The role of religious coping and social support on medication adherence and quality of life among the elderly with type 2 diabetes

The Effect of Biopsychosocial-Spiritual Factors on Medication Adherence in Chronic Diseases in Turkey Using Structural Equation Modeling

This study was to examine the factors associated with medication adherence in individuals with chronic diseases within the concept of the biopsychosocial-spiritual model. A cross-sectional study design was used. A total of 837 patients diagnosed with chronic diseases were included in this study between November 2022 and December 2023. Data were collected based on the biopsychosocial-spiritual model. Medication adherence level was evaluated with the "Medication Adherence Report Scale." "Hospital Anxiety Depression Scale," "Multidimensional Perceived Social Support Scale," and "Spiritual Well-Being Scale" were used to evaluate the psychological, social, and spiritual dimensions. Data were analyzed using descriptive statistics and a multiple linear regression model. Anxiety, social support status, and spiritual status were important correlates of medication adherence levels in individuals with chronic diseases. It was determined that variables such as age, gender, and number of chronic diseases did not affect medication adherence. Medication adherence in individuals with chronic diseases is significantly associated with psychological, social, and spiritual factors. Therefore, when evaluating medication adherence, it should not be forgotten that it is a multifaceted concept and individuals should also be evaluated from psychological, social, and spiritual perspectives.

The Combined Effect of Multisensory Stimulation and Therapist Support on Physical and Mental Health of Older Adults Living in Nursing Homes: Pilot Randomized Controlled Trial

BACKGROUND

Increasing life expectancy has led to a rise in nursing home admissions, a context in which older adults often experience chronic physical and mental health conditions, chronic pain, and reduced well-being. Nonpharmacological approaches are especially important for managing older adults' chronic pain, mental health conditions (such as anxiety and depression), and overall well-being, including sensory stimulation (SS) and therapist support (TS). However, the combined effects of SS and TS have not been investigated.

OBJECTIVE

This randomized controlled trial examines the specific and combined effects of brief SS and TS interventions on older adults' physical and mental health and pain intensity levels, among individuals living in nursing homes.

METHODS

A total of 96 patients aged 65-99 years from a nursing home were randomly assigned to 3 groups: SS, TS, and combined SS+TS interventions, each delivered as four 20-minute sessions. SS was implemented using a multisensory Snoezelen room. Pain intensity levels (per a Visual Analog Scale), blood pressure, heart rate, blood oxygen saturation, and hand grip strength (using a Jamar hand dynamometer) were measured before and after each of the 4 weekly therapeutic sessions. In addition, life satisfaction (per the Satisfaction with Life Scale) and anxiety (per the 7-item General Anxiety Disorder Scale) were evaluated before and after the whole intervention. Mixed model analyses tested the relative efficacy of the 3 interventions, applying simple slope analysis with Tukey correction. Study rationale and analytical plans were preregistered.

RESULTS

The combined intervention of SS and TS (SS+TS) resulted in reduced pain levels compared with SS (B=0.209, P=.006) and TS alone (B=0.23, P=.002) over 4 sessions (F6,266=2.62; P=.017; R2=0.23). Further, the combined SS+TS intervention resulted in reduced systolic blood pressure versus SS (B=0.09, P=.01) and TS alone (B=0.016, P<.001) groups (F6,272=5.42; P<.001; R2=0.29). In addition, the combined SS+TS intervention resulted in an increased grip strength versus SS (B=-0.35, P=.003) and TS alone (B=-0.032, P=.008) groups (F6,273=2.25; P=.04; R2=0.19). Moreover, combined SS+TS resulted in an improvement in life satisfaction (B=-4.29, P<.0001) compared with SS (B=-2.38, P=.0042) and TS alone (B=-1.20, P=.13) groups (F2,39=3.47; P=.04). Finally, SS+TS demonstrated greater improvement in symptoms of general anxiety disorder (B=10.64, P<.0001) compared with SS (B=3.30 P=.01) and TS alone (B=1.13, P=.37) (F2,38=13.5; P<.001) groups. No differences between the interventions were shown for blood oxygen saturation (F6,273=2.06; P=.06), diastolic blood pressure (F6,272=1.12; P=.35), and heart rate (F6,273=1.33; P=.23).

