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Nielsen MH, Jensen AL, Pedersen ML, Seibæk L. Living with chronic obstructive pulmonary disease or type 2 diabetes in Greenland - a qualitative interpretive description study. Int J Circumpolar Health 2024; 83:2296706. [PMID: 38127836 PMCID: PMC10763871 DOI: 10.1080/22423982.2023.2296706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
Non-communicable diseases such as chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (T2D) represent major challenges for health systems all over the world. In an interview study, we explored patient experiences and perspectives of being diagnosed and living with COPD or T2D in Greenland. Participants (n = 24) were selected by purposeful sampling and recruited by phone. We conducted individual semi-structured interviews at the National Hospital in Nuuk and the four regional hospitals. Interviews were audio-recorded, transcribed verbatim, and analysed using interpretive description. Three themes emerged: shock and shame on receiving the diagnosis, coping with a changed life, and varying needs for care and communication. We found that being diagnosed with COPD or T2D required a rapid change in the participants' everyday lives and lifestyle behaviours. Some self-managed their disease well and were able to transfer their knowledge and integrate it into their daily lives, while others struggled to make lifestyle changes. Additionally, living with COPD or T2D could be related to silence and shame. The findings contribute to a better understanding of living with COPD or T2D in the Arctic region and the development of future, culturally-adapted patient education initiatives.
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Affiliation(s)
- Maja Hykkelbjerg Nielsen
- Queen Ingrid’s Hospital, Steno Diabetes Center Greenland, Nuuk, Greenland
- Greenland Center for Health Research, Department of Health and Nature, Ilisimatusarfik/University of Greenland, Nuuk, Greenland
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Annesofie Lunde Jensen
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Michael Lynge Pedersen
- Queen Ingrid’s Hospital, Steno Diabetes Center Greenland, Nuuk, Greenland
- Greenland Center for Health Research, Department of Health and Nature, Ilisimatusarfik/University of Greenland, Nuuk, Greenland
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lene Seibæk
- Greenland Center for Health Research, Department of Health and Nature, Ilisimatusarfik/University of Greenland, Nuuk, Greenland
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
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Hepper EC, Wilson J, Drinnan M, Patterson JM. Psychosocial impacts of being nil-by-mouth as an adult: A scoping review. J Adv Nurs 2024; 80:3499-3515. [PMID: 38414146 DOI: 10.1111/jan.16100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/25/2024] [Accepted: 02/06/2024] [Indexed: 02/29/2024]
Abstract
AIM To map existing evidence and identify gaps in the literature concerning psychosocial impacts of being nil by mouth (NBM) as an adult. DESIGN A scoping review of the literature was undertaken using JBI guidance. A protocol was registered on the Open Science Framework (osf.io/43g9y). Reporting was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). METHODS A comprehensive search of six databases (CINAHL, Embase, MEDLINE, PsycINFO, SCOPUS and Web of Science) was performed for studies published up to February 2023, with no restriction to study type. A scope of the grey literature was also undertaken. Two authors independently assessed eligibility and extracted data. Descriptive statistical analysis and narrative synthesis were used, and patient and public involvement included in funding discussions. RESULTS A total of 23 papers were included in the review, consisting of 14 primary studies (7 qualitative and 7 quantitative) and 9 grey literature. Both global psychological distress and distress specific to being NBM (thirst, missing food and drink) were reported. Caregivers also experience distress from their family member being NBM. Furthermore, social impacts were reported for both patient and caregiver, primarily social isolation and subsequent low mood. CONCLUSION Furthermore, research is needed to understand the prevalence of this population, how best to measure psychosocial impacts and to explore whether (and how) psychosocial impacts change over time. Advancement in this area would enable better service development to optimize care for this patient group. WHAT IS KNOWN ABOUT THIS TOPIC?: Eating and drinking provides more than nutrition and hydration. A wide range of conditions can lead to recommendations for no longer eating and drinking (nil by mouth). Being nil by mouth (NBM) for short periods such as pre-operative fasting causes distress; however, little is understood about impact on longer-term abstinence from eating and drinking. WHAT THIS PAPER ADDS?: Psychosocial consequences of being nil by mouth (NBM)have been investigated by both quantitative and qualitative studies. Being NBM impacts both patients and caregivers in various psychosocial aspects, including distress and social isolation. Several gaps remain, however, regarding ways to measure psychosocial impact of being NBM.
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Affiliation(s)
- Elizabeth C Hepper
- School of Health Sciences, Liverpool University, Liverpool, UK
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - John Wilson
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Michael Drinnan
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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Nasir A, Hassan II, Ma’ruf A, Suharno NE, Goenharto S, Purwanto CR, Tyas APM. Coping efforts made: Psychological burden of people living with tuberculosis due to social stigma in society. A qualitative phenomenology study. PLoS One 2024; 19:e0303331. [PMID: 39078843 PMCID: PMC11288456 DOI: 10.1371/journal.pone.0303331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 04/23/2024] [Indexed: 08/02/2024] Open
Abstract
The psychological burden is greatly felt by people living with tuberculosis because the characteristics of the disease are very visible and very contagious, and the obligation to take the right dose of medication with long treatment. This is what makes tuberculosis a very stigmatic disease. The aim of this research is to explore the psychological burden felt by people living with tuberculosis due to social stigma by society and how coping efforts are made. This research uses a qualitative phenomenological design through in-depth face-to-face interviews which take place in a semi-structured manner with the hope of obtaining complete data. The purposive sampling method was used in this research with Participatory Interpretative Phenomenology analysis involving 25 participants consisting of 16 men and 9 women. This research produced several themes, including 1) "The Perception of stigma limiting space and time", 2) "The Opportunities for interpersonal interaction become narrow", 3) "The mental stress as a challenging emotion", and 4) " Expanding coping efforts". The psychological burden is felt by people living with tuberculosis because society's treatment is felt to be very discriminatory due to the social stigma that has developed in society so they lose the opportunity to interact with society. For that reason, they tried to explore some of the personal and environmental resources used to modify adaptive coping in resolving perceived psychological burdens. Given the possibility of ongoing stigma and discrimination during tuberculosis treatment programs, it is important to consider the psychological burden in this context, both on the general population and on groups affected by stigma.
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Affiliation(s)
- Abd Nasir
- Faculty of Vocational Studies, Universitas Airlangga, Surabaya, Indonesia
| | | | - Anwar Ma’ruf
- Faculty of Vocational Studies, Universitas Airlangga, Surabaya, Indonesia
- Department of Basic Veterinary Science, Faculty of Veterinary Medicine, Universitas Airlangga Surabaya, Surabaya, Indonesia
| | | | | | - Cucuk Rahmadi Purwanto
- Doctoral Candidate of Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
- Faculty of Vocational Studies, Airlangga University, Surabaya, Indonesia
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Chen M, Che C. Perceived social support, self-management, perceived stress, and post-traumatic growth in older patients following stroke: Chain mediation analysis. Medicine (Baltimore) 2024; 103:e38836. [PMID: 39029078 DOI: 10.1097/md.0000000000038836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2024] Open
Abstract
Stroke is a potentially traumatic event that can lead to both positive changes associated with post-traumatic growth (PTG) and enduring mental distress. This study aimed to investigate the association between perceived stress and PTG among older postsurvivors, as well as to explore the potential mediating role of perceived social support and self-management in this relationship. A cross-sectional study was conducted to recruit 354 older poststroke survivors from 2 tertiary hospitals in Shenyang, China, between January 2022 and October 2023. Various multidimensional scales were utilized to measure perceived stress, perceived social support, self-management, and PTG. Structural equation modeling was employed by Amos 24.0 to analyze the mediating pathways. The average score of PTG was 50.54 ± 22.69 among older poststroke patients. Pearson analysis revealed significant associations between perceived stress, perceived social support, self-management, and PTG (all P < .01). The mediation model showed that perceived stress could both direct influence PTG (Effect = -0.196, 95% CI = [-0.259, -0.129]), and indirectly impact PTG through perceived social support (Effect = -0.096, 95% CI = [-0.157, -0.044]), through self-management (Effect = -0.033, 95% CI = [-0.064, -0.012]), and sequentially through perceived social support and self-management (Effect = -0.007, 95% CI = [-0.017, -0.002]), accounting for 58.9%, 28.8%, 9.9%, and 2.1% of the total effect, respectively. These findings confirmed the mediating roles of perceived social support and self-management between perceived stress and PTG among older poststroke survivors. This provides valuable insights into developing targeted social intervention programs to improve stroke management among older survivors.
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Affiliation(s)
- Meng Chen
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
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Hiefner AR, Raman S, Woods SB. Family Support and Type 2 Diabetes Self-management Behaviors in Underserved Latino/a/x Patients. Ann Behav Med 2024; 58:477-487. [PMID: 38795386 DOI: 10.1093/abm/kaae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2024] Open
Abstract
BACKGROUND Latino/a/x families experience persistent Type 2 diabetes mellitus (T2DM) disparities, including higher rates of diagnosis and mortality due to disease complications than their non-Hispanic White counterparts. Though greater social support is associated with improved disease outcomes for Latino/a/x patients with diabetes, research has yet to identify the specific pathways through which social support, and specifically family support, influences self-management. PURPOSE This study tested a theoretical model highlighting the mechanisms and pathways linking social support and physical health. Specifically, self-efficacy and depression were tested as psychological pathways connecting family support to diabetes self-management behaviors and diabetes morbidity in Latino/a/x patients with T2DM. METHODS Data from 177 patients were analyzed using structural equation modeling. Measures included diabetes-specific family support needed and received, depressive symptoms, self-efficacy in diabetes management, diabetes self-management behaviors, health appraisal, and hemoglobin A1c. RESULTS Greater diabetes-specific family support was significantly associated with more frequent engagement in diabetes self-management behaviors, both directly (p < .001) and through diabetes self-efficacy's partial mediation of this relationship (p = .013). Depression was not significantly associated with either family support (support received, p = .281; support needed, p = .428) or self-management behaviors (p = .349). CONCLUSIONS Family support and diabetes self-efficacy may be important modifiable psychosocial factors to target via integrated care interventions aimed at supporting Latino/a/x patients with T2DM. Future research is needed to test empirically based, culturally adapted interventions to reduce T2DM-related health disparities in this population.
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Affiliation(s)
- Angela R Hiefner
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Shivani Raman
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sarah B Woods
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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Özkan E, İnal Özün Ö, Göktaş A, İlhan B. Patient activation in adults with visual impairment: a study of related factors. BMC Public Health 2024; 24:1599. [PMID: 38877430 PMCID: PMC11179267 DOI: 10.1186/s12889-024-18856-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 05/15/2024] [Indexed: 06/16/2024] Open
Abstract
This study aims to analyze variables related to patient activation in 78 individuals with visual impairment. The Patient Activation Measure (PAM) scores of participants showed no differences between males and females. It was found that the individuals living in urban areas, and participants with higher income and education levels had higher PAM scores. Still, the difference between the groups was statistically insignificant (p > 0.05). The PAM scores of the visually impaired individuals reflect taking action level of activation (66.51 ± 18.14-PAM level 3). There was a moderately significant relationship between PAM scores and visually impaired individuals' self-management, self-efficacy, healthy life awareness, social relations, and environment (p < 0.001). We found that the variables included in the regression model (marital status, self-management, self-efficacy, healthy life awareness, social relations, and environment) explained 72.2% of the PAM score. Individuals with visual impairment can be given training on self-management, self-efficacy, healthy life awareness, and quality of life associated with social relations and environment to develop positive health behaviors.
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Affiliation(s)
- Esma Özkan
- Department of Occupational Therapy, Gülhane Faculty of Health Sciences,, University of Health Sciences Turkey, Keçiören, Ankara, 06018, Türkiye.
| | - Özgü İnal Özün
- Neurological Physiotherapy-Rehabilitation, Gülhane Faculty of Physiotherapy and Rehabilitation, University of Health Sciences Turkey, Ankara, Türkiye
| | - Ayşe Göktaş
- Department of Occupational Therapy, Gülhane Faculty of Health Sciences,, University of Health Sciences Turkey, Keçiören, Ankara, 06018, Türkiye
| | - Bayazıt İlhan
- University of Health Sciences Turkey Ulucanlar Eye Training and Research Hospital, Ankara, Türkiye
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Rutledge SE, Zhang J, Icard LD, Jemmott JB. Do syndemic conditions predict HIV medication adherence among urban African American men? AIDS Care 2024; 36:781-789. [PMID: 38387445 DOI: 10.1080/09540121.2024.2305149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 01/09/2024] [Indexed: 02/24/2024]
Abstract
Much progress has been made in advancing antiretroviral (ART) adherence, yet disparities remain. To explore relationships of syndemic conditions - co-occurring health conditions caused by combinations of biological, social, and structural factors - to ART adherence among African American men, we used data from longitudinal assessments of 302 African American men enrolled in a study designed to increase physical activity and healthy eating. Syndemic conditions included alcohol dependency, drug dependency, depression, post-traumatic stress disorder, and unstable housing. A syndemic conditions variable was operationalized to indicate the presence of 0-5 conditions. About 55% of participants had 1 or more syndemic conditions. Age and marriage were positively associated with ART adherence, whereas number of syndemic conditions was negatively associated with adherence during the 12-month period. The interaction of being married and the syndemic conditions variable significantly predicted greater adherence. Similarly, the interaction of more education and the syndemic conditions variable predicted greater adherence. In multiple regression models, the syndemic conditions variable remained significant (-0.018) in predicting adherence; however, there was no significant interaction among the 5 conditions. This study lends evidence to syndemics literature indicating deleterious consequences of negative life experiences on health outcomes.
