British Journal of Health Psychology最新文献_第6页

IF 7.9 2区心理学 Q1 Psychology

British Journal of Health Psychology

Pub Date : 2023-12-13 DOI: 10.1111/bjhp.12709

Vica Marie Jelena Tomberge, Akina Shrestha, Regula Meierhofer, Jennifer Inauen

Objectives

Decisions about reproductive health are often influenced by women's female family members, particularly in low-resource contexts. However, previous research has focused primarily on individual behavioural determinants. We investigated the interrelatedness of female family members' reproductive health behaviour with a dyadic version of an extended health action process approach. We investigated this for carrying heavy loads during pregnancy and postpartum, a risk factor for reproductive health in many low-income countries such as Nepal.

Design

This cross-sectional study included dyads of daughters-in-law and mothers-in-law in rural Nepal (N = 476, nested in 238 dyads).

Methods

Dyads of daughters- and mothers-in-law were surveyed about avoiding carrying heavy loads during pregnancy and postpartum. The effects of a woman's cognitions and her female dyadic partner's cognitions on their intention and behaviour about avoiding carrying loads were estimated using linear mixed models.

Results

The results showed that a mother-in-law's cognitions were related to her daughter-in-law's intentions and vice versa. The mother-in-law's cognitions were also related to the daughter-in-law's behaviour. The mother-in-law's self-efficacy and injunctive norms related to the daughter-in-law's intention and behaviour over and above the daughter-in-law's own self-efficacy and injunctive norms.

Conclusion

Female Nepali family members' cognitions about carrying heavy loads during pregnancy and postpartum are interrelated. Including female family members in interventions to help women manage their reproductive health in low-resource populations seems promising. These novel findings add to the growing body of research indicating the importance of including a dyadic perspective when understanding and changing health behaviour.

有关生殖健康的决定往往受到女性家庭成员的影响，尤其是在资源匮乏的情况下。然而，以往的研究主要侧重于个人行为决定因素。我们采用扩展的健康行动过程方法，对女性家庭成员生殖健康行为的相互关联性进行了研究。在尼泊尔等许多低收入国家，孕期和产后负重是影响生殖健康的一个风险因素。

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引用次数: 0

Attentional bias in psoriasis: The role of processing time and emotional valence 银屑病的注意偏差：处理时间和情绪情感的作用

IF 3.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2023-12-11 DOI: 10.1111/bjhp.12712

Sarah Etty, David N. George, Antoinette I. M. van Laarhoven, C. Elise Kleyn, Shernaz Walton, Henning Holle

Purpose

The present study explored whether people with psoriasis display an attentional bias towards disease-related threat words and whether this bias occurs relatively early during the phase of stimulus disengagement, or during a later maintained attention phase dominated by controlled strategic processes. We also explored the degree to which attentional bias is dependent on the emotional valence of control words.

Methods

Individuals with psoriasis and matched controls took part in 4 online experiments. Participants completed a spatial cueing paradigm using disease-related threat words and control words as cues, in order to obtain reaction time estimates of attentional bias.

Results

We did not observe evidence for attentional bias when control words were matched with threat words for emotional valence, regardless of whether processing time for the cues was limited (Experiment 1: SOA = 250 ms) or extended (Experiment 2: SOA = 1050 ms). We also did not observe evidence for attentional bias when control words of positive valence were used, but processing time was limited (Experiment 3). An attentional bias was only observed (p = .012, Cohen's d = .37) when sufficient processing time was available and positively-valanced control words were used (Experiment 4).

Conclusion

Rather than showing large and generalized AB effects as predicted by previous accounts, our results tentatively suggest that AB in psoriasis is restricted to situations where participants have ample processing time and threat words are easily distinguishable from control words on the basis of emotional valence. The pattern of results suggests that attentional bias in psoriasis is best characterized as a relatively slow strategic process.

