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Application of the theoretical framework of acceptability in a surgical setting: Theoretical and methodological insights 可接受性理论框架在外科手术中的应用:理论和方法学见解。
IF 7.9 2区 心理学 Q1 Psychology Pub Date : 2023-06-24 DOI: 10.1111/bjhp.12677
Camille Paynter, Cassie McDonald, David Story, Jill J. Francis

Purpose

Methods for assessing acceptability of healthcare interventions have been inconsistent until the development of the theoretical framework of acceptability (TFA). Despite its rapid adoption in healthcare research, the TFA has rarely been used to assess acceptability of surgical interventions. We sought to explore the sufficiency of the TFA in this context and provide methodological guidance to support systematic use of this framework in research.

Method

Acceptability was assessed in a consecutive sample of 15 patients at least 3 months post-joint replacement surgery via theory-informed semi-structured interviews. A detailed description of the application of the TFA is reported. This includes: development of the interview guide (including questions to assess theoretical sufficiency), analysis of interview data and interpretation of findings.

Results

Interview data were substantially codable into the TFA constructs but required the addition of a construct, labelled ‘perceived safety and risk’, and relabelling and redefining an existing construct (new label: ‘opportunity costs and gains’). Methodological recommendations for theory-informed interview studies include producing interview support material to enhance precision of the intervention description, conducting background conversations with a range of stakeholders in the healthcare setting, and conducting first inductive and then deductive thematic analysis.

Conclusion

The sufficiency of the TFA could be enhanced for use when assessing interventions with an identifiable risk profile, such as surgery, by the inclusion of an additional construct to capture perceptions of risk and safety. We offer these methodological recommendations to guide researchers and facilitate consistency in the application of the TFA in theory-informed interview studies.

目的:在可接受性理论框架(TFA)发展之前,评估医疗干预可接受性的方法一直不一致。尽管TFA在医疗保健研究中迅速被采用,但它很少被用于评估外科干预的可接受性。我们试图在这种情况下探索TFA的充分性,并提供方法指导,以支持在研究中系统地使用该框架。方法:对15名至少3名患者的连续样本进行可接受性评估 关节置换术后数月,通过理论知情的半结构化访谈。报告了TFA应用的详细说明。这包括:制定面试指南(包括评估理论充分性的问题)、分析面试数据和解释调查结果。结果:访谈数据基本上可以纳入TFA结构,但需要添加一个标记为“感知安全和风险”的结构,并重新标记和重新定义现有结构(新标签:“机会成本和收益”)。基于理论的访谈研究的方法建议包括制作访谈支持材料以提高干预描述的准确性,在医疗保健环境中与一系列利益相关者进行背景对话,以及首先进行归纳然后进行演绎的主题分析。结论:在评估具有可识别风险的干预措施(如手术)时,可以通过纳入额外的结构来捕捉风险和安全性,从而提高TFA的充分性。我们提供这些方法论建议,以指导研究人员,并促进TFA在理论知情访谈研究中应用的一致性。
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引用次数: 1
How to debunk misinformation? An experimental online study investigating text structures and headline formats 如何揭穿错误信息?一项调查文本结构和标题格式的实验性在线研究。
IF 7.9 2区 心理学 Q1 Psychology Pub Date : 2023-06-01 DOI: 10.1111/bjhp.12670
Johannes Kotz, Helge Giese, Laura M. König

Objectives

Misinformation is a crucial problem, particularly online, and the success of debunking messages has so far been limited. In this study, we experimentally test how debunking text structure (truth sandwich vs. bottom-heavy) and headline format (statement vs. questions) affect the belief in misinformation across topics of the safety of COVID vaccines and GMO foods.

Design

Experimental online study.

Methods

A representative German sample of 4906 participants were randomly assigned to reading one of eight debunking messages in the experimentally varied formats and subsequently rated the acceptance of this message and the agreement to misinformation statements about the mentioned topics and an unrefuted control myth.

