Beliefs about medicines as mediators in medication adherence in type 2 diabetes

Illness beliefs relation to physical activity and quality of life in patients with peripheral arterial disease

Intermittent claudication is the most common symptom of Peripheral Arterial Disease (PAD) and is associated with decreased quality of life (QoL) due to walking impairment. The level of threat attributed to the disease affects QoL and physical activity. This study explores beliefs and illness drawings, and their relationship with quality of life and physical activity in patients undergoing conservative treatment for PAD. A cross-sectional study was carried out including 119 patients with PAD and Intermittent Claudication, in which patients were asked to freely draw their disease and 33 agreed to participate. The profile of beliefs about PAD is characterized by a low level of threat. Belief in the emotional impact of the disease, representations about the consequences and concern about the disease were associated with worse quality of life; the belief of having a high personal control over the disease was associated with more physical activity. The analysis of the disease drawings revealed three categories: extension of the disease (category 1), location and representations of the disease (category 2), and level of detail and complexity of the drawings (category 3). Greater disease extent was associated with more disease symptoms (IPQ 6) (rs = 0.399, p = .021). It is necessary to address beliefs and representations about the disease in consultations with patients with PAD. Patient drawings are a useful, practical, and free tool that does not require a lot of time and can facilitate the approach of health professionals to patient training and education.

Illness perception and treatment adherence in haemodialysis: a systematic review

Patients with kidney failure need lifelong renal replacement therapy to survive and, worldwide, in-centre haemodialysis is the most common modality. The efficacy of this treatment largely depends on the patients' adherence to several health behaviours. According to Leventhal's self-regulation model, patients' illness perceptions can be a key factor for treatment adherence. Therefore, it is of utmost importance to better understand this relationship to further fine-tune the effectiveness of renal rehabilitation programs. This study aimed to systematically review the literature on the association between illness perceptions and treatment adherence in adults undergoing in-centre haemodialysis. The search was performed on PubMed, Scopus, CINAHL, Web of Science (all databases included), and ProQuest (all databases included), from the 17th to the 21st of December 2020. The last update was performed on the 9th of June of 2022. Articles were critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklists for Analytical Cross-Sectional Studies. Nine studies were included comprising a total of 1161 patients undergoing in-centre haemodialysis. Associations between illness perceptions and treatment adherence were found in six studies. Adherence to dietary restrictions was the type of adherence with more significant associations with illness perceptions, followed by fluid control and medication intake. Two studies combining several types of adherences into an overall score also showed significant associations with illness perceptions. No significant associations were found between illness perceptions and adherence to dialysis sessions. These findings suggest that illness perceptions in patients undergoing in-centre haemodialysis should continue to receive research attention. Future interventions should acknowledge the importance of modifying maladaptive illness perceptions to improve treatment adherence in kidney failure. The protocol for this systematic review was registered on PROSPERO (CRD42021231929).

The role of illness representations of internet gaming disorder (IGD) in help-seeking intention among undergraduates: A longitudinal study

BACKGROUND AND AIMS

The Common-Sense Model asserts that illness representations of a health threat affect coping and behavioral reactions to it. Internet gaming disorder (IGD) is a newly defined mental disorder and leads to various health consequences. Little is known about illness representations of IGD and help-seeking for IGD among young adults who are at particular risk of IGD.

OBJECTIVE

This study investigated the roles of illness representations in intention to seek help from professionals and important others (families and friends) for IGD in college students in China.

METHODS

A two-wave longitudinal study was conducted with a convenience sample of college students in China (N = 591, 57.9% females, Mean_age = 19.10). Descriptive analyses and logistic regression analyses were conducted.

RESULTS

Approximately 10% of participants were classified as having probable IGD. However, over 70% endorsed self-diagnosed IGD. Less than 40% perceived resources of help-seeking, and most perceived shame for help-seeking. Less than 40% intended to seek help from professionals, and 26% from family and friends. Significant predictors of intention to seek professional help included probable IGD, perceived resources of help-seeking for IGD, consequence, timeline, and treatment. Significant predictors of intention to seek help from family and friends included probable IGD, self-diagnosed IGD, perceived resources of help-seeking for IGD, shame for help-seeking for IGD, timeline, treatment control, identity, concern, and emotional response. Females were more likely to seek both types of help.

DISCUSSION AND CONCLUSIONS

Perceptions of IGD and help-seeking play significant roles in help-seeking intentions. These modifiable factors can be used to guide the development of health promotion and behavioral change programs to promote help-seeking for IGD.

