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Allen V, Mahieu A, Kasireddy E, Shouman W, Pourrahmat MM, Collet JP, Cherkas A. Humanistic burden of pediatric type 1 diabetes on children and informal caregivers: systematic literature reviews. Diabetol Metab Syndr 2024; 16:73. [PMID: 38515123 PMCID: PMC10956250 DOI: 10.1186/s13098-024-01310-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 03/09/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Diagnosis of children with type 1 diabetes (T1D) imposes an unprecedented burden on children and their caregivers. OBJECTIVE To assess the burden of T1D on children and their informal caregivers, both after a recent diagnosis or after a longer duration of disease. METHODS A series of systematic literature reviews were performed to explore the burden of T1D on children with the disease and their primary informal caregivers, based on the time of diagnosis. After the extraction of the qualitative and quantitative data from the included studies, two literature-based conceptual frameworks were developed: on the burden of pediatric T1D on children, and on informal caregivers. A third conceptual framework on the shared burden of pediatric T1D on both children and informal caregivers as part of the same family unit was also developed. RESULTS The review of literature has identified a series of factors that affect the quality of life of children with T1D and their informal caregivers, with a direct impact on physical, emotional, and social outcomes. Generally, female patients and older adolescents experience more worry and stress that affects their quality of life. Other categories of factors affecting the child's and caregiver's burden include social, emotional, and physical factors, treatment-related and disease-related factors, as well as their coping abilities. Anxiety, depression, stress, and worry were commonly found among children and caregivers, starting with the diagnosis of T1D and continuing over time in relation to new challenges pertaining to aging or the disease duration. CONCLUSION T1D causes a significant burden to affected children and their caregivers, both independently and through transactional interaction within the family unit. Disease burden can be reduced by strengthening individuals for the benefit of the whole family.
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Affiliation(s)
| | | | | | - Walid Shouman
- Evidinno Outcomes Research Inc., Vancouver, BC, Canada
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Shneider CE, Robbertz AS, Cohen LL. A Systematic Review of Relationships Between Illness Identity and Health-Related Outcomes in Individuals with Chronic Illnesses. J Clin Psychol Med Settings 2024; 31:130-142. [PMID: 37751072 DOI: 10.1007/s10880-023-09973-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2023] [Indexed: 09/27/2023]
Abstract
The aim of the current systematic review is to examine relationships among illness identity and illness-specific variables, adherence, and health-related outcomes. Studies were included if they (a) presented quantitative data on illness identity's relationship with adherence or health-related outcomes, (b) included chronic medical illness samples, (c) were peer-reviewed, and (d) were available in English. PubMed and EBSCOhost were searched. Quality was evaluated using the EPHPP Tool. Twelve papers were included. Moderate evidence supports the relationship between engulfment, enrichment, and illness complexity. Moderate evidence supports relationships between multiple identities and adherence as well as with various health-related outcomes. There is somewhat consistent evidence for associations between engulfment and negative health-related outcomes. It may be important to inform healthcare providers of possible identity challenges that patients face and their associations with adherence and health-related outcomes. Routine illness identity screening may allow for identification of individuals who would benefit from increased support.
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Affiliation(s)
- Caitlin E Shneider
- Department of Psychology, Georgia State University, 140 Decatur Street SE, Atlanta, GA, 30302-5010, USA
| | - Abigail S Robbertz
- Department of Psychology, Georgia State University, 140 Decatur Street SE, Atlanta, GA, 30302-5010, USA
| | - Lindsey L Cohen
- Department of Psychology, Georgia State University, 140 Decatur Street SE, Atlanta, GA, 30302-5010, USA.
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AlBurno H, Schneider F, de Vries H, Al Mohannadi D, Mercken L. Determinants of adherence to insulin and blood glucose monitoring among adolescents and young adults with type 1 diabetes in Qatar: a qualitative study. F1000Res 2024; 11:907. [PMID: 38515508 PMCID: PMC10955191 DOI: 10.12688/f1000research.123468.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2024] [Indexed: 03/23/2024] Open
Abstract
Background Adherence to insulin and blood glucose monitoring (BGM) is insufficient in adolescents and young adults (AYAs) with type 1 diabetes (T1D) worldwide and in Qatar. Little is known about the factors related to being aware of suboptimal adherence and the beliefs related to suboptimal adherence in this group. This qualitative study investigated factors related to awareness of, and beliefs about suboptimal adherence, as well as the existence of specific action plans to combat suboptimal adherence using the I-Change model. Methods The target group was comprised of 20 Arab AYAs (17-24 years of age) with T1D living in Qatar. Participants were interviewed via semi-structured, face-to-face individual interviews, which were audio-recorded, transcribed verbatim, and analyzed using the Framework Method. Results Suboptimal adherence to insulin, and particularly to BGM, in AYAs with T1D was identified. Some AYAs reported to have little awareness about the consequences of their suboptimal adherence and how this can adversely affect optimal diabetes management. Participants also associated various disadvantages to adherence ( e.g., hypoglycemia, pain, among others) and reported low self-efficacy in being adherent ( e.g., when outside home, in a bad mood, among others). Additionally, goal setting and action-planning often appeared to be lacking. Factors facilitating adherence were receiving support from family and healthcare providers, being motivated, and high self-efficacy. Conclusions Interventions that increase awareness concerning the risks of suboptimal adherence of AYAs with T1D are needed, that increase motivation to adhere by stressing the advantages, creating support and increasing self-efficacy, and that address action planning and goal parameters.
