Kathryn Thirlaway

The Sexual Activity Questionnaire: A measure of women's sexual functioning

Sexual activity is an important dimension of quality of life. Therefore it is important to assess the impact that any treatment may have on sexual functioning so that patients can be warned of possible side effects and interventions offered to help ameliorate these. The Sexual Activity Questionnaire (SAQ) was developed to investigate the impact of long-term tamoxifen on the sexual functioning of women at high risk of developing breast cancer. It was also tested on a sample of women with no such risk. The majority of variance in sexual functioning can be explained by three factors: pleasure from sexual intercourse, discomfort during sexual intercourse and habit. We found that the frequency of sexual activity decreased steadily with age. Furthermore, pleasure dropped and discomfort increased in women aged over 55. We report psychometric data showing that the SAQ is a valid, reliable and acceptable measure for describing the sexual functioning of women in terms of activity, pleasure and discomfort. It is quick and easy to administer and has good face validity discriminating between the sexual functioning of pre- and post-menopausal women.

The stigmatising implications of presenting schizophrenia as a genetic disease.

This study aimed to investigate the hypothesis that belief in a genetic aetiology of schizophrenia will increase the stigma associated with the disorder. Levels of five potentially stigmatising attitudes were compared in two groups of participants who had read a vignette describing an individual who has schizophrenia. In one group the disorder was explained as being caused by ‘genetic’ factors, and in the other by ‘environmental’ factors. This study found that three of the five potentially stigmatising attitudes measured were increased when participants read a vignette with a genetic causation rather than an environmental causation. Firstly, genetic attributions increased levels of associative stigma towards close relatives (p < 0.001). Secondly, participants viewed recovery as less likely when genetic factors were implicated as causative (p < 0.001). Finally, there was also an increased perception of the character’s “dangerousness” when the condition was explained by genetic factors (p < 0.05). Contrary to previous research was the finding that perceived aetiology had no effect on participant’s desire for social distance from an affected individual. Neither did perceived aetiology influence beliefs about moral accountability. The implications of these findings suggest that genetic counsellors and other health professionals, who are providing genetic information to those affected by schizophrenia should be aware of the possibility that a genetic explanation of schizophrenia could increase potentially stigmatising attitudes towards their clients and their clients’ families. It is also possible that individuals with a diagnosis of schizophrenia may themselves form deterministic interpretations of the genetic information they receive and subsequently be less likely to adopt behavioural advice or adhere to treatment. Counsellors and health professionals should strive to present information in a balanced manner, ensuring recipients understand the multi-factorial causes of the disease.

Interpreting risk messages: Women's responses to a health story

Risk communication is an integral part of modern health care and is often high on news agendas having news values such as negativity. Recently concern has been raised by the government, the academic community and journalists themselves about the way risk is reported (Harrabin et al. 2003). Harrabin et al. (2003) illustrate their argument for guidelines on reporting risk by analysing the content of recent media risk communications. The present study set out to evaluate the effect of a media risk communication on its audience by asking a large sample of women (176) how they responded to a media risk communication published in the national press.  From this study a picture emerges of a process whereby many women experience an emotive response to risk and then attempt to defend themselves from any anxiety incurred. Altering risky behaviour is only one of many anxiety reduction strategies utilized by the women in this study. The way women respond to risk is mediated by the context in which the risk is experienced. Individual contexts such as age or personal experiences of the person receiving the message, the context of the message itself and the social context in which the message is received interplay to influence the way individuals respond.

The Psychology of Lifestyle : Promoting Healthy Behaviour

Improving lifestyles is thought to be one of the most effective means of reducing mortality and morbidity in the developed world. However, despite decades of health promotion, there has been no significant difference to lifestyles and instead there are rising levels of inactivity and obesity. The psychology of lifestyle addresses the role psychology can play in reversing the trend of deleterious lifestyle choices. It considers the common characteristics of lifestyle behaviors and reflects on how we can inform and improve interventions to promote healthy lifestyles. Health promotion has taught people what a healthy lifestyle is—now we need to enable people to live that life. The chapters cover key lifestyle behaviors that impact on health—eating, physical activity, drinking, smoking, sex and drug use—as well as combinations of behaviors. Each chapter contains interventions that have been developed to influence and promote lifestyle change among patients and clients. This unique book will enable readers to develop a clear theoretical and practical grasp of the psychological principles involved in all aspects of lifestyle change. It is a useful resource for students and professionals committed to health promotion within all health-related disciplines.

Individuals' experiences of, and responses to, a negative genetic test result for familial hypercholesterolaemia.

