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Blakoe M, Olesen CS, Christensen AV, Palm P, Hoejskov IE, Berg SK. The rise and fall of a social support intervention feasibility trial targeting loneliness in patients with cardiac disease - lessons learned and future perspectives. BMC Nurs 2024; 23:423. [PMID: 38910234 PMCID: PMC11194936 DOI: 10.1186/s12912-024-02113-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 06/19/2024] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND One of the psychosocial factors recognized for its positive impact on health outcomes among patients with heart disease, is social support provided by network members. However, an increasing number of patients report to experience loneliness. This study addresses the gap in research on the feasibility of an individually structured social support intervention targeting patients treated for cardiac disease who experience loneliness. METHOD A feasibility trial of a 6-month social support intervention targeted patients treated for cardiac disease who experienced loneliness. The intervention involved providing the patient with an informal caregiver, either a person from the patient's social network or a peer, in the long-term rehabilitation phase. Furthermore, the intervention included nurse consultations and motivational text messages. Feasibility was assessed in terms of acceptability and adherence. RESULTS During October 2022-July 2023, n = 464 patients were screened for loneliness and 28 (6.0%) screened positive of which 17 (60.7%) accepted to be contacted and receive additional information about the social support intervention. Of these, 2 (11.8%) accepted participation. The low recruitment rate did not meet the predetermined acceptability criterion of 25%. CONCLUSION This individually structured social support intervention targeting patients treated for cardiac disease who experience loneliness was non-feasible. The study highlights the complexities of engaging lonely patients in a social support intervention program and contributes with valuable insights for future research aiming to develop effective social support interventions tailored to the needs of cardiac patients who experience loneliness. TRIAL REGISTRATION The trial is registered on clinicaltrials.gov (NCT05503810) 18.08.2022.
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Affiliation(s)
- Mitti Blakoe
- The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
| | - Cathrine S Olesen
- The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | - Pernille Palm
- The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | - Selina Kikkenborg Berg
- The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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de Sales PC, McCarthy MM, Dickson VV, Sullivan-Bolyai S, Melkus GD, Chyun D. The Importance of Social Support in the Management of Hypertension in Brazil. J Cardiovasc Nurs 2024:00005082-990000000-00198. [PMID: 38888420 DOI: 10.1097/jcn.0000000000001108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
BACKGROUND The prevalence of hypertension (HTN) is high in Brazil, and control rates are low. Little is known about the factors that contribute to HTN control from a family-based perspective. OBJECTIVES Guided by the family management style framework, specific aims were to (1) describe the prevalence of adequate blood pressure (BP) control in individuals cared for the Family Health Strategy, (2) identify facilitators and barriers to HTN management, and (3) identify individual contextual sociocultural influences (sociocultural context and social and Family Health Strategy support), definition of the situation, and management behaviors that help or interfere with individual functioning (BP control in the individual with HTN). METHODS This descriptive, cross-sectional study included 213 individuals with HTN randomly selected from 3 Family Health Strategy units from July 2016 until July 2017. RESULTS Most of the individuals were female (n = 139, 65.3%), retired (n = 129, 60.5%), and White (n = 129, 60.2%) and had less than a high school education (n = 123, 57.6%). Family income (n = 166, 77.8%) was less than 5500 reals (US $1117/month). Mean (SD) systolic BP was 137.1 (±24.1) mm Hg, and mean (SD) diastolic BP was 83.8 (±18.6) mm Hg, with 47.9% (n = 102) having uncontrolled BP. In the multivariate logistic model, only high levels of perceived social support were significantly associated (odds ratio, 3.29; 95% confidence interval, 1.44-7.5; P = .005) with controlled BP. CONCLUSIONS Social support is strongly associated with BP control. Optimizing support may play an important role in BP control and preventing HTN-related complications.
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Patel MI, Agrawal M, Blayney DW, Bundorf MK, Milstein A. Long-Term Engagement of Patients With Advanced Cancer: Results From the EPAC Randomized Clinical Trial. JAMA Oncol 2024:2819240. [PMID: 38814627 PMCID: PMC11140577 DOI: 10.1001/jamaoncol.2024.1221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/22/2023] [Indexed: 05/31/2024]
Abstract
Importance The long-term effect of interventions that assist patients with establishing their end-of-life care preferences among patients with cancer remain relatively unknown. Objective To evaluate the association of a long-term intervention of a lay health worker-led advance care planning intervention among patients with advanced stages of cancer with overall survival and end-of-life health care use and costs. Design, Setting, and Participants This follow-up study of the EPAC randomized clinical trial conducted between August 2013 and February 2015 used data from 9.4 years after the first patient was enrolled with a data cut-off date of February 1, 2023. Overall, 213 participants with stage 3 or 4 or recurrent cancer in the US Veterans Affairs Palo Alto Health Care System were included. Interventions A 6-month lay health worker-led education and support intervention to assist patients with establishing their end-of-life preferences vs usual care. Main Outcomes and Measures The outcomes of interest were overall survival, risk of death, restricted mean survival time, and palliative care, hospice, and acute care use in the final 30 days before death for participants who died. Results Among 213 participants randomized and included in the intention-to-treat analysis, the mean (SD) age was 69.3 (9.1) years; 211 (99.1%) were male, 2 (0.90%) were female. There were no demographic or clinical characteristic imbalances at enrollment. As of February 1, 2023, 188 had died. The intervention group had a 25% reduction in risk of death (hazard ratio, 0.75; 95% CI, 0.56-0.98); more palliative care (44 [50.0%] vs 35 [35.0%]) and hospice use (64 [72.7%] vs 53 [53.0%]); and lower emergency department use (20 [22.7%] vs 47 [47.0%]), hospitalizations (17 [19.3%] vs 46 [46.0%]), and median (IQR) total health care costs (median [IQR], $1637 [$383-$9026] vs $18 520 [$4790-$50 729]) than control group participants. Conclusions and Relevance The effects of the lay health worker-led intervention remain durable, with nearly complete follow-up, supporting integration into routine cancer care. Trial Registration ClinicalTrials.gov Identifier: NCT02966509.
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Affiliation(s)
- Manali I. Patel
- Department of Medicine, Stanford University School of Medicine, Stanford, California
- VA Palo Alto Health Care System, Palo Alto, California
| | | | - Douglas W. Blayney
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | | | - Arnold Milstein
- Department of Medicine, Stanford University School of Medicine, Stanford, California
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Guan M, Li R, Shen Q, Wang GP, Li Z, Xiao M, Lei J. Women's experience of polycystic ovary syndrome management: A systematic review and meta-synthesis. Int J Gynaecol Obstet 2024; 164:857-868. [PMID: 37605982 DOI: 10.1002/ijgo.15031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/09/2023] [Accepted: 07/23/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common chronic condition in women of child-bearing age. There is currently no effective treatment, so early and long-term management is essential. However, there are many problems in the practice of disease management in women with PCOS that make it difficult to achieve good outcomes. OBJECTIVE To explore women's experience of PCOS management and identify the relevant facilitators and barriers to management. SEARCH STRATEGY A structured search was undertaken in five bibliographic databases (MEDLINE, Web of Science, CINAHL, Embase, PubMed, and Cochrane) from the date of establishment of the database up to December 2022. SELECTION CRITERIA All qualitative and mixed-methods studies available in English describing the experience of PCOS management from the patients' perspective were included. DATA COLLECTION AND ANALYSIS The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to appraise study quality. The evidence was synthesized using a pragmatic meta-aggregative approach guided by the capability, opportunity, and motivation model of behavior (COM-B). MAIN RESULTS A total of 13 studies were included with 85 equivocal findings and 12 credible findings. The findings were meta-aggregated into three themes: (1) capability of women with PCOS, including patients' attitudes toward disease and management, knowledge, and skills of the disease; (2) opportunities in PCOS management, including information about PCOS, diagnostic delay, disease characteristics, disease management plan, and logistical and environmental problems; and (3) motivation in PCOS management, including impact of symptoms, perceived needs, support and feedback, and unpleasant medical experience. CONCLUSIONS This study identifies facilitators and barriers to PCOS management from the patient perspective, which can guide the design and implementation of PCOS management programs for patients. This study also provides information for future research into how the COM-B theory can be incorporated into specific management plans to promote patient action.
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Affiliation(s)
- Minhui Guan
- Xiang Ya Nursing School of Central South University, Changsha, China
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Rong Li
- Xiang Ya Nursing School of Central South University, Changsha, China
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Quan Shen
- Xiang Ya Nursing School of Central South University, Changsha, China
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Guang Peng Wang
- Xiang Ya Nursing School of Central South University, Changsha, China
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Ziyan Li
- Xiang Ya Nursing School of Central South University, Changsha, China
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Meili Xiao
- Xiang Ya Nursing School of Central South University, Changsha, China
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jun Lei
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China
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Ng GW, Gan KF, Liew H, Ge L, Ang G, Molina J, Sun Y, Prakash PS, Harish KB, Lo ZJ. A Systematic Review and Classification of Factors Influencing Diabetic Foot Ulcer Treatment Adherence, in Accordance With the WHO Dimensions of Adherence to Long-Term Therapies. INT J LOW EXTR WOUND 2024:15347346241233962. [PMID: 38377963 DOI: 10.1177/15347346241233962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
PURPOSE Effective treatment of diabetic foot ulcers (DFUs) involves a multidisciplinary treatment plan to promote wound healing and prevent complications. Given the lack of consensus data on the factors affecting patient adherence, a systematic review was performed to identify and classify factors according to the WHO Dimensions of Adherence to Long-Term Therapies. METHODS Six hundred and forty-three articles from PubMed, Embase, and Scopus were reviewed. The inclusion criteria included qualitative and quantitative studies which discussed factors affecting patient adherence to DFU treatment, had study populations that comprised patients with either prior history of or existing DFU, and had either prior history of DFU treatment or were currently receiving treatment. Factors, and associated measures of adherence, were extracted and organized according to the WHO Dimensions of Adherence to Long-Term Therapies. RESULTS Seven quantitative and eight qualitative studies were included. Eleven patient-related factors, seven condition-related factors, three therapy-related factors, five socioeconomic factors, and five health system-related factors were investigated by the included studies. The largest proportion of factors studied was patient-related, such as patient insight on DFU treatment, patient motivation, and patient perception of DFU treatment. There was notable overlap in the range of discussed factors across various domains, in the socioeconomic (including social support, income, social and cultural acceptability of DFU therapy, cost) and therapy-related domains (including duration of treatment, offloading footwear, and reminder devices). Different studies found that specific factors, such as gender and patients having a low internal locus of control, had differing effects on adherence on different cohorts. CONCLUSION Current literature presents heterogeneous findings regarding factors affecting patient adherence. It would be useful for future studies to categorize factors as such to provide more comprehensive understanding and personalized care to patients. Further research can be done to explore how significant factors can be addressed universally across different cohort populations in different cultural and socioeconomic contexts.
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Affiliation(s)
- Gwyneth Wy Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Keith F Gan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Huiling Liew
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Lixia Ge
- National Healthcare Group Health Services and Outcomes Research Unit, Singapore, Singapore
| | - Gary Ang
- National Healthcare Group Health Services and Outcomes Research Unit, Singapore, Singapore
| | - Joseph Molina
- National Healthcare Group Health Services and Outcomes Research Unit, Singapore, Singapore
| | - Yan Sun
- National Healthcare Group Health Services and Outcomes Research Unit, Singapore, Singapore
| | - Prajwala S Prakash
- Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | | | - Zhiwen Joseph Lo
- Department of Surgery, Woodlands Health, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Ruark A, Bidwell JT, Butterfield R, Weiser SD, Neilands TB, Mulauzi N, Mkandawire J, Conroy AA. "I too have a responsibility for my partner's life": Communal coping among Malawian couples living with HIV and cardiometabolic disorders. Soc Sci Med 2024; 342:116540. [PMID: 38199009 PMCID: PMC10913151 DOI: 10.1016/j.socscimed.2023.116540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 12/16/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024]
Abstract
RATIONALE HIV and cardiometabolic disorders including hypertension and diabetes pose a serious double threat in Malawi. Supportive couple relationships may be an important resource for managing these conditions. According to the theory of communal coping, couples will more effectively manage illness if they view the illness as "our problem" (shared illness appraisal) and are united in shared behavioral efforts. METHODS This study qualitatively investigated communal coping of 25 couples living with HIV and hypertension or diabetes in Zomba, Malawi. Partners were interviewed separately regarding relationship quality, shared illness appraisal, communal coping, and dyadic management of illness. RESULTS Most participants (80%) were living with HIV, and more than half were also living with hypertension. Most participants expressed high levels of unity and the view that illness was "our problem." In some couples, partners expected but did not extend help and support and reported little collaboration. Communal coping and dyadic management were strongly gendered. Some women reported a one-sided support relationship in which they gave but did not receive support. Women were also more likely to initiate support interactions and offered more varied support than men. In couples with poor relationship quality and weak communal coping, dyadic management of illness was also weak. Partner support was particularly crucial for dietary changes, as women typically prepared meals for the entire family. Other lifestyle changes that could be supported or hindered by a partner included exercise, stress reduction, and medication adherence. CONCLUSION We conclude that gendered power imbalances may influence the extent to which couple-level ideals translate into actual communal coping and health behaviors. Given that spouses and families of patients are also at risk due to shared environments, we call for a shift from an illness management paradigm to a paradigm of optimizing health for spouses and families regardless of diabetes or hypertension diagnosis.
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Affiliation(s)
- Allison Ruark
- Wheaton College, Biological and Health Sciences, Wheaton, IL, USA.
| | - Julie T Bidwell
- University of California Davis, Betty Irene Moore School of Nursing, Sacramento, CA, USA
| | - Rita Butterfield
- University of California San Francisco, Center for AIDS Prevention Studies, San Francisco, CA, USA
| | - Sheri D Weiser
- University of California San Francisco, Division of HIV, Infectious Disease, and Global Medicine, San Francisco, CA, USA
| | - Torsten B Neilands
- University of California San Francisco, Center for AIDS Prevention Studies, San Francisco, CA, USA
| | | | | | - Amy A Conroy
- University of California San Francisco, Center for AIDS Prevention Studies, San Francisco, CA, USA
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Babygeetha A, Devineni D. Social Support and Adherence to Self-Care Behavior Among Patients With Coronary Heart Disease and Heart Failure: A Systematic Review. EUROPES JOURNAL OF PSYCHOLOGY 2024; 20:63-77. [PMID: 38487598 PMCID: PMC10936663 DOI: 10.5964/ejop.12131] [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: 06/07/2023] [Accepted: 08/19/2023] [Indexed: 03/17/2024]
Abstract
Cardiovascular diseases stand out as the foremost cause of mortality on a global scale and encompass conditions that require long term self-care. Coronary heart disease and heart failure are two cardiovascular conditions that require significant lifestyle modifications. Adherence to self-care is a multifaceted phenomenon, and is influenced by various factors that include social, economic, disease-related and healthcare system-related factors. A key factor in adherence to self-care in chronic illnesses is social support. To explore this relationship between social support and adherence to self-care, a systematic review was carried out across Scopus, EBSCO host and ProQuest from October 2022 to February 2023 using predefined search criteria. Studies from inception to February 2023 were considered for the review, ultimately incorporating a total of 11 studies. Six studies had an adult population with coronary heart disease while the remaining five had adults with heart failure. All the studies reported a significant positive correlation between social support and adherence to self-care. Our findings revealed that social support plays a significant role in promoting self-care, emphasizing the need for a holistic understanding of self-care to develop effective interventions. Along with self-report measures, objective measures should be used to assess adherence accurately. There is a need for scales that assess all aspects of self-care, as well as the development of new interventions and teaching strategies to facilitate the individual's self-care journey. In addition, family members and trusted resources should be involved in encouraging self-care, and interventions should target both patients and their family members.
