国外行为医学文献摘要(2)    

                  国外行为医学文献摘要(2)

 

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71

【题名】

Workforce competencies in behavioral health: an overview.

【作者】

Hoge MA;Paris M Jr;Adger H Jr;Collins FL Jr;Finn CV;Fricks L;Gill KJ;Haber J;Hansen M;Ida DJ;Kaplan L;Northey WF Jr;O'Connell MJ;Rosen AL;Taintor Z;Tondora J;Young AS;

【机构】

Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA. michael.hoge@yale.edu

【刊年卷期】

Adm Policy Ment Health. 2005V32N5-6

【页】

593-631

ISSN】

0894-587X

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*education;EKBehavioral Medicine/standards;Competency-Based Education;Employee Performance Appraisal;Family Therapy;Family Therapy/standards;Humans;Mental Disorders;Mental Disorders/rehabilitation;Mental Disorders/therapy;Mental Health Services;Mental Health Services/manpower;Mental Health Services/*standards;Patient Care Team;Patient Care Team/standards;Psychiatric Nursing;Psychiatric Nursing/education;Psychiatric Nursing/standards;Psychiatry;Psychiatry/education;Psychiatry/standards;Psychology, Clinical;Psychology, Clinical/education;Psychology, Clinical/standards;Research Support, U.S. Gov't, P.H.S.;Social Work, Psychiatric;Social Work, Psychiatric/education;Social Work, Psychiatric/standards;Staff Development;Staff Development/methods;Substance-Related Disorders;Substance-Related Disorders/rehabilitation;Substance-Related Disorders/therapy;United States;*Clinical Competence

【中文关键词】

行为医学;CK行为医学/教育;CK行为医学/标准;基于能力的教育;雇员能力评定;家庭心理疗法;家庭心理疗法/标准;人类;精神障碍;精神障碍/康复;精神障碍/治疗;精神卫生服务;精神卫生服务/人力;精神卫生服务/标准;病人医疗小组;病人医疗小组/标准;精神病护理学;精神病护理学/教育;精神病护理学/标准;精神病学;精神病学/教育;精神病学/标准;心理学, 临床;心理学, 临床/教育;心理学, 临床/标准;研究性资助, 美国政府, 公共卫生署;社会工作, 精神病;社会工作, 精神病/教育;社会工作, 精神病/标准;人员开发;人员开发/方法;物质相关性障碍;物质相关性障碍/康复;物质相关性障碍/治疗;美国;临床工作能力

【摘要】

Competency-based training approaches are being used more in healthcare to guide curriculum content and ensure accountability and outcomes in the educational process. This article provides an overview of the state of competency development in the field of behavioral health. Specifically, it identifies the groups and organizations that have conducted and supported this work, summarizes their progress in defining and assessing competencies, and discusses both the obstacles and future directions for such initiatives. A major purpose of this article is to provide a compendium of current competency efforts so that these might inform and enhance ongoing competency development in the varied behavioral health disciplines and specialties. These varied resources may also be useful in identifying the core competencies that are common to the multiple disciplines and specialties.

 

 

72

【题名】

Best practices for assessing competence and performance of the behavioral health workforce.

【作者】

Bashook PG;

【机构】

Department of Medical Education, University of Illinois at Chicago, 808 South Wood Street (MC591), Chicago, IL 60612, USA. pgb@uic.edu

【刊年卷期】

Adm Policy Ment Health. 2005V32N5-6

【页】

563-592

ISSN】

0894-587X

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*education;EKBehavioral Medicine/standards;Benchmarking;Decision Making, Organizational;Educational Measurement;Employee Performance Appraisal;Employee Performance Appraisal/*methods;Guidelines;Humans;Mental Health Services;Mental Health Services/manpower;Mental Health Services/*standards;Models, Organizational;Research Support, U.S. Gov't, P.H.S.;Total Quality Management;Total Quality Management/*methods;United States;*Clinical Competence

【中文关键词】

行为医学;CK行为医学/教育;CK行为医学/标准;规范;决策, 组织;教育考核;雇员能力评定;雇员能力评定/方法;方针政策;人类;精神卫生服务;精神卫生服务/人力;精神卫生服务/标准;模型, 组织管理;研究性资助, 美国政府, 公共卫生署;全面质量管理;全面质量管理/方法;美国;临床工作能力

【摘要】

The need for mechanisms to assess the competence and performance of the behavioral health workforce has received increasing attention. This article reviews strategies used in general medicine and other disciplines for assessing trainees and practitioners. The possibilities and limitations of various approaches are reviewed, and the implications for behavioral health are addressed. A conceptual model of competence is presented, and practical applications of this model are reviewed. Finally, guidelines are proposed for building competency assessment protocols for behavioral health.

 

 

73

【题名】

Strategies for developing competency models.

【作者】

Marrelli AF;Tondora J;Hoge MA;

【机构】

Caliber Associates, Fairfax, VA, USA. annemarrelli@earthlink.net

【刊年卷期】

Adm Policy Ment Health. 2005V32N5-6

【页】

533-561

ISSN】

0894-587X

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/education;EKBehavioral Medicine/*standards;Clinical Competence;Clinical Competence/*standards;Communication;Data Collection;Data Collection/methods;Employee Performance Appraisal;Focus Groups;Humans;Interviews;Mental Health Services;Mental Health Services/manpower;Mental Health Services/*standards;Organizational Objectives;Personnel Selection;Personnel Selection/*methods;Research Support, U.S. Gov't, P.H.S.;Staff Development;United States;*Benchmarking;*Models, Educational;*Models, Organizational

【中文关键词】

行为医学;CK行为医学/教育;CK行为医学/标准;临床工作能力;临床工作能力/标准;信息交流;数据收集;数据收集/方法;雇员能力评定;集中研讨小组;人类;采访;精神卫生服务;精神卫生服务/人力;精神卫生服务/标准;组织目标;人员选用;人员选用/方法;研究性资助, 美国政府, 公共卫生署;人员开发;美国;规范;模型, 教育;模型, 组织管理

【摘要】

There is an emerging trend within healthcare to introduce competency-based approaches in the training, assessment, and development of the workforce. The trend is evident in various disciplines and specialty areas within the field of behavioral health. This article is designed to inform those efforts by presenting a step-by-step process for developing a competency model. An introductory overview of competencies, competency models, and the legal implications of competency development is followed by a description of the seven steps involved in creating a competency model for a specific function, role, or position. This modeling process is drawn from advanced work on competencies in business and industry.

 

 

74

【题名】

The fundamentals of workforce competency: implications for behavioral health.

【作者】

Hoge MA;Tondora J;Marrelli AF;

【机构】

Yale University School of Medicine, Yale Department of Psychiatry, 34 Park Street, Room 139, New Haven, CT 06519, USA. michael.hoge@yale.edu

【刊年卷期】

Adm Policy Ment Health. 2005V32N5-6

【页】

509-531

ISSN】

0894-587X

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*education;EKBehavioral Medicine/standards;Humans;Mental Health Services;Mental Health Services/manpower;Mental Health Services/*standards;Models, Educational;Organizational Innovation;Patient Participation;Physician-Patient Relations;Research Support, U.S. Gov't, P.H.S.;United States;*Clinical Competence;*Staff Development

【中文关键词】

行为医学;CK行为医学/教育;CK行为医学/标准;人类;精神卫生服务;精神卫生服务/人力;精神卫生服务/标准;模型, 教育;组织改革;病人参与;医生病人关系;研究性资助, 美国政府, 公共卫生署;美国;临床工作能力;人员开发

【摘要】

Increasing attention is being directed to the competency of those who deliver healthcare in the United States. In behavioral health, there is growing recognition of the need to define, teach, and assess essential competencies. Since attention to this issue in behavioral health is relatively recent, there is much to be gained by learning from the principles, definitions, and conceptual models of competency that have been developed in other fields. This article outlines the forces that drive the current focus on competency of the healthcare workforce. Relevant history, principles, definitions, and models that have evolved through research and application in business and industry are reviewed. From this analysis, recommendations are offered to guide future work on competencies in behavioral health.

 

 

75

【题名】

Achieving the promise through workforce transformation: a view from the Center for Mental Health Services.

【作者】

Power AK;

【机构】

Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 1 Choke Cherry Road, Room 6-1057, Rockville, MD 20857, USA. kathryn.power@samhsa.hhs.gov

【刊年卷期】

Adm Policy Ment Health. 2005V32N5-6

【页】

489-495

ISSN】

0894-587X

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*education;EKBehavioral Medicine/standards;Consumer Participation;Health Care Coalitions;Humans;Maryland;Mental Health Services;Mental Health Services/manpower;Mental Health Services/*standards;Organizational Innovation;Organizational Objectives;Public Health Administration;Public Health Administration/education;Public Health Administration/standards;Research Support, U.S. Gov't, P.H.S.;United States;*Clinical Competence;*Staff Development

【中文关键词】

行为医学;CK行为医学/教育;CK行为医学/标准;用户参与;卫生保健联合体;人类;马里兰;精神卫生服务;精神卫生服务/人力;精神卫生服务/标准;组织改革;组织目标;公共卫生管理;公共卫生管理/教育;公共卫生管理/标准;研究性资助, 美国政府, 公共卫生署;美国;临床工作能力;人员开发

 

 

76

【题名】

Guest editors' introduction: workforce competencies in behavioral health.

【作者】

Hoge MA;Morris JA;Paris M Jr;

【刊年卷期】

Adm Policy Ment Health. 2005V32N5-6

【页】

485-488

ISSN】

0894-587X

【出版国】

United States

【语种】

eng

【文献类型】

Editorial

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*education;EKBehavioral Medicine/standards;Health Care Coalitions;Humans;Mental Health Services;Mental Health Services/manpower;Mental Health Services/*standards;Research Support, U.S. Gov't, P.H.S.;Staff Development;United States;*Clinical Competence

【中文关键词】

行为医学;CK行为医学/教育;CK行为医学/标准;卫生保健联合体;人类;精神卫生服务;精神卫生服务/人力;精神卫生服务/标准;研究性资助, 美国政府, 公共卫生署;人员开发;美国;临床工作能力

 

 

77

【题名】

Proceedings of the Annapolis Coalition on Behavior Health Workforce Education Conference on Behavior Health Workforce Competencies. May 10-11, 2004. Annapolis, Maryland, USA.

【刊年卷期】

Adm Policy Ment Health. 2005V32N5-6

【页】

485-663

ISSN】

0894-587X

【出版国】

United States

【语种】

eng

【文献类型】

Congresses; Overall

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*standards;Clinical Competence;Clinical Competence/*standards;Humans;Mental Health Services;Mental Health Services/*standards;Psychiatry;Psychiatry/education;Psychiatry/standards

【中文关键词】

行为医学;CK行为医学/标准;临床工作能力;临床工作能力/标准;人类;精神卫生服务;精神卫生服务/标准;精神病学;精神病学/教育;精神病学/标准

 

 

78

【题名】

The INTERHEART study: intersection between behavioral and general medicine.

【作者】

Sheps DS;Frasure Smith N;Freedland KE;Carney RM;

【刊年卷期】

Psychosom Med. 2004V66N6

【页】

797-798

ISSN】

1534-7796

【出版国】

United States

【语种】

eng

【文献类型】

Editorial

【英文关键词】

Behavioral Medicine;Depressive Disorder;Depressive Disorder/epidemiology;Family Practice;Humans;Multicenter Studies;Myocardial Infarction;Myocardial Infarction/*epidemiology;Research Design;Risk Factors;Stress, Psychological;Stress, Psychological/epidemiology;*Case-Control Studies;*Cross-Cultural Comparison;*Randomized Controlled Trials

【中文关键词】

行为医学;抑郁症;抑郁症/流行病学;家庭医学;人类;多中心研究;心肌梗死;心肌梗死/流行病学;研究设计;危险因素;应激, 心理学;应激, 心理学/流行病学;病例对照研究;文化交叉比较;随机对照试验

 

 

79

【题名】

The adventures of a "different" pair.

【作者】

McHugh PR;

【机构】

Department of Psychiatry and Behavioral Science, School of Medicine, Johns Hopkins University, Meyer 127, 600 N. Wolfe St., Baltimore, MD 21287, USA. pmchugh@mail.jhmi.edu

【刊年卷期】

Physiol Behav. 2004V82N1

【页】

171-174

ISSN】

0031-9384

【出版国】

United States

【语种】

eng

【文献类型】

Biography; Historical Article; Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*history;History, 20th Century;Hospitals, Military;Humans;Military Medicine;Military Medicine/history;Physiology;Physiology/*history;*Cooperative Behavior

【中文关键词】

行为医学;CK行为医学/历史;历史, 20世纪;医院, 军队;人类;军事医学;军事医学/历史;生理学;生理学/历史;合作行为

【摘要】

Gerry Smith had been a fellow in the Neuropsychiatry Division at the Walter Reed Army Institute of Research. There, he and Paul McHugh first worked together. This is the story of the formation of their two companion careers in physiology and behavior and the issues they confronted at this early stage.

 

 

80

【题名】

Motivation concepts in behavioral neuroscience.

【作者】

Berridge KC;

【机构】

Department of Psychology, University of Michigan, 525 E University Street, Ann Arbor, MI 48109-1109, USA. berridge@umich.edu

【刊年卷期】

Physiol Behav. 2004V81N2

【页】

179-209

ISSN】

0031-9384

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Animals;Drive;Humans;Research Support, U.S. Gov't, Non-P.H.S.;Research Support, U.S. Gov't, P.H.S.;*Behavioral Medicine;*Motivation;*Neurosciences

【中文关键词】

动物;内驱力;人类;研究性资助, 美国政府, 非公共卫生署;研究性资助, 美国政府, 公共卫生署;行为医学;动机;神经科学

【摘要】

Concepts of motivation are vital to progress in behavioral neuroscience. Motivational concepts help us to understand what limbic brain systems are chiefly evolved to do, i.e., to mediate psychological processes that guide real behavior. This article evaluates some major motivation concepts that have historic importance or have influenced the interpretation of behavioral neuroscience research. These concepts include homeostasis, setpoints and settling points, intervening variables, hydraulic drives, drive reduction, appetitive and consummatory behavior, opponent processes, hedonic reactions, incentive motivation, drive centers, dedicated drive neurons (and drive neuropeptides and receptors), neural hierarchies, and new concepts from affective neuroscience such as allostasis, cognitive incentives, and reward 'liking' versus 'wanting'.

 

81

【题名】

A national survey of PNP curricula: preparing pediatric nurse practitioners to meet the challenge in behavioral mental health.

【作者】

Hawkins Walsh E;Stone C;

【机构】

The Catholic University of America School of Nursing, Washington DC, USA.

【刊年卷期】

Pediatr Nurs. 2004V30N1

【页】

72-78

ISSN】

0097-9805

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*education;Child Psychiatry;Child Psychiatry/*education;Data Collection;Humans;Nurse Practitioners;Nurse Practitioners/*education;Pediatric Nursing;Pediatric Nursing/*education;United States;*Curriculum

【中文关键词】

行为医学;CK行为医学/教育;儿童精神病学;儿童精神病学/教育;数据收集;人类;开业护士;开业护士/教育;儿科护理学;儿科护理学/教育;美国;课程

【摘要】

The emergent mental health needs of children and adolescents have been declared a national priority by the Surgeon General of the United States (United States Department of Health and Human Services [USDHHS], 1999). Pediatric nurse practitioners (PNP) are called upon to respond to a new challenge by increasing their knowledge and skills in providing mental health care in the primary care setting. In turn, educators of PNP programs across the country are called upon to evaluate the status of PNP curricula in the field of behavioral/mental health and determine the essential competencies needed to meet the challenge. A survey was conducted to determine the extent of pediatric mental/behavioral health content currently taught in nationally approved PNP programs to discern the level of preparation PNP students received both in the classroom and clinically in the area of the assessment, diagnosis, and management of mental/behavioral health problems in children and adolescents. The final survey included a total of 78 nationally recognized PNP programs. Pediatric behavioral/mental health content was found to vary widely across programs, but it was apparent that all programs had begun to expand their curricula to include more content in this area. As the role of the PNP continues to expand, the burden of providing a sound education in a feasible time frame will be an increasing challenge.

 

 

82

【题名】

Using biofeedback to make childhood headaches less of a pain.

【作者】

Allen KD;

【刊年卷期】

Pediatr Ann. 2004V33N4

【页】

241-245

ISSN】

0090-4481

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/methods;Child;Child Welfare;Headache;Headache/*therapy;Humans;Migraine Disorders;Migraine Disorders/therapy;Time Factors;*Biofeedback (Psychology);*Biofeedback (Psychology)/methods;*Relaxation Techniques;*Skin Temperature

【中文关键词】

行为医学;CK行为医学/方法;儿童;儿童福利;头痛;头痛/治疗;人类;偏头痛;偏头痛/治疗;时间因素;生物反馈(心理学);生物反馈(心理学)/方法;松弛技术;皮肤温度

 

 

83

【题名】

The soft science of medicine.

【刊年卷期】

Lancet. 2004V363N9417

【页】

1247

ISSN】

1474-547X

【出版国】

England

【语种】

eng

【文献类型】

Editorial

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*education;Physician-Patient Relations;Social Sciences;Social Sciences/*education;United States;*Curriculum;*Education, Medical, Undergraduate;*Health Promotion

【中文关键词】

行为医学;CK行为医学/教育;医生病人关系;社会科学;社会科学/教育;美国;课程;教育, 医学, 本科;健康促进

 

 

84

【题名】

Strategies and innovations for successful quality improvement in behavioral health.

【作者】

Beaudin CL;Beaty J;

【机构】

PacifiCare Behavioral Health, 5990 Sepulveda Blvd, Suite 400, Van Nuys, CA 91411, USA. christy.beaudin@phs.com

【刊年卷期】

J Nurs Care Qual. 2004V19N3

【页】

197-206

ISSN】

1057-3631

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*organization & administration;Humans;Mental Health Services;Mental Health Services/*organization & administration;Models, Organizational;Needs Assessment;Planning Techniques;Program Development;Quality Assurance, Health Care;Quality Assurance, Health Care/*organization & administration;Quality Indicators, Health Care;Total Quality Management;Total Quality Management/*organization & administration;*Health Behavior

【中文关键词】

行为医学;CK行为医学/组织与管理;人类;精神卫生服务;精神卫生服务/组织与管理;模型, 组织管理;需求估价;规划技术;规划制订;质量保证, 卫生保健;质量保证, 卫生保健/组织与管理;质量指标, 卫生保健;全面质量管理;全面质量管理/组织与管理;健康行为

【摘要】

The success of any behavioral health organization depends on its ability to respond to demands from consumers, stakeholders, and accreditation and regulatory agencies, while maintaining effective and safe treatment. The authors provide a quality improvement strategy with exemplars from practice. Readers will appreciate how planning results in accountability and yielding measurable and meaningful outcomes.