CONCLUSIONS

The combined intervention of SS and TS showed therapeutic benefits for pain management and physical and mental health of older adults living in nursing homes, relative to each therapeutic component in isolation. This brief intervention can be readily implemented to improve well-being and optimize therapeutic resources in nursing home settings.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05394389; https://clinicaltrials.gov/ct2/show/NCT05394389.

Early Predictors of Quality of Life among Patients with Type 2 Diabetes Mellitus in Southern Jordan

Background

Type 2 Diabetes Mellitus is highly prevalent worldwide and especially in Jordan, presenting a significant challenge in mitigating its associated complications, thereby emphasizing the need for effective management strategies.

Aim

The aim of the study was to investigate early predictors of quality of life (QOL) among patients with Type 2 Diabetes Mellitus in Southern Jordan, focusing on examining the relationships and associations between diabetes self-efficacy, glycemic control, and diabetes self-care with QOL.

Methodology

The study adopted a cross-sectional approach conducted within Southern Jordan, employing a convenience sampling method. Participants were chosen based on their availability and willingness to take part. The study encompassed a sample size of 204 patients diagnosed with type 2 diabetes. The study utilized the Diabetes Self-Management Questionnaire and the Diabetes Management Self-Efficacy Scale to assess diabetic patients' self-care levels and self-efficacy, respectively. Data collection spanned from 1 February to 15 May 2023.

Results

Patients demonstrated suboptimal self-care and low self-efficacy. Significant positive correlations were found between QOL dimensions, self-management, and self-efficacy. Predictors for Type 2 Diabetes Miletus (T2DM) patients' QOL were identified. For physical health, factors such as gender, comorbidities, age, occupation, location, self-care behaviors, and self-efficacy influenced QOL. Similar predictors were found for psychological, social, and environmental health dimensions, including gender, comorbidities, HbA1c levels, city of residence, marital status, and income, as well as self-care behaviors and self-efficacy.

Conclusions

The study findings underscore the importance of targeted interventions to improve the QOL for individuals with T2DMin Southern Jordan.

The potential role of religiosity, psychological immunity, gender, and age group in predicting the psychological well-being of diabetic patients in Saudi Arabia within the Bayesian framework

This study aimed to investigate the differences in Religiosity (R), Mental Immunity (MI), and Psychological Well-Being (PWB) in patients with diabetes due to gender and age group variables, and to detect the best predictors of PWB in diabetic patients within the Bayesian framework. The study was conducted from May 2022 to February 2023 on a random sample of 186 Saudis diagnosed with diabetes. After obtaining participants' consent, they completed three R, MI, and PWB scales. Bayesian Independent Samples t-test was performed to identify differences, and Bayesian linear regression analysis was used to reveal the best prediction model of PWB. The results of the Bayesian independent samples t-test indicated strong evidence supporting the alternative hypothesis H1, suggesting differences between male and female diabetic patients in R, MI, and PWB, with Bayesian factor values exceeding 10 (8.338×10+23, 1.762×10+25, and 1.866×10+24), and Cohen's δ of (-1.866, -1.934, -1.884). These results indicated that females with diabetes have higher means of R, MI, and PWB compared to males. However, the results also suggested evidence for the null hypothesis H0 of no differences in R, MI, and PWB among diabetic patients due to age group, with Bayesian factor values (0.176, 0.181, and 0.187) less than 1.00 and small Cohen's δ of (-0.034, -0.050, -0.063). Bayesian linear regression analysis detected strong evidence that the model including MI is the best predictive model (BF10 for mental immunity is 1.00 and for the other two models are 0.07 and 4.249×10-16) for the PWB of diabetic patients, however, there is no evidence that the model including R or the interaction between R and MI is the best predictor of PWB for diabetic patients. These findings highlight the need for direct psychological care services for male diabetic patients and the urgent need to enhance IM in diabetic patients to improve their PWB. Furthermore, results recommended that healthcare providers in Saudi Arabia integrate MI interventions into diabetes care programs.

