ISSN:1359-107X    

DOI:10.1111/bjhp.12117

年代:2014

数据来源: WILEY

摘要:

ObjectivesThis study tested ana prioricontextual model of the mediating effects of participation on the predictive relationships of functional impairment, family satisfaction, and pain to quality of life (QoL) following traumatic spinal cord injury (SCI).DesignA longitudinal design was used to study 144 persons following discharge for traumaticSCI. Predictor variables included functional impairment and family satisfaction (at 12 months post‐discharge) and the presence of pain (at 24 months), and mediating variables were two indicators of participation (assessed 48 months post‐discharge). Life satisfaction and self‐rated health status at 60 months post‐discharge were the outcome variables.MethodsA path model tested hypothesized prospective effects of functional impairment, family satisfaction and pain on participation and the subsequent effects of participation on theQoLvariables.ResultsGreater functional impairment and pain were predictive of less participation, and participation significantly predicted both indicators ofQoL. The two participation variables mediated the relationship of functional impairment and pain to life satisfaction over time. Family satisfaction had an indirect effect onQoLthrough its association with social integration.ConclusionsParticipation appears to mediate the prospective influence of functional impairment, family satisfaction, and pain onQoLin the years followingSCI. These findings provide insight into factors that can predictQoLpost‐SCIand support the use of contextual models to understand the temporal influence of disability and psychological variables on participation and subsequentQoL.Statement of contributionWhat is already known on this subject?Life satisfaction and self‐rated health status are important aspects of quality of life following traumatic spinal cord injury.Functional impairment has been inconsistently predictive of these variables over time.Prospective research to date has not examined the mediating effects of participation in predicting quality of life.What does this study add?The results indicate that greater functional impairment and pain are prospectively predictive of lower participation.Greater participation, in turn, is prospectively predictive of greater quality of life.Participation appears to mediate the prospective influence of functional impairment, family satisfaction, and pain to

ISSN:1359-107X    

DOI:10.1111/bjhp.12063

年代:2014

数据来源: WILEY

摘要:

ObjectivesThe objectives of this study were to investigate the importance of commitment strength in the theory of planned behaviour (TPB) and to test whether behaviour change techniques (BCTs) aimed at increasing commitment strength indeed promote switching to arsenic‐safe wells by changing commitment strength.DesignA cluster‐randomized controlled trial with four arms was conducted to compare an information‐only intervention to information plus one, two, or three commitment‐enhancingBCTs.MethodsRandomly selected households (N = 340) ofMonoharganj,Bangladesh, in seven geographically separate areas, whose members were drinking arsenic‐contaminated water at baseline and had access to arsenic‐safe wells, participated in this trial. The areas were randomly allocated to the four intervention arms. Water consumption behaviour, variables of theTPB, commitment strength, and socio‐demographic characteristics were assessed at baseline and at 3‐month follow‐up by structured face‐to‐face interviews. Mediation analysis was used to investigate the mechanisms of behaviour change.ResultsChanges in commitment strength significantly increased the explanatory power of theTPBto predict well‐switching. Commitment‐enhancingBCTs – public self‐commitment, implementation intentions, and reminders – increased the behaviour change effects of information by up to 50%. Mediation analyses confirmed that theBCTs indeed increased well‐switching by increasing commitment strength. Unexpectedly, however, mediation via changes in behavioural intentions was the strongest mechanism of the intervention effects.ConclusionsCommitment is an important construct to consider in water‐ and health‐related behaviour change and may be for other health behaviours as well.BCTs that alter behavioural intentions and commitment strength proved highly effective at enhancing the behaviour change effects of information alone.Statement of contributionWhat is already known on this subject?Millions of people drink contaminated water even if they have access to safe water alternatives and despite increased awareness of the consequences to health. The theory of planned behaviour (TPB) and commitment strength are predictive of safe water consumption. The potentially commitment‐enhancing behaviour change techniques (BCTs) – reminders, implementation intentions, and public self‐commitment – can promote health behaviours, including safe water consumption.What does this study add?Changes in commitment strength significantly added to the prediction of switching to arsenic‐safe wells by theTPB.Information‐plus‐BCTs aimed at increasing commitment strength led to>50% more well‐switching than information alone.Behaviour change effects of theBCTs were mediated by ch

ISSN:1359-107X    

DOI:10.1111/bjhp.12068

年代:2014

数据来源: WILEY

摘要:

BackgroundMany health risks are associated with both genetic and behavioural factors. Concerns have been raised that learning about suchmultifactorialrisks might have detrimental effects on health‐related beliefs, cognitions, and affect. However, experimental evidence is sparse.ObjectiveTo explore the effects of reading an online news article about the discovery of a genetic basis for nicotine addiction.MethodsSmokers (N = 333) were recruited from the psychology subject pools of two major universities. Participants were randomly assigned to read one of three news articles: one describing a genetic basis for nicotine addiction and lung cancer obtained from a national news source, one altered to indicate no genetic basis for nicotine addiction and lung cancer, or one unrelated attention control. Participants then completed an online questionnaire, which assessed smoking‐related cognitions and affect, and beliefs about nicotine addiction, quitting smoking, and whether the harms of tobacco use are delayed.ResultsThere was no statistically significant influence of experimental condition on smoking‐related cognitions/affect (ps > .05, η2  .05, η2 < .002).ConclusionReading an online news article about the presence or absence of a genetic basis for nicotine addiction was not found to change smoking‐related cognitions/affect or beliefs among young adult smokers. Concerns about negative effects of multifactorial risk information on health beliefs may be premature. Nevertheless, to effectively translate basic genomics research into effective public health practice, further research should investigate these issues in different populations, via different communication modalities, and for different health outcomes.Statement of contributionWhat is already known on this subject?Information about the health implications of the interaction between genetics and behaviour is becoming prevalent.Learning about these interactions may reduce perceived risk and intentions to engage in health behaviours.What does this study add?Informing young adult smokers about the genetic basis for nicotine addiction does not affect health beliefs negatively.Responses are not moderated by endorsing the idea of genetic causation or current/

ISSN:1359-107X    

DOI:10.1111/bjhp.12069

年代:2014

数据来源: WILEY

摘要:

ObjectivesPsychosocial factors have previously been linked with survival and mortality in cancer populations. Little evidence is available about the relationship between these factors and outcomes in gynaecologic cancer populations, particularly endometrial cancer, the fourth most common cancer among women. This study examined the relationship between several psychosocial factors prior to surgical resection and risk of all‐cause mortality in women with endometrial cancer.DesignThe study utilized a non‐experimental, longitudinal design.MethodsParticipants were 87 women (Mage = 60.69 years,SDage = 9.12 years) who were diagnosed withT1N0–T3N2 endometrial cancer and subsequently underwent surgery. Participants provided psychosocial data immediately prior to surgery. Survival statuses 4–5 years post‐diagnoses were abstracted via medical record review.Cox regression was employed for the survival analysis.ResultsOf the 87 women in this sample, 21 women died during the 4‐ to 5‐year follow‐up. Adjusting for age, presence of regional disease and medical comorbidity severity (known biomedical prognostic factors), greater use of an active coping style prior to surgery was significantly associated with a lower probability of all‐cause mortality, hazard ratio (HR) = 0.78,p = .04. Life stress, depressive symptoms, use of self‐distraction coping, receipt of emotional support and endometrial cancer quality of life prior to surgery were not significantly associated with all‐cause mortality 4–5 years following diagnosis.ConclusionsGreater use of active coping prior to surgery for suspected endometrial cancer is associated with lower probability of all‐cause mortality 4–5 years post‐surgery. Future research should attempt to replicate these relationships in a larger and more representative sample and examine potential behavioural and neuroendocrine/immune mediators of this relationship.Statement of contributionWhat is already known on this subject?Psychosocial factors have previously been linked with clinical outcomes in a variety of cancer populations. With regards to gynecologic cancer, the majority of the research has been conducted in ovarian cancer and examines the protective role of social support in mortality outcomes.What does this study add?Demonstrates association between active coping during perioperative period and 5 year survival.Demonstrates psychosocial–survival relationshi

ISSN:1359-107X    

DOI:10.1111/bjhp.12070

年代:2014

数据来源: WILEY

摘要:

ObjectivesPost‐partum weight retention (PWR) has been identified as a critical pathway for long‐term overweight and obesity. In recent years, psychological factors have been demonstrated to play a key role in contributing to and maintainingPWR.DesignTherefore, the aim of this study was to explore the relationship between post‐partum psychological distress andPWRat 9 months, after controlling for maternal weight factors, sleep quality, sociocontextual influences, and maternal behaviours.MethodPregnant women (N = 126) completed a series of questionnaires at multiple time points from early pregnancy until 9 months post‐partum.ResultsHierarchical regression indicated that gestational weight gain, shorter duration (6 months or less) of breastfeeding, and post‐partum body dissatisfaction at 3 and 6 months are associated with higherPWRat 9 months; stress, depression, and anxiety had minimal influence.ConclusionInterventions aimed at preventing excessivePWRshould specifically target the prevention of body dissatisfaction and excessive weight gain during pregnancy.Statement of contributionWhat is already known on this subject?Post‐partum weight retention (PWR) is a critical pathway for long‐term overweight and obesity.Causes ofPWRare complex and multifactorial.There is increasing evidence that psychological factors play a key role in predicting highPWR.What does this study add?Post‐partum body dissatisfaction at 3 and 6 months is associated withPWRat 9 months post‐birth.Post‐partum depression, stress and anxiety have less influence onPWRat 9 months.Interventions aimed at preventing excessivePWRshoul

