Self-regulation, Stress

​​Make or break: the importance of breaks in healthcare

By Julia Allan, Aberdeen University, Scotland

Modern life is hectic. We live in an increasingly ‘switched on’ digital world where periods of true respite from work are rare. Many people regularly work for lengthy periods and this is particularly the case for health professionals working in frontline healthcare services. In the healthcare context, working hours and demands are typically high, shifts routinely exceed the 8 hours of a ‘normal’ working day, and work demands can be relentless in nature. If a continuous series of patients require urgent care, health professionals are obligated to provide it, regardless of how busy they have been, or how long they have been working. As a result of these high demands, missed breaks are extremely common in healthcare settings – for example, it is reported that  1 in 10 nurses never take a proper break and 1 in 3 rarely or never take meal breaks during shifts.

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Automaticity, Behavioural theory, E-health, Habit, Motivation

Linking the Elephant to the Rider: The Role of Motivation

By António Labisa Palmeira, CIDEFES – Universidade Lusófona, Portugal; ISBNPA Executive Director

Long-term motivation for health-related behaviors can come from different sources. Behavioral scientists are still trying to work out how these sources fit together. For example, I go running nearly every day and have done so for 30+ years. How and why have I maintained this pattern? Daniel Kahnemann would suggest that dual motivational systems are at play: a system 1 that deals with instincts and emotions, and a system 2 that is deliberative and conscious. He might argue that system 2 prompts me to run because I am aware of the health benefits of exercise. On the other hand, Ed Deci might suggest that I am intrinsically motivated to run and do it because it aligns with my values and self and because I enjoy it.

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E-health, Interventions

Your intervention, your way! Short appraisal interventions

by Katarzyna Cantarero, SWPS University, Poland

Subjective well-being is a function of what we were born with, situations that pop up in our lives and (luckily!) what we intentionally do. Many researchers have examined what can effectively boost our psychological functioning. Short appraisal (or affirmation) interventions can be one helpful tool in enhancing positive outcomes for people.

Research shows that short writing tasks (e.g., gratitude lists or letters) can enhance psychological well-being. In a large multi-lab study, researchers from 87 countries indicated that simple reappraisal interventions (i.e., changing how one feels about a situation or focusing on positive aspects of a situation) boosted positive emotions during the COVID-19 pandemic. Appraising an event that is potentially stressful can be helpful in drawing benefits from it. During these appraisal tasks, individuals come up with arguments about the positive side of situations they find themselves in. 

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E-health, Mental Health

Carrying counseling outside the clinic: The promising potential of mobile technology

Egon Dejonckheere & Peter Kuppens, KU Leuven, Belgium.

Many forms of counseling and psychotherapy still predominantly take place within the therapy room. Yet, once patients leave the therapy room, they sometimes struggle to face their challenges, seize opportunities to get better, and implement what they learned in session. Evidence shows that therapeutic practice can greatly benefit from having direct access to information about what takes place in people’s daily lives. Such information can identify ways to intervene, and effectively close the gap between counseling sessions and real life. 

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Assessment, Communication, Coping, Illness representation

Helping patients manage their condition: Illness representations matter

By Yael Benyamini, Tel Aviv University, Israel and Evangelos C. Karademas, University of Crete, Greece

Anna and Mary are both healthy 45-year-old women, living in a large European city. Each of them knows several people who have contracted COVID-19 and constantly hears and reads about it. Anna believes it is a very serious disease, and is very concerned that if she contracts it, even though she believes that given her age she will recover, she will probably suffer from long-term bothersome symptoms. She works from home as much as possible, never walks outside without a mask, and is waiting for the next dose of vaccination.

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Coping, Social Support, Stress

How new insights into stress can help calm the worried mind

Bart Verkuil, Department of Clinical Psychology, Leiden University, The Netherlands and PEP Group, Noordwijk, The Netherlands.

“What if I get infected and end up in the hospital?” “What if I can’t pay my bills in a few months?” “What effect will this lockdown have on my children’s the health?”

The threat of the coronavirus is having a huge impact on most of our lives. To determine what measures need to be taken and to estimate what risks we are facing, scientists use statistical models to gain insight into the spread of the virus. This surely helps to gain some control over this pandemic. Interestingly, we as individual human beings are continuously acting like these scientists, but in a more automatic manner; our human minds can be thought of as ‘prediction machines’, constantly estimating whether we are currently at risk of getting infected, losing our jobs or being criticized. Yet, there are large differences in how people estimate these risks and for some people these estimations spiral down to intense worries.

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Patient engagement

If medicine is a team game, patients should play too: a psychological perspective on patient engagement

 

By G. Graffigna, Università Cattolica del Sacro Cuore, Italy

Healthcare professionals along the whole care journey must collaborate and coordinate their efforts for healthcare systems to function effectively. In other words, medicine requires teamwork to be successful. If we agree on this principle, then –adopting a sports metaphor –the patient too should be considered a player in the team!

