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Larivière C, Preuss R, Coutu MF, Sullivan MJ, Roy N, Henry SM. Disability reduction following a lumbar stabilization exercise program for low back pain: large vs. small improvement subgroup analyses of physical and psychological variables. BMC Musculoskelet Disord 2024; 25:358. [PMID: 38704535 PMCID: PMC11069239 DOI: 10.1186/s12891-024-07480-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/28/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Little is known about why patients with low back pain (LBP) respond differently to treatment, and more specifically, to a lumbar stabilization exercise program. As a first step toward answering this question, the present study evaluates how subgroups of patients who demonstrate large and small clinical improvements differ in terms of physical and psychological changes during treatment. METHODS Participants (n = 110) performed the exercise program (clinical sessions and home exercises) over eight weeks, with 100 retained at six-month follow-up. Physical measures (lumbar segmental instability, motor control impairments, range of motion, trunk muscle endurance and physical performance tests) were collected twice (baseline, end of treatment), while psychological measures (fear-avoidance beliefs, pain catastrophizing, psychological distress, illness perceptions, outcome expectations) were collected at four time points (baseline, mid-treatment, end of treatment, follow-up). The participants were divided into three subgroups (large, moderate and small clinical improvements) based on the change of perceived disability scores. ANOVA for repeated measure compared well-contrasted subgroups (large vs. small improvement) at different times to test for SUBGROUP × TIME interactions. RESULTS Statistically significant interactions were observed for several physical and psychological measures. In all these interactions, the large- and small-improvement subgroups were equivalent at baseline, but the large-improvement subgroup showed more improvements over time compared to the small-improvement subgroup. For psychological measures only (fear-avoidance beliefs, pain catastrophizing, illness perceptions), between-group differences reached moderate to strong effect sizes, at the end of treatment and follow-up. CONCLUSIONS The large-improvement subgroup showed more improvement than the small-improvement subgroup with regard to physical factors typically targeted by this specific exercise program as well as for psychological factors that are known to influence clinical outcomes.
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Affiliation(s)
- Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505, boul. De Maisonneuve Ouest, Montreal, QC, H3A 3C2, Canada.
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Montreal, QC, H3S 1M9, Canada.
| | - Richard Preuss
- School of Physical & Occupational Therapy, McGill University, 845 Sherbrooke Wst, Montreal, QC, H3G 1Y5, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Montreal, QC, H3S 1M9, Canada
| | - Marie-France Coutu
- Charles-Le Moyne Hospital Research Centre, University of Sherbrooke, 150 Place Charles-Le Moyne, Office 200, Longueuil, QC, J4K 0A8, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Montreal, QC, H3S 1M9, Canada
| | - Michael J Sullivan
- Department of Psychology, McGill University, 1205 Docteur Penfield, Montreal, QC, H3A 1B1, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Montreal, QC, H3S 1M9, Canada
| | - Nicolas Roy
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Montreal, QC, H3S 1M9, Canada
| | - Sharon M Henry
- Department of Neurological Sciences, University of Vermont, Burlington, VT, 05401, USA
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Jeong H, Lee Y, Park JS, Lee Y. Influence of Illness Uncertainty on Health Behavior in Individuals with Coronary Artery Disease: A Path Analysis. J Korean Acad Nurs 2024; 54:162-177. [PMID: 38863186 DOI: 10.4040/jkan.23136] [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: 10/16/2023] [Revised: 03/22/2024] [Accepted: 04/15/2024] [Indexed: 06/13/2024]
Abstract
PURPOSE This study aimed to investigate the influence of uncertainty-related factors on the health behavior of individuals with coronary artery disease (CAD) based on Mishel's uncertainty in illness theory (UIT). METHODS We conducted a cross-sectional study and path analysis to investigate uncertainty and factors related to health behavior. The study participants were 228 CAD patients who visited the outpatient cardiology department between September 2020 and June 2021. We used SPSS 25.0 and AMOS 25.0 software to analyze the data. RESULTS The final model demonstrated a good fit with the data. Eleven of the twelve paths were significant. Uncertainty positively affected danger and negatively affected self-efficacy and opportunity. Danger had a positive effect on perceived risk. Opportunity positively affected social support, self-efficacy, perceived benefit and intention, whereas it negatively affected perceived risk. Social support, self-efficacy, perceived benefit and intention had a positive effect on health behavior. We found that perceived benefit and intention had the most significant direct effects, whereas self-efficacy indirectly affected the relationship between uncertainty and health behavior. CONCLUSION The path model is suitable for predicting the health behavior of CAD patients who experience uncertainty. When patients experience uncertainty, interventions to increase their self-efficacy are required first. Additionally, we need to develop programs that quickly shift to appraisal uncertainty as an opportunity, increase perceived benefits of health behavior, and improve intentions.
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Affiliation(s)
- Hyesun Jeong
- Department of Nursing, Graduate School, Pusan National University, Yangsan, Korea
| | - Yesul Lee
- Department of Nursing, Graduate School, Pusan National University, Yangsan, Korea
| | - Jin Sup Park
- Department of Cardiology, Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Yoonju Lee
- College of Nursing, Research Institute of Nursing Science, Pusan National University, Yangsan, Korea.
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Gu X, Shen X, Zhou JR, Chu JH, Jiang L. The effects of common-sense model interventions on cancer patients: A systematic review. Medicine (Baltimore) 2024; 103:e37777. [PMID: 38669411 PMCID: PMC11049692 DOI: 10.1097/md.0000000000037777] [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: 10/01/2023] [Accepted: 03/12/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND From the time of new diagnosis to treatment, cancer patients experience a variety of health problems that can affect the patient's health outcomes. Individuals with cancer are being given increasing responsibility for the self-management of their health and illness. The self-regulating common-sense model (CSM) is effective in patients' disease management. This article briefly introduces the common-sense model intervention, in which patients with cancer are affected by these interventions, what they are about, and what effects they have. METHODS The authors systematically review evidence for the common-sense model of self-regulation for cancer using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Based on a comprehensive literature search, we searched the Cochrane Library, PsycINFO, Embase, PubMed, Medline, CINAHL, CNKI, and WanFang databases. The included studies underwent a quality assessment using the Effective Public Health Practice Project (EPHPP). RESULTS Eleven empirical studies illustrated the aspects of common-sense model interventions for cancer patients. It is concluded that common-sense model intervention has an effect on symptoms in cancer treatment, behavior, and quality of life, but more studies are needed to verify the use of common-sense model intervention to explore in patients with different cancers. The systematic review summarized a four-point paradigm about intervention content, including assessing the current situation, setting goals, having a disease education and psychological adjustment, and getting feedback for further response. However, the application of intervention requires specific analysis of patient behavior and outcomes. CONCLUSION Common-sense model interventions are beneficial for the self-management of cancer patients; however, more intervention studies are needed to specify the cognitive, emotional, and coping styles of people with a particular cancer.
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Affiliation(s)
- Xue Gu
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Xia Shen
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Jun-Rui Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Jiang-Hui Chu
- Department of Cardiothoracic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Lei Jiang
- Department of Radiology, Huadong Sanatorium, Wuxi, China
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von der Warth R, Rudolph M, Bengel J, Glattacker M. The association of early response with the outcome of psychosomatic rehabilitation in patients with mental disorders and its link to treatment and illness beliefs-A prospective longitudinal cohort study. Psychother Res 2024:1-16. [PMID: 38381978 DOI: 10.1080/10503307.2024.2316014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/02/2024] [Indexed: 02/23/2024] Open
Abstract
Early response is considered to be an important predictor for therapy outcomes; yet little is known about its relevance in psychosomatic rehabilitation. This paper aims to describe the association of early response in psychosomatic rehabilitation, as well as the associations of early response with pre-rehabilitative factors such as illness and treatment beliefs. A longitudinal study with three measurement points was applied. Early response was defined using the percent improvement method after two weeks of treatment. Its association with therapy outcome and with illness and treatment beliefs was analyzed using multiple regression analyses. A total of 264 participants took part. Early response was a significant predictor of psychosomatic rehabilitation outcome, explaining an incremental variance of 1-30% after controlling for initial symptom burden. Illness and treatment beliefs predicted 6-20% variance in early response. Important illness beliefs referred to perceived symptoms, consequences and comprehensibility of the illness. Important treatment beliefs referred to expectations about rehabilitation structure, processes and concerns. Early response is associated with the therapy outcome of psychosomatic rehabilitation, with illness and treatment beliefs found to be associated with early response. Further research on the predictors of early response in psychosomatic rehabilitation is needed.
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Affiliation(s)
- Rieka von der Warth
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Matthias Rudolph
- Deutsche Rentenversicherung Rheinland-Pfalz (German Statutory Pension Insurance Rhineland Palatinate), Mittelrhein-Klinik (Clinic for Psychosomatic Rehabilitation), Boppard-Bad Salzig, Germany
| | - Jürgen Bengel
- Section of Rehabilitation Psychology and Psychotherapy, Department of Psychology, University of Freiburg, Freiburg, Germany
| | - Manuela Glattacker
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Nau A, Metzner G, von der Warth R, Sehlbrede M, Bengel J, Rudolph M, Glattacker M. Psychometric properties of the rehabilitation treatment beliefs questionnaire for psychosomatic rehabilitation. Disabil Rehabil 2024; 46:369-377. [PMID: 36524758 DOI: 10.1080/09638288.2022.2157057] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Treatment beliefs play a crucial role for patient satisfaction and the treatment outcome in psychosomatic rehabilitation. The aim of this study was the development and the psychometric evaluation of an indication-specific questionnaire of beliefs about psychosomatic rehabilitation. MATERIALS AND METHODS The study was conducted at a psychosomatic rehabilitation clinic. The primary item list comprised k = 125 items. After a descriptive item analysis, we conducted an exploratory factor analysis. Furthermore, we tested reliability via McDonald's Omega and construct validity by analyzing correlations of the scales with related constructs. RESULTS Of the N = 264 participants, 50% were female and the mean age was 50.4 (SD = 9.8) years. K = 85 items were suitable for factor analysis, which resulted in k = 30 items constituting six scales, explaining of 57% the overall variance. The corrected item-total correlations were between r = 0.48 and r = 0.83. Internal consistency ranged from ω = 0.81 to ω = 0.86. CONCLUSION The newly developed questionnaire assesses specific treatment beliefs about inpatient psychosomatic rehabilitation. The psychometric properties of the six scales are acceptable. Further studies should confirm the psychometric results, such as the factorial structure of the questionnaire.IMPLICATIONS FOR REHABILITATIONTreatment beliefs are known to play an important role for the adherence, therapy outcome and satisfaction in psychosomatic rehabilitation.We developed and tested a indication-specific questionnaire assessing treatment beliefs in psychosomatic rehabilitation.The questionnaire can be used to explore patient's rehabilitation-related treatment beliefs, predict treatment outcomes, and to develop interventions attempting to modify these.
