British Journal of Health Psychology最新文献_第10页

Implementation of a national programme to train and support healthcare professionals in brief behavioural interventions: A qualitative study using the theoretical domains framework 实施国家方案，培训和支持医疗保健专业人员进行简短的行为干预：使用理论领域框架的定性研究。

IF 2.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2025-01-15 DOI: 10.1111/bjhp.12777

Oonagh Meade, Lena Aehlig, Maria O'Brien, Agatha Lawless, Jenny McSharry, Anda Dragomir, Jo K. Hart, Chris Keyworth, Kim L. Lavoie, Molly Byrne

Objectives

Behaviour change interventions offered opportunistically by healthcare professionals can support patient health behaviour change. The Making Every Contact Count (MECC) programme in Ireland is a national programme to support healthcare professionals to use brief behavioural interventions. The aim of this study was to gain an in-depth understanding of the enablers of, and barriers to, embedding MECC across the healthcare system.

Design

A qualitative interview study.

Methods

We conducted individual semi-structured interviews to understand barriers and enablers to MECC implementation. Our sample was 36 participants (11 health promotion and improvement officers, 9 nurses, 15 allied health professionals and 1 training instructor) who have a direct role in either supporting or delivering brief interventions to patients. Data were analysed using a Framework Analysis approach guided by the Theoretical Domains Framework (TDF).

Results

Eight theoretical domains influenced MECC implementation: environmental context and resources, intentions/goals, beliefs about the consequences of MECC delivery, knowledge, healthcare professionals' beliefs about their capability to deliver MECC interventions, social and professional role and identity, and reinforcement and skills. Environmental context and resources was the most strongly endorsed domain with key influencing factors including consultation type/setting, making MECC a routine part of clinical practice, a multi-professional approach, access to/visibility of resources/services, management support/expectations, impacts of the COVID-19 pandemic, and the salience of the MECC programme and the strategic fit of MECC with other health service initiatives.

Conclusions

While individual factors influence national implementation of behaviour change interventions, creating enabling environments for healthcare staff is crucial for widespread adoption across healthcare systems.

目的：医疗保健专业人员机会性地提供的行为改变干预措施可以支持患者健康行为改变。爱尔兰的“珍惜每一次接触”方案是一项支持保健专业人员使用简短行为干预措施的国家方案。本研究的目的是深入了解在整个医疗保健系统中嵌入MECC的推动因素和障碍。设计：定性访谈研究。方法：我们进行了单独的半结构化访谈，以了解MECC实施的障碍和推动因素。我们的样本是36名参与者（11名健康促进和改善官员，9名护士，15名专职卫生专业人员和1名培训讲师），他们直接支持或向患者提供简短的干预措施。使用由理论领域框架（TDF）指导的框架分析方法分析数据。结果：八个理论领域影响MECC实施：环境背景和资源、意图/目标、对MECC实施后果的信念、知识、医疗保健专业人员对其提供MECC干预措施能力的信念、社会和专业角色和认同、强化和技能。环境背景和资源是最受支持的领域，其关键影响因素包括咨询类型/设置、MECC是否成为临床实践的常规部分、多专业方法、资源/服务的获取/可见性、管理支持/期望、COVID-19大流行的影响、MECC计划的突出性以及MECC与其他卫生服务举措的战略契合度。结论：虽然个别因素影响国家实施行为改变干预措施，但为卫生保健人员创造有利环境对于在整个卫生保健系统中广泛采用至关重要。

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引用次数: 0

Pre-disability resilience and well-being following the onset of functional impairments 残疾前的复原力和功能损伤后的幸福感。

IF 2.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2025-01-11 DOI: 10.1111/bjhp.12781

Mikaela Spooner, Timothy R. Elliott, Wen Luo, Kelly M. Lee, Meredith L. C. Williamson

Objectives

Tested the prospective relationship of a resilient personality prototype determined prior to disability onset to well-being among persons with and without debilitating functional impairments nine to 10 years later. A resilient profile was expected to predict well-being through its beneficial associations with positive affect, perceived control and social support.

