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Chen M, Che C. Perceived social support, self-management, perceived stress, and post-traumatic growth in older patients following stroke: Chain mediation analysis. Medicine (Baltimore) 2024; 103:e38836. [PMID: 39029078 DOI: 10.1097/md.0000000000038836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2024] Open
Abstract
Stroke is a potentially traumatic event that can lead to both positive changes associated with post-traumatic growth (PTG) and enduring mental distress. This study aimed to investigate the association between perceived stress and PTG among older postsurvivors, as well as to explore the potential mediating role of perceived social support and self-management in this relationship. A cross-sectional study was conducted to recruit 354 older poststroke survivors from 2 tertiary hospitals in Shenyang, China, between January 2022 and October 2023. Various multidimensional scales were utilized to measure perceived stress, perceived social support, self-management, and PTG. Structural equation modeling was employed by Amos 24.0 to analyze the mediating pathways. The average score of PTG was 50.54 ± 22.69 among older poststroke patients. Pearson analysis revealed significant associations between perceived stress, perceived social support, self-management, and PTG (all P < .01). The mediation model showed that perceived stress could both direct influence PTG (Effect = -0.196, 95% CI = [-0.259, -0.129]), and indirectly impact PTG through perceived social support (Effect = -0.096, 95% CI = [-0.157, -0.044]), through self-management (Effect = -0.033, 95% CI = [-0.064, -0.012]), and sequentially through perceived social support and self-management (Effect = -0.007, 95% CI = [-0.017, -0.002]), accounting for 58.9%, 28.8%, 9.9%, and 2.1% of the total effect, respectively. These findings confirmed the mediating roles of perceived social support and self-management between perceived stress and PTG among older poststroke survivors. This provides valuable insights into developing targeted social intervention programs to improve stroke management among older survivors.
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Affiliation(s)
- Meng Chen
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
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Villaécija J, Luque B, Cuadrado E, Vivas S, Tabernero C. Psychometric Properties of the Revised Self-Efficacy for Diabetes Self-Management Scale among Spanish Children and Adolescents with Type 1 Diabetes. CHILDREN (BASEL, SWITZERLAND) 2024; 11:662. [PMID: 38929241 PMCID: PMC11201513 DOI: 10.3390/children11060662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 05/24/2024] [Accepted: 05/26/2024] [Indexed: 06/28/2024]
Abstract
A longitudinal design was used to examine the psychometric properties of the Self-Efficacy for Diabetes Self-Management (SEDM) for children and adolescents with a diagnosis of type 1 diabetes (T1D). The SEDM was adapted to Spanish and the best factorial solution was selected to test the invariance of the measures of age and gender. Individuals between the ages of 10 and 19 years old with a diagnosis of T1D completed a self-reported questionnaire (167 at Time 1 [mean age = 14.49, SD = 2.76; 56.9% boys] and 122 at Time 2 [mean age = 14.77, SD = 2.58; 56.6% boys]). Two unifactorial solutions were tested. The psychometric properties of the scale were validated. The proposed validation obtained excellent reliability indices (χ2 (26) = 25.59, p > 0.49, RMSEA = 0.00, 95% CI [0.00, 0.07], CFI = 1.00, GFI = 0.96, AGFI = 0.92, TLI = 1.00, and CMIN = 0.98), and it appeared to be invariant for gender and for age groups. The Cronbach's α was 0.85. The test-retest reliability was high (r = 0.69 [p < 0.001]). Convergent, discriminant, and external validity were proven. The nine-item SEDM is a brief measure with satisfactory structural validity. From our knowledge, this study provides the first reliable tool to assess self-efficacy in the management of T1D for Spanish children and adolescents.
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Affiliation(s)
- Joaquín Villaécija
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain; (J.V.); (S.V.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
| | - Bárbara Luque
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain; (J.V.); (S.V.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
| | - Esther Cuadrado
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain; (J.V.); (S.V.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
| | - Sebastián Vivas
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain; (J.V.); (S.V.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
| | - Carmen Tabernero
- Department of Social Psychology and Anthropology, University of Salamanca, 37005 Salamanca, Spain;
- Instituto de Neurociencias de Castilla y León (INCYL), University of Salamanca, 37005 Salamanca, Spain
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Pan L, Yeung NCY. Positive Psychology Interventions for Improving Self-management Behaviors in Patients with Type 1 and Type 2 Diabetes: a Narrative Review of Current Evidence. Curr Diab Rep 2023; 23:329-345. [PMID: 37910312 DOI: 10.1007/s11892-023-01525-z] [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] [Accepted: 10/12/2023] [Indexed: 11/03/2023]
Abstract
PURPOSE OF REVIEW Interests have been emerging in using positive psychology interventions (PPIs) to improve diabetes self-management (DSM) behaviors (e.g., blood glucose monitoring, physical activity). To explore the impact of those interventions on DSM behaviors, we summarized the evidence of PPIs on self-management behaviors among both type 1 diabetes (T1D) and type 2 diabetes (T2D) patients between 2012 and 2022. RECENT FINDINGS Among the eight studies identified, different study designs and types of PPIs were apparent. Typical PPIs (e.g., activities enhancing positive affect/gratitude/self-affirmation/optimism) were usually applied to T1D patients (N = 5); PPIs were usually combined with motivational interviewing for T2D patients (N = 3). Contrary to expectations, PPIs did not consistently demonstrate positive effects on self-management behaviors' change regardless of the types of diabetes patients, compared to the control groups. Improvements in diabetes patients' self-management behaviors from PPIs are still unclear. Future studies should more rigorously evaluate and identify the active ingredients of PPIs for behavioral changes among diabetes patients.
