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Hou J, Fu R, Jiang T, Yu NX. Delineating the dyadic coping process in HIV serodiscordant male couples: a dyadic daily diary study using the common fate model. Qual Life Res 2025; 34:1317-1332. [PMID: 39899139 PMCID: PMC12064454 DOI: 10.1007/s11136-025-03903-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2025] [Indexed: 02/04/2025]
Abstract
PURPOSE Although HIV is likely to be a couple-based issue among serodiscordant male couples due to cross-partner transmission, little is known about how they cope with HIV as a team. This study aimed to examine the dyadic coping process among serodiscordant couples. METHODS A dyadic daily diary study was used to answer our research questions. One hundred and forty-one Chinese HIV serodiscordant male couples completed measures of we-disease appraisal, common dyadic coping, quality of life, and relationship satisfaction for 14 consecutive days and ART adherence, attitudes toward PrEP, quality of life, and relationship satisfaction at a 2-month post-diary assessment. Computations were based on the common fate mediation model, using multilevel structural equation modeling. RESULTS Regarding direct effect, we-disease appraisal was associated with both partners' quality of life at the between-person level, post-diary quality of life, attitudes toward to PrEP, relationship satisfaction at both levels as well as post-diary relationship satisfaction. Common dyadic coping mediated the association between we-disease appraisal and both partners' quality of life as well as relationship satisfaction at the within-person level. However, no mediating effects were observed at the between-person level. CONCLUSIONS Our findings highlighted the importance of the daily dyadic coping process among HIV serodiscordant couples. Future interventions should direct resources toward fostering a shared disease appraisal and training couples in common dyadic coping strategies for their daily lives.
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Affiliation(s)
- Jianhua Hou
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, People's Republic of China
| | - Rong Fu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, People's Republic of China
| | - Taiyi Jiang
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Nancy Xiaonan Yu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, People's Republic of China.
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Zheng H, Fan X, Liu Y, Wu Y, Liu Y, Xu Y, Zhi J, Yang C, Liao J. How dyadic appraisal moderate the association between dyadic coping and diabetes management efficacy. J Health Psychol 2025; 30:845-857. [PMID: 38584333 PMCID: PMC11977803 DOI: 10.1177/13591053241240735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024] Open
Abstract
To explore the moderating role of dyadic appraisal in the association between dyadic coping and diabetes management efficacy. Two hundred seventy six middle-aged and older couple pairs with one spouse who had diabetes were recruited from 14 community healthcare centers across Guangzhou. The moderating role of dyadic appraisal was investigated using the actor-partner interdependence moderation model. When both couples considered diabetes to be a shared condition, statistically-significant associations were found between patients' negative (β = -22.7, p = 0.008) and neutral behaviors (β = 13.6, p = 0.017), plus spouses' positive behaviors (β = 22.8, p = 0.009) on their own diabetes management efficacy, respectively (i.e. actor effects); as well as between spouses' positive (β = 16.8, p = 0.028), negative (β = -28.5, p < 0.001), and neutral behaviors (β = 16.9, p = 0.006) on patient's diabetes management efficacy (i.e. partner effects). Dyadic appraisal moderates the association between dyadic coping and diabetes management efficacy.
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Affiliation(s)
| | | | - Yuyang Liu
- Sun Yat-sen University, China
- Shenzhen Health Development Research and Data Management Center, China
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Litchman ML, Miller NA, Lee S, Kauwe Tuitama AI, Mirus K, Layton R, Layton S, Farovitch L, Allen NA. Development of a Diabetes Education Video Series in American Sign Language for Deaf and Hard of Hearing Populations. Sci Diabetes Self Manag Care 2025; 51:203-212. [PMID: 40119772 DOI: 10.1177/26350106251315676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2025]
Abstract
ObjectiveThe purpose of the study was to describe the collaborative process of a deaf-hearing research team developing diabetes education videos in American Sign Language (ASL) for deaf and hard of hearing (DHH) populations.MethodsDiabetes education videos were guided by a DHH community advisory board (CAB) who were living with diabetes (N = 10), DHH video production team (N = 9), DHH research team members (N = 3), hearing clinical experts and research team members (N = 3), and a hearing designer (N = 1). Over 10 meetings, the CAB provided ongoing feedback to enhance video content and design. Videos were then developed using a rigorous 5-step process that involved script development, design of visual supports, script translation into ASL by native signers, video recording, and video editing. Interviews with individual CAB members were obtained to understand future video needs.ResultsUsing a design thinking and collaborative approach between deaf-hearing team members, 20 diabetes education videos were designed to prioritize ASL and DHH culture while still being inclusive for hearing family members who may not know ASL. The videos met the WebAIM guidelines for accessibility. CAB members rated the videos positively.ConclusionsThe diabetes education videos in ASL fill an existing void in diabetes education for DHH populations and are still being evaluated in the Deaf Diabetes Can Together intervention and will be placed on a future diabetes education website in ASL. This article highlights key details of developing diabetes education videos using a deaf-hearing team that future studies could learn from.
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Affiliation(s)
| | | | - Shinduk Lee
- College of Nursing, University of Utah, Salt Lake City, Utah
| | | | - Karissa Mirus
- College of Nursing, University of Utah, Salt Lake City, Utah
| | | | | | | | - Nancy A Allen
- College of Nursing, University of Utah, Salt Lake City, Utah
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Penfornis A, Down S, Seignez A, Vives A, Bonnemaire M, Kulzer B. European Survey on Adults with Type 1 Diabetes and their Caregivers: Insights into Personal Experience and Needs for Improving Diabetes Care. Diabetes Ther 2025; 16:471-484. [PMID: 39883287 PMCID: PMC11867988 DOI: 10.1007/s13300-024-01685-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 12/10/2024] [Indexed: 01/31/2025] Open
Abstract
INTRODUCTION Type 1 diabetes (T1D) requires constant self-management and substantially impacts daily life. We surveyed the experiences/burdens of people with T1D (PWD) and their caregivers. METHODS An online survey of PWD/caregivers (aged ≥ 18 years) living in five European countries was conducted from July to August 2021. The survey included questions on the impact of T1D on physical and mental abilities, the frequency of hypoglycemic and hyperglycemic episodes and the impact of T1D on the daily lives of PWD. RESULTS Respondents included 458 PWD and 54 caregivers. The main impacts of T1D included fatigue (50% of PWD rated a high/very high impact), a hindrance to daily activities (43%), feeling different than others (42%), and anxiety (40%). The perceived impact of complication risk was significantly lower for PWD paying more attention to controlling their disease (p < 0.001). Most caregivers (80%) reported feeling more anxious than the PWD about their T1D complications. Hypoglycemia/hyperglycemia was a significant predictor of perceived distress owing to T1D. Most PWD (68%) would have liked more psychological support. Over half of respondents (PWD: 53%, caregivers: 56%) felt they had insufficient knowledge about T1D. Acceptance, positivity, and self-organization are the main strategies recommended by PWD/caregivers for living with T1D. CONCLUSIONS T1D remains a significant burden for PWD/caregivers, and more educational and psychological support for T1D management is required.
