Families Systems & Health最新文献

Background: Warm handoffs have shown to improve engagement in care for integrated services; however, often patients cannot stay for an additional appointment. The current work set out to understand if a brief introduction-a nonbillable encounter where a psychology team member meets with the patient and schedule a future appointment-can improve attendance in care for patients.

Method: Participants included 171 patients who were referred to an integrated psychology team with behavioral health consultants (BHCs) within a primary care clinic. Data was tracked from December 2023 until February 2024. Team members were asked to notify the psychology team when placing a referral to complete a warm handoff or brief introduction. Referrals, brief introductions, and attendance were pulled from the electronic medical record.

Results: About 38.6% of patients referred to the psychology team completed a brief introduction with a BHC. About 80.3% of patients who completed a brief introduction went on to complete a visit with a BHC whereas 57.1% of those who were referred for an appointment without a brief introduction completed an appointment. There is a significant relationship between the brief introduction and attendance at a future appointment (McNemar's test χ² = 28.99, p < .01).

Discussion: Briefly meeting with a BHC is linked with attendance at future visits. The current work extends research with warm handoffs to show that a brief nonbillable encounter is associated with engagement in psychological services in an integrated care setting with a diverse patient population and calls for specificity in strategies to increase patient engagement. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Introduction: Posttraumatic stress disorder (PTSD) among primary care patients is common, associated with negative health outcomes, and has inadequate rates of mental health treatment. Evidence-based interventions for PTSD that are appropriate for Primary Care Mental Health Integration (PCMHI) settings have been developed but are not yet widely disseminated. Therefore, the nature of psychological interventions to treat PTSD in PCMHI settings is largely unknown.

Method: The study describes the content of 223 PCMHI sessions delivered as part of normal clinical care for 88 patients with PTSD across two Veterans Health Administration (VHA) health care systems. Session notes were coded using a general inductive approach for (a) assessment content, (b) problem focus, (c) interventions delivered, and (d) referrals to behavioral health services.

Results: Assessment was typically included in sessions, but repeated administration of self-report measures was less common. Sessions were most commonly focused on PTSD, stress, and sleep. Common interventions delivered were recommending specific self-help tools (e.g., apps and websites), recommending relaxation strategies, and providing psychoeducation about PTSD and PTSD treatment. Almost half (48%) of patients were referred to additional behavioral health services.

Conclusion: Veterans Health Administration PCMHI providers are routinely delivering evidence-informed interventions for PTSD. However, there is room for improvement in adhering to measurement-based care principles and delivering interventions with the strongest evidence for reducing PTSD. The methods of this study can be used to engage in quality improvement efforts to enhance the quality of PCMHI services for PTSD. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Background: Acute cardiovascular events are highly distressing for patients and their romantic partners. Partner presence in the emergency department (ED) may increase patients' distress due to mutual exposure to hospital stressors and dyadic influences, but studies are lacking. This pilot feasibility study enrolled patients with stroke/transient ischemic attack (TIA) and their partners to complete surveys and physical activity monitoring. Dyadic disruption theory informed hypotheses about distress transmission (i.e., corumination and shared reality as moderators).

Method: Partners of stroke/TIA patients were recruited from an ongoing observational cohort study in a large, urban academic medical center. Surveys were conducted at baseline and 1-month posthospital discharge. Partners present during ED evaluation additionally completed accelerometry to monitor physical inactivity. Feasibility outcomes were recruitment, retention, and adherence to study procedures. ED distress, acute stress symptoms, and posttraumatic stress within patients and partners were explored.

Results: Of 35 partners contacted, 18 provided consent (51.4%), 16 of whom (88.9%) were retained (M_age = 56.13, SD = 14.73, 56.3% women, 50.0% White). Partner adherence to accelerometry was high (72.7%). ED distress predicted acute stress and posttraumatic stress symptoms for dyads reporting a high degree of shared understanding about the stroke/TIA ("shared reality").

Conclusion: Despite challenges presented by the COVID-19 pandemic, recruitment rates are typical for this population, and retention was excellent. As hypothesized, ED distress persisted when shared reality was high. Larger studies powered to detect dyadic influence effects in distress development and correspond distress to secondary prevention behaviors are warranted. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Introduction: Hypertensive disorders of pregnancy (HDP) significantly affect patients and their families. This study investigates the changes in family resilience in HDP patients from diagnosis to 6 months postpartum, highlighting factors that influence resilience over time.

Method: A prospective longitudinal study was conducted with 270 families of HDP patients. Data were collected using standardized psychometric tools at four time points: first diagnosis of hypertension in pregnancy (baseline; T0), during late pregnancy (≥ 28 weeks) and through delivery (T1), 3 months postpartum (T2), and 6 months postpartum (T3). Analysis of variance compared family resilience across time points, and generalized estimating equations assessed influencing factors.

Results: Family resilience scores increased significantly from T0 (95.50) to T3 (141.36), with notable differences between time points (p < .01). The generalized estimating equations model identified key determinants of resilience, including family function, social support, maternal education, employment status, religious beliefs, type of care, and methods of conception. These factors significantly influenced resilience levels at different stages, emphasizing the dynamic nature of family adaptation during HDP and the postpartum period.

Discussion: Family resilience in HDP patients increased over time, influenced by family dynamics and external support. These results suggest that targeted interventions focusing on improving family function and social support are crucial for enhancing family resilience during pregnancy and postpartum. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Introduction: This study investigated the mental health status of caregivers of children with asthma and analyzed the associated influencing factors.

