Health-related behavior, profile of health locus of control and acceptance of illness in patients suffering from chronic somatic diseases

Social capital and health beliefs: Exploring the effect of bridging and bonding social capital on health locus of control among women in Dhaka

This cross-sectional study examined if social capital affects women's health attributions. The study used the Internet Social Capital Scale (ISCS) and Multidimensional Health Locus of Control (MHLC) Scale to measure Social Capital and Health Locus of Control. A predefined 38-item questionnaire was used to survey 485 purposively selected women. A bidirectional reciprocal structural equation model was used to measure the covariance between Social Capital and Health Locus of Control. We hypothesized that women with strong social capital, particularly those rich in bridging ties, would exhibit a greater sense of agency and empowerment over their health, attributing their health outcomes less to internal factors like fate and more to external influences like powerful others and broader social support. However, we found that when women have higher social capital, their external health locus of control increases. Bridging and bonding social capital lower women's internal health control, but bridging social capital leads to higher attributes to powerful others. Likewise, we expected women with more social capital would exhibit a lower perception of uncontrollability over their health, but is not the case. The findings underscore the necessity for women to have more social capital.

The Interplay of Sports and Nutrition in Neurological Health and Recovery

This comprehensive review explores the dynamic relationship between sports, nutrition, and neurological health. Focusing on recent clinical advancements, it examines how physical activity and dietary practices influence the prevention, treatment, and rehabilitation of various neurological conditions. The review highlights the role of neuroimaging in understanding these interactions, discusses emerging technologies in neurotherapeutic interventions, and evaluates the efficacy of sports and nutritional strategies in enhancing neurological recovery. This synthesis of current knowledge aims to provide a deeper understanding of how lifestyle factors can be integrated into clinical practices to improve neurological outcomes.

Socioeconomic status and health behavior in children and adolescents: a systematic literature review

Socioeconomic status affects individuals' health behaviors and contributes to a complex relationship between health and development. Due to this complexity, the relationship between SES and health behaviors is not yet fully understood. This literature review, therefore, aims to assess the association between socioeconomic status and health behaviors in childhood and adolescence. Preferred Reporting for Systematic Review and Meta-Analysis protocol guidelines were used to conduct a systematic literature review. The electronic online databases EBSCO Host, PubMed, Web of Science, and Science Direct were utilized to systematically search published articles. The Joanna Briggs Institute's critical appeal tool was used to assess the quality of included studies. Eligibility criteria such as study context, study participants, study setting, outcome measures, and key findings were used to identify relevant literature that measured the association between socioeconomic status and health behaviors. Out of 2,391 studies, only 46 met the final eligibility criteria and were assessed in this study. Our review found that children and adolescents with low socioeconomic status face an elevated risk of unhealthy behaviors (e.g., early initiation of smoking, high-energy-dense food, low physical activity, and involvement in drug abuse), in contrast to their counterparts. Conversely, children and adolescents from higher socioeconomic backgrounds exhibit a higher prevalence of health-promoting behaviors, such as increased consumption of fruit and vegetables, dairy products, regular breakfast, adherence to a nutritious diet, and engagement in an active lifestyle. The findings of this study underscore the necessity of implementing specific intervention measures aimed at providing assistance to families from disadvantaged socioeconomic backgrounds to mitigate the substantial disparities in health behavior outcomes in children and adolescents.

Life satisfaction, generalized sense of self-efficacy and acceptance of illness in rheumatoid arthritis patients depending on age and severity of the disease

Introduction

Rheumatoid arthritis (RA) is a chronic autoimmune condition characterized by periods of exacerbation (physical limitations, depressed mood, depressive states and decreased life satisfaction) and remission (hope of health improvement). Our objective was to present social functioning of RA patients taking into consideration their age and employing selected determinants: satisfaction with life, generalized sense of self-efficacy and acceptance of illness.

Material and methods

Standardized tools were employed: the Satisfaction with Life Scale, Generalized Self Efficacy Scale and Acceptance of Illness Scale. The study group included 46 RA patients aged 18-45 years and 54 RA patients aged over 60 years. The control group consisted of 24 non-RA subjects in every group.

Results

Rheumatoid arthritis patients in the period of disease exacerbation reported low and moderate levels of satisfaction with life, in the patients in remission period the score was moderate, while the control group subjects described their level of satisfaction with life as high and moderate. The level of acceptance of illness was described by the RA patients in the period of disease exacerbation as 20.4/40 points; the patients in remission defined their level of acceptance of illness as 29.38/40 points. The patients with RA exacerbation showed a low sense of self-efficacy, yet a large group of such patients also presented high self-efficacy levels and the majority of the RA subjects in remission reported a high sense of self-efficacy.

Conclusions

In the RA patients, satisfaction with life, generalized sense of self-efficacy and acceptance of illness were closely related and affected their general psychosocial functioning.

Religious Beliefs About Health and the Body and their Association with Subjective Health

Evidence supports an association between religion and spirituality and health outcomes. The aim of this study is to examine religious beliefs related to health and their relationship to self-rated health in a large and diverse population-based sample in Chicago. Three religious beliefs were assessed-the importance of prayer for health, God's will as the most important factor in getting well, and sanctity of the body. All three beliefs were highly prevalent, especially among racial/ethnic minorities. Unadjusted models showed a significant association between two of the beliefs and self-rated health, which did not persist in the adjusted models. This study provides insight into different belief patterns among racial/ethnic groups and has practical implications for both clinicians and public health practitioners.

Negative impact of chronic pain: The role of locus of control and perceived family validation of chronic pain

The present study investigates how participants' locus of control and their family and friends' validation of their pain influences participants' chronic pain experiences. Four thousand, 25 adults were recruited through the Chronic Pain In America survey. Results show that individuals who endorse an internal locus of control and experience family and friends' validation of their chronic pain reported better chronic pain outcomes and less negative life impact due to chronic pain. The current results indicate the locus of control and family and friends' validation of chronic pain experience plays an important role in chronic pain and the impact of chronic pain across the life course.

Patient empowerment and self-management behaviour of chronic disease patients: A moderated mediation model of self-efficacy and health locus of control

AIMS

To explore the role of self-efficacy (SE) in the effect of patient empowerment on self-management behaviours among patients with chronic illness and to investigate the moderating effect of three types of health locus of control (HLC) in this moderated mediation model.

