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Saguban R, Shanmugam SR, Rondilla E, Buta J, Alatawi NAH, Maestrado R, Alkubati SA, Mostoles R, Alrashidi NA, Alreshidi MS. Self-Efficacy, Social Support, and Depression: Mediators of Medication Adherence in Dialysis Patients. Healthcare (Basel) 2025; 13:425. [PMID: 39997300 PMCID: PMC11855104 DOI: 10.3390/healthcare13040425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2024] [Revised: 01/29/2025] [Accepted: 02/12/2025] [Indexed: 02/26/2025] Open
Abstract
Introduction: Healthcare providers' understanding of how self-efficacy and social support affect medication adherence and depression in dialysis patients can lead to holistic interventions and improve outcomes. This study aimed to investigate how self-efficacy and social support indirectly influence the relationship between medication adherence and depressive symptoms in patients with chronic kidney disease (CKD) undergoing dialysis. Methods: We employed a cross-sectional observational study design with 668 CKD patients from outpatient departments (OPDs) and dialysis centers in the Hail region of Saudi Arabia. The data were collected between April and May 2024. Results: The participants had a relatively high level of self-efficacy (median = 82.00/100) and greater perception of social support (median = 75.500/84) with minimal to mild depressive symptoms (median = 15.00/63); however, 50% of participants scored ≥ 5 (out of 10) on the level of adherence to their medication regimen. Depression was prevalent, with a mean score of 5.03 on the PHQ-9 scale, and was positively correlated with nonadherence. Social support and self-efficacy were negatively correlated with depression, and both partially mediated the link between depression and non-adherence. Conclusions: This study found that, despite high social support and self-efficacy, a significant number of patients with CKD on dialysis exhibited medication non-adherence. Depression has emerged as a key factor influencing adherence, even in the presence of social support and self-efficacy. These findings suggest that depression is crucial for CKD management. Healthcare providers, owing to their frequent interactions with patients with CKD, are ideally placed to screen for depression and incorporate management strategies into patient care plans. By addressing both the biological and psychological aspects of CKD, they can empower patients to take a more active role in their treatment, ultimately leading to improved health outcomes.
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Affiliation(s)
- Reynita Saguban
- College of Nursing, University of Hail, Hail 55473, Saudi Arabia; (E.R.); (J.B.); (R.M.); (S.A.A.); (N.A.A.); (M.S.A.)
| | - Sumathi Robert Shanmugam
- Department of Maternity and Pediatric Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia;
| | - Evalynn Rondilla
- College of Nursing, University of Hail, Hail 55473, Saudi Arabia; (E.R.); (J.B.); (R.M.); (S.A.A.); (N.A.A.); (M.S.A.)
| | - Joyce Buta
- College of Nursing, University of Hail, Hail 55473, Saudi Arabia; (E.R.); (J.B.); (R.M.); (S.A.A.); (N.A.A.); (M.S.A.)
| | - Nuha Ayad H. Alatawi
- Medical Surgical Nursing Department, Faculty of Nursing, University of Tabuk, Tabuk 47512, Saudi Arabia;
| | - Richard Maestrado
- College of Nursing, University of Hail, Hail 55473, Saudi Arabia; (E.R.); (J.B.); (R.M.); (S.A.A.); (N.A.A.); (M.S.A.)
| | - Sameer A. Alkubati
- College of Nursing, University of Hail, Hail 55473, Saudi Arabia; (E.R.); (J.B.); (R.M.); (S.A.A.); (N.A.A.); (M.S.A.)
| | - Romeo Mostoles
- College of Nursing, University of Hail, Hail 55473, Saudi Arabia; (E.R.); (J.B.); (R.M.); (S.A.A.); (N.A.A.); (M.S.A.)
| | - Nojoud Abdullah Alrashidi
- College of Nursing, University of Hail, Hail 55473, Saudi Arabia; (E.R.); (J.B.); (R.M.); (S.A.A.); (N.A.A.); (M.S.A.)
| | - Maha Sanat Alreshidi
- College of Nursing, University of Hail, Hail 55473, Saudi Arabia; (E.R.); (J.B.); (R.M.); (S.A.A.); (N.A.A.); (M.S.A.)
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Zhu Y, Liu J, Chen F, Wang Q, Cao K, Huang J, Wang H, Wang Q, Luo X. The association between chronotype and social anxiety among Chinese university students: a moderated mediation analysis of loneliness and perceived social support. BMC Public Health 2024; 24:3336. [PMID: 39614256 DOI: 10.1186/s12889-024-20811-3] [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: 06/14/2024] [Accepted: 11/21/2024] [Indexed: 12/01/2024] Open
Abstract
BACKGROUND Social anxiety has been a burning problem among contemporary college students in China. Increasing evidence suggests that individual circadian typology-chronotype may play an important role in the development of social anxiety. However, little research has focused directly on examining the association between chronotype and social anxiety, and less is known about the mediating and moderating mechanisms underlying this relationship. The aim of the present study was to investigate the link between chronotype and social anxiety among Chinese college students, and to explore the mediating effect of loneliness and the moderating effect of perceived social support in the association between chronotype and social anxiety. METHODS A cross-sectional design was conducted among 1616 college students (16-29 years old) from several public universities in Northern China, including 1172 females (72.52%) and 444 males (27.48%), with an average age of 19.68 years old (SD = 1.49). All participants completed the standardized self-report questionnaires including the Social Avoidance and Distress Scale, Morningness-Eveningness Questionnaire, UCLA Loneliness Scale, and the Perceived Social Support Scale. Common method bias was performed using Harman's single-factor test. The mediation and moderation effects were analyzed using SPSS software and PROCESS macros. RESULTS Chronotype had a negative predictive effect on social anxiety in college students. Specifically, the greater the inclination of individuals' chronotypes toward evening preference, the more pronounced their symptoms of social anxiety would be. Loneliness served as a partial mediator in the relationship between chronotype and social anxiety, accounting for 30.0% of the total effect. In addition, perceived social support, particularly from friends and significant others, was found to play a moderating role in the process of loneliness affecting social anxiety among college students, while support from family did not. Interestingly, the perceived social support displayed a limited protective effect when college students suffered from higher levels of loneliness. CONCLUSION These findings deepened our understanding of how and when (or for "whom") chronotype is related to social anxiety, offering a theoretical foundation and practical insights for preventing and addressing social anxiety risk in young adult university students, particularly those with evening chronotypes.
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Affiliation(s)
- Yingying Zhu
- Key Research Base of Humanities and Social Sciences of the, Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, 300387, China.
- Faculty of Psychology, Tianjin Normal University, Tianjin, 300387, China.
- Tianjin Social Science Laboratory of Students' Mental Development and Learning, Tianjin, 300387, China.
