Mediating effect of self-efficacy on the relationship between social support and self-management behaviors among patients with knee osteoarthritis: a cross-sectional study

Social support and psychological distress of patients with pituitary adenomas: chain-mediated effects of self-efficacy and rumination

Introduction

Psychological distress in patients with pituitary adenomas affects their quality of life and is influenced by various aspects such as sociocultural factors, personal resources, and stressors. Therefore, the aim of this study was to investigate the chain-mediated role of self-efficacy and rumination in the relationship between social support and psychological distress.

Methods

The study was based on the Wilson-Cleary model of health-related quality of life and self-efficacy theory. We investigated 500 patients with surgically treated pituitary adenomas in three tertiary hospitals in Shaanxi Province, China. We used the "Social Support" and "General Self-Efficacy" scales, "Rumination Scale," and the "Psychological Distress in Patients with Pituitary Adenomas" questionnaire to conduct the survey, and the data were analyzed using structural equation modeling and bootstrap methods to examine the relationships between the variables.

Results

The results showed that there was a significant positive correlation between social support and self-efficacy, social support and self-efficacy negatively predicted rumination and psychological distress, respectively. Rumination significant positive correlation with psychological distress, and social support, indirectly affected psychological distress through the chain-mediated effect of self-efficacy and rumination. This represents a compound multiple mediating effect on psychological distress.

Discussion

Clinical practitioners should enhance social support for patients with pituitary adenomas, improve patients' self-efficacy, and mitigate rumination to reduce patients' psychological distress.

Feeding tube self-management experience of patients at home after discharge following esophageal cancer surgery

BACKGROUND

Esophageal cancer (EC) is an aggressive malignancy with low survival (10%-30%). Nutritional problems are present throughout the perioperative period and are key to prognosis. Home enteral nutrition appears to improve the nutritional status of patients with EC. Few studies have addressed the experience of patients administering their own nutritional fluids and managing their own feeding tubes at home. The aim of this study was to explore the real-life experience of self-management of feeding tubes in patients at home after EC surgery in the first 3 months after discharge following surgery.

AIM

To explore feeding tube self-management experience of patients at home 3 months after discharge following EC surgery.

METHODS

Face-to-face semi-structured interviews were conducted with 18 patients using a feeding tube at home after EC surgery. Thematic analysis of the recordings identified themes related to feeding tube self-management.

RESULTS

Patients expressed similar feelings about their tube management experiences concerning three contextualized themes: Self-management dilemmas, distressing experiences, and self-management facilitators.

CONCLUSION

There are many dilemmas and problems in self-managing feeding tubes in postoperative homebound patients with EC. Clinical staff should provide guidance to promote a positive change in self-management behavior.

Trajectories and Influencing Factors of Self-Management Behaviour in Patients With Knee Osteoarthritis: A Longitudinal Study

AIM

To explore the trajectory of self-management behaviour and its influencing factors in patients with knee osteoarthritis.

DESIGN

This is a prospective, longitudinal observational study.

METHODS

From January 2024 to April 2024, 126 patients with knee osteoarthritis who were hospitalized in two tertiary-level hospitals in Hunan Province were selected to be surveyed on the day of discharge, 1 month after discharge and 3 months after discharge using the Chinese version of the Chronic Disease Self-Management Research Measurement Scale. The trajectories of self-management behaviours were performed using latent category growth analysis. The influencing factors were performed using Lasso regression.

RESULTS

Two classes were identified, including 'slow decline class' (37.1%) and 'significant decline class' (62.9%). Age, education, history of knee surgery and number of other chronic diseases combined were significant factors. Finally, older patients were more likely to be in the 'significant decline group' and patients with a history of knee surgery were more likely to be in the 'slow decline group'.

CONCLUSION

We reported the existence of heterogeneity in self-management trajectories in patients with KOA and found that younger age and history of knee surgery were significantly associated with slow decline class trajectories. Further studies are needed to test the generalizability of these identified self-management trajectories in patients with KOA and their association with psychosocial aspects.

IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE

To identify the trajectory of self-management behaviours of patients with KOA and explore their influencing factors, to provide reference for healthcare professionals to formulate targeted intervention programmes, so as to prevent the recurrence of knee osteoarthritis and delay the course of the disease.

REPORTING METHOD

STROBE checklist was followed.

PATIENT OR PUBLIC CONTRIBUTION

The authors would specially thank all the participants in this study.

Exploring the role of the built environment and psychosocial mediators on knee function in knee osteoarthritis patients in Singapore: a cross-sectional study

OBJECTIVES

(1) To examine if a more accessible built environment (BE) is significantly associated with better knee function outcomes in knee osteoarthritis (OA) patients. (2) To assess if the relationship between BE and knee function is mediated by fear of movement and self-efficacy.

DESIGN

Cross-sectional study.

SETTING

Two tertiary hospitals in Singapore.

PARTICIPANTS

212 knee OA patients (mean: 63.81±8.27 years old), majority female (69.8%).