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Affiliation(s)
- Anne Nau
- Section of Health Care Research and Rehabilitation Research (SEVERA), Institute of Medical Biometry and Statistics (IMBI), Medical Center, University of Freiburg, Freiburg, Germany
| | - Gloria Metzner
- Section of Health Care Research and Rehabilitation Research (SEVERA), Institute of Medical Biometry and Statistics (IMBI), Medical Center, University of Freiburg, Freiburg, Germany
| | - Rieka von der Warth
- Section of Health Care Research and Rehabilitation Research (SEVERA), Institute of Medical Biometry and Statistics (IMBI), Medical Center, University of Freiburg, Freiburg, Germany
| | - Matthias Sehlbrede
- Section of Health Care Research and Rehabilitation Research (SEVERA), Institute of Medical Biometry and Statistics (IMBI), Medical Center, University of Freiburg, Freiburg, Germany
| | - Jürgen Bengel
- Section of Rehabilitation Psychology and Psychotherapy, Department of Psychology, University of Freiburg, Freiburg, Germany
| | - Matthias Rudolph
- German Statutory Pension Insurance Rhineland Palatinate, Clinic for Psychosomatic Rehabilitation, Boppard-Bad Salzig, Germany
| | - Manuela Glattacker
- Section of Health Care Research and Rehabilitation Research (SEVERA), Institute of Medical Biometry and Statistics (IMBI), Medical Center, University of Freiburg, Freiburg, Germany
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DeShazo JM, Kouwijzer I, de Groot S, Post MWM, Valent LJM, van Leeuwen CMC, Wen H, Cowan RE. Effect of Training for an Athletic Challenge on Illness Cognition in Individuals with Chronic Disability: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:58. [PMID: 38248523 PMCID: PMC10815898 DOI: 10.3390/ijerph21010058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/19/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024]
Abstract
Illness cognitions (IC) influence how a patient adapts to a chronic disease. The aim was (1) to determine if training for a handcycling mountain time trial (HandbikeBattle) improves IC and (2) to identify factors associated with IC change scores. Persons with a chronic disability (N = 220; including N = 151 with spinal cord disorder) trained 5 months and participated in the time trial. The IC Questionnaire measured helplessness, acceptance, perceived benefits and was assessed before training (T1), after training (T2), and four months after the event (T3). Age, sex, body mass index (BMI), time since injury (TSI), disability characteristics, self-efficacy, mental health (MH) and musculoskeletal pain were obtained at T1. Multilevel regression analyses showed that helplessness decreased (from 11.96 to 11.28, p < 0.01) and perceived benefits increased (from 16.91 to 17.58, p < 0.01) from T1 to T2. For helplessness this decrease persisted during follow-up (11.16 at T3). Changes in helplessness were associated with self-efficacy (p = 0.02), MH (p = 0.02) and lesion completeness (p = 0.02), and were independent of disability type (p = 0.66), lesion level (p = 0.30) and demographics such as sex (p = 0.29) and age (p = 0.67). Training with peers may improve helplessness and perceived benefits in individuals with a chronic disability. Especially individuals with MH problems might benefit from training for an athletic challenge with peers to improve illness cognitions, and ultimately, quality of life.
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Affiliation(s)
- Joy M. DeShazo
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (J.M.D.); (H.W.); (R.E.C.)
| | - Ingrid Kouwijzer
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands;
- Amsterdam Rehabilitation Research Center|Reade, 1054 HW Amsterdam, The Netherlands
| | - Sonja de Groot
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands;
- Amsterdam Rehabilitation Research Center|Reade, 1054 HW Amsterdam, The Netherlands
| | - Marcel W. M. Post
- Center of Excellence for Rehabilitation Medicine, UMCU Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, 3583 TM Utrecht, The Netherlands; (M.W.M.P.); (C.M.C.v.L.)
- Center for Rehabilitation, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Linda J. M. Valent
- Research and Development, Heliomare Rehabilitation Center, 1949 EC Wijk aan Zee, The Netherlands;
| | - Christel M. C. van Leeuwen
- Center of Excellence for Rehabilitation Medicine, UMCU Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, 3583 TM Utrecht, The Netherlands; (M.W.M.P.); (C.M.C.v.L.)
| | - Huacong Wen
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (J.M.D.); (H.W.); (R.E.C.)
| | - Rachel E. Cowan
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (J.M.D.); (H.W.); (R.E.C.)
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Gu X, Shen X, Chu JH, Fang TT, Jiang L. Frailty, Illness Perception and Lung Functional Exercise Adherence in Lung Cancer Patients After Thoracoscopic Surgery. Patient Prefer Adherence 2023; 17:2773-2787. [PMID: 37936716 PMCID: PMC10627072 DOI: 10.2147/ppa.s435944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/20/2023] [Indexed: 11/09/2023] Open
Abstract
Background Lung cancer patients will have lung damage after surgery, need rehabilitation exercise. Common-sense model has shown the impact of patients' perception of illness on health behaviors. However, for patients with lung cancer after thoracoscopic surgery, there has been no relevant exploration of disease perception. Objective The purpose of this study was to investigate the clinical status of patients with lung cancer patients who have undergone thoracoscopic surgery, and to explore the correlation between frailty, disease perception, and lung functional exercise compliance. Methods The cross-sectional study included 218 patients with lung cancer after thoracoscopic surgery. We collected participants' frailty, disease perception, exercise adherence, and relevant clinical information. T-test, Chi-square, Linear regression, Pearson's correlation, and mediation analysis were used for statistical analysis of patient data. Results We analyzed the data by disease perception with high and low median scores and found significant differences in lymphatic dissection, stool within three days, pain, thoracic drainage tube placement time. Linear regression results show that, after controlling for confounding factors, frailty and disease perception were significantly associated with pulmonary function exercise compliance. The higher the frailty score, the worse the compliance, and the higher the disease perception negative score, the less exercise. Illness perception played a partially mediating role in the association between frailty and lung functional exercise adherence. Conclusion Frailty and disease perception have an impact on exercise adherence, therefore, we need to consider these factors in the intervention to improve exercise compliance after thoracoscopic surgery for lung cancer.
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Affiliation(s)
- Xue Gu
- Wuxi School of Medicine, Jiangnan University, Wuxi, People’s Republic of China
| | - Xia Shen
- Wuxi School of Medicine, Jiangnan University, Wuxi, People’s Republic of China
| | - Jiang-Hui Chu
- Department of Cardiothoracic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, People’s Republic of China
| | - Ting-Ting Fang
- Department of Cardiothoracic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, People’s Republic of China
| | - Lei Jiang
- Department of Radiology, Huadong Sanatorium, Wuxi, People’s Republic of China
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Mohamed R, Siddiqui Z, Sutphin R, Kelly KM. Illness representations of vaping associated lung injury (VALI) and E-cigarette use: common sense model of self-regulation driven mixed-method approach. Psychol Health 2023; 38:1494-1514. [PMID: 35014574 DOI: 10.1080/08870446.2021.2024828] [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: 01/20/2021] [Revised: 12/01/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The study explored differences in illness representations of VALI guided by the Common-Sense Model of Self-Regulation (CSM-SR) among non-patient adults. DESIGN We employed a cross-sectional concurrent mixed-methods design. In the quantitative analysis, we used multivariate analysis of covariance (MANCOVA). Immersion/crystallization was used to analyze qualitative data. MAIN OUTCOME MEASURES We measured differences in illness representations of VALI by e-cigarette use status, gender, and urban/rural residence. RESULTS E-cigarette use was associated with illness representations of VALI. Current e-cigarette users discounted the detrimental nature of VALI, compared to former and never e-cigarette users. Gender and urban/rural residence moderated the association between e-cigarette use and illness representation of VALI. In the qualitative analysis, 49.3% respondents reported components of the timeline (e.g. permanent), identity (e.g. shortness of breath), causes (e.g. THC products), consequences (e.g. life-threatening), cure/control (e.g. stop vaping), and worry (e.g. fearful). CONCLUSION Perceptions about VALI, such as cure and timeline, were associated with e-cigarettes use. Understanding the context in which adults perceive VALI, such as gender and rurality, may contribute to developing interventions that influence e-cigarette cessation. Future research employing CSM-SR to target strategies for promoting vaping abstinence is warranted.
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Affiliation(s)
- Rowida Mohamed
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Zasim Siddiqui
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Richard Sutphin
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Kimberly M Kelly
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
- West Virginia University Cancer Institute, Morgantown, West Virginia, USA
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Barut S, Bahçecioğlu Turan G, Özer Z, Aytaçç E. Investigation of illness perception and pregnancy avoidance in sexually active women with epilepsy. Epilepsy Behav 2023; 147:109399. [PMID: 37619467 DOI: 10.1016/j.yebeh.2023.109399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/26/2023]
Abstract
AIM The aim of the study was to examine the perception of illness and avoidance of pregnancy in sexually active women with epilepsy. METHODS This study was completed with 82 women with epilepsy who were sexually active and who were admitted to the neurology clinic and outpatient clinic between June and September 2022. The descriptive information form, Brief Illness Perception Questionnaire (IPQ-B), and Pregnancy Avoidance Scale (PAS) were used to collect the data. RESULTS The mean age of the patients in the study was 32.96 ± 5.92 years and the mean disease duration was 11.19 ± 7.46 years. Among the patients, 75.6% had previous pregnancies, 70.7% did not have miscarriage or abortion, 69.5% previously gave birth, 61% used a contraceptive method (condom, intrauterine device (IUD), pills, etc.) in their last sexual intercourse, 52.4% had good communication with their spouses, 20% had two children, 51.2% had three or more seizures, and 86.6% used antiseizure medications (ASMs). The mean PAS score of the patients was 2.31 ± 1.14 and the mean IPQ-B score was 35.10 ± 13.16. The regression analysis found that the perception of illness was a significant positive predictor of avoidance of pregnancy and explained 17% of it. CONCLUSION Women with epilepsy avoided pregnancy and had negative illness perceptions. Moreover, negative illness perception increased pregnancy avoidance in women with epilepsy.
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Affiliation(s)
- Sümeyye Barut
- Department of Midwifery, Faculty of Health Sciences, Fırat University, Elazığ, Turkey.
| | | | - Zülfünaz Özer
- Department of Nursing, Faculty of Health Sciences, Istanbul Sabahattin Zaim University, Istanbul, Turkey.
| | - Emrah Aytaçç
- Department of Internal Medical Sciences, Faculty of Medicine, Fırat University, Elazığ, Turkey.
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Ní Néill E, Richards HL, Hennessey D, Fortune DG. 'Like a ticking time bomb': A qualitative study exploring the illness experiences of adults with kidney stone disease. Br J Health Psychol 2023; 28:705-723. [PMID: 36724897 DOI: 10.1111/bjhp.12649] [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: 04/19/2022] [Accepted: 11/29/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Kidney stone disease (KSD) is a common, complex and painful urological condition, but how patients make sense of and respond to the challenges of KSD is poorly understood. Using the common-sense model of illness self-regulation (CSM-SR), we aimed to explore the illness experiences of individuals with KSD. DESIGN A qualitative design using individual semi-structured interviews. METHODS Thirty-three patients with KSD attending outpatient urology services participated in interviews informed by the CSM-SR. Data were analysed using reflexive thematic analysis. Themes were mapped onto the domains of the CSM-SR. RESULTS Five main themes were generated, broadly echoing domains within the CSM-SR: (1) making sense of KSD, (2) normality paused, (3) the psychological burden of KSD, (4) the tensions of managing KSD, and (5) improving understanding of KSD. Additionally, findings suggested that partners' perceptions of KSD were an additional contextual factor that informed patients' own perceptions and management of KSD. Participants appraised initial KSD symptoms as indicative of a serious health threat. Diagnosis brought some relief, however, KSD wielded multi-dimensional impacts on patients' perceptions, self-management and well-being. Anxiety, including fear of KSD recurrence, and low mood were common psychological burdens across narratives. CONCLUSION The majority of the themes identified were commensurate with an extended CSM-SR. This model has utility in informing how patients perceive and manage KSD. Examining patients' KSD representations and routinely assessing for psychological distress may be of benefit to improve health outcomes for this patient group.
