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Behaviour change, the itchy spot of healthcare quality improvement: How can psychology theory and skills help to scratch the itch? 行为改变,医疗质量提高的盲点:心理学理论和技能如何帮助消除瘙痒?
IF 2.9 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2023-09-21 eCollection Date: 2023-07-01 DOI: 10.1177/20551029231198938
Charlotte Emma Hilton

Despite the clear utility and transferability, National Health Service (NHS) quality improvement initiatives have yet to benefit fully from what is already known within health psychology. Thus far, evidence from established, seminal behaviour change theory and practice have been ignored in favour of newly developed models and frameworks. Further, whilst there is a growing interest in what is commonly referred to as 'human factors' of change and improvement, there is scant transferability of known psychologically informed implementation skills into routine NHS Improvement practice. The science and practice of healthcare improvement is growing, and the behaviour change aspect is critical to sustainable outcomes. Therefore, this paper offers practical guidance on how seminal psychological behaviour change theory and motivational interviewing (a person-centred skills-based approach specifically developed to support people through change) can be combined to better address individual and organisational change within a healthcare improvement context.

尽管有明显的实用性和可转移性,但国家医疗服务体系(NHS)的质量改进举措尚未完全受益于健康心理学中已知的内容。到目前为止,已有的开创性行为改变理论和实践的证据被忽视,取而代之的是新开发的模型和框架。此外,尽管人们对通常被称为“人为因素”的改变和改进越来越感兴趣,但已知的心理知情实施技能很少能转化为常规的NHS改进实践。医疗保健改善的科学和实践正在发展,行为改变方面对可持续结果至关重要。因此,本文就如何将开创性的心理行为改变理论和动机访谈(一种专门为支持人们通过改变而开发的以人为中心的技能为基础的方法)结合起来,在医疗保健改善的背景下更好地应对个人和组织的变化提供了实际指导。
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引用次数: 0
Perceptions and experiences of prenatal mental health: A qualitative study among pregnant women in Ghana. 产前心理健康的认知和经验:加纳孕妇的定性研究。
IF 2.9 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2023-07-01 DOI: 10.1177/20551029231202316
Buruwaa Adomako Agyekum

Prenatal mental health problems can have adverse effects on the health and wellbeing of the mother as well as her baby. However, the factors associated with its etiology, expression, and coping mechanisms in Ghana remain understudied. This qualitative study explored the perceptions and experiences of prenatal mental health problems among 21 pregnant women in Accra through semi-structured interviews. Interpretative Phenomenological Analysis led to three dominant themes; "conceptions of prenatal mental disorders" (sub-themes: awareness and constructions of prenatal mental health problems), "experiences of mental health problems" (sub-themes: symptoms of prenatal mental health problems and causal attributions of prenatal mental health problems) and "coping mechanisms of the pregnancy experience" (subthemes: faith, social support and work). The lack of knowledge of mental health disorders in this study and the expression of contextually relevant and culturally defined constructions and experiences of prenatal mental health problems, highlight the need for the development of culturally suitable interventions within the Ghanaian context.

产前心理健康问题会对母亲和婴儿的健康和幸福产生不利影响。然而,与加纳的病因、表达和应对机制相关的因素仍未得到充分研究。本质性研究通过半结构式访谈,探讨了阿克拉21名孕妇对产前心理健康问题的认知和经历。解释性现象学分析导致了三个主要主题;"产前精神障碍的概念"(分主题:产前精神健康问题的认识和建构)、"精神健康问题的经历"(分主题:产前精神健康问题的症状和产前精神健康问题的因果归因)和"怀孕经历的应对机制"(分主题:信仰、社会支持和工作)。在这项研究中缺乏对精神健康障碍的了解,以及对产前精神健康问题的语境相关和文化定义的结构和经验的表达,突出了在加纳背景下发展文化上适合的干预措施的必要性。
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引用次数: 0
Trait mindfulness and sleep: Interactions between observing and nonreactivity in the association with sleep health. 特质正念与睡眠:观察与非反应与睡眠健康之间的相互作用
IF 2.9 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2023-01-01 DOI: 10.1177/20551029221149282
Elisabeth Bailin Xie, Ivan D Sedov, Hangsel Sanguino, Makayla Freeman, Jeshna Kumari, Lianne Tomfohr-Madsen

The current study investigated the associations between trait mindfulness and sleep health and examined the interactions between theoretically related mindfulness subscales. Participants (n = 162, Mage = 19.93) reported trait levels of mindfulness and sleep was assessed using questionnaires and actigraphy. Higher mindfulness scores in awareness, nonreactivity, and nonjudgment were associated with better sleep health. The associations between observing and sleep health were moderated by nonreactivity. Results indicate that observing is associated with better sleep health at higher levels of nonreactivity and worse sleep health at lower levels, helping to explain the often-contradictory findings between observing and health outcomes.

