Presidential reflections. Past and future

Key federal health initiatives and psychology's participation in public policy are briefly reviewed. There has long been agreement that psychologists have a responsibility to affirmatively address society's pressing needs, not only in health care but in other areas that affect the well being of society. The behavioral sciences are key to the United States' science and health policy in the 21st century. The unanswered question is, Has the field matured sufficiently to establish its own programmatic agenda via the public policy process? Community health, lifestyle choices, psychologically managed pharmacological treatment, and the use of telecommunications technology in education and treatment are areas in which psychology can contribute a great deal to the development of a healthier society.     

美国卫生保健的公正和分配问题

除了卫生保健服务的费用问题以外,美国社会中关于医疗卫生保健的比较严重的问题是服务的公平和分配问题,在美国无论是城市还是农村,在经济上处于弱势地位的人,在医疗上也处于不利地位,另一个由公平性问题影响的社会层面是;大量的美国人没有参加健康保险,他们中的大多数人是生活贫困的究人或接近于贫穷的人。此外,美国卫生保健提供体系在地理分布上是不均衡的,初级保健医生或家庭医生在医生中也没有充分的代表性,医生的矩缺不只限于农村,也扩展至城市的某些区域。     

Advances in the conceptualization and measurement of religion and spirituality. Implications for physical and mental health research

Empirical studies have identified significant links between religion and spirituality and health. The reasons for these associations, however, are unclear. Typically, religion and spirituality have been measured by global indices (e.g., frequency of church attendance, self-rated religiousness and spirituality) that do not specify how or why religion and spirituality affect health. The authors highlight recent advances in the delineation of religion and spirituality concepts and measures theoretically and functionally connected to health. They also point to areas for areas for growth in religion and spirituality conceptualization and measurement. Through measures of religion and spirituality more conceptually related to physical and mental health (e.g., closeness to God, religious orientation and motivation, religious support, religious struggle), psychologists are discovering more about the distinctive contributions of religiousness and spirituality to health and well-being.     

Social and psychiatric influences on urban-rural differentials in Australian suicide

The purpose of this study was to investigate urban-rural differentials in Australian suicide rates, and to examine influences that previously have remained largely speculative. Suicide rates for males (all ages and young adults) were significantly higher in rural areas compared to urban areas. Urban-rural suicide rate differences in males were rendered nonsignificant after adjustment for migrant and area socioeconomic status. Adjusting for mental disorder prevalence, in addition to migrant status, reduced the excess suicide risk in rural areas; the excess was reduced further with addition of mental health service utilization. The implications of this study are that socioeconomic circumstances in rural populations contribute to higher male suicide rates compared to urban areas, but these conditions may be partly mediated by mental disorder prevalence and mental health service utilization.     

The Impact of Region and Urbanicity on the Discrimination-Cognitive Health Link Among Older Blacks

Little research has examined how the link between discrimination and cognitive health varies by where people live. This study investigates how living in non-urban versus urban areas in different regions in the United States moderates the discrimination-cognitive health link among older non-Hispanic Blacks. Data are from the 2012 and 2014 waves of the Health and Retirement Study (HRS; N = 2,347). Regression analyses indicate that experiencing more everyday discrimination is significantly associated with lower episodic memory when living in urban areas. Among non-Hispanic Blacks, the discrimination-episodic memory link does not significantly vary across U.S. regional contexts. Findings highlight variation in the association between everyday discrimination and cognitive health by where older non-Hispanic Blacks live. Results suggest the importance of socio-environmental factors in shaping how stressful experiences such as discrimination are linked to cognitive health in later life.     

FEMINIST CONTRIBUTIONS TO HEALTH PSYCHOLOGY

A brief review of health psychology shows that the early leadership began what has come to be a major alternative to traditional medical models of diagnosis and treatment. Numerous women were involved with these implementations and changes in the field. Many of the key developments within health psychology—for example, behavioral prevention, compliance, coping, health promotion, locus of control, and social support—reflect essentially feminist principles that emphasize the legitimate authority and significance of the individual. Feminist principles of equity and inclusiveness are also represented in emerging concerns that the health needs of many underprivileged groups deserve more focused attention, and, additionally, that entirely new areas of health can be profitably examined within the framework of health psychology.     

A Comparison of Homeless Male Veterans in Metropolitan and Micropolitan Areas in Nebraska: A Methodological Caveat

This study explored differences between homeless male veterans in metropolitan and micropolitan cities in Nebraska on sociodemographic, housing, clinical, and psychosocial characteristics as well as health service use. A convenience sample of 151 homeless male veterans (112 metropolitan, 39 micropolitan) were recruited from Veterans Affairs facilities and area shelters in Omaha, Lincoln, Grand Island, and Hastings in Nebraska. Research staff conducted structured interviews with homeless veterans. Results showed that compared to homeless veterans in metropolitans, those in micropolitans were more likely to be White, unmarried, living in transitional settings, and were far more transient but reported greater social support and housing satisfaction. Veterans in micropolitans also reported more medical problems, diagnoses of anxiety and personality disorders, and unexpectedly, were more likely to report using various health services and less travel time for services. Together, these findings suggest access to homeless and health services for veterans in micropolitan areas may be facilitated through Veterans Affairs facilities and community providers that work in close proximity to one another. Many homeless veterans in these areas are transient, making them a difficult population to study and serve. Innovative ways to provide outreach to homeless veterans in micropolitan and more rural areas are needed.     

