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1.
Cancer Nurs ; 46(1): 3-13, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-34974507

RESUMO

BACKGROUND: Patients with advanced cancer are increasingly experiencing financial hardship (FH) and associated negative health outcomes. OBJECTIVE: The aims of this study were to describe FH and explore its relationship to quality of life (QOL) in patients with advanced cancer receiving outpatient palliative care (PC). METHODS: Validated questionnaires assessed FH, QOL dimensions, symptom burden, and sociodemographic and clinical characteristics. Descriptive statistics characterized the sample and described FH. Pearson correlation and linear regression assessed relationships between FH and QOL. RESULTS: The average participant (n = 78) age was 56.6 (SD, 12.2) years. Most were female (56.4%), White (50%) or Black (46.2%), and had a range of education, partner statuses, and cancer diagnoses. Median time since cancer diagnosis was 35.5 months (interquartile range, 9-57.3 months). Highest mean symptom burden scores were for pain (2.5 [SD, 1.0]) and fatigue (2.0 [SD, 1.1]), on a 0- to 3-point scale (higher score representing worse symptom burden). The median COST (COmphrehensive Score for financial Toxicity) score was 15.0 (interquartile range, 9.0-23.0). Most (70%) had some (n = 43) or extreme (n = 9) difficulty paying for basic needs. Greater than 28% (n = 21) incurred cancer-related debt. Multivariate models indicated that FH negatively affected role limitations due to physical health ( P = .008), pain ( P = .003), and emotional well-being ( P = .017) QOL dimensions. CONCLUSIONS: Financial hardship, QOL, and symptom burden scores demonstrate need for continued support for and research among patients with advanced cancer. Data support links between FH and important QOL dimensions. Larger, longitudinal studies are needed to understand how FH affects QOL in patients with advanced cancer. IMPLICATIONS FOR PRACTICE: Proactive financial assessment and interventions are needed to support patients with advanced cancer experiencing the cumulative effects of cancer and its treatment.


Assuntos
Neoplasias , Qualidade de Vida , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Qualidade de Vida/psicologia , Cuidados Paliativos , Estresse Financeiro , Projetos Piloto , Pacientes Ambulatoriais , Neoplasias/psicologia , Inquéritos e Questionários , Dor
2.
Psychoneuroendocrinology ; 147: 105958, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36332274

RESUMO

Particular phases of the menstrual cycle may exacerbate affective symptoms for females with a diagnosed mental health disorder. However, there are mixed findings regarding whether affective symptoms change across the menstrual cycle in females without a clinical diagnosis. The window of vulnerability model proposes that natural increases in ovarian hormones in the mid-luteal phase of the menstrual cycle lead to systematic changes in brain networks associated with affective processing. Consequently, the model posits that females may experience stress more intensely and remember negative events more readily in the mid-luteal phase, increasing their risk for higher affective symptoms. Using a 35-day longitudinal study design, we tested the window of vulnerability model in a non-clinical sample. We tracked naturally cycling females' daily stress and three types of affective symptoms: anxious apprehension, anxious arousal, and anhedonic depression. Using multilevel modeling, we simultaneously modeled within- and between-person associations among stress and menstrual phase for each affective symptom. We found increased anhedonic depression in the mid-luteal phase but not anxious apprehension or anxious arousal. Moreover, we detected a positive association between within- and between-person stress and anxious apprehension and anhedonic depression, but not anxious arousal. These associations were not stronger in the mid-luteal phase. Overall, we provide weak evidence for a window of vulnerability for affective symptoms in the mid-luteal phase of the menstrual cycle. Our findings suggest that stress is a better predictor of fluctuations in affective symptoms than the menstrual cycle. Moreover, our findings highlight the importance of measuring multiple negative affective symptoms because they may be differentially related to stress and the menstrual cycle.


