Questionnaire Package Research Articles

How does social support relieve depression among flood victims? The contribution of feelings of safety, self-disclosure, and negative cognition

BackgroundDepression is one of the most common post-trauma symptoms that can be alleivated by social support. The purpose of this study was to examine the multiple mediating effects of social support on depression via feelings of safety, disclosure, and negative cognition. MethodOne hundred and eighty-seven flood victims in Wuhu City, an area affected most severely by a flood during July 2016, were selected to complete a self-report questionnaire package. ResultsSocial support has four indirect negative effects on depression, including a one-step indirect path to self-disclosure, 2 two-step paths from feelings of safety to self-disclosure, and from self-disclosure to negative cognition about self, and a three-step indirect path from feelings of life safety via self-disclosure to negative self-cognition. LimitationsAll variables were measured using self-report scales. ConclusionSocial support may relieve depression in flood victims by inducing feelings of safety and self-disclosure, and by relieving negative cognition.

Factors involved in patients’ perceptions of self-improvement after chronic pain treatment

ABSTRACT Background Patients’ self-reported levels of improvement after having attended a chronic pain management program can provide a subjective rating of how successful they perceive they were at accomplishing their goals in the program. Past studies have demonstrated that successful patients differ from less successful ones on several cognitive–behavioral factors such as coping strategies over physical characteristics such as pain intensity. Aims This study explored factors that determine patients’ perceptions of self-improvement after undergoing chronic pain treatment in a pain management program. Methods Participants (n = 174) underwent a 4-week, interdisciplinary, multimodal, chronic pain management program at a hospital located in southern Ontario. Questionnaire packages that evaluate pain intensity, pain-related disability, emotional distress (e.g., depression, anxiety, catastrophizing), acceptance of pain (activity engagement and pain willingness), readiness to change, and use of adaptive or maladaptive coping strategies were completed by patients at admission and discharge. Participants were grouped into one of three categories depending on their rating of self-improvement on the Self-Evaluation Scale (SES). The groups were compared on the magnitude of change they reported on the variables mentioned above. Results Changes in emotional distress, general health, readiness to change, activity engagement, and adaptive coping strategies (e.g., task persistence, pacing, and seeking social support) were significantly associated with differences in ratings of self-improvement. Conclusions This study provided insight into what patients value most when rating their self-improvement, which can then be used to facilitate increased patient success and satisfaction with treatment.

Reliability and validity of a Japanese version of the Sensory Gating Inventory (SGI)

The purpose of this study was to develop a Japanese version of the Sensory Gating Inventory (SGI; Hetrick, Erickson, & Smith, 2012) and to examine its reliability and validity. SGI measures abnormalities in the quality of sensory input, heightened awareness of background noises, and poor selective attention at the phenomenological level. The questionnaire was completed by 515 university and graduate students. The questionnaire package included 3 scales; 35 items from the Japanese version of SGI, 27 items from the Japanese version of the Highly Sensitive Person Scale (HSPS; Funahashi, 2011), and 25 items from the Japanese version of the Cognitive Failures Questionnaire (CFQ; Yamada, 1991). Confirmatory factor analysis showed that the Japanese SGI had an acceptable level of internal consistency. Cronbach’s alpha was calculated to examine reliability and showed high values. Correlation analyses showed that the Japanese SGI and Japanese HSPS or CFQ were moderately positively correlated. This study suggests that the Japanese SGI is reliable and valid. It can be used to screen for abnormal sensory gating before physiological or behavioral inspection.

Respect toward partner mediates the relationship between authenticity and subjective happiness

The present study investigates the extent to which respect toward partner play as a mediator role on the relationship between authenticity and subjective happiness. Participants were 211 teachers who completed a questionnaire package that included the respect toward partner scale, the authenticity scale, and the subjective happiness scale. Findings demonstrated that subjective happiness is predicted positively by authenticity and respect toward partner. Respect toward partner is predicted positively by authenticity. Also the relationship between authenticity and subjective happiness is partially mediated by respect toward partner. The results are discussed in the light of the related literature and dependent recommendations to the area were given.

