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van Griethuysen SRG, Dumoulin QA, van Mulligen E, van der Helm-van Mil AHM. Can treatment expectations or treatment itself in patients with arthralgia suspicious for progression to rheumatoid arthritis improve illness perceptions? Rheumatology (Oxford) 2025; 64:3444-3450. [PMID: 39945847 DOI: 10.1093/rheumatology/keaf095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2024] [Accepted: 02/04/2025] [Indexed: 05/29/2025] Open
Abstract
OBJECTIVES 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). METHODS 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. RESULTS 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). CONCLUSION 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.
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Affiliation(s)
| | - Quirine A Dumoulin
- Department of Rheumatology, Leiden University Medical Centre, Leiden, Netherlands
| | - Elise van Mulligen
- Department of Rheumatology, Leiden University Medical Centre, Leiden, Netherlands
- Department of Rheumatology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Annette H M van der Helm-van Mil
- Department of Rheumatology, Leiden University Medical Centre, Leiden, Netherlands
- Department of Rheumatology, Erasmus Medical Centre, Rotterdam, Netherlands
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Truter I, Regnart J, Meyer A. Assessment of Potential Factors Influencing Attention-Deficit/Hyperactivity Disorder Drug Adherence: A Database Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2025; 22:716. [PMID: 40427832 DOI: 10.3390/ijerph22050716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2025] [Revised: 04/12/2025] [Accepted: 04/29/2025] [Indexed: 05/29/2025]
Abstract
First-line treatment for Attention-Deficit/Hyperactivity Disorder (ADHD) is pharmacological but is associated with poor success rates in adults. The potential to discontinuously use stimulants may confound adherence assessment. Approximately 30-50% of adults with ADHD will experience depressive episodes, and associated treatment with antidepressants is generally recommended. It can therefore be expected that patients with a formal F90 diagnosis would show higher medication adherence than patients without a diagnosis and that the simultaneous use of antidepressants would increase adherence to ADHD medication. The primary aim was to explore the influence of factors of ADHD diagnosis and comorbid antidepressant use on stimulant adherence. A retrospective, longitudinal pharmacoepidemiological study was conducted on South African community pharmacy dispensing records for 2012-2016 for all patients aged between 18 and 40 years with any record of receiving a drug classified as "Central nervous system other" by the MIMS in 2015. Patients endorsed with an ADHD-linked diagnostic code (F90) were identified and contrasted with those receiving ADHD-indicated medication in the absence of a confirmatory diagnostic code. Two methods were applied to assess adherence to ADHD and/or depression treatment drugs: monthly medicine plotting and Proportion of Days Covered (PDC). Patients were classified as being more or less adherent based on monthly medicine plotting criteria. A study population of 89 patients was identified: 50 had F90 diagnostic codes and 39 were classified as "Non F90". Adherence as measured based on PDC was generally higher for antidepressant use than for methylphenidate for patients classified as being more adherent. A trend towards higher consumption of antidepressants was shown for the treatment-adherent group. Diagnostic code distinction revealed significantly higher adherence rates to methylphenidate for F90 code patients. Adherence rates to antidepressants appeared to be generally higher for non-F90 patients. Many factors may influence adherence to ADHD-indicated drugs; however, the impact of a confirmed diagnosis may be a strong determinant of motivation to be adherent to ADHD pharmacotherapy.
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Affiliation(s)
- Ilse Truter
- Drug Utilization Research Unit (DURU), Department of Pharmacy, Faculty of Health Sciences, Nelson Mandela University, P.O. Box 77000, Gqeberha 6031, South Africa
| | - Judith Regnart
- Drug Utilization Research Unit (DURU), Department of Pharmacy, Faculty of Health Sciences, Nelson Mandela University, P.O. Box 77000, Gqeberha 6031, South Africa
| | - Anneke Meyer
- Drug Utilization Research Unit (DURU), Department of Pharmacy, Faculty of Health Sciences, Nelson Mandela University, P.O. Box 77000, Gqeberha 6031, South Africa
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Mui L, Morgan B, Chassé M, Crawshaw J, Martin CM. Development and initial testing of an illness perception questionnaire for substitute decision makers of critically ill patients: a mixed methods study. Can J Anaesth 2025; 72:473-480. [PMID: 40102376 DOI: 10.1007/s12630-025-02919-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 07/23/2024] [Accepted: 07/23/2024] [Indexed: 03/20/2025] Open
Abstract
PURPOSE The Brief Illness Perception Questionnaire (Brief-IPQ) is used to quantify a patient's understanding of their condition. In critical care settings, substitute decision makers (SDMs) are tasked with making decisions on behalf of patients, but it can be difficult to evaluate how they perceive the patient's illness. We developed the Illness Perception Questionnaire for Substitute Decision Makers (IPQ-SDM) by adapting the Brief-IPQ and testing it with SDMs of patients in critical care. METHODS In a mixed methods study, we modified the Brief-IPQ for the context of SDMs of critically ill patients using qualitative feedback. We then approached SDMs of critically ill patients three days after intensive care unit (ICU) admission to complete the IPQ-SDM in a prospective observational study. We calculated summary statistics for the individual questions and the total score. We evaluated prespecified associations between individual questions as well as the total score with clinical data that were abstracted from the patient chart. RESULTS We received 44/50 (88%) complete responses with a mean (standard deviation [SD]) total score of 43 (11). Forty-six percent reported that they did not have any in-person visits due to the restrictions during the COVID-19 pandemic. The correlation of total score with the nine equivalents of nursing manpower score (NEMS) was 0.42 (P = 0.005) but it was not correlated (P = 0.07) with the multiple organ dysfunction score (MODS). The total mean (SD) score was higher (i.e., worse) for patients who died in hospital (48.2 [9.7], n = 13) than for those who were discharged alive (40.5 [10.2], n = 31, P = 0.03). Concern regarding the illness was correlated with MODS (Spearman correlation coefficient [ρ] = 0.39, P = 0.01) and NEMS (ρ = 0.29, P = 0.04). CONCLUSION We observed a modest level of correlation of the IPQ-SDM score with clinical measures in the adult ICU setting. Further research is needed before such a tool is broadly implemented.
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Affiliation(s)
- Louise Mui
- Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Brenda Morgan
- Critical Care Trauma Centre, London Health Sciences Centre, London, ON, Canada
| | - Michaël Chassé
- Department of Medicine, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Jacob Crawshaw
- Centre for Evidence-Based Implementation, Hamilton Health Sciences, Hamilton, ON, Canada
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Claudio M Martin
- Division of Critical Care Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
- Lawson Health Research Institute, St. Joseph's Health Care London and London Health Sciences Centre, London, ON, Canada.
- , 800 Commissioners Rd E, London, ON, N6A 5W9, Canada.
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Zamora T, Nokes B, Malhotra A, Stepnowsky C. Obstructive sleep apnea illness perception relative to other common chronic conditions. J Clin Sleep Med 2025; 21:229-235. [PMID: 39297551 PMCID: PMC11789261 DOI: 10.5664/jcsm.11360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 09/10/2024] [Accepted: 09/10/2024] [Indexed: 10/09/2024]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) is a common chronic medical condition that results in impaired daytime functioning. While the link between OSA and cardiovascular disease is important, there has been increasing recognition of the impact of OSA on daytime functioning and experience. Better insight into illness perceptions can help better understand how to initiate and maintain treatment. METHODS Data from 2 OSA clinical trials were examined. The baseline respiratory event index was obtained from diagnostic sleep testing. The Brief Illness Perception Questionnaire assesses the cognitive and emotional representation of illness and was administered at baseline along with the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index. RESULTS A total of 523 patients diagnosed with OSA were studied. The sample had a mean age of 51.1 ± 16.6, mean respiratory event index of 28.6 ± 17.9 events/h, and mean body mass index of 32.8 ± 15.5 kg/m2. The mean Brief Illness Perception Questionnaire total score at baseline was 43.3 ± 11.3. Brief Illness Perception Questionnaire scores were significantly correlated with sleepiness and sleep quality but not with respiratory event index. Relative to other common chronic conditions with major comorbidities, Brief Illness Perception Questionnaire scores for patients with OSA were higher on consequences, identity, concern, and emotional representation dimensions. CONCLUSIONS The study shows that veterans with OSA report elevated illness perceptions across several dimensions at levels as high, or higher, than other common chronic conditions. Implications for clinical practice are that it is important to ask patients about their understanding of illness across several dimensions to appreciate better patient needs and preferences. CITATION Zamora T, Nokes B, Malhotra A, Stepnowsky C. Obstructive sleep apnea illness perception relative to other common chronic conditions. J Clin Sleep Med. 2025;21(2):229-235.
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Affiliation(s)
- Tania Zamora
- Health Services Research & Development Unit, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Brandon Nokes
- Sleep Section, Veterans Affairs San Diego Healthcare System, San Diego, California
- Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, University of California, San Diego, California
| | - Atul Malhotra
- Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, University of California, San Diego, California
| | - Carl Stepnowsky
- Health Services Research & Development Unit, Veterans Affairs San Diego Healthcare System, San Diego, California
- Department of Medicine, University of California, San Diego, California
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Priego-Parra BA, Remes-Troche JM. Perceptions and emotions in postoperative recovery of patients with perianal diseases. World J Psychiatry 2025; 15:101563. [PMID: 39831012 PMCID: PMC11684218 DOI: 10.5498/wjp.v15.i1.101563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Revised: 10/30/2024] [Accepted: 11/15/2024] [Indexed: 12/18/2024] Open
Abstract
This article examines the complex relationship between disease perception, negative emotions, and their impact on postoperative recovery in patients with perianal diseases. These conditions not only cause physical discomfort, but also carry a significant emotional burden, often exacerbated by social stigma. Psychological factors, including stress, anxiety, and depression, activate neuroendocrine pathways, such as the hypothalamic-pituitary-adrenal axis, disrupting the gut microbiota and leading to dysbiosis. This disruption can delay wound healing, prolong hospital stay, and intensify pain. Drawing on the findings of Hou et al, our article highlights the critical role of illness perception and negative emotions in shaping recovery outcomes. It advocates for a holistic approach that integrates psychological support and gut microbiota modulation, to enhance healing and improve overall patient outcomes.
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Affiliation(s)
- Bryan Adrian Priego-Parra
- Digestive Physiology and Gastrointestinal Motility Lab, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz 91700, Mexico
| | - Jose Maria Remes-Troche
- Digestive Physiology and Gastrointestinal Motility Lab, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz 91700, Mexico
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Nazaré B, Mendes TP. Pediatric epilepsy representations among children/adolescents and parents: The role of age, gender, and clinical variables. Epilepsy Behav 2024; 161:110094. [PMID: 39467449 DOI: 10.1016/j.yebeh.2024.110094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 10/07/2024] [Accepted: 10/08/2024] [Indexed: 10/30/2024]
Abstract
According to the common-sense model of self-regulation, illness representations influence treatment adherence and, thus, health status. As pediatric epilepsy management is usually shared between children/adolescents and parents, we aimed to assess and compare illness representations of both groups. Additionally, the role of gender and clinical variables in pediatric epilepsy representations was explored. One hundred and seventy-three dyads of Portuguese children/adolescents with epilepsy and parents were assessed with the Brief Illness Perception Questionnaire. Pediatric epilepsy was perceived as a moderate threat. Although epilepsy symptoms and consequences were mainly perceived as low, the emotional impact of the illness was moderate to high. Compared to children/adolescents, parents presented higher understanding of epilepsy, higher concern, and more intense emotional responses to the illness. Adolescents understood the illness better than children. Gender did not relate to illness representations among children/adolescents or parents. Epilepsy severity and control were the clinical variables most strongly associated with illness representations. Pediatric epilepsy representations should be routinely assessed separately for children/adolescents and parents, particularly following changes in epilepsy severity. When pediatric illness representations are found to be incongruent with medical information, such beliefs should be challenged, preferably with a tailored approach.
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Affiliation(s)
- Bárbara Nazaré
- Católica Research Centre for Psychological - Family and Social Wellbeing, Universidade Católica Portuguesa, Palma de Cima, 1649-023 Lisboa, Portugal.
| | - Teresa Pompeu Mendes
- HEI-Lab-Digital Human-Environment Interaction Lab, Lusófona University, Campo Grande 376, 1749-024 Lisboa, Portugal.