Results

While the debunking messages specifically decreased the belief in the targeted myth, these beliefs and the acceptance of the debunking message were unaffected by the text structures and headline formats. Yet, they were less successful when addressing individuals with strong pre-existing, incongruent attitudes and distrust in science.

Conclusions

The risk of backfire effects in debunking misinformation is low. Text structure and headline format are of relatively little importance for the effectiveness of debunking messages. Instead, writers may need to pay attention to the text being comprehensive, trustworthy and persuasive to maximize effectiveness.

目标:虚假信息是一个关键问题,尤其是在网上,到目前为止,揭穿信息的成功是有限的。在这项研究中,我们通过实验测试了揭穿文本结构(真相三明治与底部沉重)和标题格式(陈述与问题)如何影响人们对新冠疫苗和转基因食品安全性等主题错误信息的信念。设计:实验性在线学习。方法:一个有代表性的德国样本4906名参与者被随机分配阅读八条不同格式的揭穿信息中的一条,随后对该信息的接受程度以及对有关上述主题的错误信息陈述和无可辩驳的控制神话的同意程度进行评分。结果:虽然揭穿消息特别降低了对目标神话的信念,但这些信念和对揭穿消息的接受不受文本结构和标题格式的影响。然而,在处理那些对科学有强烈的预先存在、不一致的态度和不信任的人时,他们并不那么成功。结论:在揭穿错误信息的过程中,适得其反的风险很低。文本结构和标题格式对揭穿信息的有效性来说相对不重要。相反,作者可能需要注意文本的全面性、可信赖性和说服力,以最大限度地提高效果。
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引用次数: 2
The GLA:D BACK self-management adherence and competence checklist (SMAC Checklist)—Development, content validity and feasibility GLA:D BACK自我管理依从性和能力检查表(SMAC检查表)——开发、内容有效性和可行性。
IF 7.9 2区 心理学 Q1 Psychology Pub Date : 2023-05-15 DOI: 10.1111/bjhp.12668
Bibi Dige Heiberg, Inge Ris, Henrik Hein Lauridsen, Jan Hartvigsen, Corrie Myburgh, Alice Kongsted

Objectives

To unpack the complexity and impact of self-management interventions targeting musculoskeletal health conditions, we need to learn more about treatment delivery in clinical settings. Fidelity evaluation can illuminate how complex treatments are delivered and help understand the elements that lead to the effect. The objective of this study was to develop a checklist for the evaluation of the clinicians’ delivery of structured patient education and exercise intervention for people with persistent back pain, the GLA:D Back intervention. The intent was to provide a checklist adaptable for the general delivery of self-management interventions for musculoskeletal pain.

Methods

We derived items for the treatment delivery fidelity checklist from behaviour change techniques and theory about communication style. We applied a three-step developmental process covering developing a preliminary fidelity intervention framework, validating checklist content and piloting and refining the checklist.

Results

We developed the adaptable fidelity checklist, The GLA:D BACK Self-management Adherence and Competence Checklist (SMAC Checklist). Evaluation of clinical practice using the checklist was feasible and acceptable by clinicians. Preliminary results indicate satisfactory observer agreement during pilot testing of the checklist.

Conclusion

The GLA:D BACK Self-management Adherence and Competence Checklist is a fidelity measurement tool for the assessment of the delivery of a self-management supportive intervention for people with persistent back pain. The intention is that it can be useful as an adaptable tool for use across self-management interventions for musculoskeletal pain.