DESIGN

Cross-sectional design.

METHODS

Data were collected in a general tertiary hospital, and a sample of 254 patients was recruited between August and October 2020. The effect of moderation and mediation was tested by the PROCESS macro (Model 4 and Model 8) for SPSS 25.0 by Hayes using 5000 bootstrap samples.

RESULTS

Self-efficacy significantly mediated the relationship between patient empowerment and self-management behaviour with a 95% confidence interval excluding zero. The chance HLC demonstrated a moderating effect, and the interaction effect on SE and self-management behaviour was significant.

CONCLUSION

Patient empowerment may improve confidence and adherence to self-management among people with chronic illness, and such benefits were conditional on the HLC of patients.

IMPACT

This study addresses the relationship between patient empowerment and self-management behaviour in patients with different personality characteristics. This result indicated that classifying the type of HLC may enable the identification of subgroups of patients who may subsequently benefit from patient empowerment. In a patient-centred programme, nurses and other healthcare professionals correctly identifying patients' HLC type and understanding the implications and then providing appropriate health care plans for patients with different health beliefs may be useful to tailor the decision-making process.

One-Year Change in Locus of Control among People with Dementia

INTRODUCTION

Knowledge of how perceptions of personal control change over time may provide valuable insights into how people cope with having dementia. The present study aimed to examine change in locus of control over a 12-month period in persons with dementia.

METHOD

The study included 52 participants with dementia. Locus of control was measured with the Locus of Control of Behavior Scale (LoCB), with higher scores indicating a more external locus of control, interpreted as perceiving less personal control. A ≥5% change on the LoCB was considered clinically meaningful. We recorded sociodemographic characteristics and assessed dementia severity, cognition, ability to function independently in daily activities and physical self-maintenance, depressive symptomatology, and number of prescribed medications. Analyses were performed to examine differences between those with increases (more external) or decreases (less external) in the LoCB score after 12 months and to examine associations between baseline variables and change in the LoCB score.

RESULTS

The mean LoCB score for the total sample did not change after 12 months (baseline mean 29.33 vs. follow-up mean 30.33, p = 0.553); however, 2 subgroups emerged. Using the ≥5% cutoff revealed that the LoCB score changed for 92.3% of the sample, becoming less external (lower LoCB) for 21 participants and more external (higher LoCB) for 27 participants. At baseline, the mean LoBC score was higher in the group that became less external (33.81 vs. 24.56), p = 0.006, while this was reverse at follow-up (23.57 vs. 34.41), p = 0.001. Dementia severity and dependence in physical self-maintenance increased during the 12 months in both groups. Among those becoming more external, we also found a decline in cognition (p = 0.002), an increase in dependence in daily activities (p = 0.003), an increase in the use of prescribed medication, and a decrease in depressive symptomatology (p = 0.003). The baseline LoCB score was the only variable associated with 12-month change in LoCB scores (p = 0.001).

CONCLUSION

Most participants showed a clinically meaningful change in locus of control after 12 months. Those with more signs of dementia progression reported a decrease in personal control but also a decrease in depressive symptoms. These findings are interesting for our understanding of coping but must be replicated with a larger sample.

Psychometric properties of the Chinese version of the Courtauld Emotional Control Scale in women newly diagnosed with breast cancer

PURPOSE

Emotional control, the attempt to suppress the expression of negative effects, is an essential factor in the prevalence of psychological distress in women with breast cancer. The Courtauld Emotional Control Scale (CECS) is a commonly used self-report tool for assessing emotional suppression in both clinical and general groups. This study aimed to validate the Chinese version of the Courtauld Emotional Control Scale (CECS) in women newly diagnosed with breast cancer.

METHODS

The study involved 680 women newly diagnosed with breast cancer aged 25 to 76 (mean age = 48.19, standard deviation (SD) = 8.57) from Changsha (China). Data analysis included Cronbach's alpha coefficients, the intraclass correlation coefficient (ICC), Pearson's correlations, Independent-Samples T test, confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were conducted to determine the optimal model. For the best fitting model stability was assessed with tests for invariance across age, educational level, and employment status.

RESULTS

Internal consistency (α = 0.987) and test-retest reliability (ICC = 0.715) of the CECS were presented. Results confirm the structure of the Chinese version of the CECS with 21 items divided into three dimensions, anger suppression (CECS_AG), depression suppression (CECS_MD), and anxiety suppression (CECS_AX). Convergent and known-groups validity were acceptable. Additionally, this model remained invariant across age, educational levels, and employment status.

CONCLUSIONS

The Chinese version of the CECS has good psychometric properties in terms of reliability and validity, remaining invariant across age, educational levels, and employment status in women newly diagnosed with breast cancer.

Effect of health locus of control on physical activity in stable patients with chronic obstructive pulmonary diseases

[Purpose] A strong correlation exists between low physical activity and the prognosis of patients with chronic obstructive pulmonary disease (COPD). The interaction between psychological factors and low physical activity remains unclear in patients with COPD. Here, we investigated the impact of the health locus of control (HLOC) on the response to an education program in patients with COPD. [Participants and Methods] We assessed the physical activities and HLOC in participants with COPD before and after a five-month education program. We assessed physical activity using the Japanese version of the International Physical Activity Questionnaire (IPAQ). We evaluated the HLOC using the Japanese version of the HLOC scales. We provided an identical educational program to all participants after the initial evaluation. [Results] The total activity and walking scores were significantly elevated after the intervention. We observed a significant negative correlation between the IPAQ Total score after the intervention and the supernatural HLOC. We also observed significant negative correlations between the IPAQ Vigorous score after the intervention and Family HLOC and Chance HLOC. [Conclusion] The response of patients with COPD to self-care educational programs was influenced by the HLOC.

