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Smith A, Lange LJ. Do labels matter? Implications of ongoing symptomatic chronic illnesses labeled as conventional diagnoses vs. functional somatic syndromes. Chronic Illn 2024; 20:271-282. [PMID: 37218120 DOI: 10.1177/17423953231174926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE A consideration of chronic illness according to illness labels that are medically understood as opposed to being outside of medical understanding may reveal unique differences in how individuals understand their illness and how such lay understandings relate to health-related quality of life. Study aims are framed according to the commonsense model of self-regulation with a focus on characterizing illness representations according to chronic illness diagnosis type. METHODS Individuals suffering from symptomatic chronic illnesses (n = 192) completed measures of illness representations, coping, and general health. Participants were categorized into one of two groups based on reported diagnosis/symptoms: (a) conventional diagnosis (CD) or (b) functional somatic syndrome (FSS). RESULTS FSS participants reported lower illness coherence and greater illness identity than CD participants. Overall, illness coherence predicted negative coping which mediated the relationship between illness coherence and general health. CONCLUSIONS Minimal differences were found in illness representations across FSS and CD groups with distinctions found only for illness coherence and identity. Illness coherence stands out as particularly important for coping and health-related quality of life for individuals with ongoing symptoms. Healthcare professionals should work carefully with chronically ill populations to address potential impacts of illness coherence, especially among FSS patients.
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Affiliation(s)
- Ashley Smith
- Department of Psychology, University of North Florida, Jacksonville, Florida, USA
| | - Lori J Lange
- Department of Psychology, University of North Florida, Jacksonville, Florida, USA
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2
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Yang N, Masingboon K, Samartkit N. Factors influencing diabetes self-management among adults with type 2 diabetes mellitus in China. BELITUNG NURSING JOURNAL 2022; 8:389-395. [PMID: 37554488 PMCID: PMC10405646 DOI: 10.33546/bnj.2199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/04/2022] [Accepted: 10/04/2022] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND In China, the prevalence of Type 2 Diabetes Mellitus (T2DM) continues to rise, and Diabetes Self-Management (DSM) is generally suboptimal. Thus, identifying the factors influencing DSM in adults with T2DM is crucial for healthcare providers. OBJECTIVES This study aimed to 1) describe DSM among adults with T2DM in Wenzhou, China, 2) examine the correlations between diabetes knowledge, perceived self-efficacy, fatalism, social support, and DSM, and 3) determine how much power of the correlated independent variables could predict DSM. METHODS This study adopted the cross-sectional design and included 108 adults with T2DM who were randomly selected from the outpatient clinic of a hospital in Wenzhou, China. Data were recruited using a demographic questionnaire, and standardized tools were utilized to determine the correlation between DSM, diabetes knowledge, perceived self-efficacy, fatalism, and social support. Data were analyzed using descriptive statistics, Pearson correlation, and multiple regression analysis. RESULTS 62% of participants had poor blood glucose control (HbA1c ≥8.0%) and suboptimal DSM. Significant factors related to DSM were diabetes knowledge (r = 0.594, p <0.001), perceived self-efficacy (r = 0.447, p <0.001), and social support (r = 0.312, p = 0.001). The regression analysis revealed that all variables significantly explained 38.2% of the variance in DSM among adults with T2DM. However, only diabetes knowledge and perceived self-efficacy significantly predicted DSM (β = 0.468, p <0.001; β = 0.184, p = <0.05, respectively). CONCLUSION The findings indicated that increasing diabetes knowledge and perceived self-efficacy could help improve DSM in T2DM to ascertain the ultimate treatment outcomes. Nurses and healthcare providers should improve the ability of patients and their families to think critically and act autonomously.
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Affiliation(s)
- Ni Yang
- Master of Nursing Science Program Adult Nursing (International Program), Faculty of Nursing, Burapha University, Chon Buri, Thailand
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Warth RVD, Rudolph M, Bengel J, Glattacker M. Kontextfaktoren der patient*innenseitigen Selbstregulation in
der psychosomatischen Rehabilitation – eine Querschnittsanalyse vor
Rehabilitationsbeginn. REHABILITATION 2022; 61:222-229. [PMID: 35995052 DOI: 10.1055/a-1865-1311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
BACKGROUND Contextual factors are a central element of the ICF and important factors for therapy planning in psychosomatic rehabilitation. At the same time, little is known about the relationship between contextual factors and patient self-regulation, an important goal of rehabilitation.The aim of this study is therefore to investigate the relationship between contextual factors and illness belies. Illness beliefs are a core element of self-regulation in psychosomatic rehabilitation and part of the common sense model of self-regulation. METHODS Between April 2019 and January 2020, a cross-sectional questionnaire study was conducted in a psychosomatic rehabilitation clinic, in which registered rehabilitation patients were questioned about their illness beliefs using the Illness Perception Questionnaire (IPQ-R). Contextual factors were divided into clinically modifiable and non-clinically modifiable and included gender, age, duration of illness, subjective social status, main diagnosis (dichotomised: F3/F4), occupational stress, depressive stress as well as activity and participation (operationalised by the Health-49). Multiple regressions were used for the analysis, in which the scales of the IPQ-R served as dependent variables. RESULTS N=264 rehabilitants took part in the survey, 50% of them were female. The average age was 50 years. With regard to the non-clinically modifiable contextual factors, it was shown that a younger age was associated with higher control assumptions, but that younger rehabilitation patients simultaneously perceived more symptoms due to their illness (identity). A longer duration of illness showed a connection with the chronic timeline assumptions. A lower social status showed correlations with lower control assumptions and more assumptions about the cyclical timeline. Regarding clinically modifiable contextual factors, an F3 diagnosis was associated with more expected consequence, but also with a higher perceived personal control than an F4 diagnosis. A higher occupational burden was associated with the assumption of a more chronic course of the disease. Reduced activity and participation were associated with more expected consequences and more perceived symptoms (identity). Depressive stress showed associations with six out of eight domains of illness beliefs. CONCLUSION The study supports the relevance of contextual factors, which in majority can be discussed as person-related factors, for patient self-regulation in psychosomatic rehabilitation. Interventions to increase self-regulation, e. g. by taking illness beliefs into account, have already achieved promising results, also in the context of rehabilitation. The patient-oriented approach of these interventions could be further strengthened by a stronger inclusion of contextual factors.
