Health psychology

健康心理学
  • 文章类型: Journal Article
    我们评估了躯体和认知/情感抑郁症状簇与单核细胞激活(可溶性CD14,sCD163)的关联,全身性炎症(白细胞介素-6(IL-6),高敏C反应蛋白(hsCRP),和凝血(D-二聚体,纤维蛋白原)在患有抑郁症的HIV(PWH)患者中进行抑制性抗逆转录病毒治疗。利用随机对照试验的基线数据,我们在检测个体抑郁症状簇的线性回归模型中没有发现显著关联;然而,同时检查两个簇的模型表明,体细胞簇与炎症生物标志物呈正相关,而认知/情感簇与炎症和凝血生物标志物呈负相关(提示协同抑制作用).我们的研究结果表明,HIV患者的抑郁症状簇和心血管疾病(CVD)的生物学机制存在差异。这可能是由每个抑郁症状集群的独特成分驱动的。这项研究可以确定患有抑郁症的PWH亚组在CVD风险升高时需要早期CVD预防方法。由R01HL126557支持。
    We assess associations of somatic and cognitive/affective depressive symptom clusters with monocyte activation (soluble (s)CD14, sCD163), systemic inflammation (interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP)), and coagulation (D-dimer, fibrinogen) in people with HIV (PWH) on suppressive antiretroviral therapy with depression. Utilizing baseline data from a randomized controlled trial, we found no significant associations in linear regression models examining individual depressive symptom clusters; however, models examining both clusters simultaneously showed that the somatic cluster was positively associated with inflammation biomarkers, while the cognitive/affective cluster was negatively associated with inflammation and coagulation biomarkers (suggesting a cooperative suppression effect). Our findings indicate a differential association with depressive symptom clusters and biological mechanisms underlying cardiovascular disease (CVD) in HIV, which may be driven by unique components of each depressive symptom cluster. This line of research could identify subgroups of PWH with depression at elevated CVD risk needing early CVD prevention approaches. Supported by R01 HL126557.
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  • 文章类型: Journal Article
    在布里斯班的一家三级医院的多学科睡眠障碍服务中开发了“直接针对心理失眠”途径,澳大利亚。该项目通过实施科学原理和方法来重新设计护理模型(MoC)。与12名多学科工作人员一起,使用名义组技术(NGT)进行了共识小组研讨会,以开发新的MoC。研讨会探讨了直接心理学途径的纳入和排除标准,包括患者流量和推动者。团队认可了利益相关者可以接受的MoC,并解决了服务水平的要求。研究结果强调,患者的纳入或排除应由睡眠医师团队和具有行为睡眠医学专业知识的高级心理学家进行监督。考虑了通过初级保健提供者转诊的患者的连续护理。确定了MoC变化的障碍和风险,为MoC的改进提供了依据。
    A \'Direct to Psychology Insomnia\' pathway was developed for implementation within a multidisciplinary sleep disorders service in a tertiary hospital in Brisbane, Australia. The project was informed by implementation science principles and methodology to re-design the model of care (MoC). A consensus group workshop using the Nominal Group Technique (NGT) with 12 multidisciplinary staff was undertaken to develop the new MoC. The workshop explored inclusion and exclusion criteria for a Direct to Psychology pathway including patient flow and enablers. The team endorsed a MoC that was acceptable to stakeholders and addressed service-level imperatives. The findings highlighted that patient inclusion or exclusion should be overseen by the Sleep Physician team and an Advanced Psychologist with behavioural sleep medicine expertise. Continuum of care for patients referred via primary care providers was considered. Barriers and risks to the MoC changes were identified which informed the refinement of the MoC.
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  • 文章类型: Journal Article
    目的:口腔卫生相关自我效能感(OHSE)描述了一个人成功执行口腔卫生行为的信心。这项研究的目的是调查初始牙周治疗(IPT)和支持性牙周治疗(SPT)期间OHSE的长期病程及其与临床参数的关系。
    方法:诊断为牙周炎的患者,接受IPT或SPT,在两个时间点进行评估。临床检查包括口袋探查深度(PPD),临床附着丧失(CAL),探查出血(BOP),菌斑指数(PI)和牙龈指数(GI)。用问卷评估患者的OHSE。统计分析包括t检验和线性回归模型。
    结果:最初的201名患者中的98名患者在4年后进行了评估。IPT组OHSE总分显著增加(平均11.65±15.6,p=.001)。OHSE类别“齿间清洁”的增加与需要治疗的口袋数量减少(Spearman相关性rs=-.2349,p=.022)和牙周发炎表面积(PISA)(rs=-.2099,p=.042)显着相关。
    结论:与SPT患者相比,IPT患者的OHSE显著增加。改善OHSE,特别是在齿间清洁中,似乎与牙周治疗的持续成功有关。
    OBJECTIVE: Oral hygiene-related self-efficacy (OHSE) describes one\'s confidence to successfully execute oral hygiene behaviour. The aim of this study was to investigate the long-term course of OHSE in patients during initial periodontal therapy (IPT) and supportive periodontal therapy (SPT) and its association with clinical parameters.