Design

Longitudinal, prospective observation study.

Methods

Data obtained from participants with no functional impairments at the first assessment of the Midlife in the United States (MIDUS) project and who participated in the second survey (1147 men, 985 women at Time 1). Cluster analysis was used to create personality profiles at the first time point. Differences between resilient and non-resilient individuals were examined. A structural equation model (SEM) tested the prospective effects of resilience on positive affect, perceived control and social support to well-being.

Results

A resilient personality profile was identified, as expected (n = 877). Individuals with a resilient personality prototype reported higher social support, positive affect, perceived control, life satisfaction and self-rated health at both measurement occasions than the non-resilient group. The SEM revealed that a resilient prototype operated through the three mediating variables to prospectively predict life satisfaction, and through social support and positive affect to predict self-rated health. These effects were independent of gender and disability severity.

Conclusions

A resilient personality profile prospectively operates through positive affect, perceived control and social support to predict well-being following the onset of debilitating impairments. The theoretical and clinical implications of these findings are discussed, and limitations are considered.

目的：测试在残疾发生前确定的弹性人格原型与患有或不患有衰弱性功能障碍的人在9至10年后的幸福感之间的前瞻性关系。预期弹性剖面通过其与积极影响、感知控制和社会支持的有益关联来预测幸福感。设计：纵向、前瞻性观察研究。方法：从参加第一次美国中年（MIDUS）项目评估和第二次调查的参与者（1147名男性，985名女性）中获得的数据。聚类分析用于创建第一个时间点的个性档案。研究了弹性个体和非弹性个体之间的差异。结构方程模型（SEM）检验了心理弹性对积极情感、感知控制和社会支持对幸福感的预期影响。结果：与预期一致（n = 877），确定了弹性人格特征。具有弹性人格原型的个体在社会支持、积极影响、感知控制、生活满意度和自评健康方面均高于非弹性人格原型组。SEM发现弹性原型通过三个中介变量对生活满意度进行前瞻性预测，通过社会支持和积极影响对自评健康进行前瞻性预测。这些影响与性别和残疾严重程度无关。结论：弹性人格可以通过积极影响、感知控制和社会支持来预测衰弱性损伤发生后的幸福感。讨论了这些发现的理论和临床意义，并考虑了局限性。

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引用次数: 0

Exploring weight management beliefs during the menopausal transition (ME-WEL project): A qualitative comparative study based on Health Belief Model 绝经期体重管理信念探索（ME-WEL项目）：基于健康信念模型的质性比较研究。

IF 2.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2025-01-09 DOI: 10.1111/bjhp.12779

Mafalda Leitão, Faustino R. Pérez-López, João Marôco, Filipa Pimenta

Objectives

While most women experience weight gain during the menopausal transition, a subset successfully maintains a healthy weight. This study explores the determinants influencing different weight experiences during the menopausal transition, using the Health Belief Model (HBM).

Design

Qualitative design.

Methods

Semi-structured individual interviews with 62 Portuguese post-menopausal women were performed. Among them, 31 women maintained a normal weight from pre-menopause to post-menopause, with a variation not exceeding 5% of pre-menopausal weight, while another 31 women transitioned from normal weight in pre-menopause to overweight or obesity in post-menopause, with an increase above 7% of pre-menopausal weight. Deductive-dominant content analysis and multiple correspondence analysis were performed.

Results

Prominent differences exist between the Unhealthy Weight Gain Group (UWG-G) and the Healthy Weight Maintenance Group (HWM-G). The UWG-G lacks perceived susceptibility in pre-menopause and perceives obesity as stigmatizing. They prioritize immediate changes as benefits, while the HWM-G focuses on self-concept. Both groups face barriers like food cravings and weight loss challenges in middle-aged. For cues to action, the UWG-G emphasizes social support and self-care resources, while the HWM-G emphasizes age progression and healthy behaviour adherence. The HWM-G presents higher self-efficacy.