| | - Junling Liu
- Faculty of Psychology, Tianjin Normal University, Tianjin, 300387, China
| | - Fulin Chen
- Faculty of Psychology, Tianjin Normal University, Tianjin, 300387, China
| | - Qian Wang
- Faculty of Psychology, Tianjin Normal University, Tianjin, 300387, China
| | - Kunxia Cao
- Faculty of Psychology, Tianjin Normal University, Tianjin, 300387, China
| | - Jiahao Huang
- Faculty of Psychology, Tianjin Normal University, Tianjin, 300387, China
| | - He Wang
- Institute of Biomedical Engineering, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin, 300192, China
| | - Qiang Wang
- Key Research Base of Humanities and Social Sciences of the, Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, 300387, China
- Faculty of Psychology, Tianjin Normal University, Tianjin, 300387, China
| | - Xue Luo
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
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Zhang M, Jin A, Zhou X, Xu L, Zhang J, Dong F, Cai S, Xiang X, Huang L, Shao R. A quasi-experimental study on couple-based exercise program improving cardiac rehabilitation exercise compliance in post-PCI patients. BMC Cardiovasc Disord 2024; 24:640. [PMID: 39538140 PMCID: PMC11562107 DOI: 10.1186/s12872-024-04282-3] [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: 06/27/2024] [Accepted: 10/21/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND Percutaneous coronary intervention (PCI) helps treat coronary artery disease but only provides short-term relief and doesn't stop disease progression. Exercise rehabilitation can improve outcomes for patients after PCI and lower the risk of death and new heart problems, but many patients struggle to stick with their exercise routines. Spouses play a crucial role in supporting patients and helping them stay committed to their rehabilitation. This study aims to evaluate the effectiveness of a couple-based exercise program in improving exercise adherence among post-PCI patients. METHODS This study used a quasi-experimental design, 70 dyads were recruited for a 12-week investigation. Participants were divided into an intervention group to receive the Couple-Based exercise program and a control ensemble for conventional exercise-based cardiac rehabilitation. The primary parameter under examination was exercise adherence. Secondary endpoints encompass exercise self-efficacy, the 6-minute walk test, the 9-item Patient Health Questionnaire, and the Generalized Anxiety Disorder Scale. Data were harvested at baseline and post-intervention (12 weeks). RESULT Following a three-month monitoring period, noticeable differences were observed in the Couples exercise group compared to the control group in the realms of exercise adherence, exercise self-efficacy, the 6-minute walk test, and anxiety-depression indices (P < 0.05). CONCLUSION A couple-based exercise program developed based on a developmental-contextual framework improves exercise adherence and exercise self-efficacy, enhances cardiac function and exercise capacity, and improves anxiety and depression in post-coronary arteriography patients. This approach is likely to be an effective way to improve rehabilitation outcomes, leading to the broader goal of improving patient prognosis and reducing adverse cardiovascular events. TRIAL REGISTRATION The study's registration was recorded with the Chinese Clinical Trials Registry (12/04/2022, registration number ChiCTR2200058600).
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Affiliation(s)
- Mingyue Zhang
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Aiyun Jin
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Xiaoyu Zhou
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Liwei Xu
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Jianli Zhang
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Fanghong Dong
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Shasha Cai
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Xinyue Xiang
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Lihua Huang
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
| | - Rongya Shao
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
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Alaofè H, Okechukwu A, Yeo S, McClelland JD, Hounkpatin WA, Ehiri J. Social network interventions for dietary adherence among adults with type 2 diabetes: a systematic review and meta-analysis protocol. BMJ Open 2024; 14:e082946. [PMID: 39521477 PMCID: PMC11551984 DOI: 10.1136/bmjopen-2023-082946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 10/02/2024] [Indexed: 11/16/2024] Open
Abstract
INTRODUCTION Optimal adherence to recommended diets is crucial to achieving long-term glycaemic control among individuals with type 2 diabetes (T2D) individuals. However, there is limited evidence on the effectiveness of interventions that target dietary adherence through social networks. Since social networks can influence individuals' health behaviours, it is important to thoroughly evaluate the impact of social network interventions on dietary adherence in adults with T2D. This systematic review protocol aimed to provide insights into future interventions and improve diabetes management strategies. METHOD AND ANALYSIS PubMed, Embase, CINAHL Complete, Cochrane Central Register of Controlled Trials, ProQuest Dissertations and Theses and Google Scholar will be searched from inception to December 2023 for relevant randomised and non-randomised controlled trials of at least 3 months' duration. In addition, studies that compared interventions involving the social networks (families, friends and peers) of adults with T2D with usual care, no intervention or an intervention with no explicit social network component will be included. Two reviewers will independently screen search outputs according to inclusion and exclusion criteria, critically evaluate the selected literature and extract data on the study setting, design, participants' characteristics, interventions, controls, social network functions and duration of follow-up, using a standard data extraction form. Quantitative data analysis will be performed where studies are homogeneous in characteristics and provide adequate outcome data for meta-analysis. Otherwise, data will be synthesised using narrative synthesis. Finally, trials will be assessed for bias risk and overall evidence certainty using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. ETHICS AND DISSEMINATION Ethical approval is not required for literature-based studies. The results will be disseminated through peer-reviewed publications. PROSPERO REGISTRATION NUMBER CRD42023441223.
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Affiliation(s)
- Halimatou Alaofè
- Health Promotion Sciences, The University of Arizona, Tucson, Arizona, USA
| | - Abidemi Okechukwu
- Health Promotion Sciences, The University of Arizona, Tucson, Arizona, USA
| | - Sarah Yeo
- Health Promotion Sciences, The University of Arizona, Tucson, Arizona, USA
| | - Jean D McClelland
- Arizona Health Sciences Library, The University of Arizona, Tucson, Arizona, USA
| | | | - John Ehiri
- Health Promotion Sciences, The University of Arizona, Tucson, Arizona, USA
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Du M, Wu Y, Wang B, Jiang M, Chen J, Hui H. Mediating effect of self-efficacy on the relationship between Big Five personality and medication adherence in Chinese hypertensive patients: a national cross-sectional study. Front Psychol 2024; 15:1442031. [PMID: 39539302 PMCID: PMC11559385 DOI: 10.3389/fpsyg.2024.1442031] [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: 07/25/2024] [Accepted: 10/21/2024] [Indexed: 11/16/2024] Open
Abstract
Objective The study aims to evaluate personality characteristics, self-efficacy, and medication adherence in Chinese patients with hypertension, while also investigating how self-efficacy mediates the relationship between personality traits and medication adherence. Methods This investigation included 787 Chinese patients diagnosed with hypertension, as reported in the "2021 China Family Health Index Survey Report." The study employed several assessment tools such as a General Information Questionnaire, the Brief Big Five Inventory (BFI-10), the New General Self-Efficacy Scale (NGSES), and the Medication Adherence Rating Scale (MARS). Statistical analyses encompassed the Mann-Whitney U test, chi-square test, multiple logistic regression, Spearman's rank correlation, standardized regression coefficients, and Bootstrap techniques. Results (1) Individuals with debt, who also possess high levels of self-efficacy, tend to adhere more consistently to their medication regimens. (2) An analysis of personality traits indicated that Extroversion,Conscientiousness and Openness positively influences self-efficacy,while Agreeableness and Neuroticism negatively impacts it. (3) Self-efficacy plays a mediating role in the indirect relationship between personality traits such as Extroversion and neuroticism and medication adherence. Conclusion In the context of Chinese adults, both self-efficacy and Extroversion positively influence medication adherence, whereas high levels of neuroticism adversely impact it. Furthermore, self-efficacy serves as a mediating factor in the linkage between personality traits and medication adherence.
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Affiliation(s)
- Mingliang Du
- Department of Coronary Heart Disease, Central Hospital of Dalian University of Technology (Dalian Municipal Central Hospital), Dalian, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China
| | - Boran Wang
- Medical Record Room, Central Hospital of Dalian University of Technology (Dalian Municipal Central Hospital), Dalian, China
| | - Miao Jiang
- Department of Coronary Heart Disease, Central Hospital of Dalian University of Technology (Dalian Municipal Central Hospital), Dalian, China
| | - Jiangyun Chen
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Hui Hui
- Department of Coronary Heart Disease, Central Hospital of Dalian University of Technology (Dalian Municipal Central Hospital), Dalian, China
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Liu L, Liu B, Zheng J, Wang L, Liao Z, Xu H. Medical service satisfaction and depression among middle-aged and older Chinese adults: moderating role of distinct Internet-using patterns. BMC Public Health 2024; 24:2836. [PMID: 39407136 PMCID: PMC11481550 DOI: 10.1186/s12889-024-20292-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 10/04/2024] [Indexed: 10/19/2024] Open
Abstract
BACKGROUND Patient satisfaction is a powerful predictor of an individual's mental health, according to previous research. However, there has not been a thorough study on the relationship between depression and overall medical service satisfaction (OMSS) in middle-aged and older adults. Moreover, little is known about how different Internet-using patterns affect this relationship. METHODS We selected 4,523 participants from the China Family Panel Studies (CFPS) 2020 dataset who were aged 45 and older. The relationship between OMSS and depression was examined using logistic regression analysis, distinct Internet-using patterns were investigated using latent class analysis, and the moderating effects of these patterns were examined using SPSS PROCESS macro analysis. RESULTS The results showed OMSS was negatively related to depression in middle-aged and older adults (β = -0.181, p < 0.001). For skilled Internet users, there was a significant positive moderating effect (β = -0.272, SE = 0.096, p < 0.01), for unskilled users, there was a significant negative moderating effect (β = 0.497, SE = 0.156, p < 0.01). Yet, there is no moderating effect of a controlled Internet-using pattern on the correlation between OMSS and depression. CONCLUSIONS This study highlights the potential value of improving medical service satisfaction in reducing depressive symptoms in middle-aged and older adults. Additionally, in order to maximize the benefits of healthcare for mental health, the study suggests that Internet-using patterns could be a significant area for intervention.