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Affiliation(s)
- Lihua Pan
- JC School of Public Health and Primary Care, Room 508, Postgraduate Education Centre, Prince of Wales Hospital, School of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Nelson C Y Yeung
- JC School of Public Health and Primary Care, Room 508, Postgraduate Education Centre, Prince of Wales Hospital, School of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
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Mutluer T, Aslan Genç H, Demir T, Demirel Ç, Bakır ÇN, Necef I, Muradoğlu S, Yeşiltepe Mutlu G, Hatun Ş. The effect of problem-solving skills on blood glucose regulation and disease management in children with type 1 diabetes mellitus. J Pediatr Endocrinol Metab 2023; 36:949-956. [PMID: 37623928 DOI: 10.1515/jpem-2023-0282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVES This cross-sectional study examined the relationship between problem-solving skills, glucose regulation, and disease management in children with type 1 diabetes mellitus (T1DM) as well as the role of depression in this association. METHODS The participants (n=54) were recruited from a diabetes camp. Problem-solving inventory (PSI), Beck depression inventory (BDI), and diabetes self-management profile (DSMP) were administered as tests. Forty-six participants who have been diagnosed with T1DM for at least a year and completed the survey were included in the analyses. Participants were categorized into high and low depression groups based on the median split. Student's t-test was used to detect demographic differences in groups. Linear regression models were used to examine the association between PSI, HbA1c, and DSMP. Regressions for PSI and DSMP were repeated in low and high-depression groups. RESULTS Of the 46 participants with T1DM, 52 % were female, with a mean age of 13.96 ± 1.94 (range 10-17). Avoidant and monitoring style of problem solving as well as the total score of PSI significantly predicted HbA1c levels. Impulsive and avoidant style of problem solving, problem-solving confidence, and total scores of PSI significantly predicted DSMP (p<0.05). The high depression group had a significantly higher DSMP score than the low depression group (p=0.001), with no difference in HbA1c levels (p=0.968). When the DSMP regressions were repeated, no significant associations were seen in the low depression group. Avoidant style of problem solving, problem-solving confidence, and the total score of PSI significantly predicted DSMP in the high depression group (p<0.005). CONCLUSIONS Problem solving-skills are essential in children with T1DM for a successful disease management. Depression modulates the association between the problem-solving and self-management profile.
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Affiliation(s)
- Tuba Mutluer
- Department of Child and Adolescent Psychiatry and Mental Health, Koç University School of Medicine, Istanbul, Türkiye
| | - Herdem Aslan Genç
- Department of Child and Adolescent Psychiatry and Mental Health, Koç University School of Medicine, Istanbul, Türkiye
| | - Tuana Demir
- Koç University School of Medicine, Istanbul, Türkiye
| | - Çağrı Demirel
- Koç University School of Medicine, Istanbul, Türkiye
| | | | - Işıl Necef
- Department of Child Psychology, Koç Üniversitesi Hastanesi, Istanbul, Türkiye
| | - Serra Muradoğlu
- Department of Child Psychology, Koç Üniversitesi Hastanesi, Istanbul, Türkiye
| | - Gül Yeşiltepe Mutlu
- Department of Pediatric Endocrinology, Koç University School of Medicine, Istanbul, Türkiye
| | - Şükrü Hatun
- Department of Pediatric Endocrinology, Koç University School of Medicine, Istanbul, Türkiye
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Zhang H. Technostress, Academic Self-Efficacy, and Resistance to Innovation: Buffering Roles of Knowledge Sharing Culture and Constructive Deviant Behavior. Psychol Res Behav Manag 2023; 16:3867-3881. [PMID: 37745271 PMCID: PMC10516214 DOI: 10.2147/prbm.s424396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/05/2023] [Indexed: 09/26/2023] Open
Abstract
Aim Scholarly works have primarily found a negative relation between technostress and individual performance outcomes. Nevertheless, there needs to be more empirical research that casts light on the underlying causal mechanism. The current study hypothesizes that technostress affects students' resistance to innovation through the mediating role of academic self-efficacy. Further, the study proposes innovation as a salient goal as a meta-level moderator. To capture this factor, the study investigates constructive deviant behavior and knowledge sharing culture as the buffering agents stimulating these links. Methods On a sample of 412 Chinese university students, the authors assess the structural model guided by the social cognitive theory to examine the predictive capability of the hypothesized relationships. Results The study found that technostress diminishes students' self-efficacy, which in turn augments resistance to innovation. Besides, constructive deviant behavior and knowledge sharing culture significantly moderate the direct association between technostress and self-efficacy and the indirect relationship between technostress and self-efficacy and then resistance to innovation. Discussion The study offers several meaningful theoretical and practical implications related to the critical role of technostress in deteriorating students' self-efficacy beliefs and enhancing resistance to innovation.
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Affiliation(s)
- Hua Zhang
- College of Educational Science, Nanyang Normal University, Nanyang, 473061, People’s Republic of China
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Villaécija J, Luque B, Castillo-Mayén R, Farhane-Medina NZ, Tabernero C. Influence of Family Social Support and Diabetes Self-Efficacy on the Emotional Wellbeing of Children and Adolescents with Type 1 Diabetes: A Longitudinal Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1196. [PMID: 37508693 PMCID: PMC10377974 DOI: 10.3390/children10071196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023]
Abstract
Type 1 diabetes (T1D) is a chronic disease that is usually diagnosed in childhood, underscoring the importance of early disease control for overall wellbeing. Our aim was to design an explanatory model of subjective emotional wellbeing in children and adolescents with T1D. A longitudinal study was conducted at the Reina Sofia University Hospital in Cordoba (Spain). A total of 151 patients (mean age = 14.50, SD = 2.67; 41.1% girls) participated at T1, while 97 participated at T2 (mean age = 14.93, SD = 2.56; 39.2% girls). Participants completed a self-report questionnaire. Descriptive, reliability, correlation, path, and mediation analyses were performed. The explanatory model showed excellent fit indices [χ2 (10) = 8.62, p = 0.57, RMSEA = 0.00, 95% [0.00, 0.10], CFI = 1.00, GFI = 0.98, AGFI = 0.93, and TLI = 1.01]. The results showed significant and positive relationships between family social support and subjective emotional wellbeing and improved self-care skills. Self-efficacy presented a mediating role between family social support and subjective emotional wellbeing. Given that self-efficacy is a self-regulatory mechanism and a determinant of health, it is argued that future psychoeducational interventions could aim to improve self-efficacy to manage chronic diseases, to achieve greater emotional wellbeing in children and adolescents with T1D.
