Health Psychology Review最新文献

Behavioural theories, predictions, and interventions should be relevant to complex, real-world health behaviours and conditions. Habit theory and habit formation interventions show promise for predicting and promoting, respectively, longer-term behaviour change and maintenance than has been attained with theories and interventions focused only on deliberative behavioural factors. However, the concept of habit has largely been treated as uniform across different types of behaviours. In this conceptual review, we contend that the definitional aspects of habit differ at a conceptual level for simple versus more complex behaviours, with ramifications for prediction, promotion, and measurement of habits. Specifically, habits are defined as direct context-response associations learned through repeatedly rewarded responding - but what is meant by 'response' and 'reward' depends upon the complexity of the behaviour. We review literature that suggests (1) responses in complex habits have separable and substitutable components (vs a single and static, unitary component) and (2) rewards for complex habits are necessarily continued and intrinsic (vs temporary and extrinsic, respectively). We discuss some empirical and theoretical questions raised by these issues around behavioural complexity and habit. Lastly, we outline the ramifications of these issues for habit measurement (habit strength and habit formation) via self-report and objective measures.

Background: Psychological interventions for managing emotional distress in neurodegenerative diseases are needed, but progressive worsening of symptoms and increasing disability might pose difficulties with engagement. We aimed to synthesise the experiences of engaging with and using psychological interventions in neurodegenerative diseases and identify relevant barriers and facilitators. Methods: Systematic searches were conducted in six electronic databases and results were screened. We included qualitative and mixed methods studies reporting patient or caregivers' views or experiences of psychological interventions. Qualitative data were extracted and thematically synthesised. Results: 34 papers were included, covering a range of diseases and interventions. Engagement was facilitated by flexible intervention formats and tailoring to the specific needs of people with neurodegenerative diseases. Interventions were sometimes inaccessible or burdensome because of physical and cognitive symptoms, and the time and effort required for the intervention. Participants' levels of acceptance and readiness often differed and influenced engagement with the intervention. Across different interventions, participants experienced wide-ranging benefits including changes in insight, perspective, self-efficacy, emotions and relationships. Conclusion: Although people with neurodegenerative diseases and caregivers experience benefits from psychological interventions, burden-reducing adaptations and sensitive tailoring to the specific disease context is required to improve acceptability and engagement.

Medical diagnoses offer a structure by which psychological uncertainty can be attenuated, allowing patients to diminish psychological threats and focus on health prognosis. Yet when no diagnosis can be made, patients may experience diagnostic uncertainty - perceiving the medical field as unable to provide an accurate explanation of the cause of their health problems. This review examines the psychological threat that diagnostic uncertainty imposes on individuals' need for control and understanding, and the resulting consequences experienced by patients, parents of pediatric patients, and physicians. Using compensatory control theory as a framework, we propose a taxonomy of behaviors that people may adopt in order to regain control in the face of diagnostic uncertainty and to reaffirm that the world is not random and chaotic. To manage diagnostic uncertainty, people may bolster their personal agency, affiliate with external systems they see as acting in their interest, affirm clear connections between behaviors and outcomes, and affirm nonspecific epistemic structure. Diagnostic uncertainty is approached from the perspectives of patients, parents of pediatric patients, and physicians, demonstrating how each group responds in order to maintain a sense that the world has structure and is not random. Discussion centers on moderators, limitations, and implications for clinical practice.

Physical activity (PA) is recommended for childhood cancer survivors (CCSs). However, many CCSs have low levels of activity. This review aimed to systematically identify, appraise and synthesise qualitative research evidence on the barriers and facilitators to PA from the perspective of CCSs. Six databases (MEDLINE, Embase, PsycINFO, CINAHL, SPORTDiscus, and Scopus) were searched to identify qualitative data on PA gathered from CCSs diagnosed ≤18 years of age and who had completed active treatment. An inductive thematic synthesis was undertaken to identify descriptive themes relating to barriers and facilitators to PA, before mapping these onto the Theoretical Domains Framework (TDF). Methodological quality was assessed using CASP, and confidence in review findings was assessed using the GRADE-CERQual approach. Eight original studies were eligible. A total of 45 descriptive themes (29 facilitators and 16 barriers) were mapped onto nine domains of the TDF; they were most commonly mapped onto the Environmental Context and Resources (n = 13 descriptive themes) and the Social Influences (n = 13) domains. Study quality was variable and overall confidence in review findings was low. Conclusive/strong evidence for the barriers and facilitators to PA is lacking, highlighting the need for further research on the perceived influences on PA in CCSs. PROSPERO Registration: CRD42019147829.