Participation profiles and the barriers and facilitators that impact on participation of children with Autism Spectrum Disorders living in regional and remote Western Australia.

Background:Autism Spectrum Disorder (ASD) is a heterogeneous condition, influencing participation in activity and occupation. Approximately, 1% of Australian children have an ASD diagnosis, with many of these families living in remote and regional areas. Given the environments role in facilitating or hindering participation, there is a need to understand how geographical location impacts the participation profiles of children with ASD.Objective:This study aims to describe the participation profiles, and environmental barriers and facilitators to participation for children with ASD living in regional or remote Western Australia.Methods:A total of 32 families completed a questionnaire pack including a socio-demographic questionnaire and the Participation and Environment Measure – Children and Youth.Results:Children with ASD had reduced participation in community activities. Within the home, children most commonly participated in computer and video games, and in school settings, children participated rarely in non-classroom and extracurricular activities. Parents reported a desire for their children to decrease time spent engaging in video games and increase time spent in the community, socializing, engaging in extracurricular activities, and completing chores. Parents reported a number of barriers to participation across community, home, and school settings.Conclusion:Children with ASD living in regional areas had restricted participation profiles and a number of barriers to participation as reported by their parents. There is a need for additional support and services in non-metropolitan areas for families of children with ASD to increase participation. This study also highlights the need to expand the definition of participation in the International Classification of Functioning, Disability and Health to include aspects of involvement.

Understanding muscle-immune interactions in adolescent idiopathic scoliosis: a feasibility study

BackgroundAdolescent idiopathic scoliosis (AIS) is the most common form of scoliosis in children, and its cause remains unknown. The Immune-metabolic CONnections to Scoliosis (ICONS) Study was designed to elucidate the potential mechanisms by which immune system-paraspinal muscle crosstalk contributes to the development of AIS. In this report, we document the evaluation of ICONS Study feasibility.MethodsThis study was conducted at a tertiary pediatric academic center in Hamilton, Ontario, Canada. We included boys and girls, aged 10–17 years with a diagnosis of AIS requiring corrective spinal surgery. Exclusion criteria included patients on high-dose steroids, immunosuppressive therapy, anti-thrombotic medications, those with an active infection for 15 days before participation, autoimmune disease, pregnancy, and patients who were unwilling to consent.Pre-determined feasibility criteria included permission to approach participants and recruitment rates of 80%, consenting of at least 80% of participants to provide biological samples, 90% or higher case report form and questionnaire completion, resources to be sufficient in at least 80% of recruitments, and the ability to successfully collect and process 80% or more of the biological samples needed for this study.ResultsBetween August 2013 and October 2014, we identified 32 potential participants with AIS, but had the resources to approach only 16, of which 12 (75%) agreed to be approached by the research team, and all consented to participate. Of the 12 participants recruited, 11 questionnaire packages and muscle biopsies (91.7% for each objective) were collected, while other biological samples (serum, plasma, whole blood for DNA and RNA processing, urine) were collected from all participants.ConclusionsThe ICONS study protocols and procedures are feasible. However, recruitment rates were less than predicted. For the full study, we plan on prolonging the recruitment phase and the inclusion of additional centers to achieve recruitment targets.

The Relationship between Quality of Sleep, Job Commitment and Wellness of Night Shift Nurses in Medium and Small-sized Hospitals

