were analyzed by ANCOVA statistical tool. The Results indicated that there was a significant difference between the scores of the experimental and control subjects (P< 0.01). In conclusion , CBT intervention can reduce the symptoms of ODD and can increase the appropriate social problem solving skills in children and preadolescent. Keywords: CBT, ODD, social problem solving skills, children and preadolescent.

Background: The literature emphasizes the use of screening tools to identify patients with distress due difficulties in adjusting to cancer. This paper presents the development and validation of the RIPA scale, structured on the assumption that identifying risk factors could allow a preventive referring of patients for psychosocial support. Methods: The literature was examined to identify predictors of psychological adjustment to cancer. The most frequent were used to develop an instrument with risk indicators - social support (SS), distress, coping and illness perception (IP), whose items were based on previously validated scales. The RIPA was administered in 300 patients with cancer and submitted to exploratory factor analysis. Findings: The analysis indicated the retention of five factors. After the principal axis factoring, 27 items were kept and grouped in the following factors: emotional SS (n=6; ?=0.84), instrumental SS (n=4; ?=0.90), active coping (n=5; ?=0.71), IP (n=5; ?=0.78) and distress (n=8; ?=0.90). Discussion: The instrument demonstrated good psychometric qualities. Future studies need to establish scores, predictive validity, sensitivity and specificity levels.

Background: Vestibular schwannoma induces balance disorders which impaired balance control performances and have an impact on daily life of patient. Objective: to identify relationships between postural performances, illness perceptions and quality of life of patients before surgery. Methods: Assessments include posturography evaluation and questionnaires (Illness Perceptions Questionnaire-Revised and World Health Organisation Quality Of Life-Bref) three days before surgery. Means were compared with controls. Correlations between postural performances, illness perceptions and quality of life were calculated. Results: Postural performances and quality of life of patients are impaired before surgery. Correlations between postural performances, consequences (CES :p=0.002) and illness coherence (CES :p=0.020) were found. Discussion: Impaired postural performances have an impact on physical health and psychological domains of patient’s quality of life. Health care of vestibular schwannoma should be focused on patient physical rehabilitation and psycho-education to improve quality of life of patients before surgery and to prepare postoperative recovery.

Background: By supporting the earliest parent-child relationship and parenting capacities the prevention program aims to have a positive impact on the socio-emotional, cognitive and language development of immigrant children. Methods: In the randomized trial study the effects of a psychoanalytically early prevention program are investigated compared to groups organised by paraprofessionals. The sample comprises 190 families being supported from pregnancy until the children enter kindergarten. Two of the major instruments applied are the Emotional Availability Scales (Biringen, 2008) for analysing the quality of parent-child-interactions and the children’s hair cortisol level as a marker of stress. Findings: Since FIRST STEPS is a still ongoing study the research design as well as a sample description will be presented. Discussion: Children with an immigrant background are more likely to live in high-risk environments. We expect that supporting immigrant families from pregnancy on should have a positive impact on the quality of the parent-child relationships and on the children’s ability to cope with stressful events such as the transition kindergarten.

Background Recent findings show the importance of acceptance in the treatment of chronic tinnitus. Acceptance has also been identified as a key construct in the treatment of chronic pain. Our aim was to determine main parameters influencing acceptance in pain and tinnitus patients and to detect similarities across those groups. Method The samples consisted of outpatients taking part in a tinnitus coping therapy group (N1=97)and a pain coping therapy group (N2=56). Via stepwise regression analysis the different influencing factors on acceptance in pain and tinnitus (dependent variables) were determined. Findings In the tinnitus group three predictor variables could explain 45% of the variance in the pain group two variables could explain 54% of the variance. In both groups emotional strain was a significant predicting variable. Global screening instruments as the Brief Symptom Inventory could not explain any further variance. Discussion The identification of factors supporting the development of acceptance in different populations are important to promote well-being. Due to the findings it is advised to use specific instruments to assess acceptance in different clinical populations.

