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Chen XY, Shi X, Li C, Fan F. Longitudinal associations between social support trajectories and quality of life mediated by depressive symptoms: A 10-year cohort study of Wenchuan earthquake. J Adolesc 2023; 95:1702-1714. [PMID: 37674388 DOI: 10.1002/jad.12239] [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: 03/03/2023] [Revised: 07/11/2023] [Accepted: 08/17/2023] [Indexed: 09/08/2023]
Abstract
INTRODUCTION Previous studies on associations between social support and quality of life (QoL) have usually employed a variable-centered approach, without considering individual variances in time-varying changes in social support. This study explores trajectories of social support and whether depressive symptoms mediate associations between social support trajectories and QoL 10 years after an earthquake. METHODS Seven hundred and forty-four Chinese adolescents exposed to the Wenchuan earthquake were surveyed on social support at 6-, 18-, and 24-months and depressive symptoms at 30-months postearthquake (T30m ). They provided valid data on QoL after 10 years of the earthquake (T10y ). The latent class growth analysis was used to estimate social support trajectories. Mediation analysis was then conducted to test whether depressive symptoms at T30m mediated associations between social support trajectories and QoL at T10y . RESULTS Three trajectories of social support were identified: low decreasing (31.6%), moderate decreasing (55.4%), and persistent high (13.0%) groups. Depressive symptoms significantly mediated the effects of social support trajectories (relative to the low support trajectory) on future QoL (95% CIs: 0.70-1.78 and 1.41-3.37 for moderate decreasing and persistent high groups, respectively). CONCLUSIONS Social support shows individual differences over time. Moderate and high social support trajectories improve 10-year QoL partly by reducing depressive symptoms. Therefore, interventions aimed at enhancing social support and reducing depressive symptoms may be more effective in enhancing QoL in the aftermath of disasters.
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Affiliation(s)
- Xiao-Yan Chen
- Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
| | - Xuliang Shi
- College of Education, Hebei University, Hebei, China
| | - Chao Li
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
| | - Fang Fan
- Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
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Wooldridge JS, Morse JL, Delgado J, Afari N. Daily Functioning of Veterans With Type 2 Diabetes: Protocol for an Ambulatory Assessment Study. JMIR Res Protoc 2023; 12:e53874. [PMID: 37983070 PMCID: PMC10696502 DOI: 10.2196/53874] [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: 10/22/2023] [Revised: 10/27/2023] [Accepted: 10/29/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Diabetes impacts nearly 25% of veterans. Many veterans do not engage in recommended physical activity and other diabetes self-management behaviors. Type 2 diabetes is generally asymptomatic; as such, the long-term consequences of inadequate self-management and benefits of consistent self-management are not salient in the short term. Furthermore, self-management behaviors typically take place outside of medical visits; however, self-management-related factors are only assessed during medical visits, likely missing large amounts of variability. Thus, ambulatory assessment methods such as ecological momentary assessment (EMA), accelerometry, and continuous glucose monitoring are needed to understand the dynamics of daily self-management and identify potential intervention targets. OBJECTIVE The overarching goal of this study is to understand daily, time-varying factors (comorbid affective symptoms and social context) that influence physical activity, diabetes self-management, glycemic management, daily functioning, and quality of life in participants' natural environments. METHODS We are recruiting veterans with type 2 diabetes (target N=100). Participants are required to complete a battery of baseline assessments related to mental health, psychosocial factors, and self-management behaviors. Participants then receive 5 momentary EMA surveys and 1 daily EMA survey per day, in which veterans report comorbid affective symptoms (mood, stress, and pain), social support, social interactions, physical activity, and other self-management behaviors. Momentary surveys are delivered randomly during daily preprogrammed intervals over a 14-day sampling period. Accelerometry and continuous glucose monitoring are also used to assess physical activity and blood glucose, respectively. The first 6 participants also completed interviews assessing their experience in the study and barriers to participation. These test participants informed modifications to the protocol for the remaining participants. RESULTS The project received funding in April of 2023. Enrollment began in March of 2023 and is planned to be completed in April 2025. Among the 6 test participants, the overall EMA response rate was 87% (range 74%-95%). The response rate for the EMA survey including daily items (67%, range 21%-93%) was lower than the earlier shorter EMA surveys (89%, range 81%-96%). The mean rate of valid accelerometer wear of at least 20 hours per day was 93% (SD 11%), and continuous glucose monitoring data were available for 91% (SD 17%) of days on average. Participants reported few barriers to completing EMA surveys but noted the random timing of questions made it difficult to plan around, and the end-of-day survey was long. Two participants reported survey items reminded or motivated them to engage in diabetes self-management behaviors. CONCLUSIONS Assessment tools developed from this study can inform clinical decision-making by considering barriers to self-management that occur in daily life. Clinical applications include tailored, adaptive technology-supported interventions to improve self-management that provide the right type and amount of support at the right time by adapting to an individual's changing internal and contextual state. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53874.
