British Journal of Health Psychology最新文献_第7页

Mutual communication intervention for colorectal cancer patient–spousal caregiver dyads: A randomized controlled trial 针对结直肠癌患者-配偶照顾者二人组的相互沟通干预：随机对照试验。

IF 3.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2024-06-07 DOI: 10.1111/bjhp.12734

Junrui Zhou, Zhiming Wang, Xuan Chen, Chunyan Lin, Jie Zhao, Alice Yuen Loke, Qiuping Li

Objective

Gender could impact the psychosocial outcomes and coping strategies of cancer patients and their spousal caregivers (SCs). This study aims to develop a gender-concerned program for colorectal cancer (CRC) couple-based mutual communication intervention (MCI) and to assess its effectiveness on the intra-couple relationship and the individual functions of the partners.

Design

A randomized clinical trial with two study groups was utilized.

Methods

A total of 144 CRC patients and their SCs were randomly assigned to either MCI or usual care (UC) groups, and all of them were required to complete the measurements at baseline and post-intervention. The primary outcome was for mutual communication, and the secondary outcomes included dyadic coping, relationship satisfaction, anxiety, depression, benefit finding and quality of life. The data were analysed by multi-level modelling.

Results

The MCI program was feasible and acceptable for Chinese CRC couples and was effective for the improvement of the intra-couple relationship and the individual functions of each partner. CRC patients showed more improvement in mutual communication and dyadic coping than their SCs in the MCI group. Also, this intervention effectiveness was found to be independent of gender.

Conclusions

The MCI program is beneficial for Chinese CRC couple's adaptation outcomes. This suggests that clinical medical staff should consider the gender tendency during the implementation of interventions. More researches are needed to extend the application of the MCI program to different participants (e.g. patients with the diagnosis of other types of cancer and their SCs).

目的性别会影响癌症患者及其配偶照顾者（SCs）的社会心理结果和应对策略。本研究旨在为结肠直肠癌（CRC）患者制定一项基于夫妻相互沟通干预（MCI）的性别关注计划，并评估其对夫妻内部关系和伴侣个人功能的影响：设计：采用随机临床试验，分为两个研究组：共有 144 名 CRC 患者及其 SC 被随机分配到 MCI 组或常规护理组（UC），所有患者均需完成基线和干预后的测量。主要结果为相互沟通，次要结果包括：患者的应对能力、关系满意度、焦虑、抑郁、受益发现和生活质量。数据采用多层次模型进行分析：结果：MCI项目对于中国的CRC夫妇来说是可行和可接受的，并能有效改善夫妇内部关系和双方的个人功能。与 SC 相比，MCI 组的 CRC 患者在相互沟通和双向应对方面表现出更大的改善。此外，干预效果与性别无关：结论：MCI项目有利于中国CRC夫妇的适应结果。结论：MCI项目有利于中国CRC夫妇的适应结果，这表明临床医务人员在实施干预时应考虑性别倾向。还需要开展更多的研究，将MCI项目的应用范围扩大到不同的参与者（如确诊为其他类型癌症的患者及其SC）。

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引用次数: 0

Loneliness, perceived social support, and their changes predict medical adherence over 12 months among patients with coronary heart disease 孤独感、感知到的社会支持及其变化可预测冠心病患者在 12 个月内坚持治疗的情况。

IF 3.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2024-05-23 DOI: 10.1111/bjhp.12732

Yunge Fan, Biing-Jiun Shen, Moon-Ho Ringo Ho

Objectives

This study investigated whether changes in loneliness and perceived social support predicted medical adherence in patients with coronary heart disease (CHD) over 12 months. Moreover, short-term and long-term buffering effects of social support on the association between loneliness and medical adherence were systematically examined.

Design

A three-wave longitudinal study.

Methods

Participants were 255 CHD patients with a mean age of 63 years. Medical adherence, loneliness, and perceived social support were assessed at baseline, 3 months, and 12 months. Hierarchical regression analyses were conducted to examine the influences of loneliness and social support as well as their changes on medical adherence over 12 months. Moderation analyses were performed to test buffering effects of baseline social support and its changes against loneliness and its changes, respectively.

