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Kristensen CB, Chilcot J, Jackson SE, Steptoe A, Hackett RA. The impact of a diabetes diagnosis on health and well-being: Findings from the English Longitudinal Study of Ageing. J Diabetes 2024; 16:e13518. [PMID: 38112231 PMCID: PMC11212344 DOI: 10.1111/1753-0407.13518] [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: 06/30/2023] [Revised: 10/27/2023] [Accepted: 11/23/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Poorer health and well-being are associated with diabetes risk. However, little is known about the trajectory of health and well-being from before to after diabetes diagnosis. We compared depressive symptoms, quality of life, self-rated health, and loneliness at three time points (prediagnosis, diagnosis, 2-4 years post diagnosis) in individuals who developed diabetes and a comparison group. METHODS Health and well-being measures were self-reported by 3474 participants from the English Longitudinal Study of Ageing. Repeated measures analysis of variance and generalized estimating equations were used to investigate differences by group, time, and group-by-time interactions. RESULTS A total of 473 (13.6%) participants developed diabetes. The diabetes group reported greater depressive symptoms (W2(1) = 20.67, p < .001) and lower quality of life (F = 1, 2535 = 10.30, p = .001) and were more likely to rate their health as fair/poor (W2(1) = 67.11, p < .001) across time points, adjusting for age, sex, and wealth. They also reported greater loneliness (F = 1, 2693 = 9.70, p = .002) in unadjusted analyses. However, this was attenuated to the null in adjusted analyses. The group-by-time interaction was significant for quality of life (F = 1.97, 5003.58 = 5.60, p = .004) and self-rated health (W2(2) = 11.69, p = .003), with a greater decline in these measures over time in the diabetes group in adjusted analyses. CONCLUSION People who received a diabetes diagnosis had greater depressive symptoms, lower quality of life, and poorer self-rated health than those who did not develop diabetes. Quality of life and self-rated health deteriorated more rapidly following a diagnosis. Screening for these factors around the time of diagnosis could allow for interventions to improve the health and well-being of those with diabetes.
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Affiliation(s)
- Camilla Böhme Kristensen
- Health Psychology Section, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Joseph Chilcot
- Health Psychology Section, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Sarah E. Jackson
- Department of Behavioural Science and Health, Institute of Epidemiology and Health CareUniversity College LondonLondonUK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, Institute of Epidemiology and Health CareUniversity College LondonLondonUK
| | - Ruth A. Hackett
- Health Psychology Section, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
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2
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Cho E, Kim J, Bang S. Loneliness in older adults with diabetes mellitus: a scoping review. PSYCHOL HEALTH MED 2024:1-16. [PMID: 38179980 PMCID: PMC11224135 DOI: 10.1080/13548506.2023.2299665] [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: 03/16/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024]
Abstract
This scoping review aimed to explore and synthesize existing research on predictors of loneliness, and the impact of loneliness on physiological and psychological health outcomes and health behaviors in older adults with diabetes. Results from 12 studies showed that low education, being unmarried/divorced/separated, having diabetes-related complications, being physically inactive, having diabetes distress, being of a certain race/ethnicity, being female, having depressive symptoms, and being younger age were consistently identified as predictors of loneliness. In addition, loneliness was found to affect both psychological (depressive symptoms and negative perceptions of diabetes) and physiological health outcomes (increased postprandial blood glucose and A1C levels, decreased cortisol levels, increased MCP-1 levels, slower gait speed, and weaker hand grip) and health behaviors (decreased engagement in physical activity, increased disability in activities of daily living and instrumental activities of daily living, and increased likelihood of antidepressant use). The results of this scoping review suggest that loneliness is a complex issue for older adults with diabetes and its effects are far-reaching. Therefore, further research should be conducted to explore the potential causal relationships between loneliness and physiological and psychological health outcomes and to identify the best interventions to reduce loneliness in older adults with diabetes. For healthcare providers, it is important to recognize that loneliness is an appropriate risk factor for older adults with diabetes that may affect psychological and physiological health outcomes and health behaviors and to address it through interventions such as social support programs, group therapy, or psychosocial counseling.
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Affiliation(s)
- Emma Cho
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Jeeyeon Kim
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Sohyeon Bang
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
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3
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Cho E. Loneliness and Other Factors Associated with Physical Activity in Older Adults with Diabetes: A Cross-Sectional Study. Gerontol Geriatr Med 2024; 10:23337214241253365. [PMID: 38737719 PMCID: PMC11084991 DOI: 10.1177/23337214241253365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/16/2024] [Accepted: 04/19/2024] [Indexed: 05/14/2024] Open
Abstract
The purpose of this study was to examine the association of physical activity with socioeconomic conditions, demographic factors, depression, and loneliness among older adults with diabetes in the United States. Using data from Wave 3 of the National Social Life, Health, and Aging Project (NSHAP), we found that male respondents, those with incomes greater than $100,000, and those with less depression were more likely to be physically active among older adults with diabetes. Education level and loneliness were not significant factors influencing physical activity among older adults with diabetes. This suggests that changing gender-based social norms and increasing awareness of the need for physical activity should be considered when designing physical activity interventions for older adults with diabetes and highlights the need for programs to reduce disparities in physical activity opportunities among low-income populations. It also suggests the need to further integrate programs to promote mental health, such as depression, into physical activity interventions.
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Affiliation(s)
- Emma Cho
- The University of Pennsylvania School of Nursing, Philadelphia, USA
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4
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Kuczmarski MF, Orsega-Smith E, Evans MK, Zonderman AB. The Association of Loneliness with Diabetes Is Mediated by Physical Activity and BMI but Not Diet Quality. Nutrients 2023; 15:4923. [PMID: 38068781 PMCID: PMC10708230 DOI: 10.3390/nu15234923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Loneliness is considered a predictor of poor health through numerous pathways. Mediators of this association has not been extensively explored. The study objective was to determine if diet quality and physical activity are parallel mediators with body mass index (BMI) as the third mediator in the association of loneliness with diabetes. The sample, middle-aged and older African American and White adults, 36-77 years, participated in the second follow-up wave of the prospective Healthy Aging in Neighborhoods of Diversity across the Life Span study, 2013-2017. Loneliness was measured by the UCLA 3-item loneliness scale. Participants were categorized as not diabetic, pre-diabetic, or diabetic based on fasting blood glucose, self-reports, or taking medication for diabetes. The Mean Healthy Eating Index-2010 score was calculated from two 24 h dietary recalls collected using the USDA automated multiple pass method. Physical activity was derived from the Baecke questionnaire. The Hayes PROCESS macro, model #80, was used to perform the mediational analysis. Covariates were age, sex at birth, race, income, alcohol intake, and education. Loneliness was inversely and significantly associated with diet quality and physical activity. The only significant indirect path was loneliness > physical activity > BMI > diabetes. Better understanding of modifiable lifestyle behaviors when developing interventions may improve mental health, thereby improving health.
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Affiliation(s)
- Marie Fanelli Kuczmarski
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA; (M.K.E.)
| | - Elizabeth Orsega-Smith
- Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, DE 19716, USA;
| | - Michele K. Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA; (M.K.E.)
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA; (M.K.E.)
