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Boring BL, Maffly-Kipp J, Mathur VA, Hicks JA. Meaning in Life and Pain: The Differential Effects of Coherence, Purpose, and Mattering on Pain Severity, Frequency, and the Development of Chronic Pain. J Pain Res 2022; 15:299-314. [PMID: 35140515 PMCID: PMC8820455 DOI: 10.2147/jpr.s338691] [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: 09/10/2021] [Accepted: 01/05/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Meaning in life is consistently associated with better health outcomes across a range of mental and physical domains. However, meaning in life is a complex construct involving three distinct facets: coherence, purpose, and mattering. While these facets have been studied individually in relation to pain, they have not been assessed concurrently to parse out their potential distinct contributions to pain outcomes. We sought to identify the unique relationships of these individual facets of meaning with pain experiences and specify the components associated with pain-related resilience. Methods The associations of coherence, purpose, and mattering with pain outcomes were examined across three studies. Study 1 used data from the Midlife in the United States National Survey to determine associations between facets and the frequency of various recently experienced pains, and the development of chronic pain nine years later. Study 2 cross-sectionally observed the association between facets and recent pain severity in young adults. Using a diary-type approach, Study 3 captured fluctuations of pain severity in relation to the facets across the span of four weeks. Results Coherence was uniquely associated with less headache, backache, joint, and extremities pain frequency in Study 1, over and above purpose and mattering, controlling for other health variables. Coherence was also associated with lower odds of developing chronic pain. In Study 2, coherence was associated with less pain severity and fully mediated the relationship between global meaning in life and pain. Study 3 found that coherence predicted the most unique variance in weekly pain fluctuations. Conclusion Across three studies and timescales, coherence was uniquely associated with fewer and less severe pain experiences over and above purpose and mattering. These findings provide support for the value of coherence as a resilience factor in the context of pain and suggest a potential benefit for coherence-specific interventions in clinical settings.
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Affiliation(s)
- Brandon L Boring
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, 77843, USA
- Correspondence: Brandon L Boring, Department of Psychological and Brain Sciences, Texas A&M University, 4235 TAMU, College Station, TX, 77843, USA, Email
| | - Joseph Maffly-Kipp
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, 77843, USA
| | - Vani A Mathur
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, 77843, USA
- Institute for Neuroscience, Texas A&M University, College Station, TX, 77843, USA
| | - Joshua A Hicks
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, 77843, USA
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Liang Y, Chen D, Ou R, Zhao B, Song W, Yi X, Yang R, Chen X. Current Status of Acceptance of Disability and the Correlation With the Life Quality in Parkinson's Disease in Southwest China. Front Med (Lausanne) 2022; 8:767215. [PMID: 35118084 PMCID: PMC8804473 DOI: 10.3389/fmed.2021.767215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/24/2021] [Indexed: 11/25/2022] Open
Abstract
Background Acceptance of disability (AOD) is a process that a patient must undergo to cope with altered abilities, but its effect in Parkinson's disease (PD) remains unclear. The present study aimed to determine the level of AOD, examine the influence of sociodemographic variables and disease characteristics on the AOD level, and evaluate the relation between AOD level and quality of life in a cohort of PD patients from Southwest of China. Methods A total of 336 PD patients were consecutively recruited from November 2018 to October 2020. At enrollment, demographic and clinical data were obtained using a questionnaire, and the Acceptance of Disability Scale-Revised (AODS-R) scale was used to measure the AOD level. Results The mean total score of AOD is 87.28, indicating a moderate level of disability acceptance in PD patients. Statistical analysis showed that understanding of PD, family support, and UPDRS-II score were major factors affecting AOD level, and patients with low AOD levels were more likely to have poorer quality of life. Conclusion AOD is a serious problem in PD patients in Southwest China, especially among individuals with insufficient family support and a lack of recognition of the disease. AOD was also associated with motor function and daily living ability, thus suggesting that evaluation of the AOD and promotion of the awareness may be helpful to improve the quality of life in patients with PD.