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Affiliation(s)
- Alfred Penfornis
- Diabetology Department, Centre Hospitalier Sud Francilien, Corbeil-Essonnes, Université Paris-Saclay, Gif-sur-Yvette, France.
| | - Su Down
- Somerset NHS Foundation Trust, Somerset, UK
| | | | | | | | - Bernhard Kulzer
- Diabetes-Zentrum Mergentheim, Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Universität Bamberg, Bamberg, Germany
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Allen NA, Berg CA, Iacob E, Gonzales BR, Butner JE, Litchman ML. Examining Share plus-A Continuous Glucose Monitoring Plus Data-Sharing Intervention in Older Adults and Their Care Partners: Protocol for a Randomized Control Study. JMIR Res Protoc 2024; 13:e60004. [PMID: 39680874 PMCID: PMC11686024 DOI: 10.2196/60004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 10/14/2024] [Accepted: 10/31/2024] [Indexed: 12/18/2024] Open
Abstract
BACKGROUND Older adults with type 1 diabetes (T1D) are increasingly turning to care partners (CPs) as resources to support their diabetes management. With the rise in diabetes technologies, such as continuous glucose monitoring (CGM), there is great potential for CGM data sharing to increase CP involvement in a way that improves persons with diabetes' glucose management and reduces distress. OBJECTIVE The specific aims of this paper are to (1) evaluate the feasibility, usability, and acceptability of the Share plus intervention compared to the CGM Follow app plus diabetes self-management education and support; (2) evaluate the effect of the Share plus intervention on time-in-range (TIR; primary outcome) and diabetes distress (secondary outcome); and (3) explore differences between groups in person with diabetes and CP dyadic appraisal and coping, quality of life, diabetes self-care, and CP burden at 12 and 24 weeks and associations of dyadic variables on outcomes. METHODS This is a protocol for a feasibility, pilot randomized controlled trial. Older adults with T1D and their CP (N=80 dyads) will be randomized 1:1 to the Share plus intervention or Follow app plus diabetes self-management education. The trial will include a 12-week active intervention to determine the change in primary (TIR) and secondary (diabetes distress) outcomes, followed by a 12-week, observation-only phase to examine maintenance effects. The evaluation is guided by the Dyadic Coping Model. Patient-level effectiveness outcomes (TIR, hemoglobin A1c [HbA1c], diabetes distress, diabetes appraisal, coping, quality of life, diabetes self-care behaviors, and CP burden) will be assessed, using patient-reported outcomes measures and a home HbA1c test kit. Patient- and CP-level acceptability and feasibility will be assessed using surveys and interviews. Quantitative feasibility, acceptability, and usability data will be described using frequencies and percentages. Acceptability will be summarized based on Likert questions and open-ended questions. Usability will be examined separately for the intervention and control groups based on the System Usability Scale, with a study benchmark of ≥68 indicating good usability. TIR will be computed based on 2 weeks' worth of data at baseline (prior to intervention) and 2 weeks each after the intervention (week 12) and at follow-up (week 24). RESULTS Recruitment started in August 2023 and enrollment began in November 2023. To date, 24 participants have been enrolled in this study. We expect to conclude this study in March 2026 and expect to disseminate results in March 2026. CONCLUSIONS To our knowledge, this will be the first pilot randomized controlled trial to evaluate both feasibility and effectiveness outcomes for the web-based, platform-delivered Share plus intervention for older adults with T1D and their CP. This research has implications for CGM data sharing in other age groups with T1D and type 2 diabetes. TRIAL REGISTRATION ClinicalTrials.gov NCT05937321; https://clinicaltrials.gov/study/NCT05937321. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/60004.
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Affiliation(s)
- Nancy A Allen
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Cynthia A Berg
- Department of Psychology, University of Utah, Salt Lake City, UT, United States
| | - Eli Iacob
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | | | - Jonathan E Butner
- Department of Psychology, University of Utah, Salt Lake City, UT, United States
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Holmstrom AJ, Dorrance-Hall E, Wilcox S, Schmälzle R. Confirmation, Disconfirmation, and Communal Coping for Joint Physical Activity in Romantic Dyads. HEALTH COMMUNICATION 2024; 39:1067-1081. [PMID: 37081795 DOI: 10.1080/10410236.2023.2201748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Most people in the United States do not engage in sufficient physical activity (PA). However, certain communication behaviors from romantic partners can motivate PA. Research indicates that confirming communication and communal coping (CC) in romantic relationships can increase PA efforts, but less research has examined the role of explicitly disconfirming communication or relationships between confirmation, disconfirmation, and CC on PA outcomes. We examined models in which shared PA appraisals mediate relationships between (a) confirmation and (b) disconfirmation and joint PA behavior in heterosexual, romantic dyads. Sex differences in actor and partner effects were also considered. Partners (N = 144) in 72 dyads completed assessments of key constructs. Results indicated that shared PA appraisals were critical in the confirmation model, mediating relationships between perceptions of confirmation and reports of joint PA. Unexpectedly, both partners' reports of partner disconfirmation were positively associated with their partners' reports of joint PA. Only one statistically significant sex difference emerged. Theoretical and pragmatic implications are discussed.
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Affiliation(s)
| | | | - Shelby Wilcox
- Department of Communication, Michigan State University
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Berg CA, Mansfield JH, Boggess SB, Martin JV, Creer B, Peck TK, Wiebe DJ, Butner JE, Mayberry LS. Goal change and goal achievement for emerging adults across the pilot FAMS-T1D intervention for type 1 diabetes. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2024; 5:1297422. [PMID: 38685920 PMCID: PMC11056594 DOI: 10.3389/fcdhc.2024.1297422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/21/2024] [Indexed: 05/02/2024]
Abstract
Objective Interventions for emerging adults (EAs) with type 1 diabetes (T1D) focus on goal setting, but little is known about how goal achievement relates to intervention outcomes. We examined how goals change, how goal achievement relates to diabetes outcomes, and identified barriers and facilitators to goal achievement. Method EAs with T1D (N=29, M age=21.6 years, 57% female) were coached monthly to set a behavioral goal across a 3-month feasibility trial. Coaching notes were qualitatively coded regarding type, complexity, and changes in goals. Goal achievement was measured via daily responses to texts. HbA1c, self-efficacy, diabetes distress, and self-care were assessed pre- and post-intervention. Results EAs frequently set food goals (79%) in combination with other goals. EAs overwhelmingly changed their goals (90%), with most increasing goal complexity. Goal achievement was high (79% of days) and not affected by goal change or goal complexity. Goal achievement was associated with increases in self-efficacy and self-care across time. Qualitative themes revealed that aspects of self-regulation and social-regulation were important for goal achievement. Conclusion Meeting daily diabetes goals may enhance self-efficacy and self-care for diabetes. Practice Implications Assisting EAs to reduce self-regulation challenges and enhance social support for goals may lead to better diabetes outcomes.
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Affiliation(s)
- Cynthia A. Berg
- Department of Psychology, University of Utah, Salt Lake City, UT, United States
| | | | - Silas B. Boggess
- Department of Psychology, University of Utah, Salt Lake City, UT, United States
| | - Julia V. Martin
- Department of Psychology, University of Utah, Salt Lake City, UT, United States
| | - Benjamin Creer
- Department of Psychology, University of Utah, Salt Lake City, UT, United States
| | - Torri K. Peck
- Department of Psychology, University of Utah, Salt Lake City, UT, United States
| | - Deborah J. Wiebe
- Psychological Sciences, University of California, Merced, CA, United States
| | - Jonathan E. Butner
- Department of Psychology, University of Utah, Salt Lake City, UT, United States
| | - Lindsay S. Mayberry
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
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Canela SM, Allen NA, Henderson M, Lee S, Miller NA, Howes Z, Litchman ML. Care Partner Experiences in Supporting Deaf and Hard of Hearing Adults With Diabetes. Diabetes Spectr 2024; 37:335-341. [PMID: 39649697 PMCID: PMC11623034 DOI: 10.2337/ds22-0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2024]
Abstract
Objective Care partners play an important role in diabetes management of people with diabetes. Although deaf and hard of hearing (DHH) adults experience diabetes at a higher rate than their hearing counterparts, there is a lack of information regarding the experience of care partners assisting those in the DHH community. There is a need to identify intentional support for this population. The purpose of this study was to explore how care partners of DHH people with diabetes provide helpful and unhelpful support, the care partner experience of providing support, and care partners' perceived diabetes self-management education, support needs, and recommendations. Research Design and Methods We engaged a community advisory board of care partners to DHH people with diabetes to explore how care partners provide support, their individual experiences in providing support, and their suggestions for diabetes self-management education. We used thematic analysis to analyze individual and collective responses. Results Three emergent themes were identified suggesting that care partners give support in a variety of ways, are often overwhelmed in meeting the demanding and ongoing needs of DHH people with diabetes, and have a multitude of suggestions for implementing a future diabetes care partner education program. We also identified some DHH population-specific challenges to diabetes care, including communication barriers with health care providers, inability to use hearing cues if a person with diabetes experiences a fall, and limited access to diabetes care education in sign language. Conclusion These findings highlight a need to provide more support for care partners of DHH people with diabetes and to address the needs of DHH populations to ensure more equitable diabetes care. Further research is needed to adequately inform successful interventions for DHH people with diabetes and their care partners.
