Self-Efficacy in Children with Functional Constipation Is Associated with Treatment Success

OBJECTIVES

To assess the relationship between self-efficacy, the belief that an individual can succeed at a goal, and short-term treatment outcome in children with functional constipation.

STUDY DESIGN

Patients with functional constipation age 8-16 years completed the Self-Efficacy for Functional Constipation Questionnaire (SEFCQ), consisting of 14 statements about performing tasks needed for defecation. Patients completed SEFCQ before, immediately after, and 3 weeks after their clinic visit. Treatment success was defined as ≥3 bowel movements into the toilet and no fecal incontinence in the third week.

RESULTS

75% of patients had a successful outcome. Scores were higher in the group that was successful than in those that failed before, immediately after the visit, and 3 weeks later (P < .001). Self-efficacy improved at all time points in the group that was successful (P < .001). In the group that failed, scores improved immediately after clinic visit (P < .01) but were unchanged at follow-up (P > .05).

CONCLUSIONS

Improved self-efficacy is associated with successful outcomes in children with functional constipation, thus, it may be beneficial to enhance self-efficacy for defecation during treatment.

Assessing Family-Like Dynamics in the Workplace as Possible Precursors of Workplace Bullying: Psychometric Analysis of a Modified Instrument

Background and Purpose

Family-like dynamics in workplaces may serve as antecedents to workplace bullying. This study addressed the psychometric properties of an instrument modified to assess family-like dynamics in the workplace.

Design

The investigators used categorical principal components analysis (CATPCA) to investigate the psychometric properties of an instrument modified to measure coworker perceptions of family-like dynamics in the workplace.

Methods

Primarily White (95%) study participants (N= 273) completed a brief, demographic form and the modified Family Relationships Index (FRI) of the Family Assessment Scale (FES) (Moos & Moos, 1981, 1986). Demographic data were analyzed using descriptive statistics and perceptions of family-like dynamics in the workplace were analyzed using CATPCA.

Results

The modified FRI served as a reasonable model for capturing coworker perceptions of family-like dynamics in the workplace.

Conclusions

Further research is indicated to determine the overall utility of the modified FRI and to ascertain whether family-like dynamics actually are precursors to workplace bullying victimization.

Feasibility, utility and symptom impact of modified mindfulness training in sarcoidosis

Sarcoidosis is a multisystem disorder characterised by noncaseating granulomatous inflammation of unknown aetiology. It may resolve spontaneously, but ∼30% of patients have progressive disease with significant organ damage [1]. Although any organ is vulnerable, the lungs are frequently involved resulting in shortness of breath and dry cough. Fatigue is an overarching symptom in sarcoidosis, originating from multiple and combined causes of mental fatigue and physical fatigue [2]. This is also true of the psychosocial impact of sarcoidosis, which may include depression, anxiety, isolation and feelings of uncertainty. The prevalence of these factors remains high even for those who achieve clinical remission, resulting in psychological distress and reduced health status [3].

A modified mindfulness-based exercise intervention has beneficial impact on people living with sarcoidosishttp://ow.ly/XYTO30jtmms

Development and validation of a childhood self-efficacy for functional constipation questionnaire

BACKGROUND

Children with functional constipation fear painful bowel movements leading to stool withholding behavior. Self-efficacy is the belief that an individual can accomplish a given goal. If children with constipation avoid defecation because they think that they are unable defecate comfortably, this low self-efficacy may prevent treatment success. The aim of the current study was to develop and validate a constipation specific self-efficacy scale.

METHODS

The self-efficacy for functional constipation questionnaire (SEFCQ) was developed by the authors and evaluated by 10 children and seven experts. Ninety-nine healthy children and 122 children with functional constipation completed the SEFCQ and three other questionnaires measuring related constructs.

KEY RESULTS

Minor changes were made in wording based on feedback from experts and children. Factor analysis showed two scales, a 7 item Action scale (Cronbach's α = 0.88) and a 7 item Emotion scale (Cronbach α = 0.86). The SEFCQ total scale correlated positively with general self-efficacy (r = .32, P < .001) and quality of life (r = .20; P < .01) and negatively with anxiety (r = -.15; P < .05). Scores on the SEFCQ were higher in children without functional constipation compared to those with functional constipation (53.33 + 3.38 vs 39.34 + 7.19, P < .001).

CONCLUSIONS & INFERENCES

We developed a constipation specific self-efficacy questionnaire with good initial internal reliability, excellent face validity and adequate content validity. A low self-efficacy for defecation, may make the child resist their physical urge to defecate and hence, the need for further studies to assess its effect on treatment outcomes.

Water Load Test in Children with Chronic Abdominal Pain or Obesity Compared with Nonobese Controls

OBJECTIVE

Satiety is the perception of satisfied fullness and represents a summation of neural and hormonal influences. Satiety can be assessed by drink tests, including water load. The objective of our study was to confirm the difference in water load volume between nonobese control children and children with functional dyspepsia (FD), children with irritable bowel syndrome (IBS), and obese children.

METHODS

A total of 158 children ages 6 to 13 years participated in the study. There were 43 children with FD, 25 with IBS, 44 obese children, and 46 nonobese age-matched control children. Subjects drank as much water as possible in 3 minutes or until their stomachs felt full.

