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Rosagemma Ciliberti, Matteo Gulino, Ilaria Gorini
The Italian Parliament has recently approved the Law n. 219/2017 concerning "Rules on informed consent and advance directives". The manuscript points out the main key points of the new law, in order to clarify the role of the advance directives and to provide clear operational guidelines for healthcare personnel. Taking into consideration the Italian deontological and juridical context, along with the main jurisprudential judgements, the law has been analysed. The Authors discussed the new rules and the bioethical issues also in relation to the provisions stated by the Convention on Human Rights and Biomedicine (Convention of Oviedo)...
May 2018: Recenti Progressi in Medicina
Mingming Zhou, Chester Chun Seng Kam
In this study, we sought to extend the research on self-determination, future orientation, and personal identity construction by integrating the theories on self-determination and future orientation to provide a conceptual framework for understanding the relations between personal identity and the following individual characteristics: Hope, optimism, awareness of self, and perceived choice. 191 university students in China responded surveys in hardcopies on an individual basis. Our SEM results revealed that proximal future orientation influenced the mechanisms through which distal psychological traits affected identity construction...
May 17, 2018: Spanish Journal of Psychology
Liang-Chih Chang
The current study examined the main and interaction effects of leisure self-determination and two leisure social support types (emotional and instrumental) on stress in nursing home residents. A total of 139 nursing home residents (mean age = 79.4 years) in Taichung City, Taiwan, were recruited. Data were collected using face-to-face surveys, which included measures of leisure self-determination, leisure emotional support, leisure instrumental support, and stress. Data were analyzed using a hierarchical regression analysis...
May 16, 2018: Research in Gerontological Nursing
Hilary Craig, Carel le Roux, Fiona Keogh, Francis M Finucane
Despite overwhelming evidence that bariatric interventions reduce morbidity and mortality and are cost-effective, access for affected patients is limited. We sought to describe the extent to which health policy makers and publically funded health services have an ethical obligation to provide bariatric care. We conducted a narrative review of the literature pertaining to the efficacy, safety, and cost-effectiveness of bariatric surgical interventions, in the context of the core principles of medical ethics...
May 15, 2018: Obesity Surgery
Guillaume Martinent, Valérian Cece, Marije Titia Elferink-Gemser, Irene Renate Faber, Jean-Claude Decret
This study examined the prognostic relevance of self-determined motivation, coping, burnout, perceived stress and recovery experienced by 159 youth table-tennis players involved in intensive training centers with regard to their participation and success six years later. Results of ANCOVAs showed that players who still practiced at time 2 (T2; six years later; n = 130) reported lower time 1 (T1; while they were involved in intensive training centers) amotivation (large effect), disengagement-oriented coping, sport devaluation and reduced accomplishment (moderate effects) than their counterparts who dropped out at T2 (n = 29)...
May 15, 2018: Journal of Sports Sciences
Niels Keiding
The prestigious journal Biostatistics published in July 2017 six solicited commentaries on the role of the U.S. Food and Drug Administration (FDA), as times change, with ever developing technical tools for clinical trials and their evaluation, with increased focus on personalised medicine (possibly aided by genetic testing), and on patient self-determination. Two were written by American economists, four by leading biostatisticians, mostly from the USA. This paper summarises these texts for a Danish audience...
May 7, 2018: Ugeskrift for Laeger
Cristina Mumbardó-Adam, Joan Guàrdia-Olmos, Climent Giné
BACKGROUND: Self-determination is a psychological construct that applies to both the general population and to individuals with disabilities that can be self-determined with adequate accommodations and opportunities. As the relevance of self-determination-related skills in life has been recently acknowledged, researchers have created a measure to assess self-determination in adolescents and young adults with and without disabilities. The Self-Determination Inventory: Student Report (Spanish interim version) is empirically being validated into Spanish...
May 10, 2018: Research in Developmental Disabilities
Bjørg Karlsen, Bettina Rasmussen Bruun, Bjørg Oftedal
Research suggests that guided self-determination programmes can support self-management of diabetes by empowering self-determined goal setting and competence building. As most research in this area has focused on people with type 1 diabetes, knowledge is lacking on how adults with type 2 diabetes mellitus experience participation in such programmes. This study reports the modelling phase of a complex intervention design that explored the experiences of adults with type 2 diabetes who participated in a nurse-led guided self-determination programme in general practice and examines how the programme affected patients' motivation to self-manage diabetes...
2018: Nursing Research and Practice
Julia Lohmann, Adamson S Muula, Nathalie Houlfort, Manuela De Allegri
"Intrinsic motivation crowding out", the erosion of high-quality, sustainable motivation through the introduction of financial incentives, is one of the most frequently discussed but yet little researched potential unfavorable consequence of Performance-based Financing (PBF). We used the opportunity of the introduction of PBF in Malawi to investigate whether and how PBF affected intrinsic motivation, using a mixed-methods research design theoretically grounded in Self-Determination Theory (SDT). The quantitative component served to estimate the impact of PBF on intrinsic motivation, relying on a controlled pre- and post-test design, with data collected from health workers in 23 intervention and 10 comparison facilities before (March/April 2013; n = 70) and approximately two years after (June/July 2015; n = 71) the start of the intervention...
April 30, 2018: Social Science & Medicine
Greg Hext, Louise L Clark, Andreas Xyrichis
Reducing 'restrictive practices' is an issue of national importance, pertinent to all NHS sectors, yet there is poor awareness of the issue in mainstream adult services. Such practices potentially restrict a person's rights to choice, self-determination, privacy and freedom. Challenging behaviour is often the result of unmet needs, communication difficulties or diagnostic overshadowing, but there is a common misconception that patients exhibit such behaviours because of their impaired intellectual abilities or mental health problems...
