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Doctors must be gentle. 医生必须温柔。
IF 1 4区 医学 Q3 FAMILY STUDIES Pub Date : 2025-03-01 DOI: 10.1037/fsh0000940
Ansel Eve Hoffman, Susan Holmes McDaniel

The second author, who is a doctor, describes a message written by her 6-year-old granddaughter, Ansel. The message said that doctors must be patient, kind, loving, giving, generous, and forgiving. Ansel has always said she wants to be a physician when she grows up. When her grandmother asked her about what she wrote, Ansel said: "I was pretending to study to be a doctor, and this was a test I had to take about what makes a good doctor." The grandmother asked her: How do you know these things? She said: "What if you're doing surgery, or a little kid is nervous and getting a shot? You have to be kind and distract the kid so you're halfway through before they notice." (PsycInfo Database Record (c) 2025 APA, all rights reserved).

第二名作者是一名医生,她描述了她6岁的孙女安塞尔(Ansel)写的一封信。这条信息说,医生必须耐心、善良、有爱心、给予、慷慨和宽容。安塞尔总是说她长大后想成为一名医生。当她的祖母问她写了些什么时,安塞尔说:“我假装在学习成为一名医生,这是我必须接受的一个测试,关于如何成为一名好医生。”奶奶问她:你是怎么知道这些事情的?她说:“如果你正在做手术,或者一个小孩正在紧张地打针怎么办?你必须友善地转移孩子的注意力,这样他们才会注意到你已经完成了一半。”(PsycInfo Database Record (c) 2025 APA,版权所有)。
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引用次数: 0
Review of Just Health: Treating Structural Racism to Heal America. 公正的健康:治疗结构性种族主义以治愈美国。
IF 1 4区 医学 Q3 FAMILY STUDIES Pub Date : 2025-03-01 DOI: 10.1037/fsh0000942
Erick da Luz Scherf

Reviews the book, Just Health: Treating Structural Racism to Heal America by Dayna B. Matthew (2024). Matthew's book provides a compelling argument that structural racism and racialized structural inequality are fundamental drivers of health inequity and poor health outcomes for people of color and other marginalized groups in the United States. Through her eloquent storytelling and meticulous analysis, Matthew (2024) illustrates how systemic racial and economic inequalities, ingrained in U.S. public policy history, have perpetuated health disparities and contributed to premature deaths within these communities. Anyone interested in the fields of public law, health care, health policy, and allied health sciences should read this book. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

评论戴娜·b·马修(Dayna B. Matthew)所著的《只是健康:治疗结构性种族主义以治愈美国》(2024)一书。马修的书提供了一个令人信服的论点,即结构性种族主义和种族化的结构性不平等是美国有色人种和其他边缘化群体健康不平等和健康状况不佳的根本驱动因素。通过她雄辩的故事和细致的分析,马修(2024)说明了美国公共政策历史中根深蒂固的系统性种族和经济不平等如何使健康差距永久化,并导致这些社区的过早死亡。任何对公法、卫生保健、卫生政策和相关卫生科学领域感兴趣的人都应该阅读这本书。(PsycInfo Database Record (c) 2025 APA,版权所有)。
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引用次数: 0
Effect of a diabetes education program on family members' attitudes toward diabetes. 糖尿病教育计划对家庭成员糖尿病态度的影响。
IF 1 4区 医学 Q3 FAMILY STUDIES Pub Date : 2025-03-01 Epub Date: 2024-09-19 DOI: 10.1037/fsh0000928
Esra Saraçoğlu, Ilknur Aydin Avci

Aim: Attitude is a response to certain events and phenomena based on past knowledge and experience. This study aimed to improve the attitudes of family members toward diabetes after the implementation of the program.

Method: The study was a one-group quasi-experimental design conducted with family members of patients with diabetes in a city in northern Turkey. There were a total of 38 family members of people with diabetes in the study group. The participants completed the personal information form and the Diabetes Attitude Scale as a pretest. They then took part in a diabetes education program based on the health belief model. After the education program, family members received an education booklet, health belief model-based text messages (twice per week for 3 months/total of 24), and phone calls (once per month/total of three). The family members completed the posttests at the end of the 3 months.

Results: Of the family members, 55.3% were female, 42.1% were primary school graduates, 52.6% were spouses of patients with diabetes, and the mean age was 45.32 ± 13.99 years. The Diabetes Attitude Scale total score was 3.2 ± 0.2 on the pretest and 4.0 ± 0.0 on the posttest (p < .001). There was a significant increase in all subscale scores after the intervention.

