Search Results (115)

Background/Objectives: The increasing population of childhood cancer survivors presents new challenges for healthcare systems worldwide. While advances in oncological treatments have dramatically improved survival rates, survivors face a broad spectrum of late effects that extend beyond the biological to encompass profound psychological and social dimensions. Methods: This quasi-systematic review synthesizes data from recent studies on adolescent survivors, revealing significant disruptions in cognitive function, mental health, social integration, education, romantic relationships, and vocational outcomes. Results: This review highlights the inadequacy of a solely biomedical model and advocates for a biopsychosocial approach to long-term follow-up care. An emphasis is placed on the necessity of personalized, interdisciplinary, and developmentally informed interventions, especially in countries like Poland, where structured survivorship care models remain underdeveloped. Conclusions: The findings underscore the importance of integrating medical, psychological, and social services to ensure adolescent cancer survivors achieve not only physical recovery but also meaningful life participation and emotional well-being. Full article

Background/Objectives: Pelvic organ prolapse (POP) is a common condition that significantly impacts quality of life. Research has focused largely on older women, while experiences of younger women remain relatively underexplored despite challenges unique to this population. Informed by the biopsychosocial model of illness, this study aims to assess the symptom burden, treatment goals, and information needs of younger women complaining of prolapse by analyzing questionnaire responses from an existing electronic Personal Assessment Questionnaire—Pelvic Floor (ePAQ-PF) dataset. Methods: Mixed-methods content analysis was conducted using free-text data from an anonymized multi-site ePAQ-PF dataset of 5717 responses collected across eight UK NHS trusts (2018–2022). A quantitative, deductive approach was first used to identify younger women (≤50 years old) with self-reported prolapse. ePAQ-PF scores for younger women with prolapse were compared with those aged >50 years, using Mann–Whitney tests. Free-text response data were analyzed inductively to qualitatively explore younger women’s symptom burden, treatment goals, and information needs. Results: Of the 1473 women with prolapse identified, 399 were aged ≤50 years. ePAQ-PF scores of the younger cohort demonstrated significantly greater symptom severity and bother than those aged >50, particularly in bowel, prolapse, vaginal, body image, and sexual health domains (p < adjusted threshold). Qualitative analysis undertaken to understand women’s concerns and priorities produced five health-related themes (physical health; functionality; psychosocial and emotional wellbeing; reproductive and sexual health; and healthcare journeys) and a sixth intersecting theme representing information needs. Conclusions: The findings highlight the substantial symptom burden of younger women with prolapse, as well as treatment goals and information needs specific to this population. The development of age-specific resources is identified as a requirement to support this group. Full article

Famed lawyer Clarence Darrow (1857–1938) argued strongly for an early-life public health approach to crime prevention, one that focused on education, poverty reduction, and equity of resources. Due to his defense of marginalized persons and his positions that were often at odds with his legal colleagues and public opinion, he was known as the Big Minority Man. He argued that the assumption of free will—humans as free moral agents—justifies systems of inequity, retributive punishment, and “unadulterated brutality.” Here, the authors revisit Darrow’s views and expand upon them via contemporary research. We examine increasingly louder argumentation—from scholars across multiple disciplines—contending that prescientific notions of willpower, free will, blameworthiness, and moral responsibility, are contributing to social harms. We draw from biopsychosocial perspectives and recent scientific consensus papers calling for the dismantling of folk psychology ideas of willpower and blameworthiness in obesity. We scrutinize how the status quo of the legal system is justified and argue that outdated notions of ‘moral fiber’ need to be addressed at the root. The authors examine recent arguments for one of Darrow’s ideas—a public health quarantine model of public safety and carceral care that considers the ‘causes of the causes’ and risk assessments through a public health lens. In our view, public health needs to vigorously scrutinize the prescientific “normative” underpinnings of the criminal justice system. Full article

Background/Objectives: The pediatric mental health crisis in the United States has reached unprecedented levels. Severe shortages in specialized health care professionals, particularly child and adolescent psychiatrists (CAPs), exacerbate the challenge of delivering timely and quality mental health care, especially in rural areas like Kansas. Innovative models such as Pediatric Mental Health Care Access (PMHCA) programs and School-Based Health Clinics (SBHCs) aim to integrate mental health expertise into primary care settings to address this gap. Methods: This paper examines an integrated care model to support SBHCs developed by the Kansas PMHCA. The Interprofessional Child-Centered Integrated Care Model (ICX2) was implemented within an SBHC in Haysville, KS. ICX2 utilizes biweekly collaborative team meetings (CTMs) via zoom involving primary care, psychology, child psychiatry, social work, and school resource coordinators to discuss patient cases and enhance the primary care management of pediatric mental health. This descriptive study analyzes data from January 2023 to June 2023, focusing on patient demographics, case characteristics discussed during CTMs, and recommendations made by the interprofessional team. Results: Findings illustrate the complex biopsychosocial needs of patients seen and define themes of case consultation and recommendations. Conclusions: Integrated care programs like ICX2 can be feasibly implemented through PMHCA programs and may be an efficient intervention to bridge resource gaps. Full article