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Affiliation(s)
- Sierra M. Canela
- University of Utah Department of Educational Leadership and Policy, Salt Lake City, UT
| | - Nancy A. Allen
- University of Utah College of Nursing, Salt Lake City, UT
| | | | - Shinduk Lee
- University of Utah College of Nursing, Salt Lake City, UT
| | | | - Zach Howes
- University of Utah College of Nursing, Salt Lake City, UT
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Kastrinos A, Bylund C, Bacharz K, Applebaum A, Fisher CL. Understanding the role of parents' information sharing and withholding on emerging and young adults' caregiving and coping during their parents' advanced cancer. J Psychosoc Oncol 2023; 42:412-426. [PMID: 37929571 PMCID: PMC11070447 DOI: 10.1080/07347332.2023.2276940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Emerging and young adult caregivers (EYACs) who provide care to their parents are a hidden, unsupported population of caregivers. Research identifies information sharing or withholding as a key aspect of caregivers' ability to cope and adjust, which may be especially critical when a parent is diagnosed with advanced cancer. The goal of this study was to examine the impact of parent information sharing/withholding on EYACs' caregiving and coping experiences. We conducted in-depth, semi-structured interviews with 33 EYACs between the ages of 18-35 who cared for a parent that died of advanced cancer. Interview transcripts were thematically analyzed. Three factors played a role in how parents' information sharing/withholding affected EYACs' caregiving/coping: 1) topic, 2) timing, and 3) who is included. Findings highlight the adaptive functioning of parents' information sharing and negative outcomes associated with information withholding, illustrating how parents' disclosure decisions function to promote or inhibit EYACs' care involvement and coping.
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Affiliation(s)
- Amanda Kastrinos
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, NY
| | - Carma Bylund
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL
| | - Kelsey Bacharz
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL
| | - Allison Applebaum
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, NY
| | - Carla L. Fisher
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL
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Fu R, Chen C, Gu Y, Wu D, Darbes LA, Yu NX. Communal or Autonomous? Coping Experiences of Chinese Serodiscordant Male Couples to HIV Care: A Dyadic Qualitative Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3553-3564. [PMID: 37365447 DOI: 10.1007/s10508-023-02643-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/19/2023] [Accepted: 06/04/2023] [Indexed: 06/28/2023]
Abstract
Limited empirical evidence exists on the interpersonal challenges faced by Chinese serodiscordant male couples in HIV care. This study aimed to explore their coping experiences in HIV care by applying the communal coping process theoretical framework. A dyadic qualitative study using face-to-face interviews with 20 serodiscordant male couples (n = 40) was conducted between July and September 2021 in two Chinese metropolitan areas through purposive sampling. Eligibility included one partner living with HIV and the other being HIV-negative, both aged 18 or older, born male, gay or bisexual, and in a relationship together for at least 3 months. A hybrid deductive-inductive approach integrated with dyadic interview analysis and framework method was used for data analysis. We identified three themes in the coping process in HIV care: (1) coping as an autonomous process, (2) coping as a dissonant process, and (3) coping as a contextualized communal process. Concerning autonomous coping, most couples adopted either disengaged avoidance or mutual noninvolvement as negative coping strategies. We also identified potential risk factors for dissonant coping, which are a partner living with internalized HIV stigma and the couple's asymmetric relationship goals. Our results indicate the communal coping process of HIV care is contextual, and our expansion of the communal coping theory sheds light on how serodiscordant male couples cope with stressors connected to HIV care. Our findings provide theoretical insights for the development of dyadic interventions based on health psychology for Chinese serodiscordant male couples to engage in HIV care.
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Affiliation(s)
- Rong Fu
- Department of Social and Behavioural Sciences, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon Tong, Kowloon, Hong Kong, People's Republic of China
| | - Chen Chen
- Department of Social and Behavioural Sciences, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon Tong, Kowloon, Hong Kong, People's Republic of China
| | - Yuzhou Gu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, People's Republic of China
| | - Dan Wu
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Lynae A Darbes
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Nancy Xiaonan Yu
- Department of Social and Behavioural Sciences, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon Tong, Kowloon, Hong Kong, People's Republic of China.
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Helgeson VS. Romantic Relationships Among Emerging Adults With and Without Type 1 Diabetes. Diabetes Spectr 2023; 37:100-108. [PMID: 38385095 PMCID: PMC10877211 DOI: 10.2337/ds23-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
We compared the romantic relationships of emerging adults with type 1 diabetes to those without type 1 diabetes. We examined whether there were group differences in romantic relationships and relationship quality and whether aspects of romantic relationships were connected to psychological and diabetes health. Emerging adults (mean age 27 years) with (n = 88) and without (n = 99) type 1 diabetes took part in the study. Participants completed an online questionnaire that assessed romantic relationships, psychological health, and diabetes health. Results showed that males with type 1 diabetes were significantly less likely than males without diabetes and either group of females to be involved in a romantic relationship. Among those in a relationship, there were no group differences in relationship quality. For both groups, being in a relationship was associated with less loneliness and greater life satisfaction. Among those in a romantic relationship, the quality of the relationship was more strongly related to psychological outcomes for those with than for those without diabetes. There was modest evidence that relationship quality was linked to better diabetes outcomes. When partner supportive and unsupportive diabetes interactions were examined, there was more evidence that unsupportive interactions were harmful (i.e., related to worse psychological and diabetes outcomes) than there was evidence that supportive interactions were beneficial. These findings underscore the importance of romantic relationships for health among emerging adults in general and suggest that there may be an even greater impact for those with type 1 diabetes.
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Bristol AA, Litchman M, Berg C, Grigorian E, Small D, Glazener A, Jones C, Allen NA. Using Continuous Glucose Monitoring and Data Sharing to Encourage Collaboration Among Older Adults With Type 1 Diabetes and Their Care Partners: Qualitative Descriptive Study. JMIR Nurs 2023; 6:e46627. [PMID: 37494110 PMCID: PMC10413231 DOI: 10.2196/46627] [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: 02/19/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Persons with diabetes use continuous glucose monitoring (CGM) to self-manage their diabetes. Care partners (CPs) frequently become involved in supporting persons with diabetes in the management of their diabetes. However, persons with diabetes and CP dyads may require more communication and problem-solving skills regarding how to share and respond to CGM data. OBJECTIVE The purpose of this study was to describe the experiences of persons with diabetes and CPs who participated in the Share "plus" intervention, which addresses dyadic communication strategies, problem-solving, and action planning to promote sharing of CGM data among the dyad. METHODS Ten dyads participated in the Share "plus" telehealth intervention. Participants were interviewed during and after the Share "plus" intervention. Thematic analysis was used to analyze interview data. RESULTS During postsession interviews, dyads described feeling a sense of shared responsibility yet viewed the persons with diabetes as ultimately responsible for the disease. Additionally, dyads shared that communication patterns improved and were able to recognize the negative aspects of previously established communication patterns. Dyads reported communication focused on hypoglycemia episodes while also differing in the frequency they reviewed CGM data and set alerts. Overall, dyads expressed positive reactions to the Share "plus" intervention. CONCLUSIONS Share "plus" was helpful in promoting positive CGM-related communication among dyads and encouraged more CP support. CPs play an important role in supporting older adults with type 1 diabetes. Communication strategies help support dyad involvement in CGM data sharing and self-management among persons with diabetes.