The present study had two aims , firstly , to contribute with information to identify sexual risk behaviors in Mexican youth with hearing impairments, and secondly , to know to what extent the frequency with which young people communicate with their parents and mothers about the care of your sexual health is related to the sex of the young, the type of disability (deafness or hearing loss ), age of onset (congenital or acquired) and their pattern of sexual behavior. The study was conducted with a purposive sample of 300 young people (53.5 % male) with hearing impairment with a mean age of 19.4 years (SD = 2.59) , chosen from four institutions that serve people with this disability . Instrument adapted for hearing impaired people of Robles et al was used (2013 ) to assess history of disability , sexual risk behavior of participants, and sexual communication with parents . An instructor fluent in sign language for the deaf explained the content and how to respond to the assessment instruments . We found that 38.3 % (n = 115 ) have had sex, 49.1 % reported that their first sexual intercourse was forced , and 66.7 % did not use any contraceptive method. Differential effects by sex, type of disability and sexual behavior of participants on the frequency with which they communicate with their fathers and mothers on the care of their sexual health were found . We discuss the need for more research and education programs with young people with disabilities to assure a healthy sex life and respect for their sexual and reproductive rights.

The purpose of this study was to evaluate the relationship between the level of knowledge on how to use a condom, the demonstrated ability to place and remove it from a penis model for teaching and, the frequency of the condom use failures that ocurred during the intercourse, as well as investigate whether these variables are associated with breakage and slippage of the condoms during the intercourse. The participants were 939 sexually active Mexican university students (62.5% women) with a mean age of 19 years. The results show that the level of knowledge was positively correlated only with the demonstrated ability to use condoms (r = .373, p < .01), and this one, in turn, was negatively correlated only with the frequency of condom failures (r = - .355, p < .01). Also, condom breakage and slippage were associated with failures in their use. Finally, the frequency of condom use was negatively correlated only with the frequency of the failures (r = -0.254, p < .01). The results are discussed in the context of HIV/AIDS prevention, considering the importance of collecting data that serve as objective indicators of correct condom use.

The PTGI attempts to evaluate the perceived positive changes following a vital crisis. In the original study 5 factors emerged. However many studies failed to replicate this factorial model having been found 1, 2, 3 and 4 factors. Our aim was to analyse the structure of the PTGI and to contrast previous models in a sample of parents after having a child admitted on a Paediatric Intensive Care Unit (PICU). A total of 130 parents responded the PTGI 6 months after their child’s discharge from PICU. We have used the factor analysis of principal components, and an analysis with the structural equations model to contrast the factorial structure. Also, we did ANOVAS to study the influence of demographic and medical variables. Through the principal component analysis, we found 3 factors that explain 67,99% of the variance. Using confirmatory analysis of this model, we found an acceptable adjustment (X2/df = 2,2; GFI=0,86; CFI=0,92; RMSEA=0,09). We called the first factor personal growth, the second interpersonal growth and the third transpersonal growth. None of the other previous models had a better adjustment. We found statistical difference in posttraumatic growth by gender, spiritual beliefs, illness severity and length of the admission. Using the European Spanish PTGI in parents after a child’s PICU admission, 3 dimensions of growth emerged. This suggests the need to assess these dimensions after crisis.

Background. A deep mental health distress has been introduced by the current economic and social crisis. Methods. A control group observational research design has been used to point out the differences among the personality organization (Kernberg 1975, 1984) in subjects affected by “crisis-related” disorders who asked help to “Crisis and Psychopathology Observatory” of “Ospedale Maggiore Policlinico” of Milan, compared to the other subjects taken over the same Mental Health Care Center. Participants (N=35) were tested at the first psychiatric visit with Inventory of Personality Organization (Lenzenweger et al., 2001;) – Primitive Defense, ?=.83; Reality Testing, ?=.88; Identity Diffusion, ?=.85. Findings. One-way ANOVA points out that “crisis-related” subjects show (A) higher identity diffusion: F(1,33)=10.48; p<.003; (B) higher use of primitive defenses: F(1,33)=30,67; p<.001; (C) a lower reality testing: F(1,33)=20.12; p<.001. Discussion. Results suggest that “crisis-related” patients show a particular configuration of personality organization. They also suggest a way in the research to better understand who the “crisis-related” subjects really are.