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Affiliation(s)
- Athira Babygeetha
- Department of Applied Psychology, Pondicherry University, Puducherry, India
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Al-Maskari A, Al-Maamari Q, Al-Abdali M, Al-Shaaibi H, Nadar SK. Adherence to Medications in Patients with Ischaemic Heart Disease in Oman. Sultan Qaboos Univ Med J 2024; 24:109-114. [PMID: 38434452 PMCID: PMC10906756 DOI: 10.18295/squmj.7.2023.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 05/25/2023] [Accepted: 07/02/2023] [Indexed: 03/05/2024] Open
Abstract
Objectives This study aimed to evaluate the level of adherence to medication among patients with ischaemic heart disease (IHD) in Oman and assess the related factors. Methods This cross-sectional questionnaire-based study among patients with IHD attending the outpatient clinic at Sultan Qaboos University Hospital, Muscat, Oman, was performed between January and December 2021. Results A total of 105 patients (mean age = 49.9 ± 11.1 years, 78.1% male) were recruited. Most of the patients (80%) reported taking the medications by themselves; 77 (73.3%) patients said that over the preceding 2 weeks, they had missed at least 3 doses of their medication. The reasons for missing the medications included forgetting (100%), having to take too many tablets (57%), feeling that the tablets are not effective (48%) and having to take the tablets too often each day (23%). The factors responsible for patients failing to take medications could not be identified. Conclusion Medication adherence was low among patients with IHD in Oman, with high pill burden being the most common reason for non-adherence. Physicians must bear this in mind when reviewing patients.
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Affiliation(s)
| | | | - Mariya Al-Abdali
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Hajer Al-Shaaibi
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Sunil K. Nadar
- Department of Medicine, Sultan Qaboos University Hospital
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Williams NJ, Grant AB, Butler M, Ebben M, Belisova-Gyure Z, Bubu OM, Jean-Louis G, Wallace DM. The effects of social support and support types on continuous positive airway pressure use after 1month of therapy among adults with obstructive sleep apnea. Sleep Health 2024; 10:69-74. [PMID: 38007302 DOI: 10.1016/j.sleh.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND The relationship between perceived social support and continuous positive airway pressure remains understudied among individuals with obstructive sleep apnea. The aim of this prospective cohort study was to determine if baseline perceived social support and subtypes predict regular continuous positive airway pressure use after 1month of therapy. METHODS Adults with obstructive sleep apnea initiating continuous positive airway pressure therapy were recruited from sleep clinics in New York City. Demographics, medical history, and comorbidities were obtained from patient interview and review of medical records. Objective continuous positive airway pressure adherence data was collected at the first clinical follow-up. RESULTS Seventy-five participants (32% female; non-Hispanic Black 41%; mean age of 56 ± 14years) provided data. In adjusted analyses, poorer levels of overall social support, and subtypes including informational/emotional support, and positive social interactions were associated with lower continuous positive airway pressure use at 1month. Relative to patients reporting higher levels of support, participants endorsing lower levels of overall social support, positive social interaction and emotional/informational support had 1.6 hours (95% CI: 0.5,2.7, hours; p = .007), 1.3 hours (95% CI: 0.2,2.4; p = .026), and 1.2 hours (95% CI: 0.05,2.4; p = .041) lower mean daily continuous positive airway pressure use at 1month, respectively. CONCLUSION Focusing on social support overall and positive social interaction particularly, could be an effective approach to improve continuous positive airway pressure adherence in patients at risk of suboptimal adherence.
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Affiliation(s)
- Natasha J Williams
- NYU Grossman School of Medicine, Institute for Excellence in Health Equity, Department of Population Health, New York, New York, USA.
| | - Andrea Barnes Grant
- VA: Department of Veterans Affairs: New York Harbor HealthCare System, Brooklyn Campus, Brooklyn, New York, USA
| | - Mark Butler
- Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Matthew Ebben
- Weill Cornell Medicine, Center for Sleep Medicine, New York, New York, USA
| | - Zuzana Belisova-Gyure
- VA: Department of Veterans Affairs: New York Harbor HealthCare System, New York Campus, New York, New York, USA
| | - Omonigho M Bubu
- NYU Grossman School of Medicine, Department of Psychiatry, New York, New York, USA
| | - Girardin Jean-Louis
- NYU Grossman School of Medicine, Department of Psychiatry, New York, New York, USA
| | - Douglas M Wallace
- Neurology Service, Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, Florida, USA; Psychiatry and Behavioral Sciences, Neurology, Psychology and Public Health, University of Miami Miller School of Medicine, Miami, Florida, USA
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Datta BK, Coughlin SS, Gummadi A, Mehrabian D, Ansa BE. Perceived Social Support and Cardiovascular Risk Among Nonelderly Adults in the United States. Am J Cardiol 2023; 209:146-153. [PMID: 37865124 DOI: 10.1016/j.amjcard.2023.09.106] [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: 07/13/2023] [Revised: 09/17/2023] [Accepted: 09/27/2023] [Indexed: 10/23/2023]
Abstract
Hypertension, diabetes mellitus, dyslipidemia, and obesity are major risk factors of cardiovascular diseases. A recent study projected a marked surge in these cardiometabolic conditions in the United States by the year 2060, posing a challenge for cardiovascular disease management in the coming years. This study aimed to explore and quantify the relation of a key psychosocial factor, social support, with the cardiovascular risk factors among nonelderly US adults (aged 18 to 64 years). Using data on 19,827 adults from the 2021 National Health Interview Survey, we assessed whether lower level of social support was associated with higher likelihood of having cardiovascular risks. We found that for subjects who "rarely/never" received social support, the adjusted odds of having hypertension, high cholesterol, and diabetes were 1.42 (95% confidence interval [CI] 1.20 to 1.67), 1.39 (95% CI 1.18 to 1.65), and 1.53 (95% CI 1.22 to 1.91) times those of subjects "always" receiving support, respectively. Further, compared with the base outcome of no CV risk, the adjusted relative risks of having 3+ cardiovascular risks for subjects "rarely/never" receiving support were 1.91 (95% CI 1.49 to 2.46) times that of those "always" receiving support. These results were robust across socioeconomic status condition sub-groups manifested by educational attainment and income. In conclusion, our findings suggest that social support may be considered as a critical part of the comprehensive efforts to mitigate the future burden of cardiovascular diseases in the United States.
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Affiliation(s)
- Biplab Kumar Datta
- Institute of Public and Preventive Health, Augusta University, Augusta, Georgia; Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, Georgia.
| | - Steven S Coughlin
- Institute of Public and Preventive Health, Augusta University, Augusta, Georgia; Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Aneesha Gummadi
- Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Daniel Mehrabian
- Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Benjamin E Ansa
- Institute of Public and Preventive Health, Augusta University, Augusta, Georgia
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Salazar LJ, Srinivasan K, Heylen E, Ekstrand ML. Medication Adherence among Primary Care Patients with Common Mental Disorders and Chronic Medical Conditions in Rural India. Indian J Psychol Med 2023; 45:622-628. [PMID: 38545530 PMCID: PMC10964881 DOI: 10.1177/02537176231173869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Background Only a few studies have explored the relationship between psychosocial factors and medication adherence in Indian patients with noncommunicable diseases (NCDs). We aimed to examine the association of psychosocial variables with medication adherence in people with NCDs and comorbid common mental disorders (CMDs) from primary care in rural southern India. Methods We performed a secondary analysis using baseline data from a randomized controlled trial in 49 primary care health centers in rural southern India (HOPE study). Participants were adults (≥30 years) with NCDs that included hypertension, diabetes, and/or ischemic heart disease, and comorbid depression or anxiety disorders. Medication adherence was assessed by asking participants if they had missed any prescribed NCD medication in the past month. Data were collected between May 2015 and November 2018. The association between psychosocial and demographic variables and medication nonadherence were assessed via logistic regression analyses. Results Of the 2486 participants enrolled, almost one-fifth (18.06%) reported missing medication. Male sex (OR = 1.74, 95% CI 1.37-2.22) and higher internalized mental illness stigma (OR = 1.46, 95% CI 1.07-2.00) were associated with higher odds of missing medication. Older age (OR = 0.40, 95% CI 0.26-0.60, for participants aged 64-75 years vs 30-44 years), reporting more social support (OR = 0.65, 95% CI 0.49-0.86), and higher satisfaction with health (OR = 0.74, 95% CI 0.61-0.89) were associated with lower odds of missing medication. Conclusions Greater internalized mental illness stigma and less social support are significantly associated with lower rates of medication adherence in patients with NCDs and comorbid CMDs in rural India.
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Affiliation(s)
- Luke Joshua Salazar
- Dept. of Psychiatry, St. John’s Medical College, Sarjapur Road, Bengaluru, Karnataka, India
| | - Krishnamachari Srinivasan
- Division of Mental Health and Neurosciences, St. John’s Research Institute, Bengaluru, Karnataka, India
| | - Elsa Heylen
- Center for AIDS Prevention Studies, Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, California, United States
| | - Maria L. Ekstrand
- Division of Mental Health and Neurosciences, St. John’s Research Institute, Bengaluru, Karnataka, India
- Center for AIDS Prevention Studies, Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, California, United States
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Carpallo-González M, Muñoz-Navarro R, González-Blanch C, Cano-Vindel A. Symptoms of emotional disorders and sociodemographic factors as moderators of dropout in psychological treatment: A meta-review. Int J Clin Health Psychol 2023; 23:100379. [PMID: 36922928 PMCID: PMC10009192 DOI: 10.1016/j.ijchp.2023.100379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 02/08/2023] [Indexed: 03/07/2023] Open
Abstract
Objective Dropout from psychological treatment is an important problem that substantially limits treatment effectiveness. A better understanding of this phenomenon, could help to minimize it. Therefore, we performed a systematic review of meta-analyses (MA) on dropout from psychological treatments to (1) determine the estimated overall dropout rate (DR) and (2) to examine potential predictors of dropout, including clinical symptoms (anxiety and depression) and sociodemographic factors. Method A literature search of the PubMed PsycINFO, Embase, Scopus and Google Scholar databases was conducted. We identified 196 MAs on dropout from psychological treatment carried out primarily in adult patients or mixed samples (adults and children) between 1990 and 2022. Of these, 12 met all inclusion criteria. Two forest plots were created to visualize the DR and the relationship between DR and the disorder. Results The DR ranged from 15.9% to 46.8% and was significantly moderated by symptoms of emotional disorders. The highest DR were observed in younger, unmarried patients, and those with lower educational and income levels. Conclusions DR in patients undergoing psychological treatment is highly heterogeneous, but higher in individuals presenting symptoms of anxiety and/or depression, especially the latter. Given that high DR undermine the effectiveness of psychological interventions, it is clear that greater efforts are needed to reduce dropout, particularly among individuals with symptoms of emotional disorders.
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Affiliation(s)
| | | | - César González-Blanch
- Mental Health Centre, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain
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13
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Maleki G, Norian R, Moeini B, Barati M, Maleki S, Afshari M. Factors related to medication adherence in patients with hypertension in Iran: a systematic review study. Blood Press Monit 2023; 28:221-235. [PMID: 37661726 DOI: 10.1097/mbp.0000000000000665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
OBJECTIVES This study aimed to review the available studies of the factors in Iranian hypertensive patients' adherence to drug treatment. METHODS Four Persian databases and seven English databases were searched. The articles, which were published from 2000 to 2022 in Persian and English and examined the adherence to drug treatment in the Iranian population of adults with high blood pressure, were reviewed. Based on the primary examination, 31 of the initial 1062 articles met the inclusion criteria and were included in the analysis. The evidence, which was provided by the examined articles, was summarized and discussed using the 5-dimensional framework of adherence to long-term treatments, which was developed by WHO. RESULTS The factors that significantly correlated with adherence to drug treatment in the examined studies were: (1) factors that were related to the health team or the health system: patients' satisfaction with their doctor-patient relationship; (2) factors that were related to the conditions: the number of concomitant diseases, high quality of life and the implementation of effective interventions; (3) factors which were related to the treatment: long duration of illness, short intervals between the visits, duration of treatment, lower numbers of drugs, and the patient's blood pressure control; and (4) factors that were related to the patient: self-efficacy, health literacy, social support, locus of control, illness perception, beliefs, attitude, knowledge, and cues to action. CONCLUSION It is possible to draw definite conclusions about the factors which affect adherence to drug treatment in patients with high blood pressure because most of the relevant studies have been cross-sectional. Therefore, in the future, valuable results can be obtained by conducting more studies that preferably use objective instruments for assessing adherence to drug treatment.
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Affiliation(s)
- Golara Maleki
- Department of Psychology, Sari Branch, Islamic Azad University, Sari
| | - Rohollah Norian
- Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran
| | | | | | | | - Maryam Afshari
- Social Determinants of Health Research Center
- Department of Public Health, School of Health
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
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Jarujumrus I, Taychakhoonavudh S. Impact of prescription length supply policy on patient medication adherence in Thailand. BMC Health Serv Res 2023; 23:533. [PMID: 37226134 DOI: 10.1186/s12913-023-09530-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 05/10/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Phramongkutklao Hospital is one of the largest military hospitals in Thailand. Beginning in 2016, an institutional policy was implemented in which medication prescription length was increased from 30 to 90 days. However, there have been no formal investigations into how this policy has impacted medication adherence among patients in hospitals. As such, this study evaluated how prescription length impacted medication adherence among dyslipidemia and type-2 diabetes patients who were treated at Phramongkutklao Hospital. METHODS This pre-post implementation study compared patients who received prescription lengths of 30 and 90 days based on information recorded in the hospital database between 2014 and 2017. Therein, we used the medication possession ratio (MPR) to estimate patient adherence. Focusing on patients with universal coverage insurance, we employed the difference-in-difference method to examine changes in adherence from before and after policy implementation, then conducted a logistic regression to test for associations between the predictors and adherence. RESULTS We analyzed data from a total of 2,046 patients, with equal amounts of 1,023 placed into the control group (no change to 90-day prescription length) and intervention group (change from 30 to 90-day prescription length). First, we found that increased prescription length was associated with 4% and 5% higher MPRs among dyslipidemia and diabetes patients in the intervention group, respectively. Second, we found that medication adherence was correlated with sex, comorbidities, history of hospitalization, and the number of prescribed medications. CONCLUSION Increasing the prescription length from 30 to 90 days improved medication adherence in both the dyslipidemia and type-2 diabetes patients. This shows that the policy change was successful for patients in the hospital considered for this study.