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Zhang M, Nie S, Hai Z, Du Y, Jiang M, Cai C. Effects of Illness Perception and Coping Style on Self-Management in Peritoneal Dialysis Patients: A Cross-Sectional Study. Psychol Res Behav Manag 2024; 17:3381-3393. [PMID: 39376735 PMCID: PMC11456736 DOI: 10.2147/prbm.s474427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 09/19/2024] [Indexed: 10/09/2024] Open
Abstract
Aim Chronic disease self-management is critical to disease prognosis and patient quality of life. Several psychological factors influence this process of self-management. In this background, the present study investigated the impact of illness perceptions and coping style on self-management in people with peritoneal dialysis (PD). Methods The study is a cross-sectional study. From May 2022 to January 2023, a convenience sampling method was used to recruit 246 peritoneal dialysis patients. General information questionnaire, brief illness perception questionnaire, medical coping style modes questionnaire and the self-management scale for peritoneal dialysis patients were used in this study. We used SPSS 24.0 to analyze the data, and the statistical methods included descriptive analysis, single factor analysis, Pearson correlation analysis and multiple linear regression analysis. Results A total of 246 patients were included in this study (93.89% response rate). Cognitive representations and emotional representations were 30.40, 14.18, respectively. However, illness comprehensibility was 2.87. Illness perceptions were negative significantly correlated with self-management. With regard to coping style, our patients were more likely to adopt avoidance and resignation coping style. Confrontation and avoidance were positively related to self-management, while acceptance-resignation was negatively related. Conclusion Self-management of peritoneal dialysis patients needs to be improved. Age, female sex, monthly income, illness perceptions and coping style were independently associated with self-management. Impact These findings suggest that interventions that improve illness perceptions and coping style should be explored to ultimately improve their self-management. For example, patients can be provided with psychological counseling so that they can face the disease correctly, and we should pay attention to the positive role of social support.
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Affiliation(s)
- Man Zhang
- Department of Oncology, The First Medical Centre, Chinese PLA General Hospital, Beijing, People’s Republic of China
- Wuhan University School of Nursing, Wuhan, Hubei, People’s Republic of China
| | - Siman Nie
- Beijing Tsinghua Changgung Hospital, Beijing, People’s Republic of China
| | - Ziwei Hai
- Wuhan University School of Nursing, Wuhan, Hubei, People’s Republic of China
| | - Yixin Du
- Wuhan University School of Nursing, Wuhan, Hubei, People’s Republic of China
| | - Menghan Jiang
- Shandong University of Traditional Chinese Medicine College of Health Sciences, Jinan, Shandong, People’s Republic of China
| | - Chunfeng Cai
- Wuhan University School of Nursing, Wuhan, Hubei, People’s Republic of China
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Holmlund L, Hörnsten C, Hörnsten Å, Olsson K, Valham F, Hellström Ängerud K. More positive patient-reported outcomes in patients newly diagnosed with atrial fibrillation: a comparative longitudinal study. Eur J Cardiovasc Nurs 2024; 23:618-626. [PMID: 38170563 DOI: 10.1093/eurjcn/zvad139] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/29/2023] [Accepted: 12/23/2023] [Indexed: 01/05/2024]
Abstract
AIMS To compare patient-reported outcomes (PROs) in patients newly (<6 months) diagnosed with atrial fibrillation (AF) with those who have had a longer diagnosis (≥6 months) and to investigate whether or not these outcomes change over a 6-month period. METHODS AND RESULTS In this longitudinal survey study, 129 patients with AF completed the Revised Illness Perception Questionnaire, the Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia, and the Hospital Anxiety and Depression Scale at baseline and after 6 months. At baseline, patients newly diagnosed with AF (n = 53), compared with patients with a previous diagnosis (n = 76), reported AF as more temporary (P = 0.003) and had a higher belief in personal and treatment control (P = 0.004 and P = 0.041, respectively). At a 6-month follow-up, patients newly diagnosed reported a lower symptom burden (P = 0.004), better health-related quality of life (HRQoL); (P = 0.015), and a higher personal control (P < 0.001) than patients previously diagnosed. Over time, in patients newly diagnosed, symptom burden and the anxiety symptom score decreased (P = 0.001 and P = 0.014, respectively) and HRQoL improved (P = 0.002). CONCLUSION Patients newly diagnosed with AF reported more positive PROs both at baseline and at a 6-month follow-up than patients with a previous diagnosis of AF. Therefore, it is important to quickly capture patients newly diagnosed to support their belief in their own abilities. Such support may, alongside medical treatments, help patients manage the disease, which may lead to reduced symptom burden and better HRQoL over time.
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Affiliation(s)
- Lena Holmlund
- Department of Nursing, Umeå University, Linnaeus väg 9, 907 36 Umeå, Sweden
| | - Carl Hörnsten
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
| | - Åsa Hörnsten
- Department of Nursing, Umeå University, Linnaeus väg 9, 907 36 Umeå, Sweden
| | - Karin Olsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Fredrik Valham
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Best G, Morunga E, Wells A, Allison J, Reynolds L. A Cross-Sectional Survey Investigating Māori and Non-Māori Cancer Patients' Views on Psychedelic-Assisted Therapy in Aotearoa New Zealand. J Psychoactive Drugs 2024:1-13. [PMID: 39230415 DOI: 10.1080/02791072.2024.2397427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 05/15/2024] [Accepted: 07/02/2024] [Indexed: 09/05/2024]
Abstract
People with cancer experience higher rates of psychological dysfunction than the general population, with extreme inequity among indigenous people. Psychedelic-assisted therapy (PAT) is a reemerging area with promising evidence as a treatment for mental health difficulties. The current study aimed to investigate the perceptions of PAT in indigenous (Māori) and non-indigenous cancer patients in Aotearoa, New Zealand. Eighty-five cancer patients (Māori n = 32, non-Māori n = 53) completed a brief anonymous survey assessing demographics, psychological factors, and awareness and perceptions of PAT. Participants were recruited online (via social media and cancer support e-mail lists) and in person at Auckland City Hospital. Maori had significantly poorer psychological well-being than non-Māori. All participants had low awareness of this novel treatment and held largely neutral attitudes. Regression analyses revealed that predictors of more favorable attitudes toward PAT included greater awareness of psychedelics, advanced cancer stage, younger age, poorer holistic well-being, greater demoralization, and prioritizing treatment effectiveness over possible risks and uncertainty. The current study provides a foundational step in exploring perceptions toward PAT in indigenous and non-indigenous groups. These results have the potential to shape future research trials investigating PAT and further highlight the importance of indigenous involvement in the psychedelic research space.
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Affiliation(s)
- Georgia Best
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Eva Morunga
- Te Toka Tumai - Auckland City Hospital, Te Whatu Ora Health New Zealand, Auckland, New Zealand
| | - Alesha Wells
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Jenny Allison
- Te Pūriri o Te Ora, Te Toka Tumai-Auckland City Hospital, Te Whatu Ora Health New Zealand, Auckland, New Zealand
| | - Lisa Reynolds
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
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Saunders C, Gordon M, Righini C, Pedersen HF, Rask CU, Burton C, Frostholm L. Participatory design of bodysymptoms.org: An interactive web resource to explain multisystem functional somatic symptoms. J Psychosom Res 2024; 183:111827. [PMID: 38871534 DOI: 10.1016/j.jpsychores.2024.111827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/12/2024] [Accepted: 06/03/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE There is a lack of trustworthy information about Functional Somatic Symptoms (FSS) on the internet. This means integrative bio-psycho-social explanations of FSS and related health advice are not readily available to the public. To explore and address this problem, we carried out the bodysymptoms project, with the aim to build a website which presents current widely accepted explanations for FSS and shows how different explanations are inter-connected. METHODS Bodysymptoms was set up as a research-in-action project with a diverse range of international stakeholder-participants, combining approaches from patient and public involvement in healthcare with participatory design. 7 participants with lived experience of multi-system functional symptoms took part in the project and measures of meaningful engagement throughout the project were rated highly. This manuscript describes the methodology by which the website was developed. RESULTS Through iterative cycles we determined the requirements for an interactive explanatory model and co-created a novel online health interactive resource with integrated actionable health advice. The target end user are young adults with persistent physical symptoms, maintained by functional mechanisms. The overall aim is to empower people at risk of developing functional disorders to seek better health outcomes. The website is intended to be used prior to or alongside engagement with healthcare. CONCLUSION Bringing lived experience and multi-disciplinary perspectives into dialogue through participatory design can harness the power of research to create immediate shared value. This project has resulted in a usable open access website, bodysymptoms.org, which provides education about FSS for patients, healthcare professionals and members of the public looking to understand FSS.
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Affiliation(s)
- Chloe Saunders
- Department for Functional Disorders and Psychosomatic Medicine, Aarhus University Hospital, Denmark.
| | - Maria Gordon
- Department for Functional Disorders and Psychosomatic Medicine, Aarhus University Hospital, Denmark
| | - Cecilia Righini
- Department for Functional Disorders and Psychosomatic Medicine, Aarhus University Hospital, Denmark
| | - Heidi Frølund Pedersen
- Department for Functional Disorders and Psychosomatic Medicine, Aarhus University Hospital, Denmark
| | - Charlotte Ulrikka Rask
- Department for Functional Disorders and Psychosomatic Medicine, Aarhus University Hospital, Denmark
| | - Chris Burton
- Department for Functional Disorders and Psychosomatic Medicine, Aarhus University Hospital, Denmark
| | - Lisbeth Frostholm
- Department for Functional Disorders and Psychosomatic Medicine, Aarhus University Hospital, Denmark
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Reynolds LM, Barnett B, Weleff J, Morunga E, Wells A, Stack A, Akroyd A, Hoeh N, Sundram F, Muthukumaraswamy S, Lawrence N, Evans WJ. The perceptions of cancer health-care practitioners in New Zealand and the USA toward psychedelic-assisted therapy with cancer patients: A cross-sectional survey. Palliat Support Care 2024; 22:664-673. [PMID: 36325995 DOI: 10.1017/s1478951522001481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES A resurgence of research investigating the administration of psychedelic compounds alongside psychotherapy suggests that this treatment is a promising intervention for anxiety, depression, and existential distress in people with cancer. However, psychedelic treatment that induces a mind-altering experience potentially poses barriers to vulnerable cancer patients, and health-care practitioners may have concerns about referring their patients to trials investigating this approach. The aim of the current study was to investigate the perceptions of cancer health-care practitioners based in New Zealand and the USA related to psychedelic-assisted therapy. METHODS This study utilized a cross-sectional survey of cancer health-care practitioners in New Zealand and the USA via convenience sampling to identify their perceptions about the concept of conducting psychedelic-assisted therapy with cancer patients. RESULTS Participants perceived that (1) psychedelic-assisted therapy has the potential to provide benefit for cancer patients, (2) research in this area across a variety of domains is important, (3) work should consider spiritual and indigenous perspectives of health, and (4) there was willingness to refer patients to trials in this area, especially patients with advanced disease who were no longer going through curative treatment. Participants in the USA had greater awareness of psychedelics than the New Zealand sample; however, New Zealand participants more strongly believed that spiritual/indigenous factors should be considered in psychedelic-assisted therapy. SIGNIFICANCE OF RESULTS Cancer health-care practitioners in our sample considered research investigating the potential for psychedelic-assisted therapies to be important and may be more open to studies that start in palliative and end-of-life contexts.
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Affiliation(s)
- Lisa M Reynolds
- Department of Psychological Medicine, The University of Auckland, Grafton, Auckland, New Zealand
| | - Brian Barnett
- Department of Psychiatry and Psychology, Center for Behavioral Health, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
- Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, OH, USA
| | - Jeremy Weleff
- Department of Psychiatry and Psychology, Center for Behavioral Health, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Eva Morunga
- Department of Psychological Medicine, The University of Auckland, Grafton, Auckland, New Zealand
- Cancer and Blood Service, Te Whatu Ora Te Toka Tumai, Auckland, New Zealand
| | - Alesha Wells
- Department of Psychological Medicine, The University of Auckland, Grafton, Auckland, New Zealand
| | - Aideen Stack
- Department of Psychological Medicine, The University of Auckland, Grafton, Auckland, New Zealand
| | - Amelia Akroyd
- Department of Psychological Medicine, The University of Auckland, Grafton, Auckland, New Zealand
| | - Nicholas Hoeh
- Department of Psychological Medicine, The University of Auckland, Grafton, Auckland, New Zealand
| | - Frederick Sundram
- Department of Psychological Medicine, The University of Auckland, Grafton, Auckland, New Zealand
| | | | - Nicola Lawrence
- Cancer and Blood Service, Te Whatu Ora Te Toka Tumai, Auckland, New Zealand
- The Department of Oncology, The University of Auckland, Auckland, New Zealand
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12
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Selvadurai D, Coleshill MJ, Day RO, Briggs NE, Schulz M, Reath J, Aung E. Patient factors and health outcomes associated with illness perceptions in people with gout. Rheumatology (Oxford) 2024; 63:1927-1937. [PMID: 37769230 DOI: 10.1093/rheumatology/kead501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/10/2023] [Accepted: 09/01/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVE Illness perceptions are views and beliefs formed in response to a health threat, and they may influence self-management behaviours and chronic disease outcomes. Despite effective medication, sub-optimal outcomes in gout are common. This study aimed to quantitatively investigate illness perceptions in gout to examine how illness perceptions relate to health outcomes. METHODS Data were obtained from a randomized controlled trial in which people with gout (n = 493) completed surveys measuring illness perceptions [Brief Illness Perception Questionnaire (B-IPQ)], gout flares, medication adherence, health-related quality of life, health-care utilization, and productivity, alongside serum urate blood tests at baseline, and at 6- and 12-month follow-ups. Multivariable linear regression identified patient factors independently associated with each B-IPQ item score. Logistic and linear regression, adjusted for age and sex, determined whether baseline B-IPQ items could predict current and future health outcomes. RESULTS Younger individuals and those with severe gout were more likely to experience pessimistic illness perceptions at baseline. Optimistic illness perceptions were associated with lower odds of having had at least one flare in the preceding 6 months. Every 1-point increase in B-IPQ treatment control, indicating an increasingly optimistic view that gout is treatable, decreased the odds of a recent flare prior to baseline by 33% [odds ratio (OR): 0.67; 95% CI: 0.53, 0.85; P < 0.001] and prior to the 12-month follow-up by 15% (OR: 0.85; 95% CI: 0.76,0.96; P = 0.01). Pessimistic illness perceptions also predicted poorer medication adherence, health-related quality of life, and productivity, but not serum urate levels. CONCLUSION Modifying pessimistic illness perceptions, including, but not limited to, patient education, may promote prudent self-management behaviours and better outcomes in gout. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry; https://www.anzctr.org.au/, ACTRN12616000455460.