Objectives The purpose of this study was to identify the relationship between quality of sleep, job commitment, wellness, and identify contributing factors affecting on the wellness of night shift nurses in medium and small-sized hospitals. Methods One hundred twenty four nurses who had working experiences with night shifts for 6 months or more completed a pack of questionnaires. Collected data were analyzed using t-test, ANOVA with Scheffe test, and stepwise multiple regression. Results Factors including quality of sleep, job commitment, and wellness were identified. The quality of sleep score of the subject was 7.55 (0-21), the job commitment was 20.17 (7-35), and the wellness was 2.93 (1-5). There was no significant in wellness according to general characteristics of subjects. The subjects’ wellness had a significant negative correlation with quality of sleep (r=-0.31, p<0.001), and a significant positive correlation with job commitment (r=0.45, p<0.001). Regression analysis to identify factors affecting the wellness of night shift nurses showed that job commitment was the most significant factor (p<0.001), followed by quality of sleep (p=0.049). In the regression analysis, quality of sleep and job commitment were significant predictors and explained 21.9% (p<0.001) of wellness. Conclusions Results of this study have suggested that job commitment and quality of sleep were significantly related to nurses’ wellness in medium and small-sized hospitals. Therefore, there is a needed to develop a program with an enhancement of job commitment and a strategy of improving quality of sleep. Key words: Quality of sleep, Job commitment, Wellness, Nurses

CHARACTERISTICS OF DEPRESSION IN PATIENTS WITH DIFFERENT CHRONOTYPES

Background: Approximately 30−40% of depressive patients does not improve or show a partial response. Since biological rhythm involved in the pathogenesis of mood disorders is regarded as a unique characteristic of a person, it opens new opportunities for personalized medicine.Aim: to evaluate clinical characteristics and treatment effectiveness in depressive patients with different chronotypes.Materials and methods: In prospective, hospital-based study MADRS was performed weekly (dMADRS), therapeutic response (R) was defined as a 50% or greater decrease from baseline in the score. Chronotype was evaluated using the Morningness−Eveningness Questionnaire (MEQ). Participants completed a questionnaire package: HDRS-21, PSQI, ТОВ, «individual minute». Statistical analysis was performed using Excel for Windows, Statistica 13.0.Results: All patients (n=100, mean age 48±16 yrs) were divided into groups based on their circadian type: evening types (ETs) had more severe condition; antidepressants (SSRIs; R=72%) were effective given at morning in ETs, at evening (other; R=100%) ― in morning types (MTs) (p0.00001) with a greater reduction in depressive symptoms (p0.05). Prescribing drugs with balanced potency were effective in both groups (F=4.62, p=0.032). Cluster analysis on 25 clinical, biological, and therapeutic variables to establish the role of chronotype as a factor important for identifying patients with similar socio-demographic, clinical, and health characteristics was conducted. Cluster 1 achieved a reduction of depression severity (19% MTs; R=81%; 43.4±17.7 yrs; single episode; dMADRS 16.9±2.7; 23% monotherapy). Cluster 3 (80% ETs; R=50%; 40.4±15.2; early onset dMADRS 15.23±2.29; 7% monotherapy) was the most unfavorable prognostic group.Conclusions: Depressive patients with morning/evening chronotypes have significant differences in clinical presentation, the course of the illness and efficacy of antidepressants. Evening chronotype was found to be associated with poor prognosis. Circadian typology should be considered when choosing the appropriate therapeutic options.

The Pain of Ambivalence over Emotional Expression.

Ambivalence over emotional expression (AEE) is defined as the desire to express emotion but failing to do so. Recent studies have revealed that AEE is associated with more pain. Pain is common among cancer survivors. This cross-sectional study investigated the association between AEE and pain, its underlying mechanism, and cultural relevance among cancer survivors. Ninety-six Chinese American breast cancer survivors completed a questionnaire package assessing AEE and pain. AEE was positively associated with pain severity and pain interference. The association between AEE and pain interference was mediated by intrusive thoughts. Cancer survivors who are ambivalent over emotional expression may experience high levels of intrusive thoughts, which results in high levels of symptom reports in their pain. The study confirmed the association between AEE and pain and its underlying mechanism among a group whose culture generally encourages emotional suppression. Findings suggest interventions focusing on reducing intrusive thoughts may be effective at reducing pain.

