This study examined the heterogeneity of illness perceptions in patients with lung cancer and evaluated the mediating role of self-transcendence in the relation between illness perception and demoralization.

A convenience sample of 477 patients with lung cancer was selected from three tertiary hospitals in Wuhan, China, between January and June 2024. Participants completed the Brief Illness Perception Questionnaire, Self-Transcendence Scale, and Demoralization Scale. Data were analyzed using Mplus 8.3 and SPSS 25.0.

Three latent illness perception profiles were identified among patients with lung cancer: low (27.25%), moderate (40.04%), and high (32.71%). Mediation analyses revealed a partial mediation effect in the relation between illness perception and demoralization in the low versus moderate (SE ​= ​1.56, 95% CI ​= ​14.71, 20.86) and high versus low illness perception groups (SE ​= ​1.71, 95% CI ​= ​35.44, 42.71).

Patients with lung cancer exhibited heterogeneous illness perceptions, and self-transcendence partially mediated the relation between illness perception and demoralization. Promoting self-transcendence may help mitigate the negative impact of illness perceptions on demoralization. Clinical interventions aimed at reducing negative illness perceptions and enhancing self-transcendence should be prioritized in the care of patients with lung cancer.

Evaluate a knee/hip osteoarthritis eLearning course for patients.

Randomised controlled trial. 124 community volunteers with knee/hip osteoarthritis were randomised to either i) a 4-week self-directed eLearning or ii) an electronic osteoarthritis pamphlet (control).

change in knowledge (Osteoarthritis Knowledge Scale (OAKS)) and pain self-efficacy (Arthritis Self-Efficacy Scale (ASES pain subscale)) over 5 weeks.

fear of movement, exercise self-efficacy, osteoarthritis illness perceptions, physical activity levels, and use of physical activity/exercise, weight loss, pain medication, and health professional care seeking to manage joint symptoms.

117(94 %) participants (mean (SD) age, 67.1(8.8) years; 91(77.8 %) female) provided 5-week primary outcomes. At 5-weeks, eLearning group showed greater improvements in osteoarthritis knowledge (mean difference 5.3(95 % CI 2.5,8.2), < 0.001), which was sustained at 13-weeks (4.6(2.1,7.0), < 0.001). There were no between-group differences in pain self-efficacy. Between-group differences for exercise self-efficacy and osteoarthritis illness perceptions at 5-weeks, and fear of movement and use of weight loss to manage joint symptoms at 13-weeks, favoured eLearning group.

eLearning produced immediate and sustained improvements in osteoarthritis knowledge but not pain self-efficacy compared to a typical osteoarthritis education intervention (information pamphlet).

Self-directed interactive eLearning is an effective method to educate patients about hip/knee osteoarthritis and its management.

To use group-based trajectory modeling to identify patterns of medication adherence in patients with primary open-angle glaucoma (POAG) and to identify factors associated with each pattern.

Prospective cohort study.

Seventy-two patients with POAG who were enrolled in a National Institutes of Health-funded progression study at the University of Alabama at Birmingham were included in this study. Patients were required to be >18 years of age, have a diagnosis of POAG, and be prescribed hypotensive eye drops to treat their glaucoma.

Fifty-two weeks of mean weekly medication adherence data were collected using Medication Event Monitoring Systems. Group-based trajectory modeling was used to estimate models with 2, 3, 4, 5, and 6 medication adherence trajectory groups. Self-reported race and illness perception were included as covariates. The model with the lowest Bayesian information criterion (which provides a measure of the trade-off between model fit and model complexity) and the highest number of clinically relevant trajectory groups was deemed optimal.

Medication adherence trajectory groups.

The Bayesian information criterion was -1041.1 for the 2-group model, -755.9 for the 3-group model, -643.8 for the 4-group model, -590.4 for the 5-group model, and -559.0 for the 6-group model. We identified the 4-group model as the most optimal. The 4 trajectory groups estimated by this model were near-perfect adherence (51.8% of participants), good adherence (23.2% of participants), declining adherence (18.1% of participants), and poor adherence (6.9% of participants). Compared with the poor adherence group, a higher illness perception score predicted a lower probability of membership in the good (B = -0.276, P = 0.042) and declining (B = -0.303, P = 0.028) adherence groups.

Medication adherence is an important clinical outcome that is associated with disease severity and disease progression in POAG. Further investigation of this important topic may reveal other shared clinical characteristics that can be used to identify patients who may be at risk for adverse clinical outcomes such as glaucoma progression.

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Aortic dissection (AD) is a rare but dangerous cardiovascular condition, and research on the health-related quality of life (HRQOL) of postoperative patients after discharge is limited. This study aimed to classify patterns of HRQOL among this population, and to examine the psychological and social factors associated with different HRQOL categories based on the common sense model of self-regulation and the social-cognitive processing model.

A cross-sectional study was conducted in two tertiary general hospitals in Wuhan from January 2022 to August 2022. HRQOL was assessed via the validated Patient-Reported Outcomes Measurement Information System 29-item Profile. Characteristic categories of HRQOL were identified through exploratory latent profile analysis. Univariate analysis and multinominal logistic regression were employed to explore the factors associated with HRQOL.

Among the 379 patients, the mean health utility was 0.36 ± 0.17. A total of 35.4% and 32.5% of the patients had obvious anxiety and depression, respectively. The patients were divided into three HRQOL subgroups: "high psychological distress-pain group" (29.0%), "mild functional impairment-anxiety group" (49.3%), and "mild functional impairment-adaptation group" (21.6%). Significant factors associated with HRQOL included age, AD type, illness cognitive representation, fear of disease progression, daily life management and exercise (P < 0.05).

The self-reported health status of postoperative AD patients is concerning. HRQOL within this population displays significant heterogeneity, and stratified care tailored to each group is recommended. Interventions targeting cognitive representations and fear reduction may enhance HRQOL. Continuous care to facilitate self-management behaviors is essential for improving health outcomes for postoperative AD patients. These findings require further longitudinal and interventional studies to confirm.

To investigate the association of health literacy, illness perceptions, and beliefs about medications on medication-taking behavior among first- and second-generation Australians of Chinese heritage living with type 2 diabetes mellitus (T2DM).

A nationwide cross-sectional online survey of (N = 455) of whom 196 responded, was conducted among adults (≥18 years) with T2DM of Chinese heritage residing in Australia. Participants were recruited via direct invitation (national registry and specialist clinic). Data collection utilized four validated questionnaires: The Brief Medication Questionnaire, Beliefs about Medicines Questionnaire Specific (BMQ-Specific), Brief Illness Perception 9 Questionnaire (BIPQ), and a 12-item short-form health literacy (HL) questionnaire (HLS-SF12). Bivariate and multivariate analyses were conducted to explore the factors associated with medication-taking.

Overall, 27 % of participants reported missing diabetes medication(s) in the past week, with access barriers most cited (38 %), followed by belief (27 %) and recall (24 %) barriers. Median scores for health literacy, illness perception and beliefs about medications showed problems with health literacy (General Health Literacy Index, median [IQR] =31.94 [26.39ꟷ38.89], a moderate threat to illness perception (BIPQ:= 38.56 ± 10.52) and higher perceived necessity of taking diabetes medications relative to concern (BMQ-Specific Necessity: = 3.80 [3.20-4.20]; BMQ-Specific Concern: = 3.00 [2.50-3.67]). Better medication-taking was seen in people with high necessity beliefs and with low concerns in the use of medications. Health literacy and illness perceptions were not significantly associated with medication-taking behavior.