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Affiliation(s)
- Daniel Selvadurai
- St Vincent's Healthcare Clinical Campus, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia
- Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia
| | - Matthew J Coleshill
- Black Dog Institute, Sydney, Australia
- UNSW Medicine & Health, UNSW Sydney, Sydney, Australia
| | - Richard O Day
- St Vincent's Healthcare Clinical Campus, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia
- Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia
| | - Nancy E Briggs
- Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Sydney, Australia
| | - Marcel Schulz
- St Vincent's Healthcare Clinical Campus, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia
- Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia
| | - Jennifer Reath
- Department of General Practice, Western Sydney University, Sydney, Australia
| | - Eindra Aung
- St Vincent's Healthcare Clinical Campus, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia
- Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia
- Kolling Institute of Medical Research, Pain Management Research Institute, University of Sydney, Sydney, Australia
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13
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Reston RE, Caskey FJ, Hole B, Udayaraj U, Weinman J. CareKnowDo-A Multichannel Digital and Telephone Support Program for People With Chronic Kidney Disease: Feasibility Randomized Controlled Trial. JMIR Form Res 2023; 7:e33147. [PMID: 37995117 DOI: 10.2196/33147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 07/05/2022] [Accepted: 01/03/2023] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is a common, progressive condition. Lifestyle changes and antihypertensive medication can slow the progression to end-stage kidney disease, which requires renal replacement therapy. However, adherence to these recommendations is often low. OBJECTIVE The aim of CareKnowDo was to assess the feasibility of rolling out a digital self-management support and adherence program integrated with a patient-facing electronic health record, Patient View (PV). METHODS A 2-arm, parallel, individual-level pragmatic feasibility pilot randomized controlled trial was conducted at 2 National Health Service (NHS) sites in the United Kingdom. A total of 61 patients with CKD were randomized 1:1 into 2 groups and provided with either a new, tailored digital and telephone support program (CareKnowDo: 31/61, 51%) integrated with PV or standard care (PV alone: 30/61, 49%). Quantitative measures included clinical and psychosocial measures. The primary outcomes were feasibility based: recruitment rate, dropout, and the exploration of associations. RESULTS Of the 1392 patients screened in local kidney clinics, 269 (19.32%) met the basic inclusion criteria; the first 22.7% (61/269) who met the eligibility criteria were recruited to participate in the study. Of the 69 patients, 23 (38%) patients completed the final 6-month follow-up web-based survey. Reasons for the attrition were explored. A higher belief in the ability of the treatment to control CKD was associated with lower blood pressure at baseline (r=0.52; P=.005), and a higher perceived understanding of CKD at baseline was associated with lower blood pressure at follow-up (r=0.66; P<.001). Beliefs about medicines at baseline were associated with blood pressure at baseline but not at follow-up. This was true for both concerns about medicines (r=0.58; P=.001) and perceived necessity of medicines (r=0.42; P=.03). CONCLUSIONS A tailored digital and nurse call-based program to enhance support for patients with CKD was piloted in 2 NHS sites and found to be feasible and acceptable. However, to maximize the effectiveness of the intervention (and of future trials), consideration should be given to the target audience most likely to benefit, as well as how to help them access the program as quickly and easily as possible. TRIAL REGISTRATION NHS Health Research Authority, IRAS ID 184206; https://www.hra.nhs.uk/planning-and-improving -research/application-summaries/research-summaries/careknowdo-pilot-version-1/.
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Affiliation(s)
| | - Fergus J Caskey
- University of Bristol, Bristol, United Kingdom
- North Bristol National Health Service Trust, Bristol, United Kingdom
| | - Barnaby Hole
- University of Bristol, Bristol, United Kingdom
- North Bristol National Health Service Trust, Bristol, United Kingdom
| | - Udaya Udayaraj
- Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - John Weinman
- School of Cancer & Pharmaceutical Sciences, King's College London, London, United Kingdom
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14
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Johnsen TL, Tveito TH, Øyeflaten I. Helpful elements in a brief work-oriented intervention targeting musculoskeletal and mental health literacy. Health Promot Int 2023; 38:daad132. [PMID: 37864799 PMCID: PMC10590157 DOI: 10.1093/heapro/daad132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2023] Open
Abstract
Musculoskeletal and mental health complaints are common in the general population and frequent reasons for healthcare utilization and work absence. Illness perceptions, coping expectancies, rumination and self-stigma are important factors in the management of these health complaints and factors closely linked to health literacy (HL). The aims of the study were to identify helpful elements in a brief intervention (BI) targeting HL regarding common musculoskeletal and mental health complaints and to identify patient perceptions of how the intervention was helpful and whether it affected their subsequent coping. Three focus group interviews with 14 patients were conducted. Systematic text condensation was used for the analysis, supported by the health literacy skill (HLS) framework to sharpen the focus on intervention elements related to the acquisition and utilization of HLSs. Results revealed the importance of receiving comprehensible health information and guidance, the use of metaphors to create recognizable narratives and the use of practical examples and exercises. Normalizing the experienced health complaints, together with a safe and accommodating clinical environment, facilitated the change process. The BI initiated processes that contributed to acceptance, resilience and empowerment, aiding work-life balance and return to work. The study presents authentic narratives of value for future focus in BI.
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Affiliation(s)
- Tone Langjordet Johnsen
- Division of Physical Medicine and Rehabilitation, Vestfold Hospital Trust, POB 2168, 3103 Tønsberg, Norway
- Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Raveien 215, 3184 Horten, Norway
| | - Torill Helene Tveito
- Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Raveien 215, 3184 Horten, Norway
| | - Irene Øyeflaten
- NORCE Norwegian Research Centre, Nygårdsgaten 112, 5008 Bergen, Norway
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15
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Williams L, Deacon E, Van Rensburg E, Segal D. Continuous glucose monitoring empowers adolescents to take responsibility of diabetes management. Afr J Prim Health Care Fam Med 2023; 15:e1-e6. [PMID: 37042539 PMCID: PMC10157418 DOI: 10.4102/phcfm.v15i1.3879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Managing diabetes is especially challenging for adolescents, and they often struggle to believe they can manage the condition. Illness perception has been widely associated with better diabetes management outcomes, but the influence of continuous glucose monitoring (CGM) on adolescents has been largely neglected. AIM The study aimed to explore the illness perception of a group of adolescents living with type 1 diabetes (T1D) using CGM. SETTING The study was conducted at a medical centre that provides diabetes care services to youth living with T1D in Parktown, South Africa. METHODS A qualitative research approach using semi-structured online interviews was used to gather data that was thematically analysed. RESULTS Themes emerging from the data confirmed that CGM creates a sense of control over diabetes management as blood glucose measures were more visible. A sense of normalcy was established as CGM influences a new routine and a way of life, integrating diabetes into a young person's identity. Despite the users' awareness of being different due to diabetes management, CGM assisted in creating a sense of belonging, contributing to developing a better quality of life. CONCLUSION Findings of this study support the use of CGM as a means of empowering adolescents struggling with diabetes management to achieve better treatment outcomes. The important role of illness perception in facilitating this change was also evident.Contribution: By listening to the adolescent's voice, CGM was identified as a possible intervention to empower adolescents to improve diabetes management.
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Affiliation(s)
- Letitia Williams
- Compres Research Focus Area, Faculty of Health Science, North-West University, Potchefstroom.
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16
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Agrawal H, Lamari-Fisher A, Hasbani K, Philip S, Fraser CD, Mery CM. Decision making in anomalous aortic origin of a coronary artery. Expert Rev Cardiovasc Ther 2023; 21:177-191. [PMID: 36846957 DOI: 10.1080/14779072.2023.2184799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
INTRODUCTION There are many uncertainties surrounding anomalous aortic origin of a coronary artery (AAOCA) including the pathophysiology of sudden cardiac death, how to best risk stratify patients, how to best evaluate patients, who would benefit from exercise restriction, who should undergo surgical intervention, and which operation to perform. AREAS COVERED The goal of this review is to provide a comprehensive but succinct overview of AAOCA to help clinicians with the difficult task of navigating optimal evaluation and treatment of an individual patient with AAOCA. EXPERT OPINION Beginning in year 2012, some of our authors proposed an integrated, multi-disciplinary working group which has become the standard management strategy for patients diagnosed with AAOCA. A multi-disciplinary team with a focus on shared decision-making with the patients/families is likely necessary to optimize outcomes. Long-term follow-up and research are needed to improve our understanding of AAOCA.
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Affiliation(s)
- Hitesh Agrawal
- Department of Pediatrics, Texas Center for Pediatric and Congenital Heart Disease, University of Texas Dell Medical School/Dell Children's Medical Center, Austin, TX, USA
| | - Alexandra Lamari-Fisher
- Department of Pediatrics, Texas Center for Pediatric and Congenital Heart Disease, University of Texas Dell Medical School/Dell Children's Medical Center, Austin, TX, USA
| | - Keren Hasbani
- Department of Pediatrics, Texas Center for Pediatric and Congenital Heart Disease, University of Texas Dell Medical School/Dell Children's Medical Center, Austin, TX, USA
| | - Stephanie Philip
- Department of Pediatrics, Texas Center for Pediatric and Congenital Heart Disease, University of Texas Dell Medical School/Dell Children's Medical Center, Austin, TX, USA
| | - Charles D Fraser
- Department of Pediatrics, Texas Center for Pediatric and Congenital Heart Disease, University of Texas Dell Medical School/Dell Children's Medical Center, Austin, TX, USA
| | - Carlos M Mery
- Department of Pediatrics, Texas Center for Pediatric and Congenital Heart Disease, University of Texas Dell Medical School/Dell Children's Medical Center, Austin, TX, USA
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17
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Calvache-Mateo A, López-López L, Martín-Núñez J, Heredia-Ciuró A, Granados-Santiago M, Ortiz-Rubio A, Valenza MC. Pain and Clinical Presentation: A Cross-Sectional Study of Patients with New-Onset Chronic Pain in Long-COVID-19 Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4049. [PMID: 36901059 PMCID: PMC10001485 DOI: 10.3390/ijerph20054049] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 06/01/2023]
Abstract
The aim of this study was to evaluate the characteristics of pain (i.e., pain intensity, pain interference, clinical presentation) in Long-COVID-19 patients and compare the location of pain between successfully recovered COVID-19 patients and healthy matched controls. A cross-sectional case-control study was carried out. Long-COVID-19 patients, age- and sex-matched patients with a history of COVID-19 who had successfully recovered, and healthy controls were included. Outcomes included were pain characteristics (Brief Pain Inventory and Short-Form McGill Pain Questionnaire) and clinical presentation (Widespread Pain Index and Euroqol-5 Dimensions 5 Levels Visual Analogue Scale). Sixty-nine patients with Long-COVID-19 syndrome, sixty-six successfully recovered COVID-19 patients, and sixty-seven healthy controls were evaluated. Patients with Long-COVID-19 syndrome showed greater pain intensity and interference. In addition, they showed worse quality of life and greater widespread pain, with the most frequent locations of pain being the neck, legs, and head. In conclusion, patients with Long-COVID-19 syndrome show a high prevalence of pain, characterized by widespread pain of moderate intensity and interference, with the most frequent locations being the neck, legs, and head, significantly affecting the quality of life of these patients.
