The associations among illness perceptions, resilient coping, and medication adherence in young adult hypertensive black women

Illness perception and resilience in patients with cancer: a cross-sectional study

BACKGROUND

Cancer is the second leading cause of death after cardiovascular diseases and is considered a debilitating and incurable condition. Following diagnosis, individuals often experience anxiety, depression, and diminished social energy. Therefore, identifying factors that influence the psychological state of these patients and intervening to improve their well-being is crucial.

AIM

This study aims to examine the relationship between illness perception and resilience in cancer patients visiting healthcare centers.

METHODS

The study was conducted in a cross-sectional design, involving 262 cancer patients selected through stratified random sampling from two public and two private oncology treatment centers in Tabriz, Iran. Data were collected using a demographic checklist, the Connor-Davidson Resilience Scale (CD-RISC), and the Revised Illness Perception Questionnaire (IPQ-R). Data analysis was conducted using IBM SPSS Statistics (V.20) at a significance level of 0.05. Statistical methods included descriptive statistics, one-way ANOVA, t-test, Pearson correlation, and multiple linear regression to examine relationships between demographic variables, illness perception, and resilience.

RESULTS

The majority of participants in the study were male (74%), married (72%), suffering from gastrointestinal cancers (62%), with an average age of 40.9 (SD: 11.9) years. The average overall resilience score was 60.1 (SD: 16.6). Pearson correlation results showed a significant positive correlation between overall resilience and the subscales of illness identity (r = 0.26, p < 0.001), consequences of illness (r = 0.20, p < 0.001), personal control (r = 0.47, p < 0.001), treatment control (r = 0.61, p < 0.001), and time line cyclical (r = 0.33, p < 0.001). Linear regression analysis revealed that illness Identity (B = 0.94, CI [0.43, 1.44], p < 0.001), personal control (B = 1.75, CI [1.30, 2.21], p < 0.001), treatment control (B = 2.37, CI [1.87, 2.88], p < 0.001), and time line cyclical (B = 0.30, CI [0.40, 1.01], p = 0.04) significantly predicted resilience.

CONCLUSION

The findings suggest that improving patients' understanding and control over their illness may enhance their psychological resilience. These results highlight the importance of patient education and psychological interventions in cancer care, aimed at strengthening personal control and resilience. Integrating these strategies into standard care has the potential to improve patients' ability to cope with the psychological challenges of cancer and ultimately lead to an enhanced quality of life.

Illness perception and self-care in hypertension treatment: a scoping review of current literature

BACKGROUND

Self-care and self-perception of the disease are of fundamental importance in the management of systemic arterial hypertension. Therefore, the objective of this study is to identify identified how "illness perception and self-care" concepts are reported in scientific evidence regarding Systemic arterial hypertension treatment.

METHODS

A scoping review was systematically conducted following the methodological framework of the Joanna Briggs Institute's Manual for Evidence Synthesis (2020). A comprehensive search of a total of eight electronic databases and grey literature sources was performed. All studies addressing illness perception and/or self-perception, self-care activities and/or behaviors based on Medical subject headings (MeSH) were included. Full texts were assessed to map: (1) study characteristics: authors, publication year, country, aim, methods, sample size and intervention setting (assessment or intervention activities); (2) illness perception concepts (i.e.) and self-care behaviors (e.g. physical activity, diet, smoking cessation); (3) and authors' professional contribution to the publication.

RESULTS

Eight hundred ninety-two studies were identified, resulting in a sample of 39 after applying the inclusion criteria. Of these, there was a predominance of publications in the last 5 years, with the majority being developed in the United States and described as observational studies without any intervention and carrying out only one assessment. All participants were hypertensive, of both sexes, recruited mainly from the community. Antihypertensive medication and the individual's perception of the disease are the concepts most evaluated in the analyzed context. In no process involving the concepts of disease perception and self-care, it was possible to observe a predominance of nurse and doctor participation.

CONCLUSIONS

Self-care and self-perception are presented, in the scientific literature, as essential factors in the control of chronic diseases, mainly hypertension. These topics appear mainly in assessment instruments. Such concepts show domains of great importance for rehabilitation. Future research could investigate the psychometric properties of the different tools within the same sphere.