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Affiliation(s)
- Jennalee S Wooldridge
- VA San Diego Healthcare System, San Diego, CA, United States
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
| | - Jessica L Morse
- VA San Diego Healthcare System, San Diego, CA, United States
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
| | - Jorge Delgado
- VA San Diego Healthcare System, San Diego, CA, United States
| | - Niloofar Afari
- VA San Diego Healthcare System, San Diego, CA, United States
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
- VA Center of Excellence for Stress and Mental Health, San Diego, CA, United States
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Tsai YH, Chuang LL, Lee YJ, Chiu CJ. Behavioral and Psychological Factors in Buffering Diabetes-related Disability Development. Ann Behav Med 2023; 57:1046-1057. [PMID: 37549141 DOI: 10.1093/abm/kaad038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Diabetes is associated with disability development. Healthy behaviors and psychosocial support can help patients manage their disease. PURPOSE To examine the role of various behavioral and psychological factors in buffering the effect of diabetes on disability development over time in Taiwanese adults. METHODS Data on 5,131 adults aged ≥50 years were obtained from the Taiwan Longitudinal Study on Aging. A cohort sequential multilevel design was employed to analyze the association between behavioral and psychosocial factors and the risk of disability over a 11-year period. RESULTS In patients with diabetes, having social support and exercising more than six times a week were associated with 4% and 49% reductions in the risk of disability, respectively (βdiabetes*socialsupport = -0.285, p = .006; βdiabetes*exercise3 = -2.612, p = .007). Exercising more than six times a week had an additional significant protective effect against disability development per year (βdiabetes*exercises3*age = -0.241, p = .038). Depression did not significantly interact with diabetes. However, a trajectory analysis revealed that individuals who had both diabetes and depression had the highest disability score from middle age among all participants. CONCLUSIONS Engaging in frequent exercise is the most influential factor for reducing the risk of disability in patients with diabetes. Social support provides an additional benefit for disability prevention in individuals with diabetes.
