骨密度异常中老年女性健康信念、自我效能与预防保健行为的相关分析

目的：调查骨密度异常中老年女性健康信念、自我效能与预防保健行为的现状及相关性。方法采用骨质疏松健康信念量表、自我效能量表( OSES)和预防保健行为量表对218例骨密度异常的中老年女性进行调查。结果该组人群健康信念中易感性和严重性维度分值偏低。 OSES总分为(69.87±14.76)分,运动和钙摄入效能维度得分分别是(64.07±13.32)和(75.08±15.13)分。预防保健行为总分为(10.68±2.98)分,体育锻炼、营养行为和与OP相关的生活习惯得分分别为(3.07±2.12)、(4.18±2.08)和(3.43±3.07)分,总得分指标为29.07%。 Pearsonˊs相关分析显示：健康信念总分、易感性、严重性、健康动机、自我效能与预防保健行为总分及各维度呈正相关( P<0.05或P<0.01);运动及钙摄入益处分别与体育锻炼、营养行为呈正相关( P<0.01);运动及钙摄入障碍分别与体育锻炼、营养行为呈负相关( P<0.05)。结论本组人群健康信念、自我效能水平中等,预防保健行为欠佳。护士应全面提升其健康信念及自我效能水平,促进预防保健行为的形成。     

桂西多民族地区脑卒中患者生活质量与自我效能水平的关系

目的 了解首发脑卒中患者生活质量与自我效能的关系,为实现两者的相互促进提供参考依据.方法 采用脑卒中影响量表(SIS)和慢性病自我效能量表对164例首发脑卒中患者进行调查,并分析其影响因素.结果 首发脑卒中患者生活质量总分为(143.77±27.33)分,自我效能平均得分为(6.81±2.34)分,患者的生活质量与自我效能水平多维度上呈显著相关,患者家庭经济状况、民族、自我效能、是否伴偏瘫、睡眠情况、医疗费用支付方式、康复训练为生活质量的主要影响因素.结论 临床工作中,应高度重视患者的康复训练和护理,全面了解患者的家庭经济状况和思想状况,以多种形式帮助患者争取最大的社会支持.同时,加强乡村医疗护理服务建设,提高服务能力,缩短患者住院天数,节省医疗费用,减轻经济负担,以最大限度提高患者的生活质量.     

Psychometric assessment of the Temptations to Try Alcohol Scale

Effective interventions require an understanding of the behaviors and cognitions that facilitate positive change as well as the development of psychometrically sound measures. This paper reports on the psychometric properties of the Temptations to Try Alcohol Scale (TTAS), including factorial invariance across different subgroups. Data were collected from 3565 6th grade RI middle school students. Structural equation modeling was used to determine the appropriate factorial invariance model for the 9-item TTAS. The measure consists of three correlated subscales: Social Pressure, Social Anxiety, and Opportunity. Three levels of invariance, ranging from the least to the most restrictive, were examined: Configural Invariance, which constrains only the factor structure and zero loadings; Pattern Identity Invariance, which requires factor loadings to be equal across the groups; and Strong Factorial Invariance, which requires factor loadings and error variances to be constrained. Separate analyses evaluated the invariance across two levels of gender (males vs. females), race (white vs. black) ethnicity (Hispanic vs. Non-Hispanic) and school size (small, meaning <200 6th graders, or large). The highest level of invariance, Strong Factorial Invariance, provided a good fit to the model for gender (CFI: .95), race (CFI: .94), ethnicity (CFI: .94), and school size (CFI: .97). Coefficient Alpha was .90 for Social Pressure, .81 for Social Anxiety, and .82 for Opportunity. These results provide strong empirical support for the psychometric structure and construct validity of the TTAS in middle school students.     

自我效能对糖尿病视网膜病变患者定期眼底检查的影响

目的 探讨自我效能增强干预对糖尿病视网膜病变定期眼底检查的影响.方法 将100例糖尿病视网膜病变患者,随机分成对照组和观察组各50例.对照组按传统的糖尿病视网膜病变治疗和护理,观察组在对照组的基础上实施自我效能增强干预,采用糖尿病自我效能量表(DSES)在干预前及干预1年后进行自我效能评价,比较分析两组患者自我效能、定期眼底检查及早期眼底激光治疗的差异.结果 自我效能增强干预后观察组患者自我效能为(114.45±11.31),50例定期眼底检查,38例早期行眼底激光治疗;对照组患者自我效能为(92.44±14.21),12例定期眼底检查及早期眼底激光治疗;两组比较差异有显著性(P＜0.05).结论 对糖尿病视网膜病变患者实施自我效能干预,能提高患者的自我管理及定期眼底检查依从性,早发现,及时行眼底激光治疗,延缓疾病的发展.     