Assuntos
Sintomas Afetivos , Fase Luteal , Feminino , Humanos , Estudos Longitudinais , Progesterona , Ciclo Menstrual/psicologia , Estradiol
3.
Psychoneuroendocrinology ; 147: 105953, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36334546

RESUMO

Chronic stress is a known risk factor for the development of major depression (MDD) and is commonly used to induce a depression-like phenotype in rodents. Similar phenotypic effects are also observed in rodents when treated chronically with the stress hormone corticosterone. In this study, we investigated the neuropsychological consequences of chronic corticosterone treatment in male rats using two translational rodent assays of affective bias, the judgement bias task (JBT) and affective bias test (ABT). We also used the reward learning assay (RLA) and sucrose preference test (SPT) to quantify reward-related behaviours. Negative biases in decision-making were observed in the chronic corticosterone-treated group but only when the treatment was given shortly before each behavioural session. The same dose of corticosterone, when given daily after completion of the behavioural session had no effects. Chronic corticosterone treatment did not potentiate negative affective biases in the ABT induced by either an acute pharmacological or stress manipulation but both reward learning and reward sensitivity were blunted. Analysis of the brain tissue from animals receiving chronic corticosterone found reduced hippocampal neurogenesis consistent with previous studies suggesting corticosterone-induced neurotrophic deficits. Taken together, these data suggest chronic corticosterone treatment induces neuropsychological effects related to changes in reward learning, memory and negative biases in decision making, but these decision-making biases depend on whether rewarding outcomes were experienced during the acute effects of the drug. These findings suggest an important interaction between psychological and biological factors resulting in negative biases in decision-making in this model.


Assuntos
Corticosterona , Transtorno Depressivo Maior , Ratos , Masculino , Animais , Corticosterona/farmacologia , Depressão/psicologia , Recompensa , Julgamento
4.
Psychoneuroendocrinology ; 147: 105969, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36335755

RESUMO

Pregnancy and the early postpartum signify a period of high stress. Perinatal stress can include psychological distress (PD), such as anxiety, depression, and stress, as well as neuroendocrine stress, indexed by activation of the hypothalamic-pituitary-adrenal (HPA) axis and the production of the hormone cortisol. Elevated PD and cortisol levels during the perinatal period can have long-term implications for the mother and child. Methodological advances have enabled the sampling of cortisol from hair, to provide a retrospective marker of HPA axis activity over several months. Despite knowing that maternal PD and HPA activity during the perinatal period independently impact health and development, research to date is unclear as to the association between maternal PD and hair cortisol. The present meta-analysis included 29 studies to assess the strength of the relation between maternal PD and hair cortisol levels during pregnancy and the early postpartum period. Several sample and methodological factors were assessed as moderators of this effect. Analyses were conducted using multilevel meta-analysis. Results of the multilevel meta-analysis indicated that the overall effect size between PD and HCC was small but not significant z = 0.039, 95% CI [- 0.001, 0.079]. Moderator analyses indicated that the strength of the association between PD and hair cortisol was moderated by pregnancy status (i.e., effects were stronger in pregnant compared to postpartum samples), timing of HCC and PD measurements (i.e., effects were larger when PD was measured before HCC) and geographic location (i.e., effects were larger in North American studies). The findings advance our understanding of the link between PD and HPA activity during the perinatal period, a time of critical impact to child development.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Angústia Psicológica , Feminino , Criança , Gravidez , Humanos , Hidrocortisona/análise , Sistema Hipotálamo-Hipofisário/química , Sistema Hipófise-Suprarrenal/química , Estudos Retrospectivos , Estresse Psicológico , Cabelo/química , Período Pós-Parto/psicologia , Parto
5.
Addict Behav ; 137: 107538, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36368277

RESUMO

Gambling harms can impact the health and wellbeing of both individuals who gamble and those close to them. While harms occur across a spectrum of gambling risk levels, most research is conducted on people close to those gamblers who have severe problems. This study examined the health and wellbeing of people living with gamblers across the entire spectrum of gambling risk levels, via secondary analysis of the nationally-representative Household Income and Labour Dynamics in Australia Survey (HILDA). The subsample of interest comprised 13,698 respondents without a gambling problem of their own, aged between 15 and 84, and who lived in households where all residents completed the Problem Gambling Severity Index (PGSI). Health and wellbeing were measured via the SF-6D, the SF-36, and subjective wellbeing measures. Compared to those living in non-problem gambling households, participants living in problem-gambling households reported significantly lower mean SF-6D scores, lower scores on the SF-36 mental health domain, and significantly less satisfaction with both their financial situation and with feeling part of their local community. Participants living in moderate-risk gambling households also reported less satisfaction with their financial situation than those in non-problem gambling households. Conclusions: The results indicate that measurable impacts to the health and wellbeing of those living with gamblers occur predominantly at the more severe end of the risk level spectrum, except for financial dissatisfaction, which is also evident in those residing with gamblers categorised as moderate-risk.


