Influences on clinical reasoning in family and psychosocial interventions in nursing practice with patients and their families living with chronic kidney disease.

AIMS: To explore how Registered Nurses address psychosocial issues for patients and their families living with chronic kidney disease. BACKGROUND: It is in the scope of registered nursing practice to address the emotional, psychological and relational implications of living with chronic disease through psychosocial and family interventions. Patients living with chronic kidney disease frequently report poor quality of life and numerous psychosocial issues; however, they do not find that these issues are always adequately addressed. DESIGN: This research was hermeneutic inquiry as guided by Gadamer's philosophy of understanding. METHODS: Family/psychosocial nursing practices are examined from the perspective of self-reports of Registered Nurses working in acute care nephrology units. Interviews with nurses were conducted throughout 2012. RESULTS: Nurses attribute, or explain, patient and family member behaviour in a variety of ways. These explanations may or may not align with actual patient/family reasons for behaviour. Nurses' explanations influence subsequent nursing practice. While there is some evidence of practices that overcome biased attributions of patient behaviour, the cognitive processes by which nurses develop these explanations are more complex than previously reported in nursing literature. CONCLUSION: Clinical reasoning and subsequent nursing practice are influenced by how nurses explain patients'/families' behaviour. Exploration of this issue with the support of social cognition literature suggests a need for further research with significant implications for nursing education and practice to improve family/psychosocial interventions.

Affect in the aftermath: how goal pursuit influences implicit evaluations.

Previous research has shown that the activation of a goal leads to more implicit positivity toward goal-relevant stimuli. We examined how the actual pursuit of a goal influences subsequent implicit positivity toward such stimuli. Participants were consciously or non-consciously primed with a goal, or not, and then completed a goal-relevant task on which they succeeded or failed. We then measured their goal-relevant implicit attitudes. Those who were primed with the goal (consciously or non-consciously) and experienced success exhibited more implicit positivity toward the goal, compared with the no-goal condition. Experiencing failure in the goal priming conditions reduced implicit positivity toward the goal, indicating disengagement from the goal. We discuss the theoretical implications for understanding the role of implicit attitudes in self-regulation.

Condom embarrassment: coping and consequences for condom use in three countries.

This study investigates embarrassment related to condom purchase, carrying, storage, use, and disposal in three countries. We identify the consequences of purchase embarrassment for condom use and explore strategies that individuals use to cope with purchase-related embarrassment. Surveys were distributed in Shanghai, China and Seoul, Republic of Korea based on a survey developed and previously distributed in Vancouver, Canada. Despite different levels of development and differences in attitudes and policies toward sexuality in these countries, we find remarkably similar results. In all three countries, condom-related embarrassment extends beyond condom use to pre- and post-use situations. The embarrassment associated with purchasing condoms exceeds that of using condoms, and purchase-related condom embarrassment significantly and negatively impacts the frequency of condom use. Individuals use multiple coping strategies to combat purchase-related embarrassment until this embarrassment decreases with age and experience, and coping strategies are no longer needed to enable condom purchase. In short, embarrassment associated with condoms goes beyond embarrassment about condom use. Purchase-related embarrassment and the strategies individuals use to cope with this embarrassment must be considered in order to promote consistent condom use and improve sexual and reproductive health worldwide.

Should we ask our Children about Sex, Drugs and Rock & Roll?: Potentially Harmful Effects of Asking Questions About Risky Behaviors.

Research shows that asking questions can fundamentally change behavior. We review literature on this question-behavior effect, which demonstrates that asking questions changes both normal and risky behaviors. We discuss potential explanations for the effect and review recent findings that reveal interesting moderators of the influence of questions on behavior. We then highlight the potential impact of the question-behavior effect in an important public health context: screening adolescents for risky behavior. While medical guidelines emphasize the importance of asking adolescents questions about substance (drug, alcohol) use and sexual behaviors, research on the question-behavior effect suggests that asking adolescents about risky behaviors has the potential to increase the frequency with which they engage in these behaviors. We argue that the act of screening or measuring risky behavior is potentially counterproductive. We emphasize the importance of interventions beyond screening, and suggest ways in which screening can be carried out to minimize its impact. In short, asking questions about behaviors can change behavior, and asking questions about risky behaviors may itself be a risky undertaking.

Coping with condom embarrassment.

This study assesses the embarrassment associated with purchasing, carrying, storing, using and disposing of condoms. It incorporates coping theory into the investigation of embarrassment by analysing the strategies individuals use to cope with embarrassment during condom purchase. The results of a survey show that individuals are embarrassed at various stages related to condom use. Purchasing condoms elicits the most embarrassment, followed by carrying and disposing, while using and storing are the least embarrassing. To cope with their embarrassment while purchasing condoms, people use multiple cognitive and behavioural coping strategies, with embarrassed people using more strategies. Both embarrassment and the number of strategies used decrease with age and experience. It appears that embarrassment associated with condoms remains a barrier to condom acquisition and consistent condom use, particularly among young adult populations. Coping strategies help individuals to bridge the gap between embarrassment and use.