Illness Perception and the Severity of Depression and Anxiety Symptoms in Patients with Multimorbidity: Observational Cohort Studies

INTRODUCTION

Many studies have shown a correlation between the patient's engagement in treatment and their perception of the illness.

AIM

The aim of this study has been to explore the link between the patient's perception of their illness with anxiety and depression, and to leverage this link to promote health education.

MATERIALS AND METHODS

The study was carried out using the following tools: the Hospital Anxiety and Depression Scale and the Illness Perception Questionnaire-Revised. The study participants included N = 143 patients.

RESULTS

The participants' age was statistically significantly associated with the expected duration of the illness (p < 0.01), the conviction that the treatment was effective (p < 0.01), and the perception of the severity of the disease symptoms (p < 0.05). The employment status was statistically significantly associated with the illness perception (p < 0.01). Anxiety and depression levels were statistically significantly associated with the perceived impact of the illness on life (p < 0.001) and emotional status (p < 0.001), the perceived control over the illness (p < 0.01), the potential for recovery (p < 0.001), the concern about the illness (p < 0.001), and the impact of the illness on emotional well-being (p < 0.001).

CONCLUSIONS

Individuals who perceived a high severity of illness symptoms also assessed that the illness significantly impacted their life and emotional state. The authors demonstrate a strong link of a "negative" perception of the illness with depression and anxiety. A better understanding of the illness predicted a less severe depression and lower anxiety.

IMPLICATIONS FOR PRACTICE

The results suggest that the study of illness perception holds significant potential to contribute effectively to educational and psychotherapeutic practices.

Through the Lens of Chronic Kidney Disease: A Qualitative Study of the Experiences of Young Women Living With CKD

Background:

Young women may be particularly vulnerable to the negative psychosocial consequences of living with chronic kidney disease (CKD). To date, little is known about how women themselves experience and manage their illness.

Objectives:

This study explored the experiences of young women living with CKD.

Design:

Qualitative descriptive study.

Setting:

Nephrology program in an urban setting in Ontario, Canada.

Participants:

Women with category G1-3 glomerular-based CKD between 18 and 40 years of age.

Methods:

Focus group discussions guided by semi-structured interview questions. Qualitative content analysis was used to analyze interview transcripts.

Results:

Eleven women participated in 3 separate focus group discussions. Participants described living life through the lens of CKD, which was the central theme unifying their experiences of encountering CKD, re-encountering CKD, and getting on with life. Life decisions significant to women like pursuing a career or motherhood were often colored by CKD, particularly by illness-related challenges, such as unsatisfactory health care support and the physical implications of chronic illness. The women used a variety of strategies including seeking information and relying on supportive people to mitigate these challenges. Although these strategies sometimes enabled them to balance the demands of illness with other life priorities, the lack of resources directed toward their unique needs as young women with CKD often caused them difficulties in managing their illness.

Limitations:

Participants were from one nephrology program in an urban setting and were well educated overall. Their experiences may not be reflective of young women in other settings or from diverse backgrounds.

Conclusions:

The women’s emotional well-being and life choices were considerably influenced by CKD. Although the women were often able to manage challenges associated with CKD, they acknowledged the need to seek additional professional resources to complement their own self-identified strategies. As the women sought out these supports, they identified gaps in resources specific to women with CKD. This article summarizes recommendations from their perspective.

Trial Registration:

Not applicable as this was a qualitative study.

Religious Women's Coping with Infertility: Do Culturally Adapted Religious Coping Strategies Contribute to Well-Being and Health?

BACKGROUND

Infertility is a source of stress, particularly in pronatalist societies in which a lifestyle without children is viewed as an unacceptable option. The present study examined the relationship between the use of culturally adapted religious coping strategies and emotional adjustment among women coping with fertility problems.

METHODS

This is a cross-sectional correlational study. One hundred and eighty-six religious Israeli women undergoing fertility treatment filled out questionnaires assessing their use of culturally adapted religious coping strategies and emotional adjustment (distress/well-being).

RESULTS

A path analysis showed that the culturally adapted religious coping strategies of seeking the support of Rabbis and seeking the support of God had a strong correlation with reduced psychological distress, but not with enhanced psychological well-being. Seeking approval and recognition from the community was correlated with reduced distress and enhanced well-being. However, seeking ties and belonging to the community was correlated with increased psychological distress and reduced psychological well-being. Finally, women without children experienced greater psychological distress than women with children and sought more support of Rabbis and fewer ties with the community.

CONCLUSIONS

In a pronatalist culture that sanctifies childbirth, infertility is a source of significant distress. Professionals' awareness of the culturally adapted religious coping strategies utilized by their clients may help them conduct culturally sensitive intervention, which may greatly help to enhance emotional adjustment. Future research is recommended to develop instruments that measure culturally adapted strategies and their influence on emotional adjustment over time, in different states of health while comparing different cultures.

Within-Gender Differences in Medical Decision Making Among Male Carriers of the BRCA Genetic Mutation for Hereditary Breast Cancer

An intersectional approach was used to understand sex/gender differences in men's health decisions with regard to hereditary breast cancer (BRCA). A sequential explanatory mixed method design was employed consisting of an online survey with a convenience sample of 101 men who tested positive for the breast cancer mutation following up with an in-depth interview with a subsample of 26 males who participated in the survey. The survey results revealed that 70.3% ( n = 45) considered "Family Risk" as the primary reason for getting BRCA tested; 21.9% ( n = 14) considered "Medical Considerations," and 7.8% ( n = 5) considered "Social Support" as their primary reason. Male participants who were 50 years old or younger or who did not have children were more likely to consider medical reasons as the primary reason to get tested. In terms of self-concept, younger men were more stigmatized than their older counterparts; married men felt a greater loss of control with regard to their BRCA-positive mutation diagnosis than single men; and professional men as a whole felt more vulnerable to the negative influences of the disease than those who had already retired. Regression analysis results indicated that negative self-concept was strongly related to sampled males' BRCA involvement 6 months after testing. Applying an intersectional approach to health care, decision-making outcomes among BRCA-positive mutation males provides an important lens for ascertaining the within-sex/gender demographic and psychosocial factors that affect the diversity of men's pretesting and posttesting medical decisions.

