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Holding A, Lavigne G, Vermette L, Carbonneau N. Motivation to regulate eating behaviors, intuitive eating, and well-being: A dyadic study with mothers and adult daughters. Appetite 2024; 199:107403. [PMID: 38723670 DOI: 10.1016/j.appet.2024.107403] [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: 01/24/2024] [Revised: 04/12/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024]
Abstract
Intuitive eating, defined as relying on physiological cues to determine when, what, and how much to eat while maintaining a positive relationship with food (Tribole & Resch, 1995), has gained a lot of research attention in the last two decades. The present study sought to determine how motivation for regulating eating behaviors is related to intuitive eating and well-being outcomes in dyads of mothers and their adult daughters (n = 214). Structural equation modelling revealed that controlling for dieting and desire to lose weight, both mothers' and daughters' autonomous motivation was positively associated with their own intuitive eating while their controlled motivation was negatively associated with intuitive eating. In turn, intuitive eating was positively associated with well-being in both mothers and daughters. Interestingly, mothers' intuitive eating was also positively related to their daughters' well-being. The analysis of indirect effects suggests that mothers' motivation to regulate eating behaviors has an indirect (mediating) relationship with daughters' well-being through mothers' intuitive eating. The implications for women's health and well-being are discussed.
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Affiliation(s)
- Anne Holding
- Department of Psychology, New York University, 6 Washington Place, New York, NY, 10001, USA.
| | - Geneviève Lavigne
- Department of Psychology, Université Du Québec à Trois-Rivières (UQTR), 3351, boulevard des Forges, Trois-Rivières, Québec, Canada, G9A 5H7.
| | - Laurence Vermette
- Department of Psychology, Université Du Québec à Trois-Rivières (UQTR), 3351, boulevard des Forges, Trois-Rivières, Québec, Canada, G9A 5H7.
| | - Noémie Carbonneau
- Department of Psychology, Université Du Québec à Trois-Rivières (UQTR), 3351, boulevard des Forges, Trois-Rivières, Québec, Canada, G9A 5H7; Institute of Nutrition and Functional Foods (INAF), Université Laval, 2440, boulevard Hochelaga, Québec, Québec, Canada, G1V 0A6.
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Marentes-Castillo M, Castillo I, Tomás I, Álvarez O. Towards a Healthy Diet in an Adolescent Population: The Mediating Role of Motivation and Perceived Barriers between Self-Efficacy and Weight Regulation. Healthcare (Basel) 2024; 12:1454. [PMID: 39057597 PMCID: PMC11276526 DOI: 10.3390/healthcare12141454] [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: 05/22/2024] [Revised: 07/05/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024] Open
Abstract
(1) Background: Adolescence is a critical period when dietary choices are a major concern. It is therefore important to understand the psychological factors that explain these choices. The objective of this study was to assess the predictive role of perceived self-efficacy for healthy eating and weight regulation on healthy and unhealthy eating behavior through the mediation of autonomous motivation, controlled motivation, amotivation, and perceived barriers to daily mechanisms affecting healthy consumption. (2) Methods: A total of 994 adolescents between 15 and 19 years old from Mexico and Spain participated in the study. The Spanish versions of the healthy eating and weight self-efficacy questionnaire, the behavioral regulation in exercise questionnaire, the barriers to healthy eating scale, and the weight-related behaviors scale questionnaire were used to measure the variables of interest. (3) Results: Mediated serial regression analysis showed that barriers to healthy eating (the daily mechanism of food consumption) reduced healthy eating choices. Healthy eating and weight self-efficacy also showed a positive significant relationship with autonomous motivation and a negative relationship with controlled motivation and amotivation. All the types of motivation showed a positive relationship with barriers to healthy eating. (4) Conclusions: The results point out the need to enhance self-efficacy, promote autonomous motivation, and reduce perceived barriers in young people with respect to healthy eating.
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Affiliation(s)
- María Marentes-Castillo
- Department of Social Psychology, University of Valencia, 46010 Valencia, Spain; (M.M.-C.); (O.Á.)
- National Council for Humanities, Science and Technology, Mexico City 03940, Mexico
| | - Isabel Castillo
- Department of Social Psychology, University of Valencia, 46010 Valencia, Spain; (M.M.-C.); (O.Á.)
| | - Inés Tomás
- Department of Methodology of the Behavioral Sciences, University of Valencia, 46010 Valencia, Spain;
| | - Octavio Álvarez
- Department of Social Psychology, University of Valencia, 46010 Valencia, Spain; (M.M.-C.); (O.Á.)
