451
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King K, Horne R, Cooper V, Glendinning E, Michie S, Chalder T. The development of an intervention to support uptake and adherence to antiretroviral therapy in people living with HIV: the SUPA intervention. A brief report. Transl Behav Med 2021; 12:6348018. [PMID: 34379122 DOI: 10.1093/tbm/ibab104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The effectiveness of antiretroviral therapy (ART) depends on prompt uptake of treatment and a high level of adherence over the long-term, yet these behaviors are suboptimal. Previous interventions have significantly improved adherence but effect sizes are generally small. The aim of this article is to describe the design and content of an intervention to support uptake and adherence to treatment in HIV positive patients (SUPA intervention), utilizing cognitive behavioral and motivational interviewing (MI) techniques. The intervention was developed in line with Medical Research Council (MRC) guidance for the development of complex interventions and informed by the NICE (National Institute for Health and Care Excellence) Guidelines for adherence, empirical evidence and focus groups. Behavior change techniques were mapped to perceptual and practical barriers to uptake and adherence to ART, identified in previous research. Intervention materials were designed and later discussed within focus groups, where feedback enabled an iterative process of development. We conclude it is possible to transparently report the design and content of a theory-based intervention to increase uptake and adherence to ART. The intervention has been evaluated within a randomized controlled trial (RCT) at 10 HIV clinics in England, the results of which will be reported elsewhere.
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Affiliation(s)
- Kathryn King
- Centre for Behavioural Medicine, UCL School of Pharmacy, London, United Kingdom
| | - Rob Horne
- Centre for Behavioural Medicine, UCL School of Pharmacy, London, United Kingdom
| | - Vanessa Cooper
- Centre for Behavioural Medicine, UCL School of Pharmacy, London, United Kingdom
| | | | - Susan Michie
- Centre for Behavioural Medicine, UCL School of Pharmacy, London, United Kingdom
| | - Trudie Chalder
- Psychological Medicine, King's College London, London, United Kingdom
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452
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Coifman KG, Disabato DJ, Aurora P, Seah THS, Mitchell B, Simonovic N, Foust JL, Sidney PG, Thompson CA, Taber JM. What Drives Preventive Health Behavior During a Global Pandemic? Emotion and Worry. Ann Behav Med 2021; 55:791-804. [PMID: 34165145 PMCID: PMC8344868 DOI: 10.1093/abm/kaab048] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background & Purpose Primary prevention of COVID-19 has focused on encouraging compliance with specific behaviors that restrict contagion. This investigation sought to characterize engagement in these behaviors in U.S. adults early during the pandemic and to build explanatory models of the psychological processes that drive them. Methods US adults were recruited through Qualtrics Research Panels (N = 324; 55% female; Mage = 50.91, SD = 15.98) and completed 10 days of online reports of emotion, COVID-19 perceived susceptibility and worry, and recommended behaviors (social distancing, hand washing, etc.). Factor analysis revealed behaviors loaded on two factors suggesting distinct motivational orientations: approach and avoidance. Results Changes in approach and avoidance behaviors over the 10 days indicated large individual differences consistent with three types of participants. Discrete emotions, including fear, guilt/shame, and happiness were associated with more recommended behaviors. Fear and COVID-19 worry indirectly influenced each other to facilitate more behavioral engagement. While emotions and worry strongly predicted individual differences in behavior across the 10 days, they did not predict as well why behaviors occurred on one day versus another. Conclusions These findings suggest how daily affective processes motivate behavior, improving the understanding of compliance and efforts to target behaviors as primary prevention of disease.
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Affiliation(s)
- Karin G Coifman
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - David J Disabato
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Pallavi Aurora
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - T H Stanley Seah
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Benjamin Mitchell
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Nicolle Simonovic
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Jeremy L Foust
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Pooja Gupta Sidney
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Clarissa A Thompson
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Jennifer M Taber
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
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453
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Winograd DM, Fresquez CL, Egli M, Peterson EK, Lombardi AR, Megale A, Tineo YAC, Verile MG, Phillips AL, Breland JY, Santos S, McAndrew LM. Rapid review of virus risk communication interventions: Directions for COVID-19. PATIENT EDUCATION AND COUNSELING 2021; 104:1834-1859. [PMID: 33583651 PMCID: PMC7817441 DOI: 10.1016/j.pec.2021.01.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/15/2021] [Accepted: 01/16/2021] [Indexed: 05/05/2023]
Abstract
OBJECTIVE In response to COVID-19, we conducted a rapid review of risk communication interventions to mitigate risk from viruses to determine if such interventions are efficacious. METHODS We searched for risk communication interventions in four databases: Medline, PsycInfo, the ProQuest Coronavirus Research Database, and CENTRAL. The search produced 1572 articles. Thirty-one articles were included in the final review. RESULTS Results showed risk communication interventions can produce cognitive and behavior changes around viruses. Results were more consistently positive for interventions focused on HIV/AIDS as compared to influenza. There was no consistent best intervention approach when comparing peer health, audio/visual, and intensive multi-media interventions. Tailoring risk communication toward a target population, in comparison to not tailoring, was related to better outcomes. CONCLUSION The results suggest that risk communication interventions can be efficacious at reducing risk from viruses. They also highlight the complexity of risk communication interventions. Additional research is needed to understand the mechanisms that lead risk communication to reduce risk from viruses. PRACTICAL VALUE Results support risk communication interventions to reduce risk from viruses.
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Affiliation(s)
- Darren M Winograd
- Department of Educational and Counseling Psychology, University at Albany, State University of New York, Albany, NY, 12222, USA
| | - Cara L Fresquez
- Department of Educational and Counseling Psychology, University at Albany, State University of New York, Albany, NY, 12222, USA
| | - Madison Egli
- Department of Psychology, Colorado State University, Fort Collins, CO, 80526, USA
| | - Emily K Peterson
- Department of Educational and Counseling Psychology, University at Albany, State University of New York, Albany, NY, 12222, USA
| | - Alyssa R Lombardi
- Department of Educational and Counseling Psychology, University at Albany, State University of New York, Albany, NY, 12222, USA
| | - Allison Megale
- Department of Educational and Counseling Psychology, University at Albany, State University of New York, Albany, NY, 12222, USA
| | - Yajaira A Cabrera Tineo
- Department of Educational and Counseling Psychology, University at Albany, State University of New York, Albany, NY, 12222, USA
| | - Michael G Verile
- Department of Educational and Counseling Psychology, University at Albany, State University of New York, Albany, NY, 12222, USA
| | - Alison L Phillips
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs New Jersey Healthcare System, East Orange, NJ, 07018, USA; Department of Psychology, Iowa State University, Ames, IA, 50011, USA
| | - Jessica Y Breland
- Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, 94025, USA
| | - Susan Santos
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs New Jersey Healthcare System, East Orange, NJ, 07018, USA
| | - Lisa M McAndrew
- Department of Educational and Counseling Psychology, University at Albany, State University of New York, Albany, NY, 12222, USA; War Related Illness and Injury Study Center (WRIISC), Veterans Affairs New Jersey Healthcare System, East Orange, NJ, 07018, USA.
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454
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Dorough A, Narendra JH, Wilkie C, Hegde A, Swain K, Chang EH, Oliver T, Flythe JE. Stakeholder-Guided Development of Dialysis Vascular Access Education Materials. KIDNEY360 2021; 2:1115-1123. [PMID: 35368361 PMCID: PMC8786100 DOI: 10.34067/kid.0002382021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 04/29/2021] [Indexed: 02/04/2023]
Abstract
Background Initiating hemodialysis via an arteriovenous (AV) access is considered best practice for most patients. Despite the well-recognized advantages of AV access, 80% of US patients start hemodialysis with a catheter. Limited patient knowledge about vascular access, among other factors, may play a role in this high rate. We used iterative stakeholder input to develop novel, mixed media vascular access education materials and evaluated their preliminary acceptability. Methods We conducted preliminary focus groups and interviews with key stakeholders to assess patient vascular access understanding and elicit perspectives on existing education materials. We then used stakeholder input to inform initial development and iterative updates to the content and design of an animated video and complementary brochure. Video development (scripting, storyboarding, animation) was guided by an evidence-based framework and two health behavior change models. We assessed acceptability of the completed materials with patients and medical providers/personnel via interviews. Results Overall, 105 stakeholders participated in education materials development and review (80 patients/care partners, 25 medical providers/personnel). Preliminary qualitative work included 52 patients/care partners and 16 providers/personnel; video development included 28 patients/care partners and nine providers/personnel. The video script, storyboards, and animation underwent 14, four, and nine stakeholder-guided iterations, respectively. Responsive changes included aesthetic modifications, technical updates, and content additions (e.g., HD circuit, access self-monitoring, enhanced patient testimonials). The final 18-minute video and complementary brochure define vascular access types, describe care processes, outline potential complications, and address common patient concerns. Interviews with 28 patients/care partners and nine providers/personnel from diverse geographic regions revealed preliminary acceptability of, and enthusiasm for, the materials by patients and providers. Conclusions In collaboration with key stakeholders, we developed mixed media vascular access education materials that were well-received by patients and providers. Preliminary findings suggest that the materials are promising to improve vascular access understanding among patients.
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Affiliation(s)
- Adeline Dorough
- University of North Carolina Kidney Center, Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Julia H. Narendra
- University of North Carolina Kidney Center, Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | | | - Akhil Hegde
- University of North Carolina Kidney Center, Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Kawan Swain
- University of North Carolina Kidney Center, Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Emily H. Chang
- University of North Carolina Kidney Center, Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Terence Oliver
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, North Carolina
| | - Jennifer E. Flythe
- University of North Carolina Kidney Center, Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina
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455
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Moosa AS, Leng NSY, Kum CL, Tan NC. A qualitative research study on the illness perception of chronic pruritus in older Asian adults based on the Common-Sense Model of self-regulation. Health Expect 2021; 24:1801-1811. [PMID: 34309980 PMCID: PMC8483190 DOI: 10.1111/hex.13320] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/30/2021] [Accepted: 07/11/2021] [Indexed: 12/02/2022] Open
Abstract
Background Chronic pruritus (CP), itch lasting more than 6 weeks, is common in community‐dwelling older adults. Understanding their illness perception allows the attending physician to develop a personalised care plan to mitigate CP. Aim This study explores the illness perception of CP among older Asian adults in an urban community. Design Qualitative research was conducted, framed by the Common‐Sense Model of self‐regulation (CSM). Through in‐depth interviews (IDIs), qualitative data were gathered from Asian patients with CP, and then a thematic analysis was carried out. The emergent themes were grouped according to the five domains of CSM: ‘identity’, ‘cause’, ‘time’, ‘controllability’ and ‘consequence’. Setting and Patients IDIs were conducted in a Singapore public primary care clinic before the data were saturated. Results The CSM domains illustrate the illness perception of CP. CP was identified as a ‘problem’ rather than a disease and was often described in metaphor. Patients' perception of the cause was diverse due to the lack of provision of a clear explanation by their physicians. They opined that CP continued indefinitely. Without definite time to resolution, patients adapted their help‐ and health‐seeking behaviours to control it. The consequences included therapeutic experimentation, alternative therapy, self‐isolation, avoidance behaviours, emotional disturbance and dermatological complications. Conclusion and Patient Contribution Patients provided information on their perception of CP, which aligned with the CSM. A multipronged approach is needed to deliver holistic and personalised care to patients with CP, providing clarity on its natural progression, to set their expectations on its timeline, treatment effectiveness and undertake appropriate behaviour modification to adapt to its chronicity.
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Affiliation(s)
| | | | | | - Ngiap Chuan Tan
- SingHealth Polyclinics, Singapore, Singapore.,SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore, Singapore
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456
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Sikorski F, König HH, Wegscheider K, Zapf A, Löwe B, Kohlmann S. The efficacy of automated feedback after internet-based depression screening: Study protocol of the German, three-armed, randomised controlled trial DISCOVER. Internet Interv 2021; 25:100435. [PMID: 34401394 PMCID: PMC8350593 DOI: 10.1016/j.invent.2021.100435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/16/2021] [Accepted: 07/16/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Depression is one of the most disabling disorders worldwide, yet it often remains undetected. One promising approach to address both early detection and disease burden is depression screening followed by direct feedback to patients. Evidence suggests that individuals often seek information regarding mental health on the internet. Thus, internet-based screening with automated feedback has great potential to address individuals with undetected depression. OBJECTIVES To determine whether automated feedback after internet-based depression screening reduces depression severity as compared to no feedback. METHODS The internet-based, observer-blinded DISCOVER RCT aims to recruit a total of 1074 individuals. Participants will be screened for depression using the Patient Health Questionnaire (PHQ-9). In case of a positive screening result (PHQ-9 ≥ 10), participants with undetected depression will be randomised into one of three balanced study arms to receive either (a) no feedback (control arm), (b) standard feedback, or (c) tailored feedback on their screening result. The tailored feedback version will be adapted to participants' characteristics, i.e. symptom profile, preferences, and demographic characteristics. The primary hypothesis is that feedback reduces depression severity six months after screening compared to no feedback. The secondary hypothesis is that tailored feedback is more efficacious compared to standard feedback. Further outcomes are depression care, help-seeking behaviour, health-related quality of life, anxiety, somatic symptom severity, intervention acceptance, illness beliefs, adverse events, and a health economic evaluation. Follow-ups will be conducted one month and six months after screening by self-report questionnaires and clinical interviews. According to a statistical analysis plan, the primary outcome will be analysed on an intention-to-treat basis applying multilevel modelling. DISCUSSION The results of the DISCOVER RCT will inform about how automated feedback after internet-based screening could improve early detection and resolution of depression. Ways of dissemination and how the trial can contribute to an understanding of help-seeking behaviour processes will be discussed. If the results show that automated feedback after internet-based depression screening can reduce depression severity, the intervention could be easily implemented and might substantially reduce the disease burden of individuals with undetected depression. ETHICAL APPROVAL The study is approved by the Ethics Committee of the Hamburg Medical Association. TRIAL REGISTRATION The trial was registered at ClinicalTrials.gov in November 2020 (identifier: NCT04633096).