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Affiliation(s)
- Lunxin Liu
- School of Public Health, Chongqing Medical University, Chongqing, 400016, People's Republic of China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Boya Liu
- School of Public Health, Chongqing Medical University, Chongqing, 400016, People's Republic of China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Jing Zheng
- School of Public Health, Chongqing Medical University, Chongqing, 400016, People's Republic of China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Lang Wang
- School of Public Health, Chongqing Medical University, Chongqing, 400016, People's Republic of China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Zhiliu Liao
- School of Public Health, Chongqing Medical University, Chongqing, 400016, People's Republic of China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, People's Republic of China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Hong Xu
- School of Public Health, Chongqing Medical University, Chongqing, 400016, People's Republic of China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, People's Republic of China.
- Research Center for Public Health Security, Chongqing Medical University, Chongqing, 400016, People's Republic of China.
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Hidalgo-Muñoz AR, Tabernero C, Luque B. Network analysis to examine sex differences linked to emotional well-being in cardiovascular disease. J Health Psychol 2024; 29:1404-1415. [PMID: 38433658 DOI: 10.1177/13591053241230263] [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: 03/05/2024] Open
Abstract
Psychosocial dimensions are essential to guarantee an optimal approach to improve emotional well-being in patients with cardiovascular disease (CVD). There is evidence of sex differences regarding these dimensions. Thus, the connections between them are crucial to implement personalized therapies. Network model analyses were conducted on data from 593 CVD patients. The models included scores from the Hospital Anxiety and Depression Scale (HADS), positive (PA) and negative affect (NA), positivity (PS), satisfaction of life (SLS), social support (SS), self-efficacy on emotion regulation (RESE), cardiac self-efficacy (CSE) and the Short Form-12 Health Survey. The main sex differences were found in: PA-PS (p = 0.03), SS-RESE (p = 0.04), for which the positive associations are stronger for men than for women and PA-RESE (p < 0.01) for which the positive association is stronger for women than for men. These nuances should be considered to implement tailored and integrative therapies for each CVD patient.
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Affiliation(s)
| | | | - Bárbara Luque
- Maimonides Biomedical Research Institute of Cordoba, Spain
- University of Cordoba, Spain
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Cho ME, Hwang SK. Self-efficacy-based Interventions for Patients With Obstructive Sleep Apnea: A Systematic Review. Asian Nurs Res (Korean Soc Nurs Sci) 2024; 18:420-433. [PMID: 39260616 DOI: 10.1016/j.anr.2024.09.002] [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: 03/17/2024] [Revised: 07/28/2024] [Accepted: 09/05/2024] [Indexed: 09/13/2024] Open
Abstract
PURPOSE This study aimed to systematically review self-efficacy-based interventions for patients with obstructive sleep apnea (OSA) and identify the relationship between the number of used techniques for prompting self-efficacy and the main outcome variables. METHODS This systematic review was conducted in accordance with the PRISMA guidelines. Experimental studies on the use of self-efficacy-based interventions for patients with OSA were analyzed. Five databases, EMBASE, CINAHL, PubMed, SCOPUS, and Web of Science, were systematically searched for articles published until December 2023. Interventions were classified based on the behavior change technique (BCT) taxonomy and the theoretical sources of self-efficacy to conduct a narrative synthesis. RESULTS Of the 6,968 articles evaluated, 11 were included for analysis (1,304 participants). The results showed that the most frequently employed BCTs in the analyzed studies were "instruction on how to perform a behavior," "exposure," and "social support." Regarding the number of techniques, an average of 6.0 BCTs (range, 4-8) and 3.2 theoretical sources (range, 2-4) were utilized in studies that showed significant improvements in self-efficacy (5 studies), whereas an average of 4.8 BCTs (range, 2-5) and 2.8 theoretical sources (2-3) were used in studies that indicated null results related to self-efficacy (6 studies). CONCLUSION This review underscores the potential of self-efficacy-based interventions in the management of OSA and provides a solid theoretical foundation for designing effective interventions. Additionally, the results indicate that utilizing a greater diversity of BCTs and theoretical sources may contribute to the effectiveness of self-efficacy interventions. Therefore, clinicians should consider incorporating various behavior change techniques and four sources of prompting self-efficacy from self-efficacy theory into interventions to enhance self-efficacy, and consequently, treatment adherence in patients with OSA.
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Affiliation(s)
- Min-Eun Cho
- College of Nursing, Pusan National University, Republic of Korea
| | - Sun-Kyung Hwang
- College of Nursing, Research Institute of Nursing Science, Pusan National University, Republic of Korea.
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Whitted WM, Southward MW, Howard KP, Wick SB, Strunk DR, Cheavens JS. Seeing is believing: The effect of subtle communication in social media on viewers' beliefs about depression and anxiety symptom trajectories. J Clin Psychol 2024; 80:1050-1064. [PMID: 38287680 DOI: 10.1002/jclp.23647] [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: 07/28/2023] [Revised: 12/23/2023] [Accepted: 01/10/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVE One barrier to treatment seeking, uptake, and engagement is the belief that nothing can be done to reduce symptoms. Given the widespread use of social media to disseminate information about important issues, including psychological health, we sought to understand how the influence of social media communication regarding mental health impacts viewers' beliefs about psychopathology recovery. METHOD Undergraduate participants from a large Midwestern university (N = 322) were randomized to view a series of Tweets characterizing psychopathology from a fixed mindset perspective, a growth mindset perspective, or, in the control condition, Tweets unrelated to psychopathology. Afterward, they completed a series of questionnaires designed to assess beliefs about recovery from depression and anxiety. RESULTS Participants in the growth mindset condition endorsed less pessimistic beliefs about their ability (i.e., self-efficacy) to alleviate symptoms of depression and anxiety, and they believed these symptoms to be less stable and innate relative to those in the fixed mindset condition. CONCLUSION Social media communication that characterizes psychopathology from a growth mindset perspective may be a viable intervention for improving beliefs around mental health self-efficacy and the malleable nature of mental illness, particularly depression and anxiety. Clinicians may be able to use social media platforms to promote functional beliefs around mental illness.
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Affiliation(s)
- Whitney M Whitted
- Department of Psychology, The Ohio State University, Columbus, Ohio, USA
| | | | - Kristen P Howard
- Department of Psychology, The Ohio State University, Columbus, Ohio, USA
| | - Samantha B Wick
- Department of Psychology, The Ohio State University, Columbus, Ohio, USA
| | - Daniel R Strunk
- Department of Psychology, The Ohio State University, Columbus, Ohio, USA
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Yu J, Xie L, Chen S, Fang Z, Zhu L, Zhang H, Xu RH, Yang H, Dong D. Social support and medication adherence among adult myasthenia gravis patients in China: the mediating role of mental health and self-efficacy. Orphanet J Rare Dis 2024; 19:143. [PMID: 38576038 PMCID: PMC10993533 DOI: 10.1186/s13023-024-03145-6] [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: 06/22/2023] [Accepted: 03/24/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Myasthenia gravis (MG), a rare chronic neuromuscular disorder, is characterized by progressive physical decline and requires long-term pharmacological treatment. Due to the decline of physical and social abilities, MG patients are in great need of social support, including tangible and emotional support. This study aims to examine the association between social support and medication adherence and the possible mediating effects of mental health and self-efficacy among MG patients. METHODS A cross-sectional analysis of a nationwide MG registry was conducted on 865 patients under oral medication treatment in China between June and July 2022. Validated scales were used to measure the respondent's mental distress (Four-item Patient Health Questionnaire), social support (Modified Medical Outcomes Study Social Support Scale), self-efficacy for medication use (Self-efficacy for Appropriate Medication Use Scale), and medication adherence (Morisky Medication Adherence Scale, MMAS). RESULTS The association between social support and medication adherence and possible mediating effects of mental distress and self-efficacy were tested by structural equation model, with significant demographic and disease-related factors adjusted. The respondents showed a very low level of medication adherence (71.2% poor adherence; 1.4% high adherence; mean MMAS = 4.65). The level of social support was positively associated with medication adherence, and such association was fully mediated by two indirect pathways: through self-efficacy (β = 0.07, proportion mediated = 63.8%); and through mental distress and then self-efficacy (β = 0.01, proportion mediated = 6.7%). CONCLUSION Provision of social support and interventions on mental health with emphasis on improving self-efficacy for medication use may effectively improve medication adherence among MG patients.