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3
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Leget DL, LaCaille LJ, Hooker SA, LaCaille RA, Lauritsen MW. Applying self-determination theory to internalized weight stigma and mental health correlates among young and middle adult women: A structural equation model. J Health Psychol 2024:13591053241248283. [PMID: 38679895 DOI: 10.1177/13591053241248283] [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: 05/01/2024] Open
Abstract
Limited research has explored the relationship between self-determination theory constructs (basic psychological needs, autonomous/controlled regulation) and internalized weight stigma (IWS). This cross-sectional, online study surveyed 480 U.S. women aged 18-40 between 2021 and 2022. We hypothesized that need frustration and controlled weight regulation would relate to higher IWS, which would be associated with dysfunctional eating, distress, and lower life satisfaction. Conversely, we predicted that need satisfaction, autonomous regulation, and body satisfaction would be associated with reduced IWS, dysfunctional eating and distress, and higher life satisfaction. Structural equation modeling demonstrated an acceptable model fit (CMIN/DF = 2.95, CFI = 0.90, RMSEA = 0.06, SRMR = 0.07), accounting for 74% of IWS variance. Findings indicate the relevance of self-determination theory in understanding IWS, supporting a dual-process model whereby adverse and adaptive outcomes follow distinct pathways. Longitudinal studies are warranted to validate psychological needs and regulatory styles as mechanisms for IWS development and to assess generalizability across diverse populations.
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Affiliation(s)
- Dakota L Leget
- University of Minnesota Duluth, USA
- University of Florida, USA
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Hong HS, Im Y. Factors associated with healthcare transition readiness for adolescents with chronic conditions: A cross-sectional study. J Child Health Care 2024:13674935241248859. [PMID: 38669312 DOI: 10.1177/13674935241248859] [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] [Indexed: 04/28/2024]
Abstract
Healthcare transition readiness (HCTR) plays a vital role by fostering autonomy, self-management skills, and active involvement in healthcare, leading to positive health outcomes. This study aimed to examine the factors associated with HCTR in adolescents with chronic conditions (ACCs) including adolescents' autonomy, parental overprotection, and autonomy support from healthcare providers (HCPs). This descriptive study included 107 adolescents aged 14-19 years (median age: 17 years, IQR = 1), recruited from online communities and support groups in South Korea. Data were analyzed using hierarchical linear regression. Our research has shown that HCTR is linked to a lower level of parental overprotection (β = -0.46, 95% CI [-0.59, -0.33]) and higher levels of autonomy support from HCPs (β = 0.46, 95% CI [0.36, 0.56]). Among general characteristics, we also found that having a transfer plan to adult care (β = 0.24, 95% CI [0.04, 0.44]) is significantly associated with HCTR. This study contributes to a broader understanding of HCTR by examining its associated factors in ACC. The results emphasize the pivotal roles of parental involvement, healthcare provider support, and structured transition to adult care in enhancing HCTR. These findings underscore the need for comprehensive assistance to ensure successful healthcare transitions.
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Affiliation(s)
- Hye Seung Hong
- Department of Delivery Room, Chung-Ang University Gwang Myeong Hospital, Gwangmyeong-si, Republic of Korea
- Department of Nursing, Graduate School, Kyung Hee University, Republic of Korea
| | - YeoJin Im
- College of Nursing Science, East-West Nursing Research Institute, Kyung Hee University, Seoul, Republic of Korea
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Prasetyawati AE, Probandari A, Claramita M, Julia M. What Are the Various Comprehensive Treatment Models to Improve Self-Efficacy and Self-Management in Adolescents with Diabetes Mellitus? A Scoping Review. IRANIAN JOURNAL OF PUBLIC HEALTH 2023; 52:1320-1333. [PMID: 37593519 PMCID: PMC10430395 DOI: 10.18502/ijph.v52i7.13234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/10/2023] [Indexed: 08/19/2023]
Abstract
Background This review aimed to synthesize intervention models involving the role of adolescent and family support as part of comprehensive care to improve self-efficacy and self-management among adolescents with Diabetes Mellitus (DM). Methods A review was conducted to conform to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) standards. We searched PubMed, Research Gate, Science Direct, Cochrane Library databases, and grey literature. We included articles exploring family intervention models on improving self-efficacy and self-management among adolescents with DM, published from January 1, 2009, to June 30, 2022, and in English. Articles were declared eligible, reviewed critically, and then synthesized narratively. Results We identified 487 abstracts and title records from the initial search and excluded 409 irrelevant studies. Sixty-six full-text articles were screened, and nine were included in the synthesis. Five articles presented findings from using models focusing on child and adolescent intervention, while in the remaining four articles, the intervention models involved adolescents and their caregivers or parents. Only two models provide comprehensive care that requires collaboration among healthcare providers, patients, and families. Adolescent self-efficacy and self-management schemes as intermediary variables are closely related to everything that can influence health behavior, metabolic control, and quality of life for adolescents, which requires support from a multidisciplinary collaborative team. Conclusion Excellent comprehensive care team collaboration involving family support is essential to increase the self-efficacy and self-management of adolescents with DM.
