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Filippi M, Ferrè L, Zanetta C, Rizzi C, Pessina G, Assogna F, Rocca MA. Prospective observational study to evaluate treatment satisfaction and effectiveness in patients with relapsing multiple sclerosis starting cladribine tablets (CLADREAL) in Italy. Front Neurol 2024; 15:1379712. [PMID: 38638312 PMCID: PMC11024245 DOI: 10.3389/fneur.2024.1379712] [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: 01/31/2024] [Accepted: 03/14/2024] [Indexed: 04/20/2024] Open
Abstract
Disease-modifying therapies (DMTs) for multiple sclerosis (MS) reduce relapse frequency, magnetic resonance imaging (MRI) activity, and slow disability progression. Numerous DMTs are approved for relapsing forms of MS although real-world data on patient-reported outcomes (PROs) and quality of life (QoL) are needed to inform treatment choice. Immune reconstitution therapy with cladribine tablets is a highly effective treatment for relapsing MS (RMS). We present the protocol for an observational study to prospectively assess the effectiveness of cladribine tablets on clinical and MRI parameters as well as on PROs, including treatment satisfaction, QoL, sleep quality, self-perceived health, fatigue, and physical function. Enrolled patients at study sites in Italy will be adults with RMS (including relapsing-remitting and active secondary progressive MS) who are either treatment naïve or have received at least one first-line disease modifying DMT or no more than one second-line DMT. The primary objective will be change in global treatment satisfaction measured with the Treatment Satisfaction Questionnaire for Medication Version 1.4 approximately 24 months after initiating cladribine tablets in patients switching from previous DMTs. Secondary objectives will include global treatment satisfaction at earlier timepoints, will comprise treatment naïve patients, and will quantify treatment effectiveness and tolerability. We will also assess relapses, disability progression, MRI activity, and other PROs at approximately 12 and 24 months. The findings will provide insight from daily clinical practice into the patient's experience to complement data from controlled trials and inform treatment choice. EU PAS Registration Number EUPAS49334 filed 17/10/2022.
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Affiliation(s)
- Massimo Filippi
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Laura Ferrè
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Zanetta
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Caterina Rizzi
- Merck Serono S.p.A., An Affiliate of Merck KGaA, Rome, Italy
| | | | | | - Maria A. Rocca
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
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Fichten CS, Wing S, Costin G, Jorgensen M, Havel A, Wileman S, Bailes S, Creti L, Libman E. Sleep and Well-Being during the COVID-19 Remote and In-Person Periods: Experiences of College Faculty and Staff with and without Disabilities. Behav Sci (Basel) 2023; 13:844. [PMID: 37887493 PMCID: PMC10604366 DOI: 10.3390/bs13100844] [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: 08/16/2023] [Revised: 10/07/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
We explored the impacts of the remote and return-to-in-person work periods on sleep and well-being as reported by faculty (n = 22) and non-teaching staff (n = 21) with and without disabilities. Participants were recruited through college platforms and personal contacts. Our results show that contrary to expectations, the COVID-19 remote teaching/working period resulted in better sleep, as well as greater well-being, than the return-to-in-person work period. With respect to sleep, faculty members had slightly more negative outcomes than staff, most evident in heightened anxiety and work aspects. Faculty with disabilities had somewhat worse sleep and well-being during the remote period than faculty without disabilities. During the return to in-person work, both faculty and non-teaching staff reported more negative than positive sleep and well-being outcomes. In particular, during the in-person period, faculty members experienced slightly more negative sleep outcomes related to anxiety and work, while staff members experienced slightly more negative sleep outcomes related to the need to commute and lifestyle. Our findings show that there were benefits and disadvantages to both remote and in-person work periods, suggesting a hybrid work schedule should be considered in more detail, particularly as an optional reasonable accommodation for faculty and staff with disabilities. Our study highlights that training to keep faculty abreast of the latest technological innovations, ways to promote work-life balance, and steps to remedy classroom size and building ventilation to prevent the spread of disease all need urgent attention.
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Affiliation(s)
- Catherine S. Fichten
- Department of Psychology, Dawson College, 3040 Sherbrooke St. W., Montreal, QC H3Z 1A4, Canada
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; (S.B.); (L.C.); (E.L.)