The Impact of the COVID-19 Pandemic on Psychological Health and Insomnia among People with Chronic Diseases

The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic highlighted the serious problems of health care systems but also threatened the mental and physical health of patients worldwide. The goal of this study was to assess psychological health and insomnia in people with chronic diseases in the time of elevated stress associated with the pandemic. The study involved 879 people from Zachodniopomorskie province in Poland. Each participant provided basic demographic data, data on symptoms of insomnia, depression, anxiety and information on concomitant diseases such as hypertension, diabetes mellitus, coronary heart disease, heart failure, dyslipidemia, chronic obstructive pulmonary disease, Hashimoto’s disease and smoking cigarettes. Chronic diseases included in this study showed a strong correlation between Hashimoto’s disease and increase scores according to the Insomnia Severity Index (ISI, r = 0.797, p < 0.001), the Generalized Anxiety Disorder scale (GAD-7, r = 0.766, p < 0.001) and the Patient Health Questionnaire (PHQ-9, r = 0.767, p < 0.001). After the results were corrected for age, gender, diagnosed hypertension, dyslipidemia and cigarette smoking, it was confirmed that the diagnosis of Hashimoto’s disease was associated with an increased risk of anxiety (odds ratio (OR) = 2.225; p < 0.001), depression (OR = 2.518; p < 0.001) and insomnia (OR = 3.530; p < 0.001). Our study showed that during the SARS-CoV-2 pandemic patients with Hashimoto’s disease show a higher risk of insomnia, anxiety and depression.

Age-related differences in valence and arousal of emotion concepts

Emotion concepts are representations that enable people to make sense of their own and others’ emotions. The present study, theoretically driven by the conceptual act theory, explores the overall spectrum of emotion concepts in older adults and compares them with the emotion concepts of younger adults. Data from 178 older adults (⩾55 years) and 176 younger adults (20–30 years) were collected using the Semantic Emotion Space Assessment task. The arousal and valence of 16 discrete emotions – anger, fear, sadness, happiness, disgust, hope, love, hate, contempt, guilt, compassion, shame, gratefulness, envy, disappointment, and jealousy – were rated by the participants on a graphic scale bar. The results show that (a) older and younger adults did not differ in the mean valence ratings of emotion concepts, which indicates that older adults do not differ from younger adults in the way they conceptualise how pleasant or unpleasant emotions are. Furthermore, (b) older men rated emotion concepts as more arousing than younger men, (c) older adults rated sadness, disgust, contempt, guilt, and compassion as more arousing and (d) jealousy as less arousing than younger adults. The results of the present study indicate that age-related differentiation of conceptual knowledge seems to proceed more in the way that individuals understand how arousing their subjective representations of emotions are rather than how pleasant they are.

Factor analysis of the Korean version of the Illness Cognition Questionnaire for adolescents with chronic illness

Aim

The purpose of this study was to examine the reliability and validity of the Korean version of the Illness Cognition Questionnaire.

Methods

A total of 237 adolescent Participants ages 13–20 years were collected from two hospitals for purposes of the study. The participants were diagnosed with blood cancer, congenital heart disease, paediatric rheumatoid arthritis, multiple sclerosis and diabetes mellitus.

Results

The Illness Cognition Questionnaire is composed of three subscales and 18 items. Exploratory factor analysis and confirmatory factor analysis were performed for all 18 items. The data used in the exploratory factor analysis were obtained from 126 adolescents with blood cancer. The data used for confirmatory factor analysis were obtained from 111 adolescents who had chronic diseases. The three‐factor model of 18 items showed general fitness close to the standard but not a very good fit.

Conclusions

This study indicated that the Korean version of the Illness Cognition Questionnaire is reasonable to use for Korean adolescents with chronic illness. The authors recommend that the meaning of Item 10 be clarified from ‘I have learned to accept the limitations imposed by my illness’ to ‘I have learned to positively accept the limitations imposed by my illness’.

What is already known about this topic?

Illness cognition is the process of evaluating the meaning of a negative event.

Illness cognition has a significant impact on patients' quality of life because it is inherently involved in long‐term stresses caused by chronic or serious illnesses.

What this paper adds?

The Korean version of the Illness Cognition Questionnaire is reliable and valid.

The Korean version of Illness Cognition Questionnaire consisted of three categories of disease awareness: acceptance, helplessness and perceived benefits

The meaning of Item 10 in the Illness Cognition Questionnaire Korean version needs to be clarified as ‘I have learned to positively accept the limitations imposed by my illness’.

The implications of this paper:

The Korean version of the Illness Cognition Questionnaire can be used for adolescent participants experiencing serious or chronic illnesses.

The Korean version of the Illness Cognition Questionnaire can be used in developing the psychological intervention for adolescents with chronic illness.

Receiving a Diagnosis of Pernicious Anemia: Exploring Experiences of Relationships With Health Professionals

OBJECTIVES

Pernicious anemia (PA) is a chronic condition caused by vitamin B12 deficiency. This is a qualitative study using interpretative phenomenological analysis (IPA), which aimed to explore the patients lived experience of diagnosis and treatment.

METHODS

Eleven semistructured interviews were conducted in PA patients; these covered participants' diagnostic and treatment journeys, the responses of others to their diagnosis, and the role health professionals have played in their medical care. Interviews were analyzed for recurrent themes using IPA.

RESULTS

Three superordinate themes were identified: "The struggle to achieve a diagnosis," "The significance of a diagnosis," and "Battling for sufficient treatment." Participants were dissatisfied with their medical care due to diagnostic delay, insufficient treatment, and poor relationships with their health professionals. Many experienced, anticipated, and internalized stigma, which led to a reduced quality of life and withdrawal from the medical profession.

DISCUSSION

Participants' interactions with their health professionals hindered their adaptation to their condition; this affected their psychological and physical well-being. Increased clinician awareness of stigma in the PA population symptoms and effective patient-centered communication is required.

Perception of cancer in patients diagnosed with the most common gastrointestinal cancers

BACKGROUND

Gastrointestinal cancers, including colorectal cancer, stomach cancer and pancreatic cancer are among the most common cancers in Poland. Cancer patients usually assess their quality of life much worse than the general population, while negative emotions associated with the illness may affect the results of treatment.

METHODS

The study involved 378 patients with colorectal cancer, stomach cancer and pancreatic cancer, treated as outpatients at the Oncology Center - Maria Skłodowska-Curie Institute in Warsaw in 2013-2018. Standardized tools were used in the study: the Beliefs about Pain Control Questionnaire (BPCQ), the Pain Coping Strategies Questionnaire (CSQ), Approval Illness Scale (AIS), Mental Adjustment to Cancer (MiniMAC). The main goal of the study was to assess pain control, pain management strategies, illness acceptance and adaptation to cancer in patients with the most common gastrointestinal cancers.

