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Cojocaru CM, Popa CO, Schenk A, Jakab Z, Suciu BA, Olah P, Popoviciu H, Szasz S. A Single-Session Process-Based Cognitive-Behavioral Intervention Combined with Multimodal Rehabilitation Treatment for Chronic Pain Associated with Emotional Disorders. Behav Sci (Basel) 2024; 14:327. [PMID: 38667123 PMCID: PMC11047417 DOI: 10.3390/bs14040327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/29/2024] [Accepted: 04/12/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Defined by chronic pain, rheumatic diseases are often co-occurring with anxiety and depression. Among the available psychological interventions, cognitive-behavioral therapies have an already-proven efficiency in these cases. However, the need to adjust their structure became ubiquitous during the post-pandemic period. Hence, the objective of this study was to investigate the impact of a single-session, process-based cognitive-behavioral intervention for patients with rheumatic conditions within an in-patient setting. MATERIALS AND METHODS A total of 31 participants (mean age 58.9 years) completed the single-session intervention. Assessments were conducted prior to the intervention, post-intervention and after one month. RESULTS Pearson's correlations, paired samples T tests and a covariance analysis based on the Linear Mixed Model were performed for exploring the relations between baseline variables and evaluating the impact of the SSI intervention. Immediately after the intervention, a significant reduction in cognitive fusion (p = 0.001, d = 1.78), experiential avoidance (p = 0.001, d = 1.4) and dysfunctional behavioral processes was observed. At the one-month evaluation, participants reported decreased pain (p = 0.001, d = 1.11), anxiety (p = 0.004, d = 0.55) and depression (p = 0.001, d = 0.72). CONCLUSIONS The single-session, process-based approach represents a promising intervention in healthcare contexts, as an integrative part of a multimodal rehabilitation treatment in patients with rheumatic conditions.
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Affiliation(s)
- Cristiana-Manuela Cojocaru
- The Doctoral School of George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (C.-M.C.); (A.S.)
| | - Cosmin Octavian Popa
- Department of Ethics and Social Sciences, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania
| | - Alina Schenk
- The Doctoral School of George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (C.-M.C.); (A.S.)
| | - Zsolt Jakab
- Department of Counseling, Career Guidance and Informing Students, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania;
| | - Bogdan Andrei Suciu
- Department of Anatomy and Morphological Sciences, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540142 Targu-Mures, Romania;
| | - Peter Olah
- Department of Medical Informatics and Biostatistics, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania;
| | - Horațiu Popoviciu
- Department of Rheumatology, Physical and Rehabilitation Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (H.P.); (S.S.)
| | - Simona Szasz
- Department of Rheumatology, Physical and Rehabilitation Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (H.P.); (S.S.)
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Doumen M, De Meyst E, Lefevre C, Pazmino S, Joly J, Bertrand D, Devinck M, Westhovens R, Verschueren P. Effectiveness and feasibility of a mobile health self-management intervention in rheumatoid arthritis: study protocol for a pragmatic multicentre randomised controlled trial (AEGORA). Trials 2023; 24:697. [PMID: 37898781 PMCID: PMC10613379 DOI: 10.1186/s13063-023-07733-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/16/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) considerably impacts patients' lives. Patients' confidence in their ability to manage this impact, or self-efficacy, can be supported with self-management interventions. One approach is to use mobile health (mHealth) applications, which can additionally provide insight into disease impact by remotely monitoring patient-reported outcomes. However, user engagement with mHealth-apps is variable, and concerns exist that remote monitoring might make patients overly attentive to symptoms. METHODS App-based Education and GOal setting in RA (AEGORA) is a multicentre, pragmatic randomised controlled trial investigating an mHealth-based self-management intervention to improve self-efficacy and remotely monitor disease impact in patients with RA. The intervention is provided via an adapted version of the application Sidekick (Sidekick Health, Reykjavik, Iceland) and consists of education, goal setting, lifestyle advice, and remote assessment of the Rheumatoid Arthritis Impact of Disease (RAID) questionnaire. Across two centres, 120 patients will be recruited and randomised (2:1:1) to usual care or intervention group A/B (study app with weekly/monthly prompts to complete the RAID, respectively). Outcomes are assessed at baseline and after 4-6 months. The primary endpoint is a clinically important improvement (≥ 5.5/110) in the Arthritis Self-Efficacy Scale in the combined intervention group compared to usual care. Secondary endpoints are (a) non-inferiority regarding pain catastrophising, as a measure of symptom hypervigilance; (b) superiority regarding the RAID, sleep quality, and physical activity; and (c) participant engagement with the study app. Finally, the relationship between engagement, prompted frequency of RAID questionnaires, and the primary and secondary outcomes will be explored. DISCUSSION The AEGORA trial aims to study the effectiveness of mHealth-based, multicomponent self-management support to improve self-efficacy in the context of RA, while providing potentially valuable insights into temporal disease activity dynamics and the feasibility and possible negative effects of remote symptom monitoring in this population. TRIAL REGISTRATION Clinicaltrials.gov NCT05888181. Retrospectively registered on March 23, 2023. Study inclusion started on March 3, 2023.
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Affiliation(s)
- Michaël Doumen
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, KU Leuven, Leuven, Belgium.
