Association of Coping Strategies and Medication Adherence: A Systematic Review

Impact of COVID-19-Related Disruptions on Antiretroviral Therapy Adherence Among Young Adults Living with HIV in Southern Uganda

We investigated how COVID-19-related disruptions influenced antiretroviral therapy (ART) adherence among young adults living with HIV (YALHIV) in Southern Uganda, a region with limited resources and high rates of HIV. Data were analyzed from 499 YALHIV aged 19 to 25, participating in the Suubi+Adherence-R2 COVID-19 Supplement study. The study measured COVID-19 disruptions using an 8-item Coronavirus Impact Scale and evaluated ART adherence through self-reported measures. Our analytical framework was informed by the Health Belief Model and generalized estimating equations were estimated. We find no statistically significant association between COVID-19 disruptions, as quantified by the COVID-19 Impact Score, and sub-optimal ART adherence (OR = 0.99, 95% CI [0.87-1.14]). However, findings revealed that being employed (OR = 1.99, 95% CI [1.07-3.71]) and older age (OR = 1.18, 95% CI [1.02-1.37]) was associated with higher likelihood of poor adherence highlighting the complex interplay between economic activity, working schedules, and health management. Other notable predictors included marital status, with cohabiting individuals showing decreased odds of poor adherence (OR = 0.25, 95% CI [0.08-0.74]) compared to single and separated YALHIV. These insights emphasize the need for multifaceted intervention strategies that consider both individual and systemic factors affecting ART adherence. Tailored interventions must address the socioeconomic challenges intensified by the pandemic and leverage the inherent resilience within this population to enhance ART adherence outcomes for YALHIV in challenging environments. Trial Registration ClinicalTrials.gov, ID: NCT01790373.

Impact of stress coping style on self-care behaviors and prognosis in patients with heart failure: A prospective longitudinal observational study

BACKGROUND

Heart failure (HF) requires effective management and self-care education to improve outcomes. However, daily self-care routines necessary for managing HF can lead to psychological issues, including stress, potentially exacerbating the condition. Patient stress-coping behaviors may significantly impact prognosis.

OBJECTIVE

We aimed to identify stress coping styles in patients with HF and examine their impact on self-care behavior and prognosis. s.

METHODS

This study utilized a longitudinal prospective observational design. Patients were categorized into task-oriented (task), emotion-oriented (emotion), and avoidance (avoidance) coping groups using the Coping Inventory for Stress Situations. Stress levels and self-care behaviors were evaluated during hospitalization and 1 and 3 months after discharge. The primary outcome was a composite of HF readmission and all-cause mortality during the 180-day post-discharge period. Longitudinal changes in self-care behaviors were assessed according to stress intensity.

RESULTS

We included 151 patients (age, 74 [60-80] years; female, 37.1 %) hospitalized for HF exacerbation between August 2021 and August 2023. The task group comprised 45 patients (29.8 %); emotion group, 47 (31.1 %); and avoidance group, 59 (39.1 %). The avoidance group had a higher risk of adverse events during follow-up (task, emotion, and avoidance: 8.9 % vs. 14.9 % vs. 32.2 %, p = 0.004). The avoidance-coping style was the only independent predictor of the primary outcome (hazard ratio: 3.84, 95 % confidence interval: 1.40-10.53, p = 0.009). Self-care behaviors were notably poorer in the avoidance group, particularly under conditions of high stress.

CONCLUSIONS

Stress-coping strategies impact both prognosis and self-care outcomes in patients with HF, and education programs should consider incorporating these strategies.

Study on psychological resilience and associated influencing factors in lung cancer patients with bone metastases

BACKGROUND

Evaluating the psychological resilience of lung cancer (LC) patients helps understand their mental state and guides future treatment. However, there is limited research on the psychological resilience of LC patients with bone metastases.

AIM

To explore the psychological resilience of LC patients with bone metastases and identify factors that may influence psychological resilience.