Death Obsession, COVID-19-Related Fear and Religiosity in People Living with Type 2 Diabetes

Patients diagnosed with type 2 diabetes were included among high-risk groups for more severe manifestations in case of COVID-19 infection and higher risk of mortality. The current study aims to (1) examine the relationship between death obsession, religiosity, and fear of COVID-19 among type 2 diabetes patients, and (2) assess if religiosity moderates the relationship between death obsession and fear of COVID-19. This cross-sectional online survey involved 306 type 2 diabetes patients. We found that 35.6 % of the participants were overweight and 14.6 % were suffering from obesity. Results showed that death obsession was positively associated with fear of COVID-19 and more religious individuals experience higher levels of fear. The overall level of religiosity did not moderate the relationship between death obsession and fear of COVID-19 but only the preoccupation with God dimension of the religiosity scale. The practical implications of these findings are discussed.

Psychosocial Facilitators and Barriers to Type 2 Diabetes Management in Adults: A Meta-Synthesis

BACKGROUND

Globally, the cases of type 2 diabetes are increasing, and this is largely attributed to lifestyle changes. Though diabetes is primarily a metabolic disease determined by biological factors, psychosocial aspects play a crucial role in its progression and management. However, the literature on psychosocial dimensions of diabetes management is minuscule and scattered.

OBJECTIVE

This synthesis sought to understand the psychosocial facilitators and barriers to type 2 diabetes management and coping among adults.

METHODS

We have adopted a meta-synthesis to review available qualitative studies using Pub- Med and Scopus databases. Based on inclusion criteria, we have chosen 24 studies published between 2010 and 2023. We have considered studies across countries, among which 63% of the studies included were from Western countries, and most have employed qualitative descriptive design. The selected studies were analyzed thematically using a deductive framework.

RESULTS

Six themes emerged as the psychosocial barriers and facilitators of managing and coping with type 2 diabetes: 1) cognitive-emotional factors, 2) faith, 3) constraints to behavioural change, 4) social constraints and support, 5) healthcare provider-patient relationship, and 6) awareness. Further, a conceptual framework was developed from the synthesis.

CONCLUSION

The patients' experiences evident from this synthesis signify the crucial role of psychosocial factors in diabetes management and coping. This evidence emphasizes the need for integrated care so that psychosocial aspects are addressed by healthcare providers and behavioural health professionals, which may lead to the promotion of facilitators and the minimization of barriers.

Behavioral and Psychological Factors in Buffering Diabetes-related Disability Development

BACKGROUND

Diabetes is associated with disability development. Healthy behaviors and psychosocial support can help patients manage their disease.

PURPOSE

To examine the role of various behavioral and psychological factors in buffering the effect of diabetes on disability development over time in Taiwanese adults.

METHODS

Data on 5,131 adults aged ≥50 years were obtained from the Taiwan Longitudinal Study on Aging. A cohort sequential multilevel design was employed to analyze the association between behavioral and psychosocial factors and the risk of disability over a 11-year period.

RESULTS

In patients with diabetes, having social support and exercising more than six times a week were associated with 4% and 49% reductions in the risk of disability, respectively (βdiabetes*socialsupport = -0.285, p = .006; βdiabetes*exercise3 = -2.612, p = .007). Exercising more than six times a week had an additional significant protective effect against disability development per year (βdiabetes*exercises3*age = -0.241, p = .038). Depression did not significantly interact with diabetes. However, a trajectory analysis revealed that individuals who had both diabetes and depression had the highest disability score from middle age among all participants.

CONCLUSIONS

Engaging in frequent exercise is the most influential factor for reducing the risk of disability in patients with diabetes. Social support provides an additional benefit for disability prevention in individuals with diabetes.