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Affiliation(s)
| | - Jingwen Zhang
- Department of Communication, University of California, Davis, CA, USA
| | - Larry D Icard
- School of Social Work, Temple University, Philadelphia, PA, USA
- Centre for Community Technologies, Nelson Mandela University, Port Elizabeth, South Africa
| | - John B Jemmott
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Stine JG, Medic N, Pettersson B, Venerus M, Blau JE. The health care experience of adults with metabolic dysfunction-associated steatohepatitis and influence of PNPLA3: A qualitative study. Hepatol Commun 2024; 8:e0451. [PMID: 38780312 PMCID: PMC11124700 DOI: 10.1097/hc9.0000000000000451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/06/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Metabolic dysfunction-associated steatohepatitis (MASH) is a progressive form of metabolic dysfunction-associated steatotic liver disease, for which there is limited information about patient experience, including the patient journey. METHODS In this study, we conducted interviews with patients with MASH to qualitatively evaluate the patient journey and help elucidate the experiences of this patient population. We also investigated if the patatin-like phospholipase domain-containing protein 3 (PNPLA3) I148M variant (non-Hispanic) or being of Hispanic ethnicity may influence patient experiences because these 2 subgroups develop advanced liver disease more frequently than other patient groups. RESULTS One-to-one interviews were conducted with 28 adults (with PNPLA3 I148M genetic variant, n = 10; Hispanic, n = 8) living in the United States who had been diagnosed with MASH with liver fibrosis. Patients were asked open-ended questions about their experiences before, at, and after their diagnosis. The data collected found that patients experienced a long process of misdiagnoses before their diagnosis of MASH, a lack of clear information provided by clinicians, and limited accessibility to support groups. Hispanic patients reported "impact on family/friends" (75%) and "fear of disease progression" (75%) more frequently than the other patient cohorts interviewed. This is the first report of "fear of progression" in patients with MASH. No patients who were White and had the PNPLA3 I148M variant reported nausea/vomiting, in contrast to other patient cohorts. CONCLUSIONS This qualitative study identified key aspects of the patient journey that are important for clinical providers and medical teams to recognize. We also propose a new algorithm that could be developed to help screen relatives of patients who are found to carry the PNPLA3 I148M variant.
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Affiliation(s)
- Jonathan G. Stine
- Department of Medicine, Division of Gastroenterology and Hepatology, The Pennsylvania State University Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
- Fatty Liver Program, Pennsylvania State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
- Liver Center, The Pennsylvania State University Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Cancer Institute, The Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Nenad Medic
- Patient Centered Science, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK
| | - Billie Pettersson
- Patient Centered Science, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden
| | | | - Jenny E. Blau
- Research and Early Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA
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Pryce H, Smith S, Burns O'Connell G, Hussain S, Straus J, Shaw R. The lived experience of hearing loss - an individualised responsibility. Int J Audiol 2024:1-9. [PMID: 38767328 DOI: 10.1080/14992027.2024.2351037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 04/26/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVE This study aimed to provide a conceptual model to understand what typifies the lived experience of hearing loss. DESIGN A grounded theory informed study of adults with hearing loss (n = 46) who participated in individual interviews. The data were analysed in line with the constant comparative approach of grounded theory. A substantial patient and public engagement (PPIE) strategy underpinned decisions and processes throughout. STUDY SAMPLE Adults were recruited from age bands (16-29; 30-49;50-79 and 80 upwards) to provide different lived experience. We recruited individuals from across the UK including urban, sub-urban and rural communities and included a typical constituency of each location including black and minority ethnic participants. Our PPIE groups included adults often marginalised in research including South Asian community groups, adults in residential care and those with additional disabilities. RESULTS We identified the consistent features of the lived experience with hearing loss, as the individualised responsibility that hearing loss confers. These are an individual auditory lifeworld; social comparison and social support; individual and patient-centred care and individual agency and capability. CONCLUSIONS This work provides new insights for those practising audiology and highlights the importance of building social support systems through implementation of family and peer support approaches.
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Affiliation(s)
- Helen Pryce
- Department of Audiology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Sian Smith
- Institute of Health and Neurodevelopment and School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Georgie Burns O'Connell
- Department of Audiology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Saira Hussain
- Department of Audiology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | | | - Rachel Shaw
- Institute of Health and Neurodevelopment and School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, UK
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Stoustrup AL, Janssen DJA, Nakken N, Wouters EFM, Marques A, Weinreich UM, Spruit MA. Association of inadequate social support and clinical outcomes in patients with chronic obstructive pulmonary disease - A cross-sectional study. Respir Med 2024; 226:107625. [PMID: 38570144 DOI: 10.1016/j.rmed.2024.107625] [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: 12/18/2023] [Revised: 02/27/2024] [Accepted: 04/01/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION In patients with chronic obstructive pulmonary disease (COPD), loneliness and social isolation are associated with increased morbidity and decreased mobility, self-reliance, and health-related quality of life. Social support has been shown to improve these outcomes. AIMS This cross-sectional study aimed to investigate the level of experienced social support and the clinical outcomes associated with inadequate social support among patients with COPD with a resident loved one. METHODS Level of social support was assessed with the Medical Outcomes Study - Social Support Survey (MOS-SSS) in patients with COPD with a resident loved one. Patients were sub-grouped into adequate or inadequate social support. Multiple clinical outcomes were assessed, including lung function, degree of dyspnoea, health status, symptoms of anxiety and depression, the degree of care dependency, functional status, and mobility. RESULTS The study included 191 Dutch patients with COPD (53.4% men, age: 65.6 ± 8.9 years, FEV1: 47.3 ± 17.7% predicted). Eighteen percent of the patients reported inadequate social support. Patients with inadequate social support reported a significantly symptom severity of COPD (p = 0.004), a higher care dependency level (p = 0.04) and a higher level of depression (p = 0.004) compared to patients with adequate social support. Other traits were comparable for both groups. CONCLUSION Patients with COPD with a resident loved one who perceive an inadequate level of social support are more likely to report a higher impact of COPD, a higher care dependency and symptoms of depression. Other characteristics are comparable with patients who perceive adequate social support.
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Affiliation(s)
- Anna L Stoustrup
- Department of Respiratory Diseases, Aalborg University Hospital, Denmark.
| | - Daisy J A Janssen
- Department of Research and Development, Ciro, Horn, the Netherlands; Department of Health Services Research and Department of Family Medicine, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
| | - Nienke Nakken
- Department of Research and Development, Ciro, Horn, the Netherlands.
| | - Emiel F M Wouters
- Department of Research and Development, Ciro, Horn, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
| | - Alda Marques
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), and Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal.
| | | | - Martijn A Spruit
- Department of Research and Development, Ciro, Horn, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
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Vall-Vargas A, Constans M, Torà N, Arnau A, Altés A, de Juan Pardo MÁ. Determinants associated with activation in patients with oral anticoagulant treatment: A cross-sectional study. ENFERMERIA CLINICA (ENGLISH EDITION) 2024; 34:148-160. [PMID: 38796107 DOI: 10.1016/j.enfcle.2024.05.002] [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: 12/01/2023] [Accepted: 04/16/2024] [Indexed: 05/28/2024]
Abstract
AIMS The terms "patient activation" and "patient empowerment" are used to describe the extent to which individuals are able to manage their own healthcare. Health outcomes and quality of life improve in patients who are more active in health care. The aim of this study was to identify sociodemographic, clinical, sociological and psychological determinants associated with activation in a group of chronically anticoagulated patients. METHODS Cross-sectional study of patients treated with oral antivitamin-k drugs attended at a specialized outpatient anticoagulant unit between November 2021 and June 2022. The main dependent variable was the level of patient activation according to the 13-item Patient Activation Measure (PAM-13). Simple and multiple linear regression models were conducted to identify the determinants associated with PAM-13 score. RESULTS A total of 137 patients who met all the inclusion criteria were recruited for the study. The mean age was 59.6 years (SD 13.8; range 22-86) and 60.6% were male. Sixty per cent presented a level IV of activation according to the PAM-13 scale. Mean patient activation score was 73.9 (SD 15.4). The factors independently associated with significantly lower activation were: emergency department visits in the past 12 months, intermediate social risk, anxiety symptoms, stress symptoms and low self-efficacy. CONCLUSIONS Five determinants were found to be associated with activation. Knowing the factors that modify the level of activation can help to identify subgroups of chronic anticoagulated patients who are less likely to engage in self-management and are therefore candidates for tailored educational interventions.
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Affiliation(s)
- Alba Vall-Vargas
- Department of Hematology, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain; Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain; Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain.
| | - Mireia Constans
- Department of Hematology, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain; Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Núria Torà
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain; Research and Innovation Unit, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain
| | - Anna Arnau
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain; Research and Innovation Unit, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain; Faculty of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain; Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
| | - Albert Altés
- Department of Hematology, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain; Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain; Faculty of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
| | - M Ángeles de Juan Pardo
- Nursing Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
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Yuan GF, Qiao S, Li X, Shen Z, Zhou Y. How Does Anticipated HIV Stigma Affect Medication Adherence? A Longitudinal Path Analysis Model. AIDS Behav 2024; 28:1684-1693. [PMID: 38340222 DOI: 10.1007/s10461-024-04293-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 02/12/2024]
Abstract
Prior research has documented that anticipated HIV stigma may play an important predictive role in medication adherence among people living with HIV (PLWH). However, longitudinal data on the mechanisms underlying this linkage are scarce. The current study aimed to explore the longitudinal mediation association among anticipated HIV stigma, medication adherence support, HIV self-management, and medication adherence. A four-wave sample consisting of 1,098 Chinese PLWH (Mage = 38.63, SD = 9.20; 63.9% male) with a six-month interval was used in the current study. Participants were asked to complete self-report questionnaires. A path analysis model was analyzed. Results indicate that anticipated HIV stigma at baseline was positively related to medication adherence at Time 4 (T4). Medication adherence support at Time 2 (T2) and HIV self-management at Time 3 (T3) serially mediated the anticipated HIV stigma at Time 1 (T1) and medication adherence at T4. These findings provide critical insights into the mediating roles of medication adherence support and HIV self-management in the relationship between anticipated HIV stigma and medication adherence over time. Such an understanding has important implications for the development of tailored interventions and public health strategies aimed at improving medication adherence among PLWH in the context of HIV-related stigma.
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Affiliation(s)
- Guangzhe Frank Yuan
- School of Education Science, Leshan Normal University, Leshan, Sichuan, China.
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Shan Qiao
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Xiaoming Li
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Zhiyong Shen
- Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China
| | - Yuejiao Zhou
- Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China
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13
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Aitken GL, Motta M, Samuels S, Gannon CJ, Llaguna OH. Racial disparities in the attainment of textbook oncologic outcomes following colectomy for colon cancer: a national cancer database cohort study. Langenbecks Arch Surg 2024; 409:140. [PMID: 38676721 DOI: 10.1007/s00423-024-03330-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 04/19/2024] [Indexed: 04/29/2024]
Abstract
INTRODUCTION Textbook oncologic outcome (TOO) is attained when all desired short-term quality metrics are met following an oncologic operation. The objective of this study was to determine the impact of race on TOO attainment following colectomy for colon cancer. METHODS The 2004-2017 National Cancer Database was queried for patients with non-metastatic colon cancer who underwent colectomy. TOO was defined as: negative margins (R0), adequate lymphadenectomy (LAD) (n ≥ 12), no prolonged length of stay (LOS), no 30-day readmission or mortality, and initiation of systemic therapy in ≤ 12 weeks. Racial groups were defined as White, Black, or Hispanic. RESULTS 508,312 patients were identified of which 34% achieved TOO. Blacks attained the least TOO (31.4%) as well as the TOO criteria of adequate LAD (81.1%), no prolonged LOS (52.3%), and no 30-day readmission (89.7%). Hispanics were least likely to have met the criteria of R0 resection (94.3%), no 30-day mortality (87.3%), and initiation of systemic therapy in ≤ 12 weeks (81.8%). Patients who attained TOO had a higher median overall survival (OS) than those without TOO (148.2 vs. 84.2 months; P < 0.001). Hispanic TOO patients had the highest median OS (181.2 months), while White non-TOO patients experienced the lowest (80.2 months, P < 0.001). Multivariate logistic regression models suggest that Black and Hispanic patients are less likely to achieve TOO than their White counterparts. CONCLUSIONS Racial disparities exist in the achievement of TOO, with Blacks and Hispanics being less likely to attain TOO compared to their White counterparts.
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Affiliation(s)
- Gabriela L Aitken
- Department of Surgery, Memorial Healthcare System, Hollywood, FL, USA
| | - Monique Motta
- Department of Surgery, Memorial Healthcare System, Hollywood, FL, USA
| | - Shenae Samuels
- Office of Human Research, Memorial Healthcare System, Hollywood, FL, USA
| | - Christopher J Gannon
- Division of Surgical Oncology, Memorial Healthcare System, 601 N Flamingo Road Suite 301, Pembroke Pines, FL, 33028, USA
| | - Omar H Llaguna
- Division of Surgical Oncology, Memorial Healthcare System, 601 N Flamingo Road Suite 301, Pembroke Pines, FL, 33028, USA.