May 10, 2018: British Journal of Nursing: BJN
Malin Hildingsson, Ulrika Tranaeus Fitzgerald, Marie Alricsson
Compliance with a rehabilitation program is significant among athletes following a sports injury. It is also one of the main factors that influence the rehabilitation process; moreover, the outcome is also influenced by the athlete's motivation. It is primarily an autonomous motivation, resulting in rehabilitation adherence. The aim of this study was to investigate the perceived motivation of female football players during rehabilitation after a sports injury and the extent to which these motivating factors were autonomous...
April 2018: Journal of Exercise Rehabilitation
Nachoum Reut, Yaniv Kanat-Maymon
OBJECTIVES: Maternal postpartum depression symptoms (PDS) are linked with negative personal, family, and child developmental outcomes. However, paternal PDS, let alone dyadic process, are understudied. Grounded in the Self-Determination Theory of motivation, this longitudinal study examined whether mothers' and fathers' type of prenatal motivation to have a child predicted depression symptoms 3-6 months after birth. METHOD: The data (N = 90 heterosexual couples) were analyzed using the Actor-Partner Interdependence Model...
May 7, 2018: Journal of Clinical Psychology
Morgan Carpenter
Once described as hermaphrodites and later as intersex people, individuals born with intersex variations are routinely subject to so-called "normalizing" medical interventions, often in childhood. Opposition to such practices has been met by attempts to discredit critics and reasserted clinical authority over the bodies of women and men with "disorders of sex development." However, claims of clinical consensus have been selectively constructed and applied and lack evidence. Limited transparency and lack of access to justice have helped to perpetuate forced interventions...
May 7, 2018: Journal of Bioethical Inquiry
Lisa Ferretti, Philip McCallion, Emily McDonald, Hayoung Kye, Angelica Hererra-Vensom, James Firman
Background : Successful aging is best determined by active management and self-determination of one’s aging roadmap. Some individuals are ready to respond to these challenges, others may benefit from assistance that might be offered through an evidence-based intervention. The Aging Mastery Program® (AMP) has been developed to meet these needs. Method : In a cross over design the intervention was tested in ten senior centers and aging network agencies looking at impacts upon general health and quality of life, patient activation, physical activity and advanced care planning...
May 7, 2018: Healthcare (Basel, Switzerland)
Ove Hellzen, Marit Haugenes, May Østby
 Examining everyday challenges in the interactions between people with intellectual disabilities and their staff, as seen from the user's perspective, is an important perspective in health care research. Involving people with intellectual disabilities as so-called co-researchers is a relatively unexplored research strategy. In this paper, co-researchers participated in all the steps of the research process, from planning to reporting, in addition to the written reporting of the findings. The aim of this study was to explore how people with intellectual disabilities experienced a filmed vignette of an everyday situation...
December 2018: International Journal of Qualitative Studies on Health and Well-being
Sally Lindsay, De-Lawrence Lamptey, Elaine Cagliostro, Dilakshan Srikanthan, Neda Mortaji, Leora Karon
PURPOSE: Youth with disabilities have lower rates of enrollment and completion of post-secondary education compared with youth without disabilities. The objective of this systematic review is to understand the best practices and components of post-secondary transition programs for youth with disabilities. METHOD: Systematic searches of six international databases identified 18 studies meeting our inclusion criteria (youth with a disability, aged 15-30; focusing on post-secondary education program or intervention, published from 1997 to 2017)...
May 4, 2018: Disability and Rehabilitation
Anthony Wayne Knight
Given the close interpersonal nature of the student-clinical instructor (CI) relationship and the unpredictable and often stressful clinical environment in which they interact with one another, it is extremely important that clinical instructors understand how their behavior directly affects their students' motivation to engage in educationally important clinical activities. This article presents a review of the motivation literature grounded in self-determination theory with the goal of providing the reader insight into how clinical instructor psychological need-supporting/thwarting behaviors affect student clinical engagement...
May 3, 2018: Journal of Nuclear Medicine Technology
David González-Cutre, Ángel Megías, Vicente J Beltrán-Carrillo, Eduardo Cervelló, Christopher M Spray
This study provides an in-depth analysis of the psychosocial benefits that 10 post-bariatric patients (nine female, 31-59 years) perceived from their participation in an exercise program grounded in self-determination theory. Qualitative data were collected through observations and interviews. Participants reported many factors which facilitated basic psychological need satisfaction such as the instructors caring about their opinion, affection, fitness improvement, pain reduction, and knowledge acquisition...
April 1, 2018: Journal of Health Psychology
Michael Poulsen, Anne A Poulsen
Radiation oncology trainees in Australia and New Zealand have relatively high levels of emotional exhaustion and depersonalisation which are core components of burnout. The stresses of a demanding clinical load, studying for exams as well as family commitments are all contributing factors. Self-Deter mination Theory (SDT) provides a framework for optimising motivation which may be intrinsic or extrinsic. The three core components of SDT are competence, relatedness and autonomy. These factors should be addressed at a college level, Institutional and a personal level if the best outcomes are to be achieved...
May 2, 2018: Journal of Medical Imaging and Radiation Oncology
Kevin S Masters, Kaile M Ross, Stephanie A Hooker, Jennalee L Wooldridge
Background: There has been a notable disconnect between theories of behavior change and behavior change interventions. Because few interventions are both explicitly and adequately theory-based, investigators cannot assess the impact of theory on intervention effectiveness. Theory-based interventions, designed to deliberately engage the theory's proposed mechanisms of change, are needed to adequately test theories. Thus, systematic approaches to theory-based intervention development are needed...
April 28, 2018: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
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