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Affiliation(s)
- Inthorn Jarujumrus
- Pharmacy division, Phramongkutklao hospital, 315 Ratchawithi Rd., Thung Phaya Thai, Ratchathewi District, Bangkok, 10400, Thailand
| | - Suthira Taychakhoonavudh
- Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Phayathai Rd, Wang Mai, Pathum Wan District, Bangkok, 10330, Thailand.
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Al-Noumani H, Alharrasi M, Lazarus ER, Panchatcharam SM. Factors predicting medication adherence among Omani patients with chronic diseases through a multicenter cross-sectional study. Sci Rep 2023; 13:7067. [PMID: 37127692 PMCID: PMC10151315 DOI: 10.1038/s41598-023-34393-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/28/2023] [Indexed: 05/03/2023] Open
Abstract
Management of chronic diseases is complex and requires a long-term commitment to therapeutic medications. However, medication adherence is suboptimal. There is limited understanding of factors predicting medication adherence in chronic diseases in Oman. This study aimed to examine predictors of medication adherence (i.e. patient clinical and demographic data, patient-physician relationship, health literacy, social support) among Omani patients with chronic diseases. This study used a cross-sectional correlation design. Data were collected from 800 participants using convenience sampling between December 2019 and April 2020. Arabic versions of the Brief Health Literacy Screening tool, Multidimensional Scale of Perceived Social Support, Patient-Doctor Relationship Questionnaire, and Adherence in Chronic Disease Scale were used to measure study variables. Descriptive statistics, independent t tests, one-way ANOVA, Pearson correlations, and multivariate linear regression were used for analysis. The study found that factors such as the patient-physician relationship, social support, disease duration, employment status, and medication frequency significantly predicted medication adherence. Medication adherence was higher among those who were unemployed, had a better patient-physician relationship, and greater social support. However, medication adherence was lower with longer disease duration and higher daily medication frequency. Additionally, medication adherence was positively associated with perceived social support and the patient-physician relationship, but not with health literacy. In conclusion, the study reveals that patient characteristics, social support, and patient-physician relationships are key factors in predicting medication adherence in patients with chronic diseases in the Middle East. It emphasizes the importance of improving these aspects, considering factors like employment status, disease duration, and medication frequency, and enhancing healthcare provider-patient relationships and social support systems to boost adherence.
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Affiliation(s)
- Huda Al-Noumani
- Adult Health and Critical Care Department, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Maryam Alharrasi
- Adult Health and Critical Care Department, College of Nursing, Sultan Qaboos University, Muscat, Oman
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Al-Noumani H, Al Omari O, Al-Naamani Z. Role of Health Literacy, Social Support, Patient-Physician Relationship, and Health-Related Quality of Life in Predicting Medication Adherence in Cardiovascular Diseases in Oman. Patient Prefer Adherence 2023; 17:643-652. [PMID: 36935939 PMCID: PMC10022437 DOI: 10.2147/ppa.s401666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/25/2023] [Indexed: 03/16/2023] Open
Abstract
Purpose Cardiovascular diseases (CVDs) remain a global health threat, and medication adherence remains low. Medication adherence is a complex phenomenon and is affected by many factors that require investigation. Oman has limited literature examining medication adherence and influencing factors among patients with CVDs. This study examined the influence of health literacy, social support, the patient-physician relationship, and health-related quality of life on medication adherence among patients with cardiovascular diseases. Patients and Methods This cross-sectional study used a correlation design. The study included 360 participants with CVDs. Descriptive statistics, independent t-test, one-way ANOVA, and multiple regression analysis were utilized for data analyses. Results Findings revealed that higher social support (B=0.117; p=0.033), good patient-physician relationship (B=0.124; p < 0.01), better mental health (B=0.045; p < 0.01), more bodily pain (B=0.030; p < 0.01), and unemployment (B=1.297; p < 0.01) were predictors of higher adherence. High school education and above predicted lower medication adherence (B= -1.255; p= 0.019), while health literacy was not a significant predictor of medication adherence (B= 0.061; p= 0.289). Conclusion To improve medication adherence, healthcare providers and researchers should consider improving patients' social support, mental health, and the patient-physician relationship. In addition, patients' socioeconomic status should always be considered and examined as an influencing factor of medication adherence.
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Affiliation(s)
- Huda Al-Noumani
- Adult Health and Critical Care Department, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Omar Al Omari
- Fundamental and Administration Department, College of Nursing, Sultan Qaboos University, Muscat, Oman
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Psychosocial and behavioral correlates of self-efficacy in treatment adherence
in older patients with comorbid hypertension and type 2 diabetes. HEALTH PSYCHOLOGY REPORT 2023. [DOI: 10.5114/hpr/159284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
BackgroundAdhering to clinical prescriptions is known to protect against the effects of uncontrolled hypertension and of acute and chronic cardiovascular diseases, including diabetes. Contextually, positive associations between self-care behaviors and psychological constructs, such as self-efficacy, are widely acknowledged in the literature. However, still little is known about the psychological factors underlying the patient’s self-efficacy. This study aimed to investigate the psychosocial and behavioral correlates of self-efficacy related to treatment adherence in older patients with comorbid hypertension and type 2 diabetes mellitus.Participants and procedureItalian and Polish patients (≥ 65 years; N = 180) consecutively responded to self-report questionnaires measuring psycho-social (i.e., beliefs about medicines, perceived physician’s communication effectiveness, medication-specific social sup-port, self-efficacy) and behavioral factors (i.e., pharmacological adherence, medications refill adherence, intentional non-adherence) related to treatment adherence. Between-group comparisons and regression analyses were performed.ResultsFisher’s least significant difference (LSD) test showed significant differences between the Italian and Polish groups in all questionnaires (p < .01) with the Italian patients reporting more satisfactory scores. Younger age (β = .08, p = .045), female gender (β = 1.03, p = .042), higher medication refills adherence (β = –.07, p = .024), lower intentional non-adherence (β = –.03, p = .009), positive beliefs about medications (β = .13, p < .001), better quality of communication with the physician (β = .09, p < .001), and stronger perceived medication-specific social support (β = .06, p = .001) were significantly associat-ed with self-efficacy related to treatment adherence.ConclusionsFuture research and interventions should leverage psychosocial and behavioral factors to address self-efficacy contributing to enhancing adherence to clinical prescriptions.
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Guo A, Jin H, Mao J, Zhu W, Zhou Y, Ge X, Yu D. Impact of health literacy and social support on medication adherence in patients with hypertension: a cross-sectional community-based study. BMC Cardiovasc Disord 2023; 23:93. [PMID: 36803662 PMCID: PMC9940429 DOI: 10.1186/s12872-023-03117-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/09/2023] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND Previous studies have examined the associations of health literacy and social support with medication adherence among patients with hypertension. However, limited evidence exists regarding the mechanisms underlying the relationship between these factors and medication adherence. PURPOSE To explore the prevalence of medication adherence and its determinants in patients with hypertension in Shanghai. METHODS A community-based cross-sectional study was conducted among 1697 participants with hypertension. We collected sociodemographic and clinical characteristics as well as data regarding health literacy, social support, and medication adherence using questionnaires. We examined interactions among the factors using a structural equation model. RESULTS The participants included 654 (38.54%) patients with a low degree of medication adherence and 1043 (61.46%) patients with a medium/high degree of adherence. Social support directly influenced adherence (β = 0.165, P < 0.001) and indirectly influenced adherence through health literacy (β = 0.087, P < 0.001). Health literacy directly influenced adherence (β = 0.291, P < 0.001). Education indirectly affected adherence through both social support (β = 0.048, P < 0.001) and health literacy (β = 0.080, P < 0.001). Moreover, there was a sequential mediating effect of social support and health literacy on the association between education and adherence (β = 0.025, P < 0.001). After controlling for age and marital status, similar results were also obtained, indicating a good model fit. CONCLUSIONS The degree of medication adherence among hypertensive patients needs to improve. Health literacy and social support had both direct and indirect effects on adherence, and thus, these factors should be considered as tools to improve adherence.
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Affiliation(s)
- Aizhen Guo
- grid.24516.340000000123704535Department of General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090 China ,Shanghai General Practice and Community Health Development Research Center, Shanghai, 200090 China
| | - Hua Jin
- grid.24516.340000000123704535Department of General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090 China ,Shanghai General Practice and Community Health Development Research Center, Shanghai, 200090 China
| | - Jianbo Mao
- Changbai Community Health Service Center, Yangpu District, Shanghai, 200093 China
| | - Weihong Zhu
- Wujiaochang Community Health Service Center, Yangpu District, Shanghai, 200433 China
| | - Ye Zhou
- Yanji Community Health Service Center, Yangpu District, Shanghai, 200093 China
| | - Xuhua Ge
- grid.24516.340000000123704535Department of General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090 China ,Shanghai General Practice and Community Health Development Research Center, Shanghai, 200090 China
| | - Dehua Yu
- Department of General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, China. .,Shanghai General Practice and Community Health Development Research Center, Shanghai, 200090, China.
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Blakø M, Christensen AV, Højskov IE, Palm P, Berg SK. Protocol for a feasibility randomized trial of a social support intervention plus usual care versus usual care, targeting patients treated for cardiac disease who experience loneliness. Pilot Feasibility Stud 2023; 9:22. [PMID: 36747245 PMCID: PMC9900972 DOI: 10.1186/s40814-023-01255-9] [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: 07/01/2022] [Accepted: 01/28/2023] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION In patients treated for cardiac disease, loneliness is known to contribute negatively to health behavior, health outcome, and increase risk of cardiac and all-cause mortality. Even so, in health care research, social support interventional studies targeting patients who experience loneliness are lacking. AIM To determine the feasibility of an individually structured social support intervention targeting patients treated for cardiac disease who experience loneliness. DESIGN A feasibility study based on randomized clinical trial design with 1:1 randomization to a 6-month social support program, plus usual care (intervention) versus usual care, (i.e., regular guidelines-based follow-up). INTERVENTION Patients classified as high risk lonely according to the High Risk Loneliness tool will be provided with an informal caregiver in the 6 months rehabilitation phase following cardiac disease treatment. The informal caregiver will be designated by the patient from the existing social network or a peer, depending on patients' preferences. The core content of the intervention is through nurse consultations at baseline and 1, 3, and 6 months, to enhance and reinforce the informal caregiver's competences to be a social support resource. The theoretical framework of the nurse consultations will be based on middle-range theory of self-care. OUTCOME Feasibility will be evaluated in terms of acceptability and adherence according to predefined feasibility criteria. The preliminary effect of the intervention on patient-reported outcomes, health behaviors, and health outcomes will be evaluated in the intervention and the control group at baseline and 1, 3, 6, and 12 months. DISCUSSION The present study will contribute with knowledge on how to implement a feasible social support intervention targeting patients treated for cardiac disease who experience loneliness and, furthermore, investigate the preliminary effect on health behavior and health outcome in the early rehabilitation period. TRIAL REGISTRATION The trial is registered on clinicaltrials.gov (NCT05503810) 18.08.2022.
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Affiliation(s)
- Mitti Blakø
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Anne Vinggaard Christensen
- grid.4973.90000 0004 0646 7373Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Ida Elisabeth Højskov
- grid.4973.90000 0004 0646 7373Department of Heart- and Lung Surgery, RT, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Pernille Palm
- grid.4973.90000 0004 0646 7373Department of Cardiology B, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Selina Kikkenborg Berg
- grid.4973.90000 0004 0646 7373Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XFaculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, N 2200 Copenhagen, Denmark
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Ferdinand DP, Reddy TK, Wegener MR, Guduri PS, Lefante JJ, Nedunchezhian S, Ferdinand KC. TEXT MY BP MEDS NOLA: A pilot study of text-messaging and social support to increase hypertension medication adherence. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2023; 26:100253. [PMID: 37712088 PMCID: PMC10500631 DOI: 10.1016/j.ahjo.2023.100253] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 09/16/2023]
Abstract
Study objective Non-Hispanic Black (NHB) adults have high hypertension (HTN) and cardiovascular disease (CVD) burden. Medication nonadherence limits control and self-measured blood pressure (SMBP) improves diagnosis and adherence. This predominantly NHB cohort pilot, via community-clinical linkages, with uncontrolled HTN and low adherence, utilized bidirectional electronic messaging (BEM) with team-care, to assess medication adherence, quality of life, and BP. Setting Academic clinic and community sources. Design Recruitment included: uncontrolled HTN (BP ≥130/80 mm Hg), low adherence (Krousel-Wood Medication Adherence Scale (K-Wood-MAS-4) ≥1 score), and smartphone access. Participants and interventions Participants (N = 36) received validated Bluetooth-enabled BP devices, synced to smartphones, via a secured cloud-based application. Main outcome measures Demographics, adherence scores, Centers for Disease Control and Prevention (CDC) health-related quality of life (HRQOL-14), BP, body mass index (BMI), 8 weeks daily BEM, SMBP and text responses were obtained. Results Age was 58.7 ± 12.8 years; BMI 34.8 ± 7.9; 63.9 % female; 88.9 % self-identified NHB adults; 72.2 % with obesity; 74.3 % with diabetes. K-Wood-MAS-4 adherence composite score improved: 2.19 to 1.58 (median -0.5, p = 0.0001). Systolic BP decreased by 10.5 ± 20.0 mm Hg (median -11.0, p = 0.0027). QOL did not significantly change. Mean 7-day average SBP/DBP differences were -4.94 ± 16.82 (median -3.5, p = 0.0285) and -0.17 ± 7.42 (median 0, p = 0.7001), respectively. Social support with taking BP medication was: "yes" (n = 19); 143.8 mm Hg to 131.5 mm Hg (median -12.5, p = 0.0198) and "no" (n = 14); 142.32 mm Hg to 130.25 mm Hg (median -4.0, p = 0.0771). Conclusions Community-clinical linkages and SMBP with BEM significantly improved medication adherence and SBP without modifying pharmacotherapy.