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Affiliation(s)
- Jiazhou Yu
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Luyao Xie
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shanquan Chen
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Zhilan Fang
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Liling Zhu
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Huanyu Zhang
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
- Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Richard H Xu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Huan Yang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Dong Dong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China.
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11
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Smoktunowicz E, Maciejewski J, Lesnierowska M, Carlbring P. Bridging the adherence gap in internet interventions: A randomized controlled trial study protocol investigating context-specific self-efficacy. Internet Interv 2024; 35:100697. [PMID: 38149089 PMCID: PMC10750058 DOI: 10.1016/j.invent.2023.100697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 11/22/2023] [Accepted: 12/01/2023] [Indexed: 12/28/2023] Open
Abstract
Low adherence in self-guided internet interventions is linked to poorer outcomes. Although some predictors of adherence have been identified, few are modifiable for widespread application. One personal variable with the potential to increase adherence in internet interventions is context-specific self-efficacy. This protocol outlines a randomized controlled trial design, divided into two phases. In Phase 1 (students, N = 216), participants will complete a self-efficacy-enhancing exercise, which will be compared to a waitlist control group to test its effectiveness in increasing internet intervention adherence self-efficacy. Phase 2 will be the main two-arm trial, where all participants (medical students, N = 952) will undergo an internet intervention called Med-Stress Student. In the experimental group, the program will be preceded by the self-efficacy-enhancing exercise developed in Phase 1. We anticipate that participants in the experimental group will show higher adherence (primary outcome) to the intervention and greater improvement in intervention outcomes (secondary outcomes i.e., lower stress and higher work engagement) at posttest, as well as at six-month and one-year follow-ups. If effective, enhancing context-specific self-efficacy could be recommended before any internet intervention as a relatively simple way to boost participants' adherence.
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Affiliation(s)
- Ewelina Smoktunowicz
- StresLab Research Centre, Institute of Psychology, SWPS University, Warsaw, Poland
| | - Jan Maciejewski
- StresLab Research Centre, Institute of Psychology, SWPS University, Warsaw, Poland
| | | | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
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12
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Khalili Azar K, Mirzaei A, Babapour AR, Fathnezhad-Kazemi A. The mediating effect of self-efficacy on the relationship between social support and medication adherence in adults with type 2 diabetes. SAGE Open Med 2024; 12:20503121231221446. [PMID: 38264407 PMCID: PMC10804924 DOI: 10.1177/20503121231221446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 12/01/2023] [Indexed: 01/25/2024] Open
Abstract
Objective To evaluate the status of medication adherence in diabetic patients and its effective factors. Methods A cross-sectional descriptive study was conducted with 170 diabetic patients in Iran. Participants were assessed for medication adherence, self-efficacy, and social support. Descriptive statistics, bivariate analyses, and multiple stepwise regression were conducted to explore predictors for medication adherence. Results Regression analysis showed that 48% of medication adherence changes stemmed from the four variables including social support, self-efficacy, income, and education levels, (R2adj = 0.480, F = 39.943, p < 0.001). According to the model, the highest effects were related to income level (β = 0.332, t = 5.493, p ⩽ 0.001) and self-efficacy (β = 0.330, t = 4.789, p ⩽ 0.001), respectively. Based on the final model, only the social support variable showed no significant relationship with adherence (β = 0.002, t = 0.032, p = 0.947). Conclusion Social support and self-efficacy were related to medication adherence in diabetic patients, and social support can improve medication adherence in patients with diabetes by affecting self-efficacy. Healthcare workers who interact with individuals with diabetes should take into account the factors mentioned above when designing health promotion interventions to address the needs of these individuals.
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Affiliation(s)
- Khadijeh Khalili Azar
- Department of Nursing, Faculty of Nursing and Midwifery, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran
| | - Amirreza Mirzaei
- Department of Internal Medicine, Faculty of Medical Sciences, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran
| | - Ali-Reza Babapour
- Student Research Committee, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran
| | - Azita Fathnezhad-Kazemi
- Department of Midwifery, Women’s Reproductive and Mental Health Research Center, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran
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13
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Arenas A, Cuadrado E, Castillo-Mayén R, Luque B, Rubio S, Gutiérrez-Domingo T, Tabernero C. Spanish validation of the cardiac self-efficacy scale: a gender invariant measure. PSYCHOL HEALTH MED 2024; 29:334-349. [PMID: 36782395 DOI: 10.1080/13548506.2023.2177683] [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: 01/10/2022] [Accepted: 02/02/2023] [Indexed: 02/15/2023]
Abstract
The aim is to validate the Spanish version of the Cardiac Self-Efficacy (S-CSE) Scale by examining its psychometric properties and to test the invariance for women and men. Two groups - 722 and 522- of patients completed the S-CSE Scale and other psychosocial measures during a medical revision several months after being diagnosed with cardiovascular disease. Construct validity was psychometrically evaluated using exploratory factor analysis (EFA) with a split of the first sample and confirmatory factor analysis (CFA) with a second split of the same sample. Scale structure was confirmed using the second sample. Convergent, discriminant, and external validity were tested. Results revealed that the S-CSE Scale was represented by three dimensions (control symptoms, control illness, maintain functioning) obtaining excellent reliability indexes and it appeared to be invariant for women and men. The S-CSE scale is a useful tool for monitoring the general well-being of these patients to promote individualized interventions.
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Affiliation(s)
- Alicia Arenas
- Department of Social Psychology, Universidad de Sevilla, Sevilla, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Esther Cuadrado
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Department of Psychology, Universidad de Córdoba, Córdoba, Spain
| | - Rosario Castillo-Mayén
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Department of Psychology, Universidad de Córdoba, Córdoba, Spain
| | - Bárbara Luque
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Department of Psychology, Universidad de Córdoba, Córdoba, Spain
| | - Sebastián Rubio
- Department of Psychology, Universidad de Córdoba, Córdoba, Spain
- Department of Specific Didactics, Universidad de Córdoba, Córdoba, Spain
| | - Tamara Gutiérrez-Domingo
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Department of Psychology, Universidad de Córdoba, Córdoba, Spain
| | - Carmen Tabernero
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Department of Social Psychology and Anthropology, Universidad de Salamanca, Salamanca, Spain
- Instituto de Neurociencias de Castilla y León, Universidad de Salamanca, Salamanca, Spain
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14
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Di Giacomo D, Ranieri J, Guerra F, Cilli E, Sciarra L, Romano S. Cardiovascular risk and biopsychosocial interplay: Association among hypertension, anxiety, and emotional dysregulation-observational study in primary care setting for efficient self-care. Clin Cardiol 2024; 47:e24152. [PMID: 37771169 PMCID: PMC10765995 DOI: 10.1002/clc.24152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/28/2023] [Accepted: 09/03/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Aim of the study was to explore the relationship between emotional dimensions of hypertensive patients and the self-care skills; we tried to draw the psychological aspects could impact the health management in hypertension analyzing the effect of emotional regulation on self-care skills: our scope was to highlight the psychological dynamics into behavioral medicine approach. METHODS In an observational study design, patients were collected. Patients with diagnosis of hypertension were recruited in primary care setting. Inclusion criteria included patients older than 18 years, with known and medically treated primary hypertension undergoing antihypertensive medication. RESULTS Statistical analysis was carried out based on the data of 28 primary hypertensive patients (seven females, 21 males, mean age ± SD: 49.8 ± 7.8 years mean; clinic blood pressure: mean systolic blood pressure: 137.2 ± 13.1 mmHg, mean diastolic blood pressure: 82.1 ± 9.9 mmHg). Mean duration of hypertension in the sample was 13.1 years (±8.2 years). Correlations among the main variables of interest showed a positive and significant relationship between emotional dysregulation indexes, psychological distress, and self-care domains: awareness resulted negatively and significantly correlated to self-efficacy; nonacceptance, goals and impulse indexes seemed positively and significantly correlated to anxiety and depression; finally, stress was correlated positively and significantly to awareness and impulse. CONCLUSIONS Evidencing the role of emotion dysregulation on self-care skills and psychological outcomes, and specifically highlighting the impact of emotion dysregulation on self-care, our findings could inform the development and implementation of psychological interventions aimed at promoting psychological well-being and healthy behavior by focusing on the promotion of emotion regulation strategies, to reduce the risk for co-morbidity and/or severe cardiovascular diseases.