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Affiliation(s)
- Hanan AlBurno
- Care and Public Health Research Institute, Maastricht University, Maastricht, P.O. Box 616, The Netherlands
| | - Francine Schneider
- Care and Public Health Research Institute, Maastricht University, Maastricht, P.O. Box 616, The Netherlands
| | - Hein de Vries
- Care and Public Health Research Institute, Maastricht University, Maastricht, P.O. Box 616, The Netherlands
| | - Dabia Al Mohannadi
- Endocrinology and Diabetes Department, Hamad Medical Corporation, Doha, P.O. Box 3050, Qatar
| | - Liesbeth Mercken
- Care and Public Health Research Institute, Maastricht University, Maastricht, P.O. Box 616, The Netherlands
- Department of Health Psychology, Open University of the Netherlands, Heerlen, P.O. Box 2960, The Netherlands
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San Miguel GG, Muñoz K, Barrett TS, Twohig MP. Acceptance and Action Questionnaire-Adult Hearing Loss (AAQ-AHL): validation with hearing aid users. Int J Audiol 2023; 62:1095-1100. [PMID: 36373617 DOI: 10.1080/14992027.2022.2142161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 10/21/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Individuals who are deaf or hard of hearing (DHH) may find adherence to their hearing devices difficult due to internal experiences related to their hearing loss such as sadness or frustration. The Acceptance and Action Questionnaire-Adult Hearing Loss (AAQ-AHL) is the only measure available to assess psychological inflexibility as it relates to hearing loss. The purpose of this study was to confirm the single latent structure of the AAQ-AHL (through confirmatory factory analysis) and test convergent and discriminant validity. DESIGN Cross-sectional data was used to further validate the AAQ-AHL. STUDY SAMPLE Participants were 146 adults who had diagnosed hearing loss and used a hearing aid. RESULTS Results revealed the AAQ-AHL has a single latent structure, correlated to other similar constructs (psychological flexibility and hearing aid efficacy), and not correlated to unrelated constructs (hearing loss severity). These results suggest that the AAQ-AHL is a valid instrument to assess psychological flexibility as it relates to hearing aid use. CONCLUSION Together, the findings imply the AAQ-AHL has strong psychometric properties and justification to use in a clinical setting.
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Affiliation(s)
| | - Karen Muñoz
- Communication Disorders & Deaf Education, Utah State University, Logan, UT, USA
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Zukerman G, Maor M, Reichard T, Ben-Itzhak S. Does older mean flexible? Psychological flexibility and illness cognitions in chronic medical conditions - the moderating effect of age. PSYCHOL HEALTH MED 2023; 28:1844-1860. [PMID: 37088966 DOI: 10.1080/13548506.2023.2206145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 04/17/2023] [Indexed: 04/25/2023]
Abstract
Adjustment to a Chronic Medical Condition (CMC) is associated with developing hypotheses regarding one's symptoms, known as illness cognition (IC). Aging is associated with a higher rate of CMC. We assessed the effects of aging and psychological flexibility (PF)-one's ability to be open to change, and to alter or persist in behaviors according to environmental circumstances - on IC development in CMC. In a cross-sectional study of hospitalized patients with CMC, 192 patients in four age groups: younger (<50), midlife (50-59), young old (60-69), and elderly (≥70) completed questionnaires sampling IC, PF and demographics. Younger participants reported less helplessness (IC) while lower scores in one PF component (perceiving reality as multifaceted) were reported by the elderly (≥70); older age was associated with a more fixed, narrow perception of reality. Both effects remained significant when using the medical condition severity as a covariate. In general, age was positively associated with IC of acceptance and Helplessness. In regression analysis, CMC severity significantly predicted all IC. Moreover, the interaction of age and perceiving reality as dynamic and changing (PF-RDC component) significantly predicted IC- acceptance of illness; follow-up analysis revealed significant correlations between PF-RDC and acceptance only for younger patients (< age 50). PF-RDC also significantly predicted IC - perceived benefit; among the entire sample higher RDC was associated with less IC - perceived benefit. Implications for theory and practice are discussed.