本研究探讨了银屑病患者是否会对疾病相关的威胁词表现出注意偏向，以及这种偏向是在刺激脱离阶段相对较早的时候出现，还是在控制策略过程主导的后期维持注意阶段出现。我们还探究了注意偏向在多大程度上取决于控制词的情绪价值。

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引用次数: 0

Targeting persistent fatigue with tailored versus generic self-management strategies in adolescents and young adults with a fatigue syndrome or rheumatic condition: A randomized crossover trial 针对患有疲劳综合征或风湿病的青少年和年轻成年人的持续性疲劳，采用量身定制的自我管理策略和普通自我管理策略：随机交叉试验

IF 3.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2023-12-10 DOI: 10.1111/bjhp.12711

Anouk Vroegindeweij, Nico M. Wulffraat, Elise M. Van De Putte, Hanne B. T. De Jong, Desiree A. Lucassen, Joost F. Swart, Sanne L. Nijhof

Objectives

To evaluate the use of two self-management intervention strategies for persistent fatigue in adolescents and young adults with a fatigue syndrome or rheumatic condition.

Design

A randomized crossover trial administering tailored lifestyle advice and generic dietary advice, each 12 weeks, with a four-week washout period between.

Methods

Sixty participants (aged 12–29) were included. Tailoring was achieved through the PROfeel method. Dietary guidelines were conceptualized by the Netherlands Nutrition Centre. Questionnaires were used pre–post-interventions to measure primary outcome ‘fatigue severity’ (Checklist Individual Strength-8) and secondary outcomes ‘self-efficacy’ (Self-Efficacy Scale-28) and ‘quality of life’ (QoL) (Paediatric Quality of Life Inventory 4.0). Feasibility and adherence were self-rated on a scale of 1 to 10 (low to high). Linear mixed modelling was used to assess change over time, compare strategy effectiveness and study the impact of intervention order.

Results

Fatigue severity, self-efficacy and QoL regarding ‘physical’ and ‘emotional’ functioning improved significantly over time (all p < .015). The average improvement of the two QoL subscales was clinically relevant, as was the fatigue improvement in 20 out of 46 participants who completed the trial and 5 dropouts. The interventions were equally effective, and intervention order did not impact the improvement level (p_range = .242–.984). The self-management strategies received similar feasibility (M = 6.45, SD = 1.91) and adherence (M = 7.67, SD = 1.67) ratings.

Conclusions

As small to clinically relevant improvements were observed, self-management strategies might be particularly useful to bridge waiting time for guided treatments such as Cognitive Behavioural Therapy.

目的：评估针对患有疲劳综合症或风湿病的青少年和年轻人持续疲劳的两种自我管理干预策略的使用情况。

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引用次数: 0

The development and validation of the Worries About Recurrence or Progression Scale (WARPS) 对复发或进展的担忧量表(WARPS)的开发与验证。

IF 7.9 2区心理学 Q1 Psychology

British Journal of Health Psychology

Pub Date : 2023-12-01 DOI: 10.1111/bjhp.12707

Louise Sharpe, Rachel E. Menzies, Bethany Richmond, Jemma Todd, Carolyn MacCann, Joanne Shaw

Objectives

Worry about recurrence or progression is a common concern among people with chronic physical illnesses. Although there are options to measure the fear of cancer recurrence and other illness-specific measures, there is only one transdiagnostic measure of fear of progression, which does not assess the fear of recurrence or relapse.

Design

A multi-phase study outlining the development and validation of a novel transdiagnostic measure of fear of recurrence or progression, the Worries About Recurrence and Progression Scale (WARPS).

Method

From a prior systematic review, we used quotes from people with lived experience to generate 55 items. Next, we piloted the items with 10 people with a range of chronic conditions, leading to a final total of 57 items. We then recruited four groups of people with cardiac disease, rheumatic disease, diabetes and respiratory disease (n = 804). An exploratory factor analysis in a randomly split sample resulted in an 18 item, single factor scale. We then performed confirmatory factor analysis on these 18 items in the remaining sample.

Results

The 18-item WARPS demonstrated good construct validity, internal consistency and test–retest reliability. Specifically, the WARPS was strongly correlated with the Fear of Progression Questionnaire, and with illness-specific fears. Significant, moderate correlations were observed with depression, anxiety, stress, and death anxiety. The WARPS demonstrated the validity and reliability amongst people with four of the most common chronic conditions and the factor structure was invariant across genders.