Medication beliefs play a role in sub-optimal medication-taking behavior among Chinese adults with T2DM. Increased attention needs to be placed on examining and enhancing understanding of diabetes medications while addressing concerns among individuals of Chinese backgrounds to better understand the complexities of medication-taking behavior. Culturally relevant clinical discussion and structured diabetes education may support the development of health promoting medication beliefs potentially supporting optimal medication-taking behavior.

To examine the psychometric properties of the Intentional Nonadherence Scale (INAS) among people with type 2 diabetes mellitus (PwT2D) in the United Kingdom.

This validation study recruited 260 PwT2D at diabetes intermediate care team clinics in London. Thirty of them participated in the test-retest reliability analysis in 2-4 weeks, while 124 were followed up in 3-6 months for the predictive validity analysis. The psychometric evaluation also comprised internal reliability, structural validity and construct validity that assessed the relationship between the INAS and other established measures, such as the Medication Adherence Report Scale-5 (MARS-5), Beliefs about Medicine Questionnaire (BMQ)-specific, Brief Illness Perception Questionnaire (BIPQ), Patient Health Questionnaire-2 (PHQ-2) and glycated haemoglobin (HbA1c).

Exploratory factor analysis revealed four factors, namely 'Resisting illness', 'Resisting medication', 'Testing treatment' and 'Sensitivity to medication'. All INAS factors demonstrated high internal reliability (Cronbach's alpha = 0.92-0.96). Their test-retest reliability varied between <0.001 and 0.92. Construct validity was demonstrated by its relationship with other measures, including its negative correlations with medication adherence and positive correlations with medication concerns. Significant correlations were also found with HbA1c, as well as with PwT2D's perceptions of diabetes consequences, treatment control, identity and emotional responses to diabetes. 'Testing Treatment' showed a trend towards statistical significance with adherence in 3-6 months (coefficient = -0.34, p = 0.09).

The INAS performed well on a number of psychometric properties in this study. It may be a helpful tool for clinicians in identifying specific drivers of intentional nonadherence among PwT2D.

Background/Objectives: Persistent breathlessness impacts people living with advanced chronic obstructive pulmonary disease (COPD) and carers. Accessible services are limited. This translational pilot study evaluated the feasibility, impacts on patient and carer-reported outcomes, and hospital use of a home-based breathlessness intervention service (BLIS). Methods: People with stable COPD, ≥1 COPD-related hospital admissions in the previous year, and persistent breathlessness participated in a pre-post study. The BLIS program involved home visits/phone contacts by a nurse/physiotherapist (average 8 contacts, 7 weeks). Uptake, retention, and fidelity were recorded prospectively, and participant experience was explored (post-program interviews). Breathing discomfort (Multidimensional Dyspnea Profile A1 scale), threat (Brief Illness Perception Questionnaire), and carer stress/strain (Zarit Burden Interview) were compared pre- and post-program (week 9, 3 and 6 months) using mean difference and 95% confidence intervals (CIs). Hospital use for COPD-related causes in 12 months before/after participation was reported. Results: A total of 16/19 eligible people agreed to participate, and 15/16 completed the program. In participants with COPD (73 [9] years, FEV1%pred 42% [15], mean [SD]; a median of 3 COPD-related hospital admissions in the previous year) and carers (n = 6), BLIS was highly (in 95%) acceptable. Compared to pre-program, breathing discomfort was reduced in week 9 and 6 months; breathlessness threat was reduced in week 9 and 3 months; and carer burden was reduced at 6 months. Compared to the 12 months prior, hospital admissions decreased in the 12 months post-program. Conclusions: Translation of this service to the local setting was feasible, with high program uptake and retention. Post-program improvements in key patient- and carer-reported outcomes and a reduction in public hospital admissions support the implementation of the BLIS program for this cohort in this setting.

Gout flares are the most important clinical feature of the disease. A hypothetical maximum flare occurrence in the preceding six months has been suggested to be no flares for a patient-acceptable symptom state (PASS) and only one flare for low disease activity (LDA). The aim of this analysis was to determine the relationship between gout flare states (PASS, LDA, and not in LDA or PASS [non-LDA/PASS]) and patient-reported outcomes.

Post hoc analyses of variance were undertaken using data from a 12-month randomized controlled trial involving 172 people with gout, which compared low-dose colchicine to placebo for the first 6 months while starting allopurinol with a further 6-month follow-up. Self-reported gout flares were collected monthly. Health Assessment Questionnaire (HAQ) and EuroQol 5-domain (EQ-5D-3L) were completed at 0, 3, 6 ,9, and 12 months, and the gout-specific brief illness perception questionnaire (BIPQ) was collected at months 0, 6, and 12.

In the final six months of the study, 68 participants (38%) were classified as being in PASS, 34 (19%) as in LDA, and 77 (43%) as non-LDA/PASS. There was no association between gout flare states and EQ-5D-3L or HAQ. There was a statistically significant association between three of eight BIPQ items with increasing consequences, identity, and concern scores across the three states of PASS, LDA, and non-LDA/PASS.

The majority of people were able to achieve gout flare PASS or LDA in the second six months after commencing allopurinol. As flare burden increases, so does the impact of gout on the patient. These findings highlight the importance of flare prevention in the management of gout.

This study employs a dyadic analysis approach to explore the relationship between illness perception and fear of progression among digestive system cancer patients and caregivers using the Actor-Partner Interdependence Model (APIM). We selected 242 pairs of digestive system cancer patients and their primary caregivers from two tertiary hospitals in Guangdong Province using convenient sampling method. Participants completed the Brief Illness Perception Questionnaire and Fear of Progression Questionnaire. Structural equation modelling based on the APIM framework was used to assess both actor effects (individuals' illness perception on their own fear of progression) and partner effects (individuals' illness perception on the other member's fear of progression). This study included a total of 242 sets of participants, with patients having an average age of 55.97 (SD = 14.19) years and caregivers having an average age of 49.40 (SD = 13.18) years. The study revealed that the paired patterns of illness perception and fear of progression among patients and caregivers were couple patterns. Specifically, in terms of actor effects, illness perception among digestive system cancer patients and their caregivers was able to influence their own fear of progression (β = 0.238, 0.163; 95% CI = 0.167-0.310, 0.094-0.233; both p < 0.001). Regarding the partner effects, the illness perception of digestive system cancer patients and their caregivers positively influenced each other's fear of progression (β = 0.238, 0.163; 95% CI = 0.167-0.310, 0.094-0.233; both p < 0.001). This study confirms the existence of the actor-partner relationships between illness perception and fear of progression among digestive system cancer patients and their caregivers. These interdependent effects highlight the importance of adopting dyad-centred interventions in psycho-oncology care, where clinicians should address both patients and caregivers as an emotionally connected unit rather than isolated individuals.

Negative illness perceptions (IPs) are associated with poorer disease outcomes in rheumatoid arthritis (RA). Unfortunately, IPs are generally stable in established RA. We hypothesized that IPs, especially in the cognitive domain, are modifiable in arthralgia at risk of RA. We aimed to study if receiving DMARD treatment, or the offer of DMARD treatment associates with more positive IPs in patients with clinically suspect arthralgia (CSA).