Relationship Between Illness Representations and Symptoms of Internet Gaming Disorder Among Young People: Cross-Lagged Model

BACKGROUND

The common-sense model of illness suggests that mental representations of health threats may affect one's behavioral reactions to them and health status. Internet gaming disorder is a newly defined mental disorder. Illness representations of internet gaming disorder may affect one's risk of internet gaming disorder. In turn, symptoms of internet gaming disorder may affect one's perceptions of the disorder.

OBJECTIVE

This study aimed to investigate the relationships between illness representations and symptoms of internet gaming disorder in college students.

METHODS

A 1-year longitudinal study was conducted with a convenience sample of Chinese college students (n=591; 342/591, 57.9% female).

RESULTS

Of the participants, 10.1% (60/591) and 9.1% (54/591) were classified as having probable internet gaming disorder at baseline (T1) and follow-up (T2), respectively. The correlations between some dimensions of illness representations regarding internet gaming disorder (ie, consequence, timeline, personal control, treatment control, and concern) at T1 and symptoms of internet gaming disorder at T2 and between symptoms of internet gaming disorder at T1 and the dimensions of illness representations at T2 (ie, consequence, timeline, personal control, and emotional response) were statistically significant. The cross-lagged model fit the data well ((χ2/df=2.28, comparative fit index=.95, root mean square error of approximation=.06) and showed that internet gaming disorder at T1 was positively associated with unfavorable illness representations at T2.

CONCLUSIONS

Individuals with more severe symptoms of internet gaming disorder had more pessimistic perceptions about the disorder. Such cognitive perceptions may affect one's emotional and behavioral reactions towards the disorder (eg, greater levels of depression and low self-control intention) and should be modified by educational programs and psychological interventions.

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.

The Consequences of General Medication Beliefs Measured by the Beliefs about Medicine Questionnaire on Medication Adherence: A Systematic Review

(1) Background: Medication adherence is a key determinant of patient health outcomes in chronic illnesses. However, adherence to long-term therapy remains poor. General beliefs about medicine are considered factors influencing medication adherence. It is essential to address the gap in the literature regarding understanding the impact of general beliefs about medicine on medication adherence to promote adherence in chronic illnesses. (2) Methods: PubMed, CINHAL, and EMBASE databases were searched. Studies were included if they examined medication beliefs using the Beliefs about Medicine Questionnaire in one of four chronic illnesses: hypertension, diabetes, chronic obstructive pulmonary disease, and/or asthma. (3) Results: From 1799 articles obtained by the search, only 11 met the inclusion criteria. Hypertension and diabetes represented 91% of included studies, while asthma represented 9%. Higher medication adherence was associated with negative general medication beliefs; 65% of the included studies found a negative association between harm beliefs and adherence, while 30% of studies found a negative association with overuse beliefs. (4) Conclusions: This review evaluated the impact of harm and overuse beliefs about medicines on medication adherence, highlighting the gap in literature regarding the impact of harm and overuse beliefs on adherence. Further research is needed to fully identify the association between general beliefs and medication adherence in people with different cultural backgrounds, and to explore these beliefs in patients diagnosed with chronic illnesses, particularly asthma and chronic obstructive pulmonary disease (COPD). Healthcare providers need to be aware of the impact of patients’ cultural backgrounds on general medication beliefs and adherence.

The association between frailty and medication adherence among community-dwelling older adults with chronic diseases: Medication beliefs acting as mediators

OBJECTIVE

To explore the association between frailty and medication adherence by modeling medication beliefs (i.e., necessity and concerns) as mediators among community-dwelling older patients.

METHODS

This cross-sectional study was conducted among 780 Chinese older patients. Frailty, medication adherence and medication beliefs were assessed using the Comprehensive Frailty Assessment Instrument (CFAI), the 4-item Morisky Medication Adherence Scale (MMAS-4) and the Beliefs about Medicines Questionnaire-Specific (BMQ-Specific), respectively. The PROCESS SPSS Macro version 2.16.3, model 4 was used to test the significance of the indirect effects.

RESULTS

Frailty was associated with high medication necessity (β = 0.091, p = 0.011) and high medication concerns (β = 0.297, p < 0.001). Medication adherence was positively associated with medication necessity (β = 0.129, p = 0.001), and negatively associated with medication concerns (β = -0.203, p < 0.001). Medication necessity and medication concerns attenuated the total effect of frailty on medication adherence by -13.6% and 70.3%, respectively CONCLUSION: High medication concerns among frail older patients inhibit their medication adherence, which cannot be offset by the positive effect of their high medication necessity on medication adherence.

PRACTICE IMPLICATIONS

Interventions should target medication beliefs among frail older patients, particularly medication concerns, to efficiently improve their medication adherence.