Noa Vilchinsky

The Multidimensional Attitudes Scale toward Persons with Disabilities (MAS): Construction and Validation.

This study presents the development of a new instrument, the Multidimensional Attitudes Scale Toward Persons With Disabilities (MAS). Based on the multidimensional approach, it posits that attitudes are composed of three dimensions: affect, cognition, and behavior. The scale was distributed to a sample of 132 people along with a self-esteem measure and a frequently employed attitude scale, the Attitudes Toward Disabled Persons Scale (ATDP). The construct and concurrent validity of the questionnaire was demonstrated by reliability and factor analyses, as well as by comparison with the ATDP scale. Principal component factor analysis revealed three correlated but distinct factors. Results show that women hold more positive behavioral attitudes than men. Interestingly, men with high self-esteem were found to hold more positive cognitions than men with low self-esteem. Results indicate the importance of a multidimensional approach both for the construction of sound instruments and for professional interventions aimed at modifying attitudes toward persons with disabilities.

Gender and Attitudes Toward People Using Wheelchairs: A Multidimensional Perspective

This study aims to investigate the effect of observer’s gender and target’s gender on attitudes toward people who use wheelchairs due to a physical disability. Four hundred four Jewish Israeli students without disabilities completed the Multidimensional Attitudes Scale Toward Persons With Disabilities (MAS). Initially, confirmatory factor analysis was used to revalidate the MAS. Five factors of attitudes were confirmed: distancing behaviors, positive cognitions, negative emotions, interpersonal stress, and calm. Findings showed that an encounter with a person using a wheelchair raised more positive cognitions and less distancing behaviors, but also evoked more negative emotions, than an encounter with a person without a disability. In the case of an encounter with a person without a disability, men contributed to greater interpersonal stress among women, whereas women contributed to greater interpersonal stress among men. The multidimensional approach revealed that the effect of gender was mostly salient with regard to interpersonal stress.

Attitudes Toward Israel's Equal Rights for People With Disabilities Law: A Multiperspective Approach

Objective: To examine attitudes toward the new Equal Rights for People With Disabilities Law in Israel among members of specific professional groups. Study Design: An exploratory, descriptive, crosssectional survey, using convenience samples. Measure: The Disability Rights Attitude Scale—Israel (DRASI) was designed. Results: Factor analysis yielded 4 defined factors. The most positive attitudes were found for the factor of punishment, followed by accessibility, governmental support, and, finally, employment. The most positive attitudes were expressed by the social workers and the teachers, followed by the employers, the architects, and the lawyers. Conclusions: Findings shed light on the important role of professional identity in shaping the attitudes toward disability rights. Results may contribute to the development of appropriate rehabilitation and support services. In 1998, the Equal Rights for People With Disabilities Law (1998) was accepted by the Israeli parliament. Following the passage of legislation advancing the rights of persons with disabilities in the United States and other countries, this law is a major milestone, marking the beginning of a process of real legal and social change in Israeli society. The law that has been legislated includes only chapters regarding employment, public transport services, and the establishment of the commission office for the implementation of the Equal Rights for People With Disabilities Law. Issues of accessibility, education, health, leisure time, and more are included in the complete law proposal planned to be legislated in the future. In intention, this law is similar to the Americans with Disabilities Act (ADA; 1991). It, too, is a declaration that persons with disabilities should be enabled to be equal members of society (West, 1993). Thus, it also shares the ADA’s aim of achieving full inclusion for individuals with disabilities. In this sense, legislation such as Israel’s Equal Rights for Persons With Disabilities Law and the United States’ ADA constitute a clear message that society’s attitude toward persons with disabilities should be one of respect, inclusion, and support (Hernandez, Keys, Balcazar, & Drum, 1998; West, 1993).