Conclusion

This study confirms the suitability of the HBM in understanding weight management beliefs among post-menopausal women, highlighting differences between women who maintain a healthy weight and those who experience weight gain during this life phase. This facilitates identifying key determinants (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action and self-efficacy) crucial for future interventions in weight management.

目的：虽然大多数妇女在更年期过渡期间体重增加，但有一部分妇女成功地保持了健康的体重。本研究使用健康信念模型（HBM）探讨影响绝经过渡期不同体重体验的决定因素。设计：定性设计。方法：对62名葡萄牙绝经后妇女进行半结构化的个人访谈。其中31名妇女从绝经前到绝经后体重保持正常，变化幅度不超过绝经前体重的5%，另有31名妇女从绝经前体重正常过渡到绝经后体重超重或肥胖，增加幅度超过绝经前体重的7%。进行演绎显性内容分析和多重对应分析。结果：不健康体重增加组（UWG-G）与健康体重维持组（HWM-G）之间存在显著差异。UWG-G缺乏绝经前的易感性，认为肥胖是一种耻辱。他们优先考虑即时的变化作为利益，而HWM-G则侧重于自我概念。这两个群体都面临着一些障碍，比如对食物的渴望和中年时的减肥挑战。在行动线索方面，UWG-G强调社会支持和自我保健资源，而HWM-G强调年龄发展和健康行为坚持。HWM-G组具有较高的自我效能感。结论：本研究证实了HBM在理解绝经后妇女体重管理信念方面的适用性，强调了在这一生命阶段保持健康体重的妇女和体重增加的妇女之间的差异。这有助于确定关键决定因素（感知易感性、感知严重性、感知益处、感知障碍、行动线索和自我效能），对未来体重管理干预至关重要。

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引用次数: 0

Characteristics of refractory disease and persistent symptoms in inflammatory arthritis: Qualitative framework analysis of interviews with patients and health care professionals 炎症性关节炎难治性疾病和持续性症状的特征：对患者和卫生保健专业人员访谈的定性框架分析。

IF 2.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2025-01-08 DOI: 10.1111/bjhp.12780

Hema Chaplin, Carol Simpson, Kate Wilkins, Jessica Meehan, Nora Ng, James Galloway, Ian C. Scott, Debajit Sen, Rachel Tattersall, Rona Moss-Morris, Heidi Lempp, Sam Norton

Objectives

This study aims to explore patients' and clinicians' understanding and experiences of refractory disease (RD) and persistent physical and emotional symptoms (PPES) in patients with inflammatory arthritis (IA), namely rheumatoid arthritis or polyarticular juvenile idiopathic arthritis from their perspectives through interviews and/or focus groups.

Design

A qualitative study was conducted, following a pragmatic epistemology approach with framework analysis employed.

Methods

Semi-structured interviews or focus groups with IA patients (n = 25) and multi-disciplinary rheumatology HCPs (n = 32) were conducted at one time point to obtain participants respective understanding and experiences of managing RD/PPES, and its impact on the patient-professional relationship.

Results

Three key themes were identified from both patients and professionals' experiences of RD/PPES: (1) relevant treatment experiences, (2) symptoms (with or without inflammation) and (3) impact: physical, psychological and social. These themes included 28 specific categories that would be considered as components characterizing RD/PPES, most common to both patients and HCPs with six being patient-specific and only one HCP-specific. The specific biopsychosocial symptoms and impacts of RD/PPES pertain to pain, fatigue, stiffness, joint involvement and physical, psychological and social functioning and quality of life, covering disease-related distress, mobility and independence. Wider influential factors such as comorbidities, non-adherence, health/medication beliefs and behaviours and social support were also identified.

Conclusion

Common persistent symptoms that have both mental and physical impact characterize RD/PPES in IA and therefore a more integrated holistic approach to treatment is needed from multi-disciplinary HCPs, including health psychologists.