- Rheumatology, University Hospitals Leuven, Leuven, Belgium.
| | - Elias De Meyst
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, KU Leuven, Leuven, Belgium
- Rheumatology, University Hospitals Leuven, Leuven, Belgium
| | - Cedric Lefevre
- Rheumatology, University Hospitals Leuven, Leuven, Belgium
| | - Sofia Pazmino
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, KU Leuven, Leuven, Belgium
| | - Johan Joly
- Rheumatology, University Hospitals Leuven, Leuven, Belgium
| | - Delphine Bertrand
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, KU Leuven, Leuven, Belgium
| | | | - René Westhovens
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, KU Leuven, Leuven, Belgium
- Rheumatology, University Hospitals Leuven, Leuven, Belgium
| | - Patrick Verschueren
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, KU Leuven, Leuven, Belgium
- Rheumatology, University Hospitals Leuven, Leuven, Belgium
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Wang Y, Guang Z, Zhang J, Han L, Zhang R, Chen Y, Chen Q, Liu Z, Gao Y, Wu R, Wang S. Effect of Sleep Quality on Anxiety and Depression Symptoms among College Students in China's Xizang Region: The Mediating Effect of Cognitive Emotion Regulation. Behav Sci (Basel) 2023; 13:861. [PMID: 37887511 PMCID: PMC10603987 DOI: 10.3390/bs13100861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/05/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND While the exact mechanisms are not fully understood, there are significant links between sleep quality, anxiety, depressive symptoms, and cognitive emotion regulation. This research examines how sleep quality affects anxiety and depressive symptoms, as well as the potential of cognitive emotion regulation strategies (CERS) to moderate the impact of sleep quality on these symptoms. METHODS The Chinese version of the Pittsburgh Sleep Quality Index (CPSQI), the Cognitive Emotion Regulation Questionnaire (CERQ), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder Scale-7 (GAD-7) were all completed online by students from two colleges in China's Xizang region. RESULTS The study included 4325 subjects. The prevalence of poor sleep quality, anxiety symptoms, and depression symptoms was 45.69%, 36.81%, and 51.86%, respectively. We observed significant direct effects on poor sleep and severity of anxiety/depression: c'1 = 0.586 (0. 544-0.628), and c'2 = 0.728 (0.683-0.773). Adaptive CERS only had a mediating effect on the relationship between sleep quality and depression symptoms, with a1b3 = -0.005 (-0.011--0.001). The link between poor sleep quality and the intensity of anxiety and depression was significantly affected by the indirect effects of maladaptive CERS: effect a2b2 = 0.126 (0.106-0.147), and effect a2b4 = 0.145 (0.123-0.167). CONCLUSIONS Individuals who experience poor sleep quality are more likely to have increased levels of anxiety and depression. However, enhancing sleep quality led to a decrease in anxiety and depression levels. Adaptive CERS did not predict anxiety, but they did predict depression. Multiple maladaptive CERS could increase levels of anxiety and depression. To prevent mental stress, it is crucial to examine sleep problems among college students, understand their cognitive strategies, promote the adoption of adaptive CERS, and reduce the reliance on maladaptive CERS.
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Affiliation(s)
- Yingting Wang
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Zixuan Guang
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Jinjing Zhang
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Lixin Han
- School of Public Health, Xi’an Jiaotong University Health Science Center, No.76 Yanta West Road, Xi’an 710049, China
- Disease Control and Prevention Division, Shaanxi Provincial Health Commission, No.112 Lianhu Road, Xi’an 710003, China
| | - Rongqiang Zhang
- School of Public Health, Shaanxi University of Chinese Medicine, Xianyang 712046, China
| | - Yichun Chen
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Qi Chen
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
| | - Zhenjia Liu
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Yuan Gao
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Ruipeng Wu
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang 712082, China
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
| | - Shaokang Wang
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
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Bacon AM, White L, Norman A. Coping with fibromyalgia during the COVID-19 pandemic: adjustment and wellbeing. Psychol Health 2023; 38:1345-1360. [PMID: 34903135 DOI: 10.1080/08870446.2021.2013484] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 10/20/2021] [Accepted: 11/28/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Fibromyalgia syndrome (FMS) is a chronic condition with symptoms known to be exacerbated by stress. Individuals with FMS may be experiencing particular distress under Covid-19 pandemic-related lifestyle restrictions. The present study examined wellbeing, perceived symptom change and coping in individuals with and without FMS during pandemic-related social lockdown in the UK. DESIGN Participants with a diagnosis of FMS (N = 390) and a general public sample with no FMS (N = 151) completed questionnaires at three time points. MAIN OUTCOME MEASURES BBC Wellbeing Scale, Cognitive-Emotional Regulation Questionnaire measure of coping, perception of extent to which symptoms have worsened or improved over time. RESULTS Contrary to expectations, FMS participants reported no worsening of symptoms and an increase in wellbeing over the study period. Non-FMS participants experienced worsening health symptoms and no change in wellbeing. Coping strategies involving positive reappraisal, refocussing and planning were positively associated with wellbeing in the FMS group. CONCLUSION The unpredictable symptom profile in FMS, and the regular readjustment this necessitates, may support a form of resilience which has been adaptive during the pandemic. The results have implications for supporting people with FMS, and potentially other chronic conditions, especially at times of stress.