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Affiliation(s)
- Arsita Eka Prasetyawati
- Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Public Health, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Ari Probandari
- Department of Public Health, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Mora Claramita
- Department of Medical Education and Bioethics and Department of Family & Community Medicine, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Madarina Julia
- Department of Child Health, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada, Yogyakarta, Indonesia
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Joseph PL, Gonçalves C, Fleary SA. Psychosocial correlates in patterns of adolescent emotional eating and dietary consumption. PLoS One 2023; 18:e0285446. [PMID: 37224099 DOI: 10.1371/journal.pone.0285446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/20/2023] [Indexed: 05/26/2023] Open
Abstract
Unhealthy eating behaviors, such as consumption of unhealthy diet and emotional eating, are common in adolescence and tend to co-occur. However, how these behaviors are patterned may vary among adolescents. This study identified patterns of dietary consumption and emotional eating behaviors in adolescents and examined the sociodemographic and psychosocial (e.g., self-efficacy beliefs and motivation) covariates associated with these eating patterns. Data were from the Family Life, Activity, Sun, Health and Eating study. Latent class analysis was used to estimate adolescent dietary patterns from dietary consumption (i.e., fruits, vegetables, sugar-sweetened beverages, junk food, etc.) and emotional eating variables (i.e., eating when feeling sad or anxious). The sample included 1,568 adolescents (Mean age = 14.48-years-old, 49% girls, 55% White). A four-class solution best fit the data (e.g., Bayesian Information Criteria [BIC] = 12263.568, three-class model BIC = 12271.622). Four unhealthy eating behavior patterns were identified: poor diet/high emotional eating, mixed diet/high emotional eating, poor diet/low emotional eating, and mixed diet/low emotional eating. Compared to the poor diet/high emotional eating group, the other groups were less likely to include older adolescents, girls, and adolescents who experienced food insecurity, and more likely to have higher self-efficacy for eating fruits and vegetables and limiting junk foods as well as motivation for consuming fruits and vegetables and limiting junk foods. Our findings highlight adolescents' complex dietary patterns that include dietary consumption and emotional eating behaviors. Future studies should examine other potential dietary patterns that include emotional eating. Efforts to address unhealthy patterns of adolescents' dietary consumption and emotional eating behaviors should be expanded.
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Affiliation(s)
- Patrece L Joseph
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Child Study and Human Development, Tufts University, Medford, MA, United States of America
| | - Carolina Gonçalves
- Department of Child Study and Human Development, Tufts University, Medford, MA, United States of America
| | - Sasha A Fleary
- Department of Child Study and Human Development, Tufts University, Medford, MA, United States of America
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States of America
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Yahya AS, Khawaja S, Naguib M. ‘Diabulimia’: current insights into type 1 diabetes and bulimia nervosa. PROGRESS IN NEUROLOGY AND PSYCHIATRY 2023. [DOI: 10.1002/pnp.782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- Ahmed Saeed Yahya
- Dr Yahya is a Consultant Psychiatrist at both the Priory Hospital North London and The Maudsley Hospital in South London; Dr Khawaja is a Consultant Psychiatrist and ECT Clinical Lead, and Dr Naguib is a Locum Consultant Psychiatrist, both at North East London NHS Foundation Trust
| | - Shakil Khawaja
- Dr Yahya is a Consultant Psychiatrist at both the Priory Hospital North London and The Maudsley Hospital in South London; Dr Khawaja is a Consultant Psychiatrist and ECT Clinical Lead, and Dr Naguib is a Locum Consultant Psychiatrist, both at North East London NHS Foundation Trust
| | - Meena Naguib
- Dr Yahya is a Consultant Psychiatrist at both the Priory Hospital North London and The Maudsley Hospital in South London; Dr Khawaja is a Consultant Psychiatrist and ECT Clinical Lead, and Dr Naguib is a Locum Consultant Psychiatrist, both at North East London NHS Foundation Trust
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8