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Affiliation(s)
- Andrés Calvache-Mateo
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Laura López-López
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Javier Martín-Núñez
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Alejandro Heredia-Ciuró
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | | | - Araceli Ortiz-Rubio
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Marie Carmen Valenza
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
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18
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Kaptein AA. Torn between two lovers - on being a psychologist in a university medical centre. Health Psychol Behav Med 2023; 11:2170379. [PMID: 36733298 PMCID: PMC9888463 DOI: 10.1080/21642850.2023.2170379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background Psychology as applied to health and illness has a relatively short history. Nevertheless, that history shows a rapid development of the theoretical models that guide the field over the past 60 years. Core theoretical approaches are concisely reviewed, in the context of Kaplan's paper 'Behavior as the central outcome in health care' (1990), which is used as a model to examine the extent to which these approaches embrace Kaplan's notions. Advances Empirical studies from the health psychology domain are used, which demonstrate the gains in terms of quality of life and behavioural outcomes in patients with (chronic) somatic diseases. Over a period of some 60 years, theoretical models and core concepts in psychology as applied to health and illness have evolved from psychosomatic views to neuropsychology, quality of life, patient education, self-management, illness perceptions, patient-reported outcome measures (PROMs), shared decision-making (SDM) and health humanities (HH). The more recent models (SDM, HH) appear to align to a considerable degree with adopting 'behavior as the central outcome an outcome in health care'; shared decision-making and health humanities focus on encouraging patients to make sense of and give meaning to their illness in order to attain optimal psychosocial adjustment. Conclusions In addition to 'behavior as the central outcome in health care', a new definition of the concept of health (i.e. 'the ability to adapt and to self-manage' - Huber et al., 2011) seems to favour patients, healthcare providers, society, and health psychology. Incorporating this concept into medical care may be viewed as a challenge for health psychologists - and as a source of continual struggle with strong biomedical forces.
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Affiliation(s)
- Ad A. Kaptein
- Medical Psychology, Leiden University Medical Centre, Leiden, The Netherlands, Ad A. Kaptein Medical Psychology, Leiden University Medical Centre, PO Box 9600, Leiden2300, The Netherlands
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19
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Deacon E. Smile with diabetes: reflections on illness perception and diabetes management behaviors of adolescents in private health care in South Africa. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2023; 4:1097441. [PMID: 37187938 PMCID: PMC10175576 DOI: 10.3389/fcdhc.2023.1097441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 04/06/2023] [Indexed: 05/17/2023]
Abstract
Background The association between illness perception and diabetes management has been well established in adults but is not clearly understood for adolescents. This article reflects on qualitative findings on illness perception from the perspective of adolescents, and suggests future research to operationalize findings. Methods Qualitative document analysis was conducted on four research projects forming part of the Smile with Diabetes project, which aims to investigate psychosocial variables in diabetes management, including illness perception, within the adolescent and youth populations. Thematic analysis was used to derive four themes from the qualitative and review studies examined in the document analysis. Results The voices of the adolescents were evident as four prominent themes: 1) living with diabetes leads to a sense of being different; 2) integration of diabetes into identity is critical, but difficult to achieve; 3) fear of potential negative consequences motivates adherence to treatment; 4) diabetes management is difficult, but possible. Conclusion The findings not only confirmed the importance of illness perception in the management of diabetes by adolescents, but also indicate that illness perceptions should be investigated from a developmental perspective, specifically taking identity development into consideration in this group. Adolescents should be made aware of how their thinking about diabetes and its management affects their experience of living with diabetes and its future management. This study further contributes to the literature by focusing on the patient's voice in understanding living with a chronic condition, and reassures that positive outcomes are possible when living with a chronic condition such as diabetes.
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20
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Kumar K, Mohammadnezhad M. "Once you get cancer you die. There is no way to get saved from cancer." A qualitative exploration of patients' perceptions towards cancer in Fiji. PLoS One 2022; 17:e0277970. [PMID: 36525441 PMCID: PMC9757585 DOI: 10.1371/journal.pone.0277970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/07/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Understanding patients' perspective to get an insight into cancer, and how best the public health systems can battle with this disease is the way forward in this current world. This study aimed to explore patients' knowledge about common cancers, barriers to assessing cancer information and cancer preventative approaches in Fiji. METHODS The study used a qualitative method approach that was conducted among patients who attended Special Outpatients (SOPD) at the four selected health centres in Lautoka Subdivision, Fiji from 1st March to 30th April 2021. A semi-structured open-ended questionnaire was used to guide in-depth interviews. These audio recordings were transcribed and analysed using thematic analysis. All interview transcripts were read and similar words and phrases were assigned numbers which were grouped together to identify themes and sub themes. RESULTS Twenty-eight patients took part in the in-depth interview and the responses were grouped into four themes including; cancer knowledge, diagnosis of cancer in a close friend/family, barriers of communication and optimizing cancer awareness. Patients' awareness about common cancers and cancer risk factors was low. Many barriers for cancer screening were highlighted including stigmatization, fear, worry, death, lack of information, herbal medicine use, lack of resources and delay in diagnosis. Awareness strategies highlighted by participants included community outreach programs, house to house visits, opportunistic screening, engagement of community health care workers and the concept of a cancer hub centre. CONCLUSION It is evident that there is a range of views from patients towards cancer and it is important to understand these perceptions to better guide public health interventions concerning cancer. This puts more focus on the need to invest more in information, education, and communication material for public campaigns that target a variety of people for a wider reach.
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Affiliation(s)
- Kaushal Kumar
- Fiji Ministry of Health and Medical Services, Lautoka Hospital, Lautoka, Fiji Islands
| | - Masoud Mohammadnezhad
- School of Nursing and Healthcare Leadership, University of Bradford, Bradford, United Kingdom
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Nakhon Pathom, Thailand
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21
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Bass C, Petrie KJ. New pain labels are unhelpful for patients and clinicians. J Psychosom Res 2022; 160:110960. [PMID: 35752138 DOI: 10.1016/j.jpsychores.2022.110960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Christopher Bass
- Consultant in Liaison Psychiatry, St Lukes Hospital, Oxford, OX3, UK.
| | - Keith J Petrie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand.
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22
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Samenjo KT, Bengtson M, Onasanya A, Zambrano JCI, Oladunni O, Oladepo O, van Engelen J, Diehl JC. Stakeholders’ Perspectives on the Application of New Diagnostic Devices for Urinary Schistosomiasis in Oyo State, Nigeria: A Q-Methodology Approach. GLOBAL HEALTH: SCIENCE AND PRACTICE 2022; 10:GHSP-D-21-00780. [PMID: 36041843 PMCID: PMC9426976 DOI: 10.9745/ghsp-d-21-00780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 05/31/2022] [Indexed: 11/16/2022]
Abstract
New diagnostic devices for schistosomiasis should be designed to function best within the local endemic health care context and support stakeholders at various levels of the health care system in performing the tasks to help control and eventually eliminate schistosomiasis. Urinary schistosomiasis is a waterborne parasitic infection caused by Schistosoma haematobium that affects approximately 30 million people annually in Nigeria. Treatment and eradication of this infection require effective diagnostics. However, current diagnostic tests have critical shortcomings and consequently are of limited value to stakeholders throughout the health care system who are involved in targeting the diagnosis and subsequent control of schistosomiasis. New diagnostic devices that fit the local health care infrastructure and support the different stakeholder diagnostic strategies remain a critical need. This study focuses on understanding, by means of Q-methodology, the context of use and application of a new diagnostic device that is needed to effectively diagnose urinary schistosomiasis in Oyo State, Nigeria. Q-methodology is a technique that investigates subjectivity by exploring how stakeholders rank-order opinion statements about a phenomenon. In this study, 40 statements were administered to evaluate stakeholder perspectives on the context of use and application of potential new diagnostic devices and how these perspectives or viewpoints are shared with other stakeholders. Potential new diagnostic devices will need to be deployable to remote or distant communities, be affordable, identify and confirm infection status before treatment in patients whose diagnosis of urinary schistosomiasis is based on self-reporting, and equip health care facilities with diagnostic devices optimized for the local setting while requiring local minimal infrastructural settings. Similarly, the context of use and application of a potential new diagnostic device for urinary schistosomiasis is primarily associated with the tasks stakeholders throughout the health care system perform or procedures employed. These findings will guide the development of new diagnostic devices for schistosomiasis that match the contextual landscape and diagnostic strategies in Oyo.
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Affiliation(s)
- Karlheinz Tondo Samenjo
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands.
| | - Michel Bengtson
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Adeola Onasanya
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Juan Carlo Intriago Zambrano
- Department of Water Management, Faculty of Civil Engineering and Geosciences, Delft University of Technology, Delft, Netherlands
| | - Opeyemi Oladunni
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oladimeji Oladepo
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Jo van Engelen
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Jan-Carel Diehl
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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23
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Shan LL, Telianidis S, Qureshi MI, Westcott MJ, Tew M, Choong PF, Davies AH. A Review of Illness Perceptions in Chronic Limb-Threatening Ischemia: Current Knowledge Gaps and a Framework for Future Studies. Ann Vasc Surg 2022; 87:321-333. [PMID: 36029950 DOI: 10.1016/j.avsg.2022.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/18/2022] [Accepted: 07/15/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To review illness perceptions (IP) in chronic limb-threatening ischemia (CLTI) patients undergoing revascularisation (open surgical or endovascular), major lower extremity amputation, or conservative management. METHODS MEDLINE, EMBASE, PsycINFO, CINAHL, WOS, and Scopus databases were searched from inception to August 20th, 2021 for studies evaluating IP in CLTI according to Leventhal's Common-Sense Model (CSM). Since only one study was identified, a post-hoc secondary literature search of MEDLINE was performed for reviews of IP in cardiovascular disease and diabetes to identify potential learning points for future research. All studies underwent narrative synthesis guided by tabulated data. RESULTS One study and seven reviews were included from the primary and secondary literature searches, respectively. Timeline and controllability were the main aspects of IP that predict prosthetic use in CLTI patients, more so at six months than one month. Other reviews in cardiovascular disease and diabetes identified important targets for future research: (i) factors that affect IP and whether IP can be used as an outcome measure, (ii) relationship between IP and clinician-reported and patient-reported outcomes, and (iii) methods to educate and change maladaptive IP. The importance of using valid and reliable measures of IP that encompass all components of Leventhal's' CSM was stressed. CONCLUSIONS Knowledge of IP in CLTI patients is severely limited in contrast to other fields in cardiovascular disease and diabetes. This review helps to close this gap by raising awareness of IP and its importance within the vascular surgical community, and by providing a framework for future studies.
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Affiliation(s)
- Leonard L Shan
- Department of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia.
| | - Stacey Telianidis
- Department of Vascular Surgery, St. Vincent's Hospital Melbourne, Australia
| | - Mahim I Qureshi
- Centre for Surgical Research, Bristol Medical School, The University of Bristol, United Kingdom
| | - Mark J Westcott
- Department of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia
| | - Michelle Tew
- Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia
| | - Peter F Choong
- Department of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia
| | - Alun H Davies
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, United Kingdom
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Affiliation(s)
- Julie Duncan Millar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Helen Mason
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Lisa Kidd
- School of Health and Life Sciences/ Research Centre for Health, Glasgow Caledonian University, Glasgow, UK
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Ngetich E, Pateekhum C, Hashmi A, Nadal IP, Pinyopornpanish K, English M, Quansri O, Wichit N, Kinra S, Angkurawaranon C. Illness perceptions, self-care practices, and glycemic control among type 2 diabetes patients in Chiang Mai, Thailand. Arch Public Health 2022; 80:134. [PMID: 35524335 PMCID: PMC9078014 DOI: 10.1186/s13690-022-00888-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 05/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diabetes Self-Management Education (DSME) is a fundamental aspect of diabetes care, but no standard program exists in Thailand. Understanding current patterns of illness perceptions (concerns) and self-management practices among patients with diabetes in Thailand is vital to develop culturally tailored DSME programs. This study sought to explore the association between reported self-management practices and diabetes perceptions on glycemic control among patients with type 2 diabetes in Chiang Mai Province, Thailand. Specifically, the study examined whether the association between illness perceptions and diabetes control was mediated by self-management. METHODS This was a cross-sectional study conducted among type 2 diabetes patients on outpatient care and follow-up in four districts hospitals in Chiang Mai, Thailand. Illness perceptions was measured by the Brief Illness Perceptions Questionnaire (BIPQ). Self-management practices were measured by Summary Diabetes Self-Care activities (SDSCA). For illness perceptions and self-management practices, patients were classified into two groups, high level and low level based on the median values. Univariate and multivariable analyses were done to determine the association between the determinant factors: self-care practices and illness perceptions and the outcome of interest- good glycemic control (HbA1c < 7%). RESULTS Of the 200 participants recruited into the study, 180 completed the questionnaire. Only 35% of participants had good glycemic control (HBA1c < 7.0). Both illness perceptions and self-management practices were independently linked to glycemic control. Among illness perceptions, a sense of personal control was strongly associated with good glycemic control (p = 0.01). For self-management, appropriate diet (p = 0.03) and medication adherence (p = 0.05) were associated with good glycemic control. After adjustments for key baseline characteristics, patients with high levels of illness perceptions were less likely to achieve glycemic control (OR 0.55, 95% CI 0.29 to 1.14, p = 0.11) and those with high level of self-management were more likely to achieve glycemic control (OR 2.11, 95% CI 1.04 to 4.30, p = 0.04). The effect size for illness perception attenuated when further adjusted for levels of self-management (OR 0.88, 95% CI 0.39 to 1.96, p = 0.75) while the effect size for self-management and glycemic control did not materially change (OR 2.30, 95% CI 1.06 to 5.02, p = 0.04). CONCLUSION Illness perceptions and self-management practices are associated with glycemic control. Future culturally tailored interventions in Thailand aimed at improving glycemic should focus on personal control, improving diet and treatment adherence as these are more likely to help improve diabetes control as demonstrated in this study.