The role of depression and antidepressant treatment in antihypertensive medication adherence and persistence: Utilising electronic health record data

Higher blood pressure levels in patients with depression may be associated with lower adherence to antihypertensive medications (AHMs). Here, we use electronic health record (EHR) data from the Estonian Biobank (EstBB) to investigate the role of lifetime depression in AHM adherence and persistence. We also explore the relationship between antidepressant initiation and intraindividual change in AHM adherence among hypertension (HTN) patients with newly diagnosed depression. Diagnosis and pharmacy refill data were obtained from the National Health Insurance database. Adherence and persistence to AHMs were determined for hypertension (HTN) patients initiating treatment between 2009 and 2017 with a three-year follow-up period. Multivariable regression was used to explore the associations between depression and AHM adherence or persistence, adjusting for sociodemographic, genetic, and health-related factors. A linear mixed-effects model was used to estimate the effect of antidepressant treatment initiation on antihypertensive medication adherence, adjusting for age and sex. We identified 20,724 individuals with newly diagnosed HTN (6294 depression cases and 14,430 controls). Depression was associated with 6% lower probability of AHM adherence (OR = 0.943, 95%CI = 0.909-0.979) and 12% lower odds of AHM persistence (OR = 0.876, 95%CI = 0.821-0.936). Adjusting for sociodemographic, genetic, and health-related factors did not significantly influence these associations. AHM adherence increased 8% six months after initiating antidepressant therapy (N = 132; β = 0.078; 95%CI = 0.025-0.131). Based on the EHR data on EstBB participants, depression is associated with lower AHM adherence and persistence. Additionally, antidepressant therapy may help improve AHM adherence in patients with depression.

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).

Resilience among women with breast cancer surviving longer than five years: The relationship with illness perception and body image

PURPOSE

This study aimed to investigate the correlations and identify the relationships between the resilience, perception of illness and body image of women with breast cancer in the 5-year-or-above survivorship.

METHODS

We used convenient sampling to recruit from an outpatient department 106 women with breast cancer. The inclusion criteria were participants aged >20 years currently in a stable condition and were able to understand the Chinese language. Those women with mental health illness were excluded. All participants completed questionnaires on the following: demographic information, revision of illness perception (IPQ-R), body image scale (BIS), Eysenck personality questionnaire (EPQ), and resilience scale (RS). We conducted the structural equation modeling (SEM) to explore the factor structure.

RESULTS

SEM results showed a good fit to the data (comparative fit index = 0.97, Tucker-Lewis index = 0.94). Findings F indicated the existence of significant relationships between resilience and either illness perception or body image. Personality had a direct association with illness perception (β = 0.73, P < 0.05). Body image had an indirect effect on the relationship between resilience and illness perception (coefficient = -2.52; 95% bootstrapping CI = -31.36, -0.62).

CONCLUSIONS

Results indicated that illness perception is a crucial predictor for better resilience as mediated through body image. To provide adequate information to women with breast cancer can improve their perception of breast cancer more positively. Hence, their body image and their way of coping with survival life turn better.

Self-management and illness perception among cervical cancer patients: A cross-sectional study

AIM

This study aimed to describe self-management among cervical cancer patients and to elucidate the relationship between illness perception and self-management in patients with cervical cancer.

METHODS

This was a cross-sectional study. A convenience sample of 220 cervical cancer patients was recruited from the gynaecology outpatient department of a cancer hospital. Data were collected from September 2018 to February 2019. Self-management and illness perception were assessed using the Cancer Self-Management Assessment Scale and the Revised Illness Perception Questionnaire for cervical cancer, respectively. Data were analysed using Pearson correlation analysis, univariate analysis and hierarchical linear regression analysis.

RESULTS

The mean score of self-management was 3.87 ± 0.53, and daily life management showed the highest score (4.18 ± 0.58), while symptom management was the lowest (3.11 ± 082). Hierarchical linear regression analysis showed that family monthly income per person, types of surgery and personal control were factors that significantly influenced self-management.

CONCLUSIONS

The results demonstrate that self-management among patients with cervical cancer needs to be improved. The significant influence of illness perception offers an opportunity for nurses to improve self-management behaviours of patients with cervical cancer.

Experiences of stress among West Africa-born immigrant women with hypertension in Washington DC area

OBJECTIVE

To report a study that explored hypertension (HTN) stress and coping experiences of West-Africa-born immigrant (WABI) women in Washington DC Metropolitan area of the United States.

