摘要:

Statement of contributionWhat is already known?Adapting to chronic illness is a phrase commonly used in health psychology.Common operationalizations include presence or absence of psychopathology, or low negative affect and good functional status.A variety of models are currently used to study adaptation to chronic illness. Each explain some variance in adjustment outcomes.What does this editorial add?An argument for a consistent overarching theory that is specific to the process of adaptation to chronic illness.Adaptation is characterized as a return to equilibrium after critical illness events or stressors.A new working model of adapting to chronic illness.

ISSN:1359-107X    

DOI:10.1111/bjhp.12072

年代:2013

数据来源: WILEY

摘要:

ObjectivesThis study examines the hypothesis that a past history of heart interventions will moderate the relationship between psychosocial factors (stressful life events, social support, perceived stress, having a current partner, having a past diagnosis of depression or anxiety over the past 3 years, time pressure, education level, and the mental health index) and the presence of chest pain in a sample of older women.DesignLongitudinal survey over a 3‐year period.MethodsThe sample was taken from a prospective cohort study of 10,432 women initially aged between 70 and 75 years, who were surveyed in 1996 and then again in 1999. Two groups of women were identified: those reporting to have heart disease but no past history of heart interventions (i.e., coronary artery bypass graft/angioplasty) and those reporting to have heart disease with a past history of heart interventions.ResultsBinary logistic regression analysis was used to show that for the women with self‐reported coronary heart disease but without a past history of heart intervention, feelings of time pressure as well as the number of stressful life events experienced in the 12 months prior to 1996 were independent risk factors for the presence of chest pain, even after accounting for a range of traditional risk factors. In comparison, for the women with self‐reported coronary heart disease who did report a past history of heart interventions, a diagnosis of depression in the previous 3 years was the significant independent risk factor for chest pain even after accounting for traditional risk factors.ConclusionThe results indicate that it is important to consider a history of heart interventions as a moderator of the associations between psychosocial variables and the frequency of chest pain in older women.Statement of contributionWhat is already known on this subject?Psychological factors have been shown to be independent predictors of a range of health outcomes in individuals with coronary heart disease, including the presence of chest pain. Most research has been conducted with men or with small samples of women; however, the evidence does suggest that these relationships exist in women as well as in men.What does this study add?Most studies have looked at overall relationships between psychological variables and health outcomes. The few studies that have looked at moderators have mainly examined gender as a moderator. To our knowledge, this is the first published study to examine a history of heart interventions as a moderator of the relationship between psychological variables and the presence of c

ISSN:1359-107X    

DOI:10.1111/bjhp.12011

年代:2013

数据来源: WILEY

摘要:

ObjectiveThere is a current need for interventions that provide information to stroke survivors in a patient‐centred, interactive, personalized and flexible manner. To this purpose, a standardized but content‐flexible patient education programme based on theInternationalClassification ofFunctioning,Disability andHealth (ICF) was developed. This study evaluated the effect of this programme on perceived self‐efficacy.DesignSingle‐blind, randomized, multi‐centre controlled trial.MethodsStroke patients undergoing neurological rehabilitation were enrolled. Perceived self‐efficacy was measured with theLiverpoolSelf‐EfficacyScale. Secondary outcomes were life satisfaction and self‐perception of the impact of the stroke on life, measured with theWHOQOLand theStrokeImpactScale, respectively. Data obtained at baseline, post‐intervention and 6‐month follow‐up were analysed using multi‐level models of change.ResultsTwo hundred and thirteen patients received either theICF‐based patient education (n = 110) or an attention‐placebo (n = 103) control intervention. Over time, patients' self‐efficacy (p < .01) and participation (p < .01) improved, while emotional functioning (p < .01) deteriorated, although no significant between‐group differences were observed. Explorative analyses showed that gender, loci of control, difficulty in accessing health services after discharge and life satisfaction were significant predictors of self‐efficacy.ConclusionThere was no significant benefit of theICF‐based patient education in comparison with an attention‐placebo control group. Considering the importance of the programme for the further implementation of theICFand the need of developing effective health education interventions for stroke, the methodology used was reviewed and an updated version proposed.Statement of contributionWhat is already known on this subject?Stroke survivors frequently report dissatisfaction about content, delivery and timing of information provision on several aspects of the disease as well as on available support. Although several interventions targeting information provision have been developed in the past years, an optimal format for such interventions has not been established yet. A recent review of health education interventions for stroke survivors encourages therefore the development of new programmes providing information in a patient‐centred, interactive, personalized, flexible and repetitive manner.What does this study add?An innovative, standardized but content flexible patient education based on theICFis evaluated. An implementation possibility of theICFand of anICFCore Set in clinical practice is presented. The usefulness of theICFin providing a valuable framework to