The Prevalence of Burnout in Occupational Therapists

Burnout is a stress which may affect an health all health professionals. In this paper its process, causes and characteristics in various health professions are outlined. A survey of burnout in Australian occupational therapists was conducted. The results show that occupational therapists working in the psychosocial area have significantly more burnout on the measure of frequency of feelings of personal accomplishment than do those working in paediatric or physical rehabilitation areas. These feelings are related to specific differences in job characteristics. Implications for prevention of burnout are discussed.     

我国心理健康研究现状的文献计量学分析

对收录在中国期刊网上的488条心理健康研究的论文题录进行计量学分析,发现心理学刊物上的心理健康研究论文数量不多,主要集中在心理健康相关因素和现状调查两个方面,内部合作研究已经成为心理健康研究的主要形式,研究力量的机构分布主要集中在高等师范院校和医科院校及医院,研究力量的地区分布主要集中在经济较为发达地区。     

“A joke a day keeps the doctor away?” Meta‐analytical evidence of differential associations of habitual humor styles with mental health

Humor and mental health are interconnected as is evidenced by a large number of studies. However, associations are only small and inconsistent as the operationalization of humor poses a methodological challenge. The Humor Styles Questionnaire (HSQ ) differentiates four humor styles that might be beneficial or harmful to mental health. The aim of the present study was to meta‐analytically aggregate studies using the HSQ to assess the associations of different humor styles with four areas of mental health (self‐esteem, life satisfaction, optimism, depression). An extensive electronic database literature search identified 37 studies that reported correlations between the HSQ scales and the four areas of mental health in 45 independent samples (total N = 12,734). In total, 16 meta‐analyses were conducted. Moderating effects of participant age, sex, and geographic region were examined via subgroup analyses and meta‐regression. Humor styles differed in terms of their associations with mental health. Health‐promoting humor styles were overall positively correlated with mental health (small‐to‐medium effect sizes). Self‐defeating humor was overall negatively correlated with mental health. Aggressive humor was overall unrelated with mental health. Moderator analyses suggested geographic differences (Eastern vs. Western samples) and sex differences for some of these associations. Fostering specific humor styles may be beneficial for mental health. In addition, observing the habitual use of humor styles might help therapists to develop a better understanding of their clients. Differences in the utilization and the correlates of humor styles in Eastern and Western societies, and sex differences, need to be addressed in future research.     

Rural mental health in America

Mental health services are in short supply in rural America. This article describes both the mental health service needs in rural areas and the barriers to improving the availability, accessibility, and acceptability of rural mental health services. Federal programs in rural mental health care in the Departments of Health and Human Services, Agriculture, and Education are described, as well as selected congressional initiatives. The role of the federal Office of Rural Health Policy is emphasized, and policy recommendations for improving rural mental health care delivery are presented.     

Targeting Self-Stigma in Returning Military Personnel and Veterans: A Review of Intervention Strategies

Research suggests that mental health-related stigma significantly decreases the use of mental health services by military personnel and veterans. The goal of this article is to review what is known about mental health stigma as it relates to military personnel and veterans, as well as to offer an interpretive review of self-stigma intervention strategies that have been applied within the field. Target areas for future work and the concerns and challenges faced by interventionists are discussed.     

印度农村医疗的现状与对策

自印度独立以来,政府就致力于采取各种有力措施来改善人们的健康情况并已卓见成效。尽管印度政府采取了一系列的发展政策,经济、地区发展不平衡及男女不平等还是为医疗部门带来了巨大的挑战。分析印度政府在农村所面临的问题以及为解决这些问题政府颁布的新政策。     

医疗纠纷非诉讼解决机制与和谐医患关系

医疗纠纷的急剧攀升与解决医疗纠纷的方式和途径较为单一、过分倚重诉讼有直接的关系.要改变医疗纠纷的现状,构建和谐医患关系,必须克服法治等于诉讼的误区,建立以法律规范为指导,以预防机制为基础,以非诉讼解决机制为主要方式,以法律诉讼为最终途径的多元化的医疗纠纷解决机制.     

Psychology and rural America. Current status and future directions

Rural people constitute about one fourth of the U.S. population, and their special mental health needs have been largely neglected. For a variety of reasons psychologists have focused little attention on this group. Recent economic developments affecting agriculture, farm families, and rural communities have increased awareness of problems facing rural areas. Psychologists can respond to the unique challenges created by rural mental health needs through research on stress, psychopathology, and community well-being. Training programs should be encouraged to recognize rural concerns. Psychologists are needed to practice in rural areas and to help develop effective rural service models. They can also support the development of state and federal policies that address rural needs.     

