Patient Satisfaction with Healthcare Services: Bangladesh Perspective

Patient satisfaction is a useful measure for providing a quality benchmark for healthcare services. Concern about the quality of healthcare services in Bangladesh has led to a loss of confidence in healthcare providers, low use of public health facilities and increased outflows of patients from Bangladesh to hospitals abroad. The key obstacles to access to health services are insufficient infrastructure and poor quality of existing facilities, lack of medical equipment, scarcity of doctors due to high patient load, long distance to the facilities and long waiting times until facilities have been reached, very short appointment hours, lack of empathy of health professionals, their generally callous and casual attitude, aggressive pursuit of monetary gains, poor levels of competence and, occasionally, disregard for the suffering that patients endure without being able to voice their concerns-all of these service failures are reported frequently in the print media. Such failures can play a powerful role in shaping patients\u27 negative attitudes and dissatisfaction with healthcare service providers and healthcare itself

A Single Case Study of Cognitive Remediation Therapy with an Adolescent with Disordered Eating

Picky eating is currently not included in the diagnostic classification system DSM-IV TR as a distinct category of eating disorders in childhood. It can reach clinical significance requiring intervention when it results in chronic nutritional inadequacies and/or harmful impact on social development or family functioning. Studies have shown that patients with eating disorders have difficulties with executive functioning. These findings have been used to develop an intervention based on cognitive remediation therapy (CRT) which targets thinking skills and their role in the development and maintenance of an eating disorder. To further investigate, this study assessed the efficacy of an 8-week, intensive cognitive training program in a pre-adolescent with picky eating behaviors. The participant was assessed before and after the eight sessions using assessments of executive function and a personality measure. The parent participated in a clinical interview and completed a paper-and-pencil measure of executive functioning at baseline and post-treatment. Assessment results showed improvements in logical planning, shifting, and self-confidence. The participant was aware of an improvement in his attention. Participant feedback was generally negative towards cognitive training. This study suggests that cognitive training appears promising as an intervention in improving executive functioning. The short nature and promising results of this intervention make it an attractive addition in the school setting for at-risk students with disordered eatin

Too heavy to be popular? : lay theories about weight and social status in adolescence

The present research examines causal lay theories about the relation between weight and social status in adolescence. We hypothesize that these causal schemata are expected to manifest in social information processing in the presence of weight and social status cues. Participants include 80 ninth grade adolescents and 203 college adults. First, in probabilistic judgment scenarios (Part 1), we show that participants expect statistical covariation between weight and social status when inferring others’ social status. Next, in a weight social categorization task (Part 2), participants were more likely to use weight cues to categorize people when they were presented with cues that were inconsistent with their lay theories (e.g., weight causes certain social status). Lastly, in a weight attribution task (Part 3), young adults tended to make more negative, dispositional attribution to overweight targets relative to thin targets when interpreting ambiguously-caused negative social events. As an initial test of the developmental process model, the findings support our theoretical predictions that adolescents’ and young adults’ causal lay theories about weight and social status serve as mental models that guide social information processing in judgment of others’ social status.Psycholog

The Effects of Active Social Media Engagement on Eating Disorder Risk Factors in Young Women

This study examined how engaging with female peers on social media affects young womens body image and self-esteem. Participants were 90 female undergraduate students. Fifty participants left comments on photos of one of their own subjectively more attractive acquaintances and interacted with her social media profiles for 10 minutes. The other 40 participants completed the same procedure with a family member they did not consider more attractive than themselves. Women who had engaged with attractive acquaintances had lower state self-esteem and body image than those who had engaged with family members on social media. Self-evaluative salience of appearance investment, drive for thinness, and downward (but not upward) physical appearance tendencies moderated various relationships between condition and self-esteem and body image. The findings reveal active social media engagement is causally related to eating disorder risk factors in young women, and young women with certain traits are more susceptible to such effects

I Wish I Looked Like Her: the endless pursuit for the ideal body

The purpose of this investigation was to examine the influence that images of models in beauty and fashion magazines had on women\u27s body image satisfaction. Participants were 23 college women. They were randomly assigned to two experimental conditions: ten women were assigned to the fashion magazine group and the remaining thirteen were assigned to the non-fashion magazine group. A fifty-eight item questionnaire was used to assess overall body image satisfaction, appearance concerns, dieting and eating behaviors, and thinness ideals between participants who were exposed to depictions of models in fashion magazines and those who were not. It was hypothesized that those exposed to images of women in beauty and fashion magazines would be: less satisfied with their overall body type, less satisfied with their appearance, favor a thinner body type, and show more of a concern with dieting and exercise