ISSN:1359-107X    

DOI:10.1111/bjhp.12013

年代:2013

数据来源: WILEY

摘要:

PurposeComputerized cognitive behaviour therapy (cCBT) is becoming an increasingly well‐recognized therapeutic option for the treatment of depression. With acknowledged high prevalence of depression within chronic physical ill‐health populations and a need to increase access to psychological therapies,cCBTrepresents a low‐intensity intervention with the potential to have great utility within health care settings.MethodsThis article systematically reviews the evidence for the effectiveness ofcCBTfor the treatment of depression with people who have a chronic physical health problem. A comprehensive search was conducted to identify relevant randomized, controlled trials. Identified studies were quality‐assessed, and data were extracted by two reviewers.ResultsOne study investigatingcCBTfor the treatment of depression in people with diabetes fulfilled inclusion criteria. The trial reported positive outcomes compared to a waiting‐list control condition.ConclusionsThe available literature suggestscCBTprogrammes may be beneficial for populations with a chronic physical illness experiencing depression. This conclusion is based on the findings of a single study, which involved the evaluation of acCBTpackage by its developers, included a short follow‐up and featured specialist health care support. Additionally, the study reported considerable attrition suggesting the intervention might not have been acceptable to many participants. It is likely thatcCBTmay be a way in which to increase access to psychological therapies. However, prior to any definitive conclusions being made, further high‐quality research to establish the acceptability, feasibility, efficacy, and effectiveness ofcCBTfor specific chronic physical health conditions is required.Statement of contributionWhat is already known on this subject?Computerized cognitive behaviour therapy (cCBT) is increasingly being utilized as a low‐intensity treatment for depression within general adult populations following positive randomized, controlled trials of both commercial and free‐to‐use programmes. There is potential application for such programmes in addressing the high prevalence of depression within physically ill populations. However, to date, there has been no attempt to review the literature regarding the application of cCBT to treat depression in people with a chronic physical illness.What does this study add?Fifty‐six studies were identified and screened for inclusion in the present systematic review.One RCT, applying cCBT to a diabetes population, fulfilled inclusion criteria.Development of complex interventions should be guided by a recognized flexi

ISSN:1359-107X    

DOI:10.1111/bjhp.12014

年代:2013

数据来源: WILEY

摘要:

ObjectivesThe aim of the current study is to explore the predictive utility of the temporal self‐regulation theory (TST) for maintaining a healthy lifestyle (Hall&Fong, 2007,Health Psychology Review,1, 6). According toTST, the influence of intention, self‐regulation, and behavioural prepotency differs depending on the environmental context in which the behaviour is performed. This study examined the influence of perceptions about the supportiveness of the environmental context onTST‐related factors.DesignTemporal self‐regulation theory was tested using a prospective design with a 1‐week follow‐up.MethodsOne hundred and fifty‐two undergraduates were administered three executive functioning tasks and an online questionnaire regarding their intentions to maintain a healthy lifestyle, environmental responsiveness, and previous behaviour. One week later, they completed a follow‐up questionnaire.ResultsParticipants who were supported by the environment were significantly more likely to maintain a healthy lifestyle than those distracted by the environment. Behavioural prepotency was significantly predictive of behaviour performance for ‘supported’ participants. Behavioural prepotency, planning, and response inhibition were significantly predictive of ‘unsupported’ participants' behaviour.ConclusionsThese findings provided preliminary support for the use ofTSTfor the prediction of healthy lifestyle behaviour. Importantly, this study provided support for the contention that the influence ofTST‐related factors would vary according to the perceived supportiveness of the environment. These findings suggest that environmental responsiveness may be an important determinant to close the intention–behaviour gap for maintaining a healthy lifestyle.Statement of contributionWhat is already known on this subject?Young adults fail to adhere to behaviours indicative of healthy lifestyle. Self‐regulation and behavioural prepotency add unique variance to the prediction of health behaviour. The influence of these factors is thought to vary according to environmental context.What does this study add?Individuals who feel supported by the environment are more likely to maintain a healthy lifestyle than those who feel distracted by the environment. Behavioural prepotency is predictive of healthy lifestyle for individuals who feel ‘supported’ by the environment. Behavioural prepotency, planning and response inhibition are predictive of healthy lifestyle for individuals who feel