The development of the Cultural Health Attributions Questionnaire (CHAQ)

Current general health belief measures that are used to assess health behaviors do not capture the full range of health beliefs present among Latinos. The purpose of this study was to develop a reliable and valid measure of Latino health beliefs, the Cultural Health Attributions Questionnaire (CHAQ). Three hundred forty participants were recruited in 2 metropolitan areas with large Latino populations. Exploratory factor analysis revealed 2 highly interpretable 12-item subscales: the Equity Attribution and the Behavioral-Environmental Attribution scales. Examination of the relationships between the subscales and measures of acculturation provided evidence of construct validity. Moreover, the prediction of health care behavior by the CHAQ also indicated initial criterion validity.     

Implementing a Comprehensive Program for the Prevention of Conduct Problems in Rural Communities: The Fast Track Experience

Childhood conduct problems are predictive of a number of serious long-term difficulties (e.g., school failure, delinquent behavior, and mental health problems), making the design of effective prevention programs a priority. The Fast Track Program is a demonstration project currently underway in four demographically diverse areas of the United States, testing the feasibility and effectiveness of a comprehensive, multicomponent prevention program targeting children at risk for conduct disorders. This paper describes some lessons learned about the implementation of this program in a rural area. Although there are many areas of commonality in terms of program needs, program design, and implementation issues in rural and urban sites, rural areas differ from urban areas along the dimensions of geographical dispersion and regionalism, and community stability and insularity. Rural programs must cover a broad geographical area and must be sensitive to the multiple, small and regional communities that constitute their service area. Small schools, homogeneous populations, traditional values, limited recreational, educational and mental health services, and politically conservative climates are all more likely to emerge as characteristics of rural rather than urban sites (Sherman, 1992). These characteristics may both pose particular challenges to the implementation of prevention programs in rural areas, as well as offer particular benefits. Three aspects of program implementation are described in detail: (a) community entry and program initiation in rural areas, (b) the adaptation of program components and service delivery to meet the needs of rural families and schools, and (c) issues in administrative organization of a broadly dispersed tricounty rural prevention program.     

Predictors of Self-Appraised Health Status in Sub-Saharan Africa: The Case of Ghana

Whereas determinants of self-assessed health status -subjective health are well scrutinized in developed countries, little is known about factors influencing how people appraise their own health in Sub-Sahara Africa. In the context of increasing burden of care due to high incidence of chronic diseases, poverty and social transformation this paper explores the predictors of self-appraised health status in Ghana. Using 2005–2008 wave of the World Values Survey, the authors employ parametric and ordered logistic regression techniques to assess the relative effect of economic, cultural, social capital, geographic, and demographic factors in molding subjective health among Ghanaians. The study reveals that cultural background has independent significant effect on subjective health over and above individual characteristics. The relative importance of cultural background in shaping subjective health is more significant and salient for Ewes compared to Akans. Income, age and satisfaction with life are noncultural variables that consistently emerged as predictors of subjective health among the respondents. Policy implications of the study are discussed echoing the need to adopt multidimensional approach to improving overall health paying attention to cultural background in the country. It is also suggested that more studies into the interplay between cultural background and social capital variables and subjective health are needed to untangle the rationale behind the association between culture and social capital and health status in the country. Future areas of research are also alluded to.     

大学生心理健康变迁的横断历史研究

自恢复高考至今, 中国的高等教育取得了巨大进步, 这一历史时期大学生整体的心理健康水平如何变化呢？本研究对1986至2010年间237项采用90项症状自评量表(SCL-90)的研究报告进行了横断历史的元分析, 以考察这些研究(被试为30多万名大学生)所测心理问题的9个因子得分随年代的变化趋势。结果表明：(1)SCL-90各因子均值与年代之间均呈负相关, 年代可以解释9个因子4%至36%的变异; 25年来9个因子均值分别下降了1%至13%, 其中偏执、人际关系、抑郁、敌对因子变化较明显。这说明25年来大学生的心理问题逐渐减少, 即大学生心理健康的整体水平逐步提高。(2)25年来大学生心理健康水平的提高, 主要体现在大学一年级以上的学生上, 而且重点大学学生(较之非重点大学)、城市生源学生(较之农村)、男生(较之女生)的心理健康改善更快。     

手外伤患者健康认知及康复行为的调查

了解手外伤患者健康认知与康复行为状况,为医院健康教育工作及相关部门决策提供可考依据。选取2013年1月～12月我院手外伤患者,随机分为城市患者100名、农村患者100名进行问卷调查。结果患者健康认知程度和健康的行为习·赁受家庭、教育程度和社会等诸多方面影响,接受健康教育行为养成率城区略好于乡村。本次的调查,反映出患者接受健康教育认知程度和健康的行为习惯受家庭、教育程度和社会等诸多的方面影响,只有患者康复意识不断累积增加时,术后手部运动功能恢复才能提高。