Cardiac-disease-induced PTSD (CDI-PTSD): A systematic review

The goal of the current systematic review was to provide an overview of the findings in the field of Cardiac-Disease-Induced Posttraumatic Stress Disorder (CDI-PTSD) in order to establish CDI-PTSD as a valid diagnostic entity for a wide spectrum of cardiac diseases and related medical procedures. In accordance with PRISMA guidelines, we conducted a systematic electronic literature search. Of the 3202 citations identified, 150 studies meeting the selection criteria were reviewed. Our main findings were that the prevalence of CDI-PTSD ranged between 0% and 38% (averaging at 12%) and was highly dependent on the assessment tool used. The most consistent risk factors are of a psychological nature (e.g., pre-morbid distress). The consequences of CDI-PTSD range from psychosocial difficulties to lack of adherence and heightened mortality rates. Much inconsistency in the field was found with regard to patients who present with diagnoses other than acute coronary syndrome (e.g., cardiac arrest) and who undergo potentially traumatic medical procedures (e.g., defibrillator implantation). Yet the current review seems to strengthen the conceptualization of CDI-PTSD as a valid diagnostic entity, at least with regard to acute cardiac events.

Testing the concept of relational entitlement in the dyadic context: further validation and associations with relationship satisfaction.

The sense of relational entitlement is the perception one has of what one deserves from ones partner, and it may play a crucial role in determining the quality of a couples relationship. However, the concept was only recently subjected to empirical examination. The main goals of the current study were to continue the work initiated by the scale developers (Tolmacz & Mikulincer, 2011) by (1) further validating the Sense of Relational Entitlement Scale (SRE) in a sample of adult couples; and (2) examining the contribution of each partners sense of relational entitlement to his or her own and his or her partners relationship satisfaction. A sample of 120 Israeli, heterosexual, older couples (age = 58 years) in long-term relationships completed the study measurements. Factor analyses revealed that the SRE scale consisted of two major dimensions: conflicted entitlement and assertive entitlement. Applying an Actor-Partner-Interdependence Model (APIM) analysis indicated that the more conflicted one felt with regard to what one was entitled to, the less satisfaction one felt with the relationship. Additionally, the higher ones entitlement expectations were of ones partner (a subfactor of the assertive entitlement dimension), the more ones partner was satisfied with the relationship. The sense of entitlement construct seems to be relevant to the context of dyadic relationships and, as such, is worthy of further attention and investigation.

Gender and Caregiving: The Costs of Caregiving for Women

It is short sighted to study caregiving in the illness context without considering gender. Historically, caring for ill family members was an expected role for women within the privacy of the family. Caregiving is still commonly perceived to be a part of “women’s work” in societies throughout the world (Esplen, 2009). This perception persists despite more flexible sharing of household tasks by women and men in Westernized societies (Hook, 2010). However, it is not just a perception: 60% of caregivers are women (National Alliance for Caregiving & AARP, 2015). The average “composite” US caregiver is a 49-year-old woman, married and employed, caring for her 60-year-old mother who does not live with her (Feinberg, Reinhard, Houser, & Choula, 2011).

Systemic determinants as barriers to participation in cardiac prevention and rehabilitation services after Acute Coronary Syndrome

literature [6,8–10] during long-term follow-up as well. Our study is novel as the independent prognostic significance of post-procedural biomarker release was investigated in the context of standard clinical risk factors andmarkers as well asmore recently proposed biomarkers for risk stratification in CAD, such as NT-proBNP and hs-CRP. In summary, cTnT release after elective PCI is frequent even when the procedure is uncomplicated and successful, but compared with traditional risk factors and novel biomarkers for risk stratification post-PCI cardiac damage biomarker increase is of lower prognostic relevance for long-term outcome in patients with stable CAD undergoing elective PCI. The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology.

Change in health behaviours following acute coronary syndrome: Arab–Jewish differences