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Affiliation(s)
- Franziska Sikorski
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Corresponding author at: Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Karl Wegscheider
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Antonia Zapf
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Sebastian Kohlmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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457
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van Kruijsbergen M, Schröder CD, Ketelaar M, van der Pol WL, Cuppen I, van der Geest A, Asselman F, Fischer MJ, Visser‐Meily JMA, Kars MC. Parents' perspectives on nusinersen treatment for children with spinal muscular atrophy. Dev Med Child Neurol 2021; 63:816-823. [PMID: 33550591 PMCID: PMC8248060 DOI: 10.1111/dmcn.14825] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/23/2020] [Indexed: 01/24/2023]
Abstract
AIM To gain insight into parents' perspectives about their decision-making process concerning nusinersen treatment for their child, including perceived needs and concerns, and to explore factors that influence this process. METHOD This was an exploratory qualitative interview study among parents of children with spinal muscular atrophy types 1 to 3. Data were analysed using inductive thematic analysis. RESULTS Nineteen parents of 16 children representing 13 families participated. A wide variety of perspectives was reported ranging from a biomedical approach, which focused on battling the disease, to a holistic approach, which aimed for a good quality of life for their child. The most important factors that helped parents to decide were honest and neutral communication with their physician and access to available information. INTERPRETATION It is important physicians understand that there are different perspectives influencing the decision-making process. Physicians should create an environment that allows parents to accept or reject treatment by communicating honestly and openly with them and by discussing both options extensively. Clear information about pros and cons, recent developments in research, and the experiences of other parents should be made available to enable parents to make an informed decision. What this paper adds Parents perceived different needs and concerns about nusinersen treatment, which emphasized individual differences. Parents' perspectives varied from battling the disease to preserving quality of life. Life expectancy, stopping deterioration, and improving quality of life were the perceived benefits of nusinersen treatment. Open communication about the pros and cons of treatment with clinicians facilitated decision-making. Clear and honest information facilitated the alignment of values and goals.
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Affiliation(s)
- Mette van Kruijsbergen
- Center of Excellence in Rehabilitation MedicineUMC Utrecht Brain Center and De Hoogstraat RehabilitationUniversity Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands
| | - Carin D Schröder
- Center of Excellence in Rehabilitation MedicineUMC Utrecht Brain Center and De Hoogstraat RehabilitationUniversity Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands,Ecare4youAmersfoortthe Netherlands
| | - Marjolijn Ketelaar
- Center of Excellence in Rehabilitation MedicineUMC Utrecht Brain Center and De Hoogstraat RehabilitationUniversity Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands
| | - W Ludo van der Pol
- UMC Utrecht Brain CenterDepartment of NeurologyUniversity Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands
| | - Inge Cuppen
- UMC Utrecht Brain CenterDepartment of NeurologyUniversity Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands
| | - Annette van der Geest
- Center of Excellence in Rehabilitation MedicineUMC Utrecht Brain Center and De Hoogstraat RehabilitationUniversity Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands,Department of RehabilitationPhysical Therapy Science & SportsUniversity Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands
| | - Fay‐Lynn Asselman
- UMC Utrecht Brain CenterDepartment of NeurologyUniversity Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands
| | - Maarten J Fischer
- Center of Excellence in Rehabilitation MedicineUMC Utrecht Brain Center and De Hoogstraat RehabilitationUniversity Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands
| | - Johanna M A Visser‐Meily
- Center of Excellence in Rehabilitation MedicineUMC Utrecht Brain Center and De Hoogstraat RehabilitationUniversity Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands,Department of RehabilitationPhysical Therapy Science & SportsUniversity Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands
| | - Marijke C Kars
- Center of Expertise in Palliative CareJulius Center for Health Sciences and Primary CareUniversity Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands
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458
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Wyatt TH, Bayless AK, Krauskopf P, Gaylord N. Using mHealth Applications to Promote Self-Managed Health Behaviors Among Teens. J Pediatr Nurs 2021; 59:164-172. [PMID: 33932646 DOI: 10.1016/j.pedn.2021.04.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 11/30/2022]
Abstract
THEORETICAL PRINCIPLES As technology use increasingly expands, the opportunity to capitalize on it for healthcare education, monitoring, and assessment has grown rapidly, especially among adolescent patients. As apps are developed, consideration should be given to self-management theory concepts. PHENOMENA ADDRESSED The proliferation of mobile health (mHealth) applications allows adolescents to access healthcare information in new, innovative ways. Many health applications focus on health promotion, fitness, and nutrition and others help persons with chronic disease. This article offers a compelling case for incorporating mHealth into teen healthcare by reviewing current data on teens' technology use, showing how mHealth aligns with self-management theory concepts, and offering a case scenario on mHealth-enhanced self-management care. RESEARCH LINKAGES The ability to combine accurate and immediate healthcare information with continual social support could radically improve teen's self-management behaviors, especially when mHealth apps use connectivity, a feedback loop, and concepts known to enhance self-management behaviors.
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Affiliation(s)
- Tami H Wyatt
- University of Tennessee, Knoxville College of Nursing, Knoxville, TN, United States of America.
| | - Adaya Kirk Bayless
- University of Tennessee, Knoxville College of Nursing, Knoxville, TN, United States of America
| | - Patti Krauskopf
- Shenandoah University Health & Life Sciences, University Drive, Winchester, VA, United States of America.
| | - Nan Gaylord
- The University of Tennessee-Knoxville College of Nursing, Knoxville, TN, United States of America.
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459
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Li QF, Ma QW, Zhu CH, Chen JB, Liang SW, Cai CC, Zhao JB. Neuroticism and patients’ depressive symptoms: a moderated mediation model of illness perception and patient-physician trust. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01918-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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460
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Smoking among adult congenital heart disease survivors in the United States: Prevalence and relationship with illness perceptions. J Behav Med 2021; 44:772-783. [PMID: 34185220 DOI: 10.1007/s10865-021-00239-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 06/12/2021] [Indexed: 10/21/2022]
Abstract
The relationship between smoking and illness perceptions among congenital heart disease (CHD) survivors is unknown. The primary aims of the present study were to compare the smoking prevalence among CHD survivors to a nationally representative U.S. sample and examine the relationship between smoking and illness perceptions. CHD survivors (N = 744) from six U.S. sites participated in the study. The smoking prevalence among CHD survivors (9.3%) was lower than the general population (15.3%). However, 23.3% of CHD survivors with severe functional limitations smoked. Smoking prevalence differed by U.S. region, with a greater proportion of those attending CHD care in the Midwest reporting smoking (11.8%). The illness perception dimensions of Concern and Emotional Response were independently associated with smoking. Differences in illness perceptions enhance our understanding of smoking among CHD survivors and may guide interventions promoting positive health behaviors. The protocol for the study from which the present analyses were conducted was recorded at ClinicalTrials.gov: NCT02150603.
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461
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Kee D, O'Conor R, Wisnivesky JP, Wolf MS, Federman AD. Patient characteristics associated with retention in an asthma self-management trial for older adults. J Asthma 2021; 59:1652-1660. [PMID: 34112032 DOI: 10.1080/02770903.2021.1941090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE New self-management interventions are being developed for older adults who suffer from worse asthma morbidity than their younger counterparts, but high rates of study drop out have hampered these efforts and there is limited literature on what factors may influence retention in behavioral intervention studies with older adults. This study analyzed illness beliefs and patient characteristics that may contribute to retention in an asthma self-management trial for older adults. METHODS This is a secondary analysis of data from a randomized controlled trial of a self-management support intervention for adults 60 years and older with persistent, uncontrolled asthma. Multivariable logistic regression was used to evaluate the association of medication and illness beliefs, and other subject characteristics with study retention, which was defined as completion of the research study interview at 6 and 12 months. RESULTS The randomized trial enrolled 388 individuals; 261 (67.3%) completed the 12-month interview. Higher perceived threat of chronic diseases relative to asthma was associated with higher study retention (OR = 1.11, 95% CI = 1.00-1.24) at 12 months. Other variables including asthma beliefs, age, cognitive function, health literacy, and asthma symptoms were not significantly associated with retention. CONCLUSIONS Concern about non-asthma chronic conditions, but no other illness beliefs, or patient characteristics, were associated with retention in an asthma self-management support intervention. Further research, including qualitative studies, is needed to better understand why patients drop out of asthma behavioral intervention studies.
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Affiliation(s)
- Dustin Kee
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rachel O'Conor
- Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Juan P Wisnivesky
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael S Wolf
- Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Alex D Federman
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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462
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Psychological well-being in people with multiple sclerosis and its association with illness perception and self-esteem. Mult Scler Relat Disord 2021; 54:103114. [PMID: 34217996 DOI: 10.1016/j.msard.2021.103114] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/16/2021] [Accepted: 06/22/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Illness perception and self-esteem were found to improve adjustment to disease in many chronic conditions. However, so far, little is known about the role of illness-appraisal and self-appraisal factors in psychological well-being in people with multiple sclerosis (MS). Thus, we aimed to assess the association between illness perception, self-esteem and psychological well-being in people with MS while controlling for sociodemographic variables, clinical variables, and sleep-related problems. METHODS The General Health Questionnaire-28, the Brief Illness Perception Questionnaire, the Rosenberg Scale of Self-esteem, the Expanded Disability Status Scale, the Pittsburgh Sleep Quality Index, and the Multidimensional Fatigue Inventory were used. Multiple linear regressions and mediation analyses were utilized to analyse the data. RESULTS Positive illness perception (p<0.001) and self-esteem (p<0.05) were significantly associated with psychological well-being in MS. Low income (p<0.05) and sleep-related problems (p<0.001) were significantly associated with lower level of psychological well-being in people with MS. Positive illness perception and self-esteem were able to diminish the association between low income (p>0.05), poor sleep quality (p<0.01), fatigue (p>0.05), and low level of psychological well-being. Self-esteem also mediated the association between illness perception and psychological well-being. DISCUSSION People with MS may benefit from psychological support aimed at promoting self-esteem and diminishing negative illness perception.
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463
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Suresh M, Young J, Fan V, Simons C, Battaglia C, Simpson TL, Fortney JC, Locke ER, Trivedi R. Caregiver Experiences and Roles in Care Seeking During COPD Exacerbations: A Qualitative Study. Ann Behav Med 2021; 56:257-269. [PMID: 34165138 DOI: 10.1093/abm/kaab045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a progressive, debilitating illness characterized by exacerbations that require timely intervention. COPD patients often rely on informal caregivers-relatives or friends-for assistance with functioning and support. Caregivers perform roles that may be particularly important during acute exacerbations in monitoring symptoms and seeking medical intervention. However, little is known about caregivers' roles and experiences as they support their patients during exacerbations. PURPOSE To explore the experiences, roles in care seeking, and needs of caregivers during COPD exacerbations. METHODS Semi-structured interviews were conducted with 24 caregivers of Veterans with COPD who experienced a recent exacerbation. Interviews were recorded, transcribed, and analyzed using inductive content analysis. RESULTS Five themes arose: (a) caregivers reported continuously monitoring changes in patients symptom severity to identify exacerbations; (b) caregivers described emotional reactions evoked by exacerbations and constant vigilance; (c) caregivers described disagreements with their patient in interpreting symptoms and determining the need for care seeking; (d) caregivers noted uncertainty regarding their roles and responsibilities in pursuing care and their approaches to promote care varied; and (e) expressed their need for additional information and support. Caregivers of patients with COPD often influence whether and when patients seek care during exacerbations. Discrepancies in symptom evaluations between patients and caregivers paired with the lack of information and support available to caregivers are related to delays in care seeking. Clinical practice should foster self-management support to patient-caregiver dyads to increase caregiver confidence and patient openness to their input during exacerbations.
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Affiliation(s)
- Madhuvanthi Suresh
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA.,Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, CA, USA
| | - Jessica Young
- Center of Innovation for Veteran-Centered Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Vincent Fan
- Center of Innovation for Veteran-Centered Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Carol Simons
- Center of Innovation for Veteran-Centered Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Catherine Battaglia
- Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, CO, USA
| | - Tracy L Simpson
- Center of Innovation for Veteran-Centered Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - John C Fortney
- Center of Innovation for Veteran-Centered Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Emily R Locke
- Center of Innovation for Veteran-Centered Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Ranak Trivedi
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
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464
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Bennett RJ, Saulsman L, Eikelboom RH, Olaithe M. Coping with the social challenges and emotional distress associated with hearing loss: a qualitative investigation using Leventhal's self-regulation theory. Int J Audiol 2021; 61:353-364. [PMID: 34148485 DOI: 10.1080/14992027.2021.1933620] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To explore the lived experience of social challenges and emotional distress in relation to hearing loss and the coping mechanisms employed to manage them. DESIGN Two focus groups and two one-on-one semi-structured interviews were conducted during February 2020. Transcripts were first inductively analysed to identify experiential categories of social and emotional difficulty, and then deductively analysed using Leventhal's self-regulation model to identify how individuals conceptualised these experiences and the coping mechanisms employed to manage them. STUDY SAMPLE Adults with hearing loss and self-reported emotional distress due to their hearing loss (n = 21) and their significant others (n = 9). RESULTS Participants described their social and emotional experiences of hearing loss in terms of negative consequences (social overwhelm, fatigue, loss, exclusion), identity impact (how they perceive themselves and are perceived by others), and emotional distress (frustration, grief, anxiety, loneliness, and burdensomeness). While many participants described a general lack of effective coping strategies, others described employing coping strategies including avoidance (helpful and unhelpful), controlling the listening environment, humour, acceptance, assertiveness, communication repair strategies, and accepting support from significant others. CONCLUSION Many participants described a lack of effective coping strategies and tended to rely on avoidance of social interaction,deepening their isolation and loneliness.
