Predictors of dietary self-efficacy in high glycosylated hemoglobin A1c type 2 diabetic patients

Associations between cooking skills, cooking with processed foods, and health: a cross-sectional study

To improve health outcomes, home cooking has been suggested as a solution to reduce intakes of processed foods. However, little is known about how cooking skills or cooking with processed foods influence health. This cross-sectional study examined associations between diet and health outcomes with cooking skills and cooking with processed foods. The dataset included a nationally representative sample of 18 460 adults from Canadian Community Health Survey (CCHS) annual component rapid response modules on food skills. In the CCHS rapid response modules, diet and health outcomes (fruit and vegetable intake, general health, mental health, and obesity) and data related to cooking skills and cooking with processed foods were collected through self-report. Separate logistic regression models were fitted for each outcome, controlling for age, income, and education, and stratified by sex. Adults with poor cooking skills were less likely to have adequate fruit and vegetable intake (≥5 servings per day) (p < 0.001), very good general health (p < 0.001) or mental health (p < 0.001), and obesity (p = 0.02) compared to advanced cooking skills. Adults who cooked with highly processed foods were less likely to have adequate fruit and vegetable intake (p < 0.001), very good general health (p = 0.002) or mental health (p < 0.001), but more likely to have obesity (p = 0.03) compared to cooking with minimally processed foods. Cooking skills alone appear insufficient to protect against obesity. Results suggest that not only are cooking skills important, but the quality of ingredients also matter. Limiting the use of processed foods in addition to improving cooking skills are potential intervention targets to promote better health and diet outcomes.

The relationship between patient empowerment and related constructs, affective symptoms and quality of life in patients with type 2 diabetes: a systematic review and meta-analysis

Introduction

The aim of this systematic review is to assess the relationship between patient empowerment and other empowerment-related constructs, and affective symptoms and quality of life in patients with type 2 diabetes.

Methods

A systematic review of the literature was conducted, according to the PRISMA guidelines. Studies addressing adult patients with type 2 diabetes and reporting the association between empowerment-related constructs and subjective measures of anxiety, depression and distress, as well as self-reported quality of life were included. The following electronic databases were consulted from inception to July 2022: Medline, Embase, PsycINFO, and Cochrane Library. The methodological quality of the included studies was analyzed using validated tools adapted to each study design. Meta-analyses of correlations were performed using an inverse variance restricted maximum likelihood random-effects.

Results

The initial search yielded 2463 references and seventy-one studies were finally included. We found a weak-to-moderate inverse association between patient empowerment-related constructs and both anxiety (r = -0.22) and depression (r = -0.29). Moreover, empowerment-related constructs were moderately negatively correlated with distress (r = -0.31) and moderately positively correlated with general quality of life (r = 0.32). Small associations between empowerment-related constructs and both mental (r = 0.23) and physical quality of life (r = 0.13) were also reported.

Discussion

This evidence is mostly from cross-sectional studies. High-quality prospective studies are needed not only to better understand the role of patient empowerment but to assess causal associations. The results of the study highlight the importance of patient empowerment and other empowerment-related constructs such as self-efficacy or perceived control in diabetes care. Thus, they should be considered in the design, development and implementation of effective interventions and policies aimed at improving psychosocial outcomes in patients with type 2 diabetes.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020192429, identifier CRD42020192429.

Personality and weight management in adults with type 2 diabetes: A systematic review

Aims

Managing weight in the context of type 2 diabetes presents unique hormonal, medicinal, behavioural and psychological challenges. The relationship between weight management and personality has previously been reviewed for general and cardiovascular disease populations but is less well understood in diabetes. This systematic review investigated the relationship between personality constructs and weight management outcomes and behaviours among adults with type 2 diabetes.