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Affiliation(s)
- Gil Zukerman
- Department of Communication Disorders, School of Health Sciences, Ariel University, Ariel, Israel
| | - Maya Maor
- Department of Sociology and Anthropology, Faculty of Humanistic and Social Sciences, Ariel University, Ariel, Israel
| | - Tamar Reichard
- Tel Aviv Sourasky Medical Center, Psychological Service, Tel Aviv, Israel
| | - Shulamit Ben-Itzhak
- Head Clinical Psychologist, Psychological Service, Sourasky Tel Aviv Medical Center, Tel Aviv, Israel
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Prokopowicz A, Stańczykiewicz B, Uchmanowicz I. Anxiety and Psychological Flexibility in Women After Childbirth in the Rooming-in Unit during the COVID-19 Pandemic. J Midwifery Womens Health 2023; 68:107-116. [PMID: 36565212 PMCID: PMC9880685 DOI: 10.1111/jmwh.13445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 09/15/2022] [Accepted: 10/13/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic has intensified perinatal anxiety disorders. Psychological flexibility (PF), considered a specific mental toughness, has not been examined with regard to its relationship with anxiety in women after childbirth. We aimed to compare levels of anxiety, PF, and pain in women depending on the mode of birth, parity, and the magnitude of risk of developing an anxiety disorder. We also investigated the association of anxiety with PF and pain. METHODS A total of 187 women after childbirth completed validated questionnaires for anxiety (State-Trait Anxiety Inventory, Hospital Anxiety and Depression Scale-Anxiety, Numerical Rating Scale for anxiety [NRS-A]), PF, and pain (Numerical Rating Scale for pain). Specific postpartum anxieties were assessed with a numerical scale from 0 to 10. The relationship of anxiety with PF and pain was examined. Women at low and high risk of developing anxiety disorder were compared in terms of PF, anxiety, and pain. RESULTS On the second postpartum day, women after cesarean birth demonstrated significantly greater anxiety on NRS-A and pain than those after vaginal birth. Primiparous women experienced significantly greater anxieties and pain compared to multiparous women. The higher the PF patients demonstrated, the less anxiety and pain they had. Patients at high risk of developing an anxiety disorder had a lower level of PF (P < .001) and higher levels of anxiety (P < .001) and pain (P < .01) than patients at low risk of developing an anxiety disorder. No difference in the anxiety of getting COVID-19 was observed between the groups (P > .05). CONCLUSIONS PF is an important psychological construct related to the mental and physical condition of women after childbirth. Increasing PF in women after childbirth may be considered as an important goal of preventive and intervention measures.
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Affiliation(s)
- Anna Prokopowicz
- Division of Midwifery and Gynaecological Nursing, Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wrocław, Poland
| | - Bartłomiej Stańczykiewicz
- Division of Consultation Psychiatry and Neuroscience, Department of Psychiatry, Faculty of Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Izabella Uchmanowicz
- Division of Internal Medicine Nursing, Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wrocław, Poland
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Najafi Ghezeljeh T, Sharif Nia H, Bagheri H, Abbasi A, Keyvanloo Shahrestanaki S, Amiri Largani H, Marôco J. Psychometric evaluation of Persian version of Diabetes Acceptance Scale (DAS). BMC Endocr Disord 2022; 22:225. [PMID: 36076182 PMCID: PMC9461147 DOI: 10.1186/s12902-022-01123-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/05/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Acceptance of diabetes is a psychological adaptation to the potential limitations of the disease. Poor acceptance of diabetes impairs effective self-management of diabetes, leading to worsening metabolic control. This study aimed at determining the psychometric properties of the Persian version of the Diabetes Acceptance Scale. METHODS This cross-sectional methodological study was performed on diabetic patients in Iran in 2021. The questionnaire consisted of two parts: demographic characteristics and Diabetes Acceptance Scale. The questionnaire was translated into Persian through the forward-backward translation method. The face validity and content validity were performed qualitatively and quantitatively. Exploratory (n = 200) and confirmatory (n = 200) factor analysis were performed to evaluate the validity of the structure. Internal consistency and temporal stability were estimated to determine reliability. RESULTS Exploratory factor analysis on the polychoric correlation matrix obtained three factors: Rational dealing, Resentment and Avoidance, which explained 68.8% of the total DAS variance. Confirmatory factor analysis showed that the 3-fractor model had a good fit to a second independent data set. Finally, Ordinal Cronbach's alpha coefficient was 0.96, 0.94 and 0.93, respectively for the Rational dealing, Resentment, and Avoidance factor. Also, using intraclass correlation coefficient, the stability of the instrument was 0.97. CONCLUSION Based on the findings of this study, the Persian version of DAS has sufficient validity and reliability to measure the admission of Iranian diabetic patients.
