Journal of Clinical Psychology in Medical Settings最新文献

Pain in sickle cell disease (SCD) causes profound emotional and psychological consequences. Poor communication between clinicians and people with SCD can worsen the acute pain experience, yet strategies to improve these interactions remain unclear. We aimed to understand how people with SCD communicate with clinicians about pain and how patient-clinician communication could be improved.We conducted semi-structured qualitative interviews with people with SCD aged 16 and older (n = 30). We used rapid qualitative analysis to provide early insights into intervention development.Five themes emerged: 1) people with SCD want clinicians to believe their pain experiences, to show they care, and to demonstrate knowledge about SCD; 2) SCD-related pain directly impacts the ability to communicate; 3) communication about SCD pain should be tailored in content and pace based on the pain severity; 4) prior experiences influence how people with SCD communicate about pain; and 5) healthcare system and institutional factors can positively influence patient-clinician communication in SCD.Empathic communication from clinicians can have significant impact on the pain experiences of people with SCD, who adapt their communication strategies to access proper medical care. Training clinicians in SCD-specific communication skills may improve pain care for this population.

Graduate school admissions are competitive, and few studies have documented post-baccalaureate (post-bacc) training program outcomes. This paper describes a post-bacc training program at an academic medical center and aims to (a) characterize participants and program recruitment, (b) examine productivity and graduate school matriculation, and (c) assess change in key outcomes (e.g., publications), demographic characteristics, and program reflections. Seventy-nine post-baccs have completed the post-bacc training program since 2017. Publication data were obtained via institution record-keeping and public resources (e.g., PubMed). Starting in 2021, new post-baccs (n = 28) completed entry and exit surveys (reporting demographics/academic history, awards/honors, publications/presentations, research skill confidence, and next steps). Of 79 post-baccs, 89% (n = 70) matriculated to graduate or medical school (41% clinical psychology). The median number of publications during training was three. Publications, presentations, and confidence were higher at exit vs. entry (p's < .05). There were no differences based on underrepresented group status (p > .05). Program satisfaction was high. Findings demonstrate success preparing post-baccs for admission into advanced degree programs, improving research productivity/skill (regardless of underrepresented group status), and garnering high satisfaction among post-baccs. This program model can serve as a bridge, offering rigorous clinical research training for the future workforce of clinical psychologists and related professionals.

Introduction: Healthcare professionals are expected and motivated to engage empathetically with patients, their families, yet how different components of empathy, coping traits interact to shape psychological responses remains unclear. This study examined these relationships in medical, nursing students to inform tailored educational interventions METHODS: Participants who completed two surveys 2 years apart (30 medical students and 88 nursing students) were included. Empathy traits were assessed using the Interpersonal Reactivity Index, coping traits using the Brief Coping Orientation to Problems Experienced Inventory, and psychological responses using the Professional Quality of Life Scale. Mixed-effects models for repeated measures analyzed the impact of empathy and coping traits. Latent profile analysis (LPA) classified participants by empathy and coping traits.

Results: Personal distress was significantly associated with increased secondary traumatic stress (STS) and burnout, and decreased compassion satisfaction. Empathic concern was associated with increased compassion satisfaction. Active coping and support seeking were associated with increased compassion satisfaction and reduced burnout, whereas indirect coping was associated with increased STS and burnout. LPA identified three distinct profiles of empathy and coping traits, showing significant differences in psychological responses.

Discussion: Differences in empathy and coping traits influence psychological responses in medical and nursing students. Tailored interventions that consider these traits may be more effective.

Binge eating disorder and loneliness have both been identified as risk factors for developing Type 2 Diabetes (T2DM), and thus require attention and intervention. The interpersonal model of binge eating proposes that interpersonal problems lead to binge eating via the mediating pathway of negative affect. However, it is unclear whether the interpersonal construct of loneliness may serve a similar function. The current study aimed to test a loneliness model of binge eating in a T2DM population. Study participants (n = 192; mean age = 48.68 ± 14.85; 52.1% female gender) completed an online survey including measures of loneliness (UCLA Three-item Loneliness Scale and direct loneliness question), negative affect (Patient Health Questionnaire-4) and binge eating (Binge Eating Disorder Screener-7). We used structural equation modelling to assess the model and analysed mediation effects. The loneliness model of binge eating showed excellent model fit, and negative affect fully mediated the relationship between loneliness and binge eating (95% CI: 0.33, 0.90). Our findings indicate that interventions addressing loneliness may also be effective in reducing binge eating behaviours, contributing to the growing body of research emphasising the impact of loneliness on those living with T2DM.

Integrated Behavioral Health is a key solution in addressing significant problems of access and quality of care. This study assessed practice members' perspectives on the feasibility, acceptability, and appropriateness of an integrated care model called Colorado Integrated Behavioral Health Plus (CIBH +) in a large integrated health system. Seven family medicine practices implemented CIBH + . Practice members completed surveys regarding feasibility, acceptability, and appropriateness (analyzed with descriptive statistics) and semi-structured interviews (analyzed using a grounded theory hermeneutic editing approach). A total of 156 practice members responded to the survey (62% response rate) and 46 participated in interviews (78% response rate). Respondents indicated high levels of agreement about the perceived feasibility, acceptability, and appropriateness of CIBH + . Qualitative themes included: (1) observing the benefits to patients and comprehensive team care reinforced the value of integrating care; (2) supports from teamwork, leadership, and telehealth facilitated implementation; and (3) limitations from role clarity, staffing, space, telehealth, and lack of long-term care options remained challenging for implementation. Identifying the key features of CIBH + may make practical implementation in other settings more feasible to implement and acceptable for patients and care teams to use.