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Affiliation(s)
- Rieka von der Warth
- Sektion Versorgungsforschung und Rehabilitationsforschung, Institut für medizinische Biometrie und Statistik, Universitätsklinikum Freiburg, Albert-Ludwigs-Universität Freiburg
| | - Matthias Rudolph
- Deutsche Rentenversicherung Rheinland-Pfalz, Mittelrhein-Klinik, Boppard-Bad Salzig
| | - Jürgen Bengel
- Abteilung für Rehabilitationspsychologie und Psychotherapie, Institut für Psychologie, Albert-Ludwigs-Universität Freiburg
| | - Manuela Glattacker
- Sektion Versorgungsforschung und Rehabilitationsforschung, Institut für medizinische Biometrie und Statistik, Universitätsklinikum Freiburg, Albert-Ludwigs-Universität Freiburg
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Nabolsi MM. Perception of diabetes management and cardiovascular disease risk among men with type 2 diabetes: A qualitative study. Nurs Open 2020; 7:832-840. [PMID: 32257271 PMCID: PMC7113530 DOI: 10.1002/nop2.458] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 01/29/2020] [Indexed: 11/13/2022] Open
Abstract
Aim The aim of this study was to explore the perception and understanding of men with type 2 diabetes about their illness control, risk for CVD and their adherence to healthcare management plans in Jordan. Design A qualitative descriptive design was used, recruiting a purposive sample of 13 men diagnosed with type 2 diabetes. Methods Data were collected between February and April 2019 through in-depth semi-structured interviews and analysed using content analysis. Results Data analysis revealed four themes: (a) Perception of diabetes control; (b) Perception of cardiovascular disease risk; (c) Coping with disease-imposed limitations; and (d) Information validation. Conclusion The study concludes that the perception of disease control does not necessarily coincide with actual disease control. Examining patients with diabetes perception and knowledge of their healthcare management and increased CVD risks is essential. An individualized culture and gender-sensitive health education and counselling involving spouses are recommended. Social media to disseminate scientific valid health instructions can enhance adherence.
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Sukkarieh-Haraty O, Egede LE, Abi Kharma J, Bassil M. Diabetes fatalism and its emotional distress subscale are independent predictors of glycemic control among Lebanese patients with type 2 diabetes. ETHNICITY & HEALTH 2019; 24:767-778. [PMID: 28870122 DOI: 10.1080/13557858.2017.1373075] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 08/17/2017] [Indexed: 06/07/2023]
Abstract
Background: Achieving and sustaining optimal glycemic control in type 2 diabetes (T2DM) is difficult because of socio-cultural and psychosocial factors including diabetes fatalism. Diabetes fatalism is 'a complex psychological cycle characterized by perceptions of despair, hopelessness, and powerlessness'. Purpose: The purpose of this paper is to explore whether diabetes fatalism and other psychosocial and socio-cultural variables are correlates of glycemic control in Lebanese population with T2DM. Methods: A convenience sample of 280 adult participants with T2DM were recruited from a major hospital in greater Beirut-Lebanon area and from the community. Diabetes fatalism was assessed using the Arabic version of 12-item Diabetes Fatalism Scale. Multiple linear regression models were used to assess the relationship between HbA1c and psychosocial and socio-cultural characteristics including diabetes fatalism. Four models were run to examine the independent association between HbA1c and diabetes fatalism and to identify which of the 3 subscales (emotional distress, spiritual coping and perceived self-efficacy) were associated with HbA1c. Results: The mean age of the participants was 58.24(SD = 13.48) and the majority were females (53.76%), while 32.73% of the sample had diabetes for more than 10 years. Fully adjusted multiple linear regression models showed that higher scores on diabetes fatalism and the emotional distress subscale (P = 0.018) were significantly associated with higher HbA1c values. In addition, having diabetes for more than 11 years (P = 0.05) and a higher number of diabetes complications (P < 0.001) were associated with higher HbA1c levels. However, advanced age (P = 0.055), female gender (P = 0.003), and diabetes education (P = 0.011) were significantly associated with lower HbA1c levels. Conclusion: This is the first study in the Arab region that identifies diabetes fatalism as an independent predictor of glycemic control among Lebanese. Future studies should further investigate this construct to guide interventions that can address it for better diabetes outcomes.
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Affiliation(s)
- Ola Sukkarieh-Haraty
- a Alice Ramez Chagoury School of Nursing, Lebanese American University , Byblos , Lebanon
| | - Leonard E Egede
- b Center for Health Disparities Research, Medical University of South Carolina , Charleston , SC , USA
- c Division of General Internal Medicine, Froedtert & The Medical College of Wisconsin , Milwaukee , WI , USA
| | - Joelle Abi Kharma
- d Department of Natural Sciences, School of Arts and Sciences, Lebanese American University , Beirut , Lebanon
| | - Maya Bassil
- d Department of Natural Sciences, School of Arts and Sciences, Lebanese American University , Beirut , Lebanon
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Jones DJ, Loiselle R, Highlander A. Parent-Adolescent Socialization of Social Class in Low-Income White Families: Theory, Research, and Future Directions. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2018; 28:622-636. [PMID: 30515948 PMCID: PMC6282858 DOI: 10.1111/jora.12392] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
The formative role of social class in the United States has long been a focus of fields such as economics, history, and political science. Yet, little psychological theory or data are available to guide our understanding of what messages regarding social class are transmitted within and across generations and how those transmissions are most likely to occur. As a launching point for such work, we focus this initial contextual and largely theoretical review on parent-adolescent socialization of social class in low-income, White families of adolescents in particular. To this end, our goal was to raise potential hypotheses about the implicit and explicit ways that White low-income parents may shape adolescent views of class, as well as the meaning and implications of status socialization for adolescent health and well-being.
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Sukkarieh-Haraty O, Egede LE, Abi Kharma J, Bassil M. Predictors of Diabetes Fatalism Among Arabs: A Cross-Sectional Study of Lebanese Adults with Type 2 Diabetes. JOURNAL OF RELIGION AND HEALTH 2018; 57:858-868. [PMID: 28597199 DOI: 10.1007/s10943-017-0430-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Fatalism is a grounded cultural belief that is common among Arabs and is known to hinder self-care in chronic diseases including diabetes (Nabolsi and Carson in Scand J Caring Sci 25(4):716-724, 2011). The purpose of this study is to identify predictors of diabetes fatalism in this population. Data on 280 Lebanese patients with type 2 diabetes (mean age 58.24 ± 13.48 years; mean HbA1c 7.90 ± 1.90%; 53.76% females) recruited from one hospital in greater Beirut, Lebanon, and from the community using snowballing technique were examined. Multiple linear regression was used to assess the independent association between diabetes fatalism and demographic and patient characteristics. Age (β = -.14, 95% CI -.27, -.002), BMI (β = .35, 95% CI .15; .54), level of education (β = -3.98, 95% CI -7.64; -.32) and number of diabetes problems (β = -5.03, 95% CI -9.89; -.18) were significantly associated with diabetes fatalism in the regression model. The combination of demographic and patient characteristics accounted for 14.5% of the variance in diabetes fatalism scores' change. Patients with type 2 diabetes who exhibited more fatalistic attitudes were younger, of lower education levels, had higher BMI and had fewer diabetes comorbidities. Such findings are crucial for healthcare practitioners to identify fatalistic patients and to tailor culturally appropriate strategies in diabetes management. Further studies are warranted to explore other potential determinants of diabetes fatalism with larger sample and non-Lebanese Arabic population.