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Affiliation(s)
- Joaquín Villaécija
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
| | - Bárbara Luque
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
| | - Rosario Castillo-Mayén
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
| | - Naima Z Farhane-Medina
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
| | - Carmen Tabernero
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Instituto de Neurociencias de Castilla y León (INCYL), University of Salamanca, 37007 Salamanca, Spain
- Department of Social Psychology and Anthropology, University of Salamanca, 37005 Salamanca, Spain
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Fu Y, Wu J, Zhao B, Lai C, Xue E, Wang D, Wang M, Tang L, Shao J. Development of a Chinese version of the Stress Adaption Scale and the assessment of its reliability and validity among Chinese patients with multimorbidity. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:361-370. [PMID: 37476947 PMCID: PMC10409896 DOI: 10.3724/zdxbyxb-2022-0721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/31/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVES To develop a Chinese version of the Stress Adaption Scale (SAS) and to assess its reliability and validity among Chinese patients with multimorbidity. METHODS The Brislin model was used to translate, synthesize, back-translate, and cross culturally adapt the SAS. A total of 323 multimorbidity patients selected by convenience sampling method from four hospitals in Zhejiang province. The critical ratio method, total question correlation method, and graded response model (item characteristic curve and item discrimination) were used for item analysis. Cronbach's alpha coefficient and split-half reliability were used for the reliability analysis. Content validity analysis, structural validity analysis, and criterion association validity analysis were performed by expert scoring method, confirmatory factor analysis, and Pearson correlation coefficient method, respectively. RESULTS The Chinese version of the SAS contained 2 dimensions of resilience and thriving, with a total of 10 items. In the item analysis, the critical ratio method showed that the critical ratio of all items was greater than 3.0 (P<0.001); the correlation coefficient method showed that the Pearson correlation coefficients for all items exceeded 0.4 (P<0.01). The graded response model showed that items of the revised scale exhibited distinct item characteristic curves and all items had discrimination parameters exceeding 1.0. In the reliability analysis, Cronbach's alpha coefficient of the revised Chinese version of the SAS scale was 0.849, and the split-half reliability was 0.873. In the validity analysis, the item-level content validity index and scale-level content validity index both exceeded 0.80. In the confirmatory factor analysis, the revised two-factor model showed satisfactory fit indices (χ2/df=3.115, RMSEA=0.081, RMR=0.046, GFI=0.937, AGFI=0.898, CFI=0.936, TLI=0.915). In the criterion-related validity analysis, the Chinese version of the SAS score was negatively correlated with the Perceived Stress Scale and the Treatment Burden Questionnaire, with correlation coefficients of -0.592 and -0.482, respectively (both P<0.01). CONCLUSIONS The Chinese version of the SAS has good reliability and validity, which can be used to evaluate the stress adaption capacity among multimorbidity patients in China, and provides a reference for developing individualized health management measures.
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Affiliation(s)
- Yujia Fu
- Department of Nursing, the Forth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China.
- Institute of Nursing Research, Zhejiang University School of Medicine, Hangzhou 310058, China.
| | - Jingjie Wu
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Binyu Zhao
- Department of Nursing, the Forth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China
- Institute of Nursing Research, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Chuyang Lai
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Erxu Xue
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Dan Wang
- Department of Nursing, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310005, China
| | - Manjun Wang
- Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Leiwen Tang
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Jing Shao
- Department of Nursing, the Forth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China.
- Institute of Nursing Research, Zhejiang University School of Medicine, Hangzhou 310058, China.
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Cserép M, Szabó B, Tóth-Heyn P, Szabo AJ, Szumska I. The Predictive Role of Cognitive Emotion Regulation of Adolescents with Chronic Disease and Their Parents in Adolescents' Quality of Life: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16077. [PMID: 36498149 PMCID: PMC9739128 DOI: 10.3390/ijerph192316077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The purpose of this study was to investigate cognitive emotion regulation in adolescents with chronic illness and their parents. METHODS Eighty-five young people (mean = 15.86 years, standard deviation = ± 1.42, girls 65.88%) with chronic illnesses (inflammatory bowel disease n = 40 or type 1 diabetes n = 45), and their parents (mean = 46.06 years, 87.06% mother) completed the Cognitive Emotion Regulation Questionnaire (CERQ) for themselves and the Inventory of Quality of Life in Children and Adolescents (ILC) questionnaire adolescent and parent version. We conducted two hierarchical linear regression analyses with "enter" method. The CERQ scales and the diagnosis of chronic disease were chosen as independent variables, and the total ILC score in the first analysis and the ILC proxy score in the second analysis were chosen as dependent variables. RESULTS Among adolescents, cognitive emotion regulation strategies such as self-blame, positive reappraisal, and catastrophizing have been proven to be predictors of their own quality of life; however, parental self-blame was also found to be a predictor of adolescents' quality of life. Parental rumination and positive refocusing have been shown to be predictors of how parents rate their child's quality of life. CONCLUSIONS The present study sheds light on cognitive emotion regulation strategies in adolescents with chronic illness and their parents that have a significant impact on the development of young people's quality of life.