Examining occupational stress, sources of stress and stress management strategies through the eyes of management consultants: a multiple correspondence analysis for latent constructs

To date, little research has yet focused in broad assessment for management consultancy professionals. This investigation aims to analyse management consultants' self-perceptions of occupational stress (SPoOS), sources of stress (SoS) and stress management strategies (SMS) and to find latent constructs that can work as major determinants in consultants' conceptualization of SPoOS, SoS and SMS. Measures were completed, including demographics and interviews. Complete data were available for 39 management consultants, 53.8% male and aged between 23 and 56 years (M = 38.0; SD = 9.2). The data were subjected to content analysis. Representation of the associations and latent constructs were analysed by a multiple correspondence analysis. Results indicated that 'intellectual disturber' (31.4%) was the most referred SPoOS, 'high workload' (15.1%) was identified as the most prevalent perceived SoS and 'coaching' (19.0%) was the most mentioned SMS. No significant differences between the two gender groups were found regarding the three total scores. SPoOS was explained by a two-factor model: 'organization-oriented' and 'person-oriented'. A three-dimension model formed by 'job concerns', 'organizational constraints' and 'career expectations' was indicated as a best-fit solution for SoS, and SMS was best explained in a three-dimension model by 'group dynamics strategies', 'organizational culture strategies' and 'individual support strategies'. This research makes a unique contribution for a better understanding of what defines SPoOS, SoS and SMS for management consultants.

Intolerance of uncertainty, appraisals, coping, and anxiety: the case of the 2009 H1N1 pandemic

OBJECTIVES

Although ambiguous and uncertain situations, such as those dealing with the threat of widespread viral illness, may have pronounced psychological ramifications, there have been few studies that examined the factors that contributed to such outcomes. The purpose of the present investigation was to examine emotional reactions to a health threat.

DESIGN

A structural equation model examined the interplay between anxiety and intolerance of uncertainty, as sequentially mediated by appraisals and coping strategies.

METHODS

Adult participants over the age of 18 (N = 1,027) completed online self-report measures during the H1N1 pandemic in 2009.

RESULTS

Greater intolerance of uncertainty was related to lower appraisals of self- and other control, which predicted low levels of problem-focused coping and greater reports of H1N1-related anxiety. Additionally, individuals with a high intolerance of uncertainty were more likely to perceive the pandemic as threatening and also were more apt to use emotion-focused coping strategies, and both of these factors predicted elevated levels of anxiety.

CONCLUSIONS

Together, these data indicate that threats, such as those related to a potential pandemic, not only have implications for physical health, but also for psychological distress, and that such outcomes vary with a constellation of appraisal and coping factors.

STATEMENT OF CONTRIBUTION

What is already known on this subject? It has been established that the public is often confused by the threat that a potential pandemic virus poses and that they are unsure of what information related to the disease they can trust. Government health agencies often walk the line of minimizing the threat to prevent panic, but simultaneously emphasize the importance of action (vaccination) to prevent a worldwide pandemic. What does this study add? Beyond the physical threat of a pandemic, a significant psychological toll may occur for certain individuals. Anxiety regarding H1N1 is heightened amongst those who cannot tolerate uncertainty. Appraisals of threat, control, and the use of emotion-focused coping mediate the above relationship.

Coping and involuntary responses to stress in Chinese university students: psychometric properties of the responses to stress questionnaire

Our objective in this study was to develop a Chinese version of the Responses to Stress Questionnaire (RSQ; Connor-Smith, Compas, Wadsworth, Thomsen, and Saltzman, 2000) and to evaluate its reliability and validity. The Chinese (C) RSQ (RSQ-C) exhibited moderate internal consistency and moderate test-retest reliability. Results of the confirmatory factor analyses indicated that the fit of a 3-factor model of voluntary coping and a separate 2-factor model of involuntary responses to stress were acceptable for the Chinese university sample. With regard to predictive validity, the Primary and Secondary Control Engagement Coping factors were associated with lower levels of depressive and anxious symptoms, whereas the Disengagement, Involuntary Engagement, and Involuntary Disengagement Coping factors were associated with higher levels of such symptoms.

Do coping strategies discriminate eating disordered individuals better than eating disorder features? An explorative study on female inpatients with anorexia and bulimia nervosa

The purpose of this explorative research was to examine how the COPE (Coping Orientation to Problem Experienced Inventory), an established instrument for measuring coping styles, and EDI-2 (Eating Disorder Inventory-2), a widely used questionnaire for assessing psychological and behavioural features of eating disorders (ED), discriminate among healthy individuals, inpatients with anorexia nervosa (AN) and inpatients with bulimia nervosa (BN). A discriminant analysis approach was used. Results showed that coping styles such as positive attitude, planning and social support are even more discriminative variables than eating disorder features. Implications for further studies are discussed.

Commentary on the Special Section “Theory-Based Approaches to Stress and Coping”

The six articles that comprise the special section on stress and coping each illuminate a different facet of the stress process. The issues addressed in these studies of dyadic coping, collective trauma, gender issues, and protective coping provide new information and, as is inevitable, raise new questions. Several studies also demonstrate some of the challenges inherent in the study of a dynamic, multilevel, recursive system that is anchored in the appraisal process of an individual in a given social context. This commentary reviews the issues and challenges raised in these studies, and suggests next steps for research in this field.