Conclusion

The WARPS is a valid and reliable tool to measure transdiagnostic worries about recurrence and progression.

目的:担心复发或进展是慢性身体疾病患者普遍关注的问题。虽然有多种方法可以测量对癌症复发的恐惧和其他疾病特异性的测量，但只有一种对进展恐惧的跨诊断测量，它不评估对复发或复发的恐惧。设计:一项多阶段研究概述了对复发或进展恐惧的新型跨诊断测量方法的开发和验证，即复发和进展担忧量表(WARPS)。方法:从之前的系统回顾中，我们引用了有生活经验的人的话来生成55个项目。接下来，我们在10名患有各种慢性疾病的人中试用了这些项目，最终总共有57个项目。然后，我们招募了四组患有心脏病、风湿病、糖尿病和呼吸系统疾病的人(n = 804)。一个探索性的因素分析在一个随机分割的样本导致18项，单因素量表。然后，我们对剩余样本中的这18个项目进行验证性因子分析。结果:18项WARPS量表具有良好的结构效度、内部一致性和重测信度。具体而言，WARPS与恐惧进展问卷和疾病特异性恐惧密切相关。观察到与抑郁、焦虑、压力和死亡焦虑有显著的中度相关性。WARPS在四种最常见的慢性疾病患者中证明了其有效性和可靠性，并且因素结构在性别之间是不变的。结论:WARPS是一种有效、可靠的工具，可用于评估对复发和进展的诊断担忧。

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引用次数: 0

Attitudes and perceptions of cancer patients and healthcare providers towards prehabilitation: A thematic synthesis 癌症患者和保健提供者对康复的态度和看法:专题综合。

IF 7.9 2区心理学 Q1 Psychology

British Journal of Health Psychology

Pub Date : 2023-11-20 DOI: 10.1111/bjhp.12705

Chen Shen, Lianqi Gu, Na Li, Rao Wang, Xin Yang, Zhiping Chu

Purpose

Prehabilitation, which is the process of enhancing functional capacity before undergoing surgery or other treatments, has been shown to improve cancer patients' outcomes. Patient and healthcare provider attitudes and perceptions are essential factors in the successful implementation of prehabilitation. The purpose of this systematic review is to synthesize qualitative evidence and explore the barriers and facilitators to prehabilitation implementation.

Methods

From the earliest available date to October 2023, 7 databases (PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, and MEDLINE) were searched for a systematic review. Data were extracted, thematically analysed, and mapped onto the Capability, Opportunity, and Motivation Model of Behaviour (COM-B). The Critical Appraisal Skills Programme (CASP) tool was used to assess the quality of the studies.

Results

A total of 26 studies were included, involving 377 patients, 51 caregivers, and 156 healthcare providers. 16 factors were identified and mapped onto the COM-B model: reflective/automatic motivation, physical/social opportunity, physical/ psychological capability.

Conclusions

Patients and healthcare provides identified a lack of reflective motivation and physical opportunities as the most significant barriers to engagement in prehabilitation. Personalized approaches, social support, and healthcare providers' engagement are key factors for prehabilitation. Future research should focus on developing effective interventions to enhance the uptake and sustainability of prehabilitation.

目的:预康复是在接受手术或其他治疗之前增强功能能力的过程，已被证明可以改善癌症患者的预后。患者和保健提供者的态度和看法是成功实施康复的关键因素。本系统综述的目的是综合定性证据，探讨康复实施的障碍和促进因素。方法:从最早可查日期到2023年10月，检索PubMed、Web of Science、Cochrane Library、Embase、CINAHL、PsycINFO和MEDLINE 7个数据库进行系统评价。数据被提取，主题分析，并映射到行为的能力，机会和动机模型(COM-B)。使用关键评估技能计划(CASP)工具来评估研究的质量。结果:共纳入26项研究，涉及377名患者、51名护理人员和156名医疗保健提供者。16个因素被确定并映射到COM-B模型:反思/自动动机，物理/社会机会，物理/心理能力。结论:患者和医疗保健提供者认为，缺乏反思动机和身体机会是参与康复的最大障碍。个性化方法、社会支持和医疗保健提供者的参与是康复的关键因素。未来的研究应侧重于开发有效的干预措施，以提高康复的吸收和可持续性。