Metacognitions or distress intolerance: The mediating role in the relationship between emotional dysregulation and problematic internet use

ObjectiveGiven the relevance of problematic Internet use (PIU) to everyday life, its relationship to emotional dysregulation and the importance of metacognitions and distress intolerance in process and intermediaries research, this study examined which of metacognitions and distress intolerance acts as an intermediary between emotional dysregulation and PIU. MethodsIn the current study, 413 undergraduate students from the University of Tehran, Iran (202 females; mean age=20.13) voluntarily completed a questionnaire package which included the Internet Addiction Test (IAT), Difficulties in Emotion Regulation Scale (DERS), Metacognitions Questionnaire 30 (MCQ-30(, and Distress Tolerance Scale (DTS). The data were then analyzed using structural equation modeling by LISREL software. ResultsSignificant correlations were found between PIU and emotional dysregulation and both distress intolerance and metacognitions (P<0.001). Structural equation modeling and path analysis results fit well to the data (χ2/df=1.73; p<0.001; RMSEA=0.05; SRMR=0.04; CFI=0.97; NFI=0.95). The results of the mediational model indicated that emotional dysregulation has an indirect impact via metacognition (β=0.31; SE=0.02) and distress tolerance (β=−0.60; SE=0.03) on PIU. The analysis also revealed a significant direct impact of emotional dysregulation on PIU, although this impact is much less than the indirect impact. The variables in this model accounted for 62% of the variance in participants' PIU levels. ConclusionThe results of this study provide evidence for the impact of emotional dysregulation on PIU through metacognitions and distress intolerance. Also, these findings emphasize that distress intolerance has a more significant mediating role than metacognition in the relationship between emotional dysregulation and PIU.

Motivational Antecedents of Well-Being and Health Related Behaviors in Adolescents.

Grounded in the Achievement Goal Theory framework of motivation and optimal functioning, there were two objectives of this study: (a) to test a model hypothesizing links between personal theories of school achievement, indices of the quality of academic engagement, wellbeing, and health-related behaviors, and (b) to explore whether the hypothesized model was invariant across gender groups. A multisection questionnaire pack tapping the targeted variables was administered to 967 teenagers (475 boys and 492 girls) aged between 11 to 16 years old. Structural equation modeling analysis revealed that Task theory of achievement predicted positively satisfaction in school and negatively boredom in school. An Ego theory of achievement was linked to higher levels of boredom in school. Satisfaction in school corresponded to higher life satisfaction, while boredom was negatively related. Higher life satisfaction was associated with lower tobacco, alcohol and marijuana consumption, more healthy food intake and greater levels of physical activity. The results revealed partial invariance of the model by gender. The quality of adolescents’ involvement in the classroom holds important implications for adolescent’s well-being and their health related behaviors. Interventions on the creation of a task-involving motivational climate in the school are proposed to promote healthy lifestyles among young people.

Exercise program design considerations for head and neck cancer survivors

The present study aimed to establish exercise preferences, barriers, and perceived benefits among head and neck cancer survivors, as well as their level of interest in participating in an exercise program. Patients treated for primary squamous cell carcinoma of the head and neck between 2010 and 2014 were identified from the hospital database and sent a postal questionnaire pack to establish exercise preferences, barriers, perceived benefits, current physical activity levels, and quality of life. A postal reminder was sent to non-responders 4 weeks later. The survey comprised 1021 eligible patients of which 437 (43%) responded [74% male, median (interquartile range) age, 66 (60–73) years]. Of the respondents, 30% said ‘Yes’ they would be interested in participating in an exercise program and 34% said ‘Maybe’. The most common exercise preferences were a frequency of three times per week, moderate-intensity, and 15–29 min per bout. The most popular exercise types were walking (68%), flexibility exercises (35%), water activites/swimming (33%), cycling (31%), and weight machines (19%). Home (55%), outdoors (46%) and health club/gym (33%) were the most common preferred choices for where to regularly exercise. Percieved exercise benefits relating to improved physical attributes were commonly cited, whereas potential social and work-related benefits were less well-acknowledged. The most commonly cited exercise barriers were dry mouth or throat (40%), fatigue (37%), shortness of breath (30%), muscle weakness (28%) difficulty swallowing (25%), and shoulder weakness and pain (24%). The present findings inform the design of exercise programs for head and neck cancer survivors.

