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Seage CH, Evans R, Scott KZ, Nazir W, James DH. Using the common-sense model of illness representations to explore individuals' experiences and perceptions of migraine and its management in the United Kingdom. Int J Pharm Pract 2024; 32:223-228. [PMID: 38567941 DOI: 10.1093/ijpp/riae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/21/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVES Migraine is considered a chronic health condition that impacts both quality of life and psychological wellbeing. People with migraines use a range of management strategies, which include pharmacological and non-pharmacological treatments. The aim of this study was to explore individuals' experiences and perceptions of migraines and its treatment using the Common-Sense Model (CSM) of Illness Representations. METHODS Semi-structured, one-to-one interviews were conducted with eleven individuals with a history of migraine to explore their experiences and perceptions of migraine and its treatment. Participants were recruited from across the United Kingdom via convenience sampling using social media advertisement. Interviews were recorded, transcribed verbatim, and qualitative data were analysed using theoretical framework analysis using the CSM. RESULTS The three dimensions of the CSM were mapped on to the qualitative data. These were: (i) Cognitive representations of migraine, within five domains: (a) identity of migraine, (b) perceived causes, (c) perceived timeline, (d) perceived control/cure, and (e) perceived consequences; (ii) Emotional representations of migraine relating to (a) migraine specific emotions and (b) emotional representation of the impact of migraine; and (iii) Coping/self-management behaviours, namely (a) self-medicating behaviours and (b) care-seeking behaviours. No incongruous data were found; therefore, no further thematic analysis was required. CONCLUSION This is the first study to apply the CSM to migraine for framework analysis of qualitative data in this way. The findings illustrate the emotional impact of migraine and the range of illness perceptions associated with appropriate self-management. The data will be used to design a questionnaire for quantitative studies to investigate the extent to which these perceptions are generalizable to the wider population of people who experience migraines.
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Affiliation(s)
- Catherine Heidi Seage
- Applied Psychology, Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Llandaff Campus, Cardiff, Wales, CF5 2YB, United Kingdom
| | - Rebecca Evans
- Applied Psychology, Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Llandaff Campus, Cardiff, Wales, CF5 2YB, United Kingdom
| | - Kayla Z Scott
- Applied Psychology, Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Llandaff Campus, Cardiff, Wales, CF5 2YB, United Kingdom
| | - Wardah Nazir
- Applied Psychology, Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Llandaff Campus, Cardiff, Wales, CF5 2YB, United Kingdom
| | - Delyth H James
- Applied Psychology, Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Llandaff Campus, Cardiff, Wales, CF5 2YB, United Kingdom
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Knoop I, Gu S, Fareghzadeh S, Jones ASK, Gall N, Moss-Morris R. Exploring the complexities of illness identity and symptom management in seeking a diagnostic label of postural orthostatic tachycardia syndrome (POTS): An inductive approach. Br J Health Psychol 2024; 29:297-316. [PMID: 37845822 DOI: 10.1111/bjhp.12700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 06/06/2023] [Accepted: 10/01/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES Postural orthostatic tachycardia syndrome (POTS) is a debilitating and under-recognized condition of the autonomic nervous system. This study applied Leventhal's Common-Sense Model of Illness Representations to explore the journey to a diagnosis of POTS and to understand its relevance to poorly understood conditions which have common comorbidities. DESIGN An inductive qualitative approach was used to explore the processes by which patients formulate explanations and management of symptoms within the search for a diagnostic label and to investigate illness identity in the context of existing diagnoses or multimorbidity. METHODS Participants (n = 29) for this nested qualitative study were recruited from a larger longitudinal study of people who had been newly referred to a specialist POTS service. Semi-structured interviews were conducted via video call. Three researchers coded and analysed data using Reflexive Thematic Analysis and elements of Grounded Theory. RESULTS The analysis resulted in three overarching themes: 'Seeking physiological coherence and validation', 'Individual persistence', and 'Navigating the cumulative burden'. 'Accessibility and disparities of health care' was noted as a contextual factor. Receiving a POTS diagnosis was regarded by participants as providing legitimacy and increased access to treatment. Overall, delays in the diagnostic journey and the lack of a clear diagnosis impacted negatively on patients through increased uncertainty and a lack of clear guidance on how to manage symptoms. Findings also suggested there were great complexities in assigning symptoms to labels in the context of multimorbidity. CONCLUSIONS Participants' stories highlighted the urgent need for better recognition of POTS so that the self-regulatory process can be initiated from the early stages of symptom detection.
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Affiliation(s)
- Iris Knoop
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Stephanie Gu
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Shamim Fareghzadeh
- Neuroscience Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Annie S K Jones
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nicholas Gall
- Cardiology Department, King's College Hospital, London, UK
| | - Rona Moss-Morris
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Hussein S, Jespersen LN, Ingersgaard MV, Skovby P, Grabowski D. Trying to be like everybody else: A qualitative study revealing the importance of social contexts and illness representations among adolescents with type 1 diabetes and their parents. Chronic Illn 2024; 20:37-48. [PMID: 36760087 DOI: 10.1177/17423953231155287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
OBJECTIVE Type 1 diabetes is one of the most common chronic conditions in young children and adolescents. During the period of adolescence, young people with diabetes often struggle with self-management and have compromised health-related quality of life. This often leads to familial conflicts affecting all family members negatively. The aim of this study is to provide qualitative insight into the everyday life of families with adolescents with type 1 diabetes. METHODS The data consisted of participatory family workshops conducted using interactive dialogue tools. The total number of participants was 33 (adolescents n = 13, parents n = 20). The adolescents were between 15 and 17 years. The data were analyzed using systematic text condensation. RESULTS The results showed two main themes. The first theme, Diabetes-friendly and unfriendly social contexts, highlighted how the (dis)comfortability of disclosing diabetes was a significant factor in achieving optimal metabolic control. For parents, it affected their perception of social support. The second theme, incongruent illness representations among family members, dealt with the extended family conflict during the period of adolescence. DISCUSSION Insights from our study could help healthcare professionals apply a family-centered approach minimizing family conflict and supporting metabolic control when consulting families with adolescents with type 1 diabetes.
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Affiliation(s)
- Sana Hussein
- Department of Health Promotion Research, Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Louise Norman Jespersen
- Department of Health Promotion Research, Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Marianne Vie Ingersgaard
- Department of Health Promotion Research, Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Pernille Skovby
- Herning Hospital, Region of Central Jutland, Herning, Denmark
| | - Dan Grabowski
- Department of Health Promotion Research, Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark
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Hill K, Hug S, Smith A, O’Sullivan P. The Role of Illness Perceptions in Dyspnoea-Related Fear in Chronic Obstructive Pulmonary Disease. J Clin Med 2023; 13:200. [PMID: 38202207 PMCID: PMC10780095 DOI: 10.3390/jcm13010200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/21/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
Dyspnoea is often the most distressing symptom described by people with a chronic respiratory condition. The traditional biomedical model of neuromechanical uncoupling that explains the physiological basis for dyspnoea is well accepted. However, in people with chronic obstructive pulmonary disease (COPD), measures that are linked with neuromechanical uncoupling are poorly related to the restriction in activity during daily life attributed to dyspnoea. This suggests that activity restriction that results from dyspnoea is influenced by factors other than expiratory airflow limitation and dynamic pulmonary hyperinflation, such as the ways people perceive, interpret and respond to this sensation. This review introduces the common-sense model as a framework to understand the way an individual's lay beliefs surrounding sensations can lead to these sensations being perceived as a health threat and how this impacts their emotional and behavioural responses. The aim is to provide insight into the nuances that can shape an individual's personal construct of dyspnoea and offer practical suggestions to challenge unhelpful beliefs and facilitate cognitive re-structuring as a pathway to reduce distress and optimise health behaviours and outcomes.
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Affiliation(s)
- Kylie Hill
- Curtin School of Allied Health, Curtin University, Perth, WA 6102, Australia; (S.H.); (A.S.); (P.O.)
| | - Sarah Hug
- Curtin School of Allied Health, Curtin University, Perth, WA 6102, Australia; (S.H.); (A.S.); (P.O.)
- Physiotherapy Department, Royal Perth Hospital, Victoria Square, Perth, WA 6000, Australia
| | - Anne Smith
- Curtin School of Allied Health, Curtin University, Perth, WA 6102, Australia; (S.H.); (A.S.); (P.O.)
| | - Peter O’Sullivan
- Curtin School of Allied Health, Curtin University, Perth, WA 6102, Australia; (S.H.); (A.S.); (P.O.)
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Van Huysse JL, Bilek EL. Common caregiver illness representations in the context of family-based treatment: Commentary on Marchetti and Sawrikar (2023). Int J Eat Disord 2023. [PMID: 38156597 DOI: 10.1002/eat.24123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023]
Abstract
In their systematic review on parent illness representations in their children with anorexia nervosa (AN), Marchetti and Sawrikar (International Journal of Eating Disorders, 2023) integrate past research on the parental experience of the illness, investigating whether the Common Sense Model of Self-Regulation (CSM) is a useful framework for understanding parental responses to AN. Given that family-based treatment (FBT) is a first-line treatment for adolescents with eating disorders and is based upon integrating parents into the treatment process, it is especially relevant to explore how parent illness representations may impact FBT. In this commentary, we describe how FBT is designed to support parents and address many of the common unhelpful beliefs and emotions associated with parenting an adolescent with AN. We include specific examples of how parents can be supported within FBT as manualized. We also examine parental representations that may not be addressed by FBT, and how these may impact treatment outcomes in FBT, possibly via the impact of expressed emotion. Future research is needed to determine if modifications to FBT are required to address parental representations of the illness. We end by expanding upon Marchetti and Sawrikar's suggestions on how treatment could be extended to better support parents as necessary.
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Affiliation(s)
| | - Emily L Bilek
- Department of Psychiatry, University of Michigan, Michigan, USA
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Koutra K, Mavroeides G, Basta M, Vgontzas AN. Family Functioning, Illness-Related Self-Regulation Processes, and Clinical Outcomes in Major Depression: A Prospective Study in Greece. Healthcare (Basel) 2023; 11:2938. [PMID: 37998430 PMCID: PMC10671578 DOI: 10.3390/healthcare11222938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/17/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023] Open
Abstract
Major depressive disorder (MDD) is a common, seriously impairing, and often recurrent mental disorder. Based on the predictions of the Circumplex Model of Marital and Family Systems and the Common-Sense Self-Regulation Model, the aim of the present prospective study is to examine the predictive value of clinical outcomes of a process model in which associations between perceived family functioning and patient's clinical outcomes (i.e., symptom severity and suicide risk) are mediated by illness representations and coping strategies. A total of 113 patients with a clinical diagnosis of MDD (16.8% males and 83.2% females) aged 47.25 ± 13.98 years and recruited from the outpatient department and the mobile mental health unit of the Psychiatric Clinic of the University Hospital of Heraklion in Crete, Greece, and from a Greek online depression peer-support group participated in the study. Family functioning was assessed in terms of cohesion and flexibility (Family Adaptability and Cohesion Evaluation Scales IV) at baseline. Illness representations (Illness Perception Questionnaire-Mental Health) and coping strategies (Brief Cope Orientation to Problems Experienced) were measured about five months later (5.04 ± 1.16 months). Symptom severity (Beck Depression Inventory) and suicidality (Risk Assessment Suicidality Scale) were measured about 10 months after the baseline assessment (9.56 ± 2.52 months). The results indicated that representations about MDD impact and symptom severity serially mediated the association between family cohesion and suicide risk in MDD. Furthermore, family cohesion was found to be linked with maladaptive coping through MDD impact representations. Family-based psychotherapeutic interventions specifically designed to target unhealthy family functioning, along with negative illness perceptions and dysfunctional coping, could be further developed and explored as adjunctive therapy to standard treatment in MDD.
