Effects of a brief multimodal online intervention on the intention to conduct sun protective behaviours through targeting illness representations about skin cancer

__Objective:__ The incidence of skin cancer can be reduced by increasing sun protective behaviours. Based on the Common-Sense Model and the Intervention Mapping approach, a brief intervention targeting illness representations about skin cancer to increase the intention to conduct sun protective behaviours was developed and evaluated regarding its effectiveness. __Design:__ A randomized pre-post control group design with 509 healthy participants (69% women, mean age 39 years). Main outcome measures: Changes in illness representations about skin cancer (emotional representations, illness coherence, and prevention control) and the intention to conduct sun protective behaviours, i.e. UV protection and sun avoidance. __Results:__ ANCOVAs showed that the intervention increased illness coherence and perceived prevention control as well as the intention to conduct sun protective behaviours. Mediation analyses revealed that the increase in illness coherence and/or perceived prevention control partially mediated the effect of the intervention on the increase of the intention to use UV protection and to avoid sun exposure. __Conclusion:__ The intervention was successful in changing illness representations and thereby increasing the intention to conduct sun protective behaviours. The findings provide evidence for the usefulness of the Common-Sense Model in the context of illness prevention

Adult attachment and relationship satisfaction: The mediating role of gratitude toward the partner

Previous research indicated that insecure attachment, that is, higher levels of attachment avoidance and attachment anxiety, is negatively associated with relationship satisfaction. The present study investigated the mediating role of gratitude toward the partner in this association. In a cross-sectional design, 362 participants (84% female, age range 18–70 years) involved in a romantic relationship completed an online questionnaire assessing attachment avoidance and anxiety, gratitude toward the partner, and relationship satisfaction. Data were analyzed by means of regression and bootstrap analyses. The regression analysis revealed significant negative total and direct effects of both avoidance and anxiety on relationship satisfaction. The bootstrap analyses revealed a significant negative indirect effect of avoidance, but not anxiety, on relationship satisfaction via gratitude toward the partner. Specifically, higher levels of avoidant attachment were related to less gratitude toward the partner, which in turn was associated with lower relationship satisfaction. These findings suggest that it might be valuable applying gratitude interventions to clients high in attachment avoidance attending couples therapy

Illness perceptions and quality of life in patients with non-small-cell lung cancer

__Purpose:__ Examine illness perceptions, functional health and quality of life of lung cancer patients throughout chemotherapy treatment. __Patients and Methods:__ Longitudinal design with baseline measure 12 days after the first chemotherapy and follow-up measure 3 months later, where illness perceptions (BIPQ), functional health, and quality of life (EORTC QLQ-C-30) were measured. A total of 21 patients with non-small-cell lung cancer took part. Non-parametric testing was performed given the pilot nature of the study and the associated relatively small sample size. __Results:__ Small to medium changes in illness perceptions and functional health between the two measurement points were detected, with both becoming more positive. More negative illness perceptions at the beginning of the treatment were associated with less functioning and lower quality of life at both beginning and end of treatment. __Conclusion:__ Addressing illness perceptions seems a clinically relevant approach in improving functioning and quality of life of patients with non-small-cell lung cancer

Clinical leaders crossing boundaries: A study on the role of clinical leadership in crossing boundaries between specialties.

BackgroundDue to the growing number of complex (multimorbid) patients, integrating and coordinating care across medical specialties around patient needs is an urgent theme in current health care. Clinical leadership plays an important role in stimulating coordination both within and between specialty groups, which results in better outcomes in terms of job satisfaction and quality of care.PurposeIn this light, this study aims to understand the relation between physicians' clinical leadership and outcomes, focusing on the sequential mediation of relationships and coordination with physicians within their own medical specialty group and from other specialties.MethodologyA cross-sectional self-administered survey among physicians in a Dutch hospital (n = 107) was conducted to measure clinical leadership, relational coordination at two levels (medical specialty group and between different specialties), quality of care, and job satisfaction.ResultsClinical leadership was related to better quality of care through more relational coordination within the medical specialty group. Clinical leadership was related to more job satisfaction through more relational coordination within the medical specialty group, through more relational coordination between specialties, and sequentially through both kinds of relational coordination.ConclusionPhysicians who act as clinical leaders are important for crossing specialist boundaries and increasing care outcomes.Practical implicationsTo improve multidisciplinary collaboration, managers should encourage clinical leadership and pay attention to the strong relationships between physicians from the same specialty