Effect of a religious coping intervention of rational emotive behavior therapy on mental health of adult learners with type II diabetes

BACKGROUND

Some previous studies have highlighted the high rate of mental health problems associated with type II diabetes (T2DM). The primary purpose of this study was to investigate the effect of a religious coping intervention of rational emotive behavior therapy (REBT) on the mental health of adult learners with T2DM.

METHODS

This study utilized a randomized controlled trial to select 146 adult learners with T2DM and mental health-related problems. The treatment group was made up of 73 adult learners, while the control group was also made up of 73 adult learners. The experimental group received 8 sessions of a religious coping intervention of REBT, while the control group received usual care. Data were collected using the patient health questionnaire, Warwick-Edinburgh mental well-being scale, and Kessler psychological distress scale. Repeated ANOVA and univariate analysis of covariance were used for data analyses.

RESULTS

The religious coping intervention of REBT substantially enhanced the mental health of adult learners with T2DM as measured by Warwick-Edinburgh mental well-being scale (P < .000) and patient health questionnaire (P < .000). The religious coping intervention of REBT significantly alleviated the psychological distress of adult learners with T2DM as measured by Kessler psychological distress scale (P < .000).

CONCLUSION

In this study, it has been demonstrated that a religious coping intervention of REBT effectively improves the mental health of adult learners with T2DM. The study concludes that the religious coping intervention of REBT is a practical alternative medicine approach to enhancing the mental health of adult learners with T2DM.

Quality of life and mental health measurements among patients with type 2 diabetes mellitus: a systematic review

BACKGROUND

Over the past few decades the benefits of assessing Quality of Life (QoL) and mental health in patients with Type 2 Diabetes Mellitus (T2DM) have steadily increased with limited studies relating to the most useful method to assess these patients. This study aims to identify, review, summarise, and evaluate the methodological quality for the most validated commonly used health-related QoL and mental health assessment measurements in diabetic patients.

METHODS

All original articles published on PubMed, MedLine, OVID, The Cochrane Register, Web of Science Conference Proceedings and Scopus databases were systematically reviewed between 2011 and 2022. A search strategy was developed for each database using all possible combinations of the following keywords: "type 2 diabetes mellitus", "quality of life", mental health", and "questionnaires". Studies conducted on patients with T2DM of ≥ 18 years with or without other clinical illnesses were included. Articles designed as a literature or systematic review conducted on either children or adolescents, healthy adults and/or with a small sample size were excluded.

RESULTS

A total of 489 articles were identified in all of the electronic medical databases. Of these articles, 40 were shown to meet our eligibility criteria to be included in this systematic review. Approximately, 60% of these studies were cross-sectional, 22.5% were clinical trials, and 17.5% of cohort studies. The top commonly used QoL measurements are the SF-12 identified in 19 studies, the SF-36, included in 16 studies, and the EuroQoL EQ-5D, found in 8 studies. Fifteen (37.5%) studies used only one questionnaire, while the remaining reviewed (62.5%) used more than one questionnaire. Finally, the majority (90%) of studies reported using self-administered questionnaires and only 4 used interviewer mode of administration.

CONCLUSION

Our evidence highlights that the commonly used questionnaire to evaluate the QoL and mental health is the SF-12 followed by SF-36. Both of these questionnaires are validated, reliable and supported in different languages. Moreover, using single or combined questionnaires as well as the mode of administration depends on the clinical research question and aim of the study.

Relationship Between Attachment and Fear of Death: The Mediating Role of Religious Coping

In this research, the link between attachment, religious coping, and fear of death were examined in a sample of 224 Turkish Muslim adults. Data were gathered by Experiences in Close Relationship Scale, Religious Coping Scale, and Multidimensional Mortality Awareness Measure. Positive religious coping was adversely related to avoidant and anxious attachments. When compared to anxious attachment, which was positively related to both negative religious coping and fear of death, avoidant attachment was not correlated with any of these variables. Fear of death correlated positively with negative religious coping. Furthermore, the link between anxious attachment and fear of death was partially mediated by negative religious coping. Findings imply that negative religious coping is important in the relationship between fear of death and anxious attachment.