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Affiliation(s)
- Ola Sukkarieh-Haraty
- Alice Ramez Chagoury School of Nursing, Lebanese American University, Byblos, Lebanon
| | - Leonard E Egede
- Center for Health Disparities Research, Medical University of South Carolina, Charleston, SC, USA
- Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
| | - Joelle Abi Kharma
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Chouran, Beirut, 1102 2801, Lebanon
| | - Maya Bassil
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Chouran, Beirut, 1102 2801, Lebanon.
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8
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Singer J, Levy S, Shimon I. Group versus Individual Care in Patients with Long-Standing Type 1 and Type 2 Diabetes: A One-Year Prospective Noninferiority Study in a Tertiary Diabetes Clinic. J Diabetes Res 2018; 2018:1807246. [PMID: 29998139 PMCID: PMC5994582 DOI: 10.1155/2018/1807246] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 03/22/2018] [Accepted: 04/11/2018] [Indexed: 12/02/2022] Open
Abstract
AIMS To explore the feasibility and noninferiority of group care in a diabetes outpatient clinic in comparison with individual care. METHODS In this prospective, randomized, nonblinded, one center (university hospital) trial, 60 patients (28 with type 1 and 32 with type 2 diabetes) with a mean duration of diabetes of 22.5 ± 11.7 years were randomly assigned to group (6 patients per group) or individual care for one year. The primary endpoints were the change in HbA1c and visits to outpatient clinics. The secondary endpoints were changes in body mass index, blood pressure levels, waist circumference, non-HDL cholesterol, diabetes-related and well-being index questionnaires, and the number of hospitalizations. RESULTS Group care was not inferior to individual care for any of the above parameters except for the number of visits to a primary care physician. CONCLUSION Group care is feasible in a diabetes clinic and is as effective as individual care. Implementation of group care may facilitate access to specialized care to a larger population of patients with diabetes type 1 and 2.
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Affiliation(s)
- Joelle Singer
- Institute of Endocrinology, Diabetes and Metabolism, Beilinson Hospital, Rabin Medical Center, Jabotinski Road 39, 49100 Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Chaim Lebanon 30, 6997801 Tel Aviv, Israel
| | - Sigal Levy
- Statistical Education Unit, The Academic College of Tel Aviv-Yaffo, Khever ha-Le'umim St 10, Tel Aviv-Yafo, Israel
| | - Ilan Shimon
- Institute of Endocrinology, Diabetes and Metabolism, Beilinson Hospital, Rabin Medical Center, Jabotinski Road 39, 49100 Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Chaim Lebanon 30, 6997801 Tel Aviv, Israel
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9
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Arat S, De Cock D, Moons P, Vandenberghe J, Westhovens R. Modifiable correlates of illness perceptions in adults with chronic somatic conditions: A systematic review. Res Nurs Health 2018; 41:173-184. [PMID: 29315678 DOI: 10.1002/nur.21852] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 12/01/2017] [Indexed: 11/11/2022]
Abstract
When individuals become ill, they want to understand and give meaning to their illness. The interpretation of this illness experience, or illness perception, is influenced by a range of individual, contextual, and cultural factors. Some of these factors may be modifiable by nursing interventions. The purpose of this systematic review was to investigate which modifiable factors were correlated with illness perceptions across studies of adults with different chronic somatic diseases. Using search terms tailored to each of four electronic databases, studies retrieved were reviewed by two independent evaluators, and each relevant article was assessed for methodological quality. Results were standardized by calculating correlation coefficients. Fifteen papers on illness perceptions in a variety of chronic diseases met the inclusion criteria. All used standardized measures of illness perceptions. We identified five groups of modifiable correlates of illness perceptions: illness-related factors, psychosocial factors, medication beliefs, information provision and satisfaction with information received, and quality of care. Our findings add to the knowledge of modifiable factors correlated with illness perceptions, including the importance of illness-related factors and psychosocial factors such as anxiety and depression. Knowledge of these correlates can facilitate understanding of patients' illness perceptions and might be useful in tailoring patient education programs.
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Affiliation(s)
- Seher Arat
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium
| | - Diederik De Cock
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium.,Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Philip Moons
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.,Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Joris Vandenberghe
- Department of Psychiatry, University Hospitals Leuven, Leuven, Belgium.,Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - René Westhovens
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium.,Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium
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Roth EG, Girling LM, Chard S, Wallace BH, Eckert JK. Diabetes and the Motivated Patient: Understanding Perlocutionary Effect in Health Communication. HEALTH COMMUNICATION 2017; 32:502-508. [PMID: 27295568 PMCID: PMC5572677 DOI: 10.1080/10410236.2016.1140270] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Health care providers (HCP) understand the importance of keeping patients motivated but may be unaware how their words may have unintended negative effects upon their patient's lives. People with diabetes report being told by their HCP that they are "cured" or that they are praised for strides made in weight loss and/or lowered blood glucose, and interpret these messages in unexpected ways. For this paper, we focus upon one case to illustrate the depth and nuance of the patient-provider communication as it emerged within a larger interview-based ethnographic study. Audio-recorded interviews and transcriptions were analyzed discursively. Discourse analysis reveals the ways ideology affects how the patient responds to HCP's utterances and how this affects diabetes self-care. Findings indicate significant perlocutionary effects upon health outcomes, varying both positively and/or negatively. This study points to the importance of carefully considering the power of words and whenever possible knowing the patient's ideological orientation to their world. HCPs should be explicit and deliberate with their communication. Sensitization to the various ways patients hear and react to messages in a clinical setting may lead to improved health outcomes, especially for those with chronic health conditions such as diabetes mellitus.
