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Khalil TA, Filmban DM, Sinnah HNM, Fallatah RA, Sayis AA, Alruwaili SS, Alghamdi SA, Almutairi NFM, Haider AMI, Ajam RA, Basmih AF. Knowledge, Attitude, and Practices Regarding the Rome IV Criteria for the Diagnosis of Irritable Bowel Syndrome Among Primary Healthcare Physicians in Saudi Arabia. Cureus 2023; 15:e49460. [PMID: 38152827 PMCID: PMC10751600 DOI: 10.7759/cureus.49460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 12/29/2023] Open
Abstract
INTRODUCTION Irritable bowel syndrome (IBS) presents a significant challenge in the medical field due to its complex nature as a functional gastrointestinal illness (FGID) without clear biological markers. Diagnosis often involves ruling out other potential causes, leading to frustration for patients and difficulty in effective treatment. Given its high prevalence among FGIDs, primary healthcare (PHC) physicians play a crucial role in its initial assessment and management. METHODS This cross-sectional study surveyed 623 PHC physicians using a structured, closed-ended questionnaire. Employing a multistage sampling approach, physicians were selected from various provinces and cities in Saudi Arabia. Clusters within these cities were also sampled. RESULTS The research revealed that a majority of physicians (n = 411, 66%) exhibited a strong awareness of the Rome IV criteria, essential for diagnosing IBS. This awareness correlated significantly with variables, such as age, nationality, marital status, specialty, classifications, and years of experience. CONCLUSION PHC physicians in the study demonstrated a commendable level of familiarity with the Rome IV criteria for diagnosing IBS. Their knowledge was particularly robust concerning symptoms outlined in these criteria. However, there is room for improvement in their understanding, attitude, and application of the Rome IV guidelines in practice. Addressing these gaps could enhance the overall management of IBS cases by these physicians.
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Affiliation(s)
- Tahani A Khalil
- Family Medicine, King Salman Armed Forces Hospital, Tabuk, SAU
| | | | | | | | - Asmaa A Sayis
- Internal Medicine, Al-Noor Specialist Hospital, Mecca, SAU
| | | | | | | | | | - Razan A Ajam
- Faculty of Medicine, Ibn Sina National College, Jeddah, SAU
| | - Abeer F Basmih
- Internal Medicine, Al-Noor Specialist Hospital, Mecca, SAU
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Scime NV, Brockway ML, Metcalfe A, Nettel-Aguirre A, Tough SC, Chaput KH. Association of illness perceptions and exclusive breastfeeding intentions among pregnant women with chronic conditions: A community-based pregnancy cohort study. J Psychosom Res 2023; 172:111418. [PMID: 37429127 DOI: 10.1016/j.jpsychores.2023.111418] [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] [Received: 07/08/2022] [Revised: 06/05/2023] [Accepted: 06/13/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVE We examined whether changes in illness perceptions from preconception to pregnancy were associated with intentions to exclusively breastfeed to 6 months postpartum among women with chronic physical health conditions. METHODS We analyzed self-reported cross-sectional questionnaire data collected in the third trimester from 361 women with chronic conditions enrolled in a community-based cohort study (Alberta, Canada). For individual and total illness perceptions, measured with the Brief Illness Perception Questionnaire, women were classified using change scores (preconception minus pregnancy) into one of the following groups: "worsening," "improving," or "stable" in pregnancy. Intention to exclusively breastfeed was defined as plans to provide only breast milk for the recommended first 6 months after birth. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using multivariable logistic regression modelling, with the "stable" group as the reference and controlling for demographic factors, chronic condition duration and medication, prenatal class attendance, and social support. RESULTS Overall, 61.8% of women planned to exclusively breastfeed to 6 months. Worsened total illness perceptions (adjusted OR 0.50, 95% CI 0.30-0.82) as well as perceptions of worsened identity (i.e., degree of symptoms; adjusted OR 0.49, 95% CI 0.28-0.85) or consequences (i.e., impact on functioning; adjusted OR 0.60, 95% CI 0.34-1.06) were associated with lower odds of intending to exclusively breastfeed to 6 months. CONCLUSIONS Women who perceive their illness experience to worsen during pregnancy are less likely to plan to exclusively breastfeed to 6 months in accordance with public health recommendations.
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Affiliation(s)
- Natalie V Scime
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
| | - Meredith L Brockway
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amy Metcalfe
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada; Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Alberto Nettel-Aguirre
- Centre For Health and Social Analytics, National Institute for Applied Statistical Research, School of Mathematics and Statistics, University of Wollongong, NSW, Australia.; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Suzanne C Tough
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Kathleen H Chaput
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada
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Zukerman G, Maor M, Reichard T, Ben-Itzhak S. Does older mean flexible? Psychological flexibility and illness cognitions in chronic medical conditions - the moderating effect of age. PSYCHOL HEALTH MED 2023; 28:1844-1860. [PMID: 37088966 DOI: 10.1080/13548506.2023.2206145] [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] [Received: 07/21/2022] [Accepted: 04/17/2023] [Indexed: 04/25/2023]
Abstract
Adjustment to a Chronic Medical Condition (CMC) is associated with developing hypotheses regarding one's symptoms, known as illness cognition (IC). Aging is associated with a higher rate of CMC. We assessed the effects of aging and psychological flexibility (PF)-one's ability to be open to change, and to alter or persist in behaviors according to environmental circumstances - on IC development in CMC. In a cross-sectional study of hospitalized patients with CMC, 192 patients in four age groups: younger (<50), midlife (50-59), young old (60-69), and elderly (≥70) completed questionnaires sampling IC, PF and demographics. Younger participants reported less helplessness (IC) while lower scores in one PF component (perceiving reality as multifaceted) were reported by the elderly (≥70); older age was associated with a more fixed, narrow perception of reality. Both effects remained significant when using the medical condition severity as a covariate. In general, age was positively associated with IC of acceptance and Helplessness. In regression analysis, CMC severity significantly predicted all IC. Moreover, the interaction of age and perceiving reality as dynamic and changing (PF-RDC component) significantly predicted IC- acceptance of illness; follow-up analysis revealed significant correlations between PF-RDC and acceptance only for younger patients (< age 50). PF-RDC also significantly predicted IC - perceived benefit; among the entire sample higher RDC was associated with less IC - perceived benefit. Implications for theory and practice are discussed.
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Affiliation(s)
- Gil Zukerman
- Department of Communication Disorders, School of Health Sciences, Ariel University, Ariel, Israel
| | - Maya Maor
- Department of Sociology and Anthropology, Faculty of Humanistic and Social Sciences, Ariel University, Ariel, Israel
| | - Tamar Reichard
- Tel Aviv Sourasky Medical Center, Psychological Service, Tel Aviv, Israel
| | - Shulamit Ben-Itzhak
- Head Clinical Psychologist, Psychological Service, Sourasky Tel Aviv Medical Center, Tel Aviv, Israel
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Sexual Dysfunction in People with Multiple Sclerosis: The Role of Disease Severity, Illness Perception, and Depression. J Clin Med 2023; 12:jcm12062215. [PMID: 36983224 PMCID: PMC10051729 DOI: 10.3390/jcm12062215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/14/2023] [Accepted: 03/09/2023] [Indexed: 03/15/2023] Open
Abstract
Despite being a common issue in people with multiple sclerosis (pwMS), sexual dysfunction is still underinvestigated. This work aims to assess the potential determinants of sexual dysfunction in pwMS by considering its relationship with disease severity (in terms of global disability), illness perception, and depressive symptoms. In this multicenter study, 1010 pwMS responded to an online survey. A serial mediation model considering negative illness perception and depressive symptoms as mediators of the relationship between disease severity and sexual dysfunction was conducted using the SPSS PROCESS Macro with bias-corrected bootstrapping (5000 samples). Disease severity exerts an indirect effect on sexual dysfunction via illness perception, both independently and through depressive symptoms. However, the results indicated that illness perception plays a more crucial role in sexual dysfunction in pwMS with mild disability than in pwMS with moderate-severe disability. This study suggests that higher disability increases its magnitude by enhancing negative illness perception, that, in turn, affects sexual dysfunction both directly and through depressive symptoms, especially in pwMS with mild disability. Modulating the effect of illness perception by favoring adaptive coping strategies might represent a valid approach to mitigate sexual dysfunction symptoms in MS.
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Wang Y, Van Der Boog P, Hemmelder MH, Dekker FW, De Vries A, Meuleman Y. Understanding Health-Related Quality of Life in Kidney Transplant Recipients: The Role of Symptom Experience and Illness Perceptions. Transpl Int 2023; 36:10837. [PMID: 37125387 PMCID: PMC10134035 DOI: 10.3389/ti.2023.10837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 03/27/2023] [Indexed: 05/02/2023]
Abstract
The purpose of our article is to investigate the impact of symptom experience on health related quality of life (HRQOL) in kidney transplant recipients (KTRs) and whether illness perceptions mediated this impact. Symptom experience, illness perceptions, and HRQOL were measured at transplantation and 6 weeks after transplantation in KTRs in an ongoing Dutch cohort study. Multivariable linear regression models were used for the analysis. 90 KTRs were analyzed. Fatigue and lack of energy were the most prevalent and burdensome symptoms at transplantation. Mental HRQOL at 6 weeks after transplantation was comparable to that of the general Dutch population (mean [standard deviation, SD]: 49.9 [10.7]) versus 50.2 [9.2]), while physical HRQOL was significantly lower (38.9 [9.1] versus 50.6 [9.2]). Experiencing more symptoms was associated with lower physical and mental HRQOL, and the corresponding HRQOL reduced by -0.15 (95%CI, -0.31; 0.02) and -0.23 (95%CI, -0.42; -0.04) with each additional symptom. The identified mediation effect suggests that worse symptom experiences could cause more unhelpful illness perceptions and consequently lead to lower HRQOL. Illness perceptions may explain the negative impact of symptom experience on HRQOL. Future studies at later stages after kidney transplantation are needed to further explore the mediation effect of illness perceptions and guide clinical practice to improve HRQOL.