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Affiliation(s)
- Tahereh Najafi Ghezeljeh
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Sharif Nia
- Amol Faculty of Nursing and Midwifery, Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Bagheri
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ali Abbasi
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - João Marôco
- William James Centre for Research, ISPA – Instituto Universitário, Lisbon, Portugal
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Hannonen R, Vuorimaa H, Rantanen K, Alho I, Luukkaala T, Heikkilä A, Lappalainen R. Finnish diabetes-related quality of life questionnaire for children and adolescents: Reliability and validity. Acta Paediatr 2021; 110:1516-1525. [PMID: 33289955 DOI: 10.1111/apa.15707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/01/2020] [Accepted: 12/04/2020] [Indexed: 01/09/2023]
Abstract
AIM To study the psychometric properties, reliability and validity of the FinDiab quality-of-life questionnaire (FDQL), a strength-oriented quality-of-life (QOL) questionnaire for children and adolescents with type 1 diabetes (T1D). METHODS Participants were 215 youths with T1D (aged 10-17 years). They completed FDQL and comparison questionnaires (KINDL-R and SDQ). Demographic and disease measures were collected from the participants' medical records. The questionnaire's psychometric properties were investigated. Construct validity was studied through principal component analysis using Promax rotation, reliability with alphas, and criterion and convergent validity with correlations between sum scale, subscales, demographic and disease factors, and comparison measures. RESULTS FDQL demonstrated an adequate range of measurement and feasibility. The four-factor solution was found to be optimal, resulting in the subscales of flexibility with diabetes, well-being, social relations and health behaviour. The sum scale correlated significantly with glycaemic control and the psychosocial and QOL comparison measures. Construct, criterion and convergent validity of the subscales was also good. Children under 14 years of age reported better QOL than older adolescents. CONCLUSION FDQL is a practical QOL assessment method focusing on strengths. The questionnaire has good validity and reliability and is easy to use as a clinical tool.
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Affiliation(s)
- Riitta Hannonen
- Department of Psychology Kymenlaakso Social and Health Care Kotka Finland
| | - Hanna Vuorimaa
- Department of Pediatrics Päijät‐Häme Central Hospital Lahti Finland
| | - Kati Rantanen
- Faculty of Social Sciences, Psychology, Tampere University Department of Pediatrics Tampere University Hospital Tampere Finland
| | - Iina Alho
- Department of Psychology, University of Jyväskylä Department of Pediatrics Central Finland Health Care District Jyväskylä Finland
| | - Tiina Luukkaala
- Faculty of Social Sciences, Tampere University Research, Development and Innovation Centre Tampere University Hospital Tampere Finland
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Rajaeiramsheh F, Rezaie Z, Davoudi M, Ahmadi SM, Qorbani-Vanajemi M. Psychometric properties of the Persian versions of acceptance and action diabetes questionnaire (AADQ) and the diabetes acceptance and action scale (DAAS), in Iranian youth with type 1 diabetes. J Diabetes Metab Disord 2021; 20:655-663. [PMID: 34178858 DOI: 10.1007/s40200-021-00796-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/06/2021] [Indexed: 11/26/2022]
Abstract
Background Psychological flexibility has considerable effects on medical and psychosocial outcomes in youth with type 1 diabetes mellitus (T1DM). This study aimed to evaluate the psychometric properties of the Persian versions of the Acceptance and Action Diabetes Questionnaire (AADQ) and the Diabetes Acceptance and Action Scale for children and adolescents (DAAS), the measures of diabetes-specific psychological flexibility. Methods 196 youth with T1DM completed the DAAS, AADQ (youth-report), Child and Adolescent Mindfulness Measure (CAMM), Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA), and the Avoidance and Fusion Questionnaire for Youths (AFQ-Y8). Also, their parents completed AADQ (parent-report). Data analyzed by SPSS V.26 and LISREL 8.8. Results The mean and standard deviation of participants' age was 14.7 ± 2.08.The internal consistency due to Cronbach's alpha method was 0.87, 0.8, 0.84, and 0.83 for DAAS total scores, avoidance, values impairment, and fusion, respectively. The internal consistency of AADQ (both parent-report and youth report) was above 0.8. Test-retest reliability (from 45 participants) with a one-week interval was assessed by the interclass correlation coefficient (ICC). The DAAS, AADQ-parent report, and AADQ-youth report's reliability coefficients were 0.93, 0.82, and 0.92, respectively. The AADQ (both forms) and DAAS evidence good content validity based on correlations with other measures. Confirmatory factor analysis (CFA) and Exploratory Factor Analysis (EFA) showed DAAS has the three-factor model, which strongly a suitable model is fitting. EFA also verified the AADQ model fitting. Conclusions In general, these results support the psychometric properties of the Persian versions of DAAS and AADQ among the Iranian youth patients with T1DM. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-021-00796-1.