 

 

85

【题名】

Cognitive factors in health psychology and behavioral medicine.

【作者】

Montgomery GH;

【机构】

Mount Sinai School of Medicine, New York,NY 10029, USA. guy.montgomery@mssm.edu

【刊年卷期】

J Clin Psychol. 2004V60N4

【页】

405-413

ISSN】

0021-9762

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Humans;Neoplasms;Neoplasms/prevention & control;*Behavioral Medicine;*Cognition

【中文关键词】

人类;肿瘤;肿瘤/预防与控制;行为医学;认知

【摘要】

Research in health psychology and behavioral medicine has increased exponentially over the past three decades. Prevention and control efforts across a variety of diseases have recognized that individual difference factors, belief systems, attitudes, behaviors, and environments can affect an individual's health. This work continues, as there has been no abatement in the rate at which aversive, chronic, and life-threatening diseases continue to affect millions of Americans each year. The purpose of this review is to discuss the influence of cognitive factors on health psychology and behavioral medicine using the cancer literature as an example. The main discussion focuses on the impact of cognitive constructs on behavioral medicine and health psychology in cancer, which appears to be widespread. The article concludes with some implications for future research in the area.

 

 

86

【题名】

Using information to guide managed behavioral health care.

【作者】

Tompkins C;Perloff J;

【机构】

Associate Professor, Schneider Institute for Health Policy, Heller Graduate School, Brandeis University, Waltham, MA 02454, USA. tompkins@brandeis.edu

【刊年卷期】

J Behav Health Serv Res. 2004V31N1

【页】

98-110

ISSN】

1094-3412

【出版国】

United States

【语种】

eng

【文献类型】

Evaluation Studies; Journal Article

【英文关键词】

Adolescent;Adult;Aged;Arizona;Behavioral Medicine;Behavioral Medicine/*organization & administration;Female;Humans;Male;Managed Care Programs;Managed Care Programs/*organization & administration;Managed Care Programs/utilization;Medicaid;Medicaid/*organization & administration;Medicaid/utilization;Mental Health Services;Mental Health Services/*organization & administration;Mental Health Services/utilization;Middle Aged;Outcome Assessment (Health Care);Quality of Health Care;Rate Setting and Review;Research Support, U.S. Gov't, P.H.S.;State Health Plans;State Health Plans/*organization & administration;Substance Abuse Treatment Centers;Substance Abuse Treatment Centers/organization & administration;Substance-Related Disorders;Substance-Related Disorders/rehabilitation;United States

【中文关键词】

青少年;成年人;老年人;亚利桑那;行为医学;行为医学/组织与管理;女(雌)性;人类;男(雄)性;管理医疗规划;管理医疗规划/组织与管理;管理医疗规划/利用;Medicaid;Medicaid/组织与管理;Medicaid/利用;精神卫生服务;精神卫生服务/组织与管理;精神卫生服务/利用;中年人;结果评价(卫生保健);卫生保健质量;支付标准制定和审核;研究性资助, 美国政府, 公共卫生署;州卫生计划;州卫生计划/组织与管理;物质滥用治疗中心;物质滥用治疗中心/组织与管理;物质相关性障碍;物质相关性障碍/康复;美国

【摘要】

This evaluation of substance abuse and mental health treatment services in Arizona discusses and illustrates the use of data already collected by the State to manage and monitor the public behavioral health sector. The authors utilize a framework that focuses on rate-setting and financial incentives; provider profiling and education; and monitoring of data quality and system-wide performance. Information and analysis can contribute to key management activities and forces that guide behavior in the system toward optimal system performance. Using data from 33,208 Medicaid-covered and uninsured adults, service mix varied substantially by region; for example, spending on residential care ranged from 0% to 40% for substance abuse treatment clients. By focusing on a smaller group of client with functional assessments, it also appears that regional spending levels varied considerably, for reasons not explained by client demographics or clinical measures. Finally, longitudinal data show that the regional managed care organizations are moving in different directions with regard to client mix and spending priorities. All of this variation suggests that there may be considerable latitude to guide and improve system-wide performance.

 

 

87

【题名】

Need seeds homegrown CPOE.

【作者】

Briggs B;

【刊年卷期】

Health Data Manag. 2004V12N6

【页】

90

ISSN】

1079-9869

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;Efficiency, Organizational;Florida;Medical Records Systems, Computerized;Medical Records Systems, Computerized/*organization & administration;Mental Health Services;Mental Health Services/*organization & administration;Organizational Case Studies;Systems Integration;User-Computer Interface;*Medication Systems, Hospital;*Physician's Practice Patterns

【中文关键词】

行为医学;效率, 组织;佛罗里达;病案系统, 计算机化;病案系统, 计算机化/组织与管理;精神卫生服务;精神卫生服务/组织与管理;组织状况研究;系统综合;用户计算机接口;给药系统, 医院;医师诊疗模式

 

 

88

【题名】

A preliminary investigation of balint and non-balint behavioral medicine training.

【作者】

Turner AL;Malm RL;

【机构】

WWAMI Medical Education Program, University of Wyoming, USA. aturner@uidaho.edu

【刊年卷期】

Fam Med. 2004V36N2

【页】

114-122

ISSN】

0742-3225

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Adult;Behavioral Medicine;Behavioral Medicine/*education;Family Practice;Family Practice/*education;Female;Hospitals, Community;Humans;Male;Physician-Patient Relations;Teaching;Teaching/methods;*Clinical Competence;*Internship and Residency

【中文关键词】

成年人;行为医学;行为医学/教育;家庭医学;家庭医学/教育;女(雌)性;医院, 社区;人类;男(雄)性;医生病人关系;教学;教学/方法;临床工作能力;实习医师和住院医师职务

【摘要】

BACKGROUND AND OBJECTIVES: Despite inclusion of Balint training in US family medicine residency programs, little research exists about the effectiveness of this training in improving residents' behavioral medicine skills. This study compared the outcomes for residents who did and did not undergo Balint training to increase residents' psychological medicine skills in two rural training programs. METHODS: Fourteen residents from two rural community-based training programs were assessed using the Psychological Medicine Inventory, following standard first-year behavioral medicine training. At one residency program, residents then participated in 9 months of Balint training during the second year of residency training, while at the other program they did not. Both groups were reassessed at the end of the second year of residency. RESULTS: Only Balint-trained residents showed gains in self-reported psychological medicine skills, abilities, and confidence beyond levels developed in year 1. CONCLUSIONS: Balint training enhances the levels of residents' self-reported psychological medicine skills, when compared to standard behavioral medicine curriculum for first- and second-year family medicine residents.

 

 

89

【题名】

Pharmacologic management of behavioral instability in medically ill pediatric patients.

【作者】

Cummings MR;Miller BD;

【机构】

Child and Adolescent Psychiatry, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York 14215, USA. mrcmd98@yahoo.com

【刊年卷期】

Curr Opin Pediatr. 2004V16N5

【页】

516-522

ISSN】

1040-8703

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Adolescent;Adrenergic alpha-Agonists;Adrenergic alpha-Agonists/therapeutic use;Aggression;Aggression/psychology;Analgesics, Non-Narcotic;Analgesics, Non-Narcotic/therapeutic use;Benzodiazepines;Benzodiazepines/therapeutic use;Carbamazepine;Carbamazepine/therapeutic use;Central Nervous System Stimulants;Central Nervous System Stimulants/therapeutic use;Child;Clonidine;Clonidine/therapeutic use;Diphenhydramine;Diphenhydramine/therapeutic use;Histamine H1 Antagonists;Histamine H1 Antagonists/therapeutic use;Humans;Lithium;Lithium/therapeutic use;Methylphenidate;Methylphenidate/therapeutic use;Psychomotor Agitation;Psychomotor Agitation/drug therapy;Valproic Acid;Valproic Acid/therapeutic use;*Behavior Therapy;*Behavioral Medicine

【中文关键词】

青少年;肾上腺素能α激动剂;肾上腺素能α激动剂/治疗应用;攻击;攻击/心理学;镇痛药, 非麻醉;镇痛药, 非麻醉/治疗应用;苯二氮|ZHUO|类;苯二氮|ZHUO|类/治疗应用;卡马西平;卡马西平/治疗应用;中枢神经系统刺激剂;中枢神经系统刺激剂/治疗应用;儿童;可乐定;可乐定/治疗应用;苯海拉明;苯海拉明/治疗应用;组胺H1拮抗剂;组胺H1拮抗剂/治疗应用;人类;锂;锂/治疗应用;哌醋甲酯;哌醋甲酯/治疗应用;精神运动性激动;精神运动性激动/药物疗法;丙戊酸;丙戊酸/治疗应用;行为疗法;行为医学

【摘要】

PURPOSE OF REVIEW: Behavioral instability in children and adolescents is a vexing problem faced by many clinicians. This dilemma is magnified when it presents in a child with an acute medical condition. Effective treatment in these cases with medications may help to reduce morbidity and facilitate appropriate medical care for the underlying condition. RECENT FINDINGS: There are many reviews, but few studies examine the treatment of behavioral instability in the pediatric population. There are even fewer that address behavioral instability in the presence of a comorbid medical condition. Many effective agents may worsen a given condition or interfere with the treatment of that condition. There are no prospective studies addressing this issue. SUMMARY: Many psychotropic medications must be considered when treating behavioral instability in medically ill children. Antihistamines, benzodiazepines, and antipsychotics may be of particular benefit. Definitive research is lacking and necessary to develop appropriate clinical guidelines. This article considers the most current literature and provides an overall summary of the topic.

 

 

90

【题名】

Behavioral health aspects of bioterrorism.

【作者】

Flynn BW;

【刊年卷期】

Biosecur Bioterror. 2004V2N3

【页】

232

ISSN】

1538-7135

【出版国】

United States

【语种】

eng

【文献类型】

Comment; Letter

【英文关键词】

Humans;*Behavioral Medicine;*Bioterrorism;*Disaster Planning

【中文关键词】

人类;行为医学;生物恐怖;救灾计划

 

91

【题名】

Bridging between basic theory and clinical practice.

【作者】

Barnard PJ;

【机构】

MRC Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 2EF, UK. philip.barnard@mrc-cbu.cam.ac.uk

【刊年卷期】

Behav Res Ther. 2004V42N9

【页】

977-1000

ISSN】

0005-7967

【出版国】

England

【语种】

eng

【文献类型】

Historical Article; Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*history;Behavioral Research;Behavioral Research/history;England;History, 20th Century;History, 21st Century;Humans

【中文关键词】

行为医学;CK行为医学/历史;行为研究;行为研究/历史;英格兰;历史, 20世纪;历史, 21世纪;人类

【摘要】

This paper articulates and discusses the parts played by different processes and representations in the overall conduct of applied clinical science. It distinguishes two sorts of representation, theories in the science base and bridging representations needed to map from real world behaviour to basic theory and from theory back to the real world. It is then argued that macro-theories of the "normal" human mental architecture could help synthesise basic theoretical accounts of diverse psychopathologies, without recourse to special purpose clinical cognitive theories of particular psychopathologies or even specific symptoms. Using the Interacting Cognitive Subsystems model [Affect, Cognition and Change: Re-modelling Depressive Thought, Lawrence Erlbaum Associates, Hove, 1993], some specific macro-theoretic variables are identified. Concrete illustrations are given of how the essence of quite complex basic theory can be translated into a simpler representational format to help clinicians conceptualise a psychopathological state and pinpoint relevant variables that might be changed by therapeutic interventions. Some suggestions are also offered about how the inevitable problem of complexity in multiple component theories might be directly confronted.

 

 

92

【题名】

John Teasdale: a tribute.

【作者】

Rachman J;

【机构】

Department of Psychology, University of British Columbia, 1605-2136 West Mall, Vancouver, Canada V6T 1ZA. rachman@unixg.ubc.ca

【刊年卷期】

Behav Res Ther. 2004V42N9

【页】

975-976

ISSN】

0005-7967

【出版国】

England

【语种】

eng

【文献类型】

Biography; Historical Article; Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*history;Behavioral Research;Behavioral Research/history;England;History, 20th Century;History, 21st Century;Humans

【中文关键词】

行为医学;CK行为医学/历史;行为研究;行为研究/历史;英格兰;历史, 20世纪;历史, 21世纪;人类

 

 

93

【题名】

Interfacing basic science with clinical practice: a Festschrift special issue for John Teasdale.

【作者】

Dalgleish T;

【刊年卷期】

Behav Res Ther. 2004V42N9

【页】

971-974

ISSN】

0005-7967

【出版国】

England

【语种】

eng

【文献类型】

Biography; Editorial; Festschrift; Historical Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*history;Behavioral Research;Behavioral Research/history;England;History, 20th Century;History, 21st Century;Humans

【中文关键词】

行为医学;CK行为医学/历史;行为研究;行为研究/历史;英格兰;历史, 20世纪;历史, 21世纪;人类

 

 

94

【题名】

Therapeutics in cognitive and behavioral neurology.

【作者】

Small SL;

【刊年卷期】

Ann Neurol. 2004V56N1

【页】

5-7

ISSN】

0364-5134

【出版国】

United States

【语种】

eng

【文献类型】

Comment; Editorial

【英文关键词】

Animals;Cerebrovascular Accident;Cerebrovascular Accident/physiopathology;Cerebrovascular Accident/therapy;Dopamine Agents;Dopamine Agents/therapeutic use;Humans;*Behavioral Medicine;*Cognition Disorders;*Neurology

【中文关键词】

动物;脑血管意外;脑血管意外/病理生理学;脑血管意外/治疗;多巴胺药;多巴胺药/治疗应用;人类;行为医学;认知障碍;神经病学

 

 

95

【题名】

fMRI biomarker of early neuronal dysfunction in presymptomatic Huntington's Disease.

【作者】

Paulsen JS;Zimbelman JL;Hinton SC;Langbehn DR;Leveroni CL;Benjamin ML;Reynolds NC;Rao SM;

【机构】

Department of Psychiatry, University of Iowa College of Medicine, Iowa City, USA.

【刊年卷期】

AJNR Am J Neuroradiol. 2004V25N10

【页】

1715-1721

ISSN】

0195-6108

【出版国】

United States

【语种】

eng

【文献类型】

Evaluation Studies; Journal Article

【英文关键词】

Adult;Basal Ganglia;Basal Ganglia/*physiopathology;Behavioral Medicine;Behavioral Medicine/methods;Behavioral Medicine/standards;Brain;Brain/pathology;Brain/physiopathology;Case-Control Studies;Comparative Study;Discrimination (Psychology);Female;Humans;Huntington Disease;Huntington Disease/*diagnosis;Huntington Disease/physiopathology;Huntington Disease/*psychology;Male;Middle Aged;Research Support, Non-U.S. Gov't;Research Support, U.S. Gov't, P.H.S.;Sensitivity and Specificity;Time Perception;*Magnetic Resonance Imaging;*Magnetic Resonance Imaging/standards;*Neurons

【中文关键词】

成年人;基底神经节;基底神经节/病理生理学;行为医学;行为医学/方法;行为医学/标准;脑;脑/病理学;脑/病理生理学;病例对照研究;对比研究;辨别(心理学);女(雌)性;人类;杭廷顿病;杭廷顿病/诊断;杭廷顿病/病理生理学;杭廷顿病/心理学;男(雄)性;中年人;研究资助, 非美国政府;研究性资助, 美国政府, 公共卫生署;敏感性与特异性;时间知觉;磁共振成像;磁共振成像/标准;神经元

【摘要】

BACKGROUND AND PURPOSE: Functional MR imaging (fMRI) has been used to probe basal ganglia function in people with presymptomatic Huntington's disease (pre-HD). A previous fMRI study in healthy individuals demonstrated activation of the basal ganglia during a time-discrimination task. The current study was designed to examine the relative sensitivity of fMRI compared with that of behavioral testing and morphometric measurements in detecting early neurodegenerative changes related to Huntington's disease (HD). METHODS: Pre-HD participants were assigned to two groups based on estimated years to diagnosis of manifest disease: close <12 years and far >or=12 years. Age at disease onset was estimated using a regression equation based on the number of trinucleotide CAG repeats. The time-discrimination task required participants to determine whether a specified interval was shorter or longer than a standard interval of 1200 milliseconds. RESULTS: Participants in the close group performed more poorly on the time-task discrimination than did control subjects; however, no differences were observed between far participants and control subjects. Similarly, close participants had reduced bilateral caudate volume relative to that of control subjects, whereas far participants did not. On functional imaging, close participants had significantly less activation in subcortical regions (caudate, thalamus) than control subjects; far participants had an intermediate degree of activation. In contrast, far participants had hyperactivation in medial hemispheric structures (anterior cingulate, pre-supplementary motor area) relative to close and control subjects. CONCLUSION: Hyperactivation of medial prefrontal regions compensated for reduced subcortical participation during time discrimination in pre-HD. This pattern of brain activation may represent an early neurobiologic marker of neuronal dysfunction.

 

 

96

【题名】

Transforming the workforce in children's mental health.

【作者】

Huang L;Macbeth G;Dodge J;Jacobstein D;

【机构】

American Institutes for Research, Washington, DC, USA.

【刊年卷期】

Adm Policy Ment Health. 2004V32N2

【页】

167-187

ISSN】

0894-587X

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*education;EKBehavioral Medicine/manpower;Child;Child Health Services;Child Health Services/*manpower;Child Health Services/organization & administration;Health Personnel;Health Personnel/*education;Humans;Mental Health Services;Mental Health Services/*manpower;Mental Health Services/organization & administration;United States;*Health Planning

【中文关键词】

行为医学;CK行为医学/教育;CK行为医学/人力;儿童;儿童保健服务;儿童保健服务/人力;儿童保健服务/组织与管理;卫生人员;卫生人员/教育;人类;精神卫生服务;精神卫生服务/人力;精神卫生服务/组织与管理;美国;健康计划

【摘要】

Building on the President's New Freedom Commission on Mental Health, this article highlights the twofold crisis in children's mental health: a critical shortage of practitioners in child-serving disciplines, and a mismatch between training and preparation and actual practice and service delivery. The authors discuss the challenges of transforming the workforce in the context of changing population demographics, the prevalence of complex childhood disorders, and emerging evidence-based practices. The authors conclude with recommendations targeted to states, community agencies, universities, professional associations, and advocates.

 

 

97

【题名】

Innovation in behavioral health workforce education.