The population studied were CSA patients to which a wait-and-see approach was adopted without offering DMARD treatment, or patients were offered DMARD treatment via the TREAT EARLIER trial and subsequently randomized to receive methotrexate or placebo. IPs were assessed using the Brief Illness Perception Questionnaire (BIPQ), covering cognitive, emotional and comprehensibility domains. The effect of DMARD treatment on IPs over time was studied by comparing the 2-year course of BIPQs of patients receiving methotrexate or placebo. The effect of offering DMARD treatment was examined by comparing the BIPQs of CSA patients in the trial with those undergoing a wait-and-see policy.

In total, 375 CSA patients were studied, of which 236 of the TREAT EARLIER trial and 139 with a wait-and-see approach. Patients who received treatment showed sustained improvements in IPs over time compared with placebo in four cognitive domains: experience of physical complaints (P = 0.040), the illness's influence on life (P = 0.001), treatment effectiveness (P = 0.041) and disease duration (P = 0.045). Comparison at baseline showed that CSA patients to whom treatment was offered had more confidence in treatment (P < 0.001) and tended to have a deeper understanding of their disease (P = 0.054).

Both the prospect of and DMARD treatment itself improved IPs in CSA, mainly in cognitive domains. These data suggest CSA as a suitable time period for influencing IPs, which may provide possibilities to improve disease outcomes in patients developing RA.

Our study aimed to examine medication adherence (MA) to tadalafil 5 mg once daily (OaD) in patients undergoing treatment for erectile dysfunction (ED) and to identify factors contributing to potential drug noncompliance. This cross-sectional study included 233 patients diagnosed with ED. Sociodemographic and clinical data were recorded. MA was assessed using the Medication Adherence Report Scale (MARS). Additionally, the Brief Illness Perception Questionnaire (B-IPQ), the Beliefs about Medicines Questionnaire (BMQ), and the International Index of Erectile Function (IIEF) were employed to evaluate patients' perceptions and beliefs regarding their condition and treatment. The influence of these factors on MA was thoroughly analyzed. High MA was reported in 136 (58.4%) of 233 patients. Factors, such as education level, monthly income, frequency of medical examinations, smoking habits, and a history of radical pelvic surgery, were found to influence MA (p < 0.05) significantly. Multivariate analysis identified monthly income and radical pelvic surgery history as statistically significant predictors of adherence (p ≤ 0.05). Additionally, adherence was significantly associated with IIEF scores, five items on the B-IPQ, and the BMQ subscales, including specific concerns, necessity, and general harm (p < 0.05). Tadalafil OaD demonstrates acceptable rates of MA in the treatment of ED. Socioeconomic and clinical factors, patients' cognitive and sensory status, and perceptions regarding medications and healthcare providers significantly influence adherence. Physicians should exercise caution when prescribing tadalafil 5 mg OaD to patients with lower socioeconomic status, as they may be at higher risk for reduced MA.

Functional abdominal pain disorders (FAPDs) are prevalent in youth and affect daily life. Therapist-supported Internet-delivered cognitive-behavioral-therapy (ICBT) is promising, though the detailed trajectories of therapeutic effects unknown. This study aimed to analyze trajectories of effect and timing of changes in abdominal symptoms (primary outcome) and psychological factors (catastrophizing, avoidance and control behavior, pain acceptance (secondary outcomes)) in children and adolescents during 10 weeks of exposure-based ICBT for FAPDs in a randomized multiple-baseline single-case experimental design study in six children and six adolescents with FAPDs, referred from pediatric departments. Outcomes were assessed daily during baseline (A), treatment (B1: Main treatment components, B2: Training repeated exposures), and three-month follow-up (C). Effects were evaluated with visual analyses, Tau-U effect sizes for each individual, and multilevel modeling for group-level effects. All participants completed all treatment modules. Individually, treatment effectively reduced abdominal symptoms in half of the participants at three-month follow-up, following diverse trajectories with varying sequences of secondary outcome changes. At group-level, children demonstrated significant effects on estimated means of all outcomes at follow-up (P<0.05), while adolescents did on all outcomes (P<0.05) except one pain acceptance item (pain control). The group trajectories differed: children showed significant daily changes in abdominal symptoms during treatment B2, while adolescents exhibited significant slopes in most outcomes except one pain acceptance item (pain control) as early as during treatment B1. The findings support the effect of ICBT for FAPDs in youth, although with varying effect trajectories and differences in the timing of outcome changes across individuals and age-groups. PERSPECTIVES: This study provides evidence for the effect of ICBT in managing FAPDs in children and adolescents while uncovering individual and age-related differences in trajectories of changes in abdominal symptoms and psychological factors. Clinicians and researchers can use these findings to refine treatment protocols and explore mechanisms underlying these variations. CLINICAL TRIAL PREREGISTRATION: NCT05237882.

Health literacy and digital health literacy are crucial for spreading information that enhances self-management and health outcomes. IBD patients have called for relevant and reliable information to enable self-management. However, mapping conditional capacities for adapting IBD health information remains unaddressed. This study examines IBD patients' health literacy and digital health literacy covariance with clinical, demographic and patient-reported outcomes.

This cross-sectional study recruited patients between April 2023 to February 2024 from a Norwegian university hospital. Canonical correlations identified maximum covariance between health literacy and digital health literacy dimensions against clinical, demographic and patient-reported characteristics. Hierarchical clustering of covariance patterns were compared on external variables using bivariate analyses and logistic regression.

Of 432 consents, 380 (87.96%) IBD patients ≥ 18 years were included. Mean age was 43.6 (14.9) years, 173 (45.5%) had UC, 207 (54.5%) had CD, and 108 (53%) were male. Self-efficacy, illness perception, health status and age correlated with several health literacy and digital health literacy dimensions. Of two identified patient clusters, cluster 1 embodied patients with lowest levels of health literacy, digital health literacy, self-efficacy, health status, illness perception and longest disease duration. Cluster 1 demonstrated significantly lower medication adherence and QoL, higher rates of unemployment, elevated disease activity and fewer receiving biological treatment. Disease activity and biological treatment were the strongest predictors of cluster membership.

The findings emphasize the necessity of addressing clinical characteristics alongside health literacy and digital health literacy in the dissemination of IBD health information.

Alzheimer's disease and related dementias (ADRD) disproportionately impact Latinos in the US. Interventions that promote engagement in established protective behaviors throughout the life course may offer an opportunity to address disparities. To inform brain health promotion efforts, this study aimed to examine current brain health-related attitudes, awareness, and actions of middle-aged Latinos. A cross-sectional, online survey was completed by 200 Latinos 35-64 years old. Survey items assessed concern about ADRD, beliefs related to ways to support brain health, knowledge of protective behaviors, and actual engagement in protective behaviors. Multivariable analyses examined differences in knowledge, attitudinal, and behavioral outcomes by sociodemographic and psychosocial factors including health literacy and health activation. A third (36.0%) of participants were "very concerned" about ADRD. Nearly two thirds (61.0%) "strongly agreed" steps can be taken to reduce risk of ADRD. Less than a third (29.5%) were able to name three steps to support brain health, and 45.5% reported currently engaging in behaviors to support brain health. In multivariable analyses, participants with lower acculturation were more likely to be "very concerned" about ADRD and to "strongly agree" that steps can be taken to support brain health. Participants with low health activation were less likely to agree that steps can be taken. Those who were older and had a family member with ADRD were more likely to be able to name three steps that can be taken. Most middle-aged Latinos believed brain health is actionable, while concern for ADRD, awareness of ways to protect the brain, and engagement in science-based protective behaviors was variable. Opportunities exist for increasing education about well-established modifiable risk factors for ADRD, yet more research is needed to understand these factors in historically minoritized communities.