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Affiliation(s)
- Melinda Cserép
- Institute of Behavioural Sciences, Semmelweis University, 1089 Budapest, Hungary
- First Department of Pediatrics, Semmelweis University, 1083 Budapest, Hungary
| | - Brigitta Szabó
- Doctoral School of Psychology, ELTE Eötvös Loránd University, 1064 Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, 1064 Budapest, Hungary
| | - Péter Tóth-Heyn
- First Department of Pediatrics, Semmelweis University, 1083 Budapest, Hungary
| | - Attila J. Szabo
- First Department of Pediatrics, Semmelweis University, 1083 Budapest, Hungary
| | - Irena Szumska
- Institute of Behavioural Sciences, Semmelweis University, 1089 Budapest, Hungary
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Zhang Y, Yang Z, Zhang H, Xu C, Liu T. The role of resilience in diabetes stigma among young and middle-aged patients with type 2 diabetes. Nurs Open 2022; 10:1776-1784. [PMID: 36289558 PMCID: PMC9912450 DOI: 10.1002/nop2.1436] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 03/24/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022] Open
Abstract
AIM To explore the prevalence and related factors influencing diabetes stigma among Chinese young and middle-aged patients with type 2 diabetes. DESIGN A cross-sectional, quantitative study was conducted through questionnaires. METHODS A total of 453 young and middle-aged patients with type 2 diabetes were recruited. Questionnaire survey was conducted with convenience sampling from September 2019 to December 2020. This included demographic questionnaire, Type 2 Diabetes Stigma Assessment Scale (DSAS-2) and Connor-Davidson Resilience Scale (CD-RISC). The STROBE checklist was applied as the reporting guideline for this study. RESULTS The scores of diabetes stigma and resilience of patients were 48.18 ± 14.52 and 66.02 ± 7.18, respectively. Diabetes stigma was negatively correlated with resilience, the correlation coefficient was -0.581. The results showed that the complications, diabetes year, monthly income and insulin treatment are important factors affecting stigma. In addition, it is resilience that was a protective factor of diabetes stigma, explaining 27.2% of the variance in diabetes stigma.
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Affiliation(s)
- Yi‐Bo Zhang
- Department of NursingJinzhou Medical UniversityJinzhouChina
| | - Zhen Yang
- Department of NursingJinzhou Medical UniversityJinzhouChina
| | - Hui‐Jun Zhang
- Department of NursingJinzhou Medical UniversityJinzhouChina
| | - Chao‐Qiang Xu
- Department of NursingJinzhou Medical UniversityJinzhouChina
| | - Tao Liu
- Department of NursingJinzhou Medical UniversityJinzhouChina
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Mediation of Self-Management and Treatment Adherence Health-Related Quality of Life for Adolescents With Congenital Heart Disease. Nurs Res 2022; 71:353-359. [PMID: 36007227 DOI: 10.1097/nnr.0000000000000596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Improved autonomy, relatedness, competence, self-management, and treatment adherence have been linked to better health-related quality of life (HRQOL) in adolescents with chronic illnesses. Nonetheless, potential mediating relationships among these concepts have not been investigated. Mediation research is necessary to fully examine ways to improve health and other outcomes for adolescents living with chronic illnesses. OBJECTIVES The purpose of this study was to examine the relationship among the three innate needs (autonomy, relatedness, and competence) of the self-determination theory (SDT)-self-management and treatment adherence-and its relationship to HRQOL for adolescents with congenital heart disease (CHD). The current study examined the potential mediation effects of self-management and treatment adherence on the relationship between the three SDT variables on HRQOL. METHODS Ninety-two adolescents with CHD completed self-report surveys (Basic Psychological Needs Autonomy and Relatedness subscales, Generalized Self-Efficacy Scale, UNC TRxANSITION Scale, and Pediatric Quality of Life 4.0 Generic Core Scale). Exploratory multiple regression and the bootstrap method were used to examine the relationship between the SDT variables and HRQOL and test whether these relationships were mediated by self-management and treatment adherence after controlling for covariates. RESULTS The mediation hypothesis was not supported, indicating that self-management and treatment adherence do not mediate the relationship between the SDT variables and HRQOL for adolescents with CHD. However, multiple regression findings suggest optimizing autonomy and competence contributes to better self-management and treatment adherence and that better autonomy, competence, and relatedness improves HRQOL. DISCUSSION The findings in this study indicate that studies with larger samples are needed if self-management and treatment adherence mediates the innate needs and HRQOL in adolescents with CHD. Future research focusing on other potential mediators affecting the relationship with HRQOL is warranted to improve the transition into adulthood.
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Pembroke S, Cody D, Roche EF, Sleath B, Hilliard C, Brenner M, Coyne I. Encouraging adolescents' participation during paediatric diabetes clinic visits: Design and development of a question prompt list intervention. Diabetes Res Clin Pract 2022; 190:109985. [PMID: 35809690 DOI: 10.1016/j.diabres.2022.109985] [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: 05/10/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 11/30/2022]
Abstract
AIMS To investigate adolescents' communication with healthcare providers (HCPs) and co- design a question prompt list as one part of an intervention to increase patient participation and communication at diabetes clinic visits. METHODS Using an adolescent-led co-design approach we conducted interviews and focus groups with adolescents, parents, and healthcare providers (HCPs) and held workshops with both a Youth Advisory Group (YAG) and a Parent Advisory Group (PAG). RESULTS Adolescents and parents identified challenges categorised into four themes: negative experience communicating with HCPs, lacking patient education leading to disinterest, low self-confidence out of fear of being wrong and forgetting to ask question(s). Adolescents identified that a Question Prompt List (QPL) could help them to ask questions, be more confident and participate more. The design process was an iterative development that engaged all stakeholders. Parents and HCPs assumed adolescents had greater knowledge about diabetes than they had in reality. CONCLUSIONS Divergence in perceptions between adults and adolescents regarding patient knowledge of diabetes care demonstrates the importance of encouraging adolescents to ask the questions that matter to them. The QPL could be a useful means of supporting adolescents to actively participate in clinic encounters with healthcare providers.
