Margaret Charles

Linking values and organizational commitment: A correlational and experimental investigation in two organizations

The aim of the two studies was to confirm and clarify the relationships between values and components of organizational commitment (OC) in two organizations. Study 1 extended the work of Finegan (2000) by investigating antecedents of OC in terms of personal and perceived organizational values while

Age Related Changes in Inhibitory Control as Measured by Stop Signal Task Performance

A modified version of the stop signal task (suitable for use with very young children) was administered to a pre primary school group of children (< 5 years, 6 months); a young primary group (5 years, 7 months to 7 years, 6 months); a mid primary group (7 years, 7 months to 9 years, 6 months) and a group of adults. Significant age differences in the ability to inhibit responding were found. These results highlight the need for measures of response inhibition which are appropriate for use with very young children, when the first signs of inhibitory skills are emerging. It is also imperative that such measures allow the assessment of skills across a broad range of age groups in order to comprehensively monitor their development.

Validation of the subscales of the Edinburgh Postnatal Depression Scale in a sample of women with unsettled infants

BACKGROUND The Edinburgh Postnatal Depression Scale (EPDS) was developed as a uni-dimensional measure of depression, however there is evidence that it also measures anxiety. This study examined the factor structure of the EPDS and validity of the identified subscales. METHOD 309 women with infants aged up to 12 months completed the EPDS, BDI-II, BAI and the SCID-I. RESULTS Exploratory factor analysis revealed distinct anxiety and depression factors. Confirmatory factor analyses showed the identified two-factor model to be an adequate fit to the data and superior to a uni-dimensional model. An anxiety subscale score of 4 or more detected the presence of an anxiety disorder with sensitivity of 63%, specificity 70%, positive predictive value of 45% and negative predictive value of 81%. LIMITATIONS All participants were mothers with unsettled infants, a group that is known to have higher than average rates of depression and anxiety. The factor structure of the EPDS may have unique features in this group and so these results may not be generalizable to general postnatal samples. Also, participants in this study ranged from 1 week to 12 months postpartum and there may be variations in the factor structure of the EPDS over this time. CONCLUSION The 7-item depression subscale could be used in place of the total scale to identify women with major depression and the 3-item anxiety subscale could be used to identify women with anxiety disorders (occurring co-morbidly with depression or occurring alone). Future research should seek to replicate these findings in a general postnatal sample and to develop anxiety-specific screening tools for use in the postnatal period.

Relief of incident dyspnea in palliative cancer patients: a pilot, randomized, controlled trial comparing nebulized hydromorphone, systemic hydromorphone, and nebulized saline.

Acute episodic breathlessness in patients receiving palliative care is a distressing symptom with little evidence-base to inform management. This pilot, double-blind, controlled, crossover study compared the effects of nebulized hydromorphone, systemic hydromorphone and nebulized saline for the relief of episodic breathlessness in advanced cancer patients. On three occasions of acute breathlessness, patients randomly received either nebulized hydromorphone, a systemic breakthrough dose of hydromorphone or nebulized saline together with a blinding agent. Breathlessness was scored before and 10, 20, 30, and 60 minutes post-treatment completion using a 100 mm visual analog scale. Twenty patients completed the trial. Ratings did not differ significantly across pretest treatments. Change in ratings from pretest to 10 minutes after completion of nebulization (about 20 minutes after administration of systemic hydromorphone) indicated that each of the treatments resulted in statistically significant improvements in breathlessness, with no significant differences between treatments. Over time, breathlessness decreased significantly for all treatments, with no significant differences between treatments. Only nebulized hydromorphone produced a rapid improvement in breathlessness that reached a magnitude considered to be clinically important. Interpretation of these results is considered in relation to our definition of clinical significance, the dose of hydromorphone used and the possibility of a placebo effect. This study can serve to inform the design of future trials to investigate the management of incident breathlessness.

Shared decision making in oncology: assessing oncologist behaviour in consultations in which adjuvant therapy is considered after primary surgical treatment

Introduction  Shared decision making (SDM) is now considered a desirable goal in health care, yet little is known about current practice in cancer care, and its impact on patient outcomes. This study aimed to develop an oncology‐specific coding system for SDM, explore variations in SDM according to patient and disease characteristics, determine the relationship between SDM and patient satisfaction with the consultation, and explore the impact of SDM on patient anxiety.