Community pharmacists, as primary healthcare practitioners, play a crucial role in supporting mental health consumers. They often serve as the first point of contact and see mental health consumers more frequently than other healthcare professionals. While their contributions to mental healthcare are increasingly recognized, insight is emerging about the factors that support pharmacists in providing mental healthcare. The aim of this study was to assess the applicability of a framework for pharmacists, pharmacy staff and consumers' empowerment in mental health.

This study used interview data from pharmacists and mental health consumers who had participated in the Australian PharMIbridge RCT. PharMIbridge pharmacists delivered a person-centred, goal-oriented medication support service to mental health consumers. The qualitative data investigating the experiences of pharmacists (n = 16) and consumers (n = 26) were categorized in relation to the existing framework and inconsistencies or differences discussed to identify new factors.

Study results supported many aspects of the published framework, with two new factors (prevalence of mental distress and looking beyond the mental illness) suggested for inclusion. Additionally, eight factors were expanded with further nuanced details and experiences from the data and are presented with supporting quotations.

This study adds further understanding of the factors that moderate the empowerment of pharmacists and consumers in mental healthcare within community pharmacy settings. The inclusion of consumer perspectives has enriched the framework, which can be further utilized by policymakers and community pharmacists to support targeted primary healthcare responses with mental health consumers.

Neurodevelopmental challenges are common among children and adolescents with congenital heart disease (CHD), affecting up to 50% of patients, and recent data suggests they are also present in adulthood. Longitudinal predictors of these challenges in adults have not been studied. The goal of this study was to assess well-being in adults with d-transposition of the great arteries (d-TGA) who had been enrolled in the Boston Circulatory Arrest Study (BCAS) where developmental follow-up was reported throughout childhood and adolescence with brain MRI imaging correlation in adolescence. Well-being was defined through neuropsychological, behavioral and mental health outcomes, quality of life, and social and educational attainment. Brain MRI metrics were also collected.

Study participants were age 26-33 years and recruited from the BCAS cohort (n= 171 in neonatal cohort, n=139 age 16 years). We assessed neuropsychological, psychiatric, and lifestyle outcomes, and brain MRI features. In this paper, we detail the BCAS-Adult protocols for the study assessments and data collected, approaches, and challenges encountered. Key analyses proposed from this study and its outcomes are outlined including comparisons to local controls or national norms and longitudinal outcome predictors.

The results from this study will elucidate neuropsychological performance, mental health status, and brain MRI patterns of the BCAS cohort in young adulthood, as well as the predictors and trajectory of these outcomes beginning in early infancy. Study results can inform screening and assessment, anticipatory guidance, and interventions to give children with CHD the best chance to maximize success in adulthood.

Patients undergoing tyrosine kinase inhibitor (TKI) therapy for chronic myeloid leukemia (CML) often face challenges with adherence, despite the efficacy of the treatment. Theory-guided and evidence-informed interventions addressing psychosocial and adherence barriers are critical for promoting adherence. Using a mixed-method approach, the pilot study developed and evaluated the feasibility and potential impact of an intervention "txt4TKI," to support medication and symptom management among CML patients undergoing TKI therapy.

Guided by the Necessity and Concerns framework, the study comprised two phases: Phase 1 involved qualitative patient needs assessment interviews informing intervention design. Phase 2 was a single-arm pilot study conducted for 6 months. The objectives of Phase 2 were to assess the feasibility and acceptability of the txt4 TKI intervention, examining enrollment and retention rates, intervention utilization, patient satisfaction, and changes in TKI medication adherence, psychosocial and symptom factors, from baseline to the 6-month follow-up. The intervention integrates a smart pill bottle activated with light, chimes to remind medication taking and three proactive text messages per week addressing clinical importance of TKI, symptom, lifestyle, and distress management as well as a biweekly toxicity assessment with tailored management feedback. Adherence was also objectively measured by the smart pill bottle and psychosocial survey was repeatedly assessed at 3- and 6-month.

The intervention, developed iteratively and theoretically through patient-centered inputs (n = 10) and evidence-based information during Phase 1, integrates knowledge on CML, TKI therapy, self-care symptom management, emotional support, and healthy lifestyle recommendations. In Phase 2, 20 out of 30 eligible patients (67% consent rate), with a mean age of 55.3, 60% females and 65% Non-White participants, were enrolled. Fifty-five percent have been taking their medication for 1-3 years and 50% were taking Dasatinib. A high satisfaction and engagement rate of 90% with an 85% retention rate were observed. While medication self-efficacy significantly improved from baseline to 6 months, the adherence rate to TKI was slightly decreased over time. Post-intervention interviews indicated that participants found the intervention user-friendly, providing valuable information and emotional support, but adjusting the timing and content of interventions to tailor to different stages of therapy might better support sustained adherence.

The txt4 TKI intervention using interactive text messaging and a smart pill bottle, feasible, and acceptable, demonstrated an increase in medication self-efficacy, an important aspect of medication adherence behaviors. Further research is needed to explore factors that influence the promotion and maintenance of adherence behaviors.

This study aimed to examine the association between health literacy and illness perception among Chinese patients with chronic disease in the community through a national cross-sectional study.

This cross-sectional study was conducted in China from June 20, 2022, to August 31, 2022, and used a multistage sampling approach to select patients with chronic diseases. The study included 5,525 participants from 15 provinces, drawn from the Psychology and Behavior Investigation of Chinese Residents in 2022. We constructed univariate analysis, smooth curve fitting, threshold saturation effect analysis, and forest plot of subgroup analysis to evaluate the association between health literacy and illness perception.

The analysis revealed an inverted J-shaped association between health literacy and illness perception (P < 0.001). Moreover, the identified inflection point was 22.22. When the health literacy score was below 22.22, illness perception exhibited a positive association with health literacy (β = 0.12, 95%CI = 0.03, 0.21, P = 0.009). When the health literacy score was higher than 22.22, illness perception decreased with the increasing health literacy (β=-0.23, 95%CI=-0.27, -0.19, P < 0.001). The significant association between health literacy and illness perception did not differ significantly across subgroups, except for the Hukou subgroup.

This study determined a threshold of health literacy that was associated with the illness perception of Chinese chronic disease patients. Additionally, an inverted J-shaped association between health literacy and illness perception was observed, suggesting that targeted health literacy intervention measures should be tailored to specific chronic disease groups rather than a uniform approach.

Not applicable.

Illness perceptions play an important role in outcomes for patients with advanced kidney failure receiving dialysis, though they are rarely examined over a sustained period and in distinct cultural settings. This observational cohort study used a prospective longitudinal design to examine how illness perceptions change overtime. It also considered whether these trajectories are related to patient experience of psychological and physical symptoms including those associated with dialysis, and depressive mood. Data were collected from 181 patients recruited from four dialysis centres in Northern Cyprus between 2020-2021. There were 124 patients receiving dialysis (91.1% haemodialysis) and 57 patients in the pre-dialysis phase at baseline. Self-reported measures including the Brief Illness Perception Questionnaire, Patient Health Questionnaire-9, and Dialysis Symptom Index, were completed at the start (time 1) of the study and then again at six months (Time 2) and at 12 months (Time 3) using versions validated in the local language (Turkish). Multilevel Models (MLM) for repeated measures were used to understand trajectories of illness perceptions over the 12-months of follow-up. On average, perceptions of consequences and emotional response to illness decreased over a one-year period. Depressive symptoms and dialysis symptom burden were found to be relatively stable over the same period. However, patients who reported higher perceptions of illness consequences and emotional response at baseline were more likely to report greater depressive symptoms at 12 months. Similarly, those already receiving dialysis who reported greater emotional response and lower levels of personal control at baseline were more likely to continue to report higher dialysis symptom burden at 12 months. The findings underscore the importance of illness perceptions as a framework to identify patients who may benefit from support, importantly offering an anchor for intervention design. Establishing cultural acceptability of such an approach will be an important next step.