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Affiliation(s)
- Erin G. Roth
- University of Maryland Baltimore County, Center for Aging Studies, PUP, 1000 Hilltop Circle, Baltimore, MD 21250, USA
| | - Laura M. Girling
- University of Maryland Baltimore County, Center for Aging Studies, PUP, 1000 Hilltop Circle, Baltimore, MD 21250, USA
| | - Sarah Chard
- University of Maryland Baltimore County, Center for Aging Studies, PUP, 1000 Hilltop Circle, Baltimore, MD 21250, USA
- University of Maryland Baltimore County, Sociology & Anthropology Department, PUP, 1000 Hilltop Circle, Baltimore, MD 21250, USA
| | - Brandy Harris Wallace
- University of Maryland Baltimore County, Center for Aging Studies, PUP, 1000 Hilltop Circle, Baltimore, MD 21250, USA
- University of Maryland Baltimore County, Sociology & Anthropology Department, PUP, 1000 Hilltop Circle, Baltimore, MD 21250, USA
| | - J. Kevin Eckert
- University of Maryland Baltimore County, Center for Aging Studies, PUP, 1000 Hilltop Circle, Baltimore, MD 21250, USA
- University of Maryland Baltimore County, Sociology & Anthropology Department, PUP, 1000 Hilltop Circle, Baltimore, MD 21250, USA
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The Self-Regulation Model of Illness: Comparison between Zika and Dengue and Its Application to Predict Mosquito Prevention Behaviours in Malaysia, a Dengue-Endemic Country. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13121210. [PMID: 27929451 PMCID: PMC5201351 DOI: 10.3390/ijerph13121210] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 11/11/2016] [Accepted: 11/21/2016] [Indexed: 11/17/2022]
Abstract
Perceptions about illnesses may influence self-care and preventive health behaviours. Illness perceptions of the Zika virus (ZIKV) infection were investigated under the framework of the Self-Regulation Model of Illness. Illness perception differences between ZIKV and dengue fever were also examined. Lastly, associations between illness perceptions of ZIKV with mosquito prevention practices were studied. Samples were drawn from landline telephone numbers using computer-assisted telephone interviewing in Malaysia. A total of 567 respondents completed the survey between February 2015 and May 2016. The median and interquartile range (IQR) for the total six dimensions of illness perceptions score was higher for dengue (23.0 (IQR 17.0-28.0)) than ZIKV (20.0 (IRQ 11.0-28.0)), p < 0.001. Respondents who planned to have children (OR 1.670, 95% CI 1.035-2.694 vs. no intention to have children) and had friends or acquaintances who died of dengue (OR 2.372, 95% CI 1.300-4.327 vs. no friends who died of dengue) were more likely to have a higher total score for six illness perceptions for ZIKV compared to dengue. Multivariate analysis indicated that the best predictors for mosquito control practices after the ZIKV outbreak was declared a Public Health Emergency of International Concern, in descending order, were causes, control, timeline, and consequences dimensions of illness perception. Understanding the context in which a person perceives ZIKV may contribute to developing interventions that influence prevention behaviours.
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12
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Berardi V, Bellettiere J, Nativ O, Ladislav S, Hovell MF, Baron-Epel O. Fatalism, Diabetes Management Outcomes, and the Role of Religiosity. JOURNAL OF RELIGION AND HEALTH 2016; 55:602-617. [PMID: 26002058 DOI: 10.1007/s10943-015-0067-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study aimed to determine whether fatalistic beliefs were associated with elevated levels of glycated hemoglobin (HbA1c) and to establish the role of religiosity in this relationship. A cross-sectional survey was conducted on a sample of 183 Jewish adults with diabetes visiting a large medical center in northern Israel. Self-administered questionnaires assessed level of religiosity, fatalistic beliefs, diabetes management behaviors, and demographic/personal characteristics; laboratory tests were used to measure HbA1c. Multivariate regression indicated that fatalism was significantly associated with HbA1c (β = 0.51, p = 0.01). The association was no longer statistically significant after including self-reported religiosity in the model (β = 0.31, p = 0.13). This phenomenon is likely due to a confounding relationship between the religious/spiritual coping component of the fatalism index and self-reported religiosity (r = 0.69). The results indicate that addressing fatalistic attitudes may be a viable strategy for improving diabetes management, but call for a better understanding of the interplay between religiosity and fatalism in this context.
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Affiliation(s)
- Vincent Berardi
- Computational Sciences Research Center, San Diego State University, San Diego, CA, 92182-1245, USA.
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA, USA.
| | - John Bellettiere
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Orit Nativ
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Slezak Ladislav
- Clalit Healthcare Services, The Diabetes Clinic, Lin Medical Center, Haifa, Israel
| | - Melbourne F Hovell
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Orna Baron-Epel
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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13
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Houle J, Lauzier-Jobin F, Beaulieu MD, Meunier S, Coulombe S, Côté J, Lespérance F, Chiasson JL, Bherer L, Lambert J. Socioeconomic status and glycemic control in adult patients with type 2 diabetes: a mediation analysis. BMJ Open Diabetes Res Care 2016; 4:e000184. [PMID: 27239316 PMCID: PMC4873951 DOI: 10.1136/bmjdrc-2015-000184] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 02/27/2016] [Accepted: 03/22/2016] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The purpose of this study is to examine the contribution of health behaviors (self-management and coping), quality of care, and individual characteristics (depressive symptoms, self-efficacy, illness representations) as mediators in the relationship between socioeconomic status (SES) and glycemic control. METHODS A sample of 295 adult patients with type 2 diabetes was recruited at the end of a diabetes education course. Glycemic control was evaluated through glycosylated hemoglobin (HbA1c). Living in poverty and education level were used as indicators of SES. RESULTS Bootstrapping analysis showed that the significant effects of poverty and education level on HbA1c were mediated by avoidance coping and depressive symptoms. The representation that diabetes is unpredictable significantly mediated the relationship between living in poverty and HbA1c, while healthy diet mediated the relationship between education level and HbA1c. CONCLUSIONS To improve glycemic control among patients with low SES, professionals should regularly screen for depression, offering treatment when needed, and pay attention to patients' illness representations and coping strategies for handling stress related to their chronic disease. They should also support patients in improving their self-management skills for a healthy diet.