ISSN:1359-107X    

DOI:10.1111/bjhp.12074

年代:2014

数据来源: WILEY

摘要:

ObjectivePalatable food, such as sweets, contains properties that automatically trigger the impulse to consume it even when people have goals or intentions to refrain from consuming such food. We compared the effectiveness of two interventions in reducing the portion size of palatable food that people select for themselves. Specifically, the use of dieting implementation intentions that reduce behaviour towards palatable food via top‐down implementation of a dieting goal was pitted against a stop‐signal training that changes the impulse‐evoking quality of palatable food from bottom‐up.DesignWe compared the two interventions using a 2 × 2 factorial design.MethodsParticipants completed a stop‐signal training in which they learned to withhold a behavioural response upon presentation of tempting sweets (vs. control condition) and formed implementation intentions to diet (vs. control condition). Selected portion size was measured in a sweet‐shop‐like environment (Experiment 1) and through a computerized snack dispenser (Experiment 2).ResultsBoth interventions reduced the amount of sweets selected in the sweet shop environment (Experiment 1) and the snack dispenser (Experiment 2). On average, participants receiving an intervention selected 36% (Experiment 1) and 51% (Experiment 2) fewer sweets than control participants. In both studies, combining the interventions did not lead to additive effects: Employing one of the interventions appears to successfully eliminate instrumental behaviour towards tempting food, making the other intervention redundant.ConclusionsBoth interventions reduce self‐selected portion size, which is considered a major contributor to the current obesity epidemic.Statement of contributionWhat is already known on this subject?Exposure to temptations, such as unhealthy palatable food, often frustrates people's attainment of long‐term health goals. Current approaches to self‐control suggest that this is partly because temptations automatically trigger impulsive or hedonic processes that override the influence of more deliberate processes on behaviour. This perspective has stimulated the development of new interventions – which have so far been studied in isolation – aimed at decreasing the influence of impulsive or hedonic processes to decrease unhealthy eating behaviour.What does this study add?Linking sweets to stop signals and diet‐prime implementation intentions both reduce self‐selected portion size.Combining the interventions does not lead to additive effects.Each intervention reduces self‐selected portion size of sw

ISSN:1359-107X    

DOI:10.1111/bjhp.12075

年代:2014

数据来源: WILEY

摘要:

ObjectivesHigh trait anxiety (HTA) determines depressive symptoms and state anxiety in women with breast cancer (BC) or benign breast disease (BBD). Before implementing screening for psychological counselling in these women, it is important to evaluate whether high state anxiety and depressive symptoms are determined by (the threat of) havingBCor solely byHTA. Therefore, we compared women with a lump in the breast with women with gallstone disease (GD).MethodsWomen diagnosed withBC(n = 152),BBD(n = 205), andGD(n = 128) were included in a prospective longitudinal study. Questionnaires concerning trait anxiety (baseline), state anxiety, and depressive symptoms were completed before diagnosis was known (BCandBBD) or the laparoscopic cholecystectomy and 6 months later.ResultsPre‐diagnosisBCpatients scored higher on state anxiety (p = .001) and depressive symptoms (p < .001) compared withGD. At 6 months, scores on depressive symptoms inBCremained higher thanGD(p = .005). In women withHTA, before being diagnosed withBCorBBD, scores on state anxiety were higher compared withHTAwomen withGD(p < .001,p = .040). State anxiety and depressive symptoms at 6 months were predicted by baseline depressive symptoms in women withBC.ConclusionsThe severity of diagnosis (BC) in combination withHTAdetermined the level of state anxiety and depressive symptoms. Therefore, we recommend identifying women withHTAand offering them a tailor‐made follow‐up protocol during and after the diagnostic process forBBDorBC.Statement of contributionWhat is already known on this subject?Women diagnosed withBCorBBDexperience high levels of anxiety and distress during the diagnostic process. These adverse psychological effects are strengthened by the personality characteristic trait anxiety. Before implementing screening for psychological counselling in women with high trait anixety, it is important to evaluate whether high state anxiety and depressive symptoms are determined by (the threat of) havingBCor solely byHTA.What does this study add?To our knowledge, this is the first study comparing women who are confronted with the possibility of having a life‐threatening disease, that is,BC, with women who were not suspected of having a life‐threatening disease, that is,GD. This study reveals that the severity of diagnosis (BC) in combination withHTAdetermined the level of state anxiety and depressive symptoms. Therefore, we recommend identifying women withHTAand offering them a tailor‐made follow‐up protocol during and after