Assuntos
Jogo de Azar , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Jogo de Azar/psicologia , Austrália/epidemiologia , Inquéritos e Questionários , Emprego , Satisfação Pessoal
6.
Addict Behav ; 137: 107540, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36371859

RESUMO

Gambling behaviour is likely to be strongly influenced by operant learning principles. Most forms of gambling, and most notably slot machine play, follow a random ratio (RR) schedule of reinforcement that should lead to rapid and extinction-resistant behaviour. In this paper we highlight the caveats that need to be applied when generalising animal models of learning to human behaviour. Studies need to be cognisant of the role of verbal rules and cognitive appraisals of contingency; the ability for participants to self-modify important elements of reward schedules; potential differences between concurrent and longitudinal schedule preferences; and, the role of important human motivations in financial decision-making. In particular, we believe that operant approaches to gambling may need to incorporate a greater focus on FOMO (or the fear of missing out) as a motivational construct that may explain some of the observed patterns of behaviour, including riskier behaviours, on slot games. The implications of these observations for future research and harm minimisation are discussed.


Assuntos
Jogo de Azar , Animais , Humanos , Jogo de Azar/psicologia , Motivação , Recompensa , Reforço Psicológico , Redução do Dano
7.
Med Educ Online ; 28(1): 2149292, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36419226

RESUMO

BACKGROUND: During the COVID-19 pandemic, pre-clerkship medical education, including all physiology classes, was obliged to change to online teaching due to limitations of on-site (face-to-face) classes. However, the effectiveness of online teaching in non-lecture physiology topics during the COVID-19 pandemic has not been thoroughly investigated. METHOD: We conducted a prospective study to evaluate the students' academic achievement and opinions on online teaching during the COVID-19 academic year. Academic achievement of 312 students in the COVID-19 year was compared with that of 299 students in the pre-COVID-19 year. Student opinions regarding social interactions and the preferred learning method were also collected. RESULTS: We found that student academic achievement in the non-lecture physiology topics, assessed by summative scores, was 4.80±0.92 percent higher in the pre-COVID-19 year than in the COVID-19 year (P < 0.01, Cohen's d = 0.42). Students rated that online classes tended to reduce their interactions with peers and teachers; however, students preferred online learning over traditional on-site learning. CONCLUSIONS: This study pointed out that students' academic performance related to the physiology topics taught by online non-lecture methods during the COVID-19 pandemic was lower than their performance when the topics were taught by the traditional (on-site) methods, although students reported that they preferred the online teaching. Hence, we suggest that medical teachers should deliberately plan and utilise a variety of tools and techniques when developing online non-lecture classes to preserve the interactivity of the classes, which might overcome this gap in students' academic performance.


Assuntos
Desempenho Acadêmico , COVID-19 , Educação à Distância , Estudantes de Medicina , Humanos , COVID-19/epidemiologia , Pandemias , Estudos Prospectivos , Educação de Graduação em Medicina , Estudantes de Medicina/psicologia
8.
Med Educ Online ; 28(1): 2151069, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36420940

RESUMO

PURPOSE: Contact-based education, offering meaningful contact with individuals living in recovery with mental illness, reduces stigma. This study evaluated the effectiveness of the National Alliance on Mental Illness Provider Education Program (NAMI PEP) when implemented as a curricular requirement across two cohorts of third-year osteopathic medical students, comparing traditional, passive learning and active, online delivery formats. MATERIALS AND METHODS: Participants were two cohorts of third-year medical students (Cohort 1 n = 186; Cohort 2 n = 139; overall N = 325) who completed questionnaires measuring affect, beliefs, and behaviors toward patients with mental illness at pre-program, 1-week follow-up, and 6-month follow-up. For Cohort 1, the existing community-based NAMI PEP was implemented. For Cohort 2, the program was adapted to an online, active learning format tailored to medical students, and an additional 3-month follow-up assessment was added to better identify intermediate-term effects. RESULTS: The NAMI PEP was associated with longitudinal improvements in target outcomes, with enhanced effects with the adapted curriculum in Cohort 2. At 6-month follow-up, students reported less stigma, fewer stereotyping negative attitudes, and lower anxiety treating patients with mental illness. They also reported increased confidence integrating psychiatry into routine care and increased competence in principles of collaborative mental health treatment. CONCLUSIONS: This study demonstrates the longitudinal effectiveness of the NAMI PEP across two cohorts of medical students, with strengthened effects observed when the program is tailored to contemporary medical education.