- Behavioural Psychotherapy and Research Unit, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4, Canada
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
| | - Samantha Wing
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
- McGill Cognitive Science Program, McGill University, 845 Rue Sherbrooke O, Montréal, QC H3A 0G4, Canada
| | - Georgiana Costin
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
- Department of Psychology, McGill University, 845 Rue Sherbrooke O, Montréal, QC H3A 0G4, Canada
| | - Mary Jorgensen
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
| | - Alice Havel
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
- Scholars in Residence Program, Dawson College, 3040 Sherbrooke St. W., Montreal, QC H3Z 1A4, Canada
| | - Susie Wileman
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
- Scholars in Residence Program, Dawson College, 3040 Sherbrooke St. W., Montreal, QC H3Z 1A4, Canada
| | - Sally Bailes
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; (S.B.); (L.C.); (E.L.)
- Behavioural Psychotherapy and Research Unit, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4, Canada
| | - Laura Creti
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; (S.B.); (L.C.); (E.L.)
- Behavioural Psychotherapy and Research Unit, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4, Canada
| | - Eva Libman
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; (S.B.); (L.C.); (E.L.)
- Behavioural Psychotherapy and Research Unit, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4, Canada
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Pei C, Fan C, Luo H, Bai A, Ni S, Luo M, Huang J, Zhou Y, Huo L. Sleep problems in adolescents with depression: Role of childhood trauma, alexithymia, rumination, and self-esteem. J Affect Disord 2023; 338:83-91. [PMID: 37269886 DOI: 10.1016/j.jad.2023.05.095] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND While sleep problems are common in adolescents with depression, the exact prevalence has not been reported. Although previous studies have shown that childhood trauma, alexithymia, rumination, and self-esteem are related to sleep problems, the interactions between these factors remain unclear. METHODS This study, conducted from March 1, 2021 to January 20, 2022, employed a cross-sectional design. The participants were 2192 adolescents with depression with a mean age of 15 years. The Chinese version of the Pittsburgh Sleep Quality Index, Childhood Trauma Questionnaire, Toronto Alexithymia Scale-20, Ruminative Response Scale, and Rosenberg Self-Esteem Scale were used to measure sleep problems, childhood trauma, alexithymia, rumination, and self-esteem, respectively. We used PROCESS 3.3 for SPSS to determine the chain mediating effect of alexithymia and rumination and the moderating effect of self-esteem in the relationship between childhood trauma and sleep problems. RESULTS Up to 70.71 % of adolescents with depression had sleep problems. Furthermore, alexithymia and rumination played a chain mediation role in the relationship between childhood trauma and sleep problems. Finally, self-esteem moderated the relationships between alexithymia and sleep problems and rumination and sleep problems. LIMITATIONS Owing to the study design, we cannot derive causal relationships between variables. Further, the self-reported data may have been influenced by subjective participant factors. CONCLUSIONS This study reveals potential ways of how childhood trauma influences sleep problems in adolescents with depression. These findings suggest that interventions targeting alexithymia, rumination, and self-esteem in adolescents with depression may be effective in reducing their sleep problems.
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Affiliation(s)
- Chenran Pei
- Key Laboratory of Brain, Cognition and Education Science, Ministry of Education; Institute for Brain Research and Rehabilitation, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Changhe Fan
- Department of Psychiatry, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Haocheng Luo
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Ayu Bai
- Key Laboratory of Brain, Cognition and Education Science, Ministry of Education; Institute for Brain Research and Rehabilitation, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Shengmiao Ni
- Key Laboratory of Brain, Cognition and Education Science, Ministry of Education; Institute for Brain Research and Rehabilitation, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Min Luo
- Key Laboratory of Brain, Cognition and Education Science, Ministry of Education; Institute for Brain Research and Rehabilitation, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Junxuan Huang
- Key Laboratory of Brain, Cognition and Education Science, Ministry of Education; Institute for Brain Research and Rehabilitation, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yongjie Zhou
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China.