    METHODS: Patients diagnosed with periodontitis, undergoing either IPT or SPT, were evaluated at two timepoints. Clinical examination included pocket probing depths (PPDs), clinical attachment loss (CAL), bleeding on probing (BOP), plaque index (PI) and gingival index (GI). Patients\' OHSE was assessed with a questionnaire. Statistical analyses included t-tests and linear regression models.
    RESULTS: Ninety-eight patients from an initial group of 201 patients were evaluated after 4 years. The overall OHSE score increased significantly in the IPT group (mean 11.65 ± 15.6, p = .001). The increase in the OHSE category \'interdental cleaning\' was significantly correlated with a decrease in the number of pockets requiring treatment (Spearman correlation rs = -.2349, p = .022) and periodontal inflamed surface area (PISA) (rs = -.2099, p = .042).
    CONCLUSIONS: Patients under IPT showed a significant increase of OHSE compared to those under SPT. Improved OHSE, particularly in interdental cleaning, appears to be associated with sustained success of periodontal therapy.
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  • 文章类型: Journal Article
    我们研究了身体活动的心理测量特性,营养,和技术(PANT)调查,由研究人员开发,用于跟踪青少年的体重管理行为。对2,039名中学生(M年龄=12.4,SD=0.5;51.4%的女孩)的数据进行了分析,以探索并确认PANT调查的因素结构。我们还检查了PANT调查之间的双变量关联,体重指数(BMI),和渐进式有氧心肺耐力运行(PACER)。结果表明,PANT调查由两个因素组成-身体活动和健康选择-每个因素都具有足够的内部一致性(分别为α=0.79和0.86)。身体活动分量表似乎在预期方向上与z-BMI(r=-0.10,p<.001)和PACER(r=0.33,p<.001)显着相关,但是健康选择子量表的标准有效性不太清楚。我们讨论了这些发现,并探索了为青年开发有意义的自我报告健康行为量表的未来方向。
    We examined the psychometric properties of the Physical Activity, Nutrition, and Technology (PANT) survey, developed by researchers to track weight management behaviors among youth. Data from 2,039 middle school students (M age = 12.4, SD = .5; 51.4% girls) were analyzed to explore and then confirm the factor structure of the PANT survey. We also examined the bivariate associations between the PANT survey, body mass index (BMI), and the Progressive Aerobic Cardiorespiratory Endurance Run (PACER). Results suggest that the PANT survey is comprised of two factors-Physical Activity and Healthy Choices-each with adequate internal consistency (α = .79 and 0.86, respectively). The Physical Activity subscale appears to be significantly associated with both z-BMI (r = -0.10, p < .001) and the PACER (r = 0.33, p < .001) in the anticipated directions, but the criterion validity of the Healthy Choices subscale is less clear. We discuss these findings and explore future directions for developing meaningful self-report wellness behavior scales for youth.
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  • 文章类型: Journal Article
    背景:筛查不良的童年经历(ACE)和妊娠恢复能力是减轻ACE相关健康并发症的有希望的做法。然而,对于ACEs高和/或心理弹性低的妊娠患者的最佳随访尚未确定.
    目的:本研究评估了对患有ACE和/或低弹性的妊娠患者进行嵌入式健康心理学家(EHP)干预的转诊和参与情况。
    方法:纳入3个KaiserPermanente北加州医疗中心患有ACE的患者,这些患者在标准产前护理期间也接受了韧性筛查,并参与了EHP干预(N=910)。作者使用多变量逻辑回归来检查ACE(0,1-2,3+)和弹性(高与低)是否与EHP干预的转诊和参与相关。他们还通过临床医生(N=53)和患者(N=51)调查评估了EHP干预的影响。
    结果:ACEs为3+vs0的患者更有可能接受EHP转诊(调整比值比[aOR]=2.89,95%置信区间[CI]:1.93-4.33),并且更有可能参与EHP干预(aOR=2.85,95%CI:1.87-4.36)。低弹性与高弹性者也更有可能接受EHP转诊(aOR=1.86,95%CI:1.32-2.62)并参与EHP(aOR=1.71,95%CI:1.19-2.44)。当ACE和弹性结合在一起时,高ACE和低复原力的患者转诊和参与的可能性最大.患者和临床医生报告了EHP干预的积极经验。
    结论:具有较高ACE和较低韧性评分的患者更有可能被转诊并参与EHP干预。这表明,在产科护理中,有风险的患者可以成功地与健康心理学家联系起来。
    BACKGROUND: Screening for adverse childhood experiences (ACEs) and resilience in pregnancy is a promising practice for mitigating ACEs-related health complications. Yet, the best follow-up for pregnant patients with high ACEs and/or low resilience has not been established.