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Affiliation(s)
- Yi-Hsuan Tsai
- Division of Pulmonary & Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Li-Lun Chuang
- Department of Endocrinology & Metabolism, Lee's Endocrinology Clinic, Pingtung, Taiwan
| | - Yau-Jiunn Lee
- Department of Endocrinology & Metabolism, Lee's Endocrinology Clinic, Pingtung, Taiwan
| | - Ching-Ju Chiu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Jiao D, Miura KW, Sawada Y, Matsumoto M, Ajmal A, Tanaka E, Watanabe T, Sugisawa Y, Ito S, Okumura R, Kawasaki Y, Anme T. Social Relationships and Onset of Functional Limitation among Older Adults with Chronic Conditions: Does gender matter? Sultan Qaboos Univ Med J 2023; 23:13-21. [PMID: 36865429 PMCID: PMC9974036 DOI: 10.18295/squmj.5.2022.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/11/2022] [Accepted: 04/27/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives This study aimed to examine the longitudinal association between social relationships and physical functioning among community-dwelling older adults with chronic conditions. Methods Self-reported questionnaires were distributed and collected between 2014 and 2017 from participants ≥65 years old. The Index of Social Interaction was used to evaluate social relationships and the instrumental activities of daily living (IADL) subscale of the Tokyo Metropolitan Institute of Gerontology Index of Competence was used to examine functional status. Results A total of 422 participants (190 males and 232 females) were included in the final analysis. High social relationships demonstrated significant adverse effects (odds ratio [OR] = 0.77, 95% confidence interval [CI]: 0.64-0.93) on the decline of IADL in the overall sample, particularly for females (OR = 0.71, 95% CI: 0.55-0.93) but not as much for males (P = 0.131). Conclusion This finding suggests that functional limitation was influenced by social relationships among disabled older adults and the influence of social relationships on functional limitation differed based on gender.
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Affiliation(s)
- Dandan Jiao
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan,Department of Nursing, The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Kumi W. Miura
- RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
| | - Yuko Sawada
- Department of Physical Therapy, Morinomiya University of Medical Sciences, Osaka, Japan
| | - Munenori Matsumoto
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Ammara Ajmal
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Emiko Tanaka
- Department of Community Nursing, Musashino University, Tokyo, Japan
| | - Taeko Watanabe
- College of Nursing and Nutrition, Shukutoku University, Chiba, Japan
| | - Yuka Sugisawa
- Department of Nursing, Tsukuba International University, Tsukuba, Japan
| | - Sumio Ito
- Department of Public Welfare, Tobishima, Japan
| | | | | | - Tokie Anme
- Faculty of Medicine, University of Tsukuba, Tsukuba, Japan,Corresponding Author’s e-mail:
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Thomas S, Kanske P, Schäfer J, Hummel KV, Trautmann S. Examining bidirectional associations between perceived social support and psychological symptoms in the context of stressful event exposure: a prospective, longitudinal study. BMC Psychiatry 2022; 22:736. [PMID: 36443716 PMCID: PMC9703701 DOI: 10.1186/s12888-022-04386-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND After stressful event exposure, higher perceived social support is a well-established correlate of decreased risk for psychological symptoms, including depressive, anxiety and posttraumatic stress (PTS) symptoms. However, longitudinal data on the direction of this association and the stability of perceived social support are scarce and have yielded mixed results, with a particular lack of prospective studies. We aimed to investigate changes in perceived social support and bidirectional associations between perceived social support and psychological symptoms in a prospective, longitudinal study. METHODS A sample of German soldiers was assessed before and after deployment to Afghanistan. Group-based trajectory modelling was used to investigate the stability of perceived social support and to identify possible distinguishable trajectories of perceived social support. Bidirectional associations between perceived social support (general and workplace) and psychological symptoms (depressive, anxiety and PTS) were examined using gamma regressions. RESULTS Average levels of perceived general social support did not change, while perceived workplace social support increased slightly (t(344) = 5.51, p < .001). There were no distinguishable trajectories of perceived social support. Higher perceived general (Mean ratio (MR) = 0.84, 95% CI = [0.74, 0.95]) and workplace social support (MR = 0.82, 95% CI = [0.72, 0.92]) predicted lower depressive symptoms, but not anxiety or PTS symptoms. Only higher PTS (MR = 0.95, 95% CI = [0.91, 0.99]) and higher depressive symptoms (MR = 0.96, 95% CI = [0.93, 0.99]) predicted lower perceived general social support. CONCLUSIONS Perceived social support can remain relatively stable under exposure to environmental stressors such as military deployment. Higher perceived social support could protect against depressive symptoms via a stress-buffering mechanism, while support may need to be more tailored to individual needs for a protection against PTS symptoms. Individuals with elevated depressive and PTS symptoms might have impaired abilities or opportunities to access social support after stressful event exposure. Future studies could investigate distressing social emotions and associated maladaptive social cognitions as possible mechanisms in the association between symptoms and lower perceived social support. Especially with respect to PTS symptoms, future studies could focus on conditions that enable individuals to benefit from social support.