Results

Changes in loneliness significantly predicted medical adherence at 12 months (β = −.23, p = .001) but not at 3 months (β = −.10, p = .142). Changes in social support predicted medical adherence at both 3 (β = .23, p = .002) and 12 months (β = .26, p = .001). Social support concurrently buffered the adverse impact of loneliness on medical adherence (B = .29, SE = .12, p = .020) at baseline but did not at 3 or 12 months (Bs = −.21 to .40, SEs = .12 to .30, ps = .177 to .847).

Conclusions

Findings highlight the importance of monitoring loneliness and perceived social support continuously over time for CHD patients to promote medical adherence.

研究目的本研究调查了孤独感和感知到的社会支持的变化是否能预测冠心病（CHD）患者在12个月内的医疗依从性。此外，还系统研究了社会支持对孤独感与坚持治疗之间关系的短期和长期缓冲作用：设计：三波纵向研究：参与者为255名心脏病患者，平均年龄为63岁。分别在基线、3 个月和 12 个月时对医疗依从性、孤独感和感知到的社会支持进行评估。进行了层次回归分析，以研究孤独感和社会支持的影响因素及其在 12 个月内对坚持医疗的影响变化。同时还进行了调节分析，分别检验基线社会支持及其变化对孤独感及其变化的缓冲作用：结果：孤独感的变化能显著预测 12 个月的医疗依从性（β = -.23，p = .001），但不能预测 3 个月的医疗依从性（β = -.10，p = .142）。社会支持的变化可预测 3 个月 (β = .23, p = .002) 和 12 个月 (β = .26, p = .001) 的医疗依从性。在基线时，社会支持可同时缓冲孤独感对坚持医疗的不利影响（B = .29，SE = .12，P = .020），但在3个月或12个月时却不能（Bs = -.21 to .40，SEs = .12 to .30，Ps = .177 to .847）：研究结果凸显了对心脏病患者的孤独感和感知到的社会支持进行长期持续监测以促进其坚持治疗的重要性。

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引用次数: 0

Care or sabotage? A reflexive thematic analysis of perceived partner support throughout the bariatric surgery journey 关怀还是破坏？对减肥手术整个过程中感知到的伴侣支持进行反思性专题分析。

IF 3.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2024-05-23 DOI: 10.1111/bjhp.12733

Sophia Quirke-McFarlane, Jane Ogden

Objective

Social support is mostly seen as a positive resource for many health outcomes. However, some research indicates that weight loss may disrupt the equilibrium of relationships and highlights the potential for a more negative form of social support. This qualitative study aimed to explore bariatric surgery (BS) patients' perceptions of the way in which their current or previous partner supported them throughout their BS journey.

Design

BS patients (N = 30) participated in semi-structured interviews.

Methods

The data were analysed using an inductive approach to reflexive thematic analysis.

Results

Four themes were derived from the data. While two themes reflected social support as a form of caring (Mutual Investment and Positive Reinforcements), the other two themes indicated aspects of sabotage (Feeder Behaviours and Negative Reactions to Weight Loss Attempts and Successes). Transcending these themes was the notion of Bariatric Surgery as an Opportunity or Threat to the Relationship.

Conclusions

Some patients perceived social support as a positive resource in BS success involving Mutual Investment from their partners and being offered Positive Reinforcements for changes in their weight status and wellbeing. Some, however, described more negative aspects of support which had undermined their BS goals, either unintentionally or intentionally, through acts of sabotage including Feeder Behaviours and Negative Reactions to Weight Loss Attempts and Successes. Future research should develop interventions to help prepare the partners of those undergoing BS for the changes to both their partner's weight status and the dynamics of their relationship.