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Affiliation(s)
- Yiman Wang
- Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, Netherlands
- *Correspondence: Yiman Wang,
| | - Paul Van Der Boog
- Division of Nephrology, Department of Internal Medicine, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Marc H. Hemmelder
- Department of Nephrology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Friedo W. Dekker
- Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Aiko De Vries
- Division of Nephrology, Department of Internal Medicine, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Yvette Meuleman
- Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, Netherlands
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Symptom perceptions in functional disorders, major health conditions, and healthy controls: A general population study. CLINICAL PSYCHOLOGY IN EUROPE 2022; 4:e7739. [DOI: 10.32872/cpe.7739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 08/14/2022] [Indexed: 12/24/2022] Open
Abstract
Background
The present study investigated differences in symptom perceptions between individuals with functional disorders (FD), major health conditions, and FDs + major health conditions, respectively, and a group of healthy individuals. Furthermore, it investigated the relevance of FDs among other health-related and psychological correlates of symptom perceptions in the framework of the Common Sense Model of Self-Regulation (CMS).
Method
This cross-sectional study used epidemiological data from the Danish Study of Functional Disorders part two (N = 7,459 participants, 54% female, 51.99 ± 13.4 years). Symptom perceptions were assessed using the Brief Illness Perception Questionnaire (B-IPQ) and compared between the four health condition groups. Multiple regression analyses were performed to examine associations between symptom perceptions, FDs, and other health-related and psychological correlates from the CMS framework.
Results
Individuals with FDs (n = 976) and those with FDs + major health conditions (n = 162) reported less favorable symptom perceptions compared to the other two groups, particularly regarding perceived consequences, timeline, and emotional representations (effect size range Cohen’s d = 0.12-0.66). The presence of a FD was significantly associated with all B-IPQ items, even in the context of 16 other relevant health-related and psychological correlates from the CMS framework, whereas symptom presence last year or last week was not.
Conclusion
In the general population, symptom perceptions seem to play a more salient role in FD than in individuals with well-defined physical illness. Symptom perceptions should therefore be targeted in both primary and secondary interventions for FDs.
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Zhang Q, Zhou W, Song D, Xie Y, Lin H, Liang Y, Ren Y, Liang Y, Chen Y. Vision-related quality of life in patients with glaucoma: the role of illness perceptions. Health Qual Life Outcomes 2022; 20:78. [PMID: 35550590 PMCID: PMC9097073 DOI: 10.1186/s12955-022-01979-x] [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: 09/24/2021] [Accepted: 04/21/2022] [Indexed: 11/10/2022] Open
Abstract
Purpose To explore the predictive effects of illness perceptions on vision-related quality of life (VRQoL) in Chinese glaucoma patients. Methods In this cross-sectional study, 97 patients with glaucoma completed the brief illness perception questionnaire (BIPQ), the glaucoma quality of life-15 (GQL-15) questionnaire, and a questionnaire regarding sociodemographic and clinical information. A correlation analysis and hierarchical linear regression analysis were performed. Results The BIPQ total score was positively correlated with the total score of the GQL-15 questionnaire and the scores of its four dimensions. Chronic comorbidities, the type of glaucoma, the best-corrected visual acuity (BCVA), the mean defect (MD) of visual field in the better eye, and identity in the BIPQ were critical predictors of VRQoL. Illness perceptions independently accounted for 7.8% of the variance in the VRQoL of glaucoma patients. Conclusions Patients with stronger illness perceptions and those who perceive themselves as having more glaucoma symptoms are likely to experience worse VRQoL. Illness perceptions in glaucoma patients deserve clinical attention, and further studies are needed to examine whether cognitive interventions targeting illness perceptions can improve VRQoL. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-022-01979-x.
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Affiliation(s)
- Qiqi Zhang
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wenzhe Zhou
- The Eye Hospital, Wenzhou Medical University, 270 Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, China
| | - Di Song
- Huzhou First People's Hospital, Huzhou, Zhejiang, China
| | - Yanqian Xie
- The Eye Hospital, Wenzhou Medical University, 270 Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, China
| | - Hao Lin
- The Eye Hospital, Wenzhou Medical University, 270 Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, China
| | - Youping Liang
- The Eye Hospital, Wenzhou Medical University, 270 Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, China
| | - Yanhan Ren
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Yuanbo Liang
- The Eye Hospital, Wenzhou Medical University, 270 Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, China.
| | - Yanyan Chen
- The Eye Hospital, Wenzhou Medical University, 270 Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, China.
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Yang L, Chen X, Liu Z, Sun W, Yu D, Tang H, Zhang Z. The Impact of Illness Perceptions on Depressive Symptoms Among Benign Prostatic Hyperplasia Patients with Lower Urinary Tract Symptom. Int J Gen Med 2021; 14:9297-9306. [PMID: 34887677 PMCID: PMC8651631 DOI: 10.2147/ijgm.s342512] [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: 10/03/2021] [Accepted: 11/08/2021] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed at exploring whether illness perceptions may mediate the relationship between depressive symptoms and lower urinary tract symptoms (LUTS) among benign prostatic hyperplasia (BPH) patients. Methods The Patient Health Questionnaire (PHQ-9) for depression, the International Prostate Symptom Score (IPSS) for the severity of LUTS and the brief Illness Perception Questionnaire (B-IPQ) for illness perceptions (IPs) were used among the 157 BPH patients with LUTS. Pearson’s correlation test and hierarchical regression analyses were used to assess the correlations between LUTS, depressive symptoms and IPs. Results Our study found that the severity of LUTS was associated with depressive symptoms and subscales of illness perception; meanwhile, IPs were associated with the level of education. A positive relationship was found between the scores of PHQ9 and the B-IPQ subscales of illness consequences, identity, timeline, concern and emotion; thus, a negative correlation was found between scores of PHQ9 and the B-IPQ subscales of illness coherence, personal control and treatment control. The hierarchical regression analysis showed IPSS and the B-IPQ subscales of illness consequences, concern and emotion were significantly associated with depression, and explained 85.1% of the variance in depressive symptoms (R2 = 0.851, p < 0.05). Conclusion The relationship between LUTS and depressive symptoms may be mediated by the negative IPs, including consequences, concern and emotions. Clinicians should not only focus on the LUTS but also on the IPs to improve depressive symptoms among BPH patients.
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Affiliation(s)
- Linlin Yang
- Department of Geriatrics Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.,Department of General Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Xin Chen
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Zhiqi Liu
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Wei Sun
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Dexin Yu
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Haiqin Tang
- Department of Geriatrics Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.,Department of General Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Zhiqiang Zhang
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
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Li S, Cui G, Yin Y, Wang S, Liu X, Chen L. Health-promoting behaviors mediate the relationship between eHealth literacy and health-related quality of life among Chinese older adults: a cross-sectional study. Qual Life Res 2021; 30:2235-2243. [PMID: 33661455 PMCID: PMC8298362 DOI: 10.1007/s11136-021-02797-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE The aim of this study was to examine the association between eHealth literacy and health-related quality of life (HRQoL) and explore whether health-promoting behaviors mediate the association between eHealth literacy and HRQoL among Chinese older adults. METHODS An anonymous cross-sectional survey was conducted among 2300 adults aged 60 or older from Jinan, China. The eHealth Literacy Scale, Short-Form Health-Promoting Lifestyle Profile, and Short-Form Health Survey (SF-12) were used to measure eHealth literacy, health-promoting behaviors, and HRQoL. Multivariate linear regression analyses were conducted to test the association between eHealth literacy, health-promoting behaviors, and HRQoL. The mediation analyses, composed of PROCESS analysis and bootstrapping method, were preformed to test both total (c), direct (c'), and indirect effects (a*b) of eHealth literacy on HRQOL through health-promoting behaviors. RESULTS Regression analyses indicated that eHealth literacy (B = 0.487, p < 0.001) was significantly positively associated with health-promoting behaviors, and health-promoting behaviors (B = 0.257, p < 0.001) were associated with HRQoL. The mediation analyses indicated that eHealth literacy had a significant direct (c' = 0.183, p < 0.001) and indirect effect on older adults' HRQoL through health-promoting behaviors (a*b = 0.125, bootstrapped 95% confidence interval (CI) = 0.094-0.157). The indirect effect accounted for 40.6% of the total effect (c = 0.308, bootstrapped 95% CI 0.241-0.376) of eHealth literacy on HRQoL. CONCLUSIONS Health-promoting behaviors mediated the association between eHealth literacy and HRQoL in Chinese older adults. The establishment of interventions focused on health-promoting behavior may be an effective way to help older adults with low eHealth literacy improve their HRQoL.