Medical treatments for task-specific dystonia (TSD) often have limited long-term success, leading to interest in rehabilitative approaches. Our previous feasibility study supported the acceptability and short-term benefits of sensory-motor rehabilitation for a cohort of 12 individuals. Long-term outcomes remain unknown.

Investigate the long-term (7 year) follow-up of clinical outcomes and treatment effectiveness in participants with TSD who engaged in our previous feasibility study.

Follow-up study.

Online surveys and telephone interviews were undertaken at 1 and 7 years. A telephone interview was completed at 7 years.

All 12 participants (seven musicians dystonia, five writing dystonia) who had completed the original feasibility study took part. All showed improvements in clinical outcomes at one and 7 years (effect sizes 0.25-0.93). Interviews and surveys indicated continued use of effective rehabilitation strategies 7 years after completing the program.

Following treatment, people continue to use rehabilitative strategies, perceived by them as effective, with sustained benefits across varying domains for up to 7 years.

Benefits of sensory-motor rehabilitation can be sustained. The underlying mechanisms of these changes require investigation.

In the context of vulvodynia, a gynecological disorder characterized by chronic vulvar pain affecting an estimated 10% of women, with significant impacts on sexual health, mental well-being, and productivity, the Common-Sense Model of Illness Self-Regulation, a well-established framework for understanding the impact of illness perceptions and coping strategies on mental health, has not yet been empirically tested.

We aimed to explore whether illness perceptions and pain-specific coping strategies-namely, pain catastrophizing and chronic pain acceptance-influence the relationship between vulvar pain severity and depression in women with vulvodynia.

A cross-sectional study was conducted on a total of 119 women with reporting diagnosis of vulvodynia.

Through an online questionnaire, we assessed demographic and clinical characteristics, vulvar pain severity, illness beliefs, pain catastrophizing, pain acceptance, and depressive symptoms.

The path analysis showed that vulvar pain positively influences directly illness perceptions (β = .56, P < .001) and depressive symptoms (β = .24, P < .001). Negative perceptions of the illness were significantly associated with increased pain catastrophizing (β = .66, P < .001), and decreased pain acceptance (β = -.59, P < .001), resulting in heightened depressive symptoms (β = .33, P < .001, β = -.27, P < .001, respectively).

Interventions that challenge negative illness perceptions and promote more positive views could reduce maladaptive coping strategies, enhance pain acceptance, and ultimately diminish psychological distress.

This study's strengths lie in its foundation on a theoretical, well-established model and the use of validated measures. However, the cross-sectional design precludes concluding causality between predictor and outcome variables, and the clinical information was self-reported and could not be verified with medical records.

The findings underscore the importance of targeting illness perceptions and coping strategies in shaping psychological outcomes for women with vulvodynia.

Inflammatory bowel disease (IBD) causes fatigue, pain, and fecal urgency/incontinence symptoms. Identifying symptom profile subgroups and related psychological correlates might enable earlier intervention and more effective tailored treatment pathways.

This study was nested within a randomized controlled trial of a digital symptom intervention for people with IBD (n = 780). Latent profile analysis was conducted on pre-randomization baseline measures of fatigue, pain, and fecal incontinence. Multinominal logistic regression examined associations between profile membership and clinical, demographic and psychological factors.

Latent profile analysis determined a three-profile model: Moderate (50%), High (40%), and Severe symptoms (10%). Diagnosis and fecal calprotectin were not associated with profile membership, but female gender, comorbidity, time since diagnosis, and irritable bowel syndrome (IBS)-type symptoms were associated with High and Severe symptoms profiles. Depression, anxiety, negative symptom perceptions, all-or-nothing and avoidance behaviors significantly increased the relative risk of High and Severe symptoms profile membership.

Many participants experienced symptoms even when deemed to be in clinical remission. After controlling for clinical, inflammatory, and demographic factors, the relative risk of High or Severe symptom profile membership was associated with potentially modifiable cognitive behavioral factors. These factors were also associated with IBS-type symptoms. Recognizing the potential impact of cognitive behavioral factors in exacerbating symptoms can lead to earlier identification of patients who require support and allows treatment plans to be tailored more precisely. The findings from this study promote a more integrated approach to IBD management, combining medical treatment with cognitive behavioral interventions to enhance patient care and improve outcomes.

There has been limited exploration into the nature and development of psychotic experiences (PEs) in Parkinson's disease (PD). We aimed to comprehensively assess the frequency, severity, and associated distress of paranoia and unusual sensory experiences (USEs) in PD, and to assess what variables are significantly associated with these experiences, focussing on psychological processes central to understanding PEs in non-PD groups.

A questionnaire battery was completed by 369 individuals with PD with a mean age of 66 years and mean time since diagnosis of 5 years. Recruitment was via Parkinson's UK, social media, and local community groups. For a subset of measures, comparisons were made to age-matched controls using pre-existing data.

182 (49%) participants reported USEs, including almost half of those not taking dopaminergic medication. For 83 (23%), the experience was distressing. Paranoia across the sample was significantly lower than in age-matched controls. However, specific paranoid concerns around abandonment (16%) and spousal betrayal (10%) were reported by some. Depression, anxiety, loneliness, and stigma and desire for support with PEs were high across the sample. Almost all psychological variables were significantly associated with PEs in structural equation models.

PEs in PD are common, even in those not taking dopaminergic medication. For a small subset, these experiences are distressing and not resolved by existing treatment. Cognitive-affective variables like depression and anxiety could play a maintaining role in PEs in PD thus providing easy avenues for trialling intervention.

This systematic review addressed the following topics: (1) psychometric measures used to evaluate the identity/self in MS patients; (2) impact of MS on the identity/self of patients; (3) relationships between the identity/self and the adjustment to MS.

Five electronic databases were searched for all peer-reviewed empirical studies published up to April 2024 (PROSPERO CRD42023485972). Studies were eligible if they included MS patients and examined identity/self through quantitative, qualitative, or mixed-method study design. MMAT (Mixed Method Appraisal Tool) checklist was used to assess the quality of included studies. After conducting narrative synthesis (quantitative studies) and thematic synthesis (qualitative studies), an integration was undertaken following a convergent segregated approach.

Forty-three studies were included (13 quantitative, 26 qualitative, and four mixed methods). Studies used measures of "self" to refer to specific domains, and of "identity" to highlight the individual's uniqueness and continuity of experience over time. MS causes a loss of various aspects of self (physical, working, family, and social self) and identity discontinuity. Maintaining a positive self-concept and integrating MS into one's identity are associated with better adjustment to MS.

Clinicians should consider the centrality of identity redefinition for the promotion of MS patients' adjustment to the illness.

Cardioembolic stroke is the most common cause of ischemic stroke, and patients frequently have motor dysfunction as well as psychological disorders. Both physical and psychological causes can have an impact on a patient's motor function.