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Affiliation(s)
- Alison M Bacon
- School of Psychology, University of Plymouth, Plymouth, Devon, UK
| | - Leah White
- School of Psychology, University of Plymouth, Plymouth, Devon, UK
| | - Alyson Norman
- School of Psychology, University of Plymouth, Plymouth, Devon, UK
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SeyedAlinaghi S, MohsseniPour M, Aghaei E, Zarani F, Fathabadi J, . MM. The Relationships Between Early Maladaptive Schemas, Quality of Life and Self-care Behaviors in a Sample of Persons Living with HIV: The Potential Mediating Role of Cognitive Emotion Regulation Strategies. Open AIDS J 2020. [DOI: 10.2174/1874613602014010100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
People who are living with HIV often experience physical as well as psychological challenges. Therefore, the aim of this descriptive, correlational study was to explore the potential mediating role of cognitive emotion regulation strategies in the relationships between early maladaptive schemas, quality of life, and self-care behavior in patients with HIV/AIDS.
Methods:
In the first half of 2017, patients with HIV/AIDS (N=240) were recruited from an HIV clinic in Tehran, Iran. A self-report questionnaire included the Young Schema Questionnaire-Short Form (YSQSF), Short Form Health Survey (SF-36), short form of Cognitive Emotion Regulation Questionnaire (CERQ), and a self-care behaviors questionnaire. The data analysis involved using advanced statistical techniques for structural equation modeling.
Results:
There were significant, inverse relationships between all five areas of early maladaptive schemas and positive cognitive emotional regulation strategies, self-care behaviors, and quality of life. Also, there were significant, positive relationships between all five areas of early maladaptive schemas and negative cognitive and emotional regulation strategies.
Conclusion:
The findings suggest that practical interventions to reduce maladaptive responses may result in healthier outcomes for persons living with HIV.
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Wang LN, Tao H, Wang M, Yu HW, Su H, Wu B. Efficacy of path-oriented psychological self-help interventions to improve mental health of empty-nest older adults in the Community of China. BMC Psychiatry 2019; 19:365. [PMID: 31752762 PMCID: PMC6868724 DOI: 10.1186/s12888-019-2327-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 10/17/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND China has the world's largest aging population and the number of empty-nest older adults is on the rise. In comparison to the aging population in general, empty-nest older adults have a lower level of subjective well-being and poorer mental health status due to a lack of emotional support from their children. The aim of this study is to conduct an empirical study to evaluate the efficacy of the 'Path-oriented Psychological Self-help Intervention' (P-oPSI) led by nurses on the mental health of empty-nest older adults in the community, to provide a scientific foundation for improving their quality of life. METHODS A Quasi-Experimental controlled intervention study was conducted from 2015 to 2017. A total of 76 empty-nest older adults from 2 districts were recruited using a convenience sampling and assigned to 2 groups based on their residential communities in the city of Chifeng in the Inner Mongolia Autonomous Region, China. The wait list control group participated in a mental health lecture to gain knowledge and learn techniques of mental health promotion. The intervention group additionally received 1 month of training in a nurse-led 'P-oPSI' for a month. Both groups were followed-up for 3 months. Mental health status, coping styles, and psychological self-help ability of the participating empty nest older adults were assessed at the baseline, 1 month, and 3-months follow up, respectively. Two-way analysis of variance and a simple effect test were used to analyse the differences of the two groups. RESULTS The P-oPSI yielded a greater benefit for the mental health status, coping styles, and psychological self-help ability of the participants in the intervention group. Combined with a simple effect test, the scores of the mental health status, positive coping style, and psychological self-help ability of those in the intervention group significantly increased at 1 month after the baseline (F mental health status = 7.59, F positive coping style = 7.24, F psychological self-help ability = 7.07); and the sustainable effect of this program lasted for 3 months after the intervention (F mental health status = 13.24, F positive coping style = 10.42, F psychological self-help ability = 10.45), which reached statistical significance (P < 0.01). CONCLUSIONS The P-oPSI program significantly improved the level of mental health of empty-nest older adults in China. This intervention provides a new approach of self-management to improve mental health of older adults in community settings. TRIAL REGISTRATION chictr.org.cn: ChiCTR1900025552. Retrospectively registered 1 September 2019.
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Affiliation(s)
- Li-Na Wang
- School of Medicine, Huzhou University, Huzhou Central Hospital, Huzhou, 313000 Zhejiang China
| | - Hong Tao
- AdventHealth Whole-Person Research, Orlando, FL 32804 USA
| | - Mi Wang
- School of Nursing, Binzhou Polytechnic, Binzhou, 256600 Shandong China
| | - Hong-Wei Yu
- School of Medicine, Huzhou University, Huzhou Central Hospital, Huzhou, 313000 Zhejiang China
| | - Hong Su
- 0000 0001 2204 9268grid.410736.7School of Nursing, Harbin Medical University, DaQing Campus, Daqing, 163319 China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY, 10010, USA.