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Affiliation(s)
- Shaojie Li
- Department of Social Medicine and Health Service Management, Xiangya School of Public Health, Central South University, Changsha, 410078, China
| | - Guanghui Cui
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Yongtian Yin
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China.
| | - Shiyuan Wang
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China.
| | - Xinyao Liu
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Lei Chen
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
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Personality Traits and Health-Related Quality of Life in Irritable Bowel Syndrome (IBS) Patients: The Mediating Role of Illness Perceptions. PSYCHOLOGICAL STUDIES 2021. [DOI: 10.1007/s12646-021-00618-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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De Petrillo A, Hughes LD, McGuinness S, Roberts D, Godfrey E. A systematic review of psychological, clinical and psychosocial correlates of perceived food intolerance. J Psychosom Res 2021; 141:110344. [PMID: 33383523 DOI: 10.1016/j.jpsychores.2020.110344] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 12/14/2020] [Accepted: 12/14/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Perceived food intolerance (PFI) is a distressing condition reported by 3% - 35% of individuals, whereas prevalence of food allergy is 0.9%-3%. The present paper aims to systematically review the evidence for psychological, clinical and psychosocial factors associated with PFI in order to advance the current understanding. METHODS Articles published from 1970 until October 2020 were identified. Case-control, prospective cohort, cross-sectional and retrospective studies published in English that a) included a subject population of adults over 18 with PFI and b) examined psychological, clinical and/or psychosocial factors of PFI were reviewed against inclusion criteria. Methodological quality was assessed, data extracted, and a narrative synthesis conducted. RESULTS Of 2864 abstracts identified, thirty-six articles met inclusion criteria. Evidence consistently found PFI is associated with female sex, and individuals with PFI often report physical health complaints including gastrointestinal and extraintestinal symptoms, and gastrointestinal and atopic conditions. Evidence for an association between psychological factors and PFI was inconsistent, although some suggested increased levels of common mental disorders and distress. Findings regarding psychosocial factors were mixed and sociodemographic data were infrequently collected. CONCLUSIONS PFI is associated with female sex and gastrointestinal and extraintestinal complaints. Limited high-quality evidence supports the role of psychological factors associated with PFI. High-quality research using prospective and longitudinal designs with multivariate analyses is needed. Future research should explore modifiable psychological factors as potential targets for intervention and identify clinical and psychosocial risk factors of PFI to aid in formulating a biopsychosocial model of PFI.
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Affiliation(s)
- Alessandra De Petrillo
- King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, United Kingdom.
| | - Lyndsay D Hughes
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th floor Bermondsey Wing, Guy's Hospital Campus London Bridge, London SE1 9RT, United Kingdom
| | - Serena McGuinness
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th floor Bermondsey Wing, Guy's Hospital Campus London Bridge, London SE1 9RT, United Kingdom
| | - Danniella Roberts
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th floor Bermondsey Wing, Guy's Hospital Campus London Bridge, London SE1 9RT, United Kingdom
| | - Emma Godfrey
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th floor Bermondsey Wing, Guy's Hospital Campus London Bridge, London SE1 9RT, United Kingdom.
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12
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Zhang L, Wang J, Chen T, Tian M, Zhou Q, Ren J. Symptom Clusters and Quality of Life in Cervical Cancer Patients Receiving Concurrent Chemoradiotherapy: The Mediating Role of Illness Perceptions. Front Psychiatry 2021; 12:807974. [PMID: 35173639 PMCID: PMC8841507 DOI: 10.3389/fpsyt.2021.807974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/23/2021] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES Although studies shows that symptom clusters and illness perceptions are negatively associated with quality of life (QoL), it is unclear how these variables of cervical cancer patients who receive concurrent chemoradiotherapy (CCRT) relate to each other. This study aimed to identify the symptom clusters in cervical cancer patients who receive CCRT and evaluate the mediating effect of illness perceptions on the relationship between symptom clusters and QoL. METHODS A cross-sectional survey was conducted on 286 cervical cancer patients receiving CCRT from October 2019 to October 2020. M.D. Anderson Symptom Inventory, Brief Illness Perception Questionnaire, and Functional Assessment Cancer Therapy-Cervix were applied to investigate the symptom clusters, illness perceptions and QoL of the participants, respectively. Exploratory factor analysis was conducted to identify symptom clusters. The relationships among symptom clusters, illness perceptions, and QoL were analyzed with the structural equation modeling. RESULTS A total of four symptom clusters were identified, including psychological status symptom cluster, therapy side-effect symptom cluster, sickness symptom cluster, and gastrointestinal symptom cluster (χ2 = 1,552.282, Df = 78, P < 0.001). Symptom clusters, illness perceptions, and QoL were significantly correlated. Symptom clusters had significant direct (β = -0.38, P < 0.001) and indirect effects (β = -0.21, P < 0.001) on QoL. CONCLUSION Illness perceptions played a significant mediating role between symptom clusters and QoL in cervical cancer patients receiving CCRT. Strategies like prompting effective symptom management for the purposes of alleviating illness perceptions may contribute to improving their QoL.
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Affiliation(s)
- Lan Zhang
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.,Department of Health Psychology, School of Nursing, Shandong University, Jinan, China
| | - Jia Wang
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Tangzhen Chen
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Min Tian
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Qimin Zhou
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Jianhua Ren
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
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13
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Pereira M, Moreira CS, Nogueira-Silva C, Izdebski P, Pereira MG. Breast cancer post-surgical impact on women´s quality of life during chemotherapy treatment: A structural equation modelling approach. Eur J Cancer Care (Engl) 2020; 30:e13349. [PMID: 33159394 DOI: 10.1111/ecc.13349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 07/02/2020] [Accepted: 08/07/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Breast cancer is an important public health problem that is increasing in incidence, being a stressor with a negative impact on women's quality of life. This study is focused on the evaluation of temporal precursors (one month before) of women's quality of life undergoing chemotherapy, considering post-surgical personal, clinical, cognitive and neuropsychophysiological factors, according to the Transactional Stress and Coping Model. METHODS This longitudinal study included 112 patients with breast cancer. Data were collected in two different moments: before and during the adjuvant chemotherapy. Structural equation modelling was used to support a theoretically based model in which some antecedent factors impact patients' long-term quality of life through a set of mediators. RESULTS The associations of breast symptoms, body image and sexual functioning with psychological distress and quality of life were totally mediated by illness perceptions, while the associations of working memory with psychological distress and quality of life were totally mediated by self-efficacy for coping. Patients with greater psychological distress showed higher levels of nadir cortisol. CONCLUSIONS Results showed the importance of assessing patients' perceptions of their illness, prior to chemotherapy, as well as promoting more self-efficacy for coping, in order to improve women's emotional state and quality of life.
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Affiliation(s)
- Marta Pereira
- School of Psychology, University of Minho, Psychology Research Center (CIPsi), Braga, Portugal
| | - Célia Sofia Moreira
- Faculty of Sciences and Center of Mathematics (FCUP & CMUP), University of Porto, Porto, Portugal
| | - Cristina Nogueira-Silva
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,Life and Health Sciences Research Institute /3B's-PT Government Associate Laboratory, Braga, Portugal.,Department of Obstetrics and Gynaecology, Hospital de Braga, Braga, Portugal
| | - Pawel Izdebski
- Institute of Psychology of the Kazimierz Wielki, University in Bydgoszcz, Bydgoszcz, Poland
| | - M Graça Pereira
- School of Psychology, University of Minho, Psychology Research Center (CIPsi), Braga, Portugal
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The Impact of an Individual Educational Program on the Quality of Life and Severity of Symptoms of Patients with Irritable Bowel Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124230. [PMID: 32545800 PMCID: PMC7344839 DOI: 10.3390/ijerph17124230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 12/15/2022]
Abstract
Background: Irritable bowel syndrome (IBS) is one of the most common functional diseases of the gastrointestinal tract. A typical symptom is changed bowel patterns: diarrhea, constipation, or alternation of the two. Abdominal pains vary in intensity and location, with periods of exacerbation and remission, causing disorganization in everyday life and work. Educational intervention could be one strategy to improve the well-being of IBS patients. Only a few trials have examined this hypothesis. The aim of this study was to examine the effect of an educational program combined with elements of behavioral therapy, individualized for each patient, on quality of life (QOL) and severity of pain of patients with IBS. Methods: In total, 150 IBS patients and 100 healthy persons in the control group were included. QOL (36-Item Short Form Health Survey, SF-36) and pain severity (Visual Analogue Scale) were measured at baseline and six months after education of IBS patients. Results: At baseline, patients with IBS showed highly significantly worse QOL. In the IBS group, significantly higher physical component summary (PCS) and mental component summary (MCS) scores were noted for 35- to 50-year-old patients compared to other patients. Six months after education and behavioral therapy, significant improvement in QOL and a significant decrease in the subjective perception of pain severity were noted compared to values before therapeutic education. Conclusion: An educational program combined with elements of behavioral therapy, individualized for patients with IBS, is an important part of therapy for these patients.
