Effects of acceptance of disability on death or dialysis in chronic kidney disease patients: a 3-year prospective cohort study

Acceptance of disability in stroke: a systematic review

BACKGROUND

Evidence for the association between acceptance of disability (AOD) and positive rehabilitation outcomes, as well as for the use of AOD measurements in stroke rehabilitation practice, has increased in the international literature in the last decade. However, measurement tools for AOD are heterogenous and there has not been a systematic review summarizing the current evidence on the use of AOD measures and factors associated with AOD.

OBJECTIVE

This study aimed to summarize current evidence on measurement tools used, present existing AOD scores in people with stroke and identify risk factors for and protective factors against poor AOD in people with stroke.

METHODS

The original design and protocol of this systematic review were registered with PROSPERO. The included studies were published from 2008 to 2020 and identified from 5 databases-PubMed, EMBASE, CINAHL Plus, PsycInfo, and the Cochrane Library-using the following inclusion criteria: participants diagnosed with stroke and aged ≥16 years, measurement of AOD, and published in English in a peer-reviewed scientific journal. Review articles were excluded.

RESULTS

Five measurement tools for AOD were reported. The Revised Acceptance of Disability Scale (ADS-R) and the acceptance subscale of the Illness Cognition Questionnaire (ICQ) had the highest internal consistency. Scores ranged from 71.7 to 74.2 on the ADS-R, 16.9-18.3 on the ICQ, 16.5-26.9 on the Acceptance of Illness Scale, and 87.8-93.2 on the Attitudes towards Disabled Persons Form A. Poorer function and depressive symptoms were associated with poor AOD, whereas religious beliefs, support from others, and an understanding of stroke were associated with better AOD.

CONCLUSIONS

The ADS-R and the acceptance subscale of the ICQ are currently the most reliable measurement tools for measuring AOD in people with stroke. Further research to validate the measurement tools is required. This may help to identify people who require additional support.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews CRD42017077063; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=77063.

Prevalence and associated risk factors for chronic kidney disease in the elderly physically disabled population in Shanghai, China: a cross-sectional study

BACKGROUND

The global prevalence of chronic kidney disease (CKD) in the general population is relatively clear. Our previous study showed that elderly individuals who are physically disabled are more likely to experience kidney function impairment, and the main purpose of this study was to determine the prevalence and risk factors associated with CKD in elderly patients with physical disabilities.

METHODS

A total of 2679 elderly individuals with physical disabilities from the 2018 Shanghai Disability Health Survey were screened to calculate the prevalence of CKD. Multiple logistic regression was performed to identify the factors associated with CKD. Detailed subgroup analyses of disability level were also conducted.

RESULTS

We confirmed CKD in 287 of 2679 (10.7%) participants. Female sex, age, history of hypertension, red blood cell count, albumin, urea, and uric acid (UA) were independently correlated with CKD. Age and UA abnormalities were common risk factors for different levels of disabilities.

CONCLUSION

The prevalence of CKD is higher in the mild level of older physically handicapped individuals. Age and the level of UA should also be considered in this population. The preventive strategies for patients with two levels of elderly disability should have different focuses.

A smartphone-based supportive counseling on health anxiety and acceptance of disability in Systemic Lupus Erythematosus patients: A randomized clinical trial

OBJECTIVE

This study aimed to evaluate the effects of a supportive counseling via the smart phone on the health anxiety, and acceptance of disability in the patients with Systemic Lupus Erythematosus.

METHODS

The present study was a randomized clinical trial with pre-post design. Randomly dividing 124 patients into experimental and control groups. Before and after the intervention, all patients answered the health anxiety and disability acceptance questionnaires. For eight weeks, the trial group received remote counseling help using the WhatsApp platform.

RESULTS

All 124 patients randomized into groups, completed follow-up which were analyzed. By the end of 8th week, the level of health anxiety (MD=11.34, P < 0.001) of the experiment group was significantly lower than the control group, while the level of acceptance of disability (MD=91.42, P < 0.001) of experiment group was significantly higher than the control group.

CONCLUSION

Smartphone-based supportive counseling may help people with Systemic Lupus Erythematosus manage their symptoms better, and live better by reducing health worry and increasing acceptance of impairment.