ISSN:1359-107X    

DOI:10.1111/bjhp.12015

年代:2013

数据来源: WILEY

摘要:

ObjectivesThe diagnosis of fibromyalgia is based on self‐report and indirect measures and thus is unavoidably influenced by patients' own understanding of their symptoms. In order to provide appropriate support for people with fibromyalgia, it is important to understand variation in patients' interpretations of their own symptoms.MethodsTwenty people with fibromyalgia participated in email interviews exploring their experiences, history and diagnosis. Respondents answered a series of questions in their own time. Rich accounts were elicited. A hermeneutic phenomenological approach linked two stages of analysis. In the first instance, an in‐depth, inductive analysis was developed around a subset of eight transcripts, using interpretative phenomenological analysis. The outcomes of this work were then used to inform a template analysis, which was applied to the remaining 12 transcripts, in order to extend and check the credibility of the in‐depth analysis.ResultsParticipants describedenduring the course of a‘giant mess’of unpleasant symptoms, some of which were understood to be symptoms of fibromyalgia and some the interactive or parallel effects of comorbid illness. The respondents also demonstrated their considerable efforts atimposing order and sense on complexity and multiplicity, in terms of the instability of their symptoms. They expressedambivalence towards diagnosis, doctors and medication, and we noted that each of the above areas appeared to come together to create a context ofrelational uncertainty, which undermined the security of connections to family, friends, colleagues and the workplace.ConclusionsThree key issues were discussed. First, there was not one overall symptom (e.g., pain) driving the unpleasantness of fibromyalgia; second, participants spent excessive time and energy trying to manage forces outside their control; third, because there is no definitive ‘fibromyalgia experience’, each diagnosis is unique, and our participants often appeared to be struggling to understand the course of their illness. Issues of stigma and legitimacy need to be considered carefully by health professionals in the context of the complex and uncertain experience of patients.Statement of contributionWhat is already known on this subject?Diagnosis of fibromyalgia is based on exclusion of clinical problems combined with symptom report. Diagnosis is therefore uncertain, controversial and personal. Previous studies have suggested that the experience of fibromyalgia is defined by pain, fatigue and cognitive difficulties.What does this study add?There is not one overall symptom, including pain, which drives the unpleasantness of the experience of fibromyalgia. Salient difficulties may be diffuse and changeable. Fibromyalgia is experienced as intrusively embodied and worryingly variable. In the absence of established treatment pathways subjective patient interpretations of their symptom patterns become increasingly personal and complex. This study adopts reasonably novel methodological features, firstly to engage with participants who might find face‐to‐face interviews tiring and inconvenient, and secondly to combine in‐depth, bottom‐up qualitative analyses with more top‐down processes, in order to increase credibility, cohere

ISSN:1359-107X    

DOI:10.1111/bjhp.12020

年代:2013

数据来源: WILEY

摘要:

ObjectivesPrior research has focused on the association between negative affect and eating behaviour, often utilizing laboratory or cross‐sectional study designs. These studies have inherent limitations, and the association between positive affect and eating behaviour remains relatively unexplored. Therefore, the objective of this study was to investigate the bidirectional relationships between daily negative and positive affective experiences and food consumption in a naturalistic setting among healthy young adults.DesignDaily diary study across 21 days (microlongitudinal, correlational design).MethodsA total of 281 young adults with a mean age of 19.9 (±1.2) years completed an Internet‐based daily diary for 21 consecutive days. Each day they reported their negative and positive affect, and their consumption of five specific foods. Hierarchical linear modelling was used to test same‐day associations between daily affect and food consumption, and next‐day (lagged) associations to determine directionality. Moderating effects ofBMIand gender were also examined in exploratory analyses.ResultsAnalyses of same‐day within‐person associations revealed that on days when young adults experienced greater positive affect, they reported eating more servings of fruit (p = .002) and vegetables (p < .001). Results of lagged analysis showed that fruits and vegetables predicted improvements in positive affect the next day, suggesting that healthy foods were driving affective experiences and not vice versa. Meaningful changes in positive affect were observed with the daily consumption of approximately 7–8 servings of fruit or vegetables.ConclusionsEating fruit and vegetables may promote emotional well‐being among healthy young adults.Statement of contributionWhat is already known on this subject?Laboratory and cross‐sectional studies have found a strong link between experiences of negative affect and food consumption. These studies generally show that people eat more food and less healthy food when experiencing negative affect; however, there is less evidence of this association in a natural setting. Moreover, the association between positive affect and eating remains relatively unexplored. Some studies have found stronger links between negative affect and unhealthy food consumption among women and individuals with higherBMI. Conversely, the foods people eat may influence their affective experiences. Cross‐sectional research has shown that a diet high in fruits and vegetables is associated with a lower lifetime prevalence of depression and anxiety, but it is not known whether healthy food consumption may also influence affective experiences on a day‐to‐day basis.What does this study add?Using online daily diaries for three weeks, we found strong relationships between daily positive affect and fruit and vegetable consumption. Lagged analyses showed that fruit and vegetable consumption predicted improvements in positive affect the next day, and not vice versa. Gender andBMIwere not major factors in these associations. Fruit and vegetable consumption may promote feelings of well‐

ISSN:1359-107X    

DOI:10.1111/bjhp.12021

年代:2013

数据来源: WILEY

摘要:

ObjectivesPost‐traumatic stress disorder (PTSD) can be a consequence of acute medical events and has been associated with non‐adherence to medications. We tested whether increased concerns about medications could explain the association betweenPTSDand non‐adherence to medication in stroke survivors.DesignWe surveyed 535 participants aged 40 years or older who had at least one stroke or transient ischaemic attack in the previous 5 years.MethodsWe assessedPTSDusing thePTSDchecklist‐specific for stroke, medication adherence with the Morisky Medication Adherence Questionnaire, and beliefs about medications with the Beliefs about Medicines Questionnaire. We used logistic regression to test whether concerns about medications mediated the association between stroke‐inducedPTSDand non‐adherence to medication. Covariates for adjusted analyses included age, sex, race, comorbid medical conditions, stroke‐related disability, years since last stroke/TIA, and depression.ResultsSymptoms ofPTSDwere correlated with greater concerns about medications (r = 0.45;p < .001), and both were associated with medication non‐adherence. Adjustment for concerns about medications attenuated the relationship betweenPTSDand non‐adherence to medication, from an odds ratio [OR] of 1.04 (95% confidence interval [CI], 1.01–1.06;OR, 1.63 per 1SD) to anORof 1.02 (95%CI, 1.00–1.05;OR, 1.32 per 1SD), and increased concerns about medications remained associated with increased odds of non‐adherence to medication (OR, 1.17; 95%CI, 1.10–1.25;OR, 1.72 per 1SD) in this fully adjusted model. A bootstrap mediation test suggested that the indirect effect was statistically significant and explained 38% of the association ofPTSDto medication non‐adherence, and the direct effect ofPTSDsymptoms on medication non‐adherence was no longer significant.ConclusionIncreased concerns about medications explain a significant proportion of the association betweenPTSDsymptoms and non‐adherence to medication in stroke survivors.Statement of contributionWhat is already known on this subject?Posttraumatic stress disorder (PTSD) is common after cardiovascular events, including stroke and transient ischemic attack.PTSDdue to non‐stroke cardiovascular events is associated with increased risk of cardiovascular disease recurrence and mortality.PTSDdue to stroke is associated with increased risk for medication nonadherence in stroke survivors.What does this study add?WhilePTSDhas been associated with medication nonadherence in stroke survivors and acute coronary syndrome survivors, no mechanism for that association has been tested. This is the first study to provide evidence for a mediator of thePTSD‐nonadherence association, increased concerns about medications, and point to potential interventions