    OBJECTIVE: This study evaluates referrals to and participation in an embedded health psychologist (EHP) intervention for pregnant patients with ACEs and/or low resilience.
    METHODS: Patients in 3 Kaiser Permanente Northern California medical centers with ACEs who had also received resilience screening during standard prenatal care and who were participating in an EHP intervention were included (N = 910). The authors used multivariable logistic regression to examine whether ACEs (0, 1-2, 3+) and resilience (high vs low) were associated with referrals to and participation in EHP intervention. They also evaluated the impact of EHP intervention through clinician (N = 53) and patient (N = 51) surveys.
    RESULTS: Patients with 3+ vs 0 ACEs were more likely to receive an EHP referral (adjusted odds ratio [aOR] = 2.89, 95% confidence interval [CI]: 1.93-4.33) and were more likely to participate in EHP intervention (aOR = 2.85, 95% CI: 1.87-4.36). Those with low vs high resilience were also more likely to receive an EHP referral (aOR = 1.86, 95% CI: 1.32-2.62) and participate in EHP (aOR = 1.71, 95% CI: 1.19-2.44). When ACEs and resilience were combined, those with high ACEs and low resilience had the greatest odds of referrals and participation. Patients and clinicians reported positive experiences with EHP intervention.
    CONCLUSIONS: Patients with higher ACEs and lower resilience scores were more likely to be referred to and participate in EHP intervention, suggesting that at-risk patients can be successfully linked with a health psychologist when accessible within obstetric care.
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  • 文章类型: Journal Article
    有物质使用问题的人表现出较低的执行控制和前额叶大脑系统的改变,从而支持情绪调节和冲动控制。另一篇文献表明,炎症加剧也会增加物质使用的风险,在某种程度上,通过瞄准参与执行控制的大脑系统。物质使用中神经和炎症信号的研究,然而,同时发生。借鉴最近的神经免疫网络模型,我们使用功能磁共振成像来检查与执行控制相关的大脑活动之间的关系(由n-back工作记忆任务引起),外周炎症,通过炎性细胞因子和C反应蛋白(CRP)定量,93名参与者过去一个月的药物使用情况[平均年龄=24.4(SD=0.6)]。我们在n-back任务中将低执行控制作为神经效率低下来实现规范性能,这反映在较高的工作记忆相关的大脑活动和较低的活动在默认模式网络(DMN)。与预测一致,低执行控制和高炎症的个体在过去一个月报告了更多的物质使用,控制n-back的行为表现,性别,评估之间的时间,身体质量指数(BMI),和个人社会经济地位(SES)(炎症和工作记忆相关的大脑活动之间的相互作用,b=0.210,p=0.005;炎症和DMN之间的相互作用,b=-0.219,p<0.001)。研究结果表明,低执行控制和高炎症可能与较高的物质使用有关。这对理解心理学有影响,神经,以及物质使用问题的免疫风险,以及针对这些组成部分的干预措施的发展。
    Individuals with substance use problems show lower executive control and alterations in prefrontal brain systems supporting emotion regulation and impulse control. A separate literature suggests that heightened inflammation also increases risk for substance use, in part, through targeting brain systems involved in executive control. Research on neural and inflammatory signaling in substance use, however, has occurred in parallel. Drawing on recent neuroimmune network models, we used fMRI to examine the relationships between executive control-related brain activity (as elicited by an n-back working memory task), peripheral inflammation, as quantified by inflammatory cytokines and C-reactive protein (CRP), and substance use for the past month in 93 participants [mean age = 24.4 (SD = 0.6)]. We operationalized low executive control as a neural inefficiency during the n-back task to achieve normative performance, as reflected in higher working memory-related brain activity and lower activity in the default mode network (DMN). Consistent with prediction, individuals with low executive control and high inflammation reported more substance use over the past month, controlling for behavioral performance on the n-back, sex, time between assessments, body-mass-index (BMI), and personal socioeconomic status (SES) (interaction between inflammation and working memory-related brain activity, b = 0.210, p = 0.005; interaction between inflammation and DMN, b = -0.219, p < 0.001). Findings suggest that low executive control and high inflammation may be associated with higher substance use. This has implications for understanding psychological, neural, and immunological risk for substance use problems and the development of interventions to target each of these components.