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Affiliation(s)
- Fereshteh Rajaeiramsheh
- Department of clinical psychology, Faculty of behavioral science, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Zeinab Rezaie
- Department of clinical psychology, School of Medical, Kashan University of Medical Sciences (KAUMS), Kashan, Iran
| | - Mohammadreza Davoudi
- Department of clinical psychology, Faculty of behavioral science, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Majid Ahmadi
- Department of Internal Medicine, School of Medical, Yasouj University of Medical Sciences (YUMS), Yasouj, Iran
| | - Milad Qorbani-Vanajemi
- Department of counseling, Faculty of behavioral science, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Maor M, Zukerman G, Amit N, Richard T, Ben-Itzhak S. Psychological well-being and adjustment among type 2 diabetes patients: the role of psychological flexibility. PSYCHOL HEALTH MED 2021; 27:1456-1467. [PMID: 33573400 DOI: 10.1080/13548506.2021.1887500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Elevated rates of psychological disorders are reported among those with type 2 diabetes (T2D). Thus, research into factors enhancing psychological aspects of well-being is critical in T2D. We examine the association between a multifaceted measure of Psychological Flexibility (PF), and its relationship to adjustment and well-being, among this population. Adults with T2D (N = 102) completed an online battery of self-reported questionnaires and were asked for demographics, general T2D features, treatment adherence, PF, adjustment, and well-being. We examined the association between PF (Psychological Flexibility Questionnaire, PFQ), adjustment to diabetes (ATT-39) and well-being (Mental Health Inventory), among adults with T2D. Greater PF was significantly associated with greater well-being, but unrelated to adjustment, which was positively associated with well-being. In a hierarchical regression analysis, perception of change as positive (one of the five PFQ factors) significantly contributed to the explained variance in well-being, beyond the contribution of adjustment. These findings indicate that positive perception of change may enhance well-being independently from adjustment to diabetes since these two constructs are distinct and independent. Such an association between PF and well-being may apply to other medical conditions. Implications for psychological intervention are discussed.
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Affiliation(s)
- Maya Maor
- Society and Behavior program, Ramat Gan Academic College, Israel
| | - Gil Zukerman
- Department of Communication Disorders, School of Health Sciences, Ariel University, Ariel, Israel
| | - Neta Amit
- Psychological Service, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Tamar Richard
- Psychological Service, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Shulamit Ben-Itzhak
- Head Clinical Psychologist, Psychological Service, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Berlin KS, Keenan ME, Cook JL, Ankney RL, Klages KL, Semenkovich K, Rybak TM, Banks GG, Alemzadeh R, Eddington AR. Measuring psychological flexibility in youth with type 1 diabetes. Pediatr Diabetes 2020; 21:1566-1574. [PMID: 32915520 DOI: 10.1111/pedi.13110] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/11/2020] [Accepted: 09/02/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To determine reliability and validity of the acceptance and action diabetes questionnaire (AADQ) and the diabetes acceptance and action scale for children and adolescents (DAAS), measures of diabetes-specific psychological flexibility. METHODS One hundred and eight-one youth with type 1 diabetes completed the AADQ, DAAS, and measures of mindfulness, cognitive fusion, and health-related quality of life. HbA1c was extracted from medical records. Confirmatory factor analysis (CFA) was used to cull items and evaluate the factor structures of the AADQ and DAAS. Bivariate correlations were conducted between all measures to explore content validity. RESULTS CFAs supported a one-factor structure of the AADQ (for youth and parent report) and a second-order DAAS solution with a total score indicated by avoidance, values impairment, and avoidance subscales. All scales and subscales displayed strong internal consistency (α = .86-.95). The AADQ and DAAS evidence good content validity based on associations with other measures. CONCLUSIONS The AADQ and DAAS are reliable, valid measures of diabetes-specific psychological flexibility.