Sexual dysfunction is a prevalent and often under-addressed concern among prostate cancer survivors, significantly affecting quality of life for patients and their partners. The True North Sexual Health and Rehabilitation eClinic (SHAReClinic) is a virtual, biopsychosocial intervention developed to improve access to sexual health support for prostate cancer survivors and their partners. This study used a qualitative descriptive design to examine barriers and facilitators influencing the integration of SHAReClinic into oncology care across nine Canadian health care centres. Semi-structured interviews were conducted with 17 knowledge users, including health care providers and institutional leaders. Data were analyzed using a hybrid deductive–inductive thematic approach guided by the Consolidated Framework for Implementation Research (CFIR) 2.0. Participants described SHAReClinic as a much-needed resource, particularly in the absence of standardized sexual health pathways in oncology care. The virtual format was seen as accessible and well suited to addressing sensitive topics. However, limited funding, lack of institutional support, and workflow integration challenges emerged as primary barriers to implementation. Findings offer practical, theory-informed guidance for integrating SHAReClinic into oncology care and highlight key considerations for developing sustainable and scalable survivorship care models. Full article

Background/Objective: Non-specific chronic neck pain (CNP) greatly affects the social dynamics, the work performance, and the personal independence of patients. Research emphasizes the significant role of sociological factors, psychological stress, and emotional conflicts in the development, regulation, and endurance of chronic pain. This study aims to explore the influence of emotional conflicts on pain experience among CNP patients, drawing from their experiences. Methods: A phenomenological investigation was conducted, grounded in Heideggerian philosophy, involving CNP patients and healthcare professionals in Madrid, Spain. Participants were recruited from Primary Health Care centers. Data collection methods included semi-structured in-depth interviews, focus groups with patients, focus groups with healthcare providers, participant observation, and reflective diaries. Hermeneutic phenomenology guided the data interpretation. Thematic analysis was applied to transcribed audio recordings. Results: This study included 12 patients with CNP who participated in two in-depth interviews conducted at different time points—before and after receiving physiotherapy treatment. Additionally, 23 CNP patients took part in four focus groups, and 46 healthcare professionals (including physicians, nurses, and physiotherapists) participated in three focus groups. A hermeneutic analysis revealed the following three main categories: “Self-concept and pain experience”, “Daily life obligations and pain perception”, and “Emotional conflicts related to CNP”. Patients described themselves as nervous, having communication difficulties, and often prioritizing family or work tasks, leading to stress. They indicated that their interpersonal conflicts with close relations intensified their perceived pain in the neck, head, shoulders, and arms. Conclusions: From the perspective of the participants in this study, interpersonal and emotional conflicts appear to influence their perception of CNP. Full article

Planetary health is a transdisciplinary concept that erases the dividing lines between individual and community health, and the natural systems that support the wellbeing of humankind. Despite planetary health’s broad emphasis on justice, the promotion of science-based policies, and stated commitments to fairness, equity, and harm reduction, the criminal justice system has largely escaped scrutiny. This seems to be a major oversight, especially because the criminalization of mental illness is commonplace, and the system continues to be oriented around a prescientific compass of retribution and folk beliefs in willpower, moral fiber, and blameworthiness. Justice-involved juveniles and adults are funneled into landscapes of mass incarceration with ingrained prescientific assumptions. In non-criminal realms, such as obesity, there is a growing consensus that folk psychology ideas must be addressed at the root and branch. With this background, the Nova Institute for Health convened a transdisciplinary roundtable to explore the need for a ‘Copernican Revolution’ in the application of biopsychosocial sciences in law and criminal justice. This included discussions of scientific advances in neurobiology and omics technologies (e.g., the identification of metabolites and other biological molecules involved in behavior), the need for science education, ethical considerations, and the public health quarantine model of safety that abandons retribution. Full article