PRACTICE IMPLICATIONS

Virtual supportive counseling can assist healthcare professionals to optimize the potential of education and support processes.

The predictive role of hope and social relational quality in disability acceptance among Iranian patients under hemodialysis

BACKGROUND

Patients undergoing hemodialysis face disabilities that its acceptance may influenced by several factors. This study aimed to determine the predictive role of hope and quality of social relationship on accepting disability amongst patients undergoing hemodialysis.

METHODS

This cross-sectional study was conducted on 120 hemodialysis patients referred to hemodialysis centers in Nemazi and Shahid Faghihi hospitals and Imam Reza Clinic in Shiraz. Snyder Hope Scale, Acceptance of Disability Scale (ADS), and Social Relational Quality Scale (SRQS) were used for data collection. The data were analyzed through the Smart PLS-3 and SPSS software using Pearson's correlation and multiple linear regression analysis tests, and confirmatory factor analysis.

RESULTS

Face, content, and construct validities and internal consistency of the Persian version of ADS and SRQS were confirmed. The patients' mean score of hope was 38.83 (SD = 4.35), which was not desirable. Their mean score of SRQS was 45.45 (SD = 3.87), which was at the moderate level. Nonetheless, the mean score of disability acceptance (66.01 (SD = 7.15)) was lower than expected. The results showed disability acceptance was associated with having good level of hope (β = 0.44, p = 0.002) and social relationship (β = 0.31, p = 0.04).

CONCLUSIONS

Hope and social relational quality predicted the acceptance of disabilities. Therefore, designing interventions to promote hope and social relationship in hemodialysis patients may increase their disability acceptance.

The relationship among psychosocial adaptation, medication adherence and quality of life in breast cancer women with adjuvant endocrine therapy

BACKGROUND

Patients undergoing endocrine therapy for breast cancer often suffer from poor psychosocial adaptation, low compliance with endocrine therapy and poor quality of life. However, the relationship among the three is not completely clear. The aims of this study were to investigate the status of psychosocial adaptation (PSA), medication adherence and quality of life (QOL) in breast cancer women with adjuvant endocrine therapy (AET), and to analyze the influencing factors of QOL and explore the relationship among them.

METHODS

346 breast cancer women were selected who underwent endocrine therapy after surgery, and data collected by the general information questionnaire, the PSA questionnaire among breast cancer women with AET, Morisky Medication Adherence Scale and The Functional Assessment of Cancer Therapy-Breast (FACT-B). The relationship among the variables was investigated by univariate analysis, multiple stepwise regression analysis and mediating effect analysis.

RESULTS

The scores of PSA, medication adherence and QOL were slightly above the medium level. Univariate analysis showed that there were significant differences in QOL among breast cancer women of AET with different types of exercise, medical payment methods, discomfort symptoms (headache, hypomnesis, arthralgia, perturbation), type of discomfort symptoms, medication adherence and PSA; Multi-factor analysis showed that PSA and medication adherence were the influential factors of QOL; mediating effect showed that medication adherence played a partial mediating role in PSA and QOL.

CONCLUSION

The QOL of breast cancer women with AET will be directly affected by PSA. Medication compliance has a weak mediating effect in the indirect impact of PSA on the QOL. In the future, clinical nursing work should take targeted measures to improve the PSA level of patients, and effectively improve the compliance of patients with medication, so as to better improve the QOL of breast cancer women.

Current Status of Acceptance of Disability and the Correlation With the Life Quality in Parkinson's Disease in Southwest China

Background

Acceptance of disability (AOD) is a process that a patient must undergo to cope with altered abilities, but its effect in Parkinson's disease (PD) remains unclear. The present study aimed to determine the level of AOD, examine the influence of sociodemographic variables and disease characteristics on the AOD level, and evaluate the relation between AOD level and quality of life in a cohort of PD patients from Southwest of China.

Methods

A total of 336 PD patients were consecutively recruited from November 2018 to October 2020. At enrollment, demographic and clinical data were obtained using a questionnaire, and the Acceptance of Disability Scale-Revised (AODS-R) scale was used to measure the AOD level.

Results

The mean total score of AOD is 87.28, indicating a moderate level of disability acceptance in PD patients. Statistical analysis showed that understanding of PD, family support, and UPDRS-II score were major factors affecting AOD level, and patients with low AOD levels were more likely to have poorer quality of life.