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Stephens SB, Raphael JL, Zimmerman CT, Garland BH, de Guzman MM, Walsh SM, Hergenroeder AC, Wiemann CM. The Utility of Self-Determination Theory in Predicting Transition Readiness in Adolescents With Special Healthcare Needs. J Adolesc Health 2021; 69:653-659. [PMID: 34059429 DOI: 10.1016/j.jadohealth.2021.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/10/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Adolescents and young adults with chronic health conditions must learn skills to successfully manage their health as they prepare to transition into adult-based care. Self-determination theory (SDT), an empirically based theory of human motivation, posits that competence (feeling effective), autonomy (volition to perform behaviors), and relatedness (support for autonomy from others) influence behavioral change. This study evaluates the utility of SDT constructs in predicting transition readiness among adolescents and young adults recruited into an intervention to promote successful healthcare transition. METHODS Baseline assessments were completed by 137 patients aged 17-23 years recruited from pediatric renal, gastroenterology, or rheumatology clinical services. Surveys measured transition readiness (Transition Readiness Assessment Questionnaire) as well as SDT constructs, including competence (Patient Activation Measure); provider relatedness and parent autonomy support (Health Care Climate Questionnaire); and health care-related autonomy (Treatment Self-Regulation Questionnaire). Relationships between SDT constructs and transition readiness were evaluated using linear regression. RESULTS Between 44 and 48 participants were recruited from each service. Bivariate correlation coefficients between transition readiness and SDT constructs were competence (r = .44), autonomous autonomy (r = .34), controlled autonomy (r = .27), provider relatedness (r = .46), and parental autonomy support (r = .35) (p < .01). Age positively correlated with transition readiness (r = .47, p < .001). After controlling for age, gender, and clinical service, competence (p < .001) and provider relatedness (p = .008) successfully predicted transition readiness (R2 = .423; F change; p < .001). CONCLUSIONS Findings from this cross-sectional study support the utility of SDT constructs in promoting transition readiness among adolescents and young adults with chronic conditions, underscoring the importance of building competence and provider support for autonomy during this critical period.
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Affiliation(s)
- Sara B Stephens
- Section of Cardiology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | - Jean L Raphael
- Center for Child Health Policy and Advocacy, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | - Cortney T Zimmerman
- Section of Psychology, Renal Service, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | - Beth H Garland
- Sections of Adolescent Medicine & Sports Medicine and Psychology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | - Marietta M de Guzman
- Section of Rheumatology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | - Seema M Walsh
- Section of Gastroenterology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | - Albert C Hergenroeder
- Section of Adolescent Medicine & Sports Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | - Constance M Wiemann
- Section of Adolescent Medicine & Sports Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
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Ribeiro LB, Pieper CM, Frederico GA, Gamba MA, Rosa ADS. A relação entre a mulher com diabetes e o seu corpo: o risco da diabulimia. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023] Open
Abstract
Resumo Objetivo compreender a relação que as mulheres com diabulimia têm com o corpo. Método pesquisa qualitativa, desenvolvida com o Método da História Oral Temática, com quatro mulheres entre 18 e 30 anos que autorreferiram diabulimia. Resultados a relação das mulheres com o seu corpo foi pautada pela pressão social de magreza feminina que distorce a autoimagem, gera insatisfação com o corpo e a diminuição da autoestima. A perda de peso é proporcionalmente associada ao aumento da aceitação social e justifica a utilização de métodos deletérios à saúde como a diminuição da dose ou a suspensão do uso de insulina. As narradoras demonstraram conhecer os riscos, mas admitiram repeti-la em determinados contextos. Considerações finais e implicações para a prática o desejo que as mulheres com Diabetes Mellitus têm de perder peso precisa ser incorporado às estratégias de cuidado com a atenção dos profissionais da saúde à subjetividade, atuando para reconhecer e prevenir os transtornos alimentares em mulheres com diabetes e minimizar a adoção de ações prejudiciais à saúde.