Assuntos
Transtornos Mentais , Psiquiatria , Estudantes de Medicina , Humanos , Aprendizagem Baseada em Problemas , Estudantes de Medicina/psicologia , Estigma Social , Transtornos Mentais/terapia , Transtornos Mentais/psicologia , Psiquiatria/educação
9.
J Atten Disord ; 27(1): 38-45, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35927980

RESUMO

OBJECTIVE: Cognitive disengagement syndrome (CDS, previously referred to as "sluggish cognitive tempo") is a set of symptoms defined by excessive mind-wandering, mental confusion, and slowed behaviors separable from ADHD inattention. METHOD: Of the studies examining CDS in relation to psychosocial outcomes, one of the most established correlates of CDS is social withdrawal. However, studies have yet to test mechanisms or moderators of the link between CDS and social withdrawal. RESULTS: As a parallel body of literature exists in developmental psychopathology on predictors and outcomes of social withdrawal, this review merges these literatures to identify themes and advance a conceptual model on mechanisms (e.g., task-unrelated thought, poorer social skills, social anxiety) and moderators (e.g., behavioral inhibition, sex, parenting) of the CDS and social withdrawal link. CONCLUSION: This model provides researchers and clinicians with testable hypotheses to better understand the link between CDS and social withdrawal and to identify treatment targets to improve the social engagement of youth with CDS.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtornos Cognitivos , Adolescente , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Cognição , Transtornos Cognitivos/psicologia , Psicopatologia , Síndrome , Isolamento Social
10.
J Atten Disord ; 27(1): 57-66, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36047471

RESUMO

Almost 30% of ADHD adults do not respond to standard pharmaceuticals. Transcranial direct current stimulation (tDCS) is a method for modulation of cortical excitability. On the other hand, dialectical behavioral therapy (DBT) is a cognitive-behavioral approach that might be utilized for adults with ADHD. The effects of integration of these interventions are only beginning to be explored. In the present work, we used both subjective and objective measures to investigate the effects of tDCS, DBT, and the integration of the two in treating adult ADHD symptoms. A total of 80 adults with ADHD (63 females, 17 males) participated in the study and were grouped into control, DBT, tDCS, and combined groups. Based on the observed results, the combination of DBT and tDCS was significantly effective in improving the mentioned variables compared to administration of each method in isolation. The results are discussed in terms of neurophysiological and psychological aspects of treatment methods.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Terapia do Comportamento Dialético , Estimulação Transcraniana por Corrente Contínua , Adulto , Masculino , Feminino , Humanos , Estimulação Transcraniana por Corrente Contínua/métodos , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Córtex Pré-Frontal/fisiologia
11.
Nicotine Tob Res ; 25(1): 19-27, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35894290

RESUMO

INTRODUCTION: Poly-tobacco use (PTU), or the concomitant use of two or more nicotine and tobacco products, are a growing public health concern. Adults reporting increased psychological distress (PD) experience profound nicotine and tobacco health-related disparities. Sexual minority (SM) adults report more PTU and higher levels of PD than heterosexuals, yet little is known about patterns of nicotine and tobacco use and its relationship to PD in SM populations. AIMS AND METHODS: The purpose of this study was to investigate sexual identity differences in PD and PTU. Data were drawn from the 2016-2018 National Health Interview Survey (N = 83 017), an annual cross-sectional survey of a nationally representative sample of U.S. adults. PD was assessed using the Kessler Psychological Distress Scale (K6). We fit sex-stratified, weighted, adjusted logistic models to compare PTU and PD by sexual identity. RESULTS: PTU was more prevalent in adults with higher K6 scores. Female adults and SM adults had significantly higher K6 scores and were significantly more likely to experience serious PD when compared to their male and heterosexual counterparts. CONCLUSIONS: The current study provides a snapshot of trends in PTU in relation to PD, gender, and sexual identity. Findings suggest higher rates of both PD and PTU in SM adults. Further research examining the mechanisms underlying this disparity is critical to the development of effective intervention and prevention strategies. IMPLICATIONS: Little is known about sex and sexual identity differences in the relations between patterns of tobacco product use and PD. This study is the first to examine the effect of gender and sexual identity on both PD and PTU. SMs reported higher rates of PD and were more likely to be poly-tobacco users. As new ways of engaging nicotine/tobacco continue to proliferate, health risks will endure especially for marginalized populations. An increased understanding of the psychological and social correlates of PTU in SMs is warranted.