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5
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Al-Azayzih A, Kanaan RJ, Altawalbeh SM. Assessment of Drug-Related Problems and Health-Related Quality of Life Domains in Elderly Patients with Type 2 Diabetes Mellitus. Ther Clin Risk Manag 2023; 19:913-928. [PMID: 38023626 PMCID: PMC10655742 DOI: 10.2147/tcrm.s434235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/04/2023] [Indexed: 12/01/2023] Open
Abstract
Aims of the Study This study aimed to investigate the prevalence and predictors of Drug-related problems (DRPs), as well as to evaluate the impact of DRPs on the health-related quality of life in geriatric patients with type 2 diabetes mellitus. Methodology A cross-sectional study was conducted over a three-month period. Patients aged 60 years and older visited diabetes clinics from October 1, 2022, to December 31, 2022, were included in the study. Data were collected through structured questionnaires, whereas lab results, medication records, comorbidities, and the consequences of DRPs were collected from electronic medical records. DRPs were identified and classified using the PCNE V501 classification system. Health-related quality of life (HRQoL) was evaluated using the validated EuroQol criteria. Results A total of 491 patients participated in the study, and the mean age of the patients was 67.51 years (SD = 5.84 years). Female patients represented 52.34% of total subjects. A total of 461 (around 94%) experienced at least one drug-related problem (DRP), ranging from one to nine DRPs per patient, with a total number of DRPs equal to 1625 identified. The most common DRP was the drug choice problem, affecting 52.98% of patients. Factors such as high drug frequency, living conditions, the number of diabetes medications, comorbidities, and smoking were significantly associated with higher numbers of DRPs. Higher numbers of DRPs were found to significantly worsen health-related quality of life (HRQoL) among patients. Conclusion Geriatric individuals with type 2 diabetes mellitus encounter a significant prevalence of DRPs, with drug choice problems being the most common followed by dosing problems. Risk factors contributing to these DRPs include high drug frequency, living conditions, high number of diabetes medications, multimorbidity, and smoking. Also, the study concluded that the increased number of DRPs was associated with negative impact on HRQoL domains in geriatric patients with type 2 diabetes.
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Affiliation(s)
- Ahmad Al-Azayzih
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Roaa J Kanaan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Shoroq M Altawalbeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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6
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Wang SL, Shien TWH, Chen TH, Hsiao PN, Hsiao SM, Kung LF, Hwang SJ, Chiu YW, Tsai YC, Chang JM. The factors of perceived disease knowledge and self-care behavior in type 2 diabetic patients with chronic kidney disease: A cross-sectional study. Medicine (Baltimore) 2023; 102:e34791. [PMID: 37933073 PMCID: PMC10627621 DOI: 10.1097/md.0000000000034791] [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: 01/25/2023] [Accepted: 07/26/2023] [Indexed: 11/08/2023] Open
Abstract
Chronic kidney diseases (CKD) is an important public health issue worldwide, and diabetes mellitus is the main cause of CKD. Having sufficient disease knowledge and good self-care behavior both help to prevent the progression of diabetes mellitus and CKD. This cross-sectional study enrolled 181 type 2 diabetic patients with CKD from July 2017 to October 2017. Perceived Kidney Knowledge survey and structured questionnaires of self-care behavior were used to measure perceived disease knowledge and CKD Self-Care (CKDSC) scales respectively with the determinants analyzed by linear regression. Meanwhile, socio-demographic information, kidney function and laboratory data were collected. Of 181 enrolled patients, the mean age was 66.8 ± 9.7 years, 59.1% were male and the mean estimated glomerular filtration rate was 33.1 ± 23.1 mL/min/1.73 m2. The mean scores of CKDSC and perceived disease knowledge were 63.2 and 22.4, respectively. High scores of disease knowledge were significantly correlated with low glycated hemoglobin (P = .03) and high scores of overall self-care behavior (P = .03) and aspects of self-care behavior, including diet (P = .003), exercise (P = .02), and home blood pressure monitoring (P = .04). The relationship between young age and high scores of disease knowledge was found (P = .001); however, old age was significantly associated with high scores of overall self-care behavior (P < .001) while additionally, married patients had high scores of regular medication behavior (P = .03). Our findings identified the significant factors correlated with disease knowledge and self-care behavior in type 2 diabetic patients with CKD. Healthcare givers should establish personalized health education plans to improve perceived disease knowledge and self-care behavior.
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Affiliation(s)
- Shu-Li Wang
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | - Tzu-Hui Chen
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Ni Hsiao
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shih-Ming Hsiao
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Lan-Fang Kung
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shang-Jyh Hwang
- Department of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung M University, Kaohsiung, Taiwan
- Doctoral Degree Program in Toxicology, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Wen Chiu
- Department of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung M University, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Chun Tsai
- Department of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung M University, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of General Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Liquid Biopsy and Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jer-Ming Chang
- Department of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung M University, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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7
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Kanbay M, Tanriover C, Copur S, Peltek IB, Mutlu A, Mallamaci F, Zoccali C. Social isolation and loneliness: Undervalued risk factors for disease states and mortality. Eur J Clin Invest 2023; 53:e14032. [PMID: 37218451 DOI: 10.1111/eci.14032] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/07/2023] [Accepted: 05/12/2023] [Indexed: 05/24/2023]
Abstract
Social isolation and loneliness are two common but undervalued conditions associated with a poor quality of life, decreased overall health and mortality. In this review, we aim to discuss the health consequences of social isolation and loneliness. We first provide the potential causes of these two conditions. Then, we explain the pathophysiological processes underlying the effects of social isolation and loneliness in disease states. Afterwards, we explain the important associations between these conditions and different non-communicable diseases, as well as the impact of social isolation and loneliness on health-related behaviours. Finally, we discuss the current and novel potential management strategies for these conditions. Healthcare professionals who attend to socially isolated and/or lonely patients should be fully competent in these conditions and assess their patients thoroughly to detect and properly understand the effects of isolation and loneliness. Patients should be offered education and treatment alternatives through shared decision-making. Future studies are needed to understand the underlying mechanisms better and to improve the treatment strategies for both social isolation and loneliness.
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Affiliation(s)
- Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey
| | - Cem Tanriover
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Sidar Copur
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Ibrahim B Peltek
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Ali Mutlu
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Francesca Mallamaci
- Nephrology, Dialysis and Transplantation Unit Azienda Ospedaliera "Bianchi-Melacrino-Morelli" & CNR-IFC, Institute of Clinical Physiology, Research Unit of Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, Reggio Calabria, Italy
| | - Carmine Zoccali
- Renal Research Institute, New York City, New York, USA
- Institute of Molecular Biology and Genetics (Biogem), Ariano Irpino, Italy and Associazione Ipertensione Nefrologia Trapianto Renal (IPNET), c/o Nefrologia, Grande Ospedale Metropolitano, Reggio Calabria, Italy
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8
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Freilich CD. How does loneliness "get under the skin" to become biologically embedded? BIODEMOGRAPHY AND SOCIAL BIOLOGY 2023; 68:115-148. [PMID: 37800557 PMCID: PMC10843517 DOI: 10.1080/19485565.2023.2260742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Loneliness is linked to declining physical health across cardiovascular, inflammatory, metabolic, and cognitive domains. As a result, loneliness is increasingly being recognized as a public health threat, though the mechanisms that have been studied do not yet explain all loneliness-related health risk. Potential mechanisms include loneliness having 1.) direct, causal impacts on health, possibly maintained by epigenetic modification, 2.) indirect effects mediated through health-limiting behaviors, and 3.) artifactual associations perhaps related to genetic overlap and reverse causation. In this scoping review, we examine the evidence surrounding each of these pathways, with a particular emphasis on emerging research on epigenetic effects, in order to evaluate how loneliness becomes biologically embedded. We conclude that there are significant gaps in our knowledge of how psychosocial stress may lead to physiological changes, so more work is needed to understand if, how, and when loneliness has a direct influence on health. Hypothalamic-pituitary adrenocortical axis disruptions that lead to changes in gene expression through methylation and the activity of transcription factor proteins are one promising area of research but are confounded by a number of unmeasured factors. Therefore, wok is needed using causally informative designs, such as twin and family studies and intensively longitudinal diary studies.