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Affiliation(s)
- Katerina Koutra
- Department of Psychology, School of Social Sciences, University of Crete, 74100 Rethymnon, Crete, Greece;
| | - Georgios Mavroeides
- Department of Psychology, School of Social Sciences, University of Crete, 74100 Rethymnon, Crete, Greece;
| | - Maria Basta
- Department of Psychiatry & Behavioral Sciences, Faculty of Medicine, University of Crete, 71003 Heraklion, Crete, Greece;
| | - Alexandros N. Vgontzas
- Mobile Mental Health Unit, University Hospital of Heraklion, University of Crete, 71003 Heraklion, Crete, Greece;
- Sleep Research & Treatment Center, Department of Psychiatry & Behavioral Health, Penn State College of Medicine, Hershey, PA 17033, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Deninotti J, Le Vigouroux S, Gosling CJ, Charbonnier E. Influence of illness representations on coping strategies and psychosocial outcomes of infertility: Systematic review and meta-analysis. Br J Health Psychol 2023; 28:1132-1152. [PMID: 37386693 DOI: 10.1111/bjhp.12676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 06/02/2023] [Accepted: 06/09/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND This systematic review and meta-analysis was based on the Common Sense Model, applied to infertility. AIMS The aim was to examine the relationships between cognitive (i.e. cause, coherence, consequences, controllability, identity and timeline) or emotional representations of infertility and both coping (i.e. maladaptive and adaptive) and psychosocial outcomes (i.e. distress, anxiety, depressive symptoms, social isolation, low well-being and poor quality of life), reporting followed PRISMA guidelines. MATERIALS & METHODS Five databases (PubMed, PsycINFO, PsycARTICLES, PubPsych and CINAHL) were searched, and 807 articles were initially identified. RESULTS Seven cross-sectional studies (N = 1208 participants) were retained in qualitative and quantitative analyses. These studies assessed the associations of seven types of representations with either maladaptive or adaptive coping (20 effect sizes), or with psychosocial outcomes (131 effect sizes). A multivariate meta-analysis revealed that none (0/2) of the associations between the sole type of representation considered (i.e. controllability) and coping strategies were statistically significant, whereas three (3/7) of the associations between representations of infertility and psychosocial outcomes were statistically significant. Regardless of p-values, pooled estimates ranged from low (r = .03) to very high (r = .59). DISCUSSION Future studies should validate specific measurement tools for measuring cognitive and emotional representations of infertility. CONCLUSION Our results highlight the influence of representations of infertility (particularly cognitive representations of consequences and emotional representations) on the psychosocial outcomes of infertility.
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Affiliation(s)
| | | | - Corentin J Gosling
- DysCo Laboratory, Paris Nanterre University, Nanterre, France
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Boulogne-Billancourt, France
- Centre for Innovation in Mental Health (CIMH), School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Cherry MG, Brown SL, Purewal R, Fisher PL. Do metacognitive beliefs predict rumination and psychological distress independently of illness representations in adults with diabetes mellitus? A prospective mediation study. Br J Health Psychol 2023; 28:814-828. [PMID: 36859760 DOI: 10.1111/bjhp.12655] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 12/13/2022] [Accepted: 02/06/2023] [Indexed: 03/03/2023]
Abstract
OBJECTIVE Adults with Diabetes Mellitus (DM) experience high levels of depression and anxiety that are not always effectively ameliorated by current therapeutic approaches. The Self-Regulatory Executive Function (S-REF) model, which underpins metacognitive therapy (MCT), posits that depression and anxiety become persistent when stored metacognitive beliefs guide an individual to respond to common thoughts and feelings in a certain way. We hypothesized that (i) metacognitive beliefs would predict depression and anxiety independently of participants' representations of their illness; and (ii) rumination would mediate independent prediction of depression and anxiety by metacognitive beliefs. DESIGN A prospective mediation study. METHODS Four hundred and forty-one adults with DM (Types 1 and 2) completed a two time-point survey. Metacognitive beliefs, illness representations and rumination were measured at baseline, and depression and anxiety measured at baseline and 6-months later. Data were analysed using structural equation modelling. Baseline illness representations, depression and anxiety were used as control variables. RESULTS A structural equation analysis showed potential mediation, by baseline rumination, of any effects of baseline metacognitive variables on 6-month distress in Type 1 and 2 diabetes samples. Significant standardized coefficients for relationships between the metacognitive latent variable and rumination were .67 (Type 1) and .75 (Type 2) and between rumination and distress of .36 and .43, respectively. These effects were independent of direct and independent effects of illness representation variables. CONCLUSIONS Findings are consistent with metacognitive beliefs playing a key role in depression and anxiety by increasing the likelihood of rumination in adults with DM. MCT may be an effective intervention for this population, subsequent to further longitudinal testing of the S-REF model.
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Affiliation(s)
- Mary Gemma Cherry
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- Clinical Health Psychology Service, Linda McCartney Centre, Liverpool University NHS Foundation Trust, Liverpool, UK
| | - Stephen L Brown
- School of Psychology, University of New England, Armidale, NSW, Australia
| | - Rebecca Purewal
- Department of Clinical, Educational, and Health Psychology, University College London, London, UK
| | - Peter L Fisher
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- Clinical Health Psychology Service, Linda McCartney Centre, Liverpool University NHS Foundation Trust, Liverpool, UK
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Dias Neto D, Nunes da Silva A, Roberto MS, Lubenko J, Constantinou M, Nicolaou C, Lamnisos D, Papacostas S, Höfer S, Presti G, Squatrito V, Vasiliou VS, McHugh L, Monestès JL, Baban A, Alvarez-Galvez J, Paez-Blarrina M, Montesinos F, Valdivia-Salas S, Ori D, Lappalainen R, Kleszcz B, Gloster A, Karekla M, Kassianos AP. Corrigendum: Illness perceptions of COVID-19 in Europe: predictors, impacts and temporal evolution. Front Psychol 2023; 14:1227506. [PMID: 37384172 PMCID: PMC10299725 DOI: 10.3389/fpsyg.2023.1227506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 05/30/2023] [Indexed: 06/30/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyg.2021.640955.].
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Affiliation(s)
- David Dias Neto
- ISPA - Instituto Universitário, Lisboa, Portugal
- Applied Psychology Research Center Capabilities & Inclusion, Lisboa, Portugal
| | | | | | - Jelena Lubenko
- Psychological Laboratory, Faculty of Public Health and Social Welfare, Riga Stradiņš University, Riga, Latvia
| | - Marios Constantinou
- Department of Social Sciences (Cyprus), School of Humanities and Social Sciences, University of Cyprus, Nicosia, Cyprus
| | - Christiana Nicolaou
- Department of Nursing (Cyprus), Cyprus University of Technology, Limassol, Cyprus
| | - Demetris Lamnisos
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
| | - Savvas Papacostas
- The Cyprus Institute of Neurology and Genetics, The University of Nicosia Medical School, Nicosia, Cyprus
| | - Stefan Höfer
- Medical University Innsbruck, Innsbruck, Austria
| | - Giovambattista Presti
- Department of Human and Social Sciences, Kore University Behavioral Lab (KUBeLab), Kore University of Enna, Enna, Italy
| | - Valeria Squatrito
- Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy
| | | | - Louise McHugh
- School of Psychology (Ireland), University College Dublin, Dublin, Ireland
| | | | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cádiz, Spain
| | | | | | | | - Dorottya Ori
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | | | - Andrew Gloster
- Division of Clinical Psychology & Intervention Science, Department of Psychology, University of Basel, Basel, Switzerland
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Angelos P. Kassianos
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
- Department of Applied Health Research, University College London (UCL), London, United Kingdom
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Smith A, Lange LJ. Do labels matter? Implications of ongoing symptomatic chronic illnesses labeled as conventional diagnoses vs. functional somatic syndromes. Chronic Illn 2023:17423953231174926. [PMID: 37218120 DOI: 10.1177/17423953231174926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE A consideration of chronic illness according to illness labels that are medically understood as opposed to being outside of medical understanding may reveal unique differences in how individuals understand their illness and how such lay understandings relate to health-related quality of life. Study aims are framed according to the commonsense model of self-regulation with a focus on characterizing illness representations according to chronic illness diagnosis type. METHODS Individuals suffering from symptomatic chronic illnesses (n = 192) completed measures of illness representations, coping, and general health. Participants were categorized into one of two groups based on reported diagnosis/symptoms: (a) conventional diagnosis (CD) or (b) functional somatic syndrome (FSS). RESULTS FSS participants reported lower illness coherence and greater illness identity than CD participants. Overall, illness coherence predicted negative coping which mediated the relationship between illness coherence and general health. CONCLUSIONS Minimal differences were found in illness representations across FSS and CD groups with distinctions found only for illness coherence and identity. Illness coherence stands out as particularly important for coping and health-related quality of life for individuals with ongoing symptoms. Healthcare professionals should work carefully with chronically ill populations to address potential impacts of illness coherence, especially among FSS patients.
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Affiliation(s)
- Ashley Smith
- Department of Psychology, University of North Florida, Jacksonville, Florida, USA
| | - Lori J Lange
- Department of Psychology, University of North Florida, Jacksonville, Florida, USA
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13
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McCready JL, Deary V, Collins TL, Lendrem DW, Hackett KL. Coping strategies, illness perceptions, and relationship dynamics contribute to female sexual function and sexual distress in Sjögren's syndrome. J Sex Med 2023; 20:781-791. [PMID: 37019613 DOI: 10.1093/jsxmed/qdad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 02/23/2023] [Accepted: 03/06/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND Sexual dysfunction and sexual distress are common complaints for women with the autoimmune rheumatic disease Sjögren's syndrome (SS); however, the role of psychosocial and interpersonal factors has not previously been explored in SS. AIM This study investigated whether psychosocial variables, such as coping strategies, illness perceptions, and relationship dynamics, contributed to sexual function and sexual distress for women with SS. METHODS Participants with SS completed an online cross-sectional survey that included prevalidated questionnaires assessing sexual function, sexual distress, disease-related symptom experiences, cognitive coping strategies, illness perceptions, relationship satisfaction, and partners' behavioral responses. Multiple linear regression was used to identify factors significantly associated with sexual function (total Female Sexual Function Index [FSFI] score) and sexual distress (total Female Sexual Distress Scale score) for women with SS. OUTCOMES Study outcome measures were the FSFI, Female Sexual Distress Scale, EULAR Sjӧgren's Syndrome Patient Reported Index, numeric rating scale for vaginal dryness (0-10), Profile of Fatigue and Discomfort, Cognitive Emotion Regulation Questionnaire (CERQ), Brief Illness Perceptions Questionnaire (B-IPQ), West Haven-Yale Multidimensional Pain Inventory (WHYMPI), and Maudsley Marital Questionnaire. RESULTS A total of 98 cisgender women with SS participated in the study (mean age = 48.13 years, SD = 13.26). Vaginal dryness was reported by 92.9% of participants, and clinical levels of sexual dysfunction (total FSFI score <26.55) were observed in 85.2% (n = 69/81) of cases. More vaginal dryness, lower CERQ positive reappraisal, and higher CERQ catastrophizing were significantly associated with poorer self-rated sexual function (R2 = 0.420, F3,72 = 17.394, P < .001). Higher CERQ rumination, lower CERQ perspective, lower WHYMPI distracting responses, and higher B-IPQ identity were significantly associated with higher sexual distress (R2 = 0.631, F5,83 = 28.376, P < .001). CLINICAL IMPLICATIONS This study suggests that interpersonal and psychosocial factors are important contributors to sexual function and distress in women with SS and that the development of psychosocial interventions for this population is warranted. STRENGTHS AND LIMITATIONS This study is one of the first to explore the impacts of coping strategies, illness perceptions, and relationship dynamics on sexual function and sexual distress for women with SS. Limitations of our study include its cross-sectional nature and narrow sample demographic, which limit the generalizability of our results to other population groups. CONCLUSION Women with SS who utilized adaptive coping strategies had better sexual function and lower levels of sexual distress than women who utilized maladaptive coping strategies.