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Affiliation(s)
- Alycia A Bristol
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Michelle Litchman
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Cynthia Berg
- College of Social and Behavioral Science, University of Utah, Salt Lake City, UT, United States
| | - Ernest Grigorian
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Denise Small
- College of Pharmacy, Roseman University, South Jordan, UT, United States
| | - Ashley Glazener
- College of Pharmacy, Roseman University, South Jordan, UT, United States
| | - Christopher Jones
- Cottonwood Medical Clinic Endocrine and Diabetes, Intermountain Healthcare, Murray, UT, United States
| | - Nancy A Allen
- College of Nursing, University of Utah, Salt Lake City, UT, United States
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Delaney RK, Zhong L, Wang X, Sossenheimer L, Neuberger J, Fagerlin A, Litchman ML. Are people with diabetes getting the support they need? Deficits between support desired and received from family and friends relates to poorer health. PATIENT EDUCATION AND COUNSELING 2023; 110:107653. [PMID: 36807127 PMCID: PMC10546474 DOI: 10.1016/j.pec.2023.107653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 12/19/2022] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To determine the mismatch of desired support versus support received and to evaluate the impact of these mismatches on health outcomes of people with diabetes. METHODS This cross-sectional study is a secondary data analysis of medical record and survey data of participants with Type 1 and Type 2 diabetes from a diabetes care and education program. Biophysical metrics included HbA1c, body mass index, systolic blood pressure, diastolic blood pressure, triglycerides, and high- and low-density lipoproteins. Psychosocial and self-care survey outcomes included diabetes distress, diabetes self-care, and diabetes self-efficacy. Support mismatch was a difference score (support desired-support received). Descriptive statistics were computed for demographics, clinical characteristics, and primary outcomes. Multiple linear regressions were computed. RESULTS The percentage of participants experiencing support mismatch (surplus/deficits) across six domains was: 15%/27% (foot care), 22%/24% (take medicine), 24%/23% (test blood sugar), 21%/29% (physical activity), and 18%/34% (follow meal plan). Greater support deficits were associated with higher triglyceride levels, increased diabetes distress, and lower diabetes self-efficacy. CONCLUSIONS Findings indicate that greater support deficits can be a risk factor for some poorer physical and psychosocial health outcomes. PRACTICE IMPLICATIONS Interventions to facilitate functional supportive behaviors are an avenue for future research and clinical practice.
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Affiliation(s)
- Rebecca K Delaney
- University of Utah Intermountain Healthcare Department of Population Health Sciences, University of Utah, Salt Lake City, USA.
| | - Lingzi Zhong
- University of Utah Intermountain Healthcare Department of Population Health Sciences, University of Utah, Salt Lake City, USA
| | - Xuechen Wang
- University of Utah Intermountain Healthcare Department of Population Health Sciences, University of Utah, Salt Lake City, USA
| | | | - Julie Neuberger
- Division of Endocrinology, School of Medicine, University of Utah, Salt Lake City, USA
| | - Angela Fagerlin
- University of Utah Intermountain Healthcare Department of Population Health Sciences, University of Utah, Salt Lake City, USA; Salt Lake City VA Center for Informatics Decision Enhancement and Surveillance, Salt Lake City, USA
| | - Michelle L Litchman
- College of Nursing, University of Utah, Salt Lake City, USA; Division of Endocrinology, School of Medicine, University of Utah, Salt Lake City, USA
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14
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Novak JR, August KJ, Kavookjian J, Whitley H, Burnett D. Exploring typologies of appraisals, involvement, and distress in type 2 diabetes family members. J Health Psychol 2023; 28:133-148. [PMID: 35924837 DOI: 10.1177/13591053221115326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The present study conducted a latent profile analysis from a US national sample of 446 family members to identify and predict unique clusters of family members' PWD illness appraisals, involvement, and psychological distress. Time since diagnosis, diabetes adherence, the relationship with the PWD, age, gender, race/ethnicity, income, and economic pressure were included as predictors. Class membership was used to predict the family members' own health behaviors (sleep quality, days of physical activity, and diet quality). Results revealed four distinct classes: Moderately Concerned, Involved, and Distressed (32.51%), Least Concerned, Distressed, and Involved (27.13%), Less Concerned and Distressed, Moderately Involved (23.77%), and Most Concerned, Involved, and Distressed (16.82%). The significant predictors and outcomes of class membership revealed interesting patterns in associations with class membership. Consequently, in addition to involving family members, health promotion and intervention efforts must consider the psychological health and illness appraisals of family members rather than a one-size-fits-all approach.
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Affiliation(s)
- Josh R Novak
- Department of Human Development and Family Science, Auburn University, Auburn, AL, USA.,Boshell Diabetes and Metabolic Diseases Research Program, Auburn University, Auburn, AL, USA
| | - Kristin J August
- Department of Psychology and Health Sciences Center, Rutgers University, Camden, NJ, USA
| | - Jan Kavookjian
- Boshell Diabetes and Metabolic Diseases Research Program, Auburn University, Auburn, AL, USA.,Harrison School of Pharmacy, Auburn University, Auburn, AL, USA
| | - Heather Whitley
- Boshell Diabetes and Metabolic Diseases Research Program, Auburn University, Auburn, AL, USA.,Harrison School of Pharmacy, Auburn University, Auburn, AL, USA
| | - Donna Burnett
- Boshell Diabetes and Metabolic Diseases Research Program, Auburn University, Auburn, AL, USA.,Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL, USA
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15
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Helgeson VS, Allen NA, Tracy EL, Butner J, Berg CA. Diabetes stress contagion among romantic partners: a daily diary investigation. J Behav Med 2022; 45:716-727. [PMID: 35819741 PMCID: PMC10369354 DOI: 10.1007/s10865-022-00337-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 06/16/2022] [Indexed: 10/17/2022]
Abstract
The stress of diabetes management not only affects persons with type 1 diabetes (PWD) but also their social network. We examined the extent to which romantic partners of PWD (n = 199) identified their most significant daily stressor as diabetes-related (i.e., partner diabetes stress) using a 14-day daily diary design. Utilizing a communal coping framework, we examined appraisal and communication as predictors of partner diabetes stress and examined links of partner diabetes stress to supportive/unsupportive behavior and mood by assessing each construct daily. We also examined whether a survey measure of partner anxious attachment moderated these links. Results showed that viewing diabetes as a shared problem and greater diabetes communication were associated with greater partner diabetes stress. Partner diabetes stress was linked to partner provision of greater supportive and unsupportive behavior-especially so for anxiously attached partners. Importantly, partner diabetes stress was not linked to mood for PWDs or partners.