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Jarrah M, Khader Y, Alkouri O, Al-Bashaireh A, Alhalaiqa F, Al Marzouqi A, Qaladi OA, Alharbi A, Alshahrani YM, Alqarni AS, Oweis A. Medication Adherence and Its Influencing Factors among Patients with Heart Failure: A Cross Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050960. [PMID: 37241192 DOI: 10.3390/medicina59050960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/26/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Background and objectives: The chronic nature of heart failure requires long-lasting consumption of various medications. Despite the therapeutic benefits of heart failure medications, about 50% of patients with heart failure don't adequately adhere to their medications as prescribed globally. This study aimed to determine medication adherence levels among Jordanians with heart failure and its influencing factors. Materials and Methods: A cross-sectional study was conducted among 164 patients with heart failure attending cardiac clinics in the north of Jordan. The Medication Adherence Scale was used to measure medication adherence. Results: Overall, 33.5% of patients had high adherence, and 47% had partial to poor adherence. The proportion of patients with good to high adherence was significantly higher among patients younger than 60 years, having >high school level of education, being married, living with somebody, and having insurance. Conclusions: Patient-centered approach, targeting age, level of education, marital status, and health insurance coverage, should be developed using evidence-based guidelines to enhance adherence to medication and health outcomes in Jordanian patients with heart failure. The development and implementation of new and feasible strategies, particularly suited to Jordan's healthcare system capabilities, is important to improve medication adherence.
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Affiliation(s)
- Mohamad Jarrah
- Department of Internal Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Yousef Khader
- Department of Public Health, Community Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Osama Alkouri
- Faculty of Nursing, Yarmouk Univerity, P.O. Box 566, Irbid 21163, Jordan
| | - Ahmad Al-Bashaireh
- Higher Colleges of Technology, Abu Dhabi P.O. Box 25026, United Arab Emirates
| | | | - Ameena Al Marzouqi
- College of Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
| | - Omar Awadh Qaladi
- College of Nursing, King Saud University, P.O. Box 11451, Riyadh 11451, Saudi Arabia
| | - Abdulhafith Alharbi
- College of Nursing, University of Hail, P.O. Box 2440, Hail 81451, Saudi Arabia
| | | | | | - Arwa Oweis
- Faculty of Nursing, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
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Çelik Z, Törüner FB, Güçlü MB. Evaluation of quality of life and physical activity in patients with type 1 diabetes mellitus during the COVID-19 pandemic. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:206-213. [PMID: 36468917 PMCID: PMC10689036 DOI: 10.20945/2359-3997000000531] [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: 03/03/2022] [Accepted: 08/03/2022] [Indexed: 12/12/2022]
Abstract
Objective The aim of the study is to compare the quality of life, physical activity, anxiety, depression, fear of hypoglycemia, loneliness perception in patients with type 1 diabetes mellitus and controls. Subjects and methods Forty-four patients and 63 controls were included in this cross-sectional study. Quality of life (Short Form 36-SF-36), physical activity level (International Physical Activity Questionnaire-short form), anxiety and depression (Hospital Anxiety and Depression Scale), fear of hypoglycemia (Hypoglycemia Fear Survey), loneliness perception (UCLA Loneliness Scale) were evaluated. Results Physical role limitations and general health perception subscale scores of SF-36 questionnaire in patients were significantly higher than the controls (p < 0.05). Conclusion Role limitations due to physical problems and fear of hypoglycemia are increased, and general health perception is impaired in patients with type 1 diabetes mellitus. Physical inactivity is an important symptom in individuals in the pandemic period. In this regard, telerehabilitation approaches will be beneficial for all individuals in increasing physical activity, improving quality of life, and decreasing anxiety, depression and loneliness perception during the pandemic period for all individuals. The importance of a multidisciplinary approach in diabetes management and dealing with problems should be considered in pandemic.
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Affiliation(s)
- Zeliha Çelik
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey,
| | - Füsun Baloş Törüner
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Meral Boşnak Güçlü
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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11
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Iovino P, Vellone E, Cedrone N, Riegel B. A Middle-Range Theory of Social Isolation in Chronic Illness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4940. [PMID: 36981849 PMCID: PMC10049704 DOI: 10.3390/ijerph20064940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
Chronic illnesses and social isolation are major public phenomena that drive health and social policy worldwide. This article describes a middle-range theory of social isolation as experienced by chronically ill individuals. Key concepts include social disconnectedness, loneliness, and chronic illness. Antecedents of social isolation include predisposing factors (e.g., ageism and immigration) and precipitating factors (e.g., stigma and grief). Outcomes of social isolation include psychosocial responses (e.g., depression and quality of life), health-related behaviors (i.e., self-care), and clinical responses (e.g., cognitive function and health service use). Possible patterns of social isolation in chronic illness are described.
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Affiliation(s)
- Paolo Iovino
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
- Department of Nursing and Obstetrics, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Nadia Cedrone
- Unità di Medicina Interna, Ospedale S. Pertini, 00157 Rome, Italy
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, Fitzroy, VIC 3065, Australia
- Center for Home Care Policy & Research, VNS Health, New York, NY 10017, USA
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12
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Cohn-Schwartz E, Joshi R, McClure LA. The Associations of Loneliness and Social Support with Cognitive Impairment among Middle-Aged and Older Individuals with Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1885. [PMID: 36767249 PMCID: PMC9914689 DOI: 10.3390/ijerph20031885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 06/18/2023]
Abstract
Diabetes mellitus is a chronic disease with significant morbidity and mortality and it is associated with poor cognitive performance in later life. This study seeks to determine the relationship between social support and cognitive function among participants with type 2 diabetes mellitus (T2DM). We used data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, including participants with T2DM aged 45 and older (n = 4821). We examined different aspects of perceived social support, measured as structural social support (e.g., marital status), functional social support (having a caregiver in case of sickness or disability), and loneliness. We examined cognitive functioning using a six-item screener. Our results indicate that adults who felt lonely for 5-7 days per week had almost double the odds of cognitive impairment compared to those who didn't feel lonely. These results suggest that among middle-aged and older individuals with T2DM, interventions targeting lonely adults and which aim to reduce loneliness may combat some of the risks of cognitive decline.
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Affiliation(s)
- Ella Cohn-Schwartz
- Department of Epidemiology, Biostatistics, and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva 8410501, Israel
| | - Rennie Joshi
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, USA
| | - Leslie A. McClure
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, USA
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Kim HN, Sutharson SJ. Individual differences in emotional intelligence skills of people with visual impairment and loneliness amid the COVID-19 pandemic. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2023; 41:20-32. [PMID: 36605534 PMCID: PMC9791000 DOI: 10.1177/02646196211013860] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In response to the novel coronavirus (COVID-19) pandemic, public health interventions such as social distancing and stay-at-home orders have widely been implemented, which is anticipated to contribute to reducing the spread of COVID-19. On the contrary, there is a concern that the public health interventions may increase the level of loneliness. Loneliness and social isolation are public health risks, closely associated with serious medical conditions. As COVID-19 is new to us today, little is known about emotional well-being among people with visual impairment during the COVID-19 pandemic. To address the knowledge gap, this study conducted phone interviews with a convenience sample of 31 people with visual impairment. The interview incorporated the University of California, Los Angeles (UCLA) Loneliness Scale (version 3) and the trait meta-mood scale (TMMS) to measure loneliness and emotional intelligence skills, respectively. This study found that people with visual impairment were vulnerable to the feeling of loneliness during the COVID-19 pandemic and showed individual differences in emotional intelligence skills by different degrees of loneliness. Researchers and health professionals should consider offering adequate coping strategies to those with visual impairment amid the COVID-19 pandemic.
