The Agreement between Patients’ and Healthcare Professionals’ Assessment of Patients’ Health Literacy—A Systematic Review

Healthcare professionals (HCPs) can play a key role in promoting health literacy (HL) in patients to help them navigate the healthcare system effectively. This involves assisting patients to locate, comprehend and evaluate health information. HCPs should assess patients’ health literacy needs and check the patient´s understanding to communicate adequate health information. This review investigates the agreement between the patients’ and HCPs assessment of patients’ HL. A systematic literature search in PubMed, Scopus, PsycINFO, CINAHL and the Cochrane Library was performed in November 2019. The search yielded 6762 citations, seven studies met the inclusion criteria. The following HL measurement instruments were completed by the patients in the included studies: REALM (n = 2), REALM-R (n = 1), S-TOFHLA (n = 1), NVS (n = 1), SILS (n = 1), HLSI-SF (n = 1) and HLS-EU-Q16 (n = 1). The HCPs assessed patients’ HL by answering questions that reflect the content of standardized tools. Six studies reported that a high proportion of patients assigned to have HL needs based on their self-report were overestimated by their HCPs in terms of the HL level. The results demonstrated that HCPs had difficulty determining patients’ HL adequately. Differences between the HL estimation of HCPs and the actual HL skills of patients might lead to communication problems

What Do Patients Think about the Cause of Their Mental Disorder? A Qualitative and Quantitative Analysis of Causal Beliefs of Mental Disorder in Inpatients in Psychosomatic Rehabilitation.

Patients' causal beliefs about their mental disorders are important for treatment because they affect illness-related behaviours. However, there are few studies exploring patients' causal beliefs about their mental disorder.(a) To qualitatively explore patients' causal beliefs of their mental disorder, (b) to explore frequencies of patients stating causal beliefs, and (c) to investigate differences of causal beliefs according to patients' primary diagnoses.Inpatients in psychosomatic rehabilitation were asked an open-ended question about their three most important causal beliefs about their mental illness. Answers were obtained from 678 patients, with primary diagnoses of depression (N = 341), adjustment disorder (N = 75), reaction to severe stress (N = 57) and anxiety disorders (N = 40). Two researchers developed a category system inductively and categorised the reported causal beliefs. Qualitative analysis has been supplemented by logistic regression analyses.The causal beliefs were organized into twelve content-related categories. Causal beliefs referring to "problems at work" (47%) and "problems in social environment" (46%) were most frequently mentioned by patients with mental disorders. 35% of patients indicate causal beliefs related to "self/internal states". Patients with depression and patients with anxiety disorders stated similar causal beliefs, whereas patients with reactions to severe stress and adjustment disorders stated different causal beliefs in comparison to patients with depression.There was no opportunity for further exploration, because we analysed written documents.These results add a detailed insight to mentally ill patients' causal beliefs to illness perception literature. Additionally, evidence about differences in frequencies of causal beliefs between different illness groups complement previous findings. For future research it is important to clarify the relation between patients' causal beliefs and the chosen treatment

Influence of established and subjectively perceived as well as evaluated individual characteristics on the utilization of mental health services among individuals with depressive disorders: protocol of a longitudinal study examining how to supplement the “behavioral model of health services use” and on need-congruent use of mental health services