Predictors of breast cancer screening behavior in women with a strong family history of the disease

This study applied the self-regulation model to examine cognitive and emotional predictors of screening in unaffected women with a strong family history of breast cancer. 748 unaffected female members of an Australian registry of multiple-case breast cancer families formed the sample. Participants completed a baseline psychosocial questionnaire and a screening questionnaire 3 years later. Multinomial logistic regression was employed to determine predictors of under- and over-screening according to national guidelines. At follow-up 16% of women under-screened and 10% over-screened with mammography; 55% under-screened with clinical breast examination (CBE); and 9% over-screened with breast self-examination (BSE). Of the women found screening according to guidelines for mammography 72% reported ever having received specific recommendations for mammography screening from a health professional. Compared to appropriate screeners, under-screeners on mammography were less likely to have received a screening recommendation (as were under-screeners on CBE), were younger and reported lower perceived breast cancer risk, but were at higher relative risk (RR) of breast cancer and were more likely to report elevated depression. Over-screeners on mammography were more likely to be younger and have a lower RR of breast cancer. Over-screeners on BSE reported elevated cancer-specific anxiety, were less likely to be university educated and more likely to have received a recommendation for BSE. Under- and over-screening is common in women with a strong family history of breast cancer. Evaluation of interventions targeting perceived risk of breast cancer, anxiety and depression are needed to ensure women obtain accurate advice from relevant specialists and enact screening recommendations.

The effect of body dissatisfaction on women's perceptions of female celebrities

OBJECTIVE Research suggests that media exposure causes some women to feel heightened dissatisfaction with their body shape. This study attempts to determine which women are effected as such, by investigating how women feel about their own bodies and how this effects their perceptions of female celebrities in the media. METHOD Undergraduate females (n = 116) were shown one accurate and six distorted photographs of thin and heavy female celebrities. Each distorted photograph made the celebrity appear thinner or heavier than actuality. Participants chose which photograph portrayed each celebritys true body shape. Body shape concerns were measured by the Body Shape Questionnaire. RESULTS Women concerned about their body shape judged thin celebrities as thinner than actuality, whereas unconcerned women judged them accurately. Both groups judged heavy celebrities as heavier than actuality. DISCUSSION Results suggest certain women are effected by media exposure due to their own perception of females in the media. Prevention strategies, and the medias role in body dissatisfaction and dieting disorders, are discussed.

Lack of benefit from paracetamol (acetaminophen) for palliative cancer patients requiring high-dose strong opioids: a randomized, double-blind, placebo-controlled, crossover trial.

CONTEXT The adjunctive use of paracetamol (acetaminophen) with strong opioids has become entrenched practice in palliative care pain management, despite little evidence to support its use. OBJECTIVE The study aim was to investigate potential analgesic benefits of 4 g of paracetamol daily for palliative cancer patients requiring high-dose opioids. METHODS Thirty-one patients, using at least 200mg of oral morphine equivalent daily, were recruited to a prospective, double-blinded, randomized, crossover trial. Patients received usual medications plus 4 g of paracetamol or placebo for five days each in random order. Primary outcome, effect on pain, was assessed using daily diaries, including a numerical rating scale (NRS) from zero (no pain) to 10 (unbearable) and recording numbers of breakthrough analgesics. Secondary outcomes-nausea, vomiting, cognitive impairment, constipation, and overall well-being--were assessed using the NRS. Data from the last four days of each treatment were analyzed. Patients also indicated in which part of the study their pain was better controlled. RESULTS Twenty-two patients, requiring a median dose of 255 mg of oral morphine equivalent daily, completed the trial. There were no significant order or treatment-by-order interaction effects for any variable; paired t-tests were conducted to investigate change in mean levels on outcome variables with placebo vs. paracetamol. For none of the variables was there a statistically significant difference when assessed with placebo compared with paracetamol. No change approached clinically significant levels, with a mean difference in rated pain of 0.16, and mean difference of 0.42 for a number of breakthrough medications. Fifteen patients were undecided whether paracetamol improved pain. CONCLUSIONS These data do not support the common practice of adding regular paracetamol daily as an adjunct to high-dose opioids for pain control in cancer patients receiving palliative care.

Further manipulation of the stop-signal task: Developmental changes in the ability to inhibit responding with longer stop-signal delays

The stop-signal task, a measure of inhibitory control, was further modified in order to examine its suitability as a task for very young children. A previous study (Carver et al., 2001) showed that it can be successfully adapted for use with primary school-aged children. The present study manipulated the presentation of the signal to inhibit responding and found that this improved the likelihood of responding. A pre-primary school group of children (<5 years, 6 months), a young primary school group (5 years, 7 months to 7 years, 6 months), and a mid-primary school group (7 years, 7 months to 9 years, 6 months) participated in the study. The results emphasize the pre- and early school years as a sensitive time for the development of inhibitory skills. Measures of inhibitory control must therefore be age-appropriate and sensitive to these early developmental changes.

Exploring the impact of training on the experience of Australian support group leaders: current practices and implications for research

Background  Existing literature suggests that the effectiveness of a support group is linked to the qualifications, skills and experience of the group leader. Yet, little research has been conducted into the experiences of trained vs. untrained support group leaders of chronic‐illness support groups. The current study aimed to compare the experience of leaders, trained vs. untrained in group facilitation, in terms of challenges, rewards and psychological wellbeing.