In this study, we used the fear-avoidance model to examine the impact of patients' illness perception and kinesiophobia (excessive fear of exercise) on their motor function.

Between June 2021 and February 2022, we conducted a cross-sectional study of 319 participants diagnosed with cardioembolic stroke in the selected hospitals. Correlation analyses and mediation effects tests were used to analyze the relationship between patients' illness perception, kinesiophobia, and motor function.

The total motor function score of the patients was (21.39 ± 29.30), the total kinesiophobia score was (48.51 ± 8.33), and the total illness perception score was (53.37 ± 16.82). There was a negative correlation between illness perception and motor function (r = -0.734, P < 0.001), a negative correlation between kinesiophobia and motor function (r = -0.522, P < 0.001), and a positive correlation between illness perception and kinesiophobia (r = 0.508, P < 0.001); kinesiophobia played a mediating role between illness perception and motor function (β = -0.63, P < 0.001).

The findings revealed that individuals with cardioembolic strokes had poor motor function, as well as negative illness perception and kinesiophobia. Negative illness perception had a direct impact on patients' motor function as well as an indirect effect via kinesiophobia. The fear-avoidance model contributes to understanding the process of reduced motor function in cardioembolic stroke patients.

Patients with cardiovascular disease (CVD) are susceptible to influenza virus infection, and influenza vaccination is effective in preventing influenza, but its uptake remains low. This study will investigate the influencing factors affecting patients' intention to receive influenza vaccination based on the extended protection motivation theory (PMT) and explore whether there are differences in this psychological pathway among patients with different levels of illness perception.

Cross-sectional study.

In this study, the extended PMT model was used, which consists of the original construct (threat and coping assessment) and the extended construct (social norms and trust). Based on this, the model used to explain influenza vaccination intentions in CVD patients was constructed. Structural equation modelling was then used to test the extended theory from the overall population, the high-illness-perception and low-illness-perception populations, respectively.

Intention toward influenza vaccination was positively correlated with severity (β = .211), vulnerability (β = .154), response efficacy (β = .243), self-efficacy (β = .154), and social norms (β = .179), while being negatively associated with response costs (β = -.244). Social norms influenced intention by mediating response efficacy and self-efficacy, while trust in information sources was mediated by self-efficacy. Extended PMT had higher interpretative efficacy in patients with high illness perception than in patients with low illness perception (75.1 % vs 35.2 %).

The study found that the extended PMT is appropriate for explaining the intention toward influenza vaccination of patients with CVD. Patients with different illness perception levels have differences in the paths. It is suggested that patients with different levels of illness perception be subdivided, and intervention strategies should be developed by considering the theoretical models of each subgroup.

The role of occupational therapy in the rehabilitation of adults with persistent postconcussion symptoms (PPCS) following mild traumatic brain injury is an emerging practice area. Research that contributes to growing knowledge and understanding of the profession's role may increase the recognition and visibility of occupational therapy in concussion rehabilitation programs.

To identify and categorize (using World Health Organization International Classification of Functioning, Disability and Health [WHO ICF] One-Level Classification domains) existing literature that describes occupational therapy practice (including assessments and interventions) in the rehabilitation of adults with PPCS.

Five scientific databases (MEDLINE, Embase, Emcare, PsycINFO, and CINAHL Complete) and gray literature were searched.

Eligibility criteria included publications between 2013 and 2023, written in English, and within the peer-reviewed literature or on specified web domains (.gov, .edu, or .org).

Nineteen publications from 16 sources met eligibility criteria, consisting of quantitative studies (n = 6); case studies, series, or reports (n = 3); qualitative studies (n = 2); systematic or scoping literature reviews (n = 2); and gray literature sources (n = 3). The United States was the origin for many sources (n = 10). Assessments and interventions reported were heterogenous, mapping across 27 of the 30 WHO ICF One-Level Classifications.

Evidence to inform occupational therapy practice in adult PPCS rehabilitation is limited; however, some useful information about the assessments and interventions used by occupational therapists was found. At a time when considerable advancements in concussion rehabilitation are occurring, further research on evidence-informed occupational therapy practice is required. Plain-Language Summary: This study reviewed existing evidence about the role of occupational therapy in the rehabilitation of adults with persistent postconcussion symptoms (PPCS). It identifies and methodically documents a range of occupational therapy assessments and interventions described in the literature that may be used by occupational therapists within concussion rehabilitation programs or research. The study also categorizes these by using an internationally recognized taxonomy, the World Health Organization's International Classification of Functioning, Disability and Health. The review offers a novel synthesis of published evidence to guide occupational therapy practice and inform resource allocation in concussion rehabilitation. It also highlights the need for further research about the role of occupational therapy-including both high-quality evidence of current approaches and identification of future practice opportunities-in the rehabilitation of adults experiencing PPCS following brain injury.

Kinesiophobia is prevalent among patients with atrial fibrillation (AF), leading to a notable decrease in exercise tolerance and quality of life (QoL). AF-related kinesiophobia encompasses a complex cascade reaction, influenced by psycho-physiological and behavioral factors. To investigate the complex interconnections associated with kinesiophobia among AF patients and identify potential intervention points for its management.

From June 2021 to November 2022, we collected data through paper surveys, using convenience sampling to invite patients with AF. 541 AF patients were included in this study. Data were collected using Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), the Atrial Fibrillation Effect on Quality-of-Life (AFEQT), the Brief Illness Perception Questionnaire (BIPQ), and Medical Coping Modes Questionnaire (MCMQ), respectively. Network analysis and directed acyclic graphs (DAG) were used to visualize the intricate relationships of the factors.

The network structure identifies "Avoidance of Exercise" as a central node, which, alongside "Illness Perception" and "Resignation," acting as bridges that link and activate other factors of AF-related kinesiophobia. The DAG suggests that AF symptoms, located upstream, may act as a trigger, initiating a cascade effect impacting illness perception and coping styles.

"AF symptoms," along with psychological factors such as "illness perception," and "coping styles," may serve as potential action points to reduce AF-related kinesiophobia and ultimately improve the overall QoL for AF patients.

Non-battle injuries significantly impact military readiness and individuals' quality of life, yet research on their effects on soldiers remains inadequate.

This study examines relationships between non-battle injury characteristics, perceptions, health-related quality of life (HRQOL), and service capability in the Israel Defense Forces.

This retrospective cohort study assesses relationships between injury characteristics, perception, HRQOL, and service capability among active duty soldiers at an Israel Defense Forces clinic over 12 months (February 2023-February 2024).

Among 85 participants, predominant injuries occurred from falls/jumps (30.6%) and sports/training (23.5%), mainly affecting lower limbs (44.7%), upper limbs (24.7%), and back/spine (11.8%). Primary diagnoses included blunt contusions (20%) and fractures (18.8%). Lower-limb injuries were associated with mobility difficulty, upper-limb injuries with self-care difficulty, and blunt contusions with improved HRQOL. Injury perception was negatively correlated with HRQOL, while penetrating injuries, particularly open cuts/wounds, were linked to reduced military service capability.

This first comprehensive analysis of non-battle injuries in the Israel Defense Forces reveals key associations between injury characteristics, perceptions, HRQOL, and service capability. Findings highlight the need for early detection and targeted intervention to preserve soldiers' well-being and performance.

