Objective Versus Subjective Ratings of Asthma Severity: Differential Predictors of Illness Uncertainty and Psychological Distress in College Students With Asthma

Uncertainty and Perceived Control as Predictors of Communicative Participation and Mental Health in Adults Who Stutter

PURPOSE

This study examined the role of uncertainty and perceived control in predicting the communicative participation and mental health of adults who stutter.

METHOD

Two hundred sixty-nine adults who stutter completed measures of uncertainty about stuttering, perceived control of stuttering, communicative participation, and global mental health. In addition, participants self-reported on a variety of demographic and speech-related measures. Correlational analyses and hierarchical regression were performed to determine associations between variables of interest.

RESULTS

Uncertainty accounted for significant variance in communicative participation and global mental health after statistically controlling for the effects of demographic and speech-related variables. Perceived control accounted for significant variance in communicative participation over and above what was accounted for by demographic variables, speech-related variables, and uncertainty.

CONCLUSIONS

The findings suggest that uncertainty about stuttering and perceived control of stuttering should be accounted for during assessment and intervention with adults who stutter. Interventions that specifically target uncertainty and perceived control may be useful in improving therapeutic outcomes for individuals who stutter.

Parent-child conflict and physical health trajectories among youth with asthma

OBJECTIVE

To investigate the role of caregiver- and youth-reports of parent-child conflict on trajectories of asthma-related health outcomes over 2 years.

METHODS

In a sample of 193 youth with asthma (42.7% female; M age = 12.78) and their primary caregivers, we used a multi-method and multi-informant approach to assess self-reported parent-child conflict from youth and caregivers at both the daily and global levels at baseline. Next, we annually assessed subjective (i.e., youth self-reported asthma symptoms) and clinical (i.e., peak flow) asthma health outcomes for 2 years.

RESULTS

Latent growth curve models revealed an effect of baseline youth-reported global family conflict on peak flow trajectories such that youth who reported greater parent-child conflict at baseline experienced less of an increase in peak flow over time than youth who reported less parent-child conflict at baseline (standardized β = -0.27, p = .003).

CONCLUSIONS

Youth with asthma who perceive greater overall conflict with their caregivers experience less improvement in peak flow as they age. The research and clinical implications of these findings are discussed.

Predictors of uncertainty in parents of children living with chronic conditions

BACKGROUND

Uncertainty in illness implies no meaning has been attributed to an illness event. Although many studies focus on this issue in adults, there is limited research into children with chronic illnesses. Parental uncertainty has been associated with increased risk of post-traumatic stress, which can in turn adversely affect child and parent coping strategies.

AIM

To identify the characteristics of parents who are at greater risk of uncertainty and the associated characteristics of their children's chronic illnesses.

METHOD

An exploratory, cross-sectional study design was adopted across three different sites in the United Arab Emirates. Data were collected from parents who accompanied their children, who were receiving treatment, using a validated, culturally adapted Parent Perception of Uncertainty Scale.

RESULTS

Scores for illness uncertainty ranged from 86.5 to 92.6, on a scale of 31-155, with higher scores indicating greater uncertainty. The highest scores were found in parents of children being cared for in ward settings who had previously been hospitalised, parents of children up to two years of age or those approaching adolescence, fathers, and parents whose first language was Arabic.

CONCLUSION

The groups of parents with the highest illness uncertainty may benefit most from interventions to improve communication and psychological support.

Incertidumbre ante la enfermedad crónica. Revisión integrativa

Este estudio tiene como objetivo integrar la evidencia acerca de la incertidumbre ante la enfermedad en el paciente con enfermedad crónica y su cuidador familiar, guiados por la teoría de la incertidumbre ante la enfermedad. Para esto se realizó una síntesis integrativa de la literatura durante los años 2007 a 2017. Se usaron las bases de datos Medline, Science Direct, Ovid Nursing, Scielo, Scopus, CINAHL y Psycinfo en los idiomas inglés y español. Para realizar la síntesis integrativa se incluyeron 46 publicaciones, con 21 estudios de tipo cualitativo, 19 cuantitativo, 2 mixtos y 4 revisiones. Los estudios se realizaron en su mayoría en pacientes con cáncer, enfermedades neurodegenerativas, fallos orgánicos, falla cardiaca, EPOC y en cuidados paliativos de distintas enfermedades. Dentro de las principales conclusiones del estudio se plantea que la persona con enfermedad crónica y su cuidador familiar desarrollan incertidumbre ante la enfermedad crónica debido a falencias en la educación acerca de la enfermedad y el cuidado, así como el soporte social que reciben del equipo de salud y de sus redes de apoyo.