Predicting Factors of Health-Related Quality of Life Among Adults With Type 2 Diabetes: A Systematic Review

Introduction

One of the most important outcomes of diabetes care and treatment is an improvement in patients' health-related quality of life (HRQoL).

Objective

This study aimed to review the empirical evidence regarding the predictors of HRQoL among adults with type 2 diabetes mellitus (T2DM).

Methods

To find all English-language articles published between 2012 and 2022, a comprehensive literature search was conducted using ProQuest, Scopus, PubMed, Science Direct, and CORE. Cross-sectional studies were the focus of this analysis. Search terms included "type 2 diabetes" OR "T2DM" AND "health-related quality of life" OR "HRQoL" AND ("predicting factors" OR "influencing factors" OR "associated factors"). The original search yielded a total of 1,089 studies, from which 35 met the review's inclusion criteria. The systematic review protocol was registered with PROSPERO CRD42023431229.

Results

The final analysis comprised 24,346 people with type 2 diabetes and used data from 35 cross-sectional studies conducted during the preceding decade. Socio-demographic factors (age, marital status, gender, monthly income, education, area of residence, and religiosity), patient-centered factors (diabetes knowledge and self-efficacy), disease characteristics (comorbidities, duration of diabetes, and insulin treatment), self-management behaviors (physical activity, medication adherence, and frequent glucose checks), and family support were found to be predictors of HRQoL.

Conclusion

A diabetes program to enhance the HRQoL among people with T2DM is highly encouraged to address these factors, which can be focused on promoting self-management behaviors, diabetes distress management, and encourage family support.

Potential influences of religiosity and religious coping strategies on people with diabetes

Diabetes is a significant health issue that threatens patients’ overall wellbeing and quality of life. Critical public health concerns center on creating the best approach for diabetes management. Patients and caregivers have different approaches to diabetes management; however, this and the associated physiological, physical and mental health issues remain challenging. This review explores the potential influences of religiosity and religious coping strategies on people with diabetes. This study used a literature review approach to investigate how religiosity and religious coping strategies can influence the effective management of diabetes among patients. Based on the literature search, the researchers were able to identify and cite published papers that were analyzed using the descriptive-narrative analysis. An important goal of the descriptive-narrative analysis was to provide descriptions of the selected literature and take implications from the literature. The results of studies reviewed show some religious coping strategies for managing chronic diseases such as diabetes. The studies did establish a relationship between religiosity and diabetes management and suggest that religious coping strategies could positively impact the management of diabetes; however, they reported some adverse effects. Hence, we propose a pathway for the development of religion-oriented interventions and support framework for the management of diabetes.

A scoping review of spirituality and religiosity in people who have had a kidney transplant

AIM

To conduct a scoping review to discover what is known about the presence of spirituality and religiosity in people who have received a kidney transplant.

DESIGN

Using Arksey and O'Malley's five-stage framework, a scoping review of seven key databases was performed in June 2020. The scoping review follows the PRISMA extension for scoping review process.

METHODS

CINAHL, MEDLINE, Embase, OvidPsychINFO, JBI, Scopus and Cochrane databases were searched to identify original research, from which seven studies were identified with only four meeting the criteria. The search strategy focused on studies that were published between January 2000-May 2020.

RESULTS

In synthesizing the available research, two key areas of interest were identified within the included studies, (1) clinical outcomes (medical adherence, renal function and transplant-related outcomes) and (2) well-being outcomes (locus of control and coping).