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Affiliation(s)
| | - Claudia Maurício Pieper
- Pontifícia Universidade Católica do Rio de Janeiro, Brasil; Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, Brasil
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Goethals ER, Soenens B, de Wit M, Vansteenkiste M, Laffel LM, Casteels K, Luyckx K. "Let's talk about it" The role of parental communication in adolescents' motivation to adhere to treatment recommendations for type 1 diabetes. Pediatr Diabetes 2019; 20:1025-1034. [PMID: 31369191 PMCID: PMC7008457 DOI: 10.1111/pedi.12901] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/29/2019] [Accepted: 06/03/2019] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE Grounded in Self-Determination Theory, this study examines the role of parental expectations and communication style (ie, in an autonomy-supportive vs controlling way) in the prediction of adolescent motivation (ie, internalization or defiance) to adhere to self-management for type 1 diabetes. METHODS Structural Equation Modeling was used in a cross-sectional, multi-informant study of 129 adolescents (Mage = 14.43; 54.4% girls), 110 mothers, and 98 fathers. Adolescents reported on self-motivation, treatment adherence, and parental expectations and communication styles; parents reported on their own expectations, communication style, and perceptions of adolescent treatment adherence. Medical record review provided HbA1c values. RESULTS Across adolescent and parent reports, parental communication of diabetes-specific expectations and an autonomy-supportive style of communicating expectations related positively to adolescents' internalization of diabetes self-management and negatively to defiance against diabetes self-management. In contrast, a controlling parental communication style showed the opposite patterns of associations. Higher adolescent defiance was related to poorer treatment adherence and worse glycemic control. CONCLUSIONS Parental communication styles related to adolescent motivation, which in turn, related to adolescent treatment adherence and glycemic control. Future longitudinal research can address the long-term impact of both maternal and paternal communication styles on adolescent motivation to adhere to treatment and their subsequent glycemic control.
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Affiliation(s)
- Eveline R. Goethals
- University Hospital Leuven, Leuven, Belgium,KU Leuven, Leuven, Belgium,Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
| | | | - Maartje de Wit
- VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | | | - Lori M. Laffel
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
| | - Kristina Casteels
- University Hospital Leuven, Leuven, Belgium,KU Leuven, Leuven, Belgium
| | - Koen Luyckx
- KU Leuven, Leuven, Belgium,UNIBS, University of the Free State, Bloemfontein, South Africa
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McCoy MA, Theeke LA. A systematic review of the relationships among psychosocial factors and coping in adults with type 2 diabetes mellitus. Int J Nurs Sci 2019; 6:468-477. [PMID: 31728402 PMCID: PMC6838910 DOI: 10.1016/j.ijnss.2019.09.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 07/17/2019] [Accepted: 09/04/2019] [Indexed: 01/28/2023] Open
Abstract
Type 2 diabetes mellitus contributes to poor health outcomes including mortality, yet there is a gap in the literature when seeking to understand the influence of psychosocial factors on coping in this population. The paper presents a systematic review of quantitative studies that examined relationships among psychosocial determinants and coping in adults with type 2 diabetes. This review is the second layer of knowledge discovery for the concept, “Taking on a life-altering change is a rhythmical journey of experiencing ups and downs on the way to acceptance.” The life-altering change was determined to be a diagnosis of type 2 diabetes, the journey is the ups and downs of coping with the diagnosis as people work toward acceptance of type 2 diabetes. The review includes a synthesis of findings from 22 quantitative studies of psychosocial factors and coping in adults with type 2 diabetes. Anxiety, depression, stress, and diabetes distress were identified as key influential psychosocial factors. Increased social support was inversely related to emotional distress and coping styles were related to social well-being, psychological health, and physical health outcomes. The positive coping style of problem-focused coping was linked to improved psychological and physical health. Emotional responses to diagnosis were related to depression and anxiety. Negative coping styles of resignation, protest, or isolation were higher in women and linked to poorer quality of life, while avoidance was linked to increased diabetes-related distress and depressive symptoms.
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Affiliation(s)
- Melissa A. McCoy
- Division of Nursing, Davis and Elkins College, Elkins, WV, United States
- School of Nursing, West Virginia University, Morgantown, WV, United States
- Corresponding author. Division of Nursing, Davis and Elkins College, Elkins, WV, United States.
| | - Laurie A. Theeke
- School of Nursing, West Virginia University, Morgantown, WV, United States
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12
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Wilt L. The Relationships Among School Nurse to Student Ratios, Self-Efficacy, and Glycemic Control in Adolescents With Type 1 Diabetes. J Sch Nurs 2019; 37:230-240. [DOI: 10.1177/1059840519870314] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Adolescents with Type 1 diabetes (T1D) experience unique self-management challenges, which can lead to poor glycemic control and sequelae. School nurses may impact student self-efficacy behaviors for T1D management in adolescents. The purpose of this study was to determine the relationships among school nurse staffing patterns, measured by school nurse to student ratios, self-efficacy, and glycemic control in adolescents with T1D. The sample consisted of 89 parent–adolescent dyads. Adolescents aged 10–16 years old with T1D completed the Self-Efficacy for Diabetes Self-Management (SEDM) Scale. Parents completed a demographic questionnaire. Higher school nurse to student ratios correlated with better glycemic control and older age. Higher SEDM scores correlated with older age, and females scored significantly higher. Findings contribute new knowledge to the paucity of literature on school nursing and adolescents with T1D, with implications for nursing practice, education, research, and policy.