INCLUSION CRITERIA

(i) meets National Institute for Health and Care Excellence criteria for knee OA, (ii) independent community ambulant.

EXCLUSION CRITERIA

(i) alternative diagnosis to knee OA, (ii) secondary osteoarthritis, (iii) severe medical and/or cognitive comorbidity impairing activities of daily living, (iv) previous knee arthroplasty, (v) wheelchair bound, or (vi) pregnant. PRIMARY AND SECONDARY OUTCOME MEASURES; STATISTICS: How self-efficacy (Arthritis Self-Efficacy Scale-8 (ASES-8)) and fear of movement (Brief Fear of Movement (BFOM)) mediates impact of overall BE (IPAQ-Environment module: Access to Destinations) and five item-specific domains of BE accessibility on knee function (Knee Injury and Osteoarthritis Outcome Score-12 (KOOS-12)). For variables significantly correlated with BE and KOOS-12 in bivariate Pearson correlation tests, mediation analysis was performed with confounders adjusted.

RESULTS

Total BE (r=0.142, p=0.038) and accessibility to transit station (r=0.161, p=0.019) were positively correlated with KOOS-12. Structural barriers (r=-0.138, p=0.045) were negatively correlated with KOOS-12. ASES-8 was a significant mediator in the relationship between accessibility to transit station and KOOS-12 (coeff=0.87, 95% CI=(0.24, 1.69), p=0.005) and between total BE and KOOS-12 (coeff=0.25, 95% CI=(0.10, 0.45), p=0.004). BFOM was a marginally significant mediator between structural barriers and KOOS-12 (coeff=-0.36, 95% CI=(-0.86, -0.02); p=0.054).

CONCLUSION

More accessible BE and lesser structural barriers in the BE are associated with better knee function. Self-efficacy mediates the relationship between overall BE accessibility and knee function. Fear of movement mediates the negative association between barriers in the BE and knee function.Applications include assessing BE barriers and psychosocial mediators in clinician consultations, developing multidisciplinary integrated care models and urban designers planning mobility friendly BEs.

TRIAL REGISTRATION NUMBER

The study has been registered under clinicaltrials.gov registry (Identifier: NCT04942236).

Mediation effect of illness acceptance between perceived social support and self-management behaviors in rural elderly with coronary heart disease

OBJECTIVE

To explore the relationship between perceived social support, acceptance of illness, and self-management behaviors and the mediating role of acceptance of illness in perceived social support and self-management behaviors.

METHODS

Between August 2022 and February 2023, 731 rural older adults with coronary heart disease in Feicheng City participated in this study. Correlation analysis was used to analyze the relationship between variables, and mediating effects were analyzed using AMOS 23.0 software.

RESULTS

Perceived social support and acceptance of illness were positively correlated with self-management behaviors. Acceptance of illness mediated the relationship between the perceived social support and the three dimensions of self-management behavior.

CONCLUSION

These findings contribute to the understanding that increased perceived social support and acceptance of illness are more likely to improve self-management behaviors.

How social support influences learned helplessness in lung cancer patients: the chain mediation role of individual resilience and self-efficacy

Background

Social support, which is a crucial external resource for cancer patients, was demonstrated to be a positive predictor of learned helplessness (LH). But it is far from clear whether and how social support decreases the LH in cancer patients. The purpose of present study is to detect the association between social support and LH and the role of individual resilience and self-efficacy in mediating this relationship.

Methods

The convenience sampling method was utilized. From August 2022 to February 2024, a total of 537 lung cancer patients (M age = 60.25 years, SDage = 9.85 years) from five tertiary hospitals in one municipalities (Chongqing), and two provinces (Sichuan and Yunnan) were recruited, among which 389 were males and 148 were females. LH, social support, individual resilience, and self-efficacy were assessed by using standard scales. A structural equation model was constructed employing AMOS 23.0 to examine the interrelationships among social support, individual resilience, self-efficacy, and LH of lung cancer patients.

Results

A total of 537 lung cancer patients were finally included. Social support, individual resilience, and self-efficacy were positively related to LH (r = -0.299 to -0.451, p < 0.01). The mediation model revealed that the direct effect of social support on LH was significant (β = -0.407, p < 0.001). Besides, social support could also affect LH through three pathways: (1) the mediating effect of individual resilience (β = -0.075, p < 0.001); (2) the mediating effect of self-efficacy (β = -0.060, p < 0.05); (3) the chain mediating effect of individual resilience and self-efficacy (β = -0.011, p < 0.05).

Conclusion

The results indicate that social support alleviates lung cancer patients' LH, and that individual resilience and self-efficacy mediate the correlation between social support and LH. Besides providing adequate social support, intervention strategies built on individual resilience and self-efficacy should be applied to reduce LH in lung cancer patients.