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Screening preoperative anxiety – when does it relate to the quality of life among patients before total joint replacement? Preliminary reports. HEALTH PSYCHOLOGY REPORT 2019. [DOI: 10.5114/hpr.2019.85660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Investigating the association between fantasy proneness and emotional distress: the mediating role of cognitive coping strategies. PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2018.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Hu A, Hillel A, Zhao W, Meyer T. Anxiety and depression in spasmodic dysphonia patients. World J Otorhinolaryngol Head Neck Surg 2018; 4:110-116. [PMID: 30101219 PMCID: PMC6074012 DOI: 10.1016/j.wjorl.2018.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 04/17/2018] [Indexed: 12/01/2022] Open
Abstract
Objective/Hypothesis Experts used to believe that spasmodic dysphonia (SD) was a psychogenic disorder. Although SD is now established as a neurological disorder, the rates of co-morbid anxiety and depression range from 7.1% to 62%. Our objective was to study the prevalence and risk factors associated with these mood disorders in SD patients. Study design Retrospective. Methods SD patients who presented for botulinum toxin injections were recruited. Demographic data, Hospital Anxiety and Depression Scale (HADS), Voice Handicap Index-10 (VHI-10), General Self-Efficacy scale (GSES), Disease Specific Self-Efficacy in Spasmodic Dysphonia scale (DSSE), and Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) were collected. Results One hundred and forty two patients (age (59.2 ± 13.6) years, 25.4% male) had VHI-10 of 26.3 ± 6.9 (mean ± standard deviation), GSES 33.2 ± 5.8, CAPE-V 43.9 ± 20.9, HADS anxiety 6.7 ± 3.7, and HADS depression 3.6 ± 2.8. About 19 (13.4%) and 4 (2.8%) had symptoms of anxiety and depression respectively. Final linear regression model for HADS anxiety (R2 = 32.90%) showed that patients who were less likely to have anxiety symptoms were older age (p < 0.001), male (p = 0.002), have higher GSES (p < 0.001) and lower VHI-10 (p = 0.004). Final linear regression model for HADS depression score (R2 = 34.42%) showed that patients who were less likely to have depressive symptoms had high DSSES (p < 0.001). Conclusions Prevalence of anxiety (13.4%) and depression (2.8%) in SD were lower than previously reported in the literature. Risk factors for anxiety were: younger age, female gender, lower general self-efficacy, and higher perceived vocal handicap. The main risk factor for depression was lower disease specific self-efficacy.
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Affiliation(s)
- Amanda Hu
- Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada
| | - Al Hillel
- Department of Otolaryngology - Head & Neck Surgery, University of Washington, Seattle, WA, USA
| | - Wei Zhao
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Tanya Meyer
- Department of Otolaryngology - Head & Neck Surgery, University of Washington, Seattle, WA, USA
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Mocan AŞ, Iancu SŞ, Băban AS. Association of cognitive-emotional regulation strategies to depressive symptoms in type 2 diabetes patients. ROMANIAN JOURNAL OF INTERNAL MEDICINE 2018; 56:34-40. [DOI: 10.1515/rjim-2017-0037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Indexed: 12/15/2022] Open
Abstract
Abstract
Aim. The present cross-sectional observational study aimed to investigate the relation between cognitive–emotional regulation strategies and depressive symptoms in type 2 diabetes patients in the context of sociodemographic and clinical factors, of diabetes distress, perception of illness consequences and previous depression.
Method. Multiple logistic regression was performed on the responses of 354 adults with type 2 diabetes (58.5% women; mean ± SD age: 61.14 ± 8.5 years; diabetes duration: 9.7 ± 6.4 years; BMI: 30.9 ± 5.3 kg/m2). Depressive symptoms were present in 16.9% and diabetes distress in 45.5%. Participants completed questionnaires on depression (BDI-II), cognitive-emotional regulation strategies (CERQ), diabetes distress (DDS), illness perceived consequences (IPQ-R).
Results. Of the cognitive–emotional strategies, lower positive reappraisal of diabetes (OR:0.49;CI:0.34-0.70) and increased catastrophizing (OR:2.08; CI:1.47-2.91) were found to increase the likelihood of experiencing depressive symptoms in the presence of higher diabetes distress (OR: 1.53; CI:1.07-2.19), increased negative perception of diabetes consequences (OR:2.02; CI:1.34-3.06) and the presence of previous depression (OR:4.18; CI:2.03-8.63).
Conclusion. To our knowledge, this is the first study to report on cognitive-emotional regulation strategies in type 2 diabetes and provides evidence for the beneficial influence of positive reappraisal and adverse effect of catastrophizing on depressive symptoms in the context of diabetes distress, perceived consequences of diabetes and previous history of depression.
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Affiliation(s)
- Andreia Ş. Mocan
- Center for Diabetes, Nutrition and Metabolic Disease; Emergency Clinical County Hospital Cluj , Romania
- Department of Psychology , “Babeş-Bolyai” University Cluj , Romania
| | - Silvia Ş. Iancu
- Department of Psychology , “Babeş-Bolyai” University Cluj , Romania
| | - Adriana S. Băban
- Center for Diabetes, Nutrition and Metabolic Disease; Emergency Clinical County Hospital Cluj , Romania
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Lambert SD, Beatty L, McElduff P, Levesque JV, Lawsin C, Jacobsen P, Turner J, Girgis A. A systematic review and meta-analysis of written self-administered psychosocial interventions among adults with a physical illness. PATIENT EDUCATION AND COUNSELING 2017; 100:2200-2217. [PMID: 28734559 DOI: 10.1016/j.pec.2017.06.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/19/2017] [Accepted: 06/30/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The cost of implementing professionally-led psychosocial interventions has limited their integration into routine care. To enhance the translation of effective psychosocial interventions in routine care, a self-administered format is sometimes used. The meta-analysis examined the efficacy of written self-administered, psychosocial interventions to improve outcomes among individuals with a physical illness. METHODS Studies comparing a written self-administered intervention to a control group were identified through electronic databases searching. Pooled effect sizes were calculated across follow-up time points using random-effects models. Studies were also categorised according to three levels of guidance (self-administered, minimal contact, or guided) to examine the effect of this variable on outcomes. RESULTS Forty manuscripts were retained for the descriptive review and 28 for the meta-analysis. Findings were significant for anxiety, depression, distress, and self-efficacy. Results were not significant for quality of life and related domains as well as coping. Purely self-administered interventions were efficacious for depression, distress, and self-efficacy; only guided interventions had an impact on anxiety. CONCLUSIONS Findings showed that written self-administered interventions show promise across a number of outcomes. PRACTICE IMPLICATIONS Self-administered interventions are a potentially efficacious and cost-effective approach to address some of the most common needs of patients with a physical illness.