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Affiliation(s)
- Janie Houle
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
- CRCHUM, Montréal, Québec, Canada
| | | | - Marie-Dominique Beaulieu
- CRCHUM, Montréal, Québec, Canada
- Department of Family and Emergency Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Sophie Meunier
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Simon Coulombe
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - José Côté
- CRCHUM, Montréal, Québec, Canada
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
| | - François Lespérance
- CRCHUM, Montréal, Québec, Canada
- Department of Psychiatry, Université de Montréal, Montréal, Québec, Canada
| | - Jean-Louis Chiasson
- CRCHUM, Montréal, Québec, Canada
- Department of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Louis Bherer
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
- Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Jean Lambert
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, Québec, Canada
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14
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Patel NR, Chew-Graham C, Bundy C, Kennedy A, Blickem C, Reeves D. Illness beliefs and the sociocultural context of diabetes self-management in British South Asians: a mixed methods study. BMC FAMILY PRACTICE 2015; 16:58. [PMID: 25958196 PMCID: PMC4438635 DOI: 10.1186/s12875-015-0269-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 04/27/2015] [Indexed: 12/30/2022]
Abstract
Background British South Asians have a higher incidence of diabetes and poorer health outcomes compared to the general UK population. Beliefs about diabetes are known to play an important role in self-management, yet little is known about the sociocultural context in shaping beliefs. This study aimed to explore the influence of sociocultural context on illness beliefs and diabetes self-management in British South Asians. Methods A mixed methods approach was used. 67 participants recruited using random and purposive sampling, completed a questionnaire measuring illness beliefs, fatalism, health outcomes and demographics; 37 participants completed a social network survey interview and semi-structured interviews. Results were analysed using SPSS and thematic analysis. Results Quantitative data found certain social network characteristics (emotional and illness work) were related to perceived concern, emotional distress and health outcomes (p < 0.05). After multivariate analysis, emotional work remained a significant predictor of perceived concern and emotional distress related to diabetes (p < 0.05). Analysis of the qualitative data suggest that fatalistic attitudes and beliefs influences self-management practices and alternative food ‘therapies’ are used which are often recommended by social networks. Conclusions Diabetes-related illness beliefs and self-management appear to be shaped by the sociocultural context. Better understanding of the contextual determinants of behaviour could facilitate the development of culturally appropriate interventions to modify beliefs and support self-management in this population. Electronic supplementary material The online version of this article (doi:10.1186/s12875-015-0269-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Neesha R Patel
- Centre for Endocrinology and Diabetes and Manchester Centre for Health Psychology, Institute of Human Development, The University of Manchester, Room S42, Second Floor, Zochonis Building, Brunswick Street, Manchester, M13 9PT, UK.
| | - Carolyn Chew-Graham
- Primary Care and Health Sciences, and NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) West Midlands, Research Institute, Keele University, Keele, Staffordshire, ST5 5BG, UK.
| | - Christine Bundy
- Institute for Inflammation and Repair, The University of Manchester, 1.530 Stopford Building, Oxford Road, Manchester, M13 9PL, UK.
| | - Anne Kennedy
- NIHR CLAHRC Wessex, Faculty of Health Sciences, Building 67, University of Southampton, Highfield Campus, Southampton, SO17 1BJ, UK.
| | - Christian Blickem
- NIHR CLAHRC Greater Manchester, The University of Manchester, Centre for Primary Care, 5th Floor Williamson Building, Oxford Road, Manchester, M13 9PL, UK.
| | - David Reeves
- Centre for Primary Care, The University of Manchester, 5th Floor Williamson Building, Oxford Road, Manchester, M13 9PL, UK.
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Abstract
Increasing use of the Internet for health information delivery has created considerable discussion among digital divide scholars (i.e. how online information delivery benefits those individuals in higher socioeconomic brackets more than their counterparts). Because it is health information, we need to integrate how patients seek out online information. This study included patients’ information-seeking behaviour along with digital divide scholars’ constructs (i.e. literacy and computer skills). Using 1617 observations from the 2010 Pew Internet and American Life Project, this study found that individuals with a significant number of health problems, who are likely to be in a lower income bracket, are proactive online health information seekers; however, they are less likely to search general information. This finding adds value to existing research revealing that usefulness, which has been overlooked in online health information seeking, is important and should be a part of the research model.
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Affiliation(s)
- Yong-Mi Kim
- School of Library and Information Studies, University of Oklahoma, USA
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16
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District-level primary care supply buffers the negative impact of functional limitations on illness perceptions in older adults with multiple illnesses. Ann Behav Med 2014; 49:463-72. [PMID: 25416178 DOI: 10.1007/s12160-014-9671-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Illness perceptions predict important outcomes, e.g. coping, adherence and well-being. Less is known about the sources of illness perceptions, in particular the role of environmental factors such as primary care supply. PURPOSE This study examines whether and how primary care supply (on district level) affects individual illness perceptions. METHODS We conducted a longitudinal study in 271 adults 65 years and older with multiple illnesses. Functional limitations (SF-36 physical functioning subscale) at time 1 were tested as predictors of illness perceptions 6 months later. Primary care supply on district level was matched to individual data. RESULTS In multilevel models, functional limitations predicted illness perceptions. Primary care supply on district level moderated the impact of functional limitations on individual identity and emotional response perceptions, with better supply buffering detrimental effects of functional limitations. CONCLUSIONS Illness perceptions do not only depend on individual factors, but socio-structural factors also substantially contribute to individual illness perceptions.
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17
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Clinical outcomes and incremental costs from a medication adherence pilot intervention targeting low-income patients with diabetes at risk of cost-related medication nonadherence. Clin Ther 2014; 36:1991-2002. [PMID: 25282579 DOI: 10.1016/j.clinthera.2014.09.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 08/07/2014] [Accepted: 09/03/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE The extent to which reducing cost-related barriers affects diabetes outcomes and medication adherence among uninsured patients is not known. The purpose of these analyses was to understand the clinical impact and cost considerations of a prescription assistance program targeting low-income, minority patients with diabetes and at high risk for cost-related medication nonadherence. METHODS Patients received diabetes medications without copayments for 12 months. Change in diabetes control was calculated by using glycosylated hemoglobin (HbA1c) level at follow-up compared with baseline. Clinical data were collected from the electronic health record. Medication adherence for diabetes medications was estimated by using proportion of days covered (PDC). Incremental acquisition and per-patient costs, based on actual hospital medication costs, were calculated for different baseline HbA1c levels. FINDINGS Patients with baseline HbA1c levels ≥7%, ≥8%, and ≥9% experienced mean HbA1c reductions of 0.82% (P = 0.008), 1.02% (P = 0.010), and 1.47% (P = 0.010), respectively, during the 12-month period. The average PDC was 70.55%; 45.24% had a PDC ≥80%, indicating an adequate level of medication adherence. Medication adherence ≥80% was associated with ethnicity (P = 0.015), whereas mean PDC was associated with number of diabetes medication classes used (P = 0.031). Acquisition cost for 1242 prescriptions filled by 103 patients was $13,365.82, representing per-patient costs of $132.39; however, as baseline targets increased, acquisition costs decreased and per-patient costs increased from $10,682.59 and $169.56 to $6509.91 and $192.27, respectively. IMPLICATIONS Clinically significant reductions in HbA1c levels were achieved for all patients, although greater reductions were achieved with modest per-patient cost increases when considering patients with uncontrolled diabetes. Incorporating a multifactorial intervention to address cost-related medication nonadherence with a behavior change component may yield greater reductions in HbA1c with improved diabetes outcomes and meaningful hospital-based cost savings.