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Affiliation(s)
- Hyung Nam Kim
- Hyung Nam Kim, North Carolina Agricultural
and Technical State University, 1601 East Market Street, Greensboro, NC 27411,
USA.
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14
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Kamberi F, Ndreu V, Sinaj E, Zekja I, Jaho J. Impact of COVID-19 Outbreak in Healthcare of People with Type 2 Diabetes: Evidence from a Cross-Sectional Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective
The aim was to assess the impact of the COVID-19 outbreak on the health care of type 2 diabetes patients and identify the correlated factors.
Research Design and Methods
A cross-sectional study was carried out from November 2020 to February 2021. The study enrolled 400 adults with type 2 diabetes aged 40–65 with at least one other chronic illness receiving health services in primary care in Vlore, Albania. A short questionnaire based on literature, taking into account the situation of the COVID-19 pandemic, was used for the data collection. The administration of the questionnaire was done by trained nurses. All participants gave their written informed consent before administering the questionnaire. Two-tailed Pearson correlation and linear regression were used to test the correlations.
Results
Among 400 patients with type 2 diabetes in the study, 53.0% were female and 47.0% were men. Most of the participants were married (n = 303) with a high level of education (54.3%). Treatment was mainly with oral medications (58.0%). Based on body mass index, 63.0% of participants were overweight. Employment status (p = 003), the type of treatment, oral medication vs insulin (p = 001), body mass index (p = 001), and living alone (p = 008) were the more correlated factors.
Conclusions
Care of type 2 diabetic patients due to the COVID-19 pandemic is closely associated with social determinants of health and the resources of healthcare settings. The need to address innovative approaches to care including self-care, social support, and e-health is recommended.
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15
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Huang YC, Cho E, Kuo HJ, García AA. The influences of depression and loneliness on A1C among middle-aged and older adults with diabetes. PSYCHOL HEALTH MED 2022:1-9. [PMID: 36101932 DOI: 10.1080/13548506.2022.2124287] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Even before increased social isolation associated with the COVID-19 pandemic, 43% of adults aged 60 and older reported experiencing loneliness. Depression and loneliness often co-exist and are significant issues faced by middle-aged as well as older adults because each condition is likely to worsen health outcomes. This study of middle-aged and older adults examined how depression and loneliness affect diabetes (DM) control (A1C levels). This study is a secondary analysis of data from the Midlife in the United States Refresher (MIDUS-R) survey, a national survey of adults aged 25-74 years. Correlation analyses were conducted, and a hierarchical logistic regression was estimated to predict A1C levels ≤7% (recommended goal) or >7 using 1) demographics and physical health (ethnicity, gender, education, age, and comorbidities), 2) family and friend support, and 3) depression and loneliness. The sample of 92 participants with DM and A1C data from the MIDUS-R had mean age = 57.37, were 51% male, 68% non-Hispanic White; 39.1% had A1C >7. The average level of depression was low (CES-D mean 9.42) and loneliness was moderate (UCLA scale mean 12.43). Loneliness was correlated with A1C (r= .26, p< .05); depressive symptoms (r= .71, p< .001), family and friends support (r= -.36, r= -.38, respectively, both p< .001). Only loneliness significantly predicted higher A1C levels. People with higher levels of loneliness had increased odds of having A1C >7 (OR = 1.18, p < .05) after controlling for depression and all other variables. Loneliness had a greater impact than depression on A1C level among persons with DM. Healthcare providers should assess patients for loneliness as well as depression and reduce adverse health impacts by referring to psychosocial support as needed.
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Affiliation(s)
- Ya-Ching Huang
- School of Nursing, Texas A&M University, College Station, Texas, United States
| | - Emma Cho
- School of Nursing, the University of Texas at Austin, Austin, Texas, United States
| | - Hsuan-Ju Kuo
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Alexandra A García
- School of Nursing, the University of Texas at Austin, Austin, Texas, United States
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16
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Lara-Morales A, Gandarillas-Grande A, Díaz-Holgado A, Serrano-Gallardo P. Psychosocial factors in adherence to pharmacological treatment and diabetes mellitus control in patients over 65. Aten Primaria 2022; 54:102302. [PMID: 35430460 PMCID: PMC9036116 DOI: 10.1016/j.aprim.2022.102302] [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: 11/09/2021] [Revised: 12/26/2021] [Accepted: 01/13/2022] [Indexed: 11/02/2022] Open
Abstract
Aim Design Setting and participants Main measurements Results Conclusions
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17
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Polikandrioti M. Quality of life in diabetic foot ulcer, grade 3: associated demographic factors. Folia Med (Plovdiv) 2022; 64:229-239. [DOI: 10.3897/folmed.64.e64876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 03/11/2021] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction: Patients with diabetic foot ulcer grade 3 experience some limitations that adversely affect their quality of life (QoL).
Aim: The aim of the study was to explore demographic characteristics associated with the quality of life of diabetic foot ulcer patients, grade 3.
Materials and methods: The present study recruited 120 diabetic foot ulcer patients. Data collected by completion of SF-36 Health Survey (SF-36).
Results: Of the 120 participants, 65.8% were men and 73% were more than 60 years of age. Patients showed moderate to high levels of quality of life in social functionality, energy/fatigue, emotional well-being, and physical pain (medians: 50, 60, 72, and 67.5, respectively) and poor levels in physical functioning, role physical, and role emotional (medians: 22, 0 and 0, respectively). In addition, patients had moderate levels of quality of life in general health (median: 48.5). It was observed that physical functioning was significantly associated with place of residence (p=0.005). Moreover, physical role was significantly associated with age (p=0.020) and occupation (p=0.018), while emotional role was significantly associated with age (p=0.012), marital status (p=0.016), and occupation (p=0.012). Energy/fatigue was significantly associated with age (p=0.026), marital status (p=0.018), and occupation (p=0.009). Emotional well-being was significantly associated with gender (p=0.009), level of education (p=0.001), and occupation (p=0.007). Social functionality was significantly associated with marital status (p=0.001) while pain was significantly associated with education level (p=0.010). General health was significantly associated with marital status (p=0.037), and place of residence (p=0.024).
Conclusions: The findings of the present study may adequately inform stakeholders in the field of diabetic foot ulcer grade 3 when planning effective care.