Conclusion: There was a significant improvement in the attitudes of family members who participated in the diabetes education program. Having family members with positive attitudes toward diabetes can be beneficial in the management and care of the patient's diabetes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

目的:态度是基于过去的知识和经验对某些事件和现象做出的反应。本研究旨在改善实施计划后家庭成员对糖尿病的态度:研究采用单组准实验设计,对象为土耳其北部某市的糖尿病患者家属。研究组共有 38 名糖尿病患者家属。参与者填写了个人信息表和糖尿病态度量表作为前测。然后,他们参加了基于健康信念模式的糖尿病教育计划。教育计划结束后,家庭成员收到了教育手册、基于健康信念模式的短信(每周两次,共 3 个月,共 24 条)和电话(每月一次,共 3 次)。家庭成员在 3 个月结束时完成了后测:家庭成员中,55.3%为女性,42.1%为小学毕业生,52.6%为糖尿病患者的配偶,平均年龄为(45.32±13.99)岁。糖尿病态度量表总分在前测中为(3.2 ± 0.2)分,在后测中为(4.0 ± 0.0)分(P < .001)。干预后,所有分量表得分均有明显提高:结论:参加糖尿病教育计划的家庭成员的态度有了明显改善。家庭成员对糖尿病的积极态度有利于糖尿病患者的管理和护理。(PsycInfo Database Record (c) 2024 APA,版权所有)。
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引用次数: 0
"Not just another client": Benefits provided by care managers to patients with mental health disorders in underserved areas. “不仅仅是另一个客户”:护理管理人员为服务不足地区的精神健康障碍患者提供的福利。
IF 1 4区 医学 Q3 FAMILY STUDIES Pub Date : 2025-03-01 DOI: 10.1037/fsh0000919
Linda H Takamine, Jennifer D Hall, Deborah J Cohen, Maria N Danna, Theresa J Hoeft, Leif I Solberg, Amy M Bauer, Matthew Jakupcak, Anna LaRocco-Cockburn, Paul N Pfeiffer, John C Fortney

Objective: To identify contributions made by care managers (CMs) to treatment for rural patients with posttraumatic stress disorder (PTSD) and bipolar disorder (BD), who are medically underserved and experiencing poverty, in a telepsychiatry collaborative care model.

Method: We conducted an inductive qualitative study analyzing 24 semistructured interviews with patients who screened positive for PTSD or BD and participated in telepsychiatry collaborative care at 12 Federally Qualified Health Centers in Arkansas, Michigan, and Washington between November 2016 and June 2020. Interviews took place between March 2018 and June 2020.

Results: Our findings confirmed that patients with PTSD and BD benefitted from the following collaborative care components, similarly to patients with more common depression and anxiety: individualized and practical treatment, playing an active role in treatment, and increased access. Our principal finding is one not yet fully explored in current research: CMs met patients' need to feel cared for, which may contribute to engagement and serve therapeutic ends. Feeling cared for emerged holistically from three components that occurred both within and outside therapeutic encounters: (a) interactional dynamics; (b) care management tasks; and (c) "nurturing connections" established with the CMs.

Conclusions: We addressed an understudied aspect of productive provider-patient relationships-patients' need to feel that providers care for them-and identified a range of actions and strategies that produce this feeling. CMs may be uniquely positioned to provide this type of care. For underserved segments of the population, leveraging these uniquely skilled clinical personnel could improve access, engagement, and outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

目的:探讨远程精神病学协同护理模式下,护理管理人员(CMs)对农村创伤后应激障碍(PTSD)和双相情感障碍(BD)患者治疗的贡献。方法:我们对2016年11月至2020年6月期间在阿肯色州、密歇根州和华盛顿州的12家联邦合格医疗中心接受PTSD或BD筛查阳性并参与远程精神病学协作护理的患者进行了24次半结构化访谈,并进行了归纳定性研究。采访于2018年3月至2020年6月期间进行。结果:我们的研究结果证实,PTSD和BD患者受益于以下协同护理组成部分,与更常见的抑郁症和焦虑症患者相似:个性化和实用的治疗,在治疗中发挥积极作用,增加可及性。我们的主要发现是目前研究尚未充分探索的:CMs满足了患者感到被照顾的需求,这可能有助于参与和服务于治疗目的。被照顾的感觉整体上来自于治疗接触内部和外部的三个组成部分:(a)互动动态;(b)护理管理任务;和(c)与CMs建立“培育联系”。结论:我们解决了一个未被充分研究的方面,即富有成效的医患关系——患者需要感觉到医患关心他们——并确定了一系列产生这种感觉的行动和策略。CMs在提供此类护理方面可能具有独特的优势。对于服务不足的人群,利用这些技能独特的临床人员可以改善获取、参与和结果。(PsycInfo Database Record (c) 2025 APA,版权所有)。
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引用次数: 0
The weight of expectations: Overcoming mental health barriers as an Asian American. 期望的重量:作为一个亚裔美国人克服心理健康障碍。
IF 1 4区 医学 Q3 FAMILY STUDIES Pub Date : 2025-03-01 DOI: 10.1037/fsh0000933
Rick Yang

