Relationship of health locus of control with specific health behaviours and global health appraisal: a meta-analysis and effects of moderators

Health locus of control (HLOC) refers to beliefs regarding how one’s health is influenced by oneself, others, or fate. This meta-analysis investigated whether three HLOC dimensions (internality/I-HLOC, powerful others/P-HLOC, chance/C-HLOC) were related to both specific health behaviours and global health appraisal, and whether these relationships were moderated by gender and age compositions, individualism, and power distance. Three-level mixed-effects meta-analysis was performed on studies examining the associations of HLOC with specific health behaviour (k?=?76, N?=?76,580, 57% women, M_age?=?43.75) and global health appraisal (k?=?95, N?=?12,068, 57% women, M_age?=?45.44), respectively. For specific health behaviour, the averaged correlations with the HLOC dimensions were generally weak (r’s?=??.07 to .10). However, the links between P-HLOC and exercise were moderated by all four demographic moderators, and gender composition and individualism moderated the association between the HLOC dimensions and diet. For global health appraisal, all of the averaged correlations were statistically significant (r’s?=??.16 to .21), except that between P-HLOC and mental quality of life. The results further showed individualism and power distance to moderate the links between the HLOC dimensions and both mental and physical quality of life, and gender composition to moderate those between these dimensions and two indicators of emotional problems (depression and anxiety).     

Blood tests: One too many? Evaluating blood requesting guidance developed for acute patients admitted to trauma and orthopaedic units

In a recently published report from the Academy of Medical Royal Colleges, around 20% of clinical practice which encompasses blood science investigations is considered wasteful. Blood tests including liver function tests (LFTs), C-reactive protein (CRP), coagulation screens, and international normalising ratios (INR) are frequently requested for patients who undergo emergency hospital admission. The paucity of guidance available for blood requesting in acute trauma and orthopaedic admissions can lead to inappropriate requesting practices and over investigation.Acute admissions over a period of one month were audited retrospectively for the frequency and clinical indications of requests for LFTs, coagulation screens/INR, and CRP. The total number of blood tests requested for the duration of the patient's admission was recorded. Initial auditing of 216 admissions in January 2014 demonstrated a striking amount of over-investigation. Clinical guidelines were developed with multidisciplinary expert input and implemented within the department. Re-audit of 233 admissions was carried out in September 2014.Total no. of LFTs requested: January 895, September 336 (−62.5%); coagulation screens/INR requested: January 307, September 210 (−31.6%); CRPs requested: January 894, September 317 (−64.5%). No. of blood requests per patient: January (M = 4.81, SD 4.75), September (M = 3.60, SD = 4.70). Approximate combined total cost of LFT, coagulation/INR, CRP in January £2674.14 and September £1236.19 (−£1437.95, −53.77%).A large decrease was observed in admission requesting and subsequent monitoring (p < 0.01) following the implementation. This both significantly reduced cost and venepuncture rates.     

心内科护士对冠心病健康教育效果评价认识的质性研究

目的了解心内科护士对冠心病健康教育效果评价的认识及体验。方法对11所三级甲等医院的23位心内科护士及护士长进行深度访谈，并运用现象学资料分析法分析访谈资料。结果23例受访者均认为有必要且已经实施了冠心病健康教育效果评价，并提出应构建冠心病健康教育效果评价量表的建议：构建冠心病健康教育效果评价量表，增加护理人员数量。结论我国应借鉴国外经验，选择合理的效果评价指标和评价实施者，以构建简单、适用、科学的冠心病健康教育效果评价量表，为健康教育效果评价提供量化依据。     

社工介入在社区老年人卫生服务中的作用研究

目的：研究社工与社区卫生服务机构结合的模式在社区老年人医疗卫生服务中所起的作用。方法在2012年10月～2014年3月之间选取本市5个社区的180位年龄在65岁及以上的老年人为调查对象进行老年人健康状况和社区老年人卫生服务满意度的问卷调查。结果社区老年人的健康状况总体不佳。对社区老年人卫生服务的满意度调查显示他们对健康监测类最满意，其次是临床治疗类，最后是健康指导类。满意度总体上处于中等水平，社工的作用在一些社区卫生服务项目上作用比较显著，而在另一些项目上则还比较差。结论社工与社区卫生服务机构结合的模式在社区老年人卫生服务方面所起的作用还是比较明显的，基本上可以满足老年人的需求，值得继续改进和完善，从而在将来的老龄化社会中发挥更大的作用。     

