Pathways of emotional autonomy, problem-solving ability, self-efficacy, and self-management on the glycemic control of adolescents with type 1 diabetes: A prospective study

Dyadic Spiritual Coping in Patients With Advanced Cancer and Their Family Caregivers: APIM

CONTEXT

The use of positive and negative spiritual coping has been demonstrated among patients with cancer and their family caregivers. However, the dyadic effects of family caregivers and patients with advanced cancer on spiritual coping, as well as the factors associated with spiritual coping, remain unclear.

OBJECTIVES

To identify the dyadic interactions and factors associated with spiritual coping among patients with advanced cancer and their family caregivers in China.

METHODS

This was a multicenter cross-sectional study conducted in four tertiary hospitals. The participants were 326 dyads of patients with advanced cancer and their family caregivers. A demographic information questionnaire and the Spiritual Coping Scale, General Self-Efficacy Scale, Hospital Anxiety Depression Scale, Spiritual Health Scale, Optimism-Pessimism Scale, Herth Hope Index, and Perceived Social Support Scale were used to examine study variables from January to May 2023. The Actor-Partner Interdependence Model was used to explore the dyadic effects of spiritual coping.

RESULTS

The APIM showed that patients' depression, spiritual health, and social support had actor effects on their spiritual coping, while family caregivers' self-efficacy had a partner effect on patients' spiritual coping. Additionally, family caregivers' self-efficacy, anxiety, and depression had actor effects on their spiritual coping, while patients' self-efficacy, anxiety, and spiritual health had partner effects on family caregivers.

CONCLUSION

Spiritual coping is a dyadic phenomenon in patients with advanced cancer and family caregivers. Improving self-efficacy, spiritual health, and social support, as well as addressing symptoms of anxiety and depression, can enhance spiritual coping abilities and consequently improve quality of life.

Improving Self-Efficacy, Quality of Life, and Glycemic Control in Adolescents With Type 1 Diabetes: Randomized Controlled Trial for the Evaluation of the Family-Centered Empowerment Model

BACKGROUND

Poor glycemic management in adolescents with type 1 diabetes mellitus (T1DM) increases complications. Enhanced control is associated with other factors, such as cultural, socioeconomic, and health care system disparities specific to the Middle East, which can greatly influence individuals' ability to get and use health care services as well as their reaction to treatment approaches.

OBJECTIVE

This study aims to evaluate the impact of the family-centered empowerment model on Jordanian adolescents with T1DM, focusing on their glycosylated hemoglobin levels, self-efficacy, and quality of life (QOL).

METHODS

A randomized controlled trial involved 68 adolescents with T1DM visiting Jordanian Royal Medical Services' clinics. Two sets of participant groups were created: control (n=34) and intervention (n=34). Participants were randomly assigned to either the intervention group, receiving the family-centered empowerment model intervention, or the control group, receiving standard care. Data were collected through face-to-face interviews and medical records.

RESULTS

From April to October 2023, a total of 68 adolescents with T1DM participated in the study at the Jordanian Royal Medical Services. QOL had significant improvement among 13 (38%) of the 34 participants in the intervention group, and the program significantly improved moderate self-efficacy levels in 12 (35%) patients (P<.001). In addition, the average glycosylated hemoglobin levels dropped from 11.25% to 10.23% (P<.001). Additionally, improvements were seen in stress management, communication, and treatment adherence, with a substantial decrease in treatment obstacles. The intervention was successful in improving both clinical and psychosocial outcomes, as evidenced by the fact that the control group showed no noticeable improvements in these parameters.

CONCLUSIONS

The study suggests that patients with T1DM should receive continuous care education sessions, including self-care training, to improve their health. Nurses should also incorporate this training into treatment plans and educational programs for adolescents to enhance their QOL.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06694467; https://clinicaltrials.gov/study/NCT06694467.