In the world of cultural narratives, Asian Americans find themselves trapped in a juxtaposition of societal perceptions and their own authentic experiences, particularly within the context of mental health. This personal story seeks to reveal the nuanced challenges confronting Asian Americans, with a focus on the insidious implications of the model minority myth. While this stereotype might appear as a commendation, it casts Asian Americans in a monolithic mold of success. The author gains insights into their parents' reluctance to seek help for him, uncovering stories of generational silence and community backlash against those who dare to step outside societal norms for mental health care. This reflection highlights the societal pressures that discourage open discussions about mental health and stigmatize seeking help, acting as significant barriers to care within the Asian American community. The current psychiatric paradigms, rooted in Western ideologies, fail to address the cultural contexts in Asian American communities. This oversight underscores an imperative for mental health modalities that resonate with the cultural ethos of Asian Americans. Through a meticulous examination guided by lived experience of culturally competent care, this article highlights the pivotal role of such culturally-informed mental health interventions, advocating for the deconstruction of detrimental stereotypes and championing the integration of culturally resonant practices in psychotherapy for Asian Americans. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

在文化叙事的世界里,亚裔美国人发现自己被困在社会观念和自己真实经历的并列之中,尤其是在心理健康的背景下。这个个人故事试图揭示亚裔美国人面临的微妙挑战,重点关注模范少数族裔神话的潜在含义。虽然这种刻板印象似乎是一种赞扬,但它将亚裔美国人置于一种单一的成功模式中。作者深入了解了他们的父母不愿为他寻求帮助的原因,揭示了几代人的沉默和社区对那些敢于走出社会规范寻求心理健康护理的人的强烈反对。这一反思凸显了阻碍公开讨论心理健康的社会压力,以及对寻求帮助的污名化,这些压力在亚裔美国人社区中成为治疗的重大障碍。目前的精神病学范式植根于西方意识形态,未能解决亚裔美国人社区的文化背景。这种疏忽强调了与亚裔美国人的文化气质产生共鸣的心理健康模式的必要性。通过对文化能力护理的生活经验进行细致的检查,本文强调了这种文化知情的心理健康干预的关键作用,倡导解构有害的刻板印象,并倡导将文化共鸣实践整合到亚裔美国人的心理治疗中。(PsycInfo Database Record (c) 2025 APA,版权所有)。
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引用次数: 0
What Do We Need Next? Scholarship in Health Systems Leadership and the URiM Experience. 我们下一步需要什么?卫生系统领导奖学金和URiM经验。
IF 1 4区 医学 Q3 FAMILY STUDIES Pub Date : 2025-03-01 DOI: 10.1037/fsh0000977
Stacy Ogbeide

Diversity and health system leadership issues in health care may seem like unilateral topics, but the literature states otherwise. Institutional and organizational leaders have been encouraged to find ways to better support those who are underrepresented in medicine in health care, seek ways to improve retention, and support leadership development across the system. While current research efforts have been successful in getting us where we currently are, we still have more work to do to improve representation in health care and improve leadership practices in health care. The Families, Systems, and Health journal can contribute to the change that is needed to support new research and scholarship endeavors to move the needle to transform who will be on the health care team in the near future. In the meantime, we need to focus on practices that are grounded in quality research and have a strong evidence base to ensure that the work that we do in health care is documented in the scientific literature as we wait for you all to submit new literature to get us ready for the challenges ahead. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