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14
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Kenton N, Gronowski B, Fish D, Vartanian K, Robicsek A. Capturing the emotional and social experiences of COVID-19 through journal entries: A qualitative study of COVID-19 experiences over six weeks following infection. Heliyon 2024; 10:e28930. [PMID: 38601697 PMCID: PMC11004564 DOI: 10.1016/j.heliyon.2024.e28930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/12/2024] Open
Abstract
COVID-19's wide-ranging effects on patients' physical health are well-documented, but comparatively less research has explored the impact on patients' emotional and social experiences. We examined how patients across a multi-state health system experience the emotional and social aspects of COVID-19 during the first six weeks of recovery from infection. We leveraged the larger My COVID Diary project to capture open-ended journal data from an app-based platform available to patients who test positive for COVID-19 within the health system. Our sample was limited to participants with multiple journal entries during the first six weeks after infection, with one entry in the top 5% of all participants for word count to ensure sufficient journal content was available for analysis. We randomly selected 100 eligible participants and coded and analyzed all of their journal entries in weeks 1-6 after infection, utilizing a thematic analysis approach. Despite journal entry prompts' orientation towards physical symptoms, the majority of participants discussed emotional experiences (such as anxiety, depression, and gratitude) and social factors (such as work and family) when describing their COVID-19-related experiences. Physical, emotional, and social experiences related to COVID-19 infection and recovery were often interconnected and overlapping. These findings demonstrate that a holistic understanding of the patient experience that extends beyond physical symptoms is necessary to fully support patient care and recovery.
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Affiliation(s)
- Natalie Kenton
- Center for Outcomes Research & Education (CORE), Providence St. Joseph Health, 4400 NE Glisan Street, Building 1, Suite 265, Portland, OR, 97213, USA
| | - Benjamin Gronowski
- Center for Outcomes Research & Education (CORE), Providence St. Joseph Health, 4400 NE Glisan Street, Building 1, Suite 265, Portland, OR, 97213, USA
| | - Daniel Fish
- Center for Outcomes Research & Education (CORE), Providence St. Joseph Health, 4400 NE Glisan Street, Building 1, Suite 265, Portland, OR, 97213, USA
| | - Keri Vartanian
- Center for Outcomes Research & Education (CORE), Providence St. Joseph Health, 4400 NE Glisan Street, Building 1, Suite 265, Portland, OR, 97213, USA
| | - Ari Robicsek
- Providence Research Network, 1801 Lind Ave SW, Renton, WA, USA
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15
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Ding EL, Feigl AB, Watson KT, Ng TLJ, Makerechi L, Bui N, Ireifij A, Farraj R, Zoughbie DE. Social network enhanced behavioral interventions for diabetes and obesity: A 3 arm randomized trial with 2 years follow-up in Jordan. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0001514. [PMID: 38507441 PMCID: PMC10954161 DOI: 10.1371/journal.pgph.0001514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/03/2024] [Indexed: 03/22/2024]
Abstract
While obesity and diabetes are rising pandemics, few low-cost and effective prevention and management strategies exist, especially in the Middle East. Nearly 20% of adults in Jordan suffer from diabetes, and over 75% are overweight or obese. Social network-based programs have shown promise as a viable public health intervention strategy to address these growing crises. We evaluated the effectiveness of the Microclinic Program (MCP) via a 6-month multi-community randomized trial in Jordan, with follow-up at 2 years. The MCP leverages existing social relationships to propagate positive health behaviors and information. We recruited participants from 3 community health centers in Amman, Jordan. Participants were eligible for the study if they had diabetes, pre-diabetes, or possessed ≥1 metabolic risk factor along with a family history of diabetes. We randomized participants into three trial arms: (A Group) received the Full MCP with curriculum-activated social network interactions; (B Group) received Basic MCP educational sessions with organic social network interactions; or (C Group-Control) received standard care coupled with active monitoring and parallel screenings. Groups of individuals were randomized as units in a 3:1:1 ratio, with resulting group sizes of n = 540, 186, and 188 in arms A, B, and C, respectively. We assessed the overall changes in body weight, fasting glucose, hemoglobin A1c (HbA1c) and mean arterial blood pressure between study arms in multiple evaluations across 2 years (including at 6-months and 2-years follow-up). We investigated the effectiveness of Full and Basic MCP social network interventions using multilevel models for longitudinal data with hierarchical nesting of individuals within MCP classrooms, within community centers, and within temporal cohorts. We observed significant overall 2-year differences between all 3 groups for changes in body weight (P = 0.0003), fasting blood glucose (P = 0.0015), and HbA1c (P = 0.0004), but not in mean arterial blood pressure (P = 0.45). However, significant changes in mean arterial pressure were observed for Full MCP versus controls (P = 0.002). Weight loss in the Full MCP exceeded (-0.97 kg (P<0.001)) the Basic MCP during the intervention. Furthermore, both Full and Basic MCP yielded greater weight loss compared to the control group at 2 years. The Full MCP also sustained a superior fasting glucose change over 2 years (overall P<0.0001) versus the control group. For HbA1c, the Full MCP similarly led to greater 6-month reduction in HbA1c versus the control group (P<0.001), with attenuation at 2 years. For mean arterial blood pressure, the Full MCP yielded a greater drop in blood pressure versus control at 6 months; with attenuation at 2 years. These results suggest that activated social networks of classroom interactions can be harnessed to improve health behaviors related to obesity and diabetes. Future studies should investigate how public health policies and initiatives can further leverage social network programs for greater community propagation. Trial registration. ClinicalTrials.gov Identifier: NCT01818674.
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Affiliation(s)
- Eric L. Ding
- New England Complex Systems Institute, Public Health, Cambridge, Massachusetts, United States of America
- Microclinic International, Social Network Research Group, San Francisco, California, United States of America
- Harvard T.H. Chan School of Public Health (Previous Affiliation of ABF, ELD), Boston, Massachusetts, United States of America
| | - Andrea B. Feigl
- Health Finance Institute, Washington, D.C. United States of America
| | - Kathleen T. Watson
- Behavioral Sciences, Stanford University, Stanford, California, United States of America
| | - Tin Lok James Ng
- School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
| | - Leila Makerechi
- Microclinic International, Social Network Research Group, San Francisco, California, United States of America
| | - Nancy Bui
- Microclinic International, Social Network Research Group, San Francisco, California, United States of America
| | - Amal Ireifij
- New England Complex Systems Institute, Public Health, Cambridge, Massachusetts, United States of America
- Microclinic International, Social Network Research Group, San Francisco, California, United States of America
| | - Rami Farraj
- Jordanian Royal Health Awareness Society, Amman, Kingdom of Jordan
| | - Daniel E. Zoughbie
- New England Complex Systems Institute, Public Health, Cambridge, Massachusetts, United States of America
- Microclinic International, Social Network Research Group, San Francisco, California, United States of America
- Harvard T.H. Chan School of Public Health (Previous Affiliation of ABF, ELD), Boston, Massachusetts, United States of America
- Institute of International Studies, University of California, Berkeley, Berkeley, California, United States of America
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16
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Smalls BL, Kruse-Diehr A, Ortz CL, Douthitt K, McLouth C, Shelton R, Taylor Z, Williams E. Older adults using social support to improve self-care (OASIS): Adaptation, implementation and feasibility of peer support for older adults with T2D in appalachia: A feasibility study protocol. PLoS One 2024; 19:e0300196. [PMID: 38498512 PMCID: PMC10947915 DOI: 10.1371/journal.pone.0300196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 02/21/2024] [Indexed: 03/20/2024] Open
Abstract
INTRODUCTION The prevalence of type 2 diabetes (T2D) is 17% higher in rural dwellers compared to their urban counterparts, and it increases with age, with an estimated 25% of older adults (≥ 65 years) diagnosed. Appropriate self-care is necessary for optimal clinical outcomes. Overall, T2D self-care is consistently poor among the general population but is even worse in rural-dwellers and older adults. In rural Kentucky, up to 23% of adults in Appalachian communities have been diagnosed with T2D and, of those, 26.8% are older adults. To attain optimal clinical outcomes, social environmental factors, including social support, are vital when promoting T2D self-care. Specifically, peer support has shown to be efficacious in improving T2D self-care behaviors and clinical and psychosocial outcomes related to T2D; however, literature also suggests self-selected social support can be obstructive when engaging in healthful activities. Currently available evidence-based interventions (EBIs) using peer support have not been used to prioritize older adults, especially those living in rural communities. METHOD To address this gap, we conducted formative research with stakeholders, and collaboratively identified an acceptable and feasible peer support EBI-peer health coaching (PHC)-that has resulted in improved clinical and psychosocial T2D-related outcomes among participants who did not reside in rural communities nor were ≥65 years. The goal of the proposed study is to use a 2x2 factorial design to test the adapted PHC components and determine their preliminary effectiveness to promote self-care behaviors and improve glycemic control among older adults living in Appalachian Kentucky. Testing the PHC components of the peer support intervention will be instrumental in promoting care for older adults in Appalachia, as it will allow for a larger scale intervention, which if effective, could be disseminated to community partners in Appalachia. TRIAL REGISTRATION This study was registered at www.clinicaltrials.gov (NCT06003634) in August 2023.
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Affiliation(s)
- Brittany L. Smalls
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Aaron Kruse-Diehr
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Courtney L. Ortz
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Key Douthitt
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Christopher McLouth
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, United States of America
| | - Rachel Shelton
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Zoe Taylor
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Edith Williams
- Center for Community Health and Prevention, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States of America
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17
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Thompson CM, Voorhees HL, Taniguchi-Dorios E, Makos S, Pool K, Babu S. Development and Initial Assessment of an Emotional Support Provision Training Intervention for Interpersonal Support Providers in the Context of Chronic Illness. HEALTH COMMUNICATION 2024:1-14. [PMID: 38467583 DOI: 10.1080/10410236.2024.2325183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
This study reports on the development and pilot testing of an emotional support provision training intervention for interpersonal support providers to those with chronic illnesses. Using findings from a needs assessment in combination with existing theory and research, we created a training framework consisting of verbal person-centered message design, empathic listening, and communicated perspective-taking. Then, we recruited 282 individuals to participate in a pre-training questionnaire, the online training module, a post-training questionnaire, and a two-week post-training questionnaire. Outcome variables included emotional support knowledge, efficacy, and intentions, as well as general support efficacy, response efficacy, and quality. Repeated measures MANCOVA revealed significant increases from T1 to T2 for all variables of interest. These increases were sustained at T3 for emotional support knowledge and efficacy, and support provision response efficacy. Participants rated the training favorably and provided helpful suggestions for improvement. This study answers the call for more theoretically-grounded support interventions that not only assess theory in real-world settings, but also help people better their supportive communication skills.
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Affiliation(s)
- Charee M Thompson
- Department of Communication, University of Illinois Urbana-Champaign
| | | | - Emiko Taniguchi-Dorios
- Communicology Program, School of Communication and Information, University of Hawai'i at Manoa
| | - Shana Makos
- Department of Communication, University of Illinois Urbana-Champaign
| | - Kirsten Pool
- Department of Communication, University of Illinois Urbana-Champaign
| | - Sara Babu
- Department of Communication, University of Illinois Urbana-Champaign
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18
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Dineen-Griffin S, Benrimoj SI. The landscape of self-care in Australia: A pharmacy perspective. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 13:100396. [PMID: 38174289 PMCID: PMC10762451 DOI: 10.1016/j.rcsop.2023.100396] [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: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024] Open
Abstract
The evolving landscape of self-care in Australia underscores the imperative of recognizing and integrating the crucial role of pharmacists in promoting greater levels of self-care. Although the social and economic justifications for self-care are acknowledged internationally and in the literature, there is very little policy recognition in relation to self-care specifically in Australian health policy. Additionally, the distinct contributions of pharmacies to self-care, i.e., their experiences and accessibility in primary health care, are not consistently highlighted. Community pharmacies in Australia are currently navigating a transformative shift, expanding their scope of practice to deliver highly individualized care, with a special emphasis on the implementation of professional services crucial for the sector's enduring viability. Although pharmacists already play a substantial role in supporting self-care, there exists a compelling demand for a systematic and structured approach. Despite the limited availability of theoretical frameworks or models for pharmacists in self-care support within the existing literature, tangible practical evidence attests to the success of interventions. In an era where patients increasingly assume responsibility for self-managing conditions, the pharmacist's role in facilitating self-care and judicious self-medication is pivotal, promising not only tangible benefits for individuals but also contributing significantly to the long-term sustainability of the healthcare system in Australia. This necessitates a strategic and comprehensive framework that positions pharmacists as essential catalysts in the broader landscape of healthcare, ensuring their contributions are optimally leveraged to enhance patient outcomes and system efficiency.
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Affiliation(s)
- Sarah Dineen-Griffin
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, New South Wales, Australia
| | - Shalom I. Benrimoj
- Pharmaceutical Care Research Group, Faculty of Pharmacy, University of Granada, Spain
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19
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Zhang X, Li C, Liu M, Sun J, Yue H, Bao H. The mediation effect of health literacy on social support and health lifestyle of patients with chronic diseases. Appl Nurs Res 2024; 75:151763. [PMID: 38490794 DOI: 10.1016/j.apnr.2024.151763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 08/18/2023] [Accepted: 02/18/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Previous studies have identified the antecedents of the lifestyle of many patients with chronic diseases. However, the mechanism of social support affecting the lifestyle of patients with chronic diseases is unclear, and the role of health literacy in social support affecting the lifestyle of patients with chronic diseases has not been found. Therefore, this study aims to explore the status quo of social support, health literacy and healthy lifestyle of patients with chronic diseases in China and the relationship among them. METHODS Through convenient sampling, 356 patients with chronic diseases were surveyed using a health promoting lifestyle scale, a chronic disease patients' health literacy scale and a social support scale. RESULTS There was a pairwise positive correlation between social support, health lifestyle and health literacy (R = 0.397,0.356,0.556, P < 0.01). After controlling gender, age and education level, it is found that social support has a positive impact on health lifestyle, and health literacy plays an intermediary role between social support and health lifestyle, accounting for 45.78 % of the total effect. CONCLUSION To promote the healthy lifestyle of patients with chronic diseases and delay the development of the disease, we should strengthen social support for patients with chronic diseases; We should simultaneously take various measures to improve their health literacy.