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引用次数: 0

Parents' experiences of receiving their child's diagnosis of congenital heart disease: A systematic review and meta-synthesis of the qualitative literature 父母接受孩子先天性心脏病诊断的经历:定性文献的系统回顾和综合。

IF 7.9 2区心理学 Q1 Psychology

British Journal of Health Psychology

Pub Date : 2023-11-15 DOI: 10.1111/bjhp.12703

Shannon Dandy, Anja Wittkowski, Craig D. Murray

Purpose

This systematic review aimed to synthesize qualitative research on parents' psychological experiences following their child's diagnosis of congenital heart disease (CHD).

Methods

A systematic search of six electronic databases (CINAHL, Embase, MEDLINE, PsycINFO, PubMed and Web of Science) was completed, inclusive of all years up to May 2022. Any included articles were synthesized using thematic synthesis and appraised using the Critical Appraisal Skills Programme Qualitative Checklist.

Results

Twenty-six articles were included. Four main themes, and 11 subthemes, emerged from the synthesis. Theme 1 (unpreparedness for the diagnosis) concerned parents' shock, guilt and anger regarding the diagnosis. Theme 2 (the overwhelming reality of CHD) described parental fear about decision-making and the child's prognosis, and the influence of professionals on parents' well-being. Theme 3 (mourning multiple losses) detailed parents' sadness at losing their envisioned pregnancy, birth and parenthood experiences. Theme 4 (redefining hopes to reach an acceptance of CHD) described parents' adjustment to the diagnosis.

Conclusions

Receiving a child's CHD diagnosis was a uniquely challenging situation for parents. The findings provided insight into the emotions parents experienced and how they adjusted to the diagnosis psychologically. As parents' experiences were significantly influenced by their interactions with professionals, clinicians should offer compassion, validation and clear information throughout the diagnosis process.

目的:本系统综述旨在综合定性研究儿童先天性心脏病(CHD)诊断后父母的心理体验。方法:系统检索截至2022年5月的6个电子数据库(CINAHL、Embase、MEDLINE、PsycINFO、PubMed和Web of Science)。所有纳入的文章均采用专题综合法进行综合，并使用《关键评价技能方案定性检查表》进行评价。结果:纳入26篇文献。从综合中产生了四个主要主题和11个次要主题。主题1(对诊断的不准备)涉及父母对诊断的震惊、内疚和愤怒。主题2(冠心病的压倒性现实)描述了父母对决策和孩子预后的恐惧，以及专业人士对父母幸福感的影响。主题3(哀悼多重损失)详细描述了父母在失去预期的怀孕、分娩和为人父母经历时的悲伤。主题4(重新定义希望达成对冠心病的接受)描述了父母对诊断的适应。结论:接受孩子的冠心病诊断对父母来说是一个独特的挑战。这些发现为了解父母的情绪体验以及他们如何在心理上适应诊断提供了见解。由于父母的经历受到他们与专业人员的互动的显著影响，临床医生应该在整个诊断过程中提供同情，验证和明确的信息。

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引用次数: 0

Development, validation, and accuracy of ORCHESTRA emotional exhaustion screening questionnaire among healthcare workers during COVID-19 Pandemic COVID-19大流行期间医护人员情绪耗竭筛查问卷的编制、验证和准确性

IF 7.9 2区心理学 Q1 Psychology

British Journal of Health Psychology

Pub Date : 2023-11-13 DOI: 10.1111/bjhp.12706

Rick Kye Gan, Pedro Arcos González, Guillermo Fernandez-Tardon, Alexandre Zerbo, Violeta Claudia Calota, Zuzana Klöslová, Marina Ruxandra Otelea, Eleonóra Fabiánová, Marta-Maria Rodriguez-Suarez, Adonina Tardon

Background

The COVID-19 pandemic has posed unprecedented challenges, particularly for healthcare workers (HCWs). The prolonged struggles exposed the HCWs to a variety of stressors, potentially leading to burnout. Emotional exhaustion is widely recognized as the core component of burnout. This research aims to conceptualize and develop an emotional exhaustion screening questionnaire through literature review, validation, and accuracy testing.