ISSN:1359-107X    

DOI:10.1111/bjhp.12076

年代:2014

数据来源: WILEY

摘要:

ObjectivesTheNational Health Service (NHS) Stop Smoking Service (SSS) is an extremely cost‐effective method of enabling smoking cessation. However, theSSSis only used by a minority of smokers. Developing interventions to maintain service attendance may help to increase the number of quitters. This study pilots an intervention aimed at maintaining attendance by (1) increasing motivation to attend through a booklet providing evidence of service effectiveness and (2) strengthening the link between motivation to attend and attendance through forming an implementation intention.DesignA factorial randomized controlled trial.MethodsA total of 160 newly enrolled smokers at the SurreyNHS SSSwere recruited and randomly assigned to one of four conditions: (1) standard care (SC), (2)SC + effectiveness booklet, (3)SC + implementation intention, and (4)SC + effectiveness booklet + implementation intention. The outcome measures included attendance at theSSSand the 4‐week quit rate.ResultsThe booklet increased service attendance (OR = 2.93,p < .01, 95%CI = 1.45–5.93; Number Needed to Treat = 3.3) but had no impact on the 4‐week quit rate (OR = 1.55, 95%CI = 0.75–3.21). Forming an implementation intention had no impact on service attendance or the 4‐week quit rate. Attending the service was associated with a higher 4‐week quit rate (ρ = 87.52,p < .001).ConclusionsPresenting information about the effectiveness of the service improved service attendance. A larger trial now needs to evaluate whether this intervention can also increase the quit rate.Statement of contributionWhat is already known on this subject?TheNHSStop Smoking Service is an effective yet underused method of enabling smoking cessation. Low uptake levels may be due to smokers’ misconception that the service will not improve their chances of quitting successfully. Improving smokers’ perceptions of service efficacy may be valuable for maintaining service attendance, and subsequently improving smoking cessation levels in theUnited Kingdom.What does this study add?This pilot randomized controlled trial is the first to target service attendance rather than cessation levels.The results demonstrate that providing evidence of service efficacy in a simple icon array format ca

ISSN:1359-107X    

DOI:10.1111/bjhp.12078

年代:2014

数据来源: WILEY

摘要:

ObjectivesCardiac computed tomography angiography (CCTA) is a commonly used diagnostic test for coronary artery disease. Despite its considerable clinical value, few studies have explored the psychological value ofCCTAfrom the perspective of patients undergoing testing. This study aimed to investigate the patient‐perceived value of diagnosticCCTAtesting, specifically in relation to patients' perceptions of their heart health and health behaviours.DesignThe study used a qualitative methodology incorporating thematic analysis before and after testing.MethodsSemi‐structured interviews were conducted before and after the receipt ofCCTAtest results among 13 non‐acute patients attending a heart clinic inNewZealand for diagnosticCCTA. Data analysis followed a thematic analysis approach applied at each interview time point.ResultsThree themes were identified from the pre‐diagnostic interviews: expectations that testing would facilitate heart‐related understanding; the role ofCCTAas an essential requirement for considering the use of cardiac medication; and awareness of the importance of heart‐healthy behaviours. Post‐diagnostic interview analysis identified four themes: positive psychological responses to cardiac diagnosis; perceived value of viewing scan images; the potential impact of testing on health behaviour intentions; and patients' reflections on the procedure.ConclusionsThese results suggest thatCCTAhas the potential to meet knowledge‐gaining expectations that patients bring to clinic and may increase motivation of health‐protective behaviours. DiagnosticCCTAmay therefore provide an ideal opportunity to address patients' illness understanding and behavioural intentions. The effective utilization of scan images as a supplement to consultation may enhance such practice objectives and warrants further investigation.Statement of contributionWhat is already known on this subject?Cardiac computed tomography angiography (CCTA) is an advanced diagnostic test that is particularly useful for early diagnosis of coronary artery disease.Cardiac computed tomography angiography is able to produce highly detailed images of the formation and build‐up of calcium deposits in coronary vasculature, thus providing a window into an otherwise unseen disease process.AlthoughCCTAis increasingly utilized by clinicians, little is known about its psychological value for cardiac patients undergoing the test.What does this study add?Cardiac computed tomography angiography testing can be a potentially important experience for cardiac patients in understanding their cardiac health.Cardiac computed tomography angiography could provide an opportune time to address patients' health behaviour intentions and treatment beliefs.Effective utilization ofCCTAscan images in consultation may help to enhance cons

ISSN:1359-107X    

DOI:10.1111/bjhp.12080

年代:2014

数据来源: WILEY