Using the common-sense model of illness representations to explore individuals' experiences and perceptions of migraine and its management in the United Kingdom

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.

Promoting new users' online health consultation services usage behavior strategically

Online consultation services have the potential to reduce the workload of healthcare staff, provide timely care to patients, and improve doctor-patient relationships. The COVID-19 pandemic has accelerated the development of these services and platforms, but it remains to be seen whether the general public will continue to use them after the pandemic is under control. This research proposes a framework to examine the factors contributing to UK adults' continued usage of online healthcare consultation services after COVID-19 restrictions have been lifted. A total of 430 new users completed surveys, and the results indicate that expectation confirmation, system quality, and information quality can positively impact users' self-efficacy toward using online consultation services. This, in turn, can influence their continued usage behavior. Furthermore, the results suggest that participants' perception of health risks can moderate the relationship between self-efficacy and continued usage behavior. The strategic implications of these findings are discussed.

Exploring the Experience of Breathlessness with the Common-Sense Model of Self-Regulation (CSM)

Chronic breathlessness is a multidimensional, unpleasant symptom common to many health conditions. The Common-Sense Model of Self-Regulation (CSM) was developed to help understand how individuals make sense of their illness. This model has been underused in the study of breathlessness, especially in considering how information sources are integrated within an individual's cognitive and emotional representations of breathlessness. This descriptive qualitative study explored breathlessness beliefs, expectations, and language preferences of people experiencing chronic breathlessness using the CSM. Twenty-one community-dwelling individuals living with varying levels of breathlessness-related impairment were purposively recruited. Semi-structured interviews were conducted with questions reflecting components of the CSM. Interview transcripts were synthesized using deductive and inductive content analysis. Nineteen analytical categories emerged describing a range of cognitive and emotional breathlessness representations. Representations were developed through participants' personal experience and information from external sources including health professionals and the internet. Specific words and phrases about breathlessness with helpful or nonhelpful connotations were identified as contributors to breathlessness representations. The CSM aligns with current multidimensional models of breathlessness and provides health professionals with a robust theoretical framework for exploring breathlessness beliefs and expectations.

Workplace ostracism and organizational deviance: A self-regulatory perspective

Grounded in self-regulation theory, this research assesses the relationship between employees' experiences of workplace ostracism and organizational deviance, further exploring the mediating function of procrastination and the buffering role of psychological flexibility. Results based on longitudinal (three-wave) data collected from employees in North American organizations illustrate that workplace ostracism elicits organizational deviance because employees suffer from impaired self-regulation, shown through procrastination. Accordingly, this study identifies procrastination as a way by which workplace ostracism facilitates organizational deviance but highlights that the association between procrastination and deviant behavior is mitigated when employees can actively engage in psychological flexibility. Examining the interplay between these variables may present an opportunity to potentially understand how to curb adverse workplace outcomes by encouraging employees to adapt their behaviors in the pursuit of organizational goals, despite the distracting thoughts and emotions associated with the experience of workplace ostracism.

How Work-Nonwork Conflict Affects Remote Workers' General Health in China: A Self-Regulation Theory Perspective

Difficulty in balancing the demands of work and nonwork has been shown to be associated with lower physical and psychological health. Grounded on the self-regulation theory, we examined the effect of work-nonwork conflict on general health among employees who transitioned to remote work (remote workers), and we tested whether this association was mediated by impaired self-control capacity. The study further examined the perceived boundary control as a moderator of these associations. We collected two waves of questionnaire data with a one-month interval from 461 remote workers, and the results of regression-based analyses revealed that work-nonwork conflict was negatively related to remote workers' general health through increased self-control capacity impairment. In addition, this indirect effect was weaker for remote workers with higher perceived boundary control than those with lower perceived boundary control. These findings expand our understanding of remote workers' work-nonwork conflict and have practical implications for promoting the general health of remote workers who are experiencing work-nonwork conflict.

Widowhood and Life Satisfaction Among Chinese Elderly Adults: The Influences of Lifestyles and Number of Children

Our study examined how lifestyle and number of children influence the relationship between widowhood and life satisfaction based on self-regulation theory. A sample of 2,968 elderly respondents (male = 1,515, female = 1,453, mean age = 69.12 years, SD = 7.24) participated in Chinese General Social Survey. Our findings suggest that lifestyle is positively related to life satisfaction, and number of children is positively associated with life satisfaction but negatively related to lifestyle. The moderated mediation model demonstrated that lifestyle partly mediated the relationship between widowhood and life satisfaction. Moreover, number of children moderated the relationship between widowhood and lifestyle and between lifestyle and satisfaction with life. Widowed elderly individuals who have more children are likely to show a higher level of satisfaction with life. The present study has significance in practice because it provides empirical implications obtained from a national survey on the universal two-child policy in China as two children might decrease the negative impacts of widowhood on life satisfaction.