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Affiliation(s)
- Elisha Ngetich
- Nuffield Department of Surgical Sciences, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Chanapat Pateekhum
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ahmar Hashmi
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Iliatha Papachristou Nadal
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Mike English
- Nuffield Department of Medicine, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Orawan Quansri
- ASEAN Institute for Health Development, Mahidol University, Salaya, Nakorn Pathom, Thailand
| | | | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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O'Connor S, Hevey D, O'Keeffe F. Illness Perceptions, Coping, Health-Related Quality of Life and Psychological Outcomes in Cervical Dystonia. J Clin Psychol Med Settings 2022; 30:129-142. [PMID: 35438357 PMCID: PMC10042972 DOI: 10.1007/s10880-022-09851-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 01/03/2023]
Abstract
This study examined the predictive ability of the Common-Sense Model to explain psychological outcomes in cervical dystonia, a movement disorder that affects the muscles of the head and neck. Illness Perceptions Questionnaire-Revised, brief COPE, Hospital Anxiety and Depression Scale, Cervical Dystonia Impact Profile and the Post-Traumatic Growth Inventory were completed by 118 people with cervical dystonia. Correlations and hierarchical multiple regression models were conducted. Illness perceptions and coping strategies explained 59% of variance in anxiety, 61% of variance in depression and health-related quality of life and 19% of variance in post-traumatic growth. Illness perceptions and coping strategies are significant factors to consider in terms of psychological adjustment and outcomes in cervical dystonia. Psychological interventions targeting illness perceptions and coping strategies may be beneficial in improving psychological outcomes for people with cervical dystonia.
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Affiliation(s)
- Sarah O'Connor
- School of Psychology, Trinity College Dublin, Dublin, Ireland.
| | - David Hevey
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Fiadhnait O'Keeffe
- School of Psychology, Trinity College Dublin, Dublin, Ireland.,Department of Psychology, St Vincent's University Hospital, Dublin, Ireland
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Unni E, Bae S. Exploring a New Theoretical Model to Explain the Behavior of Medication Adherence. PHARMACY 2022; 10:43. [PMID: 35448702 PMCID: PMC9025348 DOI: 10.3390/pharmacy10020043] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 01/25/2023] Open
Abstract
Medication adherence is essential for optimal therapeutic outcomes. However, non-adherence with long-term therapy is at 50%. Several theoretical models have identified several key factors that could explain medication adherence. Though numerous interventions have been developed based on these theoretical models, the success rates with interventions are not the best. This paper proposes a new Hierarchical Model for Medication Adherence. In this model, we propose medication adherence as a five-tier model with medication adherence as the desirable behavior on the top of the pyramid. From the bottom of the hierarchy upwards, the skills/beliefs/behaviors to be achieved are: health literacy, belief in illness (impacted by perceived susceptibility and severity of illness), belief in medicines (impacted by treatment satisfaction), and self-efficacy (impacted by social support). The model further proposes that each individual will achieve or already have these skills/beliefs/behaviors at various levels. Screening patients for these benchmarks will enable providers to decide where to target interventions.
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Affiliation(s)
- Elizabeth Unni
- Department of Social, Behavioral, and Administrative Sciences, Touro College of Pharmacy, 230 West 125th Street, Room 505, New York, NY 10027, USA
| | - Sun Bae
- Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, 301 Pharmacy Lane, Chapel Hill, NC 27599, USA;
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28
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Manouchehri E, Taghipour A, Ebadi A, Homaei Shandiz F, Latifnejad Roudsari R. Understanding breast cancer risk factors: is there any mismatch between laywomen perceptions and expert opinions. BMC Cancer 2022; 22:309. [PMID: 35321682 PMCID: PMC8941798 DOI: 10.1186/s12885-022-09372-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 03/04/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Women's perception and knowledge of breast cancer signs, symptoms, and risk factors could be conducive to breast cancer risk management and interventions. The present study aimed to explore Iranian laywomen perceptions and expert opinions regarding breast cancer risk factors. METHODS This qualitative study was conducted from March to November 2019 in Mashhad, northeast of Iran. Through purposive sampling, 24 laywomen (women with and without BC) and 10 experts of different fields including oncology, surgery, gynecology and reproductive health were selected. Data collection was carried out using semi-structured interviews, which was mainly focused on the participants' understanding and perception of BC risk factors. The data was analyzed utilizing conventional content analysis developed by Graneheim & Lundman. Components of trustworthiness, including credibility, dependability, confirmability, and transferability were considered. RESULTS The main category of risk factors, which emerged from the lay participants' data analysis, were "unhealthy lifestyle and habits" , "hormonal influences", "environmental exposures", "Individual susceptibility "and "belief in supernatural powers". The experts had similar perspectives for certain risk factors, yet not for all. The category of "Individual history of disease" was emerged only from experts' interviews. CONCLUSION In the present study, the lay participants' perception concerning BC risk factors was found to be a mixture of cultural beliefs and the scientific knowledge dispersed by the media, internet, and health services. Primary prevention approaches, including awareness of breast cancer risk factors, are required for women to make improved health-related choices.
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Affiliation(s)
- E. Manouchehri
- Department of Midwifery, Faculty of Nursing and Midwifery, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran
- Department of Midwifery, School of Nursing & Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - A. Taghipour
- Present Address: Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Epidemiology, School of Public Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - A. Ebadi
- Behavioral Sciences Research Center, Life style Institute, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - F. Homaei Shandiz
- Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - R. Latifnejad Roudsari
- Department of Midwifery, School of Nursing & Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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29
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Tang S, Anderson NE, Faasse K, Adams WP, Newby JM. A Qualitative Study on the Experiences of Women With Breast Implant Illness. Aesthet Surg J 2022; 42:381-393. [PMID: 33904898 DOI: 10.1093/asj/sjab204] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Breast implant illness (BII) is a term used to describe physical and psychological symptoms experienced by some women following breast implant surgery. Few studies have examined the experiences of women with BII-a poorly understood condition with no clear cause or treatment. OBJECTIVES The aim of this study was to explore women's experiences of BII, including symptoms, healthcare encounters, social media, and explant surgery. METHODS Employing an exploratory qualitative methodology, researchers undertook semistructured interviews with 29 women who self-identified as having BII. Interviews were audio-recorded and transcribed verbatim. Data were analyzed by inductive thematic analysis. RESULTS Thematic analysis of the interviews identified 6 themes: (1) symptoms without explanation; (2) invalidation and invisibility; (3) making the BII connection; (4) implant toxicity; (5) explant surgery: solution to suffering?; and (6) concealed information. BII was described as distressing and debilitating across multiple domains including relationships, work, identity, and physical and mental health, and symptoms were attributed to implant toxicity and immune system rejection of foreign objects. When their experience was not validated by healthcare professionals, many looked to social media for information, support, and understanding, and saw explant as their only chance of recovery. CONCLUSIONS BII is disabling mentally and physically. Women with BII require support, understanding, and validation, and proactive treatment to prevent disability. With unclear pathophysiology, future research should examine how biopsychosocial approaches can be used to guide treatment, and how to best support women with BII, focusing on early detection and evidence-based education and intervention. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Samantha Tang
- Dr Tang is a research assistant and Dr Faasse is a senior lecturer, School of Psychology, Faculty of Science, UNSW Sydney, Sydney, New South Wales, Australia
| | - Natalie E Anderson
- Dr Anderson is a professional teaching fellow, Department of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Kate Faasse
- Dr Tang is a research assistant and Dr Faasse is a senior lecturer, School of Psychology, Faculty of Science, UNSW Sydney, Sydney, New South Wales, Australia
| | - William P Adams
- Dr Adams is a program director, UT Southwestern Aesthetic Surgery Fellowship and associate professor, UT Southwestern Department of Plastic Surgery, TX, USA
| | - Jill M Newby
- Dr Newby is an associate professor, Black Dog Institute, Faculty of Medicine and School of Psychology, Faculty of Science, UNSW Sydney, Sydney, New South Wales, Australia
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30
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Rodríguez-Rubio P, Lacomba-Trejo L, Valero-Moreno S, Montoya-Castilla I, Pérez-Marín M. 10Vida: A Mental and Physical Health Intervention for Chronically Ill Adolescents and Their Caregivers in the Hospital Setting: An Open Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063162. [PMID: 35328851 PMCID: PMC8953533 DOI: 10.3390/ijerph19063162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/04/2022] [Accepted: 03/05/2022] [Indexed: 02/04/2023]
Abstract
Suffering from a chronic disease (CD) in adolescence can significantly impact the emotional health of adolescents and their families. MHealth can be a useful tool for these groups. However, few intervention programmes include the family system. The aim is to design an intervention programme (10Vida) for a paediatric population with a CD, and their families, to improve their adaptation to the disease. The study is a quasi-experimental repeated measures design in a open study, where the patients themselves, and their families, are their own control group. Participants will receive an intervention of seven individual sessions: five sessions with each patient, and two sessions with their caregivers. In the case of the patients, the aim is to improve their emotional state, their self-esteem, and their emotional competencies, reducing their perceived threat of illness. Furthermore, in the case of the caregivers, the aim is to improve their emotional state and reduce their burden. Indirectly, working with caregivers and those being cared for will improve family ties. The pilot study will involve 25 to 30 chronically ill adolescents aged between 12 and 16 years and their primary caregivers. Following the results, the necessary modifications will be included, and the programme will be offered to adolescents and their families who are willing to participate.
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Affiliation(s)
- Pilar Rodríguez-Rubio
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology and Speech Therapy, Universitat de València, Av. Blasco Ibáñez, 21, 46010 Valencia, Spain; (P.R.-R.); (L.L.-T.); (I.M.-C.)
| | - Laura Lacomba-Trejo
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology and Speech Therapy, Universitat de València, Av. Blasco Ibáñez, 21, 46010 Valencia, Spain; (P.R.-R.); (L.L.-T.); (I.M.-C.)
| | - Selene Valero-Moreno
- Department of Developmental and Educational Psychology, Faculty of Psychology and Speech Therapy, Universitat de València, Av. Blasco Ibáñez, 21, 46010 Valencia, Spain;
| | - Inmaculada Montoya-Castilla
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology and Speech Therapy, Universitat de València, Av. Blasco Ibáñez, 21, 46010 Valencia, Spain; (P.R.-R.); (L.L.-T.); (I.M.-C.)
| | - Marián Pérez-Marín
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology and Speech Therapy, Universitat de València, Av. Blasco Ibáñez, 21, 46010 Valencia, Spain; (P.R.-R.); (L.L.-T.); (I.M.-C.)
- Correspondence: ; Tel.: +34-963983392
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Emad Y, Dalbeth N, Weinman J, Chalder T, Petrie KJ. Why do patients with gout not take allopurinol? J Rheumatol 2022; 49:622-626. [DOI: 10.3899/jrheum.210950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2022] [Indexed: 10/19/2022]
Abstract
Objective The objectives of this study were to examine the reasons patients give for non-adherence to allopurinol and examine differences in intentional non-adherence for patients with and without serum urate at treatment target. Methods Sixty-nine men with gout attending rheumatology clinics, all prescribed allopurinol for at least six months, completed the Intentional Non-Adherence Scale (INAS). Differences in the types of intentional non-adherence were analysed between those with and without a serum urate (SU) at treatment target (<0.36mmol/L, 6mg/dL). Results Among most frequently endorsed reasons for not taking their urate lowering medication was because participants wanted to lead a normal life (23%) or think of themselves as a healthy person again (20%). Patients also reported not taking allopurinol as way of testing if they really needed it (22%). Participants with SU above target endorsed significantly more INAS items as reasons for not taking their medicine, had higher medicine-related concerns and were more likely to give testing treatment as a reason for non-adherence. Participants who were younger, single and non-NZ European also endorsed more reasons for not taking their allopurinol. Conclusion Major reasons behind the decision not to take allopurinol relate to wanting to lead a normal life and the strategy of testing treatment to see if patients could reduce the dose without getting symptoms. The results provide some potentially modifiable targets for adherence interventions and also some indications to clinicians about how urate-lowering treatment may be purposely framed for patients in order to improve adherence.