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18
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Durmuş M, Çiftci N, Gerçek A, Durmuş Y. The Effect of COVID -19 Crisis on Hopelessness, Loneliness and Spiritual Well-Being of Patients with Type 1 and Type 2 Diabetes in Turkey. JOURNAL OF RELIGION AND HEALTH 2022; 61:1703-1718. [PMID: 35025008 PMCID: PMC8756405 DOI: 10.1007/s10943-021-01496-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/30/2021] [Indexed: 06/14/2023]
Abstract
This study aims to examine the relationship between the levels of hopelessness, loneliness, and spiritual well-being of patients with Type 1 and Type 2 diabetes during the process of COVID-19 outbreak. The study was carried out with diabetic patients living in three different cities that are in the Eastern Anatolia region of Turkey between the dates of 15 of November and 30 of November 2020. The sample of the study consisted of 500 (Type 1, n = 218, Type 2, n = 282) diabetes patients. Data were collected using a demographic information form, Beck Hopelessness Scale (BHS), Loneliness Scale (UCLA-LS), and Spiritual Well-being Scale (FACIT-Sp). While the mean scores of hopelessness and loneliness of type 1 patients were below the moderate level, the mean scores of their spiritual well-being were found to be above the moderate level. Moreover, while the mean scores of hopelessness and loneliness in type 2 patients were below the moderate level, the mean scores of their spiritual well-being were found above the moderate level. A significant relationship was found between Type 1 and Type 2 diabetes patients' levels of hopelessness, loneliness, and spiritual well-being during the COVID-19 outbreak. It was found that as the spiritual well-being levels of Type 1 and Type 2 diabetic patients increased, the levels of their loneliness and hopelessness decreased. It is recommended that mass communication that includes spiritual care practices can be used effectively to reduce diabetes patients' levels of loneliness and hopelessness during the pandemic. In addition, while providing care to diabetes patients, it can be suggested that health professionals offer a holistic approach with initiatives that will increase diabetes patients' spiritual well-being.
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Affiliation(s)
- Mustafa Durmuş
- Department of Gerontology Faculty of Health Sciences, Mus Alparslan University, 49100, Muş, Turkey.
| | - Necmettin Çiftci
- Health Services Vocational School, Mus Alparslan University, 49100, Muş, Turkey
| | - Abdullah Gerçek
- Health Services Vocational School, Mus Alparslan University, 49100, Muş, Turkey
| | - Yusuf Durmuş
- Malazgirt Vocational School, Muş Alparslan University, 49100, Muş, Turkey
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19
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Corno D, Burns RJ. Loneliness and functional limitations among older adults with diabetes: Comparing directional models. J Psychosom Res 2022; 154:110740. [PMID: 35114603 DOI: 10.1016/j.jpsychores.2022.110740] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 01/11/2022] [Accepted: 01/19/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Middle-aged and older adults with diabetes are at increased risk for loneliness and functional limitations. Cross-sectional and longitudinal associations between loneliness and functional limitations have been demonstrated among the general population, but have not been established among those with diabetes. The purpose of this study was to directly compare the following models describing the direction of the association between loneliness and functional limitations among people with diabetes: (1) loneliness leads to functional limitations, (2) functional limitations lead to loneliness, and (3) a bidirectional association between loneliness and functional limitations. METHODS Data came from the Health and Retirement Study. Participants were middle-aged and older individuals with diabetes in the United States (n = 2934). Loneliness and functional limitations were measured at baseline, 4-year follow-up, and 8-year follow-up. Path models for each of the three models, as well as a stability model, were created. Model fit was compared using Akaike's Information Criteria (AIC). RESULTS Participants were 54.6% female, 74.98% White, had a mean age of 69.66 years, had an average of 1.48 comorbid chronic conditions, and had diabetes for an average of 10.40 years. The bidirectional model best fit the data as evidenced by the lowest AIC value (AIC = 171,162.81). ∆AIC between the bidirectional model and the next best fitting model was 16.19, indicating strong support for selecting the bidirectional model. Higher levels of loneliness were associated with subsequent higher levels of functional limitations at some time points (βs = 0.07, 0.02) and higher levels of functional limitations were associated with subsequent higher levels of loneliness (βs = 0.13, 0.06) at all time points. CONCLUSION Results suggest that the association between loneliness and functional limitations among individuals with diabetes is bidirectional. This study demonstrates the value of directly comparing directional models.
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Köbling T, Katona É, Maroda L, Váradi Z, Somodi S, Páll D, Zrínyi M. Discriminating Low to High Adherent Type 2 Patients with Diabetes by Glycosylated Hemoglobin A1c, Eating Self-Efficacy and Other Psychosocial Determinants: Difference Between Patient and Physician Adherence Models. Patient Prefer Adherence 2022; 16:1405-1414. [PMID: 35694282 PMCID: PMC9176633 DOI: 10.2147/ppa.s361413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/26/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Develop individual discriminant models using clinical and psychosocial variables for physicians and patients with diabetes based on their perceptions of patient adherence. METHODS This was a cross-sectional research design utilizing a discriminant analysis approach. Type 2 patients on treatment for diabetes for at least 2 years prior to research were selected. Clinical data were obtained from patient records, and psychosocial variables were collected by survey instruments filled out by patients. A final sample of 200 patients was recruited. RESULTS We found a positive correlation between patient and physician assessment of patient adherence behaviors. Greater adherence efforts were associated with lower HbA1c. Better quality of the patient-physician relationship was linked to better patient adherence. Increased HbA1c, longer therapy duration and higher BMI described low patient adherence for physicians. Lower HbA1c, female gender and fewer difficulties in marital adjustment characterized high adherence for patients. Dietary self-efficacy as well as emotional and social isolation discriminated mid-level adherers in both models. CONCLUSION This research confirmed that patients and physicians perceived and judged patients' adherence behaviors differently. Physicians and patients associated different clinical and psychological factors with low and high adherence. Further research is recommended to clarify how the quality of the physician-patient as well as the patient-spouse relationship affect dietary efficacy and patient adherence. A randomized, controlled clinical trial approach is recommended to establish the effectiveness of interventions aiming to improve dietary self-efficacy on adherence outcomes.
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Affiliation(s)
- Tamás Köbling
- Department of Medicine, University of Debrecen, Debrecen, Hungary
- Department of Medical Clinical Pharmacology, University of Debrecen, Debrecen, Hungary
| | - Éva Katona
- Department of Medicine, University of Debrecen, Debrecen, Hungary
| | - László Maroda
- Department of Medical Clinical Pharmacology, University of Debrecen, Debrecen, Hungary
- Coordination Center for Drug Development, University of Debrecen, Debrecen, Hungary
| | - Zita Váradi
- Department of Medicine, University of Debrecen, Debrecen, Hungary
| | - Sándor Somodi
- Department of Emergency Care, University of Debrecen, Debrecen, Hungary
| | - Dénes Páll
- Department of Medicine, University of Debrecen, Debrecen, Hungary
- Department of Medical Clinical Pharmacology, University of Debrecen, Debrecen, Hungary
| | - Miklós Zrínyi
- Department of Medical Clinical Pharmacology, University of Debrecen, Debrecen, Hungary
- Coordination Center for Drug Development, University of Debrecen, Debrecen, Hungary
- Correspondence: Miklós Zrínyi, Coordination Center for Drug Development, University of Debrecen, Nagyerdei blvd. 98., Debrecen, 4032, Hungary, Email
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21
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Healthcare Professionals' Perceptions of Loneliness amongst Older Adults: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212071. [PMID: 34831824 PMCID: PMC8625378 DOI: 10.3390/ijerph182212071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/11/2021] [Accepted: 11/15/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Loneliness amongst older adults is linked to poor health outcomes and constitutes a public health issue worldwide. Healthcare professionals' perceptions could influence the strategies they implement in order to prevent, detect and manage loneliness amongst older adults. The aim of this study was to describe and understand healthcare professionals' perceptions of loneliness amongst older adults. METHODS A descriptive qualitative study. Twenty-six Spanish healthcare professionals with experience caring for older adults participated in the study. Data were collected between November 2019 and September 2020 using focus groups and in-depth interviews. Data were analysed following a content analysis method using ATLAS.ti software. RESULTS Healthcare professionals' perceptions of loneliness amongst older adults is represented by three themes: (1) "when one's personal life and social context lead to loneliness"; (2) "from abandonment to personal growth: the two faces of loneliness"; and (3) "loneliness as a health issue that needs to be addressed". CONCLUSIONS Healthcare professionals perceive loneliness as a multifactorial, subjective experience that can trigger different coping mechanisms and negatively affect older people's health. Healthcare professionals consider that a greater involvement of the whole society is needed in order to fight loneliness amongst older adults as a public health issue.