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Affiliation(s)
- Jemma L McCready
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE7 7XA, United Kingdom
| | - Vincent Deary
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, United Kingdom
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, United Kingdom
| | - Tracy L Collins
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE7 7XA, United Kingdom
| | - Dennis W Lendrem
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE1 7RU, United Kingdom
| | - Katie L Hackett
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE7 7XA, United Kingdom
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, United Kingdom
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14
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Almeida AC, Leandro ME, Pereira MG. Diabetes representations on adherence and quality of life: Do parents and adolescents differ? Psych J 2023; 12:108-118. [PMID: 36100433 DOI: 10.1002/pchj.591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 07/20/2022] [Indexed: 02/04/2023]
Abstract
Type 1 diabetes is one of the most frequent chronic diseases in adolescents. To manage diabetes and prevent complications, a set of self-care behaviors needs to be implemented into family daily routines. This study analyzed diabetes representations in adolescents and their parents, the dissimilarities between them, and the relationship between illness dissimilarities and adherence/quality of life (QoL) in adolescents with type 1 diabetes. The sample included 200 participants: 100 adolescents with type 1 diabetes and 100 parents who accompanied the adolescents. Adolescents were assessed on adherence (Self-Care Inventory-Revised), quality of life (Diabetes QoL) and family support (Diabetes Family Behavior Scale). Both adolescents and parents were assessed on illness representations (Brief-Illness Perception Questionnaire). Dissimilarities in illness representations between parents and adolescents were performed using Olsen et al's proposal. Parents showed a more negative representation of diabetes than adolescents. Adolescents' illness representations, the dissimilarities between adolescents' and parents' illness representations, and family support were associated with adolescents' adherence and QoL. Higher family support moderated the relationship between the dissimilarity in timeline representations and QoL, explaining 17.8% of the variance on QoL. Adolescent's gender (male) was a moderator in the relationship between adolescent's coherence and QoL, explaining 18.6% of the variance on QoL. Adolescent's gender (female) was a moderator in the relationship between timeline and QoL, explaining 11.9% of the variance on QoL. Being a male parent was a moderator in the relationship between adolescent's concerns and QoL, explaining 13.5% of the variance on QoL. Intervention programs should focus on illness representations, particularly on the dissimilarities between adolescents and parents, as well as on family support in order to promote adolescents' adherence and QoL.
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Affiliation(s)
- Ana C Almeida
- Psychology Research Center, School of Psychology, University of Minho, Braga, Portugal
| | - M Engrácia Leandro
- Centre for Research and Studies in Sociology, University Institute of Lisbon, Campus da Cidade Universitária de Lisboa, Lisbon, Portugal
| | - M Graça Pereira
- Psychology Research Center, School of Psychology, University of Minho, Braga, Portugal
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15
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Shih CY, Pai HC. Factors Affecting the Relationship Between Stress and Anxiety in Critically Ill Patients: A Partial Least Squares Structural Equation Modeling Approach. Clin Nurs Res 2023; 32:366-374. [PMID: 34866443 DOI: 10.1177/10547738211062346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This study aimed to examine the factors affecting the relationship between stress and anxiety in critically ill patients. A cross-sectional research paradigm was employed to enroll patients admitted to the medical intensive care unit (ICU) of a medical university hospital. Partial least squares structural equation modeling (PLS-SEM) was used to examine the data. A total of 90 ICU patients were included in this study; 56 were men and 34 were women. The patients' mean age was 65.3 years. Only the emotional responses dimension of illness was significantly positively correlated with stress. However, the emotional responses dimension of illness representation, acute physiology and chronic health evaluation system (APACHE) score, age, and education level were significantly positively correlated with anxiety. Nevertheless, treatment control was significantly negatively correlated with anxiety. Overall, illness representations (emotional responses and treatment control), APACHE score, age, and education were important predictors of anxiety, with an explanatory power of 37.9%. We recommend that for clinically relevant practice, besides focusing on ICU patients' illness representation, attention should also be paid to their individual characteristics, such as differences in age and education levels.
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Affiliation(s)
| | - Hsiang-Chu Pai
- Chung-Shan Medical University.,Chung-Shan Medical University Hospital
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16
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Luo S, She R, Lau MMC, Lau JTF. Would Illness Representations of COVID-19 and COVID-19 Fears During Clinic Visits Promote or Reduce Behavioral Intention to Seek Medical Consultations for Flu Symptoms? A Random Telephone Survey in Hong Kong, China. Front Public Health 2022; 10:903290. [PMID: 35757650 PMCID: PMC9226407 DOI: 10.3389/fpubh.2022.903290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/19/2022] [Indexed: 11/16/2022] Open
Abstract
Background The study investigated the level of behavioral intention to consult doctors for flu symptoms (BICDFS) during the Coronavirus Disease 2019 (COVID-19) pandemic and examined its associations with illness representations of COVID-19 and fear of COVID-19 during clinic visits in a general Chinese adult population. Methods A random telephone survey was conducted among 300 residents in Hong Kong, China in April 2020 when the second wave of COVID-19 was just ended in the region. The participants were asked about their intention to consult doctors if they had mild or severe flu symptoms in the next week (from 1 = definitely no to 5 = definitely yes). Illness representations of COVID-19 were measured by the Chinese version of the Brief Illness Perception Questionnaire (BIPQ). The fear of COVID-19 during clinic visits were assessed by two single items. Linear regression adjusted for background variables and hierarchical strategies were employed. Results Of the participants, 52.3 and 92.0% showed an intention to consult doctors for mild and severe flu symptoms, respectively. Adjusted for background factors, COVID-19-related cognitive representations (consequences: standardized b = 0.15, p = 0.010; understanding: standardized b = 0.21, p = 0.001) and emotional representations (concern: standardized b = 0.17, p = 0.001; negative emotions: standardized b = 0.19, p = 0.001) were positively associated with BICDFS. In the hierarchical model, independent significant factors of BICDFS included understanding (standardized b = 0.16, p = 0.013) and negative emotions (standardized b = 0.17, p = 0.008). The fear-related variables showed non-significant associations with the BICDFS. Conclusions Promotion of care-seeking behaviors for flu symptoms during the COVID-19 pandemic should consider improving people's understanding of COVID-19 and providing advice on related coping strategies for emotional responses to COVID-19.
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Affiliation(s)
- Sitong Luo
- Vanke School of Public Health, Tsinghua University, Beijing, China.,Institute for Healthy China, Tsinghua University, Beijing, China
| | - Rui She
- Centre for Health Behaviors Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Mason M C Lau
- Centre for Health Behaviors Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Joseph T F Lau
- Centre for Health Behaviors Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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17
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Cannon M, Crede M, Kimber JM, Brunkow A, Nelson R, McAndrew LM. The Common-Sense Model and Mental Illness Outcomes: A Meta-Analysis. Clin Psychol Psychother 2022; 29:1186-1202. [PMID: 35112427 DOI: 10.1002/cpp.2721] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 01/29/2022] [Accepted: 01/31/2022] [Indexed: 11/09/2022]
Abstract
Psychotherapists can improve their patients' outcomes during and after therapy by improving patients' self-management. Patients who do not effectively manage their mental illness generally have worse outcomes. Leventhal's Common-Sense Model of Self-Regulation theorizes that patients' perceptions of their illness (illness representations) guide their self-management, influencing health outcomes. The present study quantified the relations between illness representations, self-management, and outcomes for mental illnesses. We conducted a meta-analysis and included articles if they reported: 1) on adults with mental illnesses; and 2) the correlation between mental illness representations and mental illness outcomes. 25 articles were included which represented 28 independent samples. The pattern of correlations among illness representations (identity, consequences, timeline, control, coherence, and emotional representations), self-management strategies (attendance, engagement, and adherence to treatment) and mental illness outcomes (symptom severity and quality of life) was consistent with analyses from previous studies of mental and physical illnesses. The results found threat-related illness representations mostly had a large relationship with worse mental illness outcomes and self-management. Protective illness representations had a small-to-large relationship with better mental illness outcomes and self-management. The results suggest patients' perceptions of their mental illness may be a critical indicator of their mental illness outcomes, including symptom severity and quality of life. This theory-driven meta-analysis supports calls for the inclusion of illness representations in psychotherapy for mental illness.
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Affiliation(s)
- Margeaux Cannon
- University at Albany, State University of New York 1400, Washington, NY, USA
| | - Marcus Crede
- Iowa State University 901 Stange Rd. Ames, IA, USA
| | - Justin M Kimber
- University at Albany, State University of New York 1400, Washington, NY, USA
| | - Alexandria Brunkow
- University at Albany, State University of New York 1400, Washington, NY, USA
| | - Rebecca Nelson
- University at Albany, State University of New York 1400, Washington, NY, USA
| | - Lisa M McAndrew
- University at Albany, State University of New York 1400, Washington, NY, USA
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18
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Yang X, Wong KM, She R, Zhao C, Ding N, Xu H, Tu X, Lai X, Zhang G. Relationship Between Illness Representations and Symptoms of Internet Gaming Disorder Among Young People: Cross-Lagged Model. JMIR Serious Games 2021; 9:e28117. [PMID: 34851298 PMCID: PMC8672285 DOI: 10.2196/28117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/16/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The common-sense model of illness suggests that mental representations of health threats may affect one's behavioral reactions to them and health status. Internet gaming disorder is a newly defined mental disorder. Illness representations of internet gaming disorder may affect one's risk of internet gaming disorder. In turn, symptoms of internet gaming disorder may affect one's perceptions of the disorder. OBJECTIVE This study aimed to investigate the relationships between illness representations and symptoms of internet gaming disorder in college students. METHODS A 1-year longitudinal study was conducted with a convenience sample of Chinese college students (n=591; 342/591, 57.9% female). RESULTS Of the participants, 10.1% (60/591) and 9.1% (54/591) were classified as having probable internet gaming disorder at baseline (T1) and follow-up (T2), respectively. The correlations between some dimensions of illness representations regarding internet gaming disorder (ie, consequence, timeline, personal control, treatment control, and concern) at T1 and symptoms of internet gaming disorder at T2 and between symptoms of internet gaming disorder at T1 and the dimensions of illness representations at T2 (ie, consequence, timeline, personal control, and emotional response) were statistically significant. The cross-lagged model fit the data well ((χ2/df=2.28, comparative fit index=.95, root mean square error of approximation=.06) and showed that internet gaming disorder at T1 was positively associated with unfavorable illness representations at T2. CONCLUSIONS Individuals with more severe symptoms of internet gaming disorder had more pessimistic perceptions about the disorder. Such cognitive perceptions may affect one's emotional and behavioral reactions towards the disorder (eg, greater levels of depression and low self-control intention) and should be modified by educational programs and psychological interventions.
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Affiliation(s)
- Xue Yang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Kei Man Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Rui She
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Chengjia Zhao
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Nani Ding
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Huihui Xu
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Xiaolian Tu
- Renji College, Wenzhou Medical University, Wenzhou, China
| | - Xinyi Lai
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Guohua Zhang
- The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Wenzhou Medical University, Wenzhou, China
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19
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Foley L, Hynes L, Murphy AW, Molloy GJ. 'Just keep taking them, keep hoping they'll work': A qualitative study of adhering to medications for multimorbidity. Br J Health Psychol 2021; 27:691-715. [PMID: 34719079 DOI: 10.1111/bjhp.12568] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 08/26/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Compared to single diseases, health psychology reflects many areas of medical research by affording relatively less attention to the experiences of people self-managing multiple co-occurring conditions and, in particular, the experience of managing the associated complex medication regimens. This study aimed to explore the experience of self-managing multimorbidity among older adults, with a focus on medication adherence. DESIGN A qualitative approach was taken, using individual semi-structured interviews. METHODS Sixteen people with complex multimorbidity aged 65 years or older were recruited through general practice to take part in semi-structured interviews. Data were analysed following guidelines for reflexive thematic analysis. RESULTS Two themes were generated, with each theme comprising three subthemes. Theme one represents the amplified burden arising from multimorbidity that leads to unique challenges for self-management, such as integrating multiple medications into daily life, accumulating new symptoms and treatments, and managing evolving medication regimens. Theme two represents pathways towards relief that reduce this burden and promote medication adherence, such as prioritising certain conditions and treatments, resigning to the need for multiple medications, and identifying and utilising adherence supports. CONCLUSIONS We identified factors relevant to medication adherence for older adults with multimorbidity that go beyond single-disease influences and account for the amplified experience of chronic disease that multimorbidity can produce for some people. While evidence of single-disease influences remains fundamental to tailoring behavioural interventions to individuals, the impact of multimorbidity on medication adherence should be accounted for in research and practice.