Our aim is to introduce to ideas motivating Wholesome Contact Project. In 2012 interdisciplinary, volunteers-based programme for prevention of iatrogenic influence of elders hospitalization was founded. The Project is to improve well-being and to protect patients in geriatric internal ward from somatic and psychological stress connected with hospitalization. The programme focuses on the most frequent complication – delirium: suffering itself, marker of poor outcome, higher mortality and institutionalization for older patients. In the design of prevention a special interest is given to risk and protective factors of delirium, to the use of experience and motivation of volunteers chosen from professionals-to-be (students of medicine and psychology) and to development of social and communication skills in medical staff to improve doctor-patient relationship. The parellel goal is evidence-based evaluation of designed prevention with the ideal of methodologically strict and highly contextualized study. The quantitative research on efficacy and cost-efectiveness of the programme as well as qualitative research on volunteers' experience and proper management of their work is being made.

Background: Psychological symptoms are common in coeliac disease (CD). This review examined the incidence of depression in CD, focusing on factors responsible for the link between the two conditions and the impact of depressive symptoms on gluten free diet (GFD) adherence. Methods: A literature search was conducted across several electronic databases using the following search terms: coeliac/celiac disease OR gluten free diet adherence AND depression OR psychological. Findings: 41 studies were included. 16/22 studies found evidence for increased depressive symptoms in CD compared to healthy controls/norms; 11/14 established a link with poorer adherence. Mechanisms to explain the link included gluten exposure in newly diagnosed/poorly treated patients via deficient serotonin metabolites; psychosocial reaction to the restrictions of the GFD; and comorbidity with other gastrointestinal or autoimmune conditions. Discussion: Regardless of the direction of the relationship, CD patients with comorbid depression had poorer adherence and may require psychological treatment to experience symptom relief and reduce the negative impact of depression on adherence and quality of life.

Background For strategies to increase the consumption of healthier bread one aspect to explore is consumers’ quality perceptions of bread from a health perspective. Method Survey, response rate 38 % n=1134. Open-ended questions regarding perceptions of healthy bread were content analyzed. Statistics: Correspondence analysis, Mann-Whitney U test and Chi-square. Findings 1/3 had decreased their intake of bread, mainly to maintain/improve health. 1/5 did not know any bread that they considered healthy. Among respondents who did know healthy bread, 1/3 found it hard to identify. Most frequent descriptions of healthy bread were coarse, fiber, wholegrain, sourdough, dark. Most listed health effects were: good for stomach, fiber content, bowel health and satiating. Discussion Increasing consumers’ awareness of different types of breads contribution to a healthy diet is a challenge. The general health perception of bread was in line with recommendations but cues used may be misleading. Health is a credence quality attribute, but health effects that to some extent can be evaluated by the consumer after consumption are more relevant forming health related quality expectation of bread.

The Road Traffic Accidents (RTA) causes around the world a large number of victims and is one of the biggest health problems facing by the world community. This kind of event, quite common in young people, can affect the personal, social, professional and familiar lives of patients (WHO, 2007). Some studies report that the attitude of family and friends to the disability can affect the welfare of the patient and his/her recovery, because it may increase their sense of security for survival (e.g. Ross & Mirowsky 2002; Sousa, Relvas, & Mendes, 2007). The main aim was to understand family and friends’ support on youth adjustment after the crash. This is a quantitative and longitudinal study, conducted in Portugal with 302 young people, aged between 16 to 24 years, involved in road traffic accidents. For data gathering, it was applied a questionnaire to access background variables, road traffic accidents variables and family and friend’s support variables ( Network of Relationships Inventory, Furman & Buhrmester, 1985, 1992). The finding reveals some reliable differences in regard to family and friends’ support. In addition, time had a significant effect on family and friends’ support. Youth involved in road traffic accidents felt that their family provided higher levels of companionship, affection, admiration, instrumental aid, intimacy, nurturance and reliable alliance.