RESULTS

Patients with gastrointestinal cancers ascribe the greatest role in controlling pain to internal factors (M = 16.84, SE = .34), and the highest score in this area was obtained by patients with colorectal cancer (M = 17.33, SE = .35). The most frequently chosen strategy is declaring coping (M = 20.95, SE = .57), although patients with pancreatic cancer obtained a high score also in the area of catastrophizing (M = 17.99, SE = 1.14). The average value of illness acceptance for patients with gastrointestinal cancers was M = 25.00 (SE = .50) and it was the lowest in the group of patients diagnosed with pancreatic cancer (M = 23.41, SE = 1.16), and the highest in a group of people with colorectal cancer (M = 27.76, SE = .51). Patients with gastrointestinal cancers obtained the highest values of the MiniMAC test in the area of the fighting spirit (M = 21.30, SE = .25), characteristic mainly for patients with colorectal cancer. Patients with pancreatic cancer were characterized by high anxiety and helplessness/hopelessness.

CONCLUSIONS

Patients with gastrointestinal cancers use different methods of pain control and pain coping strategies, with active behaviors being preferred by patients with colorectal cancer and destructive - by patients with pancreatic cancer. The majority of socio-economic variables, as well as the treatment method, affect the patients' behaviors.

Evaluation of Mental Health Factors among People with Systemic Lupus Erythematosus during the SARS-CoV-2 Pandemic

There are considerable psychological and psychiatric consequences of the pandemic. Researchers have started to take into account the real or perceived sense of social threats that may be expressed, such as anxiety, depression, and sleep disorders. However, analyses on pandemic-related anxiety, depression, and sleep disorders mostly rarely addresses the situation of people with autoimmune diseases. Therefore, the aim of this study was to assess the mental health factors among people with systemic lupus erythematosus by quantifying the severity of anxiety, depression, and sleep disorders during the SARS-CoV-2 pandemic. In total, 723 people took part in the study. The study group consisted of 134 individuals with a systemic lupus erythematosus. The control group consisted of 589 people without systemic lupus erythematosus. The regression adjusted by age, gender, and diagnosis of other chronic diseases showed individuals with systemic lupus erythematosus were at a much higher risk of elevated symptoms of anxiety on the GAD-7 scale (OR = 3.683; p < 0.001), depression on the PHQ-9 scale (OR = 4.183; p < 0.001), and sleep disorders on the Insomnia Severity Index (ISI) scale (OR = 6.781; p < 0.001). Therefore, the mental health of patients with systemic lupus erythematosus in the times of the SARS-CoV-2 pandemic is not only an extremely important medical problem but also a social one and must require special attention.

The effect of interbrain synchronization in gesture observation: A fNIRS study

INTRODUCTION

Gestures characterize individuals' nonverbal communicative exchanges, taking on different functions. Several types of research in the neuroscientific field have been interested in the investigation of the neural correlates underlying the observation and implementation of different gestures categories. In particular, different studies have focused on the neural correlates underlying gestures observation, emphasizing the presence of mirroring mechanisms in specific brain areas, which appear to be involved in gesture observation and planning mechanisms.

MATERIALS AND METHODS

Specifically, the present study aimed to investigate the neural mechanisms, through the use of functional Near-Infrared Spectroscopy (fNIRS), underlying the observation of affective, social, and informative gestures with positive and negative valence in individuals' dyads composed by encoder and decoder. The variations of oxygenated (O2Hb) and deoxygenated (HHb) hemoglobin concentrations of both individuals were collected simultaneously through the use of hyperscanning paradigm, allowing the recording of brain responsiveness and interbrain connectivity.

RESULTS

The results showed a different brain activation and an increase of interbrain connectivity according to the type of gestures observed, with a significant increase of O2Hb brain responsiveness and interbrain connectivity and a decrease of HHb brain responsiveness for affective gestures in the dorsolateral prefrontal cortex (DLPFC) and for social gestures in the superior frontal gyrus (SFG). Furthermore, concerning the valence of the observed gestures, an increase of O2Hb brain activity and interbrain connectivity was observed in the left DLPFC for positive affective gestures compared to negative ones.

CONCLUSION

In conclusion, the present study showed different brain responses underlying the observation of different types of positive and negative gestures. Moreover, interbrain connectivity calculation allowed us to underline the presence of mirroring mechanisms involved in gesture-specific frontal regions during gestures observation and action planning.

Psychological factors associated with self-management in multiple sclerosis

OBJECTIVE

Patient's engagement in their own treatment has been shown to improve clinical outcomes. A better understanding of the association between self-management in multiple sclerosis (MS) and potentially modifiable psychological factors may provide clinicians with strategies to design and stimulate better patient activation for self-managing health. Therefore, in this study, we examined whether cognitive factors, namely self-efficacy, acceptance of illness, optimism, and health locus of control (HLC), are associated with self-management in MS.

METHODS

This is a cross-sectional study. A total of 382 patients with MS who completed the MS Self-Management Scale-Revised and the questionnaires that measure self-efficacy, optimism, illness acceptance, and HLC were included in the study.

RESULTS

A hierarchical multiple regression revealed that power of others' HLC (b = 0.42, P ≤ .001), optimism (b = 0.27, P ≤ .01), internal HLC (b = -0.11, P = .017), and self-efficacy (b = 0.11, P = .031), together with control variables (longer disease duration and higher disability), explained 30% of the variance in the dependent variable.

CONCLUSIONS

In the case of MS, self-management is associated with patient's perception that healthcare professionals control their health, higher self-efficacy, optimism, and, surprisingly, lower internal HLC. The results of this study indicate the vital role of the healthcare staff in encouraging the patients with MS toward activities related to self-management and provide new insights on the psychological intervention aimed at improving self-management by patients.

Affective, Social, and Informative Gestures Reproduction in Human Interaction: Hyperscanning and Brain Connectivity

Gestural communication characterizes daily individuals' interactions in order to share information and to modify others' behavior. Social neuroscience has investigated the neural bases which support recognizing of different gestures. The present research, through the use of the hyperscanning approach, that allows the simultaneously recording of the activity of two or more individuals involved in a joint action, aims to investigate the neural bases of gestural communication. Moreover, by using hyperscanning paradigm we explore the inter-brain connectivity between two inter-agents, the one who performed the gesture (encoder) and the one who received it (decoder), with functional Near-infrared Spectroscopy (fNIRS) during the reproduction of affective, social and informative gestures with positive and negative valence. Result showed an increase in oxygenated hemoglobin concentration (O2Hb) and inter-brain connectivity in the dorsolateral prefrontal cortex (DLPFC) for affective gestures, in the superior frontal gyrus (SFG) for social gestures and the frontal eye fields (FEF) for informative gestures, for both encoder and decoder. Furthermore, it emerged that positive gestures activate more the left DLPFC, with an increase in inter-brain connectivity in DLPFC and SFG. The present study revealed the relevant function of the type and valence of gestures in affecting intra- and inter-brain connectivity.