ISSN:1359-107X    

DOI:10.1111/bjhp.12022

年代:2013

数据来源: WILEY

摘要:

ObjectivesSmokers might think that the negative effects of smoking can be compensated for by other behaviours, such as doing exercise or eating healthily. This phenomenon is known as compensatory health beliefs (CHBs). Graphic warning labels on cigarette packets emphasize the negative effects of smoking, which may impactCHBs. Research so far has assessedCHBs explicitly only via questionnaires, although implicit cognition might be an important factor in continuing to smoke. This study investigated the impact of graphic warning labels onCHBs, by testingCHBs both implicitly and explicitly.DesignThe study had a three‐group experimental design.ANOVAs and multiple regression analyses were run on the results.MethodsWe assessed explicitCHBs among non‐smokers, smokers, and smokers confronted with graphic warning labels (N = 107; 47 females, 23.89 years old, 78 daily smokers). Implicit associations between smoking andCHB‐specific behaviours (e.g., eating healthy food) were measured using aSingle‐TargetImplicitAssociationTest. After the experiment, participants were able to choose between a healthy and unhealthy food reward.ResultsNon‐smokers and smokers differed in explicitCHBs but not in implicit cognitions. Warning labels influenced implicit associations among smokers but did not affect explicitCHBs. Most interestingly, implicit associations and explicitCHBs predicted food choice and smoking among smokers not confronted with warning labels.ConclusionsGraphic warning labels could be used in interventions to inhibit automatic associations between smoking and healthy behaviours. Unlearning implicit cognitions might in turn affect explicitCHBs, thus decreasing their role in reducing the negative feelings caused by smoking.Statement of contributionWhat is already known on this subject?Smokers develop compensatory health beliefs as means to reduce cognitive dissonance.CHBs predict behavioural intentions but not actual behaviours.CHBs so far are assessed via questionnaires. The influence of warning labels has not been investigated so far.What does this study add?Warning labels only affected implicit cognitions. Implicit as well as explicitCHBs predicted smoking behaviour as well as actual healthy nutrition behaviour among the smokers c

ISSN:1359-107X    

DOI:10.1111/bjhp.12023

年代:2013

数据来源: WILEY

摘要:

ObjectivesComorbid depression is highly prevalent in patients with chronic obstructive pulmonary disease (COPD) and associated with a worse course of disease; however, the exact mechanisms linking both remain unclear. In currently depressed individuals without lung disease, depression‐specific biases in information processing have been suggested as risk factors for the development and maintenance of depression. We examined whether comparable biases in cognitive information processing might underlie depression inCOPD.DesignDifferent aspects of cognitive information processing were examined with computer‐based tasks measuring selective attention and memory in patients withCOPDwho were compared with age‐matched, currently depressed patients without lung disease and healthy control participants.MethodsThe Self‐Referential Encoding and Incidental Recall Task as well as the emotion face dot‐probe task was applied to 21 never‐depressedCOPDpatients, 18 currently depressedCOPDpatients, 20 currently depressed patients without lung disease and 19 healthy controls to examine cognitive biases.ResultsIn both patients withCOPDwho were never and who were currently depressed, depression‐like cognitive biases were observed for some attention‐ and memory‐related tasks, but not for all tested aspects of information processing. These biases were particularly prominent in patients withCOPDand current depression and comparable to those observed in currently depressed patients without lung disease.ConclusionsThe results of this pilot study suggest that patients withCOPDmay potentially show depression‐like biases in some aspects of cognitive information processing. Future studies are required to examine whether these biases represent a vulnerability factor for the development of depression in patients withCOPD.Statement of contributionWhat is already known on this subject?Depression is a highly prevalent comorbidity in patients withCOPDand associated with a negative course of disease, as well as considerable social and economic burden. Cognitive biases in information processing are important aspects since they have been shown to be risk factors in the onset as well as maintenance of depression.What does this study add?DepressedCOPDand lung healthy depressed patients show comparable cognitive biases. Some cognitive biases are even present inCOPDwithout depression. This could be an explanation for vulnerability t

ISSN:1359-107X    

DOI:10.1111/bjhp.12025

年代:2013

数据来源: WILEY