Method

A literature review of questionnaires and extraction of items on emotional exhaustion were performed in June 2022. We proceed with the face validity of the items by experts. The items with good content validity ratio and index were selected and reworded to suit the context of HCWs working during the COVID-19 pandemic. A pilot test of the questionnaire was done in the Central University Hospital of Asturias (HUCA) from October to December 2022 with a sample of 148 HCWs from the ORCHESTRA cohort to determine its reliability, convergent validity, and accuracy.

Results

Our literature review identified 15 validated questionnaires. After exclusion, 32 items were sent for content validation by experts, yielding five final items that proceeded with the pilot test. Resulting in a Cronbach's alpha-coefficient of .83 for the scale and .78 for dichotomous responses, demonstrating good internal consistency and convergent validity. The result of our accuracy test yielded sensitivity (90.6%) and specificity (91.6%) for the OEEQ scale; and sensitivity (88.7%) and specificity (89.5%) for OEEQ dichotomous responses.

Conclusion

This study developed and validated the ORCHESTRA Emotional Exhaustion Questionnaire, demonstrating the questionnaire's clarity, relevance, and comprehensibility in screening emotional exhaustion among HCWs.

背景:COVID-19大流行带来了前所未有的挑战，特别是对卫生保健工作者(HCWs)。长期的斗争使医护人员暴露在各种压力源下，有可能导致精疲力竭。情绪衰竭被广泛认为是职业倦怠的核心组成部分。本研究旨在通过文献回顾、验证和准确性检验，构思并编制一份情绪耗竭筛查问卷。方法:于2022年6月进行问卷调查和情绪衰竭项目提取。我们继续由专家进行项目的表面有效性。选取内容效度比和指标较好的项目进行改写，以适应新冠肺炎大流行期间卫生保健工作者的工作环境。于2022年10月至12月在阿斯图里亚斯中央大学医院(HUCA)对来自ORCHESTRA队列的148名HCWs样本进行了问卷的试点测试，以确定其信度、收敛效度和准确性。结果:我们的文献综述确定了15份有效的问卷。排除后，32个项目被发送给专家进行内容验证，产生5个最终项目，继续进行试点测试。量表的Cronbach α系数为0.83，二分类反应的Cronbach α系数为0.78，显示出良好的内部一致性和收敛效度。准确度测试的结果为OEEQ量表的灵敏度(90.6%)和特异性(91.6%);OEEQ二分类反应的敏感性(88.7%)和特异性(89.5%)。结论:本研究编制并验证了ORCHESTRA情绪耗竭问卷，显示了问卷在筛查医护人员情绪耗竭方面的清晰性、相关性和可理解性。

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引用次数: 0

Effects of a modified invitation letter to follow-up colonoscopy for bowel cancer detection 修改邀请函对肠癌结肠镜随访检查的影响。

IF 7.9 2区心理学 Q1 Psychology

British Journal of Health Psychology

Pub Date : 2023-11-13 DOI: 10.1111/bjhp.12704

Elizabeth Travis, Laura Ashley, Daryl B. O'Connor

Objective

To investigate whether modifications made to the current National Health Service (NHS) invitation letter for follow-up colonoscopy examination affect participant state anxiety and behavioural intentions to attend.

Methods

Five hundred and thirty-eight adults of bowel cancer-eligible screening age (56–74) were randomized to receive the current NHS invitation letter or the modified version of the letter as a hypothetical scenario. Modifications to the letter included fewer uses of the term cancer and awareness of alternative screening options. The history of the colonoscopy invitation, anticipated state anxiety, behavioural intention to attend the nurse appointment, and colonoscopy concerns upon reading the letter were measured.

Results

Behavioural intentions were high in both conditions; however, participants reading the current letter reported significantly higher behavioural intentions compared to the modified letter. There was no main effect of previous invite status or interaction between previous invite status and letter condition on behavioural intentions. However, the effect of the letter on levels of anxiety depended on the participant's invitation history. Those never invited for a colonoscopy were more anxious when reading the modified letter compared to the current letter. Conversely, previous colonoscopy invitees were less anxious following reading the modified letter than those reading the current letter. Those never invited for a colonoscopy were more concerned about embarrassment and test invasiveness. All findings remained the same when controlling for age and education.