Patients' health locus of control and preferences about the role that they want to play in the medical decision-making process

Health locus of control (HLOC) may influence people's behavior regarding their health as well as their desires to be involved in the medical decision-making. Our study aimed to examine HLOC's relations with people's control preferences about the medical decision-making. A total of 153 people filled out the self-administered version of the Control Preference Scale and the Multidimensional Health Locus of Control Scale - form C. The most preferred role is the collaborative one. However, HLOC explained heterogeneity in people's control preferences: lower scores in external HLOC were related to a greater preference for the active and the collaborative role. From the personalized medicine perspective, an accurate evaluation of the patient's HLOC could help tailoring the decision-making process within the clinical context.

Relationship between Morbidity and Health Behavior in Chronic Diseases

This study aimed to analyze the demographic characteristics and health behaviors related to chronic diseases and to identify factors that may affect chronic diseases. Data from the Seventh Korea National Health and Nutrition Examination Survey were used, and 3795 adults aged above 40 years were included. The following demographic variables were obtained: sex, age, education, income, type of health insurance, and private insurance. The following health behavior factors were also analyzed: medical checkup, drinking, smoking, exercise, obesity, and hypercholesterolemia. Participants with lower socioeconomic status had a higher risk of developing chronic diseases. Meanwhile, those with private health insurance had a lower risk of developing chronic diseases. In addition, participants who underwent medical checkups and performed exercises had a lower risk, while those with obesity and hypercholesterolemia had a higher risk of developing chronic diseases. It is necessary to manage chronic diseases through comprehensive programs, rather than managing these diseases individually, and through community primary care institutions to improve health behaviors.

The impact of internal locus of control on healthcare utilization, expenditures, and health status across older adult income levels

Our objectives were to 1) determine the prevalence of locus of control (LOC) dimensions stratified by older adult income levels; 2) characterize internal LOC attributes within income subgroups; and 3) investigate LOC associations with healthcare utilization and expenditures; self-rated health and functionality. The survey sample was identified from adults age ≥65 years with diagnosed pain conditions. Internal LOC characteristics were determined from logistic regressions; outcomes regression-adjusted. Among respondents, internal prevalence for low (N = 554), medium (N = 1,394) and high income (N = 2040) was 27%, 30% and 30%, respectively. Internal was associated with high resilience, less stress, exercise and less opioid use across income levels. Lower-income internal was additionally associated with diverse social networks, physical therapy and less drug use. Those with high internal generally had lower healthcare utilization and expenditures; better self-rated health and functionality. Internal LOC is a powerful positive resource associated with better health outcomes, especially influential for lower income.

Unmet needs of people with Parkinson's disease: A cross-sectional study

AIMS

To identify the type and extent of unmet needs in people with Parkinson's disease and to examine the impact of health locus of control and family support on these needs.

DESIGN

A cross-sectional study.

METHODS

This study was conducted from October 2015 - February 2016 in Korea. Data were collected through questionnaires focusing on unmet needs, health locus of control, family support and clinical features.

RESULTS

Therapeutic needs represented the highest percentage of unmet needs in people with Parkinson's disease (85.05%), followed by social/spiritual/emotional needs (82.72%). Physical needs were the lowest reported score (75.01%). Unmet needs were more frequent in those with more severe non-motor symptoms. Also, higher family support, internal locus of control and doctor locus of control were correlated with more unmet needs.

CONCLUSION

Understanding factors that determine the type and degree of unmet needs in people with PD is important to provide appropriate nursing care. The findings of this study can be used for providing nursing interventions reflecting unmet needs and reducing their unmet needs to improve the overall well-being of people with PD.

IMPACT

This study addressed unmet needs unmet needs specific to Parkinson's disease with respect to their nursing needs. Therapeutic needs were the highest unmet needs in people with PD, followed by social/spiritual/emotional needs, need for certainty and physical needs. The findings may be useful for nurses to identify the unmet needs of people with PD which need to be addressed. By reflecting on unmet needs, nurses can give personally tailored nursing care.

The association of pain locus of control with pain outcomes among older adults

Our primary objective was to 1) determine the prevalence of pain locus of control (LOC) subscales in a population of older adults with pain conditions, and 2) estimate their associated protective effects on pain outcomes. A mailed survey was sent to a stratified sample of older adults age≥65 with diagnosed back pain, osteoarthritis and/or rheumatoid arthritis. Multivariate logistic regression modeling was used to determine the relative protective associations of positive resources, including LOC, resilience and social networks, on pain outcomes. Among respondents (N = 3,824), 31% were identified as internal; 34% as powerful others; and 35% as chance. In adjusted models, internal was associated with outcomes of lower pain severity, reduced chronic opioid use and increased physical functionality. Powerful others was partially protective; chance was associated with the poorest outcomes. Multidimensional pain programs should incorporate the enhancement of positive resources, including LOC, to maximize the effectiveness of pain management strategies.

Medical Drama Viewing and Healthy Lifestyle Behaviors: Understanding the Role of Health Locus of Control Beliefs and Education Level

The present study advances the understanding of how medical drama viewing influences healthy lifestyle behaviors (e.g., smoking, exercising, and consuming vegetables) by examining the role of the health locus of control (HLOC) beliefs and education level. An analysis of nationally representative data reveals that watching medical dramas is positively associated with chance and powerful others' HLOC beliefs. In addition, healthy lifestyle behaviors are positively associated with the internal HLOC belief and are negatively associated with the chance and powerful others' HLOC beliefs. Research findings demonstrate that there are indirect effects of medical drama viewing on these behaviors via chance and powerful others' HLOC beliefs. The indirect effect through the powerful others' HLOC belief is also contingent on the education level. The implications for the role of HLOC beliefs and education level in terms of the effects of medical dramas on health-promoting behaviors are discussed.