While the Trust in Physicians Scale demonstrates strong reliability and validity in previous findings, further research is necessary to continue evaluating item response theory parameters and the effects of social desirability. Undergraduate participants (N = 730) between 17 and 48 years of age (M = 18.41, SD = 1.63) completed the Trust in Physicians questionnaire and criterion validity measures. Results from Gulliksen's Pool indicated suitability for factor analysis and goodness of fit was appropriate for a unidimensional model (GFI = 1.00; RMSEA = .09; CFI = .98). When controlling for social desirability, factor loadings ranged from .39 to .84 for the Trust in Physicians factor. Loadings on the social desirability control scale ranged from .08 to .25, suggesting positive links with trust in physician and social desirability. Item response theory analyses under Samejima's graded response model reveal item discrimination values between .42 and 1.71 (m = 1.01). Proper measurement may enable physicians to identify patients who may require attention to therapeutic rapport.

Risky alcohol use and post-traumatic stress disorder (PTSD) commonly co-occur with musculoskeletal injury-related pain, forming a recovery-delaying cycle. Web/app-based digital Personalized Feedback Interventions (dPFIs) show promise as a first-step adjunct for addressing this comorbidity. We conducted an exploratory cross-sectional survey of 138 musculoskeletal clinicians assessing (1) screening/referral practices for risky alcohol use and PTSD, and (2) interest in a dPFI for alcohol/PTSD treatment engagement, integrated with pain-coping skills. Clinicians indicated that risky alcohol use and PTSD impose multiple recovery challenges. Screening was largely interview-driven (alcohol: 40.4%; PTSD: 55.8%) with low use of validated questionnaires (~ 6% for both). Notably, 6.5% and 9.4% never discussed risky alcohol use and PTSD respectively, and 50.7% reported no on-site PTSD services. Referrals were fragmented: for risky alcohol use, 39.9% referred to primary care, exceeding specialty options; for PTSD, on-site treatment was most common (22.5%) yet half reported no on-site service. Adoption readiness was high: 89.1% expressed interest in an integrated web/app-based dPFI for alcohol and PTSD, 78.3% believed patients would benefit, and referral likelihood was strong (90.6% for each condition/comorbidity). Rates of app-favoring exceeded medication-assisted-treatment-favoring (37.2% vs. 13.9%). Findings support the development and implementation of accessible, scalable integrated dPFIs for PTSD, risky alcohol use, and pain in orthopedic settings.

Emotional Awareness and Expression Therapy (EAET) targets traumatic or conflictual emotional and interpersonal contributors to chronic pain. This qualitative study examined patients' experiences of 4-session, group EAET conducted in an Australian tertiary pain clinic. Interviews with 10 adults who completed the therapy were analyzed via thematic analysis. Seven themes were identified. Patients noted that EAET was emotionally "challenging but worth it," and that the group "provided strength in numbers, usually." Although only some patients reported pain reduction, most reported that EAET was beneficial in various respects, including improving their relationship to pain ("pain takes a back seat") and improved interpersonal and emotional functioning ("changing relationships"). Regarding therapy structure and content, patients experienced "validation in pain education," but felt that the program was too short and needed additional care provision given its high intensity ("healing takes time" and "need for ongoing care"). All patients recommended EAET, although with some caveats, especially about format and patient readiness. This study finds that EAET is viewed as helpful by people with chronic pain, especially regarding their emotional and interpersonal functioning, and with some improvement in pain or how it is experienced. Yet, EAET is also emotionally challenging, and the 4-session version conducted here is too brief; attention needs to be given to extending its length and monitoring and responding to individual differences among patients.

Inherited cardiac conditions (ICC) require lifelong management and raise significant psychological challenges. Patients with suspected ICCs typically begin their journey with a clinical diagnosis in cardiology, an often-distressing experience that leaves them feeling vulnerable. Yet, psychological care remains inconsistently integrated into cardiogenetics, while fields such as oncogenetics, reproductive genetics, and neurogenetics have integrated psychological support much earlier. These latter fields are driven by ethically complex decisions like prophylactic surgery, pregnancy termination, and predictive testing for conditions such as Huntington's disease. Consequently, psychologists in those fields are routinely involved across all stages of genetic testing, offering emotional support and guiding decision-making. Despite growing openness to biopsychosocial approaches, cardiogenetics has traditionally prioritized symptom management, medical interventions, and risk stratification, with less attention for emotional and psychosocial needs.As a result, patients with ICCs may remain vulnerable to distress, grief, and uncertainty, especially when a genetic risk (carriership of a pathogenic variant in an ICC gene) is discovered, following events like the sudden cardiac death of a relative. Many carriers struggle with guilt, fear of passing on a pathogenic variant, and challenges in family communication, all of which can impact adherence to medical advice.Drawing on international experiences of disparities observed across countries and centres, this viewpoint calls for the structured integration of psychologists in cardiogenetic care teams, emphasizing their role in patient-centred communication, informed decision-making, and long-term psychological support.