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Freund A, Cohen M, Azaiza F. The doctor is just a messenger: beliefs of ultraorthodox Jewish women in regard to breast cancer and screening. JOURNAL OF RELIGION AND HEALTH 2014; 53:1075-1090. [PMID: 23543095 DOI: 10.1007/s10943-013-9695-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Screenings for the early detection of breast cancer greatly improve survival odds. Studies of minority groups have shown lower attendance of screenings; however, these studies seldom focused on religious minorities. This study examines perceptions of cancer and cancer screening among healthy ultraorthodox women in order to gain insight about ways to promote screening. In this qualitative-phenomenological study of two focus groups, three main themes were found: faith in God; the Rabbi as a guide; one's relationship with the community. The study's findings point to the importance of studying the unique needs of members of certain religious groups.
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Affiliation(s)
- Anat Freund
- Faculty of Social Welfare & Health Sciences, School of Social Work, University of Haifa, 31905, Mount Carmel, Haifa, Israel,
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Barnard KD, Lloyd CE, Dyson PA, Davies MJ, O'Neil S, Naresh K, Lawton J, Ziegler R, Holt RIG. Kaleidoscope model of diabetes care: time for a rethink? Diabet Med 2014; 31:522-30. [PMID: 24506524 DOI: 10.1111/dme.12400] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 12/03/2013] [Accepted: 01/28/2014] [Indexed: 01/02/2023]
Abstract
National Audit Data highlight persistent sub-optimum control among increasing numbers of people living with diabetes, with severe consequences for the individual and the NHS. The aim of the present review was to introduce a new cohesive, holistic model of care, tailored to individual needs to support optimum diabetes outcomes. This model of diabetes is necessary in order to understand the driving forces behind behaviour and their impact on diabetes management. Feelings (an emotional state or reaction) and beliefs (an acceptance that something is true or real) are fundamental behavioural drivers and influence diabetes self-management choices. Individually, these explain some of the complexities of behaviour and, collectively, they impact on personal motivation (rationale/desire to act) to achieve a specific outcome. Inevitably, they independently affect diabetes self-management and the environment in which individuals live. A model of care that proposes the encompassing of environment, intrinsic thought and therapy regimens to provide tailored, personalized healthcare should support enhanced diabetes self-management and outcomes from diagnosis. The Kaleidoscope model of care could be deliverable in routine care, incorporating each of the influences on diabetes self-management, and should benefit both individuals with diabetes and healthcare professionals.
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Affiliation(s)
- K D Barnard
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
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20
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de Figueiredo RC, Snoek FJ, Barreto SM. Do patients and physicians agree on diabetes management? A study conducted in public healthcare centres in Brazil. PATIENT EDUCATION AND COUNSELING 2013; 92:107-113. [PMID: 23478448 DOI: 10.1016/j.pec.2013.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 01/21/2013] [Accepted: 01/25/2013] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To explore to what extent patients with diabetes agree with their physicians on diabetes management and whether the agreement varies according to patients' socio-demographic characteristics. METHODS A cross-sectional study was conducted among patients with diabetes and their Family Health physicians in 108 healthcare centres in Belo Horizonte, Brazil. Patients and physicians were interviewed face-to-face using standard questionnaires. Physicians were unaware of which of their patients would be interviewed. Their responses were compared using descriptive statistics and Cohen's weighted kappa. RESULTS 282 patient-physician pairs were included. Kappa coefficients were often low, the highest was found for presence of diabetic foot and the lowest for kidney disease. Physicians tended to overestimate patients' risk of diabetes complications and underestimate patients' adherence to all diabetes self-management activities as well as diabetes control. Moreover, the agreement rate regarding adherence to diet, foot care and medicine prescriptions was significantly higher among male, younger and higher educated patients. CONCLUSION Results indicate that physicians' recommendations are generally poorly apprehended by their patients, especially by the lower educated, compromising the goal of patient-centred care. PRACTICE IMPLICATIONS Educational programmes need to incorporate strategies to improve the comprehension and effectiveness of physician-patient communication, especially with the most socially vulnerable groups.
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21
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Self-as-Doer for Diabetes: Development and Validation of a Diabetes-Specific Measure of Doer Identification. J Nurs Meas 2013; 21:188-209. [DOI: 10.1891/1061-3749.21.2.188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: The purpose of this study was to develop and validate a scale to measure the level of self-care behavior “doer identity” in persons with diabetes. Methods: Persons with diabetes (N = 355) completed questionnaires assessing self-as-doer identity and other related constructs. Principle components and parallel analyses and tests of reliability and validity were performed. Results: A 7 factor solution explained 55.24% of the total variance on behaviors. Cronbach’s alpha was .93 for the overall scale. Extracted components moderately correlated with one another and theoretically similar constructs. Self-as-doer identity significantly predicted all self-care behaviors (except for blood glucose monitoring) and glycemic control over and above related variables for persons with type 1 diabetes. Self-as-doer identity also predicted diet behaviors for persons with type 2 diabetes. Conclusions: Evidence for a reliable and valid factor structure of the Self-as-doer-Diabetes measure was demonstrated.
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22
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Walker RJ, Smalls BL, Hernandez-Tejada MA, Campbell JA, Davis KS, Egede LE. Effect of diabetes fatalism on medication adherence and self-care behaviors in adults with diabetes. Gen Hosp Psychiatry 2012; 34:598-603. [PMID: 22898447 PMCID: PMC3479321 DOI: 10.1016/j.genhosppsych.2012.07.005] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 07/09/2012] [Accepted: 07/10/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Diabetes fatalism is defined as "a complex psychological cycle characterized by perceptions of despair, hopelessness, and powerlessness" and associated with poor glycemic control. This study examined the association between diabetes fatalism and medication adherence and self-care behaviors in adults with diabetes. METHODS Data on 378 subjects with type 2 diabetes recruited from two primary care clinics in the Southeastern United States were examined. Previously validated scales were used to measure diabetes fatalism, medication adherence, diabetes knowledge and diabetes self-care behaviors (diet, physical activity, blood sugar testing and foot care). Multiple linear regression was used to assess the independent effect of diabetes fatalism on medication adherence and self-care behaviors controlling for relevant covariates. RESULTS Fatalism correlated significantly with medication adherence (r=0.24, P<.001), diet (r=-0.26, P<.001), exercise (r=-0.20, P<.001) and blood sugar testing (r=-0.19, P<.001). In the linear regression model, diabetes fatalism was significantly associated with medication adherence [β=0.029, 95% confidence interval (CI) 0.016, 0.043], diabetes knowledge (β=-0.042, 95% CI -0.001, -0.084), diet (β=-0.063, 95% CI -0.039, -0.087), exercise (β=-0.055, 95% CI -0.028, -0.083) and blood sugar testing (β=-0.055, 95% CI -0.023, -0.087). There was no significant association between diabetes fatalism and foot care (β=-0.018, 95% CI -0.047, 0.011). The association between diabetes fatalism and medication adherence, diabetes knowledge and diabetes self-care behaviors did not change significantly when depression was added to the models, suggesting that the associations are independent of depression. CONCLUSION Diabetes fatalism is associated with poor medication adherence and self-care and may be an important target for education and skills interventions in diabetes care. In addition, the effect of diabetes fatalism is independent of depression, suggesting that interventions that target depression may not be sufficient to deal with diabetes fatalism.