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Affiliation(s)
- Louise Foley
- School of Psychology, National University of Ireland Galway, Ireland
| | - Lisa Hynes
- Croí Heart and Stroke Centre, Galway, Ireland
| | - Andrew W Murphy
- Discipline of General Practice, National University of Ireland Galway, Ireland.,HRB Primary Care Clinical Trials Network Ireland, National University of Ireland Galway, Ireland
| | - Gerard J Molloy
- School of Psychology, National University of Ireland Galway, Ireland
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20
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Gold-Watts A, Aamodt G, Gandhimathi S, Sudha R, Bastien S. Corrigendum: Understanding Adolescents' Perceptions of Diarrhea: A Formative Research Study of a Visual Scale to Measure Self-Reported Diarrhea in Low-Resource Settings. Front Public Health 2021; 9:780587. [PMID: 34692634 PMCID: PMC8531743 DOI: 10.3389/fpubh.2021.780587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fpubh.2021.561367.].
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Affiliation(s)
- Anise Gold-Watts
- Department of Public Health, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
| | - Geir Aamodt
- Department of Public Health, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
| | | | - Rajamani Sudha
- Department of Obstetrics and Gynecology Nursing, Sri Narayani College and School of Nursing, Vellore, India
| | - Sheri Bastien
- Department of Public Health, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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21
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Otto I, Hilger C, Magheli A, Stadler G, Kendel F. Illness representations, coping and anxiety among men with localized prostate cancer over an 18-months period: A parallel vs. level-contrast mediation approach. Psychooncology 2021; 31:227-237. [PMID: 34467601 DOI: 10.1002/pon.5798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Men diagnosed with localized prostate cancer (lPCa) are confronted with the decision for a treatment strategy, potentially experiencing treatment side effects and psychological distress. The Common Sense Model proposes that coping with such challenges is related to illness representations: Beliefs regarding consequences, coherence, timeline, and controllability of the illness. We analyzed the interplay of illness representations, coping and anxiety over an 18-month period among men with lPCa undergoing different treatment options (Active Surveillance, curative treatment). METHODS In this longitudinal study, 183 men (age M = 66.83) answered a questionnaire before starting treatment, and 6, 12, and 18 months later. We analyzed time trajectories with growth curve modeling and conducted mediation analyses to evaluate the influence of coping on the association of illness representations and anxiety. Using a novel methodological approach, we compared a classic parallel mediation model with a level-contrast approach for the correlated mediators problem- and emotion-focused coping. RESULTS Independent of treatment (b = 1.31, p = 0.200) men reported an elevated level of anxiety after diagnosis which declined considerably within the following 6 months (b = -1.87, p = 0.009). The perceived seriousness of consequences was significantly associated with greater anxiety, at baseline (β = 0.471) and over time (all β ≥ 0.204). This association was mediated by coping: Using more emotion-than problem-focused coping was associated with higher anxiety. CONCLUSIONS Receiving a lPCa diagnosis is associated with a phase of increased anxiety. In order to reduce anxiety, information provision should be accompanied by developing concrete action plans to enable problem-focused coping strategies.
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Affiliation(s)
- Isabella Otto
- Gender in Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Caren Hilger
- Gender in Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Ahmed Magheli
- Clinic for Urology, Vivantes Klinikum Am Urban, Berlin, Germany
| | - Gertraud Stadler
- Gender in Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Friederike Kendel
- Gender in Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
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22
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Vollmann M, Salewski C. To Get Vaccinated, or Not to Get Vaccinated, That Is the Question: Illness Representations about COVID-19 and Perceptions about COVID-19 Vaccination as Predictors of COVID-19 Vaccination Willingness among Young Adults in The Netherlands. Vaccines (Basel) 2021; 9:vaccines9090941. [PMID: 34579178 PMCID: PMC8473367 DOI: 10.3390/vaccines9090941] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 11/16/2022] Open
Abstract
Mass vaccination is considered necessary to reduce the spread of COVID-19; however, vaccination willingness was found to be especially low among young adults. Therefore, based on the extended Common Sense Model, the unique effects and the interplay of illness representations about COVID-19 and perceptions about COVID-19 vaccination in explaining COVID-19 vaccination willingness was investigated using a cross-sectional design. An online survey measuring the relevant variables was filled in by 584 participants (69.9% female) between 18 and 34 years. Correlation analyses showed that all illness representation dimensions except from timeline and both dimensions of vaccination perceptions were related to vaccination willingness. The mediation analysis revealed that less personal control, more prevention control, more concerns about COVID-19 as well as more perceived necessity of and fewer concerns about the vaccination were directly related to higher vaccination willingness. Additionally, prevention control was indirectly related to higher vaccination willingness through stronger perceptions of necessity of the vaccination. The extended Common Sense Model proved to be useful in the context of illness prevention. Campaigns to improve vaccination rates should aim at increasing the perception that COVID-19 is preventable through vaccination and the personal need of the vaccination as well as at decreasing concerns about the vaccination.
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Affiliation(s)
- Manja Vollmann
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 3000 DR Rotterdam, The Netherlands
- Correspondence:
| | - Christel Salewski
- Department of Health Psychology, Faculty of Psychology, University of Hagen, 58097 Hagen, Germany;
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23
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Gold-Watts A, Aamodt G, Gandhimathi S, Sudha R, Bastien S. Understanding Adolescents' Perceptions of Diarrhea: A Formative Research Study of a Visual Scale to Measure Self-Reported Diarrhea in Low-Resource Settings. Front Public Health 2021; 9:561367. [PMID: 34113594 PMCID: PMC8185169 DOI: 10.3389/fpubh.2021.561367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 04/19/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction: Although water, sanitation, and hygiene interventions are effective in reducing diarrhea, there are methodological issues regarding the research tools used to evaluate their health impact. Moreover, there is limited research on individuals' subjective interpretations of diarrheal illness which may introduce further limitations in relying on self-reported data. Therefore, we conducted a study that aims to understand adolescents' perceptions of diarrheal illness in rural Tamil Nadu, India. Next, we wish to explore the acceptability of the Bristol Stool Form Scale to assess self-reported diarrhea in water, sanitation, and hygiene interventions involving adolescent participants in low-resource settings. Materials and Methods: The study was conducted as part of the formative research phase in the cultural adaptation of Project SHINE, a school-based educational water, sanitation, and hygiene intervention in Thirumalaikodi, Tamil Nadu, India. A convergent parallel mixed-methods study design with a purposive sampling strategy was used. Qualitative data included 10 in-depth interviews with student participants aged 13–14. Quantitative data were collected through interviewer-administered face-to-face surveys (n = 14) and one-week stool diaries (n = 14). Each data set was analyzed separately and compiled during the interpretation of the findings. Results: Across all data sets, diarrhea was reported to be perceived as unhealthy and an irregular occurrence among participants. Participants also reported diarrheal-taboos, local methods to cure or control diarrhea, and discussed how diarrheal illness can lead to absenteeism or withdrawal from school and social activities. Moreover, participants were able to understand and answer questions about their stool using the Bristol Stool Form Scale, suggesting that is an acceptable tool. Discussion: Visual tools demonstrate promise in improving self-reported diarrheal illness among adolescents in low-resource settings in India. However, until we address diarrhea-related taboos it will be difficult to address methodological issues in the assessment and reporting of diarrheal illness among adolescents.
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Affiliation(s)
- Anise Gold-Watts
- Department of Public Health, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
| | - Geir Aamodt
- Department of Public Health, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
| | | | - Rajamani Sudha
- Department of Obstetrics and Gynecology Nursing, Sri Narayani College and School of Nursing, Vellore, India
| | - Sheri Bastien
- Department of Public Health, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Brand H, Speiser D, Besch L, Roseman J, Kendel F. Making Sense of a Health Threat: Illness Representations, Coping, and Psychological Distress among BRCA1/2 Mutation Carriers. Genes (Basel) 2021; 12:741. [PMID: 34069035 DOI: 10.3390/genes12050741] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 11/17/2022] Open
Abstract
Little is known about how women with a BRCA1/2 mutation develop an individual understanding of their breast and ovarian cancer risk and how this affects their psychological distress. In this study, we investigated associations between illness representations, coping strategies and psychological distress. N = 101 BRCA1/2 mutation carriers answered self-report questionnaires on illness representations, coping strategies, cancer worry and depressive symptoms. Women without cancer were compared to women with a previous cancer diagnosis. Illness representations explained 50% and 45% of the variability in cancer worry and depressive symptoms, respectively. Woman perceiving severe consequences (β = 0.29, p < 0.01) and having more concerns (β = 0.37, p < 0.01) were found to report more cancer worry. Perceiving information about the mutation as less coherent (β = −0.17, p < 0.05) and experiencing negative emotional responses (β = 0.60, p < 0.01) were both associated with more depressive symptoms. Women with a previous cancer diagnosis show patterns of illness representations that are potentially more distressing than women without a cancer diagnosis. Findings suggest that physicians involved in counseling should pay attention to illness representations of distressed women. Thereby, it would be possible to detect maladaptive thoughts associated with the mutation, address negative emotions and encourage adaptive coping strategies.
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Dias Neto D, Nunes da Silva A, Roberto MS, Lubenko J, Constantinou M, Nicolaou C, Lamnisos D, Papacostas S, Höfer S, Presti G, Squatrito V, Vasiliou VS, McHugh L, Monestès JL, Baban A, Alvarez-Galvez J, Paez-Blarrina M, Montesinos F, Valdivia-Salas S, Ori D, Lappalainen R, Kleszcz B, Gloster A, Karekla M, Kassianos AP. Illness Perceptions of COVID-19 in Europe: Predictors, Impacts and Temporal Evolution. Front Psychol 2021; 12:640955. [PMID: 33935893 PMCID: PMC8079952 DOI: 10.3389/fpsyg.2021.640955] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/12/2021] [Indexed: 12/23/2022] Open
Abstract
Objective: Illness perceptions (IP) are important predictors of emotional and behavioral responses in many diseases. The current study aims to investigate the COVID-19-related IP throughout Europe. The specific goals are to understand the temporal development, identify predictors (within demographics and contact with COVID-19) and examine the impacts of IP on perceived stress and preventive behaviors. Methods: This was a time-series-cross-section study of 7,032 participants from 16 European countries using multilevel modeling from April to June 2020. IP were measured with the Brief Illness Perception Questionnaire. Temporal patterns were observed considering the date of participation and the date recoded to account the epidemiological evolution of each country. The outcomes considered were perceived stress and COVID-19 preventive behaviors. Results: There were significant trends, over time, for several IP, suggesting a small decrease in negativity in the perception of COVID-19 in the community. Age, gender, and education level related to some, but not all, IP. Considering the self-regulation model, perceptions consistently predicted general stress and were less consistently related to preventive behaviors. Country showed no effect in the predictive model, suggesting that national differences may have little relevance for IP, in this context. Conclusion: The present study provides a comprehensive picture of COVID-19 IP in Europe in an early stage of the pandemic. The results shed light on the process of IP formation with implications for health-related outcomes and their evolution.