目的:为了揭示针对肌肉骨骼健康状况的自我管理干预措施的复杂性和影响,我们需要了解更多关于临床环境中治疗提供的信息。保真度评估可以阐明如何提供复杂的治疗,并有助于了解导致效果的因素。本研究的目的是制定一份检查表,用于评估临床医生为持续背痛患者提供的结构化患者教育和运动干预,即GLA:D背部干预。目的是提供一份适用于肌肉骨骼疼痛自我管理干预的一般实施的检查表。方法:我们从行为改变技术和沟通风格理论中推导出治疗交付忠诚度检查表的项目。我们采用了三步发展过程,包括制定初步的保真度干预框架、验证检查表内容以及试行和完善检查表。结果:我们制定了适应性忠诚度检查表,即GLA:D-BACK自我管理依从性和能力检查表(SMAC检查表)。使用检查表对临床实践进行评估是可行的,临床医生可以接受。初步结果表明,在检查表的试点测试期间,观察者达成了令人满意的一致意见。结论:GLA:D BACK自我管理依从性和能力检查表是一种保真度测量工具,用于评估持续背痛患者自我管理支持性干预的实施情况。其目的是,它可以作为一种适应性强的工具,用于肌肉骨骼疼痛的自我管理干预。
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引用次数: 0
An interview study to explore applied psychologists' experiences of implementing health psychology in global health partnerships: The Change Exchange 一项访谈研究,探讨应用心理学家在全球健康伙伴关系中实施健康心理学的经验:变革交流。
IF 7.9 2区 心理学 Q1 Psychology Pub Date : 2023-05-11 DOI: 10.1111/bjhp.12669
Rebecca R. Turner, Shreya Epuru Reddy, Lucie M. T. Byrne-Davis, Eleanor R. Bull, Jo Hart

Introduction

Health partnerships in global health aim to build capacity by strengthening training and education. Health psychology has an important role to play, as traditionally health partnerships focus upon increasing capability such as increasing knowledge but do not tackle opportunity and motivation. The Change Exchange recruits applied psychologist volunteers to utilize health psychology in global health partnerships, which is a novel approach. This study aimed to understand the experiences of applied psychologist volunteers working in health partnerships and how such interventions were implemented.

Methods

Semi-structured interviews were carried out. Interviews were analysed using inductive thematic analysis to explore the translation and implementation of health psychology in health partnerships. A deductive approach was then taken using the higher level constructs of the Normalization Process Theory to inform and interpret the themes into recommendations.

Results

Fifteen applied psychologists, all of whom were from the UK and had volunteered in health partnerships between the UK and low- to middle-income countries participated. Key themes and sub-themes were identified: (1) The challenges of the application of behavioural science within the health partnerships, (2) Building relationships within the health partnership, (3) Exploring the communal and individual effort carried out within the health partnership and (4) Reflecting on the work carried out within the health partnership.

Discussion

Barriers exist in regards to the implementation of health psychology in health partnerships but capacity building is possible. Recommendations suggest, future work should establish clear roles for applied psychologists in health partnerships and critical evaluation of current psychological models, methods and measures for use outside of Western, Educated, Industrialized, Rich and Democratic societies.

导言:全球卫生领域的卫生伙伴关系旨在通过加强培训和教育来建设能力。健康心理学发挥着重要作用,因为传统的健康伙伴关系侧重于提高能力,如增加知识,但不涉及机会和动机。变革交流会招募应用心理学家志愿者,在全球健康伙伴关系中利用健康心理学,这是一种新颖的方法。本研究旨在了解在健康伙伴关系中工作的应用心理学家志愿者的经验,以及如何实施此类干预措施。方法:采用半结构化访谈。采用归纳主题分析法对访谈进行分析,探讨健康心理学在健康伙伴关系中的翻译和实施。然后采用演绎方法,使用规范化过程理论的更高层次结构,将主题告知并解释为建议。结果:15名应用心理学家参加了此次活动,他们都来自英国,自愿参加了英国与中低收入国家之间的健康伙伴关系。确定了关键主题和分主题:(1)在健康伙伴关系中应用行为科学的挑战,(2)在健康合作伙伴关系中建立关系,(3)探索在健康合作关系中进行的社区和个人努力,以及(4)反思在健康合作伙伴关系中开展的工作。讨论:在健康伙伴关系中实施健康心理学存在障碍,但能力建设是可能的。建议建议,未来的工作应为应用心理学家在健康伙伴关系中确立明确的作用,并对当前的心理模型、方法和措施进行批判性评估,以供西方、受过教育、工业化、富裕和民主社会之外使用。
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引用次数: 0
Adapted motivational interviewing for brief healthcare consultations: A systematic review and meta-analysis of treatment fidelity in real-world evaluations of behaviour change counselling 简短医疗咨询的适应性动机访谈:行为改变咨询真实世界评估中治疗忠诚度的系统综述和荟萃分析。
IF 7.9 2区 心理学 Q1 Psychology Pub Date : 2023-05-04 DOI: 10.1111/bjhp.12664
Alison K. Beck, Amanda L. Baker, Ben Britton, Alistair Lum, Sonja Pohlman, Erin Forbes, Lyndell Moore, Ditte Barnoth, Sarah J. Perkes, Chris Oldmeadow, Gregory Carter

