时限性自我调节理论:健康行为研究的一种新取向

时限性自我调节理论是在“意图-行为”模型基础上,强调时间、行为优势和自我调节能力对健康行为共同影响的新理论.该理论认为一致性观念和时限性效价影响行为意图,行为优势和自我调节能力调节“意图-行为”联系的强度或直接影响行为.与其他健康行为模型的主要区别在于加入了影响行为的自我调节能力和时间因素.未来研究应进一步明确针对健康行为的干预措施,给予行为优势合理的定位.     

精准医疗的理念及其技术体系

精准医疗模式本着患者的最大获益和社会医疗投入的高效配置为宗旨,结合现代流行病学和预防医学、临床诊断学和治疗学、分子医学、医学信息学技术以及卫生经济学和医学社会学,使传统的医疗模式走向整合化,为每一个人提供量体裁衣般的疾病预防、筛查、诊断、治疗和康复计划,以最小资源投入获取最大健康保障,从而提高整体人群的健康水平。     

The Future of Psychology in Academic Health Care Centers

A promising opportunity exists to continue psychology's move beyond its traditional mental health emphasis into a general health care discipline. Abundant empirical evidence supports that psychologists treat a wide array of physical disorders as well as psychological components of medical problems. The immediate issues confronting psychology's full emergence into the health care world are discussed and recommendations are offered to assure the success of this initiative. Office of the Senior Vice President and Provost     

医务人员组织公民行为理论及其研究进展

介绍了组织公民行为概念的来源,以及医务人员组织公民行为研究状况。在分析已有研究的基础上,指出了未来研究的三个方向：基于医疗服务组织特性的医务人员组织公民行为概念及其构成研究,医务人员组织公民行为与相关概念的关系研究,基于中国社会文化情境的医务人员组织公民行为研究。     

中西方心理健康标准的比较与整合

心理健康标准是心理健康研究中的重要理论问题。比较中西方心理健康标准,在研究恩路、自我观念、人格观念等方面存在差异,在重视人际关系的和谐、重视对自我和现实的认识、重视对人生意义的探索等方面有相似之处。整合中西方心理健康标准应重视探讨社会群体的心理健康标准;引导青少年树立正确的自我观念;塑造具有独立性与创造性的现代社会人格。     

Integrating Mental Health and Primary Care Services in the Department of Veterans Affairs Health Care System

Integrating mental health care in the primary care setting has been identified in the literature as a model for increasing access to mental health services and has been associated with enhanced clinical and functional patient outcomes and higher patient satisfaction. The Department of Veterans Affairs (VA), which operates the nation’s largest integrated health care system, has taken a leadership role in creating a health care system in which mental health care is provided in the primary care setting. This article examines VA’s efforts and progress to date in implementing evidence-based models of integrated mental health services nationally in community based outpatient clinics, home based primary care, and outpatient primary clinics at medical facilities. Psychology plays an important role in this progress, as part of an overall interdisciplinary effort, in which all professions are crucially important and work together to promote the overall well-being of patients. This article is based in part on a presentation by the first author at the 3rd National Conference of the Association of Psychologists in Academic Health Centers (APAHC) in May of 2007 in Minneapolis, Minnesota.     

Health Care Reform and Psychologists in Medical Schools: Stress, Challenge, and Change

Psychologists from 45 academic health science centers throughout the United States and Canada gathered at Georgetown University for a national conference November 2–5, 1995 organized by the Association of Medical School Psychologists. This paper introduces the proceedings of that conference described in the next four articles in this issue of the Journal of Clinical Psychology in Medical Settings[Volume 4, number 1]. Papers prepared by the working groups focus upon clinical services, education and training, research, and governance and administration within the academic medical setting.     

The NIH Science of Behavior Change Program: Looking Toward the Future

The National Institutes of Health established the Science of Behavior Change (SOBC) program to promote basic research on the initiation, personalization, and maintenance of health behavior change. The SOBC Resource and Coordinating Center now leads and supports activities to maximize the creativity, productivity, scientific rigor, and dissemination of the experimental medicine approach and experimental design resources. Here, we highlight those resources, including the Checklist for Investigating Mechanisms in Behavior-change Research (CLIMBR) guidelines introduced in this special section. We describe the ways in which SOBC can be applied across a range of domains and contexts, and end by considering ways to extend SOBC’s perspective and reach, so as to best promote behavior change linked with health, quality of life, and well-being.     