Assuntos
Angústia Psicológica , Minorias Sexuais e de Gênero , Adulto , Masculino , Feminino , Humanos , Estudos Transversais , Nicotina , Uso de Tabaco/psicologia
12.
Nicotine Tob Res ; 25(1): 151-158, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35931100

RESUMO

INTRODUCTION: There is increasing recognition that non-daily cigarette smoking is common in early adulthood but less is known about its stability over time, or what influences transitions to heavier or nonsmoking. We examined the stability of non-daily smoking in a sample of young adults, and tested whether social and cognitive factors predicted transitions to other smoking patterns over time. AIMS AND METHODS: Participants were 579 young adults (18-24 years old at enrollment, 52% male) who were non-daily and never-daily cigarette smokers and California residents. Participants completed 13 waves of assessment over 3 years. We used descriptive statistics to evaluate the frequency of consistent abstinence, defined as no cigarette use at two consecutive waves and no cigarette use at any subsequent waves. Cox and logistic regression were used to test predictors of consistent abstinence. RESULTS: We found that 55% of participants smoked intermittently throughout the study, while 43% were consistently abstinent by the end of the study; few transitioned to daily smoking. Stopping smoking was associated with having fewer smoking friends, smoking less in social situations, having lower positive reinforcement expectancies for smoking, and having stronger intent to quit. Post hoc analyses indicated those who stopped smoking tended to report reductions in positive reinforcement expectancies and increased intent to quit in the 6 months before stopping. CONCLUSIONS: Findings suggest a substantial minority of young adult non-daily smokers may stop on their own, but that the majority continue smoking and may require intervention. Interventions for this population should address social motives and reinforcement expectancies. IMPLICATIONS: The majority of young adults who are non-daily cigarette smokers appear to maintain this habit over an extended period and may require intervention. Interventions that focus on reducing expectancies for positive effects of and social motives for cigarette use and on increasing intent to quit smoking may be most effective.


Assuntos
Fumar Cigarros , Sistemas Eletrônicos de Liberação de Nicotina , Abandono do Hábito de Fumar , Produtos do Tabaco , Adulto Jovem , Masculino , Humanos , Adulto , Adolescente , Feminino , Fumar Cigarros/epidemiologia , Abandono do Hábito de Fumar/psicologia , Fumantes/psicologia
13.
Patient Educ Couns ; 106: 163-169, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36333195

RESUMO

OBJECTIVE: To describe the development of a web-based, theory-guided narrative intervention that replaces conventional pre-test genetic counseling for women at elevated breast cancer risk. METHODS: We used an iterative process that was guided by health behavior theory and feedback from multiple stakeholder groups including: 1) content input from genetic experts; 2) study team input; 3) review of video storyboards, video example, study logo, recruitment materials, post-test patient preference counseling survey, and additional study surveys; 4) video series development; and 5) intervention review and finalization of study-related materials. RESULTS: The intervention is patient-centered providing convenience and an opportunity for an individual's preferences for post-test counseling delivery. The intervention's efficacy is being determined in a randomized controlled trial compared to conventional genetic counseling for adherence to recommended guidelines and changes in knowledge, perception of breast cancer risk, breast cancer-specific worry, and satisfaction with counseling. CONCLUSION: If efficacious, the intervention may improve the delivery of the genetic testing and counseling process, inform best practices, and reduce the genetic counseling workforce burden. PRACTICE IMPLICATIONS: The developed intervention has the potential to improve the genetic testing and counseling experience for women at elevated risk for breast cancer, inform best practices, and reduce genetic counseling workforce burden.