Research supports that internet-based interventions are cost effective and cater to individuals who are unable/unwilling to attend weekly treatment sessions with a therapist. An advantage they may have is that they utilize technology attractive to youth (interactive games, animation, video clips etc.) and may reach and engage a wider range of individuals than traditional face-to-face interventions. Acceptance and Commitment Therapy (ACT) is an empirically-based intervention that uses acceptance and mindfulness strategies and has been shown to increase psychological flexibility. Smoking remains a global concern especially in adolescence. The present study aimed to create and investigate the usefulness and effectiveness of an ACT internet-based smoking cessation intervention for high school student smokers. This intervention was compared to a waitlist control group. Participants were asked to complete questionnaires relating to process and outcome measures pre-, during, and post-treatment. Results indicate an increase in psychological flexibility, self-efficacy and motivation to quit smoking and show promise that internet-based interventions can reach youth for smoking cessation.

Background: Diabetes is a common problem in older adults, which requires numerous life-style changes for optimizing blood glucose control. To target effectively self-care, interventions with young and middle-aged patients focus on self-efficacy and social support, but as yet there has been little focus on older people in these studies. Methods: This cross-sectional study examined the effect of self-efficacy and social support on self-care among patients with type 2 diabetes. Data were collected from seventy-two patients (mean age 63.9 yrs) using structured interviews and self-report measures of diabetes-related self-efficacy (DES-SF), of diabetes self-care activities (SDSCA), and of perceived social support (WSUD). Findings: Self-efficacy, but not social support was associated with self-care in the areas of diet and exercise. No mediators were found, but self-efficacy and social support were closely associated. Discussion: The consequences for improving self-care in older diabetic patients will be discussed.

Background: As self-rated health (SRH) and subjective well-being (SWB) are important determinants of mortality in later life, there is a major interest to identify influences on elderly people’s SRH and SWB. There is high evidence that self-perceptions of aging are also related to health. Former studies indicate an association between a positive perception of aging with a higher SRH. However this relation has not been addressed adequately. Methods: Data from the German Aging Survey (DEAS) are used to investigate the relationships between self-perceived aging, SWB and SRH in the transition period to retirement including effects of social relations. DEAS is a nationwide representative cross-sectional and longitudinal survey of the population 40+. Findings: Correlations of subj. aging and SH/SWB are going to be presented. In particular the moderating effects of social relations as well as parameters of retirement such as voluntariness and timing are discussed. Discussion: This research shows the importance of self-perceptions of aging for SWB and SRH. Identifying ways to promote a positive self-perception of aging from retirement on seems to be an important task for health promotion.

Background: The transition to young adulthood is a period of life with many changes, developmental tasks, uncertainties and important decisions in life. Recently this age period is being studied under the headline "emerging adulthood". Usually young adults are physically in good health, whereas mental health and subjective well-being (SWB) are more heterogeneous. This study focuses on the role of social relationships for SWB. Methods: Data from the population representative study German Socio-Economic Panel (SOEP) are analysed cross-sectionally. The outcomes affective balance, global life satisfaction and domain satisfaction based on the 2011 data set are of special interest. Findings: The association of social relationships and SWB in young adulthood will be presented. The meanings of social support, quality of friendships and relationships to relatives are shown. Especially close friendships seem to be an important determinant of SWB. Discussion: The importance of social relationships for SWB is discussed. Young adults should be more in focus as a target group for health psychologists and in health promotion as this is a sensitive life period concerning health and well-being.

Background: The purpose of this study was to test whether lifestyle habits (alcohol consumption, smoking cigarettes, marihuana use and healthy eating habits) and self-regulation skills predict changes in emotional well-being (EWB). Methods: A sample of university students from Slovakia, Lithuania, Hungary, Poland, Bulgaria, Turkey and Czech Republic participated in an online survey at the baseline (n=3560) and the follow up 12 months later (response rate 29%; n=1044; 25.8% males). The administered measures included: AUDIT, items on smoking & marihuana use, the Food Frequency Questionnaire (FFQ), the Short Self-Regulation Questionnaire and the WHO-5 Well-being Index. Linear regression was performed to assess the relationship between the life style habits (T2), self-regulation (T2), and changes in EWB (T2-T1). Findings: Healthy eating habits and self-regulation were shown to be a strong positive predictor of an increase in EWB. Alcohol use, smoking and marihuana use were not found predict any changes in EWB . Discussion: This study confirmed a positive role of self-regulation skills and healthy food habits in relation to increases in EWB.