Performance of Mental Health Counselors in Integrated Primary and Behavioral Health Care

Integrated primary and behavioral health care (IPBH) is becoming a preferred mode of service delivery in the United States. Integrated care includes the participation of medical and mental health professionals, such as mental health counselors. The clinical outcomes of these professionals need to be studied to determine their effectiveness in such settings. We examined the performance of 10 mental health counselors on the clinical outcome of 1,747 clients treated in an IPBH center. Analyses using growth curve modeling and pre‐post test design revealed that mental health counselors were effective overall, but they differed in client dropout rates and efficiency in reducing clients' initial symptoms. We used the analyses to rank order counselors based on their effectiveness. Counselors who were the most effective varied in their efficiency but demonstrated the lowest client dropout rates. Implications for future research and counseling practice were discussed.     

A New Frontier: Integrating Behavioral and Digital Technology to Promote Health Behavior

Modifiable behavioral risk factors such as cigarette smoking, physical inactivity, and obesity contribute to over 40 % of premature deaths in the USA. Advances in digital and information technology are creating unprecedented opportunities for behavior analysts to assess and modify these risk factors. Technological advances include mobile devices, wearable sensors, biomarker detectors, and real-time access to therapeutic support via information technology. Integrating these advances with behavioral technology in the form of conceptually systematic principles and procedures could usher in a new generation of effective and scalable behavioral interventions targeting health behavior. In this selective review of the literature, we discuss how technological tools can assess and modify a range of antecedents and consequences of healthy and unhealthy behavior. We also describe practical, methodological, and conceptual advantages for behavior analysts that stem from the use of technology to assess and treat health behavior.     

共享信息资源 促进卫生研究

近20年来,由于住处技术的迅速发展,住处的采集、处理和传播也随之发生了革命性的变化,住处技术的应用是提高卫生研究能力的有效措施之一,必须把计算机和网络功能等住处技术在卫生研究领域中的广泛应用提高到战略高度来认识,在卫生研究创新中住处是必备的条件,信息筛选和加工本身就是研究工作,需要发展、促进。卫生研究的成果,不仅要公开发表,而且要向决策者提供,互联网上拥有大量的医药卫生信息,要充分发挥它的巨大潜力。行政管理部门应充分重视作为信息源的网络建设和互联网的利用,信息开放和共享能力的提高是加强卫生研究能力、促进卫生研究发展的重要条件。     

Outdoor Behavioral Health Care: A Longitudinal Assessment of Young Adult Outcomes

This article details a 3‐year outdoor behavioral health care outcome study. Hierarchical linear modeling was used to analyze data from 186 young adults in a wilderness therapy program. Participants completed the Outcome Questionnaire–45.2 (Lambert et al., 2004 ) 6 times from Week 1 to 18‐month postdischarge follow‐up. Results indicated that clinically and statistically significant change occurred in treatment. Rates of change varied, and posttreatment scores remained stable, thus demonstrating that in‐treatment gains were maintained. Implications and recommendations for future research are discussed.     

医务社会工作对医护联盟信任关系提升的支持研究

选取江苏省某医院的癌症幸存者、严重心脑血管疾病患者（术后）作为研究对象,采用医疗保健联盟问卷、医学面对方式、创伤后成长量表进行统计学分析,共发放问卷165份。结果显示,医护联盟在性别和年龄两个方面差异具有统计学意义（P＜0.05）。医护联盟与面对、创伤后成长呈显著正相关,屈服与医护联盟、面对呈显著负相关。且87.2%的重症患者对医护联盟的信任呈不满意状态。从医务社会工作的角度出发,探讨影响患者对于医护联盟的信任度的因素并提供建议。

     

Mapping Ethical Consumer Behavior: Integrating the Empirical Research and Identifying Future Directions

The concept of “ethical consumer behavior” has gained significant attention among practitioners and academic researchers, generating increasing but disjointed knowledge on the topic. By analyzing the empirical research on ethical consumer behavior, this article provides researchers with a map to guide future research. In total, we review 80 studies. The main contributions of the article include the identification of the main trends in the ethical consumer literature and the conceptualization of ethical consumer behavior. In addition, several areas for future research are proposed and discussed.     

入世出世心理对压力和心理健康的中介作用

以319名大一学生为被试研究入世出世心理对压力和心理健康的中介作用,结果发现：（1）平常心对压力和生活满意度起部分中介作用,拼搏精神对压力和自尊起部分中介作用。（2）平常心对压力和心理症状总分、自卑、网络成瘾、敌对起部分中介作用,拼搏精神对压力和人际过敏、抑郁起部分中介作用。说明拼搏精神与平常心能缓减压力对心理健康的消极影响,培养拼搏精神和平常心是应对压力的有效途径。     

Governance of Transnational Global Health Research Consortia and Health Equity

Global health research partnerships are increasingly taking the form of consortia of institutions from high-income countries and low- and middle-income countries that undertake programs of research. These partnerships differ from collaborations that carry out single projects in the multiplicity of their goals, scope of their activities, and nature of their management. Although such consortia typically aim to reduce health disparities between and within countries, what is required for them to do so has not been clearly defined. This article takes a conceptual approach to explore how the governance of transnational global health research consortia should be structured to advance health equity. To do so, it applies an account called shared health governance to derive procedural and substantive guidance. A checklist based on this guidance is proposed to assist research consortia determine where their governance practices strongly promote equity and where they may fall short.     