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Stressful Life Events Moderate the Relationship Between Changes in Symptom Severity and Health-related Quality of Life in Patients With Irritable Bowel Syndrome. J Clin Gastroenterol 2020; 54:445-451. [PMID: 31503051 DOI: 10.1097/mcg.0000000000001261] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The relationship between changes in symptom severity and health-related quality of life (HRQOL), which may be impacted by stressful life events, in irritable bowel syndrome (IBS), is unclear. Therefore, we investigated the relationship between changes in symptom severity and HRQOL and examined the moderating role of stressful life events in patients with IBS. METHODS This study is part of a cohort follow-up study on psychological factors in patients with IBS in tertiary care, and it included 158 patients. In addition to symptom severity and HRQOL, stressful life events were assessed by the Social Readjustment Rating Scale (SRRS). The relationship between symptom severity and HRQOL and the moderating role of stressful life events (in the 12 mo before the follow-up assessment) were analyzed. RESULTS The majority of participants had moderate levels of stressful life events (41.8%), followed by those who had mild levels (39.2%) and severe levels (19.0%) of stressful life events. Symptom severity could predict HRQOL, and the relationship between symptom severity and HRQOL was affected by the level of stressful life events. Compared with mild levels of stressful life events, a severe level of stressful life events significantly affected the relationship between changes in symptom severity and HRQOL (Z=-3.048, P<0.01). A similar result was found when comparing moderate and severe levels of stressful life events (Z=-1.810, P<0.10). CONCLUSIONS The study demonstrated that symptom severity predicted HRQOL during the progression of IBS and that stressful life events moderated the impact of symptom severity on HRQOL. The more stressful life events an IBS patient experiences, the less predictable the relationship is between changes in symptom severity and HRQOL.
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16
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Emmanuel A, Goosey RW, Wiseman G, Baker S, Törnblom H. Impact of symptom severity in patients with diarrhoea-predominant irritable bowel syndrome (IBS-D): results from two separate surveys of HCPs and patients with IBS-D. BMC Gastroenterol 2020; 20:127. [PMID: 32336287 PMCID: PMC7183708 DOI: 10.1186/s12876-020-01252-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 03/30/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Management of diarrhoea-predominant irritable bowel syndrome (IBS-D) is generally based on patient-reported symptoms; however, limited information on symptom severity exists. The objective of the study was to assess the impact of IBS-D severity on patient burden and patient and healthcare professional attitudes towards IBS. METHODS We conducted two web-based surveys of healthcare professionals and patients from Australia, Canada and Europe. We analysed patient characteristics and attitudes by IBS-D severity, which was assessed retrospectively using a composite of four variables: worst abdominal pain, IBS symptom frequency, Bristol Stool Form Scale and quality of life. RESULTS Of 679 healthcare professional respondents, one-third routinely classified patients by severity. The patient survey was completed by 513 patients with mild (26%), moderate (33%) and severe (41%) IBS-D, classified using the composite scale. Age, sex and treatment satisfaction did not change with severity; however, 19% of patients classified with severe IBS-D agreed with the statement: 'When my IBS is bad, I wish I was dead' versus 4 and 7% of patients with mild and moderate IBS-D, respectively (p < 0.05). Significantly more patients classified with severe IBS-D reported medication use versus mild IBS-D. CONCLUSION Compared with milder symptoms, severe IBS-D was associated with increased medication use and a negative perspective of IBS-D. This highlights the need for a validated severity scale to inform treatment decisions.
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Affiliation(s)
- Anton Emmanuel
- University College Hospital, 235 Euston Road, London, NW1 2BU, UK.
| | | | - Gwen Wiseman
- Former employee of Allergan plc, Marlow, Buckinghamshire, UK
| | | | - Hans Törnblom
- Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Bowers H, Gillanders D, Ferreira N. Moderating effect of IBS acceptance on psychosocial mediators of Irritable Bowel Syndrome. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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18
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Wolf J, Sattel H, Limburg K, Lahmann C. From illness perceptions to illness reality? Perceived consequences and emotional representations relate to handicap in patients with vertigo and dizziness. J Psychosom Res 2020; 130:109934. [PMID: 31972479 DOI: 10.1016/j.jpsychores.2020.109934] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 01/11/2020] [Accepted: 01/11/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Vertigo and dizziness (VD) are frequent symptoms that can occur due to various structural pathologies or due to functional impairment. Independent of their aetiology, the symptoms are often associated with physical and psychological burden which manifests in severe handicap in more than half of the patients. It is suggested that illness perceptions, the patients' cognitive and emotional concept of their disease, most likely impact the degree of handicap. For patients with VD, however, this relation of illness perceptions and handicap is so far not well understood. This study aimed to investigate the relation of illness perceptions and handicap for patients with VD. METHODS In a cross-sectional study design, n = 419 patients with VD were examined (53.7% female, age 53.5 ± 15.5 years). Participants underwent neurological and psychiatric examinations as well as a comprehensive assessment using self-report questionnaires. RESULTS Illness perceptions, specifically perceived consequences and emotional representations showed a moderate correlation with VD related handicap (r(419) = 0.62, p < .001). Our regression model including symptom severity, psychiatric comorbidity, and aspects of cognitive and emotional illness perceptions accounted for 52% of the variance in VD related handicap. In a moderation analysis, this relation did not differ significantly in patients with functional VD symptoms. CONCLUSION Findings of the present study provide evidence for the relevance of illness perceptions to handicap in patients with VD symptoms.
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Affiliation(s)
- Johannes Wolf
- Department of Psychosomatic Medicine and Psychotherapy, Albert-Ludwigs-Universität Freiburg, Hauptstraße 8, 79104 Freiburg, Germany.
| | - Heribert Sattel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Karina Limburg
- Department of Psychology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Claas Lahmann
- Department of Psychosomatic Medicine and Psychotherapy, Albert-Ludwigs-Universität Freiburg, Hauptstraße 8, 79104 Freiburg, Germany
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19
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Oliveira TSS, Andrade RCPD, Santos DND, Orrico KF, Abraão Neto J, Oliveira CJVD, Rocha PN, Carvalho EMD. Prevalence of Bowel Symptoms in Patients Infected with Human T-Lymphotropic type 1 Virus. Rev Soc Bras Med Trop 2019; 52:e20180486. [PMID: 31778419 DOI: 10.1590/0037-8682-0486-2018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 10/03/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Bowel dysfunction is frequent in patients with spinal cord diseases, but little is known about the prevalence of bowel symptoms in human T-lymphotropic virus-(HTLV-1) infected individuals. The purpose of this study is to determine the frequency of bowel symptoms in HTLV-1 infected individuals and their correlation with the degree of neurologic disease. METHODS This is a cross-sectional study comparing the frequency of bowel symptoms in HTLV-1-infected individuals* and seronegative donors (controls). Patients answered a questionnaire, the Rome III Criteria was applied, and stool consistency was evaluated by the Bristol Stool Form Scale. The individuals were classified as HTLV-1 carriers, probable HTLV-1 myelopathy and definitive HTLV-1 associated myelopathy or tropical spastic paraparesis (definitive HAM / TSP)**. RESULTS We studied 72 HTLV-1 infected individuals and 72 controls with equal age and gender distribution. Constipation was the most frequent complaint, occurring in 38 % of HTLV-1 individuals and in 15 % of the controls. In comparison to the seronegative controls, the probability of constipation occurrence was approximately 18 times higher in definitive HAM / TSP patients. Straining, lumpy or hard stools, sensation of anorectal obstruction/blockage, fewer than 3 defecations per week, flatulence, soiling, evacuation pain, and bleeding were also more frequent in the HTLV-1 patients than in the controls. Moreover, bowel symptoms were more frequent in patients with definitive or probable HAM / TSP than in carriers. CONCLUSIONS Bowel symptoms were more frequent in HTLV-1-infected patients than in seronegative controls and the frequency of bowel symptoms correlated with the severity of neurologic disease.