目的：对于许多健康结果而言，社会支持大多被视为一种积极的资源。然而，一些研究表明，体重减轻可能会破坏人际关系的平衡，并凸显出一种更为消极的社会支持形式的可能性。这项定性研究旨在探讨减肥手术（BS）患者对其现任或前任伴侣在整个减肥过程中对其提供支持的方式的看法：减肥手术患者（N = 30）参加了半结构化访谈：方法：采用归纳法对数据进行反思性主题分析：结果：从数据中得出了四个主题。其中两个主题反映了作为一种关爱形式的社会支持（相互投资和积极强化），另外两个主题则反映了破坏行为的各个方面（喂食行为和对减肥尝试和成功的消极反应）。在这些主题中，"减肥手术是人际关系的机遇还是威胁 "这一概念是最重要的：一些患者认为社会支持是减肥成功的积极资源，包括其伴侣的相互投资，以及为其体重状态和健康状况的改变提供积极的鼓励。然而，有些患者则描述了社会支持的消极方面，这些方面通过破坏行为（包括喂食行为以及对减肥尝试和成功的消极反应）无意或有意地破坏了他们的减肥目标。未来的研究应开发干预措施，帮助接受 BS 者的伴侣做好准备，以应对伴侣体重状况的变化和双方关系的动态变化。

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引用次数: 0

Trust in cervical screening and attributions of blame for interval cancers following a national controversy 宫颈癌筛查的信任度和全国性争议后的间期癌症归咎。

IF 3.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2024-05-17 DOI: 10.1111/bjhp.12727

Olga Poluektova, Deirdre A. Robertson, Alexandros Papadopoulos, Peter D. Lunn

Objectives

This study investigated levels of trust and attributions of blame in connection with a cervical screening programme following a controversy related to the programme's audit, incorporating an experimental test of the effectiveness of new information materials.

Design

We compared responses in Ireland (N = 872) to equivalent responses in Scotland (N = 400). Participants in Ireland were randomly assigned to either a treatment group that received the information materials or a control group that did not. Participants then responded to questions about their trust in cervical screening and to whom they would attribute blame in a range of scenarios describing women diagnosed with cervical cancer between screening rounds.

Results

Results showed that the control group in Ireland had lower trust and attributed higher blame towards screening services than participants in Scotland. However, exposure to information materials in the treatment group improved trust and reduced blame.

Conclusions

The findings suggest that public controversies influence perceptions of screening programmes and underscore the importance of transparent, choice-based communication in mitigating these effects. The findings have valuable implications for screening services worldwide as all screening programmes will have associated false negative and false positive results.

研究目的：本研究调查了宫颈癌筛查项目审计争议后的信任度和责任归因：本研究调查了在宫颈癌筛查计划的审计出现争议后，人们对该计划的信任程度和责任归属，并对新信息材料的有效性进行了实验性测试：我们比较了爱尔兰（872 人）和苏格兰（400 人）的同等反应。爱尔兰的参与者被随机分配到接受信息材料的治疗组或未接受信息材料的对照组。然后，参与者回答了他们对宫颈癌筛查的信任度问题，以及在一系列描述妇女在两轮筛查之间被诊断出患有宫颈癌的情况下，他们会将责任归咎于谁的问题：结果显示，与苏格兰的参与者相比，爱尔兰的对照组对筛查服务的信任度较低，对筛查服务的指责程度较高。然而，在治疗组中，接触到信息资料后，信任度提高了，指责也减少了：结论：研究结果表明，公众争议会影响人们对筛查计划的看法，并强调了透明、基于选择的沟通对于减轻这些影响的重要性。由于所有筛查项目都会出现相关的假阴性和假阳性结果，因此研究结果对全球筛查服务具有重要意义。

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引用次数: 0

Holding the hope? Therapist and client perspectives on long COVID recovery: A Q-methodology 保持希望？治疗师和客户对长期 COVID 恢复的看法：Q-方法论。

IF 3.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2024-05-12 DOI: 10.1111/bjhp.12724

William Burton-Fisher, Kim Gordon

Purpose

Long COVID is a global health concern which has debilitating effects on the individual experiencing it. In the United Kingdom, psychological therapies are being offered to people with long COVID, although the evidence for these therapies is yet to be demonstrated. This research aimed to understand how therapists and clients define and understand recovery from long COVID, and use hope theory to interpret the results.