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Affiliation(s)
- Yan Liang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Dezhi Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Ruwei Ou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Bi Zhao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Song
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaojiang Yi
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Rong Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Xueping Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Xueping Chen
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Chai Q, Yuan Z, Jin Y, Zhang Q. Factors influencing acceptance of disability among stroke patients in Tianjin, China:A cross-sectional study. NeuroRehabilitation 2016; 38:37-44. [PMID: 26889796 DOI: 10.3233/nre-151293] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Stroke has become the leading cause of acquired disability worldwide. Psychological maladjustment and related reactions for stroke disability has subsequently revealed a negative impact on stroke rehabilitation process. Acceptance of disability (AOD) is widely confirmed as a critical factor for psychosocial regulation and disability acceptance. OBJECTIVE This study aims to investigate acceptance of disability and its influencing factors among stroke patients in China. METHODS A total of 220 hospitalized stroke patients were investigated using questionnaire on demographics and disease characters, Adaptation Of Disability Scale-Revised, and other psychological instruments: Medical Coping Modes Questionnaire (MCMQ), Functional Activities Questionnaire (FAQ), Self-Rating Depression Scale (SDS), and Perceived Social Support Scale (PSSS). RESULTS The mean score of AOD is 74.15 (range 32∼128), which reflected a moderate level of disability acceptance among stroke patients in China. Statistical analysis showed that confrontation, the understanding of stroke, self-rating depression, ability of functional activities and family support were major factors affecting acceptance of disability among disabled stroke patients, which explained 49.6% of the total variance. CONCLUSIONS In clinical practice, professionals should identify patients with low levels of disability acceptance and explore effective psychological intervention model on the theoretical foundation of different dimensions in AOD theory and related predictors.
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Affiliation(s)
- Qianwen Chai
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Zhifang Yuan
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Yi Jin
- Huanhu Hospital, Tianjin, China
| | - Qing Zhang
- School of Nursing, Tianjin Medical University, Tianjin, China
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Chiang HH, Livneh H, Guo HR, Yen ML, Tsai TY. Effects of acceptance of disability on death or dialysis in chronic kidney disease patients: a 3-year prospective cohort study. BMC Nephrol 2015; 16:202. [PMID: 26637344 PMCID: PMC4670522 DOI: 10.1186/s12882-015-0197-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 11/25/2015] [Indexed: 02/04/2023] Open
Abstract
Background Acceptance of disability (AOD) is a useful construct that assesses the ability of a patient to psychologically cope with chronic diseases, but its effect on long-term outcomes of patients with chronic kidney disease (CKD) remains unclear. This study aimed to evaluate the relation between AOD level and clinical outcomes in a cohort of CKD patients in Taiwan. Methods 262 CKD patients without dialysis at a hospital in Taiwan were consecutively recruited, from 2010 to 2011, and followed up for 3 years. At enrollment, demographic and clinical data were obtained, including baseline level measurement of AOD, using the Acceptance of Disability Scale-Revised (AODS-R). During follow-up, the authors assessed the effect of AOD on progression to dialysis and all-cause mortality by using Cox proportional hazard regression analysis. Results Of the patients included in the analyses, 145 (55.3 %) whose total scores of AOD were below the median (86.00) were regarded as having low AOD at enrollment. At the end of 3-year follow-up, 25 have died and 57 initiated dialysis. Participants with low AOD were more likely to have the composite end-point of progression to dialysis or death (adjusted hazard ratios [AHR] = 1.89, 95 % confidence interval [CI]: 1.18-3.20). In addition, CKD stage at IV or above and hemoglobin level were found to be associated with the occurrence of the composite end-point. Conclusion AOD was associated with an increased risk for poor clinical outcomes, thus suggesting that prompt awareness and management of the psychological reactions may improve clinical outcomes of patients with CKD.
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Affiliation(s)
- Hsin-Hung Chiang
- Department of Nursing, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan.,College of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Hanoch Livneh
- Rehabilitation Counseling Program, Portland State University, Oregon, USA
| | - How-Ran Guo
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Mei-Ling Yen
- Department of Nursing, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
| | - Tzung-Yi Tsai
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan. .,Department of Medical Research, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, No. 2, Minsheng Rd., Dalin Township, Chiayi, County 62247, ROC, Taiwan. .,Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan.