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Affiliation(s)
- Kristoffer S Berlin
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA.,Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Mary E Keenan
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Jessica L Cook
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Rachel L Ankney
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Kimberly L Klages
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | | | - Tiffany M Rybak
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Gabrielle G Banks
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Ramin Alemzadeh
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Angelica R Eddington
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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Abstract
PURPOSE OF REVIEW Diabetes self-management and diabetes distress are complex processes implicated in glycemic control and other health outcomes for youth with type 1 diabetes. Growing integration of medical and behavioral care provides opportunities for brief psychosocial interventions during routine diabetes care. This review focuses on interventions for self-management and diabetes distress that can be delivered alongside usual medical care or via a single-patient encounter. RECENT FINDINGS Recent research underscores the potential of brief interventions delivered by both medical providers and integrated behavioral health professionals, but little is known regarding the comparative effectiveness of different interventions or the factors that impact dissemination and implementation. This article asserts that brevity is critical to maximizing the reach, scalability, and impact of psychosocial interventions for youth with type 1 diabetes. The authors review existing evidence for brief interventions, describe several untested clinical strategies, and make recommendations for accelerating the translational study of brief interventions.
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Affiliation(s)
- Samantha A Barry-Menkhaus
- The Madison Clinic for Pediatric Diabetes and Benioff Children's Hospital, University of California, San Francisco, San Francisco, CA, USA
| | - David V Wagner
- Institute on Development & Disability, Department of Pediatrics, Oregon Health & Science University, 707 SW Gaines St., Portland, OR, 97239, USA
| | - Andrew R Riley
- Institute on Development & Disability, Department of Pediatrics, Oregon Health & Science University, 707 SW Gaines St., Portland, OR, 97239, USA.
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Smith PJ, Cendales LC. Psychosocial dimensions of hand transplantation: lessons learned from solid organ transplantation. Curr Opin Organ Transplant 2019; 24:705-13. [PMID: 31689261 DOI: 10.1097/MOT.0000000000000712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW The present review examines psychosocial factors emerging as predictive of clinical outcomes among solid organ transplant (SOT) recipients, with possible extensions to vascular composite allograft (VCA) and hand transplantation, in particular. The Chauvet Workgroup report and International Society of Heart and Lung Transplantation consensus guidelines are used to delineate areas of commonality between SOT and VCA, as well as unique features contributing to post-VCA psychosocial risk. RECENT FINDINGS Increasing evidence suggests that depression, cognitive function, and other posttransplant psychosocial factors consistently associate with clinical risk in SOT. However, the mechanisms precipitating these psychosocial risk factors are likely diverse in their cause, with large individual differences across SOT and VCA. Transdiagnostic dimensions may serve as mechanistic factors, increasing the risk of adverse clinical outcomes and suggesting potential treatment strategies for risk mitigation. Psychosocial dimensions including psychological flexibility, self-efficacy, and posttraumatic growth are discussed as potential contributory factors. SUMMARY Psychosocial factors hold importance in predicting posttransplant clinical outcomes. Emerging transdiagnostic factors may provide insight into mechanisms and potential treatments.
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Karadere ME, Yavuz KF, Asafov EY, Küçükler FK. Reliability and Validity of a Turkish Version of the Acceptance and Action Diabetes Questionnaire. Psychiatry Investig 2019; 16:418-424. [PMID: 31247700 PMCID: PMC6603703 DOI: 10.30773/pi.2019.02.26.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 02/26/2019] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The aim of this study is to perform validity and reliability examination of the Turkish form of Acceptance and Action Diabetes Questionnaire, and to investigate whether this scale is a measurement tool for evaluation of psychological flexibility levels in a sample of patients with diabetes in Turkey. METHODS This study was conducted with 105 patients. Turkish forms of the Beck Depression Inventory (BDI), Problem Areas in Diabetes Questionnaire (PAID), State-Trait Anxiety Inventory (STAI-I and STAI-II), Audit of Diabetes-Dependent Quality of Life (ADDQoL) and Turkish form of Acceptance and Action Diabetes Questionnaire (TAADQ) were applied. SPSS 20.0 and AMOS was used in statistical analysis. RESULTS 56.12% of the patients were female and the mean of age was 54 (SD=±9.9) years. The mean duration of education was found 7.65 (SD=3.97) years. 74.8% of the patients most of whom (83.3%, n=85) had diabetes mellitus and the mean glycemic control calculated with HbA1c was 8.02±1.91. According to the final fit indices, we found that the revised and corrected 9-item model was superior over the previous model. Cronbach Alpha coefficient of TAADQ was found as 0.836. CONCLUSION TAADQ is a valid and reliable assessment tool in Turkish population. So TAADQ will be a powerfull tool in assessing psychological flexibility in diabetes patients.