Methods

An online Q-methodology was employed, where participants sorted a range of statements pertaining to long COVID recovery based on their level of agreement with them. These arranged statements (Q-sorts) were collated and factor analysed to explore and compare underlying perspectives.

Results

Sixteen participants were recruited for the study, including eleven clients, four IAPT therapists and one therapist working in the broader long COVID pathway. A four-factor model is reported, including (1) Psychological Pathways to Recovery, (2) Social Context and Agency, (3) Physiological Goals of Recovery and (4) Personal Meaning Making. All IAPT therapists loaded onto the psychological pathways factor, whereas the remaining participants shared more diverse perspectives.

Conclusions

The belief that long COVID recovery was possible, taken as an indicator of hopefulness, was rated highest for Factor 1, Psychological Pathways to Recovery, and Factor 3, Physiological Recovery Goals. This suggested that having a clear definition of recovery, or clear guidance on how to intervene, promoted hopefulness and, theoretically, well-being. However, clients reported experiences of being invalidated and disbelieved by health professionals, with psychological explanations sometimes being experienced as dismissive and invalidating. Clinical implications and future research directions are discussed.

目的：长期慢性阻塞性脑损伤是一个全球性的健康问题，会对患者的身体造成严重影响。在英国，长期慢性阻塞性肺气肿患者可接受心理治疗，但这些疗法的证据尚待证实。本研究旨在了解治疗师和客户如何定义和理解长期 COVID 的康复，并使用希望理论来解释研究结果：研究采用了在线 Q 方法，参与者根据自己的同意程度对一系列与长期 COVID 康复相关的陈述进行排序。对这些排列好的陈述（Q-sorts）进行整理和因素分析，以探索和比较潜在的观点：研究共招募了 16 名参与者，其中包括 11 名客户、4 名 IAPT 治疗师和 1 名在更广泛的长期 COVID 途径中工作的治疗师。报告中提出了一个四因素模型，包括（1）心理康复途径；（2）社会环境和机构；（3）生理康复目标；（4）个人意义建构。所有的 IAPT 治疗师都在心理路径因子上有所体现，而其余参与者的观点则更加多样化：认为长期 COVID 康复是可能的这一充满希望的指标，在因子 1 "心理康复途径 "和因子 3 "生理康复目标 "中得分最高。这表明，对康复有一个明确的定义，或对如何进行干预有一个明确的指导，会增强希望，从理论上讲，也会增强幸福感。然而，客户也报告了被医疗专业人员否定和不相信的经历，心理解释有时被认为是轻蔑和无效的。本文讨论了临床影响和未来研究方向。

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引用次数: 0

Editorial: Updates from the new editors-in-chief 社论：新任主编的最新消息。

IF 3.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2024-05-07 DOI: 10.1111/bjhp.12725

Fuschia Sirois, Andrew R. Thompson

引用次数: 0

A meta-analysis of coping strategies and psychological distress in rheumatoid arthritis 类风湿性关节炎患者应对策略和心理困扰的荟萃分析。

IF 3.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2024-05-05 DOI: 10.1111/bjhp.12726

Rebecca Hinch, Fuschia M. Sirois

Purpose

Theory and research indicate that coping plays a central role in the experience of psychological distress in people with rheumatoid arthritis (RA). This study meta-analysed the associations of adaptive and maladaptive coping strategies with psychological distress in people with RA to quantify and better understand the proposed differential relationships, as well as the factors that might influence these links.

Methods

Searches of four databases identified eligible studies according to a pre-registered protocol. Two random effects meta-analyses examined the direction and magnitude of the links between adaptive coping (problem-focused and emotional approach coping) and maladaptive coping (emotional avoidance and pre-occupation coping) and psychological distress (stress, anxiety, and depression). Study quality was evaluated using a bespoke tool. Moderator analyses for sample characteristics and distress type were conducted.

