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Keyte R, Mantzios M, Hussain M, Tahrani AA, Abbott S, Strachan R, Singhal R, Egan H. 'Surgery is my only hope': A qualitative study exploring perceptions of living with obesity and the prospect of having bariatric surgery. Clin Obes 2024; 14:e12643. [PMID: 38302857 DOI: 10.1111/cob.12643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/21/2023] [Accepted: 01/02/2024] [Indexed: 02/03/2024]
Abstract
The health benefits of bariatric surgery are well documented; however, the occurrence of weight-regain after surgery, along with the development of mental health difficulties poses a question of how contemporary psychology could assist to prepare people living with obesity prior to undergoing bariatric surgery. This research explored individuals' (in the immediate pre-operative and post-operative population) attitudes, beliefs and experiences towards obesity and their journey to bariatric surgery. Seventeen adult participants (males n = 4; age range: 26-64 years) were recruited and participated in a semi-structured interview. Twelve individuals participated prior to undergoing bariatric surgery. Five individuals participated in the early post-operative period (<3 months post-surgery). People living with obesity displayed high optimism for positive outcomes, with participants hoping that bariatric surgery would be different to previous attempts at weight regulation, with there being a clear shift in the locus of control for weight management from self to healthcare professionals. Whilst this is adaptive, there was the presence of seemingly unrealistic optimism, with many pre-surgery participants not relaying the realistic possibility of post-surgery weight-regain. Despite the optimism individuals feel about bariatric surgery, participants felt that the psychological factors influencing eating behaviours are not being addressed by healthcare. These findings suggest that mindfulness, mindful eating, and self-compassion approaches should be incorporated into clinical practice to support weight regulation and adaption to physiological changes after bariatric surgery.
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Affiliation(s)
- Rebecca Keyte
- Department of Psychology, School of Social Sciences, Birmingham City University, Birmingham, UK
| | - Michail Mantzios
- Department of Psychology, School of Social Sciences, Birmingham City University, Birmingham, UK
| | - Misba Hussain
- Department of Psychology, School of Social Sciences, Birmingham City University, Birmingham, UK
| | - Abd A Tahrani
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Sally Abbott
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Rachel Strachan
- Black Country Healthcare NHS Foundation Trust, West Bromwich, UK
| | | | - Helen Egan
- Department of Psychology, School of Social Sciences, Birmingham City University, Birmingham, UK
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Vaziri S, McGarry ME, Huang CY, Cuneo AA, Willen SM, Iwanaga K, Neemuchwala F, Gibb ER, Chan M, Ly NP. Time to be blunt: Substance use in cystic fibrosis. Pediatr Pulmonol 2024. [PMID: 38251844 DOI: 10.1002/ppul.26880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND As the population of people with cystic fibrosis (pwCF) continues to age, attention is shifting towards addressing the unique challenges teenagers and adults face, including substance use. Changing attitudes and legality regarding marijuana and cannabidiol (CBD) may influence their use among pwCF, but data on the rate of use, reasons for use, and administration methods are lacking. OBJECTIVE Investigate marijuana, CBD, e-cigarette, and cigarette usage among pwCF and explore differences in demographics, disease severity, and cystic fibrosis transmembrane receptor (CFTR) modulator use between recent users and nonusers. METHODS This cross-sectional study used a one-time electronic survey to assess marijuana, CBD, e-cigarette, and cigarette use in pwCF aged >13 years. Demographic and clinical characteristics were compared between recent users and nonusers. The association between recent substance use and CFTR modulator use was analyzed using logistic regressions. RESULTS Among 226 participants, 29% used marijuana, 22% used CBD, 27% used e-cigarettes, and 22% used cigarettes in the last 12 months. Users of all substances were more likely to be college-educated or aged 29-39 years than nonusers. E-cigarette users were 2.9 times more likely to use CFTR modulators (95% confidence interval [95% CI]: 0.98-11.00, p = .08) and marijuana users were 2.5 times more likely to use CFTR modulators compared to nonusers, adjusted for confounders. CBD, e-cigarettes, and cigarettes users were more likely to have an abnormal mental health screen compared to nonusers. A high proportion of never-users of marijuana and CBD expressed interest in using. CONCLUSION Substance use is more prevalent among pwCF than previously reported and needs to be addressed by healthcare providers.