Development of the SOSS-D: a scale to measure stigma of occupational stress and burnout in medical doctors

Background: Occupational stress and burnout are highly prevalent among doctors, with stigma identified as a barrier to help-seeking in this population. However, there has been a lack of a standardised tool to measure stigma of occupational stress and burnout among doctors.Aims: The aim of the current study was to develop and investigate the psychometric properties of the Stigma of Occupational Stress Scale for Doctors (SOSS-D).Method: An online questionnaire package was completed by 200 (38 male, 162 female) doctors. Participants completed measures relating to help-seeking intentions, general stigma, and the SOSS-D.Results: Exploratory Factor Analysis was used to refine the scale to an 11-item version. The analysis revealed a three-factor structure, which explained 63.4% of variance. Factors related to perceived structural stigma, personal stigma and perceived other stigma. The internal consistency, convergent, discriminant and criterion validity of the scale were supported.Conclusions: The SOSS-D may assist educators and mental health professionals in measuring and assessing the efficacy of interventions designed to reduce stigma. As such, it is anticipated that the SOSS-D will be a useful instrument for understanding and addressing stigma of occupational stress and burnout among medical doctors, to improve help-seeking behaviours in this population.

Physicians’ and pharmacists’ information provision and patients’ psychological distress

ABSTRACTProviding information related to medication has many benefits for patients. However, patients’ conflicting perceptions about medical information provided by physicians and pharmacists may be associated with their psychological distress regarding treatment and medication. This study investigated associations between patients’ perceptions of agreement between physicians and pharmacists about medical information and improvements in their psychological distress. It also clarified the specific relationships of their perceptions with psychological distress. A cross-sectional survey was conducted in Japanese community pharmacy settings. Pharmacists approached 1,500 patients visiting community pharmacies and provided them with questionnaire packages. Patients completed the questionnaires at home and returned them to the researchers by mail. Multivariate logistic regression analysis and signal detection analysis were conducted to examine associations of patients’ perceptions of information agreement with improvement in psychological distress. Measures of improvement in worry and anxiety about disease, improvement in worry and anxiety about medication, and improvement in depressive mood were used to assess alleviation of psychological distress. A total of 645 patients returned the questionnaires; 628 contributed to the data. Multivariate logistic regression analyses clarified that patients’ perceptions of agreement in information regarding need for medication, methods for adverse drug reaction reduction, adverse drug reaction symptoms, coping with forgetting to take medication, and advice for daily life were significantly associated with improvements in psychological distress. Furthermore, signal detection analysis showed that several combinations of patients’ perceptions of agreement between physicians and pharmacists about specific medical information were also significantly associated with improvement in psychological distress. Consistent information provision by physicians and pharmacists could contribute to decreased psychological distress in patients, and consequently to adherence to treatment and taking medication.

Measuring participation in patients with chronic back pain—the 5-Item Pain Disability Index