Background Health-promoting behaviours after acute coronary syndrome (ACS) are effective in preventing recurrence. Ethnicity impacts on such behaviours. We assessed the independent association of Arab vs. Jewish ethnicity with persistence of smoking and physical inactivity 6 months after ACS in central Israel. Design Prospective cohort study. Methods During their admission for ACS and subsequently 6 months later, 420 patients were interviewed about their smoking and exercise habits. The association of ethnicity with health-promoting behaviours was assessed by logistic regression adjusting for socio-demographic and clinical covariates. Results Smoking prevalence and physical inactivity were substantially higher among Arab patients than Jewish patients at admission (gender-adjusted prevalence rate ratio (RR) 2.25, 95% CI 1.80–2.81, p < 0.01 and RR 1.46, 95% CI 1.28–1.67, p < 0.001, respectively). The relative differences increased at 6 months (RR 2.94, 95% CI 2.13–4.07, p < 0.001 and RR 3.00, 95% CI 2.24–4.04, p < 0.001, respectively). Excess persistent smoking at 6 months among Arab vs. Jewish patients who were smokers at admission (adjusted OR 2.05, 95% CI 1.00–4.20, p = 0.049) was largely mediated through the 3.5-fold higher participation of Jewish patients in cardiac prevention and rehabilitation program (CPRP) (OR adjusted also for CPRP 1.31, 95% CI 0.59–2.93, p = 0.51). Greater persistent sedentary behaviour at 6 months among nonexercisers at admission among Arab patients (adjusted OR 3.68, 95% CI 1.93–7.02, p < 0.001) was partly mediated through attendance of CPRP (OR adjusted also for CPRP 2.38, 95% CI 1.19–4.76, p = 0.014). Conclusions Culturally sensitive programmes need to be developed to enhance CPRP participation and favourable health-promoting changes among Arab patients. A comprehensive understanding of the determinants of the Arab–Jewish differences in efficacious health-promoting behaviours is crucial to inform appropriate ethnic-specific health-promoting strategies.

Attitudes toward the sexuality of persons with physical versus psychiatric disabilities.

OBJECTIVE Research has shown that attitudes toward different disabilities form a hierarchy, with observers exhibiting more positive attitudes toward persons with physical disabilities than toward persons with psychiatric disabilities. In addition, investigations of attitudes toward persons with a disability indicate that they are often perceived as asexual. The current study examined whether involvement of persons with either a physical or psychiatric disability in a sexual relationship moderates the relation between their type of disability and attitudes toward them. METHOD After reading one of six randomly assigned vignettes, university students (N = 195) filled out a semantic differential-based attitude scale (Katz & Shurka, 1977; Kravetz, Katz, & Albez, 1994). The six vignettes consisted of a male with a physical disability/with a psychiatric disability/without a disability, who was either involved/not involved in a sexual relationship. RESULTS An interaction between type of disability and involvement in a sexual relationship was found for two subscales of the attitudes scale, occupation and intelligence. Involvement in a sexual relationship was found to generate more positive attitudes when the target person had a physical disability but more negative attitudes when he had a psychiatric disability. CONCLUSIONS Involvement in a sexual relationship seems to work in favor of persons with a physical disability because of the association of such a relationship with normality and adaptation. However, attributing such a relationship to persons with a psychiatric disability seems to be stigmatic.

Identifying barriers to participation in cardiac prevention and rehabilitation programmes via decision tree analysis: establishing targets for remedial interventions.

Background Participation rates of patients with acute coronary syndrome (ACS) in efficacious cardiac prevention and rehabilitation programmes (CPRPs) are low, particularly in ethnic minorities. Few studies have evaluated the full array of potential barriers to participation in a multiethnic cohort with identical insurance coverage. Objective To assess the hierarchy of multiple barriers (ie, sociodemographic, systemic, illness related, psychological and cultural) to participation in CPRP of Jewish and Arab patients served by a regional hospital in Israel. Methods Patients with ACS (N=420) were interviewed during hospitalisation about potential barriers and subsequently about participation in CPRP. Decision tree analysis determined, hierarchically, the best predictors of participation in CPRP. Results Ethnicity was the salient predictor of participation in CPRP (61.1% (95% CI 55.6% to 66.5%) of Jewish patients versus 17.2% (95% CI 11.2% to 24.9%) of Arab patients). Among Jewish patients the dominant determinant was a recommendation for CPRP in the hospital discharge letter (32.5% (95% CI 23.1% to 43.1%) vs 71.9% (95% CI 65.8% to 77.6%) participation without and with a recommendation, respectively). Other major hierarchical determinants included age, discharge diagnosis, socioeconomic position and perceived benefits of exercise. Among Arab patients, anxiety was the main predictor (5.5% (95% CI 1.1% to 14.1%) vs 27.9% (95% CI 17.7% to 40.0%) participation among those with high vs lower anxiety levels). Additional contributors were a predischarge visit to the rehabilitation centre (familiarisation) and car ownership (access). Conclusions Utilisation of decision tree analysis enables us to identify the key barriers to participation in CPRP in an ethnic-specific mode. Interventions to improve participation can then be designed to address each groups specific barriers.