The spine is the most affected region, which compromises functionality and generates absenteeism, increased health care costs, and disability retirement rates. Based on the biopsychosocial model, it is believed that chronic back problems are the result of a complex network of factors, both individual and contextual. A cross-sectional study was developed with data from the 2013 National Health Survey, the United Nations Development Programme, and the National Register of Health Establishments (state level) for the second and third levels of aggregation, respectively. Multilevel Poisson regression was performed at three levels. The prevalence of chronic back problems was 18.5% (95% CI 17.8; 19.1), with a higher prevalence in females (RP = 1.23; 95% CI 1.15; 1.30), those aged above 49 years (RP = 1.75; 95% CI 1.61; 1.90), those performing heavy activities at work (RP = 1.37; 95% CI 1.28; 1.46), those with depressive days (RP = 1.70; 95% CI 1.50; 1.94), those who were smokers (RP = 1.37; 95% CI 1.27; 1.48), and those in states with a higher coefficient of Family Health Support Team per 100,000 inhabitants (PR = 1.28; 95% CI 1.07; 1.54). Chronic spine problems were associated with biological and behavioral factors and were more strongly associated with the coefficient of Family Health Support Team in Brazilian municipalities. Full article

Multimorbidity is the conjoint presence of multiple conditions in patients, which is a public health problem. Multimorbidity is like the elephant in the clinic room because it remains the unaddressed challenge we face in healthcare. Clinical health psychology has a role to play in this undertaking because it recognizes the intersection and interface of concurrent mental and/or behavioral problems and physical diseases. The current article will define multimorbidity, describe current statistics, how it differs from comorbidity, how to use the biopsychosocial model, and ways in which clinical health psychologists can manage and prevent it in their clinics. A model of how to address multimorbidity will be shared using the role of a clinical health psychologist working in a multidisciplinary pain clinic in a hospital setting serving patients who are socioeconomically disadvantaged. Full article

Despite the proliferation of biomedical and psychological treatments, the global burden of chronic intractable (long-term) pain remains high—a treatment-prevalence paradox. The biopsychosocial model, introduced in the 1970s, is central to strategies for managing pain, but has been criticised for being decontextualised and fragmented, compromising the effectiveness of healthcare pain support services and patient care. The aim of this study was to apply a simplified version of Ken Wilber’s All Quadrant All Levels (AQAL) framework to pain in a healthcare context to advance a biopsychosocial understanding. Utilising domain knowledge, the author mapped features of pain and coping to intrasubjective, intraobjective, intersubjective, and interobjective quadrants (perspectives), as well as levels of psychological development. Narratives were crafted to synthesize the findings of mapping with literature from diverse disciplines within the contexts of salutogenesis and a social model of health. The findings showed that AQAL-mapping enhanced contextual biopsychosocial coherence and exposed the conceptual error of reifying pain. Its utility lay in highlighting upstream influences of the painogenic environment, supporting the reconfiguration of pain within a social model of health, as exemplified by the UK’s Rethinking Pain Service. In conclusion, a simple version of the AQAL framework served as a heuristic device to develop an integral vision of pain, opening opportunities for health promotion solutions within a salutogenic context. Full article

High levels of stigma among the healthcare workforce impede efforts to increase access to effective substance use disorder (SUD) treatments. Education on SUDs that (1) is tailored to physicians in training and (2) directly addresses and attempts to combat SUD stigma may help produce lasting reductions in SUD stigmatization within the healthcare setting. This study aims to describe the development of a technology-based, interactive SUD stigma intervention for medical students, created in collaboration with medical students, practicing clinicians, and experts in the fields of psychology and addiction medicine. This intervention is unique in its interactive application-based approach and the use of a computerized intervention authorizing system (CIAS) to guide the participant through the training. The final intervention includes four interactive online modules focused on SUD education using a biopsychosocial model, including stigma acknowledgment, an examination of patient perspectives, and the application of skills. Planned future studies will examine the feasibility, acceptability, and preliminary efficacy of the intervention among medical students. This intervention leverages the existing CIAS to provide interactive training that can be used as a part of medical student training and be expanded to other healthcare professionals (e.g., nurses and community health workers). Ultimately, this work will be used to drive a reduction in SUD stigma in medical settings. Full article

Background: Prostate cancer is recognised as the second most common diagnosed cancer in men and remains a significant global public health concern. In Ireland, the incidence of prostate cancer continues to rise, with approximately 1 in 6 men being diagnosed in their lifetime. Men’s experiences with prostate cancer are complex, necessitating further research into the factors influencing diagnosis and treatment. Therefore, this study aims to explore men’s experiences with prostate cancer, emphasising the interplay between screening, diagnosis, and the lived experiences of those affected. Methods: A qualitative descriptive study was conducted among men with prostate cancer in Ireland. Using a purposive sampling (n = 11) were interviewed with data saturation guiding sample size determination. A semi-structured interview guide was used for data collection either face-to-face or via Microsoft Teams and phone calls. Data were analysed using Braune and Clarke’s thematic analysis approach after transcription, with NVivo 12.0 software supporting analysis. Results: Thematic analysis identified five themes: systemic obstacle in timely cancer detection, the role of efficient system in cancer care, emotional resilience in cancer recovery, redefining normalcy post treatment and harnessing specialised support network in coping strategies. These themes were examined through the lens of the Biopsychosocial Model to understand their interconnected nature and impact on patient experiences. Conclusions: This study highlights the complex factors affecting prostate cancer patients’ experiences, emphasizing the need for a patient-centred approach, addressing systemic disparities, and promoting multidisciplinary care. It suggests implementing evidence-based survivorship care frameworks to improve quality of life for survivors, with future research exploring long-term effects of integrated care models. Full article