Is Work Time Control Good for Innovation? A Two-Stage Study to Verify the Mediating and Moderating Processes

As a part of job resources, work time control is essential for innovation. We examine how work time control impacts knowledge employees’ innovation in the workplace. A two-stage study was conducted to verify the mediating and moderating processes. In Study 1, adopting the job demands–resources model as a theoretical framework, we conducted a laboratory test to find the relation between work time control, job engagement, job burnout, and innovation, and verified the path between work time control and innovation. In Study 2, drawing on the job demands–resources model verified by Study 1 and self-regulation theory, it is proposed that during the psychological process in the workplace, job engagement plays a mediating role, and the vocational delay of gratification plays a moderating role between work time control and innovation. A total of 254 knowledge employees from diverse organizations participated in the survey study. After taking demographic variables, job demands, and neuroticism as control variables, the results showed that job engagement would mediate the relationship between work time control and innovation. A higher level of delay of gratification buffered the effect of a higher level of work time control on innovation. All these findings verified and expanded knowledge on work time control and innovation literature, showing that work time control is important for innovation. Based on Chinese cultural background, managers should offer employees the opportunity to conduct self-control training and encourage them with great freedom to foster employee innovation.

Inspired and Effective: The Role of the Ideal Self in Employee Engagement, Well-Being, and Positive Organizational Behaviors

This study explores the efficacy of a specific tool – the articulation of the ideal self – in job engagement, psychological well-being, and organizational citizenship behavior. We hypothesized that employees who can visualize their jobs as part of their ideal self – in particular how it helps in its development and realization – would feel higher levels of engagement and fulfillment in their lives, as well as engage in greater amounts of helping and voice OCB. A total of 239 full time employees from five companies in Costa Rica filled out the ideal self questionnaire, the job engagement, and psychological well-being surveys, and were evaluated by their peers on task behavior and helping and voice OCB. Results of the SEM model showed that the ideal self was positively related to job engagement, psychological well-being and helping and voice. These findings contribute to the research on the impact and importance for organizations to help employees find meaningfulness in their work.

Self-Regulation Failure? The Influence Mechanism of Leader Reward Omission on Employee Deviant Behavior

Contingent reinforcement behavior is generally regarded as one of the key elements of being a "good" leader, yet the question of what happens when this behavior is absent has received little attention in past empirical research. Drawing upon self-regulation theory, we develop and test a model that specifies the effects of leader reward omission on employes' deviant behavior. Using the data of 230 workers from two manufacturing companies located in South China collected across three time points, we find that leader reward omission is positively associated with deviant behavior. Moreover, the indirect effects of leader reward omission on employes' deviant behavior are mediated by moral disengagement. Our study also reveals that Machiavellianism can aggravate the positive effect of leader reward omission on moral disengagement, and subsequently exacerbate the indirect effect on employes' deviant behavior. Taken together, our findings reveal the consequences of leader reward omission, and the importance of examining subordinate self-regulation under the lack of positive reinforcement.

Does Paradoxical Leadership Facilitate Leaders' Task Performance? A Perspective of Self-Regulation Theory

As an emerging Chinese indigenous leadership style, paradoxical leadership has received considerable attention from researchers. Many studies have demonstrated the positive impact of paradoxical leadership on employees, teams, and organizations; however, there is less information on how paradoxical leaders influence their own work outcomes. On the basis of self-regulation theory, in this study, we examined the impact of paradoxical leadership on leaders’ task performance. In addition, we investigated the mediating effects of job crafting and career resilience on this relationship. Through a survey of 120 leaders and 271 of their immediate followers, our empirical analysis found the following: (1) paradoxical leadership was positively related to leaders’ task performance, (2) job crafting mediated the relationship between paradoxical leadership and leaders’ task performance, and (3) career resilience positively moderated the relationship between paradoxical leadership and job crafting, and had an indirect effect on task performance through job crafting. Our model offers novel insights into the paradoxical leadership literature and implications for improving leaders’ job crafting and task performance.

The Bright Side of Stressed Frontline Employees in Service Recovery: The Combination Causes of Organizational Empowerment and Self-Regulation Processes

Purpose

This study aims to extend the previous research on the structural relationships between organisational empowerment and frontline employees’ behaviours by exploring the role of the self-regulating processes and its impact on service recovery performance (SRP).

Methods

This study adopts fuzzy-set qualitative comparative analysis (fsQCA). Following the procedure of applying fsQCA, including data calibration, truth table construction and fsQCA analysis, the 287 dyadic data from the express mail industry was collected and analysed.