Results

Searches identified 16 eligible studies with 46 effects. Meta-analysis of maladaptive coping and distress yielded a significant, medium sized association, k = 12, r = .347, 95% CIs [.23, .46]. Moderator analyses were significant only for type of distress, with effects for depression being larger than that for combined distress. Effects did not vary as a function of age, participant sex, or disease duration. Meta-analysis for adaptive coping was not significant, k = 10, r = −.155, 95% CIs [−.31, .01].

Conclusions

Findings from this first meta-analysis of coping and distress in RA indicate that maladaptive but not adaptive coping is associated with greater distress. Further research is needed to grow the evidence base to verify the current findings especially with respect to adaptive coping.

目的：理论和研究表明，应对策略在类风湿关节炎（RA）患者的心理压力体验中起着核心作用。本研究对RA患者的适应性应对策略和适应不良应对策略与心理困扰之间的关系进行了荟萃分析，以量化和更好地理解所提出的不同关系，以及可能影响这些关系的因素：方法：根据预先登记的协议，在四个数据库中搜索符合条件的研究。两项随机效应荟萃分析检验了适应性应对（问题集中应对和情绪接近应对）和适应性应对（情绪回避应对和先占应对）与心理困扰（压力、焦虑和抑郁）之间的联系的方向和程度。研究质量采用定制工具进行评估。对样本特征和困扰类型进行了调节分析：搜索发现了 16 项符合条件的研究，共产生了 46 项影响。对适应不良的应对方式和痛苦进行的元分析表明，两者之间存在显著的中度关联，k = 12, r = .347, 95% CIs [.23, .46]。调节因子分析仅对苦恼类型有显著影响，抑郁的影响大于综合苦恼的影响。影响与年龄、参与者性别或病程无关。适应性应对的荟萃分析不显著，k = 10, r = -.155, 95% CIs [-.31, .01]：本研究首次对RA患者的应对方式和痛苦进行了荟萃分析，结果表明，适应不良的应对方式与更大的痛苦相关，而适应性应对方式与更大的痛苦无关。还需要进一步的研究来扩大证据基础，以验证当前的发现，尤其是适应性应对方面的发现。

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引用次数: 0

The presence of attentional and interpretation biases in patients with severe MS-related fatigue 严重多发性硬化症相关疲劳患者存在注意和解释偏差

IF 3.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2024-04-04 DOI: 10.1111/bjhp.12723

Marieke de Gier, Joukje M. Oosterman, Alicia M. Hughes, Rona Moss-Morris, Colette Hirsch, Heleen Beckerman, Vincent de Groot, Hans Knoop

Objective

Severe fatigue is a prevalent and disabling symptom in multiple sclerosis (MS). This study tested if a fatigue- and physical activity-related attentional bias (AB) and a somatic interpretation bias (IB) are present in severely fatigued patients with MS. Biases were compared to healthy controls and patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

Method

Severely fatigued patients with MS or ME/CFS and healthy controls completed a Visual Probe Task (VPT) assessing fatigue- and physical activity-related AB and an IB task that assesses the tendency to interpret ambiguous information in either a somatically threatening way or in a more neutral manner. The VPT was completed by 38 MS patients, 44 ME/CFS patients, and 46 healthy controls; the IB task was completed by 156, 40 and 46 participants respectively.

Results

ANOVA showed no statistically significant group differences in a fatigue-related AB or physical activity-related AB (omnibus test of interaction between topic × condition: F_2,125 = 1.87; p = .159). Both patient groups showed a tendency to interpret ambiguous information in a somatically threatening way compared to healthy controls (F_1,2 = 27.61, p < .001). This IB was significantly stronger in MS patients compared to ME/CFS patients. IB was significantly correlated with cognitive responses to symptoms in MS patients.

Conclusion

MS patients tend to interpret ambiguous information in a somatically threatening way. This may feed into unhelpful ways of dealing with symptoms, possibly contributing to the perpetuation of severe fatigue in MS.