DESIGN AND SAMPLE

This qualitative study conducted from December 2017 to May 2018 involved WABI women (n = 15) in Washington Metropolitan area that self-reported diagnosis of HTN. The transactional model of stress and coping (TMSC) provided the conceptual framework. Data collection was through semi-structured one-on-one interviews.  Data analysis was done through manual open-hand coding of themes.

RESULTS

Three themes emerged from the analysis: Perceived Stressors, Sources of Stress, and Coping Measures. Participants perceived that their HTN diagnosis contributed to their stress; reported other financial, school, work, trauma, household and marriage-related stressors, and coping measures that include faith-based and other recreational leisure activities.

CONCLUSION

Participants mentioned stressors related to lack of support with domestic house chores and described various religious practices as coping strategies. These findings provide additional insights relevant to several ongoing public health nursing conversations on acute and chronic stress management in different parts of the globe. Public health nurses need to utilize these findings when assessing stressors and considering safe coping measures that appeal to WABI women experiencing HTN or chronic illness.

Relationship between resilience and self-care in people with chronic conditions: A systematic review and meta-analysis

BACKGROUND

Living with chronic condition(s) is difficult, due in part to the complexities of effective disease self-care. Self-care has been considered a challenging process according to the literature which describes multiple barriers patients with chronic conditions experience. Resilience has the potential to buffer the adversities of daily self-care and maintain physical and emotional well-being. No systematic review and meta-analysis have been conducted to synthesise and quantify the relationship between resilience and self-care across chronic conditions.

AIMS

(1) To examine how the definitions and measurements of self-care and resilience align with the middle-range theory of self-care of chronic illness (i.e. self-care maintenance, self-care monitoring, and self-care management) and 3 Rs of resilience process from the society-to-cells framework (i.e. resistance, recovery and rebound) across different chronic conditions; and (2) to examine whether and the degree to which resilience is correlated with self-care across different chronic conditions.

DESIGN

Systematic review and meta-analysis, following PRISMA guidelines.

METHODS

PubMed, CINAHL, SocINDEX and PsychINFO were searched for quantitative studies published from January 2000 through July 2020. Descriptive data were summarised using numerical counting to provide an overview of the study characteristics. Definitions and measurements of self-care and resilience were synthesised narratively based on self-care and resilience theories. Numerical data with Pearson's product-moment correlation among observational studies were examined using meta-analysis.

RESULTS

This review included 20 articles, involving 9,269 individuals across 11 chronic conditions. Despite self-care and resilience being defined and operationalised in a variety of ways, most definitions shared some underlying core constructs. Meta-analysis showed a positive relationship between resilience and self-care across chronic conditions. Findings from interventional studies indicated a bidirectional relationship between resilience and self-care.

CONCLUSIONS

Overall, resilience was positively associated with self-care in people with chronic conditions. Longitudinal and experimental studies are needed to better understand the causal relationship between resilience and self-care.

RELEVANT TO CLINICAL PRACTICE

Resilience has the potential to buffer the adversities of daily self-care and maintain physical and emotional well-being. The positive relationship between resilience and self-care found in this review provides preliminary evidence for clinicians to not only focus on reducing barriers and risk factors of self-care but also to improve or increase patients' resilience through various evidence-based interventions.

Heart in art: cardiovascular diseases in novels, films, and paintings

BACKGROUND

Understanding representations of disease in various art genres provides insights into how patients and health care providers view the diseases. It can also be used to enhance patient care and stimulate patient self-management.

METHODS

This paper reviews how cardiovascular diseases are represented in novels, films, and paintings: myocardial infarction, aneurysm, hypertension, stroke, heart transplantation, Marfan's disease, congestive heart failure. Various search systems and definitions were used to help identify sources of representations of different cardiovascular diseases. The representations of the different diseases were considered separately. The Common Sense Model was used a theoretical model to outline illness perceptions and self-management in the various identified novels, films, and paintings.

RESULTS

Myocardial infarction followed by stroke were the most frequently detailed diseases in all three art genres. This reflects their higher prevalence. Representations ranged from biomedical details through to social and psychological consequences of the diseases.

CONCLUSIONS

Artistic representations of cardiovascular diseases reflect cognitions, emotions, and images of prevalent disease. These representations shape views and behaviour of ill and healthy persons regarding heart diseases. As these representations are amenable to change, they deserve further research, which may be instrumental in improving the quality of life of persons struck by cardiovascular diseases. Changing illness perceptions appears to be a method to improve self-management and thereby quality of life in patients with various cardiovascular diseases.