Background. The study aimed to describe a cognitive-behavioral intervention to patients beginning antiretroviral therapy and analyze the intervention effects on adherence behavior. Methods. Quasi-experimental design, without control group, with evaluation at baseline and twelve months after intervention. Participants were 22 patients, 17 men, aged 20 to 61 years (mean=40.8; SD=9.68). The instruments included semi-structured interview and a self-efficacy scale for treatment adherence on HIV/AIDS. The individual intervention included techniques such as self-monitoring, problem solving and cognitive restructuring about the treatment. Results. Fifteen participants reported adherence at or above 95% of the number of pills prescribed in the follow up. Analysis of self-efficacy indicated a statistically significant difference in the average score twelve months after intervention (p?0,01). Blood tests showed a reduction in viral load levels, reaching undetectable limits for 19 cases. Discussion. Intervention proves to be feasible and their inclusion in the routine of health service should prevent future problems of adherence, in a perspective of comprehensive care.

Backgrounds: Recently, medical treatment has improved, but patients are getting older, symptoms are getting serious, and nursing work has become diversified in Japan. Therefore, many nurses get exhausted and leave their jobs. The effect of resilience of nurses on organization-based self-esteem(OBSE) and stress responses was investigated. Methods: Participants were full-time nurses working in hospitals. A questionnaire survey was conducted using the Resilience Evaluation Scale for Nurses. Organization-based self-esteem and stress responses were also assessed. Cluster analysis was conducted using the resilience score. ANOVA and multiple comparison were conducted to investigate differences in OBSE and stress responses based on resilience. Results: Resilience was classified into four clusters. Results of an ANOVA indicated significant between-group differences in OBSE and stress response. The first cluster with high resilience showed higher OBSE and lower stress responses than other clusters. Discussion: It is suggested that offering support and solutions for work related problems, as well as controlling emotions and thinking might increase OBSE and decrease stress responses.

Background: The aim of this study was to determine if exercise self-efficacy predicts attendance and functional exercise capacity at the end of pulmonary rehabilitation over and above demographic and clinical indicators. Methods: Sixty-four people with Chronic Obstructive Pulmonary Disease completed assessments of exercise self-efficacy (task, coping, and scheduling) and the 6-minute walk test (6MWT) at the beginning and end of pulmonary rehabilitation. Demographic and standard clinical data were obtained from health records. Hierarchical multiple regressions were conducted to predict attendance and post rehabilitation 6MWT, with demographic and clinical indicators entered before exercise self-efficacy. Findings: Task self-efficacy (?=.32) was the only statistically significant predictor of attendance. Age (?= -.15) and coping self-efficacy (?=.20) were statistically significant predictors of post rehabilitation 6MWT, after controlling for baseline 6MWT. The 6MWT increased by 32m from baseline to post rehabilitation, p=.00, ?2=.18. Discussion: Future research designing and implementing strategies to increase exercise self-efficacy in pulmonary rehabilitation are warranted.

Background: While much research attention has been given to the impact of health behavior interventions, relatively little is known about the efficacy of communication channels for health messages. The purpose of this study was to evaluate the efficacy of various communication channels for behavior change messages that focus on promoting physical activity and healthy diet in Japanese suburban populations. Methods: A health communication campaign was created collaboratively in 2011–2013 with researcher-designed materials derived from enhanced community health resources presented in a variety of communication channels. Participants (n = 1,500) were recruited from the community. Findings: Public relations magazines, leaflets and newsletters were found to be effective channels for communicating health messages than other resources (Chi-square = 328.25, df = 7, p < .01, Cohen’s w = .74). This finding remained constant across gender and age differences. Discussion: These findings suggest that using a combination of public relations magazines, leaflets, and newsletters based on community health resources is effective way to disseminate health information in suburban populations.