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Affiliation(s)
- Rebecca J Bennett
- Ear Science Institute Australia, Subiaco, Australia.,Ear Sciences Centre, The University of Western Australia, Crawley, Australia
| | - Lisa Saulsman
- School of Psychological Science, The University of Western Australia, Crawley, Australia
| | - Robert H Eikelboom
- Ear Science Institute Australia, Subiaco, Australia.,Ear Sciences Centre, The University of Western Australia, Crawley, Australia.,Department of Speech-Language Pathology and Audiology, University of Pretoria, Gauteng, South Africa
| | - Michelle Olaithe
- School of Psychological Science, The University of Western Australia, Crawley, Australia
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465
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Hayward G, Butler CC, Yu LM, Saville BR, Berry N, Dorward J, Gbinigie O, van Hecke O, Ogburn E, Swayze H, Bongard E, Allen J, Tonner S, Rutter H, Tonkin-Crine S, Borek A, Judge D, Grabey J, de Lusignan S, Thomas NPB, Evans PH, Andersson MI, Llewelyn M, Patel M, Hopkins S, Hobbs FDR. Platform Randomised trial of INterventions against COVID-19 In older peoPLE (PRINCIPLE): protocol for a randomised, controlled, open-label, adaptive platform, trial of community treatment of COVID-19 syndromic illness in people at higher risk. BMJ Open 2021; 11:e046799. [PMID: 34145016 PMCID: PMC8214989 DOI: 10.1136/bmjopen-2020-046799] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 05/14/2021] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION There is an urgent need to idenfy treatments for COVID-19 that reduce illness duration and hospital admission in those at higher risk of a longer illness course and complications. METHODS AND ANALYSIS The Platform Randomised trial of INterventions against COVID-19 In older peoPLE trial is an open-label, multiarm, prospective, adaptive platform, randomised clinical trial to evaluate potential treatments for COVID-19 in the community. A master protocol governs the addition of new interventions as they become available, as well as the inclusion and cessation of existing intervention arms via frequent interim analyses. The first three interventions are hydroxychloroquine, azithromycin and doxycycline. Eligible participants must be symptomatic in the community with possible or confirmed COVID-19 that started in the preceding 14 days and either (1) aged 65 years and over or (2) aged 50-64 years with comorbidities. Recruitment is through general practice, health service helplines, COVID-19 'hot hubs' and directly through the trial website. Participants are randomised to receive either usual care or a study drug plus usual care, and outcomes are collected via daily online symptom diary for 28 days from randomisation. The research team contacts participants and/or their study partner following days 7, 14 and 28 if the online diary is not completed. The trial has two coprimary endpoints: time to first self-report of feeling recovered from possible COVID-19 and hospital admission or death from possible COVID-19 infection, both within 28 days from randomisation. Prespecified interim analyses assess efficacy or futility of interventions and to modify randomisation probabilities that allocate more participants to interventions with better outcomes. ETHICS AND DISSEMINATION Ethical approval Ref: 20/SC/0158 South Central - Berkshire Research Ethics Committee; IRAS Project ID: 281958; EudraCT Number: 2020-001209-22. Results will be presented to policymakers and at conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER ISRCTN86534580.
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Affiliation(s)
- Gail Hayward
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Christopher C Butler
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Ly-Mee Yu
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Benjamin R Saville
- Berry Consultants, Austin, Texas, USA
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | | | - Jienchi Dorward
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Centre for the Aids Programme of Research in South Africa, Durban, South Africa
| | - Oghenekome Gbinigie
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Oliver van Hecke
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Emma Ogburn
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Hannah Swayze
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Emily Bongard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Julie Allen
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Sharon Tonner
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Heather Rutter
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Sarah Tonkin-Crine
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Aleksandra Borek
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - David Judge
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jenna Grabey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK
| | - Nicholas P B Thomas
- Windrush Medical Practice, Witney, UK
- Royal College of General Practitioners, London, UK
| | - Philip H Evans
- St Leonard's Research Practice, Exeter, UK
- University of Exeter Medical School, Exeter, UK
| | | | - Martin Llewelyn
- Department of Microbiology and Infection, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK
| | - Mahendra Patel
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - F D Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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466
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Mazor M, Wisnivesky JP, Goel M, Harris YT, Lin JJ. Racial and ethnic disparities in post-traumatic stress and illness coherence in breast cancer survivors with comorbid diabetes. Psychooncology 2021; 30:1789-1798. [PMID: 34109695 DOI: 10.1002/pon.5747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/26/2021] [Accepted: 06/07/2021] [Indexed: 11/09/2022]
Abstract
CONTEXT Breast cancer survivors (BCS) with comorbid diabetes mellitus (DM) and of racial and ethnic minority status are at higher risk of cancer-related post-traumatic stress (PTS) and severe illness beliefs. These affective and cognitive outcomes influence self-management and treatment adherence in patients with chronic conditions, yet little is known regarding the interplay of these processes in diverse BCS with comorbid DM. OBJECTIVES The purposes of this study were to (1) describe racial and ethnic differences in cancer-related PTS and illness perceptions; and (2) examine the relationship between PTS and illness perceptions in BCS with comorbid DM. METHODS Female BCS with DM completed measures of cancer related stress (Impact of Events Scale-Revised) and cancer and DM illness perception (Illness Perception Questionnaire-Revised). Logistic regression analyses were used to assess the association between PTS, race and illness perceptions. RESULTS Of the 135 BCS with comorbid DM, the mean (standard deviation) age was 65.3 (7.1) years, 38% were Black, 31% Non-Hispanic White (NHW), 13% Hispanic/Latina, and 18% were "other." Minority women were more likely to report cancer-related PTS (p < 0.01). In adjusted analyses, PTS was associated with chronicity (odds ratio [OR] = 9.79, p = 0.005), time-cycle (OR = 6.71, p = 0.001), negative consequences (OR = 3.95, p = 0.018), and negative emotional impact (OR = 12.63, p < 0.001) of cancer. CONCLUSION Minority BCS with comorbid DM report higher rates of cancer-related PTS and lower cancer illness coherence relative to NHW survivors. Cancer-related PTS influences cancer and DM illness perceptions. Culturally sensitive care is needed to improve these outcomes in minority BCS. KEY MESSAGE This article presents findings from a cross sectional cohort of an understudied population of racially and ethnically diverse BCS with comorbid diabetes. The results indicate that the occurrence of PTS is significantly higher in racial and ethnic minority women and is strongly associated with more severe illness perceptions.
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Affiliation(s)
- Melissa Mazor
- Division of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Juan P Wisnivesky
- Division of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mita Goel
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Yael Tobi Harris
- Division of Endocrinology, Diabetes & Metabolism, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, USA
| | - Jenny J Lin
- Division of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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467
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Teh WL, Samari E, Cetty L, Kumarasan R, Devi F, Shahwan S, Chandwani N, Subramaniam M. A reduced state of being: The role of culture in illness perceptions of young adults diagnosed with depressive disorders in Singapore. PLoS One 2021; 16:e0252913. [PMID: 34106985 PMCID: PMC8189483 DOI: 10.1371/journal.pone.0252913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/26/2021] [Indexed: 11/27/2022] Open
Abstract
Illness perceptions form a key part of common-sense models which are used widely to explain variations in patient behaviours in healthcare. Despite the pervasiveness of depressive disorders worldwide and in young adults, illness perceptions of depressive disorders have not yet been well understood. Moreover, while a high proportion of cases of depressive disorders reside in South-east Asia, few have explored illness perceptions that are culturally relevant to this region. To address these limitations, this study aimed to understand illness perceptions of young adults diagnosed with depressive disorders. Face-to-face semi-structured interviews were conducted among Chinese, Malay, and Indian young adults aged 20 to 35 years old, who were seeking treatment at a psychiatric hospital. Data reached saturation after 33 interviews (10 to 12 interviews per ethnic group) and five themes emerged from the thematic analysis: 1) A reduced state of being experienced at a point of goal disengagement, 2) the accumulation of chronic stressors in a system that demands success and discourages the pursuit of personally meaningful goals, 3) a wide range of symptoms that are uncontrollable and disabling, 4) poor decision making resulting in wasted opportunities, with some positive takeaways, and 5) accepting the chronicity of depression. Young adults typically experienced depression as a reduced state of being and it was thought of cognitively as an entity that may be a part of or separate from the self. Over and beyond these aspects of cognitive representations was the emergence of themes depicting conflicts and dilemmas between the self and the social environment that threatened self-identity and autonomy. Addressing these conflicts in therapy would therefore be of utmost relevance for young adults recovering from depressive disorders in the local setting.
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Affiliation(s)
- Wen Lin Teh
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Ellaisha Samari
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Laxman Cetty
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Fiona Devi
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Nisha Chandwani
- Department of Mood and Anxiety, Institute of Mental Health, Singapore, Singapore
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468
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Séguin Leclair C, Lebel S, Westmaas JL. Can Physical Activity and Healthy Diet Help Long-Term Cancer Survivors Manage Their Fear of Recurrence? Front Psychol 2021; 12:647432. [PMID: 34177701 PMCID: PMC8219846 DOI: 10.3389/fpsyg.2021.647432] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Fear of cancer recurrence (FCR) adversely affects quality of life, but health behaviors such as physical activity (PA) and fruit and vegetable intake (FVI) may help alleviate FCR for some survivors. This cross-sectional study tested the common-sense model (CSM) of FCR by investigating associations between constructs from the CSM (perceived illness consequences, control over health, and timeline), and survivors' health behaviors, health self-efficacy, and FCR. Methods: Using wave 3 data from the American Cancer Society Longitudinal Study of Cancer Survivorship-I, path analyses were conducted among mixed-cancer participants (N = 2,337) who were on average 8.8 mean years post-diagnosis. Results: A final good fitting model [χ 2 (5, N = 2,337) = 38.12, p < 0.001; SRMR = 0.02; CFI = 0.99; RMSEA = 0.05] indicated that perceiving fewer illness consequences, and greater control over one's health, were directly associated with higher PA (β = 0.15 and -0.24, p < 0.01, respectively) and higher health self-efficacy (β = 0.24, -0.38, p < 0.01, respectively). Timeline (i.e., perceiving cancer as chronic) was directly associated with lower health self-efficacy (β = -0.15, p < 0.01) and higher FCR (β = 0.51, p < 0.01). Both greater PA and FVI were directly associated with higher health self-efficacy (β = 0.10 and 0.11, p < 0.01, respectively) which in turn showed a direct association with lower FCR (β = -0.15, p < 0.01). Conclusion: Increasing survivors' sense of control over health, decreasing perceived chronicity of the illness, and mitigating its consequences may increase their health behaviors and health self-efficacy, which in turn could decrease their FCR. Longitudinal and experimental studies are needed to confirm these findings.
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Affiliation(s)
| | - Sophie Lebel
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - J Lee Westmaas
- Behavioral Research Center, American Cancer Society, Atlanta, GA, United States
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469
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Limited predictive value of illness perceptions for short-term poor recovery in musculoskeletal pain. A multi-center longitudinal study. BMC Musculoskelet Disord 2021; 22:522. [PMID: 34098929 PMCID: PMC8186079 DOI: 10.1186/s12891-021-04366-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/08/2021] [Indexed: 11/18/2022] Open
Abstract
Background Musculoskeletal pain (MSP) is recognized worldwide as a major cause of increased years lived with disability. In addition to known generic prognostic factors, illness perceptions (IPs) may have predictive value for poor recovery in MSP. We were interested in the added predictive value of baseline IPs, over and above the known generic prognostic factors, on clinical recovery from MSP. Also, it is hypothesized there may be overlap between IPs and domains covered by the Four-Dimensional Symptom Questionnaire (4DSQ), measuring distress, depression, anxiety and somatization. The aim of this study is twofold; 1) to assess the added predictive value of IPs for poor recovery and 2) to assess differences in predictive value for poor recovery between the Brief Illness Perception Questionnaire - Dutch Language Version (Brief IPQ-DLV) and the 4DSQ. Methods An eligible sample of 251 patients with musculoskeletal pain attending outpatient physical therapy were included in a multi-center longitudinal cohort study. Pain intensity, physical functioning and Global Perceived Effect were the primary outcomes. Hierarchical logistic regression models were used to assess the added value of baseline IPs for predicting poor recovery. To investigate the performance of the models, the levels of calibration (Hosmer-Lemeshov test) and discrimination (Area under the Curve (AUC)) were assessed. Results Baseline ‘Treatment Control’ added little predictive value for poor recovery in pain intensity [Odds Ratio (OR) 0.80 (Confidence Interval (CI) 0.66–0.97), increase in AUC 2%] and global perceived effect [OR 0.78 (CI 0.65–0.93), increase in AUC 3%]. Baseline ‘Timeline’ added little predictive value for poor recovery in physical functioning [OR 1.16 (CI 1.03–1.30), increase in AUC 2%]. There was a non-significant difference between AUCs in predictive value for poor recovery between the Brief IPQ-DLV and the 4DSQ. Conclusions Based on the findings of this explorative study, assessing baseline IPs, over and above the known generic prognostic factors, does not result in a substantial improvement in the prediction of poor recovery. Also, no recommendations can be given for preferring either the 4DSQ or the Brief IPQ-DLV to assess psychological factors.
