Positive Sides of the Disease: Posttraumatic Growth in Adults with Type 2 Diabetes

Constructing and Verifying an Alexithymia Risk-Prediction Model for Older Adults with Chronic Diseases Living in Nursing Homes: A Cross-Sectional Study in China

Alexithymia is a critical global public health concern. This questionnaire-based cross-sectional study explored the risk factors of alexithymia in older adults living in nursing homes with chronic diseases. It also developed and evaluated an alexithymia risk-prediction model. A total of 203 older adults with chronic diseases were selected from seven nursing homes in Changsha, China, using simple random and cluster sampling. The participants were surveyed using the Toronto Alexithymia Scale (TAS-20), Geriatric Depression Scale-15 (GDS-15), Connor-Davidson Resilience Scale (CD-RISC), Perceived Social Support Scale (PSSS), and a socio-demographic characteristics questionnaire. The alexithymia total score was 43.85 ± 9.570, with an incidence rate of 8.9%. Alexithymia had a partial mediating effect on the relationship between social support and psychological resilience (the effect value was 0.12), accounting for 19.04% of the total effect. Gender, depression, and psychological resilience were the main independent influencing factors of alexithymia (p < 0.05). The area under the receiver operating characteristic (AUC-ROC) curve of the risk-prediction model was 0.770. The participants, especially those who were male and depressed, exhibited a certain degree of alexithymia. Additionally, it partially mediated the association between social support and psychological resilience, which is a protective factor against alexithymia. The risk-prediction model showed good accuracy and discrimination. Hence, it can be used for preliminary screening of alexithymia in older adults with chronic diseases living in nursing homes.

Living with type 1 diabetes mellitus in emerging adulthood: A qualitative study

OBJECTIVE

Few studies have investigated the impact of diabetes considering its effects on developmental tasks that are typical of emerging adulthood. The present study aimed to investigate how emerging adults with a chronic condition such as type 1 diabetes mellitus manage with this developmental phase.

METHODS

30 emerging adults diagnosed with diabetes (18-34 years, females = 19) took part in an autobiographical interview investigating their experience of dealing with type 1 diabetes. Narratives were analysed by means of a qualitative thematic analysis of an inductive type.

RESULTS

Thematic analysis pointed out five thematic areas strictly related to the tasks of emerging adulthood: the development of intimate relationships, university life, work and plans for the future, the achievement of individual autonomy, the construction of an adult identity and family planning. Every thematic area reported a number of subthemes related to specific difficulties experienced by participants in reaching their developmental tasks due to chronic disease. Emerged themes considered both negative and positive outcomes of living with type 1 diabetes mellitus in emerging adulthood, such as a personal growth related to identity development.

CONCLUSION

The authors discussed results considering complexities and resources associated with diabetes in the light of developmental tasks of emerging adulthood.

Social support as a mediator of the relationship between forgiveness and post-traumatic growth in hemodialysis patients: A structural equation modeling approach

BACKGROUND

Post-traumatic growth (PTG) refers to the positive psychological changes experienced with individuals after struggling with highly challenging life circumstances. Forgiveness can facilitate positive outcomes such as reduced distress, anxiety, and depression. Many studies have tested the relationships among forgiveness, social support, and PTG; however, a mechanism of social support has not been completely explored in hemodialysis patients.

OBJECTIVE

To test the relationship between forgiveness and post-traumatic growth and verify the mediating factor of social support on the relationship between forgiveness and PTG in hemodialysis patients.

MATERIALS AND METHODS

In a descriptive cross-sectional study using convenience sampling from March to May 2021, 497 hemodialysis patients from nine hospitals filled out the Perceived Social Support Scale (PSSS), Heartland Forgiveness Scale (HFS), Post-traumatic Growth Inventory (PTGI), and general information. Data were analyzed using SPSS, and structural equation modeling was used to explore the relationships among forgiveness, social support, and PTG.

RESULTS

Forgiveness was significantly positively associated with PTG (P < 0.01). The proposed model provided a good fit to the data. Social support was found to play a partial mediating role between forgiveness and PTG (a*b = 0.122, BCa 95% CI: 0.078∼0.181).

CONCLUSION

The results imply that forgiveness significantly directly and indirectly is related to PTG. Forgiveness in hemodialysis patients should be detected and effectively managed to ameliorate positive effects on PTG. It is necessary for nurses to consider implementing forgiveness interventions with an emphasis on building social support strategies to help hemodialysis patients enhance their PTG.