The concept of patient engagement recognizes this, and it is an important ingredient for enhancing the effectiveness and sustainability of healthcare.

What is patient engagement?

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Communication, Incentives, Motivational interviewing, Social Support

How to support patients to lose weight and better manage their type 2 diabetes

By Leah Avery, Teesside University, UK.

Type 2 diabetes was previously considered a progressive condition, with an inevitable need for insulin therapy, however lifestyle behavioural change research challenges this pessimistic prognosis. As prevalence of type 2 diabetes continues to increase, so does evidence supporting the important role of the food and changing what we eat to successfully manage the condition.

Dietary approaches can largely be divided into two. Those that focus on what we eat (e.g., carbohydrates) to optimise metabolism and glycaemic control via slow and steady weight loss. Others that focus on the amount eaten, such as the low-calorie diet involving significant energy restriction for rapid weight loss.

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Communication, Goal setting

Teaching practitioners Healthy Conversation Skills 

By Wendy Lawrence, University of Southampton

The main causes of death and disease in society today are influenced by our lifestyle choices, and there is a growing focus on ways to improve health behaviours. Front-line practitioners, particularly those working in health, social and community care roles, are a key resource for supporting behavioural change. Routine appointments offer opportunities to initiate conversations about behaviour change every week, but many practitioners feel that they lack the knowledge and skills necessary to provide behaviour change support. This can reduce our confidence for having conversations with clients or patients about potentially sensitive topics, including smoking, weight loss or alcohol intake.

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Automaticity, Habit, Self-efficacy

Jesti ili ne jesti, pitanje je sad: Kako zdravstveni psiholozi mogu pomoći ljudima u upravljanju sigurnošću hrane?

Napisala Barbara Mullan, Sveučilište Curtin, Australija

Opseg problema

Godišnje svaka deseta osoba u svijetu (približno 600 milijuna ljudi) oboli nakon što jede kontaminiranu hranu, a čak 420 000 ljudi umre. Postoje velike geografske razlike u tome gdje se ti slučajevi javljaju, s tim da se regije u Africi, jugoistočnoj Aziji i istočnom Mediteranu najčešće bore s prehrambenim bolestima (detaljnije o učestalosti prehrambenih bolesti u pojedinim regijama možete pronaći ovdje). Pored ovih geografskih razlika, postoje i velike razlike u vrstama uzročnika koji su odgovorni za bolesti koje se prenose hranom (npr. virusi, bakterije, paraziti).

Mnogo je karika u lancu sigurnosti hrane od „farme do stola”. Iako se puno toga radi da se pomogne poljoprivrednicima, industrijama i restoranima u upravljanju sigurnošću hrane, često se zanemaruje uloga potrošača u sigurnom rukovanju hranom. Praksa rukovanja hranom koja je sigurna za potrošače ključna je jer čini završnu fazu prevencije bolesti koje se prenose hranom. Procjene udjela trovanja hranom koji potječu od kuće značajno variraju u rasponu od 11 do 87%. Kao zdravstveni psiholozi, puno možemo učiniti kako bismo pomogli potrošačima da minimiziraju rizik od obolijevanja zbog trovanja hranom u kući.

Ponašanja koja doprinose izbijanju trovanja hranom raznovrsna je, ali Svjetska zdravstvena organizacija ima pet ključnih uputa kako hranu održavati sigurnom za jelo. One su:

  1. Održavajte ruke i posuđe čistima
  2. Odvojite sirovu i kuhanu hranu (posebno kad se vraćate s tržnice ili trgovine i kad hranu čuvate u hladnjaku)
  3. Temeljito kuhajte hranu
  4. Držite hranu na sigurnim temperaturama (tj. držite toplu hranu toplom, a hladnu hladnom)
  5. Koristite sigurnu vodu i prehrambene namirnice.

Predviđanje ponašanja potrošača

Rana istraživanja o ulozi potrošača koncentriralo se na njihovo znanje kao primarni utjecaj na njihovo ponašanje. Međutim, sustavni pregledni rad pronašao je dokaze da znanje ne mora nužno dovesti do sigurnog ponašanja s hranom. Tako je i s drugim zdravstvenim ponašanjima, ali potrebno je znanje, čak i ako nije dovoljno za promjenu ponašanja, jer pomaže u razumijevanju toga „kako” i „zašto” treba nešto činiti.