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470
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Fann WC, Hung CC, Chaboyer W, Lee BO. Effectiveness of a Nurse-Delivered Intervention on Illness Perceptions and Quality of Life in Patients With Injury. J Nurs Res 2021; 29:e163. [PMID: 34091568 DOI: 10.1097/jnr.0000000000000439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Research has shown that nursing interventions are able to affect short-term outcomes in patients with injury. However, evidence based on a comprehensive nurse-led intervention may be beneficial for trauma care. PURPOSE This study was designed to assess the effect of a nursing intervention on the illness perceptions and quality of life of patients with injury. METHODS A two-group experimental design and a follow-up period of 12 months were used. Ninety-four patients were randomly assigned to either the experimental group or the control group. A nurse-led cognitive behavioral therapy intervention was used to improve outcomes. RESULTS The illness perception variables of "personal control" and "treatment control" were found to be significantly improved in the experimental group at 3 months after discharge, whereas "emotional perception" was significantly improved at 6 months after discharge. The intervention was also shown to improve "social quality of life" at 6 and 12 months after injury. CONCLUSIONS This study adds new knowledge related to nursing interventions for patients with injury in terms of the intervention achieving longer-term effects than the interventions examined in previous studies. The results highlight the importance of providing interprofessional collaborative care. However, the intervention protocol should be tested further in future studies.
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Affiliation(s)
- Wen-Chih Fann
- MSc, MD, Attending Physician, Department of Emergency Medicine, Chia-Yi Chang Gung Memorial Hospital, Taiwan
| | - Chang-Chiao Hung
- PhD, RN, Associate Professor, Department of Nursing, Chang Gung University of Science and Technology, and Associate Research Fellow, Department of Nursing, Chia-Yi Chang Gung Memorial Hospital, Taiwan
| | - Wendy Chaboyer
- PhD, RN, Professor, School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Bih-O Lee
- PhD, RN, Professor, College of Nursing, Kaohsiung Medical University, Taiwan, and Adjunct Professor, Faculty of Nursing, Universitas Airlangga, Indonesia
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471
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Heruti I, Levy S, Deutscher D, Gutvirtz M, Berkovitz T, Shiloh S. Comparisons Between Illness and Injury Outcomes: Potential Suppression Effects by Emotional Representations. Int J Behav Med 2021; 28:393-400. [PMID: 32978727 DOI: 10.1007/s12529-020-09931-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Based on recent findings that people perceive illness and injury as separate categories, we compared ill and injured participants with similar health conditions on illness perceptions and reported outcomes, e.g., functioning, distress, well-being. METHOD A cross-sectional study with 182 ill and 160 injured participants affected by ankle, knee, or neck conditions compared them on standard measures of illness perception and other reported outcomes (self-assessed health; physical, emotional, and social functioning; depression, anxiety, and somatization; satisfaction with life, self-esteem, and acceptance of disability). RESULTS The groups did not differ on the measured outcomes, but injury elicited stronger emotional representations, and illness was perceived as more chronic. After controlling for the effects of emotional representations, the injured group presented better outcomes on all outcome measures, including self-assessed health, physical functioning, emotional functioning, social functioning, vitality, health beliefs, depression, somatization, total distress, and acceptance of disability. CONCLUSION Emotional representations may suppress the potential superior outcomes of injury compared with illness. The theoretical implications of these results for self-regulation theories are discussed, as well as clinical implications.
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Affiliation(s)
- Irit Heruti
- Department of Psychology, Rabin Medical Center, Petach Tikva, Israel
| | - Sigal Levy
- The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | | | | | | | - Shoshana Shiloh
- School of Psychological Sciences, Gordon Faculty of Social Sciences, Tel Aviv University, 69978, Tel Aviv, Israel.
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472
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Gázquez Linares JJ, Molero Jurado MDM, Martos Martínez Á, Jiménez-Rodríguez D, Pérez-Fuentes MDC. The repercussions of perceived threat from COVID-19 on the mental health of actively employed nurses. Int J Ment Health Nurs 2021; 30:724-732. [PMID: 33491869 PMCID: PMC8014181 DOI: 10.1111/inm.12841] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/30/2020] [Accepted: 01/02/2021] [Indexed: 12/23/2022]
Abstract
In the confrontation with the COVID-19 pandemic, threat perceived by the nursing population, and its association with sociodemographic and contextual characteristics, must be measured and evaluated as well as their repercussions on their mental health. Therefore, the purpose of this study was to analyse the repercussion of perceived threat from COVID-19 on the mental health of actively employed nurses, considering a COVID-19 diagnosis, whether their own or of someone close to them. The sample was comprised of 351 nurses. Sociodemographic data were collected, and the Questionnaire on Perception of Threat from COVID-19 and the General Health Questionnaire were administered. The three demographic and contextual variables mentioned were related to mental health, mediated in some symptoms by perceived threat. These results provide important information for implementing measures or psychoeducational programs for nurses, essential in the present pandemic for improving psychological adaptation and reducing the effects on their mental health.
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473
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Duan D, Yang L, Zhang M, Song X, Ren W. Depression and Associated Factors in Chinese Patients With Chronic Kidney Disease Without Dialysis: A Cross-Sectional Study. Front Public Health 2021; 9:605651. [PMID: 34123983 PMCID: PMC8192721 DOI: 10.3389/fpubh.2021.605651] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 04/19/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Chronic kidney disease (CKD) has been a globally public health problem over the past decades. The maintenance of physical and mental health is of importance for patients nowadays. Notably, depression is prevalent and associated with various adverse events in CKD patients without dialysis. Prior studies have reported that pain, negative illness perception, pain, and low self-esteem are potential risk factors of depression, while few studies have comprehensively investigated the mechanisms among these factors and depression among this population. Purpose: This study aims to investigate the prevalence of depression and further explore the factors associated with depression among CKD patients without dialysis in China. Design and Methods: We conducted a cross-sectional study in patients with diagnosed CKD to investigate the prevalence of depression was by the Beck Depression Inventory-II (BDI-II). The data on pain interference, illness perception, and self-esteem were also collected via self-administered questionnaires. A structural equation model (SEM) was used to examine the factors associated with depression. Main Findings: From June to October 2019, we successfully interviewed 334 CKD patients at the outpatient clinics. Their mean age was 45.6 years (ranging from 19 to 74 years), and 48.5% were male. Most respondents were at early CKD stages (77.5% stage 1–3) and the prevalence of depression was 22.2%. We found a moderate association between illness perception and depression, which was modified by self-esteem. Similar but weaker association was found between pain interference and depression. Conclusion and Recommendations: Negative illness perception, low self-esteem and severe pain interference were associated with depression among Chinese CKD patients without dialysis. Future studies are warranted to investigate the underlying mechanism and formulate the intervention strategies for this high-risk population.
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Affiliation(s)
- Difei Duan
- Department of Nephrology, West China Hospital, Sichuan University, Sichuan, China.,School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.,West China School of Nursing, Sichuan University, Sichuan, China
| | - Lin Yang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Min Zhang
- Department of Nephrology, West China Hospital, Sichuan University, Sichuan, China
| | - Xiaoli Song
- Department of Nephrology, West China Hospital, Sichuan University, Sichuan, China
| | - Wen Ren
- Department of Nephrology, West China Hospital, Sichuan University, Sichuan, China
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474
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Matheson L, Nayoan J, Rivas C, Brett J, Wright P, Butcher H, Gavin A, Glaser A, Watson E, Wagland R. A Qualitative Exploration of Prostate Cancer Survivors Experiencing Psychological Distress: Loss of Self, Function, Connection, and Control. Oncol Nurs Forum 2021; 47:318-330. [PMID: 32301932 DOI: 10.1188/20.onf.318-330] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To explore the experiences of men with prostate cancer identified as having psychological distress and to identify factors influencing distress. PARTICIPANTS & SETTING 28 men with prostate cancer diagnosed 18-42 months earlier, identified as having psychological distress on survey measures. METHODOLOGIC APPROACH Semistructured telephone interviews were conducted. Thematic analysis using a framework approach was used. FINDINGS Men with psychological distress had strong perceptions of loss toward self (identity, sexuality/masculinity, self-confidence), function (physical activities), connection (relational, social, community), and control (future, emotional). Psychological vulnerability appeared heightened in particular groups of men. Maladaptive strategies of emotional concealment, help-seeking avoidance, and withdrawal appeared to contribute to distress. IMPLICATIONS FOR NURSING Distress in men with prostate cancer is multifaceted. Men with distress should be identified and offered support. Nurse- or peer-led interventions are required.
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Affiliation(s)
| | | | | | | | | | - Hugh Butcher
- Life After Prostate Cancer Diagnosis (LAPCD) patient user advisory group
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475
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Gupta SK, Margolis SA, Grant AC, Gonzalez JS, Nakhutina L. Relationships among illness representations and depressive symptom severity in predominantly African-American and Caribbean-American people with epilepsy. Clin Neuropsychol 2021; 36:462-478. [PMID: 34027793 DOI: 10.1080/13854046.2021.1923802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: Depression is the most common psychiatric comorbidity among people with epilepsy (PWE) and tends to be more prevalent among people of color (POC) and those with intractable seizures. However, the extent to which illness-related perceptions are associated with depressive symptom severity among POC with intractable seizures is unclear. Method: This cross-sectional study examined relationships among illness representations and self-rated depressive symptoms in 55 PWE (M Age = 41; 61.8% female) with intractable seizures (M seizures per month = 2) who identified as Black/African-American (52.7%), Black/Caribbean-American (27.3%), and/or Hispanic/Latino (21.8%). Epilepsy-related illness perceptions were assessed with the Illness Perception Questionnaire-Revised and depression was measured via the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). Results: Nearly half of the sample (41.8%) scored above the NDDI-E depression cut-off. PWE endorsing more severe depressive symptoms indicated that their epilepsy had more negative consequences, was hard to comprehend, was insufficiently controlled by treatment, and had a negative emotional impact (p's ≤ 0.02). Controlling for sex, these four illness representations accounted for 48% of the variance in depression severity. Interestingly, participants with probable major depressive episodes were more likely to endorse several psychological causes of seizures compared to non-depressed PWE. Conclusions: Worse depression symptom severity was associated with negative illness perceptions and a tendency to attribute one's epilepsy to psychological causes. Future research is needed to understand how the relationship between negative illness perceptions and depression symptoms unfold over time and whether interventions aimed at modifying illness representations reduce psychological distress in diverse PWE.
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Affiliation(s)
- Sugandha K Gupta
- Graduate Center, City University of New York, Psychology, New York, NY, USA
| | - Seth A Margolis
- Alpert Medical School, Brown University, Providence, RI, USA
| | - Arthur C Grant
- Downstate Medical Center, State University of New York, New York, NY, USA
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA.,Albert Einstein College of Medicine, Bronx, New York, NY, USA
| | - Luba Nakhutina
- Downstate Medical Center, State University of New York, New York, NY, USA
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476
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Akin-Odanye EO, Ogo CN, Sulaiman FA, Suleiman L, Ogunsanya ME, Odedina FT. Examining the influence of illness perception and financial toxicity on the quality of life of prostate cancer patients. AFRICAN JOURNAL OF UROLOGY 2021. [DOI: 10.1186/s12301-021-00173-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Abstract
Background
Cancer of the prostate (CaP) is a public health problem that affects the male genitourinary system causing a significant threat to men’s quality of life (QoL). Experiencing financial constraints and poor illness perception may further compromise the QoL of men with CaP.
Methods
Aim: To examine the relationship between financial toxicity and illness perception with quality of life in men with CaP. The descriptive cross-sectional study used simple random sampling technique to recruit 173 men with CaP from four tertiary health facilities in Nigeria. Data were collected with the comprehensive score for financial toxicity (COST-FACIT), the brief illness perception questionnaire (Brief IPQ) and the functional assessment of cancer therapy-prostate (FACT-P). Analysis of data was carried out using analysis of variance, correlation and hierarchical regression analyses.
Results
The 173 participants had an average age of 71.57 ± 11.18, and 53.18% had one comorbid disease. Significant difference was found in overall QoL based on treatment site and number of comorbid diseases (P < 0.01). QoL had a significant inverse relationship with all the illness perception variables and a significant linear relationship with lower financial toxicity (P < 0.01). Furthermore, financial toxicity (P < 0.05) and four illness perception variables: consequences, identity, concern and illness understanding (P < 0.01), had significant individual influences on QoL of men with CaP.
Conclusions
Quality of life in men with CaP may be improved through mitigating the financial toxicity associated with accessing care and providing appropriate counseling about the illness and what to expect following prostate cancer diagnosis and during treatment.
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477
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Cai Q, Ye L, Horne R, Ye X, Xu Q, Jin M, Li X, Lyu Q. Medication adherence in adult Chinese patients with asthma: role of illness perceptions and medication beliefs. J Asthma 2021; 59:1445-1451. [PMID: 33941026 DOI: 10.1080/02770903.2021.1924773] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study aimed to investigate the relationship between illness perceptions, medication beliefs, and self-reported adherence to inhaled corticosteroid (ICS) therapy in adult Chinese patients with asthma. METHODS A cross-sectional survey was conducted in the asthma outpatient clinic of Zhongshan Hospital, Fudan University (Shanghai, China) between October 2018 and September 2019. Illness perceptions, medication beliefs, and medication adherence were assessed using validated scales, specifically the Medication Adherence Report Scale for Asthma, Beliefs about Medicines Questionnaire -Specific, and the Brief Illness Perception Questionnaire. Spearman correlation and multiple logistic regression were used to determine the relationship among these factors. Results: A total of 234 patients were included in this study. Of this group, 99 (42.3%) participants were non-adherent to their ICS medication. Medication adherence correlated negatively with 'illness identity' (perceived symptom), 'emotional response' (perceived emotional effect) and concerns about medication (r=-0.16, -0.16 and -0.15, respectively, p < 0.05). After adjusting for illness perceptions, medication beliefs and demographics, beliefs about the necessity of medication (odds ratio [OR]: 1.14, 95% confidence interval [CI]: 1.01-1.30), and emotional response to the disease (OR: 0.89, 95% CI: 0.80-0.99) were significantly associated with medication adherence in patients with asthma. CONCLUSION Beliefs about the necessity of medication and emotional response to the illness have a strong influence on self-reported medication adherence in adult patients with asthma in China. Interventions targeted adherence improvement among patients with asthma may be tailored to the individual's baseline perceptions and medication beliefs, and focus on modifying inaccurate illness perceptions and medication beliefs as the main targets.