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Affiliation(s)
- Rebekah J. Walker
- Center for Health Disparities Research, Medical University of South Carolina, Charleston, SC
| | - Brittany L. Smalls
- Center for Health Disparities Research, Medical University of South Carolina, Charleston, SC
| | | | - Jennifer A. Campbell
- Center for Health Disparities Research, Medical University of South Carolina, Charleston, SC
| | - Kimberly S. Davis
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, SC
| | - Leonard E. Egede
- Center for Health Disparities Research, Medical University of South Carolina, Charleston, SC,Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, SC,Center for Disease Prevention and Health Interventions for Diverse Populations, Charleston VA REAP, Ralph H. Johnson VA Medical Center, Charleston, SC
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23
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Brieger WR, Okeibunor JC, Abiose AO, Ndyomugyenyi R, Wanji S, Elhassan E, Amazigo UV. Characteristics of persons who complied with and failed to comply with annual ivermectin treatment. Trop Med Int Health 2012; 17:920-30. [PMID: 22575028 DOI: 10.1111/j.1365-3156.2012.03007.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess individual compliance with annual ivermectin treatment in onchocerciasis-endemic villages. METHODS Multi-site study in eight APOC-sponsored projects in Cameroon, Nigeria and Uganda to identify the socio-demographic correlates of compliance with ivermectin treatment. A structured questionnaire was administered on 2305 persons aged 10 years and above. Two categories of respondents were purposively selected to obtain both high and low compliers: people who took ivermectin 6-8 times and 0-2 times previously. Simple descriptive statistics were employed in characterizing the respondents into high and low compliers, while some socio-demographic and key perceptual factors were employed in regression models constructed to explain levels of compliance among the respondents. RESULTS Some demographic and perceptual factors associated with compliance were identified. Compliance was more common among men (54.4%) (P < 0.001). Adults (54.6%) had greater rates of high compliance (P < 0.001. The mean age of high compliers (41.5 years) was significantly older (35.8 years) (t = 8.46, P < 0.001). Perception of onchocerciasis and effectiveness of ivermectin influenced compliance. 81.4% of respondents saw benefits in annual ivermectin treatment, high compliance among those who saw benefits was 59.3% compared to 13.3% of those who did not (P < 0.001). CONCLUSION Efforts to increase compliance with ivermectin treatment should focus on providing health education to youth and women. Health education should also highlight the benefits of taking ivermectin.
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Affiliation(s)
- William R Brieger
- Department of International Health, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Pilon R, Bailey PH, Montgomery P, Bakker D. The future is the present: diabetes complication stories. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1752-9824.2011.01095.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Shibayama T, Sato E, Nishigaki M, Ochiai R, Kazuma K. Influence of dietary therapy appraisal on future perceived control of type 2 diabetes. J Health Psychol 2011; 16:1141-50. [DOI: 10.1177/1359105311401770] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We sought to elucidate the causal effect of patients’ self-appraisal of their dietary regimen on their control beliefs among adults with type 2 diabetes. Data from 176 outpatients were assessed using a two-wave cross-lagged panel model. We found that a cross-lagged path connecting dietary appraisal at baseline to perceived control at one year (β = .30, p = .003) was larger than a path connecting perceived control at baseline to dietary appraisal at one year (β = —.16, p = .07). We conclude that dietary appraisal has a feedback effect on the future perceived control of type 2 diabetes.
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Affiliation(s)
| | - Eiko Sato
- Kiryu University, Japan, The University of Tokyo, Japan
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26
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Paddison CAM, Eborall HC, French DP, Kinmonth AL, Prevost AT, Griffin SJ, Sutton S. Predictors of anxiety and depression among people attending diabetes screening: A prospective cohort study embedded in the ADDITION (Cambridge) randomized control trial. Br J Health Psychol 2011; 16:213-26. [DOI: 10.1348/135910710x495366] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Mills T, Law SK, Walt J, Buchholz P, Hansen J. Quality of life in glaucoma and three other chronic diseases: a systematic literature review. Drugs Aging 2010; 26:933-50. [PMID: 19848439 DOI: 10.2165/11316830-000000000-00000] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Chronic diseases have a long-term negative impact on quality of life (QOL). Decreased QOL is associated with increased financial burden on healthcare systems and society. However, few publications have investigated the impact of glaucoma on patients' QOL in comparison with other chronic diseases observed in patients with similar demographic characteristics. To this end, a systematic literature search to assess QOL in glaucoma and three other chronic diseases (osteoporosis, type 2 diabetes mellitus and dementia) was performed. A total of 146 publications were identified that reported QOL using six commonly used generic QOL instruments: 36-, 12- and 20-item Short-Form Health Surveys (SF-36, -12 and -20), EuroQoL (EQ-5D), Sickness Impact Profile (SIP) and the Health Utilities Index-Mark III (HUI-III). The publication breakdown was as follows: glaucoma (10%), osteoporosis (26%), diabetes (52%) and dementia (12%); one publication assessed QOL in glaucoma, diabetes and dementia. QOL was affected to a similar or slightly lesser degree by glaucoma than by osteoporosis, diabetes or dementia. Among the publications reporting SF-36, -12 and -20 evaluations, physical component scores were generally lower than mental component scores across all diseases. QOL was affected more in patients with glaucoma than in demographically matched non-glaucomatous controls according to SF-20 assessment. EQ-5D and SIP results showed that QOL decreased as the severity of glaucoma increased. Patients with glaucoma had the lowest scores on the SIP instrument, indicating better QOL than patients with osteoporosis or diabetes (no data were available on dementia). The HUI-III instrument identified poorer QOL in patients with dementia than other diseases, probably due to cognitive deficits. However, for some of the instruments, data were scarce, and interpretation of the results should be conservative. Although there are limited published QOL studies in glaucoma, its impact on QOL appears to be broadly similar to that of other serious chronic diseases. Development of a QOL instrument that measures vision-specific and general health aspects would better document the impact of glaucoma on QOL and would facilitate comparisons with other chronic disease states.