Effectiveness of Community Intervention in Improving Bone Health Behaviors in Older Adults

An 8-week, bone-health community program addressed risks/lifestyle changes within the Health Belief Model and Theory of Reasoned Action frameworks in a randomized format (treatment group n = 35; control group n = 34). Median week 1 values for calcium (control, 963 mg; treatment, 1023 mg) and vitamin D (81 IU both groups) were below recommendations, increasing throughout the program for both control (1023 mg calcium, 128 IU vitamin D) and treatment (1005 mg calcium, 122 IU vitamin D) groups. There was limited response to the exercise outcome variables, with many not participating in that section of the program. Psychosocial variables were positive for both control and treatment groups at week 1, with no significant difference at postintervention. Regression analysis indicated that those with a positive attitude about calcium intake and belief that they could choose calcium-fortified foods were more likely to have higher calcium intake. Intention to exercise was modified by peer and family support. Community-based programs can translate and use clinical trial key topics and outcomes, but participation bias makes impact results difficult to interpret the effectiveness of the program.     

Vivencias y percepción de los profesionales sanitarios de las urgencias extrahospitalarias ante las agresiones

ObjetivoConocer las opiniones de los profesionales sanitarios que trabajan en el Punto de Atención Continuada de Ourense (PAC) con relación a las agresiones laborales.DiseñoEstudio cualitativo con enfoque fenomenológico realizado entre enero y mayo del 2019.EmplazamientoPAC.ParticipantesVeinte profesionales de distintas categorías.MédodoMuestreo estructural. Se emplearon entrevistas abiertas grabadas en audio, previo consentimiento de los participantes.ResultadosLos profesionales entrevistados manifiestas haber sido víctimas de agresiones, sobre todo verbales. Estas agresiones según los participantes son tan habituales que las han normalizado dentro de su jornada laboral. Ninguno ha denunciado nunca este tipo de conductas, en gran medida porque consideran que la burocracia y los trámites administrativos son tediosos, y otros por desconocimiento del procedimiento. Este tipo de situaciones, a nivel laboral, les causa sentimientos de tristeza, rabia e impotencia y son la causa, según ellos, del aumento de la medicina defensiva. Los profesionales consideran que la causa del aumento de las agresiones entre el colectivo es la mala educación y la gestión inadecuada del empoderamiento del paciente.ConclusionesLos profesionales sanitarios sufren continuamente agresiones, sobre todo de tipo verbal, siendo algo habitual en su día a día. Estas agresiones no son denunciadas, pero les causan múltiples sentimientos negativos y disruptivos, llegando a modificar su manera de trabajar.Palabras clave: Violencia laboral, Personal de salud, Agresión, Violencia     

Online counseling: An exploratory survey of Italian psychologists’ attitudes towards new ways of interaction†

Objective: Online counseling may be defined as an interaction between users and mental health professionals that takes place through computer mediated communication technology. This study aimed to investigate the attitudes of Italian psychologists towards different aspects of online counseling provided via email, chat, forums, and videoconference. Method: An online questionnaire was administered to a sample of 289 licensed psychologists in the Veneto Region (Italy) in order to collect opinions, preferences, and intentions to use online modalities, along with prior knowledge and practice experiences. Results: Only 18.3% of the respondents had previous experience with online counseling. Overall, the majority of psychologists (62.6%) were favorable towards online counseling, but they also had several reservations about the provision of online diagnosis and therapeutic interventions. Results showed a consistent lack of clarity regarding ethical and penal issues concerning online modalities. Conclusions: More efforts must be directed to deepening the application of new technologies in the field of psychology in order to enable an ethical and professional practice of online counseling in Italy.