【作者】

O'Connell MJ;Morris JA;Hoge MA;

【机构】

Yale Program for Recovery and Community Health, Department of Psychiatry, Yale University School of Medicine, 319 Peck Street, Building 6, Suite 1C, New Haven, CT 06513, USA. maria.oconnell@yale.edu

【刊年卷期】

Adm Policy Ment Health. 2004V32N2

【页】

131-165

ISSN】

0894-587X

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Adult;Behavioral Medicine;Behavioral Medicine/*education;Directories;Health Personnel;Health Personnel/*education;Humans;Mental Health Services;Mental Health Services/*manpower;Research Support, U.S. Gov't, P.H.S.;Teaching;Teaching/*methods;United States

【中文关键词】

成年人;行为医学;行为医学/教育;名录;卫生人员;卫生人员/教育;人类;精神卫生服务;精神卫生服务/人力;研究性资助, 美国政府, 公共卫生署;教学;教学/方法;美国

【摘要】

This article describes an effort to promote improvement in the quality and relevance of behavioral health workforce education by identifying and disseminating information on innovative training efforts. A national call for nominations was issued, seeking innovations in the education of behavioral health providers, consumers, and family members. A review committee evaluated each nomination on four dimensions: novelty, significance, transferability, and effectiveness. Nineteen innovations were selected for recognition, all of which are briefly described.

 

 

98

【题名】

Evidence-based teaching practice: implications for behavioral health.

【作者】

Stuart GW;Tondora J;Hoge MA;

【机构】

College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas Street, Charleston, SC 29425, USA. stuartg@musc.edu

【刊年卷期】

Adm Policy Ment Health. 2004V32N2

【页】

107-130

ISSN】

0894-587X

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Adult;Behavioral Medicine;Behavioral Medicine/*education;Health Personnel;Health Personnel/*education;Humans;Learning;Models, Educational;Psychological Theory;Research Support, U.S. Gov't, P.H.S.;Teaching;Teaching/*methods;United States;*Mental Health Services;*Mental Health Services/manpower

【中文关键词】

成年人;行为医学;行为医学/教育;卫生人员;卫生人员/教育;人类;学习;模型, 教育;心理学理论;研究性资助, 美国政府, 公共卫生署;教学;教学/方法;美国;精神卫生服务;精神卫生服务/人力

【摘要】

Educational practices and strategies have changed very little over the years, and even emerging advances in technology have become the prisoners of traditional academic norms. Thus, while there is increasing emphasis on evaluating and aligning caregiving processes with the strongest evidence of effectiveness, there is little demonstration or role-modeling of this same expectation in either the formal or continuing educational processes of behavioral healthcare providers. This "disconnect" is a significant problem in the field. This paper addresses the urgent need to inform the education and training of the behavioral health workforce with current theories regarding the teaching-learning process and evidence about the effectiveness of various teaching strategies. The relevant theories and available bodies of evidence are described, and the implications for workforce education and training are identified.

 

 

99

【题名】

Best practices in behavioral health workforce education and training.

【作者】

Hoge MA;Huey LY;O'Connell MJ;

【机构】

Yale University School of Medicine, Yale Department of Psychiatry, 25 Park Street, 6th Floor, New Haven, CT 06519, USA. michael.hoge@yale.edu

【刊年卷期】

Adm Policy Ment Health. 2004V32N2

【页】

91-106

ISSN】

0894-587X

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*education;Clinical Competence;Curriculum;Health Personnel;Health Personnel/*education;Humans;Mental Health Services;Mental Health Services/*manpower;Quality of Health Care;Research Support, U.S. Gov't, P.H.S.;Teaching;Teaching/methods;Teaching/*standards;United States;*Benchmarking

【中文关键词】

行为医学;CK行为医学/教育;临床工作能力;课程;卫生人员;卫生人员/教育;人类;精神卫生服务;精神卫生服务/人力;卫生保健质量;研究性资助, 美国政府, 公共卫生署;教学;教学/方法;教学/标准;美国;规范

【摘要】

Dramatic changes have occurred in the delivery of mental health and substance abuse services over the past decade and a half. There is growing concern that education programs have not kept pace with these changes and that reforms are needed to improve the quality and relevance of training efforts. Drawing on the published works of experts and a national initiative to develop a consensus among stakeholders about the nature of needed reforms, this article outlines 16 recommended "best practices" that should guide efforts to improve workforce education and training in the field of behavioral health.

 

 

100

【题名】

Implementing best practices in behavioral health workforce education-building a change agenda.

【作者】

Hoge MA;Morris JA;

【刊年卷期】

Adm Policy Ment Health. 2004V32N2

【页】

85-89

ISSN】

0894-587X

【出版国】

United States

【语种】

eng

【文献类型】

Editorial

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*education;Health Personnel;Health Personnel/*education;Humans;Mental Health Services;Mental Health Services/*manpower;United States;*Health Care Coalitions

【中文关键词】

行为医学;CK行为医学/教育;卫生人员;卫生人员/教育;人类;精神卫生服务;精神卫生服务/人力;美国;卫生保健联合体

 

101

【题名】

The future of behavioral health and primary care: drowning in the mainstream or left on the bank?

【作者】

Pincus HA;

【机构】

Department of Psychiatry, University of Pittsburgh School of Medicine, PA 15213, USA. pincusha@msx.upmc.edu

【刊年卷期】

Psychosomatics. 2003V44N1

【页】

1-11

ISSN】

0033-3182

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*trends;Forecasting;Humans;Mental Health Services;Mental Health Services/*trends;Primary Health Care;Primary Health Care/*trends;Research Support, Non-U.S. Gov't

【中文关键词】

行为医学;CK行为医学/发展趋势;预测;人类;精神卫生服务;精神卫生服务/发展趋势;初级卫生保健;初级卫生保健/发展趋势;研究资助, 非美国政府

 

 

102

【题名】

Research interests in the field of behavioral, psychosocial, and policy cancer research.

【作者】

Nehl EJ;Blanchard CM;Stafford JS;Ainsworth S;Baker F;

【机构】

Behavioral Research Center, American Cancer Society, Atlanta 30329, USA. Eric.Nehl@cancer.org

【刊年卷期】

Psychooncology. 2003V12N4

【页】

385-392

ISSN】

1057-9249

【出版国】

England

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*trends;Comparative Study;Data Collection;Humans;Neoplasms;Neoplasms/*psychology;Public Policy;Questionnaires;Research;Research/*trends;Research Personnel

【中文关键词】

行为医学;CK行为医学/发展趋势;对比研究;数据收集;人类;肿瘤;肿瘤/心理学;政府政策;问卷调查;研究;研究/发展趋势;研究人员

【摘要】

The growth of research in behavioral, psychosocial, and policy aspects of cancer is quite evident through examination of the literature. Although it is necessary to recognize the importance of past achievements in these areas, it is equally essential to identify the current interests and future areas that will form a new research agenda. The present study is the first attempt to shed light on these issues by surveying a group of behavioral, psychosocial and policy researchers from 1997 (n=714) and 2002 (n=1102). Questions were posed that dealt with current and future research interests. Results indicate a stable core of research interests in the field, as well as changing trends in interest that may affect the direction of future research. Prevention and detection, psychosocial issues, and quality of life were clearly the most recognized research interests. Emerging areas of research interest seem to be special populations and health care delivery. Examination of these findings may help with research planning, funding allocation, management, beginning researcher education, and practice.

 

 

103

【题名】

Behavioral pediatrics, part I.

【作者】

Greydanus DE;Patel DR;Pratt HD;

【机构】

Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, Kalamazoo Center for Medical Studies, 49008-1284, USA. greydanus@kcms.msu.edu

【刊年卷期】

Pediatr Clin North Am. 2003V50N4

【页】

xvii-xxxi

ISSN】

0031-3955

【出版国】

United States

【语种】

eng

【文献类型】

Historical Article; Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*history;Child;Child Behavior Disorders;Child Behavior Disorders/diagnosis;Child Behavior Disorders/*history;Child Behavior Disorders/therapy;History, 17th Century;History, 18th Century;History, 19th Century;History, 20th Century;Humans;Pediatrics;Pediatrics/*history

【中文关键词】

行为医学;CK行为医学/历史;儿童;儿童行为障碍;儿童行为障碍/诊断;儿童行为障碍/历史;儿童行为障碍/治疗;历史, 17世纪;历史, 18世纪;历史, 19世纪;历史, 20世纪;人类;儿科学;儿科学/历史

 

 

104

【题名】

Assessing the information management requirements for behavioral health providers.

【作者】

Major LF;Turner MG;

【机构】

State University of New York, Upstate Medical University, Clinical Campus at Binghamton, New York, USA.

【刊年卷期】

J Healthc Manag. 2003V48N5

【页】

323-333

ISSN】

1096-9012

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/organization & administration;Delivery of Health Care, Integrated;Delivery of Health Care, Integrated/*organization & administration;Diffusion of Innovation;Financial Management;Health Care Surveys;Humans;Information Management;Information Management/methods;Information Systems;Information Systems/*utilization;Medical Records Systems, Computerized;Medical Records Systems, Computerized/*utilization;Mental Health Services;Mental Health Services/*organization & administration;United States;*Attitude of Health Personnel

【中文关键词】

行为医学;CK行为医学/组织与管理;卫生保健提供, 联合;卫生保健提供, 联合/组织与管理;革新推广;财务管理;卫生保健调查;人类;信息管理;信息管理/方法;信息系统;信息系统/利用;病案系统, 计算机化;病案系统, 计算机化/利用;精神卫生服务;精神卫生服务/组织与管理;美国;医务工作者的态度

【摘要】

Behavioral health agencies will soon implement automated information-management systems to support their administrative, financial, and clinical care functions. Assessing current information-management capabilities and delineating future needs are prerequisite to recommending a specific information technology solution. Quantifying the discrepancy between current information-management capabilities and future requirements highlights the areas of greatest unmet need for information management. Selecting an information system that addresses the most critical areas of unmet need is a prudent purchase decision. This article describes the results of a process to assess the information-management requirements for agencies that were considering implementation of an integrated behavioral health information-management system. The assessment revealed that these agencies already employed automated systems to manage most financial functions and many administrative functions. Few agencies, however, utilized automated systems to manage clinical care functions. Selection of a behavioral health electronic medical record (EMR) effectively addressed clinical care information-management needs without duplicating existing financial and administrative management functions. Also, the EMR included features that addressed some administrative functions for which a discrepancy between current capabilities and future needs was found. Selecting an EMR instead of an integrated behavioral health information system was associated with a significant reduction in information system acquisition costs.

 

 

105

【题名】

From neurons to neighborhoods: old and new challenges for developmental and behavioral pediatrics.

【作者】

Shonkoff JP;

【机构】

The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts 02254, USA. shonkoff@brandeis.edu

【刊年卷期】

J Dev Behav Pediatr. 2003V24N1

【页】

70-76

ISSN】

0196-206X

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*trends;Child;Humans;Neurosciences;Neurosciences/*trends;Pediatrics;Social Sciences;Social Sciences/*trends;United States;*Child Behavior;*Child Development

【中文关键词】

行为医学;CK行为医学/发展趋势;儿童;人类;神经科学;神经科学/发展趋势;儿科学;社会科学;社会科学/发展趋势;美国;儿童行为;儿童发育

【摘要】

Rapidly advancing research in neurobiology and the behavioral and social sciences, coupled with dramatic changes in the social and economic circumstances under which families are raising young children, has created a highly dynamic context for early childhood policy, service delivery, and child rearing in the United States. A recent report from the National Research Council and the Institute of Medicine, presents a critical analysis of that complex knowledge base and a set of recommendations designed to close the gap between what we know and what we do to promote the healthy development of young children. This article examines the report through the lens of developmental and behavioral pediatrics and highlights both exciting opportunities and sobering challenges.

 

 

106

【题名】

A growing influence. Interview by Jane Jeffries.

【作者】

Haines P;

【刊年卷期】

J AHIMA. 2003V74N8

【页】

100

ISSN】

1060-5487

【出版国】

United States

【语种】

eng

【文献类型】

Interview

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*organization & administration;Confidentiality;Confidentiality/legislation & jurisprudence;Florida;Medical Records Systems, Computerized;Medical Records Systems, Computerized/*organization & administration;Multi-Institutional Systems;Multi-Institutional Systems/*organization & administration;*Medical Record Administrators

【中文关键词】

行为医学;CK行为医学/组织与管理;机密;机密/立法和法学;佛罗里达;病案系统, 计算机化;病案系统, 计算机化/组织与管理;多机构系统;多机构系统/组织与管理;病案管理员

 

 

107

【题名】

Living with the "unfixable".

【作者】

Soggie N;

【机构】

Atlantic Baptist University, Moncton, New Brunswick, USA.

【刊年卷期】

Health Prog. 2003V84N2

【页】

72

ISSN】

0882-1577

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Humans;Pain;Pain/*psychology;Pain/therapy;Religion and Medicine;Social Support;Social Values;United States;*Attitude of Health Personnel;*Behavioral Medicine;*Holistic Health;*Spirituality

【中文关键词】

人类;疼痛;疼痛/心理学;疼痛/治疗;宗教和医学;社会支持;社会价值;美国;医务工作者的态度;行为医学;整体保健;灵性

 

 

108

【题名】

Financing results and value in behavioral health services.

【刊年卷期】

Adm Policy Ment Health. 2003V31N2

【页】

85-110

ISSN】

0894-587X

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*economics;EKBehavioral Medicine/standards;Cost-Benefit Analysis;Decision Making, Organizational;Efficiency, Organizational;Financing, Government;Financing, Government/*methods;Financing, Government/organization & administration;Humans;Insurance, Psychiatric;Mental Health Services;Mental Health Services/*economics;Mental Health Services/standards;Organizational Objectives;Safety;Social Justice;Social Values;United States;*Reimbursement, Incentive

【中文关键词】

行为医学;CK行为医学/经济学;CK行为医学/标准;费用效益分析;决策, 组织;效率, 组织;筹资, 政府;筹资, 政府/方法;筹资, 政府/组织与管理;人类;保险, 精神病;精神卫生服务;精神卫生服务/经济学;精神卫生服务/标准;组织目标;安全;社会正义;社会价值;美国;偿还, 奖励

【摘要】

Current changes require that behavioral health care leaders understand how public and private financing mechanisms interact and how, now more than ever, behavioral health care leadership must span multiple systems and financing streams. Understanding how financing mechanisms work, what they create, and what they cause is essential if we are to make the most of increasingly limited and increasingly complex resource streams in today's health care market. This article explores a different paradigm of what adds value to publicly funded behavioral health care systems, and provides the framework for the American College of Mental Health Administration's call to behavioral health care administrators to take a new approach to the considerations behind funding decisions and payment mechanisms.

 

 

109

【题名】

Managed care and clinical decision-making in child and adolescent behavioral health: provider perceptions.

【作者】

Yanos PT;Garcia CI;Hansell S;Rosato MG;Minsky S;

【机构】

University of Medicine and Dentistry of New Jersey-University Behavioral HealthCare (UMDNJ-UBHC), Newark 07103, USA. yanosph@cmhc.umdnj.edu

【刊年卷期】

Adm Policy Ment Health. 2003V30N4

【页】

307-321

ISSN】

0894-587X

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Adolescent;Adolescent Health Services;Adolescent Health Services/*organization & administration;Behavioral Medicine;Behavioral Medicine/*organization & administration;Child;Child Health Services;Child Health Services/*organization & administration;Decision Making;Female;Health Services Research;Humans;Male;Managed Care Programs;Managed Care Programs/*organization & administration;Medicaid;Mental Health Services;Mental Health Services/*organization & administration;New England;Patient Satisfaction;Quality of Health Care

【中文关键词】

青少年;青少年保健服务;青少年保健服务/组织与管理;行为医学;行为医学/组织与管理;儿童;儿童保健服务;儿童保健服务/组织与管理;决策;女(雌)性;卫生服务研究;人类;男(雄)性;管理医疗规划;管理医疗规划/组织与管理;Medicaid;精神卫生服务;精神卫生服务/组织与管理;新英格兰;病人满意度;卫生保健质量

【摘要】

This study investigated how managed care affects clinical decision-making in a behavioral health care system. Providers serving children and adolescents under both managed and unmanaged care (n = 28) were interviewed about their awareness of differences between the benefit arrangements, how benefits affect clinical decision-making, outcomes and quality of care; and satisfaction with care. Quantitative and qualitative findings indicated that providers saw both advantages and disadvantages to managed care. Although most providers recognized the advantages of managed care in increasing efficiency, many were concerned that administrative pressures associated with managed care compromise service quality.

 

 

110

【题名】

Self-regulation training for chronic pain: can it be done effectively by telemedicine?

【作者】

Appel PR;Bleiberg J;Noiseux J;

【机构】

Psychology Science, National Rehabilitation Hospital, Washington, DC 20010, USA. philip.r.appel@medstar.net

【刊年卷期】

Telemed J E Health. 2002V8N4

【页】

361-368

ISSN】

1530-5627

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.

【英文关键词】

Chronic Disease;Humans;Pain;Pain/psychology;Pain/*therapy;Patient Education;Patient Education/*methods;Patient Satisfaction;United States;*Behavioral Medicine;*Self Care;*Telemedicine

【中文关键词】

慢性病;人类;疼痛;疼痛/心理学;疼痛/治疗;病人教育;病人教育/方法;病人满意度;美国;行为医学;自我护理;远程医学

【摘要】

The purpose of this project was to test the efficacy of behavioral telemedicine interventions designed to teach self-regulation skills to chronic pain patients who had not previously been treated. The study sought to determine whether there were differences in outcome and consumer satisfaction with the pain management intervention when delivered by conventional face-to-face methods, by telephone only, and by closed circuit TV (CCTV). We found that self-regulation techniques can be readily taught via behavioral telemedicine interventions. The primary methodologic weakness of the study is that a single experienced clinician provided all of the interventions. Thus, it is not known at this time how well the intervention can be generalized to other clinicians. In addition, there was no control on the administration of the protocols across conditions.

 

111

【题名】

Nausea and emesis: evidence for a biobehavioral perspective.