卫生保健中的多样性和卫生系统领导问题似乎是单方面的话题,但文献表明并非如此。机构和组织的领导者被鼓励寻找更好的方法来支持那些在医疗保健中代表性不足的人,寻求方法来提高保留率,并支持整个系统的领导力发展。虽然目前的研究工作已经成功地使我们达到了目前的水平,但我们仍有更多的工作要做,以提高医疗保健的代表性,并改善医疗保健的领导实践。《家庭、系统和健康》杂志可以为支持新的研究和学术努力所需要的改变做出贡献,从而在不久的将来改变卫生保健团队的成员。与此同时,我们需要把重点放在以高质量研究为基础的实践上,并拥有强有力的证据基础,以确保我们在卫生保健方面所做的工作记录在科学文献中,我们等待你们所有人提交新的文献,让我们为未来的挑战做好准备。(PsycInfo Database Record (c) 2025 APA,版权所有)。
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引用次数: 0
Ill parents' mental and physical well-being and their young children's emotional and behavioral difficulties: A cross-sectional study. 患病父母的身心健康及其幼儿的情绪和行为困难:一项横断面研究。
IF 1 4区 医学 Q3 FAMILY STUDIES Pub Date : 2025-03-01 DOI: 10.1037/fsh0000972
Meirav Hen, Isabella Mirochnik, Nawras Nassar, Lidia Izakson, Orna Gotfried Dally, Nattela Schievelman, Uri Yatzkar, Miri Keren

Introduction: The children of ill parents are in a state of vulnerability, facing a range of emotional and behavioral difficulties. This study is a dedicated effort to delve into the relationships between the mental well-being (mental component score [MCS]) and daily physical functioning of ill parents and the internal and external difficulties experienced by their young children. The study also explores the mediating role of family functioning (Family Assessment Device), social support (Multidimensional Scale of Perceived Social Support), and parents' communication of the illness with their young child (parent-child dialogue) as a moderating factor.

Method: The sample included 60 ill parents with either diabetes, cancer, or an affective mental disorder of young children recruited from outpatient clinics in a regional medical center. All parents completed self-report questionnaires.

Results: Findings showed that ill parents' MCS negatively and significantly predicted the presence of the child's internalized and externalized symptoms, and the level of Multidimensional Scale of Perceived Social Support and Family Assessment Device negatively mediated this association. Low levels of parent-child dialogue had a significant negative impact on the association between the ill parent's MCS and the child's internal symptoms.

Discussion: The results underscore the pivotal role of ill parents' mental well-being in the emotional and behavioral difficulties of young children. They highlight the potential influence of family functioning, social support, and parent-child dialogue about the illness on both parents and their young children. Future studies must delve deeper into this topic, considering different parental illnesses, cultures, and family/child characteristics to enhance family support systems and interventions further. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

患病父母的孩子处于一种脆弱的状态,面临着一系列情感和行为上的困难。本研究旨在探讨患病父母的心理健康(心理成分评分[MCS])和日常身体功能与幼儿所经历的内部和外部困难之间的关系。本研究还探讨了家庭功能(家庭评估装置)、社会支持(感知社会支持多维量表)和父母与幼儿的疾病沟通(亲子对话)作为调节因素的中介作用。方法:样本包括从地区医疗中心门诊招募的60名患有糖尿病、癌症或情感性精神障碍的幼儿的患病父母。所有家长都完成了自我报告问卷。结果:研究发现,患病父母的MCS负向且显著地预测了儿童内化和外化症状的存在,而感知社会支持多维量表和家庭评估装置的水平负向地介导了这种关联。低水平的亲子对话对患病父母MCS与儿童内部症状之间的关联有显著的负向影响。讨论:研究结果强调了患病父母的心理健康在幼儿情绪和行为困难中的关键作用。他们强调了家庭功能、社会支持和关于疾病的亲子对话对父母及其幼儿的潜在影响。未来的研究必须深入研究这一主题,考虑不同的父母疾病、文化和家庭/儿童特征,以进一步加强家庭支持系统和干预措施。(PsycInfo Database Record (c) 2025 APA,版权所有)。
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引用次数: 0
Mirror. 镜子。
IF 1.2 4区 医学 Q3 FAMILY STUDIES Pub Date : 2025-03-01 DOI: 10.1037/fsh0000950
Marzia Maliha

In this poem, a doctor describes meeting an anxious 13-year-old daughter in a waiting room. The girl asks how her mother is doing. She sounds wary. Her tired eyes that glance back send the author reeling from their familiarity. The author takes a deep breath and reminds herself of the distance between 13 and 30. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