Background/Objectives: Sarcopenia, abdominal obesity, and sarcopenic obesity are prevalent and clinically significant in older adults, each shaped by diverse biopsychosocial factors. However, integrative analyses using nationally representative data remain limited in Korea. Methods: We analyzed 2118 adults aged ≥65 years from the 2022–2023 Korea National Health and Nutrition Examination Survey (KNHANES). Body composition was classified into sarcopenia, abdominal obesity, and sarcopenic obesity. Guided by Engel’s Biopsychosocial Model, we examined biological (e.g., sex, chronic disease, nutrition, exercise), psychological (e.g., stress, sleep, self-rated health), and social (e.g., income, education, living status) variables. Complex-sample multinomial logistic regression identified condition-specific associations. Results: Prevalence rates were 18.2% for sarcopenia, 41.0% for abdominal obesity, and 3.4% for sarcopenic obesity. Eating alone and a lack of resistance exercise were common risk factors across all three conditions. Sarcopenia was associated with male sex, insufficient dietary intake, alcohol consumption, poor self-rated health, and low household income. Abdominal obesity was linked to recent weight gain, hypertension, diabetes, prolonged sedentary time, perceived obesity, and low educational attainment. Sarcopenic obesity was associated with male sex, diabetes, elevated hs-CRP, perceived stress, poor self-rated health, and economic inactivity. Conclusions: Body composition abnormalities among older Korean adults are influenced by complex, condition-specific interactions across biological, psychological, and social domains. These findings emphasize the significance of adopting an integrative perspective that considers physical, psychological, and social health components when addressing age-related body composition issues. Full article

Background: The management of chronic pain is inherently multidisciplinary, requiring collaboration across health and care professions because pain is multidimensional, involving psychological, social, biomedical, cultural, and environmental factors. However, pain education has often focused more on biomedical aspects, limiting the capacity of professionals to deliver integrated, person-centred care. Shifting pain education away from biomedically driven curricula may better prepare graduates for meaningful consultations and biopsychosocial care. Objective: This manuscript reports the development and pilot evaluation of a virtual patient simulation designed to help physiotherapy students develop person-centred pain assessment skills. Methods: We developed and piloted a virtual patient with complex pain scenarios for physiotherapy students. To evaluate the simulation, students completed a self-reported questionnaire assessing their ability, self-confidence in person-centred assessment skills, and their attitudes and beliefs regarding the simulation. Results: Frequency and confidence in person-centred inquiry ranged from 100% to 16.3%, depending on the complexity of information. Inductive thematic analysis revealed four themes: (1) Environmental factors & preferences—students’ preference for the learning environment; (2) Learning experience—including engagement, feedback, discussions, and a ‘safe’ space for building confidence; (3) Professional development—insights into person-centred inquiry, personal biases, and emotional challenges; (4) Limitations—including the desire for more complexity, and technical challenges noted. Conclusions: The development of this virtual patient simulation enabled healthcare students to engage with a multidimensional perspective on pain, fostering skills essential for biopsychosocial pain assessment and patient-centred care. Although designed and piloted with physiotherapy students, this model holds potential for broader application across healthcare disciplines. Full article

Background/Objectives: This study aimed to examine regional cancer screening participation rates among South Korean adults aged 40 and over and to identify biological, psychological, and sociocultural factors associated with cancer screening behavior using the biopsychosocial model. Methods: This research was a secondary analysis study. Data were obtained from the 2023 Korean Community Health Survey, focusing on adults residing in cities that exhibited the highest and lowest rates of cancer screening. Differences in cancer screening rates by city were visualized using a location-based open service platform. Variables were categorized into biological, psychological, and sociocultural factors, and logistic regression analysis was conducted to ascertain the factors associated with screening participation. Results: The cancer screening rate for adults aged 40 or older in 17 metropolitan cities in Korea ranged from 64.9% to 76.0%, and the national average was 70.9%. In the city with the highest screening rate, participation was positively associated with oral health, physical activity, breakfast-eating habits, and past smoking. In the city with the lowest screening rate, higher screening participation correlated with family cohabitation and satisfaction with the social environment. Conclusions: Our results suggest that cancer screening participation rates vary across regions and that the factors associated with cancer screening participation differ between regions with the highest and lowest participation rates. These results provide evidence for targeted interventions that take into account regional factors to improve cancer screening rates in South Korea. Full article