Journal of Clinical Psychology in Medical Settings最新文献

Integrated Care (IC) models have increased, but the current mechanisms to analyze the efficacy and fidelity of behavioral interventions within IC models are limited. A mixed methods concurrent process evaluation was used within the context of a randomized clinical trial to assess intervention fidelity for a Solution-focused brief therapy (SFBT) intervention implemented within an IC model. A qualitative content analysis was conducted to develop a participant survey and charting template for the SFBT intervention. Quantitative data were collected through (1) participant surveys, (2) interventionist self-report surveys, and (3) data from participant charts. Descriptive statistics and repeated measures ANOVA were used to analyze quantitative data. Data triangulation was used to present findings. The average SFBT intervention was 24.6 min and 33/34 (97%) of participants in the intervention group completed all 3 SFBT sessions. Most visits were weekly follow-ups (53.9%), followed by biweekly (28.2%) and then 3-week follow-ups (5.1%). The interventionist used session templates and a self-report checklist to monitor intervention integrity. Those in the intervention group had increased growth regarding Solution-focused core constructs (a scale created by the authors) when compared to the treatment-as-usual group (F [1, 64] = 22.7, p < 0.001): mean difference, 15.1 [95% CI 11.2 to 18.9]. Our study examined fidelity comprehensively and provides a foundation for studies interested in fidelity monitoring of SFBT interventions as well as behavioral interventions within IC models. Trial Registration: The study was pre-registered at ClinicalTrials.gov Identifier: NCT05838222 on 01/05/2023.

Research has identified that individuals with chronic pain comfort eat in response to their pain, however, little is known about the function that comfort eating serves for chronic pain patients. Given the synergistic relationship between higher body weight and chronic pain, it is important to further understand the role and impact of eating behaviours, such as comfort eating, for individuals with chronic pain. This study aimed to investigate the perceived function of pain-induced comfort eating for chronic pain sufferers. Adult participants (N = 141) with chronic pain were recruited through online advertisements. Participants completed self-report questions on an online survey platform. Over two-thirds of the sample identified with engaging in comfort eating in response to chronic pain flare-ups. Results revealed that the most endorsed function of pain-induced comfort eating was 'to have a pleasant experience' (51.8%), followed by 'distraction' (49.6%) and 'to reduce emotions' (39%). This study provides further evidence that comfort eating is common amongst individuals with chronic pain and sheds light on the perceived function of comfort eating for those who are managing chronic pain. Given the potential impact on outcomes for chronic pain patients, future studies should further investigate the relationship between comfort eating and chronic pain.

Psychologists have unique and valuable skill sets that are increasingly recognized and desired for leadership positions within academic health centers (AHCs; Kirch and Ast, in J Clin Psychol Med Settings 24:86-91, 2017). Despite this trend, there are not many specialized leadership training opportunities for psychologists employed at AHCs. The Leadership for Psychologists in Academic Health Centers (L-PAHC) Conference was conceptualized and implemented as a virtual conference offering to address this professional development need. This paper details the conference overview, target audience, content, and speakers, scheduling and implementation, and evaluation and feedback from the inaugural L-PAHC Virtual Conference. The conference was well attended (n = 97), with a range of career stages represented (41% early, 45% mid-career, 14% late career). Attendees included APAHC members (76.3%) and non-members, most of whom were already serving in leadership roles (86%). Interactive conference engagement was high, and feedback was generally positive and indicative of attainment of conference training goals (M = 4.85 of possible 5; SD = 0.36). All respondents recommended that L-PAHC should be held again and most reported that they would return. The L-PAHC Conference was well received and highly rated for addressing leadership training needs for psychologists in AHCs. Specific feedback and recommendations for future leadership training are provided.

Due to its invisible nature, individuals must make decisions around self-disclosing Inflammatory Bowel Disease (IBD). Existing reviews have explored stigma as a barrier to disclosing IBD; however, other factors potentially affecting disclosure decisions have not been recently reviewed. The current review sought to synthesise qualitative papers exploring the experiences of disclosure, and identify facilitators and barriers to disclosure, within IBD. A systematic search identified 34 journal articles, comprising 1,004 participants. Following critical appraisal, a thematic meta-synthesis was completed. (PROSPERO registration ID CRD42023481441). A total of six main themes relating to self-disclosure were identified: it's a stigmatised illness; a wish to conceal; difficulties discussing IBD; a need to disclose; balancing the need to disclose and the reluctance to disclose; and varied consequences to disclosure. Overall, the included studies were adequate quality; however, weaknesses in reflexivity were observed across a high proportion. This review highlights the complexity of disclosure decisions and describes how personal beliefs, social contexts, and previous experiences can influence these. Potential clinical implications, the impact for public health services, and the need for future research are discussed.

This study aimed to determine whether illness behavior in women with cardiovascular disease varied based on specific sociodemographic characteristics and to explore the effect of health anxiety and cyberchondria on the level of illness behavior. A descriptive and cross-sectional study was conducted with 255 women with cardiovascular disease who applied to the cardiology outpatient clinic of a state hospital in Turkey between June and August 2023. Data were collected using personal information forms, such as the Scale for the Assessment of Illness Behavior, Health Anxiety Scale, and Cyberchondria Severity Scale. The data were analyzed using ANOVA, t-test, Pearson correlation, and hierarchical linear regression. The study determined that the participants' illness behavior levels differed according to some sociodemographic characteristics (p < .05). Hierarchical regression analysis revealed that education above university level (β = - 0.276), rhythm disorder diagnosis (β = - 0.100), health anxiety (β = - 0.441), and cyberchondria (β = - 0.141) were predictors of illness behavior (p < .05). These variables explained 40% of the variance in illness behavior. Sociodemographic characteristics, health anxiety, and cyberchondria should be considered when planning health services for women with heart disease to reduce abnormal illness behavior.

