British journal of health psychology
-
Br J Health Psychol · Sep 2019
Meta AnalysisDoes health coaching improve health-related quality of life and reduce hospital admissions in people with chronic obstructive pulmonary disease? A systematic review and meta-analysis.
To systematically review the evidence for health coaching as an intervention to improve health-related quality of life (HRQoL) and reduce hospital admissions in people with chronic obstructive pulmonary disease (COPD). ⋯ This is the first systematic review to show that health coaching may be a candidate intervention to improve HRQoL and reduce costly hospital admissions in people with COPD. Statement of contribution What is already known on this subject? COPD is a leading cause of death worldwide and considerably reduces HRQoL. In turn, HRQoL is associated with a range of adverse health outcomes in COPD. Health coaching is a self-management intervention for people with long-term conditions such as COPD. Studies have examined whether health coaching improves HRQOL and other health outcomes in people with COPD, but no systematic review has been conducted. What does this study add? The first systematic review and meta-analysis of RCTs of health coaching for people with COPD. Health coaching may be a candidate intervention for improving HRQoL and reducing COPD-related hospital admissions in people with COPD. The need to establish the most effective health coaching components, delivery modality, and economic impact.
-
Br J Health Psychol · Sep 2019
Development and validation of the Treatment Expectations in Chronic Pain Scale.
To develop and examine the psychometric properties of the Treatment Expectations in Chronic Pain (TEC) scale, a brief measure of treatment expectations of chronic non-cancer pain treatment. ⋯ The TEC scale is a reliable scale measuring pain treatment expectation. Further evaluation of its psychometric properties is needed. The scale has the potential to deepen our understanding of the role treatment expectations play in chronic non-cancer pain treatment response. Statement of contribution What is already known on this subject? Expectations play a role in pain perception and the response to pain treatment Patients' expectations about pain and its management are associated with treatment satisfaction The absence of a validated tool to measure treatment expectations in chronic non-cancer pain prevents further exploration and understanding of the role of expectations in the context of multidisciplinary pain treatment . What does this study add? A new, reliable 9-item scale measuring treatment expectations among chronic non-cancer pain patients attending specialized multidisciplinary pain clinics .
-
Br J Health Psychol · May 2019
Randomized Controlled Trial Multicenter StudyCouple-focused interventions for men with localized prostate cancer and their spouses: A randomized clinical trial.
Few couple-focused interventions have improved psychological and relationship functioning among men diagnosed with localized prostate cancer and their spouses. This study compared the impact of intimacy-enhancing therapy (IET), a general health and wellness intervention (GHW), and usual care (UC) on the psychological and relationship functioning of localized prostate cancer patients and their partners. Relationship length, relationship satisfaction, and patient masculinity were evaluated as moderators. ⋯ Intimacy-enhancing therapy did not show an impact on general or cancer-specific distress, but did show an early impact on relationship satisfaction among spouses. IET was superior to UC for patients in longer relationships. It will be important for researchers to understand which couple-focused interventions benefits both patients and spouses and to identify characteristics of patients, partners, and couples who may not benefit from psychological treatments. Statement of contribution What is already known on this subject? Men diagnosed with localized prostate cancer report lower health-related quality of life and both patients and spouses report elevated distress. Relationship communication plays a role in couples' psychological adaptation to prostate cancer. Couple-focused interventions have illustrated an impact on relationship communication. There are no studies comparing different couple-focused interventions. What does this study add? Intimacy-enhancing therapy was not superior to no treatment or a comparison treatment for the broad range of psychological and relationship outcomes. Intimacy-enhancing therapy was superior to no treatment for patients in longer-term relationship. The general health and wellness intervention was not beneficial for men in shorter relationships and for men who did not endorse traditional masculine norms.
-
Fatigue is a common symptom in primary care. Chronic fatigue research highlights the value of preventing chronicity, but little research has investigated the early, subacute stage of the fatigue trajectory (<3 months). We aimed to examine patient and general practitioner (GP) perspectives of subacute fatigue in primary care: (1) to gain a better understanding of fatigue during this stage and (2) to explore how management could be improved. ⋯ Some findings, such as impact, mirror those described in chronic fatigue. New insights into early-stage fatigue management also arose, including mismatches in patient and GP perceptions on negative tests and not re-presenting. These highlight the need for better communication and shared understanding. GPs should pre-emptively present a biopsychosocial model of fatigue and keep communication channels open, particularly in the light of negative physiological tests. Statement of contribution What is already known on this subject? Patients with chronic fatigue retrospectively report lack of understanding from GPs in early stage of illness. Little research has investigated the early stages of the fatigue trajectory. What does this study add? Consequences of an episode of subacute fatigue are similar to those reported for CFS. There is discordance between GPs' positive view of negative tests and patients' need for explanation of symptoms. The length of appointments is a significant barrier for creating shared understanding.
-
Br J Health Psychol · May 2019
The relationship between the cortisol awakening response and cortisol reactivity to a laboratory stressor.
The cortisol awakening response (CAR) and cortisol reactivity to an acute laboratory stressor both involve steep increases in cortisol secretion and are associated with preparing the body to deal with stressors ahead. Alterations in both have been linked to negative clinical and health outcomes. However, these two aspects of our biological stress response have rarely been directly compared, and the extant research focuses on state, rather than trait CAR. Given the similar roles of the CAR and cortisol reactivity, and their relationships to psychopathology, it is important to understand whether trait CAR and cortisol reactivity to acute stressors are related and whether a blunted CAR may be predictive of blunted cortisol reactivity across an acute laboratory stress task. ⋯ There was a significant relationship between trait CAR and cortisol secretion across the TSST. The results provided mixed support for hypotheses. A blunted CAR was associated with impaired recovery in cortisol secretion following the TSST, but, surprisingly, a rapid rise in cortisol peaking immediately following the stress task. Statement of contribution What is already known on this subject? The CAR and cortisol reactivity to an acute laboratory stress task both are thought to marshal the body's resources to deal with stress. Both the CAR and cortisol reactivity have been related to psychosocial states and clinical and health outcomes in past research. State CAR has been linked to cortisol reactivity to stressors, and a greater CAR is thought to help an individual deal with stressors in the day ahead. What does this study add? The current study predicts trait CAR sampled across multiple days from the rise and recovery in cortisol secretion across an acute stress test. Comparison of trait CAR and cortisol reactivity may clarify both their relationship to each other and to clinical and health outcomes.