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Affiliation(s)
- David Dias Neto
- ISPA - Instituto Universitário, Lisboa, Portugal.,Applied Psychology Research Center Capabilities & Inclusion, Lisboa, Portugal
| | | | | | - Jelena Lubenko
- Psychological Laboratory, Faculty of Public Health and Social Welfare, Riga Stradiṇš University, Riga, Latvia
| | - Marios Constantinou
- Department of Social Sciences (Cyprus), School of Humanities and Social Sciences, University of Cyprus, Nicosia, Cyprus
| | - Christiana Nicolaou
- Department of Nursing (Cyprus), Cyprus University of Technology, Limassol, Cyprus
| | - Demetris Lamnisos
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
| | - Savvas Papacostas
- The Cyprus Institute of Neurology and Genetics, The University of Nicosia Medical School, Nicosia, Cyprus
| | - Stefan Höfer
- Medical University Innsbruck, Innsbruck, Austria
| | - Giovambattista Presti
- Department of Human and Social Sciences, Kore University Behavioral Lab (KUBeLab), Kore University of Enna, Enna, Italy
| | - Valeria Squatrito
- Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy
| | | | - Louise McHugh
- School of Psychology (Ireland), University College Dublin, Dublin, Ireland
| | | | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cádiz, Spain
| | | | | | | | - Dorottya Ori
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | | | - Andrew Gloster
- Division of Clinical Psychology & Intervention Science, Department of Psychology, University of Basel, Basel, Switzerland
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Angelos P Kassianos
- Department of Psychology, University of Cyprus, Nicosia, Cyprus.,Department of Applied Health Research, University College London (UCL), London, United Kingdom
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26
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Gregg JE, Simpson J, Nilforooshan R, Perez-Algorta G. What is the relationship between people with dementia and their caregiver's illness perceptions post-diagnosis and the impact on help-seeking behaviour? A systematic review. Dementia (London) 2021; 20:2597-2617. [PMID: 33787368 PMCID: PMC8704219 DOI: 10.1177/1471301221997291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: As the number of people with dementia increases, more families will be affected by the daily challenges of providing effective support, given its current incurable status. Once individuals are diagnosed with dementia, the earlier they access support, the more effective the outcome. However, once people receive a diagnosis, how they make sense of their dementia can impact on their help-seeking intentions. Exploring the illness beliefs of people with dementia and their caregivers and this relationship to help seeking may identify how best to facilitate early support.Aims: To systematically obtain and critically review relevant studies on the relationship between illness perceptions and help seeking of people with dementia and their caregivers.Method: A systematic search was conducted and included both quantitative and qualitative studies. The initial search was conducted in October 2018, with an adjacent search conducted in April 2020.Findings: A total of 14 articles met the inclusion criteria. Conceptually, the studies examined the association of illness perceptions and help-seeking post-diagnosis and revealed that people living with dementia and their caregivers sought help when symptoms became severe. Components of illness perceptions revealed that lack of knowledge, cultural beliefs, complexity of the healthcare system, threat to independence and acceptance were identified as major factors for delaying help seeking.Conclusion: Although research interest in the area of illness perceptions and their impact on help seeking for dementia is increasing, further work is needed to understand this area, particularly regarding the influence of the relationship between the person with dementia and their caregiver.
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Affiliation(s)
- Jane E Gregg
- Department of Health Research, 4396Lancaster University, Lanchester, UK
| | - Jane Simpson
- Department of Health Research, 4396Lancaster University, Lancaster, UK
| | - Ramin Nilforooshan
- Research & Development Department, 9490Surrey and Borders Partnership NHS Foundation Trust, Chertsey, UK
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27
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Vollmann M, Engelhardt G, Salewski C. Effects of a brief multimodal online intervention on the intention to conduct sun protective behaviours through targeting illness representations about skin cancer: a randomized controlled trial. Psychol Health 2020; 36:253-270. [PMID: 32524850 DOI: 10.1080/08870446.2020.1775831] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective: The incidence of skin cancer can be reduced by increasing sun protective behaviours. Based on the Common-Sense Model and the Intervention Mapping approach, a brief intervention targeting illness representations about skin cancer to increase the intention to conduct sun protective behaviours was developed and evaluated regarding its effectiveness.Design: A randomized pre-post control group design with 509 healthy participants (69% women, mean age 39 years).Main outcome measures: Changes in illness representations about skin cancer (emotional representations, illness coherence, and prevention control) and the intention to conduct sun protective behaviours, i.e. UV protection and sun avoidance.Results: ANCOVAs showed that the intervention increased illness coherence and perceived prevention control as well as the intention to conduct sun protective behaviours. Mediation analyses revealed that the increase in illness coherence and/or perceived prevention control partially mediated the effect of the intervention on the increase of the intention to use UV protection (indirect effects: .02*, .06*) and to avoid sun exposure (indirect effects: .01 ns, .04*).Conclusion: The intervention was successful in changing illness representations and thereby increasing the intention to conduct sun protective behaviours. The findings provide evidence for the usefulness of the Common-Sense Model in the context of illness prevention.
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Affiliation(s)
- Manja Vollmann
- Department of Socio-Medical Sciences, Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Gabriela Engelhardt
- Department of Health Psychology, Faculty of Psychology, University of Hagen, Hagen, Germany
| | - Christel Salewski
- Department of Health Psychology, Faculty of Psychology, University of Hagen, Hagen, Germany
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28
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Baertschi M, Favez N, Flores Alves Dos Santos J, Radomska M, Herrmann F, Burkhard PR, Canuto A, Weber K, Ghisletta P. Illness Representations and Coping Strategies in Patients Treated with Deep Brain Stimulation for Parkinson's Disease. J Clin Med 2020; 9:E1186. [PMID: 32326245 PMCID: PMC7230846 DOI: 10.3390/jcm9041186] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/16/2020] [Accepted: 04/16/2020] [Indexed: 12/26/2022] Open
Abstract
There is a debate on possible alterations of self-identity following deep brain stimulation for neurological disorders including Parkinson's disease. Among the psychological variables likely to undergo changes throughout such a medical procedure, illness representations and coping strategies have not been the target of much research to this day. In order to remedy this, we investigated the dynamics of illness representations and coping strategies in an 18-month longitudinal study involving 45 patients undergoing deep brain stimulation for idiopathic Parkinson's disease. Two research hypotheses were formulated and investigated through repeated measures of ANOVAs and structural equation modelling with full information maximum likelihood and Bayesian estimations. Representations of Parkinson's disease as a cyclical condition and perception of control over the disease diminished after surgery. Use of instrumental coping strategies was not modified after deep brain stimulation. These changes were identified by SEM but not ANOVAs; their magnitude was nevertheless relatively small, implying general stability in representations. These findings suggest that psychological variables do not undergo major changes after deep brain stimulation for Parkinson's disease.
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Affiliation(s)
- Marc Baertschi
- Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont-d’Arve 40, 1205 Geneva, Switzerland; (N.F.); (M.R.); (P.G.)
- Nant Foundation, Service of General Psychiatry and Psychotherapy, Avenue des Alpes 66, 1820 Montreux, Switzerland
| | - Nicolas Favez
- Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont-d’Arve 40, 1205 Geneva, Switzerland; (N.F.); (M.R.); (P.G.)
| | - João Flores Alves Dos Santos
- Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland;
| | - Michalina Radomska
- Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont-d’Arve 40, 1205 Geneva, Switzerland; (N.F.); (M.R.); (P.G.)
| | - François Herrmann
- Division of Geriatrics, Geneva University Hospitals, Chemin du Pont-Bochet 3, 1226 Thônex, Switzerland;
| | - Pierre R. Burkhard
- Service of Neurology, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland;
| | - Alessandra Canuto
- Faculty of Medicine, University of Geneva, Rue Michel Servet 1, 1206 Geneva, Switzerland; (A.C.); (K.W.)
| | - Kerstin Weber
- Faculty of Medicine, University of Geneva, Rue Michel Servet 1, 1206 Geneva, Switzerland; (A.C.); (K.W.)
| | - Paolo Ghisletta
- Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont-d’Arve 40, 1205 Geneva, Switzerland; (N.F.); (M.R.); (P.G.)
- Swiss Distance Learning University, Überlandstrasse 12, 3900 Brig, Switzerland
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, Universities of Lausanne and of Geneva, CH-1015 Lausanne, Switzerland
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Shinan-Altman S, Katzav KO. The relationship between illness representations, alexithymia, coping strategies and subjective well-being among persons with asthma. J Asthma 2020; 58:932-938. [PMID: 32156174 DOI: 10.1080/02770903.2020.1741610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND In order to examine subjective well-being (SWB) among persons with asthma, most of the existing studies have focused on disease-related variables or concentrated on illness representations, alexithymia and coping, making it difficult to determine whether the relationship between illness representations, alexithymia, coping and SWB is just an artifact of the disease's severity. OBJECTIVE Based on the Self-Regulation Model, this study aimed to examine the interrelationships between the disease's characteristics (annual mean of asthma attacks, preventive treatment), illness representations, alexithymia, coping strategies and SWB among persons with asthma. METHODS A convenience sample of 208 persons with asthma completed measures of the disease's characteristics (annual mean of asthma attacks, preventive treatment), illness representations (identity, causes, timeline, consequences, control, coherence, emotional representations), alexithymia, coping strategies, SWB, and socio-demographic questionnaires. A hierarchical multiple regression was calculated with SWB as the dependent variable. RESULTS The regression model was found significant (F(14, 133) = 6.42, p < 0.001), explaining 34% of the variance in SWB. Higher levels of alexithymia, identity, cause and emotional representations and lower levels of control were related to lower levels of SWB. The addition of coping strategies did not add to the explained variance of SWB. CONCLUSION This study contributes to a better understanding of the determinants of SWB among persons with asthma. The findings indicate that clinical interventions targeting persons with asthma illness representations and alexithymia may assist persons with asthma to improve their SWB.
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Affiliation(s)
- Shiri Shinan-Altman
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat-Gan, Israel
| | - Keren-Or Katzav
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat-Gan, Israel
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30
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Sødequist C, S Pedersen S, Banke ABS, Rottmann N. Living with the dilemma of the treatment for human epidermal growth factor receptor 2-positive breast cancer and the risk of incident heart disease: A qualitative investigation of patients' experiences. Eur J Cancer Care (Engl) 2020; 29:e13224. [PMID: 31951314 DOI: 10.1111/ecc.13224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 08/14/2019] [Accepted: 12/18/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Herceptin treatment improves survival and reduces the risk of recurrence in human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Yet, it increases women's risk of developing burdensome cardiovascular complications. This study examines how women experience living with HER2-positive breast cancer and the risk of incident heart disease. METHODS Danish women with breast cancer (n = 12; aged 32-75) participated in semi-structured interviews. Themes were deducted using interpretative phenomenological analysis (IPA). RESULTS Women described breast cancer as having strong associations with death, whereas heart disease to them meant decreased physical functioning or "something fixable." MUGA scans of the heart during the treatment course made them feel safe, and generally, they did not worry about risk of heart disease. Coping strategies included the following: focus on the good aspects of herceptin and acceptance of risk of heart disease as the price to pay to survive. The two most predominant coping strategies used were information and avoidance. CONCLUSION The women's focus on cancer as the primary disease seems partly to be the result of a complex coping process, by which they dealt with the dilemma of weighing risks, where the risk of dying from breast cancer was perceived as the biggest risk.
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Affiliation(s)
- Camilla Sødequist
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Susanne S Pedersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,Department of Cardiology, Odense University Hospital, Odense, Denmark
| | | | - Nina Rottmann
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,The Danish Knowledge Center for Rehabilitation and Palliative Care, REHPA, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Nyborg, Denmark.,Department of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
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31
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Schmidt‐Busby J, Wiles J, Exeter D, Kenealy T. Understandings of disease among Pacific peoples with diabetes and end-stage renal disease in New Zealand. Health Expect 2019; 22:1122-1131. [PMID: 31368649 PMCID: PMC6803558 DOI: 10.1111/hex.12946] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/12/2019] [Accepted: 07/16/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Compared with New Zealand Europeans, Pacific peoples in New Zealand develop type 2 diabetes at a higher rate and a younger age, and have 3.8 times higher incidence of end-stage renal disease (ESRD). OBJECTIVE To investigate contextual factors that shape understandings of disease for Pacific peoples with diabetes and ESRD. METHODS Focussed ethnography. In-depth interviews were conducted with 16 Pacific people on haemodialysis for diabetic ESRD, in Auckland, New Zealand. Study participants aged between 30 and 69 years old were of Samoan, Cook Islander, Tongan, Niuean or Tokelauan ethnicity. Thematic analysis was used to code and identify themes. RESULTS Participants were embedded in a multigenerational legacy of diabetes. The limited diabetes-related education of earlier generations influenced how future generations behaved and understood diabetes. Perceptions were compounded by additional factors including the invisibility of early-stage diabetes; misunderstandings of health risks during communication with health providers; and misunderstandings of multiple conditions' symptoms and management. Participants had limited engagement with health services until their diagnosis of ESRD acted as a trigger to change this behaviour. However, this trigger was not effective in itself-rather, it was in combination with relevant education delivered in a way that made sense to participants, given their current understandings. CONCLUSIONS Illness representations drive choices and behaviours with respect to self-management of diabetes and engagement with health services. Diabetes is often present in multiple generations of Pacific people; therefore, illness representations are developed and shared within a family. Changing illness representations requires engagement with the individual within a family context.