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Affiliation(s)
- Sinead Pembroke
- Trinity College Dublin, the University of Dublin College Green, Dublin 2, Ireland.
| | - Declan Cody
- Children's Health Ireland Crumlin, Cooley Road, Dublin 12, Ireland
| | - Edna F Roche
- Trinity College Dublin, the University of Dublin College Green, Dublin 2, Ireland and Children's Health Ireland, Tallaght, Tallaght, Dublin 24, Ireland
| | - Betsy Sleath
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Carol Hilliard
- Children's Health Ireland, Crumlin, Cooley Road, Dublin 12, Ireland and University College Dublin, Belfield, Dublin 4, Ireland
| | - Maria Brenner
- Trinity College Dublin, the University of Dublin College Green, Dublin 2, Ireland
| | - Imelda Coyne
- Trinity College Dublin, the University of Dublin College Green, Dublin 2, Ireland.
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Bao X, Chen D, Shi L, Xia Y, Shi Z, Wang D. The relationship between COVID-19-related prevention cognition and healthy lifestyle behaviors among university students: Mediated by e-health literacy and self-efficacy. J Affect Disord 2022; 309:236-241. [PMID: 35489556 PMCID: PMC9042721 DOI: 10.1016/j.jad.2022.04.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 04/04/2022] [Accepted: 04/09/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND At present, few studies have explored the mediating effect of e-Health literacy and self-efficacy on prevention cognition and healthy lifestyle behaviors during the normalization stage of COVID-19 prevention and control. This study aimed to determine the associations among COVID-19-related prevention cognition, self-efficacy, e-Health literacy, and healthy lifestyle behaviors at university students. METHODS By using a stratified cluster random sampling method, 971 students from five universities were recruited between May and August 2021 in Guangzhou, China. We collected participants' demographic characteristics, and assessed self-efficacy, COVID-19-related prevention cognition, e-Health literacy, and healthy lifestyle behaviors. A structural equation model was used for mediation analysis. RESULTS The overall mean value of healthy lifestyle behaviors of college students was 0.307 (SD 0.389). Between COVID-19-related prevention cognition, e-Health literacy, self-efficacy, and healthy lifestyle behaviors (r = 0.132-0.505, P < 0.01) were a significant positive correlation. The COVID-19-related prevention cognition had a direct and positive predictive effect on healthy lifestyle behaviors, with a direct effect value of 0.136. e-Health literacy and self-efficacy played both an independent mediating and serial-multiple mediating roles in the association between COVID-19-related prevention cognition and healthy lifestyle behaviors, and the indirect effect values were 0.043, 0.020 and 0.035, respectively. CONCLUSIONS The results showed that the emphasis on improving college students' prevention cognition, supplemented by improving e-Health literacy and self-efficacy, could improve college students' healthy lifestyle behaviors. LIMITATIONS This study was a cross-sectional investigation with no causal relationship between variables.
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Affiliation(s)
- Xiaolu Bao
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Dongxue Chen
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Lushaobo Shi
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Yi Xia
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Zengping Shi
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China; Institute of Health Management, Southern Medical University, Guangzhou, Guangdong, China.
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Zhang S, Wang Z, Lin X, Li Y, Xue Y, Ban J, Li G, Fa T. Kinesiophobia and self-management behaviour related to physical activity in Chinese patients with coronary heart disease: The mediating role of self-efficacy. Nurs Open 2022; 10:105-114. [PMID: 35773943 PMCID: PMC9748108 DOI: 10.1002/nop2.1283] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/05/2022] [Indexed: 01/04/2023] Open
Abstract
AIM The purpose of this study was to explore the relationship among kinesiophobia, self-efficacy and self-management behaviour related to physical activity (SMBPA) in Chinese patients with coronary heart disease(CHD) and the mediating role of self-efficacy between kinesiophobia and SMBPA in Chinese patients with CHD. DESIGN A cross-sectional study. METHODS From March to July 2021, 540 Chinese patients with CHD were investigated with three scales using convenient sampling method. The data were analysed with Pearson correlation, univariate analysis, multivariate linear regression and the PROCESS macro. RESULTS 509 valid questionnaires were collected (effective response rate: 94.2%). Low kinesiophobia and high self-efficacy were related to high-levels of SMBPA (all p < .01). Besides, the effect of kinesiophobia on SMBPA was partially mediated by self-efficacy, and the mediation effect accounted for 35.59% of the total effect.