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Affiliation(s)
- Xuemin Zhang
- School of Psychology, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China; School of Humanities and International Education, Baotou Medical College, No. 31 Jianshe Road, Donghe District, Inner Mongolia 014040, China.
| | - Cuiyun Li
- School of Psychology, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China
| | - Min Liu
- School of Psychology, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China
| | - Junfang Sun
- School of Psychology, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China
| | - Heng Yue
- School of Psychology, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China
| | - Hugejiletu Bao
- School of Physical Education, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China.
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20
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Code J. At the Heart of Resilience: Empowering Women's Agency in Navigating Cardiovascular Disease. CJC Open 2024; 6:473-484. [PMID: 38487058 PMCID: PMC10935683 DOI: 10.1016/j.cjco.2023.12.013] [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: 09/11/2023] [Accepted: 12/13/2023] [Indexed: 03/17/2024] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death among women globally, emphasizing the need for a healthcare approach that empowers women through agency. This review focuses on the critical role of women's agency in navigating CVD, integrating insights from various fields, including medicine, education, psychology, and sociology. The review highlights the shift toward patient-centred care, a framework in which women are recognized as key decision-makers, a crucial change given the historical underemphasis on women's health issues in medical practice. The diagnosis of CVD in women often involves emotional and psychological challenges. Unexpected diagnoses significantly disrupt perceived well-being, and prolonged diagnostic processes lead to professional skepticism and neglect of symptoms, resulting in delayed or inaccurate diagnoses and strained healthcare relationships. Effective management of CVD necessitates continuous self-management and a holistic approach to care, particularly for those with trauma who are at increased risk of cardiac incidents. Empowerment for women with CVD involves promoting self-confidence, autonomy, and active patient participation in healthcare. Implementing comprehensive care models is crucial for improving chronic CVD management, highlighting the need for healthcare systems that prioritize patient agency and empowerment. From the perspective of a woman with lived experience, this article examines the impact of CVD on women's agency throughout the diagnostic journey. By highlighting women's agency rather than particular behavioural changes, this review offers a comprehensive analysis that can shape policy, stimulate new research, and foster a more equitable, efficient, and empathetic healthcare system for women with CVD.
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Affiliation(s)
- Jillianne Code
- Woman with Lived Experience, Victoria, British Columbia, Canada
- HeartLife Foundation of Canada, Vancouver, British Columbia, Canada
- Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
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21
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De Risio L, Pettorruso M, Collevecchio R, Collacchi B, Boffa M, Santorelli M, Clerici M, Martinotti G, Zoratto F, Borgi M. Staying connected: An umbrella review of meta-analyses on the push-and-pull of social connection in depression. J Affect Disord 2024; 345:358-368. [PMID: 37852587 DOI: 10.1016/j.jad.2023.10.112] [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: 06/28/2023] [Revised: 09/18/2023] [Accepted: 10/15/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Depression affects approximately 4 % of the global population and has huge social and economic implications. Social factors, including support, engagement, and stigma, play a crucial role in the development and severity of depression. METHODS We provide a synthesis of the consistency and magnitude of the association between measures of social connection and depression. We searched PubMed, PsycINFO, Cochrane Library, and EMBASE and 47 meta-analyses were included in the umbrella review. The strength of the associations was extracted and compared among different populations. The quality/certainty of evidence was assessed using AMSTAR-2 and GRADE tool. RESULTS Results indicate that social support serves as a protective factor against depression, particularly in peripartum populations, while its impact is weaker in clinical populations. No association was found between social support and depression in post-disaster populations. Stigma and discrimination favour the development and maintenance of depressive symptoms in clinical populations, but have a weaker effect in ethnic minorities. LIMITATIONS The quality and certainty of evidence should be taken into account when interpreting our findings. Further research with more rigorous methodology and higher-quality evidence is needed to better understand the complex relationship between depression and social connection across various populations and contexts. CONCLUSIONS Our findings confirm the role of social determinants in the emergence and severity of depression, particularly in the case of vulnerable populations. Efforts to counteract disconnection at the societal and individual levels and to reduce stigma should be central to an effective depression prevention agenda.
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Affiliation(s)
- Luisa De Risio
- Department of Psychiatry and Addiction, ASL Roma 5, Colleferro, Rome, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti-Pescara, Italy.
| | - Rebecca Collevecchio
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti-Pescara, Italy
| | - Barbara Collacchi
- Center for Behavioural Science and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Marta Boffa
- Center for Behavioural Science and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Mario Santorelli
- School of Medicine and Surgery, University of Milano - Bicocca, Milano, Italy
| | - Massimo Clerici
- School of Medicine and Surgery, University of Milano - Bicocca, Milano, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti-Pescara, Italy
| | - Francesca Zoratto
- Center for Behavioural Science and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Marta Borgi
- Center for Behavioural Science and Mental Health, Istituto Superiore di Sanità, Rome, Italy
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Cervantes-Ortega M, Palma AM, Rook KS, Biegler KA, Davis KC, Janio EA, Kilgore DB, Dow E, Ngo-Metzger Q, Sorkin DH. Health-Related Social Control and Perceived Stress Among High-Risk Latina Mothers with Type 2 Diabetes and Their At-Risk Adult Daughters. Int J Behav Med 2023; 30:814-823. [PMID: 36650345 PMCID: PMC10350477 DOI: 10.1007/s12529-022-10145-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Diabetes-related multi-morbidity and cultural factors place Latinas with diabetes at increased risk for stress, which can threaten illness management. Families provide an ideal focus for interventions that seek to strengthen interpersonal resources for illness management and, in the process, to reduce stress. The current study sought to examine whether participating in a dyadic intervention was associated with reduced perceived stress and, furthermore, whether this association was mediated by persuasion and pressure, two forms of health-related social control. METHOD Latina mothers with diabetes and their at-risk adult daughters participated in either (1) a dyadic intervention that encouraged constructive collaboration to improve health behaviors and reduce stress, or (2) a usual-care minimal control condition. Actor-partner interdependence model analysis was used to estimate the effect of the intervention on dyads' perceived stress, and mother-daughter ratings of health-related social control as potential mediators. RESULTS Results revealed that participating in the intervention was associated with significantly reduced perceived stress for daughters, but not for mothers (β = - 3.00, p = 0.02; β = - 0.57, p = 0.67, respectively). Analyses also indicated that the association between the intervention and perceived stress was mediated by persuasion, such that mothers' who experienced more health-related persuasion exhibited significantly less post-intervention perceived stress (indirect effect = - 1.52, 95% CI = [- 3.12, - 0.39]). Pressure exerted by others, however, did not evidence a mediating mechanism for either mothers or daughters. CONCLUSION These findings buttress existing research suggesting that persuasion, or others' attempts to increase participants' healthy behaviors in an uncritical way, may be a driving force in reducing perceived stress levels.
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Affiliation(s)
| | - Anton M Palma
- Institute for Clinical and Translational Science, University of California, Irvine, Irvine, CA, 92697, USA
| | - Karen S Rook
- Department of Psychological Science, University of California, Irvine, Irvine, CA, 92697, USA
| | - Kelly A Biegler
- Department of Medicine, University of California, Irvine, Irvine, CA, 92697, USA
| | - Katelyn C Davis
- Department of Medicine, University of California, Irvine, Irvine, CA, 92697, USA
| | - Emily A Janio
- Department of Medicine, University of California, Irvine, Irvine, CA, 92697, USA
| | - David B Kilgore
- Department of Family Medicine, University of California, Irvine, Irvine, CA, 92697, USA
| | - Emily Dow
- Department of Family Medicine, University of California, Irvine, Irvine, CA, 92697, USA
| | - Quyen Ngo-Metzger
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, 91101, USA
| | - Dara H Sorkin
- Institute for Clinical and Translational Science, University of California, Irvine, Irvine, CA, 92697, USA.
- Department of Medicine, University of California, Irvine, Irvine, CA, 92697, USA.
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Brown O, Newton-John TRO. The influence of the significant other on treatment adherence in chronic pain management: a qualitative analysis. Psychol Health 2023; 38:1572-1586. [PMID: 35094627 DOI: 10.1080/08870446.2022.2032058] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/04/2021] [Accepted: 01/15/2022] [Indexed: 10/19/2022]
Abstract
Objectives. Adherence to treatment recommendations is critical for optimising quality of life for individuals with chronic pain, however adherence rates are low. This study explores the role that significant others are perceived to play in supporting or impeding treatment adherence, as well as examining patient views of the impact of their adherence regimes on their significant others.Design. 25 treatment seeking adults with chronic pain, who were currently living with a romantic partner or adult family member, took part in individual semi-structured interviews.Main outcome measures Interviews were transcribed verbatim and analysed using thematic analysis.Results. Three treatment adherence support themes emerged: social support (emotional, instrumental), positive social control, and supporting autonomy. Participants did not perceive significant others as having any negative influence on their adherence. By contrast, patients perceived that their adherence behaviors had both positive and negative effects on their significant others.Conclusions. These data present an encouraging perspective on the interpersonal context of coping with chronic pain. Significant others facilitated adherence in a range of ways. Future research identifying how best to integrate significant other support into patient self-management programs is needed, in order to lift the poor treatment adherence rates that are noted in the literature.
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Affiliation(s)
- Olivia Brown
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
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24
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Sherman LD, Cisneros-Franco CL, Prochnow T, Patterson MS, Johannes BL, Alexander J, Merianos AL, Bergeron CD, Smith ML. Personal Agency and Social Supports to Manage Health Among Non-Hispanic Black and Hispanic Men With Diabetes. Am J Mens Health 2023; 17:15579883231211057. [PMID: 38032066 PMCID: PMC10691323 DOI: 10.1177/15579883231211057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
The prevalence of type 2 diabetes (T2D) is increasing among non-Hispanic Black and Hispanic communities, especially among men who develop this chronic condition at earlier ages. Personal agency and social support are vital aspects to diabetes management. However, less is known about the relationship between these variables among men living with diabetes. The purposes of this study were to identify (1) levels of personal agency to manage health, (2) sources of social supports to manage health based on personal agency levels, and (3) factors associated with lower personal agency to manage health. Cross-sectional data from non-Hispanic Black (n = 381) and Hispanic (n = 292) men aged 40 years or older with T2D were collected using an internet-delivered questionnaire. Three binary logistic regression models were fitted to assess sociodemographics, health indicators, and support sources associated with weaker personal agency to manage health. About 68% of participants reported having the strongest personal agency relative to 32.1% reporting weaker personal agency. Men who relied more on their spouse/partner (odds ratio [OR] = 1.22, p = .025), coworkers (OR = 1.59, p = .008), or faith-based organizations (OR = 1.29, p = .029) for ongoing help/support to improve their health and manage health problems were more likely to have weaker personal agency. Conversely, men who relied more on their health care providers for ongoing help/support to improve their health and manage health problems were less likely to have weaker personal agency to manage health (OR = 0.74, p < .001). Findings suggest personal agency may influence men's support needs to manage T2D, which may also be influenced by cultural, socioeconomics, and the composition of social networks.
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Affiliation(s)
- Ledric D. Sherman
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Health Equity and Evaluation Research, Texas A&M University, College Station, TX, USA
| | | | - Tyler Prochnow
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Health Equity and Evaluation Research, Texas A&M University, College Station, TX, USA
| | - Megan S. Patterson
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
| | | | - Janae Alexander
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
| | | | | | - Matthew Lee Smith
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Health Equity and Evaluation Research, Texas A&M University, College Station, TX, USA
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25
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Paulamäki J, Jyrkkä J, Hyttinen V, Huhtala H, Jämsen E. Regional variation of potentially inappropriate medication use and associated factors among older adults: A nationwide register study. Res Social Adm Pharm 2023; 19:1372-1379. [PMID: 37355437 DOI: 10.1016/j.sapharm.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/06/2023] [Accepted: 06/17/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Certain medications should be used with caution in older persons, which challenges rational prescribing. Potentially inappropriate medications (PIMs) are defined as medicines whose potential risk of harm typically outweighs the clinical benefits in geriatric population. Earlier studies have found regional differences in PIM use, but the factors underlying this phenomenon are unclear. OBJECTIVE To compare prescription PIM prevalence among Finnish hospital districts and determine which population characteristics and factors related to social and health care are associated with regional variation. METHODS This nationwide register study was based on the Prescription Centre data on all people aged ≥75 years in 2017-2019. Hospital district (n = 20) characteristics were drawn from the Finnish Institute for Health and Welfare's, Finnish Medical Association's, and Finnish Medicines Agency's publicly open data. PIMs were defined according to the Finnish Meds75+ database. A linear mixed-effect model was used to analyze potential associations of regional characteristics with PIM prevalence. RESULTS Prevalence of PIMs varied between 16.4% and 24.8% across regions. The highest prevalence was observed in the southern regions, while the lowest prevalence was on the west coast. Hospital district characteristics associated with higher PIM prevalence were higher share of population living alone, with excessive polypharmacy, or assessed using the Resident Assessment Instrument, shortage of general practitioners in municipal health centers, and low share of home care personnel. Waiting time in health care or share of population with morbidities were not associated with PIM use. Of the total variance in PIM prevalence, 86% was explained by group-level factors related to hospital districts. The regional variables explained 75% of this hospital-district-level variation. CONCLUSIONS PIM prevalence varied significantly across hospital districts. Findings suggest that higher PIM prevalence may be related to challenges in the continuity of care rather than differences in health care accessibility or share of the population with morbidities.
