Prevalence of and risk factors for binge eating behaviour in 6930 adults starting a weight loss or maintenance programme

Objective: Conflicting data are available on the prevalence of binge eating behaviour (BE) in individuals seeking to lose or maintain weight. The present study aimed to estimate the prevalence of and the risk factors for BE in a large sample of men and women starting a weight loss or maintenance programme. Design: Cross-sectional study. BE was defined as a Binge Eating Scale (BES) score 6518. The State-Trait Anxiety Inventory and the Italian Depression Questionnaire were used to assess anxiety and depression. Besides sex, age and BMI, marital status, educational level, smoking and physical activity were evaluated as potential risk factors for BE. Uni- and multivariable Poisson working regression models were used to estimate prevalence ratios (PR) and marginal probabilities. Setting: Nutritional research centre. Subjects: Adults (n 6930; 72 % women) with a median age of 46 years (range 18\u201381 years) were consecutively studied. Results: BE prevalence in the pooled sample was 17 %. At multivariable analysis, being a woman (PR=2\ub770), smoking (PR=1\ub715) and increasing BMI (PR=1\ub705 for 1 kg/m2 increase) were risk factors for BE. On the contrary, being older (PR=0\ub799 for 1-year increase), performing physical activity (PR=0\ub789) and being married (PR=0\ub788) were protective factors for BE. Anxiety and depression were more common in subjects with BE. Conclusions: BE is common in individuals seeking to lose or maintain weight. The prevalence of BE is higher in young obese women. However, BE is present also in men, elders and normal-weight subjects

INvolvement of breast CAncer patients during oncological consultations: a multicentre randomised controlled trial--the INCA study protocol.

INTRODUCTION: Studies on patient involvement show that physicians make few attempts to involve their patients who ask few questions if not facilitated. On the other hand, the patients who participate in the decision-making process show greater treatment adherence and have better health outcomes. Different methods to encourage the active participation during oncological consultation have been described; however, similar studies in Italy are lacking. The aims of the present study are to (1) assess the effects of a preconsultation intervention to increase the involvement of breast cancer patients during the consultation, and (2) explore the role of the attending companions in the information exchange during consultation. METHODS AND ANALYSIS: All female patients with breast cancer who attend the Oncology Out-patient Services for the first time will provide an informed consent to participate in the study. They are randomly assigned to the intervention or to the control group. The intervention consists of the presentation of a list of relevant illness-related questions, called a question prompt sheet. The primary outcome measure of the efficacy of the intervention is the number of questions asked by patients during the consultation. Secondary outcomes are the involvement of the patient by the oncologist; the patient's perceived achievement of her information needs; the patient's satisfaction and ability to cope; the quality of the doctor-patient relationship in terms of patient-centeredness; and the number of questions asked by the patient's companions and their involvement during the consultation. All outcome measures are supposed to significantly increase in the intervention group. ETHICS AND DISSEMINATION: The study was approved by the local Ethics Committee of the Hospital Trust of Verona. Study findings will be disseminated through peer-reviewed publications and conference presentations. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01510964

Self-evaluated vs. perceived kindness in the physician- patient relationship: a preliminary psychometric study

Only a few contributions, often anecdotical, can be found in scientific literature concerning the role of kindness in medical interactions. As stated by Goffman (1963), kindness is the starting point for freedom in human relationships, and it is crucial in the construction of trust in physician-patient relationship (P-PR) (Kajubi, 1999). More recently, Torke et al. (2004) found kindness to be a significative predictive index for shared decision making, while Geraedts et al. (2007) reported kindness as a prominent hospital quality indicator. The role of kindness in physician-patient relationship has never been fully explored until now. A new psychometric method in the measurement of kindness in P-PR is here presented in a preliminary comparison between self-evaluated and perceived kindness. METHODS An 80-items pool of items regarding kindness and related aspects of behavior was generated, starting from literature. In a focus group 20 items (5-point Likert-type) were selected forming a self-rating scale for kindness: the Kindness Evaluation Scale (KES). A parallel form (p-KES) was developed for patients, in which items concern the perceived kindness of physician from the patient point of view. RESULTS Data will be presented regarding the convergent validity of self-evaluated vs. perceived kindness measurement scales. Preliminary data show a poor correlation between self-evaluated kindness in physicians and perceived kindness by patients, with a major role for gender, being female more able in perceiving physician kindness. DISCUSSION Further research is needed to evaluate the validity of newly proposed scales for kindness and the real perception of kindness in P-PR

Self-evaluated vs. perceived kindness in the physician-patient relationship: a preliminary psychometric study

INTRODUCTION Only a few contributions, often anecdotical, can be found in scientific literature concerning the role of kindness in medical interactions. As stated by Goffman (1963), kindness is the starting point for freedom in human relationships, and it is crucial in the construction of trust in physician-patient relationship (P-PR) (Kajubi, 1999). More recently, Torke et al. (2004) found kindness to be a significative predictive index for shared decision making, while Geraedts et al. (2007) reported kindness as a prominent hospital quality indicator. The role of kindness in physician-patient relationship has never been fully explored until now. A new psychometric method in the measurement of kindness in P-PR is here presented in a preliminary comparison between self-evaluated and perceived kindness. METHODS An 80-items pool of items regarding kindness and related aspects of behavior was generated, starting from literature. In a focus group 20 items (5-point Likert-type) were selected forming a self-rating scale for kindness: the Kindness Evaluation Scale (KES). A parallel form (p-KES) was developed for patients, in which items concern the perceived kindness of physician from the patient point of view. RESULTS Data will be presented regarding the convergent validity of self-evaluated vs. perceived kindness measurement scales. Preliminary data show a poor correlation between self-evaluated kindness in physicians and perceived kindness by patients, with a major role for gender, being female more able in perceiving physician kindness. DISCUSSION Further research is needed to evaluate the validity of newly proposed scales for kindness and the real perception of kindness in P-PR

La comunicazione e la relazione con il malato: quale formazione nelle Facolt\ue0 mediche italiane? Presentazione del Progetto Gargnano

In Gargnano (BS, Italy) was organized a meeting, led by an international group of experts, between medical School's teachers involved in the field of doctor-patient communication and helping relationship training. The aim of this work is to present the results achieved by the group. In particular, are presented: 1. A nod to the teaching-learning of doctor-patient communication in Anglo-Saxon countries ; 2. An update on the Italian historical and current framework; 3. A summary produced by the Group Gargnano, referring: a. The cultural reflection, b. The strategic and operational propose of the group, through the "Manifesto for the Communication Training"

Clinical psychology for cardiac disease

From its very beginning, modern scientific psychology has dealt with issues regarding mind-body, health-disease relationships; in particular, clinical psychology, in its various applications, has tried to provide a structure to psychological concepts tied to organic disease. Clinical psychology is described as the “area of psychology whose objectives are the explanation, understanding, interpretation and reorganization of dysfunctional or pathological mental processes, both individual and interpersonal, together with their behavioral and psychobiological correlates” [2]. Clinical psychology is characterized by a variety of models, methods, theories and techniques, each of which has its own historical reason. Its core and indispensable common denominator is clinical practice, be it intended for individuals, groups or collectives [3]. Among its areas of application we can include psychosomatics, health psychology and hospital psychology, where clinical psychology offers a relevant and coherent scientific, professional and training frame through contributions aimed at health maintenance and promotion, identification of etiological and diagnostic correlates, analysis and improvement of health care, and enhancement of public health [4]