【作者】

Morrow GR;Roscoe JA;Hickok JT;Andrews PR;Matteson S;

【机构】

Cancer Control Program, University of Rochester Cancer Center, Rochester, 601 Elmwood Avenue, Box 704, Rochester, NY 14641, USA. Gary_Morrow@URMC.Rochester.edu

【刊年卷期】

Support Care Cancer. 2002V10N2

【页】

96-105

ISSN】

0941-4355

【出版国】

Germany

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Antiemetics;EKAntiemetics/pharmacology;Antineoplastic Agents;Antineoplastic Agents/adverse effects;Autonomic Nervous System;Autonomic Nervous System/drug effects;Autonomic Nervous System/physiology;Behavioral Medicine;Dose-Response Relationship, Drug;Humans;Hypothalamo-Hypophyseal System;Hypothalamo-Hypophyseal System/drug effects;Hypothalamo-Hypophyseal System/physiopathology;Nausea;Nausea/chemically induced;Nausea/*physiopathology;Nausea/*psychology;Pituitary-Adrenal System;Pituitary-Adrenal System/drug effects;Pituitary-Adrenal System/physiopathology;Time Factors;Treatment Outcome;Vomiting;Vomiting/chemically induced;Vomiting/*physiopathology;Vomiting/*psychology

【中文关键词】

止吐药;CK止吐药/药理学;抗肿瘤药;抗肿瘤药/副作用;自主神经系统;自主神经系统/药物作用;自主神经系统/生理学;行为医学;剂量效应关系, 药物;人类;下丘脑-垂体系统;下丘脑-垂体系统/药物作用;下丘脑-垂体系统/病理生理学;恶心;恶心/化学诱导;恶心/病理生理学;恶心/心理学;垂体肾上腺系统;垂体肾上腺系统/药物作用;垂体肾上腺系统/病理生理学;时间因素;治疗结果;呕吐;呕吐/化学诱导;呕吐/病理生理学;呕吐/心理学

【摘要】

Abstract. For most people, nausea and vomiting (NV) are simply unfortunate consequences of overindulgent college days or overenthusiastic amusement rides. Yet for most cancer patients, nausea and vomiting (also referred to as emesis) remain among the most frequent side effects of cancer chemotherapy. Patients typically view control of nausea as more important than control of emesis, while physicians and nurses judge emesis control to be more important to antiemetic efficacy than nausea control. The 5-HT3 receptor antagonists have been shown to be clinically more effective in controlling emesis, particularly that caused by regimens containing high-dose cisplatin, than previously available agents. Disappointingly, however, these drugs do not appear to be more effective than previous antiemetics in reducing nausea. In addition, the 5-HT3 receptor antagonists may become less effective over repeated chemotherapy administrations, and they remain expensive. An impediment to research progress has been an insularity that has prompted two parallel research efforts: one searching for biological understanding to enhance pharmacological intervention(s) and the other searching for psychological understanding to aid in developing more effective behavioral intervention(s). While both approaches have been successful, it is time to have the two views merge into a biobehavioral framework that combines them both. This paper draws on both physiological and psychological origins of NV to begin the development of a biobehavioral model of development that integrates features of both approaches.

 

 

112

【题名】

Advances in the field of low back pain in primary care: a report from the fourth international forum.

【作者】

Borkan J;Van Tulder M;Reis S;Schoene ML;Croft P;Hermoni D;

【机构】

Department of Behavioral Sciences, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Borkan@shani.net

【刊年卷期】

Spine. 2002V27N5

【页】

E128-E132

ISSN】

1528-1159

【出版国】

United States

【语种】

eng

【文献类型】

Congresses

【英文关键词】

Attitude of Health Personnel;Attitude to Health;Behavioral Medicine;Disease Management;Evidence-Based Medicine;Humans;Information Services;Low Back Pain;Low Back Pain/*classification;Low Back Pain/economics;Low Back Pain/*therapy;Primary Health Care;Primary Health Care/*trends;World Health

【中文关键词】

医务工作者的态度;健康态度;行为医学;疾病管理;循证医学;人类;信息服务;腰痛;腰痛/分类;腰痛/经济学;腰痛/治疗;初级卫生保健;初级卫生保健/发展趋势;世界卫生

【摘要】

STUDY DESIGN: Review of advances in the primary care research on low back pain (LBP) from a unique international forum, and analysis of open-ended questionnaires from participants. SUMMARY OF BACKGROUND DATA: LBP continues to be one of the most common and challenging problems in primary care. It is associated with enormous costs in terms of direct health care expenditures, and indirect work and disability-related losses. OBJECTIVE: To ascertain the current status and state of the art regarding LBP in primary care. METHODS: Four reviewers independently assessed the content and implications of presentations at the Fourth International Forum for Primary Care Research on LBP, pooled the data, and then augmented it with open-ended questionnaires completed by 35 participants. RESULTS: The Fourth Forum documented the field's emergent new paradigm-a transition from thinking about back pain as a biomedical "injury" to viewing LBP as a multifactorial biopsychosocial pain syndrome. The paradigm shift has occurred in the context of increased interest in evidence-based medicine regarding LBP in primary care. The Forum demonstrated the strides taken in moving from research and evidence gathering, through guidelines and policy formulations and finally to the dissemination and implementation imperative. There was an increasing confidence among the Forum researchers that LBP can be managed successfully in primary care settings through a combination of encouraging activity, reassurance, short-term symptom control, and alteration of inappropriate beliefs about the correlations of back pain with impairment and disability. There is also recognition that a wide range of international, evidence-based guidelines now exists that have very similar messages. CONCLUSIONS: The Fourth Forum reflected a major shift in the conceptualization of LBP in primary care and an increased emphasis on implementation and dissemination of LBP research findings and clinical guidelines. Although there is a wide array of challenges ahead, the Fourth Forum provided a clear message regarding the need to focus research energies on changing practitioner behavior.

 

 

113

【题名】

Toilet training in primary care: current practice and recommendations from behavioral pediatrics.

【作者】

Polaha J;Warzak WJ;Dittmer Mcmahon K;

【机构】

Department of Pediatrics, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, Nebraska 68198-5450, USA.

【刊年卷期】

J Dev Behav Pediatr. 2002V23N6

【页】

424-429

ISSN】

0196-206X

【出版国】

United States

【语种】

eng

【文献类型】

Guideline; Journal Article; Practice Guideline

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*methods;Child;Humans;Parents;Patient Compliance;Pediatrics;Pediatrics/*methods;Questionnaires;*Primary Health Care;*Toilet Training

【中文关键词】

行为医学;CK行为医学/方法;儿童;人类;双亲;病人依从;儿科学;儿科学/方法;问卷调查;初级卫生保健;排便训练

【摘要】

This article is the first to evaluate pediatricians' (1). current practices regarding recommendations for toilet training typically developing first-time learners and (2). opinions on an intensive procedure for rapid toilet training. Results of surveys obtained from 103 pediatricians indicate that physicians' recommendations lean toward a gradual, passive approach to toilet training with 72% endorsing "child interest" in the toilet as one of the top criteria children must exhibit before beginning training. Respondents had a somewhat unfavorable view of intensive toilet training for first-time learners with 29% endorsing the use of such a procedure, although in most cases without all of the components. It is recommended that some components of the intensive procedure could easily "fit" with physicians' current practices to increase toilet-training effectiveness within a shorter training interval. These recommendations, including compliance training as a part of teaching, increased fluid intake to promote toileting trials, and multiple training sits, are described.

 

 

114

【题名】

Evaluating mental health outcomes in an inpatient setting: convergent and divergent validity of the OQ-45 and BASIS-32.

【作者】

Doerfler LA;Addis ME;Moran PW;

【机构】

Counseling Psychology Program, Department of Psychology, Assumption College, 500 Salisbury Street, Worcester, MA 01609, USA. doerfler@assumption.edu

【刊年卷期】

J Behav Health Serv Res. 2002V29N4

【页】

394-403

ISSN】

1094-3412

【出版国】

United States

【语种】

eng

【文献类型】

Evaluation Studies; Journal Article; Validation Studies

【英文关键词】

Adult;Behavioral Medicine;Behavioral Medicine/*organization & administration;Behavioral Medicine/standards;Diagnosis-Related Groups;Diagnosis-Related Groups/statistics & numerical data;Female;Hospitals, Teaching;Hospitals, Teaching/organization & administration;Hospitals, Teaching/standards;Humans;Male;Massachusetts;Mental Disorders;Mental Disorders/diagnosis;Mental Disorders/therapy;Mental Health Services;Mental Health Services/*organization & administration;Mental Health Services/standards;Outcome Assessment (Health Care);Outcome Assessment (Health Care)/*methods;Psychiatric Department, Hospital;Psychiatric Department, Hospital/*organization & administration;Psychiatric Department, Hospital/standards;Psychiatric Status Rating Scales;Research Support, Non-U.S. Gov't;*Questionnaires

【中文关键词】

成年人;行为医学;行为医学/组织与管理;行为医学/标准;诊断相关患者组;诊断相关患者组/统计学和数值数据;女(雌)性;医院, 教学;医院, 教学/组织与管理;医院, 教学/标准;人类;男(雄)性;马萨诸塞;精神障碍;精神障碍/诊断;精神障碍/治疗;精神卫生服务;精神卫生服务/组织与管理;精神卫生服务/标准;结果评价(卫生保健);结果评价(卫生保健)/方法;精神病科, 医院;精神病科, 医院/组织与管理;精神病科, 医院/标准;精神病状态评定量表;研究资助, 非美国政府;问卷调查

【摘要】

The evolution of managed behavioral health care has led to an increased emphasis on reliable and valid assessment of outcomes in clinical practice. The present study evaluated the convergent, divergent, and concurrent validity and sensitivity to change of two widely used measures: Behavior and Symptom Identification Scale (BASIS-32) and Outcome Questionnaire (OQ-45). Comparisons of the two measures revealed that both were sensitive to change over a relatively short inpatient stay. Both measures also showed evidence of convergent and divergent validity of specific subscales, although the total scores of each measure also were highly correlated. Evidence of concurrent validity was suggested by differences between diagnostic groups on specific subscale scores. Together with previous research, these results suggest that the BASIS-32 and OQ-45 can be useful measures for tracking patient functioning over a range of treatment contexts.

 

 

115

【题名】

The mental health care context and patient characteristics: implications for provider job satisfaction.

【作者】

Bingham CR;Valenstein M;Blow FC;Alexander JA;

【机构】

Department of Veterans Affairs, Department of Psychiatry, University of Michigan, HSR&D, Ann Arbor, MI, USA. rbingham@umich.edu

【刊年卷期】

J Behav Health Serv Res. 2002V29N3

【页】

335-344

ISSN】

1094-3412

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Activities of Daily Living;EKActivities of Daily Living/psychology;Adult;Analysis of Variance;Behavioral Medicine;Comparative Study;Data Collection;Female;Hospitals, Veterans;Hospitals, Veterans/manpower;Hospitals, Veterans/*organization & administration;Humans;Male;Mentally Ill Persons;Mentally Ill Persons/*classification;Outpatient Clinics, Hospital;Outpatient Clinics, Hospital/manpower;Outpatient Clinics, Hospital/organization & administration;Personnel, Hospital;Personnel, Hospital/*psychology;Psychiatric Department, Hospital;Psychiatric Department, Hospital/manpower;Psychiatric Department, Hospital/*organization & administration;Severity of Illness Index;United States;*Job Satisfaction

【中文关键词】

日常生活活动;CK日常生活活动/心理学;成年人;方差分析;行为医学;对比研究;数据收集;女(雌)性;医院, 退伍军人;医院, 退伍军人/人力;医院, 退伍军人/组织与管理;人类;男(雄)性;精神病人;精神病人/分类;门诊部, 医院;门诊部, 医院/人力;门诊部, 医院/组织与管理;人员, 医院;人员, 医院/心理学;精神病科, 医院;精神病科, 医院/人力;精神病科, 医院/组织与管理;疾病严重程度指数;美国;职业满意

【摘要】

This research examines job satisfaction among 282 staff providing mental health care to 574 patients with serious mental illness. The mental health staff worked in 18 Department of Veterans Affairs inpatient and outpatient mental health care units at 12 Veterans Affairs Medical Centers located across the contiguous 48 states. The purpose was to identify (1) aspects of the health care context that were associated with provider job satisfaction and (2) administrative and organizational procedures/interventions that might sustain or improve provider job satisfaction. The association of provider job satisfaction with patients' functional status and symptom severity was tested in multilevel statistical models that accounted for provider and unit characteristics. Provider job satisfaction was found to be greater on smaller units and units with higher patient functioning and lower illness severity. Implications of these results are discussed.

 

 

116

【题名】

Theoretical basis and program design of a school-based mental health intervention for traumatized immigrant children: a collaborative research partnership.

【作者】

Stein BD;Kataoka S;Jaycox LH;Wong M;Fink A;Escudero P;Zaragoza C;

【机构】

ULCA/RAND Center for Health Services Research, RAND, 1700 Main Street, Santa Monica, CA 90401, USA. stein@rand.org

【刊年卷期】

J Behav Health Serv Res. 2002V29N3

【页】

318-326

ISSN】

1094-3412

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;Child;Child Health Services;Child Health Services/*organization & administration;Community Mental Health Services;Community Mental Health Services/*organization & administration;Cooperative Behavior;Female;Health Services Research;Health Services Research/organization & administration;Humans;Los Angeles;Male;Models, Organizational;Program Evaluation;Research Support, Non-U.S. Gov't;Research Support, U.S. Gov't, P.H.S.;School Health Services;School Health Services/*organization & administration;Stress Disorders, Post-Traumatic;Stress Disorders, Post-Traumatic/*therapy;Violence;Violence/*psychology;*Emigration and Immigration;*Program Development

【中文关键词】

行为医学;儿童;儿童保健服务;儿童保健服务/组织与管理;社区精神卫生服务;社区精神卫生服务/组织与管理;合作行为;女(雌)性;卫生服务研究;卫生服务研究/组织与管理;人类;洛杉矶;男(雄)性;模型, 组织管理;方案评价;研究资助, 非美国政府;研究性资助, 美国政府, 公共卫生署;中小学生卫生保健服务;中小学生卫生保健服务/组织与管理;应激障碍, 创伤后;应激障碍, 创伤后/治疗;暴力;暴力/心理学;移民(移出和移入);规划制订

【摘要】

This article describes a collaborative research model for school-based mental health services that targets children who are recent immigrants with violence-related mental health symptoms. The model describes a conceptual framework used in the establishment of an academic-community partnership during the development, evaluation, and implementation of the Mental Health for Immigrants Program (MHIP), a school-based mental health intervention. The article discusses the challenges that occurred and provides specific examples of how a participatory research partnership may work together through all program phases--design through implementation and program evaluation--to meet a specific community's needs and produce generalizable knowledge. The challenges and limitations of collaborative research approaches also are discussed, with particular emphasis on the role of participatory research in the development and evaluation of school-based mental health programs.

 

 

117

【题名】

State mental hospitals and their host communities: the origins of hostile public reactions.

【作者】

Wolff N;Stuber J;

【机构】

Institute for Health, Health Care Policy, and Aging Research, 30 College Avenue, New Brunswick, NJ 08901-1293, USA. nwolff@rci.rutgers.edu

【刊年卷期】

J Behav Health Serv Res. 2002V29N3

【页】

304-317

ISSN】

1094-3412

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Attitude to Health;Behavioral Medicine;Behavioral Medicine/organization & administration;Data Collection;Deinstitutionalization;Delivery of Health Care, Integrated;Health Facility Closure;Health Policy;Homeless Persons;Hospitals, Psychiatric;Hospitals, Psychiatric/*organization & administration;Hospitals, Psychiatric/standards;Hospitals, State;Hospitals, State/*organization & administration;Hospitals, State/standards;Humans;Organizational Case Studies;Patient Discharge;Public Relations;Research Support, Non-U.S. Gov't;Research Support, U.S. Gov't, P.H.S.;State Health Plans;United States;*Community-Institutional Relations;*Hostility;*Public Opinion

【中文关键词】

健康态度;行为医学;行为医学/组织与管理;数据收集;医院外治疗;卫生保健提供, 联合;卫生设施关闭;卫生政策;无家可归者;医院, 精神病;医院, 精神病/组织与管理;医院, 精神病/标准;医院, 州立;医院, 州立/组织与管理;医院, 州立/标准;人类;组织状况研究;病人出院;公共关系;研究资助, 非美国政府;研究性资助, 美国政府, 公共卫生署;州卫生计划;美国;社区和机构的关系;敌意;舆论

【摘要】

This article examines the hostile public reactions of a community that, through a state policy to consolidate all long-term behavioral health services, was to become the site of the state's only mental hospital. A telephone survey conducted in the host community (n = 800) and a matched community (n = 800) was used to test whether the origins of hostility toward consolidation were related to the public's negative attitudes toward mental illness and homelessness or to the beliefs about the discharge and supervisory behavior of the hospital. The host community was not found to have more negative views of mental illness, although it did have significantly more negative views about the homeless. Disapproval of consolidation was unrelated to negative views of mental illness or homelessness but was strongly related to the expected "bad" behavior of the hospital. These results suggest that the best way to improve relations between hospitals and their host communities is for hospitals to behave like "good" neighbors.

 

 

118

【题名】

Clinicians as advocates: an exploratory study of responses to managed care by mental health professionals.

【作者】

Wolff N;Schlesinger M;

【机构】

EJ Bloustein School of Planning and Public Policy, Center for Research on the Organization and Financing of Care for the Severely Mentally Ill, Rutgers University, New Brunswick, NJ, USA. nwolff@rci.rutgers.edu

【刊年卷期】

J Behav Health Serv Res. 2002V29N3

【页】

274-287

ISSN】

1094-3412

【出版国】

United States

【语种】

eng

【文献类型】

Evaluation Studies; Journal Article

【英文关键词】

Behavioral Medicine;Female;Health Care Surveys;Humans;Interviews;Male;Managed Care Programs;Managed Care Programs/*organization & administration;Managed Care Programs/utilization;Mental Health Services;Mental Health Services/*organization & administration;Mental Health Services/utilization;Middle Aged;Research Support, U.S. Gov't, P.H.S.;United States;Utilization Review;*Patient Advocacy;*Professional Role

【中文关键词】

行为医学;女(雌)性;卫生保健调查;人类;采访;男(雄)性;管理医疗规划;管理医疗规划/组织与管理;管理医疗规划/利用;精神卫生服务;精神卫生服务/组织与管理;精神卫生服务/利用;中年人;研究性资助, 美国政府, 公共卫生署;美国;利用情况审核;病人辩护;职业作用

【摘要】

Utilization review and other managed care techniques require that health care professionals assume new responsibilities as patient advocates. This article explores the extent to which characteristics of providers or their experiences with managed care practices predict the nature and extent of advocacy behavior. Interviews of 142 mental health providers revealed that experiences of harmful utilization review and norms of professionalism significantly predicted advocacy behavior. However, providers who were concerned about disaffiliation were less likely to challenge the plan directly but more likely to alter their presentation of the case to reviewers. Providers who believe that managed care plans retaliate against advocacy behavior appear to substitute covert advocacy for direct advocacy. These results are preliminary but suggest that providers condition their advocacy behavior in response to their experiences with and perceptions of managed care plans.