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Affiliation(s)
- Emma Ní Néill
- Department of Psychology, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Helen L Richards
- Department of Psychology, University of Limerick, Limerick, Ireland
- Department of Clinical Psychology, Mercy University Hospital, Cork, Ireland
- Urology Department, Mercy University Hospital, Cork, Ireland
| | - Derek Hennessey
- Urology Department, Mercy University Hospital, Cork, Ireland
| | - Dónal G Fortune
- Department of Psychology, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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Metzner G, Höhn C, Nau A, Sehlbrede M, Waldeck E, Glattacker M. Treatment Beliefs of Children and Adolescents With Chronic Diseases: Development of the Rehabilitation Treatment Beliefs Questionnaire for Children and Adolescents. J Pediatr Psychol 2023; 48:5-13. [PMID: 35426935 DOI: 10.1093/jpepsy/jsac033] [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: 10/06/2021] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Rehabilitation is an important component in the health care of children and adolescents with chronic diseases and aims at supporting patients' self-regulation for dealing with the disease. Patients' beliefs about illness and treatment are core elements in the self-regulation process. While questionnaires measuring illness beliefs for children and adolescents exist, questionnaires about their rehabilitation-related treatment beliefs are lacking. We therefore developed a questionnaire to assess the rehabilitation-related treatment beliefs of children and adolescents with chronic diseases (Rehabilitation Treatment Beliefs Questionnaire, RTBQ) and tested its psychometric properties. METHODS Ahead of their rehabilitation, children and adolescents, aged 12-17 years, answered 129 items, which were developed based on previous qualitative findings exploring children and adolescents' rehabilitation-related treatment beliefs. Psychometric testing included item analyses, exploratory factor analysis, internal consistency and bivariate correlations of the extracted scales, and the discriminatory power and difficulty of the final items. RESULTS The sample consisted of 170 participants with a mean age of 14.3 years (SD = 1.6); 53.5% were female. After item analyses, 47 items remained for the exploratory factor analysis which revealed 22 items allocated to 4 scales: "expectations of communication and interaction," "expectations of the treatment process," "expectations of treatment success and sustainability," and "expectations of one's own role in the rehabilitation process." The psychometric properties were acceptable to good. CONCLUSIONS The RTBQ assesses various dimensions of rehabilitation-related treatment beliefs of children and adolescents with chronic diseases. While first psychometric results are promising, further psychometric testing is needed.
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Affiliation(s)
- Gloria Metzner
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Cindy Höhn
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Anne Nau
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Matthias Sehlbrede
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Edith Waldeck
- Deutsche Rentenversicherung Rheinland-Pfalz, Edelsteinklinik (Specialized Clinic for Child- and Adolescent Rehabilitation), Bruchweiler, Germany
| | - Manuela Glattacker
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
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Bankole AO, Gill SL, McSharry J, White CL, Aniemeke C, Wallington SF, Addo-Mensah DE, Braden CJ. Self-regulatory coping among community dwelling older adults with multiple chronic conditions. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2023; 13:26335565231207538. [PMID: 37867622 PMCID: PMC10588418 DOI: 10.1177/26335565231207538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/27/2023] [Indexed: 10/24/2023]
Abstract
Objectives Many older adults with multiple chronic conditions (MCC) frequently experience hospitalizations, functional limitations, and poor quality of life. Outcomes may be improved by promoting self-regulation, which may individuals respond to health threats and manage their health conditions. The aim of this study was to describe self-regulatory coping among older adults with MCC. Methods A qualitative descriptive study using semi-structured interviews and content analysis and guided by the Common-Sense Self-Regulation Model. Seventeen community-dwelling older adults with two or more chronic conditions participated in our study. Results Three themes were developed from the analysis: (1) "I don't think about it unless something happens": coping in the absence of a health event, (2) "doing what I am supposed to do": coping during a health event, and (3) "How do I know if what I did works?": appraisal of coping success. Discussion Self-regulatory coping was influenced by individual beliefs and experiences (illness representations), context, self-efficacy and availability of support and resources to cope with MCC. These findings suggest implications for clinical practice and future self-regulation interventions for older adults with MCC.
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Affiliation(s)
| | - Sara L. Gill
- San Antonio School of Nursing, University of Texas Health Science Center, San Antonio, TX, USA
| | - Jenny McSharry
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
| | - Carole L. White
- San Antonio School of Nursing, University of Texas Health Science Center, San Antonio, TX, USA
| | - Chidinma Aniemeke
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
| | - Sherrie Flynt Wallington
- School of Nursing and the Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | - Carrie Jo Braden
- San Antonio School of Nursing, University of Texas Health Science Center, San Antonio, TX, USA
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Warth RVD, Rudolph M, Bengel J, Glattacker M. Kontextfaktoren der patient*innenseitigen Selbstregulation in
der psychosomatischen Rehabilitation – eine Querschnittsanalyse vor
Rehabilitationsbeginn. REHABILITATION 2022; 61:222-229. [PMID: 35995052 DOI: 10.1055/a-1865-1311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
BACKGROUND Contextual factors are a central element of the ICF and important factors for therapy planning in psychosomatic rehabilitation. At the same time, little is known about the relationship between contextual factors and patient self-regulation, an important goal of rehabilitation.The aim of this study is therefore to investigate the relationship between contextual factors and illness belies. Illness beliefs are a core element of self-regulation in psychosomatic rehabilitation and part of the common sense model of self-regulation. METHODS Between April 2019 and January 2020, a cross-sectional questionnaire study was conducted in a psychosomatic rehabilitation clinic, in which registered rehabilitation patients were questioned about their illness beliefs using the Illness Perception Questionnaire (IPQ-R). Contextual factors were divided into clinically modifiable and non-clinically modifiable and included gender, age, duration of illness, subjective social status, main diagnosis (dichotomised: F3/F4), occupational stress, depressive stress as well as activity and participation (operationalised by the Health-49). Multiple regressions were used for the analysis, in which the scales of the IPQ-R served as dependent variables. RESULTS N=264 rehabilitants took part in the survey, 50% of them were female. The average age was 50 years. With regard to the non-clinically modifiable contextual factors, it was shown that a younger age was associated with higher control assumptions, but that younger rehabilitation patients simultaneously perceived more symptoms due to their illness (identity). A longer duration of illness showed a connection with the chronic timeline assumptions. A lower social status showed correlations with lower control assumptions and more assumptions about the cyclical timeline. Regarding clinically modifiable contextual factors, an F3 diagnosis was associated with more expected consequence, but also with a higher perceived personal control than an F4 diagnosis. A higher occupational burden was associated with the assumption of a more chronic course of the disease. Reduced activity and participation were associated with more expected consequences and more perceived symptoms (identity). Depressive stress showed associations with six out of eight domains of illness beliefs. CONCLUSION The study supports the relevance of contextual factors, which in majority can be discussed as person-related factors, for patient self-regulation in psychosomatic rehabilitation. Interventions to increase self-regulation, e. g. by taking illness beliefs into account, have already achieved promising results, also in the context of rehabilitation. The patient-oriented approach of these interventions could be further strengthened by a stronger inclusion of contextual factors.
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Affiliation(s)
- Rieka von der Warth
- Sektion Versorgungsforschung und Rehabilitationsforschung, Institut für medizinische Biometrie und Statistik, Universitätsklinikum Freiburg, Albert-Ludwigs-Universität Freiburg
| | - Matthias Rudolph
- Deutsche Rentenversicherung Rheinland-Pfalz, Mittelrhein-Klinik, Boppard-Bad Salzig
| | - Jürgen Bengel
- Abteilung für Rehabilitationspsychologie und Psychotherapie, Institut für Psychologie, Albert-Ludwigs-Universität Freiburg
| | - Manuela Glattacker
- Sektion Versorgungsforschung und Rehabilitationsforschung, Institut für medizinische Biometrie und Statistik, Universitätsklinikum Freiburg, Albert-Ludwigs-Universität Freiburg
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14
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Li X, Huo Z, Hu Z, Lam TP, Cheng JCY, Chung VCH, Yip BHK. Which interventions may improve bracing compliance in adolescent idiopathic scoliosis? A systematic review and meta-analysis. PLoS One 2022; 17:e0271612. [PMID: 35857763 PMCID: PMC9299303 DOI: 10.1371/journal.pone.0271612] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/01/2022] [Indexed: 11/19/2022] Open
Abstract
This review aimed to systematically review and meta-analyze the effects of interventions in improving bracing compliance among adolescent idiopathic scoliosis (AIS) patients. Eight databases were searched from their inception to April 2022. The eligibility criteria included controlled studies that used any type of intervention to enhance bracing compliance in braced AIS patients. Two researchers independently screened articles and extracted data based on the PICO (participant, intervention, comparator, and outcome) framework. Quality appraisal of included studies was performed using GRADE (overall assessment), and the risk of bias was assessed with Cochrane RoB Tool 2 for randomized controlled trials (RCT) and ROBINS-I for non-RCT studies. The primary outcome was bracing compliance and secondary outcomes included Cobb Angle and measurements for quality of life. Six eligible studies involving 523 participants were included. All studies were evaluated as low or very low quality with a high risk of bias. Four types of interventions were identified, including sensor monitoring (n = 2, RCTs), auto-adjusted brace (n = 1, RCT), more intensive or collaborated medical care (n = 2), and psychosocial intervention (n = 1). A meta-analysis of 215 patients from the three RCTs suggested that the compliance-enhancing intervention group had 2.92 more bracing hours per day than the usual care control (95%CI [1.12, 4.72], P = 0.001). In subgroup analysis, sensor monitoring significantly improved bracing wearing quantity compared to usual care (3.47 hours/day, 95%CI [1.48, 5.47], P = 0.001), while other aforementioned interventions did not show a significant superiority. Compliance-enhancing interventions may be favorable in preventing curve progression and promoting quality of life, but the improvements cannot be clarified according to limited evidence. In conclusion, although the results of this study suggested that sensor monitoring may be the most promising approach, limited high-quality evidence precludes reliable conclusions. Future well-designed RCTs are required to confirm the actual benefit of compliance-improving interventions in clinical practice.