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Affiliation(s)
- Jacqueline Schmidt‐Busby
- Counties Manukau HealthMiddlemore HospitalAucklandNew Zealand
- Faculty of Medical and Health Sciences, School of Population HealthUniversity of AucklandAucklandNew Zealand
| | - Janine Wiles
- Faculty of Medical and Health Sciences, School of Population HealthUniversity of AucklandAucklandNew Zealand
| | - Daniel Exeter
- Faculty of Medical and Health Sciences, School of Population HealthUniversity of AucklandAucklandNew Zealand
| | - Timothy Kenealy
- Faculty of Medical and Health Sciences, School of MedicineUniversity of AucklandAucklandNew Zealand
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Galea Holmes MN, Weinman JA, Bearne LM. Are Walking Treatment Beliefs and Illness Perceptions Associated With Walking Intention and 6-Min Walk Distance in People With Intermittent Claudication? A Cross-Sectional Study. J Aging Phys Act 2019; 27:473-81. [PMID: 30507272 DOI: 10.1123/japa.2018-0245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Intermittent claudication is debilitating leg pain affecting older people with peripheral arterial disease, which is improved by regular walking. This study evaluated associations between psychosocial variables and 6-min walk distance (6MWD) to identify factors that motivate walking. A total of 142 individuals with intermittent claudication (116 males; Mage = 66.9 years [SD = 10.2]) completed cross-sectional assessments of sociodemographics, walking treatment beliefs and intention (Theory of Planned Behaviour), illness perceptions (Revised Illness Perceptions Questionnaire), and 6MWD. Multiple linear regression was used to evaluate relationships among psychosocial variables (treatment beliefs and illness perceptions) and outcomes (walking intention and 6MWD). Theory of planned behavior constructs were associated with intention (R = .72, p < .001) and 6MWD (R = .08, p < .001). Illness perceptions were associated with 6MWD only (R = .27, p < .001). Intention (β = 0.26), treatment control (β = -0.27), personal control (β = 0.32), coherence (β = 0.18), and risk factor attributions (β = 0.22; all ps < .05) were independently associated with 6MWD. Treatment beliefs and illness perceptions associated with intention and 6MWD in people with intermittent claudication are potential intervention targets.
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Haines C, Loades M, Davis C. Illness perceptions in adolescents with chronic fatigue syndrome and other physical health conditions: Application of the common sense model. Clin Child Psychol Psychiatry 2019; 24:546-563. [PMID: 30770020 PMCID: PMC7100035 DOI: 10.1177/1359104519829796] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The common sense model (CSM) proposes that illness perceptions guide coping and illness management, which subsequently affects outcomes. Chronic fatigue syndrome (CFS) is associated with severe functional impairment. CFS is distinct from other physical health conditions in that individuals can experience high levels of uncertainty, stigma and disbelief from others. This study aimed to compare illness perceptions in adolescents with CFS with other physical health conditions, using a cross-sectional, between-groups design. METHODS Adolescents (aged 11-18) with CFS (n = 49), type 1 diabetes (n = 52) and juvenile idiopathic arthritis (n = 42) were recruited through National Health Service (NHS) clinics and online, and completed a series of questionnaires. RESULTS Adolescents with CFS differed on the perceived consequences, timeline, personal control, treatment control, identity and understanding dimensions of illness perceptions. Except for identity, these dimensions were predicted by health condition even when accounting for age, gender, fatigue, physical functioning, anxiety and depression. CONCLUSIONS Results offer preliminary evidence for the applicability of the CSM in adolescents, with implications for supporting adolescents with physical health conditions. Results suggest that psychological interventions targeting perceived control, understanding and identity may have particular utility for adolescents with CFS.
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Affiliation(s)
- Cara Haines
- 1 Department of Psychology, University of Bath, UK
| | - Maria Loades
- 1 Department of Psychology, University of Bath, UK.,2 Bristol Medical School, University of Bristol, UK
| | - Cara Davis
- 1 Department of Psychology, University of Bath, UK
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Abstract
An expanded Common-Sense Model (CSM) contextualised to the self-regulation of cancer recurrence risk identifies risk representational attributes and recurrence worry as primary processes motivating protective behaviours in cancer survivors. A systematic review examined evidence for CSM hypotheses regarding how these processes influence diet and physical activity (PA) among survivors. A research agenda is outlined and used to evaluate the evidence base. Common databases were searched for eligible, peer-reviewed, English language reports, yielding 18 studies quantitatively testing hypothesised relationships among representations of prior cancer, recurrence risk representations, recurrence worry, and diet and PA. The findings provide promising, but mixed and limited evidence for some of the hypothesised associations of specific risk recurrence attributes with recurrence worry, and risk recurrence attributes and recurrence worry with diet and PA. Findings support the distinction of recurrence risk representations and illness representations of the prior cancer, with each showing different relationships with recurrence worry and behaviours. We discuss the status of the evidence base in relation to assessment, design, and analysis priorities and propose strategies that can yield more sensitive, rigorous tests of the CSM for cancer recurrence risk as applied to diet and PA.
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Affiliation(s)
- Arturo Durazo
- Psychological Sciences, School of Social Sciences, Humanities and Arts (SSHA), University of California, Merced, San Francisco, CA, USA
| | - Linda D Cameron
- Psychological Sciences, School of Social Sciences, Humanities and Arts (SSHA), University of California, Merced, San Francisco, CA, USA
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35
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Giebel CM, Worden A, Challis D, Jolley D, Bhui KS, Lambat A, Kampanellou E, Purandare N. Age, memory loss and perceptions of dementia in South Asian ethnic minorities. Aging Ment Health 2019; 23:173-182. [PMID: 29206481 DOI: 10.1080/13607863.2017.1408772] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND South Asian older adults are represented less frequently in mainstream mental health services or those for people with dementia. This study aimed to explore in detail the perceptions of dementia (symptoms, causes, consequences, treatments) held by South Asians and to discern how these understandings vary by age and by the self-recognition of memory problems, as these influence help-seeking behaviour. METHODS Participants were allocated to three groups: younger adults; older adults; and older adults with subjective memory problems. They completed the semi-structured Barts Explanatory Model Inventory for Dementia schedule, whilst older adults also completed measures of cognition (MMSE), and depression (GDS). Interviews were conducted in English, Gujarati or Urdu. RESULTS Groups were similar in identifying unusual forgetting and confusion as the most frequent symptoms; stress and age as the most frequent causes; and talking to your GP/nurse, taking medication, and talking to family and friends as the most frequent treatments. Younger adults more often knew about risk factors and reported practical consequences more than older adults. Older adults with subjective memory problems were more likely to describe sleep related problems or symptoms commonly associated with depression. They more often cited as causes of dementia lack of sleep, side effects of medication and medical reasons, and mentioned religion as a means to cope. CONCLUSIONS Findings highlight variability in perceptions of dementia across the South Asian Community and identify specific areas where dementia awareness could be raised in South Asian sub-groups to improve timely diagnosis, treatment outcomes and service access.
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Affiliation(s)
- Clarissa M Giebel
- a Division of Neuroscience and Experimental Psychology , The University of Manchester , Manchester , UK.,b Personal Social Services Research Unit , The University of Manchester , Manchester , UK
| | - Angela Worden
- b Personal Social Services Research Unit , The University of Manchester , Manchester , UK
| | - David Challis
- b Personal Social Services Research Unit , The University of Manchester , Manchester , UK
| | - David Jolley
- b Personal Social Services Research Unit , The University of Manchester , Manchester , UK
| | - Kamaldeep Singh Bhui
- c Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London , London , UK
| | | | - Eleni Kampanellou
- b Personal Social Services Research Unit , The University of Manchester , Manchester , UK
| | - Nitin Purandare
- a Division of Neuroscience and Experimental Psychology , The University of Manchester , Manchester , UK
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Abstract
As the number of persons with dementia grows, an increasing number of families, professionals, and laypersons will come into contact with persons with cognitive deterioration. Assessing dementia illness representations (IRs) among these groups may have great importance for understanding their responses to dementia. The purpose of this study was to summarize and critically review the literature on dementia IRs. A total of 25 articles that satisfied the inclusion criteria were identified. The review revealed that conceptually, research attention on dementia IRs has increased over the past several years as a result of changes in the notion of IRs and in the dementia discourse. Regardless of the population examined, dementia was mostly described as a chronic condition, presenting more cognitive than behavioral symptoms, and as being caused mainly by age, heredity, and abnormal brain changes. Methodologically, the area of dementia IRs is characterized by design, sample, and data collection weaknesses. Findings suggest that although the literature in the area of dementia and IRs is increasing, several conceptual and methodological limitations still have to be resolved in order to advance knowledge in the area. The research and clinical implications of these findings stress the importance of IRs in the area of dementia.
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Affiliation(s)
- Shiri Shinan-Altman
- The Louis and Gabi Weisfeld School of Social Work, Faculty of Social Sciences, Bar Ilan University, Ramat Gan, Israel,
| | - Perla Werner
- Department of Community Mental Health, University of Haifa, Haifa, Israel
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Dimova ED, Ward A, Swanson V, Evans JMM. Patients' Illness Perceptions of Type 2 Diabetes: A Scoping Review. Curr Diabetes Rev 2019; 15:15-30. [PMID: 29283073 DOI: 10.2174/1573399814666171227214845] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 12/14/2017] [Accepted: 12/14/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND People's personal perceptions, or illness representations, of type 2 diabetes can act as barriers to successful self-management. INTRODUCTION Understanding patients' subjective perceptions of type 2 diabetes can aid the design of evidence-based care and appropriate educational programmes. This scoping review provides a narrative account of previous knowledge of patients' illness representations of type 2 diabetes. METHODS Quantitative and qualitative studies that explored patients' illness representations of type 2 diabetes, as defined by Leventhal's Common Sense Model, were included. RESULTS Thirty four studies were identified for this review, but only 14 studies were carried out in a general population of people with diabetes. Illness representations varied across study populations. While it is clear that the perceptions of ethnic minorities and marginalised groups are embedded in their historical and cultural backgrounds, it is also important to understand the views of the wider population. CONCLUSION The review highlights the need for self-management interventions to reflect the target population's representations of type 2 diabetes in order to inform interventions and clinical practice.
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Affiliation(s)
- Elena D Dimova
- Faculty of Health Sciences and Sport, University of Stirling, FK9 4LA, Scotland, United Kingdom
| | - Ashleigh Ward
- Faculty of Health Sciences and Sport, University of Stirling, FK9 4LA, Scotland, United Kingdom
| | - Vivien Swanson
- Faculty of Natural Sciences, University of Stirling, FK9 4LA, Scotland, United Kingdom
| | - Josie M M Evans
- Faculty of Health Sciences and Sport, University of Stirling, FK9 4LA, Scotland, United Kingdom
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Karademas EC, Dimitraki G, Thomadakis C, Giannousi Z. The relation of spouse illness representations to patient representations and coping behavior: A study in couples dealing with a newly diagnosed cancer. J Psychosoc Oncol 2018; 37:145-159. [PMID: 30372380 DOI: 10.1080/07347332.2018.1508534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The central role of spouses/partners in patients' adaptation to cancer is well-established, but few studies have examined how partners facilitate adaptation. The Common Sense Model posits that a representation of illness as more controllable and less threatening promotes adaptive coping, but this has not been examined in a dyadic context. This cross-sectional study examined the relations of spouse illness representations of personal and treatment control, and emotional representations to recently diagnosed cancer patients' coping behaviors, through patient illness representations. One hundred forty-nine heterosexual couples (39.60% female patients; 77.18% dealing with early stage cancer) participated in the study. Structural Equation Modeling showed that spouse illness representations were related to patient coping directly and indirectly through patient illness representations. Both partners' representations of control were related to greater patient adaptive coping, and both partners' emotional representations were related to greater dysfunctional coping. These findings highlight the importance of partner illness representations in patients' adaptation to cancer. They also suggest that early intervention programs that address both partners' illness representations may enhance patients' adaptation to cancer.