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Affiliation(s)
- Dina Di Giacomo
- Life, Health and Environmental Sciences DepartmentUniversity of L'AquilaL'AquilaItaly
| | - Jessica Ranieri
- Life, Health and Environmental Sciences DepartmentUniversity of L'AquilaL'AquilaItaly
| | - Federica Guerra
- Life, Health and Environmental Sciences DepartmentUniversity of L'AquilaL'AquilaItaly
| | - Eleonora Cilli
- Life, Health and Environmental Sciences DepartmentUniversity of L'AquilaL'AquilaItaly
| | - Luigi Sciarra
- Life, Health and Environmental Sciences DepartmentUniversity of L'AquilaL'AquilaItaly
- Di Lorenzo ClinicAvezzanoItaly
| | - Silvio Romano
- Life, Health and Environmental Sciences DepartmentUniversity of L'AquilaL'AquilaItaly
- Heart Failure ClinicASL Avezzano‐SulmonaL'AquilaItaly
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15
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Rapelli G, Giusti EM, Tarquinio C, Varallo G, Franceschini C, Musetti A, Gorini A, Castelnuovo G, Pietrabissa G. Psychological couple-oriented interventions for patients with heart disease and their partners: a scoping review and guidelines for future interventions. Front Psychol 2023; 14:1194767. [PMID: 37842689 PMCID: PMC10570454 DOI: 10.3389/fpsyg.2023.1194767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/21/2023] [Indexed: 10/17/2023] Open
Abstract
Objective This scoping review aims to provide an accessible summary of available evidence on the efficacy of psychological couple-based interventions among patients with heart disease and their partners focusing on specific aspects and strategies by assessing different emotional and physical cardiac-related outcome measures. Methods A literature search was performed in PubMed, Scopus, Medline, PsycINFO, and Web of Science databases using the keywords "heart diseases" and "couple-based intervention." A literature search using systematic methods was applied. Data were extracted to address the review aims and were presented as a narrative synthesis. Results The database search produced 11 studies. Psychological couple-based interventions varied in terms of the type of intervention, personnel, format (group or individual, phone or in person), number of sessions, and duration. Most of the contributions also lacked adequate details on the training of professionals, the contents of the interventions, and the theoretical models on which they were based. Finally, although partners were involved in all the treatment, in most studies, the psychological strategies and outcomes were focused on the patient. Conclusion The variability of the psychological couple-based interventions of included studies represents a challenge in summarizing the existing literature. Regarding their impact, psychological interventions for patients with cardiovascular disease and their partners were found to moderately improve patients' and partners' outcomes.
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Affiliation(s)
- Giada Rapelli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Emanuele Maria Giusti
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Claudia Tarquinio
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Giorgia Varallo
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural, University of Parma, Parma, Italy
| | - Alessandra Gorini
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Milan, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Giada Pietrabissa
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
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16
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Meraz R, McGee J, Caldwell EP, Ke W, Osteen K. The Impact of Resilience, Health Literacy, and Social Support on Medication Adherence and Self-care Among Adults With Heart Failure. J Cardiovasc Nurs 2023; 38:415-424. [PMID: 36103430 DOI: 10.1097/jcn.0000000000000948] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Personal and psychological factors, such as depression, have a considerable influence on nonadherence to medications and self-care in those with heart failure. More evidence is needed about positive personal factors that motivate adherence to medications and self-care in those with heart failure. OBJECTIVE The purpose of this study was to investigate whether there was a relationship between the personal resources of resilience, hope, health literacy, social support, and self-care activation and adherence to HF self-care and medications and whether race impacts adherence. METHODS This study used a cross-sectional, correlational design. Stepwise regression was used to test whether resilience, hope, health literacy, self-care activation, and race significantly predicted medication adherence and self-care. A diverse sample was recruited for this study. RESULTS Of the 174 participants, 51% were female, 51.7% were White, and the mean age was 62 years. After adjustment for differences in age and depressive symptoms, a predictive relationship remained between resilience, health literacy, and medication adherence. Hope, activation, and race were not selected in the final regression model. A high level of perceived social support was the only predictor of better HF self-care. CONCLUSION Persons with heart failure may have better medication adherence and overall self-care if sufficiently resilient, health literate, and supported regardless of their degree of hope or activation. Race and age may be important factors to consider. More research is needed to understand the connection between resilience and medication adherence.
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17
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Chica-Pérez A, Dobarrio-Sanz I, Correa-Casado M, Fernández-Sola C, Ruiz-Fernández MD, Hernández-Padilla JM. Spanish version of the self-care self-efficacy scale: A validation study in community-dwelling older adults with chronic multimorbidity. Geriatr Nurs 2023; 53:181-190. [PMID: 37540914 DOI: 10.1016/j.gerinurse.2023.07.016] [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: 06/10/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE To test the psychometric properties of the Spanish version of the Self-Care Self-Efficacy Scale (SCSES-Sp) in community-dwelling older adults with chronic multimorbidity. METHODS A sample of 1013 community-dwelling older adults with chronic multimorbidity participated in an observational cross-sectional study that was carried out in 3 phases. RESULTS Confirmatory factor analysis showed that the SCSES-Sp has 4 dimensions: "self-efficacy in self-care behaviours based on clinical knowledge", "self-efficacy in self-care maintenance", "self-efficacy in self-care monitoring", and "self-efficacy in self-care management". A panel of independent experts considered the content of the SCSES-Sp valid. Convergent validity analysis showed moderate-strong correlations between all of the SCSES-Sp's dimensions and the reference criteria chosen. Reliability was good for the SCSES-Sp and all its dimensions. Test-retest reliability analysis showed that the SCSES-Sp was temporally stable. CONCLUSIONS The SCSES-Sp is a valid and reliable tool to assess self-efficacy in self-care in Spanish-speaking, community-dwelling older adults with chronic multimorbidity.
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Affiliation(s)
| | - Iria Dobarrio-Sanz
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria 04120, Spain.
| | - Matías Correa-Casado
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria 04120, Spain; Andalusian Health Service District Almeria, Almeria, Spain
| | - Cayetano Fernández-Sola
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria 04120, Spain; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago 7500000, Chile
| | - María Dolores Ruiz-Fernández
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria 04120, Spain
| | - José Manuel Hernández-Padilla
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria 04120, Spain
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18
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Alqarni AS, Pasay-An E, Alshammari AE, Gonzales F, Estadilla L, Ahmed KE, Benjamin LS, Ngo A, Elmashad HAM, Gharib DAM, Alshammari SA. Patient Assessment of Care with Chronic Cardiovascular Disorders and Its Relationship with Self-Efficacy: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:2189. [PMID: 37570429 PMCID: PMC10418875 DOI: 10.3390/healthcare11152189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/21/2023] [Accepted: 07/23/2023] [Indexed: 08/13/2023] Open
Abstract
INTRODUCTION Patients' assessment of care navigating cardiovascular disorders is imperative in improving the quality of care provided. The purpose of this study was to explore the perspectives of people living with cardiovascular disorders on the care they received and its relationship with general self-efficacy. METHODS This investigation employed a cross-sectional correlational approach. The study sample was comprised of patients with cardiovascular disorders from both the King Khalid Hospital and the King Salman Specialist Hospital, in Hail City, Saudi Arabia. Convenience sampling was used, resulting in 104 participants. A survey using a self-administered questionnaire was employed to collect the data, which ran from 10 March to 20 May 2023. RESULTS The participants perceived that they occasionally (2.75 ± 1.053) received care, and they perceived themselves to have better self-efficacy (25.28/40). Of note, the age (0.062), years of being diagnosed with having the disease (-0.174), sex (0.180), educational attainment (0.125), and occupation (0.206) were found to have no significant relationship with the patient assessment of care with chronic cardiovascular disease (PACIC). However, civil status (0.867) was found to have a strong positive correlation to the PACIC. No significant relationship was found between age and GSE (0.070) and PACIC (0.62), civil status with GSE (0.013), years being diagnosed with having the disease with GSE (0.095), and PACIC (0.174) educational attainment with GSE (0.088) and PACIC (0.125) or occupation (0.115) with GSE. However, sex (0.795) was found to have a strong correlation with general self-efficacy (GSE). Of note, patient activation (0.390) and goal setting (0.360) had a moderate positive correlation while problem solving (0.228) and follow-up (0.278) had a weak positive correlation to GSE. Meanwhile, the delivery system (0.507) had a strong positive correlation to GSE. This study illuminates the value of self-efficacy and patient involvement as self-management techniques for cardiovascular illnesses. Future cardiovascular illness self-management initiatives should concentrate on enhancing patient self-efficacy by adopting the PACIC.