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Affiliation(s)
- Qingqing Cai
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, PR China
| | - Ling Ye
- Department of Respiratory, Zhongshan Hospital, Fudan University, Shanghai, PR China
| | - Robert Horne
- School of Pharmacy, University College London, London, UK
| | - Xiaofen Ye
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, PR China
| | - Qing Xu
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, PR China
| | - Meiling Jin
- Department of Respiratory, Zhongshan Hospital, Fudan University, Shanghai, PR China
| | - Xiaoyu Li
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, PR China
| | - Qianzhou Lyu
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, PR China
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478
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Zou C, Zhang W, Sznajder K, Yang F, Jia Y, Ma R, Cui C, Yang X. Factors Influencing Anxiety Among WeChat Users During the Early Stages of the COVID-19 Pandemic in Mainland China: Cross-sectional Survey Study. J Med Internet Res 2021; 23:e24412. [PMID: 33878025 PMCID: PMC8130820 DOI: 10.2196/24412] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/28/2020] [Accepted: 04/17/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The rapid outbreak of COVID-19 around the world has adversely affected the mental health of the public. The prevalence of anxiety among the public has increased dramatically during the COVID-19 pandemic. However, there are few studies evaluating the effects of positive psychological responses and information-seeking behaviors on anxiety experienced among social media users during the COVID-19 pandemic. OBJECTIVE This study evaluated the prevalence of anxiety and its associated factors among WeChat users in mainland China during the early stages of the COVID-19 pandemic. METHODS From February 10 to February 24, 2020, a nationwide, web-based cross-sectional survey study was carried out using convenience sampling. Participants' levels of anxiety, positive psychological responses, and information-seeking behaviors were assessed. The survey was distributed among WeChat users via the WeChat smartphone platform. Chi-square tests and multivariable logistic regression analyses were performed to examine the factors associated with anxiety. RESULTS This study found that the prevalence of anxiety (Generalized Anxiety Disorder 7-item [GAD-7] scale score ≥7) among WeChat users in China was 17.96% (446/2483) during the early stages of the COVID-19 pandemic. Results of multivariable logistic regression analysis showed that information-seeking behaviors such as cannot stop searching for information on COVID-19, being concerned about the COVID-19 pandemic, and spending more than 1 hour per day consuming information about the pandemic were found to be associated with increased levels of anxiety. Additionally, participants who chose social media and commercial media as the primary sources to obtain information about the COVID-19 pandemic were found more likely to report anxiety. Conversely, participants who were confident or rational about the COVID-19 pandemic were less likely to report anxiety. CONCLUSIONS This study found that positive psychological responses and information-seeking behaviors were closely associated with anxiety among WeChat users during the COVID-19 pandemic in China. It might be paramount to enhance mental well-being by helping people respond to the COVID-19 pandemic more rationally and positively in order to decrease symptoms of anxiety.
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Affiliation(s)
- Changqing Zou
- Department of Humanities and Social Sciences, China Medical University, Shenyang, China
| | - Weiyu Zhang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, China
| | - Kristin Sznajder
- Department of Public Health, College of Medicine, Pennsylvania State University, Philadelphia, PA, United States
| | - Fengzhi Yang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, China
| | - Yajing Jia
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, China
| | - Ruqing Ma
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, China
| | - Can Cui
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, China
| | - Xiaoshi Yang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, China
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479
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Liu QW, Qin T, Hu B, Zhao YL, Zhu XL. Relationship between illness perception, fear of progression and quality of life in interstitial lung disease patients: A cross-sectional study. J Clin Nurs 2021; 30:3493-3505. [PMID: 33998090 DOI: 10.1111/jocn.15852] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/31/2021] [Accepted: 04/22/2021] [Indexed: 01/02/2023]
Abstract
AIMS AND OBJECTIVES This study aimed to investigate whether fear of progression mediates the association between illness perception and quality of life among interstitial lung disease patients. BACKGROUND So far, the physiological treatment of interstitial lung disease is limited. In addition to immunosuppressants such as glucocorticoids, two anti-fibrosis drugs (pirfenidone and nintedanib) have shown moderately beneficial effects on slowing the progression of interstitial lung disease fibrosis. However, none of these drugs has shown reliable or strong beneficial effects on improving quality of life. Psychological care and mental health support strategies focusing on improving patients' quality of life are particularly important. DESIGN A cross-sectional study. METHODS A convenience sample of patients suffering from interstitial lung disease were enrolled from August to December 2019. Data including sociodemographic and clinical characteristics, illness perception, fear of progression and quality of life were collected. The descriptive analysis and Pearson correlations were analysed by SPSS 26.0 (IBM Corp.). PROCESS v3.4 (by Andrew F. Hayes) macro was applied to analyse the mediating effects. We used the STROBE checklist to report the results. RESULTS Both illness perception and fear of progression were correlated with quality of life. Fear of progression mediated the association between illness perception and quality of life. The indirect effect was 0.121, and the proportion of intermediary effect in the main effect was 26.36%. CONCLUSION Interstitial lung disease patients experience relatively poor quality of life and fear of progression exerts a mediating role between illness perception and quality of life. RELEVANCE TO CLINICAL PRACTICE This study alerts medical staff to pay attention to negative illness perception and excessive fear, which is helpful to formulate effective interventions to manage interstitial lung disease patients' quality of life.
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Affiliation(s)
- Qing-Wei Liu
- Department of Medicine, School of Nursing, Qingdao University, Qingdao, China
| | - Tong Qin
- Department of Medicine, School of Nursing, Qingdao University, Qingdao, China
| | - Bo Hu
- Department of Thoracic Surgery, Municipal Hospital, Qingdao, China
| | - Ya-Ling Zhao
- Department of Medicine, School of Nursing, Qingdao University, Qingdao, China
| | - Xiu-Li Zhu
- Department of Medicine, School of Nursing, Qingdao University, Qingdao, China
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480
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Discepoli N, Marruganti C, Mirra R, Pettinari G, Ferrari Cagidiaco E, Ferrari M. Patients' illness perception before and after non-surgical periodontal therapy. A pre-post quasi-experimental study. J Periodontol 2021; 93:123-134. [PMID: 33997985 DOI: 10.1002/jper.21-0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/24/2021] [Accepted: 04/24/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Patient's illness perception, assessed through the Brief-Illness Perception Questionnaire (Brief-IPQ), plays a decisive role in the treatment effectiveness of a wide range of chronic diseases; nonetheless, evidence is still lacking regarding periodontitis. The aim of the present pre-post quasi-experimental study was to evaluate the change in the Brief-IPQ before and after non-surgical periodontal treatment (NST) and to evaluate its ability to foresee the efficacy of NST. METHODS A total of 126 periodontitis participants starting NST were asked to participate in the study. The nine-item Brief-IPQ together with a full periodontal chart were recorded at baseline and at the 3-month follow up (reevaluation) after NST. Pre-post comparisons of psychometric and periodontal variables were carried out through the Wilcoxon signed-rank test (α = 0.05). A predictive model was built to test the ability of the Brief-IPQ items to foresee the efficacy of NST. RESULTS NST led to a significant reduction in all periodontal parameters (P < 0.001); the proportion of pockets closed was 64.18%. Although the overall sum score of the Brief-IPQ remained fairly stable (P = 0.0673), significant changes occurred for items seven ("understanding") (P < 0.001) and 8 ("emotional response") (P < 0.05). The best model (R2 = 0.068, F = 2.15, P = 0.033) obtained from the multivariate linear regression analysis demonstrated that item five ("identity") (β = 2.340, P = 0.017) and item eight ("emotional response") (β = -2.569, P = 0.008) significantly predict the efficacy of NST (i.e., the proportion of pockets closed at reevaluation). CONCLUSIONS NST significantly ameliorates patient's understanding and emotional burden related to periodontitis. Baseline values of perceived symptoms and emotional response are predictive for the short-term efficacy of NST.
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Affiliation(s)
- Nicola Discepoli
- Unit of Periodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Crystal Marruganti
- Unit of Periodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Raffaele Mirra
- Unit of Periodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Gessica Pettinari
- Unit of Periodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | | | - Marco Ferrari
- Unit of Dental Material and Fixed Prosthodontics, University of Siena, Siena, Italy
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481
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Rocholl M, Ludewig M, Brakemeier C, John SM, Wilke A. Illness perceptions of adults with eczematous skin diseases: a systematic mixed studies review. Syst Rev 2021; 10:141. [PMID: 33962662 PMCID: PMC8106167 DOI: 10.1186/s13643-021-01687-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 04/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eczematous skin diseases, e.g., atopic dermatitis or contact dermatitis, are associated with a high disease burden, a significant impact on quality of life and a higher risk for anxiety and depression. Therefore, coping strategies are of interest. In order to understand coping processes, it is necessary to examine the patients' perspectives on their illness. The aim of this systematic mixed studies review is to investigate the illness perceptions of patients with eczematous skin diseases to get a better understanding of their coping processes. METHODS We performed a systematic literature search in PubMed, The Cochrane Library, PsycInfo, PSYNDEX, CINAHL, Web of Science, and Scopus until February 20, 2019. Both qualitative and quantitative studies were included in the review. Two independent reviewers conducted data extraction and carried out a narrative synthesis. We assessed study quality with the Mixed Methods Appraisal Tool. RESULTS Three qualitative and four quantitative studies were included in the systematic review. We found different methodological approaches for investigating illness perceptions: guided interviews, focus group interviews as well as standardized questionnaires, e.g., the Brief Illness Perception Questionnaire. All studies report suspected causes of the skin disease, such as endogenous and exogenous causes (namely, psychological or occupational factors). We found long timeline beliefs as well as various perceived and experienced social, economic, and psychological consequences. Our analysis reveals complex emotional representations in patients with eczematous skin diseases, in particular impairment of emotional well-being, and feelings of shame or helplessness. Qualitative and quantitative data were predominantly complementary and convergent. CONCLUSION Patients with eczematous skin diseases have complex illness representations regarding their disease. These representations interrelate with the coping behavior of patients. Therefore, medical professionals should consider them for counseling and treatment. SYSTEMATIC REVIEW REGISTRATION PROSPERO 2018 CRD42018109217 .
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Affiliation(s)
- Marc Rocholl
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrueck, Am Finkenhuegel 7a, 49076 Osnabrueck, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrueck, Am Finkenhuegel 7a, 49076 Osnabrueck, Germany
| | - Michaela Ludewig
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrueck, Am Finkenhuegel 7a, 49076 Osnabrueck, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrueck, Am Finkenhuegel 7a, 49076 Osnabrueck, Germany
| | - Carola Brakemeier
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrueck, Am Finkenhuegel 7a, 49076 Osnabrueck, Germany
| | - Swen Malte John
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrueck, Am Finkenhuegel 7a, 49076 Osnabrueck, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrueck, Am Finkenhuegel 7a, 49076 Osnabrueck, Germany
| | - Annika Wilke
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrueck, Am Finkenhuegel 7a, 49076 Osnabrueck, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrueck, Am Finkenhuegel 7a, 49076 Osnabrueck, Germany
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482
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Tyson L, Hardeman W, Stratton G, Wilson AM, Semlyen J. The effects of social distancing and self-isolation during the COVID-19 pandemic on adults diagnosed with asthma: A qualitative study. J Health Psychol 2021; 27:1408-1420. [PMID: 33947267 PMCID: PMC9036148 DOI: 10.1177/13591053211012766] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study aimed to explore how social distancing and self-isolation measures, aimed at protecting vulnerable groups from COVID-19, affected the wellbeing and physical activity levels among adults diagnosed with asthma. Twenty-seven participants took part across four online focus groups. Transcripts were analysed using thematic analysis. Participants reported becoming more health conscious due to being labelled as vulnerable. Their relationship with the severity of their asthma was altered and they reported making positive changes to increase their physical activity levels. Findings suggest there is a window of opportunity to engage with people diagnosed with asthma to promote beneficial lifestyle changes and self-management.
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483
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Karademas EC, Thomadakis C. COVID-19 pandemic-related representations, self-efficacy, and psychological well-being in the general population during lockdown. CURRENT PSYCHOLOGY 2021; 42:4523-4530. [PMID: 33967567 PMCID: PMC8092995 DOI: 10.1007/s12144-021-01750-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2021] [Indexed: 11/28/2022]
Abstract
The aim of this study was to examine the association among representations of the COVID-19 pandemic, self-efficacy to cope with the anti-pandemic measures (e.g., general lockdown), and psychological distress in the Greek general population. The study was conducted online, during the general lockdown in the country, and 358 individuals (239 females) participated (mean age = 36.89; SD = 12.15). A perception of personal control over the condition, negative emotions towards the pandemic, and self-efficacy to cope with the current anti-pandemic measures were related to psychological distress. Also, a significant interaction between representation clusters and self-efficacy to cope with potential future difficulties (i.e., after the anti-pandemic measures are ended), was found. Specifically, the association between this type of self-efficacy and psychological distress was significant only for the 'low-impact' representations cluster (i.e., a perception of the pandemic as less burdensome and more controllable). The findings indicate that the factors which, according to previous research and theory, are significantly related to psychological distress during a health threat, are important also in times of a pandemic. They also suggest a potential adaptation-promoting synergy between pandemic-related self-efficacy and a more positive representation of COVID-19, as far as psychological distress is conerned. Thus, these factors may serve as the basis for the development of pandemic-related health behavior promotion programs.