Background

Behaviour change counselling (BCC) is an adaptation of motivational interviewing (MI) designed to maximize the effectiveness of time-limited health behaviour change consultations. To improve intervention quality and understanding of treatment effects, it is recommended that evaluations of health behaviour change interventions incorporate existing fidelity frameworks (e.g. The National Institutes of Health [NIH] Behaviour Change Consortium) and ensure that treatment fidelity is assessed and reported.

Purpose

This systematic review was designed to examine (a) adherence to NIH fidelity recommendations, (b) provider fidelity to BCC and (c) impact of these variables on the real-world effectiveness of BCC for adult health behaviours and outcomes.

Methods and Results

Searches of 10 electronic databases yielded 110 eligible publications describing 58 unique studies examining BCC delivered within real-world healthcare settings by existing providers. Mean study adherence to NIH fidelity recommendations was 63.31% (Range 26.83%–96.23%). Pooled effect size (Hedges g) for short-term and long-term outcomes was .19 (95% CI [.11, .27]) and .09 (95% CI [.04, .13]), respectively. In separate, random-effects meta-regressions, neither short-term nor long-term effect sizes were significantly modified by adherence to NIH fidelity recommendations. For the subgroup of short-term alcohol studies (n = 10), a significant inverse relationship was detected (Coefficient = −.0114, 95% CI [−.0187, −.0041], p = .0021). Inadequate and inconsistent reporting within the included studies precluded planned meta-regression between provider fidelity and BCC effect size.

Conclusions

Further evidence is needed to clarify whether adherence to fidelity recommendations modifies intervention effects. Efforts to promote transparent consideration, evaluation and reporting of fidelity are urgently needed. Research and clinical implications are discussed.

背景:行为改变咨询(BCC)是对动机访谈(MI)的改编,旨在最大限度地提高限时健康行为改变咨询的有效性。为了提高干预质量和对治疗效果的理解,建议对健康行为改变干预措施的评估纳入现有的保真度框架(例如美国国立卫生研究院[NIH]行为改变联盟),并确保评估和报告治疗保真度。目的:本系统综述旨在检查(a)对NIH保真度建议的遵守情况,(b)提供者对BCC的保真度,以及(c)这些变量对BCC对成人健康行为和结果的真实有效性的影响。方法和结果:对10个电子数据库的搜索产生了110份符合条件的出版物,描述了58项独特的研究,这些研究检查了现有提供者在现实世界医疗环境中提供的BCC。对NIH保真度建议的平均研究依从性为63.31%(范围26.83%-96.23%)。短期和长期结果的综合效应大小(Hedges g)分别为.19(95%CI[.11,.27])和.09(95%CI[0.04,.13])。在单独的随机效应元回归中,短期和长期效应大小都没有因遵守NIH保真度建议而显著改变。对于短期酒精研究的亚组(n = 10) ,检测到显著的反比关系(系数 = -.0114,95%置信区间[-.0187,-.0041],p = .0021)。纳入研究中的报告不充分且不一致,排除了提供者保真度和BCC效应大小之间的计划元回归。结论:需要进一步的证据来阐明遵守保真度建议是否会改变干预效果。迫切需要努力促进对忠诚度的透明审议、评估和报告。讨论了研究和临床意义。
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引用次数: 0
A qualitative process evaluation using the behaviour change wheel approach: Did a whole genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 within UK hospitals operate as anticipated? 使用行为改变轮方法的定性过程评估:用于减少英国医院内严重急性呼吸系统综合征冠状病毒2型的全基因组序列报告表(SRF)是否如预期那样运行?
IF 7.9 2区 心理学 Q1 Psychology Pub Date : 2023-05-01 DOI: 10.1111/bjhp.12666
Paul Flowers, Ruth Leiser, Fiona Mapp, Julie McLeod, Oliver Stirrup, Christopher J. R. Illingworth, James Blackstone, Judith Breuer