Assuntos
Neoplasias da Mama , Feminino , Humanos , Neoplasias da Mama/genética , Neoplasias da Mama/prevenção & controle , Neoplasias da Mama/psicologia , Aconselhamento Genético/psicologia , Testes Genéticos , Inquéritos e Questionários , Internet
14.
J Affect Disord ; 322: 24-30, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36336166

RESUMO

BACKGROUND: Although the sense of alienation is harmful and causes many developmental problems, very few studies have focused on its antecedent variables and when these variables are related to alienation. The purpose of this study was to examine the relationship between resilience and sense of alienation among college students, and the moderating role of baseline respiratory sinus arrhythmia (RSA) in this association. METHOD: Physiological data were collected during a resting condition in the laboratory from 109 college students aged from 17 to 21 years (M = 18.94, SD = 0.92). Questionnaires that captured demographic information, resilience, and sense of alienation, were also completed. RESULTS: Results indicated that resilience was negatively related to the sense of alienation. Moreover, this negative relationship was moderated by baseline RSA such that it was significant only among students with low levels of baseline RSA. CONCLUSION: Our findings revealed that individuals with low resilience tend to have a higher level of alienation if their baseline RSA is relatively low. DISCUSSION: The current study sheds light on the psychological and biological characteristics of these individuals who tend to have higher levels of alienation, which may be useful for intervention program developers and practitioners.


Assuntos
Arritmia Sinusal Respiratória , Humanos , Arritmia Sinusal Respiratória/fisiologia , Emoções , Estudantes/psicologia , Terapia Comportamental
15.
Patient Educ Couns ; 106: 98-106, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36184345

RESUMO

PURPOSE: Does 15-minute consult using Motivational Interviewing (MI) have a positive effect on (1) time until return to work (RTW) and relapse after work resumption for patients who have been work disabled for longer than 3 months, and (2) can psychological variables (i.e., work-related motivation, work-related psychological needs, quality of life and work ability) explain these results? METHODS: 265 patients were included in a pilot randomized controlled trial, parallel and single blind, with an allocation ratio of 1:1 comparing the consult with MI with the consult as usual group (CAU). There was a 12-month follow up on actual RTW and relapse for both groups. The psychological outcomes were work-related motivation (MAWS), work-related psychological needs (BPNSFS), quality of life (EQ5D5L)) and work ability (WAI). Measurement of these indicators took place at baseline, 1 week after the intervention and 3 months after the intervention. RESULTS: Patients in the MI group showed faster RTW and had a lower chance of relapse compared to those in the CAU condition. No significant differences were found between MI and CAU for the psychological outcomes. CONCLUSIONS: Based on our results, there is some evidence that counseling including MI helps work-disabled patients to RTW faster and experience less relapse. However, much remains unknown about the underlying psychological mechanisms explaining this effect. Suggestions are made for the full RCT.


Assuntos
Entrevista Motivacional , Retorno ao Trabalho , Humanos , Retorno ao Trabalho/psicologia , Entrevista Motivacional/métodos , Qualidade de Vida , Método Simples-Cego , Projetos Piloto , Recidiva
16.
BJOG ; 130(1): 59-67, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36209462

RESUMO

OBJECTIVE: To explore the views of women, partners, families, health workers and community leaders of potential investigations to determine the cause(s) of stillbirth, in Malawi, Tanzania and Zambia. DESIGN: Grounded theory. SETTING: Tertiary facilities and community settings in Blantyre, Malawi, Mwanza, Tanzania and Mansa, Zambia. SAMPLE: Purposive and theoretical sampling was used to recruit 124 participants: 33 women, 18 partners, 19 family members, 29 health workers and 25 community leaders, across three countries. METHODS: Semi-structured interviews were conducted using a topic guide for focus. Analysis was completed using constant comparative analysis. Sampling ceased at data saturation. RESULTS: Women wanted to know the cause of stillbirth, but this was tempered by their fear of the implications of this knowledge; in particular, the potential for them to be blamed for the death of their baby. There were also concerns about the potential consequences of denying tradition and culture. Non-invasive investigations were most likely to be accepted on the basis of causing less 'harm' to the baby. Parents' decision-making was influenced by type of investigation, family and cultural influences and financial cost. CONCLUSIONS: Parents want to understand the cause of death, but face emotional, cultural and economic barriers to this. Offering investigations will require these barriers to be addressed, services to be available and a no-blame culture developed to improve outcomes. Community awareness, education and support for parents in making decisions are vital prior to implementing investigations in these settings.