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Affiliation(s)
| | - Georgia Dimitraki
- a Department of Psychology , University of Crete , Rethymno , Crete , Greece
| | | | - Zoe Giannousi
- b Bank of Cyprus Oncology Center , Limassol , Cyprus
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Pereira MG, Pedras S, Ferreira G. Self-reported adherence to foot care in type 2 diabetes patients: do illness representations and distress matter? Prim Health Care Res Dev 2018; 20:e40. [PMID: 30095065 DOI: 10.1017/S1463423618000531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Aim This study examined the differences and the predictive role of clinical variables, illness representations, anxiety, and depression symptoms, on self-reported foot care adherence, in patients recently diagnosed with type 2 diabetes mellitus (T2DM) and assessed no longer than a year after the diagnosis (T1) and four months later (T2). Background The high rate of diabetes worldwide is one of the major public health challenges. Foot care is the behavior least performed by patients although regular foot care could prevent complications such as diabetic foot and amputation. Psychosocial processes such as illness representations and distress symptoms may contribute to explain adherence to foot self-care behaviors. Methods This is a longitudinal study with two assessment moments. The sample included 271 patients, who answered the Revised Summary of Diabetes Self-Care Activities, Brief-Illness Perception Questionnaire, and Hospital Anxiety and Depression Scale. Findings Patients reported better foot care adherence at T2. Having a higher duration of T2DM and the perception of more consequences of diabetes were associated with better self-reported foot care adherence, at T1. At T2, the predictors were lower levels of HbA1c, better self-reported foot care adherence at T1, higher comprehension about T2DM, as well as fewer depressive symptoms. Interventions to promote adherence to foot care should have in consideration these variables. The results of the present study may help health professionals in designing interventions that early detect depressive symptoms and address illness beliefs, in order to promote foot self-care behaviors reducing the incidence of future complications.
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Sarkar NDP, Bardaji A, Peeters Grietens K, Bunders-Aelen J, Baingana F, Criel B. The Social Nature of Perceived Illness Representations of Perinatal Depression in Rural Uganda. Int J Environ Res Public Health 2018; 15:ijerph15061197. [PMID: 29880729 PMCID: PMC6025508 DOI: 10.3390/ijerph15061197] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 05/14/2018] [Accepted: 05/31/2018] [Indexed: 11/23/2022]
Abstract
While the global health community advocates for greater integration of mental health into maternal health agendas, a more robust understanding of perinatal mental health, and its role in providing integrated maternal health care and service delivery, is required. The present study uses the Illness Representation Model, a theoretical cognitive framework for understanding illness conceptualisations, to qualitatively explore multiple stakeholder perspectives on perinatal depression in rural Uganda. A total of 70 in-depth interviews and 9 focus group discussions were conducted with various local health system stakeholders, followed by an emergent thematic analysis using NVivo 11. Local communities perceived perinatal depression as being both the fault of women, and not. It was perceived as having socio-economic and cultural causal factors, in particular, as being partner-related. In these communities, perinatal depression was thought to be a common occurrence, and its negative consequences for women, infants and the community at large were recognised. Coping and help-seeking behaviours prescribed by the participants were also primarily socio-cultural in nature. Placing the dynamics and mechanisms of these local conceptualisations of perinatal depression alongside existing gaps in social and health care systems highlights both the need of, and the opportunities for, growth and prioritisation of integrated perinatal biomedical, mental, and social health programs in resource-constrained settings.
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Affiliation(s)
- Nandini D P Sarkar
- Health Systems and Equity Unit, Department of Public Health, Institute of Tropical Medicine at Antwerp, Nationalestraat 155, 2000 Antwerp, Belgium.
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Rosselló 132, 08036 Barcelona, Spain.
| | - Azucena Bardaji
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Rosselló 132, 08036 Barcelona, Spain.
| | - Koen Peeters Grietens
- Medical Anthropology Unit, Department of Public Health, Institute of Tropical Medicine at Antwerp, Nationalestraat 155, 2000 Antwerp, Belgium.
| | - Joske Bunders-Aelen
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.
| | - Florence Baingana
- School of Public Health, Makerere University, Kampala PO Box 7072, Uganda.
| | - Bart Criel
- Health Systems and Equity Unit, Department of Public Health, Institute of Tropical Medicine at Antwerp, Nationalestraat 155, 2000 Antwerp, Belgium.
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Quinn C, Morris RG, Clare L. Beliefs About Dementia: Development and Validation of the Representations and Adjustment to Dementia Index (RADIX). Am J Geriatr Psychiatry 2018; 26:680-9. [PMID: 29704986 DOI: 10.1016/j.jagp.2018.02.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 02/20/2018] [Accepted: 02/20/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The Self-Regulation Model (SRM) identifies that the beliefs people hold about an illness can influence their responses to that illness. Although there are generic measures of illness representations, there is a need for a brief tailored measure to use with people with dementia. The aim of this study was to develop and validate a brief measure called the Representations and Adjustment to Dementia Index (RADIX). The RADIX contains questions on the SRM elements: Identity, Cause, Timeline, Control, and Consequences. METHODS The RADIX validation was conducted with a sample of 385 community-dwelling people with mild to moderate dementia who were taking part in the IDEAL cohort study. Test-retest reliability was conducted over a 4-week period with a separate sample of 20 people with dementia. RESULTS The validation process resulted in a reduction in the number of items in the Timeline, Control, and Consequences items. The resulting RADIX demonstrated good acceptability, internal reliability, and test-retest reliability. All the RADIX items had low missing data, indicating good acceptability. The factor analysis confirmed that the Consequences items formed two subscales (practical and emotional consequences) that had Cronbach's α of 8 and 0.91 respectively. Test-retest reliability indicated that the Identity, Timeline, and Control items had moderate reliability and the practical and emotional consequences scales had good reliability. CONCLUSIONS The RADIX demonstrates acceptable psychometric properties, proves to be a useful measure for exploring people's beliefs about dementia, and could aid the provision of tailored information and support to people with dementia.
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Heid AR, Pruchno R, Wilson-Genderson M. Illness Representations of Multiple Chronic Conditions and Self-Management Behaviors in Older Adults: A Pilot Study. Int J Aging Hum Dev 2018; 87:90-106. [PMID: 29737195 DOI: 10.1177/0091415018771327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article explores the intraindividual variability in illness representations of people with multiple chronic conditions and examines how representations of hypertension and arthritis are associated with self-management. Intraclass correlations determined the proportion of within-person variability in illness representations including Timeline, Consequences, Personal Control, and Timeline-Cyclical for 25 adults aged 64 and older. Within-person consistency across illnesses was present for Timeline and Timeline-Cyclical, but variability across illnesses in Personal Control and Consequences. Correlations revealed associations of diet, exercise, and sleep with illness representations of people with arthritis and hypertension. Representations of hypertension (Personal Control, Timeline-Cyclical, and Consequences) were associated with adherence to a reduced fat diet, walking, and total sleep time. Representations of arthritis were not associated with health behaviors. Findings demonstrate that clinical practice must consider the illness representations patients have about each of their chronic illnesses to begin to sustain positive self-management behaviors.
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Affiliation(s)
- Allison R Heid
- 1 New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Rachel Pruchno
- 1 New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
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Abstract
Illness representations play a significant role on mental health across various health conditions. The present study explores the associations between illness representations of HIV and mental health (suicidal ideation and depression), and the mediation effects of emotional representations on the associations between cognitive representations and mental health among men who have sex with men who were newly diagnosed with HIV (ND-MSM) in China. A total of 225 ND-MSM were recruited from a non-governmental organisation and were invited to complete a cross-sectional survey. Results showed that 48.0% had suicidal ideation since HIV diagnosis and 48.4% scored higher than the cut-off for mild depression or above. Stepwise regression analyses showed that higher levels of emotional representations of HIV and lower levels of treatment control were associated with both suicidal ideation and depression. Emotional representations were shown to mediate the associations between some cognitive representations variables and mental health. Findings suggest that both cognitive and emotional representations of HIV were important factors of mental health among ND-MSM. Interventions to promote the mental health of ND-MSM are warranted and should seek to improve their cognitive and emotional representations of HIV.
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Affiliation(s)
- Phoenix Kit-Han Mo
- a Centre for Health Behaviors Research, School of Public Health and Primary Care, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, Hong Kong Special Administrative Region, China.,b The Chinese University of Hong Kong Shenzhen Research Institute , Shenzhen , People's Republic of China
| | - Joseph Tak-Fai Lau
- a Centre for Health Behaviors Research, School of Public Health and Primary Care, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, Hong Kong Special Administrative Region, China.,b The Chinese University of Hong Kong Shenzhen Research Institute , Shenzhen , People's Republic of China.,c Centre for Medical Anthropology and Behavioural Health, Sun Yat-sen University , Guangzhou , People's Republic of China
| | - Xiaobing Wu
- d Department of STD control , Shenzhen Centre for Chronic Disease Control , Shenzhen , People's Republic of China
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Shinan-Altman S, Werner P. Is there an association between help-seeking for early detection of Alzheimer's disease and illness representations of this disease among the lay public? Int J Geriatr Psychiatry 2017; 32:e100-e106. [PMID: 28111803 DOI: 10.1002/gps.4661] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 12/11/2016] [Accepted: 12/15/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Help-seeking (HS) for early detection of Alzheimer's disease (AD) is clearly essential because therapeutic interventions are recognized as being most efficient in the early stages of the disease. Using the Self-Regulation Model as its conceptual framework, the present study examined the relationship between HS for early detection of AD and lay persons' beliefs and emotional reactions towards AD. METHODS A convenience sample of 236 community-dwelling adults, aged 50 and above, completed HS measures related to early detection of AD, HS sources, cognitive and emotional representations, perceived threat, familiarity with AD, and socio-demographic questionnaires. RESULTS Participants expressed low HS levels for early detection of AD. However, participants expressed higher levels of HS willingness if checking for AD would be included in the routine medical examinations conducted by their GPs. Multiple regression analyses showed that AD consequences and perceived threat were the main predictors of HS for early detection of AD, explaining 9.2% of the variance. CONCLUSIONS Our findings stress the need to increase the lay public's knowledge about available treatment options and their efficacy, even in the advances stages of the disease when the consequences of the disease are much more severe. AD awareness programs should also pay attention to the potential fear which may exist in the case of HS for early detection of AD. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Shiri Shinan-Altman
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat-Gan, Israel
| | - Perla Werner
- Department of Community Mental Health, University of Haifa, Mount Carmel, Haifa, Israel
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Ghio D, Thomson W, Calam R, Ulph F, Baildam EM, Hyrich K, Cordingley L. The prioritization of symptom beliefs over illness beliefs: The development and validation of the Pain Perception Questionnaire for Young People. Br J Health Psychol 2017; 23:68-87. [PMID: 28990337 PMCID: PMC5765490 DOI: 10.1111/bjhp.12275] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 08/28/2017] [Indexed: 11/30/2022]
Abstract
Objectives To investigate the suitability of the revised Illness Perception Questionnaire (IPQ‐R) for use with adolescents with a long‐term pain condition and to validate a new questionnaire for use with this age group. Design A three‐phase mixed‐methods study. Methods Phase 1 comprised in‐depth qualitative analyses of audio‐recorded cognitive interviews with 20 adolescents with juvenile idiopathic arthritis who were answering IPQ‐R items. Transcripts were coded using framework analysis. A content analysis of their intended responses to individual items was also conducted. In Phase 2, a new questionnaire was developed and its linguistic and face validity were assessed with 18 adolescents without long‐term conditions. In Phase 3, the construct validity of the new questionnaire was assessed with 240 adolescents with juvenile idiopathic arthritis. A subset of 43 adolescents completed the questionnaire a second time to assess test–retest reliability. All participants were aged 11–16 years. Results Participants described both conceptual and response format difficulties when answering IPQ‐R items. In response, the Pain Perception Questionnaire for Young People (PPQ‐YP) was designed which incorporated significant modifications to both wording and response formats when compared with the IPQ‐R. A principal component analysis of the PPQ‐YP identified ten constructs in the new questionnaire. Emotional representations were separated into two constructs, responsive and anticipatory emotions. The PPQ‐YP showed high test–retest reliability. Conclusions Symptom beliefs appear to be more salient to adolescents with a long‐term pain condition than beliefs about the illness as a whole. A new questionnaire to assess pain beliefs of adolescents was designed. Further validation work may be needed to assess its suitability for use with other pain conditions. Statement of contribution What is already known on this subject? Versions of the adult Revised Illness Perception Questionnaire (IPQ‐R) have been adapted for adolescents and children by changing item wording; however, research to assess the degree to which the underlying IPQ‐R constructs are relevant to adolescents with a long‐term condition had not been performed.