| | - Lijuan Huo
- Key Laboratory of Brain, Cognition and Education Science, Ministry of Education; Institute for Brain Research and Rehabilitation, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
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Aicha BT, Lobna BA, Yosra Z, Siwar BD, Ines C, Selma B, Leila R, Rawdha T, Olfa S, Ines M, Leila A. Assessment of self-esteem and community integration in spondyloarthritis. REUMATOLOGIA CLINICA 2023; 19:299-305. [PMID: 37286265 DOI: 10.1016/j.reumae.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/17/2022] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The aim of this study was to identify the associated factors with lower self-esteem and restriction in community reintegration in SpA patients. METHODS This study was a cross-sectional study including SpA patients (ASAS criteria) aged 18-50 years. The level of self-esteem was assessed using the Rosenberg Self-Esteem Scale (RSES). The Reintegration to Normal Living Index (RNLI) evaluated the degree of reintegration to normal social activities. Anxiety, depression, and fibromyalgia were screened by the Hospital Anxiety and Depression Scale (HADS)-A, HADS-D, and FiRST, respectively. Statistical analysis was performed. RESULTS A total of 72 patients were enrolled (sex-ratio=1.88), with median (IQR) age of 39 years (28.25-46). Median (IQR) disease duration was 10 (6-14) years. Median (IQR) BASDAI and ASDAS were 3 (2.1-4.7) and 2.7 (1.9-3.48), respectively. Anxiety symptoms were screened in 10% of SpA patients, depression in 11%; and fibromyalgia in 10%. Median (IQR) RSES and RNLI scores were 30 (23.25-34), and 83 (53.25-93.25), respectively. Multivariate regression analysis identified the domain (work) of pain interference, VAS pain, HAD anxiety, PGA, marital status, and morning stiffness as factors associated with lower self-esteem. Restriction in the reintegration community was predicted by the presence of IBD, VAS pain, FIRST, deformity, enjoyment of life, and HAD depression. CONCLUSION Pain intensity and interference, deformities, extra-articular manifestations, and deterioration of mental health were associated with low self-esteem and severe restriction in community reintegration among patients with SpA rather than inflammatory parameters.
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Affiliation(s)
- Ben Tekaya Aicha
- Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.
| | - Ben Ammar Lobna
- Department of Rheumatology, Military Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Zgueb Yosra
- Department of Psychiatry A, Razi Hospital, La Manouba, Tunisia; Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Ben Dhia Siwar
- Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Cherif Ines
- Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Bouden Selma
- Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Rouached Leila
- Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Tekaya Rawdha
- Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Saidane Olfa
- Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Mahmoud Ines
- Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Abdelmoula Leila
- Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
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Cudris-Torres L, Alpi SV, Barrios-Núñez Á, Gaviria Arrieta N, Mejía Gutiérrez J, Alvis Barranco L, Rios-Carlys G, Cuenca-Calderón SE, Bermúdez V, Hernández-Lalinde J, Riveira Zuleta CA, Bahamón MJ, Álvarez Herrera JS. Quality of life in the older adults: The protective role of self-efficacy in adequate coping in patients with chronic diseases. Front Psychol 2023; 14:1106563. [PMID: 37089743 PMCID: PMC10117781 DOI: 10.3389/fpsyg.2023.1106563] [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: 03/13/2023] [Indexed: 04/09/2023] Open
Abstract
The purpose of the present study was to establish the association between self-efficacy, perception of disease, emotional regulation, and fatigue and the health-related quality of life in older adults living in the departments of Cesar and Atlántico in Colombia and who have been diagnosed with a chronic disease. The participants were 325 older adults of both sexes, with literacy and no presence of cognitive impairment in the Mini-Mental State Examination (MMSE); A non-probabilistic sampling was carried out. We used the MOS-SF-36 questionnaire, the Brief Illness Perception Questionnaire scale for measuring the perception of disease, the Stanford Patient Education Research Center’s Chronic Disease Self self-efficacy questionnaire for chronic patients, the Difficulties in Emotional Regulation Scale, and the Fatigue Severity Questionnaire as measurement instruments. The design was non-experimental cross-sectional with a correlational scope. The results indicate that self-efficacy, disease perception, emotional regulation and severity of fatigue are variables that could impact the physical function of quality of life, confirming that self-efficacy would work as a factor that decreases the probability that a participant score low on this dimension of quality of life. On the other hand, both the perception of the disease and the severity of fatigue were identified as factors that probably negatively influence quality of life.