Assuntos
Pais , Natimorto , Gravidez , Feminino , Humanos , Natimorto/psicologia , Teoria Fundamentada , Tanzânia/epidemiologia , Pais/psicologia , Família
17.
J Affect Disord ; 322: 187-193, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-35439468

RESUMO

BACKGROUND: Workplace measures against COVID-19 may prevent the onset of major depressive episode (MDE) in the working population. This 13-month prospective study aimed to investigate the association of the number of workplace measures against COVID-19 and employees' worry about the measures on the onset of MDE during COVID-19 outbreaks in Japan. METHODS: Data were collected from employees by using online questionnaires at baseline (May 2020) and the 7th survey (June 2021). The onset of MDE during the follow-up was retrospectively measured at the 7th survey, with a self-report scale based on the Mini-International Neuropsychiatric Interview according to the DSM-IV/DSM-5 criteria. Participants were asked to report the number of workplace measures against COVID-19 in their companies/organizations and their worry about these measures (scored 0-3). Multiple logistic regression was conducted of MDE on the number of workplace measures and worry about these, adjusting for demographic and work-related covariates and psychological distress at baseline. RESULTS: Among 968 respondents employed in May 2020, 827 completed the 7th survey in June 2021 (80%). We excluded 75 respondents who reported they had an MDE in May 2020 or earlier. Worry about workplace measures was significantly associated with the onset of MDE after adjusting for the covariates (OR for 1 score increase, 1.53; 95% CI, 1.02-2.32; p = 0.042). No significant association was found between the number of workplace measures and the onset of MDE. CONCLUSIONS: Worrying about workplace measures taken by company/organization may be a risk factor for the onset of an MDE among employees during the COVID-19 pandemic.


Assuntos
COVID-19 , Transtorno Depressivo Maior , Humanos , Local de Trabalho/psicologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/etiologia , Estudos Prospectivos , Pandemias , Estudos Retrospectivos
18.
Nicotine Tob Res ; 25(1): 102-110, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35759949

RESUMO

INTRODUCTION: Helping smokers to quit is an important task of general practitioners (GPs). However, achieving tobacco abstinence is difficult, and smokers who fail may still want to improve their health in other ways. Therefore, Swiss GPs developed a multithematic coaching concept that encourages health behavior changes beyond smoking cessation alone. AIMS AND METHODS: To compare the effectiveness of such coaching with state-of-the-art smoking cessation counseling, we conducted a pragmatic cluster-randomized two-arm trial with 56 GPs in German-speaking Switzerland and 149 of their cigarette smoking patients. GPs were instructed in either multithematic health coaching or smoking cessation counseling. After 12 months, we compared their patients' improvements in cigarette consumption, body weight, physical inactivity, alcohol consumption, stress, unhealthy diet, and a health behavior of their own choice, using hierarchical logistic regression models and Fisher's exact and t tests. RESULTS: Over 95% of all participants achieved clinically relevant improvements in at least one health behavior, with no difference between study arms (health coaching vs. smoking cessation counseling: aOR = 1.21, 95% CI = [0.03-50.76]; and aOR = 1.78, 95% CI = [0.51-6.25] after non-responder imputation). Rates of clinically relevant improvements in the individual health behaviors did not differ between study arms either (they were most frequent in physical activity, achieved by 3 out of 4 patients), nor did the extent of the improvements. CONCLUSIONS: Multithematic health coaching and state-of-the art smoking cessation counseling were found to be comparable interventions, both in terms of smoking cessation success and, quite unexpectedly, their effects on other health behaviors. IMPLICATIONS: The findings of our study suggest that in general practice, multithematic health coaching is an effective smoking cessation intervention, and conversely, monothematic smoking cessation counseling also achieves the beneficial effects of a multithematic health behavior intervention. This opens up the possibility for GPs to support their smoking patients in improving their health behavior in additional and more flexible ways.