Conclusion

Modifications to the invitation letter were not beneficial to levels of screening intention or anxiety.

目的:探讨对现行国家卫生服务(NHS)结肠镜随访检查邀请函的修改是否影响参与者的状态焦虑和行为意愿。方法:538名符合肠癌筛查年龄(56-74岁)的成年人被随机分为两组，一组接受目前的NHS邀请函，另一组接受修改后的邀请函。对这封信的修改包括减少使用“癌症”一词，并提高对其他筛查选择的认识。结肠镜检查邀请的历史，预期状态焦虑，参加护士预约的行为意图，以及阅读信件时结肠镜检查的担忧被测量。结果:两种情况下的行为意向均较高;然而，与修改过的信件相比，阅读当前信件的参与者报告了明显更高的行为意图。之前的邀请状态或之前的邀请状态与信件条件之间的交互作用对行为意图没有主要影响。然而，信件对焦虑程度的影响取决于参与者的邀请历史。那些从未被邀请进行结肠镜检查的人在阅读修改后的信件时比阅读当前的信件时更加焦虑。相反，先前接受结肠镜检查的人在阅读修改后的信件后比阅读当前信件的人更不焦虑。那些从未被邀请进行结肠镜检查的人更担心尴尬和检查的侵入性。在控制了年龄和教育程度后，所有的研究结果都是一样的。结论:邀请函的修改不利于筛查意向和焦虑水平的提高。

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引用次数: 0

Conspiracy beliefs and intention to use conventional, complementary and alternative medicines: Two vignette studies 阴谋信念和使用常规、补充和替代药物的意图：两项小插曲研究。

IF 7.9 2区心理学 Q1 Psychology

British Journal of Health Psychology

Pub Date : 2023-10-25 DOI: 10.1111/bjhp.12702

Valentyn Fournier, Florent Varet

Objective

Conspiracy beliefs (CBs) can have substantial consequences on health behaviours by influencing both conventional and non-conventional medicine uptake. They can target powerful groups (i.e. upward CBs) or powerless groups (i.e. downward CBs). Considering their repercussions in oncology, it appears useful to understand how CBs are related to the intentions to use conventional, complementary and alternative medicines (CAM).

Design and Methods

This paper includes two pre-registered online correlational studies on a general French population (Study 1 N = 248, recruited on social media M_age = 40.07, SD_age = 14.78; 205 women, 41 men and 2 non-binaries; Study 2 N = 313, recruited on social media and Prolific, M_age = 28.91, SD_age = 9.60; 154 women, 149 men and 10 non-binaries). We investigated the links between generic and chemotherapy-related CBs and intentions to use conventional, complementary and alternative medicines. Study 2 consisted of a conceptual replication of Study 1, considering the orientation of CBs.

Results

Generic CBs and chemotherapy-related CBs appear strongly and positively correlated, negatively correlated with intentions to take conventional medicine and positively with intentions to take CAM. The link between generic CBs and medication intention is fully mediated by chemotherapy-related CBs. When distinguished, upward CBs are a stronger predictor of chemotherapy-related CBs than downward CBs.

Conclusions

The findings suggest that intentions to use medicine are strongly associated with CBs. This has several important implications for further research and practice, notably on the presence and effects of CBs on medication behaviours in cancer patients.

目的：阴谋信念会影响传统和非传统药物的摄入，从而对健康行为产生重大影响。他们可以针对强势群体（即向上的CB）或弱势群体（即向下的CB）。考虑到CBs在肿瘤学中的影响，了解CBs如何与使用常规、补充和替代药物（CAM）的意图相关似乎是有用的。设计和方法：本文包括两项针对法国普通人群的预先注册的在线相关性研究（研究1N = 248，在社交媒体Mage上招募 = 40.07，SD第页 = 14.78；205名女性、41名男性和2名非二进制；研究2 N = 313，在社交媒体和Prolific上招募，Mage = 28.91，SD年龄 = 9.60；154名女性、149名男性和10名非二进制）。我们调查了非专利和化疗相关的CB与使用常规、补充和替代药物的意图之间的联系。研究2包括对研究1的概念复制，考虑到CBs的方向。结果：普通CBs和化疗相关的CBs表现出强烈的正相关，与服用常规药物的意愿呈负相关，与使用CAM的意愿呈正相关。普通CB与用药意向之间的联系完全由化疗相关的CB介导。当进行区分时，上行CBs比下行CBs更能预测化疗相关的CBs。结论：研究结果表明，用药意向与CBs密切相关。这对进一步的研究和实践有几个重要的意义，特别是对癌症患者中CB的存在及其对药物行为的影响。