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Affiliation(s)
- Daphne P. Ferdinand
- Healthy Heart Community Prevention Project (HHCPP), New Orleans, LA, United States of America
| | - Tina K. Reddy
- Tulane University School of Medicine, New Orleans, LA, United States of America
| | - Madeline R. Wegener
- Tulane University School of Medicine, New Orleans, LA, United States of America
| | - Pavan S. Guduri
- Tulane University School of Medicine, New Orleans, LA, United States of America
| | - John J. Lefante
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States of America
| | | | - Keith C. Ferdinand
- Tulane University School of Medicine, New Orleans, LA, United States of America
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Nagamine Y, Shobugawa Y, Sasaki Y, Takagi D, Fujiwara T, Khin YP, Nozaki I, Shirakura Y, Kay Thi L, Poe Ei Z, Thae Z, Win HH. Associations between socioeconomic status and adherence to hypertension treatment among older adults in urban and rural areas in Myanmar: a cross-sectional study using baseline data from the JAGES in Myanmar prospective cohort study. BMJ Open 2023; 13:e065370. [PMID: 36653052 PMCID: PMC9853216 DOI: 10.1136/bmjopen-2022-065370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES This study aims to investigate whether there is a differential association between socioeconomic status (SES) and adherence to hypertension medication among older adults in rural and urban areas in Myanmar and assess what type of SES is associated with a difference. DESIGN Cross-sectional study using baseline data from the Japan Gerontological Evaluation Study in Myanmar prospective cohort study. A multistage random sampling method was applied in each region. SETTING An urban and a rural area in Myanmar. PARTICIPANTS A total of 1200 older adults over 60 years old in Myanmar were randomly selected in 2018 (600 each from rural and urban areas). Of them, 573 had hypertension and were eligible for the analysis (urban: 317, rural: 256). OUTCOME Adherence to hypertension medication (yes/no) is the outcome of interest. Three types of SES (wealth, education and current employment status) were the independent variables. RESULTS We found that 21.5% of urban residents and 48.4% of rural residents were non-adherent in the study population. Poisson regression modelling stratified by area was performed to estimate the prevalence ratios (PRs) of not following treatment instructions. Demographic information and complications of hypertension were adjusted for in all models as possible confounders. In terms of SES, middle level of wealth compared with low level was significantly associated with poor adherence (PR 2.68, 95% CI 1.28 to 5.59) in the urban area, but education and employment status did not show similar associations. Lower education compared with middle/high school or higher was significantly associated with poor adherence in the rural area (no school: PR 3.22, 1.37-7.58; monastic: 3.42, 1.16-5.07; primary school: 2.41, 1.18-4.95), but wealth and income did not show similar associations. CONCLUSIONS SES and adherence to hypertension medication were differently associated among older adults in rural and urban areas in Myanmar. To ensure healthcare access to hypertension treatment for every citizen, the differential association between SES and adherence in urban/rural areas needs to be recognised.
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Affiliation(s)
- Yuiko Nagamine
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Japan
- Department of Social Preventive Medical Sciences, Chiba University Center for Preventive Medical Sciences, Chiba, Japan
| | - Yugo Shobugawa
- Department of Active Ageing, Niigata University, Niigata, Japan
| | - Yuri Sasaki
- Department of International Health and Collaboration, National Institute of Public Health, Wako, Japan
| | - Daisuke Takagi
- Department of Health and Social Behavior, The University of Tokyo, Bunkyo-ku, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Yu Par Khin
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Ikuma Nozaki
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuki Shirakura
- Department of Active Ageing, Niigata University, Niigata, Japan
| | - Lwin Kay Thi
- Department of Preventive and Social Medicine, University of Medicine, Magway, Myanmar
| | - Zin Poe Ei
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon, Yangon, Myanmar
| | - Zarchibo Thae
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon, Yangon, Myanmar
| | - Hla Hla Win
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon, Yangon, Myanmar
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Tzeng HJ, Lee CB, Chen CT, Lee MC. Trajectories of Instrumental and Emotional Social Support and the Associated Risk of Mortality in Bereaved Older Adults in Taiwan. Res Aging 2022:1640275221144251. [DOI: 10.1177/01640275221144251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This study identified the trajectories of instrumental and emotional perceived social support (PSS) from 1996 to 2003 and investigated the associated risk of mortality in bereaved older adults in Taiwan. The study analyzed 1,188 bereaved older adults who had experienced loss of a spouse, a child, or both before 1996 from the Taiwan Longitudinal Study on Aging. More favorable trajectories of PSS are associated with lower mortality risk in bereaved older adults. Compared with the spousal or dual bereavement, the parental bereavement benefited more from consistently high instrumental PSS. The present study revealed that consistently high emotional PSS had a stronger protective effect on mortality risk for a widow or widower than did consistently high instrumental support. The findings of this study can serve as an empirical reference to inform social policies and clinical practices for bereaved older adults in culturally similar societies.
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Affiliation(s)
- Huei-Jia Tzeng
- Department of Social Welfare, National Chung Cheng University, Chiayi, Taiwan
- Department of Preventive Medicine, Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan
| | - Chiachi Bonnie Lee
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Cheng-Tsung Chen
- School of Information Engineering, Sanming University, Fujian, China
| | - Miaw-Chwen Lee
- Department of Social Welfare, National Chung Cheng University, Chiayi, Taiwan
- Center for Innovative Research on Aging Society, National Chung Cheng University, Chiayi, Taiwan
- Advanced Institute of Manufacturing with High-tech Innovations, National Chung Cheng University, Chiayi, Taiwan
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Dey S, Mukherjee A, Pati MK, Kar A, Ramanaik S, Pujar A, Malve V, Mohan HL, Jayanna K, N S. Socio-demographic, behavioural and clinical factors influencing control of diabetes and hypertension in urban Mysore, South India: a mixed-method study conducted in 2018. Arch Public Health 2022; 80:234. [DOI: 10.1186/s13690-022-00996-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Inadequate control of diabetes and hypertension is a major concern in India because of rising mortality and morbidity. Few studies in India have explored factors that influence control of diabetes and hypertension. The current study aimed to improve the understanding of multifactorial influence on the control of diabetes and hypertension among patients in Primary Health Care Settings(PHC) of urban Karnataka.
Methods
We used a mixed-method study design, within a project aiming to improve non-communicable disease (NCD) continuum of care across PHC in Mysore city, India, conducted in 2018. The quantitative study was conducted among 399 patients with diabetes and/or hypertension and a logistic regression model was used to assess the factors responsible for biological control levels of diabetes and hypertension measured through Glycated Haemoglobin(HbA1c) and blood pressure. Further, in-depth interviews(IDI) were conducted among these patients and the counsellors at PHCs to understand the barriers and enablers for better control.
Result
The quantitative assessment found odds of poor control amongst diabetics’ increased with older age, longer duration of disease, additional chronic conditions, and tobacco consumption. For hypertensives, odds of poor control increased with higher body mass index(BMI), alcohol consumption, and belongingness to lower social groups. These findings were elaborated through qualitative assessment which found that the control status was affected by stress as a result of family or financial worries. Stress, poor lifestyle, and poor health-seeking behaviour interplay with other factors like diet and exercise leading to poor control of diabetes and hypertension.
Conclusion
A better understanding of determinants associated with disease control can assist in designing focused patient outreach plans, customized communication strategies, need-based care delivery plans, and specific competency-based capacity-building models for health care workers. Patient-centric care focusing on biological, social and behavioural determinants is pivotal for appropriate management of NCDs at community level in low-middle income countries.
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Almutairi AS, Alhazmi TM, Alotaibi YH, Alfraidi AA, Alsaad AM, Matrood RA, Al-Khatir AN, Alsubaie AA, Alotibi WM. Medication Adherence Among Multimorbid Patients With Polypharmacy and Its Relation to Social Support at National Guard Primary Health Care Centers, Riyadh. Cureus 2022; 14:e30679. [PMID: 36439564 PMCID: PMC9689831 DOI: 10.7759/cureus.30679] [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: 10/25/2022] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE The aim of the present study was to estimate the prevalence of nonadherence to medication in multimorbid patients with polypharmacy and its relationship to social support in primary healthcare centers in Riyadh, Saudi Arabia. METHODS We conducted a cross-sectional, convenience-sample, non-randomized study in three primary healthcare centers managed by National Guard Health Affairs. The participants included 417 adult patients - (a) with two or more chronic illnesses and (b) who were taking two or more medications. The primary outcome variable was the prevalence of medication nonadherence in multimorbid patients with polypharmacy as measured by the modified Morisky Medication Adherence Scale (MMAS-8). The second main variable was the impact of functional social support, as measured by the Duke-UNC Functional Social Support Questionnaire (FSSQ), on medication adherence. RESULTS The level of medication adherence was low for 194 (46.5%) of the 417 patients, medium for 127 (30.5%), and high for 96 (23%). There were 256 (61.4%) male participants and 161 (38.6%) females, and their mean age was 59.15 (SD ± 11.186) years. Additionally, 171 (41%) participants used two or three medications, 127 (30.5%) used four or five medications, and 119 (28.5%) used more than five medications; 178 (42.7%) of the patients had two comorbidities, 136 (32.9%) had three comorbidities, 69 (16.5%) had four comorbidities, and 31 (7.5%) had five comorbidities. Some social support data from the Duke-UNC Functional Social Support Questionnaire (FSSQ) was missing for 58 (13.9%) of the participants. Among the rest of the sample, reported levels of social support levels were high for 246 (59%) patients, medium for 101 (24.2%), and low for 12 (2.9%) patients. None of the differences between social support and medication adherence were statistically significant. However, 61 (24.8%) patients reported both high social support and high medication adherence; 173 (48.2%) had low social support and low medication adherence (p = 0.470). CONCLUSION We found that medication nonadherence in multimorbid patients with polypharmacy was high (46.5%). Although there were no statistically significant relationships between social support and medication adherence, certain patient characteristics were associated with low medication adherence - age over 60 years, male gender, and number of medications.
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Affiliation(s)
- Ahmed S Almutairi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Taghreed M Alhazmi
- Family Medicine and Primary Care, King Abdulaziz Medical City, Riyadh, SAU
| | - Yazeed H Alotaibi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Abdulmajeed A Alfraidi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Abdulaziz M Alsaad
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Rashed A Matrood
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | | | - Abdulrahman A Alsubaie
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Waleed M Alotibi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
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Prognostic Factors and Nomograms for Overall and Cancer-Specific Survival of Patients with Uveal Melanoma without Metastases: A SEER Analysis of 4119 Cases. J Ophthalmol 2022; 2022:1874336. [PMID: 36157683 PMCID: PMC9492333 DOI: 10.1155/2022/1874336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 11/06/2021] [Accepted: 07/27/2022] [Indexed: 11/28/2022] Open
Abstract
Purpose To determine prognostic factors for patients with uveal melanoma without metastases and to construct nomograms to predict their 3- and 5-year overall survival (OS) and cancer-specific survival (CSS). Methods We included 4119 patients who were registered from 2004 to 2015 in the Surveillance, Epidemiology, and End Results database. The median follow-up time was 5.8 years. Independent risk factors affecting OS and CSS were identified with univariate and multivariate Cox regression analyses and used to construct nomograms. Internal and external validation were carried out by using the bootstrap method to calculate the concordance indices (C-indices) and plot the calibration curves. Results Age, primary site, histological type, T-stage, and treatment were independent risk factors for OS and CSS; marital status and sequence number were factors only for OS. The C-indices for internal validation of OS and CSS were 0.713 (95% CI, 0.697–0.729) and 0.708 (95% CI, 0.688–0.728), respectively, and for external validation they were 0.729 (95% CI, 0.705–0.753) and 0.731 (95% CI, 0.700–0.762), respectively. The calibration curves also revealed good agreement between the predicted and actual survival rates. Conclusions We constructed nomograms to predict the 3- and 5-year OS and CSS of patients with uveal melanoma without metastases. Our nomograms may improve prognostication and assist with the development of individualized treatment strategies.
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The role of sense of coherence in reducing anxiety and depressive symptoms among patients at the first acute coronary event: A three-year longitudinal study. J Psychosom Res 2022; 160:110974. [PMID: 35763942 DOI: 10.1016/j.jpsychores.2022.110974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Although several studies suggest an association between psychological distress and increased morbidity and mortality in various cardiac populations, little is known about positive psychological resources, like Sense of Coherence (SOC), that may reduce distress. This longitudinal observational study aimed to test the hypothesis that a strong SOC predicted a longitudinal decrease in anxiety and depression in a sample of patients after their first acute coronary event. METHODS A sample of 275 patients completed the Hospital Anxiety Depression Scale (HADS) and the SOC Scale at five time-points (at the baseline and after 6, 12, 24, and 36 months). Longitudinal trajectories of anxiety, depression, and SOC were examined through hierarchical (generalized) linear models, controlling for sociodemographic and clinical indicators. RESULTS 38.6% of patients experienced clinically relevant anxiety symptoms soon after the cardiovascular event, whereas only 20.8% experienced clinically relevant depressive symptoms. Anxiety symptoms decreased over time, plateaued, and then slightly increased, whereas depressive symptoms tended to be stable; these variables were positively associated during all time points. The SOC did not change over time; a strong SOC at baseline predicted decreased anxiety and depression. CONCLUSION Findings showed a strong relationship between SOC and symptoms of anxiety and depression, and they suggested the importance of a salutogenic approach in clinical practice and the relevance of interventions aimed at increasing resilience resources like the SOC in patients with cardiovascular diseases.
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Greco A, Brugnera A, D’Addario M, Compare A, Franzelli C, Maloberti A, Giannattasio C, Fattirolli F, Steca P. A three-year longitudinal study of healthy lifestyle behaviors and adherence to pharmacological treatments in newly diagnosed patients with acute coronary syndrome: hierarchical linear modeling analyses. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01369-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Abstract
Aim
Healthy lifestyle behaviors and a good adherence to pharmacological treatments are important predictors of lower recurrence rates and better overall outcomes among patients with an established acute coronary syndrome (ACS). The present study sought to investigate the longitudinal trajectories of these behaviors years after the onset of an ACS.
Subject and methods
We recruited a sample of 275 newly diagnosed consecutive patients at their first ACS event (mean age: 57.1 ± 7.87 years; 84% males) admitted to a cardiac rehabilitation program from three large public hospitals in Northern Italy. Patients completed a battery of sociodemographic questionnaires, which evaluated healthy lifestyles (smoking status, alcohol intake, diet, and physical activity) and adherence to pharmacological treatments, at five time-points (pre-event, 6-, 12-, 24-, and 36-month follow-ups). Longitudinal trajectories were examined through hierarchical (generalized) linear models, controlling for several demographic and clinical variables.
Results
We found significant changes in all healthy lifestyles from pre-event to the 6-month follow-up, suggesting the adoption of healthier behaviors soon after the cardiac event. However, from the 6-month up to the 3-year follow-up, patients experienced small but significant declines in their self-reported levels of healthy dietary behaviors and physical activity. Further, we found that the odds of being at medium risk of non-adherence to the pharmacological treatments significantly increased over the course of 3 years.