The aims of this study were to develop Teachers’ Specific Perfectionism Assessment Scale (TSPAS) and School Job Adaptation Scale (SJAS) and to examine the relationship between teachers’ perfectionism and their job adaptation. The subjects of 412 school teachers (elementary and middle) were asked to answer a questionnaire composed of socio-demographic questions, teachers’ perfectionism questions and school job adaptation questions. Exploratory and confirmatory factor analyses and reliability analyses were conducted to develop TSPAS and SJAS. Multiple regression analyses were employed to examine the relationships between TSPAS and SJAS. The results yielded a 6-factor model for TSPAS and a 1-facotr model for TSPAS. The structural validity and Cronbach’s alpha reliability of each scale were statistically acceptable. Some of the sub-scales of TSPAS had positive and the others negative association with SJAS. The results above suggest that teachers with a high degree of perfectionism have a high risk of maladaptation. This implies that appropriate psychological interventions to mitigate their perfectionism can help teachers to better adapt in their workplace and prevent their burnout.

The assessment of mental health is becoming the center of attention in disaster victims and supporters of the 2011 Tohoku Earthquake in Japan. Although there were many mental health scales, those possessed several problems to apply to them, e.g., troublesome tasks accompanied by many items. The purpose of this study was to develop the new mental health scale (Rikkyo University version: MH-R), and to examine the reliability and validity. Subjects were 328 Japanese college students (192 males and 136 females, 19.6 ± 1.2 years). They answered three scales, the MH-R (ten items), GHQ28 (Nakagawa & Daibo, 1985), and CES-D (Shima et al., 1985). As the results of exploratory factor analyses, three factors [low negative response (?=.77), vivid response (?=.86), calm response (?=.67)] were chosen finally. The result of confirmatory factor analysis showed the validity of the hierarchical model was fit to the data. There were significant negative correlations between the MH-R scores and the GHQ28 (r=-.59) or CES-D scores (r=-.52). It was suggested that the MH-R had the adequate reliability and validity. Then, the scale should be examined through the data including adulthood and senior persons.

Background: The focal concept of this study is procrastination. The author examines the experience of 35-44 years old men in terms of their health related procrastination behaviour. Currently delays in seeking help from medical practitioners are an increasing problem in Latvia, especially among 35-44 years old men (Centre of Health Economics, 2010). Any failure in primary and secondary prevention creates a number of negative consequences. Nevertheless, aforementioned group often avoids medical treatment. The aim of the study was understand the experience of procrastination of this group in qualitative terms. Method: Semi-structured in-depth interviews with 20 men aged 35-44 were conducted. Data were analyzed by means of inductive thematic analysis. Findings: The following dominant dimensions emerged: (1) understanding of one's own health from the time perspective; (2) models of the relationship to the medical practitioner; (3) cultural aspects of procrastination behaviour. Discussion: There are two main concepts - time discounting and task aversion - that bring together the experience of procrastination for the studied group.

Background: The main aim of this study is to examine whether Empathy and Group Norms contribute to the expression of explicit and implicit mental health stigma in adolescents. Stigma was conceptualised as involving cognitive, emotional and behavioural aspects. Method: 256 secondary school students (108 males, 148 females) from within the Republic of Ireland were recruited to this study. All participants were aged between 15-18 years. Participants were asked to read two vignettes and to respond to a series of questions that assessed their beliefs, attitudes and behavioural intentions toward each vignette character. One vignette depicted a peer with depression while the other vignette described a ‘typically developing’ peer. Participants also completed measures assessing their dispositional trait of empathy and perceptions of group norms. Implicit attitudes were assessed using the Implicit Association Test. Results: Results were analysed using Multiple Linear Regression. It was found that Group Norms significantly predicted aspects of explicit stigma. Discussion: There is evidence to suggest that Group Norms may be an important factor to target in future stigma-reduction programs.