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Affiliation(s)
- Sarah Thomas
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Philipp Kanske
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany ,grid.419524.f0000 0001 0041 5028Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Judith Schäfer
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Katrin Veronika Hummel
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Sebastian Trautmann
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany. .,Department of Psychology, Faculty of Human Science, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany. .,ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany.
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Wooldridge JS, Soriano EC, Harris DE, Afari N. Feasibility and Acceptability of Ecological Momentary Assessment of Psychosocial Factors and Self-Management Behaviors Among Veterans With Type 2 Diabetes. Diabetes Spectr 2022; 35:76-85. [PMID: 35308149 PMCID: PMC8914587 DOI: 10.2337/ds21-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Comorbid symptoms such as post-traumatic stress and pain are common barriers to optimal self-management among veterans with type 2 diabetes. Additionally, self-management behaviors occur in the context of veterans' daily routines and social environments. This study evaluated the feasibility and acceptability of ecological momentary assessment (EMA) among veterans with type 2 diabetes. Ten veterans with type 2 diabetes were asked to respond to random EMA surveys during preprogrammed intervals five times per day for 14 days. EMA surveys were delivered via a mobile application and assessed momentary physical location, activities, social interactions, mood, stress, and pain. The last survey of each day included additional items about daily post-traumatic stress symptoms, diabetes distress, social support, physical activity, self-management behaviors, and functioning. Participants completed interviews assessing their experience in the study and barriers to responding and indicated their likelihood of participating in similar studies. The mean survey response rate was 96%, providing 675 observations. The majority of participants completed the five momentary surveys in <1 minute and the daily EMA surveys in <5 minutes. Results revealed substantial individual day-to-day variability across symptoms and self-management behaviors that is not captured by aggregated means across all participants. Participants generally reported enjoying responding to surveys and experiencing few barriers. Nine of 10 participants reported being "extremely likely" to participate in a similar study. These pilot data suggest that intensive EMA designs are feasible and acceptable for veterans with type 2 diabetes and can inform the design of future larger studies.
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Affiliation(s)
- Jennalee S. Wooldridge
- VA San Diego Healthcare System, San Diego, CA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
- Center of Excellence for Stress and Mental Health, San Diego, CA
- Corresponding author: Jennalee S. Wooldridge,
| | - Emily C. Soriano
- VA San Diego Healthcare System, San Diego, CA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE
| | | | - Niloofar Afari
- VA San Diego Healthcare System, San Diego, CA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
- Center of Excellence for Stress and Mental Health, San Diego, CA
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Wang J, Ursano RJ, Gifford RK, Dinh H, Weinberg A, Cohen GH, Sampson L, Galea S, Fullerton CS. Suicide Ideation and Social Support Trajectories in National Guard and Reserve Servicemembers. Psychiatry 2022; 85:246-258. [PMID: 35139000 PMCID: PMC9360194 DOI: 10.1080/00332747.2021.2004785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objective: Since 2004 increased rates of suicide have been noted in the US Armed Forces. We examined the association of social support (SS) trajectories and suicide ideation (SI) over a four-year period in Reserve Component (RC) servicemembers (National Guard and Reserve). We also examined baseline mental health measures, as predictors of the identified trajectories. Methods: Structured interviews were conducted with a nationally representative sample of 1,582 RC servicemembers at baseline and three follow-up waves. Latent growth mixture modeling identified SS trajectories and the association with follow-up SI. Multinomial logistic regression analyses were used to predict SS trajectories using baseline measures of demographics and mental health. Results: We identified four trajectories of SS and their associated prevalence of follow-up SI: low (n = 60, 3.8%; SI = 30.5%), medium (n = 229, 14.5%; SI = 14.1%), high-low (n = 66, 4.2%; SI = 13.6%), and high-high (n = 1,227, 77.5%; SI = 4.2%). There were significant differences in follow-up SI prevalence between each pair of SS trajectories except between the medium-SS and high-low-SS trajectories. Baseline SI, post-traumatic stress disorder (PTSD), depression, binge drinking, and mental health diagnosis were associated with increased likelihood of being on a low-SS or medium-SS trajectory. Baseline PTSD discriminated being on the high-high-SS and high-low-SS trajectories. Conclusion: Results support four trajectories of social support and that individuals with low or decreasing SS are likely to have greater follow-up SI. Baseline mental health assessments can identify these risk trajectories.