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Cannon M, Crede M, Kimber JM, Brunkow A, Nelson R, McAndrew LM. The Common-Sense Model and Mental Illness Outcomes: A Meta-Analysis. Clin Psychol Psychother 2022; 29:1186-1202. [PMID: 35112427 DOI: 10.1002/cpp.2721] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 01/29/2022] [Accepted: 01/31/2022] [Indexed: 11/09/2022]
Abstract
Psychotherapists can improve their patients' outcomes during and after therapy by improving patients' self-management. Patients who do not effectively manage their mental illness generally have worse outcomes. Leventhal's Common-Sense Model of Self-Regulation theorizes that patients' perceptions of their illness (illness representations) guide their self-management, influencing health outcomes. The present study quantified the relations between illness representations, self-management, and outcomes for mental illnesses. We conducted a meta-analysis and included articles if they reported: 1) on adults with mental illnesses; and 2) the correlation between mental illness representations and mental illness outcomes. 25 articles were included which represented 28 independent samples. The pattern of correlations among illness representations (identity, consequences, timeline, control, coherence, and emotional representations), self-management strategies (attendance, engagement, and adherence to treatment) and mental illness outcomes (symptom severity and quality of life) was consistent with analyses from previous studies of mental and physical illnesses. The results found threat-related illness representations mostly had a large relationship with worse mental illness outcomes and self-management. Protective illness representations had a small-to-large relationship with better mental illness outcomes and self-management. The results suggest patients' perceptions of their mental illness may be a critical indicator of their mental illness outcomes, including symptom severity and quality of life. This theory-driven meta-analysis supports calls for the inclusion of illness representations in psychotherapy for mental illness.
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Affiliation(s)
- Margeaux Cannon
- University at Albany, State University of New York 1400, Washington, NY, USA
| | - Marcus Crede
- Iowa State University 901 Stange Rd. Ames, IA, USA
| | - Justin M Kimber
- University at Albany, State University of New York 1400, Washington, NY, USA
| | - Alexandria Brunkow
- University at Albany, State University of New York 1400, Washington, NY, USA
| | - Rebecca Nelson
- University at Albany, State University of New York 1400, Washington, NY, USA
| | - Lisa M McAndrew
- University at Albany, State University of New York 1400, Washington, NY, USA
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Spray J, Hunleth J, Ruiz S, Maki J, Fedele DA, Prabhakaran S, Fechtel H, Shepperd JA, Bowen DJ, Waters EA. How do embodied experiences of asthma influence caregiver conceptual models? Soc Sci Med 2022; 294:114706. [PMID: 35033796 PMCID: PMC10389678 DOI: 10.1016/j.socscimed.2022.114706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 02/05/2023]
Abstract
RATIONALE Many studies propose that patients', caregivers', and children's asthma management practices may diverge from biomedical recommendations because their understandings of asthma (i.e., conceptual models) are different from biomedical perspectives. However, little research in this area has examined conceptual models of asthma using embodiment theory, which suggests that caregivers' and children's experiences of the physical body shape their perspectives and consequent management strategies. OBJECTIVE We investigated how two embodied processes of symptom perception-detection and interpretation-may influence caregiver or patient conceptions of asthma. METHODS We interviewed 41 caregivers of children with asthma in Gainesville, Florida, and St. Louis, Missouri, and conducted ethnographic visits or virtual interviews with 19 children with asthma aged 6-16. RESULTS Four aspects of asthma's embodied experience shaped conceptual models via processes of detection and interpretation: 1) symptoms are experienced in the context of other bodily processes; 2) acute symptoms and exacerbations are more salient than their absence; 3) the embodied experience of asthma is one of integrated physiological and emotional processes; and 4) caregivers and children acquire embodied practices of perceiving symptoms that produce embodied knowledge. CONCLUSION Participant narratives suggest that embodied experiences of asthma shape caregivers' and children's understandings of asthma in ways that differ from the biomedical model. We argue that a focus on embodied experiences may provide important ground for mutual understanding and communication between providers and caregivers and/or patients.
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Affiliation(s)
- Julie Spray
- Division of Public Health Sciences, Washington University School of Medicine in St. Louis, United States
| | - Jean Hunleth
- Division of Public Health Sciences, Washington University School of Medicine in St. Louis, United States
| | - Sienna Ruiz
- Division of Public Health Sciences, Washington University School of Medicine in St. Louis, United States
| | - Julia Maki
- Division of Public Health Sciences, Washington University School of Medicine in St. Louis, United States
| | - David A Fedele
- Department of Clinical & Health Psychology, University of Florida, United States
| | | | - Hannah Fechtel
- Department of Psychology, University of Florida, United States
| | | | - Deborah J Bowen
- School of Public Health, University of Washington, United States
| | - Erika A Waters
- Division of Public Health Sciences, Washington University School of Medicine in St. Louis, United States.
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Ng S, Rodger MA, Ghanima W, Kovacs MJ, Shivakumar S, Kahn SR, Sandset PM, Kearon C, Mallick R, Delluc A. External validation of the patient reported Villalta scale for the diagnosis of post-thrombotic syndrome. Thromb Haemost 2022; 122:1379-1383. [PMID: 35021257 DOI: 10.1055/a-1738-1313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sara Ng
- Liverpool Hospital, Liverpool, Australia
| | | | | | | | | | | | - Per-Morten Sandset
- Haemotology, Oslo universitetssykehus Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, Universitetet i Oslo Institutt for klinisk medisin, Oslo, Norway
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Antunovich D, Tuck N, Reynolds LM, Bean D. "I Don't Identify with It": A Qualitative Analysis of People's Experiences of Living with Complex Regional Pain Styndrome. PAIN MEDICINE (MALDEN, MASS.) 2021; 22:3008-3020. [PMID: 33693870 DOI: 10.1093/pm/pnab094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 02/14/2021] [Accepted: 03/04/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Complex regional pain syndrome (CRPS) is a painful limb condition known to cause significant disability and distress. However, little previous research has explored CRPS from a patient perspective. The present qualitative study aimed to describe the experiences of people living with CRPS. SUBJECTS Forty-eight people with CRPS participated in this research. METHODS Participants completed a face-to-face or telephone interview about their perceptions and experiences of CRPS and completed three drawings to illustrate their experiences. Data were analyzed through reflexive thematic analysis, and images in drawings were grouped and coded by theme. RESULTS Three overarching themes encapsulated the data, including that 1) people experience CRPS as a source of severe symptoms and emotional difficulties, 2) CRPS undermines personal and social identity, and 3) this results in psychological responses that protect against the emotional and social impact of severe symptoms. Psychological responses include: a) searching for an explanation, b) "nothing is my fault," emphasizing a lack of personal responsibility and personal control, and c) detaching the limb from the self. CONCLUSIONS CRPS is experienced as highly threatening to physical ability, psychological state, and identity. In response to these threats, people may develop their own explanations for CRPS and may mentally detach themselves from responsibility, control, and the painful limb itself. Future research could explore the impact of these factors on psychological well-being and CRPS symptoms and outcomes.
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Affiliation(s)
- Dana Antunovich
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
- Pain Service, Northland District Health Board, Northland, New Zealand
| | - Natalie Tuck
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
- The Auckland Regional Pain Service, Auckland District Health Board, Auckland, New Zealand
- Chronic Pain Service, Department of Anaesthesia and Perioperative Medicine, Waitemata District Health Board, Auckland, New Zealand
| | - Lisa M Reynolds
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Debbie Bean
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
- Chronic Pain Service, Department of Anaesthesia and Perioperative Medicine, Waitemata District Health Board, Auckland, New Zealand
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Reich H, Zürn D, Mewes R. Engaging Turkish Immigrants in Psychotherapy: Development and Proof-of-Concept Study of a Culture-Tailored, Web-Based Intervention. CLINICAL PSYCHOLOGY IN EUROPE 2021; 3:e5583. [PMID: 36398285 PMCID: PMC9667227 DOI: 10.32872/cpe.5583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 08/25/2021] [Indexed: 11/25/2022] Open
Abstract
Background Culturally tailored interventions can increase the engagement and the success rate of psychotherapy in immigrant and ethnic minority patients. In this regard, the integration of the patients' illness beliefs is a key element. Applying principles of Motivational and Ethnographic Interviewing, we developed a culture-tailored, web-based intervention to facilitate engagement of Turkish immigrant inpatients in psychotherapy. Method The different aspects of the engagement intervention development are described and its acceptance and usefulness were tested in a proof-of-concept trial with an experimental control group design (active control condition: progressive muscle relaxation) in a sample of Turkish immigrant inpatients in Germany (N = 26). Illness perception, illness-related locus of control, and self-efficacy were assessed pre and post intervention. Results The engagement intervention was rated better than the control condition (p = .002) and in particular, participants felt better prepared for therapy after working with it (p = .013). By working with the engagement intervention, self-efficacy increased (p = .034) and external-fatalistic control beliefs diminished (p = .021). However, half of the participants needed assistance in using the computer and web-based interventions. Conclusion The developed intervention provides a first step towards feasible culture-tailored psychotherapeutic elements that can be integrated into routine clinical care. The first results regarding acceptance and usefulness are promising.
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Affiliation(s)
- Hanna Reich
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Marburg, Germany
- Depression Research Centre of the German Depression Foundation, Department for Psychiatry, Psychosomatics and Psychotherapy, Goethe University, Frankfurt, Germany
| | - Daniela Zürn
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Marburg, Germany
| | - Ricarda Mewes
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Marburg, Germany
- Outpatient Unit for Research, Teaching and Practice, Faculty of Psychology, University of Vienna, Vienna, Austria
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Suen YN, Yeung ETW, Chan SKW, Hui CLM, Lee EHM, Chang WC, Chan CYH, Chen CEYH. Integration of biological and psychological illness attributional belief in association with medication adherence behaviour: A path analysis. Early Interv Psychiatry 2021; 15:1686-1695. [PMID: 33461243 DOI: 10.1111/eip.13114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 12/14/2020] [Accepted: 01/04/2021] [Indexed: 01/18/2023]
Abstract
AIM This study aimed to determine the association of biological (BAB) and psychological illness attributional beliefs (PAB) with medication adherence behaviour in patients with psychosis in Hong Kong. METHODS A cross-sectional survey of 301 outpatients with psychosis in Hong Kong was conducted from August to October 2016. The survey included a set of questionnaires examining patient medication adherence behaviours (using five behavioural items from the Medication Adherence Rating Scale), illness attributional belief, insight into the illness, and attitudes towards antipsychotics and medical professionals. The associations between these variables were analysed using path analysis and adjusted for covariates of perceived social support, experience of side-effects, and gender. RESULTS The data fit a model in which medication adherence behaviour was associated with illness attributional belief, insight, and attitudes (chi-square = 32.33, p = .26; RMSEA = 0.02; SRMR = 0.04; and CFI = 0.97). BAB was positively and directly associated with medication adherence behaviour. PAB was positively and indirectly associated with medication adherence behaviour through insight into the illness and attitude towards medical professionals. PAB can strengthen the relationship between BAB and insight, and only the high PAB group exhibited a positive relationship between BAB and attitude towards medical professionals. CONCLUSIONS An integration of biological and psychological attributional beliefs in patients with psychosis is essential for better medication adherence behaviour. Future interventions should aim to modify patients' illness attributional beliefs by integrating both biological and psychological illness attribution to improve medication adherence.
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Affiliation(s)
- Yi Nam Suen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, PokfuLam, Hong Kong
| | - Emily Tsz Wa Yeung
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, PokfuLam, Hong Kong
| | - Sherry Kit Wa Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, PokfuLam, Hong Kong.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, PokfuLam, Hong Kong
| | - Christy Lai Ming Hui
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, PokfuLam, Hong Kong
| | - Edwin Ho Ming Lee
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, PokfuLam, Hong Kong
| | - Wing Chung Chang
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, PokfuLam, Hong Kong.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, PokfuLam, Hong Kong
| | - Candice Yu Hay Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, PokfuLam, Hong Kong
| | - Chan Eric Yu Hai Chen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, PokfuLam, Hong Kong.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, PokfuLam, Hong Kong
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38
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Shipston-Sharman O, Popkirov S, Hansen CH, Stone J, Carson A. Prognosis in functional and recognised pathophysiological neurological disorders - a shared basis. J Psychosom Res 2021; 152:110681. [PMID: 34872006 DOI: 10.1016/j.jpsychores.2021.110681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To compare self-reported outcomes, clinical trajectory and utility of baseline questionnaire responses in predicting prognosis in functional and recognised pathophysiological neurological disorders. METHODS Baseline data on 2581 patients included health-related quality of life, psychological and physical symptoms, illness perceptions, consultation satisfaction and demographics. The prospective cohort included neurology outpatients classified with a functional (reporting symptoms 'not at all' or 'somewhat explained' by 'organic disease'; n = 716) or recognised pathophysiological disorder ('largely' or 'completely explained'; n = 1865). Logistic regression and deep neural network models were used to predict self-reported global clinical improvement (CGI) at 12-months. RESULTS Patients with functional and recognised pathophysiological disorders reported near identical outcomes at 12-months with 67% and 66% respectively reporting unchanged or worse CGI. In multivariable modelling 'negative expectation of recovery' and 'disagreement with psychological attribution' predicted same or worse outcome in both groups. Receipt of disability-related state benefit predicted same or worse CGI outcome in the functional disorder group only (OR = 2.28 (95%-CI: 1.36-3.84) in a group-stratified model) and was not related to a measure of economic deprivation. Deep neural network models trained on all 92 baseline features predicted poor outcome with area under the receiver-operator curve of 0.67 in both groups. CONCLUSIONS Those with functional and recognised pathophysiological neurological disorder share similar outcomes, clinical trajectories, and poor prognostic markers in multivariable models. Prediction of outcome at a patient level was not possible using the baseline data in this study.