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Affiliation(s)
- Sylvie D Lambert
- Ingram School of Nursing, McGill University, Wilson Hall, 3506 University Street, Montreal, H3A 2A7, Canada; Psycho-Oncology Research Group, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Sydney, The University of New South Wales, Liverpool, Australia(1); St. Mary's Research Centre.
| | - Lisa Beatty
- School of Psychology, Flinders University, Adelaide, Australia
| | - Patrick McElduff
- School of Medicine and Public Health, The University of Newcastle, HMRI building, John Hunter Hospital Campus, New Lambton Heights, Australia
| | - Janelle V Levesque
- Psycho-Oncology Research Group, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Sydney, The University of New South Wales, Liverpool, Australia(1)
| | - Catalina Lawsin
- School of Psychology, The University of Sydney, Sydney, Australia
| | - Paul Jacobsen
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Jane Turner
- Mental Health Centre, The University of Queensland, Herston, Australia
| | - Afaf Girgis
- Psycho-Oncology Research Group, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Sydney, The University of New South Wales, Liverpool, Australia(1)
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Withers MH, Gonzalez LT, Karpouzas GA. Identification and Treatment Optimization of Comorbid Depression in Rheumatoid Arthritis. Rheumatol Ther 2017; 4:281-291. [PMID: 28815445 PMCID: PMC5696284 DOI: 10.1007/s40744-017-0072-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Indexed: 12/20/2022] Open
Abstract
Patients with rheumatoid arthritis (RA) suffer from high rates of depression but depression often remains undiagnosed and untreated among RA patients. Because of its high prevalence and its profound impact on functional disability and health-related quality of life, prompt recognition and management of comorbid depression is urgently needed in patients with RA. Rheumatologists face the challenge of addressing depression in their clinical interactions with patients. The purpose of this paper is to present the prevalence of comorbid depression in RA, to delineate the consequences of depression among RA patients, to discuss the barriers to the identification of depression among RA patients, and to outline a set of recommendations to identify and treat comorbid depression that could be implemented within the rheumatology clinic setting. A comprehensive approach to the management of both physical and mental health needs of RA patients can aid in improving patient overall quality of life. New clinical protocols should be developed to include routine depression screening as part of the rheumatology visit. Patient education to address misconceptions, knowledge gaps, and destigmatize depression is also recommended. More counseling resources, including emotional support groups, are necessary to provide treatment for those suffering from depression. Such interventions could help mitigate disability, improve quality of life, patient function, and overall satisfaction.
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Affiliation(s)
- Mellissa H Withers
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Louella T Gonzalez
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Siegel P, Tencza M, Apodaca B, Poole JL. Effectiveness of Occupational Therapy Interventions for Adults With Rheumatoid Arthritis: A Systematic Review. Am J Occup Ther 2017; 71:7101180050p1-7101180050p11. [PMID: 28027042 DOI: 10.5014/ajot.2017.023176] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We reviewed the efficacy of occupational therapy-related interventions for adults with rheumatoid arthritis. METHOD We examined 51 Level I studies (19 physical activity, 32 psychoeducational) published 2000-2014 and identified from five databases. Interventions that focused solely on the upper or lower extremities were not included. RESULTS Findings related to key outcomes (activities of daily living, ability, pain, fatigue, depression, self-efficacy, disease symptoms) are presented. Strong evidence supports the use of aerobic exercise, resistive exercise, and aquatic therapy. Mixed to limited evidence supports dynamic exercise, Tai Chi, and yoga. Among the psychoeducation interventions, strong evidence supports the use of patient education, self-management, cognitive-behavioral approaches, multidisciplinary approaches, and joint protection, and limited or mixed evidence supports the use of assistive technology and emotional disclosure. CONCLUSION The evidence supports interventions within the scope of occupational therapy practice for rheumatoid arthritis, but few interventions were occupation based.