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Affiliation(s)
- Tatiane Souza Soares Oliveira
- Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Reabilitação, Salvador, BA, Brasil.,Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Imunologia, Salvador, BA, Brasil
| | - Rosana Cristina Pereira de Andrade
- Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Reabilitação, Salvador, BA, Brasil.,Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Imunologia, Salvador, BA, Brasil
| | - Dislene Nascimento Dos Santos
- Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Reabilitação, Salvador, BA, Brasil
| | - Keith Froes Orrico
- Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Imunologia, Salvador, BA, Brasil
| | - José Abraão Neto
- Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Imunologia, Salvador, BA, Brasil
| | - Cassius José Vitor de Oliveira
- Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Imunologia, Salvador, BA, Brasil
| | - Paulo Novis Rocha
- Universidade Federal da Bahia, Escola de Medicina, Departamento de Medicina Interna e Apoio Diagnóstico, Salvador, BA, Brasil
| | - Edgar Marcelino de Carvalho
- Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Imunologia, Salvador, BA, Brasil.,Fundação Oswaldo Cruz-Bahia, Instituto Gonçalo Moniz, Laboratório de Pesquisas Clínicas, Salvador, BA, Brasil.,Ministério da Ciência, Tecnologia, Inovações e Comunicações, Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, Salvador, BA, Brasil
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20
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Sørensen J, Schantz Laursen B, Drewes AM, Krarup AL. The Incidence of Sexual Dysfunction in Patients With Irritable Bowel Syndrome. Sex Med 2019; 7:371-383. [PMID: 31604682 PMCID: PMC6963115 DOI: 10.1016/j.esxm.2019.08.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/19/2019] [Accepted: 08/22/2019] [Indexed: 02/07/2023] Open
Abstract
Introduction Several studies have suggested that patients with irritable bowel syndrome (IBS) frequently have symptoms of sexual dysfunction. Aim The current study aims to map the current knowledge about the burden of sexual dysfunction in patients with IBS. Methods A literature review was conducted on PubMed and EMBASE using the following search terms or combinations thereof: irritable bowel syndrome; functional colonic disease; sexual function; sexual health; sexual behavior; sexual dysfunction; dyspareunia; erectile dysfunction; quality of life; and questionnaire. Main Outcome Measure Sexual dysfunction. Results 1,273 texts were found, 331 duplicates were removed, and 844 texts were excluded because they did not meet the inclusion criteria, leaving 98 full text articles. These were examined and it was found that 41 fulfilled the criteria. 4 questionnaires were found; Irritable Bowel Syndrome Quality of Life (IBS-QOL) questionnaire, the Irritable Bowel Syndrome – Quality of Life (IBSQOL) questionnaire, the Irritable Bowel Syndrome-36 question (IBS-36) questionnaire, and the Arizona Sexual Experience Scale. Subscores for sexual relations in IBS-QOL ranged from 37.7−100 (11.9) for patients with IBS and 82.2−100 (6.6) for controls. The IBSQOL and IBS-36 subscores for sexual relations ranged from 49.7−90.5 (9) to 3.9−5.4 (0.8) with no healthy controls for comparison. After interventions were implemented, there was an improvement in subscores (the IBS-QOL mean changed to 10.5%, IBSQOL mean changed to 3.8%, and the IBS-36 mean changed to 40%). The study using Arizona Sexual Experience Scale showed that 51% of patients with IBS had sexual dysfunction and also scored lower on the IBSQOL questionnaire. Conclusion The information about sexual dysfunction in patients with IBS is sparse and emerges primarily from quality of life questionnaires. It seems as though patients with IBS have more sexual problems compared to controls, but further investigation regarding the extent and type of sexual dysfunction is needed. Sørensen J, Schantz Laursen B, Drewes AM, et al. The Incidence of Sexual Dysfunction in Patients With Irritable Bowel Syndrome. Sex Med 2019;7:371–383.
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Affiliation(s)
- Jeanette Sørensen
- Centre of Neurogastroenterologic Research, Clinic Medicine, The North Regional Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark; Centre for Clinical Research, The North Regional Hospital, Denmark
| | - Birgitte Schantz Laursen
- Sexological Research Centre, Department of Clinical Medicine, Aalborg University, Denmark; Clinical Nursing Research Unit, Aalborg University Hospital, Denmark
| | - Asbjørn Mohr Drewes
- Department of Clinical Medicine, Aalborg University, Denmark; MechSense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Denmark
| | - Anne Lund Krarup
- Centre of Neurogastroenterologic Research, Clinic Medicine, The North Regional Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark; MechSense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Denmark.
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21
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Wong IY, Hawes DJ, Dar-Nimrod I. Illness representations among adolescents with attention deficit hyperactivity disorder: associations with quality of life, coping, and treatment adherence. Heliyon 2019; 5:e02705. [PMID: 31687524 PMCID: PMC6820282 DOI: 10.1016/j.heliyon.2019.e02705] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/31/2019] [Accepted: 10/17/2019] [Indexed: 02/06/2023] Open
Abstract
Research into the causes and outcomes of attention deficit hyperactivity disorder (ADHD) has been extensive, yet little is known about the perception of ADHD as a disorder and its related outcomes among diagnosed youth. The present study applied the Common-Sense Model of Illness Representations (CSM) to examine the perception of ADHD and its association with quality of life (QoL), coping strategies, and treatment adherence among 63 diagnosed adolescents (10-18 years). Adolescents recruited from clinics, parent support groups, and an educational service completed self-report measures of the key constructs. Results indicated that adolescents generally perceive their ADHD as mildly threatening; four illness beliefs (perceived impact, personal control, timeline, and coherence) are significant predictors of coping and four (perceived impact, causes, personal control, and treatment control) are that of QoL. Adolescents who perceived minimal impact, expected longer duration, had strong sense of coherence, and believed in personal control of ADHD coped with the disorder more actively. Those who made weaker attribution to psychological and environmental causes, believed in personal control and the effectiveness of behavioral treatment enjoyed better QoL. In addition, female adolescents seem to experience more difficulties in the management of ADHD than male counterparts. These findings have potentially important clinical implications, suggesting that perceptions of ADHD related to the disorder's impact, duration, coherence, and personal control, may be important for clinicians to address when caring for adolescents with the disorder.
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Affiliation(s)
- Iana Y.T. Wong
- School of Psychology, The University of Sydney, Australia
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22
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Westbrook TD, Morrison EJ, Maddocks KJ, Awan FT, Jones JA, Woyach JA, Johnson AJ, Byrd JC, Andersen BL. Illness Perceptions in Chronic Lymphocytic Leukemia: Testing Leventhal's Self-regulatory Model. Ann Behav Med 2019; 53:839-848. [PMID: 30590383 DOI: 10.1093/abm/kay093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Leventhal's Self-regulatory Model proposes that somatic characteristics of a health threat (e.g., symptom severity), and prior experience with the threat (e.g., unsuccessful treatment), are determinants of illness perceptions. Chronic lymphocytic leukemia (CLL) is appropriate for test of these postulates, having three phases differing in symptom severity and prior treatment experiences: indolent disease requiring no treatment (active surveillance; AS), symptomatic disease requiring a first treatment (FT), and highly symptomatic disease in those who have relapsed and/or failed to respond to prior treatments (relapsed/refractory; RR). PURPOSE To test symptom severity and prior treatment experiences as determinants of illness perceptions, illness perceptions were characterized and contrasted between CLL groups. METHODS Three hundred and thirty CLL patients (AS, n = 100; FT, n = 78; RR, n = 152) provided illness perception data on one occasion during a surveillance visit (AS) or prior to beginning treatment (FT, RR). RESULTS Analysis of variance with planned comparisons revealed that consequences, identity, and concern were least favorable among RR patients, followed by FT, then AS (ps < .01). AS patients endorsed the lowest levels of coherence (ps < .01), and the most chronic illness timeline (ps < .01). FT patients endorsed the highest levels of personal and treatment control (ps < .01). CONCLUSIONS Data provide preliminary empirical support for Self-regulatory Model postulates that symptom severity and prior disease experiences influence illness perceptions. Unique knowledge needs for AS patients and elevated psychological/physical symptoms for later-stage CLL patients may warrant clinical attention.
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Affiliation(s)
| | | | - Kami J Maddocks
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - Farrukh T Awan
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - Jeffrey A Jones
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - Jennifer A Woyach
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - Amy J Johnson
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - John C Byrd
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
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Guadagnoli L, Mutlu EA, Doerfler B, Ibrahim A, Brenner D, Taft TH. Food-related quality of life in patients with inflammatory bowel disease and irritable bowel syndrome. Qual Life Res 2019; 28:2195-2205. [PMID: 30900206 DOI: 10.1007/s11136-019-02170-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Food-related quality of life (FRQoL) evaluates the impact of diet, eating behaviors, and food-related anxiety on a person's quality of life. This is the first study to evaluate FRQoL in inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), two illnesses where food and diet are of importance. METHODS One hundred seventy-five participants (80 IBS, 95 IBD) participated in the study by completing measures evaluating FRQoL, psychological distress, and health-related quality of life. Primary analyses evaluated differences in FRQoL between IBD and IBS patients. Secondary analyses compared differences based on remission status, dietary use, and dietary consultation, as well as evaluated potential predictors of FRQoL. RESULTS IBD patients in remission report the highest FRQoL (IBD-remission: 91.2 (26.5) vs. IBD-active: 67.7 (19.6) and IBS-active: 67.6 (18.3), p < .001). Using more dietary treatments is associated with decreased FRQoL for IBS (r = - 0.23, p < .05) and IBD patients (r = - 0.31, p < .01). IBS patients are more likely to use dietary treatments than IBD (IBS = 81% vs. IBD = 64%, p < .01), with self-directed diets being the most commonly used approach. Symptom severity is the strongest predictor of FRQoL in both groups (IBD: R2 = .27, p < .01; IBS: R2 = .23, p < .001). CONCLUSION FRQoL is a unique construct for IBD and IBS patients that can be influenced by several clinical and dietary factors, including number of diets and type of diet used, depending on the diagnosis. Thus, FRQoL should be considered when working with both IBD and IBS patients.
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Affiliation(s)
- Livia Guadagnoli
- Division of Gastroenterology & Hepatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street Suite 1400, Chicago, IL, 60611, USA
| | - Ece A Mutlu
- Division of Digestive Diseases and Nutrition, Rush Medical College, Chicago, IL, USA
| | - Bethany Doerfler
- Division of Gastroenterology & Hepatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street Suite 1400, Chicago, IL, 60611, USA
| | - Ammoura Ibrahim
- Division of Digestive Diseases and Nutrition, Rush Medical College, Chicago, IL, USA
| | - Darren Brenner
- Division of Gastroenterology & Hepatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street Suite 1400, Chicago, IL, 60611, USA
| | - Tiffany H Taft
- Division of Gastroenterology & Hepatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street Suite 1400, Chicago, IL, 60611, USA.