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Affiliation(s)
- Lorena Cudris-Torres
- Programa de Psicología, Fundación Universitaria del Área Andina, Valledupar, Colombia
- *Correspondence: Lorena Cudris-Torres,
| | | | | | | | | | | | - Gerson Rios-Carlys
- Programa de Psicología, Universidad Popular del Cesar, Valledupar, Colombia
| | | | - Valmore Bermúdez
- Centro de Investigaciones en Ciencias de la Vida, Universidad Simón Bolívar, Barranquilla, Colombia
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Novak AM, Lev-Ari S. Resilience, Stress, Well-Being, and Sleep Quality in Multiple Sclerosis. J Clin Med 2023; 12:jcm12020716. [PMID: 36675644 PMCID: PMC9864697 DOI: 10.3390/jcm12020716] [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: 12/01/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/19/2023] Open
Abstract
(1) Background: Multiple Sclerosis (MS) is a chronic, progressive, immune-mediated disorder that affects the Central Nervous System and is the most common cause of non-traumatic neurological disability in young adults. The study aimed to assess the levels of stress, resilience, well-being, sleep quality, and fatigue in Israeli people with MS (PwMS), and to examine the associations between these factors and the sociodemographic and clinical characteristics. These factors had never before been studied in conjunction in PwMS, nor had they been systematically addressed in Israel, the unique geopolitical situation of which may pose unique challenges. (2) Methods: This was a survey-based, cross-sectional study conducted through an Internet platform. (3) Results: Israeli PwMS who participated in the study were experiencing relatively high levels of stress and low resilience, poor sleep quality, and severe fatigue. The analysis revealed significant associations between resilience and stress, well-being, and anxiety, as well as stress and well-being, resilience, sleep quality, fatigue, and Clinically Isolated Syndrome (CIS). (4) Conclusions: the Israeli PwMS who participated in the study were experiencing higher levels of stress, lower resilience and worse sleep quality than PwMS in other countries, as compared to results previously reported in literature. The findings of this study ought to serve as a call to action for the MS care providers in Israel and warrant further research into the possible causes of the phenomenon and strategies to address it.
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Illness perceptions and outcome in multiple sclerosis: A systematic review of the literature. Mult Scler Relat Disord 2022; 67:104180. [PMID: 36130458 DOI: 10.1016/j.msard.2022.104180] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/08/2022] [Accepted: 09/11/2022] [Indexed: 11/24/2022]
Abstract
According to Leventhal's self-regulation model, ill people construct personal representations of their disease, namely illness perceptions, which impact their coping strategies and the emotional response to their condition. Since these representations develop in the social environment, the individuals' perceptions may also be related to the opinions of their caregivers. This systematic review aims at synthesising and critically appraising literature pertaining the relationship between illness perceptions and outcome in persons with multiple sclerosis and their caregivers. A literature search was conducted in MEDLINE, PsycINFO, and CINAHL. Only papers with the following characteristics were included: quantitative studies; written in English or Italian; published from 1992; investigating the relationship between illness perceptions and any outcome in persons with multiple sclerosis and/or their caregivers; using validated scales assessing illness perceptions. Twenty papers were included and appraised through the 16-item Quality Assessment Tool for Studies with Diverse Designs. The quality of the papers was acceptable. Eighteen out of 20 papers reported the existence of a moderate effect size when analysing the relationship between illness perceptions and outcome, whereby "positive" perceptions (e.g. stronger beliefs of control) related to better outcomes, while "negative" ones (e.g. attribution of negative consequences to the disease) related to worse outcome.
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Xu L, Wang X, Cui Y, Tian Y, Zhou N, Zhang J, Ji H, Cheng X, Zhang Q, Li Q, Hu P, Zhang L. Illness perception characteristics and influencing factors in adult patients with myasthenia gravis in China. Brain Behav 2022; 12:e2451. [PMID: 34898040 PMCID: PMC8785644 DOI: 10.1002/brb3.2451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/01/2021] [Accepted: 11/06/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE We aimed to examine the illness perception characteristics of patients with myasthenia gravis and analyze the associated factors. METHODS A general information questionnaire, Illness Perception Questionnaire, and Simplified Coping Style Questionnaire were used to survey 90 patients with myasthenia gravis. One-way analysis of variance and multivariate linear regression were used for statistical analysis. RESULTS The timeline (acute/chronic), consequence, and emotional representation scores of patients with myasthenia gravis were 18.31 ± 4.47, 18.58 ± 3.57, and 20.80 ± 4.56, respectively. Multivariate stepwise linear regression analysis showed that marital status, disease duration, educational level, disease type, and coping style are factors associated with illness perception in patients with myasthenia gravis. CONCLUSION Patients who have myasthenia gravis have a negative illness perception. Medical professionals should provide targeted intervention measures based on the factors associated with illness perception.
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Affiliation(s)
- Le Xu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Xia Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Yafeng Cui
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Yanghua Tian
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Nong Zhou
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Juanjuan Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Hiaxia Ji
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Xiumei Cheng
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Qin Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Qingfeng Li
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Panpan Hu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Long Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
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