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Affiliation(s)
- Lori Wilt
- Seton Hall University, South Orange, NJ, USA
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13
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Sansfaçon J, Gauvin L, Fletcher É, Cottier D, Rossi E, Kahan E, Israël M, Steiger H. Prognostic value of autonomous and controlled motivation in outpatient eating-disorder treatment. Int J Eat Disord 2018; 51:1194-1200. [PMID: 30171769 DOI: 10.1002/eat.22901] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 05/15/2018] [Accepted: 05/25/2018] [Indexed: 11/08/2022]
Abstract
UNLABELLED According to Self-Determination Theory, when motivation to reach an objective is fully internal, it is said to be "autonomous"; when driven by external incentives, it is said to be "controlled". Previous research has indicated that autonomously motivated individuals show better response to treatments for eating disorders. OBJECTIVE In individuals undergoing different intensities of outpatient treatment for an eating disorder, we sought to assess associations between autonomous and controlled motivations and response to treatment on the one hand, and likelihood of dropping out of treatment, on the other. METHOD Seven hundred seventy adults meeting DSM-5 criteria for an eating disorder (216 with Anorexia Nervosa, 282 with Bulimia Nervosa, and 272 with Other Specified Feeding or Eating Disorder) were included in this study. Before an interval of outpatient treatment, individuals completed the Eating Disorder Examination Questionnaire and the Autonomous and Controlled Motivations for Treatment Questionnaire. Participants completed the Eating Disorder Examination Questionnaire again at one or two subsequent timepoints. RESULTS After controlling for diagnosis, treatment intensity, and number of previous treatments, analyses showed that higher autonomous motivation was associated with better response on eating-disorder overall symptoms and lower likelihood of dropping out of treatment. In contrast, controlled motivation was not associated with response to treatment. DISCUSSION Our results suggest that autonomous motivation has trans-diagnostic influence upon response to various intensities of treatment for an eating disorder. In support of an autonomy supportive approach to treatment, findings link autonomous motivation with more favorable outcome.
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Affiliation(s)
- Jeanne Sansfaçon
- Department of Psychiatry, McGill University, Montréal, Canada.,Eating Disorders Program, Douglas Mental Health Institute, Montréal, Canada
| | - Lise Gauvin
- Département de médecine sociale et préventive, Université de Montréal, Montréal, Canada.,CHUM Research Center, Montréal, Canada
| | - Émilie Fletcher
- Eating Disorders Program, Douglas Mental Health Institute, Montréal, Canada
| | - Danaëlle Cottier
- Department of Psychiatry, McGill University, Montréal, Canada.,Eating Disorders Program, Douglas Mental Health Institute, Montréal, Canada
| | - Erika Rossi
- Eating Disorders Program, Douglas Mental Health Institute, Montréal, Canada
| | - Esther Kahan
- Eating Disorders Program, Douglas Mental Health Institute, Montréal, Canada
| | - Mimi Israël
- Department of Psychiatry, McGill University, Montréal, Canada.,Eating Disorders Program, Douglas Mental Health Institute, Montréal, Canada
| | - Howard Steiger
- Department of Psychiatry, McGill University, Montréal, Canada.,Eating Disorders Program, Douglas Mental Health Institute, Montréal, Canada.,Department of Psychology, Université du Québec à Montréal (UQAM), Montréal, Canada
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Broadley MM, White MJ, Andrew B. Executive function is associated with diabetes-specific disordered eating in young adults with type 1 diabetes. J Psychosom Res 2018; 111:1-12. [PMID: 29935740 DOI: 10.1016/j.jpsychores.2018.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 03/28/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Disordered eating behavior in young adults with type 1 diabetes is overrepresented and associated with significant negative health consequences. Thus, determining the key correlates of these behaviors is essential. The aim of the present study was to determine the association between executive function and disordered eating in young adults with type 1 diabetes, relative to a control group without diabetes. METHODS 74 young adults with type 1 diabetes and 201 demographically similar control participants completed an online survey containing the Eating Disorders Examination Questionnaire (EDE-Q), Diabetes Eating Problems Survey- Revised (DEPS-R), Behavior Rating Inventory of Executive Function- Adult version, Depression Anxiety and Stress Scales, and 3 subscales of the Family Environment Scale (independence, control, and cohesion). RESULTS Hierarchical multiple regressions showed that lower executive function was associated with significantly greater disordered eating (as measured by the DEPS-R) over and above psychological and family functioning in the type 1 diabetes group (ΔR2 = 0.056, β = 0.366, p = .031). The same relationship was not found when disordered eating was measured by the EDE-Q in either the diabetes group (ΔR2 = 0.049, β = 0.342, p = .054), or the control group (ΔR2 = 0.010, β = 0.136, p = .100). CONCLUSIONS Executive function may play a greater role in the development and/or maintenance of disordered eating in groups with type 1 diabetes relative to those without. This relationship may contribute to the over-representation of eating problems in this clinical group, and may represent a target for prevention or intervention.