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Affiliation(s)
- Jing Wang
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
- Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Bethesda, MD 20817
| | - Robert J. Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
| | - Robert K. Gifford
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
| | - Hieu Dinh
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
- Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Bethesda, MD 20817
| | - Alysse Weinberg
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
- Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Bethesda, MD 20817
| | - Gregory H. Cohen
- School of Public Health, Boston University, 715 Albany Street - Talbot 301, Boston, MA 02118
| | - Laura Sampson
- School of Public Health, Boston University, 715 Albany Street - Talbot 301, Boston, MA 02118
| | - Sandro Galea
- School of Public Health, Boston University, 715 Albany Street - Talbot 301, Boston, MA 02118
| | - Carol S. Fullerton
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
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Zhang X, Zhang X, Wang F, Wu S, Hu K, Yusufu M, Sun X, Fisher EB. Development and evaluation of the Directive and Nondirective Support Scale for Patients with Type 2 Diabetes. Int J Nurs Sci 2020; 7:453-459. [PMID: 33195758 PMCID: PMC7644558 DOI: 10.1016/j.ijnss.2020.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 08/19/2020] [Accepted: 09/18/2020] [Indexed: 11/02/2022] Open
Abstract
Objectives This study aims to develop the Directive and Nondirective Support Scale for Patients with Type 2 Diabetes (DNSS-T2DM) to measure diabetes-specific support and patients' preference as well as evaluate the construct validity and reliability of the DNSS-T2DM. Methods A cross-sectional study was conducted in Tongzhou District, Beijing, China from July to September 2015. A total of 474 participants who had been diagnosed as type 2 diabetes by physicians and completed the DNSS-T2DM were included. The original 11-item DNSS-T2DM contains five items on nondirective support (Items 1-5) and six items on directive support (Items 6-11). There were two parallel questions for each item with one to measure the preference for support (Preference part) and the other to measure the perception of support in reality (Reality part). The final DNSS-T2DM was determined based on the results of the exploratory factor analysis (EFA). The construct validity of the final DNSS-T2DM was evaluated by the confirmatory factor analysis (CFA). The reliability was evaluated by internal consistency with Cronbach's α coefficients. Results A final 7-item DNSS-T2DM loaded on 2 factors with four items representing nondirective support and three items representing directive support was determined based on the EFA. The CFA indicated a satisfactory construct validity. The internal consistency of the 7-item DNSS-T2DM as well as the nondirective support items was satisfactory with Cronbach's α ≥ 0.70. Conclusions Our study supported the validity and reliability of the 7-item DNSS-T2DM. Further studies on the application of the DNSS-T2DM in different settings and population are needed.