Purpose

The aim of this study was to conduct a process evaluation of a whole-genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 through changing infection prevention and control (IPC) behaviours within the COVID-19 pandemic.

Methods

We used a three-staged design. Firstly, we described and theorized the purported content of the SRF using the behaviour change wheel (BCW). Secondly, we used inductive thematic analysis of one-to-one interviews (n = 39) to explore contextual accounts of using the SRF. Thirdly, further deductive analysis gauged support for the intervention working as earlier anticipated.

Results

It was possible to theorize the SRF using the BCW approach and visualize it within a simple logic model. Inductive thematic analyses identified the SRF's acceptability, ease of use and perceived effectiveness. However, major challenges to embedding it in routine practice during the unfolding COVID-19 crisis were reported. Notwithstanding this insight, deductive analysis showed support for the putative intervention functions ‘Education’, ‘Persuasion’ and ‘Enablement’; behaviour change techniques ‘1.2 Problem solving’, ‘2.6 Biofeedback’, ‘2.7 Feedback on outcomes of behaviour’ and ‘7.1 Prompts and cues’; and theoretical domains framework domains ‘Knowledge’ and ‘Behavioural regulation’.

Conclusions

Our process evaluation of the SRF, using the BCW approach to describe and theorize its content, provided granular support for the SRF working to change IPC behaviours as anticipated. However, our complementary inductive thematic analysis highlighted the importance of the local context in constraining its routine use. For SRFs to reach their full potential in reducing nosocomial infections, further implementation research is needed.

目的:本研究的目的是对全基因组序列报告表(SRF)进行过程评估,该报告表用于通过改变新冠肺炎大流行中的感染预防和控制(IPC)行为来减少医院感染的SARS-CoV-2。方法:采用三阶段设计。首先,我们使用行为改变轮(BCW)描述并理论化了SRF的所谓内容。其次,我们对一对一访谈(n = 39)来探索使用SRF的上下文说明。第三,进一步的演绎分析衡量了对干预措施的支持,正如之前预期的那样。结果:可以使用BCW方法将SRF理论化,并在一个简单的逻辑模型中可视化。归纳专题分析确定了SRF的可接受性、易用性和感知的有效性。然而,据报道,在新冠肺炎危机期间,将其纳入日常实践面临重大挑战。尽管有这种见解,演绎分析显示支持假定的干预功能“教育”、“说服”和“使能”;行为改变技术“1.2问题解决”、“2.6生物反馈”、“2.7行为结果反馈”和“7.1提示和线索”;和理论领域框架领域“知识”和“行为调节”。结论:我们对SRF的过程评估,使用BCW方法来描述和理论化其内容,为SRF按照预期改变IPC行为提供了细粒度的支持。然而,我们的补充归纳主题分析强调了当地背景在限制其日常使用方面的重要性。SRF要充分发挥其在减少医院感染方面的潜力,还需要进一步的实施研究。
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引用次数: 0
Resilience and distress among young adults with chronic health conditions: A longitudinal study 患有慢性疾病的年轻人的复原力和痛苦:一项纵向研究。
IF 7.9 2区 心理学 Q1 Psychology Pub Date : 2023-04-26 DOI: 10.1111/bjhp.12667
Erika Wright, Timothy R. Elliott, Oi-Man Kwok, Qiyue Zhang, Mikaela Spooner

Objectives

To test the beneficial associations of a resilient personality prototype among emerging adults with chronic health conditions (CHC) over an 8-year period.