Rural populations in the United States face a diabetes mortality penalty. Self-management is a core component of treatment for Type 2 diabetes, but there is low uptake of self-management education and support interventions in rural areas. Rural structural barriers to diabetes self-management have been described, yet the role of rural culture has not been extensively explored.

The purpose was to examine the relationships among rural culture, diabetes beliefs, self-management behaviors, and health outcomes.

A stratified random sample of 500 adults with Type 2 diabetes were recruited from a rural integrated healthcare system and invited to participate in this nonexperimental cross-sectional study. Participants completed a survey that included validated measures of rural identity, self-reliance, perceived diabetes threat, and diabetes self-management behaviors. The most recent A1c was collected from the medical record. Descriptive, bivariate, multivariate, and moderation analyses were conducted.

One hundred twenty-eight participants returned completed surveys. Having an A1c <8% was associated with better diabetes self-management behaviors, lower perceived threat, being female, and older age. Better diabetes self-management behaviors were associated with lower self-reliance, lower perceived threat, and older age. The combined moderation effect of both self-reliance and rural identity on the relationship between perceived threat and self-management behaviors was significant.

Findings highlight the complex relationship between diabetes beliefs and behavior in rural populations and demonstrate that components of the rural culture have both direct and moderating effects on diabetes beliefs and self-management behaviors. These findings have important ramifications for nurses practicing in rural settings.

Fear of disease progression (FoP) is a multidimensional concept that refers to the fear or worry about disease progress. Little is known about the distinct FoP profiles and their determinants in culturally specific contexts, especially among hematologic malignancies (HM) patients in China. This study aimed to identify heterogeneous profiles of FoP and their associated predictors among Chinese patients with HM. A convenience sample of patients suffering from HM were enrolled from March 2023 to February 2024. To gather multidimensional data from the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Brief Illness Perception Questionnaire (BIPQ), the Hospital Anxiety and Depression Scale (HADS), the Family Hardiness Index (FHI), and the EuroQol-Visual Analogue Scale (EQ-VAS), we performed a questionnaire-based cross-sectional study on 455 survivors with HM. The statistical method included latent profile analysis (LPA) and multivariate logistic regression. Three latent profiles of FoP were found: the low-risk fear group (20.88%), the moderate-risk fear group (54.73%), and the high-risk fear group (24.49%). Patients with higher levels of illness perception, anxiety, and depression were more likely to report higher levels of FoP. The study revealed that female gender (OR 2.295-2.577), age > 65 years (OR 4.140-9.363), lower education (OR 0.270-0.365), and lymphoma diagnosis (OR 2.95) significantly predicted higher FoP risk (all P < 0.05), while higher income (OR 0.390-0.477, P < 0.05) and greater family resilience showed protective effects. The findings underscore the need for risk-stratified interventions targeting psychosocial vulnerabilities, particularly in elderly and female adults with HM. This study provides empirical evidence supporting the application of precision psycho-oncology approaches in HM survivorship management. It also contributes to the broader comprehension of FoP and highlights the importance of family-centered interventions .

Patients' illness perceptions are cognitive representations or beliefs structured around their condition. These perceptions have been associated with several important outcomes, including functional recovery and treatment adherence.

The aim of this study was to investigate the association between illness perception and related factors with treatment adherence among hemodialysis patients with cardio-renal syndrome in Yemen.

This cross-sectional study was conducted at two dialysis centers in Hadhramout Governorate, Yemen, from February to May 2021. Three self-administered questionnaires were used to collect the data. Data analysis was performed using SPSS version 23.0 with a significance level set at p < 0.05.

In total, 100 patients answered all questions with a total response rate of 100%. The mean age ± standard deviation of participants was 53.46 ± 14.24 years. Most patients (87%) had a low level of treatment adherence, particularly in medication and diet restriction adherence. Furthermore, most patients (90%) had a moderate-to-high level of perceived illness threat. The findings revealed no significant correlation between overall illness perception and overall treatment adherence (r = 0.003, p = 0.975). However, the perceived consequences (r = -0.210, p < 0.05), and perceived timeline subscales (r = -0.276, p < 0.01) showed a negative correlation with total treatment adherence. Additional findings revealed a significant positive link between adherence and cardiac disorders (β = 4.292, p = 0.009), as well as a strong correlation between adherence and income level (β = 11.132, p < 0.001).

Our research found that most patients with cardio-renal syndrome had poor treatment adherence and had a moderate-to-high level of perceived illness threat. The results of the study showed that perceived consequences and perceived timeline subscales of illness perceptions had a negative correlation with overall treatment adherence, and the results revealed a significant positive link between adherence and cardiac disorders, as well as a strong correlation between adherence and income level. The findings suggest that nurses and clinicians should assess the illness perceptions specific to patients with cardio-renal syndrome disease when developing multidisciplinary interventions to help patients cope with and manage different aspects of their condition.

People's perceptions of illness and its risks influence health behaviors, including risk management and precautionary measures. Illness perception often involves unrealistic optimism, reducing infection risk perception. However, crises disrupt self-regulation and optimism due to uncontrollable situations. This study examines optimism's link to risk and illness perception during the first COVID-19 wave in 10 countries, with 7254 participants (48.1% women, mean age = 40, SD = 14.8). We used Bayesian structural equation modeling for psychometric stability and one-way ANOVAs for country comparisons. Multiple regression analyses examined the impact of optimism and demographic variables on illness perception. Significant cross-country variations emerged in illness perception and optimism. In terms of the relationship between variables, optimism correlated with increased COVID-19 risk perception, especially for negative outcomes, concern, and consistency. During crises, optimism shifted from unrealistic to functional, promoting treatment adherence, personal control, and coherence. These dimensions represent individuals' beliefs in managing illness, highlighting optimism's adaptive role in crises.

Web-based depression screening followed by automated feedback of results is frequently used and promoted by mental health care providers. However, criticism points to potential associated harms. Systematic empirical evidence on postulated negative effects is missing.

We aimed to examine whether automated feedback after web-based depression screening is associated with misdiagnosis, mistreatment, deterioration in depression severity, deterioration in emotional response to symptoms, and deterioration in suicidal ideation at 1 and 6 months after screening.

This is a secondary analysis of the German-wide, web-based, randomized controlled DISCOVER trial. Affected but undiagnosed individuals screening positive for depression (9-item Patient Health Questionnaire [PHQ-9] ≥10 points) were randomized 1:1:1 to receive nontailored feedback, tailored feedback, or no feedback on their screening result. Misdiagnosis and mistreatment were operationalized as having received a depression diagnosis by a health professional and as having started guideline-based depression treatment since screening (self-report), respectively, while not having met the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-V) criteria of a major depressive disorder at baseline (Structured Clinical Interview for DSM-V Disorders). Deterioration in depression severity was defined as a pre-post change of ≥4.4 points in the PHQ-9, deterioration in emotional response to symptoms as a pre-post change of ≥3.1 points in a composite scale of the Brief Illness Perception Questionnaire, and deterioration in suicidal ideation as a pre-post change of ≥1 point in the PHQ-9 suicide item. Outcome rates were compared between each feedback arm and the no feedback arm in terms of relative risks (RRs).