Background: People with learning difficulties often experience social exclusion which may influence their psychological well-being. Little is known whether perceived respect can buffer these negative effects. Methods: Study 1: We tested whether loneliness affects anxious and depressive mood in persons with learning difficulties (N=20), physical impairment (N=23) and without impairments (N=20). Study 2: We tested whether perceived respect in social interaction influences reported depressive and anxious mood in people with learning difficulties (N=28). Findings: In Study 1, persons with learning difficulties and persons with physical impairment reported significantly higher levels of loneliness than persons without impairments. Loneliness was related to depression. In Study 2, perceived respect and anxious mood were negatively correlated but only in the subsample of persons working in sheltered workshops. Discussion: Loneliness is a severe problem in individuals with disability and related to mental health problems. Social factors such as perceived respect can buffer against negative effects of loneliness. Respect as influencing factor and practical implications will be discussed.

Background: This study analysed the mediating role of cognitive appraisal on the relationship between occupational stress and burnout. Methods: Participants were 333 university teachers, from north of Portugal (Age: M = 42.67; SD = 6.87). Measures included the Stress Questionnaire for Academic Staff (Gomes, 2010) to assess occupational sources of stress; the Cognitive Appraisal Scale (Gomes, 2008) to measure primary and secondary cognitive appraisals; and the Maslach Burnout Inventory-Educators Survey (Maslach et al., 1996) to evaluate burnout dimensions. Findings: Model 1 tested the mediating role of primary cognitive appraisal (e.g., threat and challenge perceptions) between stress and burnout. The model presented good fit indices (RMSEA = 0.054; CFI = 0.91; TLI = 0.90), explaining 69% of the variance in burnout. Model 2 tested the mediating role of secondary cognitive appraisal (e.g., coping potential and control perception) between stress and burnout. The model presented good fit indices (RMSEA = 0.052; CFI = 0.94; TLI = 0.91), explaining 50% of the variance. Discussion: Data confirmed that cognitive appraisals partially mediated the relationship between occupational stress and burnout at work. These findings constitute a promising underlying mechanism in the explanation of adaptation at work, which must be considered in occupational stress intervention programs.

The study examined the relationship between dating violence profiles, coping strategies and psychological adjustment in sample of 220 high school students, aged 16 to 19 years. Subjects completed self-administered questionnaires: The Conflict in Adolescent Dating Relationships Inventory, The Ways of Coping Scales and Trauma Symptom Checklist-40. Regression analyses have shown that gender and different roles in dating violence are significant predictors of all measures of psychological adjustment expressing on Trauma Symptoms Checklist. All types of psychological difficulties, expect of sexual problems, were more frequent in girls than in boys. Victims of dating violence, as well as subject who were victim and perpetrators of dating violence experienced the most of psychological difficulties. Furthermore, younger age has been predictive for depression and sexual problems, while non-adaptive coping strategies were significant predictors of dissociation, anxiety, depression, sexual abuse trauma and sleep disturbance. These results suggest that coping stress strategies may be important in reducing difficulties in psychological adjustment for adolescents involved in dating violence.

Background: This study aimed at detecting clusters of specific combinations of humor styles, as measured by the Humor Styles Questionnaire (HSQ), and at identifying eventual association of such combinations with indicators of psychological well-being. Methods: The participants in the present cross-sectional study were 458 Italian female high school students from central Italy (ages ranged from 13 to 18 years). The HSQ was employed to assess different styles of humor according to a multidimensional approach. The Ryff's Psychological Well-Being Scales (RPWB) was used to evaluate psychological well-being by six intercorrelated dimensions; in addition, the Self-Esteem Questionnaire (SEQ), and the General Self-Efficacy (GSE) were applied. A cluster analysis, based on the scores reported on the HSQ, as well as the differences between group means of the well-being indicators were computed. Findings: The two emerged groups (high and low in positive humor styles) differed in group means for all dimensions of RPWB, SEQ, and GSE. Discussion: The implementation of specific training in the effective use of humor may contribute to enriching programs that inspire psychological and psychotherapeutic well-being.

