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Breland JY, Dawson DB, Puran D, Mohankumar R, Maguen S, Timko C, Frayne SM, Nevedal AL. Common Sense Models of Obesity: a Qualitative Investigation of Illness Representations. Int J Behav Med 2023; 30:190-198. [PMID: 35445325 DOI: 10.1007/s12529-022-10082-w] [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] [Accepted: 03/24/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Common Sense Model provides a framework to understand health beliefs and behaviors. It includes illness representations comprised of five domains (identity, cause, consequences, timeline, and control/cure). While widely used, it is rarely applied to obesity, yet could explain self-management decisions and inform treatments. This study answered the question, what are patients' illness representations of obesity?; and examined the Common Sense Model's utility in the context of obesity. METHODS Twenty-four participants with obesity completed semi-structured phone interviews (12 women, 12 men). Directed content analysis of transcripts/notes was used to understand obesity illness representations across the five illness domains. Potential differences by gender and race/ethnicity were assessed. RESULTS Participants did not use clinical terms to discuss weight. Participants' experiences across domains were interconnected. Most described interacting life systems as causing weight problems and used negative consequences of obesity to identify it as a health threat. The control/cure of obesity was discussed within every domain. Participants focused on health and appearance consequences (the former most salient to older, the latter most salient to younger adults). Weight-related timelines were generally chronic. Women more often described negative illness representations and episodic causes (e.g., pregnancy). No patterns were identified by race/ethnicity. CONCLUSIONS The Common Sense Model is useful in the context of obesity. Obesity illness representations highlighted complex causes and consequences of obesity and its management. To improve weight-related care, researchers and clinicians should focus on these beliefs in relation to preferred labels for obesity, obesity's most salient consequences, and ways of monitoring change.
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Affiliation(s)
- Jessica Y Breland
- VA Palo Alto Health Care System, 795 Willow Road (MPD-152), Menlo Park, CA, 94025, USA.
| | - Darius B Dawson
- Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX, 77030, USA
- Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Deloras Puran
- VA Palo Alto Health Care System, 795 Willow Road (MPD-152), Menlo Park, CA, 94025, USA
| | - Rakshitha Mohankumar
- VA Palo Alto Health Care System, 795 Willow Road (MPD-152), Menlo Park, CA, 94025, USA
| | - Shira Maguen
- San Francisco VA Healthcare System, 4150 Clement St, San Francisco, CA, 94121, USA
- University of California, San Francisco, 505 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Christine Timko
- VA Palo Alto Health Care System, 795 Willow Road (MPD-152), Menlo Park, CA, 94025, USA
- Stanford University School of Medicine, 291 Campus Dr, Stanford, CA, 94305, USA
| | - Susan M Frayne
- VA Palo Alto Health Care System, 795 Willow Road (MPD-152), Menlo Park, CA, 94025, USA
- Stanford University School of Medicine, 291 Campus Dr, Stanford, CA, 94305, USA
| | - Andrea L Nevedal
- VA Palo Alto Health Care System, 795 Willow Road (MPD-152), Menlo Park, CA, 94025, USA
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Vileikyte L, Pouwer F, Gonzalez JS. Psychosocial research in the diabetic foot: Are we making progress? Diabetes Metab Res Rev 2020; 36 Suppl 1:e3257. [PMID: 31850665 DOI: 10.1002/dmrr.3257] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 11/25/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/METHODS This review summarizes recent advances regarding the role of psychological factors in people with a diabetic foot ulcer (DFU). It describes the detrimental effects of diabeticfoot complications and in particular, Charcot Neuroarthropathy (CN), on health status and quality of life (QoL) and emphasizes the importance of utilizing DFU-specific assessment tools. RESULTS Diabetic neuropathy (DN)-related postural instability is key in generating depression in high DFU risk patients and in predicting offloading non-adherence those with active DFUs. Patients' views of their own DFU risk are largely inconsistent with biomedical models, resulting in a lack of preventive foot self-care. Furthermore, DFUs are a source of specific emotional responses, with fear of amputation predominant. While fear of amputation is associated with better preventive foot self-care, it appears to be linked to DFU non-healing, though mechanisms are yet to be elucidated. Until now, systemically released stress hormones were recognized as the only biological mechanism through which psychological stress influences healing. Recently, the skin has been found to be an extra-adrenal site for glucocorticoid synthesis with local, tissue-specific cortisol implicated in DFU non-healing. CONCLUSIONS These observations could potentially lead to future targets for therapeutic and psychological interventions.