Background: Approximately one out of every three people in Germany who meets the diagnostic criteria for major depression has contact with mental health services. Therefore, according to treatment guidelines, two thirds of all individuals with depression are insufficiently treated. In the past, the subjective perspective of people who (do not) make use of mental health services has been neglected. Factors related to the use of health services are described in Andersen's Behavioral Model of Health Services Use (ABM). The aim of this study is to supplement operationalizations of subjectively perceived and evaluated individual characteristics in the ABM and to evaluate whether the supplemented model can better explain mental health services use in individuals with depression than established operationalizations. Methods: A representative telephone study with two measurement points will be conducted. In an explanatory mixed-methods design, qualitative interviews will be added to further interpret the quantitative data. A nationwide sample scoring 5 or more on the Patient Health Questionnaire (PHQ-9) will be recruited and interviewed via telephone at T0 and 12 months later (T1). Data on established and subjective characteristics as well as mental health service use will be collected. At T1, conducting a diagnostic interview (Composite International Diagnostic Interview, DIA-X-12/M-CIDI) enables the recording of 12-month diagnoses according to DSM-IV-TR criteria. Ideally, n = 768 datasets will be available and analyzed descriptively by means of regression analysis. Up to n = 32 persons who use or do not use depression-specific health services incongruent with their objective or subjective needs will be interviewed (face-to-face) to better explain their behavior. In addition, theories of non-need-based mental health service use are developed within the framework of the grounded theory-based analysis of the qualitative interviews. Discussion: The study intends to contribute to the theoretical foundation of health services research and to specify the characteristics described in the ABM. Thus, after completion of the study, a further sophisticated and empirically tested model will be available to explain mental health services. The identified modifiable influencing factors are relevant for the development of strategies to increase mental health service use in line with the objective and subjective needs of individuals with depression

Addressing and Overcoming Power Relations in Health Psychology (Research)

This OSF project collects material from the roundtable "Addressing and Overcoming Power Relations in Health Psychology (Research): An Interactive Discussion" held during the conference of the European Health Psychology Society (EHPS) 2023 in Breme

Content comparison of guideline-recommended instruments used in treatment for alcohol use disorders

<p><b>Purpose:</b> Practice guidelines recommend the use of standardized instruments in the treatment of alcohol use disorders (AUDs); however, the extent to which these instruments assess patients’ functioning is unclear. The aim of this study was to examine the domains of functioning and contextual factors contained in guideline-recommended instruments, using the International Classification of Functioning, Disability, and Health (ICF) as a reference.</p> <p><b>Materials and methods:</b> We identified instruments by reviewing AUD treatment guidelines used in Germany, Canada, Australia and New Zealand, United Kingdom, and United States. We included instruments which were available in English free of charge, we excluded instruments developed solely for diagnostic or epidemiological purposes and those for children or adolescents. Following a standardized set of rules, two health care researchers identified the concepts contained in the items on the instruments and independently linked them to ICF categories.</p> <p><b>Results:</b> A total of 10 instruments were included. Among 517 items, 752 meaningful concepts (MCs) were derived, and 622 of them were linked to the ICF. Inter-rater agreement was κ = 0.61. One hundred eighty eight MCs referred to <i>personal factors</i>, 175 to <i>body functions</i>, 168 to <i>activity and participation</i>, and 91 to <i>environmental factors</i>. The most frequently linked ICF chapter was b1 (<i>mental functions)</i>.</p> <p><b>Conclusions:</b> Instruments recommended in AUD treatment guidelines vary considerably in their assessment of patients’ functioning and contextual factors. Within the investigated instruments, environmental factors are under-represented in comparison to body functions and personal factors. ICF linkage provides guidance for clinicians and researchers in the selection of appropriate instruments.Implications for rehabilitation</p><p>Since instruments that are recommended in alcohol treatment guidelines vary considerably in respect the functioning domains and context factors they cover, it may be challenging for clinicians to select instruments relevant to their treatment context.</p><p>Using the ICF as framework, our results provide guidance for clinicians in how to select appropriate instruments.</p><p>Within the investigated instruments, environmental factors and activities and participation are under-represented in comparison to body functions and personal factors. Clinicians may employ AUD-unspecific or ICF-based instruments to cover these components if needed.</p><p></p> <p>Since instruments that are recommended in alcohol treatment guidelines vary considerably in respect the functioning domains and context factors they cover, it may be challenging for clinicians to select instruments relevant to their treatment context.</p> <p>Using the ICF as framework, our results provide guidance for clinicians in how to select appropriate instruments.</p> <p>Within the investigated instruments, environmental factors and activities and participation are under-represented in comparison to body functions and personal factors. Clinicians may employ AUD-unspecific or ICF-based instruments to cover these components if needed.</p