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Sturm N, Stolz R, Schalhorn F, Valentini J, Krisam J, Frick E, Mächler R, Szecsenyi J, Straßner C. Self-Efficacy, Social Activity, and Spirituality in the Care of Elderly Patients with Polypharmacy in Germany-A Multicentric Cross-Sectional Study within the HoPES3 Trial. Healthcare (Basel) 2021; 9:healthcare9101312. [PMID: 34682993 PMCID: PMC8544376 DOI: 10.3390/healthcare9101312] [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: 08/16/2021] [Revised: 09/23/2021] [Accepted: 09/28/2021] [Indexed: 11/24/2022] Open
Abstract
About one third of Europe’s elderly population takes ≥5 drugs. Polypharmacy increases their risk of adverse drug reactions. To ensure drug safety, innovative approaches are needed. The aim of this cross-sectional study was to explore the relationship between psychosocial factors and medication-related beliefs and behaviors. Medication lists of 297 patients were recorded according to the ATC classification. Correlations between the dependent variables, Medication Adherence (MARS) and Beliefs about Medicines (BMQ), and independent variables, General Self-Efficacy (GSE), self-efficacy for managing chronic diseases (SES6G), spiritual needs (SpNQ), patient activity (PAM), loneliness (DJG), and social networks (LSNS), were measured. Patients with higher self-efficacy (OR: 1.113; 95% CI [1.056–1.174]; p < 0.001) or self-confidence in managing their chronic condition (OR: 1.188; 95% CI [1.048–1.346]; p < 0.007) also showed higher adherence. Lonely patients (OR: 0.420; 95% CI [0.267–0.660]; p < 0.001) and those with a need for inner peace (OR: 0.613; 95% CI [0.444–0.846], p = 0.003) were more likely nonadherent. Stronger positive beliefs about medications’ usefulness weakly correlated with higher scores on the SES6G (ρ = 0.178, p = 0.003) and GSES scale (ρ = 0.121, p = 0.042), patient activity (ρ = 0.155, p = 0.010) and functioning social networks scale (ρ = 0.159, p = 0.008). A weak positive correlation was found between loneliness and the belief that drugs were harmful (ρ = 0.194, p = 0.001). Furthermore, interesting correlations were detected regarding the number of medications and overuse beliefs. Psychosocial factors, such as self-efficacy, loneliness, and spiritual needs and medication-related beliefs and behaviors seem to interrelate. Addressing these factors may improve medication management and drug safety.
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Affiliation(s)
- Noemi Sturm
- Department of General Practice and Health Services Research, University Hospital Heidelberg, 69120 Heidelberg, Germany; (J.S.); (C.S.)
- Correspondence:
| | - Regina Stolz
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, 72076 Tübingen, Germany; (R.S.); (F.S.); (J.V.)
| | - Friederike Schalhorn
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, 72076 Tübingen, Germany; (R.S.); (F.S.); (J.V.)
| | - Jan Valentini
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, 72076 Tübingen, Germany; (R.S.); (F.S.); (J.V.)
| | - Johannes Krisam
- Institute of Medical Biometry, University Hospital Heidelberg, 69120 Heidelberg, Germany;
| | - Eckhard Frick
- Research Center Spiritual Care, Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, University Hospital Rechts der Isar, 81675 München, Germany; (E.F.); (R.M.)
| | - Ruth Mächler
- Research Center Spiritual Care, Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, University Hospital Rechts der Isar, 81675 München, Germany; (E.F.); (R.M.)
| | - Joachim Szecsenyi
- Department of General Practice and Health Services Research, University Hospital Heidelberg, 69120 Heidelberg, Germany; (J.S.); (C.S.)
| | - Cornelia Straßner
- Department of General Practice and Health Services Research, University Hospital Heidelberg, 69120 Heidelberg, Germany; (J.S.); (C.S.)
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Kim HN, Sutharson SJ. Emotional valence and arousal induced by auditory stimuli among individuals with visual impairment. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2021. [DOI: 10.1177/02646196211042257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite significant vision loss, humans can still recognize various emotional stimuli via a sense of hearing and express diverse emotional responses, which can be sorted into two dimensions, arousal and valence. Yet, many research studies have been focusing on sighted people, leading to lack of knowledge about emotion perception mechanisms of people with visual impairment. This study aims at advancing knowledge of the degree to which people with visual impairment perceive various emotions – high/low arousal and positive/negative emotions. A total of 30 individuals with visual impairment participated in interviews where they listened to stories of people who became visually impaired, encountered and overcame various challenges, and they were instructed to share their emotions. Participants perceived different kinds and intensities of emotions, depending on their demographic variables such as living alone, loneliness, onset of visual impairment, visual acuity, race/ethnicity, and employment status. The advanced knowledge of emotion perceptions in people with visual impairment is anticipated to contribute toward better designing social supports that can adequately accommodate those with visual impairment.
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Affiliation(s)
- Hyung Nam Kim
- North Carolina Agricultural and Technical State University, USA
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Benson T, Seers H, Webb N, McMahon P. Development of social contact and loneliness measures with validation in social prescribing. BMJ Open Qual 2021; 10:bmjoq-2020-001306. [PMID: 33990393 PMCID: PMC8127978 DOI: 10.1136/bmjoq-2020-001306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/26/2021] [Accepted: 05/05/2021] [Indexed: 12/03/2022] Open
Abstract
Aims This paper describes two patient-reported measures of social contact and loneliness, which are closely related concepts. The first measure (R-Outcomes Social Contact measure) was developed from scratch, based on customer needs and literature review. It covers emotional and social aspects using positive terms. The second measure (R-Outcomes Loneliness measure) is adapted from the GSS Loneliness Harmonised Standard. Both measures are patient-reported outcome measures, based on patients’ own perception of how they feel. Method This development started in 2016 in response to customers’ requests to measure social contact/loneliness for patients in social prescribing projects. Both measures are compared with three other loneliness measures (the GSS Loneliness Harmonised Standard, De Jong Gierveld and Campaign to End Loneliness). Both measures are short (36 and 21 words, respectively). Mean improvement is reported as a positive number on a 0–100 scale (where high is good). We tested the psychometric performance and construct validity of the R-Outcomes Social Contact measure using secondary analysis of anonymised data collected before and after social prescribing interventions in one part of Southern England. Results In the validation study, 728 responses, collected during 2019–2020, were analysed. 90% were over 70 years old and 62% women. Cronbach’s α=0.76, which suggests that it is appropriate to use a single summary score. Mean Social Contact scores before and after social prescribing intervention were 59.9 (before) and 66.7 (after, p<0.001). Exploratory factor analysis shows that measures for social contact, health status, health confidence, patient experience, personal well-being, medication adherence and social determinants of health are correlated but distinct factors. Construct validation shows that the results are consistent with nine hypotheses, based on the loneliness literature. Conclusion The R-Outcomes Social Contact measure has good psychometric and construct validation results in a population referred to social prescribing. It is complementary to other R-Outcomes measures.