Background ContextOf the three broad outcome domains of body functions and structures, activities, and participation (eg, engaging in valued social roles) outlined in the World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF), it has been argued that participation is the most important to individuals, particularly those with chronic health problems. Yet, participation is not commonly measured in back pain research. PurposeThe aim of this study was to investigate the construct validity of a modified 5-Item Pain Disability Index (PDI) score as a measure of participation in people with chronic back pain. Study DesignA validation study was conducted using cross-sectional data. Patient SampleParticipants with chronic back pain were recruited from a multidisciplinary pain center in Alberta, Canada. Outcome MeasuresThe outcome measure of interest is the 5-Item PDI. MethodsEach study participant was given a questionnaire package containing measures of participation, resilience, anxiety and depression, pain intensity, and pain-related disability, in addition to the PDI. The first five items of the PDI deal with social roles involving family responsibilities, recreation, social activities with friends, work, and sexual behavior, and comprised the 5-Item PDI seeking to measure participation. The last two items of the PDI deal with self-care and life support functions and were excluded. Construct validity of the 5-Item PDI as a measure of participation was examined using Pearson correlations or point-biserial correlations to test each hypothesized association. ResultsParticipants were 70 people with chronic back pain and a mean age of 48.1 years. Forty-four (62.9%) were women. As hypothesized, the 5-Item PDI was associated with all measures of participation, including the Participation Assessment with Recombined Tools-Objective (r=−0.61), Late-Life Function and Disability Instrument: Disability Component (frequency: r=−0.66; limitation: r=−0.65), Work and Social Adjustment Scale (r=0.85), a global perceived participation scale (r=0.54), employment status (r=−0.30), and the Usual Activity domain of the 15D (r=0.50). The expected correlations observed indicating a moderate or strong association provided supporting evidence for the construct validity of the 5-Item PDI as a measure of participation. The Oswestry Disability Index and the 5-Item PDI were also strongly correlated (r=0.70). The 5-Item PDI was associated to a lesser degree with depressive symptoms and resilience, as measured by the Hospital Anxiety and Depression Scale (HADS) (r=0.25) and the Connor-Davidson Resilience Scale (r=−0.28), as would be expected. No statistically significant association was found between the 5-Item PDI and the HADS Anxiety score. ConclusionsIt is important that outcome measures of participation are included in back pain research to gauge the effects of painful spinal conditions and interventions on maintaining valued social roles. A simple, concise measure would be very useful for this purpose in clinical and research settings. The results of this study support the construct validity of the 5-Item PDI as a brief measure of participation in people with chronic back pain. These findings are likely most applicable to those with chronic back pain attending pain clinics and other tertiary centers for care.

Biopsychosocial factors predict quality of life in thoracolumbar spine surgery.

Surgical intervention is a treatment option for various spinal pathology but many patients report no improvement or even an exacerbation of symptoms like pain. This study examined the association of preoperative (pre-op) biopsychosocial risk factors with poor quality of life at 2 and 6months using hierarchical models controlling demographic and medical variables. Participants undergoing thoracolumbar spine surgery (N=214) were provided with questionnaire packages to complete pre-op, at 2 and at 6-month postoperative clinical follow-ups (i.e., demographics, psychosocial measures, SF-12, medical, and clinical measures). The surgeon recorded surgical measures. Examining the pre-op period only, greater age and medication use (for back symptoms) were associated with poorer physical quality of life [physical component summary score (PCS)], while greater catastrophizing, depression, and lower social support were associated with poorer mental QoL [mental component summary score (MCS)]. Lower preoperative PCS, social support, and greater kinesiophobia were associated with diminished PCS at 2-month. Higher pre-op MCS and higher social support was associated with better MCS at 2-month. Poorer PCS at 6-month was associated with older age and low social support, while diminished MCS was associated with lower pre-op social support, MCS, and longer time in the operation room. Preoperative kinesiophobia partially mediated the relationship between pre-op PCS and 2-month PCS. Age partially mediated the relationship between pre-op PCS and at 6-month. For MCS, social support was the lone partial mediator of baseline MCS and both 2 and 6-month MCS. These results show that preoperative psychosocial variables are significantly associated with poorer postoperative health-related QoL outcomes following spinal surgeries, supporting a biopsychosocial pre-op care map.

Do Trust and Sexual Intimacy Mediate Attachment's Pathway Toward Sexual Violence Occurring in Same Sex Romantic Relationships?

This study tested a serial mediation model examining how dyadic trust and sexual intimacy mediate the relationship between insecure romantic attachment and perpetrated sexual violence occurring between same sex intimate partners (sexual SSIPV). A community sample of adults (N = 310; 203 women, 107 men) involved in a committed (6 months or longer) same sex romantic relationship completed an encrypted online questionnaire package which included psychometric measures designed to assess the aforementioned variables. Controlling for gender effects, analyses conducted using bootstrapping procedures supported full mediation pathways for both attachment anxiety and attachment avoidance. That is, attachment anxiety and avoidance were both directly associated to the perpetration of sexual SSIPV, and these relationships were both fully mediated by dyadic trust and sexual intimacy, in that respective order.