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Affiliation(s)
| | - Stoyan Popkirov
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany
| | - Christian H Hansen
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jon Stone
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Alan Carson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
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39
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Newby JM, Tang S, Faasse K, Sharrock MJ, Adams WP. Commentary on: Understanding Breast Implant Illness. Aesthet Surg J 2021; 41:1367-1379. [PMID: 33247711 DOI: 10.1093/asj/sjaa329] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Breast implant surgery is the most common plastic surgery procedure performed globally. A subset of women with breast implants report experiencing a myriad of disabling and distressing physical and psychological symptoms attributed to their implants. Social media groups have coined the condition "breast implant illness" (BII). Little to no scientific research currently exists for BII. OBJECTIVES The aim of this study was to investigate the experiences of women with BII (both those with implants still in place and those who have explanted) and compare them with those of a control group of women with implants who do not report BII. METHODS Women with self-reported BII and implants still in place (n = 51), self-reported BII who had explanted (n = 60), and women with implants in place without BII (n = 58) completed online self-report questionnaires about their symptoms, physical and mental health, health service use patterns, and lifestyle factors (eg, exercise, smoking, alcohol consumption). RESULTS Women with BII, regardless of whether they had undergone explant surgery, reported experiencing more severe somatic symptoms, higher depression, anxiety and health anxiety, and poorer physical health than women without BII. CONCLUSIONS These findings highlight the need for further investigation into the causes, risk factors, long-term effects, and potential interventions for women who experience BII.
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Affiliation(s)
- Jill M Newby
- MRFF Career Development Fellow, Black Dog Institute, UNSW Sydney, Sydney, Australia
| | - Samantha Tang
- School of Psychology, Faculty of Science, UNSW Sydney, Sydney, Australia
| | - Kate Faasse
- ARC Discovery Early Career Research Fellow, School of Psychology, Faculty of Science, UNSW Sydney, Sydney, Australia
| | - Maria J Sharrock
- Clinical Research Unit for Anxiety & Depression, St Vincent’s Hospital, Sydney, Australia
| | - William P Adams
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
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40
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Różycka J. How I see is how I feel. Identification of illness perception schema and its association with adaptation outcomes in multiple sclerosis - a 5-year prospective study. PLoS One 2021; 16:e0258740. [PMID: 34710124 PMCID: PMC8553031 DOI: 10.1371/journal.pone.0258740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 10/04/2021] [Indexed: 11/18/2022] Open
Abstract
The aim of the study was to assess the role of illness perception in adaptation to chronic disease among patients with relapsing-remitting multiple sclerosis (RRMS). The differences between the obtained configurations of the illness perception components during four measurements and the model of predictions of the values of adaptation indicators, i.e. depression, anxiety and quality of life during subsequent measurements, were analyzed. Illness representation was assessed at baseline via the Illness Representation Questionnaire–Revised. The adaptation indicators–anxiety, depression (measured by HADS) and quality of life (measured by MSIS-29) were measured at baseline and three more times over a five-year period. The k-means cluster analysis (with two-way and repeated measures ANOVA) was conducted in a group of 90 patients (48.89% women and 51.11% men). Subsequently, the mean values of depression, anxiety, physical and psychological quality of life were compared between the clusters using the Kruskall-Wallis test. Finally, a cross-lagged panel modeled for HADS and MSIS-29 subscales in each measurement occasion (T1-T4). Three different illness perception clusters (Anxious, Realistic and Fatalistic Illness Perception named AIP, RIP and FIP) were composed which differentiated the depression, anxiety, quality of life level and age. FIP showed the lowest adaptation outcomes with small differences between AIP and RIP. It was also significantly characterized by the highest age. The positive adaptation indicators were related to the RIP cluster. The model presented rather satisfactory fit (χ2(48) = 81.05; CFI = .968; TLI = .925; SRMR = .050) with slightly inflated RMSEA = .087 (90%CI .053-.120). Based on initial measurements of individual characteristics, it was possible to predict the functioning of patients after several years. For patients with AIP, the covariance of anxiety and depression was significant, for patients with RIP–depression and anxiety, and for patients with FIP–depression. In addition, each of the variables was a predictor of subsequent measurements in particular time intervals, illustrating the dynamics of changes. Results highlight that illness perceptions formed at the beginning of RRMS are important for the process of adaptation to the disease. Moreover, they showed the differences between the adaptation outcomes supporting the idea that a cognitive representation might be important for the level of psychological functioning.
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41
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Millman LSM, Hunter ECM, Orgs G, David AS, Terhune DB. Symptom variability in depersonalization-derealization disorder: A latent profile analysis. J Clin Psychol 2021; 78:637-655. [PMID: 34487354 DOI: 10.1002/jclp.23241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/09/2021] [Accepted: 08/15/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Depersonalization-derealization disorder (DDD) is characterized by diverse symptomatology overlapping with anxiety and dissociative disorders, but the sources of this variability are poorly understood. This study aims to determine whether symptom heterogeneity is attributable to the presence of latent subgroups. METHOD We applied latent profile analysis to psychometric measures of anxiety, depersonalization-derealization, and dissociation in 303 DDD patients. RESULTS The analysis yielded evidence for five discrete subgroups: three of varying severity levels and two moderate-to-severe classes characterized by differential dissociative symptoms. The five classes reliably differed on several nondissociative symptoms, comorbidities, and factors precipitating their diagnosis but did not significantly differ in other symptoms including anxiety. CONCLUSION These results suggest the presence of three distinct DDD subtypes in the upper severity range that are distinguished by differential expression of detachment and compartmentalization symptoms. Further elucidation of these subtypes has potential implications for the etiology, mechanisms, and treatment of DDD.
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Affiliation(s)
| | | | - Guido Orgs
- Department of Psychology, Goldsmiths, University of London, London, UK
| | - Anthony S David
- Institute of Mental Health, University College London, London, UK
| | - Devin B Terhune
- Department of Psychology, Goldsmiths, University of London, London, UK
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42
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Selinheimo S, Lampi J, Pekkanen J. Parent's self-reported indoor environment-related symptoms and health worry increase symptom reports among their children at school-Study in two independent populations. INDOOR AIR 2021; 31:1298-1307. [PMID: 33955596 DOI: 10.1111/ina.12836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/12/2021] [Accepted: 03/23/2021] [Indexed: 06/12/2023]
Abstract
Little is known whether parent's indoor environment quality (IEQ)-related symptoms or health perceptions influence the risk of self- or parent-reported symptoms in their children. We assessed (i) the association of parents' IEQ-related symptoms with IEQ-related symptoms in their children at school and (ii) whether parental IEQ-related health worry increases the risk for children's symptoms. We used two Finnish studies: a national, population-based survey of indoor air and related health problems (n = 611 parents) and a subset of survey for all primary school pupils (grade 3-6) and their parents in Helsinki, which also included school IEQ-related symptoms reported by children (n = 1617 parent-child dyads). In the school survey, parent's own symptoms increased strongly their reporting of their children's symptoms at school (aOR 4.0, 95% CI 2.7-6.0 for parents experiencing a lot of symptoms) and also symptoms reported by the child itself (aOR 2.2, 95% CI 1.5-3.1). Similar, but slightly weaker associations were seen with parental IEQ-related health worries. Results remained unchanged when adjusted for the IEQ of school buildings or parental and children's allergic diseases. Similar associations were seen in the national survey between parent's symptoms at work and child's symptoms at school. The results suggest that parents' health perceptions may increase the reporting of children's IEQ-related symptoms even more than is typically seen for many indoor air contaminants.
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Affiliation(s)
| | - Jussi Lampi
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Juha Pekkanen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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43
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Korenstein D, Harris R, Elshaug AG, Ross JS, Morgan DJ, Cooper RJ, Cho HJ, Segal JB. To Expand the Evidence Base About Harms from Tests and Treatments. J Gen Intern Med 2021; 36:2105-2110. [PMID: 33479928 PMCID: PMC8298733 DOI: 10.1007/s11606-021-06597-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/01/2021] [Indexed: 12/19/2022]
Abstract
Rigorous evidence about the broad range of harms that might be experienced by a patient in the course of testing and treatment is sparse. We aimed to generate recommendations for how researchers might more comprehensively evaluate potential harms of healthcare interventions, to allow clinicians and patients to better include this evidence in clinical decision-making. We propose seven domains of harms of tests and treatments that are relevant to patients: (1) physical impairment, (2) psychological distress, (3) social disruption, (4) disruption in connection to healthcare, (5) labeling, (6) financial impact, and (7) treatment burden. These domains will include a range of severity of harms and variation in timing after testing or treatment, attributable to the service itself or a resulting care cascade. Although some new measures may be needed, diverse data and tools are available to allow the assessment of harms comprehensively across these domains. We encourage researchers to evaluate harms in sub-populations, since the harms experienced may differ importantly by demographics, social determinants, presence of comorbid illness, psychological state, and other characteristics. Regulators, funders, and editors might require either assessment or reporting of harms in each domain or require justification for inclusion and exclusion of different domains.
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Affiliation(s)
- Deborah Korenstein
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | | | - Adam G Elshaug
- Melbourne School of Population and Global Health and Melbourne Medical School, The University of Melbourne, Melbourne, Australia
- The Brookings Institution, Washington DC, USA
| | - Joseph S Ross
- Department of Medicine, Yale School of Medicine, New Haven, CT USA
| | - Daniel J Morgan
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD USA
| | - Richelle J Cooper
- UCLA Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA USA
| | - Hyung J Cho
- Department of Quality and Safety, NYC Health and Hospitals, New York, NY USA
| | - Jodi B Segal
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD USA
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Churruca K, Ludlow K, Wu W, Gibbons K, Nguyen HM, Ellis LA, Braithwaite J. A scoping review of Q-methodology in healthcare research. BMC Med Res Methodol 2021; 21:125. [PMID: 34154566 PMCID: PMC8215808 DOI: 10.1186/s12874-021-01309-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/30/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Q-methodology is an approach to studying complex issues of human 'subjectivity'. Although this approach was developed in the early twentieth century, the value of Q-methodology in healthcare was not recognised until relatively recently. The aim of this review was to scope the empirical healthcare literature to examine the extent to which Q-methodology has been utilised in healthcare over time, including how it has been used and for what purposes. METHODS A search of three electronic databases (Scopus, EBSCO-CINAHL Complete, Medline) was conducted. No date restriction was applied. A title and abstract review, followed by a full-text review, was conducted by a team of five reviewers. Included articles were English-language, peer-reviewed journal articles that used Q-methodology (both Q-sorting and inverted factor analysis) in healthcare settings. The following data items were extracted into a purpose-designed Excel spreadsheet: study details (e.g., setting, country, year), reasons for using Q-methodology, healthcare topic area, participants (type and number), materials (e.g., ranking anchors and Q-set), methods (e.g., development of the Q-set, analysis), study results, and study implications. Data synthesis was descriptive in nature and involved frequency counting, open coding and the organisation by data items. RESULTS Of the 2,302 articles identified by the search, 289 studies were included in this review. We found evidence of increased use of Q-methodology in healthcare, particularly over the last 5 years. However, this research remains diffuse, spread across a large number of journals and topic areas. In a number of studies, we identified limitations in the reporting of methods, such as insufficient information on how authors derived their Q-set, what types of analyses they performed, and the amount of variance explained. CONCLUSIONS Although Q-methodology is increasingly being adopted in healthcare research, it still appears to be relatively novel. This review highlight commonalities in how the method has been used, areas of application, and the potential value of the approach. To facilitate reporting of Q-methodological studies, we present a checklist of details that should be included for publication.