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Scheper MC, de Vries JE, Juul-Kristensen B, Nollet F, Engelbert RHH. The functional consequences of generalized joint hypermobility: a cross-sectional study. BMC Musculoskelet Disord 2014; 15:243. [PMID: 25042838 PMCID: PMC4108235 DOI: 10.1186/1471-2474-15-243] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 07/14/2014] [Indexed: 01/17/2023] Open
Abstract
Background Generalized Joint Hypermobility (GJH) has been found to be associated with musculoskeletal complaints and disability. For others GJH is seen as a prerequisite in order to excel in certain sports like dance. However, it remains unclear what the role is of GJH in human performance. Therefore, the purpose of the study was to establish the association between GJH and functional status and to explore the contribution of physical fitness and musculoskeletal complaints to this association. Methods A total of 72 female participants (mean age (SD; range): 19.6 (2.2; 17-24)) were recruited among students from the Amsterdam School of Health Professions (ASHP) (n = 36) and the Amsterdam School of Arts (ASA), Academy for dance and theater (n = 36) in Amsterdam, The Netherlands. From each participant the following data was collected: Functional status performance (self-reported Physical activity level) and capacity (walking distance and jumping capacity: side hop (SH) and square hop (SQH)), presence of GJH (Beighton score ≥4), muscle strength, musculoskeletal complaints (pain and fatigue) and demographic characteristics (age and BMI). Results GJH was negatively associated with all capacity measures of functional status. Subjects with GJH had a reduced walking distance (B(SE):-75.5(10.5), p = <.0001) and jumping capacity (SH: B(SE):-10.10(5.0), p = .048, and SQH: B(SE):-11.2(5.1), p = .024) in comparison to subjects without GJH, when controlling for confounding: age, BMI and musculoskeletal complaints. In participants with GJH, functional status was not associated with performance measures. Conclusion GJH was independently associated with lower walking and jumping capacity, potentially due to the compromised structural integrity of connective tissue. However, pain, fatigue and muscle strength were also important contributors to functional status.
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Affiliation(s)
- Mark C Scheper
- Amsterdam School of Health Professions, Education of Physiotherapy, Amsterdam, The Netherlands.
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Zhang TL, Shi CG, Hu AL, Xu HL, Zheng MC, Liang MJ. Correlation between acceptance of disability and social relational quality in patients with colostomy. Int J Nurs Sci 2014. [DOI: 10.1016/j.ijnss.2014.02.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Chiu SY, Livneh H, Tsao LL, Tsai TY. Acceptance of disability and its predictors among stroke patients in Taiwan. BMC Neurol 2013; 13:175. [PMID: 24224953 PMCID: PMC3833656 DOI: 10.1186/1471-2377-13-175] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Accepted: 11/07/2013] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Modern medicine has increased the survival rate for stroke patients; however, the patient's psychosocial adaptation after stroke onset may be related to the clinical outcomes. This study aimed to investigate patients' acceptance of disability (AOD) and its predictors in stroke patients. METHODS This cross-sectional study used a purposive sampling method to recruit 175 stroke patients from a hospital in southern Taiwan. A structured questionnaire gathered data on respondent demographics and disease characteristics, and included the Chinese version of the AOD Scale-Revised. Factors associated with AOD were examined by a multiple linear regression analysis. RESULTS The mean AOD score was 71.72, which indicated a lower level of disease acceptance (range, 32-128). Our findings showed that patients who reported no religious beliefs, shorter disease duration, recurrent stroke episodes, and poorer physical functioning also reported lower levels of disability acceptance. These factors accounted for 38.2% of the variance in AOD among participants. CONCLUSIONS The findings are beneficial to healthcare providers by identifying those stroke patients with predisposition of having lower disability acceptance, which could then facilitate the provision of appropriate rehabilitation interventions within six months after the diagnosis of stroke to support their adaptation process.