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  • 文章类型: Journal Article
    开放科学实践是提高透明度的组成部分,再现性,以及健康心理学和行为医学研究的可及性。推动开放科学实践在期刊编辑政策中变得越来越明显。包括建立新的纸质格式,如注册报告和数据说明。本文提供:(i)概述了健康心理学和行为医学中开放科学政策的现状,(ii)呼吁在《健康心理学与行为医学杂志》中以新的论文格式提交注册报告和数据注释的文章集,(iii)注册报告和数据注释概述,以及(Iv)注册报告和数据说明的作者和审阅者的实际考虑。
    Open Science practices are integral to increasing transparency, reproducibility, and accessibility of research in health psychology and behavioral medicine. Drives to facilitate Open Science practices are becoming increasingly evident in journal editorial policies, including the establishment of new paper formats such as Registered Reports and Data Notes. This paper provides: (i) an overview of the current state of Open Science policies within health psychology and behavioral medicine, (ii) a call for submissions to an Article Collection of Registered Reports and Data Notes as new paper formats within the journal of Health Psychology & Behavioral Medicine, (iii) an overview of Registered Reports and Data Notes, and (iv) practical considerations for authors and reviewers of Registered Reports and Data Notes.
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  • 文章类型: Journal Article
    以前的文献集中在任何一个单独的监督模型上,培养学员的跨专业能力,或在培训之外发展和维护专业关系。对于医疗环境中的心理学家来说,这些概念密不可分,监督必须结合这些专业实践,以成功满足心理学学员的需求,病人,和跨专业的同事,在日益一体化的医疗保健环境中。本文提出了一种模型,用于在健康心理学受训者通过临床能力的发展阶段进步时,提高跨专业协作实践能力。在监督心理学家的同时,也保持着专业间的关系。心理学的跨专业合作监督模型(IPCSM)描述了受训者,病人,以及监督心理学家在监督中要考虑的跨专业团队因素,以及各种干预措施部署时,这些相互关联的动态影响培训。提供了案例示例,并讨论了如何在监督中实现此模型。
    Previous literature has focused on either individual models of supervision, developing trainees\' interprofessional competencies, or on developing and maintaining interprofessional relationships outside of training. For psychologists in medical settings, these concepts are inextricably linked, and supervision must combine these professional practices to successfully meet the needs of psychology trainees, patients, and interprofessional colleagues, in an increasingly integrated healthcare landscape. This paper presents a model for advancing interprofessional collaborative practice competencies in supervision as health psychology trainees progress through the developmental stages of clinical competency, while supervising psychologists also maintain interprofessional relationships. The Interprofessional Collaboration Supervision Model (IPCSM)for Psychology describes trainee, patient, and interprofessional team factors for supervising psychologists to consider in supervision, as well as various interventions to deploy when these interrelated dynamics impact training. Case examples are provided along with discussion on how to implement this model in supervision.
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  • 文章类型: Journal Article
    在加拿大,五分之一的人患有慢性疼痛,一种经常与其他慢性疾病同时发生的疾病。和大多数慢性病一样,成功参与症状管理是关键.在多种疾病的背景下,自我管理涉及症状和状况的日常优先排序和决策,这可能是具有挑战性的。慢性病的自我管理可能需要更复杂的能力和任务来解决每种疾病的不同影响。
    我们的研究目标是探索患有慢性疼痛和其他慢性疾病的成年人自我管理症状优先排序的类型和过程。
    这项研究是作为一项较大研究的一部分进行的,该研究采用了解释性的顺序混合方法设计。这项研究更具体地集中在研究的定性部分。
    为定性部分招募的参与者在蒙特利尔大学中心医院在线或面对面地参加了半结构化的个人访谈。
    总共,25名参与者接受了采访,包括18名女性和7名男性。
    要参与研究的定性部分,参与者从较大的研究中选出,如果他们年龄在18岁或以上,并且疼痛时间超过3个月,并且至少有一种其他慢性疾病正在接受治疗或参与症状管理,则他们符合研究条件.半结构化访谈是亲自或虚拟进行的,并逐字记录。反思主题分析用于探索患者的叙述,并采用了开放和迭代的方法来编码访谈和生成主题。
    第一个主题,专注于症状优先排序,显示了不同的优先级过程,包括优先考虑显性疾病,优先考虑多种疾病,以避免不良后果,最后是缺少或自动进行优先级排序的过程。在第二个主题中,我们确定了疾病的几个特征,在这种情况下,慢性疼痛使其成为自我管理的优先事项:无法控制和致残的性质,无所不在,不可预测性,不愉快,和对他人的隐形。在最后一个主题中,我们强调,一些社会心理因素影响了自我管理和优先过程的参与程度,包括社会支持和医患关系。
    慢性疼痛是参与者在自我管理任务中最常优先考虑的医疗状况。由于其特点,对日常功能产生负面影响的是医疗条件。
    UNASSIGNED: In Canada, one out of five people lives with chronic pain, a condition frequently co-occurring with other chronic illnesses. As with most chronic illnesses, successful engagement in symptom management is key. In the context of multiple illnesses, self-management involves daily prioritization of symptoms and conditions and decision-making, which can be challenging. Self-management of chronic illnesses can require more complex competence and tasks to address the different implications of each condition.