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Affiliation(s)
- Jasmin Paulamäki
- Faculty of Medicine and Health Technology, Clinical Medicine, Tampere University, FI-33014, Tampere University, Finland; Development and Information Services, Finnish Medicines Agency Fimea, P.O. Box 55, FI-00034, FIMEA, Finland.
| | - Johanna Jyrkkä
- Development and Information Services, Finnish Medicines Agency Fimea, P.O. Box 55, FI-00034, FIMEA, Finland.
| | - Virva Hyttinen
- Department of Health and Social Management, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland.
| | - Heini Huhtala
- Faculty of Social Sciences, Health Sciences, Tampere University, FI-33014, Tampere University, Finland.
| | - Esa Jämsen
- Faculty of Medicine (Clinicum), University of Helsinki, P.O. Box 63, FI-00014, University of Helsinki, Finland; Department of Geriatrics, Helsinki University Hospital, P.O. Box 340, FI-00029, Helsinki, HUS, Finland.
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26
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Rosenberg M, Bar-Shalita T, Weiss M, Rahav G, Avrech Bar M. Associations between daily routines and social support among women with chronic fatigue syndrome. Scand J Occup Ther 2023; 30:1037-1046. [PMID: 37094093 DOI: 10.1080/11038128.2023.2200580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 04/03/2023] [Accepted: 04/03/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Chronic fatigue syndrome (CFS) is characterised by extreme fatigue, as well as physical and cognitive symptoms. CFS is thrice as prevalent in women than in men. OBJECTIVE To compare women with and without CFS concerning social support and participation in daily routine occupations, and to assess the relationships between the two variables among women with CFS. METHODS This study included 110 women aged 24-69: 41 were diagnosed with CFS and 64 were not diagnosed with CFS. Participants completed the Occupational Questionnaire and the Medical Outcomes Study (MOS) Social Support Survey. RESULTS Women with CFS reported lower participation in instrumental activities of daily living and work occupations than women without CFS. However, they spend more time resting and enjoying it. In addition, they reported less social support than women without CFS. Positive correlations were found between the number of close friends and time spent in play and leisure occupations and a negative correlation with sleep/rest. CONCLUSIONS Women with CFS participate less in IADL and work occupations and more in rest/sleep than women without CFS and their social support is attenuated. SIGNIFICANCE Intervention plans should be developed for women with CFS, focussing on expanding their participation while considering their social support resources.
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Affiliation(s)
- Morit Rosenberg
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Miryam Weiss
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Galia Rahav
- Infectious Disease Unit and Laboratories, Sheba Medical Center, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Michal Avrech Bar
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel
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27
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Greenfield N, Becker J, Jariwala S, Wisnivesky J, Federman A, Feldman JM. The relationship between social support, self-efficacy, and asthma outcomes in older adults. J Asthma 2023; 60:1853-1861. [PMID: 36972524 PMCID: PMC10523994 DOI: 10.1080/02770903.2023.2196560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/06/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVE There has been a call for research examining factors that influence asthma outcomes in older adults because of the notable disparities observed in this age group. Social support and self-efficacy are resources that factor into asthma outcomes. The current study aimed to examine the relationship between these resources (independently and jointly) and asthma control and quality of life. METHODS Older adults with moderate-severe asthma were recruited from NYC. Data were obtained during in-person interviews via validated measures of social support, asthma self-efficacy, asthma control, and asthma quality of life. Linear regression evaluated self-efficacy in the relationship between social support and asthma outcomes. RESULTS In a sample of 359 older adults (M = 68.04, 47.9% Hispanic, 26.5% Black, and 25.6% other), social support had an inverse association with asthma control. As social support increased, asthma control decreased (β = 0.95, t(356) = -3.13, p = .002). Self-efficacy significantly moderated this relationship (β = 0.01, t(356) = 2.37, p = .018). For individuals with low or moderate asthma self-efficacy, more received social support was associated with worse asthma control (β = -0.33, t(356) = -4.66, p < .0001; β = -0.20, t(356) = -3.21, p = .0014, respectively). For individuals with high self-efficacy, no relationship was found between received social support and asthma control (β = -0.10, t(356)= -1.20, p =.23). For asthma quality of life, higher levels of received social support were associated with worse quality of life (β = -0.88, t(356) = -2.64, p = .009), but this association was not significantly moderated by self-efficacy (β = 0.01, t(356) = 1.90, p = .0582). CONCLUSIONS For older adults with asthma, receiving more social support is associated with worse asthma outcomes, especially for older adults with lower asthma self-efficacy.
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Affiliation(s)
- Naomi Greenfield
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
| | - Jacqueline Becker
- Icahn School of Medicine at Mount Sinai, Division of General Internal Medicine, New York, NY
| | - Sunit Jariwala
- Albert Einstein College of Medicine/Montefiore Medical Center, Department of Medicine, Division of Allergy/Immunology, Bronx, NY
| | - Juan Wisnivesky
- Icahn School of Medicine at Mount Sinai, Division of General Internal Medicine, New York, NY
| | - Alex Federman
- Icahn School of Medicine at Mount Sinai, Division of General Internal Medicine, New York, NY
| | - Jonathan M. Feldman
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
- Albert Einstein College of Medicine, Children’s Hospital at Montefiore, Department of Pediatrics, Division of Academic General Pediatrics, Bronx, NY
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28
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Khachatryan K, Otten D, Beutel ME, Speerforck S, Riedel-Heller SG, Ulke C, Brähler E. Mental resources, mental health and sociodemography: a cluster analysis based on a representative population survey in a large German city. BMC Public Health 2023; 23:1827. [PMID: 37730594 PMCID: PMC10510265 DOI: 10.1186/s12889-023-16714-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Mental resources such as optimism and social support are important to face different stressors. The aim of this study is to identify groups in the population that are similar in terms of their mental resources. METHODS For this purpose, a randomly selected general population community sample was used, representative for the city of Leipzig, Germany. In a two-stage process, three clusters were identified using hierarchical cluster analysis and the K-means method and then tested with a multinomial logistic regression analysis for differences in sociodemographic characteristics. RESULTS Three clusters were identified which vary in their extent of social support and optimism. In distinguishing between those with higher and lower (medium or poor) mental resources, male gender, unemployment, being born abroad and low household income are risk factors for having fewer mental resources. Internal migrants from West Germany and persons with children at home have a higher chance of being in the type with good mental resources. The groups with medium and lower mental resources differ significantly only by variables living with a partner and employment. CONCLUSION Our results indicate that good mental resources are associated with good mental health. Special mental health care programs, focusing in particular on the needs of vulnerable groups with poor mental resources within a society, should be implemented.
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Affiliation(s)
- Kristine Khachatryan
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Untere Zahlbacher Str. 8, 55131, Mainz, Germany.
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany.
| | - Daniëlle Otten
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Sven Speerforck
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, University of Leipzig, Philipp-Rosenthal-Str. 55, Haus W, 04103, Leipzig, Germany
| | - Christine Ulke
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
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29
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Lozano-Hernández CM, Cladellas YP, Gil Conesa M, Garin O, Forés MF, del Cura-González I. Functional social support: A systematic review and standardized comparison of different versions of the DUFSS questionnaire using the EMPRO tool. PLoS One 2023; 18:e0291635. [PMID: 37713437 PMCID: PMC10503721 DOI: 10.1371/journal.pone.0291635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 09/03/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Functional social support is one of the most established predictors of health, and the Duke-UNC Functional Social Support Questionnaire (DUFSS) is one of the most commonly used instruments to measure this parameter. The objective of this study is to systematically review the available evidence on the psychometric and administration characteristics of the different versions of the DUFSS and perform a standardized assessment though to a specifically designed tool. METHODS A systematic review was performed in the PubMed/MEDLINE, SCOPUS, WOS and SCIELO databases. All articles that contained information on the development process of the instrument, the psychometric properties and aspects related to its administration were included, without restrictions based on publication date, language, or the version of the questionnaire that was studied. The selection and extraction procedure were carried out by two researchers. The articles finally included were peer-reviewed through a standardised assessment using the Evaluating the Measurement of Patient-Reported Outcomes (EMPRO) tool. PROSPERO registration number: CRD42022342977. RESULTS A total of 54 articles were identified. After eliminating duplicates and screening articles based on the selection criteria, 15 studies that examined the DUFSS questionnaire resulting in 4 different versions: 3 articles obtained the 8-item version; 11 the 11-item version; and a single article obtained two versions, the 14-item version and the 5-item version. At least 60% of them did so in a young adult population, predominantly female and with a medium-low socio-economic level or with characteristics of social vulnerability. The EMPRO evaluation showed that the 11-item version (54.01 total score) was the only one that had been studied on all recommended attributes and had higher total scores than the other versions: 8 items (36.31 total score), 14 items (27.48 total score) and 5 items (23.81 total score). This difference appears in all attributes studied, with the highest scores in "reliability (internal consistency)" and "validity". CONCLUSIONS Of the 4 versions identified in the DUFSS questionnaire, the 11-item version was found to be optimal based on the EMPRO standardized tool. Although, a priori, we could prioritise its use in epidemiological studies over the other versions, it should be noted that this version should also be used with caution because there are attributes that have not been studied.
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Affiliation(s)
- Cristina M. Lozano-Hernández
- Interuniversity Doctoral Program in Epidemiology and Public Health, Rey Juan Carlos University, Alcorcon (Madrid), Spain
- Research Unit, Primary Health Care Management Madrid, Madrid, Spain
- Research Network on Chronicity, Primary Care and Health Promotion -RICAPPS- (RICORS), Spain
- Biosanitary Research and Innovation Foundation of Primary Care (FIIBAP), Spain
| | - Yolanda Pardo Cladellas
- Networking Group of the Centre for Biomedical Research, Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Unit, Institut Mar d’Investigacion Mèdiques (IMIM-Hospital del Mar), Barcelona, Spain
- Autonomous University of Barcelona, Spain
| | - Mario Gil Conesa
- Preventive Medicine and Public Health Physician, Castellón General Hospital, Castellón, Valencian Community, Castellón, Spain
| | - Olatz Garin
- Networking Group of the Centre for Biomedical Research, Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Pompeu Fabra University, Barcelona, Spain
| | - Montserrat Ferrer Forés
- Networking Group of the Centre for Biomedical Research, Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Unit, Institut Mar d’Investigacion Mèdiques (IMIM-Hospital del Mar), Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
| | - Isabel del Cura-González
- Research Unit, Primary Health Care Management Madrid, Madrid, Spain
- Research Network on Chronicity, Primary Care and Health Promotion -RICAPPS- (RICORS), Spain
- Department of Medical Specialties and Public Health. Faculty of Health Sciences Rey Juan Carlos University, Madrid, Spain
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30
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Alhaboby ZA, Evans H, Barnes J, Short E. The Impact of Cybervictimization on the Self-Management of Chronic Conditions: Lived Experiences. J Med Internet Res 2023; 25:e40227. [PMID: 37624637 PMCID: PMC10492166 DOI: 10.2196/40227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 04/30/2023] [Accepted: 07/14/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Cybervictimization of people with long-term conditions is a disturbing phenomenon with a documented impact on health and well-being. These experiences are primarily examined using quantitative methods, focusing on children and young people. However, research centered on the cybervictimization of adults with chronic conditions is scarce, with limited qualitative input from the victims as experts in their own experiences. OBJECTIVE This study aims to understand the impact of cybervictimization on the self-management of long-term conditions among adults with chronic conditions and disabilities in the United Kingdom. METHODS This paper reports the findings from the qualitative phase of a phenomenologically informed mixed methods study. The biographical disruption concept was used to conceptualize the study. In-depth semistructured interviews were conducted with 13 participants with chronic conditions who experienced cybervictimization. A codebook was developed, and a zigzag approach to thematic analysis was used to define and refine themes. Ethical considerations and risk assessment were ongoing during the research process because of the sensitivity of the topic and cases of harassment. RESULTS Cybervictimization has direct and indirect impacts on the self-management of chronic conditions. This impact was verified across 6 overarching themes that emerged from this study. First, biomedical events included overall health deterioration because of existing conditions, new diagnoses, and subjective physical complaints. Second, the impact on mental health was perceived through psychological consequences and psychiatric disorders that developed after or during this traumatic experience. Third, the multilevel impact theme focused on disrupting the strategies for coping with health conditions and involved unplanned changes to victims' health management priorities. Fourth, the impact of complexity reflected the perceived uniqueness in each case, intersectionality, struggle to obtain formal support, and subsequent health complications. Fifth, social network involvement comprised the effects of social isolation, victim blaming, and deception. Finally, the disability discrimination theme focused on prejudice, issues on inclusion, and hostility in society, with subsequent effects on well-being. CONCLUSIONS People with long-term conditions experienced different forms of cybervictimization, all disruptive with various effects on health. Disability discrimination was a prominent finding to be further investigated. This paper reports the impact as themes to guide further research and practice, with the recognition that long-term conditions and impairments are not a homogeneous group. Despite the devastating consequences, there are positive points that strengthen potential interventions. Awareness-raising campaigns, training of support channels, and multidisciplinary research are recommended to tackle this issue and initiate change.
