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Archives of Women's Mental Health - The COVID-19 pandemic and related public health restrictions have impacted the mental health and coping strategies of many population groups, including...  相似文献   
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Symptoms of post-traumatic stress disorder (PTSS) and chronic pain have been shown to co-occur at high rates in adolescents and this co-occurrence is linked to worse pain and quality of life. Sleep disturbance has been posited as a mechanism underlying this co-occurrence in conceptual models of mutual maintenance. This study examined the mediating role of sleep in the relationship between PTSS and pain in youth (aged 10–17 years) with chronic pain. Ninety-seven participants completed measures of PTSS, pain (intensity and interference), anxiety symptoms, and sleep quality, in addition to demographic characteristics. Mediation models were conducted. Findings revealed that, over and above the influence of associated demographic characteristics (age, race) and anxiety symptoms, sleep quality partially mediated the relationships between PTSS and pain intensity and interference for youth with chronic pain. Specifically, higher levels of PTSS was linked to higher levels of pain intensity and pain interference, and these relationships were partially explained by poor sleep quality. Findings highlight the potential mechanistic role of sleep in explaining the co-occurrence of chronic pain and PTSS and suggest sleep might be an important target in future interventions.

Perspective

Consistent with the pediatric model of mutual maintenance in PTSS and chronic pain, poor sleep quality was found to underlie this co-occurrence in youth.  相似文献   
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Insomnia and disturbed sleep are common during pregnancy. This study investigated the effectiveness of group cognitive-behavioral therapy for insomnia (CBT-I) delivered in pregnancy. Thirteen pregnant women with insomnia participated in five weekly CBT-I group sessions. All participants completed the study and provided baseline and follow-up data. Significant reductions in insomnia symptoms and increases in subjective sleep quality were observed over the course of the study. Diary and actigraphy assessments of sleep also changed, such that participants reported less time in bed (TIB), shorter sleep onset latency (SOL), increased sleep efficiency (SE), and increased subjective total sleep time (TST). Additionally, symptoms of depression, pregnancy-specific anxiety, and fatigue all decreased over the course of treatment. Effect sizes ranged from medium to large. CBT-I delivered during pregnancy was associated with significant improvements in sleep and mood. The next step in this area of inquiry is to better establish effectiveness via a randomized controlled trial.  相似文献   
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Objectives

Cardiac rehabilitation (CR) is an effective treatment for cardiovascular disease, yet many referred patients do not participate. Motivational interviewing could be beneficial in this context, but efficacy with prospective CR patients has not been examined. This study investigated the impact of motivational interviewing on intention to participate in CR.

Methods

Individuals recovering from acute coronary syndrome (n?=?96) were randomized to motivational interviewing or usual care, following CR referral but before CR enrollment. The primary outcome was intention to attend CR. Secondary outcomes included CR beliefs, barriers, self-efficacy, illness perception, social support, intervention acceptability, and CR participation.

Results

Compared to those in usual care, patients who received the motivational intervention reported higher intention to attend CR (p?=?.001), viewed CR as more necessary (p?=?.036), had fewer concerns about exercise (p?=?.011), and attended more exercise sessions (p?=?.008). There was an indirect effect of the intervention on CR enrollment (b?=?0.45, 95% CI 0.04–1.18) and CR adherence (b?=?2.59, 95% CI 0.95–5.03) via higher levels of intention. Overall, patients reported high intention to attend CR (M?=?6.20/7.00, SD?=?1.67), most (85%) enrolled, and they attended an average of 65% of scheduled CR sessions.

Conclusion

A single collaborative conversation about CR can increase both intention to attend CR and actual program adherence.

Practice Implications

The findings will inform future efforts to optimize behavioral interventions to enhance CR participation.  相似文献   
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