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Affiliation(s)
- Patricia Siegel
- Patricia Siegel, OTD, OTR/L, CHT, is Lecturer II, Occupational Therapy Graduate Program, University of New Mexico, Albuquerque
| | - Melissa Tencza
- Melissa Tencza, MOTS, is Student, Occupational Therapy Graduate Program, University of New Mexico, Albuquerque
| | - Beverly Apodaca
- Beverly Apodaca, MOTS, is Student, Occupational Therapy Graduate Program, University of New Mexico, Albuquerque
| | - Janet L Poole
- Janet L. Poole, PhD, OTR/L, FAOTA, is Professor and Program Director, Occupational Therapy Graduate Program, University of New Mexico, Albuquerque;
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Hamnes B, van Eijk-Hustings Y, Primdahl J. Readability of patient information and consent documents in rheumatological studies. BMC Med Ethics 2016; 17:42. [PMID: 27422433 PMCID: PMC4947296 DOI: 10.1186/s12910-016-0126-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 06/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Before participation in medical research an informed consent must be obtained. This study investigates whether the readability of patient information and consent documents (PICDs) corresponds to the average educational level of participants in rheumatological studies in the Netherlands, Denmark, and Norway. METHODS 24 PICDs from studies were collected and readability was assessed independently using the Gunning's Fog Index (FOG) and Simple Measure of Gobbledygook (SMOG) grading. RESULTS The mean score for the FOG and SMOG grades were 14.2 (9.0-19.0) and 14.2 (12-17) respectively. The mean FOG and SMOG grades were 12.7 and 13.3 in the Dutch studies, 15.0 and 14.9 in the Danish studies, and 14.6 and 14.3 in the Norwegian studies, respectively. Out of the 2865 participants, more than 57 % had a lower educational level than the highest readability score calculated in the individual study. CONCLUSIONS As the readability level of the PICDs did not match the participants' educational level, consent may not have been valid, as the participants may have had a limited understanding of what they agreed to participate in. There should be more focus on the readability of PICDs. National guidelines for how to write clear and unambiguous PICDs in simple and easily understandable language could increase the focus on the readability of PICD.
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Affiliation(s)
- Bente Hamnes
- />Hospital for Rheumatic Diseases, Margrethe Grundvigs vei 6, 2609 Lillehammer, Norway
| | - Yvonne van Eijk-Hustings
- />Department of Patient & Care, Maastricht University Medical Centre, PO Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Jette Primdahl
- />Institute for Regional Health Research, University of Southern Denmark, Winsløwparken 19, 5000 Odense, Denmark
- />Hospital of Southern Denmark, Kresten Philipsens vej 15, 6200 Aabenraa, Denmark
- />King Christian 10th Hospital for Rheumatic Diseases, Toldbodgade 3, 6300 Graasten, Denmark
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Effectiveness of Cognitive Behavioural Self-Help for the Treatment of Depression and Anxiety in People with Long-Term Physical Health Conditions: a Systematic Review and Meta-Analysis of Randomised Controlled Trials. Ann Behav Med 2016; 49:579-93. [PMID: 25690370 DOI: 10.1007/s12160-015-9689-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Depression and anxiety are prevalent comorbidities in people with long-term physical health conditions; however, there is limited access to evidence-based treatments for comorbid mental health difficulties. PURPOSE This study is a meta-analysis examining the effectiveness of cognitive behavioural self-help for physical symptoms, depression and anxiety in people with long-term conditions. METHODS This study involves a systematic search of electronic databases supplemented by expert contact, reference and citation checking and grey literature. RESULTS The meta-analysis yielded a small effect size for 11 studies reporting primary outcomes of depression (g = -0.20) and 8 studies anxiety (g = -0.21) with a large effect size (g = -1.14) for 1 study examining physical health symptoms. There were no significant moderators of the main effect. CONCLUSIONS Limited evidence supports cognitive behavioural self-help for depression, anxiety and physical symptoms in people with long-term conditions. Small effect sizes for depression and anxiety may result from failure to recruit participants with clinical levels of these difficulties at baseline.
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van Luenen S, Kraaij V, Spinhoven P, Garnefski N. An Internet-based self-help intervention for people with HIV and depressive symptoms: study protocol for a randomized controlled trial. Trials 2016; 17:172. [PMID: 27036970 PMCID: PMC4815219 DOI: 10.1186/s13063-016-1292-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 03/15/2016] [Indexed: 01/09/2023] Open
Abstract
Background Many people living with HIV suffer from depressive symptoms. In a previous pilot study, self-help cognitive behavioral therapy (in booklet format) was found to be effective in treating depressive symptoms in people with HIV. We developed an online self-help program in Dutch and English (based on the booklet) for people with HIV and depressive symptoms. Besides the main question regarding the effectiveness of the program aimed at lowering depressive symptoms, sub-questions will focus on the moderators of treatment success (for which patients is the program especially beneficial?) and the mechanisms of change underlying the treatment outcome (which mediators affect the outcome of treatment?). In this paper, the protocol of the study will be described. Methods/design The effectiveness of the program will be investigated by comparing the intervention group with a waiting list-control group in a randomized controlled design, by including a pretest and three post-tests. The self-help program contains four main components: activation, relaxation, changing maladaptive cognitions, and goal attainment. Participants with mild to moderate depressive symptoms will work on the program for 6 to 10 weeks, during which a coach will provide motivational support by telephone once a week. Participants in the control condition will receive weekly minimal support from a coach for 8 weeks, and after the second post-test, they can gain access to the self-help program. Depressive symptoms and possible mediators (e.g., activation, cognitive coping, self-efficacy, and goal adjustment) will be assessed by self-report three times during the intervention/waiting period and at the pretest and first post-test. Discussion The proposed study aims to evaluate the effectiveness of an online self-help intervention for people with HIV and depressive symptoms. If the intervention is shown to be effective, the program will be implemented. Consequently, many patients with HIV could be reached, and their psychological care may be improved. Trial registration Netherlands Trial Register: NTR5407 Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1292-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sanne van Luenen
- Institute of Psychology, Section of Clinical Psychology, Leiden University, Faculty of Social and Behavioral Sciences, P.O. Box 9555, 2300, RB, Leiden, The Netherlands.