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16
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Berg CA, Suchy Y, de Grey RGK, Allen NA, Campbell MS, Munion A, Butner J, Helgeson VS. Cognitive Abilities and Collaboration in Couples in Type 1 Diabetes Management. Diabetes Spectr 2022; 36:33-40. [PMID: 36818410 PMCID: PMC9935285 DOI: 10.2337/ds21-0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Managing type 1 diabetes involves coordinating complex daily behaviors that may rely on the cognitive abilities of people with diabetes (PWD) and spouses, especially as couples collaborate surrounding diabetes care. The aims of the study were to examine whether 1) the cognitive abilities of PWD and their spouses predicted lower A1C, 2) collaborating with a spouse with higher cognitive abilities was especially beneficial for PWD with lower cognitive abilities, and 3) the benefit of the cognitive abilities of PWD and their spouse occurred through better self-care. Couples (n = 199) were recruited with one member diagnosed with type 1 diabetes (PWD 52% female sex, average age 46.81 years, average duration of diabetes 27 years; spouses 48% female sex; average age 46.40 years). PWD and spouses completed fluid (trail making tests from the Delis-Kaplan Executive Function System) and crystallized (information subtest from the Wechsler Adult Intelligence Scale-4th Edition) ability tests. PWD rated their spouse's collaboration in diabetes and reported self-care behaviors through surveys. A1C was assessed as a measure of blood glucose through a blood assay. Multiple regressions revealed that spouses' crystallized ability was the only statistically significant predictor, with higher values associated with lower A1C (t = -2.17, P <0.05). The interaction of crystallized ability of PWD × spouse crystallized ability × collaboration indicated that PWD with lower ability tended to benefit more when they collaborated with a spouse who scored higher in ability (t = -2.21, P <0.05). Mediational analyses indicated that spouses' crystallized ability was associated with lower A1C through better self-care behaviors of PWD (B = 0.03, SE = 0.01, P <0.01). We conclude that PWD benefit from the cognitive abilities of their spouses through better self-care behaviors that are important for maintaining lower A1C across adulthood.
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Affiliation(s)
- Cynthia A. Berg
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT
| | | | - Nancy A. Allen
- College of Nursing, University of Utah, Salt Lake City, UT
| | | | - Ascher Munion
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Jonathan Butner
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Vicki S. Helgeson
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA
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17
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Helgeson VS, Horner FS, Naqvi JB. Partner Involvement in Type 2 Diabetes Self-Management: A Mixed-Methods Investigation. Diabetes Spectr 2022; 35:102-110. [PMID: 35308152 PMCID: PMC8914591 DOI: 10.2337/ds21-0034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Researchers have recognized the role of social environment in diabetes management, with substantial attention directed toward spouses or romantic partners of people with diabetes. However, the specific ways in which partners are involved have not been articulated. This study, which included 207 couples in which one person was recently diagnosed with type 2 diabetes, used a mixed-methods approach to assess types of partner involvement in diabetes management. First, different types of partner involvement were qualitatively identified from audio-recorded interviews, and links between qualitative findings and demographics were examined. Next, qualitative codes were compared with quantitative measures of partner involvement. Finally, relations of qualitative codes to relationship quality and diabetes outcomes were assessed. Qualitative analyses identified three ways in which partners were involved in diabetes management (support provision, collaboration, and controlling behavior) and two ways in which they were not involved (independent coping and disengagement on the part of the person with diabetes). Participants with diabetes perceived less partner involvement than their partners. Comparisons with quantitative measures revealed that collaboration was distinct from partner support. Reports from participants with diabetes of collaboration, but not partner support, were connected to higher relationship quality and lower A1C, whereas partner reports of collaboration were related to better self-care. Diabetes disengagement was associated with poorer relationship and behavioral outcomes. These findings underscore the varied ways in which partners are and are not involved in diabetes management and suggest that collaboration is more beneficial than social support in terms of relationship quality and diabetes outcomes.
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18
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Helgeson VS, Zajdel M, Tracy EL, Allen NA, Kent de Grey RG, Litchman ML, Berg CA. Observed dyadic collaboration among couples coping with type 1 diabetes. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2022; 36:147-152. [PMID: 33793274 PMCID: PMC8484364 DOI: 10.1037/fam0000763] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Previous research linking collaboration to relationship and health outcomes has relied almost exclusively on individual self-report and failed to take into consideration the dyadic nature of collaboration. We enrolled couples (n = 193) in which one person had Type 1 diabetes (52% female; 91% non-Hispanic white) into the study and asked them to discuss a diabetes-related issue of high concern for 8 min. These videotaped interactions were coded for dyadic collaboration. Mood was measured before and after the discussion. After the discussion, patients and partners reported support provided and received during the discussion. Results showed that observed dyadic collaboration was related to improvements in mood and greater support exchanges for both patients and partners when self-reported collaboration was statistically controlled. Gender moderated the effects on partners, such that benefits of dyadic collaboration were stronger for women than men. Future research may benefit from including collaborative elements into couple-focused interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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19
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Zajdel M, Helgeson VS, Butner JE, Tracy EL, Berg CA. A multimethod approach to measuring communal coping in adults with type 1 diabetes. Health Psychol 2022; 41:23-31. [PMID: 34968129 PMCID: PMC9798461 DOI: 10.1037/hea0001123] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Communal coping with a chronic illness has been associated with better health outcomes and includes two components: an individual's appraisal of the illness as shared and collaborative strategies to manage the illness. Although multiple methods have been used to assess these constructs, there is limited understanding of whether these methods tap similar components of communal coping. The study goals were to assess how individuals diagnosed with type 1 diabetes communally cope with their romantic partner using multiple methods to (a) distinguish between the two components of communal coping and (b) examine links of both components to health outcomes and test whether interactions between the two are linked to health outcomes. METHOD Individuals with type 1 diabetes (n = 199, 52% female, 90% non-Hispanic white) completed self-report, diary, observational, and open-ended interviews to measure communal coping. Psychological well-being, diabetes distress, and diabetes health outcomes were assessed. RESULTS A confirmatory factor analysis supported our hypothesis that communal coping is reflected by 2 distinct components: shared appraisal and collaborative coping. There were no direct effects of either shared appraisal or collaboration to outcomes, however, the interaction between shared appraisal and collaboration was linked to diabetes distress, self-care, and self-efficacy. Specifically, collaboration was linked to worse outcomes at low shared appraisal but not high shared appraisal. CONCLUSIONS These findings support the two components of communal coping and suggest that collaboration can be detrimental for health among those who do not view an illness as shared. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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20
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Allen NA, Litchman ML, Chamberlain J, Grigorian EG, Iacob E, Berg CA. Continuous Glucose Monitoring Data Sharing in Older Adults with Type 1 Diabetes: A feasibility study (Preprint). JMIR Diabetes 2021; 7:e35687. [PMID: 35293868 PMCID: PMC8968547 DOI: 10.2196/35687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/23/2022] [Accepted: 02/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background Family members or friends (care partners [CPs]) of older adults with type 1 diabetes (T1DM) regularly become part of the diabetes care team, but they often lack knowledge about how to become involved to prevent hypo- and hyperglycemia. Continuous glucose monitoring (CGM) allows a person with diabetes to see their glucose levels continuously and to receive predictive alerts. A smartphone data-sharing app called the Follow app allows the person with diabetes to share continuous glucose numbers with others and to receive predictive alerts of impending hypo- and hyperglycemia. However, there are barriers to sharing this continuous glucose level data with CPs. Objective This study aimed to address the barriers to sharing CGM data. Our objective was to examine the feasibility of using CGM with the Follow app and a data-sharing intervention called SHARE plus in older adults with T1DM and their CPs. SHARE plus includes dyadic communication strategies, problem-solving strategies, and action planning to facilitate CGM data sharing. Methods Older adults with T1DM (n=20) and their CPs (n=20) received the SHARE plus intervention at baseline. People with diabetes wore the CGM for 12 weeks while sharing their glucose data using the Follow app with CPs. Feasibility data were analyzed using descriptive statistics. Results The SHARE plus intervention was feasible and was associated with high self-reported satisfaction for people with diabetes and their CPs as well as high adherence to CGM (mean 96%, SD 6.8%). Broad improvements were shown in the diabetes-related quality of life through the use of CGM in people with diabetes and their CPs. Although the majority of people with diabetes (11/20, 55%) were willing to share hyperglycemia data, several chose not to. The majority of people with diabetes (14/20, 70%) were willing to talk about glucose numbers with a CP. Conclusions Older adults with T1DM and their CPs identified having someone else aware of glucose levels and working together with a partner on diabetes self-management as positive aspects of the use of the SHARE plus intervention. Clinicians can use these results to provide data sharing coaching in older adults and their CPs.