Conclusion
Given the negative long-term trajectories in specific lifestyles and adherence to pharmacological treatments, cardiac rehabilitation programs are suggested to provide repeated psychological interventions aimed at fostering patients’ capabilities to self-regulate their habitual behaviors.
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Harding BN, Hawley CN, Kalinowski J, Sims M, Muntner P, Young Mielcarek BA, Heckbert SR, Floyd JS. Relationship between social support and incident hypertension in the Jackson Heart Study: a cohort study. BMJ Open 2022; 12:e054812. [PMID: 35301208 PMCID: PMC8932258 DOI: 10.1136/bmjopen-2021-054812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 02/16/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Social support may be an important mitigating factor against adverse cardiovascular outcomes by facilitating health-promoting behaviours or by buffering against the negative effects of stress. This study examined the association of social support with incident hypertension. DESIGN Prospective cohort study. SETTING We evaluated the association of social support with incident hypertension among participants in the Jackson Heart Study, a community-based cohort of African Americans. PARTICIPANTS This study included African American adults, who were free of hypertension at baseline (2000-2004). Functional social support, structural social support and satisfaction with social support were assessed at baseline among 1516, 1240 and 1503 participants, respectively. OUTCOME MEASURES Incident hypertension was assessed at follow-up examinations in 2005-2008 and 2009-2013. Incident hypertension was defined by the first visit with systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg or self-reported antihypertensive medication use. Multivariable Poisson regression was used to estimate the association of baseline social support with incident hypertension, adjusting for relevant confounders. RESULTS At baseline, the mean age of participants was 50 years and 64% were men. During a median follow-up time of 6.9 years, 54% of participants developed hypertension. A high level of functional social support was associated with lower risk of incident hypertension (incident rate ratio 0.64, (95% CI 0.41 to 0.97)), compared with a low level of functional social support. Level of structural social support and satisfaction with social support were not associated with hypertension risk. CONCLUSIONS These results suggest that greater functional support may be associated with a lower risk of incident hypertension.
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Affiliation(s)
- Barbara N Harding
- Non-Communicable Diseases and Environment, Barcelona Institute for Global Health, Barcelona, Spain
| | - Caitlin N Hawley
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Jolaade Kalinowski
- Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Mario Sims
- Department of Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Paul Muntner
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Bessie A Young Mielcarek
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Susan R Heckbert
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - James S Floyd
- Department of Medicine, University of Washington, Seattle, Washington, USA
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Faisal S, Ivo J, Tennant R, Prior KA, Grindrod K, McMillan C, Patel T. Integration of a smart multidose blister package for medication intake: A mixed method ethnographic informed study of older adults with chronic diseases. PLoS One 2022; 17:e0262012. [PMID: 35061773 PMCID: PMC8782488 DOI: 10.1371/journal.pone.0262012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 12/15/2021] [Indexed: 11/18/2022] Open
Abstract
Smart adherence products are marketed to assist with medication management. However, little is known about their in-home integration by older adults. It is necessary to investigate the facilitators and barriers older adults face when integrating these products into their medication taking routines before effectiveness can be examined. The aim of this study was to (a) examine the integration of a smart multidose blister package and (b) understand medication intake behaviour of adults with chronic diseases using an integrated theoretical model comprised of the Technology Acceptance Model (TAM), Theory of Planned Behaviour (TPB) and Capacity, Opportunity, Motivation and Behaviour (COM-B) Model. An ethnographic-informed study was conducted with older adults using the smart multidose blister package to manage their medications for eight weeks. Data was collected quantitatively and qualitatively using in-home observations, photo-elicitation, field notes, semi-structured interviews, system usability scale (SUS) and net promoter scale (NPS). The interview guide was developed with constructs from the TAM, TPB and COM-B Model. Data were analyzed using the Qualitative Analysis Guide of Leuven (QUAGOL) framework to generate themes and sub-themes which were mapped back to TAM, TBP and COM-B Model. Ten older adults with an average age of 76 years, of which 80% were female, participated in the study. On average, participants reported five medical conditions, while the average number of medications was 11.1. The mean SUS was 75.50 and overall NPS score was 0. Qualitative analysis identified three themes; (1) factors influencing medication intake behaviour (2) facilitators to the product use and, (3) barriers to the product use. The smart blister package was found to be easy to use and acceptable by older adults. Clinicians should assess an older adult’s medication intake behavior as well as barriers and facilitators to product use prior to recommending an adherence product for managing medications.
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Affiliation(s)
- Sadaf Faisal
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | - Jessica Ivo
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | - Ryan Tennant
- Faculty of Engineering, Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Kelsey-Ann Prior
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | - Colleen McMillan
- Centre for Family Medicine Family Health Team, Kitchener, Ontario, Canada
- Renison University College, University of Waterloo, Waterloo, Ontario, Canada
| | - Tejal Patel
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
- Centre for Family Medicine Family Health Team, Kitchener, Ontario, Canada
- Schlegel–University of Waterloo Research Institute of Aging, Waterloo, Ontario, Canada
- * E-mail:
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Blakoe M, Berg SK, Højskov IE, Palm P, Bernild C. Who Cares? Perception of Loneliness in Patients Treated for Coronary Heart DiseaseHvem bekymrer sig? Oplevelsen af ensomhed hos patienter med iskæmisk hjertesygdom. Glob Qual Nurs Res 2022; 9:23333936211073613. [PMID: 35083373 PMCID: PMC8785347 DOI: 10.1177/23333936211073613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 12/09/2021] [Accepted: 12/14/2021] [Indexed: 11/15/2022] Open
Abstract
Social support is known to be essential to cope with the physical and psychological aftermath following coronary heart disease treatment. Consequently, patients experiencing loneliness may be placed in a vulnerable situation. The aim of this study was to provide insight into the nuances and complexity of loneliness and its impact on health behaviour in the early rehabilitation period following treatment. The study used a hermeneutic philosophical approach. Patients classified as lonely were interviewed in either a focus group ( n = 7) or in an individual interview ( n = 10). We analysed the empirical material using inductive content analysis. The analysis illuminated various dimensions of patients’ perceived loneliness; ‘Loneliness as an emotional pain’, ‘A changed, but unmet need for social support’ and ‘Striving for symmetry in relationships’. Loneliness negatively influenced patients’ ability to adapt to the critical event and manage health behaviour changes. Insight into the mechanisms that aggravate loneliness may inform future social support interventions. Social støtte er beskrevet som essentiel i forbindelse med håndteringen af de fysiske og psykiske følger af iskæmisk hjertesygdom. Derfor kan patienter som oplever ensomhed være i en særlig sårbar situation. Formålet med dette kvalitative studie var at opnå en nuanceret indsigt i patients oplevelse af ensomhed, samt hvordan ensomhed influerer på sundhedsadfærd i den tidlige rehabiliteringsperiode efter behandlingen for iskæmisk hjertesygdom. I studiet havde vi en hermeneutisk filosofisk tilgang. Patienter klassificeret som ensomme blev interviewet enten individuelt (n = 10) eller i fokusgruppe (n = 7). Vi analyserede det empiriske materiale med induktiv indholdsanalyse. Analysen tydeliggjorde forskellige dimensioner af patienternes oplevede ensomhed: ”Ensomhed som en emotionel smerte”, ”Et ændret, men ikke imødekommet behov for social støtte”, Stræben efter symmetri i relationer”. Ensomhed havde en negativ indflydelse på patienternes mulighed for at håndtere den kritiske hændelse og på sundhedsadfærd. En øget indsigt i de mekanismer som forværrer ensomhed, har relevans ved udarbejdelsen af fremtidige sociale støtteinterventioner.
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Affiliation(s)
- Mitti Blakoe
- The Heart Center, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Mitti Blakoe, Rigshospitalet, The Heart Center, Department of Cardiology 3154 Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark.
| | - Selina Kikkenborg Berg
- The Heart Center, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ida Elisabeth Højskov
- The Heart Center, Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Pernille Palm
- The Heart Center, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Camilla Bernild
- The Heart Center, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Blakoe M, Berg SK, Højskov IE, Palm P, Bernild C. One size does not fit all: A qualitative study exploring preferences and barriers towards the design of a loneliness reduction intervention in patients with coronary heart disease. Nurs Open 2022; 9:1114-1125. [PMID: 34978762 PMCID: PMC8859028 DOI: 10.1002/nop2.1151] [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: 06/22/2021] [Revised: 11/03/2021] [Accepted: 11/24/2021] [Indexed: 12/02/2022] Open
Abstract
Aim To explore preferences and barriers towards the design of a loneliness reduction intervention in patients treated for coronary heart disease who experience loneliness. Design A qualitative study using patient involvement methodology. Methods Seventeen patients participated in either focus groups or individual interview sessions. The interview guide was based on patient involvement methodology. Interviews were analysed using deductive content analysis. Results Four overall findings emerged as follows: (a) An intervention involving a social network member must comply with patients perceived social norms; (b) An intervention involving a peer provides benefits from reciprocity and shared experiences, but also requires surplus mental energy; (c) The history of an existing relationship can act as both provider and barrier for confidentiality and (d) Start‐up, timeframe and structure of the intervention should be individually tailored to the patient's preferences. Findings illuminated preferences and barriers towards the design of a loneliness reduction intervention in patients with coronary heart disease.
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Affiliation(s)
- Mitti Blakoe
- Rigshospitalet, The Heart Center, Department of Cardiology, Copenhagen University Hospital, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Selina Kikkenborg Berg
- Rigshospitalet, The Heart Center, Department of Cardiology, Copenhagen University Hospital, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ida Elisabeth Højskov
- Rigshospitalet, The Heart Center Department of Cardiothoracic Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Pernille Palm
- Rigshospitalet, The Heart Center, Department of Cardiology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Camilla Bernild
- Rigshospitalet, The Heart Center, Department of Cardiology, Copenhagen University Hospital, Copenhagen, Denmark
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Shen B, Guan T, Du X, Pei C, Zhao J, Liu Y. Medication Adherence and Perceived Social Support of Hypertensive Patients in China: A Community-Based Survey Study. Patient Prefer Adherence 2022; 16:1257-1268. [PMID: 35610983 PMCID: PMC9124465 DOI: 10.2147/ppa.s363148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/13/2022] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Previous studies suggested perceived social support has impact on medication adherence among hypertensive patients, but did not simultaneously elucidate the different contents or key providers of social support that patients perceived. This study was to identify the contents and providers of perceived social support beneficial for improving medication adherence among hypertensive patients in China, which could prove important for targeted interventions. PATIENTS AND METHODS Following a multi-stage stratified sampling framework, a total of 903 hypertensive patients from 12 primary health institutions across a middle-income city were recruited from April to June 2021. Medication adherence was measured using the Chinese version of the Morisky, Green and Levine scale; perceived social support was determined using the name generator method. A binary logistic regression model was performed to identify the association between medication adherence and perceived social support. The contents of support included informational, emotional, and instrumental support (finances and caregiving). The support providers included spouse/partner, children, parents, siblings, other relatives, and friends. RESULTS A total of 506 (56.04%) patients optimally adhered to their antihypertensive medication. Female, older, urban patients, patients with shorter duration of hypertension and antihypertensive medications used showed better adherence (P<0.05). Optimal medication adherence was positively associated with the overall score of caregiving support (adjusted odds ratio [AOR] = 1.128; 95% confidence interval [CI] = [1.013-1.257]), informational support from the spouse/partner (AOR = 1.574; 95% CI = [1.112-2.227]), emotional support from the spouse/partner (AOR = 1.430; 95% CI = [1.032-1.981]), financial support from the spouse/partner (AOR = 1.439; 95% CI = [1.069-1.937]) and caregiving support from the spouse/partner (AOR = 1.652; 95% CI = [1.130-2.414]), whereas optimal medication adherence was negatively associated with caregiving support from friends (AOR = 0.499; 95% CI = [0.286-0.872]). CONCLUSION Informational, emotional, financial and caregiving support from spouses/partners have positive impacts on optimal medication adherence of hypertensive patients of community-level. Community-based interventions designed to improve medication adherence of hypertensive patients should target both patients and their spouses/partners; spouses/partners could be encouraged to provide various support to improve the medication adherence of hypertensive patients.
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Affiliation(s)
- Bingjie Shen
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Tianjia Guan
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Xinyu Du
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Chenyang Pei
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Jinhong Zhao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
- Correspondence: Yuanli Liu, School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, 46 Xizongbu Hutong, Dongcheng District, Beijing, 100005, People’s Republic of China, Tel +86 13522592907, Fax +86 10 65105830, Email
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Dietary adherence and associated factors among hypertensive patients in Bahir Dar city Administration, Ethiopia, 2020. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Huang J, Ding S, Xiong S, Liu Z. Medication Adherence and Associated Factors in Patients With Type 2 Diabetes: A Structural Equation Model. Front Public Health 2021; 9:730845. [PMID: 34805063 PMCID: PMC8599446 DOI: 10.3389/fpubh.2021.730845] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/06/2021] [Indexed: 01/02/2023] Open
Abstract
Background: The number of patients with type 2 diabetes (T2D) is increasing. Medication treatment is of great importance to stabilize blood glucose. Previous studies have reported that neuroticism, self-efficacy, and social support are factors associated with medication adherence, but few studies have fully investigated the mechanisms between these factors and medication adherence in patients with T2D. Purpose: To explore the prevalence of medication adherence and the factors associated with medication adherence in patients with T2D. Methods: A cross-sectional study consisting of 483 patients with T2D was conducted from July to December 2020. Questionnaires containing sociodemographic and clinical characteristics, the Morisky Medication Adherence Scale-8 (MMAS-8), the neuroticism subscale of the Eysenck Personality Questionnaire-Revised Short Scale (EPQ-RS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Diabetes Management Self-efficacy Scale (DMSES) were used to collect data. The structural equation model (SEM) was used to test the hypotheses. Results: This study included 305 (63.1%) medication adherence and 178 (36.9%) medication non-adherence patients with T2D. Social support directly influenced medication adherence (β = 0.115, P = 0.029) and indirectly influenced medication adherence through self-efficacy (β = 0.044, P = 0.016). Self-efficacy directly influenced medication adherence (β = 0.139, P = 0.023). Neuroticism indirectly affected medication adherence through social support (β = -0.027, P = 0.023) and self-efficacy (β = -0.019, P = 0.014). Moreover, there was a sequential mediating effect of social support and self-efficacy on the relationship between neuroticism and medication adherence (β = -0.010, P = 0.012). After controlling for age and gender, similar results were obtained. The model fit indices showed a good fit. Conclusions: The medication adherence of patients with T2D needs to be improved. Neuroticism, social support, and self-efficacy had direct or indirect effects on medication adherence in patients with T2D. Healthcare providers should comprehensively develop intervention programs based on neuroticism, social support, and self-efficacy to improve medication adherence in patients with T2D.