Modelling of expert nurses' pressure sore risk assessment skills as an expert system for in-service training

In the nursing literature to date there have been no reported applications of `cognitive simulation' nor of intelligent Computer Assisted Learning. In Chapter 1 of this thesis a critical review of existing nurse education by computer is used to establish a framework within which to explore the possibility of simulation of thinking processes of nurses on computer. One conclusion from this review which is offered concerns the importance of firstly undertaking reliable study of nursing cognition. The crucial issue is that an understanding must be gained of how expert nurses mentally represent their patients in order that a valid model might be constructed on computer. The construction of a valid computer based cognitive model proves to be an undertaking which occupies the remainder of this thesis. The approach has been to gradually raise the specificity of analysis of the knowledge base of expert and proficient nurses while seeking concurrently to evaluate validity of the findings. Reported in Chapter 2, therefore, are the several experimental stages of a knowledge acquisition project which begins the process of constructing this knowledge base. Discussed firstly is the choice of the skill domain to be studied - pressure sore risk assessment. Subsequently, the method of eliciting from nurses top-level and micro-level descriptors of patients is set out. This account of knowledge acquisition ends with scrutiny of the performance of nurse subjects who performed a comprehensive simulated patient assessment task in order that two groups might be established - one Expert and one Proficient with respect to the nursing task. In Chapter 3, an extensive analysis of the data provided by the simulated assessment experiment is undertaken. This analysis, as the most central phase of the project, proceeds by degrees. Hence, the aim is to `explain' progressively more of the measured cognitive behaviour of the Expert nurses while incorporating the most powerful explanations into a developing cognitive model. More specifically, explanations are sought of the role of `higher' cognition, of whether attribute importance is a feature of cognition, of the point at which a decision can be made, and of the process of deciding between competing patient judgements. Interesting findings included several reliable differences which were found to exist between the cognition of subjects deemed to be proficient and those taken as expert. In the final part of this thesis, Chapter 4, a more formal evaluation of the computer based cognitive model which was constructed and predictions made by it was undertaken. The first phase involved analysis in terms of process and product of decision making of the cognitive model in comparison to two alternative models; one derived from Discriminant Function Analysis and the other from Automated Rule Induction. The cognitive model was found to most closely approximate to the process of decision making of the human subjects and also to perform most accurately with a test set of unseen patients. The second phase reports some experimental support for the prediction made by the model that nurses represent their patients around action-related `care concepts' rather than in terms of diagnostic categories based on superficial features. The thesis concludes by offering some general conclusions and recommendations for further research

Negative body image and cognitive biases to body size

This thesis explored the relationship between cognitive biases to body size and one’s developed levels of body image concerns and weight status. Women with higher body image concerns were hypothesised to process body-related information in a biased fashion, specifically, to choose thin body ideals and rate thinner bodies higher on attractiveness, display an attentional bias towards thin bodies, and to estimate their own body size inaccurately. In study 1 (N = 84), although an attentional bias to thin bodies was not found, a positive thinness bias in young females was identified and related to one’s level of body image concerns. In study 2 (N = 61), an even more pronounced positive thinness bias was identified in a female sample with average to high levels of body image concerns. The study provided evidence that this bias can be successfully modified and that shifting the interpretation of body size can result in less extreme attitudes towards body size and improve one’s negative body image. Study 3 showed that a positive attitude towards thin female bodies exists in both young men (N = 67) and women (N = 67), but the choice of attractiveness ideals is related to one’s body image only when judging the bodies of one’s own gender. Study 4 (N = 87) indicated that regardless of one’s weight status, women higher in body image concerns present a greater discrepancy between their estimated and ideal size. However, the magnitude of one’s body size underestimation and inaccuracy in judging the amount of weight one would need to lose to achieve their body ideal was related to body image concerns for overweight and obese, but not normal weight women. Overall, the results show that cognitive body biases exist in young women and are related to one’s body image concerns and weight status