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Affiliation(s)
- Melanie M Broadley
- Queensland University of Technology, School of Psychology and Counselling, 170 Victoria Park Rd, Kelvin Grove, QLD 4059, Australia; Institute of Health and Biomedical Innovation, 60 Musk Avenue, Kelvin Grove, QLD 4059, Australia.
| | - Melanie J White
- Queensland University of Technology, School of Psychology and Counselling, 170 Victoria Park Rd, Kelvin Grove, QLD 4059, Australia; Institute of Health and Biomedical Innovation, 60 Musk Avenue, Kelvin Grove, QLD 4059, Australia
| | - Brooke Andrew
- Queensland University of Technology, School of Psychology and Counselling, 170 Victoria Park Rd, Kelvin Grove, QLD 4059, Australia; Institute of Health and Biomedical Innovation, 60 Musk Avenue, Kelvin Grove, QLD 4059, Australia
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Akgül S, Alikaşifoğlu A, Özon A, Gönç N, Düzçeker Y, Örs S, Derman O, Kanbur N. Can having a sibling with type 1 diabetes cause disordered eating behaviors? J Pediatr Endocrinol Metab 2018; 31:711-716. [PMID: 29874193 DOI: 10.1515/jpem-2017-0533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 04/16/2018] [Indexed: 12/15/2022]
Abstract
Background Adolescents with type 1 diabetes mellitus (T1DM) are at an increased risk of eating disturbances. The aim of this study was to evaluate whether the risk of a disordered eating behavior (DEB) also applies to the well sibling sharing the same environment. Methods Well siblings were included if they were 10-18 years old, had a sibling with a T1DM diagnosis for at least 6 months and lived with the sibling during the illness. The control group was comprised of healthy participants recruited from the outpatient clinic with no family history of T1DM. Participants completed a four-part questionnaire concerning their eating behaviors that was developed by the study team. This survey aimed to evaluate the dietary habits and eating patterns. All participants completed the Eating Attitudes Test-26 (EAT-26) and a 24-h food dietary recall. Any participant with a high EAT-26 score or that seemed to be at risk according to the questionnaire was re-evaluated. Results Eight cases (33.3%) in the well sibling group had either a total and/or subgroup pathological score. Three of them were found to have DEB and one case was diagnosed with anorexia nervosa (AN). In the control group, five cases (17.2%) had either a total and/or subgroup pathological score. Three of these cases were found to have DEB, no cases were diagnosed with an eating disorder. There were no statistically significant differences in the EAT-26 scores between the groups. Conclusions Although a direct relationship was not observed, the probability of having a pathologic EAT-26 score was higher in the group with a sibling with T1DM.