Psychological well-being and adjustment among type 2 diabetes patients: the role of psychological flexibility

Elevated rates of psychological disorders are reported among those with type 2 diabetes (T2D). Thus, research into factors enhancing psychological aspects of well-being is critical in T2D. We examine the association between a multifaceted measure of Psychological Flexibility (PF), and its relationship to adjustment and well-being, among this population. Adults with T2D (N = 102) completed an online battery of self-reported questionnaires and were asked for demographics, general T2D features, treatment adherence, PF, adjustment, and well-being. We examined the association between PF (Psychological Flexibility Questionnaire, PFQ), adjustment to diabetes (ATT-39) and well-being (Mental Health Inventory), among adults with T2D. Greater PF was significantly associated with greater well-being, but unrelated to adjustment, which was positively associated with well-being. In a hierarchical regression analysis, perception of change as positive (one of the five PFQ factors) significantly contributed to the explained variance in well-being, beyond the contribution of adjustment. These findings indicate that positive perception of change may enhance well-being independently from adjustment to diabetes since these two constructs are distinct and independent. Such an association between PF and well-being may apply to other medical conditions. Implications for psychological intervention are discussed.

Subjective well-being among rheumatoid arthritis patients

AIM

Subjective well-being (SWB) is a psychological construct that is synonymous with happiness. Many variables including age, sex, income, employment, and marital status are related to SWB. Health is also an important determinant of SWB that can be adversely affected in patients with chronic conditions such as rheumatoid arthritis (RA). In this study, we evaluate the SWB of RA patients and compare it with that of healthy controls.

METHODS

We obtained the original dataset from the "Quality of Life Survey, 2013", which was conducted by the Economic and Social Research Institute, Cabinet Office, Government of Japan. In this survey, SWB was determined by asking participants to rate their happiness between 0 (very unhappy) and 10 (very happy). The survey also included a 56-point questionnaire regarding well-being-related variables. This questionnaire was administered to RA patients recruited from Kobe University Hospital, and clinical and treatment data were simultaneously collected.

RESULTS

Multivariate analysis revealed that RA patients with high or moderate disease activity had SWB scores that were similar to those of controls. However, the SWB scores of RA patients in remission or with low disease activity were higher than those of controls (P = .013). SWB was associated with household income, self-assessment of living costs, self-assessment of health, depression/ anxiety, and social connection.

CONCLUSIONS

For RA patients, achieving the therapeutic target can result in better SWB than that of healthy controls. Financial status, self-assessment of health, psychological stress, and social network are also important determinants for the SWB of RA patients.

Feasibility, Acceptability, and Exploratory Outcomes of Acceptance and Commitment Therapy for Binge Eating Symptoms in Veterans: A Preliminary Clinic-Based Study

Overweight and obesity are disabling problems for veterans and place a heavy toll on their physical and mental health. Acceptance and commitment therapy (ACT) is an empirically supported intervention that shows promise in improving binge eating, weight, and psychological functioning. This preliminary study evaluated the feasibility and acceptability of an 8-week ACT group intervention for binge eating in veterans (N = 85) who were overweight or obese and explored preliminary intervention effects on binge eating and physical and mental health functioning. Veterans were predominantly male (86.7%) with an average age of 58 years, and 65% endorsed clinically significant binge eating. Qualitative results indicated the majority of veterans found the intervention useful. Baseline to post-treatment comparisons found significant reductions in binge eating symptoms, depression, global psychological distress, and body mass index, as well as improvement in functioning. Findings suggest implementing ACT for binge eating in veterans is feasible and deserves further exploration, addressing binge eating and weight control. Future studies should examine ACT for this population in a randomized controlled trial.

Traumatic Childbirth and Its Aftermath: Is There Anything Positive?

Up to 45% of new mothers have reported experiencing birth trauma. For some individuals who have experienced a traumatic event, there can be a positive legacy called posttraumatic growth. Using Tedeschi and Calhoun's Posttraumatic Growth Model as the theoretical framework, the purpose of this pilot study was to determine levels of posttraumatic stress, core beliefs disruption, and posttraumatic growth in women who have experienced traumatic childbirth. Thirty mothers completed the Posttraumatic Stress Disorder Symptom Scale-Self Report, Core Beliefs Inventory, and Posttraumatic Growth Inventory. Type of birth and length of time since the traumatic birth occurred predicted 38% of the variance in posttraumatic growth. In order to help mothers, childbirth educators need to understand the process involved in posttraumatic growth.