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Affiliation(s)
- Nancy A Allen
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | | | - James Chamberlain
- St Mark's Diabetes Center, St Mark's Hospital, Salt Lake City, UT, United States
| | - Ernest G Grigorian
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Eli Iacob
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Cynthia A Berg
- College of Social and Behavioral Science, University of Utah, Salt Lake City, UT, United States
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21
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Paschali A, Palli A, Thomadakis C, Karademas EC. The Interplay Between Individual and Dyadic/Common Coping in Female Patients With Cancer. EUROPEAN JOURNAL OF PSYCHOLOGY OPEN 2021. [DOI: 10.1024/2673-8627/a000012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abstract. Both individual and dyadic coping behaviors are important for adaptation to a severe illness. However, there is a theoretical controversy regarding the interplay between these two forms of coping. In this cross-sectional study, we examined (a) whether recently diagnosed cancer patients engage mostly with one form of coping or whether they use both in parallel; (b) the relationship of individual and supportive dyadic/common coping to emotional well-being and relationship satisfaction. Participants were 92 women recently diagnosed with cancer (mostly breast cancer) and receiving medical treatment ( Mage = 49.37 years; SD = 10.52). All had been living with their partner for at least 2 years. The parallel use of individual and supportive dyadic/common coping behaviors was frequently reported. Individual and dyadic/common coping proved to be related to each other ( p < .01), and both were related to emotional well-being and relationship satisfaction ( p < .05). The combination of high individual and high supportive dyadic/common coping was associated with greater satisfaction with the relationship ( p < .01). Patients probably use individual and dyadic coping behaviors in concert to better deal with the different aspects of their illness experience. Both types of coping should be considered in the context of personalized intervention programs to facilitate adaptation to cancer.
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Affiliation(s)
- Antonia Paschali
- Faculty of Nursing, National and Kapodistrian University of Athens, Greece
| | - Alexandra Palli
- Applied Psychology Laboratory, Department of Psychology, University of Crete, Rethymnon, Greece
| | - Christoforos Thomadakis
- Applied Psychology Laboratory, Department of Psychology, University of Crete, Rethymnon, Greece
| | - Evangelos C. Karademas
- Applied Psychology Laboratory, Department of Psychology, University of Crete, Rethymnon, Greece
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22
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Weitkamp K, Feger F, Landolt SA, Roth M, Bodenmann G. Dyadic Coping in Couples Facing Chronic Physical Illness: A Systematic Review. Front Psychol 2021; 12:722740. [PMID: 34759866 PMCID: PMC8573212 DOI: 10.3389/fpsyg.2021.722740] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/27/2021] [Indexed: 01/09/2023] Open
Abstract
Objective: Chronic physical illness affects not only patients but also their partners. Dyadic coping (DC)-the ways couples cope in dealing with a stressor such as chronic illness-has received increased attention over the last three decades. The aim of the current study was to summarize the state of research on DC in couples with chronic physical illnesses. Methods: We conducted a systematic review of qualitative, quantitative, and mixed-methods studies published between 1990 and 2020, assessing DC in couples affected by severe physical illnesses. We used DC and related search terms for the literature search in Psycinfo, Psyndex, and Medline. Five thousand three hundred thirty studies were identified in three electronic databases and 49 of these were included in the review (5,440 individuals reported on 2,820 dyads). We excluded studies on cancer, cardiovascular disease, and multiple sclerosis because of existing reviews in the respective fields. Half of the studies included were on diabetes. Other studies were on arthritis, chronic obstructive pulmonary disease (COPD), cystic fibrosis, human immunodeficiency virus (HIV), Huntington's disease, lupus erythematosus, Parkinson's disease, renal diseases, stroke, and endometriosis. Two raters extracted data using a predefined protocol, including study quality. Results were collated in a narrative synthesis organized by illness and DC operationalization. Results: Overall, DC was associated with beneficial outcomes in physical health, well-being, and relationship satisfaction. Differential effects became apparent for certain chronic conditions potentially depending on certain disease characteristics, such as early-onset, sudden-onset, or life-threatening conditions. Conclusion: Facing challenges together as a couple seemed indispensable for adapting to a diverse range of demands related to chronic illnesses with some specific demands of particular chronic diseases. There is a need for the development of truly dyadic interventions with an eye on the specific challenges of the various chronic conditions.
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Affiliation(s)
- Katharina Weitkamp
- Clinical Psychology Children/Adolescents and Couples/Families, University of Zurich, Zurich, Switzerland
| | - Fabienne Feger
- ZHAW Zurich University of Applied Science, Zurich, Switzerland
| | - Selina A Landolt
- Clinical Psychology Children/Adolescents and Couples/Families, University of Zurich, Zurich, Switzerland
| | - Michelle Roth
- Clinical Psychology Children/Adolescents and Couples/Families, University of Zurich, Zurich, Switzerland
| | - Guy Bodenmann
- Clinical Psychology Children/Adolescents and Couples/Families, University of Zurich, Zurich, Switzerland
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23
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Allen NA, Litchman ML, Neller S, Tracy EL, de Grey RGK, Grigorian E, Helgeson VS, Berg CA. Couples Managing Type 1 Diabetes Using Diabetes Technology. Diabetes Spectr 2021; 34:378-387. [PMID: 34866871 PMCID: PMC8603131 DOI: 10.2337/ds20-0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Diabetes technology has improved the lives of people with diabetes (PWD), but there is little research on how insulin pumps and continuous glucose monitoring (CGM) affect couples' relationships. The purpose of this study was to examine how the use of diabetes technology affects couple interactions. METHODS In a secondary data analysis, we used a multiple-method qualitative analysis, including a constant-comparison approach, to examine similarities and differences in couple interactions related to diabetes technology. PWD and their spouses were interviewed separately, using a semi-structured interview guide; the interviews primarily focused on how couples coped with type 1 diabetes. RESULTS Participants (n = 134 couples) were using an insulin pump or CGM system. Average age was 44 ± 12.05 years for PWD and 44 ± 12.62 years for spouses. Couples' average length of relationship was 18 ± 12.50 years. Among the PWD, 54 used a pump only, 12 used CGM only, and 68 used both. Four main themes emerged: 1) diabetes technology facilitates shared diabetes management for couples, 2) diabetes technology facilitates spousal involvement in diabetes care, 3) diabetes technology is a source of relationship tension, and 4) diabetes technology causes positive/negative responses to sleep and alarms. CONCLUSION Overall, couples perceived diabetes technology as having a positive effect on their relationship by increasing collaboration, promoting communication, and reducing diabetes burden and vigilance. Technology also was perceived to increase relationship tension, lifestyle inconveniences, and positive/negative responses regarding sleep and alarms. Involvement of spouses in diabetes technology education should be considered.