In the per protocol sample of 948 participants (n=685, 72% female; mean age of 37.3, SD 14.1 years), there was no difference in rates of misdiagnosis (ranging from 3.5% to 4.9% across all study arms), mistreatment (7.2%-8.3%), deterioration in depression severity (2%-6.8%), deterioration in emotional response (0.7%-2.9%), and deterioration in suicidal ideation at 6 months (6.8%-13.1%) between the feedback arms and the no feedback arm (RRs ranging from 0.46 to 1.96; P values ≥.13). The rate for deterioration in suicidal ideation at 1 month was increased in the nontailored feedback arm (RR 1.92; P=.01) but not in the tailored feedback arm (RR 1.26; P=.43), with rates of 12.3%, 8.1%, and 6.4% in the nontailored, tailored, and no feedback arms, respectively. All but 1 sensitivity analyses as well as subgroup analyses for false-positive screens supported the findings.

The results indicate that feedback after web-based depression screening is not associated with negative effects such as misdiagnosis, mistreatment, and deterioration in depression severity or in emotional response to symptoms. However, it cannot be ruled out that nontailored feedback may increase the risk of deterioration in suicidal ideation. Robust prospective research on negative effects and particularly suicidal ideation is needed and should inform current practice.

ClinicalTrials.gov NCT04633096; https://clinicaltrials.gov/study/NCT04633096; Open Science Framework 10.17605/OSF.IO/TZYRD; https://osf.io/tzyrd.

This study explored subjective tinnitus frequency in patients referred to an interdisciplinary orofacial pain clinic using the "web-based interdisciplinary symptom evaluation" (WISE) tool, which included a wide range of psychometric data. Our goal was to analyze the correlation between orofacial complaints and tinnitus, as well as their association with other psychometric data-an approach that, to our knowledge, has not been undertaken to this extent before.

From 2017 to 2020, we analyzed 1369 anonymized patient records using completed WISE. This included diverse questionnaires and symptom-related screener questions. Positive screening responses triggered additional assessments, such as short Tinnitus Handicap Inventory (THI-12) and Patient Health Questionnaire 4 (PHQ-4). Ear symptoms, tinnitus severity and tinnitus frequency were evaluated. Furthermore, Spearman correlations were performed with other questionnaires addressing pain, anxiety, depression, health, stress and insomnia.

Among 1369 patients with orofacial complaints, 69% were female. Notably, 19.7% (269) completed THI-12 due to severe ear symptoms; of these, 62.1% were female. Female mean THI-12 score was significantly lower (p = 0.007) with 9.3 (SD = 7.0) compared to males 11.6 (SD = 6.8). Additionally, there was a significantly different gender distribution between all patients with tinnitus and those with severe tinnitus (p = 0.032), with an increased proportion of men in the latter group. THI-12 positively correlated with all WISE questionnaires, strongest with PHQ-4 (p < 0.01).

Our study unveils a common co-occurrence of orofacial and ear complaints, particularly tinnitus. The practical implication of the observed gender differences suggests that in male patients presenting with orofacial pain, tinnitus and its associated distress should be actively addressed to initiate a multidisciplinary treatment approach.

Not applicable. Since this study was a retrospective analysis of anonymized data, trial registration was not necessary.

People with hand osteoarthritis (OA) report decreased ability to perform activities of daily living (ADL). However, few are referred to occupational therapy by their general practitioner. This study aimed to identify clinical predictors of decreased ADL ability in people with hand OA as markers of the need for referral to occupational therapy.

A cross-sectional study was conducted as an independent add-on to a randomized controlled trial of adults with hand OA (the COLOR trial). Measures of self-reported (ADL Interview) and observed (Assessment of Motor and Process Skills) ADL ability were collected. Data representing potential predictors identified by stakeholders were extracted from the COLOR trial: age, sex, symptom duration, hand OA type, grip strength, pain, stiffness, function, illness perception, and health-related quality of life. Correlational analyses and prediction models were used.

Correlations between ADL ability and potential predictors in the 62 participants were low to negligible (r < 0.5). Based on root mean square error (RMSE) estimates, prediction models for observed ADL motor (RMSE = 0.3) and ADL process (RMSE = 0.2) ability were more accurate than for self-reported ADL ability (RMSE = 0.6). However, these variables only predicted observed ADL motor and ADL process ability with 16% (adjusted Rs = 0.163) and 12% (adjusted Rs = 0.120) accuracy, respectively.

The findings suggest that variables representing body functions, perceived health, and quality of life do not predict ADL ability among people living with hand OA. An adequately powered study is recommended to explore this topic further.

Background and Purpose: Diabetes-specific distress (DD) is a crucial predictor of patients' self-care, necessitating reliable screening tools. The Diabetes Distress Scale captures typical sources of patients' distress effectively. Methods: The Hungarian Diabetes Distress Scale (HDDS) was employed in two studies with 450 type 2 diabetes patients. Study 1 explored DD's link to the specific quality of life, while study 2 examined its associations with depressive symptoms, anxiety, and illness perception. We evaluated HDDS's construct validity, internal consistency, and intercorrelations. Convergent validity and discriminant validity were analyzed in the second study. Results: Exploratory and confirmatory factor analyses validated HDDS's structure. Subscales exhibited strong internal consistency and correlated as expected with quality of life, anxiety, depression, illness perception, and demographic/medical data. Conclusions: The Hungarian DDS demonstrates robust psychometric properties, affirming its reliability and validity.

Although illness perception (IP) is a widely recognised factor in the psychosocial adjustment to cancer, little is known about the impact of individual dimensions of IP. This study aims to analyse the relationship between individual dimensions of IP and quality of life (QOL) in childhood cancer survivors.

The sample consisted of 163 long-term survivors aged 11 to 25 who were administered the Brief Illness Perceptions Questionnaire and the Minneapolis-Manchester Quality of Life Scale.

In the correlational analysis, all dimensions of IP were associated with individual dimensions of QOL, except for understanding and treatment control. The results of the hierarchical regression analysis controlling for demographic and medical factors showed that IP had predicted individual dimensions of QOL above and beyond these factors, with emotional response, concern, consequences and understanding being the most predictive dimensions. Several age-specific relationships between IP and QOL were also identified.

Illness perceptions significantly contribute to explaining QOL of childhood cancer survivors above and beyond demographic and medical factors. These results may contribute to more effective targeting of psychosocial interventions promoting QOL of survivors.

Functional neurological disorder (FND) is a common cause of neurological symptoms including seizures and movement disorders. It can be debilitating, is associated with high health and social care costs, and can have a poor prognosis. Functional magnetic resonance imaging (fMRI) has suggested FND is a multi-network disorder. Converging evidence suggests that other mechanisms including dissociation, interoception, and motor agency may be abnormal in people with FND. Psychedelics are currently under investigation for numerous neuropsychiatric disorders and have been shown to disrupt functional brain networks. Administering psychedelics to people with FND will help us to probe mechanistic theories of the disorder.

In this open-label neuroimaging study, we will administer 25mg oral psilocybin with psychological support to people with chronic FND (target n = 24). Participants will undergo resting-state and task-based (Libet's clock, a measure of motor agency) fMRI sequences which will be compared in a pre-post manner. Additional mechanistic outcomes including measures of interoception (heartbeat tracking task), somatisation, illness perceptions, suggestibility, and dissociation will be collected. Data on expectancy, preparedness, and subjective experience of the psychedelic experience will also be gathered. Participants will be followed up for three months following psilocybin administration. fMRI changes in networks will be analysed using seed-based approaches, and additional exploratory analysis of resting-state imaging will take place.

The study will help us to probe the mechanisms thought to potentially underpin FND. As the first modern study of psychedelics in FND, it will also help us to understand whether psychedelic administration alongside psychological support might be safe and feasible in this patient population.