What the present study adds? In adolescents, beliefs about symptoms of their condition are more salient than beliefs about the illness as a whole. Question response formats for children and young people need to take account of age‐specific abilities. A new questionnaire has been designed for adolescents with pain. It is theoretically congruent with the CS‐SRM.
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Affiliation(s)
- Daniela Ghio
- Division of Musculoskeletal and Dermatological Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Wendy Thomson
- Division of Musculoskeletal and Dermatological Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK.,NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, UK.,Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Rachel Calam
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Fiona Ulph
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK
| | | | - Kimme Hyrich
- Division of Musculoskeletal and Dermatological Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK.,NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, UK.,Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Lis Cordingley
- Division of Musculoskeletal and Dermatological Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK.,NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, UK
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McAndrew LM, Martin JL, Friedlander M, Shaffer K, Breland J, Slotkin S, Leventhal H. The Common Sense of Counseling Psychology: Introducing the Common-Sense Model of Self-Regulation. Couns Psychol Q 2017; 31:497-512. [PMID: 31274964 DOI: 10.1080/09515070.2017.1336076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The goal of therapy is typically to improve clients' self-management of their problems, not only during the course of therapy but also after therapy ends. Although it seems obvious that therapists are interested in improving client's self-management, the psychotherapy literature has little to say on the topic. This article introduces Leventhal's Common-Sense Model of Self-Regulation, a theoretical model of the self-management of health, and applies the model to the therapeutic process. The Common-Sense Model proposes that people develop illness representations of health threats and these illness representations guide self-management. The model has primarily been used to understand how people self-manage physical health problems, we propose it may also be useful to understand self-management of mental health problems. The Common-Sense Model's strengths-based perspective is a natural fit for the work of counseling psychologists. In particular, the model has important practical implications for addressing how clients understand mental health problems over the course of treatment and self-manage these problems during and after treatment.
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Affiliation(s)
- Lisa M McAndrew
- Department of Educational and Counseling Psychology, University at Albany War Related Illness and Injury Study Center, Department of Veterans Affairs New Jersey Healthcare System
| | - J L Martin
- Department of Educational and Counseling Psychology, University at Albany
| | - M Friedlander
- Department of Educational and Counseling Psychology, University at Albany
| | | | - J Breland
- Veterans Affairs Palo Alto Health Care System
| | - S Slotkin
- Department of Educational and Counseling Psychology, University at Albany
| | - H Leventhal
- Institute of Health, Health Care Policy and Aging Research, Rutgers University
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Junghans-Rutelonis AN, Tackett AP, Suorsa KI, Chaney JM, Mullins LL. Asthma-specific cognitions, self-focused attention, and fear of negative evaluation in adolescents and young adults diagnosed with childhood-onset asthma. PSYCHOL HEALTH MED 2017; 23:69-81. [PMID: 28524707 DOI: 10.1080/13548506.2017.1325507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The present study examined the impact of asthma-specific thought intrusion (TI) and thought suppression (TS) on two cognitive-affective variables (self-focused attention and fear of negative evaluation) among adolescents and young adults (AYAs) diagnosed with childhood-onset asthma. Participants were 290 AYAs who completed assessment questionnaires and participated in a written exercise electronically. Asthma-TI and TS were reported by participants following participation in a writing assignment. Asthma-TI was associated with increased private, public, and social anxiety self-focused attention, and greater fear of negative evaluation. Interestingly, asthma-TS was not associated with these same outcome variables. Findings suggest illness-specific cognitions are associated with cognitive-affective variables and it may be important to assess for illness-specific intrusive thoughts following asthma-focused medical appointments. Additionally, findings suggest the importance of assessing asthma-TI and TS separately in order to better understand thoughts about health and psychological functioning.
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Affiliation(s)
- Ashley N Junghans-Rutelonis
- a Department of Pain, Palliative Care and Integrative Medicine , Children's Hospitals and Clinics of Minnesota , Minneapolis , MN , USA.,b Department of Psychology , Oklahoma State University , Stillwater , OK , USA
| | - Alayna P Tackett
- b Department of Psychology , Oklahoma State University , Stillwater , OK , USA
| | - Kristina I Suorsa
- b Department of Psychology , Oklahoma State University , Stillwater , OK , USA
| | - John M Chaney
- b Department of Psychology , Oklahoma State University , Stillwater , OK , USA
| | - Larry L Mullins
- b Department of Psychology , Oklahoma State University , Stillwater , OK , USA
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Richardson EM, Scott JL, Schüz N, Sanderson K, Schüz B. 'It was all intertwined': Illness representations and self-management in patients with cancer and anxiety/depression. Psychol Health 2017; 32:1082-1108. [PMID: 28511605 DOI: 10.1080/08870446.2017.1324970] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Cancer and anxiety/depression frequently co-occur, leading to poorer outcomes for these illnesses. However, the majority of existing research investigates how participants view single illnesses alone. This study aimed to explore the content of individuals' multimorbid representations and how these relate to their coping behaviours and self-management strategies for cancer and anxiety/depression. DESIGN A semi-structured qualitative research design with theoretical thematic analysis. MAIN OUTCOME MEASURES Multimorbid illness representations, coping behaviours, and self-management strategies. RESULTS In interviews with 21 participants multimorbid representations varied, three participants viewed cancer and anxiety/depression as unrelated, five participants were uncertain about the relationship between cancer and anxiety/depression, and the majority of participants perceived cancer and anxiety/depression as related. This third group of participants often described relationships as causal, with representations having both positive and negative influences on coping behaviours and self-management strategies. Representations were shown to change over the course of the cancer experience, with fear of cancer recurrence and the influence of participants' most challenging illness also discussed. CONCLUSIONS People hold multimorbid illness representations that can influence self-management. An awareness of these representations by researchers, health professionals, and patients is important for the creation of future interventions that aim to improve and maintain patient wellbeing.
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Affiliation(s)
- Emma M Richardson
- a Division of Psychology, School of Medicine , University of Tasmania , Hobart , Australia
| | - Jennifer L Scott
- a Division of Psychology, School of Medicine , University of Tasmania , Hobart , Australia
| | - Natalie Schüz
- b School of Medicine , University of Tasmania , Hobart , Australia
| | - Kristy Sanderson
- c School of Health Sciences , University of East Anglia , Norwich , England
| | - Benjamin Schüz
- a Division of Psychology, School of Medicine , University of Tasmania , Hobart , Australia
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Abstract
In the last two decades, the life expectancy for individuals with Cystic Fibrosis (CF) has increased significantly. The limited research examining the psychosocial experiences of young adults with CF indicates that other young adults lack awareness and understanding of CF. Using the Illness Perception Questionnaire, perceptions of CF were examined in individuals with CF aged 16 to 25 and two groups of same-aged peers: those who did, or did not, know someone with CF. ANOVA with pairwise comparisons revealed that individuals with CF perceived significantly fewer physical symptoms of illness and fewer emotional and practical consequences of CF than both groups of peers. Individuals with CF also perceived significantly more personal control and greater understanding of CF than peers without experience of CF. Implications for enhancing opportunities for social engagement and for the provision of social support for young people with CF are identified.
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Affiliation(s)
- Kaya Beinke
- a Griffith University and Menzies Health Institute Queensland
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50
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Leone D, Borghi L, Lamiani G, Barlascini L, Bini T, d’Arminio Monforte A, Vegni E. Illness Representations of HIV Positive Patients Are Associated with Virologic Success. Front Psychol 2016; 7:1991. [PMID: 28066307 PMCID: PMC5179507 DOI: 10.3389/fpsyg.2016.01991] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 12/06/2016] [Indexed: 11/13/2022] Open
Abstract
Introduction: It is important for HIV positive patients to be engaged in their care and be adherent to treatment in order to reduce disease progression and mortality. Studies found that illness representations influence adherence through the mediating role of coping behaviors. However, no study has ever tested if patient engagement to the visits mediate the relationship between illness perceptions and adherence. This study aimed to explore illness representations of HIV positive patients and test the hypothesis that illness representations predict adherence through the mediating role of a component of behavioral engagement. Methods: HIV-positive patients treated with highly active antiretroviral therapy (HAART) for at least one year and presenting to a check-up visit were eligible to participate in the study. Patients completed the Illness Perception Questionnaire-Revised. Behavioral engagement was measured based on the patients' clinical attendance to the check-up visits; adherence to HAART was measured by viral load. Undetectable viral load or HIV-RNA < 40 copies/ml were considered indexes of virologic success. Results: A total of 161 patients participated in the study. Most of them coherently attributed the experienced symptoms to HIV/HAART; perceived their condition as chronic, stable, coherent, judged the therapy as effective, and attributed their disease to the HIV virus and to their behavior or bad luck. The majority of patients (80.1%) regularly attended check-up visits and 88.5% of them reached virologic success. The mediation model did not show good fit indexes. However, a significant direct effect of two independent variables on virologic success was found. Specifically, the perception that the disease does not have serious consequences on patient's life and the prevalence of negative emotions toward HIV were associated with virologic success. On the contrary, the patient's perception that the disease has serious consequences on his/her life and the prevalence of positive emotions were associated with virologic failure. This model showed good fit indexes (CFI = 1; TLI = 1; RMSEA = 0.00; and WRMSR = 0.309). Discussion: Results do not support the mediating role of behavioral engagement in the relationship between illness representations and adherence. As perception of serious consequences coupled with positive emotions are directly associated with virologic failure, clinicians should take them into account to promote treatment adherence.
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Affiliation(s)
- Daniela Leone
- Unit of Clinical Psychology, Department of Health Sciences, University of MilanMilan, Italy
| | - Lidia Borghi
- Unit of Clinical Psychology, Department of Health Sciences, University of MilanMilan, Italy
| | - Giulia Lamiani
- Department of Biomedical Sciences, Humanitas UniversityMilan, Italy
| | - Luca Barlascini
- Unit of Clinical Psychology, ASST Santi Paolo e Carlo, Presidio San Paolo University HospitalMilan, Italy
| | - Teresa Bini
- Clinic of Infectious Diseases, Department of Health Sciences, ASST Santi Paolo e Carlo, Presidio San Paolo University Hospital, University of MilanMilan, Italy
| | - Antonella d’Arminio Monforte
- Clinic of Infectious Diseases, Department of Health Sciences, ASST Santi Paolo e Carlo, Presidio San Paolo University Hospital, University of MilanMilan, Italy
| | - Elena Vegni
- Unit of Clinical Psychology, Department of Health Sciences, University of MilanMilan, Italy
- Unit of Clinical Psychology, ASST Santi Paolo e Carlo, Presidio San Paolo University HospitalMilan, Italy
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