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Affiliation(s)
| | - Hala Evans
- Coventry University, Coventry, United Kingdom
| | - James Barnes
- Fatima College of Health Sciences, Abu Dhabi, United Arab Emirates
| | - Emma Short
- London Metropolitan University, London, United Kingdom
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31
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Kandola A, Solmi F, Ajnakina O, Ingram E, Iob E, Lee S, Steptoe A, Wright T, Lewis G. The role of loneliness in the association between chronic physical illness and depressive symptoms among older adults: A prospective cohort study. J Affect Disord 2023; 334:220-226. [PMID: 37086792 PMCID: PMC10618404 DOI: 10.1016/j.jad.2023.04.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/10/2023] [Accepted: 04/16/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Chronic physical illness increases the risk of subsequent depressive symptoms, but we know little about the mechanisms underlying this association that interventions can target. We investigated whether loneliness might explain associations between chronic illness and subsequent depressive symptoms. METHODS We used English Longitudinal Study of Ageing data, a prospective cohort of adults over 50. Our exposure was chronic illnesses (wave two) including arthritis, cancer, diabetes, cardiovascular disease, stroke, and chronic obstructive pulmonary disease. Loneliness scores were a mediator on the short University of California, Los Angeles Loneliness Scale at wave three. Depressive symptom scores (outcome) were measured using the Centre for Epidemiologic Studies Depression Scale (wave four). We examined associations of chronic physical illness with loneliness and depressive symptoms in univariable and multivariable regression models. RESULTS Fully-adjusted models included 2436 participants with the depression outcome and 2052 participants with the loneliness outcome. Chronic physical illness was associated with 21 % (incident rate ratio = 1.21, 95%CI = 1.03-1.42) higher depression scores at follow-up. We found no evidence of an association between chronic physical illness and loneliness and therefore did not proceed to analyses of mediation. LIMITATIONS More prevalent chronic illnesses could have driven our results, such as cardiovascular disease. CONCLUSIONS Chronic physical illnesses increase the risk of depressive symptoms in older adults. However, we did not find any that chronic physical illnesses were associated with an increased risk of subsequent loneliness. Therefore, interventions targeting loneliness to reduce depression in older adults with chronic physical illness may be insufficient.
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Affiliation(s)
- A Kandola
- MRC Unit of Lifelong Health and Ageing, University College London, London, UK; Institute of Mental Health, University College London, London, UK.
| | - F Solmi
- Division of Psychiatry, University College London, London, UK
| | - O Ajnakina
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, University of London, London, UK; Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - E Ingram
- Department of Applied Health Research, Institute of Epidemiology and Health Care, University College London, London, UK
| | - E Iob
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - S Lee
- Division of Psychiatry, University College London, London, UK
| | - A Steptoe
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - T Wright
- Division of Psychiatry, University College London, London, UK
| | - G Lewis
- Division of Psychiatry, University College London, London, UK
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Gosch N, Schulte EM, Kauffeld S. Capturing the impact employees have on their coworkers and leaders: a holistic approach on health-specific support behavior from employees. Front Psychol 2023; 14:1183862. [PMID: 37457060 PMCID: PMC10349332 DOI: 10.3389/fpsyg.2023.1183862] [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: 03/10/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Support is a valuable resource for ensuring employee health in the workplace. However, research on health-specific support behavior (i.e., support specifically targeting concrete health aspects) has only concentrated on either leader behavior (e.g., healthy leadership styles) or support provided by employees for specific health issues (e.g., healthy eating or smoking cessation). Although the importance of employee health has been well established, the examination of a wider range of potential health-specific support behaviors from employees provided for their colleagues and leaders has been neglected. To understand employee health-specific support behavior, we adapted an existing health-oriented leadership questionnaire to cover support for colleagues (PeerCare) and their leaders (LeaderCare). Capturing the employee perspective with a sample of 347 employees, the results confirmed a delineation of health-oriented scales (factor, convergent, and discriminant validity). By testing health-specific support behavior processes at work, the positive effects of PeerCare on general health were demonstrated. Contrary to expectations, existing health effects are outweighed when leaders provide health-specific support behavior to their employees (StaffCare). However, the results imply that the health-specific support behavior practices of different actors reinforce each other: the effects of StaffCare and PeerCare enhance each other, and StaffCare has a strong influence on LeaderCare. Remarkably, SelfCare has a key role in this process. The open questions and implications regarding the effects of the different health-specific support behavior measurements are discussed.
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Saragosa M, Singh H, Steele Gray C, Tang T, Orchanian-Cheff A, Nelson MLA. Use of eco-mapping in health services research: a scoping review protocol. BMJ Open 2023; 13:e072588. [PMID: 37236661 DOI: 10.1136/bmjopen-2023-072588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION People with complex health and social needs often require care from different providers and services. Identifying their existing sources of support could assist with addressing potential gaps and opportunities for enhanced service delivery. Eco-mapping is an approach used to visually capture people's social relationships and their linkages to the larger social systems. As it is an emerging and promising approach in the health services field, a scoping review on eco-mapping is warranted. This scoping review aims to synthesise the empirical literature that has focused on the application of eco-mapping by describing characteristics, populations, methodological approaches and other features of eco-mapping in health services research. METHODS AND ANALYSIS This scoping review will follow the Joanna Briggs Institute methodology. From the date of database construction to 16 January 2023, the following databases in English will be searched: Ovid Medline, Ovid Embase, CINAHL Ultimate (EBSCOhost), Emcare (Ovid), Cochrane Central Register of Controlled Trials (Ovid) and Cochrane Database of Systematic Reviews (Ovid) Study/Source of Evidence selection. The inclusion criteria consist of empirical literature that uses eco-mapping or a related tool in the context of health services research. Two researchers will independently screen references against inclusion and exclusion criteria using Covidence software. Once screened, the data will be extracted and organised according to the following research questions: (1) What research questions and phenomena of interest do researchers address when using eco-mapping? (2) What are the characteristics of studies that use eco-mapping in health services research? (3) What are the methodological considerations for eco-mapping in health services research? ETHICS AND DISSEMINATION This scoping review does not require ethical approval. The findings will be disseminated through publications, conference presentations and stakeholder meetings. TRIAL REGISTRATION NUMBER https://doi.org/10.17605/OSF.IO/GAWYN.
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Affiliation(s)
- Marianne Saragosa
- Science of Care Institute, Lunenfeld-Tanenbaum Research Institute, Science Health System, Toronto, Ontario, Canada
| | - Hardeep Singh
- Occupational Science and Occupational Therapy Department, University of Toronto, Toronto, Ontario, Canada
| | - Carolyn Steele Gray
- Science of Care Institute, Lunenfeld-Tanenbaum Research Institute, Science Health System, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Terence Tang
- Institute for Better Health and General Internal Medicine, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Ani Orchanian-Cheff
- Library and Information Services, University Health Network, Toronto, Ontario, Canada
| | - Michelle L A Nelson
- Science of Care Institute, Lunenfeld-Tanenbaum Research Institute, Science Health System, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Saint K, Heisler M. Experiences of Participants Who Then Become Coaches in a Peer Coach Diabetes Self-Management Program: Lessons for Future Programs. Chronic Illn 2023; 19:265-275. [PMID: 34904881 DOI: 10.1177/17423953211064283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Peer support programs are effective in improving outcomes among low-resource populations. Prior studies suggest that shared experiences improve peer partnerships. We hypothesized that participants in a peer coaching program who then became coaches might bring insight into their coaching role. We explored the motivations of coaches in a diabetes self-management coaching program who became coaches after completing the program as participants. METHODS Between June 2016 and April 2017 we conducted semi-structured interviews with eight participants-turned-coaches and four of their peer partners in a six-month peer coaching program for patients with poor glycemic control at the Detroit VA. The interviews were transcribed, reviewed and coded by two researchers in an iterative process until consensus was reached. Key themes were identified and analyzed. RESULTS Participants-turned-coaches reported the importance of their own peer coach in their decision to become a coach. Participants-turned-coaches described commitment to their partners, providing realistic encouragement, and fostering a reciprocal partnership. Participants-turned-coaches shared their own difficulties to motivate their partners and create a sense of commonality. DISCUSSION Encouraging participants who complete diabetes peer coach interventions to become coaches appears to be a useful strategy for developing peer coaches who bring sensitivity, commitment, and reciprocity to their role.
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Affiliation(s)
- Kirin Saint
- 173243Department of Internal Medicine, University of Michigan, USA.,Center for Clinical Management Research, 20034Ann Arbor Veterans' Affairs Healthcare System, USA
| | - Michele Heisler
- 173243Department of Internal Medicine, University of Michigan, USA.,Center for Clinical Management Research, 20034Ann Arbor Veterans' Affairs Healthcare System, USA.,Department of Health Behavior and Health Education, 51329School of Public Health, University of Michigan, USA
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Scavarda A, Costa G, Beccaria F. Using Photovoice to understand physical and social living environment influence on adherence to diabetes. Health (London) 2023; 27:279-300. [PMID: 34041947 DOI: 10.1177/13634593211020066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Within the past several years, a considerable body of research on adherence to diabetes regimen has emerged in public health. However, the focus of the vast majority of these studies has been on the individual traits and attitudes affecting adherence. Still little is known on the role of the social and physical context in supporting or hindering diabetes self-management, particularly from a qualitative standpoint. To address these limitations, this paper presents the findings of a Photovoice study on a sample of 10 type 2 diabetic older adults living in a deprived neighbourhood of an Italian city. The findings reveal that the possibility to engage in diet, exercise and blood sugar monitoring seems to be more affected by physical and social elements of the respondents' environment than by the interviewees' beliefs and attitudes. Both environmental barriers and social isolation emerge as barriers to lifestyle changes and self-care activities related to blood sugar monitoring. The predominance of bonding social capital, the scant level of trust and the negative perception of local health services result in a low level of social cohesion, a limited circulation of health information on diabetes management and, consequently, in poor health outcomes.
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Affiliation(s)
- Alice Scavarda
- Università di Torino, Eclectica, Institute for Research and Training, Italy
| | - Giuseppe Costa
- Università di Torino, Servizio Sovrazionale di Epidemiologia, ASL TO3, Italy
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Kinch M, Kroll T, Stokes D, Somanadhan S. Interventions to support adolescents and young adults with the healthcare transition from paediatric to adult nephrology health services: A scoping review protocol. HRB Open Res 2023. [DOI: 10.12688/hrbopenres.13684.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background: Due to technological advancements and improved medical management of adolescents and young adults (AYAs) living with renal disease, there has been an exponential increase noted in the number of patients advancing from the paediatric to adult nephrology healthcare setting. Subsequently, more AYAs are required to undergo the process of healthcare transition from paediatric to adult healthcare services. This process is often a challenging period for young people and families and is often associated with a decline in physical and psychosocial health outcomes of AYAs with renal disorders. To ensure a successful transition, AYAs must develop the ability to manage their renal condition, including the medical and psychosocial aspects of their condition, independently. Despite significant research into the transition from paediatric to adult healthcare for this unique patient cohort, the transition period remains a challenge. The scoping review will aim to map, explore, and understand the interventions that are currently available to offer positive perceptions and experiences of transition for both AYAs living with renal disorders and their families. Methods: A systematic literature search will be conducted of PubMed, PsycInfo, CINAHL, ASSIA, EMBASE and Web of Science databases from the year 2000 to present. Two independent reviewers will screen the title and abstracts of peer-reviewed literature obtained and assess them against the inclusion criteria to determine their inclusion eligibility. Data will be extracted and synthesised using a template refined by the authors. The scoping review will be undertaken in accordance with PRISMA-ScR guidelines. Data will undergo a formal critical appraisal using recognised appraisal tools. Conclusions: Through mapping this knowledge, the scoping review will aim to identify interventions that are currently available and identify gaps within the literature. This evidence may support the development of transitional care interventions in the future, promote patient satisfaction, and improve patient outcome measures and experiences.
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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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Williams JS, Walker RJ, Egede LE. Gender invariance in the relationship between social support and glycemic control. PLoS One 2023; 18:e0285373. [PMID: 37155683 PMCID: PMC10166517 DOI: 10.1371/journal.pone.0285373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/21/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Social support (SS) is important in diabetes self-management; however, little is known about how different types of SS influence diabetes outcomes in men and women with type 2 diabetes mellitus (T2DM). Therefore, the aims of this study were to investigate the relationships between types of SS and glycemic control and self-care behaviors and assess whether the relationships differ by gender. METHODS Cross-sectional study of 615 adults from two primary care clinics in the southeastern U.S. Outcomes were hemoglobin A1c (HbA1c) extracted from the medical records, and self-management behaviors (general diet, specific diet, exercise, blood glucose testing, foot care) measured using the Summary of Diabetes Self-Care Activities (SDSCA). Independent variable was SS (emotional/informational, tangible, affectionate, positive social interaction) measured using the Medical Outcomes Study (MOS) SS Scale. Structural equation modeling (SEM) was used to understand pathways between SS and glycemic control based on a theoretical model. RESULTS Tangible support was significantly associated with self-care (r = 0.16; p = 0.046) and affectionate support was marginally associated with glycemic control (r = 0.15; p = 0.08) for both men and women. Using SEM to test gender invariance, there was no statistically significant difference in the meaning of SS between men and women. However, unique invariances in responses occurred, including a stronger relationship between tangible support and self-care for women (r = 0.24; p = 0.061). CONCLUSIONS Of the four components of SS, tangible and affectionate support had the strongest influence on glycemic control. While affectionate support will improve glycemic control in both men and women, tangible support will improve self-care management, particularly in women.