This study aimed to explore the responses of individuals who have undergone genetic testing for familial hypercholesterolaemia (FH) where no genetic mutation has been identified. Semi-structured interviews were conducted with 11 patients and interpretative phenomenological analysis (IPA) was employed. This article describes three inter-related themes: ‘feeling in limbo’, ‘exploring causes of raised cholesterol’ and ‘contradictions in talk about diet’. Although participants generally adhered to medication and engaged in healthy lifestyles, the findings have clinical implications for how genetic test results are communicated.

Communication of Genetic Information by Other Health Professionals: The Role of the Genetic Counsellor in Specialist Clinics

Many children with chronic genetic diseases are followed by specialty clinics that provide genetic information as part of the care. Health services restrictions in the Republic of Ireland (ROI) can make the wait for an appointment with a genetic counsellor long. We examined whether genetic information was being adequately understood when presented by medical, but non-genetics staff to long term patients, using our national metabolic service as an example. The aim was to inform health professionals about the need or role of a genetic counsellor in a specialist setting. A questionnaire was used to assess knowledge among parents and patients affected by galactosaemia and Maple Syrup Urine Disease (MSUD). Twenty seven families with galactosemia and 10 with MSUD were interviewed in clinic. Comparative analysis showed significant differences in knowledge between parents of children with galactosemia and adult patients (p = 0.001) and between ethnicities (p > 0.05). While parents are well informed, the majority expressed a wish for more information about the condition and its transmission. Adult patients with galactosemia and parents from certain ethnic backgrounds could especially benefit from genetic counselling. This study highlights the need for a genetic counsellor in specialist clinics.

The experiences of university students with a mood disorder

Mood disorders typically materialise in young adulthood, a life-stage when many enter university. However, Padron notes that few studies have examined the experiences of students with a mood disorder. The current study offers a thematic analysis of semi-structured interviews with five university students who had personal experience of such a disorder. Participants described how symptoms affected their academic and social experiences of university based around the themes of: Social and family support, Powerful symptoms, Stigma and labelling, and Inter-professional dynamic. It was concluded that stigma and lack of information prevented students from obtaining sufficient support, whilst the addition of key staff such as a university-wide mental health trainer is identified as a potential way forward to help such students negotiate the higher education environment.

The influence of genetic explanations of type 2 diabetes on patients' attitudes to prevention, treatment and personal responsibility for health.

Background/Aims: It is widely accepted that type 2 diabetes is caused by an interaction of both lifestyle and genetic factors. However, the impact of explaining disease aetiology as primarily genetic or environmental is relatively unexplored for common chronic multi-factorial conditions. This study investigates whether perceiving the cause of type 2 diabetes as primarily genetic or environmental influences attitudes towards the controllability of the condition. Methods: Using a between-participants vignette-based experimental survey design, 200 participants aged 40 years and above from a primary care setting responded to a vignette which implied the cause of diabetes as being predominantly genetic or environmental. Attitudes towards personal responsibility, prevention and treatment were measured using an attitude questionnaire. Results: There was a significant interaction effect between perceived aetiology and family history on attitude to treatment; participants with a family history of type 2 diabetes perceived treatment as less effective if they read the genetic vignette, but those without a family history did not (p < 0.05). The findings also indicated that an individual was perceived as less responsible for the development of type 2 diabetes (p < 0.05) when participants (regardless of family history) read a vignette with an implied genetic causation. Conclusion: Awareness by health professionals of the impact of genetic attributions in disease aetiology is fundamental when encouraging positive attitudes to personal responsibility for lifestyle change and treatment for the condition. These findings may impact the way preventative health messages are tailored to people depending on their family history of diabetes.

Experiences of physical activity: A phenomenological study of individuals with cystic fibrosis

Although extensive research has investigated the benefits of physical activity in cystic fibrosis, minimal exploration of the experiences for individuals from a qualitative, phenomenological perspective has been carried out. The aim of this study was to explore the subjective experiences of physical activity for individuals with cystic fibrosis. The health-care team, at an Adult Cystic Fibrosis Unit in the United Kingdom, recruited 12 participants to take part. Interview data were analysed using interpretative phenomenological analysis. A central theme of ‘self-monitoring’ emerged from the accounts and was embedded in the three super-ordinate themes.

Promoting Healthy Behaviour : A Practical Guide

1. Introduction to Healthy Behaviour 2. Health Promotion, Health Education and Public Health 3. Health and Health Inequalities 4. Psychology in Practice 5. Eating Well 6. Being Active 7. Sensible Drinking 8. Quitting Smoking 9. Safer Sex 10. Specific Conditions 11. Special Populations 12. Conclusion