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Affiliation(s)
- Kate Churruca
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia.
| | - Kristiana Ludlow
- School of Psychology, University of Queensland, Brisbane, QLD, 4072, Australia
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
| | - Wendy Wu
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia
| | - Kate Gibbons
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia
| | - Hoa Mi Nguyen
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia
| | - Louise A Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia
| | - Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia
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Heruti I, Levy S, Deutscher D, Gutvirtz M, Berkovitz T, Shiloh S. Comparisons Between Illness and Injury Outcomes: Potential Suppression Effects by Emotional Representations. Int J Behav Med 2021; 28:393-400. [PMID: 32978727 DOI: 10.1007/s12529-020-09931-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Based on recent findings that people perceive illness and injury as separate categories, we compared ill and injured participants with similar health conditions on illness perceptions and reported outcomes, e.g., functioning, distress, well-being. METHOD A cross-sectional study with 182 ill and 160 injured participants affected by ankle, knee, or neck conditions compared them on standard measures of illness perception and other reported outcomes (self-assessed health; physical, emotional, and social functioning; depression, anxiety, and somatization; satisfaction with life, self-esteem, and acceptance of disability). RESULTS The groups did not differ on the measured outcomes, but injury elicited stronger emotional representations, and illness was perceived as more chronic. After controlling for the effects of emotional representations, the injured group presented better outcomes on all outcome measures, including self-assessed health, physical functioning, emotional functioning, social functioning, vitality, health beliefs, depression, somatization, total distress, and acceptance of disability. CONCLUSION Emotional representations may suppress the potential superior outcomes of injury compared with illness. The theoretical implications of these results for self-regulation theories are discussed, as well as clinical implications.
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Affiliation(s)
- Irit Heruti
- Department of Psychology, Rabin Medical Center, Petach Tikva, Israel
| | - Sigal Levy
- The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | | | | | | | - Shoshana Shiloh
- School of Psychological Sciences, Gordon Faculty of Social Sciences, Tel Aviv University, 69978, Tel Aviv, Israel.
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Onyishi CN, Ilechukwu LC, Victor-Aigbodion V, Eseadi C. Impact of spiritual beliefs and faith-based interventions on diabetes management. World J Diabetes 2021; 12:630-641. [PMID: 33995850 PMCID: PMC8107980 DOI: 10.4239/wjd.v12.i5.630] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/23/2021] [Accepted: 03/25/2021] [Indexed: 02/06/2023] Open
Abstract
Management of diabetes constitutes significant social and economic burdens worldwide. There is a shortage of empirical studies on the management of diabetes and the associated mental health issues through spiritual beliefs and faith-based interventions (FBIs). It is not also clear how spiritual beliefs and FBIs account for the effective management of diabetic conditions. This article discusses the impact of spiritual beliefs and FBIs in the management of diabetes, from relationship and efficacy studies that report outcomes from experimental procedures of related interventions. The majority of the relationship studies showed positive relationships, while efficacy studies showed a high efficacy of interventions in faith-based approaches. However, none of the studies clearly reported the mechanisms of change or modality of operation in a FBI that can serve as a model across culture and context. Possible mechanisms of change were discussed for further development of a standard faith-based model, and finally, suggestions for future research were also highlighted by the authors.
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Affiliation(s)
- Charity Neejide Onyishi
- Department of Educational Psychology, University of Johannesburg, Gauteng, 2006, South Africa
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
| | | | - Vera Victor-Aigbodion
- Department of Educational Psychology, University of Johannesburg, Gauteng, 2006, South Africa
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
| | - Chiedu Eseadi
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
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Favarato MH, Germani ACCG, Martins MDA. Glimpsing the raging seas that stop swans: A qualitative look at living with multimorbidity and pain in patients from a tertiary care service. JOURNAL OF COMORBIDITY 2021; 11:2633556521999509. [PMID: 33796473 PMCID: PMC7968021 DOI: 10.1177/2633556521999509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 11/15/2022]
Abstract
Multimorbidity requires complex and ongoing care. Understanding the subjective illness experience is critical to effective care. Literature isn't clear about illness perception in patients with multimorbidity followed in services of high complexity. This study aims to investigate the illness experience based on narratives about daily living and symptoms of patients with multimorbidity and pain in a tertiary health care service. Methods Qualitative narrative inquiry design with framework analysis from semi-structured interviews at a tertiary internal medicine outpatient clinic. Patients with Elixhauser comorbidity index ≧3 or and pain during the last week were included. Framework analysis was performed using 3 main patterns of illness experience from a previous study: "Gliding swan" (Resilience); "Stormy Seas" (Vulnerability); and "Stuck adrift" (Disruption); and identifying subthemes. One case study was selected from each main category. 43 patients, 14 classified as "gliding swan," 12 as "stormy seas" and 17 as "stuck adrift." Within the "gliding swan" group, positive examples of how to navigate through physical and emotional factors to sustain their wellbeing based on comprehension; In the "stormy seas" group, themes revolved around vulnerability, burden and ambiguity in relation to the health team. In the "stuck adrift" group the main content was about overwhelmed feelings and limitations. Conclusions Narratives brought the content about lacking personalized understanding of diseases, with great emotional repercussion. Some meaningful anchors were highlighted. This study reinforces multimorbidity and pain interact and that healthcare professional should be aware of the turbulences that can disturb navigation in the raging seas of long-term multimorbid conditions.
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Affiliation(s)
- Maria Helena Favarato
- Departamento de Medicina Interna, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Maria Helena Favarato, Serviço de Clínica Geral e Propedêutica, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Av Dr Eneas de Carvalho Aguiar, 155, 4o andar. Emails: ;
| | | | - Milton de Arruda Martins
- Departamento de Medicina Interna, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Hagger MS, Orbell S. The common sense model of illness self-regulation: a conceptual review and proposed extended model. Health Psychol Rev 2021; 16:347-377. [DOI: 10.1080/17437199.2021.1878050] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Martin S. Hagger
- Department of Psychological Sciences, University of California, Merced, CA, USA
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Sheina Orbell
- Department of Psychology, University of Essex, Colchester, UK
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Shiha G, Korenjak M, Eskridge W, Casanovas T, Velez-Moller P, Högström S, Richardson B, Munoz C, Sigurðardóttir S, Coulibaly A, Milan M, Bautista F, Leung NWY, Mooney V, Obekpa S, Bech E, Polavarapu N, Hamed AE, Radiani T, Purwanto E, Bright B, Ali M, Dovia CK, McColaugh L, Koulla Y, Dufour JF, Soliman R, Eslam M. Redefining fatty liver disease: an international patient perspective. Lancet Gastroenterol Hepatol 2021; 6:73-79. [PMID: 33031758 DOI: 10.1016/s2468-1253(20)30294-6] [Citation(s) in RCA: 140] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/27/2020] [Accepted: 08/30/2020] [Indexed: 02/06/2023]
Abstract
Despite its increased recognition as a major health threat, fatty liver disease associated with metabolic dysfunction remains largely underdiagnosed and undertreated. An international consensus panel has called for the disease to be renamed from non-alcoholic fatty liver disease (NAFLD) to metabolic-associated fatty liver disease (MAFLD) and has suggested how the disease should be diagnosed. This Viewpoint explores the call from the perspective of patient advocacy groups. Patients are well aware of the negative consequences of the NAFLD acronym. This advocacy group enthusiastically endorses the call to reframe the disease, which we believe will ultimately have a positive effect on patient care and quality of life and, through this effect, will reduce the burden on health-care systems. For patients, policy makers, health planners, donors, and non-hepatologists, the new acronym MAFLD is clear, squarely placing the disease as a manifestation of metabolic dysfunction and improving understanding at a public health and patient level. The authors from representative patient groups are supportive of this change, particularly as the new acronym is meaningful to all citizens as well as governments and policy makers, and, above all, is devoid of any stigma.
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Affiliation(s)
- Gamal Shiha
- European Liver Patients' Association (ELPA), Brussels, Belgium; World Hepatitis Alliance, London, UK; African Liver Patient Association (ALPA), Cairo, Egypt; Association of Liver Patients Care (ALPC), Mansoura, Egypt; Hepatology and Gastroenterology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt; Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt.
| | - Marko Korenjak
- European Liver Patients' Association (ELPA), Brussels, Belgium; Association SLOVENIA HEP, Maribor, Slovenia
| | | | - Teresa Casanovas
- European Liver Patients' Association (ELPA), Brussels, Belgium; Asociación Catalana de Pacientes Hepáticos (ASSCAT), Barcelona, Spain
| | - Patricia Velez-Moller
- World Hepatitis Alliance, London, UK; Guatemala Liver Patients Association, Guatemala City, Guatemala
| | - Sari Högström
- European Liver Patients' Association (ELPA), Brussels, Belgium; Finnish Kidney and Liver Association, Helsinki, Finland
| | | | | | | | - Alioune Coulibaly
- World Hepatitis Alliance, London, UK; African Liver Patient Association (ALPA), Cairo, Egypt; Association for the Promotion of Health and Development in Mali (APSAD/MALI), Bamako, Mali; Association of the Malians of Washington DC (AMAW), Washington DC, USA
| | - Miskovikj Milan
- European Liver Patients' Association (ELPA), Brussels, Belgium; Hepar Centar, Bitola, North Macedonia
| | | | | | - Vicki Mooney
- The European Coalition for People Living with Obesity (EASO ECPO), Dublin, Ireland
| | - Solomon Obekpa
- African Liver Patient Association (ALPA), Cairo, Egypt; Advocacy for the Prevention of Hepatitis in Nigeria (APHIN), Benue State, Nigeria
| | - Eva Bech
- La Federación Nacional de Enfermos y Trasplantados Hepáticos (FNETH), Madrid, Spain
| | | | - Abd Elkhalek Hamed
- Arabic Association for the Study of Diabetes and Metabolism, Cairo, Egypt; Department of Internal Medicine, Hepatology, and Diabetes, Egyptian Military Medical Academy, Cairo, Egypt
| | - Temur Radiani
- European Liver Patients' Association (ELPA), Brussels, Belgium; Hepatitis C Cured Patient Association, Tbilisi, Georgia
| | | | | | - Mohammad Ali
- National Liver Foundation of Bangladesh, Dhaka, Bangladesh
| | - Cecil Kwaku Dovia
- World Hepatitis Alliance, London, UK; African Liver Patient Association (ALPA), Cairo, Egypt; Cedaku Foundation of Ghana, Ho, Ghana
| | | | | | - Jean-François Dufour
- Swiss NASH Foundation, Bern, Switzerland; University Clinic for Visceral Surgery and Medicine, Inselspital, Bern, Switzerland; Department of Biomedical Research, University of Bern, Bern, Switzerland
| | - Reham Soliman
- European Liver Patients' Association (ELPA), Brussels, Belgium; Association of Liver Patients Care (ALPC), Mansoura, Egypt; Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt; Department of Tropical Medicine, Faculty of Medicine, Port Said University, Port Said, Egypt
| | - Mohammed Eslam
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Westmead, NSW, Australia.
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Laferton JAC, Oeltjen L, Neubauer K, Ebert DD, Munder T. The effects of patients' expectations on surgery outcome in total hip and knee arthroplasty: a prognostic factor meta-analysis. Health Psychol Rev 2020; 16:50-66. [PMID: 33228474 DOI: 10.1080/17437199.2020.1854051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Patients' expectations are among the most frequently studied psychological prognostic factors in total knee and hip arthroplasty (TKA/THA). So far, however, evidence on the effect of patients' preoperative expectations on surgery outcome is inconclusive. Heterogeneity of expectation constructs and the use of psychometrically not evaluated measurement instruments have constituted major obstacles for the integration of the current literature. Using a theory-based model of expectation constructs , this meta-analysis set out to disentangle the conflicting results in the current literature. Systematic literature searches yielded k = 46 studies (N = 10,465) that reported associations of preoperative expectations with postoperative pain, functioning and disability, and satisfaction. Random effects meta-analysis revealed a robust small association (r = .16; 95% CI .13, .19) between patients' positive preoperative expectations and better postoperative outcomes. This effect did not differ between THA and TKA, different outcome categories and different follow-up periods. Studies using psychometrically evaluated expectation measures reported significantly higher effects (r = .19; 95% CI .16, .22). Whether this effect varies among different expectation constructs remains unclear. High-quality studies using validated, multidimensional expectation measures are needed to further understand the role of different expectation constructs in THA and TKA surgery.
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Affiliation(s)
- Johannes A C Laferton
- Division of Clinical Psychology and Psychotherapy, Psychologische Hochschule Berlin, Berlin, Germany.,Division of Clinical Psychology and Psychotherapy, Department of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Division of Psychological Medicine, Department of Medicine, Health and Medical University Potsdam, Potsdam, Germany
| | - Lara Oeltjen
- Department of Psychological Methods, Institute of Psychology, Friedrich-Schiller-Universität Jena, Jena, Germany
| | | | - David D Ebert
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Thomas Munder
- Department of Psychology, University of Zurich, Zurich, Switzerland
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