Results

The findings show that organisational empowerment is a sufficient antecedent for high SRP, especially in cases involving frontline employees with strong service recovery awareness and positive work engagement. Moreover, in the context of organisational empowerment, a reasonable level of emotional exhaustion represents a positive impact on performance in service recovery.

Conclusion

This study offers some comprehensive insights for practitioners to empower stressed frontline employees and monitor their emotions and behaviours using appropriate approaches.

The impact of an mHealth app on knowledge, skills and anxiety about dressing changes: A randomized controlled trial

AIMS

To evaluate the effectiveness of a mobile health (mHealth) application, based on self-regulation theory, on patients' knowledge of wound care, skills in changing dressings and anxiety.

DESIGN

A prospective randomized controlled trial.

METHODS

Seventy patients (or family members) at a 1,500-bed university hospital in Taiwan were randomized into an experimental (N = 35) or control group (N = 35) from March to December 2016. The experimental group used a mHealth application for wound care; the control group received verbal instructions and a booklet. Instruments to collect data were a wound care knowledge scale, wound care skills scale, State-Trait Anxiety Inventory, and a digital heart variability device. Data were collected at baseline, after three additional demonstrations and before discharge. The generalized estimating equation was used for statistical analysis.

RESULTS

The experimental group showed significantly higher levels of wound care knowledge, improved wound care skills, lower levels of state anxiety, and lower heart rate variability than the control group after baseline data collection.

CONCLUSIONS

Results support hat a mHealth application may be effective in health education. Clinicians can use the results to promote patients' wound care knowledge, enhance their wound care skills, and reduce anxiety related to dressing changes.

IMPACT

Lack of wound care knowledge and skills can affect the willingness and ability to perform effective wound dressing changes, producing anxiety and having an impact on a patient's self-care after hospital discharge. mHealth applications (apps) have the potential to deliver health information in targeted and tailored ways that strengthen the self-management of diseases. mHealth app can increase wound care knowledge, improve care skills, and reduce anxiety related to wound care. mHealth app effectively supports self-monitoring of the wound healing process, self-judgement of the wound condition, and self-reaction of wound care accuracy. mHealth app provides step-by-step visual tutorials on wound care that allow patients and family caregivers to take pictures of the wounds and monitor the wound healing process. mHealth app for wound care knowledge is an effective and individualized method for learning.

CLINICAL TRIAL

This study was registered by U.S. National Library of Medicine, ClinicalTrials.gov (ID: NCT03683303).

Nurse-Delivered Symptom Assessment for Individuals With Advanced Lung Cancer

OBJECTIVES

To assess an intervention derived from self-regulation theory (SRT) to promote well-being for individuals with advanced lung cancer.

SAMPLE & SETTING

45 adults with advanced lung cancer who were receiving chemotherapy at an ambulatory cancer center.

METHODS & VARIABLES

Participants were randomized to the intervention group or usual care control group. Feasibility assessment focused on recruitment, retention, design, methods, and fidelity. Outcome measures of quality of life, symptoms, and distress were collected at four time points. The main research variables were symptoms, quality of life, and distress.

RESULTS

The participation rate was 79%, and the retention rate was 62%. Participant loss was most often because of progressive disease and occurred early in the study. High fidelity was noted for delivery of the intervention as planned and outcome data collection by telephone. The mean number of interventions delivered was 5.5 of a planned 8. A high level of acceptability was reported for participants completing the intervention.

IMPLICATIONS FOR NURSING

Although delivering the SRT-derived intervention with fidelity was possible, feasibility findings do not warrant intervention replication in this population.

Can illness beliefs, from the common-sense model, prospectively predict adherence to self-management behaviours? A systematic review and meta-analysis

OBJECTIVE

To determine whether people's beliefs about their illness, conceptualised by the common sense model (CSM), can prospectively predict adherence to self-management behaviours (including, attendance, medication, diet and exercise) in adults with acute and chronic physical illnesses.

DESIGN AND MAIN OUTCOME MEASURES

Electronic databases were searched in September 2014, for papers specifying the use of the 'CSM' in relation to 'self-management', 'rehabilitation' and 'adherence' in the context of physical illness. Six hundred abstracts emerged. Data from 52 relevant studies were extracted. Twenty-one studies were meta-analysed, using correlation coefficients in random effects models. The remainder were descriptively synthesised.

RESULTS

The effect sizes for individual illness belief domains and adherence to self-management behaviours ranged from .04 to .13, indicating very weak, predictive relationships. Further analysis revealed that predictive relationships did not differ by the: type of self-management behaviour; acute or chronic illness; or duration of follow-up.