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Affiliation(s)
- Xue Li
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhaohua Huo
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Zongshan Hu
- Department of Spine Surgery, Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Tsz Ping Lam
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
- SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong SAR, China
| | - Jack Chun Yiu Cheng
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
- SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong SAR, China
| | - Vincent Chi-ho Chung
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Benjamin Hon Kei Yip
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- * E-mail:
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15
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Illness perceptions and adherence to breast cancer-related lymphedema risk management behaviours among breast cancer survivors. Eur J Oncol Nurs 2022; 58:102144. [DOI: 10.1016/j.ejon.2022.102144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 03/29/2022] [Accepted: 04/14/2022] [Indexed: 11/18/2022]
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16
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von der Warth R, Nau A, Rudolph M, Bengel J, Glattacker M. Illness and treatment beliefs as predictors of rehabilitation outcome in patients with mental disorders. J Psychosom Res 2022; 155:110750. [PMID: 35152184 DOI: 10.1016/j.jpsychores.2022.110750] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/30/2022] [Accepted: 01/30/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Illness and treatment beliefs are important predictors of health outcomes. However, little is known about their impact on outcomes in psychosomatic rehabilitation. Thus, the aim of this study was to investigate the impact of illness and rehabilitation-related treatment beliefs in patients with mental disorders attending psychosomatic rehabilitation. METHODS We applied a longitudinal study with two measurement points (before rehabilitation; end of rehabilitation) in a psychosomatic rehabilitation clinic. Patients with mood disorders, anxiety or fear-related disorders, stress associated disorders or bodily distress disorders were included. Using regression models, we analysed whether illness and rehabilitation-related treatment beliefs predicted the rehabilitation outcome (operationalised through "Health-49"). Illness beliefs were assessed using the IPQ-R, while treatment beliefs were assessed using the RTBQ-Psych. Analyses were conducted separately for patients with a F3 and F4 diagnosis in accordance with the ICD-10. RESULTS N = 239 patients were included, sample size per regression model ranged between n = 48 and n = 85. Mean age was 50.8 years, and n = 120 were female. Initial symptom burden was the strongest predictor in all models with 12% to 64% explained variance. Concerning illness beliefs, perceived consequences, treatment control, and cyclic timeline were negatively linked to the outcome, whereas coherence and emotional representations were shown to be positive predictors. Regarding treatment beliefs, expectations towards treatment results were positively and concerns were negatively associated predictors. CONCLUSION Illness and treatment beliefs are predictors of the rehabilitation outcome. Patients´ beliefs might therefore be good starting points for interventions in the context of rehabilitation.
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Affiliation(s)
- Rieka von der Warth
- Section of Health Care Research and Rehabilitation Research, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg; Germany.
| | - Anne Nau
- Section of Health Care Research and Rehabilitation Research, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg; Germany
| | - Matthias Rudolph
- Deutsche Rentenversicherung Rheinland-Pfalz (German Statutory Pension Insurance Rhineland Palatinate), Mittelrhein-Klinik (Clinic for Psychosomatic Rehabilitation), Boppard-Bad Salzig, Germany
| | - Jürgen Bengel
- Section of Rehabilitation Psychology and Psychotherapy, Department of Psychology, University of Freiburg, Freiburg, Germany
| | - Manuela Glattacker
- Section of Health Care Research and Rehabilitation Research, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg; Germany
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17
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Glattacker M, Rudolph M, Bengel J, von der Warth R. Illness Beliefs, Treatment Beliefs, and Fulfilled Treatment Expectations in Psychosomatic Rehabilitation: Associations with Patient Satisfaction. Patient Prefer Adherence 2022; 16:3303-3317. [PMID: 36545541 PMCID: PMC9762405 DOI: 10.2147/ppa.s390596] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Patients' illness and treatment beliefs have been shown to predict health outcomes in many health care settings. However, information about their impact on patient satisfaction is scarce. The aim of this study was to investigate illness- and rehabilitation-related treatment beliefs and met rehabilitation-related treatment expectations and their relationship with patient satisfaction in psychosomatic rehabilitation. METHODS In a repeated measures study design, patients filled out questionnaires 2 to 3 weeks before the start of rehabilitation and at the end of an inpatient rehabilitation 6 to 7 weeks later. The predictive value of illness beliefs, treatment beliefs, and fulfilled treatment expectations regarding patient satisfaction was analyzed with multiple hierarchical regression analyses controlling for sociodemographic and clinical variables. RESULTS Two hundred sixty-four patients participated. The sample was composed of equal numbers of men and women (n = 129 each). The mean age was 50.4 years. Most patients had diagnoses from the ICD-10 diagnostic group F3 (affective disorders; n = 145) or F4 (neurotic, stress-related and somatoform disorders; n = 94). Sociodemographic and clinical variables were not associated with patient satisfaction. The explained variance of patient satisfaction increased to 10% by adding illness beliefs (namely personal control and coherence) (p = 0.006), to 5% by adding rehabilitation-related treatment beliefs (namely concerns) (p = 0.063), and to 49% by adding fulfilled expectations (namely a positive discrepancy between expectations and experiences related to outcome expectations and related to participation and treatment structure, and a negative discrepancy between expectations and experiences related to concerns) (p < 0.001) as predictor variables. CONCLUSION This study highlights the relationship of fulfilled (rehabilitation-related) treatment expectations with patient satisfaction in psychosomatic rehabilitation. Given the evidence underlining the importance of patients' illness and treatment beliefs and expectations, it is vital that these constructs are addressed in corresponding interventions.
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Affiliation(s)
- Manuela Glattacker
- Section of Health Care Research and Rehabilitation Research, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Correspondence: Manuela Glattacker, Section of Health Care Research and Rehabilitation Research, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 49, Freiburg, D-79106, Germany, Tel +49 761 270 36940, Email
| | - Matthias Rudolph
- Deutsche Rentenversicherung Rheinland-Pfalz (German Statutory Pension Insurance Rhineland Palatinate); Mittelrhein-Klinik (Clinic for Psychosomatic Rehabilitation), Boppard-Bad Salzig, Germany
| | - Jürgen Bengel
- Section of Rehabilitation Psychology and Psychotherapy; Department of Psychology; University of Freiburg, Freiburg, Germany
| | - Rieka von der Warth
- Section of Health Care Research and Rehabilitation Research, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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18
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El-Krab R, Kalichman SC. Alcohol-Antiretroviral Therapy Interactive Toxicity Beliefs and Intentional Medication Nonadherence: Review of Research with Implications for Interventions. AIDS Behav 2021; 25:251-264. [PMID: 33950339 DOI: 10.1007/s10461-021-03285-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2021] [Indexed: 02/07/2023]
Abstract
The successful treatment of HIV infection relies on adherence to antiretroviral therapy (ART). Alcohol use remains a threat to ART adherence, including the beliefs held by people who drink alcohol that it is harmful to take ART when consuming alcohol (i.e., alcohol-ART interactive toxicity beliefs, AA-ITB). We reviewed the current research that has investigated AA-ITB and their relationship to intentional ART nonadherence. The review of 17 published studies found that AA-ITB are prevalent among people receiving ART and that AA-ITB are directly associated with ART nonadherence and incomplete HIV suppression. Family, friends and healthcare providers are common sources and reinforcers of AA-ITB. Studies suggest that AA-ITB may best be explained by the Medication Necessity and Concerns Beliefs Model, treating AA-ITB as a specific circumstance of medication concerns. Interventions are needed to communicate the realities of potential medication interactions and dispel myths that it is harmful to mix alcohol with ART, while not inadvertently suggesting that it is safe to drink with all medications, which could undermine adherence to ART by increasing alcohol use.
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Affiliation(s)
- Renee El-Krab
- Institute for Collaboration On Health Intervention and Policy, University of Connecticut, 2006 Hillside Road, Storrs, CT, 06269, USA
| | - Seth C Kalichman
- Institute for Collaboration On Health Intervention and Policy, University of Connecticut, 2006 Hillside Road, Storrs, CT, 06269, USA.
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Prill S, Henning C, Schroeder S, Steins-Loeber S, Wolstein J. Does Weight-Cycling Influence Illness Beliefs in Obesity? A Gender-Sensitive Approach. J Obes 2021; 2021:8861386. [PMID: 34471546 PMCID: PMC8405317 DOI: 10.1155/2021/8861386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 08/10/2021] [Indexed: 11/21/2022] Open
Abstract
Obesity is classified as a chronic disease. Women and men seem to face different obstacles in their attempts to overcome one of the most challenging tasks in the treatment of this disease, namely, weight reduction maintenance. The Common-Sense-Model (CSM) is mainly used to improve the understanding of self-regulation and health behaviour in chronic diseases but has yet to be explored for obesity. This paper applies the CSM to obesity, focussing on the construct of illness representations, which is the basis of health behaviour according to the CSM. A sample of n = 356 women and n = 77 men with obesity was investigated to assess the extent that illness representations in obesity are shaped by experiences of weight-cycling and the extent that gender influences their quality. Our results show that the representations of timeline and consequences as well as the emotional representation are particularly influenced by weight-cycling, especially in men. On average, women showed more maladaptive illness representations than men. These findings not only contribute to a better applicability of the CSM in obesity, but also emphasize the importance of gender in obesity research and interventions.
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Affiliation(s)
- Svenja Prill
- Department of Pathopsychology, University of Bamberg, Bamberg 96047, Germany
| | - Carmen Henning
- Department of Pathopsychology, University of Bamberg, Bamberg 96047, Germany
| | - Stefanie Schroeder
- Department of Pathopsychology, University of Bamberg, Bamberg 96047, Germany
| | - Sabine Steins-Loeber
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg 96047, Germany
| | - Jörg Wolstein
- Department of Pathopsychology, University of Bamberg, Bamberg 96047, Germany
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Campbell-Salome G, Buchanan AH, Hallquist MLG, Rahm AK, Rocha H, Sturm AC. Uncertainty management for individuals with Lynch Syndrome: Identifying and responding to healthcare barriers. PATIENT EDUCATION AND COUNSELING 2021; 104:403-412. [PMID: 32782180 DOI: 10.1016/j.pec.2020.07.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 04/24/2020] [Accepted: 07/21/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Examine the uncertainty management process of individuals with Lynch syndrome (LS). METHODS 19 phone interviews were conducted with individuals with LS. The interview guide included questions on family communication, risk perceptions, and uncertainty management. Data were analyzed using the constant comparison method to code for emergent themes. RESULTS Qualitative analysis found individuals with LS tried to manage their uncertainty through preventive care, but were often confounded by healthcare barriers. Healthcare barriers included cost and insurance issues, absence of coordinated care, insufficient provider knowledge, and lack of patient-centered communication. Participants reported increased uncertainty and anxiety due to these barriers and used alternative uncertainty management strategies such as advocating for themselves with providers, seeking information online, and communicating with family for emotional support. CONCLUSION Healthcare barriers identified in this study exacerbated uncertainty and anxiety for individuals with LS and challenged their ability to engage in preventive care. In response, participants used alternative uncertainty management strategies to reduce their uncertainty, which may have unintended negative consequences. PRACTICE IMPLICATIONS Findings support the need for providers to partner with specialists in genetics and/or LS to better care for individuals with LS. Findings highlight opportunities for interventions in healthcare to better support individuals with LS.