Role of quit supporters and other factors associated with smoking abstinence in adolescent smokers: a prospective study on Quitline users in the Republic of Korea

The aim of this study elucidated the effectiveness of Quitline among adolescent smokers, as well as other factors associated with adolescent smoking cessation in the Republic of Korea. For 642 adolescent Quitline users aged 13-19 years, the information on demographic characteristics, smoking and cessation related factors, and cessation outcome was collected. Cox proportional hazard models were applied. 13.4% of boys and 6.6% of girls maintained smoking cessation for 1 year. Having a high level of self-efficacy had a preventive effect on relapse in both genders. Boys with parents or other family members as quit supporters, and boys with a higher number of past cessation attempts, were more likely to relapse. It was even more pronounced among boys who reported low self-efficacy. Relapse was increased with marginal significance among girls with parents or other family members as quit supporters. It is evident that Quitline is an effective way to encourage adolescent smoking cessation in Korea. Reinforcing self-efficacy and enhancing the cooperative behaviors of parents or other family member quit supporters could be additional contributors for maintaining cessation among adolescent smokers who want to quit.     

晚期癌症患者疼痛自我管理干预的研究进展

疼痛是晚期癌症患者最常见和最难忍受的症状之一。自我管理干预对于晚期癌症患者的疼痛及其相关症状管理具有非常重要的意义。本文通过对自我管理的概念、理论基础的阐述和癌痛自我管理干预应用效果的研究,指出癌痛患者自我管理干预研究设计应更加关注个体化的需求和健康结局的改善,并以期为其在癌痛控制中的应用提供参考依据。     

A course for nurses to handle difficult communication situations. A randomized controlled trial of impact on self-efficacy and performance

Objective

To evaluate the impact of a communication skills course for nurses on how to handle difficult communication situations in their daily work.

Methods

A 7-h course was developed using a construct of “Awareness, Feelings, Listen, Solve” (AFLS). A pedagogy of experiential, learner-centered learning was adopted. The course evaluation used a randomized controlled design with pre- and post-measures of self-efficacy and performance.

Results

Forty-one nurses volunteered and thirty-three nurses completed all assigned parts of the study. On self-assessment, there was significant improvement for self-efficacy (F = 24.43, p < 0.001), but not for emotional awareness. On performance, there was no significant improvement between intervention and control groups (F = 3.46, p = 0.073).

Conclusion

A short course for nurses on handling difficult communication situations achieved significant improvements in self-efficacy but not in performance.

Practice implications

Teaching communication skills in community-based settings is important for the safety and effectiveness of patient care. Sponsoring organizations should weigh trade-offs between feasibility and achievement of measurable improvements in performance. One possible approach is to focus on specific communication skills rather than a full suite of skills.     

Associations between pain control self-efficacy, self-efficacy for communicating with physicians, and subsequent pain severity among cancer patients

Objective

Coaching patients to be more active in health encounters may improve communication with physicians but does not necessarily improve health outcomes. We explored this discrepancy by examining relationships between self-efficacy for communicating with physicians and pain control self-efficacy and subsequent pain severity among cancer patients participating in a coaching trial.

Methods

We analyzed data from 244 English-speaking adults with various cancer types reporting significant pain, recruited from 49 oncology physicians’ offices. Mixed model linear regression examined relationships between post-intervention communication self-efficacy and pain control self-efficacy and subsequent pain severity over 12 weeks.

Results

Post-intervention pain control self-efficacy (but not communication self-efficacy) was significantly related to subsequent pain severity: a one standard deviation increase was associated with a 0.19 point decrease (95% confidence interval = −0.33, −0.04; p = 0.01) in pain severity over time, approximately 25% of the effect size of the influence of post-intervention pain on subsequent pain.

Conclusion

Among cancer patients enrolled in a coaching trial, post-intervention pain control self-efficacy, but not communication self-efficacy, was significantly related to subsequent pain severity.

Practice implications

Identifying behavioral mediators of cancer pain severity may lead to coaching interventions that are more effective in improving cancer pain control.     

Self-Efficacy and Self-Care: Missing Ingredients in Health and Healthcare among Adults with Serious Mental Illnesses

To help inform the design of a self-management intervention for improving the physical health of adults with serious mental illnesses, we conducted focus groups about their perceived medical care and physical health needs. Adults with serious mental illnesses participated in four semi-structured focus groups conducted at a transitional living facility, a social club, and a Hispanic outpatient mental health clinic. Questions included their recent experiences of seeking medical care, the effect of having a mental illnesses diagnosis, strategies for active self-care, and perceived barriers to better physical health. In addition to various systemic barriers to better medical care, participants articulated limited knowledge and self-efficacy regarding active self-management of their physical health. Despite their interest in learning more about health promotion, most participants expressed a sense of personal futility and powerlessness in improving their health. These data suggest that any effort to improve the wellbeing of these adults will need to address self-efficacy in the hope of improving self-care for their physical health needs.

乳腺癌患者自我效能感培养与焦虑抑郁研究

目的分析培养乳腺癌患者的自我效能感对其焦虑抑郁心理的影响。方法对37例女性乳腺癌患者进行自我效能感培养,并分别在患者入院初期、手术后2周使用汉密顿焦虑量表（HAMA）及汉密顿抑郁量表（HAMD）评估患者的焦虑抑郁症状。结果入院初期乳腺癌患者焦虑、抑郁评分分别为20．04±5．09、22．36±5．51,进行自我效能感培养后焦虑、抑郁评分为13．66±5．02、16．53±5．03,经配对t检验,有显著差异（P〈0．05）。结论对乳腺癌患者进行自我效能感培养,可有效改善乳腺癌患者的焦虑抑郁心理。