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Affiliation(s)
- Shan-Yun Chiu
- Department of Nursing, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, No. 2, Minsheng Rd., Dalin Township, Chiayi 62247, Taiwan
| | - Hanoch Livneh
- Rehabilitation Counseling Program, Portland State University, PO Box 751, Portland, OR 97207-0751, USA
| | - Long-Lung Tsao
- Department of Neurology, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, No. 2, Minsheng Rd., Dalin Township, Chiayi 62247, Taiwan
| | - Tzung-Yi Tsai
- Department of Medical Research, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, No. 2, Minsheng Rd., Dalin Township, Chiayi 62247, Taiwan
- Department of Nursing, Tzu Chi College of Technology, No. 880, Chien-Kuo Rd. Sec. 2, Hualien 97005, Taiwan
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, No. 138, Sheng-Li Rd., Tainan 70428, Taiwan
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Findler L, Shalev K, Barak A. Psychosocial Adaptation and Adherence Among Adults With CF. REHABILITATION COUNSELING BULLETIN 2013. [DOI: 10.1177/0034355213495922] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Based on Moos and Holahan’s “Coping With Chronic Illness and Disability” model, we examined the contribution of medical impairment, illness perception, sense of coherence (SOC), relationship with the professional team, and adherence to treatment to the psychosocial adaptation (social adjustment and life satisfaction) of young adults with cystic fibrosis (CF). We also examined adherence, an important goal in and of itself for patients with CF. Seventy-one participants completed the following questionnaires: Social Adjustment, Life Satisfaction, Perceived Illness Severity, SOC, Relationship With Team, and Compliance. The legal criteria for medical impairment were also examined. Findings indicate that female patients and patients with high SOC reported better psychosocial adaptation. Participants with more severe medical impairments reported higher levels of adherence, and those who perceived their illness to be less severe reported lower levels of adherence and greater satisfaction in life. Relationship with the team was found to contribute to social adjustment. Psychosocial adaptation is associated with internal and external resources, but not necessarily with adherence to treatment. The rehabilitation counselor’s role is, therefore, to help adults with CF bridge between the contrasting dimensions of their lives, namely adherence to strict treatment protocols and psychosocial adaptation.
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Affiliation(s)
| | | | - Asher Barak
- Sheba Medical Center, The Edmond and Lili Safra Children’s Hospital, The Pediatric Pulmonology Unit, Israel
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Scientific and Clinical Abstracts From the WOCN® Society's 45th Annual Conference. J Wound Ostomy Continence Nurs 2013. [DOI: 10.1097/won.0b013e31828f9649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Chan R. The effect of acceptance on health outcomes in patients with chronic kidney disease. Nephrol Dial Transplant 2012; 28:11-4. [DOI: 10.1093/ndt/gfs334] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chao HL, Tsai TY, Livneh H, Lee HC, Hsieh PC. Patients with colorectal cancer: relationship between demographic and disease characteristics and acceptance of disability. J Adv Nurs 2010; 66:2278-86. [DOI: 10.1111/j.1365-2648.2010.05395.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cohen JS, Biesecker BB. Quality of life in rare genetic conditions: a systematic review of the literature. Am J Med Genet A 2010; 152A:1136-56. [PMID: 20425818 DOI: 10.1002/ajmg.a.33380] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Quality of life (QoL) refers to an individual's sense of overall well-being encompassing physical, psychological, emotional, social, and spiritual dimensions. Although genetics healthcare providers strive to promote patient well-being, and the term QoL is often invoked to refer to this outcome, there is lack of clarity as to what actually constitutes QoL from the patient's perspective. This systematic literature review aims to summarize and integrate research findings to help elucidate how healthcare providers can more effectively enhance the QoL of patients affected with rare genetic conditions. Eligible studies were those that measured QoL as a primary outcome variable using a validated, multi-dimensional scale. Detailed criteria were used to rate quality of design, methodology, and analytic rigor. Fifty-eight studies were selected for inclusion in the review, and a narrative synthesis of the data was performed. A central theme emerging from the literature is that, although genetic conditions have the potential to have significant negative consequences for individuals' lives, having a genetic condition does not necessarily entail poor QoL. Evidence demonstrates that factors beyond the physical manifestations of the disease, such as psychological well-being, coping, and illness perceptions, influence QoL and may serve as potent targets for intervention. The field of research on QoL in rare genetic conditions will be advanced by uniting around a clear conceptualization of QoL and using more rigorous methodology with comprehensive measures of global QoL.
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Affiliation(s)
- Julie S Cohen
- Kennedy Krieger Institute, Baltimore, MD 21205, USA.