目的：本研究旨在通过访谈和/或焦点小组，从患者和临床医生的角度探讨炎症性关节炎（IA）患者（即类风湿关节炎或多关节幼年特发性关节炎）的难治性疾病（RD）和持续性身体和情绪症状（PPES）的理解和经验。设计：进行了一项定性研究，采用了框架分析的语用认识论方法。方法：在同一时间点对IA患者（n = 25）和多学科风湿病HCPs （n = 32）进行半结构化访谈或焦点小组，以获得参与者各自对RD/PPES管理的理解和经验，及其对患者-专业关系的影响。结果：从RD/PPES患者和专业人员的经历中确定了三个关键主题：(1)相关的治疗经历，(2)症状（有无炎症）和(3)影响：身体，心理和社会。这些主题包括28个特定类别，将被视为表征RD/PPES的组成部分，在患者和hcp中最常见，其中6个是患者特异性的，只有1个是hcp特异性的。RD/PPES的特定生物心理社会症状和影响涉及疼痛、疲劳、僵硬、关节受累以及身体、心理和社会功能和生活质量，包括与疾病相关的痛苦、活动能力和独立性。还确定了更广泛的影响因素，如合并症、不遵医嘱、健康/药物信念和行为以及社会支持。结论：具有精神和身体影响的常见持续性症状是IA RD/PPES的特征，因此需要包括健康心理学家在内的多学科HCPs采用更综合的整体治疗方法。

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引用次数: 0

A qualitative exploration of the prospective acceptability of the MiDerm app; a complex digital intervention for adults living with skin conditions 对期中考试应用程序的可接受性进行定性探讨；一种针对患有皮肤病的成年人的复杂数字干预。

IF 2.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2025-01-05 DOI: 10.1111/bjhp.12778

Rachael M. Hewitt, Carys Dale, Catherine Purcell, Rachael Pattinson, Chris Bundy

Objectives

Skin conditions carry a substantial psychological burden but support for patients is limited. Digital technology could support patient self-management; we found preliminary evidence for the effectiveness and acceptability of digital psychological interventions for adults living with skin conditions. We have, therefore, developed a complex digital intervention called MiDerm with patients. This qualitative study explored the prospective acceptability of the complex intervention delivered via a smartphone application (app), and possible barriers and facilitators to use.

Design

Qualitative research involving a hybrid inductive-deductive approach. Data collection and analysis were theoretically informed by The Common-Sense Model of Self-Regulation, Theoretical Framework of Acceptability and the Capability, Opportunity, Motivation - Behaviour Model.

Methods

Eight synchronous online group interviews with 43 English-speaking adults (≥ 18 years) with skin conditions. Data were analysed using Reflexive Thematic Analysis.

Results

Three superordinate themes were generated: (1) Patients' attitudes and concerns about the MiDerm app; (2) Need for personal competence, autonomy and relatedness for effective self-management; and (3) Physical, psychological and social barriers to app use.

Conclusion

Adults with skin conditions, mainly those with vitiligo and psoriasis living in the UK, expressed the need for support to self-manage the psychological aspects of their condition(s). The idea of a new intervention comprised of informational, emotional, behavioural and peer support, delivered via a smartphone app was welcomed and may be especially beneficial for specific patients. Identified barriers must be addressed to maximize engagement and giving users choice, flexibility and control is imperative to this. We have since developed the MiDerm app using these findings.

目的：皮肤病携带大量的心理负担，但对患者的支持是有限的。数字技术可以支持患者的自我管理；我们发现了初步证据，证明了数字心理干预对患有皮肤病的成年人的有效性和可接受性。因此，我们开发了一种复杂的数字干预方法，叫做MiDerm。本定性研究探讨了通过智能手机应用程序（app）提供的复杂干预的预期可接受性，以及可能的障碍和促进因素。设计：定性研究涉及混合的归纳-演绎方法。数据收集和分析的理论依据是自我调节常识模型、可接受性理论框架和能力、机会、动机-行为模型。方法：对43名有皮肤状况的英语成年人（≥18岁）进行8次同步在线小组访谈。数据分析采用反身性主题分析。结果：生成了三个上级主题：(1)患者对mid app的态度和关注点；(2)为有效的自我管理需要个人能力、自主性和关联性；(3)使用app的生理、心理和社会障碍。结论：患有皮肤病的成年人，主要是生活在英国的白癜风和牛皮癣患者，表达了对自我管理其病情心理方面的支持的需求。通过智能手机应用程序提供由信息、情感、行为和同伴支持组成的新干预措施的想法受到欢迎，可能对特定患者特别有益。必须解决已确定的障碍，以最大限度地提高用户粘性，并为用户提供选择、灵活性和控制权。我们利用这些发现开发了期中考试应用程序。