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Affiliation(s)
- Loretta Vileikyte
- Division of Diabetes, Endocrinology and Gastroenterology, University of Manchester, Manchester, UK
- Department of Endocrinology and Dermatology, University of Miami, Miami, Florida
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- STENO Diabetes Center Odense, Odense, Denmark
- School of Psychology, Deakin University, Geelong, Australia
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York
- Albert Einstein College of Medicine, Bronx, New York
- New York Regional Center for Diabetes Translation Research, Bronx, New York
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Breland JY, Wong JJ, McAndrew LM. Are Common Sense Model constructs and self-efficacy simultaneously correlated with self-management behaviors and health outcomes: A systematic review. Health Psychol Open 2020; 7:2055102919898846. [PMID: 32030192 PMCID: PMC6978827 DOI: 10.1177/2055102919898846] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This systematic review answered two questions among adults with chronic conditions: When included in the same statistical model, are Common Sense Model constructs and self-efficacy both associated with (1) self-management behaviors and (2) health outcomes? We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included 29 articles. When included in the same statistical model, Common Sense Model constructs and self-efficacy were both correlated with outcomes. Self-efficacy was more consistently associated with self-management behaviors, and Common Sense Model constructs were more consistently associated with health outcomes. Findings support the continued inclusion and integration of both frameworks to understand and/or improve chronic illness self-management and outcomes.
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Affiliation(s)
| | - Jessie J Wong
- VA Palo Alto Health Care System, USA.,Stanford University School of Medicine, USA
| | - Lisa M McAndrew
- VA New Jersey Health Care System, USA.,University at Albany, State University of New York, USA
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Abstract
Research on the Commonsense Self-Regulation Model has emphasised reflective/conscious perceptual processes regarding illness threat (beliefs about symptoms, consequences, timeline, and curability) in predicting and changing coping behaviours. Understanding of illness self-regulation and avenues for intervention might be enriched by consideration of automatic processes that influence the recognition and identification of illness, response to illness, and ongoing management. This article adopts an integrative approach to (1) outline the theoretical importance of implicit processes in patients' self-regulation of illness and methods to study them; (2) review research evidence for these processes, including interventions tested to modify them; and (3) outline avenues for future research. A substantial body of research on implicit processes (cognitive bias and interpretational bias) in illness maintenance in chronic illness has recently been extended to detection and interpretation of acute illness and new perspectives relating to the self-system. There is encouraging evidence that cognitive accessibility of coping and implicit attitudes may impact upon coping behaviours. Procedures that strategically automatise coping responses and create habits have considerable promise. We outline an agenda for future research in which health psychology accepts the challenge posed by the interplay of the reflective and associative systems in promoting effective self-regulation of illness.
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Affiliation(s)
- Sheina Orbell
- Department of Psychology, University of Essex, Colchester, UK
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Pires GE, Peuker AC, Castro EK. Brief intervention for stress management and change in illness perception among hypertensive and normotensive workers: pilot study and protocol. PSICOLOGIA-REFLEXAO E CRITICA 2017; 30:26. [PMID: 32025986 PMCID: PMC6974342 DOI: 10.1186/s41155-017-0080-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 12/04/2017] [Indexed: 11/24/2022] Open
Abstract
The objective of this study was to describe and evaluate the effects of a pilot intervention on perceived stress, knowledge about hypertension, and illness perception among hypertensive and normotensive workers. The intervention consisted of two group sessions performed in the workplace aiming to reduce stress, increase knowledge about hypertension, and explore the effect on illness perception. The sessions included clinical aspects of systemic arterial hypertension, illness perception and health behavior, and strategies for stress management. Workers from a petrochemical industry (19 hypertensive and 14 normotensive) participated in the study by answering a biosociodemographic questionnaire, the Brief Illness Perception Questionnaire, the Perceived Stress Scale, and a quiz with questions about hypertension. The measurements were collected at an initial meeting to gather the participants and 90 days after the intervention. There was a significant reduction in the perceived stress levels of both groups, in addition to an increase in the perception of personal control and illness coherence. Normotensive workers also increased their knowledge about hypertension, while hypertensive patients increased the perception that treatment could control the illness. In conclusion, the pilot intervention generated positive effects and can be considered a strategy of illness prevention for normotensive workers and control for hypertensive patients.
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Affiliation(s)
- Gerusa Estelita Pires
- Programa de Pós-Graduação em Psicologia, Universidade do Vale do Rio dos Sinos, Avenida Unisinos, 950, prédio E01, sala 215, São Leopoldo, RS 93022-750 Brazil
| | - Ana Carolina Peuker
- Programa de Pós-Graduação em Psicologia, Universidade do Vale do Rio dos Sinos, Avenida Unisinos, 950, prédio E01, sala 215, São Leopoldo, RS 93022-750 Brazil
| | - Elisa Kern Castro
- Programa de Pós-Graduação em Psicologia, Universidade do Vale do Rio dos Sinos, Avenida Unisinos, 950, prédio E01, sala 215, São Leopoldo, RS 93022-750 Brazil
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