RESULTS

Children in the FD and IBS groups drank less water than did the nonobese controls; the obese children drank more water than did the nonobese controls. The water load test demonstrated high specificity but poor sensitivity in predicting children with FD.

CONCLUSIONS

A water load test offers a simple, noninvasive research tool to measure satiety. Children with chronic abdominal pain drank less than nonobese control children; however, the water load test did not discriminate between FD and IBS. Obese children drank more water than the other groups, suggesting the possibility of an underlying abnormality in the perception of satiety.

Age of Onset of Functional Constipation

In a review of 538 children with functional constipation, we analyzed ages of presentation and onset, symptom duration, and behavioral/developmental problems. We divided the subjects into quartiles (Q1-Q4) based on age of onset. Median onset age was 2.3 years. The oldest group had the shortest symptom duration before referral at 1.8 ± 1.8 years (compared with Q3 to Q1, P = 0.039, P = 0.001, P < 0.001, respectively). Of the Q4 subjects, 22% had a behavioral/developmental problem (P < 0.001 compared with Q1-Q3). We conclude that most children develop functional constipation as infants and toddlers, but those with later onset are more likely to have behavioral/developmental issues and see a specialist sooner.

Attitudes and the Implicit Association Test

Three studies examined the relationship between the Implicit Association Test (IAT) and explicit attitudes. In the 1st and all subsequent studies, the lack of any correlation between the IAT and explicitly measured attitudes supports the view that the IAT is independent from explicit attitudes. Study 2 examined the relationships among the IAT, explicit attitudes, and behavior and found that the explicit attitudes predicted behavior but the IAT did not. Finally, in Study 3 it was found that the IAT was affected by exposing participants to new associations between attitude objects, whereas the explicit attitudes remained unchanged. Taken together, these results support an environmental association interpretation of the IAT in which IAT scores reflect the associations a person has been exposed to in his or her environment rather than the extent to which the person endorses those evaluative associations.

Attitudes and the Implicit Association Test

Three studies examined the relationship between the Implicit Association Test (IAT) and explicit attitudes. In the 1st and all subsequent studies, the lack of any correlation between the IAT and explicitly measured attitudes supports the view that the IAT is independent from explicit attitudes. Study 2 examined the relationships among the IAT, explicit attitudes, and behavior and found that the explicit attitudes predicted behavior but the IAT did not. Finally, in Study 3 it was found that the IAT was affected by exposing participants to new associations between attitude objects, whereas the explicit attitudes remained unchanged. Taken together, these results support an environmental association interpretation of the IAT in which IAT scores reflect the associations a person has been exposed to in his or her environment rather than the extent to which the person endorses those evaluative associations.

Physiologic responses of coronary care patients to visiting

The authors examined physiologic changes in myocardial infarction patients during a family visit in the cardiac intensive care unit (CICU) and the relationship of these changes to illness variables, patient preference for visits, and patients' perceptions of the supportiveness of the visit. Forty-eight patients were studied for changes in heart rate, blood pressure, ST segment, and oxygen saturation. Patients who had the greatest physiologic changes were among those who had had more severe infarcts. However, many patients in the severe category did not show such changes. Examination of the reactive group revealed that, in addition to having more severe infarcts, it included a greater percentage of smokers than did the nonreactive group. Visit preferences were relatively low, but as visit preferences increased, so did cardiovascular changes. Supportiveness scores were quite high, and these were positively correlated with cardiovascular changes. Clinical and research implications are discussed.

Quantitative light and electron microscopic changes in thymic reticular epithelial cells during Moloney-virus-induced lymphoma development

This report describes two types of reticular epithelial cell in the thymic cortex of the BALB/c mouse, an immature and a mature form. During early stages of lymphoma development, i.e., 2-6 weeks postinfection (p.i.) with Moloney leukemia virus (M-MuLV), activation of the epithelial cells is observed. Although the percentage of these cells in the total cell population of the thymic cortex remains constant during that time, the number of mature epithelial cells is significantly increased in infected animals. Subsequently, about 6 weeks p.i., the number of immature epithelial cells starts to increase, whereas the number of mature reticular epithelial cells declines and the appearance of the mature epithelial cells changes drastically. The results of light and electron microscopic studies indicate degeneration of the mature reticular epithelial cells at the onset of lymphoma development at a time when the first deficiencies in the immunologic competence of the reticular epithelial cells are apparent.

Differentiation block of prethymic lymphocytes during Moloney-virus-induced lymphoma development associated with a thymic epithelial defect

Previous cytokinetic studies in Moloney-virus (M-MuLV)-induced lymphomas of BALB/c mice showed an intrathymic maturation block of prethymic lymphocytes derived from hematopoietic tissues. Thymus-cell cultures during the latent period of lymphoma development showed a proportion of nonlymphoid cells (NLC) from uninfected mice of 0.1% (3 days) to 0.002% (20 days), rising in infected mice to 1-2% after 5 weeks. Concomitantly, thymic epithelial cells exhibit progressive degenerative changes in vivo in infected mice with virus replication and in vitro a marked cellular polymorphism with nuclear atypia becomes overt. Immunofluorescence studies of thymopoietin II and serum thymus factor in epithelial cells indicate a marked decrease of these hormones in the epithelial cells from infected mice. These results suggest a functional defect of virus-infected thymic epithelial cells which causes a progressive accumulation of nondifferentiating T-cell precursors.