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Affiliation(s)
- Evangelos C. Karademas
- Department of Psychology, Laboratory of Applied Psychology, University of Crete, Rethymno, Greece
| | - Christophoros Thomadakis
- Department of Psychology, Laboratory of Applied Psychology, University of Crete, Rethymno, Greece
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484
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Smith R, Pinchbeck G, McGowan C, Ireland J, Perkins E. Caring for the Older Horse: A Conceptual Model of Owner Decision Making. Animals (Basel) 2021; 11:1309. [PMID: 34063176 PMCID: PMC8147395 DOI: 10.3390/ani11051309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 11/17/2022] Open
Abstract
The number of aged horses in the UK has been growing over recent years, with many horses remaining active and being cared for into old age. However, increasing age is paralleled with a heightened risk of morbidity and mortality; therefore, owners of older horses must manage changes in their horse, making decisions about management and health care provision. In this paper, we discuss data collected from an open-access online discussion forum, where forum users sought advice arising from concerns about their older horse. Qualitative data analysis was performed using grounded theory methods. A conceptual model was developed to demonstrate the multifaceted ways in which ageing affects the human-horse relationship and impacts upon outcomes for the horse. The model reflects the dynamic nature of caring for an older horse to accommodate change over time-outcomes for the horse shift as the context of day-to-day life changes. The model provides novel insight into how decisions around older horse care are made.
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Affiliation(s)
- Rebecca Smith
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK; (G.P.); (C.M.); (J.I.)
| | - Gina Pinchbeck
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK; (G.P.); (C.M.); (J.I.)
| | - Catherine McGowan
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK; (G.P.); (C.M.); (J.I.)
| | - Joanne Ireland
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK; (G.P.); (C.M.); (J.I.)
| | - Elizabeth Perkins
- Institute of Population Health, University of Liverpool, Waterhouse Building, Block B, Brownlow Street, Liverpool L69 3GL, UK;
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485
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Pétrin J, Finlayson M, Donnelly C, McColl MA. Healthcare access experiences of persons with MS explored through the Candidacy Framework. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:789-799. [PMID: 33606904 DOI: 10.1111/hsc.13320] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 12/14/2020] [Accepted: 01/26/2021] [Indexed: 06/12/2023]
Abstract
Canada has one of the highest rates of multiple sclerosis (MS) in the world, affecting 1 in every 385 individuals. This neurodegenerative condition is unpredictable and variable in symptom profile and disease course making it difficult to manage. Canadians with MS are high users of healthcare services; however, they report multiple unmet needs, high disease burden, and low satisfaction with healthcare. Access to healthcare is vital to health maintenance and may explain these poor experiences. Access is often measured using utilisation as a proxy, which may fail to capture the complexities of access experiences that this population faces. The Candidacy Framework offers an alternative to utilisation measures, by examining the process of accessing care, while considering the impact of social patterning and health system environments on this process. The aim of the current study is to align the experiences of persons with MS in accessing healthcare services with the stages of the Candidacy Framework. Forty-eight individuals with MS living across Ontario were recruited to participate in one of five focus groups or ten individual interviews. Analysis included a first inductive phase, using constant comparative methods, followed by a deductive phase, using content analysis. The Candidacy Framework was not able to capture all experiences shared by persons with MS, including patient-centred care, past experiences and outcome expectation, and care outcomes. We propose these concepts be included as refinements to the current Framework, providing a more thorough explanation of the experiences of persons with MS in accessing care to manage their condition.
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Affiliation(s)
- Julie Pétrin
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Catherine Donnelly
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Mary Ann McColl
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
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486
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Thilsted SL, Folke F, Tolstrup JS, Thygesen LC, Gamst-Jensen H. Possible associations between callers' degree-of-worry and their socioeconomic status when contacting out-of-hours services: a prospective cohort study. BMC Emerg Med 2021; 21:53. [PMID: 33910517 PMCID: PMC8080378 DOI: 10.1186/s12873-021-00452-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 04/20/2021] [Indexed: 11/28/2022] Open
Abstract
Background Telephone triage within out-of-hours (OOH) services aims to ascertain the urgency of a caller’s medical condition in order to determine the correct type of health care needed, ensuring patient safety. To improve the triage process by increasing patient-centred communication, a triage tool has been developed, whereby callers are asked to rate their degree-of-worry (DOW) as a measure of self-evaluated urgency. Studies show that low socioeconomic status (SES), being single and non-Western ethnicity are associated to low self-rated health and high morbidity and these factors may also be associated with high DOW. The aim of this paper was to examine if low SES, being single and non-Western ethnicity were associated to high DOW of callers contacting OOH services. Methods A prospective cohort study design, at the OOH services for the Capital Region of Denmark. Over 2 weeks, 6869 of 38,787 callers met the inclusion criteria: ≥18 years, patients themselves or close relative/friend, reported DOW, had a valid personal identification number and gave informed consent. Callers were asked to report their DOW (1 = minimal worry to 5 = maximal worry), which was dichotomized into low (1–3) and high (4, 5) DOW and linked to data from electronical medical records and Statistics Denmark. Socioeconomic factors (education and annual household income), marital status and ethnicity were assessed in relation to DOW by logistic regression. Results High DOW was reported by 38.2% of the participants. Low SES (low educational level; OR 1.5, 95% CI 1.3–1.7 and low annual household income; 1.5, 1.3–1.6) was associated with high DOW and so too was being single; 1.2, 1.1–1.3 and of non-Western ethnicity; 2.9, 2.5–3.4. Conclusions Knowledge of the association of low SES, marital status as single and non-Western ethnicity with high DOW among callers to OOH services may give call handlers a better understanding of callers’ DOW. If this does not correspond to the call handler’s perception of urgency, this knowledge may further encourage patient-centred communication, aid the triage process and increase patient safety. A better understanding of socioeconomic variables and their relation to callers’ DOW gives direction for future research to improve telephone triage of OOH services.
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Affiliation(s)
- Sita LeBlanc Thilsted
- Copenhagen Emergency Medical Services, University of Copenhagen, Copenhagen, Denmark.
| | - Fredrik Folke
- Copenhagen Emergency Medical Services, University of Copenhagen, Copenhagen, Denmark
| | - Janne S Tolstrup
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Hejdi Gamst-Jensen
- Copenhagen Emergency Medical Services, University of Copenhagen, Copenhagen, Denmark.,Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
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487
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Janmaat CJ, van Diepen M, Meuleman Y, Chesnaye NC, Drechsler C, Torino C, Wanner C, Postorino M, Szymczak M, Evans M, Caskey FJ, Jager KJ, Dekker FW, the EQUAL Study Investigators. Kidney function and symptom development over time in elderly patients with advanced chronic kidney disease: results of the EQUAL cohort study. Nephrol Dial Transplant 2021; 36:862-870. [PMID: 31943084 PMCID: PMC8075370 DOI: 10.1093/ndt/gfz277] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 11/22/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Initiation of renal replacement therapy often results from a combination of kidney function deterioration and symptoms related to chronic kidney disease (CKD) progression. We investigated the association between kidney function decline and symptom development in patients with advanced CKD. METHODS In the European Quality study on treatment in advanced CKD (EQUAL study), a European prospective cohort study, patients with advanced CKD aged ≥65 years and a kidney function that dropped <20 mL/min/1.73 m2 were followed for 1 year. Linear mixed-effects models were used to assess the association between kidney function decline and symptom development. The sum score for symptom number ranged from 0 to 33 and for overall symptom severity from 0 to 165, using the Dialysis Symptom Index. RESULTS At least one kidney function estimate with symptom number or overall symptom severity was available for 1109 and 1019 patients, respectively. The mean (95% confidence interval) annual kidney function decline was 1.70 (1.32; 2.08) mL/min/1.73 m2. The mean overall increase in symptom number and severity was 0.73 (0.28; 1.19) and 2.93 (1.34; 4.52) per year, respectively. A cross-sectional association between the level of kidney function and symptoms was lacking. Furthermore, kidney function at cohort entry was not associated with symptom development. However, each mL/min/1.73 m2 of annual kidney function decline was associated with an extra annual increase of 0.23 (0.07; 0.39) in the number of symptoms and 0.87 (0.35; 1.40) in overall symptom severity. CONCLUSIONS A faster kidney function decline was associated with a steeper increase in both symptom number and severity. Considering the modest association, our results seem to suggest that repeated thorough assessment of symptom development during outpatient clinic visits, in addition to the monitoring of kidney function decline, is important for clinical decision-making.
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Affiliation(s)
- Cynthia J Janmaat
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Merel van Diepen
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Yvette Meuleman
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nicholas C Chesnaye
- Department of Medical Informatics, Academic Medical Center, ERA-EDTA Registry, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Christiane Drechsler
- Department of Medicine, Division of Nephrology, University Hospital of Würzburg, Würzburg, Germany
| | - Claudia Torino
- CNR-IFC, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension, Reggio Calabria, Italy
| | - Christoph Wanner
- Department of Medicine, Division of Nephrology, University Hospital of Würzburg, Würzburg, Germany
| | - Maurizio Postorino
- Nephrology Dialysis and Transplant Unit Grande Ospedale Metropolitano, Reggio Calabria, Italy
| | - Maciej Szymczak
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Marie Evans
- Department of Clinical Sciences Intervention and Technology, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Fergus J Caskey
- UK Renal Registry, Southmead Hospital, Bristol, UK
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Kitty J Jager
- Department of Medical Informatics, Academic Medical Center, ERA-EDTA Registry, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Friedo W Dekker
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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488
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Xiao J, Ng MSN, Yan T, Chow KM, Chan CWH. How patients with cancer experience dignity: An integrative review. Psychooncology 2021; 30:1220-1231. [PMID: 33893677 DOI: 10.1002/pon.5687] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND A diagnosis of cancer and its treatments can be associated with a prominent issue of loss of dignity or an undermined sense of dignity for patients. Research is increasingly being conducted into how patients with cancer experience dignity, with the aim to build clinical foundations for care that preserves patients' sense of dignity. AIM This review summarises and synthesises the available empirical literature on the experience of dignity in patients with cancer regarding both the perception of dignity and associated factors. METHOD An integrative review method was used. A literature search was conducted in 11 databases using the search terms 'dignity' OR 'existential' OR 'existentialism' combined with 'cancer'. The Mixed Methods Appraisal Tool (version 2011) was adopted to appraise the methodological quality of the included studies. RESULTS Nine qualitative studies and 13 quantitative studies met the selection criteria and were included in the review. The ways that patients with cancer perceived dignity include autonomy/control, respect, self-worth, family connectedness, acceptance, hope/future and God/religious. Factors associated with dignity include demographics, physical and psychosocial distress, experiences of suffering and coping strategies. CONCLUSION Dignity-conserving care should respect patients' human autonomy to strengthen their sense of self-worth, acceptance, hope, reinforce family connectedness, and foster coping strategies to control the physical, psychosocial factors and experience of sufferings that threaten their sense of dignity.
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Affiliation(s)
- Jinnan Xiao
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China.,The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Marques S N Ng
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Tingting Yan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Ka Ming Chow
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Carmen W H Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, SAR, China
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489
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Laranjeira C, Querido AI, Valentim O. Psychometric properties of the revised illness perception questionnaire for people with alcohol use disorder in Portugal. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1916848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Research in Education and Community Intervention (RECI), Viseu, Portugal
- Center for Innovative Care and Health Technology (ciTechcare), Polytechnic Institute of Leiria, Leiria, Portugal
| | - Ana Isabel Querido
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Center for Innovative Care and Health Technology (ciTechcare), Polytechnic Institute of Leiria, Leiria, Portugal
- Center for Research in Health and Information Systems (CINTESIS, NursID, University of Porto, Porto, Portugal
| | - Olga Valentim
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Center for Research in Health and Information Systems (CINTESIS, NursID, University of Porto, Porto, Portugal
- Regional Health Administration of Lisbon and Tagus Valley, Taipas Center Withdrawal Unit, Lisboa, Portugal
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490
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McBride E, Marlow LAV, Chilcot J, Moss-Morris R, Waller J. Distinct Illness Representation Profiles Are Associated With Anxiety in Women Testing Positive for Human Papillomavirus. Ann Behav Med 2021; 56:78-88. [PMID: 33881145 PMCID: PMC8691260 DOI: 10.1093/abm/kaab022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background Testing positive for human papillomavirus (HPV) at cervical cancer screening has been associated with heightened anxiety. To date, the cognitive determinants of heightened anxiety remain unclear, making it difficult to design effective interventions. Purpose This study investigated latent illness representation profiles in women testing positive for HPV with no abnormal cells (normal cytology) and explored associations between these profiles and anxiety. Methods Women aged 24–66 (n = 646) who had tested HPV-positive with normal cytology at routine HPV primary screening in England completed a cross-sectional survey shortly after receiving their result. Results Latent profile analysis identified three distinct profiles of illness representations (termed “adaptive,” “negative,” and “negative somatic”), which differed significantly in their patterns of illness perceptions. Hierarchal linear regression revealed that these latent illness representation profiles accounted for 21.8% of the variance in anxiety, after adjusting for demographic and clinical characteristics. When compared with adaptive representations (Profile 1), women with negative representations (Profile 2) and negative somatic representations (Profile 3) had significantly higher anxiety, with clinically meaningful between-group differences (mean difference [MD] = 17.26, confidence interval [CI]: 14.29–20.22 and MD = 13.20, CI: 9.45–16.96 on the S-STAI-6, respectively). Conclusion The latent illness representation profiles identified in this study provide support for the role of negative beliefs contributing to anxiety in women testing HPV-positive with normal cytology. Characteristics specific to subgroups of highly anxious women (Profiles 2 and 3) could be used by policymakers to target information in routine patient communications (e.g., test result letters) to reduce unnecessary burden. Future research should adopt longitudinal designs to understand the trajectory of illness representations from HPV diagnosis through to clearance versus persistence.