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Affiliation(s)
- Nancy A. Allen
- University of Utah College of Nursing, Salt Lake City, UT
- Corresponding author: Nancy A. Allen,
| | - Michelle L. Litchman
- University of Utah College of Nursing, Salt Lake City, UT
- Utah Diabetes and Endocrinology Center, Salt Lake City, UT
| | - Sarah Neller
- University of Utah College of Nursing, Salt Lake City, UT
| | - Eunjin L. Tracy
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | | | - Vicki S. Helgeson
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA
| | - Cynthia A. Berg
- Department of Psychology, University of Utah, Salt Lake City, UT
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24
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Mayberry LS, Greevy RA, Huang LC, Zhao S, Berg CA. Development of a Typology of Diabetes-Specific Family Functioning Among Adults With Type 2. Ann Behav Med 2021; 55:956-969. [PMID: 33761527 DOI: 10.1093/abm/kaab009] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Family members' responses to adults' diabetes and efforts to manage it vary widely. Multiple aspects of diabetes-specific family functioning have been identified as important for self-management and psychosocial well-being in theoretical (i.e., theories of social support and collaborative coping) and observational literature. PURPOSE Develop a typological framework of diabetes-specific family functioning and examine cross-sectional associations between type and diabetes outcomes. METHODS We used electronic health record (EHR) data to identify a cohort of 5,545 adults receiving outpatient care for type 2 diabetes and invited them to complete a survey assessing 10 dimensions of diabetes-specific family functioning. We used k-means cluster analysis to identify types. After type assignment, we used EHR data for the full cohort to generate sampling weights to correct for imbalance between participants and non-participants. We used weighted data to examine unadjusted associations between participant characteristics and type, and in regression models to examine associations between type and diabetes outcomes. Regression models were adjusted for sociodemographics, diabetes duration, and insulin status. RESULTS We identified and named four types: Collaborative and Helpful (33.8%), Satisfied with Low Involvement (22.2%), Want More Involvement (29.6%), and Critically Involved (14.5%; reflecting the highest levels of criticism and harmful involvement). Across these types, hemoglobin A1c, diabetes distress, depressive symptoms, diabetes medication adherence, and diabetes self-efficacy worsened. After covariate adjustment, type remained independently associated with each diabetes outcome (all p's < .05). CONCLUSIONS The typology extends theories of family support in diabetes and applications of the typology may lead to breakthroughs in intervention design, tailoring, and evaluation.
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Affiliation(s)
- Lindsay S Mayberry
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt Center for Diabetes Translation Research, Nashville, TN, USA
| | - Robert A Greevy
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Li-Ching Huang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.,Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Shilin Zhao
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.,Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Cynthia A Berg
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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25
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Tracy EL, Berg CA, Kelly CS, Kent de Grey RG, Litchman ML, Allen NA, Helgeson VS. Daily stress spillover and crossover in couples coping with type 1 diabetes. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2021; 35:618-627. [PMID: 33661686 PMCID: PMC8324044 DOI: 10.1037/fam0000819] [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] [Indexed: 05/15/2023]
Abstract
In the context of a chronic illness such as Type 1 diabetes (T1D), managing general stressors may be linked to diabetes-specific stressors for persons with T1D, an intraindividual contagion phenomenon (i.e., spillover). Among those with romantic partners, stress may also be associated with the partner's stress (i.e., crossover). These intraindividual and interpersonal processes may be further strengthened or weakened in the presence of individual (e.g., sleep satisfaction) and interpersonal (e.g., relationship satisfaction) factors. This study examined spillover and crossover effects between daily general and diabetes-specific stressors and whether sleep satisfaction and relationship satisfaction moderated spillover and crossover effects among couples in which one person had T1D. Persons with T1D (n = 199; Mage = 46.82, 52.3% female) and their romantic partners (n = 199; Mage = 46.41, 47.2% female) reported general stressors and sleep satisfaction, and persons with T1D reported diabetes-specific stressors on 14 consecutive days. Both couple members completed a survey that assessed relationship satisfaction. Multilevel models revealed significant within-person and between-person stress spillover and crossover effects. When examining the moderating role of sleep satisfaction, however, persons with T1D with better sleep satisfaction did not experience spillover between one domain and the other. Furthermore, partners with higher relationship satisfaction did not experience crossover between the persons with T1D-specific stressors and their general stressors. These findings support the conceptualization of the link between general and diabetes-specific stressors as both an intraindividual and a dyadic process among couples coping with T1D. In addition, better sleep satisfaction can prevent spillover effects, and relationship satisfaction can prevent stress crossover effects. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Eunjin Lee Tracy
- Department of Psychiatry, University of Pittsburgh School of Medicine
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26
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Helgeson VS, Naqvi JB, Seltman H, Vaughn AK, Korytkowski M, Hausmann LRM, Gary-Webb TL. Links of communal coping to relationship and psychological health in type 2 diabetes: actor-partner interdependence models involving role, sex, and race. Ann Behav Med 2021; 54:346-359. [PMID: 31773151 DOI: 10.1093/abm/kaz052] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Communal coping is one person's appraisal of a stressor as shared and collaboration with a partner to manage the problem. There is a burgeoning literature demonstrating the link of communal coping to good relationships and health among persons with chronic disease. PURPOSE We examined links of communal coping to relationship and psychological functioning among couples in which one person was recently diagnosed with type 2 diabetes. We distinguished effects of own communal coping from partner communal coping on both patient and spouse relationship and psychological functioning, as well as whether communal coping effects were moderated by role (patient, spouse), sex (male, female), and race (White, Black). METHODS Participants were 200 couples in which one person had been diagnosed with type 2 diabetes (46% Black, 45% female) within the last 5 years. Couples completed an in-person interview, participated in a discussion to address diabetes-related problems, and completed a postdiscussion questionnaire. RESULTS Own communal coping and partner communal coping were related to good relationship and psychological functioning. Interactions with role, sex, and race suggested: (i) partner communal coping is more beneficial for patients than spouses; (ii) own communal coping is more beneficial for men, whereas partner communal coping is more beneficial for women; and (iii) White patients and Black spouses benefit more from own communal coping than Black patients and White spouses. CONCLUSION These findings demonstrate the benefits of communal coping across an array of self-report and observed indices, but suggest there are differential benefits across role, sex, and race.
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Affiliation(s)
- Vicki S Helgeson
- Psychology Department, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Jeanean B Naqvi
- Psychology Department, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Howard Seltman
- Statistics Department, Carnegie Mellon University, Pittsburgh, PA, USA
| | | | - Mary Korytkowski
- Department of Medicine, Division of Endocrinology and Metabolism, University of Pittsburgh, Pittsburgh, PA, USA
| | - Leslie R M Hausmann
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.,Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tiffany L Gary-Webb
- Departments of Behavioral and Community Health Services and Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
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Lee AA, Heisler M, Trivedi R, Leukel P, Mor MK, Rosland AM. Autonomy support from informal health supporters: links with self-care activities, healthcare engagement, metabolic outcomes, and cardiac risk among Veterans with type 2 diabetes. J Behav Med 2021; 44:241-252. [PMID: 33247416 PMCID: PMC8744428 DOI: 10.1007/s10865-020-00196-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 11/11/2020] [Indexed: 12/01/2022]
Abstract
This study examined the role of autonomy support from adults' informal health supporters (family or friends) in diabetes-specific health behaviors and health outcomes. Using baseline data from 239 Veterans with type 2 diabetes at risk of complications enrolled in behavioral trial, we examined associations between autonomy support from a support person and that support person's co-residence with the participant's diabetes self-care activities, patient activation, cardiometabolic measures, and predicted risk of a cardiac event. Autonomy support from supporters was associated with significantly increased adherence to healthy lifestyle behaviors (diet, p < .001 and exercise, p = .003); higher patient activation (p < .001); greater patient efficacy in interacting with healthcare providers, and lower 5-year (p = .044) and 10-year (p = .027) predicted cardiac risk. Autonomy support was not significantly associated with diabetes-specific behaviors (checking blood glucose, foot care, or medication taking); or hemoglobin A1c, systolic blood pressure, or non-HDL cholesterol. There was a significant interaction of autonomy support and supporter residence in one model such that lack of autonomy support was associated with lower patient activation only among individuals with in-home supporters. No other interactions were significant. Findings suggest that autonomy support from family and friends may play a role in patient self-management, patient activation, and lower cardiac risk.