CONCLUSION

Individual illness belief domains, outlined by the CSM, did not predict adherence to self-management behaviours in adults with physical illnesses. Prospective relationships, controlling for past behaviour, also did not emerge. Other factors, including patients' treatment beliefs and inter-relationships between individual illness beliefs domains, may have influenced potential associations with adherence to self-management behaviours.

The Situational Version of the Brief COPE: Dimensionality and Relationships With Goal-Related Variables

This study is aimed at investigating the dimensionality of the situational version of the Brief COPE, a questionnaire that is frequently used to assess a broad range of coping responses to specific difficulties, by comparing five different factor models highlighted in previous studies. It also aimed at exploring the relationships among coping responses, personal goal commitment and progress. The study involved 606 adults (male = 289) ranging in age from 19 to 71. Using confirmatory factor analysis, we compared five models and assessed relationships of coping responses with goal commitment and progress. The results confirmed the theoretical factor structure of the situational Brief COPE. All the 14 dimensions showed acceptable reliability and relationships with goal commitment and progress, attesting the reliability and usefulness of this measure to evaluate coping responses to specific events.

Validation of the Croatian and Lebanese Revised Illness Perception Questionnaires for Healthy People (IPQ-RH)

The absence of Croatian- and Arabic-language measures to assess illness representations has contributed to lack of research among Croatian and Lebanese populations. Utilising the robust confirmatory factor analysis (CFA) approach, this study aimed to validate Croatian and Arabic versions of the Revised Illness Perception Questionnaire for Healthy People (IPQ-RH) in the breast and cervical cancer contexts, and compared these illness perceptions among Croatian and Lebanese women living in Australia. Forward and back-translated versions of the IPQ-RH were administered in Croatian to Croatian-born (n = 238), and Arabic to Lebanese-born (n = 240) women. The IPQ-RH illness perceptions were assessed for each cancer type, and the Negative Affect (NA) subscale of the Positive and Negative Affect Schedule (PANAS) assessed discriminant validity. The CFA method demonstrated acceptable models across the Croatian and Lebanese IPQ-RH measures. The internal reliabilities for the IPQ-RH subscales were adequate and the subscales had low correlations with the NA subscale of the PANAS, indicating that the IPQ-RH measures are largely distinguishable from negative affective dispositions. These findings demonstrate that the Croatian and Lebanese IPQ-RH breast and cervical cancer measures have a factor structure similar to the originally developed IPQ-RH scale and provide further support for the theoretically developed illness representations.

The Self-regulation Model of Illness applied to smoking behavior in lung cancer

Thirteen to 20% of lung cancer patients continue to smoke after diagnosis. Guided by Self-regulation Theory, the purpose of this study was to examine illness perceptions over time in a sample of lung cancer patients. This prospective 1-group descriptive longitudinal design study included participants 18 years or older, with a lung cancer diagnosis within the past 60 days who self-reported smoking within the past 7 days. At baseline, patients completed a sociodemographics and tobacco use history questionnaire. The Illness Perception Questionnaire-Revised (IPQ-R) was repeated at 3 time points (baseline, 2-4 weeks, and 6 months). Fifty-two participants provided data for the IPQ-R at baseline, 47 at 2 to 4 weeks, and 29 at 6 months. Differences between mean scores for each illness representation attribute of the IPQ-R at repeated time points were calculated by within-subjects repeated-measures analysis of variance and Wilcoxon Signed-Rank Tests. Identity (baseline vs 2-4 weeks: P = .026; baseline vs 6 months: P = .005) and acute/chronic timeline (P = .018) mean scores significantly increased over time; personal and treatment control mean scores significantly decreased over time (P = .007 and P = .047, respectively). Understanding the context in which a patient perceives disease and smoking behavior may contribute to developing interventions that influence behavior change.

Psychological consequences of myocardial infarction: a self-regulation perspective on health-related quality of life and cardiac rehabilitation

The aim of this review was to gain insight into prevalence of and interventions targeted specifically at psychological distress and health-related quality of life (HRQL) after a myocardial infarction (MI). For this purpose, self-regulation theory was introduced as frame of reference. Psychological distress and a reduction in HRQL after an MI are prevalent and can, for some patients, be persistent. This can negatively influence secondary prevention efforts, adherence, return to work and progression of the underlying coronary heart disease. At the same time, the effectiveness of cardiac rehabilitation programmes in improving HRQL is inconclusive. By starting off from a theoretical framework, effective strategies can be either identified or developed. Self-regulation theory is concerned with the process of goal setting and goal attainment and offers a model for explaining well-being and quality of life. The usefulness of this theory is supported by empirical evidence. Psychological factors derived from this theoretical framework (e.g. higher order goal disturbance) are associated with psychological distress and HRQL in the short and medium term after an MI and should thus be the target of cardiac rehabilitation programmes.