在这首诗中,一位医生描述了在候诊室遇到一个焦虑的13岁女儿。女孩问她妈妈过得怎么样。她听起来很谨慎。她那双回望过去的疲惫的眼睛使作者从熟悉的眼神中晕头转向。作者深吸一口气,提醒自己13岁到30岁之间的距离。(PsycInfo Database Record (c) 2025 APA,版权所有)。
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引用次数: 0
Much has changed, but much is the same. 很多事情发生了变化,但很多事情还是一样的。
IF 1 4区 医学 Q3 FAMILY STUDIES Pub Date : 2025-03-01 DOI: 10.1037/fsh0000979
Rodger Kessler, C R Macchi

In this editorial, the authors propose the journal Families, Systems & Health adopt a framework focused on the operational and financial policies, processes, and procedures that support robust, sustainable integration efforts. To move the field of behavioral health ahead, they also propose that the field should pursue actuarial research data to evaluate the cost and cost-impact consequences of different models of behavioral interventions in primary care settings. They present their vision for the journal's role and responsibility to the field, journal priorities and focus, and journal structure and administration. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

在这篇社论中,作者建议《家庭、系统与健康》杂志采用一个框架,重点关注支持稳健、可持续整合工作的运营和财务政策、流程和程序。为了推动行为健康领域的发展,他们还建议该领域应该追求精算研究数据,以评估初级保健环境中不同行为干预模式的成本和成本影响后果。他们对期刊在该领域的角色和责任、期刊的优先级和重点、期刊的结构和管理提出了自己的看法。(PsycInfo Database Record (c) 2025 APA,版权所有)。
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引用次数: 0
In Defense of a Policy Based Approach to Health. 捍卫以政策为基础的保健办法。
IF 1 4区 医学 Q3 FAMILY STUDIES Pub Date : 2025-03-01 DOI: 10.1037/fsh0000978
Sarah Hemeida

Health policy plays a critical role in shaping individual and population health outcomes through mechanisms that extend beyond clinical care and into the broader social and structural determinants of health. This commentary examines the definition, scope, and significance of health policy, emphasizing its presence across multiple levels of governance, including federal, state, and local jurisdictions, as well as within health systems themselves. Drawing on established frameworks such as Kingdon's Policy Streams Model and Frieden's Health Impact Pyramid, the article argues that upstream policy interventions have the greatest potential for population-level impact. However, a persistent gap exists between research findings and policy implementation, particularly within academic medicine and health care delivery systems. Clinicians and health services researchers are uniquely positioned to inform and influence policy, yet are often underutilized in this space. The commentary highlights the importance of equipping health care professionals with the tools to translate clinical insights and research findings into actionable policy recommendations. It also underscores the ethical imperative of inclusive, evidence-based policy development, as articulated by Faden and Shebaya, who note that policy reflects a society's values and priorities. Ultimately, the article calls for a more intentional integration of clinical expertise and policy engagement, encouraging health professionals to leverage their real-world experience to advance equitable and effective health policies. Strengthening the bridge between health care delivery and health policy is essential for addressing persistent public health challenges and achieving long-term improvements in population health. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

卫生政策在形成个人和人口健康结果方面发挥着关键作用,其机制不仅限于临床护理,还涉及健康的更广泛的社会和结构决定因素。本评论考察了卫生政策的定义、范围和重要性,强调其存在于多个治理层面,包括联邦、州和地方司法管辖区,以及卫生系统本身。这篇文章借鉴了Kingdon的政策流模型和Frieden的健康影响金字塔等已建立的框架,认为上游政策干预对人口水平的影响具有最大的潜力。然而,研究成果和政策实施之间存在着持续的差距,特别是在学术医学和卫生保健提供系统内。临床医生和卫生服务研究人员在为政策提供信息和影响政策方面具有独特的地位,但在这一领域往往未得到充分利用。该评论强调了为卫生保健专业人员提供工具的重要性,以便将临床见解和研究结果转化为可操作的政策建议。正如法登和谢巴亚所阐述的那样,它还强调了包容性、基于证据的政策制定在道德上的必要性,他们指出,政策反映了一个社会的价值观和优先事项。最后,本文呼吁更有意地将临床专业知识与政策参与结合起来,鼓励卫生专业人员利用其实际经验来推进公平和有效的卫生政策。加强保健服务和卫生政策之间的桥梁,对于应对持续存在的公共卫生挑战和实现人口健康的长期改善至关重要。(PsycInfo Database Record (c) 2025 APA,版权所有)。
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引用次数: 0
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