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Affiliation(s)
- Aidah Sanad Alqarni
- Medical Surgical Nursing Department, College of Nursing, King Khalid University, Abha 62521, Saudi Arabia
| | - Eddieson Pasay-An
- College of Nursing, University of Hail, Hail City 2440, Saudi Arabia
| | | | - Ferdinand Gonzales
- Medical Surgical Nursing Department, College of Nursing, King Khalid University, Abha 62521, Saudi Arabia
| | - Lorraine Estadilla
- Medical Surgical Nursing Department, College of Nursing, King Khalid University, Abha 62521, Saudi Arabia
| | - Kawther Eltayeb Ahmed
- Medical Surgical Nursing Department, College of Nursing, King Khalid University, Abha 62521, Saudi Arabia
| | - Lizy Sonia Benjamin
- Medical Surgical Nursing Department, College of Nursing, King Khalid University, Abha 62521, Saudi Arabia
| | - Andrew Ngo
- Department of Community, Psychiatric and Mental Health Nursing, College of Nursing, Qassim University, Buraydah 51452, Saudi Arabia
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19
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Zhao M, Huang Y, Wang J, Feng J, Zhou B. Internet addiction and depression among Chinese adolescents: anxiety as a mediator and social support as a moderator. PSYCHOL HEALTH MED 2023; 28:2315-2328. [PMID: 37317485 DOI: 10.1080/13548506.2023.2224041] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/06/2023] [Indexed: 06/16/2023]
Abstract
This study constructed a moderated mediation model to investigate the mediating effect of anxiety and the moderating effect of social support between Internet addiction and depression. A sample of 17 058 middle school students in one district of Chengdu were selected. The Internet Addiction Test (IAT), Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and Social Support Scale for adolescents were used to investigate their Internet addiction, anxiety, depression and social support. The descriptive statistics and Spearman correlation analysis were performed with SPSS 25.0. An SPSS macro process was used to analyze the data from complex models that contained mediators and moderators. The results show that adolescents with Internet addiction are more likely to suffer from depression. Anxiety partially mediated the relations between Internet addiction and depression. Social support moderated both direct and indirect pathways leading from Internet addiction to depression, and these two effects were stronger for adolescents with low social support than for those with high social support. It will be possible for researchers to gain a better understanding of the conditions, pathways, and effects of Internet addiction on depression in adolescents through the results of this study.
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Affiliation(s)
- Meng Zhao
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yulan Huang
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
| | - Jinyu Wang
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
| | - Jie Feng
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Bo Zhou
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
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20
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Öberg S, Johansson L, Georgsson M, Sandberg J, Broström A. Primary care patients with cardiovascular disease eligible for nurse-led internet-based cognitive behavioural therapy for insomnia: Characteristics and motives for participation. Nurs Open 2023. [PMID: 36929685 DOI: 10.1002/nop2.1717] [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: 09/08/2021] [Revised: 01/05/2023] [Accepted: 02/20/2023] [Indexed: 03/18/2023] Open
Abstract
AIM To describe demographic, physical and psychological characteristics associated with insomnia in patients with cardiovascular disease (CVD) participating in nurse-led Internet-based cognitive behavioural therapy for insomnia (I-CBTI), and their motives and expectations regarding participation in I-CBTI. DESIGN A mixed method design was applied, including primary care patients with angina pectoris, myocardial infarction, heart failure, atrial fibrillation and atrial flutter or arrhythmia in southern Sweden. METHODS Data on demographics, insomnia severity and physical and psychological characteristics were collected through self-rated validated questionnaires (n = 126). Motives and expectations were collected through interviews (n = 19) and analysed using the 'personas' model. RESULTS Physical symptoms and psychological characteristics were associated with insomnia. Three personas were identified: the pragmatist (a curious and optimistic persona), the philosopher (a problem-solving persona) and the philanthropist (an altruistic persona). Expectations were positive among the three personas, but comorbid conditions reduced the perceived ability to make necessary behavioural changes.
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Affiliation(s)
- Sandra Öberg
- Department of Nursing Science, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Linda Johansson
- School of Health and Welfare, Aging Research Network-Jönköping, Institute of Gerontology, Jönköping University, Jönköping, Sweden
| | - Mattias Georgsson
- Department of Nursing Science, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Jonas Sandberg
- Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
| | - Anders Broström
- Department of Nursing Science, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
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21
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Granata N, Torlaschi V, Zanatta F, Giardini A, Maestri R, Pavesi C, Sommaruga M, Gazzi L, Bertolotti G, Sarzi Braga S, Monelli M, Zanelli E, Pierobon A. Positive affect as a predictor of non-pharmacological adherence in older Chronic Heart Failure (CHF) patients undergoing cardiac rehabilitation. PSYCHOL HEALTH MED 2023; 28:606-620. [PMID: 35603663 DOI: 10.1080/13548506.2022.2077394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In Chronic Heart Failure (CHF) patients, psychological and cognitive variables and their association with treatment adherence have been extensively reported in the literature, but few are the investigations in older people. The present study aimed to evaluate the psychological, cognitive, and adherence to treatment profile of older (>65 years) CHF patients, the interrelation between these variables, and identify possible independent predictors of self-reported treatment adherence. CHF inpatients undergoing cardiac rehabilitation were assessed for: anxiety, depression, cognitive impairment, positive and negative affect, and self-reported adherence (adherence antecedents, pharmacological adherence, and non-pharmacological adherence). 100 CHF inpatients (mean age: 74.9 ± 7.1 years) were recruited. 16% of patients showed anxiety and 24.5% depressive symptoms; 4% presented cognitive decline. Cognitive functioning negatively correlated to depression, anxiety, and negative affect (p < 0.01). The adherence antecedents (disease acceptance, adaptation, knowledge, and socio-familiar support) negatively correlated to anxiety (p < 0.05), depression (p < 0.001), and negative affect (p < 0.05), while they positively correlated to positive affect (p < 0.01). Pharmacological adherence negatively correlated to anxiety and negative affect (p < 0.05). Conversely, non-pharmacological adherence and positive affect positively correlated (p < 0.05). Furthermore, depression and anxiety negatively predicted adherence antecedents (β = -0.162, p = 0.037) and pharmacological adherence (β = -0.171, p = 0.036), respectively. Finally, positive affect was found as an independent predictor of non-pharmacological adherence (β = 0.133, p = 0.004). In cardiac rehabilitation, a specific psychological assessment focused on anxiety, depression, and affect can provide useful information to manage CHF older patients' care related to treatment adherence. In particular, positive affect should be targeted in future interventions to foster patients' non-pharmacological adherence.