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Affiliation(s)
| | | | | | - Alanna K Rahm
- Genomic Medicine Institute, Geisinger, Danville, PA, USA
| | - Heather Rocha
- Genomic Medicine Institute, Geisinger, Danville, PA, USA
| | - Amy C Sturm
- Genomic Medicine Institute, Geisinger, Danville, PA, USA
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21
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Chan VWY, Kong APS, Lau JTF, Mak WWS, Cameron LD, Mo PKH. An Intervention to Change Illness Representations and Self-Care of Individuals With Type 2 Diabetes: A Randomized Controlled Trial. Psychosom Med 2021; 83:71-84. [PMID: 33141790 DOI: 10.1097/psy.0000000000000883] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Suboptimal self-care by individuals with diabetes mellitus (DM) is a significant public health concern. The common-sense model (CSM) proposes that illness representations are associated with coping and health outcomes across various conditions. The present study examined the efficacy of a CSM-based intervention in improving illness representations, self-care, self-care self-efficacy, use of adaptive coping strategies, and glycated hemoglobin among individuals with type 2 DM (T2DM). METHODS A two-arm randomized controlled trial was used. A total of 455 T2DM patients were recruited from an outpatient DM clinic and randomized to an intervention group that consisted of five weekly group-based education sessions or a control group that received five weekly educational booklets. Evaluation was conducted at baseline and at 1- and 6-month follow-up. RESULTS The 2 × 3 linear mixed-model analysis using a modified intention to treat revealed a significant time by condition interaction effect on level of self-care (F(2,840) = 7.78, p < .001), self-care self-efficacy (F(1.89,794.57) = 14.40, p < .001), and use of adaptive coping strategies (F(1.94,812.93) = 4.75, p = .010) in which participants in the intervention group reported greater improvement in such aspects compared with those in the control group. A significant time effect was observed in some dimensions of illness representations. No significant effect was found in glycated hemoglobin. Participants reported positive feedback to the intervention and perceived improvement in various domains. CONCLUSIONS The CSM-based intervention was effective in improving self-care and coping among DM patients. The intervention also demonstrated high feasibility and acceptability. Findings provided important insights in improving health-related outcomes for patients with T2DM using the CSM framework.
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Affiliation(s)
- Virginia W Y Chan
- From the Centre for Health Behaviours Research, School of Public Health and Primary Care (Chan, Lau, Mo), and Departments of Medicine and Therapeutics (Kong) and Psychology (Mak), the Chinese University of Hong Kong, Shatin, Hong Kong; and Department of Psychological Sciences (Cameron), University of California Merced, Merced, California
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22
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Kaptein AA, Schoones JW, van der Meer PB, Matsuda A, Murray M, Heimans L, Kroep JR. Psychosocial determinants of adherence with oral anticancer treatment: 'we don't need no education'. Acta Oncol 2021; 60:87-95. [PMID: 33151764 DOI: 10.1080/0284186x.2020.1843190] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Given the potentially fatal consequences of inadequate adherence with oral anticancer treatment in persons with cancer, understanding the determinants of adherence is vital. This paper aims at identifying psychosocial determinants of adherence to oral anticancer treatment. METHODS We reviewed the literature on psychosocial determinants of adherence with oral anticancer treatment, based on published literature in English, from 2015 to present. Literature searches were performed in PubMed, Embase, Web of Science, Cochrane library, Emcare, and PsychINFO, with 'cancer', 'medication adherence', 'psychology', and 'oral anticancer treatment' as search terms. The obtained 608 papers were screened by two independent reviewers. RESULTS In the 25 studies identified, illness perceptions, medication beliefs, health beliefs, and depression were found to be the major psychosocial determinants of adherence to oral anticancer treatment; sociodemographic and clinical characteristics were found to be of no major importance. The quality of the identified studies as assessed by two independent reviewers was found to be acceptable overall. The majority of papers were from North America and focused on patients with breast cancer; sample size varied from 13 to 1371; adherence was assessed with questionnaires derived from various theoretical models, pill counts and electronic pharmacy records; illness perceptions reflecting adaptive coping, and medication beliefs reflecting high necessity and low concerns were found to be associated with adherence. CONCLUSION Psychosocial concepts are major determinants of adherence with oral anticancer treatment. 'Beliefs about medicines' and 'illness perceptions' in particular determine adherence with this treatment. Studies aiming at impacting adherence would benefit from interventions with a solid basis in behavioral theory in order to help health care providers explore and address illness perceptions and medication beliefs. Pre-consultation screening of adherence behavior may be a helpful supportive approach to improve adherence. Blaming the victim ('patients should be educated about the importance of adherence') is better replaced by encouraging health professionals to identify and address maladaptive psychosocial determinants of adherence.
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Affiliation(s)
- Adrian A. Kaptein
- Department of Medical Psychology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jan W. Schoones
- Walaeus Library, Leiden University Medical Center, Leiden, The Netherlands
| | - Pim B. van der Meer
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ayako Matsuda
- Department of Hygiene and Public Health, School of Medicine, Teikyo University, Tokyo, Japan
| | - Michael Murray
- School of Psychology, Keele University, Newcastle-under-Lyme, UK
| | - Lotte Heimans
- Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Judith R. Kroep
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
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Bérubé S, Amesse C, Sultan S. Illness perceptions and their relation to physical activity in children and adolescents with hemophilia. Health Psychol Behav Med 2020; 8:461-474. [PMID: 34040881 PMCID: PMC8114379 DOI: 10.1080/21642850.2020.1823226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 07/28/2020] [Indexed: 11/02/2022] Open
Abstract
Background: Hemophilia is a rare bleeding disorder in which illness perceptions have seldom been studied. Illness perceptions are important in predicting patients' behavior. Due to the risk of bleeding and joint damage, healthcare professionals often discourage some physical activities. Those restrictions can be difficult to follow for pediatric patients. This study investigates the relationship between illness perceptions, physical activity behavior, and intentions amongst this population. Methods: Twenty-four 6-18-year-old patients with severe hemophilia completed the Brief Illness Perception Questionnaire. A questionnaire assessing their level of physical activity and intentions toward safe and higher-risk physical activity was also administered. Clinical and socio-demographic data were collected. Associations were studied using hierarchical clustering of physical activity patterns, and Mann-Whitney U comparisons between clusters. Results: Perceptions ranged from slightly to moderately threatening, and 20-30% of participants had highly threatening perceptions on Consequences, Identity, Concern, and Emotional response. The subgroup who engaged in more high-risk physical activity and had stronger intentions to engage in this type of activity also held more concerns and perceived more symptoms. Conclusion: Patients at risk of non-adherence to recommendations concerning physical activity have more threatening illness beliefs that could be addressed during specific interventions or routine appointments. Addressing illness beliefs could be an element to behavior change. Strong emotional responses to hemophilia also stresses the need for psychosocial support strategies.
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Affiliation(s)
- Sarah Bérubé
- Université de Montréal, Montreal, Canada
- Sainte-Justine University Health Centre, Montreal, Canada
| | | | - Serge Sultan
- Université de Montréal, Montreal, Canada
- Sainte-Justine University Health Centre, Montreal, Canada
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24
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Chang WT, Wang ST, Hsu CH, Tsai LM, Chan SH, Chen HM. Effects of illness representation-focused patient education on illness representations and self-care in patients with heart failure: A randomised clinical trial. J Clin Nurs 2020; 29:3461-3472. [PMID: 32562433 DOI: 10.1111/jocn.15384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 05/24/2020] [Accepted: 06/05/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To examine the effect of an illness representation-focused patient education intervention on illness representations and self-care behaviours in patients with heart failure 3 months after discharge from the hospital. BACKGROUND Few intervention studies have examined the effect of illness representation-focused interventions on illness representations and self-care in patients with heart failure. DESIGN A randomised clinical trial based on the Consolidated Standard of Reporting Trials-CONSORT 2010-guidelines was employed. The Clinical Trial Registry number is TCTR20190903002. METHODS One hundred and seven participants were randomly assigned to 2 groups, and 62 participants (n = 30 in the intervention group and n = 32 in the usual care group) completed the baseline and one- and three-month postdischarge follow-up assessments. The instruments included the Survey of Illness Beliefs in Heart Failure and the Self-care of Heart Failure Index. The intervention group received illness representation-focused patient education while hospitalised and telephone follow-ups after discharge. Data were analysed with linear mixed-effects model analysis. RESULTS The 107 participants had a mean age of 62.17 years and a mean left ventricular ejection of 53.03%. At baseline, the two groups tended to have accurate illness beliefs but insufficient self-care confidence and self-care maintenance. The analysis showed no significant differences between groups in the illness representation total scores, dimension scores or self-care maintenance scores but did show a significant difference in the self-care confidence scores (F = 3.42, p < .05) over the three months. CONCLUSION The study did not show an effect of the intervention on illness representations or self-care maintenance behaviours. However, the intervention did maintain participants' self-care confidence three months after discharge. RELEVANCE TO CLINICAL PRACTICE It is necessary to conduct long-term follow-ups of patients' illness representations, discuss the implementation of self-care behaviours with patients, enhance patients' self-care confidence, and involve family members or caregivers in self-care practices when needed.
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Affiliation(s)
- Wan-Tzu Chang
- Department of Nursing, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Shan-Tair Wang
- Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi City, Taiwan.,Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Hsin Hsu
- Division of Cardiology, Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Liang-Miin Tsai
- Department of Internal Medicine, Tainan Municipal Hospital, Tainan, Taiwan
| | - Shih-Hung Chan
- Division of Cardiology, Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsing-Mei Chen
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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O'Donovan C, Ingles J, Broadbent E, Skinner JR, Kasparian NA. How Patient Perceptions Shape Responses and Outcomes in Inherited Cardiac Conditions. Heart Lung Circ 2020; 29:641-652. [PMID: 31974024 DOI: 10.1016/j.hlc.2019.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 11/04/2019] [Accepted: 11/07/2019] [Indexed: 02/05/2023]
Abstract
At least one-third of adults living with an inherited cardiac condition report clinically-significant levels of psychological distress. Poorer health-related quality of life compared with population norms is also consistently reported. These outcomes are associated with younger patient age, having an implantable cardioverter defibrillator, and receipt of uncertain clinical test results, and can influence self-management behaviours, such as adherence to potentially critical life-preserving medications. According to the Common Sense Model of Illness, people use information from multiple sources to 'make sense' of their health condition, and how they conceptualise the condition can strongly influence adaptation and coping responses. Previous studies with people with inherited cardiac conditions show that illness perceptions, such as greater perceived consequences and a poorer understanding of the condition, are associated with greater psychological distress and poorer adherence to medication. The Common Sense Model provides one potential framework for identifying patients who may be more vulnerable to adverse health outcomes, and for developing early interventions to reduce the physical and psychosocial burden of these conditions. Interventions based on the Common Sense Model have successfully improved physical and psychosocial outcomes associated with other cardiac conditions, and could be tailored for use with patients with an inherited cardiac condition (ICC).