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引用次数: 0

Trait responsiveness to verbal suggestions predicts nocebo responding: A meta-analysis 对言语暗示的特质反应预测反安慰剂反应：一项元分析

IF 2.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2024-12-20 DOI: 10.1111/bjhp.12774

Madeline V. Stein, Monika Heller, Sarah Chapman, G. James Rubin, Devin B. Terhune

Background

Nocebo responding involves the experience of adverse health outcomes in response to contextual cues. These deleterious responses impact numerous features of mental and physical health but are characterized by pronounced heterogeneity. Suggestion is widely recognized as a contributing factor to nocebo responding but the moderating role of trait responsiveness to verbal suggestions (suggestibility) in nocebo responding remains poorly understood.

Objective

We conducted a pre-registered meta-analysis (PROSPERO registration number CRD42023425605) to quantitatively synthesize available research on the relationship between suggestibility and nocebo responding.

Methods

Four electronic databases were searched for original studies involving both the assessment of suggestibility and symptom reports in response to an inactive stimulus.

Results

Of 7729 search results, 10 articles presenting 13 correlations between suggestibility and nocebo responding were analysed. A random-effects meta-analysis revealed a significant, albeit weak, positive correlation, r = .21 [95% CI: .04, .37], between suggestibility and nocebo responses, such that more highly suggestible individuals displayed larger responses. Sensitivity and meta-regression analyses demonstrated that studies of higher methodological quality, including those that maintained experimenter blinding, exhibited stronger effect sizes.

Conclusion

These results corroborate proposals that trait responsiveness to verbal suggestions confers greater response to nocebos and warrants renewed attention to the role of suggestibility in symptom induction and perception.

研究背景：反安慰剂反应涉及到情境线索对不良健康结果的反应。这些有害的反应影响心理和身体健康的许多特征，但具有明显的异质性。建议被广泛认为是反安慰剂反应的一个促进因素，但对言语建议的特质反应性（易受暗示）在反安慰剂反应中的调节作用仍然知之甚少。目的我们进行了一项预注册荟萃分析（PROSPERO注册号CRD42023425605），以定量综合现有的关于易受暗示与反安慰剂反应之间关系的研究。方法检索4个电子数据库中有关非活动刺激的易受暗示性评估和症状报告的原始研究。结果在7729个搜索结果中，分析了10篇文章，其中包含13个暗示与反安慰剂反应之间的相关性。随机效应荟萃分析显示，尽管弱，但显著正相关，r =。21 [95% CI: .04, .37]，在易受暗示和反安慰剂反应之间，高易受暗示的个体表现出更大的反应。敏感性和元回归分析表明，方法学质量较高的研究，包括那些保持实验者盲法的研究，显示出更强的效应值。结论这些结果证实了对言语暗示的特质反应性对反安慰剂的反应更大，并值得重新关注暗示在症状诱导和感知中的作用。

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引用次数: 0

Perceiving immunity, predicting somatic symptoms: Validation of the ‘Perceived Immunity’ scale and its association with daily health 感知免疫力，预测躯体症状：感知免疫力 "量表的验证及其与日常健康的关联。

IF 2.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2024-12-16 DOI: 10.1111/bjhp.12772

Nofar Mizrachi, Tobias Kube, Liron Rozenkrantz

Objective

While ample research links health beliefs to physical health in both healthy and clinical populations, the specific health beliefs that drive this effect remain underexplored. Addressing this gap is critical for mechanistic examinations and targeted intervention development. Building on previous work, this study aimed to assess subjective beliefs about immune system efficacy and develop a novel Perceived Immunity scale.