 

 

119

【题名】

Preventive mental health and substance abuse programs and services in managed care.

【作者】

Dorfman SL;Smith SA;

【机构】

Organization & Financing Office, Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Room 15-87, Rockville, MD 20857, USA.

【刊年卷期】

J Behav Health Serv Res. 2002V29N3

【页】

233-258

ISSN】

1094-3412

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Adolescent;Adult;Counseling;Female;Humans;Male;Managed Care Programs;Managed Care Programs/*organization & administration;Mental Disorders;Mental Disorders/prevention & control;Mental Disorders/therapy;Mental Health Services;Mental Health Services/*organization & administration;Middle Aged;Patient Education;Patient Education/organization & administration;Pregnancy;Preventive Health Services;Preventive Health Services/*organization & administration;Self Care;Substance-Related Disorders;Substance-Related Disorders/prevention & control;Substance-Related Disorders/therapy;United States;*Behavioral Medicine

【中文关键词】

青少年;成年人;咨询;女(雌)性;人类;男(雄)性;管理医疗规划;管理医疗规划/组织与管理;精神障碍;精神障碍/预防与控制;精神障碍/治疗;精神卫生服务;精神卫生服务/组织与管理;中年人;病人教育;病人教育/组织与管理;妊娠;预防卫生服务;预防卫生服务/组织与管理;自我护理;物质相关性障碍;物质相关性障碍/预防与控制;物质相关性障碍/治疗;美国;行为医学

【摘要】

If effective preventive behavioral health services were available to the millions of Americans enrolled in managed care organizations, the public health impact could be significant. This project sought to summarize published research-based information about effective preventive interventions for mental health and substance use (tobacco, alcohol, and other drugs) shown or likely to have no negative cost impact. Fifty-four studies satisfied seven screening criteria. Their findings demonstrated that preventive behavioral health interventions appropriate for managed care settings have been evaluated and have been shown to be effective. Some produced cost savings or offset costs. Six preventive behavioral health interventions are therefore recommended for managed care.

 

 

120

【题名】

Managed behavioral health care: an instrument to characterize critical elements of public sector programs.

【作者】

Ridgely MS;Giard J;Shern D;Mulkern V;Burnam MA;

【机构】

RAND Health, Santa Monica, CA 90407-2138, USA.

【刊年卷期】

Health Serv Res. 2002V37N4

【页】

1105-1123

ISSN】

0017-9124

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/organization & administration;Data Collection;Fee-for-Service Plans;Fee-for-Service Plans/*economics;Fee-for-Service Plans/organization & administration;Fee-for-Service Plans/standards;Health Services;Health Services/statistics & numerical data;Health Services Accessibility;Health Services Accessibility/classification;Health Services Research;Health Services Research/*methods;Humans;Managed Care Programs;Managed Care Programs/*economics;Managed Care Programs/organization & administration;Managed Care Programs/standards;Medicaid;Medicaid/economics;Medicaid/*organization & administration;Medicaid/standards;Mental Health Services;Mental Health Services/economics;Mental Health Services/*organization & administration;Mental Health Services/standards;Public Health Administration;Research Support, Non-U.S. Gov't;Research Support, U.S. Gov't, P.H.S.;United States

【中文关键词】

行为医学;CK行为医学/组织与管理;数据收集;按诊疗收费计划;按诊疗收费计划/经济学;按诊疗收费计划/组织与管理;按诊疗收费计划/标准;卫生服务;卫生服务/统计学和数值数据;卫生服务易得程度;卫生服务易得程度/分类;卫生服务研究;卫生服务研究/方法;人类;管理医疗规划;管理医疗规划/经济学;管理医疗规划/组织与管理;管理医疗规划/标准;Medicaid;Medicaid/经济学;Medicaid/组织与管理;Medicaid/标准;精神卫生服务;精神卫生服务/经济学;精神卫生服务/组织与管理;精神卫生服务/标准;公共卫生管理;研究资助, 非美国政府;研究性资助, 美国政府, 公共卫生署;美国

【摘要】

OBJECTIVE: To develop an instrument to characterize public sector managed behavioral health care arrangements to capture key differences between managed and "unmanaged" care and among managed care arrangements. STUDY DESIGN: The instrument was developed by a multi-institutional group of collaborators with participation of an expert panel. Included are six domains predicted to have an impact on access, service utilization, costs, and quality. The domains are: characteristics of the managed care plan, enrolled population, benefit design, payment and risk arrangements, composition of provider networks, and accountability. Data are collected at three levels: managed care organization, subcontractor, and network of service providers. DATA COLLECTION METHODS: Data are collected through contract abstraction and key informant interviews. A multilevel coding scheme is used to organize the data into a matrix along key domains, which is then reviewed and verified by the key informants. PRINCIPAL FINDINGS: This instrument can usefully differentiate between and among Medicaid fee-for-service programs and Medicaid managed care plans along key domains of interest. Beyond documenting basic features of the plans and providing contextual information, these data will support the refinement and testing of hypotheses about the impact of public sector managed care on access, quality, costs, and outcomes of care. CONCLUSIONS: If managed behavioral health care research is to advance beyond simple case study comparisons, a well-conceptualized set of instruments is necessary.

 

121

【题名】

Migraine and psychiatric comorbidity: from theory and hypotheses to clinical application.

【作者】

Sheftell FD;Atlas SJ;

【机构】

New England Center for Headache, Stamford, Connecticut, and Atlas Biomedical Communications, Columbia, Maryland, USA.

【刊年卷期】

Headache. 2002V42N9

【页】

934-944

ISSN】

0017-8748

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Anxiety Disorders;EKAnxiety Disorders/complications;EKAnxiety Disorders/psychology;Behavioral Medicine;Depressive Disorder;Depressive Disorder/complications;Depressive Disorder/drug therapy;Humans;Mental Disorders;Mental Disorders/*complications;Mental Disorders/drug therapy;Mental Disorders/psychology;Migraine Disorders;Migraine Disorders/*complications;Migraine Disorders/drug therapy;Migraine Disorders/psychology;Research Support, Non-U.S. Gov't;Substance-Related Disorders;Substance-Related Disorders/complications

【中文关键词】

焦虑症;CK焦虑症/并发症;CK焦虑症/心理学;行为医学;抑郁症;抑郁症/并发症;抑郁症/药物疗法;人类;精神障碍;精神障碍/并发症;精神障碍/药物疗法;精神障碍/心理学;偏头痛;偏头痛/并发症;偏头痛/药物疗法;偏头痛/心理学;研究资助, 非美国政府;物质相关性障碍;物质相关性障碍/并发症

【摘要】

OBJECTIVE: To review psychiatric issues that accompany migraine and means of addressing these issues. BACKGROUND: Psychiatric factors and migraine may interact in three general ways, etiologically, psychophysiologically or biobehaviorally, and comorbidly (the two disorders coexist), which is the present focus. There are several possible mechanisms of comorbidity. The relation between two disorders may be a result of chance. One disorder can cause another disorder: Diabetes can cause diabetic neuropathy. There might be shared environmental risks: Head trauma can cause both posttraumatic epilepsy and posttraumatic headache. And there may be environmental or genetic risk factors that produce a brain state giving rise to both conditions, that is, there may be some common biology underlying both conditions. This last mechanism seems to be the most likely one underlying comorbidity of migraine and psychiatric disorders. We introduce a possible role for classical paradigms of learned helplessness in regard to psychiatric comorbid depressive and anxiety disorders and migraine. RESULTS: There appears to be an association between migraine and affective disorders, particularly depression and anxiety. There are a number of formal tools for recognizing depression, but clinical evaluation should not be overlooked. Once diagnosed, depression and anxiety should be treated, both to improve the success of migraine treatment and to improve the patient's quality of life. Patients with recurring headaches are much more likely to overuse and misuse, rather than abuse, pain medications. It is important to be alert for signs that the patient may be misusing medication. Behavioral approaches can surround and support pharmacological therapy. CONCLUSIONS: Migraine is often comorbid with psychiatric disorders, particularly depression and anxiety. The relationship is likely based on shared mechanisms and successful treatment is possible.

 

 

122

【题名】

The doctor: a seminal video for cinemeducation.

【作者】

Alexander M;

【机构】

Department of Family Medicine, Carolinas Medical Center, Charlotte, NC 28232, USA. Matthew.Alexander@carolinashealthcare.org

【刊年卷期】

Fam Med. 2002V34N2

【页】

92-94

ISSN】

0742-3225

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*education;Family Practice;Family Practice/*education;Humans;North Carolina;Physician-Patient Relations;*Internship and Residency;*Medicine in Art;*Motion Pictures

【中文关键词】

行为医学;CK行为医学/教育;家庭医学;家庭医学/教育;人类;北卡罗来纳;医生病人关系;实习医师和住院医师职务;艺术中医学;电影

 

 

123

【题名】

Evaluation of the Massachusetts Behavioral Health Program: Year 8.

【作者】

Beinecke RH;Shepard DS;Leung M;Sousa D;

【机构】

Department of Public Management, Suffolk University, Boston, Massachusetts 02108-2770, USA. rickdeb61@aol.com

【刊年卷期】

Adm Policy Ment Health. 2002V30N2

【页】

141-157

ISSN】

0894-587X

【出版国】

United States

【语种】

eng

【文献类型】

Evaluation Studies; Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*organization & administration;EKBehavioral Medicine/standards;Continuity of Patient Care;Data Collection;Humans;Managed Care Programs;Managed Care Programs/organization & administration;Managed Care Programs/*standards;Massachusetts;Mental Disorders;Mental Disorders/therapy;Mental Health Services;Mental Health Services/*organization & administration;Mental Health Services/standards;Process Assessment (Health Care);Program Evaluation;Research Support, U.S. Gov't, P.H.S.

【中文关键词】

行为医学;CK行为医学/组织与管理;CK行为医学/标准;病人医护连续性;数据收集;人类;管理医疗规划;管理医疗规划/组织与管理;管理医疗规划/标准;马萨诸塞;精神障碍;精神障碍/治疗;精神卫生服务;精神卫生服务/组织与管理;精神卫生服务/标准;过程评价(卫生保健);方案评价;研究性资助, 美国政府, 公共卫生署

【摘要】

The eight-year provider evaluation of the Massachusetts Behavioral Health Program showed positive assessments of care provision, continuing problems in integration of care, high assessments of the clinical review process, high evaluations for administration, and positive ratings compared with other managed care organizations. Changes in provider organizations continue. Substance abuse and mental health providers gave similar ratings, while inpatient providers were more critical than outpatient providers. Ratings in Year 8 were higher generally than in Year 7. The program continues to be a success; however, improvement in several areas continues to be difficult.

 

 

124

【题名】

Health psychology and the study of the case: from method to analytic concern.

【作者】

Radley A;Chamberlain K;

【机构】

Department of Social Sciences, Loughborough University, Loughborough, Leicstershire, LE11 3TU, UK. a.r.radley@lboro.ac.uk

【刊年卷期】

Soc Sci Med. 2001V53N3

【页】

321-332

ISSN】

0277-9536

【出版国】

England

【语种】

eng

【文献类型】

Case Reports; Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*methods;Evaluation Studies;Humans;Mental Disorders;Mental Disorders/*diagnosis;Models, Psychological;Physician-Patient Relations;*Research Design

【中文关键词】

行为医学;CK行为医学/方法;评价研究;人类;精神障碍;精神障碍/诊断;模型, 心理学;医生病人关系;研究设计

【摘要】

This paper recommends that the study of the case be seen as of primary analytic concern to social scientists, and particularly to health psychologists. Criticism is made of the idea that a case is merely a medical instance or a methodological option. Instead, we argue that health psychologists should re-direct their attention to the 'study of the case' as being central to issues concerning health, illness and healing. There are three reasons for doing this. First, case study is basic to any procedure that involves collecting information about the context in which medicine is practiced. Second, communication between health professionals involves presenting the clinical situation of their patients as storied accounts, so that cases are made, not found. Third, there is presentational work by patients, involving communications of (as well as about) suffering and relief. This last feature is basic to how doctors and health psychologists, especially those engaged in clinical work, understand individuals as 'cases'. The paper explores differences between these different forms of case, while emphasizing portrayal as a key feature of all of them. In justifying the study of the case on conceptual as well as on clinical and methodological grounds, we highlight the position of health psychology in its attempts both to study and to intervene in health-care contexts.

 

 

125

【题名】

Bladder management in women with neurologic disabilities.

【作者】

Yang CC;Cardenas DD;

【机构】

Department of Urology, University of Washington, Veterans Affairs Puget Sound Health Care System, Seattle 98195, USA.

【刊年卷期】

Phys Med Rehabil Clin N Am. 2001V12N1

【页】

91-110

ISSN】

1047-9651

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Behavioral Medicine;Bladder;Bladder/anatomy & histology;Bladder/*innervation;Bladder/physiology;Bladder, Neurogenic;Bladder, Neurogenic/diagnosis;Bladder, Neurogenic/*etiology;Bladder, Neurogenic/*therapy;Electric Stimulation Therapy;Female;Humans;Nervous System Diseases;Nervous System Diseases/*complications;Urinary Catheterization;Urinary Tract Infections;Urinary Tract Infections/complications;Urinary Tract Infections/therapy;Urologic Surgical Procedures

【中文关键词】

行为医学;膀胱;膀胱/解剖学和组织学;膀胱/神经支配;膀胱/生理学;膀胱, 神经原性;膀胱, 神经原性/诊断;膀胱, 神经原性/病因学;膀胱, 神经原性/治疗;电刺激疗法;女(雌)性;人类;神经系统疾病;神经系统疾病/并发症;导尿管插入术;泌尿道感染;泌尿道感染/并发症;泌尿道感染/治疗;泌尿外科手术

【摘要】

Women with neurologic disabilities can experience an array of bladder disorders. There are many aspects of lower urinary tract management that are specific to women. Treatments should be based on urodynamic findings, and individualized for each woman's physical and cognitive abilities.

 

 

126

【题名】

A randomized controlled component analysis of a behavioral medicine rehabilitation program for chronic spinal pain: are the effects dependent on gender?

【作者】

Jensen IB;Bergstrom G;Ljungquist T;Bodin L;Nygren AL;

【机构】

Karolinska Institute, Section for Personal Injury Prevention, Box 127 18, 112 94, Stockholm, Sweden.

【刊年卷期】

Pain. 2001V91N1-2

【页】

65-78

ISSN】

0304-3959

【出版国】

Netherlands

【语种】

eng

【文献类型】

Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial

【英文关键词】

Absenteeism;Adult;Behavioral Medicine;Behavioral Medicine/*methods;Chronic Disease;Cognitive Therapy;Female;Humans;Male;Middle Aged;Pain;Pain/rehabilitation;Patient Compliance;Physical Therapy Modalities;Quality of Life;Reference Values;Research Support, Non-U.S. Gov't;Spinal Diseases;Spinal Diseases/physiopathology;Spinal Diseases/*rehabilitation;*Palliative Care;*Sex Characteristics

【中文关键词】

缺勤;成年人;行为医学;行为医学/方法;慢性病;认知疗法;女(雌)性;人类;男(雄)性;中年人;疼痛;疼痛/康复;病人依从;物理治疗技术;生活质量;参考值;研究资助, 非美国政府;脊柱疾病;脊柱疾病/病理生理学;脊柱疾病/康复;姑息疗法;性征

【摘要】

The aim of the present study was to evaluate the outcome of a behavioral medicine (BM) rehabilitation program and the outcome of its two main components, compared to a 'treatment-as-usual' control group (CG). The study employed a 4x4 repeated-measures design with four groups and four assessment periods (pre-treatment, post-treatment, 6-month follow-up, and 18-month follow-up). The group studied consisted of subjects on sick leave identified in a nationwide health insurance scheme in Sweden. After inclusion, the subjects were randomized to one of four conditions, which were: (1) behavior-oriented physical therapy (PT); (2) cognitive behavioral therapy (CBT); (3) BM rehabilitation consisting of PT+CBT (BM); (4) a 'treatment-as-usual' CG. The treatments were given over a period of 4 weeks, PT and CBT on a part-time basis and BM on a full-time basis. Outcome variables were sick leave, early retirement, and health-related quality of life (measured using the Short Form Health Survey, SF-36). The results showed that the risk of being granted full-time early retirement was significantly lower for females in PT and CBT compared to the CG during the 18-month follow-up period. However, the total absence from work (sick listing plus early retirement) in days over the 18-month follow-up period was not significantly different in the CG compared to the treatments. On the SF-36, women in CBT and BM reported a significantly better health-related quality of life than women in the CG at the 18-month follow-up. No significant differences for men were found on the SF-36 scales. In conclusion, the results revealed gender differences in the outcome of the treatments and that the components of this BM program yielded as good results as the whole program.

 

 

127

【题名】

Introduction: Integrating health psychology into clinical practice.

【作者】

Dornelas EA;

【机构】

Hartford Hospital, Hartford, CT 06102, USA. edornel@harthosp.org

【刊年卷期】

J Clin Psychol. 2001V57N11

【页】

1261-1262

ISSN】

0021-9762

【出版国】

United States

【语种】

eng

【文献类型】

Editorial

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*methods;Humans;Psychotherapy;Psychotherapy/*methods;United States;*Professional Practice

【中文关键词】

行为医学;CK行为医学/方法;人类;心理疗法;心理疗法/方法;美国;专业业务

 

 

128

【题名】

Evaluation of a randomized preventive behavioural medicine work site intervention for public health workers at risk for developing chronic pain.