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Affiliation(s)
- Nicolò Granata
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Montescano, Pavia, Italy
| | - Valeria Torlaschi
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Montescano, Pavia, Italy
| | - Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
| | - Anna Giardini
- Information Technology Department, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Roberto Maestri
- Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Montescano, Pavia, Italy
| | - Claudia Pavesi
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Montescano, Pavia, Italy
| | - Marinella Sommaruga
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Camaldoli, Milano, Italy
| | - Lidia Gazzi
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto di Lumezzane, Brescia, Italy
| | - Giorgio Bertolotti
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto di Tradate, Varese, Italy
| | - Simona Sarzi Braga
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCSS, Istituto di Tradate, Varese, Italy
| | - Mauro Monelli
- Subacute Care, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Camaldoli, Milano, Italy
| | - Emanuela Zanelli
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCSS, Istituto di Lumezzane, Brescia, Italy
| | - Antonia Pierobon
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Montescano, Pavia, Italy
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Prevalence of Comorbid Depression and Insomnia Among Veterans Hospitalized for Heart Failure with Alzheimer Disease and Related Disorders. Am J Geriatr Psychiatry 2023; 31:428-437. [PMID: 36863973 DOI: 10.1016/j.jagp.2023.01.026] [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: 10/25/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE To examine prevalence of Alzheimer Disease and related dementias (ADRD) and patient characteristics as a function of comorbid insomnia and/or depression among heart failure (HF) patients discharged from hospitals. DESIGN Retrospective cohort descriptive epidemiology study. SETTING VA Hospitals. PARTICIPANTS N = 373,897 Veterans hospitalized with heart failure from October 1, 2011 until September 30, 2020. MEASUREMENTS We examined VA and Center for Medicare & Medicaid Services (CMS) coding in the year prior to admission using published ICD-9/10 codes for dementia, insomnia, and depression. The primary outcome was the prevalence of ADRD and the secondary outcomes were 30-day and 365-day mortality. RESULTS The cohort were predominantly older adults (mean age = 72 years, SD = 11), male (97%), and White (73%). Dementia prevalence in participants without insomnia or depression was 12%. In those with both insomnia and depression, dementia prevalence was 34%. For insomnia alone and depression alone, dementia prevalence was 21% and 24%, respectively. Mortality followed a similar pattern with highest 30-day and 365-day mortality higher in those with both insomnia and depression. CONCLUSIONS These results suggest that persons with both insomnia and depression are at an increased risk of ADRD and mortality compared to persons with one or neither condition. Screening for both insomnia and depression, especially in patients with other ADRD risk factors, could lead to earlier identification of ADRD. Understanding comorbid conditions which may represent earlier signs of ADRD may be critical in the identification of ADRD risk.
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Fan Y, Ho MHR, Shen BJ. Loneliness predicts physical and mental health-related quality of life over 9 months among patients with coronary heart disease. Appl Psychol Health Well Being 2023; 15:152-171. [PMID: 36184794 DOI: 10.1111/aphw.12403] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 09/07/2022] [Indexed: 11/22/2022]
Abstract
This study investigated whether loneliness would predict physical and mental health-related quality of life (HRQoL) over 9 months and examined whether medical adherence would mediate their associations in patients with coronary heart disease (CHD). The overall design is a three-wave longitudinal study. A sample of 255 outpatients with CHD was recruited from a community-based cardiac rehabilitation programme. Participants, with a mean age of 63 years, completed measures assessing loneliness, depression and physical and mental HRQoL at baseline. Medical adherence was assessed at 3 months, and physical and mental HRQoL were reassessed at 9 months. A total of 88% of participants reported moderate or high loneliness. Baseline loneliness predicted physical and mental HRQoL at 9 months after adjusting for baseline physical and mental HRQoL, respectively. The effects remained significant when depression was also adjusted. Medical adherence at 3 months partially mediated the associations of baseline loneliness with 9-month physical and mental HRQoL. Findings underline the necessity of assessing loneliness for CHD patients to promote long-term medical adherence and further improve physical and mental HRQoL.
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Affiliation(s)
- Yunge Fan
- Psychology Programme, School of Social Sciences, Nanyang Technological University, Singapore
| | - Moon-Ho Ringo Ho
- Psychology Programme, School of Social Sciences, Nanyang Technological University, Singapore
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Adherence to Self-Care Recommendations and Associated Factors among Adult Heart Failure Patients in West Gojjam Zone Public Hospitals, Northwest Ethiopia. Int J Chronic Dis 2022; 2022:9673653. [PMID: 36590698 PMCID: PMC9798104 DOI: 10.1155/2022/9673653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/03/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background Self-care practices are an important part of heart failure patient management and essential to control symptoms of the disease and its exacerbation. However, poor adherence to these self-care behaviors could be associated with an increase in hospitalization, morbidity, and mortality. Even if it is an important part of management for heart failure patients, yet information is not adequate in the study area about adherence to self-care recommendations and associated factors among heart failure patients. Purpose To assess self-care recommendation adherence and associated factors among heart failure patients in West Gojjam Zone public hospitals. Methods Institutional-based cross-sectional study was conducted on 304 selected heart failure patients attending follow-up at public hospitals in West Gojjam Zone from March 16 to April 16, 2021. Consecutive sampling technique based on patient arrival with proportional allocation to each hospital was employed to select the study participants. Data were collected through face-to-face interview and reviewing patients' medical records. Data were entered into EpiData version 3.1 and analyzed using Statistical Package for Social Sciences (SPSS) version 25. Binary logistic regression model was fitted to assess the association between adherence to self-care recommendations and associated factors. P value < 0.05 with 95% confidence interval (CI) was considered to declare a statistically significant association in multivariable logistic regression. Results In this study, 304 patients participated with a response rate of 97.4%. Only 32.9% of them had good adherence to self-care recommendations. Having good knowledge on heart failure (adjusted odds ratio (AOR) = 4.6; 95% CI: 1.82, 11.86), no depression (AOR = 6.1; 95% CI: 1.92, 19.37), having strong social support (AOR = 3.57; 95% CI: 1.56-8.33), age 30-49 years (AOR = 3.37; 95% CI: 1.14, 9.89), and college and above level of education (AOR = 6.17; 95% CI: 1.22, 31.25) were factors significantly associated with good adherence to self-care recommendations. Conclusion This study showed that most of the heart failure patients had poor adherence to self-care recommendations. Policymakers and other stakeholders should develop and implement appropriate strategies to increase patients' adherence level to self-care recommendations by emphasizing on addressing identified factors.
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Poletti V, Pagnini F, Banfi P, Volpato E. The Role of Depression on Treatment Adherence in Patients with Heart Failure-a Systematic Review of the Literature. Curr Cardiol Rep 2022; 24:1995-2008. [PMID: 36327056 PMCID: PMC9747824 DOI: 10.1007/s11886-022-01815-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Although poor medication adherence is considered an impacting risk factor for worsening heart failure (HF) outcomes, adherence rates in HF patients continue to be considerably low. To improve this condition, several studies investigated the impact of many determinants on medication adherence; however, few authors explored the role of depression on it. PURPOSE OF REVIEW The purpose of this systematic review was to explore the association between depressive symptoms and medication adherence in HF patients. In particular, the research question was is depression a barrier to medication adherence in HF patients? METHODS A systematic review of quantitative analysis studies was undertaken. Six electronic databases were searched between the end of October and March 2022. Thirty-one trials were included, all of them assessed depression, adherence to medication, and their possible relationship. RESULTS As was intended, findings showed that the impact of a mild to moderate level of depression was significant on adherence to treatment in HF patients. However, many other risk factors emerged, like family support and health practices (es. low sodium diet). CONCLUSION The detection of depression in the setting of HF should be crucial to HF patients' physical health and quality of life. Future research should take depression into account, exploring this area through self-report and qualitative interview as well.