目的严重疲劳是多发性硬化症（MS）的一种普遍致残症状。本研究测试了严重疲劳的多发性硬化症患者是否存在与疲劳和体力活动相关的注意偏差（AB）和躯体解释偏差（IB）。方法严重疲劳的多发性硬化症或慢性疲劳综合症（ME/CFS）患者和健康对照组完成一项视觉探测任务（VPT），评估与疲劳和体力活动相关的注意偏差；并完成一项躯体解释偏差（IB）任务，评估以躯体威胁或更中性的方式解释模糊信息的倾向。38名多发性硬化症患者、44名ME/CFS患者和46名健康对照者完成了VPT任务；156名、40名和46名参与者分别完成了IB任务。结果表明，在与疲劳相关的AB或与体力活动相关的AB方面，组间差异无统计学意义（主题×条件间交互作用的总括检验：F2,125 = 1.87）：F2,125 = 1.87; p = .159）。与健康对照组相比，两组患者都表现出以躯体威胁的方式解释模糊信息的倾向（F1,2 = 27.61, p <.001）。与 ME/CFS 患者相比，多发性硬化症患者的这种 IB 明显更强。IB与多发性硬化症患者对症状的认知反应明显相关。这可能助长了处理症状的无益方式，并可能导致多发性硬化症严重疲劳的持续存在。

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引用次数: 0

Individual outcomes after tailored versus generic self-management strategies for persistent fatigue in youth with a fatigue syndrome or rheumatic condition: A multiple single-case study 针对患有疲劳综合征或风湿病的青少年的持续性疲劳采取定制与通用自我管理策略后的个体效果：多项单一案例研究。

IF 3.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2024-03-26 DOI: 10.1111/bjhp.12722

Anouk Vroegindeweij, Jan Houtveen, Desiree A. Lucassen, Elise M. Van De Putte, Nico M. Wulffraat, Sanne L. Nijhof, Joost F. Swart

Objective

To examine individual outcomes after tailored lifestyle (PROfeel) or generic dietary advice as self-management intervention for persistent fatigue in adolescents and young adults with a chronic condition, to compare participants who did and did not benefit and to explore changes to factors in the biopsychosocial model of fatigue after PROfeel.

Method

A multiple single-case AB-phase design was embedded in a randomized crossover trial (N = 45). Intensive longitudinal data (ILD) on outcomes ‘fatigue severity’, ‘self-efficacy’ and ‘quality of life’ (QoL) were collected through weekly smartphone measurement for 20 weeks. ILD on biopsychosocial factors were collected through experience sampling methodology for 28 days pre-post first intervention. Baseline characteristics were compared with t-tests and chi-square tests. Permutation distancing tests were used to assess change over time in all ILD.

Results

Regarding weekly measurements, nineteen participants (42.22%) showed small to large positive outcomes (d_range = .05 to 2.59), mostly after PROfeel. Eleven participants (24.44%) showed small to moderate negative outcomes (d_range = −.02 to −2.46), mostly after dietary advice. Fatigue severity improved most, followed by self-efficacy. Participants who benefitted showed higher QoL levels and lower fatigue and pain levels compared with others at baseline (all p < .02). When positive outcomes were observed after PROfeel, typically ≥1 biopsychosocial factor had been targeted successfully.

Conclusion

Self-management advice has more potential when tailored to individual characteristics, including the biopsychosocial model of fatigue. PROfeel appears particularly useful as fatigue intervention for individuals with relatively less severe symptoms.