Methods

Across three studies (total N = 378; Study 1: N = 206 healthy; Study 2: N = 132 healthy and N = 40 with immune-related diseases; and Study 3: subset of N = 87 from Study 2), we examine Perceived Immunity scale's validity, reliability, and association with everyday physical health.

Results

Perceived immunity demonstrated excellent internal consistency (Cronbach alpha = 0.9), strong construct validity (all items were loaded onto one factor) and structural validity, including convergence validity with scales assessing subjective health perceptions, and discriminant validity from scales measuring external health control. These findings were replicated across different cohorts. Furthermore, regression analyses revealed significant correlations with daily physical health measures, specifically somatic symptoms, across cohorts (all β > −0.347, all p < .001) and sick leave days (all β = −0.174, all p < .045). These associations were stronger in individuals with immune-related conditions. Finally, Perceived Immunity exhibited good test–retest reliability (interclass correlation coefficient = 0.74) and prospectively predicted somatic symptoms over time (β = −0.324, p = .002), with significant results observed up to 1 year.

Conclusions

The Perceived Immunity scale offers a valuable tool for researchers and health care providers, providing insights into the interplay between specific health beliefs and daily health. Furthermore, its validation lays the groundwork for targeted interventions that explore how health perceptions may directly influence actual physical experiences.

目的：尽管有大量研究将健康信念与健康和临床人群的身体健康联系起来，但对驱动这种效应的具体健康信念的研究仍然不足。填补这一空白对于机理研究和有针对性的干预措施开发至关重要。在以往工作的基础上，本研究旨在评估有关免疫系统功效的主观信念，并制定新的感知免疫力量表：通过三项研究（总人数 = 378；研究 1：206 名健康人；研究 2：132 名健康人和 40 名免疫相关疾病患者；研究 3：研究 2 中的 87 人子集），我们考察了感知免疫力量表的有效性、可靠性以及与日常身体健康的关联性：结果：感知免疫力表现出良好的内部一致性（Cronbach alpha = 0.9）、较强的结构效度（所有项目都被加载到一个因子上）和结构效度，包括与评估主观健康感知的量表的趋同效度，以及与评估外部健康控制的量表的区分效度。这些结果在不同的组群中得到了重复。此外，回归分析表明，该量表与不同组群的日常身体健康指标，特别是躯体症状，存在显著相关性（所有 β > -0.347，所有 p 均为结论）：感知免疫力量表为研究人员和医疗保健提供者提供了一个宝贵的工具，使他们能够深入了解特定健康信念与日常健康之间的相互作用。此外，该量表的验证还为有针对性的干预措施奠定了基础，这些干预措施将探索健康观念如何直接影响实际的身体体验。

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引用次数: 0

A network analysis to explore illness perceptions in Black adults with type 2 diabetes 通过网络分析探讨患有 2 型糖尿病的黑人成人对疾病的认知。

IF 2.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2024-12-13 DOI: 10.1111/bjhp.12775

Meng-Jung Wen, Tongtong Zou, Daniel M. Bolt, Olayinka O. Shiyanbola

Objectives

This study explores the structure of beliefs about type 2 diabetes among Black adults and informs potential targets to reframe negative beliefs and enhance diabetes self-management.

Research Design and Methods

We applied network analysis to investigate the interrelated structure and clusters of beliefs about diabetes and identify specific items that could serve as behavioural targets. We obtained self-reported survey data from 170 Black adults with type 2 diabetes. Regularised partial correlation networks and a Gaussian graphical model were used to explore and visualise the interrelationship among 21 items of a culturally adapted Illness Perception Questionnaire-Revised.

Results

Overwhelming negative emotions representing the current and long-term effects of diabetes were central to the illness perceptions network among Black adults, with feeling depressed having the highest node strength of centrality indices in the network. Four beliefs had a bridging effect with the central cluster: diabetes taking away the ability to enjoy food, diabetes keeping me away from the job I want, being poor contributed to my having diabetes, and I receive encouragement from friends and family.