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Affiliation(s)
- Jing Huang
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shenglan Ding
- Department of Nursing, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Shuyuan Xiong
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhiping Liu
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Mrosková S, Klímová E, Majerníková Ľ, Tkáčová Ľ. Quality of Life of Children and Adolescents with Multiple Sclerosis-A Literature Review of the Quantitative Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168645. [PMID: 34444393 PMCID: PMC8392317 DOI: 10.3390/ijerph18168645] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/03/2021] [Accepted: 08/09/2021] [Indexed: 11/30/2022]
Abstract
Background: Multiple sclerosis (MS) is a chronic disease of the central nervous system that also develops in patients under 18 years of age. The disease negatively affects the quality of life (QoL) of children and adolescents. We conducted a literature review. The aim of the review was to identify the QoL of pediatric patients with MS and assess the factors determining their QoL. Methods: We analyzed studies published between 2000 and 2020 in PubMed, Scopus, Science Direct, Web of Science, and EBSCO databases. Results: In all, 17 studies were included in the review. The most common tool in assessing QoL was the generic module PedsQL. The range of mean/median global score of QoL was 53.8–81.7. The worst QoL was dominantly reported in the school and emotional spheres, on the contrary, the disease’s least determined area of QoL was the social and physical dimension. In particular, disability and fatigue were important predictors of QoL. Conclusions: MS negatively affects the school and emotional spheres in particular, so it is important to pay greater attention to these spheres of life of MS patients. As the review studies pay insufficient attention to the analysis of positive factors and their impact on the QoL of MS patients, research should integrate these phenomena. The use of MS-targeted tools in future research in the pediatric MS population is also appropriate.
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Affiliation(s)
- Slávka Mrosková
- Department of Nursing, Faculty of Health Care, University of Prešov, Partizánska 1, 08001 Prešov, Slovakia; (Ľ.M.); (Ľ.T.)
- Correspondence: ; Tel.: +421-51-75-62-462
| | - Eleonóra Klímová
- Department of Physiotherapy, Faculty of Health Care, University of Prešov, Partizánska 1, 08001 Prešov, Slovakia;
| | - Ľudmila Majerníková
- Department of Nursing, Faculty of Health Care, University of Prešov, Partizánska 1, 08001 Prešov, Slovakia; (Ľ.M.); (Ľ.T.)
| | - Ľubomíra Tkáčová
- Department of Nursing, Faculty of Health Care, University of Prešov, Partizánska 1, 08001 Prešov, Slovakia; (Ľ.M.); (Ľ.T.)
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Depression symptoms as longitudinal predictors of the psychological impact of COVID-19 pandemic in hypertensive patients. Sci Rep 2021; 11:16496. [PMID: 34389793 PMCID: PMC8363734 DOI: 10.1038/s41598-021-96165-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 08/03/2021] [Indexed: 12/30/2022] Open
Abstract
COVID-19 has brought considerable changes and caused critical psychological responses, especially among frail populations. So far, researchers have explored the predictive effect of diverse factors on pandemic-related psychological distress, but none have focused on the impact of prior depression and anxiety symptomatology adopting an extended (10-year) longitudinal design. 105 patients aged over 60, affected by hypertension who participated in a previous longitudinal study were assessed through a follow-up telephone structured interview. The Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale-Revised (IES-R) were used for assessing depression and anxiety symptoms and the psychological impact of COVID-19, respectively. Multiple linear regression analyses were conducted. At the assessment, participants did not report clinically relevant depression, anxiety, and psychological pandemic-related distress symptoms. However, significant mean differences between baseline and current follow-up evaluations for both depression and anxiety were found, reflecting a decrease in symptomatology over time (p < .001). Baseline depression symptoms (β = 1.483, p = .005) significantly predicted the psychological impact of COVID-19 after 10 years. Conversely, their decrease (β = −1.640, p < .001) and living with others (β = −7.274, p = .041) significantly contributed to lower psychological distress scores. Our findings provide insight into the predisposing influence of depressive symptoms on pandemic-related psychological distress ten years later. Preventive interventions and strategies considering these factors are needed to better pre-empt the severe mental consequences of the pandemic.
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Vahedparast H, Nazarian R, Bagherzadeh R, Farhadi A. The Predictor Role of Perceived Social Support and Aging Perception in Treatment Adherence of Older Adults with Chronic Diseases. ADVANCES IN GERONTOLOGY 2021. [DOI: 10.1134/s2079057021020168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Canessa J, Glasinovic A, Nuñez C. Herramientas prácticas para el desarrollo de la medicina ambulatoria. REVISTA MÉDICA CLÍNICA LAS CONDES 2021. [DOI: 10.1016/j.rmclc.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Shahin W, Kennedy GA, Stupans I. The association between social support and medication adherence in patients with hypertension: A systematic review. Pharm Pract (Granada) 2021; 19:2300. [PMID: 34221197 PMCID: PMC8234709 DOI: 10.18549/pharmpract.2021.2.2300] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 06/06/2021] [Indexed: 11/14/2022] Open
Abstract
Background: Medication adherence is a primary determinant of treatment success in
hypertensive patients. One of the challenges for healthcare providers that
has received little attention is the impact of patients’ social
supports on medication adherence. Objective: This review evaluates the impact of patients’ social supports on
medication adherence in hypertensive patients. Methods: A systematic review methodology was used. Pubmed, CINAHL, Embase, and
PsycINFO databases were searched systematically for relevant articles. The
outcome measure in the studies was medication adherence in hypertension. Results: From 1155 articles, 238 were retained for further assessment, and finally, 14
met the inclusion criteria. Statistically significant positive associations
between medication adherence and social support were found in nine studies
(p<0.05). Conclusions: This review evaluated the impact of social support on medication adherence
and highlighted gaps in the literature regarding the impact of social
support on adherence. Family members or peer support may promote better
adherence in some patient groups. This review suggests that healthcare
providers may need to consider whether patients have appropriate social
supports in place which will assist them adhering to and benefiting from
treatment recommendations.
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Affiliation(s)
- Wejdan Shahin
- School of Health & Biomedical Sciences, RMIT University. Bundoora, VIC (Australia).
| | - Gerard A Kennedy
- School of Health & Biomedical Sciences, RMIT University. Bundoora, VIC (Australia).
| | - Ieva Stupans
- School of Health & Biomedical Sciences, RMIT University. Bundoora, VIC (Australia).
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Zhang Q, Huang F, Zhang L, Li S, Zhang J. The effect of high blood pressure-health literacy, self-management behavior, self-efficacy and social support on the health-related quality of life of Kazakh hypertension patients in a low-income rural area of China: a structural equation model. BMC Public Health 2021; 21:1114. [PMID: 34112122 PMCID: PMC8194055 DOI: 10.1186/s12889-021-11129-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/19/2021] [Indexed: 11/19/2022] Open
Abstract
Background Health-Related Quality of Life (HRQoL) of hypertensive patients is not only affected by the disease itself but also by some subjective factors. Low health literacy is prevalent among ethnic minorities. Considering the Kazakh-Chinese people have the highest prevalence of hypertension in Xinjiang, and the High Blood Pressure-Health Literacy (HBP-HL) has not been included in the study of HRQoL. The synergistic effects and the potential mechanism HBP-HL, self-management behavior, therapeutic adherence, self-efficacy, social support on HRQoL remain unclear. This study aimed to introduce the HBP-HL, and develop a structural equation model (SEM) to identify the factors influencing of the HRQoL among Kazakh hypertensive patients. Methods The data was obtained by questionnaire survey and physical examination in 2015. Patients with hypertension were recruited through random cluster sampling in Kazakh settlements in Xinjiang. Firstly, the blood pressure was measured. Then the one-for-one household interviews were conducted by Kazakh investigators. The questionnaires regarding HBP-HL, HRQoL, self-management behavior, therapeutic adherence, self-efficacy, and social support were used to collect data. Finally, SEM was constructed, and p ≤ 0.05 was taken as significant. Results The data was analysed by SPSS18.0 and AMOS18.0 software. 516 Kazakh hypertension patients were recruited, and 94.4% of them had a relatively low HBP-HL score. The mean standardized scores of HRQoL, self-management, therapeutic adherence were poor; they were 63.5, 66.2, and 64.4, respectively. But 96.1% and 98.3% of the participants had high levels of self-efficacy and social support. The SEM of the HRQoL had a good overall fit (χ2/df = 2.078, AGFI = 0.944, GFI = 0.968, CFI = 0.947, IFI = 0.949, RMSEA = 0.046). The model indicated that the HBP-HL has the highest correlation with HRQoL, following with self-management behavior, social support, and self-efficacy. Conclusions Low HBP-HL is a major influenced factor of HRQoL among Kazakh hypertensive patients. Future programs should consider HBP-HL as the breakthrough point when designing targeting intervention strategies.
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Affiliation(s)
- Qinghua Zhang
- School of Medicine, Hu Zhou University, 759-Second Ring East Road, Huzhou, 313000, Zhejiang, China.
| | - Feifei Huang
- School of Nursing, Fu Jian Medical University, Fu Zhou, Fujian, China
| | - Lei Zhang
- First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Shasha Li
- School of Medicine, Hu Zhou University, 759-Second Ring East Road, Huzhou, 313000, Zhejiang, China
| | - Jingping Zhang
- Nursing Psychology Research Center of Xiangya Nursing School, Central South University, 172 Tong Zi Po Road, Changsha, 410000, Hunan, China.
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Gesselman AN, Wion RK, Garcia JR, Miller WR. Relationship and sexual satisfaction are associated with better disease self-management in persons with epilepsy. Epilepsy Behav 2021; 119:107937. [PMID: 33892288 PMCID: PMC8154732 DOI: 10.1016/j.yebeh.2021.107937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 01/23/2023]
Abstract
Prior research has demonstrated that PWEs view intimate interpersonal relationships as personally important and as a substantive challenge in their lives. This is significant as high-quality intimate relationships have been linked with greater well-being and better healthcare self-management in other disease contexts. For persons with epilepsy (PWEs), self-management is critical for seizure control, lower mortality, and better quality of life. In the current study, we conducted the first known investigation into the quality of PWEs' intimate relationships and their self-management abilities. In a sample of 88 PWEs, using the Adult Epilepsy Self-Management Instrument, results demonstrate links between greater relationship satisfaction and sexual satisfaction with better self-management on seven of the eleven subscales: health communication, coping skills, social support, seizure tracking, seizure response, stress management, and wellness; satisfaction was unrelated to the treatment, safety, medical adherence, and proactivity subscales. Importantly, these results held while controlling for age, gender, social support, and presence of comorbidities. These findings provide some evidence of the importance of intimate relationships in understanding PWEs' healthcare management abilities. Given that intimate relationship dynamics have been shown to be highly amenable to intervention, this is an area of potential interest for improving self-management in PWEs.
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Affiliation(s)
| | - Rachel K Wion
- School of Nursing, Indiana University, United States
| | - Justin R Garcia
- The Kinsey Institute, Indiana University, United States; Department of Gender Studies, Indiana University, United States
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Smith TB, Workman C, Andrews C, Barton B, Cook M, Layton R, Morrey A, Petersen D, Holt-Lunstad J. Effects of psychosocial support interventions on survival in inpatient and outpatient healthcare settings: A meta-analysis of 106 randomized controlled trials. PLoS Med 2021; 18:e1003595. [PMID: 34003832 PMCID: PMC8130925 DOI: 10.1371/journal.pmed.1003595] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 03/25/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Hospitals, clinics, and health organizations have provided psychosocial support interventions for medical patients to supplement curative care. Prior reviews of interventions augmenting psychosocial support in medical settings have reported mixed outcomes. This meta-analysis addresses the questions of how effective are psychosocial support interventions in improving patient survival and which potential moderating features are associated with greater effectiveness. METHODS AND FINDINGS We evaluated randomized controlled trials (RCTs) of psychosocial support interventions in inpatient and outpatient healthcare settings reporting survival data, including studies reporting disease-related or all-cause mortality. Literature searches included studies reported January 1980 through October 2020 accessed from Embase, Medline, Cochrane Library, CINAHL, Alt HealthWatch, PsycINFO, Social Work Abstracts, and Google Scholar databases. At least 2 reviewers screened studies, extracted data, and assessed study quality, with at least 2 independent reviewers also extracting data and assessing study quality. Odds ratio (OR) and hazard ratio (HR) data were analyzed separately using random effects weighted models. Of 42,054 studies searched, 106 RCTs including 40,280 patients met inclusion criteria. Patient average age was 57.2 years, with 52% females and 48% males; 42% had cardiovascular disease (CVD), 36% had cancer, and 22% had other conditions. Across 87 RCTs reporting data for discrete time periods, the average was OR = 1.20 (95% CI = 1.09 to 1.31, p < 0.001), indicating a 20% increased likelihood of survival among patients receiving psychosocial support compared to control groups receiving standard medical care. Among those studies, psychosocial interventions explicitly promoting health behaviors yielded improved likelihood of survival, whereas interventions without that primary focus did not. Across 22 RCTs reporting survival time, the average was HR = 1.29 (95% CI = 1.12 to 1.49, p < 0.001), indicating a 29% increased probability of survival over time among intervention recipients compared to controls. Among those studies, meta-regressions identified 3 moderating variables: control group type, patient disease severity, and risk of research bias. Studies in which control groups received health information/classes in addition to treatment as usual (TAU) averaged weaker effects than those in which control groups received only TAU. Studies with patients having relatively greater disease severity tended to yield smaller gains in survival time relative to control groups. In one of 3 analyses, studies with higher risk of research bias tended to report better outcomes. The main limitation of the data is that interventions very rarely blinded personnel and participants to study arm, such that expectations for improvement were not controlled. CONCLUSIONS In this meta-analysis, OR data indicated that psychosocial behavioral support interventions promoting patient motivation/coping to engage in health behaviors improved patient survival, but interventions focusing primarily on patients' social or emotional outcomes did not prolong life. HR data indicated that psychosocial interventions, predominantly focused on social or emotional outcomes, improved survival but yielded similar effects to health information/classes and were less effective among patients with apparently greater disease severity. Risk of research bias remains a plausible threat to data interpretation.