    UNASSIGNED: Our research objective was to explore types and processes of self-management symptom prioritization among adults living with chronic pain and other chronic illnesses.
    UNASSIGNED: This research was carried out as part of a larger study that adopted an explanatory sequential mixed-methods design. This study focused more specifically on the qualitative part of the study.
    UNASSIGNED: Participants recruited for the qualitative component took part in a semi-structured individual interview online or in-person at the center hospitalier de l\'Université de Montréal.
    UNASSIGNED: In total, 25 participants were interviewed, including 18 women and 7 men.
    UNASSIGNED: To participate in the qualitative part of the study, participants were selected from the larger study and were eligible if they were 18 years old or older and experiencing pain for more than 3 months and had at least one other chronic illness for which they were receiving treatment or engaged in symptom management. Semi-structured interviews were conducted in-person or virtually and were transcribed verbatim. Reflexive thematic analysis was used to explore patients\' narratives, and an open and iterative approach was adopted to code interviews and generate themes.
    UNASSIGNED: The first theme, focus on symptom prioritization, showed different prioritization processes, including prioritizing a dominant illness, prioritizing multiple illnesses to avoid undesirable consequences, and finally absence of or automatic processes of prioritization. In the second theme, we identified several characteristics of an illness, in this case chronic pain that made it a self-management priority: uncontrollable and disabling nature, omnipresence, unpredictability, unpleasantness, and invisibility to others. In the last theme, we highlighted that some psychosocial factors influenced levels of engagement in self-management and prioritization processes, including social support and the patient-physician relationship.
    UNASSIGNED: Chronic pain was the medical condition most often prioritized by participants in their self-management tasks. Because of its characteristics, it was the medical condition that had the most negative impact on day-to-day functioning.
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  • 文章类型: Journal Article
    这项混合方法研究使用在线横断面调查来探索533名患有子宫内膜异位症疼痛的成年澳大利亚女性的观点,以及它们与生物心理社会因素的关系。构建了四个主题:主要主题,“耻辱和变化”反映了女性被解雇的经历,并希望像往常一样扭转疼痛的叙述。一些妇女强调自我教育和自我倡导以影响变化,反映“自我授权”的主题。参与者描述了子宫内膜异位症的“衰弱影响”和“医疗保健不足”的持久困难,反映主题三和四。分析表明,社会支持的类型可能会影响子宫内膜异位症的感知结果。分层回归分析表明,生物心理社会因素与主题之间的显着关系太少,无法指示有意义的模式,而没有共同方法差异的风险。未来的研究应该探索社会支持和干预措施的影响,这些措施可以发展参与者的自主性和从业者的能力和知识,随着时间的推移使用特定疾病的措施。
    This mixed-methods study used an online cross-sectional survey to explore perspectives of 533 adult Australian women living with endometriosis pain, and their relationship with biopsychosocial factors. Four themes were constructed: The primary theme, \'Stigma and change\' reflected women\'s experience of dismissal, and the wish to reverse the narrative of pain as normal. Some women emphasised self-education and self-advocacy to affect change, reflecting the theme \'self-empowerment\'. Participants described the \'debilitating impact\' of endometriosis and the enduring difficulty of \'inadequate healthcare\', reflecting themes three and four. Analysis indicated type of social support may impact perceived outcomes for endometriosis. Hierarchical regression analyses indicated too few significant relationships between biopsychosocial factors and themes to indicate meaningful patterns without risk of common method variance. Future research should explore the influence of social support and interventions which develop participant autonomy and practitioner competence and knowledge, using disease-specific measures over time.
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