Conclusion

AOD is a serious problem in PD patients in Southwest China, especially among individuals with insufficient family support and a lack of recognition of the disease. AOD was also associated with motor function and daily living ability, thus suggesting that evaluation of the AOD and promotion of the awareness may be helpful to improve the quality of life in patients with PD.

Differences in the quality of life of chronic kidney disease patients undergoing hemodialysis and continuous ambulatory peritoneal dialysis

Background: Chronic kidney disease (CKD) is defined as a progressive disease that causes renal failure and requires extended and long-term therapies. CKD patients need to choose one of these therapies to improve their quality of life. This study aims to investigate differences in the quality of life of chronic kidney disease patients undergoing hemodialysis and continuous ambulatory peritoneal dialysis (CAPD).

Design and Methods: The study design used is similar to the cross-sectional design. Therefore, in this study observations were carried out, an EQ_5D life quality questionnaire sheet was administered to respondents, and a purposive sampling method was used. The total number of respondents was 250 and consisted of 125 hemodialysis and CAPD patients each.

Results: The results obtained using the Mann Whitney method was a p-value (0.515)>α (0.05). These results also included five components, namely the ability to move/walk to an acceptable degree, adequate self-care, performance of usual activities, minimal amount of pain/discomfort during hemodialysis and CAPD, and acceptable levels of anxiety/sadness.

Conclusions: This research concludes that there is no difference in the quality of life between CKD patients undergoing hemodialysis and CAPD.

Interaction of Socio-demographic Characteristics on Acceptance of Disability Among Individuals With Physical Disabilities

This study aimed to investigate the interaction of sociodemographic characteristics on acceptance of disability among individuals with physical disabilities (IWPD). Data from the 8th Panel Survey of Employment for the Disabled in Korea (PSED) in the second wave were used. A sample concerning the first phase of disability was extracted using the one-step colony method to extract regions and was stratified based on the type of disability, disability grade, and age. To explore the association between acceptance of sociodemographic characteristics and of disability, we used a general linear model. A significant main effect was observed in employment, health status, degree of help, and subjective economic status. Regarding employment status, acceptance of disability in unemployment of IWPD with less than high school was lower as compared to those with more than high school. We observed that unemployed IWPD with low income or poor health status could be the group with the highest risk for acceptance of disability. Individuals in the low economic group were more religious than those in the high economic one. These findings indicate that specialized intervention programs that consider religion, economic status, employment, education, health, and their interactions would be effective for acceptance of disability. Interdisciplinary team members should consider the individual profiles of these populations and implement suitable support and rehabilitation programs.

Psychosocial Predictors of Adjustment to Disability Among Patients With Breast Cancer: A Cross-Sectional Descriptive Study

BACKGROUND

Acceptance of disability relates to the process of adaptation, which reflects how the values of a patient change over time to accept herself or himself as an intrinsically worthy person. Acceptance of disability (AOD) plays an important role in the adjustment of persons with physical disability to their environment. However, no studies on the level of AOD in patients with breast cancer are available in the literature.

PURPOSE

The aim of this study was to explore the significant factors that influence disability acceptance in Chinese women with breast cancer.

METHODS

A cross-sectional study was conducted on 292 patients with breast cancer between January and April 2017. Participants were assessed using the Acceptance of Disability Scale-Revised, Medical Coping Modes Questionnaire, Sense of Coherence Scale, Social Relational Quality Scale, and general information questionnaire. Multiple regression analysis was used to determine the factors associated with the level of disability acceptance.

RESULTS

The mean score for AOD was 79.14 and ranged from 32 to 128. Multiple regression analysis indicated that family intimacy, friendships, confrontation, manageability, family commitment, marital status, surgery, and acceptance-resignation significantly affected disability acceptance, explaining 49.1% of the total variance in disability acceptance.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The participants had a moderate level of disability acceptance. Disability acceptance is an important factor in the psychosocial adaptation to cancer. Healthcare staff should pay special attention to low scores for this factor and explore the potential of psychological interventions to effectively reduce the posttraumatic stress response, encourage the adoption of positive coping strategies, and hasten disability acceptance and return to society.