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Affiliation(s)
- Timothy B. Smith
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
- * E-mail:
| | - Connor Workman
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
| | - Caleb Andrews
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
| | - Bonnie Barton
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
| | - Matthew Cook
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
| | - Ryan Layton
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
| | - Alexandra Morrey
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
| | - Devin Petersen
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
| | - Julianne Holt-Lunstad
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
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SteelFisher GK, McMurtry CL, Caporello HL, McGowan E, Schafer TJ, Lubell KM, Friedman AL, Allen J, Shockey C, Grady A, Ben-Porath EN. Experiences and Views of Domestic Summer Travelers During the COVID-19 Pandemic: Findings from a National Survey. Health Secur 2021; 19:338-348. [PMID: 34030469 PMCID: PMC8217589 DOI: 10.1089/hs.2020.0212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/31/2021] [Accepted: 03/31/2021] [Indexed: 12/19/2022] Open
Abstract
Domestic travel creates a serious risk of spreading COVID-19, including novel strains of the virus. Motivating potential travelers to take precautions is critical, especially for those at higher risk for severe illness. To provide an evidence base for communication efforts, we examined the experiences and views of travelers during the summer of 2020 through a telephone survey of 1,968 US adults, conducted in English and Spanish, July 2 through July 16, 2020. The survey found that more than one-quarter (28%) of adults had traveled domestically in the prior 30 days, most commonly for "vacation" (43%), and less than half wore masks (46%) or practiced social distancing (47%) "all of the time." Although high-risk adults were significantly less likely to travel than non-high-risk adults (23% vs 31%; P < .001), they were no more likely to take precautions. Many travelers did not wear a mask or practice social distancing because they felt such actions were unnecessary (eg, they were outside or with friends and family). Although a substantial share of travelers (43% to 53%) trusted public health agencies "a great deal" for information about reducing risks while traveling, more travelers (73%) trusted their own healthcare providers. Findings suggest that outreach may be improved by partnering with providers to emphasize the benefits of layering precautions and provide targeted education to high-risk individuals. Messages that are empathetic to the need to reduce stress and convey how precautions can protect loved ones may be particularly resonant after more than a year of pandemic-related restrictions.
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Affiliation(s)
- Gillian K. SteelFisher
- Gillian K. SteelFisher, PhD, MSc, is a Senior Research Scientist and Deputy Director; Caitlin L. McMurtry, SM, is a Research Fellow; and Hannah L. Caporello is Program Manager; all at the Harvard Opinion Research Program, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health (HSPH), Boston, MA. Caitlin L. McMurtry is also a PhD Candidate, PhD Program in Health Policy, Harvard University, Cambridge, MA. Ericka McGowan, MS, is Senior Director, Immunization and Infectious Disease Team, Association of State and Territorial Health Officials (ASTHO), Arlington, VA. Thomas J. Schafer is Project Director, National Public Health Information Coalition, Canton, GA. Keri M. Lubell, PhD, is a Behavioral Scientist, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Allison L. Friedman, MS, is a Health Communications Specialist; Jessica Allen, MPH, MSW, is a Health Communications Specialist, Travelers' Health Branch; and Caitlin Shockey, JD, is Associate Director for Communication; all in the Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Alison Grady, MPH, is a Health Communications Strategist, Kapili Services, LLC, Atlanta, GA. Eran N. Ben-Porath, PhD, is Executive Vice President, SSRS, Glen Mills, PA. All authors acted in a personal capacity. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC, any other portion of the Government of the United States, ASTHO, National Public Health Information Coalition, HSPH, Harvard University, or SSRS. The study was conducted through a cooperative agreement between CDC and ASTHO, who subsequently subcontracted to HSPH
| | - Caitlin L. McMurtry
- Gillian K. SteelFisher, PhD, MSc, is a Senior Research Scientist and Deputy Director; Caitlin L. McMurtry, SM, is a Research Fellow; and Hannah L. Caporello is Program Manager; all at the Harvard Opinion Research Program, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health (HSPH), Boston, MA. Caitlin L. McMurtry is also a PhD Candidate, PhD Program in Health Policy, Harvard University, Cambridge, MA. Ericka McGowan, MS, is Senior Director, Immunization and Infectious Disease Team, Association of State and Territorial Health Officials (ASTHO), Arlington, VA. Thomas J. Schafer is Project Director, National Public Health Information Coalition, Canton, GA. Keri M. Lubell, PhD, is a Behavioral Scientist, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Allison L. Friedman, MS, is a Health Communications Specialist; Jessica Allen, MPH, MSW, is a Health Communications Specialist, Travelers' Health Branch; and Caitlin Shockey, JD, is Associate Director for Communication; all in the Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Alison Grady, MPH, is a Health Communications Strategist, Kapili Services, LLC, Atlanta, GA. Eran N. Ben-Porath, PhD, is Executive Vice President, SSRS, Glen Mills, PA. All authors acted in a personal capacity. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC, any other portion of the Government of the United States, ASTHO, National Public Health Information Coalition, HSPH, Harvard University, or SSRS. The study was conducted through a cooperative agreement between CDC and ASTHO, who subsequently subcontracted to HSPH
| | - Hannah L. Caporello
- Gillian K. SteelFisher, PhD, MSc, is a Senior Research Scientist and Deputy Director; Caitlin L. McMurtry, SM, is a Research Fellow; and Hannah L. Caporello is Program Manager; all at the Harvard Opinion Research Program, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health (HSPH), Boston, MA. Caitlin L. McMurtry is also a PhD Candidate, PhD Program in Health Policy, Harvard University, Cambridge, MA. Ericka McGowan, MS, is Senior Director, Immunization and Infectious Disease Team, Association of State and Territorial Health Officials (ASTHO), Arlington, VA. Thomas J. Schafer is Project Director, National Public Health Information Coalition, Canton, GA. Keri M. Lubell, PhD, is a Behavioral Scientist, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Allison L. Friedman, MS, is a Health Communications Specialist; Jessica Allen, MPH, MSW, is a Health Communications Specialist, Travelers' Health Branch; and Caitlin Shockey, JD, is Associate Director for Communication; all in the Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Alison Grady, MPH, is a Health Communications Strategist, Kapili Services, LLC, Atlanta, GA. Eran N. Ben-Porath, PhD, is Executive Vice President, SSRS, Glen Mills, PA. All authors acted in a personal capacity. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC, any other portion of the Government of the United States, ASTHO, National Public Health Information Coalition, HSPH, Harvard University, or SSRS. The study was conducted through a cooperative agreement between CDC and ASTHO, who subsequently subcontracted to HSPH
| | - Ericka McGowan
- Gillian K. SteelFisher, PhD, MSc, is a Senior Research Scientist and Deputy Director; Caitlin L. McMurtry, SM, is a Research Fellow; and Hannah L. Caporello is Program Manager; all at the Harvard Opinion Research Program, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health (HSPH), Boston, MA. Caitlin L. McMurtry is also a PhD Candidate, PhD Program in Health Policy, Harvard University, Cambridge, MA. Ericka McGowan, MS, is Senior Director, Immunization and Infectious Disease Team, Association of State and Territorial Health Officials (ASTHO), Arlington, VA. Thomas J. Schafer is Project Director, National Public Health Information Coalition, Canton, GA. Keri M. Lubell, PhD, is a Behavioral Scientist, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Allison L. Friedman, MS, is a Health Communications Specialist; Jessica Allen, MPH, MSW, is a Health Communications Specialist, Travelers' Health Branch; and Caitlin Shockey, JD, is Associate Director for Communication; all in the Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Alison Grady, MPH, is a Health Communications Strategist, Kapili Services, LLC, Atlanta, GA. Eran N. Ben-Porath, PhD, is Executive Vice President, SSRS, Glen Mills, PA. All authors acted in a personal capacity. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC, any other portion of the Government of the United States, ASTHO, National Public Health Information Coalition, HSPH, Harvard University, or SSRS. The study was conducted through a cooperative agreement between CDC and ASTHO, who subsequently subcontracted to HSPH
| | - Thomas J. Schafer
- Gillian K. SteelFisher, PhD, MSc, is a Senior Research Scientist and Deputy Director; Caitlin L. McMurtry, SM, is a Research Fellow; and Hannah L. Caporello is Program Manager; all at the Harvard Opinion Research Program, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health (HSPH), Boston, MA. Caitlin L. McMurtry is also a PhD Candidate, PhD Program in Health Policy, Harvard University, Cambridge, MA. Ericka McGowan, MS, is Senior Director, Immunization and Infectious Disease Team, Association of State and Territorial Health Officials (ASTHO), Arlington, VA. Thomas J. Schafer is Project Director, National Public Health Information Coalition, Canton, GA. Keri M. Lubell, PhD, is a Behavioral Scientist, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Allison L. Friedman, MS, is a Health Communications Specialist; Jessica Allen, MPH, MSW, is a Health Communications Specialist, Travelers' Health Branch; and Caitlin Shockey, JD, is Associate Director for Communication; all in the Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Alison Grady, MPH, is a Health Communications Strategist, Kapili Services, LLC, Atlanta, GA. Eran N. Ben-Porath, PhD, is Executive Vice President, SSRS, Glen Mills, PA. All authors acted in a personal capacity. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC, any other portion of the Government of the United States, ASTHO, National Public Health Information Coalition, HSPH, Harvard University, or SSRS. The study was conducted through a cooperative agreement between CDC and ASTHO, who subsequently subcontracted to HSPH
| | - Keri M. Lubell
- Gillian K. SteelFisher, PhD, MSc, is a Senior Research Scientist and Deputy Director; Caitlin L. McMurtry, SM, is a Research Fellow; and Hannah L. Caporello is Program Manager; all at the Harvard Opinion Research Program, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health (HSPH), Boston, MA. Caitlin L. McMurtry is also a PhD Candidate, PhD Program in Health Policy, Harvard University, Cambridge, MA. Ericka McGowan, MS, is Senior Director, Immunization and Infectious Disease Team, Association of State and Territorial Health Officials (ASTHO), Arlington, VA. Thomas J. Schafer is Project Director, National Public Health Information Coalition, Canton, GA. Keri M. Lubell, PhD, is a Behavioral Scientist, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Allison L. Friedman, MS, is a Health Communications Specialist; Jessica Allen, MPH, MSW, is a Health Communications Specialist, Travelers' Health Branch; and Caitlin Shockey, JD, is Associate Director for Communication; all in the Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Alison Grady, MPH, is a Health Communications Strategist, Kapili Services, LLC, Atlanta, GA. Eran N. Ben-Porath, PhD, is Executive Vice President, SSRS, Glen Mills, PA. All authors acted in a personal capacity. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC, any other portion of the Government of the United States, ASTHO, National Public Health Information Coalition, HSPH, Harvard University, or SSRS. The study was conducted through a cooperative agreement between CDC and ASTHO, who subsequently subcontracted to HSPH
| | - Allison L. Friedman
- Gillian K. SteelFisher, PhD, MSc, is a Senior Research Scientist and Deputy Director; Caitlin L. McMurtry, SM, is a Research Fellow; and Hannah L. Caporello is Program Manager; all at the Harvard Opinion Research Program, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health (HSPH), Boston, MA. Caitlin L. McMurtry is also a PhD Candidate, PhD Program in Health Policy, Harvard University, Cambridge, MA. Ericka McGowan, MS, is Senior Director, Immunization and Infectious Disease Team, Association of State and Territorial Health Officials (ASTHO), Arlington, VA. Thomas J. Schafer is Project Director, National Public Health Information Coalition, Canton, GA. Keri M. Lubell, PhD, is a Behavioral Scientist, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Allison L. Friedman, MS, is a Health Communications Specialist; Jessica Allen, MPH, MSW, is a Health Communications Specialist, Travelers' Health Branch; and Caitlin Shockey, JD, is Associate Director for Communication; all in the Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Alison Grady, MPH, is a Health Communications Strategist, Kapili Services, LLC, Atlanta, GA. Eran N. Ben-Porath, PhD, is Executive Vice President, SSRS, Glen Mills, PA. All authors acted in a personal capacity. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC, any other portion of the Government of the United States, ASTHO, National Public Health Information Coalition, HSPH, Harvard University, or SSRS. The study was conducted through a cooperative agreement between CDC and ASTHO, who subsequently subcontracted to HSPH
| | - Jessica Allen
- Gillian K. SteelFisher, PhD, MSc, is a Senior Research Scientist and Deputy Director; Caitlin L. McMurtry, SM, is a Research Fellow; and Hannah L. Caporello is Program Manager; all at the Harvard Opinion Research Program, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health (HSPH), Boston, MA. Caitlin L. McMurtry is also a PhD Candidate, PhD Program in Health Policy, Harvard University, Cambridge, MA. Ericka McGowan, MS, is Senior Director, Immunization and Infectious Disease Team, Association of State and Territorial Health Officials (ASTHO), Arlington, VA. Thomas J. Schafer is Project Director, National Public Health Information Coalition, Canton, GA. Keri M. Lubell, PhD, is a Behavioral Scientist, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Allison L. Friedman, MS, is a Health Communications Specialist; Jessica Allen, MPH, MSW, is a Health Communications Specialist, Travelers' Health Branch; and Caitlin Shockey, JD, is Associate Director for Communication; all in the Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Alison Grady, MPH, is a Health Communications Strategist, Kapili Services, LLC, Atlanta, GA. Eran N. Ben-Porath, PhD, is Executive Vice President, SSRS, Glen Mills, PA. All authors acted in a personal capacity. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC, any other portion of the Government of the United States, ASTHO, National Public Health Information Coalition, HSPH, Harvard University, or SSRS. The study was conducted through a cooperative agreement between CDC and ASTHO, who subsequently subcontracted to HSPH
| | - Caitlin Shockey
- Gillian K. SteelFisher, PhD, MSc, is a Senior Research Scientist and Deputy Director; Caitlin L. McMurtry, SM, is a Research Fellow; and Hannah L. Caporello is Program Manager; all at the Harvard Opinion Research Program, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health (HSPH), Boston, MA. Caitlin L. McMurtry is also a PhD Candidate, PhD Program in Health Policy, Harvard University, Cambridge, MA. Ericka McGowan, MS, is Senior Director, Immunization and Infectious Disease Team, Association of State and Territorial Health Officials (ASTHO), Arlington, VA. Thomas J. Schafer is Project Director, National Public Health Information Coalition, Canton, GA. Keri M. Lubell, PhD, is a Behavioral Scientist, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Allison L. Friedman, MS, is a Health Communications Specialist; Jessica Allen, MPH, MSW, is a Health Communications Specialist, Travelers' Health Branch; and Caitlin Shockey, JD, is Associate Director for Communication; all in the Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Alison Grady, MPH, is a Health Communications Strategist, Kapili Services, LLC, Atlanta, GA. Eran N. Ben-Porath, PhD, is Executive Vice President, SSRS, Glen Mills, PA. All authors acted in a personal capacity. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC, any other portion of the Government of the United States, ASTHO, National Public Health Information Coalition, HSPH, Harvard University, or SSRS. The study was conducted through a cooperative agreement between CDC and ASTHO, who subsequently subcontracted to HSPH
| | - Alison Grady
- Gillian K. SteelFisher, PhD, MSc, is a Senior Research Scientist and Deputy Director; Caitlin L. McMurtry, SM, is a Research Fellow; and Hannah L. Caporello is Program Manager; all at the Harvard Opinion Research Program, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health (HSPH), Boston, MA. Caitlin L. McMurtry is also a PhD Candidate, PhD Program in Health Policy, Harvard University, Cambridge, MA. Ericka McGowan, MS, is Senior Director, Immunization and Infectious Disease Team, Association of State and Territorial Health Officials (ASTHO), Arlington, VA. Thomas J. Schafer is Project Director, National Public Health Information Coalition, Canton, GA. Keri M. Lubell, PhD, is a Behavioral Scientist, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Allison L. Friedman, MS, is a Health Communications Specialist; Jessica Allen, MPH, MSW, is a Health Communications Specialist, Travelers' Health Branch; and Caitlin Shockey, JD, is Associate Director for Communication; all in the Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Alison Grady, MPH, is a Health Communications Strategist, Kapili Services, LLC, Atlanta, GA. Eran N. Ben-Porath, PhD, is Executive Vice President, SSRS, Glen Mills, PA. All authors acted in a personal capacity. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC, any other portion of the Government of the United States, ASTHO, National Public Health Information Coalition, HSPH, Harvard University, or SSRS. The study was conducted through a cooperative agreement between CDC and ASTHO, who subsequently subcontracted to HSPH
| | - Eran N. Ben-Porath
- Gillian K. SteelFisher, PhD, MSc, is a Senior Research Scientist and Deputy Director; Caitlin L. McMurtry, SM, is a Research Fellow; and Hannah L. Caporello is Program Manager; all at the Harvard Opinion Research Program, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health (HSPH), Boston, MA. Caitlin L. McMurtry is also a PhD Candidate, PhD Program in Health Policy, Harvard University, Cambridge, MA. Ericka McGowan, MS, is Senior Director, Immunization and Infectious Disease Team, Association of State and Territorial Health Officials (ASTHO), Arlington, VA. Thomas J. Schafer is Project Director, National Public Health Information Coalition, Canton, GA. Keri M. Lubell, PhD, is a Behavioral Scientist, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Allison L. Friedman, MS, is a Health Communications Specialist; Jessica Allen, MPH, MSW, is a Health Communications Specialist, Travelers' Health Branch; and Caitlin Shockey, JD, is Associate Director for Communication; all in the Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Alison Grady, MPH, is a Health Communications Strategist, Kapili Services, LLC, Atlanta, GA. Eran N. Ben-Porath, PhD, is Executive Vice President, SSRS, Glen Mills, PA. All authors acted in a personal capacity. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC, any other portion of the Government of the United States, ASTHO, National Public Health Information Coalition, HSPH, Harvard University, or SSRS. The study was conducted through a cooperative agreement between CDC and ASTHO, who subsequently subcontracted to HSPH
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Protein Intake and Physical Activity in Newly Diagnosed Patients with Acute Coronary Syndrome: A 5-Year Longitudinal Study. Nutrients 2021; 13:nu13020634. [PMID: 33669214 PMCID: PMC7919823 DOI: 10.3390/nu13020634] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/05/2021] [Accepted: 02/13/2021] [Indexed: 12/16/2022] Open
Abstract
Cardiovascular disease is one of the most common causes of hospitalization and is associated with high morbidity and mortality rates. Among the most important modifiable and well-known risk factors are an unhealthy diet and sedentary lifestyle. Nevertheless, adherence to healthy lifestyle regimes is poor. The present study examined longitudinal trajectories (pre-event, 6-, 12-, 24-, 36-, and 60-month follow-ups) of protein intake (fish, legumes, red/processed meat) and physical activity in 275 newly-diagnosed patients with acute coronary syndrome. Hierarchical Generalized Linear Models were performed, controlling for demographic and clinical variables, the season in which each assessment was made, and the presence of anxiety and depressive symptoms. Significant changes in protein intake and physical activity were found from pre-event to the six-month follow-up, suggesting the adoption of healthier behaviors. However, soon after the six-month follow-up, patients experienced significant declines in their healthy behaviors. Both physical activity and red/processed meat intake were modulated by the season in which the assessments took place and by anxiety symptoms over time. The negative long-term trajectory of healthy behaviors suggests that tailored interventions are needed that sustain patients’ capabilities to self-regulate their behaviors over time and consider patient preference in function of season.