Socio-cognitive factors influencing Greek lyceum female students' intention to receive a Pap smear and a vaccine against HPV

BACKGROUND

The human papillomavirus (HPV) is responsible for 99.7% of cervix cancers worldwide. As this is a preventable and treatable cancer, if diagnosed early, it is important to explore not only young women's related knowledge, but also their intentions for prevention activities, through a theoretical perspective.

OBJECTIVE

To investigate the role of the Health Belief Model (HBM) and the Health Locus of Control theory (HLC) (social cognitive models) to act as potentially influencing factors for the prevention intentions among lyceum female students.

METHODS

This cross-sectional study took place from January to May 2014, among 1129 female students, who attended lyceums in six islands of the Cyclades Region, Greece. Students filled-in a self-complementary questionnaire, after the necessary approval was provided by the relevant authorities.

RESULTS

Intention to take the Pap smear was determined by student's level of knowledge (p < 0.001) about Pap smears, their age (p = 0.004), HPV susceptibility (p < 0.001), subjective obstacles of taking the Pap smear (p < 0.001) and subjective benefits of the Pap smear (p < 0.001). The vaccination intention against HPV was influenced by the subjective benefit from vaccination (p < 0.001) and the level of knowledge of the vaccine (p < 0.001).

CONCLUSIONS

Knowledge, age and HBM variables were significantly associated with students' intention for vaccination and screening on HPV. The study demonstrates the importance of raising awareness through specific education programmes in schools and theory-based tailored health programmes on HPV aspects (transmission, prevention, treatment) to increase the intention for prevention.

A path analysis model suggesting the association between health locus of control and compliance with childhood vaccinations

Despite vaccines benefits, parent's vaccine hesitancy is growing. Health locus of control (HLOC) may affect decision making regarding child vaccinations. The aim of this study was to investigate the relationship between parents' HLOC and compliance with routine childhood immunization programs. A cross-sectional survey was conducted among 731 parents of children aged 3-4 years. Internal HLOC, powerful others and chance HLOC (dimensions of external HLOC), reliability of information sources, and attitudes towards vaccines were measured. Path analysis was conducted to explore direct and indirect associations between HLOC and vaccination's compliance. The results show that High powerful others HLOC has a direct association with vaccination compliance (ß = 0.23, p < 0.001). High internal and chance HLOC have indirect associations through parents' attitudes regarding vaccines. Perceived reliability of information sources was associated with not complying with vaccines (ß = -0.07, p < 0.05). For conclusions, Interaction between internal and external HLOC may explain vaccination compliance. Decreasing levels of chance HLOC and increasing powerful others HLOC may increase levels of compliance with childhood vaccinations.

Psychological predictors of the combined adoption of physical exercise and dietary change among adults with hypercholesterolemia

BACKGROUND

Although combined changes in eating habits and physical activity are pivotal to hypercholesterolemia management and the prevention of cardiovascular disease, little is known about the factors influencing the adoption of both behaviors by adults with hypercholesterolemia. The goal of this study was to identify psychological factors that predict a combined adoption of dietary modification and physical activity among adults with hypercholesterolemia.

METHODS

We recruited a sample of 1100 adults with hypercholesterolemia (56.9% male, mean age=56.5 years) through a nationally representative online panel. Participants reported their physical activity using the International Physical Activity Questionnaire (IPAQ) and their eating habits using a Food-Frequency Questionnaire (FFQ). We assessed a comprehensive set of psychological variables, including hypercholesterolemia knowledge and perception, patient's cardiovascular history, doctor-patient relationship, social-cognitive beliefs, and personality traits. Based on IPAQ and FFQ scores, we classified participants into four groups (dietary modification plus physical exercise, dietary modification, physical exercise, passive).

RESULTS

Our analysis showed that subjective hypercholesterolemia knowledge, beliefs about the effects of hypercholesterolemia, external locus of control (other people and chance), nutrition and physical exercise self-efficacy, and trait self-control significantly influenced the simultaneous adoption of physical exercise and dietary modification.

CONCLUSIONS

This study highlights the importance of psychological factors in predicting the combined adoption of physical exercise and dietary modification among adults with hypercholesterolemia. Addressing these factors could help improve hypercholesterolemia prevention strategies.

Self-compassion is associated with optimum self-care behaviour, medical outcomes and psychological well-being in a cross-sectional sample of adults with diabetes

AIM

To investigate the role of self-compassion in diabetes outcomes. Self-compassion is a construct which may be relevant to chronic conditions, given its focus on compassion toward oneself, especially in times of difficulty.

METHODS

In this cross-sectional study we collected data online from 310 adults diagnosed with diabetes. The questionnaire measured three primary outcomes: self-management behaviours; HbA_1c levels and psychological well-being. Potential predictors were also assessed, including self-compassion, locus of control, social support and demographics.

RESULTS

Multiple regression analyses showed that self-compassion had the most consistent association with better outcomes, including all forms of self-management behaviour, HbA_1c levels and psychological well-being. Self-compassion was independently associated with 55.1% of the variance in well-being. Internal locus of control was also significantly associated with better well-being and HbA_1c outcomes. Chance and external locus of control and social support were generally associated with poorer outcomes.

CONCLUSIONS

Higher levels of self-compassion are typically associated with improved self-management behaviour, medical outcomes and psychological well-being in adults with diabetes mellitus. The present findings suggest that self-compassion may be a parsimonious and suitable intervention target. Future interventions and consultations with medical professionals may benefit from fostering self-compassion in adults with diabetes mellitus.

The Relationship between Health Locus of Control and Health Behaviors in Emergency Medicine Personnel

BACKGROUND

Health locus of control defined as individual beliefs based on past experiences in health issues and having external or internal control over them, could affect health. Health locus of control plays a role in health behaviors. We aimed to investigate the relationship between health locus of control and health behavior in emergency medical personnel in Ahvaz during 2016.

METHODS

This is a cross-sectional descriptive study, which began in August 2016 for a period of six months on 215 emergency medical personnel in Ahvaz who were selected randomly. The data were collected by a demographic questionnaire, Rotter's locus of control questionnaire, and health behavior questionnaire and analyzed using SPSS software, version 22. The correlation between variables was estimated by Pearson's correlation coefficient and independent t test. The level of significance for all statistical tests was set at 0.05.