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Affiliation(s)
| | | | - Ece Yazla Asafov
- Department of Psychiatry, Hitit University Faculty of Medicine, Corum, Turkey
| | - Ferit Kerim Küçükler
- Department of Endocrinology, Hitit University Faculty of Medicine, Corum, Turkey
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Schmitt A, Reimer A, Kulzer B, Icks A, Paust R, Roelver KM, Kaltheuner M, Ehrmann D, Krichbaum M, Haak T, Hermanns N. Measurement of psychological adjustment to diabetes with the diabetes acceptance scale. J Diabetes Complications 2018; 32:384-392. [PMID: 29439862 DOI: 10.1016/j.jdiacomp.2018.01.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/21/2017] [Accepted: 01/12/2018] [Indexed: 10/18/2022]
Abstract
AIMS To develop a psychometric measure of diabetes acceptance. METHODS An item pool was developed and pilot-tested using a sample of 220 people with diabetes; item selection resulted in the 20-item 'Diabetes Acceptance Scale (DAS)'. 606 people with diabetes were then cross-sectionally assessed with the DAS to evaluate its reliability, validity and clinical utility; concurrent measurements included diabetes-related coping (FQCI), diabetes distress (PAID-5), depressive symptoms (PHQ-9), quality of life (EQ-5D), self-management (DSMQ), glycaemic control (HbA1c) and complications. RESULTS Internal reliability was high (Cronbach's α = 0.96). Factorial and criterion-related results supported validity. Higher diabetes acceptance scores correlated with more functional coping styles, lower distress and depression levels, higher treatment adherence, better glycaemic control and better quality of life (all P < .001). Persons with low diabetes acceptance (22% of the sample) were four times more likely to have HbA1c values over 9.0% (75 mmol/mol), two times more likely to be diagnosed with long-term complications and each over two times more likely to have had episodes of severe hypoglycaemia and ketoacidosis in the past year; the prevalence of major depression in this group was fivefold increased (all P < .05). CONCLUSIONS The DAS is a reliable and valid tool to measure diabetes acceptance. It may help identify patients with significant problems of accepting diabetes, a putative high-risk group in need of tailored care and support.
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Affiliation(s)
- Andreas Schmitt
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Johann-Hammer-Str. 24, 97980 Bad Mergentheim, Germany; Diabetes Center Mergentheim (DZM), Theodor-Klotzbuecher-Str. 12, 97980 Bad Mergentheim, Germany; German Center for Diabetes Research (DZD), Ingolstaedter Landstr. 1, 85764 Muenchen, Neuherberg, Germany.
| | - André Reimer
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Johann-Hammer-Str. 24, 97980 Bad Mergentheim, Germany; Diabetes Center Mergentheim (DZM), Theodor-Klotzbuecher-Str. 12, 97980 Bad Mergentheim, Germany; German Center for Diabetes Research (DZD), Ingolstaedter Landstr. 1, 85764 Muenchen, Neuherberg, Germany
| | - Bernhard Kulzer
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Johann-Hammer-Str. 24, 97980 Bad Mergentheim, Germany; Diabetes Center Mergentheim (DZM), Theodor-Klotzbuecher-Str. 12, 97980 Bad Mergentheim, Germany; German Center for Diabetes Research (DZD), Ingolstaedter Landstr. 1, 85764 Muenchen, Neuherberg, Germany; Otto-Friedrich-University of Bamberg, Department for Psychology, Markusplatz 3, 96047 Bamberg, Germany
| | - Andrea Icks
- German Center for Diabetes Research (DZD), Ingolstaedter Landstr. 1, 85764 Muenchen, Neuherberg, Germany; German Diabetes Center (DDZ), Institute for Health Services Research and Health Economics, Auf'm Hennekamp 65, 40225 Duesseldorf, Germany; Institute for Health Services Research and Health Economics, Faculty of Medicine, Heinrich-Heine-University, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Rainer Paust
- Institute for Psychosocial Medicine, Elisabeth-Hospital, Klara-Kopp-Weg 1, 45138 Essen, Germany
| | - Klaus-Martin Roelver
- Diabetes Center Quakenbrueck, Christian Hospital Quakenbrueck, Danziger Str. 2, 49610 Quakenbrueck, Germany
| | - Matthias Kaltheuner
- Specialised Diabetes Practice Leverkusen, Kalkstr. 117, 51377 Leverkusen, Germany
| | - Dominic Ehrmann
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Johann-Hammer-Str. 24, 97980 Bad Mergentheim, Germany; Diabetes Center Mergentheim (DZM), Theodor-Klotzbuecher-Str. 12, 97980 Bad Mergentheim, Germany
| | - Michael Krichbaum
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Johann-Hammer-Str. 24, 97980 Bad Mergentheim, Germany; Diabetes Center Mergentheim (DZM), Theodor-Klotzbuecher-Str. 12, 97980 Bad Mergentheim, Germany
| | - Thomas Haak
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Johann-Hammer-Str. 24, 97980 Bad Mergentheim, Germany; Diabetes Center Mergentheim (DZM), Theodor-Klotzbuecher-Str. 12, 97980 Bad Mergentheim, Germany
| | - Norbert Hermanns