Quality of Life and Health-related Quality of Life in Patients with End-stage Kidney Disease Undergoing Hemodialysis: A Literature Review

Measurements of quality are intended to drive improvements in care and provide accountability regarding costs and quality. Quality of life (QoL) and health-related QoL (HRQoL) comprise personal perceptions, health, and socioenvironmental dimensions. This structured integrative review aimed to present and analyze the nature and significance of the predictors of QoL and HRQoL in patients with end-stage kidney disease (ESKD). The articles found through searching the main databases were assessed for sample size, design, and methodological limitations. The revised Wilson-Cleary conceptual framework of HRQoL and the World Health Organization's definition of QoL guided this review. Forty-five articles were selected (36 were observational or cross-sectional studies; nine were prospective). These articles reported a range of factors related to QoL and HRQoL characterized as physical, mental, socioeconomic, biological, and symptomatic. Few studies considered spiritual beliefs and cultural beliefs. There was a lack of consistency in the use of measures of QoL and HRQoL in ESKD. The most validated measures of HRQoL and QoL identified were the Short-Form 36 v2, the QoL Index - Dialysis, the Hospital, Anxiety, and Depression Scale, the Fatigue Severity Scale, the Itch Scale, the Spiritual Well-being Scale, and the Schedule for the Evaluation of QoL - Direct Weighting. Most studies were conducted in developed countries, with only two from the Middle East. The possible measures of QoL and HRQoL are health status, disease-specific, symptom-specific, spiritual, and individualized QoL measures. This set of measures is expected to capture the patients' own perceptions concerning their QoL and HRQoL.

Psychometric properties of the Indonesia version religious health fatalism questionnaire in diabetic foot ulcer outpatients

Background:

Religious health fatalism belief that health outcome is only determined by God without seeking treatment. Tools are needed to measure fatalism among patients with chronic disease, especially diabetic foot ulcer (DFU) patients. The aim of this study was to conduct psychometric test of religious health fatalism questionnaire (RHFQ) including translation, validation, reliability, and cut-off point among DFU out-patients.

Design and methods:

This study employed cross sectional design, using self-report questionnaire. Data were collected from diabetes clinic in five hospitals, Indonesia. The inclusion criteria were patients who had history of DFU more than 2 years. Total sample in this study was 184 patients. This study was conducted from April to June 2021. Permission to use the RHFQ was permitted by the original author. We conducted translation and adaptation questionnaire to Bahasa. We employed reliability test with internal consistency, construct validity, and convergent validity. Construct validity was evaluated using exploratory factor analysis (EFA). Cut-off point RHS was analyzed using receiver operating characteristic (ROC). ROC was evaluated using correlation score between total score RHFQ and CDRISC-25 Indonesia version. Previous study mentioned that resilience is a predictor of religious. The Cronbach’s alpha for RHFQ Indonesia version was adequate.

Results:

EFA showed adequate with Kaiser–Meyer-Olkin (KMO) value of 0.72 and the Bartlett’s test of sphericity was significant. According to ROC curve analysis, the cut-off point at a score 67.5 indicated the best sensitivity and specificity.

Conclusions:

RHFQ Indonesia version had reliability and validity for screening religious health fatalism among DFU outpatients.

Fear of COVID-19 and religious coping mediate the associations between religiosity and distress among older adults

Background: A mediation model was proposed to explain how religiosity, religious coping, and fear of coronavirus disease 2019 (COVID-19) explained anxiety and depression among older adults.

Methods: With the use of a cross-sectional design, the Integrated Health System was used to randomly invite 1000 older adults residing in Qazvin to participate in an online survey. Within the period of November 2020 to January 2021, 696 older Iranian adults (mean age=69.56years; 57.9% women) agreed to participate in the study and reported demographic information as well as measures of religiosity, fear of COVID-19, religious coping, anxiety, and depression.

Results: Religiosity had direct effects on depression (B [SE]=-0.087 [0.037]; P=0.023) but not anxiety (B [SE]=-0.063 [0.036]; P=0.072). Moreover, both fear of COVID-19 and religious coping significantly mediated the association between religiosity and anxiety (B [SE]=-0.360[0.035]; p=0.002) and that between religiosity and depression (B [SE]=-0.365 [0.034];P=0.002).

Conclusion: During the tough time of COVID-19 pandemic, religiosity and religious coping were protectors for older adults in developing good mental. Therefore, future research is needed to examine education programs that are effective for older adults to obtain correct knowledge concerning COVID-19, including the protective COVID-19 infection behaviors. Therefore, older adults may reduce their fear via their enhanced correct knowledge concerning COVID-19.