Addressing Power Relations in Health Psychology Research

This report provides insights from the roundtable “Addressing and Overcoming Power Relations in Health Psychology (Research): An Interactive Discussion” at the European Health Psychology Society conference 2023 in Bremen. The overarching goal of the roundtable was to take a collaborative perspective on issues of power in health psychology: How do power relations affect our research? How can we move towards a more just and equitable health psychology

A Systematic Literature Review of Self-Reported Smoking Cessation Counseling by Primary Care Physicians.

Tobacco consumption is a risk factor for chronic diseases and worldwide around six million people die from long-term exposure to first- or second-hand smoke annually. One effective approach to tobacco control is smoking cessation counseling by primary care physicians. However, research suggests that smoking cessation counseling is not sufficiently implemented in primary care. In order to understand and address the discrepancy between evidence and practice, an overview of counseling practices is needed. Therefore, the aim of this systematic literature review is to assess the frequency of smoking cessation counseling in primary care. Self-reported counseling behavior by physicians is categorized according to the 5A's strategy (ask, advise, assess, assist, arrange). An electronic database search was performed in Embase, Medline, PsycINFO, CINAHL and the Cochrane Library and overall, 3491 records were identified. After duplicates were removed, the title and abstracts of 2468 articles were screened for eligibility according to inclusion/exclusion criteria. The remaining 97 full-text articles reporting smoking cessation counseling by primary care physicians were assessed for eligibility. Eligible studies were those that measured physicians' self-reported smoking cessation counseling activities via questionnaire. Thirty-five articles were included in the final review (1 intervention and 34 cross-sectional studies). On average, behavior corresponding to the 5A's was reported by 65% of physicians for "Ask", 63% for "Advise", 36% for "Assess", 44% for "Assist", and 22% of physicians for "Arrange", although the measurement and reporting of each of these counseling practices varied across studies. Overall, the results indicate that the first strategies (ask, advise) were more frequently reported than the subsequent strategies (assess, assist, arrange). Moreover, there was considerable variation in the items used to assess counseling behaviour and developing a standardized instrument to assess the counseling strategies implemented in primary care would help to identify and address current gaps in practice

Factors associated with help-seeking behaviour among individuals with major depression: A systematic review.

Psychological models can help to understand why many people suffering from major depression do not seek help. Using the 'Behavioral Model of Health Services Use', this study systematically reviewed the literature on the characteristics associated with help-seeking behaviour in adults with major depression. Articles were identified by systematically searching the MEDLINE, EMBASE and PsycInfo databases and relevant reference lists. Observational studies investigating the associations between individual or contextual characteristics and professional help-seeking behaviour for emotional problems in adults formally diagnosed with major depression were included. The quality of the included studies was assessed, and factors associated with help-seeking behaviour were qualitatively synthesized. In total, 40 studies based on 26 datasets were included. Several studies investigated predisposing (age (N = 17), gender (N = 16), ethnicity (N = 9), education (N = 11), marital status (N = 12)), enabling (income (N = 12)), need (severity (N = 14), duration (N = 9), number of depressive episodes (N = 6), psychiatric comorbidity (N = 10)) and contextual factors (area (N = 8)). Socio-demographic and need factors appeared to influence help-seeking behaviour. Although existing studies provide insight into the characteristics associated with help seeking for major depression, cohort studies and research on beliefs about, barriers to and perceived need for treatment are lacking. Based on this review, interventions to increase help-seeking behaviour can be designed

Causal beliefs: logistic regressions, Odds ratio (Exp(b)).

<p>Causal beliefs: logistic regressions, Odds ratio (Exp(b)).</p

Category system of causal beliefs of mental disorders.

<p>Frequencies of coded categories were reported for each category on the level of responses (N = 1858).</p