| | - Vivian Kraaij
- Institute of Psychology, Section of Clinical Psychology, Leiden University, Faculty of Social and Behavioral Sciences, P.O. Box 9555, 2300, RB, Leiden, The Netherlands
| | - Philip Spinhoven
- Institute of Psychology, Section of Clinical Psychology, Leiden University, Faculty of Social and Behavioral Sciences, P.O. Box 9555, 2300, RB, Leiden, The Netherlands
| | - Nadia Garnefski
- Institute of Psychology, Section of Clinical Psychology, Leiden University, Faculty of Social and Behavioral Sciences, P.O. Box 9555, 2300, RB, Leiden, The Netherlands
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Cognitive, behavioral and goal adjustment coping and depressive symptoms in young people with diabetes: a search for intervention targets for coping skills training. J Clin Psychol Med Settings 2015; 22:45-53. [PMID: 25614324 PMCID: PMC4336408 DOI: 10.1007/s10880-015-9417-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of the present study was to find relevant coping factors for the development of psychological intervention programs for young people with Type 1 (T1) diabetes. A wide range of coping techniques was studied, including cognitive coping, behavioral coping and goal adjustment coping. A total of 78 young people with T1 diabetes participated. They were contacted through a social networking website, several Internet sites, and flyers. A wide range of coping techniques appeared to be related to depressive symptoms. Especially the cognitive coping strategies self-blame, rumination, refocus positive, and other-blame, together with goal adjustment coping, were of importance. A large proportion of the variance of depressive symptoms could be explained (65 %). These findings suggest that these specific coping strategies should be part of coping skills trainings for young people with T1 diabetes.
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Voshaar MJH, Nota I, van de Laar MAFJ, van den Bemt BJF. Patient-centred care in established rheumatoid arthritis. Best Pract Res Clin Rheumatol 2015; 29:643-63. [PMID: 26697772 DOI: 10.1016/j.berh.2015.09.007] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Review of the evidence on patient-centred care (PCC) in rheumatoid arthritis (RA) shows that involving the patient as an individual - with unique needs, concerns and preferences - has a relevant impact on treatment outcomes (safety, effectiveness and costs). This approach empowers patients to take personal responsibility for their treatment. Because clinicians are only able to interact personally with their patients just a few hours per year, patients with a chronic condition such as RA should be actively involved in the management of their disease. To stimulate this active role, five different PCC activities can be distinguished: (1) patient education, (2) patient involvement/shared decision-making, (3) patient empowerment/self-management, (4) involvement of family and friends and (5) physical and emotional support. This article reviews the existing knowledge on these five PCC activities in the context of established RA management, especially focused on opportunities to increase medication adherence in established RA.
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Affiliation(s)
| | - I Nota
- University of Twente, Enschede, The Netherlands.
| | - M A F J van de Laar
- University of Twente, Enschede, The Netherlands; Medisch Spectrum Twente, Enschede, The Netherlands.
| | - B J F van den Bemt
- Department of Pharmacy, Sint Maartenskliniek, Nijmegen, The Netherlands; Department of Pharmacy, Radboud University Medical Center, Nijmegen, The Netherlands.
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Grønning K, Bratås O, Steinsbekk A. Which Factors Influence Self-Efficacy in Patients with Chronic Inflammatory Polyarthritis? Musculoskeletal Care 2015; 14:77-86. [PMID: 26311320 DOI: 10.1002/msc.1114] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) or unspecified polyarthritis (UA) deal with several symptoms such as joint stiffness, pain, physical limitations and fatigue. Self-efficacy is about patients' beliefs and abilities to handle the symptoms and implications of having arthritis. Patients' self-efficacy is also a phenomenon that nurses may affect through patient education. Therefore, the aim of the present study was to investigate the factors that predict self-efficacy in patients with chronic inflammatory polyarthritis. METHODS The participants (n = 132) were recruited from St Olavs University Hospital in central Norway from 2008 to 2010, and consisted of adult patients with RA, PsA or UA. We performed secondary analyses on data collected in a randomized controlled trial studying the long-term effects of nurse-led patient education. We carried out bivariate and multivariate linear regression analyses. The predictor variables consisted of baseline data on demographics, disease characteristics (diagnosis, disease duration, disease activity, use of disease-modifying anti-rheumatic drugs, pain and tiredness) and psychological variables (well-being, psychological distress and patient activation). The dependent variables were self-efficacy over other symptoms and self-efficacy over for pain after one year. RESULTS The analyses showed that female gender and patient activation predicted higher self-efficacy over other symptoms, whereas female gender and better well-being predicted higher self-efficacy over pain. CONCLUSION To strengthen arthritis patients' self-efficacy, nurses need to focus on patients' well-being and activation. Nurses also need to be aware of possible gender differences regarding patients' self-efficacy. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Kjersti Grønning
- Sør-Trøndelag University College, Faculty of Nursing & Center for Health Promotion Research, Trondheim, Norway
| | - Ola Bratås
- Sør-Trøndelag University College, Faculty of Nursing & Center for Health Promotion Research, Trondheim, Norway
| | - Aslak Steinsbekk
- Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Withers M, Moran R, Nicassio P, Weisman MH, Karpouzas GA. Perspectives of vulnerable U.S Hispanics with rheumatoid arthritis on depression: awareness, barriers to disclosure, and treatment options. Arthritis Care Res (Hoboken) 2015; 67:484-92. [PMID: 25187020 DOI: 10.1002/acr.22462] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 08/26/2014] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Despite the high prevalence of depression among vulnerable Hispanics with rheumatoid arthritis (RA), many do not disclose it or seek treatment. This study explored patient perceptions of depression, its association with their primary disease, barriers to disclosure, reasons for low utilization of mental health care resources, and culturally acceptable intervention approaches. METHODS Semistructured interviews were conducted with 46 participants with RA. Depression was evaluated using Patient Health Questionnaire 9 (PHQ-9). RESULTS Thirty-three percent of participants were moderately depressed at the time of the interview, based on PHQ-9 score ≥10; 12 of 46 patients (26%) stated they were depressed regardless of PHQ-9 score. Depression was perceived as a long-term, severe problem leading to suicide. It was associated with weakness and character flaws, contributing to stigma and reduced likelihood of disclosure. Antidepressants were not acceptable; self-reliance and interventions incorporating interpersonal connections were preferred. Systems-related barriers to disclosure included lack of verbal screening, language barriers, limited clinic visit time, and lack of continuity of care, restricting trust with providers. CONCLUSION Rectifying misconceptions, as well as providing education regarding the association between RA and depression, the continuum of symptoms, and the range of experiences incurred are needed to facilitate earlier recognition and reduce stigma. Use, duration, and goals of antidepressant therapy should be clarified. Providers should strive to establish trust and conduct in-person depression screening to facilitate disclosure. Interventions with an interpersonal component, such as support groups or patient navigators, were preferred. Themes emphasizing coping strategies, stress reduction, positive thinking, self-efficacy, and resiliency are likely to be most acceptable.