Assuntos
Medicina Geral , Abandono do Hábito de Fumar , Humanos , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Motivação , Comportamentos Relacionados com a Saúde
19.
Physiol Behav ; 258: 114012, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36341835

RESUMO

OBJECTIVES: This study aimed to determine the effects of high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) on working memory in individuals with high and low aerobic fitness. DESIGN: The protocol adopted a between-subjects crossover design. METHODS: Forty healthy male college students (mean age = 19.59 ± 1.00 years) were assigned to high fitness (n = 20) or low fitness (n = 20) groups based on their estimated maximum oxygen consumption (VO2max) in the 20 m shuttle run test. All participants were instructed to engage in three acute exercise interventions (10 min HIIE, 20 min HIIE, 20 min MICE) and a reading control intervention on separate days in a randomized order. A spatial 2-back task was performed before and after each intervention to assess working memory. RESULTS: Analyses of the 2-back task performance revealed that the working memory of high and low fitness participants benefited from different modalities of acute exercise. Specifically, reaction time in the 2-back task was significantly shorter after 20 min HIIE compared to pre-exercise in high fitness participants, whereas low fitness participants had significantly faster reaction time in the 2-back task after 20 min MICE and 10 min HIIE relative to pre-exercise. CONCLUSIONS: The effects of acute aerobic exercise on working memory are modulated by a combination of exercise modality and aerobic fitness. This finding has important implications for providing experimental evidence that participants choose appropriate exercise to undertake based on their level of aerobic fitness to improve cognitive performance.


Assuntos
Exercício Físico , Memória de Curto Prazo , Masculino , Humanos , Exercício Físico/psicologia , Tempo de Reação , Análise e Desempenho de Tarefas , Estudantes
20.
Physiol Behav ; 258: 114010, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36349660

RESUMO

Sustained operations (SUSOPS) require military personnel to conduct combat and training operations while experiencing physical and cognitive stress and limited sleep. These operations are often conducted in a state of negative energy balance and are associated with degraded cognitive performance and mood. Whether maintaining energy balance can mitigate these declines is unclear. This randomized crossover study assessed the effects of energy balance on cognitive performance, risk-taking propensity, ambulatory vigilance, and mood during a simulated 72-h SUSOPS. METHODS: Ten male Soldiers (mean ± SE; 22.4 ± 1.7 y; body weight 87.3 ± 1.1 kg) completed two, 72-h simulated SUSOPS in random order, separated by 7 days of recovery. Each SUSOPS elicited ∼4500 kcal/d total energy expenditure and restricted sleep to 4 h/night. During SUSOPS, participants consumed either an energy-balanced or restricted diet that induced a 43 ± 3% energy deficit. A cognitive test battery was administered each morning and evening to assess: vigilance, working memory, grammatical reasoning, risk-taking propensity, and mood. Real-time ambulatory vigilance was assessed each morning, evening, and night via a wrist-worn monitoring device. RESULTS: Participants exhibited heightened risk-taking propensity (p = 0.047) with lower self-reported self-control (p = 0.021) and fatigue (p = 0.013) during energy deficit compared to during energy balance. Vigilance accuracy (p < 0.001) and working memory (p = 0.040) performance decreased, and vigilance lapses increased (p < 0.001) during SUSOPS, but did not differ by diet. Percentage of correct responses to ambulatory vigilance stimuli varied during SUSOPS (p = 0.019) independent of diet, with generally poorer performance during the morning and night. Total mood disturbance (p = 0.001), fatigue (p < 0.001), tension (p = 0.003), and confusion (p = 0.036) increased whereas vigor decreased (p < 0.001) during SUSOPS, independent of diet. CONCLUSION: Prolonged physical activity combined with sleep restriction is associated with impaired vigilance, memory, and mood state. Under such conditions, maintaining energy balance prevents increased risk-taking and improves self-control, but does not improve other aspects of cognitive function or mood. Given the small sample in the present study, replication in a larger cohort is warranted.


Assuntos
Militares , Humanos , Masculino , Militares/psicologia , Estudos Cross-Over , Afeto/fisiologia , Cognição/fisiologia , Fadiga/psicologia , Metabolismo Energético , Assunção de Riscos , Privação do Sono
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