【作者】

Dahl JC;Nilsson A;

【机构】

Department of Education and Psychology, University of Gavle, Gavle, Sweden. jdo@hig.se

【刊年卷期】

Eur J Pain. 2001V5N4

【页】

421-432

ISSN】

1090-3801

【出版国】

England

【语种】

eng

【文献类型】

Clinical Trial; Journal Article; Randomized Controlled Trial

【英文关键词】

Attitude to Health;Behavioral Medicine;Behavioral Medicine/*organization & administration;Chronic Disease;Cognitive Therapy;Cognitive Therapy/organization & administration;Fear;Follow-Up Studies;Humans;Leisure Activities;Musculoskeletal Diseases;Musculoskeletal Diseases/*prevention & control;Musculoskeletal Diseases/therapy;Nursing, Practical;Occupational Health Services;Occupational Health Services/*organization & administration;Pain;Pain/*prevention & control;Pain/therapy;Preventive Health Services;Preventive Health Services/*organization & administration;Program Evaluation;Public Health Nursing;Public Health Nursing/organization & administration;Quality of Life;Random Allocation;Research Support, Non-U.S. Gov't

【中文关键词】

健康态度;行为医学;行为医学/组织与管理;慢性病;认知疗法;认知疗法/组织与管理;恐惧;随访研究;人类;闲暇活动;肌骨骼疾病;肌骨骼疾病/预防与控制;肌骨骼疾病/治疗;护理, 开业;职业卫生服务;职业卫生服务/组织与管理;疼痛;疼痛/预防与控制;疼痛/治疗;预防卫生服务;预防卫生服务/组织与管理;方案评价;公共卫生护理学;公共卫生护理学/组织与管理;生活质量;随机分配;研究资助, 非美国政府

【摘要】

Because of the substantial increase of sick listing, reports of work disabilities and early retirement due to the musculoskeletal chronic pain, prevention studies at the work site are greatly needed. The purpose of the present study was to investigate the effects of a cognitive behavioural work site intervention on a group of public health workers judged to be at risk for developing chronic pain. Following baseline measurements, a group of 29 practical nurses with daily pain symptoms working at services for the elderly were randomized into two conditions: an active treatment based on cognitive behaviour therapy and a passive treatment based on traditional symptom alleviation. The two treatment conditions, provided by a registered nurse and a physical therapist, took place 30 min a week each once a week, on an individual basis for 4 weeks at the work site during work time. Results at 4 and 8 weeks and at 6, 12 and 24 month follow-ups showed improvements for those individuals receiving the active treatment with regard to the reduction of use of pain-killers, perception of one's self as being sick and the fear-avoidance response to work-related activities. A preliminary conclusion was that this short-term work site programme for the prevention of chronic pain for individuals at risk may be a promising development in the treatment of pain.

 

 

129

【题名】

Report of the health care delivery work group: behavioral research related to the establishment of a chronic disease model for diabetes care.

【作者】

Glasgow RE;Hiss RG;Anderson RM;Friedman NM;Hayward RA;Marrero DG;Taylor CB;Vinicor F;

【机构】

AMC Cancer Research Center, Denver, Colorado, USA. russkpf@earthlink.net

【刊年卷期】

Diabetes Care. 2001V24N1

【页】

124-130

ISSN】

0149-5992

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Chronic Disease;Diabetes Mellitus;Diabetes Mellitus/*therapy;Health Priorities;Humans;Medically Underserved Area;Minority Groups;National Institutes of Health (U.S.);United States;*Behavioral Medicine;*Delivery of Health Care;*Health Services Research;*Models, Theoretical

【中文关键词】

慢性病;糖尿病;糖尿病/治疗;卫生工作重点;人类;缺医地区;少数民族;国立卫生研究院(美国);美国;行为医学;卫生保健提供;卫生服务研究;模型, 理论

【摘要】

As one of four work groups for the November 1999 conference on Behavioral Science Research in Diabetes, sponsored by the National Institute on Diabetes and Digestive and Kidney Diseases, the health care delivery work group evaluated the status of research on quality of care, patient-provider interactions, and health care systems' innovations related to improved diabetes outcomes. In addition, we made recommendations for future research. In this article, which was developed and modified at the November conference by experts in health care delivery, diabetes and behavioral science, we summarize the literature on patient-provider interactions, diabetes care and self-management support among underserved and minority populations, and implementation of chronic care management systems for diabetes. We conclude that, although the quality of care provided to the vast majority of diabetic patients is problematic, this is principally not the fault of either individual patients or health care professionals. Rather, it is a systems issue emanating from the acute illness model of care, which still predominates. Examples of proactive population-based chronic care management programs incorporating behavioral principles are discussed. The article concludes by identifying barriers to the establishment of a chronic care model (e.g., lack of supportive policies, understanding of population-based management, and information systems) and priorities for future research in this area needed to overcome these barriers.

 

 

130

【题名】

Behavioral science research in diabetes: lifestyle changes related to obesity, eating behavior, and physical activity.

【作者】

Wing RR;Goldstein MG;Acton KJ;Birch LL;Jakicic JM;Sallis JF Jr;Smith West D;Jeffery RW;Surwit RS;

【机构】

Weight Control and Diabetes Research Center, Miriam Hospital, Brown University, Providence, Rhode Island 02906, USA. rwing@lifespan.org

【刊年卷期】

Diabetes Care. 2001V24N1

【页】

117-123

ISSN】

0149-5992

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Behavior Therapy;Body Weight;Diabetes Mellitus;Diabetes Mellitus/prevention & control;Diabetes Mellitus/therapy;Diabetes Mellitus, Type 2;Diabetes Mellitus, Type 2/*prevention & control;Diabetes Mellitus, Type 2/*therapy;Diet;Eating;Exercise;Humans;Hyperphagia;Life Style;Obesity;Obesity/prevention & control;Obesity/therapy;*Behavioral Medicine;*Research

【中文关键词】

行为疗法;体重;糖尿病;糖尿病/预防与控制;糖尿病/治疗;糖尿病, 2型;糖尿病, 2型/预防与控制;糖尿病, 2型/治疗;膳食;进食;运动(Exercise);人类;摄食过度;生活方式;肥胖症;肥胖症/预防与控制;肥胖症/治疗;行为医学;研究

【摘要】

Lifestyle factors related to obesity, eating behavior, and physical activity play a major role in the prevention and treatment of type 2 diabetes. In recent years, there has been progress in the development of behavioral strategies to modify these lifestyle behaviors. Further research, however, is clearly needed, because the rates of obesity in our country are escalating, and changing behavior for the long term has proven to be very difficult. This review article, which grew out of a National Institute of Diabetes and Digestive and Kidney Diseases conference on behavioral science research in diabetes, identifies four key topics related to obesity and physical activity that should be given high priority in future research efforts: 1) environmental factors related to obesity, eating, and physical activity; 2) adoption and maintenance of healthful eating, physical activity, and weight; 3) etiology of eating and physical activity; and 4) multiple behavior changes. This review article discusses the significance of each of these four topics, briefly reviews prior research in each area, identifies barriers to progress, and makes specific research recommendations.

 

 

 

131

【题名】

Promoting behavioral science research in diabetes.

【作者】

Marrero DG;Peyrot M;Garfield S;

【刊年卷期】

Diabetes Care. 2001V24N1

【页】

1-2

ISSN】

0149-5992

【出版国】

United States

【语种】

eng

【文献类型】

Comment; Editorial

【英文关键词】

Behavior;Diabetes Mellitus;Diabetes Mellitus/*therapy;Diet;Exercise;Humans;*Behavioral Medicine;*Research

【中文关键词】

行为;糖尿病;糖尿病/治疗;膳食;运动(Exercise);人类;行为医学;研究

 

 

132

【题名】

Behavioral neurology in the emergency room: language testing, brain imaging, and acute stroke therapy.

【作者】

Kirshner HS;

【刊年卷期】

Ann Neurol. 2001V50N5

【页】

559-560

ISSN】

0364-5134

【出版国】

United States

【语种】

eng

【文献类型】

Comment; Editorial

【英文关键词】

Animals;Behavioral Medicine;Behavioral Medicine/*methods;Brain;Brain/blood supply;Brain/pathology;Brain/physiopathology;Cerebrovascular Accident;Cerebrovascular Accident/*diagnosis;Cerebrovascular Accident/physiopathology;Cerebrovascular Accident/therapy;Emergency Medical Services;Emergency Medical Services/*methods;Humans;Temporal Lobe;Temporal Lobe/blood supply;Temporal Lobe/pathology;Temporal Lobe/physiopathology;*Magnetic Resonance Imaging;*Neuropsychological Tests

【中文关键词】

动物;行为医学;行为医学/方法;脑;脑/血液供给;脑/病理学;脑/病理生理学;脑血管意外;脑血管意外/诊断;脑血管意外/病理生理学;脑血管意外/治疗;急救医疗服务;急救医疗服务/方法;人类;颞叶;颞叶/血液供给;颞叶/病理学;颞叶/病理生理学;磁共振成像;神经心理学测验

 

 

133

【题名】

The role of behavioral and psychosocial science in reducing cancer morbidity and mortality.

【作者】

Burish TG;

【机构】

Vanderbilt University, Nashville, Tennessee 37205, USA. thomas.g.burish@vanderbilt.edu

【刊年卷期】

Oncologist. 2000V5N3

【页】

263-266

ISSN】

1083-7159

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Cost-Benefit Analysis;Humans;Morbidity;Neoplasms;Neoplasms/mortality;Neoplasms/pathology;Neoplasms/*psychology;Psychotherapy;Quality of Life;Research Support;*Behavioral Medicine;*Behavioral Medicine/economics;*Social Support

【中文关键词】

费用效益分析;人类;年患病率;肿瘤;肿瘤/死亡率;肿瘤/病理学;肿瘤/心理学;心理疗法;生活质量;研究资助;行为医学;行为医学/经济学;社会支持

【摘要】

Behavioral and psychosocial science has the potential to contribute much to the overall effort to reduce cancer morbidity and mortality and to improve the quality of life for cancer patients and their families. However, for a variety of reasons, including a lack of sustained funding for research and training and a lack of confidence by some in the potential payoff for investments in the area, this potential has not only not been realized but also not been adequately explored. A special subcommittee of "The March" Research Task Force studied research in this area and issued a report making several recommendations for future funding for psychosocial and behavioral research in cancer. This article reports those recommendations and the reasons the committee supported them.

 

 

134

【题名】

Prospective randomized two-Arm controlled study to determine the efficacy of a specific intervention to improve long-term adherence to highly active antiretroviral therapy.

【作者】

Tuldra A;Fumaz CR;Ferrer MJ;Bayes R;Arno A;Balague M;Bonjoch A;Jou A;Negredo E;Paredes R;Ruiz L;Romeu J;Sirera G;Tural C;Burger D;Clotet B;

【机构】

HIV Unit, "Fundacio Lluita SIDA" and "IrsiCaixa" Retrovirology Laboratory, "Germans Trias i Pujol" University Hospital, Badalona, Spain. atuldra@ns.hugtip.scs.es

【刊年卷期】

J Acquir Immune Defic Syndr. 2000V25N3

【页】

221-228

ISSN】

1525-4135

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Clinical Trial; Journal Article; Randomized Controlled Trial

【英文关键词】

Adult;Analysis of Variance;Antiretroviral Therapy, Highly Active;Antiretroviral Therapy, Highly Active/*psychology;Behavioral Medicine;Behavioral Medicine/*methods;Female;HIV Infections;HIV Infections/*drug therapy;HIV Protease Inhibitors;HIV Protease Inhibitors/blood;HIV-1;Humans;Male;Middle Aged;Patient Compliance;Patient Compliance/*psychology;Prospective Studies;RNA, Viral;RNA, Viral/blood;Research Support, Non-U.S. Gov't;Viral Load;*Patient Education

【中文关键词】

成年人;方差分析;抗逆转录病毒治疗, 高效;抗逆转录病毒治疗, 高效/心理学;行为医学;行为医学/方法;女(雌)性;HIV感染;HIV感染/药物疗法;HIV蛋白酶抑制药;HIV蛋白酶抑制药/血液;HIV-1;人类;男(雄)性;中年人;病人依从;病人依从/心理学;前瞻性研究;RNA, 病毒;RNA, 病毒/血液;研究资助, 非美国政府;病毒载量;病人教育

【摘要】

BACKGROUND: Nearly perfect compliance seems to be indispensable to obtain the maximum benefit from highly active antiretroviral therapy (HAART). Interventions to ensure a high level of adherence during a relatively long-term period of therapy are necessary. METHODS: This is a prospective, randomized, two-arm controlled study including patients starting their first-or second-line HAART who were randomized to receive psychoeducative intervention to implement adherence (experimental group [EG]) or a usual medical follow-up (control group [CG]). We aimed to study the efficacy of a psychoeducative intervention to ensure long-term adherence to HAART, its relation with the virologic efficacy of treatment, and to determine the variables related to long-term adherence. Visits were made at weeks 0, 4, 24, and 48 for data collection. Self-reported adherence was registered at each visit and its veracity was tested by randomized blood analyses performed without previous warning to 40% of patients. Appropriate adherence was defined as the consumption of >/=95% of medication prescribed. Statistical analyses were performed both by the as treated (AT) and the intention to treat missing = failure (ITT) methods. RESULTS: In all, 116 patients were included. At week 48, 94% of patients in the EG versus 69% controls achieved adherence >/=95% (p =.008); 89% of patients in the EG versus 66% controls had HIV-1 RNA levels <400 copies/ml (p =.026). Overall, 85% of patients with adherence >/=95% but only 45% of those with adherence <95% had viral load (VL) <400 copies/ml (p =. 008). In multivariate analysis, variables significantly related to adherence were having received a psychoeducative intervention (odds ratio [OR], 6.58; p =.04), poor effort to take medication (OR, 5.38; p =.03), and high self-perceived capacity to follow the regimen (OR, 13.76; p =.04). Self-reported adherence and drug plasma levels coincided in 93% of cases. However, differences in adherence did not reach statistical significance in the ITT analysis although a clear tendency toward benefit was observed in EG. CONCLUSIONS: Specific and maintained psychoeducative interventions based on excellence on clinical practice are useful to keep high levels of adherence as well as high levels of viral suppression. There is a clear relation between high adherence levels and virologic success. Assessment of certain specific variables related to adherence may be helpful to monitor patient's compliance in the clinical setting.

 

 

135

【题名】

Community effects on access to behavioral health care.

【作者】

Gresenz CR;Stockdale SE;Wells KB;

【机构】

RAND, Santa Monica, CA 90407, USA.

【刊年卷期】

Health Serv Res. 2000V35N1Pt2

【页】

293-306

ISSN】

0017-9124

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Consumer Participation;EKConsumer Participation/statistics & numerical data;EKConsumer Participation/*utilization;Female;Health Maintenance Organizations;Health Maintenance Organizations/statistics & numerical data;Health Maintenance Organizations/utilization;Health Services Research;Health Services Research/methods;Health Services Research/statistics & numerical data;Humans;Male;Mental Health Services;Mental Health Services/statistics & numerical data;Mental Health Services/*utilization;Middle Aged;Models, Statistical;Random Allocation;Research Support, Non-U.S. Gov't;Research Support, U.S. Gov't, P.H.S.;Socioeconomic Factors;United States;*Behavioral Medicine;*Behavioral Medicine/statistics & numerical data;*Health Services Accessibility;*Health Services Accessibility/statistics & numerical data

【中文关键词】

用户参与;CK用户参与/统计学和数值数据;CK用户参与/利用;女(雌)性;健康维护组织;健康维护组织/统计学和数值数据;健康维护组织/利用;卫生服务研究;卫生服务研究/方法;卫生服务研究/统计学和数值数据;人类;男(雄)性;精神卫生服务;精神卫生服务/统计学和数值数据;精神卫生服务/利用;中年人;模型, 统计学;随机分配;研究资助, 非美国政府;研究性资助, 美国政府, 公共卫生署;社会经济因素;美国;行为医学;行为医学/统计学和数值数据;卫生服务易得程度;卫生服务易得程度/统计学和数值数据

【摘要】

OBJECTIVE: To explore the effects of community-level factors on access to any behavioral health care and specialty behavioral health care. DATA: Healthcare for Communities household survey data, merged to supplemental data from the 1990 Census Area Resource File, 1995 U.S. Census Bureau Small Area Estimates, and 1994 HMO enrollment data. STUDY DESIGN: We use a random intercept model to estimate the influences of community-level factors on access to any outpatient care, any behavioral health care conditional on having received outpatient care, and any specialty behavioral health care conditional on having received behavioral health care. DATA COLLECTION: HCC data were collected in 1997 from about 10,000 households nationwide but clustered in 60 sites. PRINCIPAL FINDINGS: Individuals in areas with greater HMO presence have better overall access to care, which in turn affects access to behavioral health care; individuals in poorer communities have less access to specialty care compared to individuals in wealthier communities. CONCLUSIONS: Our findings of lower access to specialty care among those in poor communities raises concerns about the appropriateness and quality of the behavioral health care they are receiving. More generally, the findings suggest the importance of considering the current status and expected evolution of HMO penetration and the income level in a community when devising health care policy.

 

 

136

【题名】

Social ecology and behavioral medicine: implications for training, practice, and policy.

【作者】

Stokols D;

【机构】

School of Social Ecology, University of California, Irvine, USA. dstokols@uci.edu

【刊年卷期】

Behav Med. 2000V26N3

【页】

129-138

ISSN】

0896-4289

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Humans;Sociology, Medical;Sociology, Medical/education;Sociology, Medical/standards;Sociology, Medical/trends;United States;*Behavioral Medicine;*Behavioral Medicine/education;*Behavioral Medicine/standards;*Behavioral Medicine/trends;*Ecology;*Health Policy

【中文关键词】

人类;社会学, 医学;社会学, 医学/教育;社会学, 医学/标准;社会学, 医学/发展趋势;美国;行为医学;行为医学/教育;行为医学/标准;行为医学/发展趋势;生态学;卫生政策

【摘要】

Social ecology offers a conceptual framework for understanding the etiology of multiple health problems and a basis for designing broad-gauge educational, therapeutic, and policy interventions to enhance personal and community well-being. Implications of social ecology for behavioral medicine are considered in relation to the development of diagnostic and therapeutic practices, professional training programs, and health policies implemented at municipal, state, and national levels. By influencing the training and practices of healthcare professionals and the decisions of corporate and community leaders, behavioral medicine can expand the scope and impact of future interventions beyond the health gains achievable through provision of direct services to patient populations. Potential barriers to establishing ecologically based health programs and policies and directions for research at the interface of behavioral medicine, social ecology, and public health are discussed.

 

 

137

【题名】

Group interventions and the limits of behavioral medicine.

【作者】

Dooley D;Catalano R;

【机构】

Department of Psychology and Social Behavior, School of Social Ecology, University of California, Irvine, USA. cddooley@uci.edu

【刊年卷期】

Behav Med. 2000V26N3

【页】

116-128

ISSN】

0896-4289

【出版国】

United States

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*trends;Health Promotion;Health Promotion/*methods;Humans;Primary Prevention;Sociology, Medical;Sociology, Medical/methods;United States;*Health Planning;*Public Health;*Public Health/economics

【中文关键词】

行为医学;CK行为医学/发展趋势;健康促进;健康促进/方法;人类;一级预防;社会学, 医学;社会学, 医学/方法;美国;健康计划;公共卫生;公共卫生/经济学

【摘要】

A wide range of interventions has been devised to address health hazards in the social and physical environment. The authors propose a 2-dimensional matrix to organize these interventions. The timing of interventions is divided into 4 stages: preventing exposure to hazard (proactive primary prevention), preventing symptoms from appearing (reactive primary prevention), preventing early symptoms from becoming chronic or leading to disease (secondary prevention), and managing the disease (tertiary prevention). The level at which the intervention is targeted is divided into 2 categories: micro (individual or family) and macro (more aggregate social level). Large-scale interventions such as media campaigns can target either individual health behaviors (microlevel) or the environment (macrolevel). This typology is illustrated with interventions designed to prevent or ameliorate the health consequences of adverse employment changes such as job loss. The analysis concludes that behavioral medicine and public health approaches are differentially suited to different intervention types.