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A cross-sectional study on self-reported physical and mental health-related quality of life in rheumatoid arthritis and the role of illness perception. Health Qual Life Outcomes 2018; 16:238. [PMID: 30567550 PMCID: PMC6299971 DOI: 10.1186/s12955-018-1064-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 12/10/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Psychosocial models including illness perception might explain individual differences in health-related quality of life (HRQoL) and daily functioning in chronically ill patients. The aim of this study was to assess the association of illness perception among rheumatoid arthritis (RA) patients with physical and mental HRQoL, adjusted for demographic variables, clinical variables and social support. METHODS A cross-sectional study conducted at a Viennese rheumatology outpatient clinic on 120 RA patients. Participants completed questionnaires on demographic and clinical characteristics, HRQoL (SF-36 Questionnaire), illness beliefs (Brief Illness Perception Questionnaire) and social support (Social Support Scale-8). Analyses were performed with multivariate linear regression. RESULTS The mean physical was lower (38.38) than the mean mental SF-36 summary score (46.94). In univariate analysis, all domains of illness perception except belief in a chronic disease course were associated with physical and mental HRQoL. In multivariate analyses, illness perception accounted for 51% of variance in physical HRQoL. A stronger belief in the consequences of RA (consequences, β = - 0.33) and a stronger belief in repeated disease recurrence (timeline cyclical, β = - 0 .31) were significantly associated with physical HRQoL in the fully adjusted model. Illness perception accounted for 45% of variance in mental HRQoL. Emotional representation (β = - 0 .27) and fatigue (β = - 0 .36) were significantly associated with mental HRQoL in the fully adjusted model. CONCLUSION This study highlights the importance of RA patients' beliefs about their illness and symptoms in relation to HRQoL. Identification of patients' perception of RA may be a way to positively influence disease outcomes such as quality of life as illness perception is amenable to intervention.
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Symptom Comparisons Between Asian American and White American Women With Irritable Bowel Syndrome. Gastroenterol Nurs 2018; 41:223-232. [PMID: 29847397 DOI: 10.1097/sga.0000000000000330] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
There is little information on racial/ethnic characteristics of patients with irritable bowel syndrome. In this study, we determined whether the severity of symptoms (gastrointestinal, psychological distress), cognitive beliefs about irritable bowel syndrome, and life impacts (life interference, health-related quality of life) differ between Asian American and White American women with irritable bowel syndrome. We also look at the relationships among these variables. Asian American women (N = 21) and age- and design-matched White American women (N = 63) with irritable bowel syndrome were included. Data were collected from questionnaires and a 28-day daily diary (e.g., abdominal pain, depression). The percent of days with moderate/severe abdominal pain and psychological distress were significantly higher, and constipation- and diarrhea-dominant bowel pattern subtypes were prevalent in White Americans as compared with Asian Americans. Positive relationships of gastrointestinal symptoms with psychological distress, and of gastrointestinal and psychological symptoms with negative cognitive beliefs and negative life impact, were observed in White Americans. Further studies to evaluate contributing (e.g., cultural-environmental, pathophysiological, diet) factors of symptom characteristics in Asian Americans are suggested. Our study provides useful information for healthcare providers to understand symptoms and cultural factors and the potential for culturally tailored symptom management for this patient group.
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Bass C, Yates G. Complex regional pain syndrome type 1 in the medico-legal setting: High rates of somatoform disorders, opiate use and diagnostic uncertainty. MEDICINE, SCIENCE, AND THE LAW 2018; 58:147-155. [PMID: 29865933 DOI: 10.1177/0025802418779934] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Objective The aim of this study was to review demographic and clinical characteristics of patients with complex regional pain syndrome type 1 (CRPS) seen in a UK medico-legal setting - particularly the relationship between CRPS and somatoform disorders. Methods Fifty consecutive cases of CRPS (interviewed 2005-2016) undergoing psychiatric assessment were reviewed. A systematic assessment of mental states was conducted via interview and examination of medical/psychiatric records. Thirty patients also completed the Brief Illness Perception Questionnaire (BIPQ). Results Sixty per cent of patients ( n = 30) were female, and the mean age was 43 years. Twenty-two per cent ( n = 11) were employed, and 60% ( n = 30) received disability benefits. Symptoms were reported in the upper limb (62%; n = 31), lower limb (30%; n = 15), both (6%; n = 3) or elsewhere (2%; n = 1). Eighty-four per cent ( n = 42) satisfied DSM-5 criteria for current somatoform disorder. A history of more than two pain-related functional somatic syndromes (e.g. non-cardiac chest pain) was found in 42% ( n = 21) and functional neurological symptoms (e.g. 'claw-hand') in 42% ( n = 21). BIPQ scores resembled those associated with somatoform disorders and disorders mediated by psychological factors (e.g. irritable bowel syndrome). In 38% ( n = 19), the CRPS diagnosis was disputed among experts. A history of depression was noted in 60% ( n = 30), panic attacks in 20% ( n = 10) and alcohol/substance misuse in 18% ( n = 9). Opiates were prescribed to 64% ( n = 32). Conclusions Patients diagnosed with CRPS involved in litigation have high rates of prior psychopathology (mainly somatoform disorders) and pain-related disability for which opiate use is common. They risk an adverse reaction to limb pain 'shaped' by maladaptive illness beliefs. The CRPS diagnosis lacks reliability in medico-legal settings and may cause iatrogenic harm.
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Affiliation(s)
- Christopher Bass
- 1 Department of Psychological Medicine, John Radcliffe Hospital, UK
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Weaver KR, Melkus GD, Fletcher J, Henderson WA. Perceived Stress, Its Physiological Correlates, and Quality of Life in Patients With Irritable Bowel Syndrome. Biol Res Nurs 2018; 20:312-320. [PMID: 29402137 PMCID: PMC5993079 DOI: 10.1177/1099800418756733] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Irritable bowel syndrome (IBS) is a chronic, common disorder of the gastrointestinal tract associated with high psychological comorbidity and diminished quality of life. Patients with IBS display a heightened sensitivity to stress, although the literature is inconsistent as to whether they have a dysregulated stress response. The purpose of the present investigation, a substudy of a larger research effort, was to examine physiological correlates of perceived stress in patients with IBS (cortisol and adrenocorticotropic hormone) and to explore associations between perceived stress and quality of life. A total of 101 participants (35 with IBS [predominant subtypes IBS-constipation and IBS-diarrhea] and 66 healthy controls [HCs]) completed self-report inventories regarding perceived stress and quality of life, and fasting peripheral blood was drawn. Participants with IBS did not differ from the HC in demographic or physiological measures but did differ in psychological measures, reporting significantly higher levels of perceived stress and lower levels of quality of life. Perceived stress and quality of life were not significantly associated in IBS participants. However, differential findings of the stress response were found within IBS participants by sex, race, and subtype. These findings illustrate the heterogeneity of the IBS patient population, underscore the necessity of evaluating larger sample sizes and increasing the diversity of such samples to include males and ethnic minorities, and demonstrate the importance of taking an individualized approach to evaluation and treatment in the IBS patient population.
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Affiliation(s)
- Kristen R. Weaver
- Johns Hopkins University, Baltimore, MD, USA
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | | | - Jason Fletcher
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Wendy A. Henderson
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
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Exploring Symptom Severity, Illness Perceptions, Coping Styles, and Well-Being in Gastroparesis Patients Using the Common Sense Model. Dig Dis Sci 2018; 63:958-965. [PMID: 29468373 DOI: 10.1007/s10620-018-4975-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 02/10/2018] [Indexed: 12/13/2022]
Abstract
AIMS This study aimed to examine the relationships between gastroparesis symptom severity, illness perceptions, coping styles, quality of life (QoL), and psychological distress in patients with gastroparesis, guided by the common sense model. METHODS One hundred and seventy-nine adults with gastroparesis (165 females, 14 males; mean age 41.82 years) completed an online questionnaire. The Gastroparesis Cardinal Symptom Index was used to measure gastroparesis symptom severity, QoL was explored using the PAGI-QOL, illness perceptions were measured using the Brief Illness Perception Questionnaire, the Carver Brief COPE scale assessed coping styles, and psychological distress was investigated using the DASS21. RESULTS Structural equation modeling resulted in a final model with excellent fit. Gastroparesis symptom severity directly influenced illness perceptions (β = .52, p < .001) and QoL (β = .30, p < .001). Illness perceptions directly influenced maladaptive coping (β = - .64, p < .001), psychological distress (β = - .32, p < .001), and QoL (β = .30, p = .01). Maladaptive coping directly influenced psychological distress (β = .62, p < .001), which in turn had a direct influence on QoL (β = - .38, p < .001). CONCLUSIONS The final model showed that the influence of gastroparesis symptom severity on psychological distress was fully mediated by illness perceptions, while the influence on QoL was partially mediated by illness perceptions. The study provides guidance for the development of psychological interventions targeted toward improving mediating psychological factors.
