Illness perception, health literacy, self-efficacy, adherence and quality of life in patients with intermittent claudication - a longitudinal cohort study

Adherence to Supervised and Unsupervised Exercise Programmes in Ageing Population with Intermittent Claudication: A Randomized Controlled Trial

Background: Intermittent Claudication symptomatic peripheral arterial disease (ICSPAD) is associated with reduced mobility, functional capacity, and quality of life. Physical exercise is an effective non-pharmacological intervention for the management of ICSPAD. Adherence to exercise programs is challenging, due to the nature of the disease and the complex comorbidities associated with it. This study aimed to determine adherence to three supervised physical exercise programs (a walking intervention, strength intervention, and concurrent intervention) and an unsupervised exercise program (standard advice) in individuals with ICSPAD. Methods: In this clinical trial, 122 patients were divided into four groups based on the type of exercise program they followed: standard advice, walking intervention, strength intervention, and concurrent intervention. Results: The results revealed that while the demographic characteristics were similar, the strength intervention group had a younger mean age, and the walking group had a higher prevalence of hypertension and increased usage of anti-hypertensive drugs. Adherence to physical exercise and pedometer wearing was highest in the standard advice group. Logistic regression analysis showed lower odds of adherence to exercise and pedometer wearing in the intervention groups compared to the standard advice group. Adherence did not significantly vary across ankle-brachial index categories. Furthermore, there was no significant difference in adherence between the severity levels of intermittent claudication, though mild cases tended to exhibit higher adherence. Conclusions: The results show that the standard advice from healthcare professionals positively influences treatment adherence.

Illness Perception Accorded by Language Assistance in Non-Japanese-Speaking Patients

Background and objective While over half of foreign residents in Japan need language assistance during medical consultations, no extant studies have clarified illness perception accorded by language assistance in non-Japanese-speaking patients. This cross-sectional study conducted an online questionnaire survey to investigate the illness perception of non-Japanese-speaking patients and analyze the factors related to illness perception. Methodology The survey was conducted twice, from February to May 2022 and from February to April 2023, targeting non-Japanese-speaking individuals. In total, 293 valid responses were obtained. The Brief Illness Perception Questionnaire (Brief IPQ) scores were compared between the groups receiving language assistance and those without assistance, and a logistic regression analysis was performed to examine the factors related to illness perception accorded by the status of the language assistance group. Results The total score for illness perception was significantly lower in the language assistance group than in the non-assistance group (P = 0.04). Moreover, in the language assistance group, age (odds ratio [OR] = 0.91, 95% confidence interval [CI] = 0.84-0.99) and comprehension of medical consultations (OR = 0.31, 95% CI = 0.11-0.83) were significantly associated with low illness perception among participants. However, these associations were not observed in the non-assistance group. Conclusions These findings underscore the crucial role of ensuring effective communication and promoting a better understanding of illness perception during medical consultations.

Self-regulatory coping among community dwelling older adults with multiple chronic conditions

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.