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Affiliation(s)
- Tim Mills
- Global Health Outcomes, Wolters Kluwer Pharma Solutions, Chester, UK.
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28
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Browning KK, Wewers ME, Ferketich AK, Otterson GA, Reynolds NR. The Self-regulation Model of Illness applied to smoking behavior in lung cancer. Cancer Nurs 2009; 32:E15-25. [PMID: 19444080 PMCID: PMC2910577 DOI: 10.1097/ncc.0b013e3181a0238f] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Thirteen to 20% of lung cancer patients continue to smoke after diagnosis. Guided by Self-regulation Theory, the purpose of this study was to examine illness perceptions over time in a sample of lung cancer patients. This prospective 1-group descriptive longitudinal design study included participants 18 years or older, with a lung cancer diagnosis within the past 60 days who self-reported smoking within the past 7 days. At baseline, patients completed a sociodemographics and tobacco use history questionnaire. The Illness Perception Questionnaire-Revised (IPQ-R) was repeated at 3 time points (baseline, 2-4 weeks, and 6 months). Fifty-two participants provided data for the IPQ-R at baseline, 47 at 2 to 4 weeks, and 29 at 6 months. Differences between mean scores for each illness representation attribute of the IPQ-R at repeated time points were calculated by within-subjects repeated-measures analysis of variance and Wilcoxon Signed-Rank Tests. Identity (baseline vs 2-4 weeks: P = .026; baseline vs 6 months: P = .005) and acute/chronic timeline (P = .018) mean scores significantly increased over time; personal and treatment control mean scores significantly decreased over time (P = .007 and P = .047, respectively). Understanding the context in which a patient perceives disease and smoking behavior may contribute to developing interventions that influence behavior change.
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Keeley B, Wright L, Condit CM. Functions of health fatalism: fatalistic talk as face saving, uncertainty management, stress relief and sense making. SOCIOLOGY OF HEALTH & ILLNESS 2009; 31:734-747. [PMID: 19392939 DOI: 10.1111/j.1467-9566.2009.01164.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Much research on fatalism assumes that fatalistic statements represent a global outlook that conflicts with belief in the efficacy of health behaviours. Other scholars have suggested a more contextual approach, suggesting that fatalism fulfils personal and social functions. This study analyses 96 in-depth lay interviews in the US, most with low-income members of the general public, about four diseases: heart disease, lung cancer, diabetes and depression. Within these interviews, fatalistic statements always occurred alongside statements endorsing the utility of behaviours for protecting health. This usage pattern suggests that these statements may have useful functions, rather than being simply a repudiation of the utility of health choices. We examine four functions that are suggested by previous researchers or by the participants' comments: stress relief, uncertainty management, sense making and (less strongly) face saving. As these themes indicate, individuals often make fatalistic statements to express an understanding of locally or broadly limiting factors for health efficacy, including genes, spiritual agents, prior behaviours, personality, and other factors.
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Affiliation(s)
- Bethany Keeley
- Speech Communication, University of Georgia, Athens, Georgia 30602, USA.
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Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, Maryniuk M, Peyrot M, Piette JD, Reader D, Siminerio LM, Weinger K, Weiss MA. National standards for diabetes self-management education. Diabetes Care 2009; 32 Suppl 1:S87-94. [PMID: 19118294 PMCID: PMC2613581 DOI: 10.2337/dc09-s087] [Citation(s) in RCA: 191] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Martha M Funnell
- 1Department of Medical Education, Diabetes Research and Training Center, University of Michigan, Ann Arbor, Michigan, USA.
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Aikens JE, Piette JD. Diabetic patients' medication underuse, illness outcomes, and beliefs about antihyperglycemic and antihypertensive treatments. Diabetes Care 2009; 32:19-24. [PMID: 18852334 PMCID: PMC2606823 DOI: 10.2337/dc08-1533] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The purpose of this study was to determine how patients' beliefs about antihyperglycemic and antihypertensive medications relate to medication underuse and health status. RESEARCH DESIGN AND METHODS In diabetic patients from an economically distressed region, we assessed perceived necessity and harmfulness for antihyperglycemic (n = 803) and antihypertensive (n = 573) medications, past year's medication underuse, A1C, systolic blood pressure (SBP), and diastolic blood pressure (DBP). RESULTS After correction for multiple analyses, multivariate models indicated that perceived need for antihyperglycemic medication was associated with being younger, being prescribed insulin, and being prescribed multiple medications. Concern about antihyperglycemic medications was associated with being younger, African American, dissatisfied with information received about medication, and of low health literacy. For antihypertensives, perceived necessity was associated with having numerous medical comorbidities and being dissatisfied with medication information; concern was associated with being younger, dissatisfied with information received about medication, and of low health literacy. Up to one-half of patients underused at least one of the types of medication; many of these patients attributed this underuse to cost. For both types of medications, concern was significantly associated with both cost-related and non-cost-related underuse, and antihypertensive concern was associated with higher SBP and DBP. CONCLUSIONS Even after adjustment for economic factors, patients who are younger, African American, or of low health literacy are especially concerned about medication harmfulness, which is in turn associated with medication underuse and higher blood pressure. To enhance adherence and outcomes, interventions should address patients' underlying concerns about potential adverse treatment effects and focus on both cultural factors and health literacy.
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Affiliation(s)
- James E Aikens
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA.
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Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, Maryniuk M, Peyrot M, Piette JD, Reader D, Siminerio LM, Weinger K, Weiss MA. National standards for diabetes self-management education. Diabetes Care 2008; 31 Suppl 1:S97-104. [PMID: 18165344 PMCID: PMC2797381 DOI: 10.2337/dc08-s097] [Citation(s) in RCA: 125] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Martha M Funnell
- Department of Medical Education, Diabetes Research and Training Center, University of Michigan, Ann Arbor, Michigan 48109-0489, USA.
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Piette JD. Interactive behavior change technology to support diabetes self-management: where do we stand? Diabetes Care 2007; 30:2425-32. [PMID: 17586735 DOI: 10.2337/dc07-1046] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, Maryniuk M, Peyrot M, Piette JD, Reader D, Siminerio LM, Weinger K, Weiss MA. National standards for diabetes self-management education. Diabetes Care 2007; 30:1630-7. [PMID: 17526822 DOI: 10.2337/dc07-9923] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Martha M Funnell
- Department of Medical Education, Diabetes Research and Training Center, University of Michigan, Ann Arbor, Michigan 48109-0489, USA.
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