本研究探讨了特质正念与睡眠健康之间的关系,并考察了理论相关的正念子量表之间的相互作用。参与者(n = 162, Mage = 19.93)报告了正念和睡眠的特征水平,使用问卷调查和活动记录仪进行评估。在意识、非反应性和非判断方面得分较高的正念与更好的睡眠健康有关。观察和睡眠健康之间的联系被无反应性所缓和。结果表明,观察与高水平的非反应性睡眠健康状况较好有关,而低水平的睡眠健康状况较差,这有助于解释观察与健康结果之间经常相互矛盾的发现。
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引用次数: 0
Barriers and facilitators of intuitive eating in postmenopausal women: A qualitative study. 绝经后妇女直觉进食的障碍和促进因素:一项定性研究。
IF 2.9 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2023-01-01 DOI: 10.1177/20551029231157515
Jeanne Vorlet, Isabelle Carrard

This qualitative descriptive research explored barriers and facilitators of the intuitive eating (IE) implementation process, as experienced by six postmenopausal women classified as 'overweight' or 'obese'. The data was analysed using deductive and inductive thematic analysis and six themes were identified. IE implementation included developing scepticism about weight loss diets, dealing with hunger and satiety cues, making nutritious food choices for one's body, struggling with emotional eating, learning to accept one's body and challenging weight stigma and sociocultural norms of beauty and thinness. IE allowed women to develop a more peaceful relationship with their diet, and was accepted as a welcome alternative to dieting.

这项定性描述性研究探讨了直觉饮食(IE)实施过程中的障碍和促进因素,这是6名被归类为“超重”或“肥胖”的绝经后妇女所经历的。数据分析使用演绎和归纳主题分析和六个主题确定。IE的实施包括发展对减肥饮食的怀疑,处理饥饿和饱腹感,为自己的身体选择有营养的食物,与情绪化饮食作斗争,学习接受自己的身体,挑战体重的耻辱和社会文化对美丽和苗条的规范。IE让女性与自己的饮食建立了一种更平和的关系,被认为是节食之外的一种受欢迎的选择。
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引用次数: 1
Finding benefits in a cardiac event: Direct links with positive affect and healthy dietary behaviors during cardiac rehabilitation. 在心脏事件中发现益处:与心脏康复期间的积极影响和健康饮食行为的直接联系。
IF 2.9 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2023-01-01 DOI: 10.1177/20551029231186137
Anahi R Primgaard, Kymberley K Bennett, Elizabeth J Wilson, Kadie M Harry, Kalon R Eways, Marcia A Smith, Dennis S Bergland, Andrew J Smith

Benefit finding (BF) may be a coping strategy that positively influences outcomes after a stressful event, but previous studies provide an inconsistent pattern of results across several different patient populations. This study aimed to reconcile these inconsistencies by testing whether positive affect related to a cardiac event (PA) mediates the relationship between BF and healthy dietary behaviors, and whether this mediating relationship is stronger for participants high in disease severity. Participants were patients with cardiovascular disease in a cardiac rehabilitation program. Results supported partial mediation, but the interaction was not as predicted: participants low in disease severity showed a stronger relationship between BF and PA than their counterparts high in disease severity. Additionally, the PA/healthy dietary behaviors relationship was negative. Health providers may encourage patients in CR to engage in BF, but also to make thoughtful food decisions when in a positive mood, especially for patients low in disease severity.

获益发现(BF)可能是一种应对策略,对压力事件后的结果产生积极影响,但之前的研究在不同的患者群体中提供了不一致的结果模式。本研究旨在通过检验与心脏事件相关的积极影响是否介导BF与健康饮食行为之间的关系,以及这种中介关系是否在疾病严重程度高的参与者中更强,来调和这些不一致性。参与者是参加心脏康复计划的心血管疾病患者。结果支持部分中介作用,但交互作用不像预测的那样:疾病严重程度低的参与者比疾病严重程度高的参与者表现出更强的BF和PA关系。此外,PA与健康饮食行为呈负相关。医疗服务提供者可能会鼓励CR患者参与BF,但也会在积极情绪下做出深思熟虑的食物决定,特别是对于疾病严重程度较低的患者。
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引用次数: 0
Environmental determinants of infectious and chronic disease prevention behaviours: A systematic review and thematic synthesis of qualitative research. 传染病和慢性病预防行为的环境决定因素:定性研究的系统审查和专题综合。
IF 2.9 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2023-01-01 DOI: 10.1177/20551029231179157
Abhinand Thaivalappil, Anit Bhattacharyya, Ian Young, Sydney Gosselin, David L Pearl, Andrew Papadopoulos