Design

Longitudinal, prospective observation study.

Methods

Data obtained from emerging adults in the Add Health project with a CHC and completed study measures at two time points (286 men, 459 women) were examined. Cluster analysis was used to identify a resilient personality prototype at the first time point, as defined in the Block model of personality. Differences between those with a resilient and non-resilient prototype were examined. A structural equation model (SEM) tested the association of a resilience prototype with positive affect, perceived control and family relationships in predicting distress over time.

Results

A resilient personality profile was identified (n = 256). These individuals reported higher positive affect, greater perceived control and less distress at both measurement occasions than those without this profile (n = 489). Women reported more distress than men. SEM revealed the relationship of a resilient prototype to distress was explained by its beneficial association with positive affect and perceived control at the first assessment, and through its beneficial association with perceived control 8 years later. Gender independently predicted distress.

Conclusions

A resilient personality prototype appears to operate through its beneficial association with perceived control to prospectively predict distress reported by emerging adults with CHC. The self-regulatory properties theoretically associated with a resilient personality prototype may function through perceptions of control which, in turn, prevent prolonged experiences of distress. Clinical implications are considered.

目的:在8年的时间里,在患有慢性健康状况(CHC)的新兴成年人中,测试坚韧人格原型的有益关联。设计:纵向、前瞻性观察研究。方法:对从具有CHC的Add Health项目中的新兴成年人获得的数据以及在两个时间点(286名男性,459名女性)完成的研究测量进行检查。聚类分析用于在第一个时间点识别弹性人格原型,如人格块模型中所定义的。研究了具有弹性原型和非弹性原型之间的差异。一个结构方程模型(SEM)测试了弹性原型与积极情感、感知控制和家庭关系在预测一段时间内的痛苦时的关联。结果:发现了一个有弹性的人格特征(n = 256)。这些人在两次测量中都比没有这种情况的人表现出更高的积极影响、更大的控制感和更少的痛苦(n = 489)。女性比男性更痛苦。SEM显示,弹性原型与痛苦的关系是通过其与第一次评估时的积极影响和感知控制的有益关联来解释的,以及通过其与感知控制的有利关联8 几年后。性别独立预测痛苦。结论:有弹性的人格原型似乎通过其与感知控制的有益联系来前瞻性预测新出现的CHC成年人报告的痛苦。理论上与弹性人格原型相关的自我调节特性可能通过控制感发挥作用,而控制感反过来又可以防止长期的痛苦经历。考虑了临床影响。
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引用次数: 0
Debunking nutrition myths: An experimental test of the ‘truth sandwich’ text format 揭开营养神话:“真相三明治”文本格式的实验测试。
IF 7.9 2区 心理学 Q1 Psychology Pub Date : 2023-04-26 DOI: 10.1111/bjhp.12665
Laura M. König

Objectives

Myths about diet and nutrition are widespread and may seriously impact health and well-being. This study tests whether texts in a truth sandwich format, that is, texts presenting two blocks of factual, correcting information around a text block listing a myth and identifying it as false, are effective in reducing agreement with a range of nutrition myths.

Design

Prestudy: observational survey; main study: 4 Text × 6 statement mixed experimental design.

Methods

Out of 13 nutrition myths that were presented to 58 participants in a prestudy, the six most prevalent myths were selected for the main study. In the preregistered main study, 302 participants were randomly assigned to either reading one of three texts in the truth sandwich format addressing a nutrition myth or reading a text about healthy eating (control condition) before rating their agreement with a total of six nutrition myths.