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Affiliation(s)
- Emily McBride
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Laura A V Marlow
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Joseph Chilcot
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rona Moss-Morris
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jo Waller
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
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491
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Dias Neto D, Nunes da Silva A, Roberto MS, Lubenko J, Constantinou M, Nicolaou C, Lamnisos D, Papacostas S, Höfer S, Presti G, Squatrito V, Vasiliou VS, McHugh L, Monestès JL, Baban A, Alvarez-Galvez J, Paez-Blarrina M, Montesinos F, Valdivia-Salas S, Ori D, Lappalainen R, Kleszcz B, Gloster A, Karekla M, Kassianos AP. Illness Perceptions of COVID-19 in Europe: Predictors, Impacts and Temporal Evolution. Front Psychol 2021; 12:640955. [PMID: 33935893 PMCID: PMC8079952 DOI: 10.3389/fpsyg.2021.640955] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/12/2021] [Indexed: 12/23/2022] Open
Abstract
Objective: Illness perceptions (IP) are important predictors of emotional and behavioral responses in many diseases. The current study aims to investigate the COVID-19-related IP throughout Europe. The specific goals are to understand the temporal development, identify predictors (within demographics and contact with COVID-19) and examine the impacts of IP on perceived stress and preventive behaviors. Methods: This was a time-series-cross-section study of 7,032 participants from 16 European countries using multilevel modeling from April to June 2020. IP were measured with the Brief Illness Perception Questionnaire. Temporal patterns were observed considering the date of participation and the date recoded to account the epidemiological evolution of each country. The outcomes considered were perceived stress and COVID-19 preventive behaviors. Results: There were significant trends, over time, for several IP, suggesting a small decrease in negativity in the perception of COVID-19 in the community. Age, gender, and education level related to some, but not all, IP. Considering the self-regulation model, perceptions consistently predicted general stress and were less consistently related to preventive behaviors. Country showed no effect in the predictive model, suggesting that national differences may have little relevance for IP, in this context. Conclusion: The present study provides a comprehensive picture of COVID-19 IP in Europe in an early stage of the pandemic. The results shed light on the process of IP formation with implications for health-related outcomes and their evolution.
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Affiliation(s)
- David Dias Neto
- ISPA - Instituto Universitário, Lisboa, Portugal.,Applied Psychology Research Center Capabilities & Inclusion, Lisboa, Portugal
| | | | | | - Jelena Lubenko
- Psychological Laboratory, Faculty of Public Health and Social Welfare, Riga Stradiṇš University, Riga, Latvia
| | - Marios Constantinou
- Department of Social Sciences (Cyprus), School of Humanities and Social Sciences, University of Cyprus, Nicosia, Cyprus
| | - Christiana Nicolaou
- Department of Nursing (Cyprus), Cyprus University of Technology, Limassol, Cyprus
| | - Demetris Lamnisos
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
| | - Savvas Papacostas
- The Cyprus Institute of Neurology and Genetics, The University of Nicosia Medical School, Nicosia, Cyprus
| | - Stefan Höfer
- Medical University Innsbruck, Innsbruck, Austria
| | - Giovambattista Presti
- Department of Human and Social Sciences, Kore University Behavioral Lab (KUBeLab), Kore University of Enna, Enna, Italy
| | - Valeria Squatrito
- Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy
| | | | - Louise McHugh
- School of Psychology (Ireland), University College Dublin, Dublin, Ireland
| | | | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cádiz, Spain
| | | | | | | | - Dorottya Ori
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | | | - Andrew Gloster
- Division of Clinical Psychology & Intervention Science, Department of Psychology, University of Basel, Basel, Switzerland
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Angelos P Kassianos
- Department of Psychology, University of Cyprus, Nicosia, Cyprus.,Department of Applied Health Research, University College London (UCL), London, United Kingdom
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492
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Maheu C, Singh M, Tock WL, Eyrenci A, Galica J, Hébert M, Frati F, Estapé T. Fear of Cancer Recurrence, Health Anxiety, Worry, and Uncertainty: A Scoping Review About Their Conceptualization and Measurement Within Breast Cancer Survivorship Research. Front Psychol 2021; 12:644932. [PMID: 33912113 PMCID: PMC8072115 DOI: 10.3389/fpsyg.2021.644932] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/15/2021] [Indexed: 01/01/2023] Open
Abstract
Objective: Fear of Cancer Recurrence (FCR), Health Anxiety (HA), worry, and uncertainty in illness are psychological concerns commonly faced by cancer patients. In survivorship research, these similar, yet different constructs are frequently used interchangeably and multiple instruments are used in to measure them. The lack of clear and consistent conceptualization and measurement can lead to diverse or contradictory interpretations. The purpose of this scoping review was to review, compare, and analyze the current conceptualization and measurements used for FCR, HA, worry, and uncertainty in the breast cancer survivorship literature to improve research and practice. Inclusion Criteria: We considered quantitative, qualitative, and mixed methods studies of breast cancer survivors that examined FCR, HA, worry, or uncertainty in illness as a main topic and included a definition or assessment of the constructs. Methods and Analysis: The six-staged framework was used to guide the scoping review process. Searches of PubMed, CINAHL, and PsycINFO databases were conducted. The principle-based qualitative analysis and simultaneous content analysis procedures were employed to synthesize and map the findings. Findings: After duplicate removal, the search revealed 3,299 articles, of which 82 studies met the inclusion criteria. Several critical attributes overlapped the four constructs, for example, all were triggered by internal somatic and external cues. However, several unique attributes were found (e.g., a sense of loss of security in the body is observed only among survivors experiencing FCR). Overall, findings showed that FCR and uncertainty in illness are more likely to be triggered by cancer-specific factors, while worry and HA have more trait-like in terms of characteristics, theoretical features, and correlates. We found that the measures used to assess each construct were on par with their intended constructs. Eighteen approaches were used to measure FCR, 15 for HA, 8 for worry, and 4 for uncertainty. Conclusion: While consensus on the conceptualization and measurement of the four constructs has not yet been reached, this scoping review identifies key similarities and differences to aid in their selection and measurement. Considering the observed overlap between the four studied constructs, further research delineating the unique attributes for each construct is warranted.
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Affiliation(s)
- Christine Maheu
- Faculty of Medicine and Health Sciences, Ingram School of Nursing, McGill University, Montréal, QC, Canada
| | - Mina Singh
- Faculty of Health, School of Nursing, York University, Toronto, ON, Canada
| | - Wing Lam Tock
- Faculty of Medicine and Health Sciences, Ingram School of Nursing, McGill University, Montréal, QC, Canada
| | - Asli Eyrenci
- Department of Psychology, Faculty of Humanities and Social Sciences, Maltepe University, Istanbul, Turkey
| | - Jacqueline Galica
- Faculty of Health Sciences, School of Nursing, Queen's University, Kingston, ON, Canada
| | - Maude Hébert
- Département des Sciences Infirmières, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Francesca Frati
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montréal, QC, Canada
| | - Tania Estapé
- Psychosocial Oncology Department, Fundació per l'Educació i la Formació en Càncer (FEFOC) Fundació, Barcelona, Spain
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493
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Alegria KE, Fleszar-Pavlović SE, Ngo DD, Beam A, Halliday DM, Hinojosa BM, Hua J, Johnson AE, McAnally K, McKinley LE, Temourian AA, Song AV. The Role of Risk Perceptions and Affective Consequences in COVID-19 Protective Behaviors. Int J Behav Med 2021; 28:801-807. [PMID: 33834368 PMCID: PMC8032317 DOI: 10.1007/s12529-021-09970-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Slowing the spread of the novel coronavirus (COVID-19) requires behavioral changes such as physical distancing (e.g., staying a 6-foot distance from others, avoiding mass gatherings, reducing houseguests), wearing masks, reducing trips to nonessential business establishments, and increasing hand washing. Like other health behaviors, COVID-19 related behaviors may be related to risk representations. Risk representations are the cognitive responses a person holds about illness risk such as, identity (i.e., label/characteristics of risk), cause (i.e., factors causing condition), timeline (i.e., onset/duration of risk), consequences (i.e., intrapersonal/interpersonal outcomes), behavioral efficacy (i.e., if and how the condition can be controlled/treated), and illness risk coherence (i.e., extent to which representations, behaviors, and beliefs are congruent). The current study applies the Common-Sense Model of Self-Regulation (CSM-SR) to evaluate how risk representations may relate to COVID-19 protective and risk behaviors. METHODS Participants include 400 workers from Amazon's Mechanical Turk aged ≥ 18 years and US residents. Participants completed an online survey measuring risk representations (B-IPQ) and COVID-19 related behaviors, specifically, physical distancing, hand washing, and shopping frequency. RESULTS Risk coherence, consequences, timeline, emotional representation, and behavioral efficacy were related to risk and protective behaviors. CONCLUSIONS Risk representations vary in their relationship to COVID-19 risk and protective behaviors. Implications include the importance of coherent, targeted, consistent health communication, and effective health policy in mitigating the spread of COVID-19.
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Affiliation(s)
- Katie E Alegria
- Department of Psychological Sciences, University of California, 5200 North Lake Road, Merced, CA, USA
| | - Sara E Fleszar-Pavlović
- Department of Psychological Sciences, University of California, 5200 North Lake Road, Merced, CA, USA
| | - Dalena D Ngo
- Department of Psychological Sciences, University of California, 5200 North Lake Road, Merced, CA, USA
| | - Aislinn Beam
- Department of Psychological Sciences, University of California, 5200 North Lake Road, Merced, CA, USA
| | - Deanna M Halliday
- Department of Psychological Sciences, University of California, 5200 North Lake Road, Merced, CA, USA
| | - Bianca M Hinojosa
- Department of Psychological Sciences, University of California, 5200 North Lake Road, Merced, CA, USA
| | - Jacqueline Hua
- Department of Psychological Sciences, University of California, 5200 North Lake Road, Merced, CA, USA
| | - Angela E Johnson
- Department of Psychological Sciences, University of California, 5200 North Lake Road, Merced, CA, USA
| | - Kaylyn McAnally
- Department of Psychological Sciences, University of California, 5200 North Lake Road, Merced, CA, USA
| | - Lauren E McKinley
- Department of Psychological Sciences, University of California, 5200 North Lake Road, Merced, CA, USA
| | - Allison A Temourian
- Department of Psychological Sciences, University of California, 5200 North Lake Road, Merced, CA, USA
| | - Anna V Song
- Department of Psychological Sciences, University of California, 5200 North Lake Road, Merced, CA, USA.
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494
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Hubbard G, den Daas C, Johnston M, Murchie P, Thompson CW, Dixon D. Are Rurality, Area Deprivation, Access to Outside Space, and Green Space Associated with Mental Health during the COVID-19 Pandemic? A Cross Sectional Study (CHARIS-E). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083869. [PMID: 33917067 PMCID: PMC8067699 DOI: 10.3390/ijerph18083869] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 02/04/2023]
Abstract
The study investigated if rurality, area deprivation, access to outside space (Study 1), and frequency of visiting and duration in green space (Study 2) are associated with mental health during the COVID-19 pandemic and examined if individual demographics (age, gender, COVID-19 shielding status) and illness beliefs have a direct association with mental health during the COVID-19 pandemic. A serial, weekly, nationally representative, cross-sectional, observational study of randomly selected adults was conducted in Scotland during June and July 2020. If available, validated instruments were used to measure psychological distress, individual demographics, illness beliefs, and the following characteristics: Rurality, area deprivation, access to residential outside space, frequency of visiting, and duration in green space. Simple linear regressions followed by examination of moderation effect were conducted. There were 2969 participants in Study 1, of which 1765 (59.6%) were female, 349 (11.9%) were in the shielding category, and the median age was 54 years. There were 502 participants in Study 2, of which 295 (58.60%) were female, 58 (11.6%) were in shielding category, and the median age was 53 years. Direct effects showed that psychological distress was worse if participants reported the following: Urban, in a deprived area, no access to or sharing residential outside space, fewer visits to green space (environment), younger, female, in the shielding category (demographics), worse illness (COVID-19) representations, and greater threat perception (illness beliefs). Moderation analyses showed that environmental factors amplified the direct effects of the individual factors on psychological distress. This study offers pointers for public health and for environmental planning, design, and management, including housing design and public open space provision and regulation.
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Affiliation(s)
- Gill Hubbard
- Centre for Health Sciences, Department of Nursing and Midwifery, University of the Highlands and Islands, Inverness 999020, UK
- Correspondence:
| | - Chantal den Daas
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen 999020, UK; (C.d.D.); (M.J.); (D.D.)
| | - Marie Johnston
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen 999020, UK; (C.d.D.); (M.J.); (D.D.)
| | - Peter Murchie
- Centre of Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB24 3FX, UK;
| | | | - Diane Dixon
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen 999020, UK; (C.d.D.); (M.J.); (D.D.)