Longitudinal relationship between social participation, depressive symptoms, and activity impairment among older patients with arthritis: a moderated mediation analysis

BACKGROUND

Arthritis primarily affects older people and is a prominent cause of their activity impairment. This study aimed to examine the mediating role of depressive symptoms in the relationship between social participation and activity impairment, as well as to determine whether sex moderated the mediating effect.

METHODS

A total of 2247 older patients with arthritis were included from the China Health and Retirement Longitudinal Study between 2015 and 2018. We first examined a simple mediation model where depressive symptoms were a mediator between social participation and activity impairment. Furthermore, sex was systematically integrated into the model as a moderator. The mediation model and moderated mediation model were analyzed using PROCESS macro.

RESULTS

Mediation analysis revealed that the association between social participation and activity impairment was partially mediated by depressive symptoms (B = -0.10, 95% CI = [-0.14, -0.06]) with intermediary effect of 28.6%. Moderated mediation analysis indicated that mediation model was moderated by sex. The indirect effect of social participation on activity impairment among female patients (B = -0.15, 95% CI = [-0.21, -0.09]) was stronger than male patients (B = -0.04, 95% CI = [-0.09, -0.01]).

CONCLUSION

Social participation was the key protective factor associated with depressive symptoms and activity impairment among arthritis patients. Encouraging arthritis patients to social participation and improving the depressive symptoms might avoid activity impairment, especially for female patients.

Compliance status and influencing factors of anticoagulation therapy in outpatient undergoing major orthopedic surgery

PURPOSE

This study was designed to investigate influencing factors of out-of-hospital anticoagulation therapy compliance among patients undergoing major orthopaedic surgeries.

METHODS

A cross-sectional, descriptive study was conducted from July 2022 to February 2023 among outpatients who underwent major orthopedic surgery in our hospital. Patients (n = 200) were surveyed using the General Information Questionnaire, the General Self-Efficacy Scale, the Specificity of Medication-Taking Beliefs Scale, and the Morisky Medication Adherence Scale. Factors that influenced patient compliance were also determined using univariate and multivariate regression analyses.

RESULTS

One hundred eighty-three valid questionnaires were returned, the compliance with outpatient anticoagulation therapy among patients undergoing major orthopaedic surgeries was good in 56.3% (103/183) of all cases and poor in 43.7% (80/183). Multivariate logistic regression analysis showed that medication duration, adverse effects, self-efficacy and medication beliefs influenced adherence to out-of-hospital anticoagulation therapy in patients undergoing major orthopedic surgery (P < 0.05).

CONCLUSIONS

Poor compliance with out-of-hospital anticoagulation therapy in patients undergoing major orthopedic surgery is mainly associated with a long course of medication, adverse reactions, low self-efficacy and low medication beliefs. Healthcare staff should strengthen post-discharge anticoagulation management based on relevant influencing factors to enhance patient compliance.

Unraveling the mediation role of frailty and depression in the relationship between social support and self-management among Chinese elderly COPD patients: a cross-sectional study

BACKGROUND

Self-management (SM) is the key factor in controlling the progression of chronic obstructive pulmonary disease (COPD). Previous studies have reported that majority of COPD patients later presented with frailty and mental health diseases, which affect self-management. This study attempted to explore the mediation role of depression and frailty between social support and self-management in elderly COPD population.

METHODS

Six hundred twenty-seven stable elderly COPD patients admitted to 5 public hospitals in Ningxia, China were selected as study subjects by convenience sampling method. Self-management, frailty, depression and social support were assessed using the COPD Self-management Scale (COPD-SMS), Frail Scale (FS), 15-item Geriatric Depression Scale (GDS-15), and Social Support Rating Scale (SSRS) respectively. The Pearson correlation analysis was used to assess the correlation between variables. Additionally, SPSS25.0 PROCESS plugin Model 6 was used to explore the mediating effects of frailty and depression in the relationship between social support and self-management.

RESULTS

The mean participant age was 72.87 ± 7.03 years, 60.4% of participants were male. The mean total score of the COPD-SMS was 156.99 ± 25.15. Scores for the SSRS, FS, and GDS-15 were significantly correlated with COPD-SMS (p < 0.05). The analysis of the mediation effect demonstrated that social support has a direct predictive effect on self- management (β = 1.687, 95%CI: 1.359 to 2.318). Additionally, social support can also predict self- management indirectly through the mediation of depression (β = 0.290, 95%CI: 0.161 to 0.436) and frailty-depression (β = 0.040, 95%CI: 0.010 to 0.081). However, the mediation effect of frailty alone was not found to be statistically significant (β =-0.010, 95%CI: -0.061 to 0.036). The direct effect accounted for 84.06% of the total effect, while the indirect effect accounted for 15.94% of the total effect.

CONCLUSION

Self-management among elderly COPD patients was relatively moderate to low. Furthermore, frailty and depression were found to have a partially mediation role in the relationship between social support and self-management. Therefore, healthcare professionals need to comprehensively consider the frailty and depression status of patients, and implement targeted intervention measures as part of their care, which can improve the self-management of elderly COPD patients.