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Affiliation(s)
- Siai Zhang
- Graduate School, Tianjin University of Traditional Chinese MedicineTianjinChina
| | - Zhangyi Wang
- Graduate School, Tianjin University of Traditional Chinese MedicineTianjinChina
| | - Xinyu Lin
- Graduate School, Tianjin University of Traditional Chinese MedicineTianjinChina
| | - Yawen Li
- Department of Cardiovascular MedicineTianjin Chest HospitalTianjinChina
| | - Yuanyuan Xue
- Department of Cardiovascular MedicineTianjin Chest HospitalTianjinChina
| | - Junkun Ban
- Cardiac Surgical Intensive Care UnitTianjin Chest HospitalTianjinChina
| | - Ge Li
- Public Health Science and Engineering College, Tianjin University of Traditional Chinese MedicineTianjinChina
| | - Tiane Fa
- Nursing DepartmentTianjin Chest HospitalTianjinChina
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Luciani M, De Maria M, Page SD, Barbaranelli C, Ausili D, Riegel B. Measuring self-care in the general adult population: development and psychometric testing of the Self-Care Inventory. BMC Public Health 2022; 22:598. [PMID: 35346104 PMCID: PMC8960109 DOI: 10.1186/s12889-022-12913-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background Self-care is important at all stages of life and health status to promote well-being, prevent disease, and improve health outcomes. Currently, there is a need to better conceptualize self-care in the general adult population and provide an instrument to measure self-care in this group. Therefore, the aim of this study was to develop and evaluate the Self-Care Inventory (SCI), a theory-based instrument to measure self-care in the general adult population. Methods Based on the Middle Range Theory of Self-Care, the 20-item SCI was developed with three scales: Self-Care Maintenance (8 items), Self-Care Monitoring (6 items), and Self-Care Management (6 items). A cross sectional study with a US-based sample (n = 294) was conducted to test the SCI. Internal validity was assessed with Confirmatory Factor Analysis. Internal consistency reliability was assessed with Cronbach alpha for unidimensional scales or composite reliability and the global reliability index for multidimensional scales. Construct validity was investigated with Pearson correlation to test the relationship between general self-efficacy, positivity, stress, and self-care scores. Results The Self-Care Maintenance and Management scales were multidimensional and the Self-Care Monitoring scale was unidimensional. The global reliability index for multidimensional scales was 0.85 (self-care maintenance) and 0.88 (self-care management). Cronbach alpha coefficient of the self-care monitoring scale was 0.88. Test-retest reliability was 0.81 (self-care maintenance), 0.91 (self-care monitoring), and 0.76 (self-care management). The General Self-Efficacy Scale was positively related to all three self-care scale scores: self-care maintenance r = 0.46, p < 0. 001, self-care monitoring r = 0.31, p < 0. 001, and self-care management r = 0.32, p < 0. 001. The positivity score was positively related to self-care maintenance (r = 0.42, p < 0. 001), self-care monitoring (r = 0.29, p < 0. 001), and self-care management (r = 0.34, p < 0. 001) scores. The perceived stress was positively related to the self-care management (r = 0.20, p < 0. 001) score. Conclusions The SCI is a theoretically based instrument designed to measure self-care in the general adult population. Preliminary evidence of validity and reliability supports its use in the general adult population.
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Zarifsaniey N, Shirazi MO, Mehrabi M, Bagheri Z. Promoting self-management behaviors in adolescents with type 1 diabetes, using digital storytelling: a pilot randomized controlled trial. BMC Endocr Disord 2022; 22:74. [PMID: 35317771 PMCID: PMC8941790 DOI: 10.1186/s12902-022-00988-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to assess the effects of digital storytelling on the self-management behavior of adolescents with type 1 diabetes (TID). METHODS In this pilot randomized controlled clinical trial, 60 adolescents with TID were randomly allocated into two parallel groups: intervention (training with digital storytelling method, n = 33) or control (training with a conventional method, n = 33). The primary outcome was assessing the Self-Management behavior of adolescents with TID (SMOD-A) at baseline and three months after the intervention. RESULTS The results revealed that digital storytelling could significantly improve self-management behaviors amongst adolescents with TID (P = 0.005). In contrast, in the control group, no significant changes were observed (P > 0.05). Furthermore, the mean score of Collaboration with Parents subscale was significantly higher in the digital storytelling group than in the control group after the intervention (p = 0.022). The results also showed that the level of Collaboration With Parents' subscale scores had a meaningful reverse relationship with the adolescent age after digital storytelling (p = 0.048). Repeated measures ANOVAs showed that there were significant main effects of time and group on collaboration with parents(p = 0.002) and goal subscales (p = 0.035). With respect to HbA1c levels, significant changes were not observed in any of the groups (P > 0.05). CONCLUSIONS Digital storytelling is practicable and a potentially beneficial training modality for adolescents with TID. TRIAL REGISTRATION This trial was respectively registered. CLINICALTRIALS gov Identifier: IRCT20191220045828N1 . Date of registration: Oct 29. 2020.
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Affiliation(s)
- Nahid Zarifsaniey
- Department of E-Learning, Virtual School, Shiraz University of Medical Sciences, Neshat Avenue, 1846- 71345 Shiraz, Iran
| | - Masoomeh Otrodi Shirazi
- Department of E-Learning, Virtual School, Shiraz University of Medical Sciences, Neshat Avenue, 1846- 71345 Shiraz, Iran
| | - Manoosh Mehrabi
- Department of E-Learning, Virtual School, Shiraz University of Medical Sciences, Neshat Avenue, 1846- 71345 Shiraz, Iran
| | - Zahra Bagheri
- Department of Biostatistics, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Symvoulakis EK, Volkos P, Markaki A, Linardakis M. Emotional Discomfort Scale: Instrument Development and Association With General Self-Efficacy and Data From an Urban Primary Care Setting. Cureus 2022; 14:e21495. [PMID: 35223272 PMCID: PMC8860711 DOI: 10.7759/cureus.21495] [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] [Accepted: 01/22/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction: Sense of discomfort, which is experienced in daily encounters, can develop into stress, coexist with stress, or interplay with self-efficacy. This study presents two objectives, namely, to develop and test a new instrument called the Emotional Discomfort (EmoD) Scale and to compare the EmoD with the General Self-Efficacy (GSE) Scale. Methods: The study was conducted in an urban primary healthcare center in Greece over a three-week period in 2020. Out of 314 individuals invited to participate, 263 accepted and completed the questionnaire. The EmoD is a five-point Likert-type eight-item scale for assessing individual reaction and sense of discomfort in daily life situations. Results: Cronbach’s α for the new scale reached 0.730 (acceptable reliability). Participants who used psychotropic drugs scored higher in the EmoD scale compared with nonusers. GSE scores showed reverse associations with EmoD scores. Multiple linear regression analysis indicated that an increase in self-efficacy, as measured using the GSE scale, was associated with a reduction in sense of discomfort, as measured by the EmoD scale. Conclusions: The use of the EmoD scale can aid health or social care providers in detecting levels of emotional discomfort, a finding that is demonstrated to interplay with self-efficacy. Future studies employing the use of this new instrument could examine emotional discomfort in relation to stress coping and social isolation.
