Suni Petersen

Cardiovascular disease knowledge and risk perception among underserved individuals at increased risk of cardiovascular disease.

Background: Cardiovascular disease (CVD) risk factor awareness and knowledge are believed to be prerequisites for adopting healthy lifestyle behaviors. The purpose of this study was to examine knowledge of CVD risk factors and risk perception among individuals with high CVD risk. Methods: The sample consisted of inner city and rural medically underserved patients at high risk of CVD. To be eligible for the trial, subjects were required to have a 10% or greater CVD risk on the Framingham risk score. Knowledge of CVD was assessed with a 29-item questionnaire created for this study. Subjects also rated their perception of risk as compared with individuals of their own sex and age. Results: Data were collected from 465 subjects (mean [SD] age, 60.5 [10.1] years; mean [SD] Framingham risk score, 17.3% [9.5%]). The mean (SD) CVD knowledge score was 63.7% (14.6%), and mean (SD) level of risk perception was 0.35 (1.4). Men and women had similar Framingham risk scores, but women perceived their risk to be significantly higher than that of their male counterparts. Women were also more knowledgeable than men about CVD. Urban participants had significantly higher actual risks than did their rural counterparts (18.2% [10.7%] vs 16.0% [8.9%], respectively; P = .01) but were significantly less knowledgeable about heart disease and also perceived their risk to be lower. Conclusions: These results indicate a low perception of risk and cardiovascular knowledge especially among men and inner city residents. Innovative educational strategies are needed to increase risk factor knowledge and awareness among at-risk individuals.

Homicidality in Schizophrenia: A Replication Study

This study attempted to replicate the results of R. C. Schwartz, S. Petersen, and J. L. Skaggs (2001) by testing predictors of homicidality in a new sample of participants with schizophrenia. Results of multiple regression analyses showed that manic symptoms and substance abuse were significantly positively correlated with more extreme homicidality. Global Assessment of Functioning scale ratings were significantly negatively correlated with ratings on homicidality. Finally, men displayed significantly heightened homicidality as compared with women. These findings lend support to the hypothesis that clinicians should pay particular attention to evaluating homicidality in patients who are male, have schizophrenia, who abuse substances, who show acute manic symptoms, and whose global functioning has recently declined.

Critique of recent empirical research on insight and symptomatology in schizophrenia.

During the past decade there has been a resurgence of interest in investigating the relationship between insight and symptomatology among clients with schizophrenia. The breadth and depth of the articles have dramatically increased over the past 10 years, including the number of empirical research studies. This article summarizes the strengths and limitations of the empirical research focused on the association between insight and severity of psychotic symptoms and published between 1990 and 1999.

Predictors of decision-making style among cancer patients: An empirical test of theory

Abstract Patient decision-making has been shown to be far from data-driven which results in serious consequences for physical health and psychological well-being. Cancer patients were found to have made their medical decisions in four ways: information-seeking, information-processing, advice-following, and ruminating. These four ways represent two routes of cognitive processing. The first two exemplify central route processing and the second two exemplify peripheral route processing. Medical decisions have also been shown to be highly influencable based on message presentation. This study represents the first step in applying social influence theory to medical decision-making. The elaboration likelihood model was used to determine whether the variables shown to have influenced routes of processing could predict which decisional style the cancer patients used. Specifically, the elaboration likelihood model of Petty and Cacioppo (1986) was applied as predictors of decisional processing style. Using a discriminant function analysis, the variables motivation (both cognitive and emotional), ability to process, and cognitive responding predicted whether cancer patients made their medical decisions using the four categories of decisional styles.

Predictors of Homicidal Ideation and Intent in Schizophrenia: An Empirical Study

Correlations of age, gender, and psychosocial variables with ratings of current homicidal ideation and intent were investigated among psychiatric facility clients with schizophrenia. Multiple regression analyses revealed, irrespective of age or gender, significantly positive correlations of three psychosocial variables--manic symptoms, psychotic symptoms, and impaired global functioning--with homicidal ideation and intent. Implications for research are discussed.

Social Construction of Illness

Abstract There is no question that a diagnosis of cancer has a significant impact on anyone, however, certain aspects of American culture and particularly the medical culture exacerbate the impact. This article supports the notion that a womans experience of cancer is, at least in part, socially constructed, political in nature, and therefore, uniquely disempowering to women. Those cultural forces affecting women with cancer include the stigma, the socially-embedded self-definitions, and the practices that dominate the medical-industrial complex. This article demonstrates how the use of social constructivist therapy can assist women in disengaging from these cultural forces while engaging in new ways of thinking and behaving that, in empirical studies, have resulted in decreased progression of disease, longer survival rates, and more effective coping with cancer.

Physical Illness: Social Construction or Biological Imperative?

All cultures have metaphors for mental illness that define how it is diagnosed, treated, and experienced by the patient. Cultural metaphors that define mental illness have been traced predominantly to biomedical and systems models. However, the research on factors such as progression of illness, survival rates, adherence to medical regimens, level of disability, and experience of pain in chronic and acute life-threatening illnesses suggests another metaphor. This article not only explores how a constructivist metaphor makes sense of this research, but also suggests an approach to consider in helping patients and their families deal with the difficult life circumstances that illness imposes. Implications for nurses are outlined.