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Affiliation(s)
- Sinem Akgül
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Ayfer Alikaşifoğlu
- Department of Pediatrics, Division of Pediatric Endocrinology, Hacettepe University, Ankara, Turkey
| | - Alev Özon
- Department of Pediatrics, Division of Pediatric Endocrinology, Hacettepe University, Ankara, Turkey
| | - Nazlı Gönç
- Department of Pediatrics, Division of Pediatric Endocrinology, Hacettepe University, Ankara, Turkey
| | - Yasemin Düzçeker
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Sine Örs
- Division of Nutrition, Hacettepe University, Ankara, Turkey
| | - Orhan Derman
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Nuray Kanbur
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
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Eisenberg Colman MH, Quick VM, Lipsky LM, Dempster KW, Liu A, Laffel LMB, Mehta SN, Nansel TR. Disordered Eating Behaviors Are Not Increased by an Intervention to Improve Diet Quality but Are Associated With Poorer Glycemic Control Among Youth With Type 1 Diabetes. Diabetes Care 2018; 41:869-875. [PMID: 29371234 PMCID: PMC5860841 DOI: 10.2337/dc17-0090] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 01/02/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study examines whether participation in an 18-month behavioral intervention shown previously to improve overall diet quality inadvertently increases disordered eating behaviors (DEBs) in youth with type 1 diabetes and investigates the association of DEB with multiple measures of glycemic control and variability. RESEARCH DESIGN AND METHODS Participants reported DEB and diabetes management at baseline and 6, 12, and 18 months; masked continuous glucose monitoring, HbA1c, and 1,5-anhydroglucitol (1,5-AG) were obtained concurrently. Linear mixed models estimated the intervention effect on DEB, the association of DEB with diabetes adherence and measures of glycemic control and variability, and whether DEB modified glycemic trajectories. RESULTS There was no intervention effect on DEB (P = 0.84). DEB was associated with higher HbA1c (P = 0.001), mean sensor glucose (P = 0.001), and percent sensor glucose values >180 mg/dL (P = <0.001); with lower 1,5-AG (P = 0.01); and with worse diabetes adherence (P = 0.03). DEB was not associated with percent sensor glucose values <70 mg/dL or any measures of glycemic variability. There was a significant DEB × time interaction effect for mean sensor glucose (P = 0.05) and percent sensor glucose values >180 mg/dL (P = 0.04). Participants reporting less DEB had a developmentally expected deterioration in glycemic control throughout the study. Participants reporting more DEB had poor glycemic control at baseline that remained poor throughout the study. CONCLUSIONS Findings show a potential to improve diet quality without increasing DEB and indicate an association of DEB with persistent hyperglycemia but not hypoglycemia or glycemic variability.
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Affiliation(s)
- Miriam H Eisenberg Colman
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD .,Communication Research Division, Fors Marsh Group, Arlington, VA
| | - Virginia M Quick
- Department of Landscape Architecture, School of Environmental and Biological Sciences, Rutgers University, New Brunswick, NJ
| | - Leah M Lipsky
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Katherine W Dempster
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Aiyi Liu
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Lori M B Laffel
- Section on Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - Sanjeev N Mehta
- Section on Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - Tonja R Nansel
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
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Eisenberg MH, Lipsky LM, Gee B, Liu A, Nansel TR. Parent healthful eating attitudes and motivation are prospectively associated with dietary quality among youth with type 1 diabetes. VULNERABLE CHILDREN AND YOUTH STUDIES 2017; 12:226-240. [PMID: 29861779 PMCID: PMC5978430 DOI: 10.1080/17450128.2017.1308045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A family-based behavioral nutrition intervention grounded in Social Cognitive and Self-Determination Theories showed an increased intake of whole plant foods. This study examined 1) whether the intervention changed parent diet-related attitudes/beliefs, 2) whether these attitudes/beliefs were associated with youth diet quality, and 3) the moderating roles of youth age and parent nutritional knowledge. Youth with type 1 diabetes and their parents (n = 136, mean ± SD youth age = 12.6 ± 2.8 years) participated in an 18-month trial targeting intake of whole plant foods. Parents reported attitudes/beliefs (self-efficacy, outcome expectations, perceived barriers, autonomous and controlled motivation) for providing healthy food to their families, and type 1 diabetes-specific nutrition knowledge at 6, 12, and 18 months. Whole Plant Food Density (WPFD; cup or ounce equivalents per 1000 kcal of whole grains, fruit, vegetables, legumes, nuts and seeds) was calculated from 3-day youth food records. Linear mixed models estimated the intervention effect on parent attitudes/beliefs, associations of parent attitudes/beliefs with youth WPFD and the moderating roles of parent nutrition knowledge and youth age. There was no effect of the intervention on parent attitudes/beliefs. Across groups, higher parent self-efficacy and autonomous motivation were positively associated with youth WPF. Parent perceived barriers and negative outcome expectations were inversely associated with youth WPFD, especially when parents had higher nutrition knowledge. Youth age did not modify any associations. Parent diet-related attitudes/beliefs were associated with youth diet quality, highlighting the importance of parent psychosocial factors across this age range. Despite a positive effect on youth diet, the intervention did not affect parent attitudes/beliefs, suggesting it worked through a different mechanism.
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Affiliation(s)
- Miriam H. Eisenberg
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, M.D
| | - Leah M. Lipsky
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, M.D
| | - Benjamin Gee
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, M.D
| | - Aiyi Liu
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of child Health and Human Development, Bethesda, M.D
| | - Tonja R. Nansel
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, M.D
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