METHODS

LC patients with bone metastases who met the inclusion criteria were screened from those admitted to the Third Affiliated Hospital of Wenzhou Medical University. The psychological scores of the enrolled patients were collected. They were then grouped based on the mean psychological score: Those with scores lower than the mean value were placed in the low-score group and those with scores equal to or greater than the mean value was placed in the high-score group. The baseline data (age, gender, education level, marital status, residence, monthly income, and religious beliefs), along with self-efficacy and medical coping mode scores, were compared.

RESULTS

This study included 142 LC patients with bone metastases admitted to our hospital from June 2022 to December 2023, with an average psychological resilience score of 63.24 ± 9.96 points. After grouping, the low-score group consisted of 69 patients, including 42 males and 27 females, with an average age of 67.38 ± 9.55 years. The high-score group consisted of 73 patients, including 49 males and 24 females, with a mean age of 61.97 ± 5.00 years. χ 2 analysis revealed significant differences between the two groups in education level (χ 2 = 6.604, P = 0.037), residence (χ 2 = 12.950, P = 0.002), monthly income (χ 2 = 9.375, P = 0.009), and medical coping modes (χ 2 = 19.150, P = 0.000). Independent sample t-test showed that the high-score group had significantly higher self-efficacy scores (t = 3.383, P = 0.001) and lower age than the low-score group (t = 4.256, P < 0.001). Furthermore, multivariate logistic regression hazard analysis confirmed that self-efficacy is an independent protective factor for psychological resilience [odds ratio (OR) = 0.926, P = 0.035, 95% confidence interval (CI): 0.862-0.995], while age (OR = 1.099, P = 0.003, 95%CI: 1.034-1.169) and medical coping modes (avoidance vs confrontation: OR = 3.767, P = 0.012, 95%CI: 1.342-10.570; resignation vs confrontation: OR = 5.687, P = 0.001, 95%CI: 1.974-16.385) were identified as independent risk factors. A predictive model based on self-efficacy, age, and medical coping modes was developed. The receiver operating characteristic analysis showed an area under the curve value of 0.778 (95%CI: 0.701-0.856, P < 0.001), indicating that the model has good predictive performance.

CONCLUSION

LC patients with bone metastases are less psychologically resilient than the general population. Factors such as self-efficacy, age, and medical coping modes influence their psychological resilience. Patients with low self-efficacy, old age, and avoidance/resignation coping modes should be closely observed.

Physical activity influences adherence to pharmacological treatments in patients with severe mental disorders: results from the multicentric, randomized controlled LIFESTYLE trial

Introduction: Poor adherence to pharmacological treatment is frequent in people with severe mental disorders and it often causes lack of effectiveness of many psychotropic drugs. Thus, efforts should be made to improve adherence to pharmacological treatments in patients with these disorders. Methods: In this paper, based on the LIFESTYLE randomized, controlled multicentric trial, we aim to: 1) assess the level of adherence in a real-world sample of patients with severe mental disorders; 2) evaluate differences in treatment adherence according to patients' socio-demographic and clinical characteristics; 3) evaluate the impact of an innovative psychosocial intervention, on patients' adherence to treatments. The Lifestyle Psychosocial Group Intervention consists of group sessions, focused on different lifestyle behaviours, including healthy diet; physical activity; smoking habits; medication adherence; risky behaviours; and regular circadian rhythms. At end of each session a 20-min moderate physical activity is performed by the whole group. Results: The sample consists of 402 patients, mainly female (57.1%, N = 229), with a mean age of 45.6 years (±11.8). Less than 40% of patients reported a good adherence to pharmacological treatments. Adherence to treatments was not influenced by gender, age, diagnosis and duration of illness. At the end of the intervention, patients receiving the experimental intervention reported a significant improvement in the levels of adherence to treatments (T0: 35.8% vs. T3: 47.6%, p < 0.005). Patients practicing moderate physical activity reported a two-point improvement in the levels of adherence [odds ratio (OR): 1,542; 95% confidence intervals (CI): 1,157-2,055; p < 0.001], even after controlling for several confounding factors. Discussion: The experimental lifestyle intervention, which can be easily implemented in the routine clinical practice of mental health centres, was effective in improving adherence to pharmacological treatments.