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Affiliation(s)
- Tim Benson
- R-Outcomes Ltd, Newbury, UK .,Institute of Health Informatics, University College London, London, UK
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25
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Stickley A, Matsubayashi T, Ueda M. Loneliness and COVID-19 preventive behaviours among Japanese adults. J Public Health (Oxf) 2021; 43:53-60. [PMID: 32880635 PMCID: PMC7499629 DOI: 10.1093/pubmed/fdaa151] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/04/2020] [Accepted: 08/09/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND There is some evidence that loneliness may be linked to poorer health behaviours. Despite this, there has been little research to date on the relationship between loneliness and COVID-19 preventive behaviours. We studied these associations in a sample of the Japanese population. METHODS Data were analysed from an online survey of 2000 adults undertaken in April and May 2020. Loneliness was assessed with the Three-Item Loneliness Scale. Information was also collected on 13 COVID-19 preventive behaviours. Regression analyses were used to examine associations. RESULTS In linear regression models adjusted for demographic and mental health variables, both dichotomous and continuous loneliness measures were negatively associated with engaging in COVID-19 preventive behaviours. Logistic regression analyses further showed that loneliness was also associated with reduced odds for a variety of individual preventive behaviours including wearing a mask (odds ratio [OR]: 0.77, 95% confidence interval [CI]: 0.62-0.95), disinfecting hands (OR: 0.80, 95% CI: 0.67-0.94) and social distancing when outdoors (OR: 0.75, 95% CI: 0.61-0.92). CONCLUSIONS Loneliness is associated with lower engagement in COVID-19 preventive behaviours. Interventions to prevent or ameliorate loneliness during the ongoing pandemic may be important in combating the spread of the coronavirus.
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Affiliation(s)
- Andrew Stickley
- Faculty of Political Science and Economics, Waseda University, Building No.3 1-6-1 Nishiwaseda, Shinjuku-ku, Tokyo 169-8050, Japan, Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo 187-8553, Japan
| | - Tetsuya Matsubayashi
- Osaka School of International Public Policy, Osaka University, 1-31 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
| | - Michiko Ueda
- Faculty of Political Science and Economics, Waseda University, Building No.3 1-6-1 Nishiwaseda, Shinjuku-ku, Tokyo 169-8050, Japan
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Solmi M, Miola A, Croatto G, Pigato G, Favaro A, Fornaro M, Berk M, Smith L, Quevedo J, Maes M, Correll CU, Carvalho AF. How can we improve antidepressant adherence in the management of depression? A targeted review and 10 clinical recommendations. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2021; 43:189-202. [PMID: 32491040 PMCID: PMC8023158 DOI: 10.1590/1516-4446-2020-0935] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 04/02/2020] [Indexed: 12/11/2022]
Abstract
Adherence to antidepressants is crucial for optimal treatment outcomes when treating depressive disorders. However, poor adherence is common among patients prescribed antidepressants. This targeted review summarizes the main factors associated with poor adherence, interventions that promote antidepressant adherence, pharmacological aspects related to antidepressant adherence, and formulates 10 clinical recommendations to optimize antidepressant adherence. Patient-related factors associated with antidepressant non-adherence include younger age, psychiatric and medical comorbidities, cognitive impairment, and substance use disorders. Prescriber behavior-related factors include neglecting medical and family histories, selecting poorly tolerated antidepressants, or complex antidepressant regimens. Multi-disciplinary interventions targeting both patient and prescriber, aimed at improving antidepressant adherence, include psychoeducation and providing the patient with clear behavioral interventions to prevent/minimize poor adherence. Regarding antidepressant choice, agents with individually tailored tolerability profile should be chosen. Ten clinical recommendations include four points focusing on the patient (therapeutic alliance, adequate history taking, measurement of depressive symptoms, and adverse effects improved access to clinical care), three focusing on prescribing practice (psychoeducation, individually tailored antidepressant choice, simplified regimen), two focusing on mental health services (improved access to mental health care, incentivized adherence promotion and monitoring), and one relating to adherence measurement (adherence measurement with scales and/or therapeutic drug monitoring).
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Affiliation(s)
- Marco Solmi
- Dipartimento di Neuroscienze, Università di Padova, Padova, Italy
- Azienda Ospedale Università di Padova, Padova, Italy
| | - Alessandro Miola
- Dipartimento di Neuroscienze, Università di Padova, Padova, Italy
| | - Giovanni Croatto
- Dipartimento di Neuroscienze, Università di Padova, Padova, Italy
| | | | - Angela Favaro
- Dipartimento di Neuroscienze, Università di Padova, Padova, Italy
- Azienda Ospedale Università di Padova, Padova, Italy
| | - Michele Fornaro
- Dipartimento di psichiatria, Università Federico II, Napoli, Italy
- Polyedra, Teramo, Italy
| | - Michael Berk
- Institute for Mental and Physical Health and Clinical Translation (IMPACT Strategic Research Centre), School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
- Department of Psychiatry, Orygen – The Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Victoria, Australia
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Joao Quevedo
- Programa de Pós-Graduação em Ciências da Saúde, Laboratório de Neurociências, Unidade de Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
- Department of Psychiatry and Behavioral Sciences, Center of Excellence on Mood Disorders, McGovern Medical School, UTHealth, Houston, TX, USA
- Neuroscience Graduate Program, The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA
| | - Michael Maes
- IMPACT Strategic Research Centre, Barwon Health, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Christoph U. Correll
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, NY, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - André F. Carvalho
- IMPACT Strategic Research Centre, Barwon Health, School of Medicine, Deakin University, Geelong, Victoria, Australia
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
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Jia Z, Li S. Risk of Cardiovascular Disease Mortality in Relation to Depression and 14 Common Risk Factors. Int J Gen Med 2021; 14:441-449. [PMID: 33603451 PMCID: PMC7887189 DOI: 10.2147/ijgm.s292140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 01/13/2021] [Indexed: 01/08/2023] Open
Abstract
Background Depression has been linked to a worse prognosis of Cardiovascular disease (CVD), and these two diseases share a variety of common risk factors such as unhealthy lifestyles and chronic medical conditions. However, the potential role of these common risk factors in modulating the association between depression and CVD mortality and whether the co-occurrence of depression and a specific common risk factor has a cumulative impact on CVD mortality are still largely unknown. Methods We pooled data from 2005–2014 of Nation health and nutritional examination survey, leading to a study population of 22,177 adults. The Patient Health Questionnaire was employed to assess the depression symptoms, and information on CVD mortality was obtained from the linked mortality file of NHANES. Fourteen common risk factors of depression and CVD were included in this study. Results Based on the interaction analyses, we found overweight was protective for the risk of CVD death in depressive participants, but not in people without depression. Moreover, relative risk-based analyses indicated a mutually promotive effect of depression and baseline CVD or living alone on CVD mortality. Conclusion The novel findings in our study may facilitate risk stratification in the clinical programs targeting CVD mortality and help to shed light on the differential pathophysiological mechanisms in the depression-mediated elevation of CVD mortality.
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Affiliation(s)
- Zhaoqi Jia
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Sen Li
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, People's Republic of China
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Kobos E, Szewczyk A, Kokoszka‐Paszkot J, Dziedzic B. Factors associated with loneliness in patients with diabetes mellitus. Nurs Open 2021; 8:517-524. [PMID: 33318858 PMCID: PMC7729652 DOI: 10.1002/nop2.655] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/06/2020] [Accepted: 09/22/2020] [Indexed: 01/14/2023] Open
Abstract
Aim To (a) explore the prevalence of loneliness in patients with diabetes mellitus and (b) identify loneliness-related factors in the group of hospitalized patients with diabetes mellitus. Design A cross-sectional study. Methods The study included 248 patients with diabetes mellitus who were staying in six Polish hospitals. A questionnaire including sociodemographic and clinical data, and the Revised UCLA Loneliness Scale (R-UCLA), was used for research data collection. Data were collected from March 2019 to June 2019. Results Patients with diabetes generally experience moderate loneliness, with almost one-fifth (16%) of patients experiencing intense loneliness. The patients scored a mean 9.94 out of a possible 20 in belongings and affiliation category and 20.14 out of a possible 40 in the intimate others category. Lower education, being single and the presence of chronic complications of diabetes mellitus were risk factors for increased loneliness.