Psychometric Properties of the Revised Self-Efficacy for Diabetes Self-Management Scale among Spanish Children and Adolescents with Type 1 Diabetes

A longitudinal design was used to examine the psychometric properties of the Self-Efficacy for Diabetes Self-Management (SEDM) for children and adolescents with a diagnosis of type 1 diabetes (T1D). The SEDM was adapted to Spanish and the best factorial solution was selected to test the invariance of the measures of age and gender. Individuals between the ages of 10 and 19 years old with a diagnosis of T1D completed a self-reported questionnaire (167 at Time 1 [mean age = 14.49, SD = 2.76; 56.9% boys] and 122 at Time 2 [mean age = 14.77, SD = 2.58; 56.6% boys]). Two unifactorial solutions were tested. The psychometric properties of the scale were validated. The proposed validation obtained excellent reliability indices (χ2 (26) = 25.59, p > 0.49, RMSEA = 0.00, 95% CI [0.00, 0.07], CFI = 1.00, GFI = 0.96, AGFI = 0.92, TLI = 1.00, and CMIN = 0.98), and it appeared to be invariant for gender and for age groups. The Cronbach's α was 0.85. The test-retest reliability was high (r = 0.69 [p < 0.001]). Convergent, discriminant, and external validity were proven. The nine-item SEDM is a brief measure with satisfactory structural validity. From our knowledge, this study provides the first reliable tool to assess self-efficacy in the management of T1D for Spanish children and adolescents.

Diabetes self-care behaviours among people diagnosed with serious mental illness: A cross-sectional correlational study

WHAT IS KNOWN ON THE SUBJECT?: People diagnosed with serious mental illness have a high risk of diabetes and are more likely to develop type 2 diabetes at ages below 60 years. Effective diabetes self-care behaviours among people diagnosed with serious mental illness can improve glycaemic control and reduce vascular complications. Few studies have investigated diabetes self-care behaviours and their associations with health literacy and self-efficacy in people diagnosed with serious mental illness. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Diabetes self-care behaviours in people diagnosed with serious mental illness were suboptimal; the least frequently performed self-care activities were self-monitoring of blood glucose. Factors associated with diabetes self-care behaviours are gender, age, communicative and critical health literacy and self-efficacy. Self-efficacy is the strongest predictor of self-care behaviours among people diagnosed with comorbid serious mental illness and type 2 diabetes. WHAT ARE THE IMPLICATIONS OF PRACTICE?: Mental health nurses should assess diabetes-specific health literacy of people diagnosed with serious mental illness to ensure that they possess the knowledge and skills related to diabetes self-care. When treating young people and those with newly diagnosed type 2 diabetes, nurses should incorporate strategies to minimise their perceptions of diabetes-related distress and increase their confidence in managing comorbid diabetes. ABSTRACT: Introduction People diagnosed with serious mental illness (SMI) experience greater challenges in managing their type 2 diabetes mellitus (T2DM) than do those diagnosed with T2DM alone. Aim This study investigated diabetes self-care activities and the factors associated with these activities in people diagnosed with SMI in a hospital setting. Methods A cross-sectional correlational study was conducted among 126 people diagnosed with comorbid SMI and T2DM in Taipei, Taiwan, between October 2020 and April 2021. Data were collected using self-report questionnaires and a chart review. Three-step hierarchical multiple regression analysis was used to identify factors associated with diabetes self-care behaviours. Results Diabetes self-care behaviours in people diagnosed with SMI were suboptimal overall. Hierarchical multiple regression analyses revealed that age (β = 0.18, p = .037) and self-efficacy (β = 0.27, p = .004) significantly associated with diabetes self-care behaviours. Discussion Self-efficacy is the strongest predictor of self-care behaviours among people diagnosed with comorbid SMI and T2DM. Implications for Practice Mental health professionals should focus on enhancing confidence in managing comorbid diabetes in people diagnosed with comorbid SMI, especially young people and those with newly diagnosed T2DM.

The Spiritual and Religious Coping of Mothers with Disabled Children in Turkey: Correlation Between Stress Coping Styles and Self-Efficacy

This study aimed to determine the correlation between stress coping styles and self-efficacy with regard to the spiritual and religious coping of mothers with disabled children. The descriptive and relational screening model was used in this study. The research was completed with 227 mothers in a private rehabilitation center at Turkey. The data were collected using Maternal Spiritual Coping, Religious Coping Styles, Stress Coping Styles Scales (SCSS), and General Self-Efficacy Scales. As a result of the study, there was a statistically advanced degree of significant correlation in a positive direction between effective coping with stress and spiritual coping (p < 0.001), and a negative significant correlation between ineffective coping with stress and general self-efficacy (p < 0.05). Additionally, there was a negative significant correlation between the SCSS-effective coping dimension with the SCSS-ineffective coping points (p < 0.05). The high level of spiritual coping of mothers and its effect on coping with stress is an important result. For the participation of children with disabilities and their parents in society, it is essential to identify components such as mental health and spiritual coping that will improve mothers' mental health so that mothers can effectively cope with the difficulties they experience.