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Affiliation(s)
- Mellissa Withers
- Harbor-University of California Medical Center and Los Angeles Biomedical Research Institute, Los Angeles, California
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Smartphone application for rheumatoid arthritis self-management: cross-sectional study revealed the usefulness, willingness to use and patients' needs. Rheumatol Int 2015; 35:1675-85. [PMID: 25903352 DOI: 10.1007/s00296-015-3270-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 04/16/2015] [Indexed: 10/23/2022]
Abstract
Patient-centered smartphone applications have potential to support rheumatoid arthritis (RA) self-management but remain almost unexplored in literature. Therefore, this study evaluated the usefulness of a smartphone application to support RA self-management, the willingness of RA patients to use and pay for it and the features the application should have. In this cross-sectional study, a questionnaire was developed to collect information on population, device ownership, usefulness and willingness to use and pay for a RA self-management application and application features. Descriptive statistics, Chi-square, Fisher's exact test, t test or Mann-Whitney's test and multivariate analysis were used. One hundred RA patients answered the questionnaire. Patients' mean age was 57 ± 11.9 years, most were females (91 %), with multiple drug regimens and a 40 % treatment non-compliance rate. Most patients believed that could have a more active role in self-management (94 %) and reported it would be useful to develop a RA self-management application (86 %). Patients willing to use an application (83 %) were younger, with a possible more active role in self-management, with access to a smartphone, and using short message service, electronic mail and Internet. Multivariate analysis confirmed these results, except the associations regarding access to a smartphone and use of electronic mail and Internet. Fifty-eight patients (82 %) were willing to pay for a RA self-management application and the most requested feature for it was information in a simple format. This study suggested the usefulness and patients' willingness to use and pay for a RA self-management application and provided insight on patients' needs.
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Azevedo ARP, de Sousa HML, Monteiro JAF, Lima ARNP. Future perspectives of Smartphone applications for rheumatic diseases self-management. Rheumatol Int 2014; 35:419-31. [PMID: 25168866 DOI: 10.1007/s00296-014-3117-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 08/13/2014] [Indexed: 01/17/2023]
Abstract
Rheumatic diseases (RD) self-management interventions are designed to improve health-related quality of life, health care utilization, and perceived self-efficacy. Despite these demonstrated good results, there are several issues that hinder or render less appealing these interventions. One economically and socially viable solution is exploiting the potential of Smartphone technology. This potential comes from Smartphones pervasive presence in actual society, combined with the advantages of being personal, intuitive, and computationally powerful, with capability to support applications and assist its user throughout different activities of daily living and environments persistently. With their global acceptance increasing quickly, there is a great opportunity for mobile health in using Smartphone applications for RD self-management. Besides the potential of such applications, research on the development and evaluation of such applications is in the early stages. Therefore, it is important to foresee its future applicability in order to meet the needs of the twenty-first century.
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Affiliation(s)
- Ana Rita Pereira Azevedo
- Faculty of Medicine of University of Porto (FMUP), Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal,
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Marks R. Self-efficacy and arthritis disability: An updated synthesis of the evidence base and its relevance to optimal patient care. Health Psychol Open 2014; 1:2055102914564582. [PMID: 28070346 PMCID: PMC5193269 DOI: 10.1177/2055102914564582] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Self-efficacy, denoting the degree of confidence an individual has in carrying out a specific activity, was initially discussed in the 1970s as a potential correlate of disease outcomes. Drawn from 35 years of related research, this review provides an updated understanding of the concept of self-efficacy and its relevance for arthritis management. There is a consistent link between self-efficacy, arthritis pain and disability, and adherence to recommended therapeutic strategies. A wide variety of intervention strategies improve arthritis self-efficacy, as well as outcomes. Steps to assess and intervene thoughtfully to maximize self-efficacy beliefs are likely to impact arthritis disability outcomes quite favorably and significantly, regardless of disease type, duration, or sociodemographic factors.
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Affiliation(s)
- Ray Marks
- The City University of New York, USA; Columbia University, USA
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