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Affiliation(s)
- Claire O'Donovan
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Jodie Ingles
- Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Elizabeth Broadbent
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Jonathan R Skinner
- Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand; Department of Paediatrics Child and Youth Health, The University of Auckland, Auckland, New Zealand.
| | - Nadine A Kasparian
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Sydney, NSW, Australia; Department of Cardiology, Boston Children's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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Walburn J, Anderson R, Morgan M. Forms, interactions, and responses to social support: A qualitative study of support and adherence to photoprotection amongst patients with Xeroderma Pigmentosum. Br J Health Psychol 2020; 25:89-106. [PMID: 31756279 PMCID: PMC7004138 DOI: 10.1111/bjhp.12396] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 10/23/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Social support influences adherence to treatment in chronic illness, but there is uncertainty about its facilitators and constraints. This study explored the forms, processes, and responses associated with mobilization of informal support across three life contexts amongst patients with Xeroderma Pigmentosum (XP), a condition requiring rigorous photoprotection to reduce cancer risks. DESIGN Qualitative interview study. METHODS A total of 25 adults with XP participated in semi-structured interviews conducted face to face. An inductive thematic analysis was applied using a framework approach. RESULTS Practical support, involving both assistance with recommended photoprotection and adjusting daily activities to reduce exposure, was the key form of support provided by family and friends. However, responses to this support differed with two groups identified based on the relative priority given to photoprotection in daily life and processes of disclosure. For 'positive responders', support aligned with their own priorities to photoprotect, conveyed feelings of being cared-for and was facilitated by talking openly. In contrast, for 'negative responders' support conflicted with their priority of living 'normally' and their limited disclosure hindered receipt of helpful support in personal, clinic, and work interactions. Fears of workplace stigma also reduced disclosure amongst participants open in other contexts. CONCLUSIONS Practical support conveyed psychosocial support with positive effects on adherence. This suggests the traditional separation into practical and emotional support is overly simplistic, with measures potentially missing important aspects. Interactional processes contribute to the effects of support, which can be addressed by targeting disclosure, stigma, and other barriers at individual and organizational levels. Statement of contribution What is already known on this subject? Social support can be both a facilitator and a hindrance to treatment adherence. Practical support is identified as the most important form of support in the context of adherence. The processes of support underpinning its relationship to adherence are unclear. What does this study add? Variations in the provision and impacts of support are influenced by participants' disclosure and attitudes to photoprotection, with two key groups comprising 'positive responders' and 'negative responders'. The influence of emotional support on adherence may be underestimated through neglect of the ways in which practical support often conveys feelings of being valued and cared-for. Barriers to mobilizing effective adherence support extends across life spheres, with fears of stigma and discrimination in work settings highlighting the need to intervene at individual and organizational levels.
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Affiliation(s)
- Jessica Walburn
- Faculty of Life Sciences and MedicineSchool of Cancer and Pharmaceutical SciencesKing’s College LondonUK
| | - Rebecca Anderson
- Faculty of Life Sciences and MedicineSchool of Cancer and Pharmaceutical SciencesKing’s College LondonUK
| | - Myfanwy Morgan
- Faculty of Life Sciences and MedicineSchool of Cancer and Pharmaceutical SciencesKing’s College LondonUK
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Relación entre representación de enfermedad, representación del tratamiento y adherencia en adultos con asma: Una revisión. REVISTA DIGITAL INTERNACIONAL DE PSICOLOGÍA Y CIENCIA SOCIAL 2020. [DOI: 10.22402/j.rdipycs.unam.6.1.2020.200.41-63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
La adherencia al medicamento de control es el pilar fundamental para el control del asma; sin embargo, se ha identificado que una representación negativa de la enfermedad y el tratamiento impactan de modo negativo en esta. Se hizo una revisión narrativa para identificar los estudios empíricos acerca de representación de enfermedad, representación del tratamiento y adherencia a medicamentos de control en adultos con asma, desde el modelo de sentido común y representación de la enfermedad (MSCRE). Se identificaron 17 estudios divididos en transversales y longitudinales (12), experimentales (3) y de intervención (2), reportando que las principales dimensiones del MSCRE asociadas con la adherencia son la necesidad del tratamiento, preocupación, control de la enfermedad y del tratamiento, temporalidad crónica y consecuencias. Se concluye que el MSCRE es un modelo psicológico que tiene aplicaciones en la investigación y atención clínica para explicar y promover conductas de adherencia a medicamentos de control en adultos con asma.
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Revista Digital Internacional de Psicología y Ciencia Social | Volumen 6 | Número 1 | Enero-Junio 2020 | Investigación y acción para el cambio social. REVISTA DIGITAL INTERNACIONAL DE PSICOLOGÍA Y CIENCIA SOCIAL 2020. [DOI: 10.22402/j.rdipycs.unam.6.1.2020.281.1-246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
El nombre del presente número es “La investigación para la acción y el cambio social”, decidimos titularlo de esa manera porque consideramos de fundamental interés destacar la importancia que ha adquirido el trabajo científico desarrollado por los profesionales de distintas disciplinas para favorecer a la población que atienden respectivamente, pues en los trabajos presentados se muestra una excelente articulación entre la teoría y la práctica, poniendo en evidencia que se parte de una concepción social y científica, holística, pluralista e igualitaria.
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Atwa ZT, Wahed WYA. The impact of illness perception and socio-clinico-demographic factors on perceived quality of life in children and adolescents with thalassemia intermedia. Pediatr Blood Cancer 2019; 66:e27735. [PMID: 30924610 DOI: 10.1002/pbc.27735] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 03/12/2019] [Accepted: 03/15/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND/OBJECTIVES β-Thalassemia intermedia (β-TI) accounts for up to one-fourth of β-thalassemia patients. Evaluating and improving quality of life (QOL) should be a goal in β-TI follow-up and management strategies. Patients' perceptions of their illness and its treatment may impact their QOL. This study aimed to evaluate QOL and the factors that affect it in children with β-TI and to determine the impact of the patients' and their mothers' perceptions of the illness on patients' QOL. DESIGN/METHODS This was a case-control study. A total of 143 children and adolescents (71 β-TI patients and 72 healthy controls) were enrolled. QOL, as perceived by the children and their mothers, was assessed using the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scale. Perceptions of the illness by the mothers and children were assessed using the Brief Illness Perceptions Questionnaire (Brief IPQ). The patients' clinical and sociodemographic data were extracted from their medical records. RESULTS The controls had higher QOL scores in nearly all domains (P < 0.01). The patients and mothers who had higher illness perception scores had better QOL scores (P < 0.01). Patient age and serum ferritin levels correlated negatively with QOL, while mean hemoglobin levels correlated positively. The use of hydroxyurea in treatment and high illness perception were independent predictors of better QOL. CONCLUSION QOL is significantly affected in β-TI patients; maintaining a suitable hemoglobin level and standard levels of body iron are associated with better QOL. Patients' and their mothers' perceptions of the illness play an important role in QOL.
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Affiliation(s)
- Zeze Th Atwa
- Paediatrics Department, Faculty of Medicine, Fayoum University Hospital, Fayoum University, Fayoum, Egypt
| | - Wafaa Y Abdel Wahed
- Public Health and Community Medicine Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
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30
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L’Heureux J, Coutu MF, Berbiche D, Larivière C. Adherence to a home exercise programme following a clinical programme for non-acute non-specific low back pain: an exploratory study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2019. [DOI: 10.1080/21679169.2019.1617777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Judith L’Heureux
- Université de Sherbrooke, Longueuil, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | - Marie-France Coutu
- Université de Sherbrooke, Longueuil, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
- Charles-LeMoyne Hospital Research Centre, Longueuil, Canada
| | - Djamal Berbiche
- Université de Sherbrooke, Longueuil, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | - Christian Larivière
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
- Institut Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Canada
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31
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O'Donovan CE, Waddell-Smith KE, Skinner JR, Broadbent E. Predictors of β-blocker adherence in cardiac inherited disease. Open Heart 2018; 5:e000877. [PMID: 30613409 PMCID: PMC6307606 DOI: 10.1136/openhrt-2018-000877] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/27/2018] [Accepted: 11/12/2018] [Indexed: 11/28/2022] Open
Abstract
Objective The cardiac inherited disease (CID) population has suboptimal adherence to long-term β-blocker therapy, which is known to be a risk for sudden cardiac death. This study aimed to identify the clinical and psychosocial variables associated with non-adherence in this population. Methods 130 individuals (aged 16–81 years, median: 54) from the New Zealand Cardiac Inherited Disease Registry taking β-blockers participated: 65 (50%) long QT syndrome, 42 (32%) hypertrophic cardiomyopathy and 23 (18%) other. Participants completed one questionnaire recording self-reported adherence, anxiety, depression, confidence in taking medication, illness perceptions and medication beliefs. Demographic and clinical variables were taken from the registry. Results 21 participants (16%) were classed as non-adherent. Bivariate analysis showed that self-reported adherence was worse in those who were younger (p<0.001), had a channelopathy not cardiomyopathy (p<0.01), reported lower confidence in taking β-blockers (p<0.001), had high concerns (p<0.05) and low necessity beliefs about their β-blocker (p<0.001), a poorer understanding of their CID (p<0.01), and lower treatment control beliefs (p<0.01). These variables accounted for 37% of the variance in adherence in a linear regression model. Stronger beliefs around medication necessity and higher confidence in their ability to take their medication predicted β-blocker adherence. Conclusions Factors associated with β-blocker non-adherence in patients with CID include young age, having a channelopathy, negative medication beliefs, low confidence in taking medication and poor illness perceptions. These findings present an opportunity to develop targeted interventions to improve adherence.
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Affiliation(s)
- Claire E O'Donovan
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Kathryn E Waddell-Smith
- Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand.,Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
| | - Jonathan R Skinner
- Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand.,Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
| | - Elizabeth Broadbent
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
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van Lunteren M, Scharloo M, Ez‐Zaitouni Z, de Koning A, Landewé R, Fongen C, Ramonda R, Kaptein AA, van Gaalen FA, van der Heijde D. The Impact of Illness Perceptions and Coping on the Association Between Back Pain and Health Outcomes in Patients Suspected of Having Axial Spondyloarthritis: Data From the SPondyloArthritis Caught Early Cohort. Arthritis Care Res (Hoboken) 2018; 70:1829-1839. [PMID: 29609197 PMCID: PMC6587858 DOI: 10.1002/acr.23566] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 03/27/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To investigate whether illness perceptions and coping influence the relationship between back pain and health outcomes in patients suspected of having axial spondyloarthritis (SpA). METHODS In the SPondyloArthritis Caught Early cohort, regression models were computed at baseline, with back pain intensity (range 0-10) as the determinant and health-related quality of life, the physical component summary score (PCS) and mental component summary (MCS) of the Short Form 36 (SF-36) health survey, or work productivity loss as outcomes. Subsequently, using Leventhal's Common-Sense Model of Self-Regulation, illness perceptions and, thereafter, coping were added to the models. Analyses were repeated for patients diagnosed and classified as having axial SpA according to the Assessment of SpondyloArthritis international Society axial SpA criteria (ASAS axial SpA), patients only diagnosed with axial SpA (axial SpA-diagnosed only), and those with chronic back pain. RESULTS A total of 424 patients (145 with ASAS axial SpA, 81 with only a diagnosis of axial SpA, and 198 with chronic back pain); 64% of the total group were female, the mean ± SD age was 30.9 ± 8.1 years, and the mean ± SD symptom duration was 13.3 ± 7.1 months) were studied. In all patients, the strength of the associations between back pain and the PCS, back pain and the MCS score, and back pain and loss of work productivity were decreased by adding illness perceptions to the model, but explained variance improved. Adding coping to these models did not change the results. Comparable results were observed in all subgroups. CONCLUSION Illness perception, but not coping, is important in the relationship between back pain and HRQoL and work productivity loss in patients suspected of having axial SpA, irrespective of subgroup. This finding suggests that targeting illness perceptions could improve health outcomes in patients suspected of having axial SpA.