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Harvey JM, Sibelli A, Chalder T, Everitt H, Moss-Morris R, Bishop FL. Desperately seeking a cure: Treatment seeking and appraisal in irritable bowel syndrome. Br J Health Psychol 2018; 23:561-579. [PMID: 29508539 PMCID: PMC6175452 DOI: 10.1111/bjhp.12304] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 02/01/2018] [Indexed: 12/13/2022]
Abstract
Objectives Irritable bowel syndrome (IBS) is common and adversely affects patients' quality of life. Multiple potential treatment options exist for patients (and clinicians) to choose from, with limited evidence to inform treatment selection. The aim was to explore how patients with IBS go about seeking and appraising different treatment modalities, with a view to elucidating the psychological processes involved and identifying opportunities to improve clinical practice. Design Qualitative study nested within a randomized controlled trial of therapist‐delivered and web‐based cognitive behavioural therapy versus treatment‐as‐usual for IBS. Methods A total of 52 people participated in semi‐structured interviews about their prior experiences of treatments for IBS. Transcripts were analysed using inductive thematic analysis. Results Key themes (desperation for a cure, disappointment at lack of cure, appraising the effects of diverse treatments, and hope for positive effects) clustered around an overarching theme of being trapped within a vicious cycle of hope and despair on treatment seeking. A desperation and willingness drove interviewees to try any treatment modality available that might potentially offer relief. Coming to accept there is no cure for IBS helped interviewees escape the vicious cycle. Treatments were appraised for their effects on symptoms and quality of life while also considering, but rarely prioritizing, other aspects including convenience of the regimen itself, whether it addressed the perceived root causes of IBS, perceived side‐effects, and cost. Conclusion Treatment seeking in IBS can be challenging for patients. Supportive discussions with health care professionals about illness perceptions, treatment beliefs, and goals could improve patients' experiences. Statement of contribution What is already known on this subject? Irritable bowel syndrome (IBS) is a highly prevalent chronic relapsing functional gastrointestinal disorder. Studies show few treatment modalities provide complete symptom relief. IBS is associated with emotional and physical distress, and negatively impacts personal, social, and professional aspects of quality of life.
What does this study add? Patients appraise IBS treatments for impact on quality of life and treatment characteristics. Developing acceptance and coping strategies helps escape treatment‐seeking vicious cycles of hope and despair. Clinicians could better support patients by discussing their illness perceptions, treatment goals, and values.
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Affiliation(s)
- J Matthew Harvey
- Centre for Clinical and Community Applications of Health Psychology, Department of Psychology, Faculty of Social Human and Mathematical Sciences, University of Southampton, UK
| | - Alice Sibelli
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
| | - Trudie Chalder
- Academic Department of Psychological Medicine, Kings College London, UK
| | - Hazel Everitt
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, UK
| | - Rona Moss-Morris
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
| | - Felicity L Bishop
- Centre for Clinical and Community Applications of Health Psychology, Department of Psychology, Faculty of Social Human and Mathematical Sciences, University of Southampton, UK
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Sherwin LB, Leary E, Henderson WA. Effect of Illness Representations and Catastrophizing on Quality of Life in Adults With Irritable Bowel Syndrome. J Psychosoc Nurs Ment Health Serv 2018; 54:44-53. [PMID: 27576228 DOI: 10.3928/02793695-20160803-01] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 07/25/2016] [Indexed: 12/13/2022]
Abstract
There is limited understanding of the influence of psychosocial factors on irritable bowel syndrome (IBS), which contributes to management difficulties and ineffective long-term treatment. The goal of the current study was to assess the effect illness representations and coping had on health-related quality of life (HRQOL) in adults with IBS. Self-report data were collected from 101 adults with IBS. Illness representations were measured with the Revised Illness Perception Questionnaire; catastrophizing was measured with the catastrophizing subscale of the Coping Strategies Questionnaire; and HRQOL was measured using the IBS-Quality of Life Measure. Participants perceived their IBS to be a chronic, cyclical condition with negative consequences, moderate symptomatology, and strong negative emotional impact. Their quality of life was poor and catastrophic thinking was noted to be used. Therefore, integrating illness beliefs and coping style into the management of IBS may improve well-being and minimize suffering. [Journal of Psychosocial Nursing and Mental Health Services, 54(9), 44-53.].
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Xiong NN, Wei J, Ke MY, Hong X, Li T, Zhu LM, Sha Y, Jiang J, Fischer F. Illness Perception of Patients with Functional Gastrointestinal Disorders. Front Psychiatry 2018; 9:122. [PMID: 29706904 PMCID: PMC5906533 DOI: 10.3389/fpsyt.2018.00122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/23/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To investigate the illness perception characteristics of Chinese patients with functional gastrointestinal disorders (FGID), and the mediating role between symptoms, psychopathology, and clinical outcomes. METHODS Six illness groups from four outpatient departments of a general hospital in China were recruited, including the FGID patient group. The modified and validated Chinese version of the illness perception questionnaire-revised was utilized, which contained three sections: symptom identity, illness representation, and causes. The 12-item short-form health survey was utilized to reflect the physical and mental health-related quality of life (HRQoL). The Toronto alexithymia scale was used to measure the severity of alexithymia. Additional behavioral outcome about the frequency of doctor visits in the past 12 months was measured. Pathway analyses with multiple-group comparisons were conducted to test the mediating role of illness perception. RESULTS Overall, 600 patients were recruited. The illness perceptions of FGID patients were characterized as with broad non-gastrointestinal symptoms (6.8 ± 4.2), a negative illness representation (more chronic course, worse consequences, lower personal and treatment control, lower illness coherence, and heavier emotional distress), and high numbers of psychological and culture-specific attributions. Fit indices of the three hypothesized path models (for physical and mental HRQoL and doctor-visit frequency, respectively) supported the mediating role of illness perceptions. For example, the severity of alexithymia and non-gastrointestinal symptoms had significant negative effect on mental quality of life through both direct (standardized effect: -0.085 and -0.233) and indirect (standardized effect: -0.045 and -0.231) influence via subscales of consequences, emotional representation, and psychological and risk factor attributions. Multi-group confirmatory factor analysis showed similar psychometric properties for FGID patients and the other disease group. CONCLUSION The management of FGID patients should take into consideration dysfunctional illness perceptions, non-gastrointestinal symptoms, and emotion regulation.
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Affiliation(s)
- Na-Na Xiong
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jing Wei
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mei-Yun Ke
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xia Hong
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tao Li
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Li-Ming Zhu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yue Sha
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jing Jiang
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Felix Fischer
- Medical Clinic for Internal Medicine, Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Hulme K, Chilcot J, Smith MA. Doctor-patient relationship and quality of life in Irritable Bowel Syndrome: an exploratory study of the potential mediating role of illness perceptions and acceptance. PSYCHOL HEALTH MED 2017; 23:674-684. [PMID: 29260889 DOI: 10.1080/13548506.2017.1417613] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterised by unpredictable bowel symptoms. These can be difficult to manage, consequently impacting quality of life (QoL). In addition, a strained doctor-patient relationship is independently reported in the qualitative literature. Given the doctor is often the first port of call for people with IBS, a difficult relationship may influence subsequent IBS management. Research suggests illness perceptions are important in determining IBS outcomes in therapy; however, their association with doctor-patient relationship and QoL is yet to be investigated. This exploratory study aimed to investigate the association between these constructs in IBS, as well as potential mediation by illness perceptions. Online questionnaires measuring doctor-patient relationship, illness perceptions, acceptance and QoL, were completed by 167 participants who reported an IBS diagnosis (144 female, mean age = 44.22 years, SD = 15.91 years). Bootstrapped pathway analysis was used to model the relationship and mediation effects. There was a significant positive correlation between patient-doctor relationship and QoL, r = .258, n = 167, p = .001. There was a significant indirect effect between doctor-patient relationship and QoL through illness coherence and acceptance (bootstrapped estimate = .058, 95%CI Lower-Upper = .02, .095, p = .002). No other indirect effects were observed in combination with good fit indices for the other illness perceptions. Findings suggest a doctor-patient relationship which fosters mutual understanding and helps patients make sense of symptoms, increases their ability to manage their IBS in a psychologically flexible manner, subsequently helping them maintain their QoL.