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Affiliation(s)
- Ewa Kobos
- Department of Development of Nursing, Social and Medical SciencesFaculty of Health SciencesMedical University of WarsawWarsawPoland
- Polish Federation for Education in DiabetologyWarsawPoland
| | - Alicja Szewczyk
- Polish Federation for Education in DiabetologyWarsawPoland
- Clinic of Endocrinology and DiabetologyThe Children’s Memorial Health InstituteWarsawPoland
| | | | - Beata Dziedzic
- Department of Development of Nursing, Social and Medical SciencesFaculty of Health SciencesMedical University of WarsawWarsawPoland
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Bay LT, Ellingsen T, Giraldi A, Graugaard C, Nielsen DS. "To be lonely in your own loneliness": The interplay between self-perceived loneliness and rheumatoid arthritis in everyday life: A qualitative study. Musculoskeletal Care 2020; 18:450-458. [PMID: 32491275 DOI: 10.1002/msc.1480] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/02/2020] [Accepted: 05/06/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Loneliness has a negative impact on physical health, and rheumatoid arthritis symptoms can lead to social isolation. However, there is a lack of research exploring patients' perspectives on self-perceived loneliness in everyday life with rheumatoid arthritis. The purpose of this study was to gain insight into the meaning and importance of self-perceived loneliness among adult patients diagnosed with rheumatoid arthritis. METHODS This study was designed as a qualitative, exploratory interview study using a narrative framework. Semi-structured interviews were conducted with Danish adults with rheumatoid arthritis. All interviews were recorded, transcribed verbatim, and analyzed within a narrative thematic framework. RESULTS Ten women and seven men were interviewed, aged between 18 and 73 years and a disease duration between 6 months and 40 years. Three themes were identified during the analysis: (1) explanations of loneliness in everyday life with rheumatoid arthritis, (2) disclosing or disguising loneliness, and (3) feelings of loneliness in social life. CONCLUSION The findings from this study show that loneliness can be burdensome when living with RA. Narratives of loneliness can be hard for patients to disclose, so health care practitioners should take responsibility for legitimizing this subject. A narrative approach in consultations may be helpful to support patients and to encourage a dialogue about loneliness in everyday life with rheumatoid arthritis.
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Affiliation(s)
- Laila Twisttmann Bay
- Rheumatology Research Unit, Department of Rheumatology, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | - Torkell Ellingsen
- Rheumatology Research Unit, Department of Rheumatology, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | - Annamaria Giraldi
- Sexological Clinic, Psychiatric Centre Copenhagen and Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Graugaard
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Dorthe S Nielsen
- University College Lillebaelt, Odense, Denmark
- Migrant Health Clinic, Odense University Hospital, Odense, Denmark
- Center for Global Health, University of Southern Denmark, Odense, Denmark
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Kobos E, Szewczyk A, Świątkowska T, Kryczka T, Sienkiewicz Z. Relationship between loneliness and blood glucose control in diabetes. BMC Public Health 2020; 20:1140. [PMID: 32689971 PMCID: PMC7372778 DOI: 10.1186/s12889-020-09241-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/12/2020] [Indexed: 12/21/2022] Open
Abstract
Background The data of the International Diabetes Federation show that about 463 million people have diabetes. Better understanding of psychosocial aspects of life with this disease has become one of healthcare priorities in this group of patients. The aim of this study was to assess the relationships between loneliness and blood glucose control in diabetic patients. Methods The study included 250 hospitalized patients with type 1 and 2 diabetes. The patients included in the study were those who had had diabetes for at least 1 year and received pharmacotherapy. Standardized Revised UCLA Loneliness Scale (R-UCLA) and an analysis of patient test results including 10 indicators of blood glucose control were used for data collection. Correlation analysis, i.e. Pearson’s linear correlation coefficient (r, parametric method), was used for hypothesis verification. Results Less than one-fifth (16%) of the patients included in the study had higher loneliness index (based on the R-UCLA scale), and this loneliness index (total result) was significantly correlated with higher blood pressure. No significant correlations were demonstrated between loneliness and the other 9 indicators of blood glucose control. Conclusions Systolic blood pressure was significantly correlated with loneliness in patients with diabetes. Further studies are needed to confirm these findings.
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Affiliation(s)
- Ewa Kobos
- Department of Development of Nursing, Social and Medical Sciences, Faculty of Health Sciences, Medical University of Warsaw, Żwirki i Wigury 61, 02-091, Warsaw, Poland. .,Polish Federation for Education in Diabetology, Żegańska 21/23, 03-823, Warsaw, Poland.
| | - Alicja Szewczyk
- Polish Federation for Education in Diabetology, Żegańska 21/23, 03-823, Warsaw, Poland.,The Children's Memorial Health Institute, Clinic of Endocrinology and Diabetology, Al. Dzieci Polskich 20, 04-730, Warsaw, Poland
| | - Teresa Świątkowska
- Clinic of Endocrinology and Diabetology, Teaching Clinical Hospital, Marii Skłodowskiej Curie 9, 85-094, Bydgoszcz, Poland
| | - Tomasz Kryczka
- Department of Development of Nursing, Social and Medical Sciences, Faculty of Health Sciences, Medical University of Warsaw, Żwirki i Wigury 61, 02-091, Warsaw, Poland
| | - Zofia Sienkiewicz
- Department of Development of Nursing, Social and Medical Sciences, Faculty of Health Sciences, Medical University of Warsaw, Żwirki i Wigury 61, 02-091, Warsaw, Poland
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Loneliness and its correlates amongst elderly attending non-communicable disease rural clinic attached to a tertiary care centre of North India. Asian J Psychiatr 2019; 43:189-196. [PMID: 31229701 DOI: 10.1016/j.ajp.2019.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 05/14/2019] [Accepted: 06/07/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Psychological and sociological factors like loneliness have a noteworthy influence on the aging. Very less is known about loneliness amongst the elderly populations living with various Non-communicable diseases. AIM The present study aimed to evaluate the prevalence and correlates of loneliness among elderly patients with Non-communicable diseases. METHODOLOGY 296 patients attending the chronic disease clinic of two Community Health Centres were evaluated on University of California, Los Angeles Loneliness Scale (UCLA LS), Geriatric Depression Scale, Generalized Anxiety Disorder (GAD-7 scale) and Vulnerability to Abuse Screening Scale. RESULTS More than half (55.4%) of the participants experienced loneliness as per the three item UCLA LS. When the total scores of UCLA scale were used to evaluate the severity of loneliness, half of the study participants had either moderate (N = 39; 13.2%), moderately high (N = 52; 17.6%) and high (N = 55; 18.6%) level of loneliness. Higher proportion of patients experiencing loneliness had anxiety and reported abuse. Significant predictors of loneliness included presence of diabetes mellitus or hypertension, generalized anxiety disorder and abuse. CONCLUSION Older adults living with non-communicable diseases are at a higher risk for loneliness. Mutual help groups kind of models can be developed to help in "re-peopling" elderly. Primary health centres should help in improving the overall health and morale amongst the elderly by stamping down their apprehensions and anxieties.
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