Integrating basic and applied research and the utility of Lattal and Perone's Handbook of research methods in human operant behavior

Lattal and Perone's Handbook of methods used in human operant research on behavioral processes will be a valuable resource for researchers who want to bridge laboratory developments with applied study. As a supplemental resource, investigators are also encouraged to examine the series of papers in the Journal of Applied Behavior Analysis that discuss basic research and its potential for application. Increased knowledge of behavioral processes in laboratory research could lead to innovative solutions to practical problems addressed by applied behavior analysts in the home, classroom, clinic, and community.     

Attitudes of Health Care Trainees About Genetics and Disability: Issues of Access, Health Care Communication, and Decision Making

Prior studies suggest that knowledge and attitudes of health care professionals influence patient communication and medical decision making. To study this dynamic in the context of genetic disability, we developed a survey on health professionals' attitudes regarding disability and genetic screening and pilot-tested it on a sample of medical students, residents, and genetic counseling students (N = 85). Despite minimal experience with disability or genetics, most respondents reported feeling comfortable dealing with genetics (59%) and disability (75%). The majority felt that disability caused significant suffering for both the person (51%) and family (64%), and that research should be directed toward preventing genetic disability (62%). Similar to prior literature, perceived Quality of Life was most often based on degrees of physical and cognitive functioning, pain, and social support. However, differences were found between genetic counseling trainees and other medical trainees in their relative emphasis of social versus medical issues in questions of disability and genetic testing, and these response patterns were associated with differences in the groups' priorities for offering information about social resources. Respondents agreed that access to genetic testing and information is personal and that testing should be available upon request for oneself (68%) and to a lesser degree for one's fetus (55%) or child (41%). However, the same individuals frequently stated that society should regulate access to such technologies. Although most felt that the patient and professional should jointly make such decisions on a case-by-case basis, it was also seen as appropriate for the health care professional to occasionally decline genetic testing. It seems apparent that training and experience influence knowledge and attitudes. Therefore, it is critical to document knowledge and attitudes of various health care providers and trainees, including differences between various specialties, to improve educational interventions geared to this area.     

Childhood Social Predictors of Adolescent Antisocial Behavior: Gender Differences in Predictive Accuracy and Efficacy

This study examined the ability of several childhood, school-based, social variables to correctly classify antisocial adolescents. Children (N = 314; 163 boys, 151 girls) in the 3rd–5th grade were assessed on academic and social variables (i.e., peer rejection, aggression, withdrawal, and low prosocial behavior) and followed forward for 6–7 years until the 9th and 10th grade. Adolescent antisocial outcomes included a consensus measure formed from diagnostic interviews, contact with juvenile authorities, adolescent self-report, and mother's report. The gender-differential predictive accuracy and efficacy of the early predictor domains to a consensus measure of antisocial behavior were compared with the same estimates found for adolescent self-report of antisocial behavior. Both gender and criterion-method differences were found. For girls, regardless of the measure of antisocial behavior, early academic problems were the strongest predictors of future problems. For boys' self-reported antisocial outcomes, peer rejection was the strongest independent predictor. For consensus-reported antisocial outcomes, both early fighting–anger and withdrawn behavior displayed equally strong predictive relations. For boys, the combination of early fighting–anger and disruptive and withdrawn behavior was the strongest set of predictors for the consensus measure of antisocial functioning. Predictive accuracy and efficacy estimates are discussed in terms of predictive strength as well as the cost–benefit of misidentification.     

The Survivor Health and Resilience Education (SHARE) Program: Development and Evaluation of a Health Behavior Intervention for Adolescent Survivors of Childhood Cancer

Few evidence-based health behavior interventions for adolescent survivors of childhood cancer currently exist. These interventions are necessary to address a range of lifestyle and behavioral factors (e.g., diet and physical activity, tobacco and alcohol use, excessive sun exposure) that may place survivors at increased risk for secondary cancers other chronic diseases. To address this need, the development and evaluation of a health promotion and disease prevention program for childhood cancer survivors is described, with an emphasis on the steps leading up to conducting a randomized controlled trial to test its efficacy. Data gathered from trial participants suggest the preliminary evaluation of the intervention is favorable. Trends and future directions in behavioral intervention research with childhood cancer survivors are discussed, along with the role of behavioral research in health promotion and disease prevention.