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Johann-Hammer-Str. 24, 97980 Bad Mergentheim, Germany; Diabetes Center Mergentheim (DZM), Theodor-Klotzbuecher-Str. 12, 97980 Bad Mergentheim, Germany; German Center for Diabetes Research (DZD), Ingolstaedter Landstr. 1, 85764 Muenchen, Neuherberg, Germany; Otto-Friedrich-University of Bamberg, Department for Psychology, Markusplatz 3, 96047 Bamberg, Germany
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Abstract
BACKGROUND Adherence by diabetic patients to dietary recommendations is important for effective therapy. Considering patients' expectations in case of diet is significant in this regard. The aim of this paper was to analyze the relationship between selected independent variables (eg, regular blood glucose testing) and patients' adherence to dietary recommendations, bearing in mind that the degree of disease acceptance might play a mediation role. SUBJECTS AND METHODS A cross-sectional study was conducted in 91 patients treated for type 2 diabetes mellitus in a public medical facility. Paper-and-pencil interviewing was administered ahead of the planned visit with a diabetes specialist. Two measures were applied in the study: the Acceptance and Action Diabetes Questionnaire and the Patient Diet Adherence in Diabetes Scale. Additionally, data related to sociodemographic characteristics, lifestyle-related factors, and the course of the disease (management, incidence of complications, and dietician's supervision) were also collected. The regression method was used in the analysis, and Cohen's methodology was used to estimate partial mediation. Significance of the mediation effect was assessed by the Goodman test. P-values of <0.05 were considered statistically significant. RESULTS Patients' non-adherence to dietary recommendations was related to a low level of disease acceptance (standardized regression coefficient =-0.266; P=0.010). Moreover, failure to perform regular blood glucose testing was associated with a lack of disease acceptance (standardized regression coefficient =-0.455; P=0.000). However, the lack of regular blood glucose testing and low level of acceptance had only partially negative impacts on adherence to dietary recommendations (Goodman mediation test, Z=1.939; P=0.054). This dependence was not seen in patients treated with diet and concomitant oral medicines and/or insulin therapy. CONCLUSION Effective dietary education should include activities promoting a more positive attitude toward the disease. This may be obtained by individual counseling, respecting the patient's needs, and focus on regular blood glucose testing.
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Affiliation(s)
- Mariusz Jaworski
- Division of Teaching and Outcomes of Education, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Panczyk
- Division of Teaching and Outcomes of Education, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
- Correspondence: Mariusz Panczyk, Division of Teaching and Outcomes of Education, Faculty of Health Sciences, Medical University of Warsaw, Zwirki i Wigury 61, Warsaw 02-091, Poland, Tel +48 22 572 0490, Fax +48 22 572 0491, Email
| | - Małgorzata Cedro
- Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Alicja Kucharska
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
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Gostoli S, Roncuzzi R, Urbinati S, Rafanelli C. Clinical and Subclinical Distress, Quality of Life, and Psychological Well-Being after Cardiac Rehabilitation. Appl Psychol Health Well Being 2017; 9:349-369. [PMID: 29171196 DOI: 10.1111/aphw.12098] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The literature has outlined positive effects of cardiac rehabilitation (CR) on clinical psychological distress (DSM depression and anxiety) and quality of life (QoL). In cardiac settings, subclinical distress (subthreshold depressive and anxious symptomatology) and psychological well-being also showed relevant clinical implications. This research explored these psychological variables, their changes over time and cardiac course of CR patients. METHODS Clinical and subclinical distress, QoL, and psychological well-being were assessed in 108 consecutive patients undergoing CR, at baseline and up to 12 months after the program's completion. RESULTS Of all patients, 25.9 per cent showed high distress with a DSM diagnosis, 31.5 per cent high distress without a DSM diagnosis, and 42.6 per cent low distress. Comparing these subgroups, worse QoL and psychological well-being were significantly linked not only to clinical but also to subclinical distress. After CR completion, a significant reduction in DSM diagnoses was observed, whereas there were no positive effects on subclinical distress, QoL, and well-being, or when they initially occurred, they were not long lasting. Moreover, only the subgroup with high distress without a DSM diagnosis was at greater risk for adverse cardiac outcomes, showing worse scores on items of contentment. CONCLUSIONS These findings confirm data on clinical distress reduction after CR completion. However, a large amount of relevant subclinical distress remains and predicts adverse cardiac events.
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