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Han L, Zhang J, Yang J, Yang X, Bai H. Between Personality Traits and Postpartum Depression: The Mediated Role of Maternal Self-Efficacy. Neuropsychiatr Dis Treat 2022; 18:597-609. [PMID: 35342292 PMCID: PMC8942121 DOI: 10.2147/ndt.s346327] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/09/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Postpartum depression is related to many factors, which affect the health of mothers and infants. The purpose of this study is to test the mediated effect of self-efficacy in the relationship between vulnerable personality and postpartum depression. PATIENTS AND METHODS A cross-sectional survey was conducted with pregnant women aged ≥20 years from February to April 2021 in Zhengzhou, China. We recruited 587 pregnant women, and 429 pieces of data were available. The demographic characteristics questionnaire, General Self efficacy Scale (GSES) and Vulnerable Personality Style Questionnaire (VPSQ) were distributed in the prenatal survey. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen postpartum depression symptoms at one month through WeChat and telephone follow-up. A mediated model was constructed to explain the relationship of variables and test the mediated effect of self-efficacy. RESULTS The valid questionnaires were 429 (effective response rate: 90.7%). The vulnerable personality and low self-efficacy were related to postpartum depression (all P< 0.01). The self-efficacy of pregnant women was inversely associated with vulnerable personality (β= -0.415) and postpartum depression (β= -0.216). The vulnerable personality and self-efficacy can explain 29.0% of the variation in postpartum depression. It was confirmed that a partial mediating effect of self-efficacy accounted for 18.0% (0.090/0.501) of the total effect. CONCLUSION Maternal self-efficacy partly mediates the relationship between vulnerable personality traits and postpartum depression. The study implies the importance of targeted interventions to improve self-efficacy for women with vulnerable personality traits to reduce the risk of postpartum depression.
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Affiliation(s)
- Lingli Han
- The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Ji Zhang
- Zhengzhou Maternal and Child Health Hospital, Zhengzhou, Henan, People's Republic of China
| | - Jingxuan Yang
- The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xiaoyu Yang
- The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Hua Bai
- The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
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Shelat T, Mastrandrea LD, Majumdar I, Quattrin T. Perceptions of Diabetes Self-Efficacy and Glycemic Control in Youth With Type 1 Diabetes. Diabetes Spectr 2021; 34:313-320. [PMID: 34511859 PMCID: PMC8387614 DOI: 10.2337/ds20-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Thomas JJ, Moring J, Bowen A, Rings JA, Emerson T, Lindt A. The influence of stress and coping on diabetes self-care activities among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021:1-6. [PMID: 34133266 DOI: 10.1080/07448481.2021.1928142] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/31/2021] [Accepted: 05/02/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The purpose of this pilot study was to examine relationships between perceived stress, coping, and diabetes self-care activities among college students with type 1 diabetes. PARTICIPANTS College students, self-reported as diagnosed with type 1 diabetes. METHODS Students responded to an online self-report questionnaire (Perceived Stress Scale, Brief COPE, Summary of Diabetes Self-Care Activities). RESULTS ANOVA analysis showed significant differences between levels of perceived stress for healthy diet and foot care. Simple linear regression analysis showed significant relationships between healthy diet and active coping, positive reframing, and planning; between exercise and humor; between blood glucose testing and active coping, planning, and acceptance; and between foot care and active coping and positive reframing. CONCLUSIONS Our results indicate that effective stress management and coping skills will positively impact diabetes self-care. Educational programs for college students with type 1 diabetes should address self-care activities as well as psychosocial factors that affect health.