Conclusions

In addition to highlighting the overwhelming feeling of diabetes, the illness perception network further differentiated the role of racial identity and social determinants of health as discrete, though both are related sociocultural influence constructs. To enhance self-management for Black adults with type 2 diabetes, this network informs promising intervention targets focused on culturally tailored education related to emotional regulation, internalised stigma and healthy food adaptation, and leveraging support to address social determinants of health.

目的：探讨黑人成人对2型糖尿病的信念结构，并为潜在目标提供信息，以重塑消极信念，增强糖尿病自我管理。研究设计和方法：我们应用网络分析来调查有关糖尿病的信念的相关结构和集群，并确定可以作为行为目标的具体项目。我们获得了170名黑人2型糖尿病患者的自我报告调查数据。使用正则化偏相关网络和高斯图形模型来探索和可视化文化适应性疾病感知问卷-修订版的21个项目之间的相互关系。结果：压倒性的负面情绪代表了糖尿病的当前和长期影响，是黑人成年人疾病感知网络的中心，抑郁情绪在网络中具有最高的中心性指数节点强度。四个信念与中心集群起着桥梁作用：糖尿病剥夺了我享受食物的能力，糖尿病使我无法获得我想要的工作，贫穷导致我患糖尿病，我从朋友和家人那里得到鼓励。结论：除了强调糖尿病的压倒性感觉之外，疾病感知网络进一步区分了种族认同和健康的社会决定因素的作用，尽管两者都是相关的社会文化影响结构。为了加强黑人成人2型糖尿病患者的自我管理，该网络告知有希望的干预目标，重点关注与情绪调节、内化污名和健康食物适应相关的文化定制教育，并利用支持来解决健康的社会决定因素。

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引用次数: 0

Attributes and influencing factors of hope levels in breast cancer patients: A latent profile analysis 乳腺癌患者希望水平的属性及影响因素：一项潜在剖面分析。

IF 2.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2024-12-11 DOI: 10.1111/bjhp.12773

Meidi Xiong, Hongmei Yao, Yuping Cheng, Qingyuan Zhang, Ying Luo, Yalun Guo, Hongmei Shi, Jinbing Bai, Chunhua Zhang

Purpose

This study aims to identify specific sub-types of hope levels in breast cancer (BC) patients and explore the influencing factors.

Methods

Between August and December 2023, 528 BC patients took part in this study. Latent Profile Analysis (LPA) was employed using the Herth Hope Index, Distress Thermometer, Hospital Anxiety and Depression Scale, Social Support Rating Scale, BC survivors' self-efficacy scale and Functional Assessment of Cancer Therapy-Breast to identify clusters of hope levels.

Results

Three potential categories of hope levels were identified: Low Hope Level—Harmonious-Calm Type (33.71%); Moderate Hope Level–Isolation Fear Type (37.12%); and High Hope Level—Optimistic Coping Type (29.17%). The study established that social support, quality of life, psychological distress, self-efficacy, occupation, income, education and type of surgery are factors influencing hope levels.

Conclusion

Hope levels within BC patients exhibit identifiable heterogeneity. By discerning the features associated with hope levels, the focus extends beyond patients' occupations, income, education and surgical procedures. It also underscores the importance of enhancing social support, quality of life and self-efficacy while mitigating psychological distress. This targeted approach aims to formulate interventions specifically designed to effectively elevate hope levels in BC patients.

目的：本研究旨在明确乳腺癌（BC）患者希望水平的具体亚型，并探讨其影响因素。方法：在2023年8月至12月期间，528例BC患者参与了这项研究。采用潜在特征分析（LPA），采用赫斯希望指数、痛苦温度计、医院焦虑和抑郁量表、社会支持评定量表、BC幸存者自我效能量表和癌症治疗-乳房功能评估来确定希望水平的聚类。结果：确定了3种潜在的希望水平类型：低希望-和谐-平静型（33.71%）；中度希望-隔离恐惧型（37.12%）；高希望乐观型（29.17%）。研究发现，社会支持、生活质量、心理困扰、自我效能、职业、收入、教育程度和手术类型是影响希望水平的因素。结论：BC患者的希望水平表现出明显的异质性。通过识别与希望程度相关的特征，重点超越了患者的职业、收入、教育和手术程序。它还强调了在减轻心理痛苦的同时加强社会支持、生活质量和自我效能的重要性。这种有针对性的方法旨在制定专门设计的干预措施，有效地提高BC患者的希望水平。