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Affiliation(s)
| | | | | | | | - Robert Landewé
- Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlandsand Zuyderland Medical CenterHeerlenThe Netherlands
| | | | - Roberta Ramonda
- University of Padova, Padova, Italyand Groene Hart ZiekenhuisGoudaThe Netherlands
| | - Ad A. Kaptein
- Leiden University Medical CenterLeidenThe Netherlands
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Karekla M, Karademas EC, Gloster AT. The Common Sense Model of Self-Regulation and Acceptance and Commitment Therapy: integrating strategies to guide interventions for chronic illness. Health Psychol Rev 2018; 13:490-503. [DOI: 10.1080/17437199.2018.1437550] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
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Xiong NN, Wei J, Ke MY, Hong X, Li T, Zhu LM, Sha Y, Jiang J, Fischer F. Illness Perception of Patients with Functional Gastrointestinal Disorders. Front Psychiatry 2018; 9:122. [PMID: 29706904 PMCID: PMC5906533 DOI: 10.3389/fpsyt.2018.00122] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/23/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To investigate the illness perception characteristics of Chinese patients with functional gastrointestinal disorders (FGID), and the mediating role between symptoms, psychopathology, and clinical outcomes. METHODS Six illness groups from four outpatient departments of a general hospital in China were recruited, including the FGID patient group. The modified and validated Chinese version of the illness perception questionnaire-revised was utilized, which contained three sections: symptom identity, illness representation, and causes. The 12-item short-form health survey was utilized to reflect the physical and mental health-related quality of life (HRQoL). The Toronto alexithymia scale was used to measure the severity of alexithymia. Additional behavioral outcome about the frequency of doctor visits in the past 12 months was measured. Pathway analyses with multiple-group comparisons were conducted to test the mediating role of illness perception. RESULTS Overall, 600 patients were recruited. The illness perceptions of FGID patients were characterized as with broad non-gastrointestinal symptoms (6.8 ± 4.2), a negative illness representation (more chronic course, worse consequences, lower personal and treatment control, lower illness coherence, and heavier emotional distress), and high numbers of psychological and culture-specific attributions. Fit indices of the three hypothesized path models (for physical and mental HRQoL and doctor-visit frequency, respectively) supported the mediating role of illness perceptions. For example, the severity of alexithymia and non-gastrointestinal symptoms had significant negative effect on mental quality of life through both direct (standardized effect: -0.085 and -0.233) and indirect (standardized effect: -0.045 and -0.231) influence via subscales of consequences, emotional representation, and psychological and risk factor attributions. Multi-group confirmatory factor analysis showed similar psychometric properties for FGID patients and the other disease group. CONCLUSION The management of FGID patients should take into consideration dysfunctional illness perceptions, non-gastrointestinal symptoms, and emotion regulation.
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Affiliation(s)
- Na-Na Xiong
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jing Wei
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mei-Yun Ke
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xia Hong
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tao Li
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Li-Ming Zhu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yue Sha
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jing Jiang
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Felix Fischer
- Medical Clinic for Internal Medicine, Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Pires GE, Peuker AC, Castro EK. Brief intervention for stress management and change in illness perception among hypertensive and normotensive workers: pilot study and protocol. PSICOLOGIA-REFLEXAO E CRITICA 2017; 30:26. [PMID: 32025986 PMCID: PMC6974342 DOI: 10.1186/s41155-017-0080-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 12/04/2017] [Indexed: 11/24/2022] Open
Abstract
The objective of this study was to describe and evaluate the effects of a pilot intervention on perceived stress, knowledge about hypertension, and illness perception among hypertensive and normotensive workers. The intervention consisted of two group sessions performed in the workplace aiming to reduce stress, increase knowledge about hypertension, and explore the effect on illness perception. The sessions included clinical aspects of systemic arterial hypertension, illness perception and health behavior, and strategies for stress management. Workers from a petrochemical industry (19 hypertensive and 14 normotensive) participated in the study by answering a biosociodemographic questionnaire, the Brief Illness Perception Questionnaire, the Perceived Stress Scale, and a quiz with questions about hypertension. The measurements were collected at an initial meeting to gather the participants and 90 days after the intervention. There was a significant reduction in the perceived stress levels of both groups, in addition to an increase in the perception of personal control and illness coherence. Normotensive workers also increased their knowledge about hypertension, while hypertensive patients increased the perception that treatment could control the illness. In conclusion, the pilot intervention generated positive effects and can be considered a strategy of illness prevention for normotensive workers and control for hypertensive patients.
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Affiliation(s)
- Gerusa Estelita Pires
- Programa de Pós-Graduação em Psicologia, Universidade do Vale do Rio dos Sinos, Avenida Unisinos, 950, prédio E01, sala 215, São Leopoldo, RS 93022-750 Brazil
| | - Ana Carolina Peuker
- Programa de Pós-Graduação em Psicologia, Universidade do Vale do Rio dos Sinos, Avenida Unisinos, 950, prédio E01, sala 215, São Leopoldo, RS 93022-750 Brazil
| | - Elisa Kern Castro
- Programa de Pós-Graduação em Psicologia, Universidade do Vale do Rio dos Sinos, Avenida Unisinos, 950, prédio E01, sala 215, São Leopoldo, RS 93022-750 Brazil
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Fisher L, Polonsky WH, Hessler D, Potter MB. A practical framework for encouraging and supporting positive behaviour change in diabetes. Diabet Med 2017; 34:1658-1666. [PMID: 28636745 PMCID: PMC5687986 DOI: 10.1111/dme.13414] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2017] [Indexed: 12/30/2022]
Abstract
A wide range of diabetes-directed interventions - including novel medications, devices and comprehensive education programmes - have been shown to be effective in clinical trials. But in the real world of diabetes care their efficacy is often dependent upon on how well a clinician is able to support personal engagement and motivation of the person with diabetes to use these new tools and knowledge consistently, and as directed. Although many person-centred motivational and behavioural strategies have been developed, for example, action planning, motivational interviewing and empowerment-based communication, the sheer number and apparent lack of clear differences among them have led to considerable confusion. The primary goal of this review, therefore, is to provide a practical framework that organizes and structures these programmes to enhance their more systematic use in clinical care. Its purpose is to enhance clinician efforts to respectfully encourage and support engagement and motivation for behaviour change in people with diabetes. The three-step framework for organizing and describing the specific clinical processes involved is based on self-determination theory and includes: clinician preparation for a different type of clinical encounter, clinician/person with diabetes relationship building, and clinician utilization of specific behavioural tools. We conclude with practical considerations for application of this framework to the real world of clinical care.
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Affiliation(s)
- L Fisher
- Department of Family & Community Medicine, University of California, San Francisco
| | - W H Polonsky
- Behavioral Diabetes Institute, University of California, San Diego, USA
| | - D Hessler
- Department of Family & Community Medicine, University of California, San Francisco
| | - M B Potter
- Department of Family & Community Medicine, University of California, San Francisco
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Asnani MR, Barton-Gooden A, Grindley M, Knight-Madden J. Disease Knowledge, Illness Perceptions, and Quality of Life in Adolescents With Sickle Cell Disease: Is There a Link? Glob Pediatr Health 2017; 4:2333794X17739194. [PMID: 29152543 PMCID: PMC5680938 DOI: 10.1177/2333794x17739194] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 10/03/2017] [Indexed: 01/12/2023] Open
Abstract
Disease knowledge, illness perceptions, and quality of life (QOL) were examined in 150 adolescents (mean age = 16.1 years, SD = 1.9; 49.3% males) with sickle cell disease (SCD). Females had higher knowledge (P = .004), lower QOL (P = .02), and perceived their illness to be more unpredictable (P = .03). Those with more severe disease perceived their illness to be unpredictable with worse outcomes. Those with higher knowledge scores perceived their illness to be chronic, made more sense of their illness, and perceived greater personal and treatment control. Final hierarchical regression model showed that secondary education as compared to primary education level (P < .001) was positively correlated whereas disease severity (P < .001), perceived unpredictability (P = .024), and negative emotions (P < .001) were negatively correlated with QOL. Health practitioners should assess adolescents’ illness perceptions and encouraging continuing schooling and addressing emotional/psychological problems could improve their QOL.
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Moon Z, Moss-Morris R, Hunter MS, Hughes LD. More than just side-effects: The role of clinical and psychosocial factors in non-adherence to tamoxifen. Br J Health Psychol 2017; 22:998-1018. [DOI: 10.1111/bjhp.12274] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 08/23/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Zoe Moon
- Institute of Psychiatry; Psychology & Neuroscience (IoPPN); Health Psychology Section; King's College London UK
| | - Rona Moss-Morris
- Institute of Psychiatry; Psychology & Neuroscience (IoPPN); Health Psychology Section; King's College London UK
| | - Myra S. Hunter
- Institute of Psychiatry; Psychology & Neuroscience (IoPPN); Health Psychology Section; King's College London UK
| | - Lyndsay D. Hughes
- Institute of Psychiatry; Psychology & Neuroscience (IoPPN); Health Psychology Section; King's College London UK
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Kim J, Kim O. A Health Behavior Prediction Model for Patients With Coronary Artery Disease. Clin Nurs Res 2017; 28:217-234. [DOI: 10.1177/1054773817725868] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The aim of this study was to determine the relationships among functional status, hostility, social support, illness perceptions, and health behaviors in patients with coronary artery disease using structural equation modeling. Participants comprised 215 patients with coronary artery disease who had received percutaneous coronary artery intervention or a coronary artery bypass graft in two general hospitals in Seoul, Korea. Using structured interviews with questionnaires, data accrued from July to August, 2015. Fitness of the model was verified with AMOS 21.0. As social support increased, it negatively aligned with cognitive-illness perceptions. Higher levels of hostility and greater negative cognitive-illness perceptions aligned with negative emotional-illness perceptions. Social support indirectly affected emotional-illness perceptions. Lower levels of functional status, greater social support, and more positive cognitive-illness perceptions aligned with health behaviors. Social support indirectly affected health behaviors. In conclusion, nurses should focus on coronary artery disease patients’ physical functions and cognitive-illness perceptions to provide support.
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Affiliation(s)
- Jiyoung Kim
- Dong-eui University, Busan, Republic of Korea
| | - Oksoo Kim
- Ewha Womans University, Seoul, Republic of Korea
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Kleppe M, Lacroix J, Ham J, Midden C. A dual-process view on medication adherence: The role of affect. J Health Psychol 2017; 24:1033-1042. [PMID: 28810401 DOI: 10.1177/1359105317690599] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Medication non-adherence has been recognised as one of the major problems in health care that leads to preventable costs and hospitalisations. This study aimed to assess the role of affect in medication adherence. We propose a dual-process framework of medication adherence based on the reflective-impulsive model, which includes both cognitive and affective processes. We tested this framework in a cross-sectional study (N = 525). The results supported this framework by illustrating the clear role of both cognitive and affective processes.