Results

Participants agreed less with the specific myth targeted by the truth sandwich text, while controls were not differentiating between them.

Conclusions

Thus, truth sandwiches are effective in reducing agreement with myths and can be harnessed to promote evidence-based dietary practices to promote health in the population.

目标:关于饮食和营养的神话很普遍,可能会严重影响健康和幸福。这项研究测试了真理三明治格式的文本,即呈现两个事实块的文本,围绕一个列出神话的文本块更正信息并将其认定为虚假的文本,是否能有效减少与一系列营养神话的一致性。设计:预研:观察性调查;主要研究:4个文本× 6陈述混合实验设计。方法:在一项研究前向58名参与者提出的13个营养神话中,选择六个最普遍的神话作为主要研究。在预先注册的主要研究中,302名参与者被随机分配阅读三篇关于营养神话的真理三明治形式的文本中的一篇,或者阅读一篇关于健康饮食(对照条件)的文本,然后对他们对总共六个营养神话的一致性进行评分。结果:参与者不太同意真相三明治文本所针对的特定神话,而对照组则没有区分他们。结论:因此,真理三明治在减少与神话的一致性方面是有效的,可以用来促进循证饮食实践,以促进人群健康。
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引用次数: 1
The experience of relatives and friends of patients with moderate to advanced chronic kidney disease: Insights from the CKD-REIN cohort study 中晚期慢性肾脏病患者亲友的经历:来自CKD-REIN队列研究的见解。
IF 7.9 2区 心理学 Q1 Psychology Pub Date : 2023-04-20 DOI: 10.1111/bjhp.12662
Lucile Montalescot, Géraldine Dorard, Elodie Speyer, Karine Legrand, Carole Ayav, Christian Combe, Bénédicte Stengel, Aurélie Untas

Objectives

The transition from chronic kidney disease (CKD) to kidney failure requiring kidney replacement therapy (KRT; i.e., dialysis or transplantation) to sustain life is a stressful event for patients. Families play a role in patients' treatment decision-making, but little is known about how they are involved. This study aimed to explore the experience of CKD among relatives and friends, their views and involvement in KRT choice.

Design/Methods

We conducted a qualitative study among 56 relatives or friends of patients with moderate to advanced CKD who were enrolled in the CKD-REIN cohort study. A psychologist conducted semi-structured interviews about their experience with CKD, treatment decision-making and their role in this process. Data were analysed using statistical text analysis.

Results

The mean age of participants was 56.4 ± 14 years; 75% were women, 61% were patients' partners and 48% had a relative or friend with stage G4 CKD. The analysis yielded four lexical classes: listeners with an opinion, coping with CKD on a daily basis, narrating patients' nephrological monitoring and emotions behind facts. Participants reported a listening role in the decision-making period and information needs. Some reported that CKD had no impact on their own daily lives, but others talked about its current and future physical, psychological and social consequences on them, the patients and their relationships.

Conclusions

Most relatives/friends reported having little influence on KRT decision-making but expressed opinions on these treatments. Including relatives/friends in education on KRT and providing them with decision aids, especially when family members are supportive, may allow for more suitable decisions.