ABSTRACTInformal caregiving constitutes the mainstay of a society's care supply. Motivations for caring and continuing to provide care are crucial to understanding the nature of caregiver experiences and their relationship with the person/people they support. This systematic review of qualitative evidence examines determinants of motivations and willingness to provide informal care. One hundred and five qualitative studies published before August 2019 and fitting the inclusion criteria were identified, 84 of them pertaining to cultural and societal motivations for caregiving. Grounded theory-based, thematic synthesis was conducted. Cultural and societal factors strongly underpinned motivations and willingness for informal caregiving. The main cultural motives for caregiving were cultural values and beliefs encompassing the ethnocultural context of the caregiving role, culture-specific norms, cultural and spiritual beliefs, illness beliefs and socialisation. Societal norms and perceived expectations, such as gendered roles, norms and expectations of caregiving, and perceptions of health and social care services further shaped caregiver motivations and willingness to provide care. These meta-synthesis findings contribute towards novel understandings about the cultural and societal aspects shaping informal care provision. These findings bear important implications for theory, research, policy and practice; all of which contributing to the issue of the sustainability of informal care from a 'macro' perspective.

ABSTRACTSmiling has been a topic of interest to psychologists for decades, with a myriad of studies tying this behavior to well-being. Despite this, we know surprisingly little about the nature of the connections between smiling and physical health. We review the literature connecting both naturally occurring smiles and experimentally manipulated smiles to physical health and health-relevant outcomes. This work is discussed in the context of existing affect and health-relevant theoretical models that help explain the connection between smiling and physical health including the facial feedback hypothesis, the undoing hypothesis, the generalized unsafety theory of stress, and polyvagal theory. We also describe a number of plausible pathways, some new and relatively untested, through which smiling may influence physical health such as trait or state positive affect, social relationships, stress buffering, and the oculocardiac reflex. Finally, we provide a discussion of possible future directions, including the importance of cultural variation and replication. Although this field is still in its infancy, the findings from both naturally occurring smile studies and experimentally manipulated smile studies consistently suggest that smiling may have a number of health-relevant benefits including beneficially impacting our physiology during acute stress, improved stress recovery, and reduced illness over time.

Fear of cancer recurrence (FCR) is the most common psychosocial issue amongst cancer survivors. However, fear of progression (FoP) has rarely been studied outside of the cancer context. This review aimed to: (1) meta-synthesise qualitative studies of FoP in illnesses other than cancer; and (2) quantify the relationship between FoP and anxiety, depression, and quality of life (QoL) in non-cancer chronic illnesses. We identified 25 qualitative and 11 quantitative studies in a range of chronic illnesses. Participants described fears of progression and recurrence of their illness, including fears of dying, and fears of becoming a burden to family. Fears were often triggered by downward comparison (i.e., seeing people worse off than themselves). Participants coped in different ways, including by accepting the illness or seeking knowledge. Those for whom these fears caused distress reported hypervigilance to physical symptoms and avoidance. Distress, and seeking information, were associated with adherence. In quantitative analyses, FoP was moderately associated with QoL, and strongly associated with anxiety and depression. These results suggest that FoP in illnesses other than cancer is similar to FCR. FoP appears to be an important transdiagnostic construct associated with distress. Evidence-based FCR interventions could be adapted to better manage FoP in other illnesses.

The SMART acronym (e.g., Specific, Measurable, Achievable, Realistic, Timebound) is a highly prominent strategy for setting physical activity goals. While it is intuitive, and its practical value has been recognised, the scientific underpinnings of the SMART acronym are less clear. Therefore, we aimed to narratively review and critically examine the scientific underpinnings of the SMART acronym and its application in physical activity promotion. Specifically, our review suggests that the SMART acronym: is not based on scientific theory; is not consistent with empirical evidence; does not consider what type of goal is set; is not applied consistently; is lacking detailed guidance; has redundancy in its criteria; is not being used as originally intended; and has a risk of potentially harmful effects. These issues are likely leading to sub-optimal outcomes, confusion, and inconsistency. Recommendations are provided to guide the field towards better practice and, ultimately, more effective goal setting interventions to help individuals become physically active.