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引用次数: 0

The relationships among illness perceptions, dyadic coping and illness management in breast cancer patients and their spouses: A dyadic longitudinal mediation model 乳腺癌患者及其配偶疾病感知、二元应对和疾病管理的关系：一个二元纵向中介模型

IF 2.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2024-12-04 DOI: 10.1111/bjhp.12771

Mingfang Li, Lijuan Zhang, Liping Zhang, Xinyi Li, Yantong Xie, Yuqi Qiu, Meng Zhao, Jing Chen, Jun Yan

Objectives

To describe and compare dyads' illness perceptions, dyadic coping and illness management among breast cancer patients and their spouses. In addition, we explore the direct actor and partner effects of illness perception on illness management, and whether this association is mediated by dyadic coping.

Design

A descriptive and longitudinal study.

Methods

Baseline illness perceptions and dyadic coping during hospitalization were measured by using the Illness Perception Questionnaire–revised (IPQ-R) and the Dyadic Coping Inventory (DCI). At the 3rd month after discharge, the Cancer Self-Management Assessment Scale (CSMAS) and the Caregiver's Contribution to the Cancer Patient's Self-Management Scale (CC-CPSMS) were used to test the dyads' illness management. Then, the actor–partner interdependence mediation model (APIMeM) was constructed to explore intrapersonal and interpersonal effects.

Results

A total of 225 postsurgical breast cancer patients and their spouses completed the questionnaires. It revealed that patients' or spouses' illness perceptions had both positive and negative direct actor effects on their own illness management (positive: personal control and illness coherence dimension; and negative: timeline acute/chronic, consequence, emotional representation and causes-uncontrollable factors dimension). The significant direct partner effects were only displayed in the timeline acute/chronic dimension. Moreover, dyadic coping had mediating effects on these paths, and only the actor–actor and partner–actor indirect effects were statistically significant.

Conclusions

This study demonstrates the significance of illness perceptions in influencing dyads' illness management and reveals the underlying mediating mechanism of dyadic coping. It can provide more specific guidance for dyadic interventions to optimize dyads' behaviour among breast cancer patients and their spouses.

目的描述和比较乳腺癌患者及其配偶对疾病的认知、应对和疾病管理。此外，我们还探讨了疾病感知对疾病管理的直接行为者和伙伴效应，以及这种关联是否通过二元应对介导。设计一项描述性和纵向研究。方法采用疾病知觉修正问卷（IPQ-R）和二元应对量表（DCI）对住院期间的基线疾病知觉和二元应对进行测量。出院后第3个月，采用《癌症自我管理评估量表》（CSMAS）和《护理者对癌症患者自我管理贡献量表》（CC-CPSMS）对两组患者的疾病管理情况进行测试。在此基础上，构建行为人-伴侣相互依赖中介模型（APIMeM），探讨行为人-伴侣相互依赖对个体和人际关系的影响。结果共225例乳腺癌术后患者及其配偶完成问卷调查。结果表明，患者或配偶的疾病感知对其自身疾病管理有积极和消极的直接行动者影响(积极：个人控制和疾病一致性维度；消极：时间轴急性/慢性、后果、情绪表征和原因-不可控因素维度)。显著的直接伴侣效应仅在时间轴急性/慢性维度上显示。此外，二元应对在这些路径中具有中介效应，只有行为人-行为人和伴侣-行为人的间接效应具有统计学意义。结论本研究证明了疾病感知对夫妻疾病管理的影响，揭示了夫妻应对的潜在中介机制。它可以为二元干预提供更具体的指导，以优化乳腺癌患者及其配偶的二元行为。

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引用次数: 0