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有意愿、有能力且准备好求助了吗?对有当前未治疗抑郁症状的社区样本寻求帮助行为的计划行为理论的一项调查。

Ready, Willing and Able? An Investigation of the Theory of Planned Behaviour in Help-Seeking for a Community Sample with Current Untreated Depressive Symptoms.

作者信息

Tomczyk S, Schomerus G, Stolzenburg S, Muehlan H, Schmidt S

机构信息

Institute of Psychology, Department Health and Prevention, University of Greifswald, Robert-Blum-Str. 13, 17487, Greifswald, Germany.

Medical Faculty, Department of Psychiatry, University of Leipzig, Leipzig, Germany.

出版信息

Prev Sci. 2020 Aug;21(6):749-760. doi: 10.1007/s11121-020-01099-2.

Abstract

Applying health behaviour change models, such as the theory of planned behaviour (TPB), to help-seeking for mental health problems can address the deficit in health care utilisation. However, previous studies largely focused on help-seeking intentions and not behaviour, which might be problematic due to the intention-behaviour gap. Hence, TPB and help-seeking were examined in a German community sample with current untreated depressive symptoms: 188 adults (M = 50.34; SD = 16.19; 70.7% female) participated in a baseline interview and survey measuring components of the TPB (attitudes, subjective norms and perceived behavioural control) and help-seeking intentions. They reported actual help-seeking from mental health professionals via telephone surveys 3 and 6 months later. To better understand the potential gap between help-seeking intentions and behaviour and to investigate the contributions of readiness, willingness and ability to seek help, two path models were constructed in accordance with the TPB controlling for covariates. Attitudes (β = .24), subjective norms (β = .25) and self-efficacy (β = .15) were significantly associated with intentions (R = 26%), which predicted help-seeking (Cox and Snell's pseudo-R = 23%); controllability did not predict help-seeking. In sum, the TPB provides a reliable framework to explore help-seeking behaviour for mental health problems. Based on these findings, prevention efforts should focus on readiness and willingness to seek help (e.g. foster positive attitudes and social support of treatment). However, the role of ability, operationalised as perceived behavioural control and (perceived) barriers to help-seeking, warrants further research, as self-efficacy but not controllability was associated with help-seeking.

摘要

应用健康行为改变模型,如计划行为理论(TPB),来帮助寻求心理健康问题的解决办法,可以弥补医疗保健利用方面的不足。然而,以往的研究主要集中在寻求帮助的意图而非行为上,由于意图与行为之间的差距,这可能会带来问题。因此,在一个有当前未治疗抑郁症状的德国社区样本中,对TPB和寻求帮助的行为进行了研究:188名成年人(M = 50.34;SD = 16.19;70.7%为女性)参与了基线访谈和调查,测量TPB的组成部分(态度、主观规范和感知行为控制)以及寻求帮助的意图。在3个月和6个月后,他们通过电话调查汇报了向心理健康专业人员实际寻求帮助的情况。为了更好地理解寻求帮助的意图与行为之间的潜在差距,并调查准备度、意愿和寻求帮助的能力的作用,根据TPB构建了两个路径模型,并对协变量进行了控制。态度(β = 0.24)、主观规范(β = 0.25)和自我效能感(β = 0.15)与意图显著相关(R = 26%),意图预测了寻求帮助的行为(考克斯和斯内尔的伪R = 23%);可控性并未预测寻求帮助的行为。总之,TPB为探索心理健康问题的寻求帮助行为提供了一个可靠的框架。基于这些发现,预防工作应侧重于寻求帮助的准备度和意愿(例如,培养积极的态度和对治疗的社会支持)。然而,作为感知行为控制和寻求帮助的(感知)障碍来实施的能力的作用,值得进一步研究,因为与寻求帮助相关的是自我效能感而非可控性。

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