RESULTS

We found no significant relationship between health locus of control (external and internal) and health behavior (P>0.05).Health behaviors were very good in terms of personal health (86.5%), nutrition (53%), and sleep and rest (48.4%), and poor in terms of physical activity (52.6%) and stress management (79.5%). Furthermore, 79.5% of the emergency personnel, in general, had poor heath behaviors.

CONCLUSION

Leaders and officials in the field of health must necessarily design programs in relation to health locus of control and the factors developing and affecting it as well as the role of health locus of control in doing correct behaviors.

Depression, Metabolic Syndrome, and Locus of Control in Arab Americans Living in the DC Metropolitan Area: A Structural Equation Model

Arab Americans have high prevalences of metabolic syndrome (MetS) and depression. Depression and external locus of control (LOC) may worsen MetS. We examined the relationship between depression and MetS with a convenience sample of 136 Arab Americans living in the Washington, DC, metropolitan area. Participants were surveyed with the Multidimensional Health Locus of Control questionnaire and the Center of Epidemiological Studies-Depression scale. Laboratory measurements were collected based on the components of MetS. A structural equation model was used to explore the relationship between MetS and depression through analysis of LOC. MetS was significantly correlated with external LOC (powerful others and chance), and depression was correlated with a weak internal LOC. Future study of the effect of LOC on health outcomes in Arab Americans may be used to mitigate MetS and depression in this population.

Self concepts, health locus of control and cognitive functioning associated with health-promoting lifestyles in schizophrenia

PURPOSE

The study aimed to investigate the relationship among self concepts, health locus of control, cognitive functioning and health-promoting lifestyles in patients diagnosed with schizophrenia. We examined health-promoting lifestyles through self-efficacy, self-esteem, health locus of control and neurocognitive factors.

METHOD

Fifty-six people with schizophrenia were enrolled in the study group. All subjects participated in the self-esteem (Rosenberg Self-Esteem Scale), self-efficacy (General Self-Efficacy Scale), health locus of control (The Multidimensional Health Locus of Control Scales), health-promoting lifestyles (Health Promotion Life-style Profile-II) and a series of neurocognitive measures.

FINDINGS

Stepwise regression analysis revealed that self-efficacy, internal health locus of control and attentional set-shifting accounted for 42% of the variance in total health-promoting lifestyles scores. Self-efficacy, self-esteem, internal and powerful others health locus of control and attentional set-shifting were significant predictors for domains of health-promoting lifestyles, respectively.

CONCLUSION

Study findings can help mental health professionals maintain and improve health-promoting behaviors through a better understanding of self-esteem, self-efficacy, health locus of control and neurocognitive functioning among people with schizophrenia.

What else should we know about experiencing COPD? A narrative review in search of patients' psychological burden alleviation

The present paper is a narrative review focusing on the psychological impact, identification of protective factors, and interventions minimizing the psychological burdens of chronic obstructive pulmonary disease (COPD). The research reviews studies on neurocognitive functions, personality, emotional problems, and health-related quality of life. This is done with regard to resources as well as activities enabling or enhancing a patient's adaptation. PubMed and PsychArticles databases were searched for relevant medical (eg, CODP, emphysema), psychopathology (eg, depression), and psychological (eg, personality) keywords, followed by hand search. After application of the inclusion and exclusion criteria, the search resulted in 82 articles and book chapters. The choice was based on evidence accepted by evidence-based medicine, although at different levels of strength. Psychological experiencing of COPD appears to be very unequally represented with scientific research on emotional problems and functioning decrease significantly outnumbering those addressing resources or effective interventions. As our initial literature search called for an urgent need for further exploration, we have carefully pointed out numerous areas where the knowledge on how to protect or restore psychological well-being among COPD patients should be broadened.

Depression, Anxiety, Resilience and Coping Pre and Post Kidney Transplantation - Initial Findings from the Psychiatric Impairments in Kidney Transplantation (PI-KT)-Study

PURPOSE

Depression/anxiety, impaired Health-Related Quality of Life (HRQoL) and coping and resilience structures, are associated with increased mortality/poor outcome in chronic kidney disease (CKD) patients before (CKD/pre-KT) and after kidney (CKD-T) transplantation. Less is known about prevalence rates of psychiatric symptoms and impaired HRQoL of non-transplanted compared with transplanted patients.

METHODS

In a cross-sectional study comparing 101 CKD/pre-KT patients with 151 cadaveric-transplanted (CKD-T) patients, we examined prevalence of depression/anxiety (HADS questionnaire) and coping, resilience and HRQoL (SF-12, Resilience-Scale and FKV-questionnaire).

RESULTS

The prevalence of both depressive and anxiety symptoms was not significantly different between different pre-/and CKD-T patient groups. In CKD-T no significant relations of coping strategies with kidney function were identified. Furthermore, the Resilience Scales for acceptance and competence did not suggest any differences between the CKD/pre-KT and CKD-T subgroup. In the CKD/pre-KT patients, significant correlations were identified between the acceptance subscale and partnership, as well as between the competence subscale and older age/partnership.

CONCLUSIONS

Both the CKD/pre-KT and CKD-T patients exhibited notable impairments in the HRQoL which which showed a comparable pattern of results. KT itself does not appear to be the main risk factor for the development of mental impairments.

Investigation of Anxiety and Depression in Patients with Chronic Diseases

The health of an individual depends on both his/her physical and psychological condition. In recent years it has been observed that chronic patients have frequently an affected psycho-emotional state. The purpose of this study is to investigate anxiety and depression in patients with chronic diseases and the correlation of the results with daily physical activity levels and individual health levels, as well comorbidity. This study included patients with chronic diseases that were treated in a local general hospital or were visiting often outpatient clinics of the same hospital due to their condition. The sample in this particular study included 204 patients; 118 of them were women and 86 men. From the total sample that participated in our research, 118 (57.8%) were females and the majority of the participants were secondary/basic education graduates (67%), married (71%), living in urban areas (53%). Hypertension was the most frequent chronic disease in our sample, followed by hypercholesterolemia and diabetes mellitus. Comparing the occurrence of depression and anxiety symptoms in both questionnaires in relation to the expected frequency in the general population, significant levels of depression and anxiety symptoms were recorded. Taking into consideration the findings of this research, anxiety and depression symptoms can have profound effects regarding the control of chronic diseases, the patients' quality of life and their general health.