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495
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Miller LMS, Gee PM, Katz RA. The Importance of Understanding COVID-19: The Role of Knowledge in Promoting Adherence to Protective Behaviors. Front Public Health 2021; 9:581497. [PMID: 33889557 PMCID: PMC8055953 DOI: 10.3389/fpubh.2021.581497] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 03/10/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Past research suggests that knowledge supports- but strong illness expectations thwart- adoption of protective behaviors (e.g., handwashing). Strong illness expectations may place COVID-19 essential workers at risk. It is unclear, however, whether knowledge can moderate the negative effects of pessimistic illness expectations on protective behaviors. We test COVID-19 knowledge as a moderator of the effects of (1) pessimistic illness expectations and (2) essential worker status on adherence to protective behaviors. Methods: Participants (n = 350) completed measures of knowledge, illness expectations, and protective behaviors. We used chi-square tests to examine associations between variables and logistic regressions to test the moderation models predicting adherence (low, high) while controlling for demographics. Results: Knowledge, illness expectations, and adherence were significantly associated with each other (p < 0.05). Essential workers had stronger illness expectations and lower knowledge than did non-essential workers (p < 0.001). Logistic regressions showed a non-significant Worker Status × Knowledge interaction (p = 0.59) but a significant Knowledge × Illness Expectations interaction (p < 0.05) indicating that those with strong illness expectations and low knowledge were disproportionately at risk of failing to adhere to recommended behaviors. Conclusions: Knowledge promotes protective behaviors by buffering the negative effects of pessimistic illness expectations. Essential workers are more likely to have low levels of knowledge with strong illness expectations, suggesting that educational policies may be warranted.
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Affiliation(s)
| | - Perry M. Gee
- Intermountain Healthcare, Clinical Operations, Salt Lake City, UT, United States
| | - Rachael A. Katz
- Intermountain Healthcare, Clinical Operations, Salt Lake City, UT, United States
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496
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Gormley M, Knobf MT, Vorderstrasse A, Aouizerat B, Hammer M, Fletcher J, D'Eramo Melkus G. Exploring the effects of genomic testing on fear of cancer recurrence among breast cancer survivors. Psychooncology 2021; 30:1322-1331. [PMID: 33742530 DOI: 10.1002/pon.5679] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/06/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Fear of cancer recurrence (FCR) is the greatest unmet psychosocial need among breast cancer survivors (BCS). The Oncotype Dx® test predicts the 10-year risk of distant recurrence and benefit of adjuvant chemotherapy among women with early stage hormone receptor-positive breast cancer. Despite the test's clinical utility, psychosocial responses are poorly understood. METHODS A descriptive cross-sectional study was conducted to explore associations between Oncotype Dx® test results (Recurrence Score [RS]) and FCR, health-related quality of life (HRQOL), distress, anxiety, depression, illness representation and perceived risk. Bivariate analyses were used to examine the associations between variables followed by multiple linear regression to examine predictors of FCR. RESULTS Greater FCR was associated with higher distress, anxiety, depression, illness representation and poorer HRQOL. BCS's with a high Oncotype Dx® RS reported higher overall fear (p = 0.013) and greater perceived consequences of their cancer (p = 0.034) compared to BCS's with a low RS. Using multiple linear regression, anxiety ( β = 0.21, p = 0.016), greater emotional response ( β = 0.45, p < 0.001) and perceived consequences ( β = 0.18, p = 0.039) of illness explained 58% of the variance (p < 0.001) in FCR. CONCLUSION BCS's with higher risk of recurrence may experience higher FCR. However, for FCR, modifiable factors such as anxiety and illness representation (greater emotional response and perceived consequences of illness) may be more important than non-modifiable factors such as Oncotype Dx® test results and age. Further research is needed to develop personalized interventions to improve BCS's outcomes.
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Affiliation(s)
- Maurade Gormley
- Rory Meyers College of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
| | - M Tish Knobf
- School of Nursing, Yale University School of Nursing, Orange, Connecticut, USA
| | - Allison Vorderstrasse
- College of Nursing, University of Massachusetts Amherst College of Nursing, Amherst, Massachusetts, USA
| | - Bradley Aouizerat
- College of Dentistry, New York University College of Dentistry, New York, New York, USA
| | - Marilyn Hammer
- Phyllis F. Cantor Center, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Jason Fletcher
- Rory Meyers College of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Gail D'Eramo Melkus
- Rory Meyers College of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
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497
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Santos GC, Liljeroos M, Dwyer AA, Jaques C, Girard J, Strömberg A, Hullin R, Schäfer-Keller P. Symptom perception in heart failure - Interventions and outcomes: A scoping review. Int J Nurs Stud 2021; 116:103524. [PMID: 32063295 DOI: 10.1016/j.ijnurstu.2020.103524] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/12/2019] [Accepted: 01/02/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Symptom perception in heart failure has recently been described as essential in the self-care process bridging self-care maintenance and self-care management. Accordingly, symptom perception appears to be critical for improving patient outcomes such as decreased hospital readmission and increased survival. OBJECTIVES To explore what interventions have been reported on heart failure symptom perception and to describe outcomes responsive to symptom perception. DESIGN We conducted a scoping review using PRISMA Extension for Scoping Reviews. DATA SOURCES Structured searches of Medline, PubMed, Embase, CINAHL, PsychINFO, Web of Science, Cochrane, Joanna Briggs Institute and Grey literature databases. REVIEW METHODS Two authors independently screened references for eligibility. Eligible articles were written in English, French, German, Swedish, Italian or Spanish and concerned symptom perception in adults with heart failure. Data were extracted and charted in tables by three reviewers. Results were narratively summarized. RESULTS We identified 99 eligible studies from 3055 references. Seven interventional studies targeted symptom perception as the single intervention component. Mixed results have been found: while some reported decreased symptom frequency, intensity and distress, enhanced health-related quality of life, improved heart failure self-care maintenance and management as well as a greater ability to mention heart failure symptoms, others found more contacts with healthcare providers or no impact on anxiety, heart failure self-care nor a number of diary reported symptoms. Additional interventional studies included symptom perception as one component of a multi-faceted intervention. Outcomes responsive to symptom perception were improved general and physical health, decreased mortality, heart failure decompensation, as hospital/emergency visits, shorter delays in seeking care, more consistent weight monitoring, improved symptom recognition as well as self-care management, decreased hospital length of stay and decreased costs. CONCLUSIONS While many studies allowed to map a comprehensive overview of interventions supporting symptom perception in heart failure as well as responsiveness to outcomes, only a few single component intervention studies targeting symptom perception have been reported and study designs preclude assessing intervention effectiveness. With regard to multiple component interventions, the specific impact of symptom perception interventions on outcomes remains uncertain to date. Well-designed studies are needed to test the effectiveness of symptom perception interventions and to elucidate relationships with outcomes.
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Affiliation(s)
- Gabrielle Cécile Santos
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland Fribourg, Haute Ecole de Santé Fribourg, Route des Arsenaux 16a, CH-1700 Fribourg, Switzerland; PhD Student at Institute of Higher Education and Research in Healthcare IUFRS, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, SV-A Secteur Vennes, Route de la Corniche 10, CH-1010 Lausanne, Switzerland.
| | - Maria Liljeroos
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden; Centre for Clinical Research Sörmland, Uppsala University, 631 88 Eskilstuna, Sweden.
| | - Andrew A Dwyer
- William F. Connell School of Nursing, Boston College, 140 Commonwealth Avenue, Chestnut Hill, Massachusetts 02467, United State of America.
| | - Cécile Jaques
- Medical Library, Research and Education Department, Lausanne University Hospital, Route du Bugnon 46, CH-1011 Lausanne, Switzerland.
| | - Josepha Girard
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland Fribourg, Haute Ecole de Santé Fribourg, Route des Arsenaux 16a, CH-1700 Fribourg, Switzerland.
| | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden.
| | - Roger Hullin
- Department of cardiology, Lausanne University Hospital, Route du Bugnon 46, CH-1011 Lausanne, Switzerland; Faculty of biology and medicine, University of Lausanne, CH-1015 Lausanne, Switzerland.
| | - Petra Schäfer-Keller
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland Fribourg, Haute Ecole de Santé Fribourg, Route des Arsenaux 16a, CH-1700 Fribourg, Switzerland.
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498
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Brown MC, Haste A, Araújo-Soares V, Skinner R, Sharp L. Identifying and exploring the self-management strategies used by childhood cancer survivors. J Cancer Surviv 2021; 15:344-357. [PMID: 33156449 PMCID: PMC7966631 DOI: 10.1007/s11764-020-00935-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 09/05/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE Childhood cancer survivors (CCSs) are at increased risk of chronic health problems. Effective self-management could help CCSs cope with the challenges that accompany survivorship and reduce their risk of developing further health problems. There is little evidence about the extent to which CCSs engage with self-management and the specific strategies they use. This study aimed to identify and explore the strategies that CCSs use to manage the consequences of cancer. METHODS Twenty-four CCSs were recruited via follow-up clinics. Participants completed a semi-structured interview which was audio-recorded and transcribed. Directed content analysis was used to identify self-reported self-management strategies and categorise them into main self-management types. RESULTS CCSs reported 118 specific self-management strategies which fell under 20 main self-management strategy types. All CCSs reported using several main self-management strategy types and specific self-management strategies. Main strategy types used by all CCSs were "adopting a healthy lifestyle", "self-motivating", "using support", "reasoned decision-making" and "creating a healthy environment". The most common specific self-management strategies were "receiving family support" (n = 20) and "attending follow-up and screening appointments" (n = 20). CONCLUSIONS This is the first study which has enabled CCSs to self-report the numerous strategies they employ to look after their health and well-being, contributing to a more comprehensive picture of self-management in CCSs. IMPLICATIONS FOR CANCER SURVIVORS These findings may increase healthcare professionals' awareness of the many ways in which CCSs manage their health and is a valuable first step in the development of a supported self-management intervention for CCSs in follow-up care.
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Affiliation(s)
- Morven C Brown
- Population Health Sciences Institute, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, NE1 4LP,, Newcastle upon Tyne, UK.
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK.
| | - Anna Haste
- Population Health Sciences Institute, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, NE1 4LP,, Newcastle upon Tyne, UK
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, UK
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, NE1 4LP,, Newcastle upon Tyne, UK
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
| | - Roderick Skinner
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, NE1 4LP,, Newcastle upon Tyne, UK
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
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499
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Goethe VE, Dinkel A, Schulwitz H, Nöhreiter A, Gschwend JE, Herkommer K. [What causes prostate cancer: patient-perceived causes]. Aktuelle Urol 2021; 52:136-142. [PMID: 31594005 DOI: 10.1055/a-1005-6273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Psychosocial distress caused by prostate cancer (PCa) can persist in patients for years after treatment. A possible factor in this context is the subjectively perceived cause of the disease, which can have a significant influence on the experience of distress, therapy adherence and preventive behaviour. The aim of this study was to record subjective reasons for PCa in long-term survivors and to investigate associated factors. MATERIAL AND METHODS PCa survivors from the national research project "Familial Prostate Cancer" were included in the study. As part of the annual postal follow-up questionnaire, PCa survivors were asked about subjectively perceived causes of their PCa. Responses were assigned to 18 possible categories. In addition, the association between the subjectively perceived causes of PCa and secondary tumours, a positive family history of tumour diseases and sociodemographic factors was investigated. RESULTS Of the 9 047 PCa survivors surveyed, 4 054 (44.8 %) provided information on the subjectively perceived causes of their PCa and were included in this analysis. The mean time since diagnosis was 10.1 years with a mean age of 63.1 years at diagnosis. The most frequent responses were "don't know" (31.8 %), genetics (30.1 %) and stress (18.5 %). Age, the most important risk factor for PCa, was rarely mentioned (2.5 %). In addition to these responses, unusual non-evidence-based reasons were also reported. Men with a positive family history of PCa cited genetics as the cause of their disease about 4 times more frequently than sporadic cases. This proportion increased with the number of affected family members. PCa survivors aged ≤ 65 years at diagnosis indicated stress as the cause of their PCa approximately 2 times more often than men who were older than 65 years at PCa diagnosis. CONCLUSION Most men surveyed reported non-evidence-based causes of their PCa. Preventive programs should address the evidence-based causes more distinctly and with a high visibility. Due to the significance of lay illness beliefs for the experience of distress and the adherence to treatment, the patient's subjective cause of disease should be surveyed and considered by the urologist in charge.
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Affiliation(s)
- Veronika Elisabeth Goethe
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Urologie, München
| | - Andreas Dinkel
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Urologie, München
| | - Helga Schulwitz
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Urologie, München
| | - Alexandra Nöhreiter
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Urologie, München
| | - Jürgen Erich Gschwend
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Urologie, München
| | - Kathleen Herkommer
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Urologie, München
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500
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Suffering-associated factors in chronic disease in hospitalised patients in Portugal. ENFERMERIA CLINICA 2021; 31:135-147. [PMID: 33745808 DOI: 10.1016/j.enfcli.2020.12.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 05/05/2020] [Accepted: 12/08/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To analyse the factors related to suffering in chronic patients within the hospital context. METHOD Descriptive-correlational and cross-sectional quantitative study. Conducted in a hospital in central Portugal, between January and June 2013. A convenience sample of 307 chronic patients was selected. The variables collected through the questionnaire were: age, sex, marital status, employment status, monthly income, perception of family functioning (Smilkinstein), clinical pathology, spirituality (Pinto and Pais-Ribeiro) and degree of suffering (McIntyre and Gameiro). The project was approved by the hospital's ethics committee. The participants signed an informed consent form. RESULTS The global suffering of chronic patients studied at the hospital level is moderate (M=3.01), on a scale of 1 to 5, with the psychological dimension being the most affected (M=3.18). Elderly patients suffer more physically and have more positive experiences. Women present greater socio-relational and psychological suffering. On the other hand, people who live alone, with a monthly income of less than 300 euros, with a low level of education, with the perception of belonging to a dysfunctional family and with neurological pathology, suffer the most. Multiple linear regression showed that spirituality is significantly inversely correlated with suffering. Beliefs are responsible for 6.0% of the explained variance of suffering and hope / optimism for 3.3%. CONCLUSIONS People with chronic hospitalized diseases experience multidimensional suffering, with variable intensity and that is correlated with several factors. These variables must be considered for correct planning of health care for this population adapted to their specific needs.
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