Kako bi bolje razumjeli koji drugi utjecaji mogu pomoći potrošačima da se drže sigurnog rukovanja hranom, istraživači su koristili razne teorije, uglavnom iz psihologije. To uključuje teoriju planiranog ponašanja, teoriju motivacije za zaštitom i model zdravstvenog uvjerenja. Nedavni pregledni rad koji se bavio ovim temama pokazao je da su namjera, socijalne norme, samoefikasnost i navika važni utjecaji na sigurno rukovanje hranom za potrošače te su autori zaključili da bi intervencije temeljene na tim konstruktima vjerojatno bile učinkovite za poboljšanje potrošačkog ponašanja.

Intervencije za higijenu hrane

Jedan drugi važni pregledni rad pronašao je neke dokaze u prilog tome da su obrazovne intervencije bile učinkovite za poboljšanje prehrambene sigurnosti u kući. Ali postoje i druge učinkovite intervencije koje su usmjerene na psihosocijalne konstrukte, a koje uz to educiraju potrošače. Na primjer, jedna intervencija koja se temelji na teoriji planiranog ponašanja bila je uspješna u promjeni ponašanja vezanog uz sigurno rukovanje hranom. Ova intervencija pružila je studentima preddiplomskih studija informacije o sigurnosti hrane te je koristila strategije, poput izrade specifičnih planova i utvrđivanja prepreka, kako bi pomogla povećati namjeru i poboljšati percepciju kontrole ponašanja (tj. samopouzdanja da se uključe u sigurno ponašanje). Intervencija je povećala percepciju kontrole ponašanja te sigurnog ponašanja s hranom. Ovi nalazi sugeriraju da našim klijentima možemo pomoći educirajući ih o načinima sigurnog rukovanja hranom te potičući ih da naprave posebne planove za to (npr. pomoći im u formuliranju plana korištenja odvojenih dasaka za rezanje mesa i povrća tako da se raspravlja o određenim strategijama).

Još jedna uspješna intervencija temeljila se na teoriji navika. Ova je intervencija pomogla studentima preddiplomskih studija da razviju naviku stavljanja mokre krpe za brisanje suđa u mikrovalnu pećnicu, dajući im informativni plakat (tj. podsjetnik) te pružajući im podsjetnike za izvođenje ponašanja svaka tri ili pet dana. Učestalost ponašanja se značajno povećala tijekom trotjednog razdoblja testiranja i zadržalo se tijekom trotjednog praćenja. Iz praktične perspektive, ova otkrića sugeriraju da bi bilo korisno pružiti klijentima informacije o prehrambenoj sigurnosti, te im također pomoći da formiraju navike za određena ponašanja (npr. potaknuti postavljanje podsjetnika na njihovim mobitelima za stavljanja krpa u mikrovalnu svaki tjedan).

Ukratko, gornje istraživanje ukazuje na to da mi kao zdravstveni psiholozi možemo puno toga učiniti kako bismo pomogli našim klijentima da se uključe u ponašanja ključna za njihovo zdravlje. To započinje edukacijom naših klijenata o prehrambenoj sigurnosti, a nastavlja se tako da im pomažemo da se osjećaju sigurni oko njihove sposobnosti da djeluju na ispravan način, kao i time što im pomažemo u izgradnji dobrih navika.

Na kraju, iako smo svi u opasnosti da se razbolimo od bolesti koje se prenose hranom, oko 25% populacije je u većem riziku. To uključuje trudnice, djecu mlađu od 5 godina, starije odrasle osobe i osobe s ugroženim imunološkim sustavom. Stoga je važno da zdravstveni psiholozi prepoznaju specifične prilike za provedbu prethodno opisanih intervencija, na primjer kada ljudi imaju kronična zdravstvena stanja, rade s roditeljima ili starijim odraslima te kada žene razmišljaju o trudnoći.

Praktične preporuke

  • Educirajte ljude da prehrambena sigurnost započinje kod kuće te da važne prethodnice sigurnog ponašanja uključuju namjeru, društvene norme, samoefikasnost i navike.
  • Ne podcjenjujte ulogu znanja. Koristiti nacionalne i globalne resurse za edukaciju potrošača o važnosti ponašanja u pogledu sigurnosti hrane. Kad jednom dobiju te informacije, lako se mogu usvojiti određena jednostavna ponašanja.
  • Istaknite važnost prehrambene sigurnosti, pritom naglasite da sigurno kuhanje i rukovanja hranom može utjecati na zdravlje te da može smanjiti njihov rizik od trovanja hranom, ali I rizik za njihove najmilije.
  • Koristite se i racionalnim (npr. namjerama) i automatskim (npr. navikama) procesima. Započnite s motivacijskim strategijama poput postavljanja ciljeva i planiranja, a zatim potaknite upotrebu znakova za dosjećanje (npr. plakata i podsjetnika) kako biste ljudima pomogli u izgradnji navika i rutina vezanih uz prehrambenu sigurnost.

[Preveo Borna Šimić]