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Marie Johnston and Derek Johnston, 애버딘 대학교(University of Aberdeen), 스코트랜드
의료 전문가들은 한 사람, 한 의료 팀, 한 병원 또는 한 지역과 관련된 문제에 대한 해답을 원하는 경우가 많습니다. 예를 들어, 비만인 한 남자가 간식을 얼마나 자주 먹는지, 언제 어디서 간식을 먹는지, 그리고 스트레스가 그의 간식 습관을 더 악화시키는지 알아보는 일은 중요할 수 있습니다. 의료·보건 팀원들이 손 위생을 얼마나 자주 생략하는지, 그런 생략 빈도가 인력 부족 상태에서 더 심해지는지, 그리고 병원 캠페인이 이런 문제를 개선하는지 조사해 볼 수도 있을 겁니다. 또는 임상 오류의 원인을 조사하여 그런 오류들이 일부 병동 혹은 일부 직원에게서 더 빈번하게 일어나는지 확인해 볼 수도 있을 겁니다. 끝으로 정책 수준에서는 공공 장소에서의 흡연 금지와 같은 새로운 규제가 흡연율에 영향을 미쳤는지 조사하는 것도 가치 있는 일일 수 있습니다.
이런 문제들에 대한 해답을 찾기 위해 사람들에게 생각이나 기억하는 것들을 물어 불 수 있겠지만 그 과정에서 발생하는 (즉, 과거의 문제를 회상하며 발생하는) 편견과 망각의 문제를 감소시키기 위해서는 중요한 시점과 장소에서 직접 질문하거나 관찰하는 것이 더 효과적일 수 있습니다. 스마트폰을 이용한 디지털 모니터링과 같은 최근의 기술 발전 덕분에 실시간으로 어떤 일이 일어나고 있는지 추적하는 것이 쉬워진 만큼 여러분은 단일 대상 연구(N-of-1 studies)를 통해 당면 문제에 대한 해답을 구할 수 있습니다.
단일 대상 연구는 한 대상의 시간 경과에 따른 변화를 살펴보기 위해 반복적으로 문제(현상)를 평가(관찰)할 수 있는 경우에 실시할 수 있습니다. 그런 경우, 연구자는 문제를 설명하고 어떤 조건에서 문제가 개선되는지 혹은 악화되는지 검토할 수 있습니다. 또는 새로운 중재나 치료를 도입하고 그것의 효과를 평가할 수 있습니다. .
아래 그림에서 보듯이, 단일 대상 연구에서 수집한 데이터에 대한 가장 간단한 평가는 그래프의 추이를 관찰하는 것입니다. 이것은 단일 대상 분석에서 필수적인 단계이며, 그 자체로 충분할 수 있습니다. 또한, 단일 대상 연구를 위한 통계 분석 방법들도 있으며, 더 복잡한 분석 방법들이 개발되고 있습니다 (예: methods for assessing dynamic change).
By Anne Tiedemann, The University of Sydney, Australia
“Lack of activity destroys the good condition of every human being while movement and methodical physical exercise save it and preserve it”… Plato, 400 BC.
It’s long been known that making physical activity a regular habit is important for health and wellbeing. But health promotion messages often target children and young people, with less focus on the importance of physical activity in people aged 65 years and over. However, older age is a crucial time for making activity part of every day.
By Jane Ogden, University of Surrey, UK
Weight is a tricky problem to talk about in a consultation. Some patients may be sick of hearing the words ‘You could lose some weight’ every time they visit the clinic: regardless of whether they have come in because of a sore throat, a cervical smear or a potential heart problem. They may have experienced a lifetime of feeling stigmatised by the medical profession and think that all anyone ever sees is their body size. While this is so for some individuals, others may have never considered their weight as an issue, and could be insulted or surprised if it is raised. Some people may simply not want to hear the message and block out whatever is said, thinking for example ‘what do you know – you’re thin / fat / too young / too old’ or ‘science is always wrong.’ Raising the issue of weight therefore requires careful management of ‘when,’ ‘how’ and ‘what’ is said to an overweight person.
By Ralf Schwarzer, Freie Universität Berlin, Germany and SWPS University of Social Sciences and Humanities, Poland
Changing behavior may often be desirable but difficult to do. For example, quitting smoking, eating healthily and sticking to a physical exercise regimen all require motivation, effort, and persistence. While many psychological factors play a role in behavior change, self-efficacy is one of the most important.
By Irina Todorova, Health Psychology Research Center in Sofia, Bulgaria
Taking care of aging loved ones, who are perhaps in frail health, can be a complicated and confusing experience that is both gratifying and frustrating. Medical science is helping people live longer, healthier lives, and in some cases can slow down the cognitive decline that frequently come with age. The way that families care for older members, as well as the meaning of aging, dementia and caregiving varies across cultural contexts. Most people are aging at home as members of their communities, which has psychosocial benefits for the older person as well as for the different generations of family members. At the same time, caring for people with declining health is accompanied with physical effort, psychological strain, grief related to ongoing loss and possibly financial difficulties for the caregiver. (more…)
By Keegan Knittle, University of Helsinki, Finland
Here’s a familiar story from primary care: an individual who would clearly benefit from more physical activity comes into the clinic. We discuss their physical (in)activity, and in the end, the person says they just aren’t motivated to change. What’s a clinician supposed to do? How can we motivate this person to at least consider changing their behavior for the better? Or better yet, how can we help them to form good intentions for being active?
By Alexandra Michel, Federal Institute for Occupational Health and Safety, Germany and Annekatrin Hoppe, Humboldt Universität, Germany
Employees spend a major part of their waking time at work. It is no surprise then that reducing demands and increasing resources (e.g., autonomy, social support, self-efficacy) at work are important in promoting employees’ work-life balance, well-being and health. Over the last years, research has examined not only ways to repair the negative consequences of work stress, but also ways to promote resources to improve employees’ well-being at work. Especially, introducing positive psychology interventions to the workplace is a new avenue in the occupational health psychology field. Positive psychology interventions focus on building resources and preventing resource loss, and include activities that aim to cultivate positive feelings, behaviors and cognitions. In this blog post, we highlight three approaches that can help employees to build their resources and foster well-being at work.
By Anne Marie Plass, University Medical Center of Göttingen, Germany
Sometime ago a dermatologist who works as a psoriasis (a chronic skin disorder) -specialist in a university hospital, complained to me about many patients who do not adhere to the therapy, even though a mutual goal has been set, and a shared decision has been made.
By Kerry Chamberlain, Massey University, Auckland, New Zealand
What do people do with medications once they enter the home? Surprisingly, limited research has attempted to answer that question. Yet, it is important – most medications are consumed at home under the control of the consumer. Prescription medicines are regulated, but once prescribed and collected, they are presumed to be taken as directed. People also can access and use a wide range of over-the-counter medications (e.g., for pain relief), alternative medications (e.g., homeopathic preparations), and other health-related preparations that are less obviously medications (e.g., dietary supplements, probiotic drinks). However, we should note that access to all forms of medication can vary considerably between countries.
By Tracy Epton, University of Manchester, United Kingdom
Goal setting is a popular technique
There are many different techniques that can be used to change behaviour (93 according to a recent list!). Goal setting is a well-known technique that most people have used at some point. Goal setting is used by charities (e.g., Alcohol Concern, a UK charity, asked people to set a goal to quit drinking for the month of January), as part of commercial weight loss programmes and even in fitness apps. One recent review looked at a 384 tests of the effectiveness of goal setting across a range of different fields to see if goal setting really works, which types of goals work best and if goal setting works for everyone.