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Castori M, Camerota F, Celletti C, Grammatico P, Padua L. Ehlers-Danlos syndrome hypermobility type and the excess of affected females: Possible mechanisms and perspectives. Am J Med Genet A 2010; 152A:2406-8. [DOI: 10.1002/ajmg.a.33585] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Kennedy P, Lude P, Elfström ML, Smithson E. Sense of coherence and psychological outcomes in people with spinal cord injury: appraisals and behavioural responses. Br J Health Psychol 2009; 15:611-21. [PMID: 19917152 DOI: 10.1348/135910709x478222] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
STUDY DESIGN Longitudinal, multi-wave design. OBJECTIVES To investigate the contribution of sense of coherence (SOC), appraisals, and behavioural responses when predicting psychological outcomes to spinal cord injury (SCI). METHOD Patients (N=237) sustaining a SCI aged 17 or above were recruited from specialist spinal injuries centres across six European countries. Measures of SOC, appraisals, coping strategies, and psychological well-being were administered at 6 and 12 weeks post-injury and at a 1 year follow-up. RESULTS People scoring high on SOC at 6 weeks post-injury showed significantly better psychological outcomes at 1 year post-injury and SOC showed significant relationships with appraisals at 12 weeks post-injury and coping strategies 1 year post-injury. Significant relationships were found between appraisals at 12 weeks post-injury and psychological outcomes, adaptive coping strategies were significantly related to psychological well-being at 1 year post-injury. Regression analyses found SOC, appraisals, and coping behaviours to explain 61.8% of the variance in psychological quality of life, 66.5% of the variance in depression, and 37.7% of the variance in anxiety at 1 year post-injury. CONCLUSION This study provides further evidence in support of previous findings which suggest SOC to have a primary role in long-term psychological well-being. The relationship described here - from SOC to the appraisal of injury and subsequent behavioural responses - suggests SOC to be an influential factor in the long-term adjustment of people with SCI.
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Affiliation(s)
- P Kennedy
- Isis Education Centre, Warneford Hospital, University of Oxford, UK.
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Risk and Resistance Factors for Psychological Distress in Icelandic Parents of Chronically Ill Children: An Application of Wallander and Varni’s Disability-Stress-Coping Model. J Clin Psychol Med Settings 2006. [DOI: 10.1007/s10880-006-9025-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Ehlers-Danlos syndrome (EDS), a heterogeneous group of inheritable connective tissue disorders, is attributed to mutations in connective tissue genes. These mutations cause defects in collagen. Collagen, a connective tissue protein that acts like glue, gives strength to the body and provides support and elasticity for movement. Thus, the altered gene affects the mechanical properties of skin, joints, ligaments, and blood vessels. Ehlers-Danlos syndrome is transmitted through autosomal dominant, autosomal recessive, or x-linked patterns of inheritance. The life expectancy of an affected infant varies with the type of EDS. This article provides an overview of the 6 major classifications of EDS, their unique clinical presentations, a focused physical assessment guide, considerations for nursing care, and resources for parents. Ehlers-Danlos syndrome can be a potentially debilitating syndrome. It requires preventative and protective measures starting at birth to preserve joint function to improve infant outcomes. Caring for patients with EDS requires an understanding of the potential associated complications to help minimize the physical and emotional impact of the syndrome and improve the quality of life for affected individuals.
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Affiliation(s)
- Elizabeth J Lawrence
- Neonatal Intensive Care Unit, Womack Army Medical Center, Fort Bragg, NC 28306, USA.
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Abstract
BACKGROUND Nonadherence is the primary cause of hospital readmission for patients with heart failure. While some demographic and social variables are associated with adherence, the identification of these variables does not address the complex problem of adherence. This study explored the lived experience of patients with heart failure as they attempt to adhere to a prescribed regimen of care. METHODS Fourteen patients attending an outpatient heart failure clinic after hospital readmission for exacerbation of heart failure symptoms were interviewed. Transcription of the interviews provided data for phenomenological analysis and interpretation. RESULTS Data analysis indicated that within the experience of attempting to adhere to prescribed care regimens, participants' initial acceptance of their diagnosis resulted in a changed self-image. Behaviors appropriate to the new self-image were integrated into the former lifestyle by means of planning and setting routine. Identified themes that influence adherence to the new behaviors included personal beliefs and values, support from significant others and healthcare professionals, unusual circumstances, and temptation overcoming motivation. CONCLUSIONS Adherence is primary to the effectiveness of any health regimen. Assessment of personal and circumstantial elements that affect adherence can be useful in developing more effective individualized treatment plans for this population. A closer look at discrete events of nonadherent decision making may indicate effective ways to promote adherence.
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