Background: Research suggests that military life stressors have a negative impact on the well-being of children from military families. However, little research has been conducted to examine the well-being of children from military families in Canada. This study examined the impact of military stressors on the well-being of children in Canadian Armed Forces families. Methods: Focus groups were conducted with children between the ages of 8 and 13 (N=85 children). MAXQDA software was used for the thematic analysis of the qualitative data. Results: Parental deployment and frequent relocations were found to be the main stressors reported by children. The overall well-being of the children decreased during parental deployment. Nevertheless, the vast majority of the children believed it was good to be part of a military family. Moreover, several strategies, such as seeking social support, communication with the deployed parent, and active distraction were reported to buffer the stress related to military life. Discussion: It is crucial to understand how children from military families can maintain resiliency in the face of the military life stressors. This research shows that several factors, including effective coping strategies and supportive networks, may buffer the effects of military life stressors on child well-being. Recommendations to military family service providers are offered.

Background: CF affects multiple body systems and requires complex and time-consuming daily care: chest therapy, medication and enzyme intake, nutritional monitoring and sports. Despite the importance of health, many CF patients struggle with the high level of adherence required. To support patients with advanced stages of illness in their therapy management , an intervention programme focussed on nutritional issues based on the Health Action Process Model was developed. Methods: The intervention includes goal setting, individual and detailed action plan, identifying and breaking down barriers. Since August 2013 nine inpatients (7 f/2 m; 13.6 yrs - 25.9 yrs.) were selected and participated. Up to now eight patients were re-evaluated (after 3 months), regarding appraisal of personal profit and medical outcome. The CF care team with its specific expertise was involved in the process Findings: All patients reached personal goals, their medical outcome (BMI und FEV 1) showed improvement or stabilization. Discussion: Cases investigated show that the intervention might be effective and applicable to increase self-management in CF patients over 16. Younger participants are more responsive to external reinforcement. Due to the complexity of treatment, involvement of the CF-care team was decisive in generating high-quality plans, even for this experienced and well-educated patient group.

The purpose of the study is to predict physical well – being of post – allogenic BMT patients based on demographic characteristics (economic status, occupational status, marriage status and gender). Methods: This study is correlation. Statistical universe is all of the patients with acute leukaemia ages 18 – 45 years who have allogenic BMT conditions .Pre – allogenic BMT data were gathered on 58 patients (38 men and 20 women) ages 18 – 45 years selected during 13 months via census procedure. Demographic characteristics patients were studied before allogenic BMT by questionnaire then , physical well – being of the subjects were assessed after one , two and three months post – allogenic BMT by CBC test .It was analyzed using univariate and multivariate analysis in general line model . Results: results showed that there was no significant relation between variables in multivariate analysis .But, in univariate analysis, there was significant relation between occupational status and white blood cell (WBC) in the second months post – allogenic BMT. So, occupational status could predict physical well – being after allogenic BMT. Key words: physical well – being, allogenic bone marrow transplantation, demographic characteristics and acute leukaemia

Young adults display the highest smoking rates and the lowest smoking cessation rates. However, this group until recently has gained little interest. The present research aims to study variables related to smoking cessation, which can contribute to a more effective design of relative interventions. Participants 18-30 years old (N=507;M=22.5;SD=2.9) completed a battery of questionnaires, assessing smoking behavior, beliefs related to smoking initiation, maintenance and cessation, developmental variables and psychological discomfort. Smokers were 47% of participants, 26% heavy and 9% former smokers, 17% reported high motivation to quit smoking. Motivation to quit smoking was negatively correlated with beliefs about positive effects of smoking and denial of negative impact of smoking. In regression analysis models, age, beliefs, developmental characteristics and psychological discomfort predicted motivation to quit (R2=0.33, p<0.000). High smoking rates, low motivation to quit and low predictive value of variables tested, emphasizes the necessity of public health interventions, which focus on cognitive change and motivation to quit smoking, but also on contingency management measures.