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Affiliation(s)
- Joni S Williams
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Rebekah J Walker
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Leonard E Egede
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
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Liu Q, Jin Y, Wang Y, Feng J, Qiao X, Ji L, Si H, Bian Y, Wang W, Yu J, Wang C. Association between self-efficacy and self-management behaviours among individuals at high risk for stroke: Social support acting as a mediator. J Clin Nurs 2023; 32:71-82. [PMID: 34981582 DOI: 10.1111/jocn.16191] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/02/2021] [Accepted: 12/20/2021] [Indexed: 12/14/2022]
Abstract
AIMS AND OBJECTIVES To explore the association between self-efficacy and self-management by modelling three types of social support as mediators among stroke high-risk populations. BACKGROUND Self-efficacy and social support (i.e. objective support, subjective support and support utilisation) are important for self-management among stroke high-risk populations. Self-efficacy activates three types of social support, and the effect of social support on self-management varies by types among chronic patients. Therefore, social support may act as a mediator between self-efficacy and self-management, and the mediating role may vary by types of social support. Disentangling the role of these different types of social support can guide tailored interventions. DESIGN A cross-sectional study. METHODS This study was conducted among 448 Chinese adults at high risk for stroke. Self-efficacy, self-management and social support were assessed using the Self-Efficacy Scale, the Stroke Self-management Scale and the Social Support Rating Scale respectively. The PROCESS SPSS Macro version 3.3, model 4 was used to explore the mediating role of different types of social support in the relationship between self-efficacy and self-management. This study followed STROBE checklist for cross-sectional studies (Appendix S1). RESULTS Self-efficacy improved three types of social support, and subjective support and support utilisation promoted self-management, but objective support hindered self-management. The specific indirect effect of objective support and subjective support was significant but not that of support utilisation. Objective support, subjective support and support utilisation attenuated the total effect of self-efficacy on self-management by -23.8%, 23.8% and 7.7% respectively. CONCLUSIONS Mediating effect of social support in the relationship between self-efficacy and self-management varies by type, and the positive effect of subjective support is offset by the detrimental effect of objective support. RELEVANCE TO CLINICAL PRACTICE Among stroke high-risk populations, interventions should target objective support and subjective support as well as self-efficacy to efficiently improve their self-management.
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Affiliation(s)
- Qinqin Liu
- School of Nursing, Peking University, Beijing, China
| | - Yaru Jin
- School of Nursing, Peking University, Beijing, China
| | - Ying Wang
- Liaocheng People's Hospital, Liaocheng, China
| | | | - Xiaoxia Qiao
- School of Nursing, Peking University, Beijing, China
| | - Lili Ji
- School of Nursing, Peking University, Beijing, China
| | - Huaxin Si
- School of Nursing, Peking University, Beijing, China
| | - Yanhui Bian
- School of Nursing, Peking University, Beijing, China
| | - Wenyu Wang
- School of Nursing, Peking University, Beijing, China
| | - Jiaqi Yu
- School of Nursing, Peking University, Beijing, China
| | - Cuili Wang
- School of Nursing, Peking University, Beijing, China
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Verma I, Gopaldasani V, Jain V, Chauhan S, Chawla R, Verma PK, Hosseinzadeh H. The impact of peer coach-led type 2 diabetes mellitus interventions on glycaemic control and self-management outcomes: A systematic review and meta-analysis. Prim Care Diabetes 2022; 16:719-735. [PMID: 36307372 DOI: 10.1016/j.pcd.2022.10.007] [Citation(s) in RCA: 8] [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: 12/16/2021] [Revised: 09/12/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is a major health risk and dominant cause of global mortality and morbidity. Disease-specific support from peers with similar chronic condition has shown to improve chronic disease self-management outcomes. The purpose of this systematic review is to summarise the existing evidence on the impact of peer coach-led type 2 diabetes mellitus self-management interventions on glycaemic control and self-management outcomes. Databases including MEDLINE, PubMed, CINAHL Plus, Scopus, ProQuest Central, ScienceDirect, web of science, Wiley Online Library and UOW Library were searched for eligible papers. Thirteen randomised controlled trials (RCTs) published between 2008 and 2021 were included in this review. Random-effects meta-analyses found that there were statistically significant changes in Haemoglobin A1c HbA1c) after the interventions. However, the meta-analyses showed no significant changes in LDL (low-density lipoprotein), BMI (Body mass index), systolic BP (Blood Pressure), and HRQoL (Health-related quality of life) among intervention and control groups after the intervention. The identified studies mainly recruited patients with suboptimal glucose levels; majority of them belonging to low-income population. Our findings showed that peer coaching was helpful in improving HbA1c levels, quality of life, self-efficacy, diabetes distress and patient activation. Moreover, peer coaching associations with medication adherence, hypoglycaemic symptoms, diabetes specific social support and depression were inconclusive. This review concludes that peer-led community-based interventions with longer follow up, using a mixed method of delivery among patients with suboptimal levels of HbA1c were more efficient compared to usual care for improving T2DM self-management.
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Affiliation(s)
- Iksheta Verma
- School of Health and Society, University of Wollongong, Building 29, Room 315, NSW 2522, Australia.
| | - Vinod Gopaldasani
- School of Health and Society, University of Wollongong, Building 29, Room 315, NSW 2522, Australia
| | - Vishesh Jain
- Data & Analytics, RMIT Building 106, Level 7, 222 Lonsdale Street, Melbourne, VIC 3000, Australia
| | - Saroj Chauhan
- Employees State Insurance, Faridabad, Haryana 121002, India
| | - Rajeev Chawla
- North Delhi Diabetes Centre, 180, Jai Apartment, Rohini Sector 9, New Delhi 110085, India
| | | | - Hassan Hosseinzadeh
- School of Health and Society, University of Wollongong, Building 29, Room 315, NSW 2522, Australia
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Shi J, Ferretti L, McCallion P. Attending with family members, completion rate and benefits accrued from chronic disease self-management program. Chronic Illn 2022; 18:784-795. [PMID: 34282954 DOI: 10.1177/17423953211032263] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Chronic Disease Self-Management Program (CDSMP) has been demonstrated effective in addressing the self-management of chronic conditions among older adults. With a higher attrition rate, this study investigated whether attending with family members influenced completion of and benefits accrued from the CDSMP. METHODS The baseline data were collected from CDSMP participants in New York State (n = 4184), and the follow-up data were collected from completers (attended 4+ sessions) (n = 293). Multi-level logistic regression was employed to predict the association between family accompany and program completion. Paired sample t-test was used to compare the differences in benefits from CDSMP after six months. RESULTS Attending with family members was associated with a higher likelihood of completing the CDSMP (OR = 1.626, p < .05). All completers reported small but significant improvements in self-rated health at six months (p < .001), and the changes were greater for those with family members. Males, caregivers, those aged 65 to 84 years old, with college or above education, were more accompanied by family members. Workshops in senior centers, libraries, or educational institutions attracted more family companions. DISCUSSION Engaging family members may increase CDSMP participants' motivation to complete the program. CDSMP providers should encourage participants to attend with their family members.
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Affiliation(s)
- Junrong Shi
- Department of Social Work, College of Health, Education, and Professional Studies, The University of Tennessee at Chattanooga, Chattanooga, TN, USA
| | - Lisa Ferretti
- School of Social Work, Temple University, Philadelphia PA, USA
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Upenieks L, Orfanidis C. Social Trust, Religiosity, and Self-Rated Health in the Context of National Religious Pluralism. JOURNAL OF RELIGION AND HEALTH 2022; 61:4535-4564. [PMID: 34396483 DOI: 10.1007/s10943-021-01380-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/03/2021] [Indexed: 06/13/2023]
Abstract
Trust and religiosity have been individually linked to better health outcomes, but little existing research examines how they may combine to shape health. Drawing on data from the 6th and most recent wave of the World Values Survey, we examine the relationship between particularized and generalized social trust, two dimensions of religiosity (religious attendance and one's belief in the importance of God), and self-rated health across 27 countries. Findings from multilevel models suggest that trust tends to be higher in more religiously pluralistic national contexts, while religiosity in these contexts helps individuals maintain good health. In particular, a higher importance of God (but not religious attendance) can offset the negative health effects of holding low trust in strangers and non-family members (generalized trust), but only in highly pluralistic national contexts. We conclude by offering future research directives that may shed light on the cultural complexities of the various national contexts and their religious compositions.
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Affiliation(s)
- Laura Upenieks
- Department of Sociology, Baylor University, One Bear Place, Waco, TX, 76798, USA.
| | - Christos Orfanidis
- Morality, Action, and Cognition Lab, University of Toronto, Toronto, Canada
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Abshire Saylor M, Denhaerynck K, Mielke J, Davidson PM, Dobbels F, Russell CL, De Geest S. Multi-level correlates of received social support among heart transplant recipients in the international BRIGHT Study: a secondary analysis. Eur J Cardiovasc Nurs 2022; 21:857-867. [PMID: 35670232 DOI: 10.1093/eurjcn/zvac041] [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: 10/06/2021] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 12/29/2022]
Abstract
AIMS Social support is critical in follow-up of patients after heart transplant (HTx) and positively influences well-being and clinical outcomes such as medication adherence. The purpose of this study was to (i) explore received social support variation (emotional and practical) in HTx recipients at country and centre level and (ii) to assess multi-level correlates. METHODS AND RESULTS Secondary data analysis of the multi-level cross-sectional BRIGHT study was conducted in 36 HTx centres in 11 countries. Received social support related to medication adherence was measured with emotional and practical sub-scales. The Conceptual Model of Social Networks and Health guided selection of patient, micro (interpersonal and psychosocial), meso (HTx centre) and macro-level (country health system) factors. Descriptive statistics, intraclass correlations, and sequential multiple ordinal mixed logistic regression analysis were used. A total of 1379 adult HTx recipients were included. Patient level correlates (female sex, living alone, and fewer depressive symptoms) and micro-level correlates (higher level of chronic disease management and trust in the healthcare team) were associated with better emotional social support. Similarly, patient level (living alone, younger age, and male sex), micro-level and meso-level (patient and clinician-rated higher level of chronic disease management) were associated with better practical social support. Social support varied at country and centre levels for emotional and practical dimensions. CONCLUSIONS Social support in HTx recipients varies by country, centre, and was associated with multi-level correlates. Qualitative and longitudinal studies are needed to understand influencing factors of social support for intervention development, improvement of social support, and clinical outcomes.
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Affiliation(s)
- Martha Abshire Saylor
- Johns Hopkins University School of Nursing, 525 N Wolfe St., Baltimore, MD, 21205USA
| | - Kris Denhaerynck
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland
| | - Juliane Mielke
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland
| | - Patricia M Davidson
- University of Wollongong, NSW, Australia.,Johns Hopkins University School of Nursing, 525 N Wolfe St., Baltimore, MD, 21205USA
| | - Fabienne Dobbels
- Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, KU, Leuven, Belgium
| | - Cynthia L Russell
- School of Nursing Nursing and Health Studies, University of Missouri-Kansas City, Missouri, USA
| | - Sabina De Geest
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland.,School of Nursing Nursing and Health Studies, University of Missouri-Kansas City, Missouri, USA
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Zhao YC, Zhao M, Song S. Online Health Information Seeking Among Patients With Chronic Conditions: Integrating the Health Belief Model and Social Support Theory. J Med Internet Res 2022; 24:e42447. [PMID: 36322124 PMCID: PMC9669891 DOI: 10.2196/42447] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/06/2022] [Accepted: 10/20/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Chronic diseases are the leading causes of death and disability. With the growing patient population and climbing health care expenditures, researchers and policy makers are seeking new approaches to improve the accessibility of health information on chronic diseases while lowering costs. Online health information sources can play a substantial role in effective patient education and health communication. However, some contradictory evidence suggests that patients with chronic conditions may not necessarily seek online health information. OBJECTIVE This study aims to integrate 2 theories (ie, the health belief model and social support theory) and a critical health literacy perspective to understand online health information seeking (OHIS) among patients with chronic conditions. METHODS We used the survey method to collect data from online chronic disease communities and groups on social media platforms. Eligible participants were consumers with at least 1 chronic condition and those who have experience with OHIS. A total of 390 valid questionnaires were collected. The partial least squares approach to structural equation modeling was employed to analyze the data. RESULTS The results suggested that perceived risk (t=3.989, P<.001) and perceived benefits (t=3.632, P<.001) significantly affected patients' OHIS. Perceived susceptibility (t=7.743, P<.001) and perceived severity (t=8.852, P<.001) were found to influence the perceived risk of chronic diseases significantly. Informational support (t=5.761, P<.001) and emotional support (t=5.748, P<.001) also impacted the perceived benefits of online sources for patients. In addition, moderation analysis showed that critical health literacy significantly moderated the link between perceived risk and OHIS (t=3.097, P=.002) but not the relationship between perceived benefits and OHIS (t=0.288, P=.774). CONCLUSIONS This study shows that the health belief model, when combined with social support theory, can predict patients' OHIS. The perceived susceptibility and severity can effectively explain perceived risk, further predicting patients' OHIS. Informational support and emotional support can contribute to perceived benefits, thereby positively affecting patients' OHIS. This study also demonstrated the important negative moderating effects of critical health literacy on the association between perceived risk and OHIS.