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引用次数: 0

Exploring the complexities of illness identity and symptom management in seeking a diagnostic label of postural orthostatic tachycardia syndrome (POTS): An inductive approach 在寻求体位性直立性心动过速综合征（POTS）的诊断标签时，探索疾病识别和症状管理的复杂性：一种归纳方法。

IF 7.9 2区心理学 Q1 Psychology

British Journal of Health Psychology

Pub Date : 2023-10-16 DOI: 10.1111/bjhp.12700

Iris Knoop, Stephanie Gu, Shamim Fareghzadeh, Annie S. K. Jones, Nicholas Gall, Rona Moss-Morris

Objectives

Postural orthostatic tachycardia syndrome (POTS) is a debilitating and under-recognized condition of the autonomic nervous system. This study applied Leventhal's Common-Sense Model of Illness Representations to explore the journey to a diagnosis of POTS and to understand its relevance to poorly understood conditions which have common comorbidities.

Design

An inductive qualitative approach was used to explore the processes by which patients formulate explanations and management of symptoms within the search for a diagnostic label and to investigate illness identity in the context of existing diagnoses or multimorbidity.

Methods

Participants (n = 29) for this nested qualitative study were recruited from a larger longitudinal study of people who had been newly referred to a specialist POTS service. Semi-structured interviews were conducted via video call. Three researchers coded and analysed data using Reflexive Thematic Analysis and elements of Grounded Theory.

Results

The analysis resulted in three overarching themes: ‘Seeking physiological coherence and validation’, ‘Individual persistence’, and ‘Navigating the cumulative burden’. ‘Accessibility and disparities of health care’ was noted as a contextual factor. Receiving a POTS diagnosis was regarded by participants as providing legitimacy and increased access to treatment. Overall, delays in the diagnostic journey and the lack of a clear diagnosis impacted negatively on patients through increased uncertainty and a lack of clear guidance on how to manage symptoms. Findings also suggested there were great complexities in assigning symptoms to labels in the context of multimorbidity.

Conclusions

Participants' stories highlighted the urgent need for better recognition of POTS so that the self-regulatory process can be initiated from the early stages of symptom detection.

目的：体位性直立性心动过速综合征（POTS）是一种使自主神经系统衰弱且认识不足的疾病。本研究应用Leventhal的疾病表征常识模型来探索POTS的诊断过程，并了解其与具有常见合并症的鲜为人知的疾病的相关性。设计：使用归纳定性方法来探索患者在寻找诊断标签的过程中对症状进行解释和管理的过程，并在现有诊断或多发病的背景下调查疾病身份。方法：参与者（n = 29）是从一项更大的纵向研究中招募的，该研究对象是新转诊到专业POTS服务的人。半结构化访谈通过视频通话进行。三名研究人员使用反射主题分析和基础理论的元素对数据进行了编码和分析。结果：该分析产生了三个总体主题：“寻求生理连贯性和验证”、“个体持久性”和“驾驭累积负担”卫生保健的可及性和差异”被视为一个背景因素。参与者认为接受POTS诊断提供了合法性并增加了获得治疗的机会。总的来说，诊断过程的延误和缺乏明确的诊断对患者产生了负面影响，因为不确定性增加，缺乏关于如何管理症状的明确指导。研究结果还表明，在多发性疾病的背景下，将症状分配给标签有很大的复杂性。结论：参与者的故事强调了迫切需要更好地识别POTS，以便从症状检测的早期阶段就可以启动自我调节过程。

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引用次数: 0