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Affiliation(s)
- Jenifer J Thomas
- Fay W. Whitney School of Nursing, University of Wyoming, Laramie, Wyoming, USA
| | - John Moring
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Anne Bowen
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
| | - Jeffrey A Rings
- Department of Applied Psychology and Counselor Education, University of Northern Colorado, Greeley, Colorado, USA
| | - Tori Emerson
- Fay W. Whitney School of Nursing, University of Wyoming, Laramie, Wyoming, USA
| | - Adara Lindt
- Fay W. Whitney School of Nursing, University of Wyoming, Laramie, Wyoming, USA
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Type 2 diabetes patients' views on prevention of hypoglycaemia - a mixed methods study investigating self-management issues and self-identified causes of hypoglycaemia. BMC FAMILY PRACTICE 2021; 22:114. [PMID: 34126938 PMCID: PMC8210634 DOI: 10.1186/s12875-021-01466-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/17/2021] [Indexed: 11/17/2022]
Abstract
Background Hypoglycaemia is a common and potentially avoidable adverse event in people with type 2 diabetes (T2D). It can reduce quality of life, increase healthcare costs, and reduce treatment success. We investigated self-management issues associated with hypoglycaemia and self-identified causes of hypoglycaemia in these patients. Methods In this mixed methods study qualitative semi-structured interviews were performed, which informed a subsequent quantitative survey in T2D patients. All interviews were audio recorded, transcribed verbatim and coded independently by two coders using directed content analysis, guided by the Theoretical Domains Framework. Descriptive statistics were used to quantify the self-management issues and causes of hypoglycaemia collected in the survey for the respondents that had experienced at least one hypoglycaemic event in the past. Results Sixteen participants were interviewed, aged 59–84 years. Participants perceived difficulties in managing deviations from routine, and they sometimes lacked procedural knowledge to adjust medication, nutrition or physical activity to manage their glucose levels. Grief and loss of support due to the loss of a partner interfered with self-management and lead to hypoglycaemic events. Work ethic lead some participant to overexerting themselves, which in turn lead to hypoglycaemic events. The participants had difficulties preventing hypoglycaemic events, because they did not know the cause, suffered from impaired hypoglycaemia awareness and/or did not want to regularly measure their blood glucose. When they did recognise a cause, they identified issues with nutrition, physical activity, stress or medication. In total, 40% of respondents reported regular stress as an issue, 24% reported that they regularly overestimated their physical abilities, and 22% indicated they did not always know how to adjust their medication. Around 16% of patients could not always remember whether they took their medication, and 42% always took their medication at regular times. Among the 83 respondents with at least one hypoglycaemic event, common causes for hypoglycaemia mentioned were related to physical activity (67%), low food intake (52%), deviations from routine (35%) and emotional burden (28%). Accidental overuse of medication was reported by 10%. Conclusion People with T2D experience various issues with self-managing their glucose levels. This study underlines the importance of daily routine and being able to adjust medication in relation to more physical activity or less food intake as well as the ability to reduce and manage stress to prevent hypoglycaemic events. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01466-0.
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Li G, Le TM, Wang W, Zhornitsky S, Chen Y, Chaudhary S, Zhu T, Zhang S, Bi J, Tang X, Li CSR. Perceived stress, self-efficacy, and the cerebral morphometric markers in binge-drinking young adults. NEUROIMAGE: CLINICAL 2021; 32:102866. [PMID: 34749288 PMCID: PMC8569726 DOI: 10.1016/j.nicl.2021.102866] [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: 07/05/2021] [Revised: 09/12/2021] [Accepted: 10/24/2021] [Indexed: 11/18/2022] Open
Abstract
Self-efficacy is negatively correlated with perceived stress in young adult drinkers. Binge vs. non-binge drinking men show diminished PCC thickness and dmPFC GMV. The metrics are positively/negatively each correlated with self-efficacy/stress. Path analyses show daily drinks → neural metrics → low self-efficacy → high stress.
Studies have identified cerebral morphometric markers of binge drinking and implicated cortical regions in support of self-efficacy and stress regulation. However, it remains unclear how cortical structures of self-control play a role in ameliorating stress and alcohol consumption or how chronic alcohol exposure alters self-control and leads to emotional distress. We examined the data of 180 binge (131 men) and 256 non-binge (83 men) drinkers from the Human Connectome Project. We obtained data on regional cortical thickness from the HCP and derived gray matter volumes (GMVs) with voxel-based morphometry. At a corrected threshold, binge relative to non-binge drinking men showed diminished posterior cingulate cortex (PCC) thickness and dorsomedial prefrontal cortex (dmPFC) GMV. PCC thickness and dmPFC GMVs were positively and negatively correlated with self-efficacy and perceived stress, respectively, as assessed with the NIH Emotion Toolbox. Mediation and path analyses to query the inter-relationships between the neural markers and clinical variables showed a best fit of the model with daily drinks → lower PCC thickness and dmPFC GMV → lower self-efficacy → higher perceived stress in men. In contrast, binge and non-binge drinking women did not show significant differences in regional cortical thickness or GMVs. These findings suggest a pathway whereby chronic alcohol consumption alters cortical structures and self-efficacy mediates the effects of cortical structural deficits on perceived stress in men. The findings also suggest the need to investigate multimodal neural markers underlying the interplay between stress, self-control and alcohol use behavior in women.
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Hung LC, Huang CY, Lo FS, Cheng SF. The Self-Management Experiences of Adolescents with Type 1 Diabetes: A Descriptive Phenomenology Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145132. [PMID: 32708617 PMCID: PMC7400392 DOI: 10.3390/ijerph17145132] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/11/2020] [Accepted: 07/12/2020] [Indexed: 06/11/2023]
Abstract
Many adolescents with type 1 diabetes experience challenges in achieving good glycemic control and have insufficient understanding in executing interventions for glycemic control. This study aimed to understand self-management experiences of adolescents with type 1 diabetes in Taiwan. In this descriptive phenomenological study, we conducted in-depth interviews with 18 adolescents with type 1 diabetes from the pediatric outpatient clinic of a medical center. Data were analyzed using the Colaizzi's method. Four themes were identified: (1) misconception regarding self-management of blood glucose; (2) conflict between depending on and breaking away from parental assistance for glycemic control; (3) encounter with disruptions in glycemic control regimen due to the presence of schedule changes; and (4) lack of motivation to achieve good glycemic control. The findings indicated that the misconceptions of adolescents with type 1 diabetes about managing glycemic levels resulted from an insufficient understanding of self-management of diabetes. In Taiwan, the heavy emphasis of academic achievement and changes of schedules during breaks tended to disrupt the regimen for glycemic control. Healthcare professionals are encouraged to provide individualized education focusing on the adolescents' misconceptions regarding self-management of diabetes.
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Affiliation(s)
- Li-Chen Hung
- College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan;
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan 33303, Taiwan
| | - Chu-Yu Huang
- School of Nursing, Cedarville University, Cedarville, OH 45314, USA;
| | - Fu-Sung Lo
- Division of Endocrinology, Department of Pediatrics, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 33303, Taiwan;
| | - Su-Fen Cheng
- Department of Allied Health Education and Digital Learning, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan
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