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Affiliation(s)
- Xuxi Zhang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Xing Zhang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Fengbin Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Shiyan Wu
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Kang Hu
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Mayinuer Yusufu
- Beijing Tongren Hospital, Capital Medical University, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology and Visual Science, China
| | - Xinying Sun
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Edwin B Fisher
- Gillings School of Global Public Health, University of North Carolina, North Carolina, USA
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Díaz A, Ponsoda JM, Beleña A. Optimism as a key to improving mental health in family caregivers of people living with Alzheimer's disease. Aging Ment Health 2020; 24:1662-1670. [PMID: 31960702 DOI: 10.1080/13607863.2020.1715342] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: The aim of the present work was to study the serial multiple mediating role of optimism, perceived social support and subjective burden in the relationship between objective burden and psychological distress in caregivers of people with Alzheimer´s Disease (AD).Method: One hundred and forty family caregivers of people living with AD were recruited from randomly selected Alzheimer Association Centres. They answered the General Health Questionnaire (GHQ), the Life Orientation Test-Revised (LOT-R), the Functional Social Support Questionnaire (DUKE.UNC), the Zarit Burden Interview (ZBI) and questions relating to gender, age and the amount of time spent on daily caregiving.Results: Results indicated that objective burden and subjective burden were both high in these caregivers. Optimism mediated on psychological distress through social support and through subjective burden with a full mediation role. When comparisons between indirect effects were performed, optimism was the mediator with the greatest effect between objective burden and psychological distress.Conclusion: This study highlights the indirect role of optimism and the advantages that interventions in optimism training in the early stages of the person with AD could produce. Thus, alleviating subjective burden and increasing perceived social support, which would lead to an improvement in the mental health of family caregivers of people with AD.
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Affiliation(s)
- Amelia Díaz
- Faculty of Psychology, Department of Personality, Assessment and Psychological Treatments, University of Valencia, Valencia, Spain
| | - José M Ponsoda
- Faculty of Psychology, Department of Personality, Assessment and Psychological Treatments, University of Valencia, Valencia, Spain.,Association of Relatives and Friends of Alzheimer Disease Patients and Other Dependent Patients in Cocentaina Region, Alicante, Spain
| | - Angela Beleña
- Faculty of Psychology, Department of Personality, Assessment and Psychological Treatments, University of Valencia, Valencia, Spain
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McCoy MA, Theeke LA. A systematic review of the relationships among psychosocial factors and coping in adults with type 2 diabetes mellitus. Int J Nurs Sci 2019; 6:468-477. [PMID: 31728402 PMCID: PMC6838910 DOI: 10.1016/j.ijnss.2019.09.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 07/17/2019] [Accepted: 09/04/2019] [Indexed: 01/28/2023] Open
Abstract
Type 2 diabetes mellitus contributes to poor health outcomes including mortality, yet there is a gap in the literature when seeking to understand the influence of psychosocial factors on coping in this population. The paper presents a systematic review of quantitative studies that examined relationships among psychosocial determinants and coping in adults with type 2 diabetes. This review is the second layer of knowledge discovery for the concept, “Taking on a life-altering change is a rhythmical journey of experiencing ups and downs on the way to acceptance.” The life-altering change was determined to be a diagnosis of type 2 diabetes, the journey is the ups and downs of coping with the diagnosis as people work toward acceptance of type 2 diabetes. The review includes a synthesis of findings from 22 quantitative studies of psychosocial factors and coping in adults with type 2 diabetes. Anxiety, depression, stress, and diabetes distress were identified as key influential psychosocial factors. Increased social support was inversely related to emotional distress and coping styles were related to social well-being, psychological health, and physical health outcomes. The positive coping style of problem-focused coping was linked to improved psychological and physical health. Emotional responses to diagnosis were related to depression and anxiety. Negative coping styles of resignation, protest, or isolation were higher in women and linked to poorer quality of life, while avoidance was linked to increased diabetes-related distress and depressive symptoms.
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Affiliation(s)
- Melissa A. McCoy
- Division of Nursing, Davis and Elkins College, Elkins, WV, United States
- School of Nursing, West Virginia University, Morgantown, WV, United States
- Corresponding author. Division of Nursing, Davis and Elkins College, Elkins, WV, United States.
| | - Laurie A. Theeke
- School of Nursing, West Virginia University, Morgantown, WV, United States
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