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Affiliation(s)
- Aaron A Lee
- Department of Psychology, University of Mississippi, 310C Peabody Hall, University, MS, 38677, USA.
| | - Michele Heisler
- VA Center for Clinical Management Research, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ranak Trivedi
- VA Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Division of Population Sciences and Public Mental Health, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Patric Leukel
- Department of Psychology, University of Mississippi, 310C Peabody Hall, University, MS, 38677, USA
| | - Maria K Mor
- VA Center for Health Equity Research and Promotion, Pittsburgh, PA, USA
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Ann-Marie Rosland
- VA Center for Health Equity Research and Promotion, Pittsburgh, PA, USA
- Department of Internal Medicine, University of Pittsburgh Medical School, Pittsburgh, PA, USA
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Karademas EC. A new perspective on dyadic regulation in chronic illness: the dyadic regulation connectivity model. Health Psychol Rev 2021; 16:1-21. [DOI: 10.1080/17437199.2021.1874471] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Krall J, Helgeson VS, Tracy EL, Campbell MS, Korytkowski M, Berg CA. Perspectives of Parents With Type 1 Diabetes: Role of Children in Self-Management and Support. DIABETES EDUCATOR 2020; 46:552-558. [PMID: 33063626 DOI: 10.1177/0145721720964598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE The purpose of this study was to examine parents' perceptions of the role children play in their type 1 diabetes (T1DM) care. Family members are a resource to support T1DM self-management, but how children are involved in their parents' diabetes has not been well explored. METHODS Parents with T1DM (n = 85) and a subset of their romantic partners (n = 55) participated in interviews during which they described their children's knowledge of and involvement in diabetes care. Interviews were transcribed, responses coded/tallied, and themes identified. RESULTS All parents reported that children knew of their diabetes, which they learned about progressively from a young age. Most parents reported children to be accepting and understanding of the ways that diabetes affected their family experiences (eg, pause to treat low blood glucose). When asked about specific support, parents rated "making parent feel better about diabetes" as the most frequently occurring behavior. Some parents felt that children, particularly younger ones, occasionally detracted from T1DM management, but this was usually expected and considered transient. Regardless of child age, many parents did not want diabetes to burden children and limited their involvement. Both parents with T1DM and partners requested resources to enhance child awareness and preparedness to support diabetes. Respondents, particularly partners, were also interested in learning how to communicate better as a family and share perspectives on how diabetes affects individual family members. CONCLUSIONS Diabetes care and education specialists should consider developmentally and relationally appropriate ways to engage children of parents with T1DM in education and self-management.
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Affiliation(s)
- Jodi Krall
- University of Pittsburgh Diabetes Institute, Pittsburgh, Pennsylvania
| | - Vicki S Helgeson
- Psychology Department, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Eunjin Lee Tracy
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Mary Korytkowski
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Cynthia A Berg
- Department of Psychology, University of Utah, Salt Lake City, Utah
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Zhang L, Zhang Z, Mei Y, Liu Q. Dyadic appraisals, dyadic coping, and mental health among couples coping with stroke: A longitudinal study protocol. J Adv Nurs 2020; 76:3164-3170. [PMID: 32857428 DOI: 10.1111/jan.14495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 06/26/2020] [Indexed: 11/26/2022]
Abstract
AIM The aim of this study is to describe a longitudinal research protocol for exploring the relationship of dyadic appraisal, dyadic coping (DC), and dyadic mental health among stroke survivors and their spouses and its action path. BACKGROUND Stroke can be considered as a dyad phenomenon which affects the mental health of both the survivors and their spouse caregivers. Studies based on dyadic theories are needed to examine the roles of dyadic appraisal and DC on the mental health of stroke dyads. DESIGN Longitudinal study. METHODS Stroke survivors and their spouse caregivers will be recruited from hospital, when the survivors are stable and about to discharge. Follow-up assessments will take place in 3, 6, 9, and 12 months after participants discharge. The structural equation modelling will be used for statistic analysing. DISCUSSION Our study seeks to expand the theory of Developmental-Contextual Model to examine the association among variables including dyadic appraisal, DC, and mental health for the couples coping with stroke.
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Affiliation(s)
- Leyun Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Zhenxiang Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Yongxia Mei
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Qingxuan Liu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
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Liao J, Wu X, Wang C, Xiao X, Cai Y, Wu M, Liu Y, Chen X, Wu S, Yang YJ, Xu DR. Couple-based collaborative management model of type 2 diabetes mellitus for community-dwelling older adults in China: protocol for a hybrid type 1 randomized controlled trial. BMC Geriatr 2020; 20:123. [PMID: 32228462 PMCID: PMC7106607 DOI: 10.1186/s12877-020-01528-5] [Citation(s) in RCA: 14] [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: 11/28/2019] [Accepted: 03/23/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND China's limited health care resources cannot meet the needs of chronic disease treatment and management of its rapid growing ageing population. The improvement and maintenance of patient's self-management is essential to disease management. Given disease management mainly occurs in the context of family, this study proposes to validate a Couple-based Collaborative Management Model of chronic diseases that integrates health professionals and family supporters; such as to empower the couples with disease management knowledge and skills, and to improve the couples' health and quality of life. METHODS The proposed study will validate a couple-based collaborative management model of Type 2 Diabetes Mellitus (T2DM) in a community-based multicenter, two-arm, randomized controlled trial of block design in Guangzhou, China. Specifically, 194 T2DM patients aged ≥55 and their partners recruited from community health care centers will be randomized at the patient level for each center at a 1:1 ratio into the couple-based intervention arm and the individual-based control arm. For the intervention arm, both the patients and their spouses will receive four-weekly structured group education & training sessions and 2 months of weekly tailored behavior change boosters; while these interventions will be only provided to the patients in the control group. Behavior change incentives will be targeted at the couples or only at the patient respectively. Treatment effects on patients' hemoglobin, spouses' quality of life, alongside couples' behavior outcomes will be compared between arms. Study implementation will be evaluated considering its Reach, Effectiveness, Adoption, Implementation and Maintenance following the RE-AIM framework. DISCUSSION This study will generate a model of effective collaboration between community health professionals and patients' family, which will shield light on chronic disease management strategy for the increasing ageing population. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR1900027137, Registered 1st Nov. 2019.
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Affiliation(s)
- Jing Liao
- Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China
- Sun Yat-sen Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, No.135 Xingang West Road, Guangzhou, 510275, P.R. China
| | - Xueji Wu
- Division of Primary Health Care, Guangzhou Center for Disease Control and Prevention, Guangzhou, P.R. China
| | - Caixuan Wang
- Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China
| | - Xiaochun Xiao
- School of Nursing, Sun Yat-sen University, Guangzhou, P.R. China
| | - Yiyuan Cai
- Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China
| | - Min Wu
- Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China
| | - Yuyang Liu
- Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China
| | - Xiongfei Chen
- Division of Primary Health Care, Guangzhou Center for Disease Control and Prevention, Guangzhou, P.R. China
| | - Shaolong Wu
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China
| | - Yung Jen Yang
- Taiwanese Society of Geriatric Psychiatry, Taiwan, China
| | - Dong Roman Xu
- Sun Yat-sen Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, No.135 Xingang West Road, Guangzhou, 510275, P.R. China.
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Adult attachment insecurity and associations with diabetes distress, daily stressful events and self-management in type 1 diabetes. J Behav Med 2019; 43:695-706. [PMID: 31641989 DOI: 10.1007/s10865-019-00111-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 10/05/2019] [Indexed: 10/25/2022]
Abstract
Anxious and avoidant attachment may be detrimental for diabetes distress and management. Additionally, individuals' perceptions of their partner's involvement may affect these associations. The study explored cross-sectionally and at the daily level whether anxious and avoidant attachment associated with diabetes distress or stressors and diabetes management, and whether higher perceived collaboration and support (C&S) moderated associations between attachment and diabetes management. Individuals with type 1 diabetes (N = 199; M age = 46.82; 52.3% women) completed measures of diabetes distress, diabetes-related C&S, self-care, average blood glucose (hemoglobin A1c), and attachment insecurity, and daily diary measures of diabetes-related C&S, diabetes stressors, mean blood glucose, and self-care. Higher anxious and avoidant attachment associated with higher diabetes distress. Higher anxious attachment associated with more daily stressors. Anxious attachment associated with lower self-care. C&S did not moderate any associations. Findings highlight the need to consider attachment when designing interventions to reduce diabetes-related distress.
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