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Affiliation(s)
- Yuxiang Chris Zhao
- School of Economics and Management, Nanjing University of Science and Technology, Nanjing, China
| | | | - Shijie Song
- Business School, Hohai University, Nanjing, China
- School of Information Management, Wuhan University, Wuhan, China
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Tsur N, Noyman-Veksler G, Elbaz I, Weisman L, Brill S, Shalev H, Rudich Z, Shahar G. The Personification of Chronic Pain: an Examination Using the Ben-Gurion University Illness Personification Scale (BGU-IPS). Psychiatry 2022; 86:137-156. [PMID: 36315968 DOI: 10.1080/00332747.2022.2129329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: Relying on anthropomorphism research, Illness Personification Theory (ILL-PERF) posits that individuals living with a chronic illness ascribe human-like characteristics to their illness. Herein we examine the personification of chronic pain using a new measure: the Ben-Gurion University Illness Personification Scale (BGU-IPS). Method: Three samples of chronic pain patients (Sample 1 and 2 are distinct samples sharing similar characteristics, collected in the context of a cross-sectional design, Ns = 259, 263; Sample 3: a 2-waves longitudinal, N =163) completed the 12-item BGU-IPS, and measures of pain and related factors. Results: An orthogonal, two-factor structure was revealed for the BGU-IPS pertaining to negative vs. positive personifications. Negative personification was associated with pain intensity and illness-related distress (e.g., depression and low adjustment to pain). Positive personification was correlated with hope, pain-related sense of control, and low depression. However, positive personification also augmented the associations between negative personification and several risk factors. Conclusions: Pain personification, particularly as assessed via the BGU-IPS, plays a major role in (mal)adaptation to chronic pain.
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Healy KV, Weise S, Fink A, Frese T, Richter M, Knöchelmann A. Learning Approaches as a Means to Understand Difficulties and Opportunities in Type 2 Diabetes Self-Management Training: A Qualitative Content Analysis of Two German Educational Curricula. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2120580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
| | | | - Astrid Fink
- Martin Luther University Halle-Wittenberg
- District Administration Groß-Gerau
| | | | - Matthias Richter
- Martin Luther University Halle-Wittenberg
- Technical University of Munich
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Parry M, Visintini S, Johnston A, Colella TJ, Kapur D, Liblik K, Gomes Z, Dancey S, Liu S, Goodenough C, Hay JL, Noble M, Adreak N, Robert H, Tang N, O'Hara A, Wong A, Mullen KA. Peer-support interventions for women with cardiovascular disease: protocol for synthesising the literature using an evidence map. BMJ Open 2022; 12:e067812. [PMID: 36198466 PMCID: PMC9535150 DOI: 10.1136/bmjopen-2022-067812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The leading cause of death for women is cardiovascular disease (CVD), including ischaemic heart disease, stroke and heart failure. Previous literature suggests peer support interventions improve self-reported recovery, hope and empowerment in other patient populations, but the evidence for peer support interventions in women with CVD is unknown. The aim of this study is to describe peer support interventions for women with CVD using an evidence map. Specific objectives are to: (1) provide an overview of peer support interventions used in women with ischaemic heart disease, stroke and heart failure, (2) identify gaps in primary studies where new or better studies are needed and (3) describe knowledge gaps where complete systematic reviews are required. METHODS AND ANALYSIS We are building on previous experience and expertise in knowledge synthesis using methods described by the Evidence for Policy and Practice Information (EPPI) and the Coordinating Centre at the Institute of Education. Seven databases will be searched from inception: CINAHL, Embase, MEDLINE, APA PsycINFO, the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials, and Scopus. We will also conduct grey literature searches for registered clinical trials, dissertations and theses, and conference abstracts. Inclusion and exclusion criteria will be kept broad, and studies will be included if they discuss a peer support intervention and include women, independent of the research design. No date or language limits will be applied to the searches. Qualitative findings will be summarised narratively, and quantitative analyses will be performed using R. ETHICS AND DISSEMINATION The University of Toronto's Research Ethics Board granted approval on 28 April 2022 (Protocol #42608). Bubble plots (ie, weighted scatter plots), geographical heat/choropleth maps and infographics will be used to illustrate peer support intervention elements by category of CVD. Knowledge dissemination will include publication, presentation/public forums and social media.
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Affiliation(s)
- Monica Parry
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Health Sciences Library, University of Ottawa, Ottawa, Ontario, Canada
| | - Amy Johnston
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Tracey Jf Colella
- Toronto Rehabilitation Cardiovascular Prevention & Rehabilitation Program, KITE - University Health Network, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing and the Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Deeksha Kapur
- Lawrence S. Bloomberg Faculty of Nursing (Research Assistant), University of Toronto, Toronto, Ontario, Canada
| | - Kiera Liblik
- School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Zoya Gomes
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sonia Dancey
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Shuangbo Liu
- Section of Cardiology, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Catherine Goodenough
- Canadian Women's Heart Health Alliance, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Jacqueline L Hay
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada
- Institute of Cardiovascular Sciences, St Boniface General Hospital Albrechtsen Research Centre, Winnipeg, Manitoba, Canada
| | - Meagan Noble
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Indigenous Services Canada, Toronto, Ontario, Canada
| | - Najah Adreak
- Department of Surgery, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Helen Robert
- Canadian Women's Heart Health Alliance, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Natasha Tang
- School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Arland O'Hara
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Anice Wong
- Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Kerri-Anne Mullen
- Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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Comparing the effectiveness of Family Support for Health Action (FAM-ACT) with traditional community health worker-led interventions to improve adult diabetes management and outcomes: study protocol for a randomized controlled trial. Trials 2022; 23:841. [PMID: 36192769 PMCID: PMC9527393 DOI: 10.1186/s13063-022-06764-1] [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: 08/26/2022] [Accepted: 09/17/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Diabetes self-management education and support (DSMES) programs have struggled to deliver sustainable, effective support for adults with diabetes (AWDs) to improve self-management behaviors, achieve glycemic goals, and reduce risk for complications. One largely untapped resource for this support is AWDs' social networks. Fifty to 75% of AWDs have an unpaid family member or friend ("support person") who provides ongoing help with diabetes management. However, DSMES interventions to date lack structured and effective approaches to directly engage support persons in AWDs' diabetes management. METHODS This parallel arm randomized trial is designed to determine the effectiveness of Family Support for Health Action (FAM-ACT), a novel community health worker (CHW)-delivered program focused on educating and supporting patients with type 2 diabetes (T2D) and their support persons (SPs), relative to an established, CHW-delivered, individual patient-focused DSMES and care management (I-DSMES) intervention. Both interventions were developed using a community-based participatory research (CBPR) approach. The study will be conducted in partnership with an urban Federally Qualified Health Center (FQHC) serving a low-income, Latino/a community, with target enrollment of 268 dyads consisting of an FQHC patient with T2D with high HbA1c and an SP. Patient-SP dyads will be randomized to receive FAM-ACT or I-DSMES over 6 months. The primary outcome is change in patient HbA1c from baseline to 6 months. Secondary patient outcomes include 12-month change in HbA1c, changes in patient blood pressure, diabetes self-management behaviors, diabetes distress, patient activation, diabetes self-efficacy, and perceptions of and satisfaction with SP support for diabetes. Secondary SP outcomes include self-efficacy for helping the patient with diabetes management and SP distress about the patient's diabetes. We also will assess the effect of the COVID-19 pandemic on patient's ability to manage diabetes. DISCUSSION This study will inform scalable, evidence-based approaches that leverage family support to help AWDs improve and sustain self-management strategies that underpin optimal management of multiple diabetes complication risk factors. The protocol is designed for and evaluated with a low-income and predominantly Latino/a community, which may increase applicability to other similar communities. The COVID-19 pandemic presented several challenges to study protocol and intervention delivery; modifications made to address these challenges are described. TRIAL REGISTRATION ClinicalTrials.gov NCT03812614. Registered on 18 January 2019.
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Askgaard G, Madsen LG, von Wowern N, Winther-Jensen M, Lau CJ, Christensen AI, Crooks C, West J, Jepsen P. Social support and risk of mortality in cirrhosis: A cohort study. JHEP REPORTS : INNOVATION IN HEPATOLOGY 2022; 5:100600. [PMID: 36644236 PMCID: PMC9832279 DOI: 10.1016/j.jhepr.2022.100600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 09/21/2022] [Indexed: 11/05/2022]
Abstract
Background & Aims The function and structure of social relationships influence mortality in individuals within the general population. We compared aspects of social relationships in individuals with cirrhosis and a matched comparison cohort and studied their association with health-related quality of life (HRQoL) and mortality in cirrhosis. Methods Individuals with cirrhosis and comparators were identified among participants of the Danish National Health Surveys 2010-2017. The surveys included questions on functional (social support and loneliness) and structural (living alone/cohabitating and frequency of contacts with relatives and friends) aspects of social relationships and HRQoL (Short Form-12). We estimated associations of aspects of social relationships with HRQoL and all-cause mortality in individuals with cirrhosis through 2020. Results Of 541 individuals with cirrhosis and 2,157 comparators, low social support (22% in cirrhosis vs. 13% in comparators), loneliness (35% vs. 20%), and living alone (48% vs. 22%) were more frequent in individuals with cirrhosis than comparators, whereas the frequency of contacts with relatives and friends was similar. Except for living alone, weak functional and structural social relationships were associated with lower mental HRQoL in those with cirrhosis. Physical HRQoL was only marginally associated with social relationships. During 2,795 person-years of follow-up, 269 individuals with cirrhosis died. Functional and not structural aspects of social relationships were associated with risk of mortality in cirrhosis. Specifically, the adjusted hazard ratio was 1.4 (95% CI 1.1-1.9), p = 0.011, for low vs. moderate-to-high social support (functional aspect), and 1.0 (95% CI 0.8-1.3), p = 0.85 for living alone vs. cohabitating (structural aspect). Conclusions Individuals with cirrhosis have weaker functional and structural social relationships than matched comparators. Weak functional relationships are associated with lower mental HRQoL and increased risk of mortality in individuals with cirrhosis. Impact and implications This study investigated the prevalence of weak social relationships in individuals with cirrhosis and their influence on health-related quality of life and risk of mortality. Individuals with cirrhosis were nearly twice as likely to report low social support, loneliness, and to live alone than a matched comparison cohort. Low social support and loneliness (functional measures of social relationships) were associated with lower mental health-related quality of life and increased risk of mortality risk in cirrhosis, when adjusting for known confounders. We hope that these results will make healthcare providers aware of the functional aspects of the social relationships of individuals with cirrhosis, in addition to the traditional clinical management, and motivate further research of interventions to strengthen the social support of individuals with cirrhosis.
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Affiliation(s)
- Gro Askgaard
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
- Section of Gastroenterology and Hepatology, Medical Department, Zealand University Hospital, Køge, Denmark
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, The Capital Region, Denmark
- Corresponding author. Gro Askgaard, Department of Hepatology and Gastroenterolgy, Aarhus University Hospital. Tel.: +45 78450000.
| | - Lone Galmstrup Madsen
- Section of Gastroenterology and Hepatology, Medical Department, Zealand University Hospital, Køge, Denmark
| | - Natasja von Wowern
- Section of Gastroenterology and Hepatology, Medical Department, Zealand University Hospital, Køge, Denmark
| | - Matilde Winther-Jensen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, The Capital Region, Denmark
| | - Cathrine Juel Lau
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, The Capital Region, Denmark
| | | | - Colin Crooks
- Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - Joe West
- Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Peter Jepsen
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Miley K, Michalowski M, Yu F, Leng E, McMorris BJ, Vinogradov S. Predictive models for social functioning in healthy young adults: A machine learning study integrating neuroanatomical, cognitive, and behavioral data. Soc Neurosci 2022; 17:414-427. [PMID: 36196662 PMCID: PMC9707316 DOI: 10.1080/17470919.2022.2132285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 09/14/2022] [Indexed: 10/10/2022]
Abstract
Poor social functioning is an emerging public health problem associated with physical and mental health consequences. Developing prognostic tools is critical to identify individuals at risk for poor social functioning and guide interventions. We aimed to inform prediction models of social functioning by evaluating models relying on bio-behavioral data using machine learning. With data from the Human Connectome Project Healthy Young Adult sample (age 22-35, N = 1,101), we built Support Vector Regression models to estimate social functioning from variable sets of brain morphology to behavior with increasing complexity: 1) brain-only model, 2) brain-cognition model, 3) cognition-behavioral model, and 4) combined brain-cognition-behavioral model. Predictive accuracy of each model was assessed and the importance of individual variables for model performance was determined. The combined and cognition-behavioral models significantly predicted social functioning, whereas the brain-only and brain-cognition models did not. Negative affect, psychological wellbeing, extraversion, withdrawal, and cortical thickness of the rostral middle-frontal and superior-temporal regions were the most important predictors in the combined model. Results demonstrate that social functioning can be accurately predicted using machine learning methods. Behavioral markers may be more significant predictors of social functioning than brain measures for healthy young adults and may represent important leverage points for preventative intervention.
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Affiliation(s)
- Kathleen Miley
- School of Nursing, University of Minnesota, Minneapolis MN, United States
| | - Martin Michalowski
- School of Nursing, University of Minnesota, Minneapolis MN, United States
| | - Fang Yu
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Ethan Leng
- Department of Biomedical Engineering, University of Minnesota, Minneapolis MN, United States
| | | | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis MN, United States
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