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The Influence of Marital Status on the Survival of Patients with Uveal Melanoma. J Ophthalmol 2021; 2020:7012940. [PMID: 33489340 PMCID: PMC7803291 DOI: 10.1155/2020/7012940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 08/26/2020] [Accepted: 11/12/2020] [Indexed: 12/21/2022] Open
Abstract
Background Uveal melanoma (UM) is the most common primary intraocular tumor in adults and arises from the uvea. Marital status was a vital factor among physical conditions and social networks of cancer patients. Our study aimed to evaluate the impact of marital status on the outcomes among patients with UM. Methods Patients with UM newly diagnosed from 2004 to 2015 were extracted, and the data were extracted from Surveillance, Epidemiology, and End Results (SEER) program. Overall survival (OS) was measured via the log-rank test, as well as cancer-specific survival (CSS) was also calculated via the same method. Cox proportional hazards models were applied to assess whether marital status was related to both OS and CSS. Furthermore, we performed subgroup analysis depending on different sexes and SEER stages. Results In total, 4217 eligible patients were involved. Of these patients, 66.2% (n = 2793) were married, 14.6% (n = 615) were single, and 9.0% (n = 379) were divorced or separated, as well as widowed were 10.2% (n = 430). The 5-year OS of married, single, divorced or separated, and widowed patients was 74.0%, 72.8%, 68.6%, and 55.8%, respectively. The results indicating better OS and CSS occurred among married patients. Other factors such as sex, age at diagnosis, and SEER stage were also correlated with survival in UM patients. Furthermore, subgroup analyses were consistent with the results above. Conclusion Marital status was proved to be an independent prognostic value for survival in UM patients. In addition, contrast to married patients, widowed individuals showed poor OS and CSS at different subgroup analyses.
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Leon-Gonzalez R, Rodriguez-Artalejo F, Ortola R, Lopez-Garcia E, Garcia-Esquinas E. Social Network and Risk of Poor Sleep Outcomes in Older Adults: Results from a Spanish Prospective Cohort Study. Nat Sci Sleep 2021; 13:399-409. [PMID: 33762861 PMCID: PMC7982710 DOI: 10.2147/nss.s288195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/15/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Not having social support has been associated with poor sleep, but most prospective studies were based on social support in the workplace, did not account for baseline sleep characteristics or did not assess sleep duration. Moreover, no previous research has evaluated the relationship between social network and sleep outcomes in an older Spanish population. METHODS 1444 individuals aged ≥60 years were followed between 2012 and 2015. At baseline (2012), a poor social network index (SNI) was computed by summing the following dichotomous indicators: not being married; living alone; not having daily contact with family, friends or neighbors; being alone ≥8h/day; lacking someone to go for a walk with; not having emotional support; lacking instrumental support. Higher values in SNI indicate less social support. In 2012 and 2015, information was collected on sleep duration (hours/day) and on symptoms of sleep disturbance: bad overall sleep; difficulty falling asleep, awakening during nighttime, early awakening with difficulty getting back to sleep, use of sleeping pills, feeling restless in the morning, being asleep at daytime, and having an Epworth Sleepiness Scale>10. Poor sleep duration was defined as short (<6 h) or long (>9 h) nighttime sleep, and poor sleep quality as having ≥4 indicators of sleep disturbance. Linear or logistic regression models were used to assess the relationship of SNI with changes in sleep duration and in number of sleep disturbance indicators, or with the risk of developing poor nighttime sleep or poor sleep quality. RESULTS Compared to individuals in the lowest (best) quartile of the SNI in 2012, those in the second, third and fourth quartiles, respectively, displayed a mean (95%confidence interval [95% CI]) change of 2.32 (-7.58-12.22), -2.70 (-13.19-7.79) and -13.04 (-23.41- -2.67) minutes in sleep duration from 2012 to 2015; p for trend=0.02. A 1-point increase in the SNI at baseline was associated with an increased risk of short nighttime sleep (Odds Ratio [OR] and 95% CI: 1.22 (1.05-1.42)), poor sleep quality (OR: 1.13; 95% CI: 1.00-1.30), and of the indicator of sleep disturbance "early awakening with difficulty getting back to sleep" (OR: 1.20; 95% CI: 1.07-1.35). CONCLUSION A poorer social network is associated with a higher risk of short sleep and poor sleep quality in older adults.
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Affiliation(s)
- Rocio Leon-Gonzalez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute, CEI Uam+csic, Madrid, Spain
| | - Rosario Ortola
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute, CEI Uam+csic, Madrid, Spain
| | - Esther Garcia-Esquinas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Killey J, Simons M, Tyack Z. Effectiveness of interventions for optimising adherence to treatments for the prevention and management of scars: A systematic review. Clin Rehabil 2020; 35:656-668. [PMID: 33305622 DOI: 10.1177/0269215520978528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To identify the adherence interventions used with people receiving treatments to prevent or manage scarring, the effectiveness of these interventions, and the theoretical frameworks on which these interventions were based. DATA SOURCES Databases (PubMed, Embase, Web of Science, CINAHL, PsychINFO and OTseeker) were searched (09.10.2020) with no date or language restrictions. Grey literature databases, clinical trial registries and references lists of key papers were also searched. REVIEW METHODS Eligible randomised controlled trials included people using treatments for scarring following skin wounds, interventions that may improve adherence, and outcomes measuring adherence. Risk of bias (selection, performance, detection, attrition, reporting) and certainty of evidence (inconsistency, imprecision, indirectness, publication bias) were assessed. RESULTS Four randomised trials were included with 224 participants (17 children) with burn scars. Interventions involved educational (three trials) or technology-based components (four trials) and ranged in length from two weeks to six months. All four trials reported greater adherence rates in the intervention group compared with standard practice [standardised mean difference = 1.50 (95% confidence interval (CI) = 0.91-2.08); 2.01 (95% CI 1.05-2.98); odds ratio = 0.28 (95% CI = 0.11-0.69)]. One trial did not report original data. The certainty of evidence was very low. CONCLUSION Adherence interventions using education or technology for people receiving burn scar treatment may improve adherence. Further studies are needed particularly in children, with a focus on including outcomes of importance to patients (e.g. quality of life) and identifying core components of effective adherence interventions using theoretical frameworks.
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Affiliation(s)
- Jessica Killey
- Centre for Children's Burns and Trauma Research, Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia
| | - Megan Simons
- Centre for Children's Burns and Trauma Research, Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia.,Department of Occupational Therapy, Queensland Children's Hospital, South Brisbane, QLD, Australia
| | - Zephanie Tyack
- Centre for Children's Burns and Trauma Research, Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia
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The effect of loneliness and perceived social support on medication adherence self-efficacy in hypertensive patients: An example of Turkey. JOURNAL OF VASCULAR NURSING 2020; 38:183-190. [PMID: 33279108 DOI: 10.1016/j.jvn.2020.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 07/20/2020] [Indexed: 12/31/2022]
Abstract
This study was conducted to investigate the effect of loneliness and perceived social support on medication adherence self-efficacy in hypertensive patients. This descriptive cross-sectional study was conducted between March and June 2015 at 5 Family Health Centers in central Erzincan in eastern Turkey. The data were collected through face-to-face interviews using a descriptive questionnaire, the UCLA Loneliness Scale, the Multidimensional Scale of Perceived Social Support, and the Medication Adherence Self-Efficacy Scale Short Form. The mean score obtained from the UCLA Loneliness Scale was 38.35 ± 9.85, from the Multidimensional Scale of Perceived Social Support 64.10 ± 18.31, and from the Medication Adherence Self-Efficacy Scale 40.27 ± 11.97. The mean UCLA Loneliness Scale score was found to have a low negative correlation with the mean Medication Adherence Self-Efficacy Scale score and a highly significant negative correlation with the mean Multidimensional Scale of Perceived Social Support score (P < .001). There was also a very low positive significant correlation between the mean scores of the Multidimensional Scale of Perceived Social Support and the Medication Adherence Self-Efficacy Scale (P < .001). This study revealed that individuals with hypertension perceived a moderate level of loneliness, and their perceived social support and medication adherence self-efficacy were higher than the moderate level. Perceived loneliness and perceived social support were significant indicators of perceived medication adherence self-efficacy. Therefore, effective consultancy services should be provided to hypertensive patients to increase their social support and to make positive changes in their perceived loneliness so that their perceived medication adherence self-efficacy can be improved.
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Jankowska-Polańska B, Karniej P, Polański J, Seń M, Świątoniowska-Lonc N, Grochans E. Diabetes Mellitus Versus Hypertension-Does Disease Affect Pharmacological Adherence? Front Pharmacol 2020; 11:1157. [PMID: 32848766 PMCID: PMC7432322 DOI: 10.3389/fphar.2020.01157] [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: 02/11/2020] [Accepted: 07/16/2020] [Indexed: 11/13/2022] Open
Abstract
The aim of the study was to answer the questions whether a chronic disease can have a significant impact on the level of adherence and whether there are differences in adherence-related predictors depending on the chronic disease. The study included 1,571 patients (mean age 64.7 ± 11.3) with chronic diseases [1,030 diabetes mellitus (DM) type 2 and 541 hypertension (HA)]. Adherence was assessed using the Adherence Refills Medication Scale (ARMS). The average adherence score for the whole group was 18.9. Fifty-five percent of patients had a low level of adherence. A comparison between DM and HA shows a statistically significant difference and a higher level of adherence with pharmacological recommendations in the group of patients with type 2 DM (17.5 ± 12.0 vs 19.2 ± 8.0). In the single factors analysis, HA diagnosis had a statistically significant negative effect on adherence (β=0.92, p ≤ 0.001). In simple linear regression analysis, independent of chronic disease, a higher level of adherence was observed among women (β=-0.40, p=0.015), people with secondary education (β=-1.26, p ≤ 0.001), and inactive patients (β=-0.48; p=0.005). However, place of residence - countryside (β =0.35, p=0.044) and higher education (β=0.90, p ≤ 0.001) had a negative influence on the level of adherence. In multiple linear regression analysis HA (B=0.99; p ≤ 0.001), female gender (B=-0.47; p=0.003) and secondary education (B=-1.16; p ≤ 0.001) were important independent determinants of adherence. (1) Hypertension is an independent, statistically significant predictor that reduces the adherence level. (2) Female gender and higher education are the most important determinants improving adherence to pharmacological therapy. (3) There is a different pattern of predictors of adherence among patients: occupational activity plays an important role in DM, while education plays a role in HA.
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Affiliation(s)
- Beata Jankowska-Polańska
- Department of Clinical Nursing, Public Health Department, Wroclaw Medical University, Wrocław, Poland
| | - Piotr Karniej
- Department of Health Promotion, Public Health Department, Wroclaw Medical University, Wrocław, Poland
| | - Jacek Polański
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wrocław, Poland
| | - Mariola Seń
- Department of Health Promotion, Public Health Department, Wroclaw Medical University, Wrocław, Poland
| | | | - Elżbieta Grochans
- Department of Nursing, Pomeranian Medical University in Szczecin, Szczecin, Poland
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