Standards of healthcare exist to promote beneficent treatment; however, treatment approaches are sometimes not supported by research, creating potential ethical issues for clinicians expected to use evidence-based practices. For example, walk-and-talk therapy, where therapy sessions incorporate physical activity in an outdoor setting, is being offered at increasing rates, but research regarding the practice is sparse and primarily reflects the therapists' experiences. Thus, the purpose of this interpretative phenomenological analytic study was to explore the clients' experience of the altered frame of walk-and-talk therapy through the conceptual lenses of therapeutic frame and the biopsychosocial model of well-being. Data were collected through in-depth, semistructured interviews with a sample of three former walk-and-talk therapy clients, and data were analyzed using the modified van Kaam method. Findings included that the clients' experience of walk-and-talk therapy was shaped by prior therapy experiences with participants reporting concerns and benefits related to the altered frame. Clients found walk-and-talk equally or more therapeutic than traditional therapy and felt walk-and-talk could be a less stigmatizing therapeutic alternative for individuals who find traditional, indoor therapy unappealing. Implications for social change include shaping standard practices of walk-and-talk therapy, thus informing the future of training and supervision as well as providing an alternative therapeutic offering for individuals who find traditional, indoor therapy unappealing.

The purpose of this study was to evaluate the relationship between women's sexual desire and their reported level of sexual satisfaction. This study evaluated biological, psychological, and social factors of desire that might influence satisfaction. The sample for this study consisted of 77 Caucasian individuals, 45 women and 32 men, in their first marriage, who had been married on average 2 years. Results indicated that sexual desire was positively and significantly correlated with sexual satisfaction and that psychological and social factors most strongly explain women's sexual satisfaction. Further, women's perceptions of their own sexual desire, psychological and social, were more strongly associated with sexual satisfaction than their husband's perception of their desire, biological, psychological, or social.

Back pain is one of the most expensive medical conditions to treat. There has been a great deal of research showing that back pain surgery is expensive, but less is known about the costs of less-invasive spine procedures such as radiofrequency neurotomy. Radiofrequency neurotomy is used to treat facet joint pain and typically offers temporary pain relief by coagulating the affected nerve with radiofrequency waves to block pain messages from reaching the brain. This study aimed to document the costs of radiofrequency neurotomy in a group of participants who received the procedure through the Workers’ Compensation Fund of Utah (WCFU). Another goal of the study was to determine if any biopsychosocial variables of participants predicted costs. Biopsychosocial variables include biological (e.g., age), psychological (e.g., depression), and social (e.g., hiring a lawyer) characteristics about participants. Costs and characteristics were collected from participant medical records. Compensation and medical costs were collected; compensation costs were wage payouts as a result of an on-the-job injury, and medical costs were direct medical costs. Both compensation and medical costs were substantial and similar to other more invasive procedures. Furthermore, three biopsychosocial characteristics predicted high costs. A high number of prior back and neck surgery and lawyer involvement predicted high compensation costs. Those same variables plus history of depression predicted high medical costs. This was the first known study to document medical and compensation costs associated with spinal radiofrequency neurotomy. The findings add to the line of research suggesting that a biopsychosocial framework can be used to predict costs in spine care. Discovering participant characteristics that may predict high costs can inform policylevel decisions for insurers, and can be used by medical providers to influence patient care decisions. More research on the presurgical variables may lead to interventions at the patient level that can reduce high cost outcomes which could benefit both patients and payers.

No description available.

Physical injuries to the upper extremity can have a drastic impact on an individual’s daily functioning affecting their psychological well-being, social participation, and ability to perform valued activities such as self-care, work, and leisure tasks. Due to the wide range of factors affecting a person who is recovering from an upper extremity injury, therapists treating these individuals must understand, help identify, and address the areas impacting function to support and maximize participation in and performance of valued occupations. However, often psychosocial aspects of care go unaddressed when biomechanical interventions are prioritized, which is primarily attributed to therapists’ lack of knowledge, confidence, or skills in this area. Unlocking Biopsychosocial Hand Therapy is a continuing education unit (CEU) course aimed at filling therapist gaps in knowledge and service provision, specifically regarding psychosocial factors, when treating clients with upper extremity injuries or conditions. The long-term goals of this innovative program are to improve client outcomes and to increase therapist prioritization of psychosocial factors on par with biological factors.

No description available.

No description available.

No description available.