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Affiliation(s)
- Katrin Hulme
- a Psychology Department , Northumbria University , Newcastle , UK.,b Health Psychology Section, Psychology Department , Institute of Psychiatry, King's College London , London , UK
| | - Joseph Chilcot
- b Health Psychology Section, Psychology Department , Institute of Psychiatry, King's College London , London , UK
| | - Michael A Smith
- a Psychology Department , Northumbria University , Newcastle , UK.,c Faculty of Health and Medical Sciences , University of Western Australia , Perth , Australia
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Gastrointestinal Symptom Distress is Associated With Worse Mental and Physical Health-Related Quality of Life. J Acquir Immune Defic Syndr 2017; 75:67-76. [PMID: 28177965 DOI: 10.1097/qai.0000000000001309] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The prevalence of self-reported gastrointestinal (GI) symptoms and distress is high, but few studies have quantified their impact on health-related quality of life (HRQoL). METHODS We conducted a prospective cohort study of patients with HIV in care in Ontario, Canada (2007-2014). General linear mixed models were used to assess the impact of GI symptoms (diarrhea/soft stool, nausea/vomiting, bloating/painful abdomen, loss of appetite, weight loss/wasting) and distress (range: 0-4) on physical and mental HRQoL summary scores (range: 0-100) measured by the Medical Outcomes Survey SF-36. RESULTS A total of 1787 participants completed one or more questionnaires {median 3 [interquartile range (IQR): 1-4]}. At baseline, 59.0% were men who had sex with men, 53.7% white, median age 45 (IQR: 38-52), median CD4 count 457 (IQR: 315-622), and 71.0% had undetectable HIV viremia. The mean (standard deviation [SD]) mental and physical HRQoL scores were 49.2 (8.6) and 45.3 (13.0), respectively. In adjusted models, compared with those reporting no symptoms, all GI symptom distress scores from 2 ("have symptom, bothers me a little") to 4 ("have symptom, bothers a lot") were associated with lower mental HRQoL. Loss of appetite distress scores ≥ 1; scores ≥ 2 for diarrhea, nausea/vomiting, and bloating; and a score ≥ 3 for weight loss were independently associated with lower physical HRQoL scores (P < 0.0001). Increasing GI symptom distress is associated with impaired mental and physical HRQoL (P < 0.0001). CONCLUSIONS Increasing GI symptom distress is associated with impaired mental and physical HRQoL. Identifying, treating, and preventing GI symptoms may reduce overall symptom burden and improve HRQoL for patients with HIV.
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Walsh CP, Prior JA, Chandratre P, Belcher J, Mallen CD, Roddy E. Illness perceptions of gout patients and the use of allopurinol in primary care: baseline findings from a prospective cohort study. BMC Musculoskelet Disord 2016; 17:394. [PMID: 27639692 PMCID: PMC5027094 DOI: 10.1186/s12891-016-1252-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 09/13/2016] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Patients' perceptions of their illness are dynamic and can directly influence aspects of management. Our aim was to examine the illness perceptions of gout patients in UK primary care and associations with allopurinol use. METHODS A health questionnaire was sent to 1805 people with gout aged ≥18 years identified by a gout diagnosis or prescriptions for allopurinol or colchicine in their primary care medical records in the preceding 2 years. The questionnaire included selected items from the revised illness perception questionnaire (IPQ-R). Associations between illness perceptions and use of allopurinol were calculated using multinomial logistic regression adjusted for age, gender, deprivation status, body mass index, alcohol consumption, comorbidities and gout characteristics. RESULTS One thousand one hundred eighty-four participants responded to the baseline questionnaire (65.6 %). Approximately half of responders perceived that they were able to control (51.2 %) or affect their gout through their own actions (44.8 %). Three quarters perceived treatments to be effective (76.4 %) and agreed that gout is a serious condition (76.4 %). Patients who agreed that they could control their gout (Relative Risk Ratio, 95 % confidence interval 1.66 (1.12 to 2.45)) and that treatments were effective (2.24 (1.32 to 3.81)) were more likely to currently be using allopurinol than not using allopurinol. However, this significance was attenuated after adjustment for self-reported gout characteristics (1.39 (0.89 to 2.17) & 1.78 (0.96 to 3.29) respectively). CONCLUSIONS Patients who perceive that they can control their gout and that treatments are effective are more likely to be using allopurinol, this suggests that better information is needed for the patient from GPs and rheumatologist to reassure and support their use of ULT.
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Affiliation(s)
- Ciaran P Walsh
- Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, ST5 5BG, UK
| | - James A Prior
- Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, ST5 5BG, UK.
| | - Priyanka Chandratre
- Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, ST5 5BG, UK
| | - John Belcher
- Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, ST5 5BG, UK
| | - Christian D Mallen
- Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, ST5 5BG, UK
| | - Edward Roddy
- Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, ST5 5BG, UK
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Knowles SR, Austin DW, Sivanesan S, Tye-Din J, Leung C, Wilson J, Castle D, Kamm MA, Macrae F, Hebbard G. Relations between symptom severity, illness perceptions, visceral sensitivity, coping strategies and well-being in irritable bowel syndrome guided by the common sense model of illness. PSYCHOL HEALTH MED 2016; 22:524-534. [PMID: 27045996 DOI: 10.1080/13548506.2016.1168932] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Irritable Bowel Syndrome (IBS) is a common condition affecting around 10-20% of the population and associated with poorer psychological well-being and quality of life. The aim of the current study was to explore the efficacy of the Common Sense Model (CSM) using Structural Equation Modelling (SEM) in an IBS cohort. One hundred and thirty-one IBS patients (29 males, 102 females, mean age 38 years) participating in the IBSclinic.org.au pre-intervention assessment were included. Measures included IBS severity (Irritable Bowel Syndrome Severity Scoring System), coping patterns (Carver Brief COPE), visceral sensitivity (Visceral Sensitivity Index), illness perceptions (Brief Illness Perceptions Questionnaire), psychological distress (Depression, Anxiety and Stress Scale), and quality of life (IBS Quality of Life scale; IBS-QoL). Using SEM, a final model with an excellent fit was identified (χ2 (8) = 11.91, p = .16, χ2/N = 1.49, CFI > .98, TLI > .96, SRMR < .05). Consistent with the CSM, Illness perceptions were significantly and directly influenced by IBS severity (β = .90, p < .001). Illness perceptions in turn directly influenced maladaptive coping (β = .40, p < .001) and visceral sensitivity (β = .70, p < .001). Maladaptive coping and visceral sensitivity were significantly associated with psychological distress (β = .55, p < .001; β = .22, p < .01) and IBS-QoL (β = -.28, p < .001; β = -.62, p < .001). Based on these findings, we argue that to augment the adverse impact of IBS severity on IBS-QoL and psychological distress, psychological interventions will be best to target the mediating psychological processes including illness beliefs, visceral sensitivity and maladaptive coping.
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Affiliation(s)
- Simon R Knowles
- a Faculty Health, Arts, and Design, Department of Psychology , Swinburne University of Technology , Melbourne , Australia.,b Department of Medicine , The University of Melbourne , Melbourne , Australia.,c Department of Psychiatry , St Vincent's Hospital , Melbourne , Australia.,d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia
| | - David W Austin
- e Department of Psychology , Deakin University , Melbourne , Australia
| | - Suresh Sivanesan
- d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia
| | - Jason Tye-Din
- d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia.,f Walter and Eliza Hall Institute , Melbourne , Australia
| | - Chris Leung
- d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia.,g The Austin Hospital , Melbourne , Australia
| | | | - David Castle
- b Department of Medicine , The University of Melbourne , Melbourne , Australia.,c Department of Psychiatry , St Vincent's Hospital , Melbourne , Australia
| | - Michael A Kamm
- b Department of Medicine , The University of Melbourne , Melbourne , Australia.,i Department of Gastroenterology and Medicine , St Vincent's Hospital , Melbourne , Australia.,j Division of Immunology , Imperial College , London , UK
| | - Finlay Macrae
- d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia
| | - Geoff Hebbard
- b Department of Medicine , The University of Melbourne , Melbourne , Australia.,d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia
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Shallcross AJ, Becker DA, Singh A, Friedman D, Montesdeoca J, French J, Devinsky O, Spruill TM. Illness perceptions mediate the relationship between depression and quality of life in patients with epilepsy. Epilepsia 2015; 56:e186-90. [PMID: 26391533 DOI: 10.1111/epi.13194] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2015] [Indexed: 11/27/2022]
Abstract
The current study examined whether negative illness perceptions help explain the link between depression and quality of life. Seventy patients with epilepsy completed standardized self-report questionnaires measuring depression, illness perception, and quality of life (QOL). Illness perception statistically mediated the relationship between depression and QOL (Indirect effect (CI; confidence interval) = -.72, lower limit = -1.7, upper limit = -.22, p < .05). Results held with and without adjusting for potential confounding variables (age, sex, ethnicity, income, and seizure frequency) and when operationalizing depression as a continuous variable that indexed severity of symptoms or as a dichotomous variable that indexed criteria consistent with a diagnosis of major depressive disorder. This study is the first to suggest that illness perceptions may be a useful target in screening and intervention approaches in order to improve QOL among low-income, racially/ethnically diverse patients with epilepsy.
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Affiliation(s)
- Amanda J Shallcross
- School of Medicine, Department of Population Health, New York University, New York, New York, U.S.A
| | - Danielle A Becker
- Department of Neurology, Penn Epilepsy Center, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - Anuradha Singh
- School of Medicine, Department of Neurology, New York University, New York, New York, U.S.A
| | - Daniel Friedman
- School of Medicine, Department of Neurology, New York University, New York, New York, U.S.A
| | - Jacqueline Montesdeoca
- School of Medicine, Department of Population Health, New York University, New York, New York, U.S.A
| | - Jacqueline French
- School of Medicine, Department of Neurology, New York University, New York, New York, U.S.A
| | - Orrin Devinsky
- School of Medicine, Department of Neurology, New York University, New York, New York, U.S.A
| | - Tanya M Spruill
- School of Medicine, Department of Population Health, New York University, New York, New York, U.S.A
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