 

 

138

【题名】

Psychosomatic medicine: state of the art.

【作者】

Ursin H;

【机构】

Department of Biological and Medical Psychology, University of Bergen, Norway. holger.ursin@psych.uib.no

【刊年卷期】

Ann Med. 2000V32N5

【页】

323-328

ISSN】

0785-3890

【出版国】

ENGLAND

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Behavioral Medicine;Humans;Life Style;Psychosomatic Medicine;Psychosomatic Medicine/*trends;Stress, Psychological;*Psychophysiologic Disorders;*Psychophysiologic Disorders/psychology

【中文关键词】

行为医学;人类;生活方式;心身医学;心身医学/发展趋势;应激, 心理学;心理生理性障碍;心理生理性障碍/心理学

【摘要】

Contemporary psychosomatic medicine must take into consideration developments in psychobiology. The difficulty in accepting dualistic concepts is a serious challenge to positions distinguishing between psychological and 'real' causes of disease. There is more emphasis on life style factors for disease and on the impact of psychosocial factors on illness rather than on disease. The neurophysiological concept of activation or arousal has been important in the development of rational pathophysiological models that describe how sustained arousal may be a pathophysiological factor. For illness, sensitization may be an acceptable psychobiological mechanism underlying very frequently occurring and expensive medical conditions that require medical and economical assistance. One possible alternative to old dynamic concepts is the development of a cognitive arousal theory of stress.

 

 

139

【题名】

Behavioral medicine teaching rounds: improving doctor-patient interaction skills.

【作者】

Harvey RT;Cope DW;

【机构】

Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC, USA.

【刊年卷期】

Acad Med. 2000V75N5

【页】

561-562

ISSN】

1040-2446

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*education;South Carolina;*Education, Medical;*Physician-Patient Relations

【中文关键词】

行为医学;CK行为医学/教育;南卡罗来纳;教育, 医学;医生病人关系

 

 

140

【题名】

Refractory gastrointestinal symptoms: a combined medical psychiatric approach.

【作者】

Olden KW;

【机构】

Department of Medicine and Psychiatry, Mayo Clinic Scottsdale, AZ 85259, USA.

【刊年卷期】

Semin Gastrointest Dis. 1999V10N1

【页】

37-45

ISSN】

1049-5118

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Case Reports; Journal Article

【英文关键词】

Adult;Anxiety;Anxiety/psychology;Battered Women;Behavioral Medicine;Culture;Depression;Depression/psychology;Female;Gastrointestinal Diseases;Gastrointestinal Diseases/diagnosis;Gastrointestinal Diseases/*psychology;Humans;Hypnosis;Mental Disorders;Mental Disorders/*diagnosis;Mental Disorders/*therapy;Sex Factors;*Patient Care Team

【中文关键词】

成年人;焦虑;焦虑/心理学;被殴打妇女;行为医学;文化;抑郁;抑郁/心理学;女(雌)性;胃肠疾病;胃肠疾病/诊断;胃肠疾病/心理学;人类;催眠术;精神障碍;精神障碍/诊断;精神障碍/治疗;性别因素;病人医疗小组

【摘要】

Gastroenterology has always been a collaborative specialty. Through the years, gastroenterologists have created important partnerships with pathologists, radiologists, surgeons, gynecologists, and pediatricians. These collaborative relationships have greatly enhanced patient care and research. This article reviews the literature on psychiatric comorbidity in the medical setting and gastroenterology practice in particular. The ability to recognize psychiatric comorbidity and relate it to the patient's presenting gastrointestinal (GI) complaint can pay great dividends for patients. The ability to apply these observations to help facilitate psychiatric collaboration and specifically, to initiate behavioral treatment, represents a new dimension in the care of chronic GI disorders. Finally, the relationship between physical and sexual abuse and GI illness and the usefulness of psychiatric interventions in the treatment of chronic GI disorders is reviewed in detail.

 

 

 

 

141

【题名】

Consolidation: the changing face of the behavioral health care industry.

【作者】

Dowd CE;Ashley Dixon R;

【机构】

Colleen E. Dowd & Associates, USA.

【刊年卷期】

Manag Care Q. 1999V7N1

【页】

61-63

ISSN】

1064-5454

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/organization & administration;EKBehavioral Medicine/trends;Consumer Satisfaction;Economic Competition;Health Facility Merger;Health Facility Merger/*trends;Humans;Managed Care Programs;Managed Care Programs/*organization & administration;Mental Health Services;Mental Health Services/*organization & administration;Mental Health Services/trends;United States

【中文关键词】

行为医学;CK行为医学/组织与管理;CK行为医学/发展趋势;用户满意;经济竞争;卫生设施合并;卫生设施合并/发展趋势;人类;管理医疗规划;管理医疗规划/组织与管理;精神卫生服务;精神卫生服务/组织与管理;精神卫生服务/发展趋势;美国

 

 

142

【题名】

David Hill: behavioural insights into cancer control.

【作者】

Tattam A;

【刊年卷期】

Lancet. 1999V354N9185

【页】

1186

ISSN】

0140-6736

【出版国】

ENGLAND

【语种】

eng

【文献类型】

Biography; Historical Article; News

【英文关键词】

Australia;Behavioral Medicine;Behavioral Medicine/*history;History, 20th Century;Humans;Neoplasms;Neoplasms/history;Neoplasms/*prevention & control;Portraits;Smoking;Smoking/history;Smoking/*prevention & control

【中文关键词】

澳大利亚;行为医学;行为医学/历史;历史, 20世纪;人类;肿瘤;肿瘤/历史;肿瘤/预防与控制;肖像;吸烟;吸烟/历史;吸烟/预防与控制

 

 

143

【题名】

Self-directed smoking cessation.

【刊年卷期】

J Indian Med Assoc. 1999V97N9

【页】

385

ISSN】

0019-5847

【出版国】

INDIA

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;Humans;Smoking Cessation;Smoking Cessation/economics;Smoking Cessation/*methods

【中文关键词】

行为医学;人类;戒烟;戒烟/经济学;戒烟/方法

 

 

144

【题名】

Regulating managed care: interest group competition for control and behavioral health care.

【作者】

Ross EC;

【机构】

American Managed Behavioral Healthcare Association, USA.

【刊年卷期】

J Health Polit Policy Law. 1999V24N3

【页】

599-625

ISSN】

0361-6878

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Behavioral Medicine;Conflict (Psychology);Economic Competition;Economic Competition/*legislation & jurisprudence;Facility Regulation and Control;Facility Regulation and Control/economics;Facility Regulation and Control/*legislation & jurisprudence;Health Care Reform;Health Care Reform/organization & administration;Humans;Managed Care Programs;Managed Care Programs/economics;Managed Care Programs/legislation & jurisprudence;Managed Care Programs/*organization & administration;Mental Health Services;Mental Health Services/economics;Mental Health Services/legislation & jurisprudence;Mental Health Services/*organization & administration;Power (Psychology);Quality Assurance, Health Care;Quality Assurance, Health Care/organization & administration;Social Responsibility;United States;*Consumer Advocacy;*Health Behavior;*Lobbying

【中文关键词】

行为医学;冲突(心理学);经济竞争;经济竞争/立法和法学;设施的规章和管理;设施的规章和管理/经济学;设施的规章和管理/立法和法学;卫生保健改革;卫生保健改革/组织与管理;人类;管理医疗规划;管理医疗规划/经济学;管理医疗规划/立法和法学;管理医疗规划/组织与管理;精神卫生服务;精神卫生服务/经济学;精神卫生服务/立法和法学;精神卫生服务/组织与管理;权力(心理学);质量保证, 卫生保健;质量保证, 卫生保健/组织与管理;社会责任;美国;消费者辩护;健康行为;游说

【摘要】

In this essay I identify how historic patterns of competition among health care interest groups have simultaneously retained their past contours and also changed significantly as a result of the jolt created by the rise of managed care. I explain why it is that I and other executives of for-profit managed behavioral health care organizations, traditionally advocates of market-based approaches to accountability, have begun to support some versions of regulation by the national government in order to restore consumer confidence in the credibility of managed health plans. Key concepts that are addressed include notions of public accountability, control of the purse strings, consumer protections, and provider privileges.

 

 

145

【题名】

Cost and quality trends under managed care: is there a learning curve in behavioral health carve-out plans?

【作者】

Sturm R;

【机构】

RAND, Santa Monica, CA 90401, USA. roland_sturm@rand.org

【刊年卷期】

J Health Econ. 1999V18N5

【页】

593-604

ISSN】

0167-6296

【出版国】

NETHERLANDS

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*economics;Contract Services;Contract Services/economics;Contract Services/standards;Health Benefit Plans, Employee;Health Benefit Plans, Employee/economics;Health Care Costs;Health Care Costs/*trends;Health Expenditures;Health Expenditures/trends;Health Services Research;Managed Care Programs;Managed Care Programs/*economics;Quality of Health Care;Quality of Health Care/*trends;Research Support, Non-U.S. Gov't;Research Support, U.S. Gov't, P.H.S.;United States

【中文关键词】

行为医学;CK行为医学/经济学;合同业务;合同业务/经济学;合同业务/标准;保健福利计划, 雇员;保健福利计划, 雇员/经济学;卫生保健费用;卫生保健费用/发展趋势;卫生经费支出;卫生经费支出/发展趋势;卫生服务研究;管理医疗规划;管理医疗规划/经济学;卫生保健质量;卫生保健质量/发展趋势;研究资助, 非美国政府;研究性资助, 美国政府, 公共卫生署;美国

【摘要】

The paper studies the performance of network plans over time using data from 52 managed behavioral health plans. Costs exhibit a 'learning curve' with additional cost declines of 10-15% with every doubling of experience, which are independent from time trends and scale economies. Process-of-care measures show increased appropriateness of follow-up care and reduced 30-day rehospitalization, but the relationship to experience or time is not statistically significant. Possible causes of organizational 'learning' could be faster referrals to network clinicians, increased acceptance of network providers by patients, selection of more efficient providers, improved care management procedures, or better monitoring techniques.

 

 

146

【题名】

Cardiovascular and mood responses to quantified doses of cigarette smoke in oral contraceptive users and nonusers.

【作者】

Masson CL;Gilbert DG;

【机构】

University of California, San Francisco, USA. masson@itsa.ucsf.edu

【刊年卷期】

J Behav Med. 1999V22N6

【页】

589-604

ISSN】

0160-7715

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Clinical Trial; Controlled Clinical Trial; Journal Article

【英文关键词】

Administration, Inhalation;Adolescent;Adult;Affect;Affect/*drug effects;Analysis of Variance;Behavioral Medicine;Blood Pressure;Blood Pressure/drug effects;Cardiovascular Physiology;Cardiovascular Physiology/*drug effects;Contraceptives, Oral;Contraceptives, Oral/*administration & dosage;Contraceptives, Oral/adverse effects;Coronary Disease;Coronary Disease/etiology;Coronary Disease/psychology;Diastole;Dose-Response Relationship, Drug;Female;Heart Rate;Heart Rate/drug effects;Humans;Menstruation;Menstruation/physiology;Menstruation/psychology;Nicotine;Nicotine/*administration & dosage;Nicotine/adverse effects;Self Disclosure;Smoking;Smoking/adverse effects;Systole

【中文关键词】

投药, 吸入;青少年;成年人;情感;情感/药物作用;方差分析;行为医学;血压;血压/药物作用;心血管生理学;心血管生理学/药物作用;避孕药, 口服;避孕药, 口服/投药和剂量;避孕药, 口服/副作用;冠状动脉疾病;冠状动脉疾病/病因学;冠状动脉疾病/心理学;心舒期;剂量效应关系, 药物;女(雌)性;心率;心率/药物作用;人类;月经;月经/生理学;月经/心理学;尼古丁;尼古丁/投药和剂量;尼古丁/副作用;自我揭露;吸烟;吸烟/副作用;心缩期

【摘要】

Previous research suggests that the female sex hormones may moderate cardiovascular and mood responses to cigarette smoking and abstinence. To test this possibility, acute effects of cigarette smoking on cardiovascular reactivity and mood were examined in 12 oral contraceptive users and 12 nonusers across two menstrual phases (early and late cycle). After overnight deprivation, each participant attended two sessions in which they first sham-smoked and then smoked two standard cigarettes, via a quantified smoke delivery system. Oral contraceptive users exhibited larger cigarette smoking-induced increases in heart rate compared with nonusers. In addition, cigarette smoking-induced cardiovascular changes varied with both the phase of the menstrual cycle and oral contraceptive use. No menstrual phase-dependent effects were observed for tobacco withdrawal symptoms, premenstrual symptoms, or moods prior to smoking. Cardiovascular hyperreactivity to cigarette smoke in oral contraceptive users may help explain the mechanisms by which smoking and oral contraceptive use contribute to an elevated risk for coronary heart disease.

 

 

147

【题名】

Group cohesion in older adult exercisers: prediction and intervention effects.

【作者】

Estabrooks PA;Carron AV;

【机构】

School of Kinesiology, University of Western Ontario, London, Canada.

【刊年卷期】

J Behav Med. 1999V22N6

【页】

575-588

ISSN】

0160-7715

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Clinical Trial; Controlled Clinical Trial; Journal Article

【英文关键词】

Aged;Behavioral Medicine;Exercise;Exercise/physiology;Exercise/*psychology;Humans;Social Support;Statistics;Time Factors;*Group Processes

【中文关键词】

老年人;行为医学;运动(Exercise);运动(Exercise)/生理学;运动(Exercise)/心理学;人类;社会支持;统计学;时间因素;团体处理

【摘要】

Two studies were conducted to examine the relationship between class cohesion and exercise adherence in older adult exercisers. Study 1 examined the predictive ability of four dimensions of cohesion on exercise participation at 1, 6, and 12 months following the initial assessment of cohesion. Study 2 examined the effectiveness of a team-building intervention, designed to enhance class cohesion (and based on Study 1 results), on improving exercise adherence and return rates. Participants were assigned to a team-building, placebo, or control condition. Study 1 showed that three measures of cohesion, Individual attractions to the group-social, Group integration-social, and Group integration-task, were all significantly related to exercise class attendance following a 1-month interval. Group integration-task was significantly related to class attendance following a 6-and a 12-month interval. Study 2 showed that participants in the team-building condition (a) attended more classes than the control and placebo conditions and (b) had a higher return rate following a 10-week hiatus than the control condition. It was concluded that (a) class cohesion plays a significant role in exercise class participation, both short- and long-term, and (b) samples of older adult exercisers are appropriate groups for interventions based on developing class cohesion.

 

 

148

【题名】

The negative impact of the cognitive movement on the continued growth of the behavior therapy movement: a historical perspective.

【作者】

Levis DJ;

【机构】

Department of Psychology, SUNY Binghamton 13902-6000, USA.

【刊年卷期】

Genet Soc Gen Psychol Monogr. 1999V125N2

【页】

157-171

ISSN】

8756-7547

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Historical Article; Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*history;Cognitive Therapy;Cognitive Therapy/*history;History, 20th Century;Humans;Mental Disorders;Mental Disorders/history;Mental Disorders/therapy;Philosophy;Philosophy/history

【中文关键词】

行为医学;CK行为医学/历史;认知疗法;认知疗法/历史;历史, 20世纪;人类;精神障碍;精神障碍/历史;精神障碍/治疗;哲学;哲学/历史

【摘要】

In recent years, a growing number of behavior therapists have expressed concern over the current state of the behavioral therapy movement. Some of the major problems raised center on current overload and fractionization, the lack of a coherent overall picture, the loss of identity, and the influx of cognitivism. In an attempt to enhance understanding of the factors responsible for the current crises in the behavior therapy field, the author provides a historical overview of the behavioral movement from its original conception to its current state. An argument is made that the solution to the afore-mentioned problems resides in the readoption of the underlying philosophy of science that originally gave birth and purpose to the field.

 

 

149

【题名】

[Siblings of children with chronic disease]

【作者】

Odievre M;

【刊年卷期】

Arch Pediatr. 1999V6N11

【页】

1149-1151

ISSN】

0929-693X

【出版国】

FRANCE

【语种】

fre

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;Child;Cultural Characteristics;Humans;Nuclear Family;Social Support;*Adaptation, Psychological;*Chronic Disease;*Disabled Children;*Family Health

【中文关键词】

行为医学;儿童;文化特征;人类;核型家庭;社会支持;适应, 心理学;慢性病;残疾儿童;家庭卫生

 

 

150

【题名】

Training in behavioral medicine and behavioral change for family practice residents.

【作者】

McCarthy ME;Zoorob RJ;

【机构】

Department of Family Medicine, Louisiana State University Medical Center, Kenner 70065, USA.

【刊年卷期】

Acad Med. 1999V74N5

【页】

606-607

ISSN】

1040-2446

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*education;Family Practice;Family Practice/*education;Health Behavior;Health Promotion;Humans;Louisiana;Mental Disorders;Mental Disorders/psychology;Mental Disorders/therapy;*Internship and Residency

【中文关键词】

行为医学;CK行为医学/教育;家庭医学;家庭医学/教育;健康行为;健康促进;人类;路易斯安那;精神障碍;精神障碍/心理学;精神障碍/治疗;实习医师和住院医师职务

 

151

【题名】

Journal review: Mind/Body Medicine.

【作者】

Pickering TG;Stone A;

【刊年卷期】

JAMA. 1998V279N10

【页】

749

ISSN】

0098-7484

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Letter

【英文关键词】

*Behavioral Medicine;*Periodicals;*Societies, Medical

【中文关键词】

行为医学;期刊;学会, 医学

 

 

152

【题名】

Outcomes measurement: application of performance standards and practice guidelines in managed behavioral healthcare.

【作者】

Beaudin C;

【机构】

Value Behavioral Health, Inc. Falls Church, VA, USA.