Doctor of Philosophy / Department of Family Studies and Human Services / Rick J. Scheidt / Alzheimer's disease (AD) is a chronic illness that has the capacity to impact several domains of a person's life. The purpose of this qualitative study was to explore four particular domains of meaning of an AD diagnosis to gain a systemic understanding of couples' experiences when one spouse had recently been diagnosed with Alzheimer's disease. A social constructionist framework was used in conjunction with the biopsychosocial-spiritual model, to explore the biological, psychological, social, and spiritual factors which inform and possibly influence couples' experiences in relation to an AD diagnosis. The interview guide was constructed using the underlying biopsychosocial-spiritual framework for the purpose of exploring couples' experiences in a systemic manner. Four couples were interviewed in their homes, no more than two months following a formal diagnosis of AD. This particular time frame captured the raw experience couples went through when receiving an AD diagnosis. All interviews were recorded, transcribed, and analyzed according to a modified version of Moustakas' phenomenological method of analysis. A family medicine physician served as the co-interpreter throughout the entire analysis process. Results consisted of unique descriptions for each couple's case and a composite description of the cross-case analysis, highlighting similarities and differences among cases. The biopsychosocial-spiritual model was found to be a significant tool for elliciting a systemic understanding of each couple's experience, and recognizing unique aspects of couples' experiences. Analysis across cases revealed 14 common themes that emerged across the four (five biological, four psychological, four social and two spiritual) domains. Results revealed that of the 14 common emerging themes, five themes were shared by all cases: Recognizing a Problem, Experience of Diagnosis Process, Experience of Symptoms, Social Support, and Social Activities. The overall analysis illustrated many more similarities among biological experiences than any other domain of experience. One case, #3, displayed a particularly unique psychological experience, as well as a significant spiritual foundation. Overall, this study emphasized the importance of using a systemic framework, such as the biopsychosocial-spiritual model, to gain a rich, in-depth understanding of how different couples experience the diagnosis process of AD.

O estudo apresenta o desenvolvimento e validação de um instrumento genérico de avaliação da Qualidade de Vida, no âmbito dos indicadores biopsicossociais, junto à Comunidade da USP - Campus São Paulo. Por ter grande profusão teórica, optou-se por definir Qualidade de Vida como a percepção individual de bem-estar, sustentada pelo equilíbrio do tripé biopsicossocial; entendendo, portanto, que o homem é um ser integrado nessas três dimensões. Adotou-se como ponto de partida para o desenvolvimento do instrumento, o modelo apresentado por Kertesz e Kerman (1985), tendo como base a teoria do conceito de investigação dos aspectos biológico, psicológico e social. A metodologia fundamenta-se em análises estatísticas pertinentes à psicometria. Uma amostra de 947 pessoas, de ambos os sexos, em faixas etárias a partir de 18 anos, foi usada. Foram investigados aspectos demográficos, socioeconômicos, saúde e avaliação do estado nutricional (IMC), para obtenção do perfil dos participantes, utilizando-se questão fechada e de múltipla escolha. Após o pré-teste, foram realizados os procedimentos analíticos: análise de confiabilidade, validade e fidedignidade. O resultado foi o novo Instrumento composto por 55 itens, dos 68 propostos inicialmente, e nove domínios, demonstrando bom desempenho psicométrico. Todos os domínios apresentaram um resultado final de Alfa Total com nível satisfatório (Alfa Total 0,8913, variando de 0,7032 a 0,9255), exceto o da Dimensão Hábitos Alimentares, que obteve o menor resultado (Alfa = 0,4993) e, por questões metodológicas, esse domínio foi mantido. A validade do instrumento, obtida segundo a realização da Análise Fatorial, definiu que o instrumento contivesse nove fatores, todos com autovalores maiores do que um, além de algumas modificações. A fidedignidade, análise da estabilidade por meio do teste-reteste, apresentou um resultado adequado. Conclui-se que as estratégias de análises demonstraram que os índices obtidos atenderam as exigências metodológicas e que o instrumento final apresentou confiabilidade e validade. / This study shows the development and validation of a generic instrument of evaluation of quality of life, within the ambit of biopsychosocial indicators along with USP Community - Campus of São Paulo. The methodology is based on statistical analysis belong to Psychometrics. A sample of 947 people, from both sexes, with different age groups since 18 years old, was used. In order to get a profile from the participants, demographic, health and socioeconomic aspects were analyzed, besides the evaluation of their nutritional state (CMI), through multiple choice and closed questions. It was used Kertesz and Kerman\'s (1985) instrument as a model, based on the concept of investigation of biopsychosocial aspects. After the pre-test, the analytic procedures were done: analysis of faithfulness, validity and reliability. The result was a new instrument compound by 55 items - of 68 initially proposed - and nine domains, which showed a good psychometric performance. All the domains demonstrated a final result of Total Alpha with an acceptable level (Total Alpha 0,8913, varying from 0,7032 to 0,9255), excepting the level of Dimension Eating Habits, which got the lowest result (Alpha = 0,4993); however it was kept because of methodological matters. The validity of the instrument, got according the Factorial Analysis, defined that the instrument had some modifications, besides nine factors with self values bigger than one. The reliability, analysis of the stability through test-retest, showed a satisfactory result. In conclusion, the analysis strategies demonstrated that the results met with the methodological requirements and that the final instrument is faithful and valid, less complex and practical during its employment.