Methods

Medline, PubMed, Embase, PsycINFO and SPORTDiscus databases were searched to July 2021. Eligibility: empirical quantitative studies; English language; adults with type 2 diabetes; investigation of personality-weight management association. Search terms included variants of: diabetes, physical activity, diet, body mass index (BMI), adiposity, personality constructs and validated scales. A narrative synthesis, with quality assessment, was conducted.

Results

Seventeen studies were identified: nine cross-sectional, six cohort and two randomised controlled trials (N=6,672 participants, range: 30-1,553). Three studies had a low risk of bias. Personality measurement varied. The Big Five and Type D personality constructs were the most common measures. Higher emotional instability (neuroticism, negative affect, anxiety, unmitigated communion and external locus of control) was negatively associated with healthy diet and physical activity, and positively associated with BMI. Conscientiousness had positive associations with healthy diet and physical activity and negative associations with BMI and anthropometric indices.

Conclusions

Among adults with type 2 diabetes, evidence exists of a relationship between weight management and personality, specifically, negative emotionality and conscientiousness. Consideration of personality may be important for optimising weight management and further research is warranted.

Systematic review registration

www.crd.york.ac.uk/prospero/, identifier CRD42019111002.

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

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.

Pathways Linking Health Literacy to Self-Management in People with Type 2 Diabetes

Health literacy is considered to be an emerging determinant of health behaviors and outcomes. The underlying mechanisms linking health literacy to diabetes self-management are currently unclear. This study assessed a mediation model consisting of a direct pathway between health literacy and self-management, and indirect pathways via social isolation only, self-efficacy only, and social isolation and self-efficacy serially in people with type 2 diabetes. A cross-sectional design was employed, and a total of 524 participants were recruited from outpatient clinics of multi-institutions from June 2020 to February 2021. The mediation model was analyzed using the PROCESS macro on SPSS with bootstrap bias-corrected 95% confidence intervals (CIs) with 10,000 bootstrapping iterations. Health literacy positively affected self-management. The estimated indirect effect of health literacy on self-management via social isolation was significant, at 0.018 (95% CI = 0.004–0.036). The indirect effect via self-efficacy was estimated at 0.214 (95% CI = 0.165–0.266). The indirect effect via social isolation and self-efficacy serially was 0.013 (95% CI = 0.006–0.023). The findings of this study suggest that clinical practice can be improved through more comprehensive diabetes self-management interventions that promote all of the components of health literacy, social contacts/networks, and self-efficacy in particular.

The Influence of the COVID-19 Pandemic on the Stress Levels and Occurrence of Stomatoghnatic System Disorders (SSDs) among Physiotherapy Students in Poland

Background: This study is a quantitative analysis examining the impact of the COVID-19 pandemic on the occurrence of stress and stomatognathic system disorders (SSDs) among students of physiotherapy. Objective: To assess stress severity, strategies of coping with stress and the presence of type D personality among physiotherapy students including those with symptoms of stomatognathic system disorders. Material and Methods: The research was conducted from October to December 2020 on a sample of 188 students of physiotherapy. The data were collected using a survey form related to the occurrence of SS disorders symptoms and standardized psychological questionnaires, such as the Perceived Stress Scale (PSS)-10, Mini-Cope, and the type-D Scale (DS14), developed for the purpose of this study. Results: Women experiencing at least one of the SS disorder-related symptoms were characterized by a significantly higher level of stress and a type D personality (p < 0.05). Among men, these differences were not statistically significant (p > 0.05). On the basis of the strategies of coping with stress, i.e., positive self-reevaluation, discharging and blaming oneself, and taking psychoactive substances, it is possible to predict the intensity of stress during the pandemic in the group of the examined students. Among the reported symptoms of SS, headache was a significant predictor of stress, which was accompanied by an increase in the intensity of stress by nearly 0.2 measurement points. Students with higher levels of stress showed more symptoms of type D personality, and those with more severe symptoms of SS showed higher levels of stress. Conclusions: People prone to stress and having type D personality traits should be assessed for the presence of SS disorders.