Method: We recruited 337 children with asthma and their caregivers. Student's t test, one-way analysis of variance, multiple linear regression, and Pearson's correlation analysis were used to analyze the factors influencing mental health.

Results: Caregivers' mental health scores were 2.52 ± 2.33. Statistical analysis revealed a significant difference (p < .05) in the comparison of psychological health scores among caregivers based on various factors, including their relationship with their children, occupation, degree of education, family structure, parenting styles, mean daily care time, degree of work affected, home residence, and monthly family income.

Discussion: Caregivers of children with asthma exhibited notable levels of mental well-being, albeit accompanied by concurrent experiences of anxiety and depression. In addition to their primary responsibilities of treating and caring for children, medical professionals should prioritize the mental health of caregivers and promptly offer appropriate guidance and support. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: Health-related quality of life (HRQoL) is crucial in marital well-being, especially in contexts like Iran where traditional values and religious beliefs strongly influence family dynamics. While quality-of-life research is broad, there is a specific gap in understanding how spirituality and gender roles impact HRQoL in Iranian married couples. This study aims to fill the gap by investigating how spirituality and gender moderate the association between family functioning and HRQoL.

Method: A survey was conducted with 371 married couples in Iran, using a cross-sectional approach. The Family Assessment Device was used to assess family functioning, the World Health Organization quality of life-BREF questionnaire was utilized to measure HRQoL, and spirituality was gauged with the Spiritual Value questionnaire. To reduce the influence of common method bias, the study utilized Harman's single-factor test. The impact of moderators was then examined through the use of partial least squares structural equation modeling.

Results: Findings showed no significant common method bias. Factors such as problem-solving, family roles, behavioral control, and general family functioning were found to have a positive influence on HRQoL. In contrast, family communication, affective involvement, and affective responsiveness were not significant predictors of HRQoL. Spirituality moderated the association between HRQoL problem-solving and general family functioning. Gender did not moderate the association between family functioning and HRQoL.

Discussion: These findings highlight the significance of family dynamics and spirituality in shaping HRQoL in non-Western settings. They emphasize the importance of conducting more research on the quality of life in married couples in various cultural and societal settings. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

In this article, the authors assert that a potential solution to mitigate the mental health care workforce shortage is to embed psychiatric nurses in primary care. Nurse practitioners (NPs) are nurses who have advanced education (master's or doctoral degree) and advanced clinical training to diagnose and treat illness, manage chronic disease, and contribute to population health. Although there are not yet large-scale studies of psychiatric NP integration in primary care, emerging evidence suggests that such models can improve mental health care referrals, increase uptake of mental health referrals, decrease child behavioral symptoms, and decrease repeat primary care visits for unmet behavioral health needs. The ongoing shortage of specialty mental health care providers has created a significant opportunity for physician-nurse collaborative models of care to fill this gap. An innovative and practical solution to the nation's child mental health crisis is expanding, incentivizing, and sustaining the role of psychiatric NPs in pediatric primary care models. Such models may yield distinct health benefits in underserved and low-resource communities with mental health provider shortages. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: Integrated primary care (IPC) settings serve as primary access points for mental health care, particularly for underserved populations that face barriers to traditional care. This brief report investigates the feasibility and practical implementation of two mobile health (mHealth) applications, MindLAMP and BounceBackNow, deployed in IPC settings. MindLAMP was selected for its evidence-based design tailored to support patients with depression, offering tools for mood tracking, cognitive behavioral strategies, and personalized feedback. BounceBackNow was chosen due to its focus on trauma-related symptoms, providing psychoeducational resources, symptom monitoring, and coping strategies specifically designed for individuals experiencing posttraumatic stress. Both apps were selected for their user-centered design, accessibility, and alignment with IPC goals of improving mental health access for underserved populations.

Method: The apps were deployed to support patients with depression and trauma-related symptoms, offering a digital tool to complement in-person therapy sessions. Both patient outcome measures and individual interview data from behavioral health providers and other clinical staff members were collected and analyzed.

Results: Despite the promising potential of these apps, the studies faced significant challenges, including low patient recruitment, technical barriers, and time constraints for health care providers.

Discussion: The findings highlight the need for comprehensive strategies to integrate digital health tools into existing health care systems. Future directions and lessons learned include addressing organizational barriers, enhancing provider training, and exploring community-based engagement strategies to improve patient adoption and sustained use of mHealth apps. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: Clinical supervision is a foundational experience for novice behavioral health clinicians (BHCs), with the provision of high-quality supervision in the integrated primary care (IPC) context being imperative. While the literature highlights skills, knowledge, and considerations for supervisors in these settings, less is known about the supervision needs of novice BHCs.

Method: This article presents the findings of a classical Delphi study with a panel of 12 novice BHCs who have received supervision in an IPC setting.

Results: The Delphi panelists achieved statistical consensus on 68 statements across nine themes, highlighting a wide range of supervisory needs of novice BHCs in IPC settings.

Discussion: This study expands upon the existing literature on supervision in IPC settings by indicating the various needs of novice BHCs receiving supervision in IPC. Implications for the planning, implementation, and evaluation of supervision in IPC settings are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

In this essay, the narrator reflects on her experience of taking medical leave from her work in academic health sciences during a complicated twin pregnancy. (PsycInfo Database Record (c) 2025 APA, all rights reserved).