目的研究对患有慢性疾病的青少年和年轻成年人进行量身定制的生活方式（PROfeel）或普通饮食建议作为持续疲劳自我管理干预后的个体结果，比较受益和未受益的参与者，并探讨PROfeel后疲劳的生物心理社会模型中各因素的变化：方法：在随机交叉试验（N = 45）中采用了多重单病例 AB 阶段设计。通过每周一次的智能手机测量，收集有关 "疲劳严重程度"、"自我效能 "和 "生活质量"（QoL）结果的密集纵向数据（ILD），为期20周。关于生物心理社会因素的 ILD 是通过经验抽样方法收集的，为期 28 天，在首次干预前-后进行。基线特征通过 t 检验和卡方检验进行比较。结果：关于每周的测量结果，19 名参与者（42.22%）显示出了由小到大的积极结果（drange = .05 至 2.59），其中大部分是在 PROfeel 之后。11名参与者（24.44%）显示出小到中等程度的负面结果（drange = -.02 至 -2.46），大部分是在饮食建议之后。疲劳严重程度改善最大，其次是自我效能。与基线时的其他参与者相比，受益参与者的 QoL 水平更高，疲劳和疼痛水平更低（均为 p）：自我管理建议如能根据个人特点（包括疲劳的生物心理社会模型）量身定制，则更有潜力。对于症状相对较轻的人来说，PROfeel 似乎是一种特别有用的疲劳干预方法。

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引用次数: 0

Health care professionals' knowledge and attitudes towards antibiotic prescribing for the treatment of urinary tract infections: A systematic review 医护人员对治疗尿路感染的抗生素处方的认识和态度：系统综述。

IF 3.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology

Pub Date : 2024-03-17 DOI: 10.1111/bjhp.12721

Angela Kabulo Mwape, Kelly Ann Schmidtke, Celia Brown

Purpose

Previous models identify knowledge and attitudes that influence prescribing behaviour. The present study focuses on antibiotic prescribing for urinary tract infections (UTIs) to describe levels of health care professionals' knowledge and attitude factors in this area and how those levels are assessed.

Methods

A systematic search was conducted to identify studies assessing the identified knowledge or attitude factors influencing health care professionals' antibiotic prescribing for urinary tract infections up to September 2022. Study quality was assessed using the Newcastle–Ottawa scale. Data were extracted about the types of factors assessed, the levels indicated and how those levels were assessed. Data were synthesized using counts, and levels were categorized as ‘poor’, ‘moderate’, ‘high’ or ‘very high’.

Results

Seven studies were identified, six of which relied entirely on closed-ended items. Levels of knowledge factors assessed were poor, for example, their ‘knowledge of condition’ and ‘knowledge of task environment’ were poor. Levels of the attitude factors assessed varied, for example, while health care professionals expressed moderate confidence in providing optimal patient care and appropriate attitude of fear towards the problem of antibiotic resistance, they expressed a poor attitude of complacency by giving into patient pressure to prescribe an antibiotic.

Conclusions

Present evidence suggests that clinicians have poor levels of knowledge and varying levels of attitudes about antibiotic prescribing for UTIs. However, few studies were identified, and assessments were largely limited to closed-ended types of questions. Future studies that assess more factors and employ open-ended question types could better inform future interventions to optimize antibiotic prescribing.

目的：以往的模型确定了影响处方行为的知识和态度。本研究重点关注尿路感染（UTI）的抗生素处方，以描述医护人员在该领域的知识水平和态度因素，以及如何评估这些水平：我们进行了系统性检索，以确定截至 2022 年 9 月对影响医护人员开具尿路感染抗生素处方的知识或态度因素进行评估的研究。研究质量采用纽卡斯尔-渥太华量表进行评估。提取了有关所评估因素的类型、所显示的水平以及如何评估这些水平的数据。采用计数法对数据进行综合，并将水平分为 "差"、"中"、"高 "或 "非常高"：结果：共发现七项研究，其中六项完全依赖于封闭式项目。知识因素的评估水平较低，例如，"对条件的了解 "和 "对任务环境的了解 "较低。所评估的态度因素的水平也不尽相同，例如，虽然医护人员对为患者提供最佳护理表示出了适度的信心，并对抗生素耐药性问题表现出了适当的恐惧态度，但他们却因屈服于患者的压力而开出抗生素处方，从而表现出了较差的自满态度：目前的证据表明，临床医生对UTI 抗生素处方的认识水平不高，态度也各不相同。然而，所发现的研究很少，而且评估主要局限于封闭式问题。今后的研究如果能评估更多因素并采用开放式问题类型，就能更好地为未来优化抗生素处方的干预措施提供信息。

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