【刊年卷期】

J Nurs Care Qual. 1998V13N1

【页】

14-26

ISSN】

1057-3631

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*standards;Health Maintenance Organizations;Health Maintenance Organizations/*standards;Humans;Outcome and Process Assessment (Health Care);Process Assessment (Health Care);Process Assessment (Health Care)/*standards;United States;*Practice Guidelines

【中文关键词】

行为医学;CK行为医学/标准;健康维护组织;健康维护组织/标准;人类;结果与过程评价(卫生保健);过程评价(卫生保健);过程评价(卫生保健)/标准;美国;开业医师诊疗工作准则

【摘要】

Managed behavioral health care organizations (MBHOs) have increasing accountability to their customers for measuring and managing the quality of care and service rendered to consumers. Health plans, state and federal agencies, employers, and unions express continued and growing interest in MBHOs, utilizing evidence-based practice guidelines and incorporating performance standards into daily operations. Standards and guidelines are often built into the behavioral health care program design by the customer, established by accrediting organizations, developed and disseminated by research and academic institutions, or promoted by professional associations.

 

 

153

【题名】

Managing behavioral health.

【作者】

Grazier KL;

【机构】

University of Michigan, USA.

【刊年卷期】

J Healthc Manag. 1998V43N5

【页】

393-396

ISSN】

1096-9012

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/economics;EKBehavioral Medicine/*organization & administration;Insurance Coverage;Insurance, Psychiatric;Insurance, Psychiatric/*trends;Managed Care Programs;Managed Care Programs/*organization & administration;Managed Care Programs/trends;Models, Theoretical;Referral and Consultation;United States;*Contract Services

【中文关键词】

行为医学;CK行为医学/经济学;CK行为医学/组织与管理;保险范围;保险, 精神病;保险, 精神病/发展趋势;管理医疗规划;管理医疗规划/组织与管理;管理医疗规划/发展趋势;模型, 理论;转诊和会诊;美国;合同业务

 

 

154

【题名】

Behavioral health care: the keys to successful planning and management.

【作者】

Bender PA;Reynolds ME;Nauert RC;

【机构】

American Behavioral Systems, White Plains, NY, USA.

【刊年卷期】

J Health Care Finance. 1998V25N2

【页】

63-66

ISSN】

1078-6767

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*organization & administration;Community Networks;Community Networks/organization & administration;Delivery of Health Care, Integrated;Delivery of Health Care, Integrated/*organization & administration;Humans;Mental Health Services;Mental Health Services/*organization & administration;United States

【中文关键词】

行为医学;CK行为医学/组织与管理;社区网络;社区网络/组织与管理;卫生保健提供, 联合;卫生保健提供, 联合/组织与管理;人类;精神卫生服务;精神卫生服务/组织与管理;美国

【摘要】

Behavioral health care is an important component of health system development. Unfortunately, many systems believe it is unmanageable in relation to both cost and effectiveness. The keys to success include thorough planning and modernized oversight procedures.

 

 

155

【题名】

The quarterback drops back for a grande plie.

【作者】

Holstein BB;

【机构】

holstein_barbara@mail.hcds.com

【刊年卷期】

Fam Med. 1998V30N8

【页】

551-552

ISSN】

0742-3225

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Attitude of Health Personnel;Behavioral Medicine;Behavioral Medicine/*education;Family Practice;Family Practice/*education;Health Priorities;Humans;Internship and Residency;Interprofessional Relations;Physician-Patient Relations;Students, Medical;Students, Medical/psychology;*Job Satisfaction;*Teaching;*Teaching/methods

【中文关键词】

医务工作者的态度;行为医学;行为医学/教育;家庭医学;家庭医学/教育;卫生工作重点;人类;实习医师和住院医师职务;职业间关系;医生病人关系;学生, 医科;学生, 医科/心理学;职业满意;教学;教学/方法

 

 

156

【题名】

Absorption, social desirability, and symptoms in a behavioral medicine population.

【作者】

Gick M;McLeod C;Hulihan D;

【机构】

Department of Psychology, Carleton University, Ottawa, Ontario, Canada.

【刊年卷期】

J Nerv Ment Dis. 1997V185N7

【页】

454-458

ISSN】

0022-3018

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Adult;Behavioral Medicine;Female;Humans;Hypnosis;Male;Mental Disorders;Mental Disorders/diagnosis;Mental Disorders/*psychology;Personality Inventory;Somatoform Disorders;Somatoform Disorders/diagnosis;Somatoform Disorders/psychology;*Attitude to Health;*Personality;*Social Desirability

【中文关键词】

成年人;行为医学;女(雌)性;人类;催眠术;男(雄)性;精神障碍;精神障碍/诊断;精神障碍/心理学;个性量表;躯体型障碍;躯体型障碍/诊断;躯体型障碍/心理学;健康态度;人格;社会性愿望

【摘要】

The relationships among absorption, social desirability, and psychological and somatic symptoms were examined in a clinical population of patients at a behavioral medicine clinic. Absorption, as measured by the Tellegen Absorption Scale, was significantly and positively related to the somatization and global distress indices of the Brief Symptom Inventory. However, absorption was negatively related to social desirability, as measured by the Marlowe-Crowne Scale. Global distress, but not somatization, also was negatively related to social desirability. After controlling for social desirability, global distress was marginally related to absorption. In addition, absorption interacted with a measure of how much patients were bothered by their primary symptom. Patients who had high absorption reported more somatic and global distress if they also reported being very bothered by their primary symptom than if they were less bothered by it. The results are discussed with respect to related research on absorption, social desirability, and symptoms.

 

 

157

【题名】

Managed behavioral health care: a key component of integrated regional delivery systems.

【作者】

Nauert RC;

【机构】

Radius Health System, Garden City, NY, USA.

【刊年卷期】

J Health Care Finance. 1997V23N3

【页】

49-61

ISSN】

1078-6767

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Academic Medical Centers;Behavioral Medicine;Behavioral Medicine/economics;Behavioral Medicine/organization & administration;Budgets;Capitation Fee;Delivery of Health Care, Integrated;Delivery of Health Care, Integrated/economics;Delivery of Health Care, Integrated/*organization & administration;Evaluation Studies;Hospital-Physician Joint Ventures;Hospital-Physician Joint Ventures/economics;Hospital-Physician Joint Ventures/organization & administration;Humans;Managed Care Programs;Managed Care Programs/economics;Managed Care Programs/*organization & administration;Mental Health Services;Mental Health Services/economics;Mental Health Services/*organization & administration;Models, Organizational;Regional Health Planning;Regional Health Planning/economics;Regional Health Planning/*organization & administration;Substance Abuse Treatment Centers;Substance Abuse Treatment Centers/economics;Substance Abuse Treatment Centers/organization & administration;United States

【中文关键词】

医学科学研究中心;行为医学;行为医学/经济学;行为医学/组织与管理;预算;按人收费;卫生保健提供, 联合;卫生保健提供, 联合/经济学;卫生保健提供, 联合/组织与管理;评价研究;医院-医师联合医疗协议;医院-医师联合医疗协议/经济学;医院-医师联合医疗协议/组织与管理;人类;管理医疗规划;管理医疗规划/经济学;管理医疗规划/组织与管理;精神卫生服务;精神卫生服务/经济学;精神卫生服务/组织与管理;模型, 组织管理;地区卫生计划;地区卫生计划/经济学;地区卫生计划/组织与管理;物质滥用治疗中心;物质滥用治疗中心/经济学;物质滥用治疗中心/组织与管理;美国

【摘要】

Managed behavioral health care is a key component of integrated regional delivery systems. Mental health and chemical dependency services are of growing importance in developing insurance programs and establishing health systems. Primary features include full involvement of the medical community, development of a free-standing organization, joint ventures with existing entities, and effective contract negotiations.

 

 

158

【题名】

Treatment of somatization in primary care.

【作者】

McLeod CC;Budd MA;McClelland DC;

【机构】

Health Care Partners/Bay Shores Medical Group, Torrence, CA 90503-1671, USA.

【刊年卷期】

Gen Hosp Psychiatry. 1997V19N4

【页】

251-258

ISSN】

0163-8343

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Clinical Trial; Journal Article; Randomized Controlled Trial

【英文关键词】

Adult;Affect;Analysis of Variance;Anxiety;Anxiety/therapy;Behavior Therapy;Behavior Therapy/*methods;Behavioral Medicine;Behavioral Medicine/*methods;Depression;Depression/therapy;Family Practice;Family Practice/*methods;Female;Follow-Up Studies;Humans;Male;Patient Acceptance of Health Care;Psychophysiologic Disorders;Psychophysiologic Disorders/diagnosis;Psychophysiologic Disorders/psychology;Psychophysiologic Disorders/*therapy;Research Support, Non-U.S. Gov't;Treatment Outcome;Waiting Lists

【中文关键词】

成年人;情感;方差分析;焦虑;焦虑/治疗;行为疗法;行为疗法/方法;行为医学;行为医学/方法;抑郁;抑郁/治疗;家庭医学;家庭医学/方法;女(雌)性;随访研究;人类;男(雄)性;病人接受卫生保健的程度;心理生理性障碍;心理生理性障碍/诊断;心理生理性障碍/心理学;心理生理性障碍/治疗;研究资助, 非美国政府;治疗结果;预约名单

【摘要】

A large proportion of patients present to primary care with chronic, stress-related symptoms having no organic cause. Biomedical treatment of these patients is usually ineffective and expensive. A 6-week behavioral medicine intervention designed to provide adjunctive treatment to primary care was evaluated in a randomized, controlled study. Thirty-eight individuals receiving treatment and 44 waiting for treatment completed the SCL-90-R at times corresponding to 1 week before (time 1) and 1 week after the course (time 2). The treatment group was then followed up at 6 months. After correction for initial levels, the treatment group reported significantly less somatization, anxiety, and depression than did the wait-list group at time 2. Within the treatment group, decreases in somatization, anxiety, and depression were statistically significant and were maintained 6 months later. Within the wait-list group, distress remained unchanged. A review of relevant literature reveals that a general behavioral medicine course such as the one studied here has an important adjunctive role in primary care, since 1) subsyndromal psychological distress is common in primary care; 2) physicians are reluctant to address psychosocial issues; 3) negative mood is associated with poor health; 4) negative mood is associated with high, inappropriate medical utilization; and 5) negative mood is associated with help-seeking behavior.

 

 

159

【题名】

The registered nurse's role in the office treatment of patients with histories of abuse: a proposed treatment model.

【作者】

Dill B;Dill JE;Sibcy GA;Brende JO;

【机构】

Behavioral Medicine Solutions of Virginia, Division of Roanoke Gastroenterology 24024-2268, USA.

【刊年卷期】

Gastroenterol Nurs. 1997V20N5

【页】

162-167

ISSN】

1042-895X

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Behavioral Medicine;Domestic Violence;Domestic Violence/*psychology;Humans;Nurse Practitioners;Psychiatric Nursing;*Job Description;*Models, Nursing;*Office Visits

【中文关键词】

行为医学;家庭暴力;家庭暴力/心理学;人类;开业护士;精神病护理学;职务说明;模型, 护理学;诊室就医

【摘要】

Family violence has been recognized as a significant problem and has important ramifications for nursing practice. Abuse and trauma have far-reaching biopsychosocial consequences for affected individuals, many of whom are seen in medical offices with primarily physical symptoms. These symptoms often involve the gastrointestinal tract. In this article, the authors discuss the biopsychosocial as well as psychosocial manifestations of abuse and trauma and the nurse's role in caring for this patient population. Desirable characteristics for nurses who fulfill this role and a description of the optimal therapeutic environment for this treatment approach are outlined. Finally, a nursing treatment model is proposed for the office care of patients with histories of abuse and trauma. The nurse has a crucial role in this model.

 

 

160

【题名】

Health psychology: what is an unhealthy environment and how does it get under the skin?

【作者】

Taylor SE;Repetti RL;Seeman T;

【机构】

Department of Psychology, University of California, Los Angeles 90095-1563, USA. taylor@psych.sscnet.ucla.edu

【刊年卷期】

Annu Rev Psychol. 1997V48N

【页】

411-447

ISSN】

0066-4308

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Journal Article; Review

【英文关键词】

Health Behavior;Humans;Internal-External Control;Psychophysiologic Disorders;Psychophysiologic Disorders/*psychology;Research Support, Non-U.S. Gov't;Research Support, U.S. Gov't, P.H.S.;Risk Factors;Social Support;Somatoform Disorders;Somatoform Disorders/*psychology;*Behavioral Medicine;*Social Environment

【中文关键词】

健康行为;人类;体内外控制;心理生理性障碍;心理生理性障碍/心理学;研究资助, 非美国政府;研究性资助, 美国政府, 公共卫生署;危险因素;社会支持;躯体型障碍;躯体型障碍/心理学;行为医学;社会环境

【摘要】

This review explores the role of environments in creating chronic and acute health disorders. A general framework for studying the nesting of social environments and the multiple pathways by which environmental factors may adversely affect health is offered. Treating socioeconomic status (SES) and race as contextual factors, we examine characteristics of the environments of community, work, family, and peer interaction for predictors of positive and adverse health outcomes across the lifespan. We consider chronic stress/allostatic load, mental distress, coping skills and resources, and health habits and behaviors as classes of mechanisms that address how unhealthy environments get "under the skin," to create health disorders. Across multiple environments, unhealthy environments are those that threaten safety, that undermine the creation of social ties, and that are conflictual, abusive, or violent. A healthy environment, in contrast, provides safety, opportunities for social integration, and the ability to predict and/or control aspects of that environment.

 

161

【题名】

Managed care may feature behavioral medicine.

【作者】

Marwick C;

【刊年卷期】

JAMA. 1996V275N15

【页】

1144-1146

ISSN】

0098-7484

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

News

【英文关键词】

Humans;Life Style;Managed Care Programs;Managed Care Programs/*trends;Physician's Practice Patterns;Physician-Patient Relations;Quality of Health Care;Quality of Life;*Behavioral Medicine;*Behavioral Medicine/trends

【中文关键词】

人类;生活方式;管理医疗规划;管理医疗规划/发展趋势;医师诊疗模式;医生病人关系;卫生保健质量;生活质量;行为医学;行为医学/发展趋势

 

 

162

【题名】

Behavioral and prophylactic pharmacological intervention studies of pediatric migraine: an exploratory meta-analysis.

【作者】

Hermann C;Kim M;Blanchard EB;

【机构】

Center for Stress and Anxiety Disorders, SUNY, Albany 12203, USA.

【刊年卷期】

Pain. 1995V60N3

【页】

239-255

ISSN】

0304-3959

【出版国】

NETHERLANDS

【语种】

eng

【文献类型】

Journal Article; Meta-Analysis

【英文关键词】

Biofeedback (Psychology);Child;Clonidine;Clonidine/therapeutic use;Dopamine Agents;Dopamine Agents/therapeutic use;Humans;Migraine Disorders;Migraine Disorders/prevention & control;Migraine Disorders/*therapy;Muscle Relaxation;Serotonin Agonists;Serotonin Agonists/therapeutic use;Treatment Outcome;Vasodilator Agents;Vasodilator Agents/therapeutic use;*Behavioral Medicine

【中文关键词】

生物反馈(心理学);儿童;可乐定;可乐定/治疗应用;多巴胺药;多巴胺药/治疗应用;人类;偏头痛;偏头痛/预防与控制;偏头痛/治疗;肌松弛;血清素激动药;血清素激动药/治疗应用;治疗结果;血管舒张药;血管舒张药/治疗应用;行为医学

【摘要】

In this review, the effectiveness of behavioral and pharmacological treatments for pediatric migraine was quantitatively summarized following the meta-analytic approach outlined by Hedges and Olkin (1985). A first meta-analysis based on treatment outcome within treatment conditions revealed that thermal biofeedback and interventions combining biofeedback and progressive muscle relaxation seem to be significantly more efficacious than other behavioral treatment modalities, psychological and drug placebo, and the more commonly used prophylactic drug regimens. Though there is some evidence suggesting good effectiveness of propranolol, the lack of systematic data precludes more definitive conclusions. A second meta-analysis that included only studies providing data on the comparison between control versus active treatment conditions replicated the initial findings only partially. In the light of the relative small number of studies that met basic inclusion requirements, the methodological flaws of many studies, and the under-representation of certain treatment types, conclusions regarding differential effectiveness of the treatment types have to be drawn with caution. Overall, our findings clearly demonstrate the need for direct comparisons between behavioral and pharmacological treatments and the need for more theory-driven research in order to determine the most promising treatment approaches for pediatric migraine.

 

 

163

【题名】

Fellowship programs in behavioral neurology.

【作者】

Green RC;Benjamin S;Cummings JL;

【机构】

Department of Neurology, Emory University School of Medicine, Atlanta, GA.

【刊年卷期】

Neurology. 1995V45N3Pt1

【页】

412-415

ISSN】

0028-3878

【出版国】

UNITED STATES

【语种】

eng

【文献类型】

Journal Article

【英文关键词】

Behavioral Medicine;EKBehavioral Medicine/*education;Data Collection;Fellowships and Scholarships;Fellowships and Scholarships/*statistics & numerical data;Internship and Residency;Internship and Residency/statistics & numerical data;Neurology;Neurology/*education;Questionnaires;Research Support, Non-U.S. Gov't;Research Support, U.S. Gov't, P.H.S.

【中文关键词】

行为医学;CK行为医学/教育;数据收集;助学金和奖学金;助学金和奖学金/统计学和数值数据;实习医师和住院医师职务;实习医师和住院医师职务/统计学和数值数据;神经病学;神经病学/教育;问卷调查;研究资助, 非美国政府;研究性资助, 美国政府, 公共卫生署

【摘要】

We sent a behavioral neurology fellowship questionnaire to each of the training directors of 160 neurology residency programs throughout the world, seeking information about programs offering advanced training in behavioral neurology (or similar fellowships in cognitive neurology, neurobehavior, or cognitive neuroscience). Response rate was 100%. Thirty-four respondents reported active fellowship programs in behavioral neurology, and 28 additional respondents indicated that a behavioral neurology fellowship was planned. Nine of the 34 programs (26.5%) defined themselves as exclusively or predominantly concerned with dementia and age-related neurobehavioral disorders. Directors of the 34 active fellowship programs estimated that their combined programs had graduated 199 fellows and were currently training fifty. Most fellowships concentrated on outpatient clinical training, with teaching required by 78.1% and research required by 81.8%. Specialty certification for behavioral neurology was favored by over 75% of behavioral neurology fellowship training directors but by only 30% of training directors in residency programs without behavioral neurology fellowships. Behavioral neurology training programs have grown dramatically in response to an increased recognition of the academic interest in and the clinical needs for these services.