目的:从慢性肾脏疾病(CKD)到需要肾脏替代治疗(KRT;即透析或移植)来维持生命的肾衰竭的转变对患者来说是一个压力事件。家庭在患者的治疗决策中发挥着作用,但人们对他们是如何参与的知之甚少。本研究旨在探讨CKD在亲友中的经历、他们的观点以及对KRT选择的参与。设计/方法:我们对参与CKD-REIN队列研究的56名中晚期CKD患者的亲属或朋友进行了一项定性研究。一位心理学家对他们的CKD经历、治疗决策以及他们在这一过程中的作用进行了半结构化访谈。使用统计文本分析对数据进行分析。结果:参与者的平均年龄为56.4岁 ± 14 年;75%是女性,61%是患者的伴侣,48%有G4期CKD的亲戚或朋友。该分析产生了四个词汇类别:有意见的听众、日常应对CKD、讲述患者的肾脏病监测和事实背后的情绪。与会者报告了在决策期间的倾听作用和信息需求。一些人报告说,CKD对他们自己的日常生活没有影响,但另一些人谈到了它对他们、患者及其关系的当前和未来的身体、心理和社会后果。结论:大多数亲属/朋友表示对KRT决策影响不大,但对这些治疗方法表达了意见。让亲属/朋友参与KRT的教育,并为他们提供决策辅助工具,尤其是在家人支持的情况下,可能会做出更合适的决定。
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引用次数: 0
Attitudes of mothers and health care providers towards behavioural interventions promoting breastfeeding uptake: A systematic review of qualitative and mixed-method studies 母亲和卫生保健提供者对促进母乳喂养的行为干预措施的态度:对定性和混合方法研究的系统综述。
IF 7.9 2区 心理学 Q1 Psychology Pub Date : 2023-04-15 DOI: 10.1111/bjhp.12663
Antonio Rojas-García, Sabrina Lingeman, Angelos P. Kassianos

Purpose

Recommendations for exclusive breastfeeding are not often adhered to despite the robust evidence of its benefits. This systematic review aims to collate evidence on the attitudes mothers and health care providers have towards breastfeeding interventions to understand what aspects best contribute to acceptability and feasibility.

Methods

This review further investigates the value of identifiable behaviour change techniques (BCTs) to uncover which components of an intervention are perceived to be most useful and acceptable. The main biomedical databases were searched, and 17 (n = 17) studies met the inclusion criteria.

Results

A total of nine BCTs were identified within the interventions. The thematic analysis produced four main domains: usefulness, accessibility, value and sustainability. Women discussed the importance of the support they received in these interventions and demonstrated a positive view towards three BCTs: ‘social support (unspecified)’, ‘instruction on how to perform behaviour’ and ‘demonstration of behaviour’. Additionally, women highlighted the benefit of personal, non-clinical and flexible emotional and practical support from peers, lactation consultants and support groups. Health care providers echoed these opinions and specifically highlighted the usefulness of interventions that allowed for continuity of care and more personal breastfeeding support.

Conclusions

These findings suggest that ongoing practical as well as emotional support is crucial for standard in-hospital support to succeed at increasing breastfeeding rates. Future research would need to better understand the nuances of the interventions among women and providers to enhance their implementation.

目的:尽管有强有力的证据表明纯母乳喂养有益,但人们并不经常遵守纯母乳喂养的建议。这项系统审查旨在整理有关母亲和医疗保健提供者对母乳喂养干预措施的态度的证据,以了解哪些方面最有助于提高可接受性和可行性。方法:本综述进一步调查了可识别行为改变技术(BCT)的价值,以揭示干预措施的哪些组成部分被认为是最有用和最可接受的。检索了主要的生物医学数据库 = 17) 研究符合纳入标准。结果:在干预措施中总共发现了9个BCT。专题分析产生了四个主要领域:有用性、可及性、价值和可持续性。妇女们讨论了她们在这些干预措施中获得的支持的重要性,并对三个BCT表现出积极的看法:“社会支持(未指明)”、“如何表现行为的指导”和“行为示范”。此外,女性强调了来自同龄人、哺乳顾问和支持团体的个人、非临床和灵活的情感和实践支持的好处。卫生保健提供者赞同这些意见,并特别强调了干预措施的有用性,这些干预措施允许护理的连续性和更多的个人母乳喂养支持。结论:这些发现表明,持续的实际和情感支持对于标准的住院支持成功提高母乳喂养率至关重要。未来的研究需要更好地了解妇女和提供者之间干预措施的细微差别,以加强其实施。
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引用次数: 0
期刊
British Journal of Health Psychology
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