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Affiliation(s)
- Mieke Kleppe
- 1 HAN University of Applied Sciences, The Netherlands.,2 Philips Research Eindhoven, The Netherlands.,3 Eindhoven University of Technology, The Netherlands
| | | | - Jaap Ham
- 3 Eindhoven University of Technology, The Netherlands
| | - Cees Midden
- 3 Eindhoven University of Technology, The Netherlands
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Kosse RC, Bouvy ML, de Vries TW, Kaptein AA, Geers HCJ, van Dijk L, Koster ES. mHealth intervention to support asthma self-management in adolescents: the ADAPT study. Patient Prefer Adherence 2017; 11:571-577. [PMID: 28356720 PMCID: PMC5360404 DOI: 10.2147/ppa.s124615] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Poor medication adherence in adolescents with asthma results in poorly controlled disease and increased morbidity. The aim of the ADolescent Adherence Patient Tool (ADAPT) study is to develop an mHealth intervention to support self-management and to evaluate the effectiveness in improving medication adherence and asthma control. INTERVENTION The ADAPT intervention consists of an interactive smartphone application (app) connected to a desktop application for health care providers, in this study, the community pharmacist. The app contains several functions to improve adherence as follows: 1) a questionnaire function to rate asthma symptoms and monitor these over time; 2) short movie clips with medication and disease information; 3) a medication reminder; 4) a chat function with peers; and 5) a chat function with the pharmacist. The pharmacist receives data from the patient's app through the desktop application, which enables the pharmacist to send information and feedback to the patient. STUDY DESIGN The ADAPT intervention is tested in a community pharmacy-based cluster randomized controlled trial in the Netherlands, aiming to include 352 adolescents with asthma. The main outcome is adherence, measured by patient's self-report and refill adherence calculated from pharmacy dispensing records. In addition, asthma control, illness perceptions, medication beliefs, and asthma-related quality of life are measured. CONCLUSION This study will provide in-depth knowledge on the effectiveness of an mHealth intervention to support asthma self-management in adolescents. These insights will also be useful for adolescents with other chronic diseases.
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Affiliation(s)
- Richelle C Kosse
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht
| | - Marcel L Bouvy
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht
| | | | - Ad A Kaptein
- Medical Psychology, Leiden University Medical Center, Leiden
| | - Harm CJ Geers
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht
| | - Liset van Dijk
- NIVEL, the Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Ellen S Koster
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht
- Correspondence: Ellen S Koster, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, PO Box 80082, 3508 TB Utrecht, the Netherlands, Tel +31 30 253 7324, Fax +31 30 253 9166, Email
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Xiong N, Wei J, Fritzsche K, Leonhart R, Hong X, Li T, Jiang J, Zhu L, Tian G, Zhao X, Zhang L, Schaefert R. Psychological and somatic distress in Chinese outpatients at general hospitals: a cross-sectional study. Ann Gen Psychiatry 2017; 16:35. [PMID: 29075308 PMCID: PMC5644179 DOI: 10.1186/s12991-017-0158-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 10/05/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Our study aimed (1) to describe the proportion of psychological distress among Chinese outpatients at general hospitals, (2) to compare cognitive and behavioral characteristics of patients with different distress patterns, and (3) to investigate the discriminant function of the analyzed variables in indicating the affinity towards the different distress patterns. METHODS This multicenter cross-sectional study was conducted at ten outpatient departments at Chinese general hospitals. The somatic symptom severity scale (PHQ-15), the nine-item depression scale (PHQ-9), and the seven-item anxiety scale (GAD-7) were employed to classify patients in terms of four distress patterns. RESULTS A total of 491 patients were enrolled. Among them, the proportion of patients with high psychological distress was significantly higher within those with high somatic distress (74.5% vs. 25.5%, p < .001). Patients with psychological distress alone and mixed distress were significantly younger and with lower monthly family income, while the proportion of female patients (80.9%) was highest in the somatic distress group. Patients with mixed distress had the most negative cognitive and behavioral characteristics [highest health anxiety (5.0 ± 1.9), lowest sense of coherence (35.5 ± 10.0), the worst doctor-patient relationship from both patients' (36.0 ± 7.3) and doctors' perspectives (23.3 ± 7.0)], as well as most impaired quality of life (41.6 ± 7.4 and 31.9 ± 10.3). In addition, compared with patients with somatic distress alone, those with psychological distress alone had lower sense of coherence, worse doctor-patient relationship, and more impaired mental quality of life, but less doctor visits. Discriminant analysis showed that gender, mental quality of life, health anxiety, sense of coherence, and frequent doctor visits were significant indicators in identifying patients with different distress patterns. CONCLUSIONS Our study found that (1) psychological distress was not rare in the Chinese general hospital outpatients, especially in those with high somatic distress; (2) patients with psychological distress alone sought less help from doctors, despite their severe psychosocial impairment; and (3) gender, health anxiety, sense of coherence, mental quality of life, and frequent doctor visits could help to identify different distress patterns.
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Affiliation(s)
- Nana Xiong
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730 People's Republic of China
| | - Jing Wei
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730 People's Republic of China
| | - Kurt Fritzsche
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Freiburg, Freiburg, Germany
| | - Rainer Leonhart
- Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Xia Hong
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730 People's Republic of China
| | - Tao Li
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730 People's Republic of China
| | - Jing Jiang
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730 People's Republic of China
| | - Liming Zhu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Guoqing Tian
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xudong Zhao
- Department of Psychosomatic Medicine, Dongfang Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lan Zhang
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, Sichuan China
| | - Rainer Schaefert
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
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Vedhara K, Dawe K, Miles JNV, Wetherell MA, Cullum N, Dayan C, Drake N, Price P, Tarlton J, Weinman J, Day A, Campbell R, Reps J, Soria D. Illness Beliefs Predict Mortality in Patients with Diabetic Foot Ulcers. PLoS One 2016; 11:e0153315. [PMID: 27096609 PMCID: PMC4838245 DOI: 10.1371/journal.pone.0153315] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 03/28/2016] [Indexed: 11/23/2022] Open
Abstract
Background Patients’ illness beliefs have been associated with glycaemic control in diabetes and survival in other conditions. Objective We examined whether illness beliefs independently predicted survival in patients with diabetes and foot ulceration. Methods Patients (n = 169) were recruited between 2002 and 2007. Data on illness beliefs were collected at baseline. Data on survival were extracted on 1st November 2011. Number of days survived reflected the number of days from date of recruitment to 1st November 2011. Results Cox regressions examined the predictors of time to death and identified ischemia and identity beliefs (beliefs regarding symptoms associated with foot ulceration) as significant predictors of time to death. Conclusions Our data indicate that illness beliefs have a significant independent effect on survival in patients with diabetes and foot ulceration. These findings suggest that illness beliefs could improve our understanding of mortality risk in this patient group and could also be the basis for future therapeutic interventions to improve survival.
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Affiliation(s)
- Kavita Vedhara
- Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, United Kingdom
- * E-mail:
| | - Karen Dawe
- School of Social and Community Medicine, University of Bristol, Bristol, BS8 2PS, United Kingdom
| | - Jeremy N. V. Miles
- Rand Corporation, Santa Monica, CA, 90401–3208, United States of America
| | - Mark A. Wetherell
- Department of Psychology, University of Northumbria, Newcastle, NE1 8ST, United Kingdom
| | - Nicky Cullum
- School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, M13 9PL, United Kingdom
| | - Colin Dayan
- Institute of Molecular & Experimental Medicine, University of Cardiff, Cardiff, CF14 4XN, United Kingdom
| | - Nicola Drake
- Department of Podiatry, Southmead Hospital, Bristol, BS10 5NB, United Kingdom
| | - Patricia Price
- School of Healthcare Studies, Cardiff University, Cardiff, CF14 4XN, United Kingdom
| | - John Tarlton
- Matrix Biology Research Group, University of Bristol, Bristol, BS40 5DU, United Kingdom
| | - John Weinman
- Institute of Pharmaceutical Sciences, King's College London, London, SE1 9RT, United Kingdom
| | - Andrew Day
- Department of Clinical Biochemistry, University Hospitals Bristol, Bristol, BS1 3NU United Kingdom
| | - Rona Campbell
- School of Social and Community Medicine, University of Bristol, Bristol, BS8 2PS, United Kingdom
| | - Jenna Reps
- School of Computer Science & Advanced Data Analysis Centre, University of Nottingham, Nottingham, NG8 1BB, United Kingdom
| | - Daniele Soria
- School of Computer Science & Advanced Data Analysis Centre, University of Nottingham, Nottingham, NG8 1BB, United Kingdom
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Illness perceptions of people with long-term conditions are associated with frequent use of the emergency department independent of mental illness and somatic symptom burden. J Psychosom Res 2016; 81:38-45. [PMID: 26800637 DOI: 10.1016/j.jpsychores.2016.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 12/15/2015] [Accepted: 01/04/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether illness perceptions of patients with long-term conditions (LTCs) are associated with urgent healthcare use and whether this association is independent from mental illness and somatic symptom burden. METHODS Illness perceptions (B-IPQ) and somatic symptom severity (PHQ-15) were assessed in 304 patients with diabetes, rheumatological disorders and COPD attending an Accident and Emergency Department (AED) in Greece over a one year period. The presence of mental illness was determined by the Mini International Neuropsychiatric Interview. A Generalized Linear Model (Negative Binomial) regression was used to determine the associations of illness perceptions with AED use after adjusting for mental illness, somatic symptom severity, disease parameters and demographics. RESULTS Eighty-six patients (28.3%) reported at least one visit to the AED during the previous year and 75 (24.7%) twice or more. 124 patients (40.8%) had some form of mental disorder with 85 (28.0%) meeting criteria for major depressive disorder. The degree to which the patients had an understanding of their illness (illness comprehensibility) (p<0.01) along with younger age (p<0.05), additional comorbidities (p<0.05) and greater somatic symptom burden (p<0.001) was strongly associated with AED use; AED visits were expected to be reduced by 9.1% for each unit increase in illness comprehensibility. CONCLUSIONS The way people perceive their illness influences urgent healthcare seeking behavior independent of somatic symptom burden. This finding indicates that information provision may prove effective in reducing urgent healthcare use and encourage the design of psycho-educational interventions targeting disease-related cognitions in an attempt to prevent unnecessary healthcare utilization.
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Dempster M, Howell D, McCorry NK. Illness perceptions and coping in physical health conditions: A meta-analysis. J Psychosom Res 2015; 79:506-13. [PMID: 26541550 DOI: 10.1016/j.jpsychores.2015.10.006] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 09/28/2015] [Accepted: 10/19/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE There is a considerable body of research linking elements of Leventhal's Common Sense Model (CSM) to emotional well-being/distress outcomes among people with physical illness. The present study aims to consolidate this literature and examine the evidence for the role of coping strategies within this literature. METHODS A systematic review was conducted where the outcomes of interest were: depression, anxiety and quality of life. A total of 1050 articles were identified and 31 articles were considered eligible to be included in the review. RESULTS Across a range of illnesses, perceptions of consequences of the illness and emotional representations were consistently the illness perceptions with the strongest relationship with the outcomes. Coping variables tend to be stronger predictors of outcomes than the illness perception variables. The evidence for the mediating effect of coping was inconsistent. CONCLUSIONS Illness perceptions and coping have an important role to play in the explanation of distress outcomes across a range of physical health conditions. However, some clarity about the theoretical position of coping in relation to illness perceptions, and further longitudinal work is needed if we are to apply this information to the design of interventions for the improvement of psychological health among people with physical health conditions.
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Affiliation(s)
- Martin Dempster
- School of Psychology, Queen's University Belfast, Northern Ireland, UK.
| | - Doris Howell
- Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Noleen K McCorry
- Marie Curie Cancer Care, Marie Curie Hospice Belfast, Northern Ireland, UK
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