Psychosocial Determinants of Treatment Adherence in Patients with Type 2 Diabetes - A Review

Less than 50% of patients with diabetes achieve the glycaemic goals recommended by the American Diabetes Association. The set of factors associated with adherence to treatment is very broad. Evidence suggests that psychosocial factors are related to medication adherence of patients with type 2 diabetes. Due to the lack of a clear statement from researchers regarding the relationship of psychosocial factors to adherence, an electronic search was conducted in PubMed, MEDLINE, Academic Search Ultimate, CINAHL Complete, Edition and Health Source: Nursing/Academic Edition using the following keywords "adherence", "diabetes", "social support", "stress", "anxiety and depression", "beliefs about medicine", "communication", "older age", "frailty", "cognitive impairment", "addiction", "acceptance of illness", "sense of coherence" obtaining 2758 results. After a narrowing of searches and reference scanning, 36 studies were qualified. The studies analysed showed negative effects of anxiety, diabetes distress, older age, poor communication with physicians, stress, concerns about medicines and cognitive impairment on levels of self-care and medication adherence. One study did not confirm the association of depression with adherence. Self-efficacy, social and family support, and acceptance of illness had a beneficial effect on medication adherence. In conclusion, the current evidence suggests that the relationship between psychosocial factors and adherence has reliable scientific support.

Diabetes distress and peripheral neuropathy are associated with medication non-adherence in individuals with type 2 diabetes in primary care

BACKGROUND

Psychosocial factors like diabetes distress and social support, as well as the presence of complications, affect an individual's self-management ability; however, their role in adherence behaviours is not yet clear. We examined the role of psychosocial factors and complications in non-adherence behaviours in individuals with diabetes in primary care.

METHODS

Baseline survey with nine-month follow up through medical records of patients with type 2 diabetes attending primary care. Medication adherence and diabetes distress were assessed using Morisky Green Levine Medication Adherence Scale and Problem Areas in Diabetes, respectively. Appointment adherence was assessed through medical records.

RESULTS

Of the 448 participants studied, 59.8% had medication non-adherence and 21.7% were non-adherent to scheduled appointments. PAID score (odds ratio (OR) 1.01, 95% confidence interval 1.00-1.03, p = 0.013), peripheral neuropathy (OR 1.99, 95%CI 1.18-3.37, p = 0.01), home glucose monitoring (OR 0.46, 95%CI 0.30-0.69, p < 0.001), HbA1c (OR 1.34, 95%CI 1.13-1.61, p = 0.001), and age (OR 0.96, 95%CI 0.93-0.98, p = 0.001) were associated with medication non-adherence. Indian ethnicity (OR 2.93, 95%CI 1.59-5.39, p = 0.001), secondary or higher education (OR 1.94, 95%CI 1.14-3.27, p = 0.014), and HbA1c (OR 1.38, 95%CI 1.18-1.63, p < 0.001) were associated with appointment non-adherence.

CONCLUSIONS

Non-adherence behaviours were prevalent and significantly associated with higher HbA1c. Medication non-adherence was more likely in younger individuals, those with higher diabetes distress or peripheral neuropathy. Appointment non-adherence was more likely in individuals of Indian ethnicity or those with higher education. Greater support for these groups may help improve adherence behaviours and outcomes.

Relationships of Family Emotional Support and Negative Family Interactions with the Quality of Life among Chinese People with Mental Illness and the Mediating Effect of Internalized Stigma

This study aimed to investigate the relationships of family emotional support and negative family interactions with the quality of life among Chinese people with mental illness. Furthermore, it examined the mediating role of internalized stigma in these relationships. One hundred and twenty-five Chinese adults with mental illness were recruited from community mental health service centers in Hong Kong. The results show that both family emotional support and negative family interactions were related to the quality of life. Negative family interactions had a stronger effect on the quality of life compared to family emotional support. Internalized stigma partially mediated the relationship between negative family interactions and the quality of life. These findings suggest that, for Chinese people with mental illness, interventions aimed at promoting quality of life should consider enhancing family emotional support and reducing negative family interactions. In addition, mental health service providers could consider using family approaches to address internalized stigma in the effort of improving the quality of life for their service users.