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Affiliation(s)
- Sanaz Vaziri
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Meghan E McGarry
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Chiung-Yu Huang
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Addison A Cuneo
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Shaina M Willen
- Department of Pediatrics, University of California Davis, Davis, California, USA
| | - Kensho Iwanaga
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Fatima Neemuchwala
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Elizabeth R Gibb
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Marilynn Chan
- Department of Pediatrics, Kaiser Permanente, Oakland, California, USA
| | - Ngoc P Ly
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
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Keyte R, Kauser S, Mantzios M, Egan H. The psychological implications and health risks of cystic fibrosis pre- and post- CFTR modulator therapy. Chronic Illn 2023; 19:539-556. [PMID: 35502821 DOI: 10.1177/17423953221099042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Cystic Fibrosis (CF) care is entering a period of personalised medicine with the emergence of CF transmembrane conductance regulator (CFTR) modulator therapies. Anecdotally individuals are reporting life-changing effects of modulator therapies, proposing an important area of study. METHODS Twenty adult participants (males: 8, age range: 22-51 years, average FEV1: 53.45%) were recruited via social media to participate in a semi-structured interview; 17 participants were currently taking Elexacaftor/Tezacaftor/Ivacaftor (Kaftrio). RESULTS An appreciation of a "normal life" post-modulator therapy is paramount, with improvements in symptoms and quality-of-life bringing a more urgent imperative for the provision of effective support to encourage positive health and lifestyle choices. DISCUSSION In this new era of CF care, there remains many challenges present for the CF community, with participants suggesting that proactive psychological support is required along with proactive awareness regarding health risk behaviours for the current and future CF generations.
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Affiliation(s)
- Rebecca Keyte
- Department of Psychology, School of Social Sciences, Birmingham City University, Birmingham, UK
| | - Sophia Kauser
- Department of Psychology, School of Social Sciences, Birmingham City University, Birmingham, UK
| | - Michail Mantzios
- Department of Psychology, School of Social Sciences, Birmingham City University, Birmingham, UK
| | - Helen Egan
- Department of Psychology, School of Social Sciences, Birmingham City University, Birmingham, UK
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Kauser S, Keyte R, Mantzios M, Egan H. A Qualitative Exploration into Experiences and Attitudes Regarding Psychosocial Challenges, Self-compassion, and Mindfulness in a Population of Adults with Cystic Fibrosis. J Clin Psychol Med Settings 2022; 29:898-910. [PMID: 35147829 DOI: 10.1007/s10880-022-09859-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 10/19/2022]
Abstract
To investigate the current psychosocial challenges faced by adults with Cystic Fibrosis (CF), while exploring attitudes and experiences of mindfulness and self-compassion. Mindfulness and self-compassion are important resources for supporting psychological and physical well-being, yet there is limited research exploring these positive psychology concepts in CF literature. Twenty UK domiciled adults with a diagnosis of CF, took part in a semi-structured interview. Using a thematic analysis approach, four themes were developed: (a) "I didn't expect to be here": Surpassing the CF life expectancy, (b) "Am I psychologically bringing this upon myself?": Psychological complexities of CF, (c) "I've had to really learn to be kind to myself": The importance of compassion and being self-compassionate, (d) "I think it's a great tool": The benefits of practising mindfulness. This research demonstrates a robust need for increased integration of accessible psychological practices into routine CF-care and self-care for adults with CF. Particularly, practises and interventions that draw on the concepts of mindfulness and self-compassion, which may benefit patient's health and wellbeing profoundly.