Acceptance of Cancer in Patients Diagnosed with Lung, Breast, Colorectal and Prostate Carcinoma

BACKGROUND

The ability to accept illness is a major issue in the life of a person with cancer. Acceptance of disease is simultaneously conducted at two levels: the emotional and cognitive-behavioral one. It is consequential to cancer affecting numerous aspects of patient's life, i.e. the physical, mental, social and the spiritual area. The aim of the study was to verify the influence of socioeconomic factors on acceptance of illness in patients suffering from breast, lung, colorectal and prostate carcinoma.

METHODS

The study included 902 patients treated on an outpatient basis at the Center of Oncology, the Maria Skłodowska-Curie Institute in Warsaw, in the year 2013. The Paper and Pencil Interview (PAPI) technique was applied. The questionnaire comprised basic demographic questions (socioeconomic factors) and Acceptance of Illness Scale (AIS) test estimating the level of disease acceptance in patients.

RESULTS

Prostate carcinoma patients scored highest (30, 39), whereas lung carcinoma patients scored lowest (23, 17) concerning illness acceptance according to the AIS scale. In all cases, linear dependence between the net income-per-household-member and the AIS score could be observed. Another diversification factor in the case of prostate carcinoma patients was the level of education. Yet one more dependence could be observed between the level of illness acceptance and chemotherapy over the course of past twelve months.

CONCLUSION

The degree of disease acceptance is subject to a type of carcinoma. Patient income is an economic factor significantly affecting the acceptance of illness score.

To what extent psychiatric patients feel involved in decision making about their mental health care? Relationships with socio-demographic, clinical, and psychological variables

BACKGROUND

Shared decision making (SDM) is an essential component of patient-centered care, but there is little information about its use in the psychiatric care.

OBJECTIVE

To measure to what extent psychiatric patients feel they were involved in the process and steps of decision making about treatment choice and to analyse the influence of socio-demographic, clinical, and psychological processes on this perception.

METHODS

Cross-sectional survey involving 1100 consecutive psychiatric outpatients invited to complete the nine-item Shared Decision-Making Questionnaire (SDM-Q-9), health locus of control and control preferences, self-efficacy and drug attitude scales, as well as a questionnaire including socio-demographic and clinical variables.

RESULTS

A high response rate of 77% was registered, resulting in a sample of 846 psychiatric outpatients. SDM-Q-9 total score indicate a moderately low degree of perceived participation, with differing perceived implementation of the individual the SDM process steps. Patient diagnosis evidenced significant differences in SDM perception. Patients' perception of SDM was explained by four main variables: the older the patient, the lower self-reported SDM; having a diagnosis of schizophrenia increases the likelihood of lower SDM; a positive attitude towards psychiatric drugs favors greater SDM, as well as a higher level of self-efficacy.

CONCLUSION

The result of this study suggests that SDM is currently not widely practiced in psychiatric care. Further research is needed to examine if the low level of participation self-reported is justified by psychiatric patients' decisional capacity.

Understanding and living with glaucoma and non-communicable diseases like hypertension and diabetes in the Jhaukhel-Duwakot Health Demographic Surveillance Site: a qualitative study from Nepal

Background

Primary open-angle glaucoma (POAG) is one of the most common causes of irreversible blindness. A possible association between POAG and non-communicable diseases such as hypertension and diabetes suggests that the incidence of POAG may increase. People with POAG in Nepal usually present late to hospital and have poor knowledge of glaucoma.

Objectives

Anticipating a knowledge gap regarding these diseases, this study aimed to explore the knowledge of POAG, hypertension, and diabetes in the community and barriers to health care.

Design

We conducted this qualitative study in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS), a peri-urban community near Kathmandu, a capital city of Nepal. To study how disease influences knowledge, we conducted focus group discussions separately for men and women with and without pre-existing POAG, hypertension, and diabetes. Data were analyzed using the framework analysis approach.

Results

Although people suffering from POAG, hypertension, and/or diabetes exhibited adequate knowledge of hypertension and diabetes, they lacked in-depth knowledge of POAG. People believed mostly in internal health locus of control. Perception of disease consequences and impact of disease on daily life was influenced by pre-existing POAG, hypertension, and/or diabetes but only in men. Gender disparity was observed regarding health literacy, health perception, and health barriers, which put women in a more difficult situation to tackle their health. We also revealed a gap between knowledge, attitude, and practice of health among women and healthy men.

Conclusion

Although people in JD-HDSS exhibited adequate knowledge regarding hypertension and diabetes, they lacked in-depth knowledge about POAG. This study demonstrated gender difference in health literacy and access to health care, making women more vulnerable towards disease. We also demonstrated a gap between knowledge, attitude, and practice of health. However, tailored health literacy programs may bring changes in the health status in the community.

The importance of internal health beliefs for employees' participation in health promotion programs

OBJECTIVE

To investigate associations between employees' health locus of control (HLOC) and self-perceived health, health behaviors, and participation in health promotion programs (HPPs) and the mediating effect of self-perceived health and health behaviors on the relation between HLOC and participation.

METHOD

Between 2010 and 2012, a six-month longitudinal study was conducted among 691 Dutch employees. Using questionnaires, information was collected on health behaviors, self-perceived health, HLOC, and intention to participate at baseline. Actual participation was assessed at follow-up. Logistic regression analyses were used to study associations between HLOC and self-perceived health, health behaviors, and participation, and to examine whether associations between HLOC and participation were mediated by self-perceived health and health behaviors.

RESULTS

Higher internal HLOC was associated with sufficient physical activity (moderate: OR:1.04, 95%CI:1.00-1.08; vigorous: OR:1.05, 95%CI:1.01-1.10) and fruit and vegetable intake (OR:1.05, 95%CI:1.01-1.09), a good self-perceived health (OR:1.20, 95%CI:1.11-1.30), a positive intention towards participation (OR:1.05, 95%CI:1.00-1.09), and actual participation (OR:1.06, 95%CI:1.00-1.13). Self-perceived health or health behaviors did not mediate associations between HLOC and participation.

CONCLUSION

Employees with a higher internal HLOC behaved healthier and were more likely to participate in HPPs, irrespectively of their health. Increasing internal HLOC seems a promising avenue for improving employees' health and participation in HPPs.