The Dark and the Light Side of the Expatriate’s Cross-Cultural Adjustment: A Novel Framework Including Perceived Organizational Support, Work Related Stress and Innovation

The new context of the Psychology of Sustainability and Sustainable Development has reached the attention of the scientific community in recent years, due to its comprehensive approach aimed at enhancing the sustainability of interpersonal and intrapersonal talent, as well as of groups and communities. In this scenario, research on employee cross-cultural adjustment (CCA) is considered a key theme in human resource management. It is known that psychological support in the host country may alleviate distress and facilitate the integration of the expatriate workers. However, there is a lack of research investigating expatriate adjustment as an antecedent of the perceived organizational support. The aim of the study was to investigate the relationship among cross-cultural adjustment (CCA), perception of organizational support (POS), work-related stress (WRS), and innovation, considering these factors as a part of a unique innovative framework. A cross sectional study was performed using a sample of 234 expatriate workers of a multinational organization. Data were collected through a monitoring survey for the assessment of work-related stress risk factors of their expatriate staff. The results showed a positive correlation between CCA, POS, and innovation. On the other hand, a negative correlational effect of CCA and WRS, CCA and POS on WRS, and POS and WRS was found. Finally, POS was found to be a significant antecedent of CCA. These findings have implications for both international human resource management researchers and practitioners.

Health-related quality of life in older Chinese patients with diabetes

BACKGROUND

Although older diabetes patients with unique characteristics should be cared carefully to improve their health-related quality of life (HRQOL), the association between diabetes and HRQOL remain unclear, especially in Asians. We aimed to compare the HRQOL between older Chinese patients with type 2 diabetes (T2D) and their age-gender-matched controls.

METHODS

Older patients with T2D were recruited from a community hospital in Suzhou located in the east part of China while controls were selected from a community-based health survey of older adults aged 60 years or older. HRQOL of cases and controls was assessed by the EQ-5D-3L. The impact of T2D on HRQOL was investigated using a liner regression model and the relationship between T2D and EQ-5D health problems was evaluated using logistic regression models.

RESULTS

A total of 220 cases and 440 controls were included. The mean age of the participants was 68.8 years and women accounted for 69.1% of the study sample. The EQ-5D-3L index score was lower for older people with T2D (0.886) than their controls (0.955). After multivariable adjustment, the difference in ED-5D-3L index score between older people with and without T2D was 0.072. In logistic regression analyses, T2D was positively associated with reporting of problems in mobility (odds ratio [OR] = 5.00); pain/discomfort (OR = 1.66), and anxiety/depression (OR = 3.2).

CONCLUSIONS

T2D has a detrimental effect on HRQOL of older Chinese people.

Illness perception and sense of well-being in breast cancer patients

PURPOSE

The objective of the study was to explore breast cancer patients' illness perception, its relationship to perceived sense of well-being, and the role of perceived social support.

METHODS

Women with diagnosed breast cancer were recruited from the two university hospitals in South Korea between January and April 2018. The questionnaires included the Illness Perception Questionnaire-Revised (IPQ-R) and the Functional Assessment of Cancer Therapy for Breast cancer (FACT-B). A total of 321 participants' data was analyzed using descriptive analyses, multiple regression, and structural equation modeling.

RESULTS

Negative illness perception was greater in participants currently receiving chemotherapy (p=0.044) or had received chemotherapy in the past (p=0.006). Positive illness perception was lower in older participants (p=0.001) or those who had received chemotherapy (p=0.018). Negative illness perception had a direct effect on a low sense of well-being (p<0.001). Perceived social support had a significant mediation effect on the relationship between negative/positive illness perception and sense of well-being (p<0.001).

CONCLUSION

Significant relationships between illness perception and sense of well-being were observed in breast cancer patients. Strengthening patients' perceived social support would be helpful in improving their sense of well-being.