Prevalence and Predictors of Patient Nonadherence to Pharmacological Acute Pain Therapy at Home After Day Surgery: A Prospective Cohort Study.

Good adherence to prescribed analgesics can be crucial to suppress or even prevent acute postoperative pain after day surgery. The aim of this study was to analyze prevalence and predictors of analgesic nonadherence after day surgery. Elective patients scheduled for day surgery were prospectively enrolled from November 2008 to April 2010. Outcome parameters were measured by using questionnaire packages at 2 time points: 1week preoperatively and 4days postoperatively. The primary outcome parameter was analgesic nonadherence. Adherence was defined according to the patient's response to the questionnaire item "analgesia use as prescribed": full adherence, "yes"; partial adherence, "yes, sometimes"; nonadherence, "no." Bivariate and multivariate logistic regression analyses were performed to identify predictors of analgesic nonadherence. A total of 1,248 patients were included. The prevalence rates of analgesic nonadherence and partial adherence were 21.6% and 20.0%, respectively, in the total study population but dropped to 9.4% and 19.8%, respectively, in patients with moderate to severe pain. Low postoperative pain intensity and short duration of surgery were the most important predictors of analgesic nonadherence. The most important preoperative predictors for analgesic nonadherence were low preoperative pain intensity, low preoperative expectations of pain, and low fear of short-term effects of surgery. Analgesic nonadherence and partial adherence are common after day surgery but decrease as average pain intensity increases. Patients at risk for analgesic nonadherence can be identified during the preoperative period based on preoperative pain intensity, preoperative expectations of pain, and fear of surgery.

Linking Coach Interpersonal Style With Athlete Doping Intentions and Doping Use: A Prospective Study.

We brought together various lines of work on motivation, morality, and doping by testing a theory-based model prospectively linking contextual and personal motivational variables, moral attitudes, moral disengagement in doping, doping intentions, and doping use. Participants were 257 Greek athletes who completed a questionnaire pack at the beginning of a sport season. In the case of doping use, we also obtained data close to the end of the same season. The model showed that perceptions of controlling coach behaviors predicted athlete need frustration, which in turn predicted low moral functioning and doping intentions/doping use. The findings highlight pathways (direct and indirect) by which the social environment may impact on athletes' intentions and decisions to engage in doping and could pave the way for future antidoping interventions aimed at improving coaching interpersonal style.

Reliability and screening ability of the StarT Back screening tool in patients with low back pain in physiotherapy practice, a cohort study

BackgroundLow back pain (LBP) is the most common reported musculoskeletal disorder, with large prevalence numbers and high costs. Focus on early identification of patients at risk of developing chronic LBP has increased. The Keele Start Back Tool (SBT) is a questionnaire aiming at screening prognostic indicators in LBP patients, categorizing patients into risk-groups and guide treatment. The aim of this study was to explore the Norwegian version of the SBT with regard to reliability of the SBT-scoring and the screening ability in LBP patients in primary care physiotherapy.MethodsLBP patients answered a package of questionnaires twice, with 1-3 days in between, containing SBT, Hannover functional ability questionnaire, pain intensity questions and demographics. The relative and absolute reliability of SBT was calculated using intraclass correlation coefficient (ICC) and the smallest detectable change respectively. Independent sample t-tests were used for group comparisons.ResultsFifty-two patients with LBP. Mean age (SD) was 45 (12) years and 62% were female. The ICC (95% CI) for SBT total score and psychosocial subscore was 0.89 (0.82, 0.94) and 0.82 (0.70, 0.90) respectively. None of the participants were allocated to the high risk group. The medium risk group reported significantly more pain last week and more activity limitations than the low risk group at both test and retest (0.001 ≤ p ≤ 0.003), whereas no significant difference between the groups was found on pain now (0.05 ≤ p ≤ 0.16).ConclusionsThe Norwegian version of the SBT was reliable and the screening ability was good as the subgrouping of patients into risk-groups reflected the severity of their back problems. The SBT may be an applicable and useful tool in physiotherapy practice.