Evaluating the Reliability and Validity of the Arabic Version of the Parents Perceptions of Uncertainty Scale (A-PPUS)

BACKGROUND

Uncertainty often accompanies illness and may be a major aversive component of the patients' treatment process. There is evidence that parental uncertainty has a negative impact on their own and on their child's coping strategies and may affect family functioning. Key to the provision of competent care, to address uncertainty, is the use of an appropriate validated assessment tool to understand key parental concerns. The 'Parent Perception of Uncertainty Scale' (PPUS) has been widely used for this purpose.

AIM

This study reports on the validity and reliability testing of the Arabic version of the Parents Perception of Uncertainty Scale (A-PPUS).

METHODS

The scale was translated to Arabic using the translation-back-translation method. Appropriate statistical tests were performed including measurements of internal consistency, item to total scale correlation, and univariate and multivariate analyses.

RESULTS

The study included 240 parents of children with chronic illnesses. Cronbach's alpha coefficient of the whole scale was 0.93. All the items were positively correlated to the total score. The univariate and multivariate analysis supported the previous tests and the assertion that the Arabic version of the PPUS provided a relevant measure of the uncertainty level.

CONCLUSION

This study has identified that the A-PPUS is a reliable tool for parent report of their uncertainty, in the UAE and Arabic population.

Meta-Analysis: Caregiver and Youth Uncertainty in Pediatric Chronic Illness

Objective

To conduct a systematic review on the construct of illness uncertainty in caregivers and youth as related to the following: demographic and illness variables, psychological functioning, illness-related distress, and reaction/coping style.

Methods

A meta-analysis was conducted with articles assessing the associations between illness uncertainty and variables of interest that were published between November 1983 and June 2016 ( n = 58).

Results

Psychological functioning and illness-related distress had primarily medium effect sizes. Demographic and illness variables had small effect sizes. More positive and fewer negative reaction/coping styles were associated with less illness uncertainty, with primarily small effects.

Conclusions

Illness uncertainty may be an important factor that influences psychological functioning and distress and coping in the context of pediatric chronic illness. However, additional research is needed to determine more precise mean effect sizes, as well as the potential efficacy of intervention to address uncertainty. adolescents, children, chronic illness, coping skills and adjustment, meta-analysis, parents, psychosocial functioning.

Alexithymia and posttraumatic stress disorder following asthma attack

This study examined the levels of posttraumatic stress disorder (PTSD) following asthma attack (post-asthma attack PTSD) and psychiatric co-morbidity among college students. It also investigated the association between these variables and alexithymia. One hundred and six college students participated in the study and completed an on-line survey comprising the Asthma Symptom Checklist, PTSD Checklist, General Health Questionnaire-28 and Toronto Alexithymia Scale. Ninety-one students without asthma and major illness formed the control group. 2 % met the diagnostic criteria for full-PTSD, while 42 and 56 % met the partial and no-PTSD criteria respectively. Compared with the control, the asthma group reported significantly more somatic problems, social dysfunction and depression and was five times more likely to have an elevated risk of developing a general psychiatric disorder. After adjusting age, marital status, asthma experience and symptoms, alexithymia did not predict PTSD, while difficulty identifying feelings predicted psychiatric co-morbidity. Mediational analyses showed that asthma symptoms partially mediated the link between difficulty identifying feelings and psychiatric co-morbidity. People can develop PTSD symptoms and other psychological difficulties following asthma attack. Alexithymia influenced general psychological difficulties independently of PTSD symptoms.

Posttraumatic stress disorder following asthma attack (post-asthma attack PTSD) and psychiatric co-morbidity: the impact of alexithymia and coping

This study investigated the prevalence of post-asthma attack posttraumatic stress disorder (PTSD) and the severity of psychiatric co-morbidity among a group of college students and whether alexithymia and coping strategies would relate to health outcomes. This is a cross-sectional study in which 156 college students who had previously experienced asthma attack were recruited. They completed a demographic page, Asthma Symptom Checklist, PTSD Checklist, General Health Questionnaire-28, Toronto Alexithymia Scale and the COPE. They were also matched with 141 students without asthma. The results showed that 3% met the criteria for full-PTSD, 44% for partial and 53% for no-PTSD. There were no significant differences between the asthma and control groups in severity of psychiatric co-morbid symptoms. Path analyses showed that asthma severity was significantly correlated with PTSD and psychiatric co-morbidity. It was also correlated with alexithymia which was in turn associated with psychiatric co-morbidity but not PTSD. Coping strategies were not correlated with health outcomes. To conclude, people can develop PTSD symptoms and degrees of psychiatric co-morbid symptoms after suffering asthma attack. The severity of these symptoms relates to people's perceptions of asthma severity and alexithymia.