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Affiliation(s)
- S Kauser
- Department of Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK.
| | - R Keyte
- Department of Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK
| | - M Mantzios
- Department of Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK
| | - H Egan
- Department of Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK
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Egan H, Keyte R, Mantzios M. The Challenges of Eating Well for People Living with Cystic Fibrosis: an Interview Study Exploring the Use of Mindful Eating Approaches and Behaviours to Support Optimal Nutritional Status. Int J Behav Med 2022; 29:762-774. [PMID: 35088244 DOI: 10.1007/s12529-022-10057-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nutritional status and weight are closely linked to lung function and health status in cystic fibrosis (CF). The investigation of eating behaviours has shown mindfulness practices to be useful in modifying eating behaviours, particularly with obesity; to date, no research specifically explores how these concepts may be utilised within a CF population who face specific challenges in eating behaviours. METHOD Adult patients (n = 20, M = 8, age range 21-62 years) were recruited from a UK CF regional centre to take part in qualitative semi-structured interviews. Experiences of eating behaviours focusing on the use of mindful (or mindless) eating as barriers and enablers to achieving and maintaining optimal nutritional status were explored. Data were analysed using thematic analysis with a contextualist approach to understand how participants experienced eating behaviours within the context of health and weight status. RESULTS Participants engaged readily in discussions of eating behaviour describing active self-regulation of food eaten and calorie intake. Participants who struggled to maintain weight employed strategies to increase calorie intake such as distraction and multitasking while eating. Most participants reported no pleasure in food, describing eating as another treatment to endure. Confusion existed around how to eat healthily for CF alongside co-morbid health conditions including diabetes, cholesterol and heart disease. CONCLUSION Participants were highly aware of their eating behaviours, engaging in intentional and deliberate preparations, which could be described as mindful, for making eating a more automatic or mindless activity. Modifications to usual mindful eating interventions are needed to support people with CF.
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Affiliation(s)
- Helen Egan
- Faculty of Business, Law and Social Sciences, Department of Psychology, Birmingham City University, Room C332, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK.
| | - Rebecca Keyte
- Faculty of Business, Law and Social Sciences, Department of Psychology, Birmingham City University, Room C332, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK
| | - Michail Mantzios
- Faculty of Business, Law and Social Sciences, Department of Psychology, Birmingham City University, Room C332, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK
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Kauser S, Keyte R, Regan A, Nash EF, Fitch G, Mantzios M, Egan H. Exploring Associations Between Self-Compassion, Self-Criticism, Mental Health, and Quality of Life in Adults with Cystic Fibrosis: Informing Future Interventions. J Clin Psychol Med Settings 2021; 29:332-343. [PMID: 34750694 PMCID: PMC9184429 DOI: 10.1007/s10880-021-09831-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2021] [Indexed: 01/16/2023]
Abstract
Self-compassion is increasingly recognised as an important and beneficial factor in quality of life and mental health-related research, but research within the adult cystic fibrosis (CF) population is scarce. In a cross-sectional study, 114 (56 female, 58 male) adults with CF completed and returned a series of validated questionnaires that assessed CF-related quality of life, negative emotional states (depression, anxiety and stress), self-compassion, and self-criticism. Quality of life and self-compassion were positively correlated, and each in turn were inversely correlated with negative emotional states and self-criticism. Negative emotional states correlated positively to self-criticism. Self-compassion and/or self-criticism moderated ten relationships between various sub-domains of quality of life and negative emotions. Psychological interventions that increase self-compassion may be beneficial for enhancing mental health and quality of life for adults with CF.
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Affiliation(s)
- S Kauser
- Department of Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, Room C332, The Curzon Building, 4 Cardigan Street, Birmingham, B4 7BD, UK.
| | - R Keyte
- Department of Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, Room C332, The Curzon Building, 4 Cardigan Street, Birmingham, B4 7BD, UK
| | - A Regan
- West Midlands Cystic Fibrosis Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - E F Nash
- West Midlands Cystic Fibrosis Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - G Fitch
- North West Midlands Cystic Fibrosis Centre, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - M Mantzios
- Department of Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, Room C332, The Curzon Building, 4 Cardigan Street, Birmingham, B4 7BD, UK
| | - H Egan
- Department of Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, Room C332, The Curzon Building, 4 Cardigan Street, Birmingham, B4 7BD, UK
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