Regulatory health policies facilitate desired health behaviours in communities, and among them, smoke-free policies and COVID-19 restrictions have been widely implemented. Qualitative research studies have explored how these measures and other environmental influences shape preventive behaviours. The objective of this systematic review was to synthesize previously published qualitative research, generate across-study themes, and propose recommendations for behaviour change interventions. We used a comprehensive search strategy, relevance screening and confirmation, data extraction, quality assessment, thematic synthesis, and quality-of-evidence assessment. In total, 87 relevant studies were identified. Findings were grouped under six overarching themes and mapped under three categories: (i) the political environment, (ii) the sociocultural environment, and (iii) the physical environment. These findings provide insights into the environmental influences of behaviour and indicate future interventions may be more effective by considering moral norms, community norms, policy support, and group identity.

监管卫生政策促进了社区中理想的卫生行为,其中,无烟政策和COVID-19限制措施已得到广泛实施。定性研究探讨了这些措施和其他环境影响如何影响预防行为。本系统综述的目的是综合先前发表的定性研究,产生跨研究主题,并提出行为改变干预措施的建议。我们使用了综合搜索策略、相关性筛选和确认、数据提取、质量评估、主题综合和证据质量评估。共确定了87项相关研究。调查结果分为六个总体主题,并分为三类:(i)政治环境,(ii)社会文化环境,(iii)自然环境。这些发现为行为对环境的影响提供了见解,并表明通过考虑道德规范、社区规范、政策支持和群体认同,未来的干预可能更有效。
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引用次数: 0
Are social support, loneliness, and social connection differentially associated with happiness across levels of introversion-extraversion? 社会支持、孤独和社会联系与内外倾水平的幸福感有差异吗?
IF 2.9 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2023-01-01 DOI: 10.1177/20551029231184034
Kiffer G Card, Shayna Skakoon-Sparling

This study examines whether extraversion moderates the association between subjective happiness and measures of social connectedness using data from Canadian residents, aged 16+, recruited online during the third wave of the COVID-19 pandemic (21 April 2021-1 June 2021). To accomplish this aim we tested the moderating effect of extraversion scores on the association between Subjective Happiness scores and several social health measures: Perceived Social Support, Loneliness, social network size, and time with friends. Among 949 participants, results show that lower social loneliness (p < .001) and higher social support from friends (p = .001) and from family (p = .007) was more strongly correlated with subjective happiness for people with low extraversion compared to those with high extroversion. Anti-loneliness interventions should consider the need to promote social connections among individuals across the introversion-extraversion continuum.

本研究使用第三波COVID-19大流行期间(2021年4月21日- 2021年6月1日)在线招募的16岁以上加拿大居民的数据,研究外向性是否会调节主观幸福感与社会连通性之间的关联。为了实现这一目标,我们测试了外向性得分对主观幸福得分与几个社会健康指标之间的关联的调节作用:感知社会支持、孤独感、社会网络规模和与朋友在一起的时间。结果表明,与高外向者相比,低外向者较低的社会孤独感(p < 0.001)、较高的朋友和家庭社会支持(p = 0.001)与主观幸福感的相关性更强。反孤独干预应考虑到需要促进个体之间的社会联系跨越内向-外向连续体。
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引用次数: 0
Latent change models of lifestyle in acute coronary syndrome patients: Are lifestyle changes associated with resilience changes? 急性冠脉综合征患者生活方式的潜在变化模型:生活方式的改变是否与恢复力的改变有关?
IF 2.9 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2023-01-01 DOI: 10.1177/20551029231167836
Andrea Greco, Roberta Adorni, Chiara De Matteis, Marco D'Addario, Francesco Fattirolli, Cristina Franzelli, Cristina Giannattasio, Koen Luyckx, Patrizia Steca

This study aimed to examine the role of resilience resources in patients' lifestyle changes after the first Acute Coronary event. 275 Italian patients (84.0% men; mean age = 57.5, SD = 7.9) participated in a longitudinal study. Resilience resources (Self-esteem, Dispositional Optimism, Sense of Coherence - SOC, General and Disease-specific Self-efficacy), and lifestyles (diet, physical activity, and smoking) were assessed twice (at baseline and after 6 months). Path analysis using latent change models was performed to model the combined effect of levels and changes of the resilience resources over lifestyle changes. Patients with strong SOC at baseline were less prone to smoke and more prone to decrease smoking; enhancement in SOC was associated with a smoking decrease. High Disease-specific Self-efficacy at baseline was associated with an improvement in all lifestyles; enhancement in Disease-specific Self-efficacy predicted an increase in physical activity. Findings underline the need to design psychological interventions that promote patients' Disease-specific Self-efficacy and SOC.