Individuals with inflammatory bowel disease (IBD) often experience stigmatization. Disease disclosure has been associated with lower enacted stigma (i.e., engaging in discriminatory treatment), but minimal research has investigated IBD disclosure and enacted stigma experimentally. The present study's aim was to examine the effect of IBD disclosure on enacted stigma in a vignette paradigm. Participants included 244 adults from the United States who were randomized into one of three vignette groups: disclosure of IBD, non-disclosure of IBD, and control (no IBD). Vignettes in both IBD groups depicted a person with frequent bowel movements. Each vignette group contained a workplace, social, and recreational setting. Participants completed measures of enacted stigma, IBD knowledge, and IBD familiarity after reading the vignettes. Participants reported greater propensity to enact stigma in response to vignettes depicting non-disclosure of IBD than vignettes depicting disclosure of IBD or no IBD and for vignettes depicting the recreational setting compared to the workplace and social setting. Enacted stigma was negatively correlated with IBD knowledge. Disease disclosure may result in decreased stigma from others. Furthermore, educating the public about IBD may be beneficial for reducing enacted stigma towards individuals with IBD.

Chronic pain is common in primary care and can be influenced by alcohol use. Co-occurring pain and at-risk alcohol use is associated with poor outcomes, but the prevalence of this co-occurrence is less well understood. This study aims to establish the prevalence of at-risk alcohol use in a sample of VA primary care patients with chronic pain, and determine health characteristics and care utilization of these patients. Eligible VA primary care patients with a musculoskeletal condition (n = 47,091) were classified as at risk, low risk, or abstainers based on responses to annual alcohol screening. Differences across groups in demographics, comorbid health conditions, health factors, and healthcare encounters were assessed. 45.7% of participants were abstainers, 38.5% were low risk, and 15.8% were at risk. Comparisons revealed abstainers to have higher frequencies of health conditions, as well as higher rates of emergency department and primary care utilization. At-risk patients had the highest rate of overall healthcare utilization and, when compared directly to low-risk patients, were more likely to be diagnosed with many physical and mental health conditions. Primary care teams will benefit from considering the impact of alcohol when treating patients with chronic pain. Further prioritization of integrated primary care is recommended.

Chronic orofacial pain (COFP; i.e., musculoskeletal, neurovascular, or neuropathic pain in the face, mouth, or jaw that lasts for at least 3 months) is prevalent and debilitating. Chronic pain and substance use frequently co-occur, and individuals with COFP face unique challenges (e.g., uncertainty about future pain episodes, difficulty eating, drinking and talking) that may influence substance use. Nevertheless, no work to date has comprehensively assessed substance use among individuals with COFP. Here, we examine the prevalence of substance use among adults with COFP. Participants included 246 adults with COFP who were recruited from the Facial Pain Association. Participants completed an online survey that included a comprehensive assessment of substance use (i.e., Alcohol, Smoking, and Substance Involvement Screening Test) between December 2023 and January 2024. Most participants (82.9%) have used ≥ 1 substance in their lifetime, over two-thirds (68.3%) currently use ≥ 1 substance, and nearly half (43.5%) engage in risky substance use. The most commonly used substances were alcohol, tobacco, cannabis, opioids, and sedatives. This study presents a comprehensive assessment of substance use among adults with COFP. Findings extend prior work documenting high rates of substance use among individuals with chronic pain to a sample of adults with COFP. Given that substance use can exacerbate chronic pain and interfere with pain management, findings underscore the importance of assessing and addressing substance use among individuals with COFP.

Adverse medical conditions can involve present and expected future restrictions as a double burden: mechanically ventilated patients with spinal cord injury (SCI), on the one hand, face pain and communication restrictions. On the other hand, they are confronted with significant changes in their future life perspective. While past research on emotion and appraisals has studied SCI patients alone or in comparison with healthy controls, the current work disentangles the potential impact of (a) the adverse current state and (b) expected future restrictions by comparing mechanically ventilated intensive care unit (ICU) patients with vs. without SCI in eye-tracking-based self-reports on emotions and appraisals. Results suggest that patients of either group could provide faceted accounts of their current state, such as feeling trapped and insecure. However, the feedback that SCI and other ICU patients gave was similar, suggesting that current adversities dominate self-reports.

An Addiction Consult Service (ACS) utilizes an interdisciplinary approach to fill an important gap in substance use treatment for patients who are admitted to an acute care hospital. While each ACS team's composition mirrors the needs of the patient population, there is a lack of literature on the role of psychologists within ACS teams despite psychotherapeutic intervention being a key component of substance use treatment. The current article aims to clarify how psychologists with specialized training in the treatment of substance use can contribute to the overall goal of an ACS in an acute care hospital setting. Drawing from the competency benchmarks put forth by the American Psychological Association to guide doctoral-level psychology training, we draw connections between relevant competencies for independent psychological practice and the ACS landscape. The importance of psychologists' competencies in Interdisciplinary Systems, Scientific Knowledge and Methods, Evidence-Based Practice, Individual and Cultural Diversity, and Relationships are highlighted and demonstrated through hypothetical case scenarios. This article provides an introduction to the ways in which psychology can contribute to the interdisciplinary environment of ACS, both clinically and foundationally. With this work, we hope to encourage additional inquiry into the intersection of psychology and addiction consult work.