本研究旨在探讨恢复力资源在首次急性冠状动脉事件后患者生活方式改变中的作用。275例意大利患者(84.0%男性;平均年龄57.5岁,SD = 7.9)参加了一项纵向研究。恢复力资源(自尊、性格乐观、一致性感- SOC、一般和疾病特异性自我效能)和生活方式(饮食、身体活动和吸烟)分别进行两次评估(基线和6个月后)。利用潜在变化模型进行通径分析,模拟弹性资源水平和变化对生活方式变化的综合影响。基线时SOC较强的患者吸烟倾向较低,更倾向于减少吸烟;SOC的增强与吸烟的减少有关。基线时疾病特异性自我效能高与所有生活方式的改善有关;疾病特异性自我效能的增强预示着身体活动的增加。研究结果强调了设计心理干预以促进患者疾病特异性自我效能感和SOC的必要性。
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引用次数: 0
Do cognition and emotion matter? A study of COVID-19 vaccination decision-making in college students. 认知和情感重要吗?大学生COVID-19疫苗接种决策研究
IF 2.9 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2023-01-01 DOI: 10.1177/20551029231179163
Nien-Tsu Nancy Chen, Kimmy Kee, Bianca T Villalobos, Miriam Ortiz, HyeSun Lee

The unparalleled speed of COVID-19 vaccine development has necessitated an expansion of existing knowledge on vaccination decision-making. The current study explored (1) how cognitions and emotions shaped college students' COVID-19 vaccination decisions, and (2) where vaccination-inclined and vaccination-hesitant students converged and diverged in their decision-making process. Seventy-seven students participated in 26 focus groups to discuss their complex thoughts and feelings regarding COVID-19 vaccination, offering a more nuanced understanding of COVID-19 vaccination decision-making that has not been fully captured by quantitative studies. Thematic analysis found that vaccination-inclined participants and their hesitant counterparts reported differential patterns of positive and negative emotions, systematic appraisals, and heuristics in decision-making. Future research should investigate the roles of hope and relief, non-health-related benefits of vaccination, social trust, and interpersonal influence in vaccination decision-making.

COVID-19疫苗开发的速度无与伦比,因此有必要扩大现有的疫苗接种决策知识。本研究探讨了(1)认知和情绪如何影响大学生的COVID-19疫苗接种决策,(2)倾向于接种疫苗和犹豫接种疫苗的学生在决策过程中的趋同和分化。77名学生参加了26个焦点小组,讨论了他们对COVID-19疫苗接种的复杂想法和感受,对定量研究未能充分捕捉到的COVID-19疫苗接种决策提供了更细致的理解。专题分析发现,倾向于接种疫苗的参与者和犹豫不决的参与者报告了积极和消极情绪、系统评估和决策启发的不同模式。未来的研究应探讨希望和救济、疫苗接种的非健康相关益处、社会信任和人际影响在疫苗接种决策中的作用。
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引用次数: 0
Motives for spousal involvement in a Partner's diabetes management: Considering the role of gender and links to diet-related involvement. 配偶参与伴侣糖尿病管理的动机:考虑性别的作用和与饮食相关的参与的联系。
IF 2.9 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2023-01-01 DOI: 10.1177/20551029221143670
Geneva C Gerwitz, Kristin J August, Charlotte N Markey

Using data from 148 middle-aged and older adult spouses whose partners had type 2 diabetes, we sought to examine spouses' motives for involvement in their partners' diabetes management and whether these motives were related to common types of diabetes-related spousal involvement; we also sought to understand gender differences in these dynamics. Spouses indicated being motivated to be involved in their partners' diabetes management due to altruistic motives to the greatest extent and egoistic motives to the least extent. Results from multivariable regression analyses that controlled for gender, marital quality, and spouses' own conditions requiring dietary changes revealed that all types of motives were related to the frequency of providing diet-related spousal support, whereas only egoistic motives were related to the frequency of exerting diet-related spousal control. We did not find gender differences in any motives nor in associations with spousal involvement. Findings have potential implications for couples-oriented chronic illness interventions.

利用148名伴侣患有2型糖尿病的中老年配偶的数据,我们试图检查配偶参与伴侣糖尿病管理的动机,以及这些动机是否与常见类型的与糖尿病相关的配偶参与有关;我们还试图了解这些动态中的性别差异。配偶表示,参与伴侣糖尿病管理的动机最大程度上是出于利他动机,最小程度上是出于利己动机。控制了性别、婚姻质量和配偶自身需要改变饮食的情况的多变量回归分析结果显示,所有类型的动机都与提供与饮食有关的配偶支持的频率有关,而只有自私动机与实施与饮食有关的配偶控制的频率有关。我们没有发现任何动机上的性别差异,也没有发现与配偶参与有关的性别差异。研究结果对以夫妻为导向的慢性病干预具有潜在的意义。
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引用次数: 0
期刊
Health Psychology Open
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