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Affiliation(s)
- Valentina Poletti
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Francesco Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Harvard University, Cambridge, MA USA
| | | | - Eleonora Volpato
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- IRCCS Fondazione Don Gnocchi, Milan, Italy
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Chernoff RA, Messineo G, Kim S, Pizano D, Korouri S, Danovitch I, IsHak WW. Psychosocial Interventions for Patients With Heart Failure and Their Impact on Depression, Anxiety, Quality of Life, Morbidity, and Mortality: A Systematic Review and Meta-Analysis. Psychosom Med 2022; 84:560-580. [PMID: 35354163 DOI: 10.1097/psy.0000000000001073] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this systematic review and meta-analysis was to evaluate the ability of psychosocial interventions to reduce depression and anxiety, improve quality of life, and reduce hospitalization and mortality rates in patients with heart failure. METHODS Studies of psychosocial interventions published from 1970 to 2021 were identified through four databases (PubMed, Ovid MEDLINE, PsycINFO, Cochrane). Two authors independently conducted a focused analysis and reached a final consensus on the studies to include, followed by a quality check by a third author. A risk of bias assessment was conducted. RESULTS Twenty-three studies were identified, but only 15 studies of mostly randomized controlled trials with a total of 1370 patients with heart failure were included in the meta-analysis. Interventions were either cognitive behavioral therapy (CBT) or stress management. The pooled intervention effect was in favor of the intervention for depression (combined difference in standardized mean change [DSMC]: -0.41; 95% confidence interval [CI] = -0.66 to -0.17; p = .001) and anxiety (combined DSMC: -0.33; 95% CI = -0.51 to -0.15; p < .001) but was only a trend for quality of life (combined DSMC: 0.14; 95% CI = -0.00 to 0.29; p = .053). Evidence was limited that interventions produced lower rates of hospitalization (5 of 5 studies showing a beneficial effect) or death (1 of 5 with a beneficial effect). CONCLUSIONS CBT and stress management interventions significantly reduced depression and anxiety compared with control conditions. CBT significantly improved quality of life compared with controls, but stress management did not. Longer treatment duration seemed to be an important factor related to treatment success.
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Affiliation(s)
- Robert Alan Chernoff
- From the Department of Psychiatry and Behavioral Neurosciences (Chernoff, Messineo, Pizano, Korouri, Danovitch, IsHak), and Biostatistics Core (Kim), Cedars-Sinai Medical Center, Los Angeles, CA
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Iovino P, Nolan A, De Maria M, Ausili D, Matarese M, Vellone E, Riegel B. The influence of social support on self-care is mediated by self-efficacy and depression in chronic illness: key findings from the 'SODALITY' observational study. Aging Ment Health 2022; 27:820-828. [PMID: 35416091 DOI: 10.1080/13607863.2022.2056877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Objectives: Family is a major source of support for older chronically-ill patients and known to be associated with better self-care. Depression and self-care self-efficacy are associated with healthy behaviors and thus may serve as mechanisms by which family support influences self-care.We explored depression and self-care self-efficacy as mediators of the relationship between perceived family support and self-care.Methods: Five hundred forty-one older adults with multiple chronic illnesses were recruited from outpatients and community settings. Three structural equation models (SEM) were fit on cross-sectional data. We measured perceived family support (subscale of the Multidimensional Scale of Perceived Social Support, scores range 1-7), depression (Patient Health Questionnaire, scores range 0-27), selfcare self-efficacy (Self-Care Self Efficacy Scale, standardized scores range 0-100), and self-care maintenance, monitoring, and management (Self-care of Chronic Illness Inventory, standardized scores range 0-100).Results: Participants (mean age = 76.6±7.3 yrs) were predominantly females (55.6%). In the full sample, depression and self-care self-efficacy mediated the relationship between perceived family support and self-care; in the gender-stratified SEM, men's depression was no longer a significant mediator. Depression and self-care self-efficacy were significant mediators of the relation between perceived family support and self-care.Conclusion: In older chronically-ill patients, interventions addressing perceived family support may facilitate a rapid improvement in self-care self-efficacy and a decrease in depressive symptoms, particularly among women.
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Affiliation(s)
- Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,School of Nursing, Midwifery and Paramedicine Faculty of Health Science, Australian Catholic University, Melbourne, Australia
| | - Amy Nolan
- University of Pennsylvania, Philadelphia, PA, USA
| | - Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Davide Ausili
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | | | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Lin TK, Hsu BC, Li YD, Chen CH, Lin JW, Chien CY, Weng CY. The impact of sources of perceived social support on readmissions in patients with heart failure. J Psychosom Res 2022; 154:110723. [PMID: 35078080 DOI: 10.1016/j.jpsychores.2022.110723] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 01/09/2022] [Accepted: 01/09/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Lower levels of perceived social support have been known as an independent predictor of hospital readmissions in patients with heart failure (HF). However, the impact of sources of perceived social support on readmissions remain unexplored. PURPOSE The main purpose of this study was to investigate and compare the relative importance of social support from significant other, family, and friends on all-cause readmission and cardiac readmission in patients with HF. METHODS The prospective cohort study was used to recruit a total of 299 patients with HF in Taiwan between May 2012 and December 2014. Demographic and clinical characteristics, Multidimensional Perceived Social Support Scale (MPSSS), and 18-month follow-up readmissions were recorded during the hospital stay. Univariate and multivariate logistic regressions were constructed to determine the impact of levels and sources of perceived social support with all-cause readmission and cardiac readmission. RESULTS A total of 158 patients (52.8%) and 118 patients (39.5%), respectively, had all-cause readmission and cardiac readmissions within 18 months. Multivariate logistic regression yielded inverse associations between levels of perceived social support and readmissions by 18-months. Importantly, social support from significant other was significantly associated with a lower risk of readmissions, both of all-cause readmission and cardiac readmission, in patients with HF, even after controlling for possible covariates, social support from family and friends. CONCLUSIONS Social support from significant other, rather than from family and friends, was relatively and inversely associated with 18-month all-cause readmission and cardiac readmission in patients with HF, which is consistent with the hierarchical compensatory model.
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Affiliation(s)
- Tin-Kwang Lin
- School of Medicine, Tzu Chi University, Hualien, Taiwan No.701, Sec.3, Jhongyang Rd., Hualien City, Hualien 97004, Taiwan; Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan No. 2, Min-Sheng Road, Dalin Town, Chiayi 622, Taiwan
| | - Bo-Cheng Hsu
- Department of Psychology, National Chung Cheng University, Chiayi, Taiwan No.168, Sec. 1, University Rd., Minhsiung, Chiayi 62102, Taiwan.
| | - Yi-Da Li
- School of Medicine, Tzu Chi University, Hualien, Taiwan No.701, Sec.3, Jhongyang Rd., Hualien City, Hualien 97004, Taiwan; Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan No. 2, Min-Sheng Road, Dalin Town, Chiayi 622, Taiwan
| | - Chi-Hsien Chen
- Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan No. 2, Min-Sheng Road, Dalin Town, Chiayi 622, Taiwan
| | - Jiunn-Wen Lin
- Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan No. 2, Min-Sheng Road, Dalin Town, Chiayi 622, Taiwan
| | - Chen-Yu Chien
- Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan No. 2, Min-Sheng Road, Dalin Town, Chiayi 622, Taiwan
| | - Chia-Ying Weng
- Department of Psychology, National Chung Cheng University, Chiayi, Taiwan No.168, Sec. 1, University Rd., Minhsiung, Chiayi 62102, Taiwan.
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Son H, Cho HJ, Cho S, Ryu J, Kim S. The Moderating Effect of Social Support between Loneliness and Depression: Differences between the Young-Old and the Old-Old. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2322. [PMID: 35206508 PMCID: PMC8871923 DOI: 10.3390/ijerph19042322] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 02/06/2023]
Abstract
This study aimed to investigate the moderation of social support in the association between loneliness and depression in different age groups of older adults. The sample consisted of 1532 community-dwelling adults aged 65 years or older, based on the data from the National Social Life, Health, and Aging Project (NSHAP), Wave 3 (2015-2016). Eleven items of the Center for Epidemiologic Studies Depression Scale (CES-D) were used to measure depressive symptoms. Similarly, a four-item scale was used to measure social support (each from spouse and family), and a three-item scale for loneliness. The results were as follows. Loneliness was associated with depression in both the young-old and the old-old groups. Spousal support and family support were associated with reduced depression in the young-old group, whereas only spousal support was associated with relieving depression in the old-old group. Social support had a significant moderating effect on the relationship between loneliness and depression in the old-old group, whereas it had no significant effect in the young-old group. From these results, it can be concluded that spousal support plays a significant role in seniors' mental health. The role of caregivers for a person's well-being grows later in life, so practitioners could help couples communicate with this consideration. In addition, regular contacts with family members and spousal support are recommended to prevent older old adults' depression.
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Affiliation(s)
- Hyegyeong Son
- College of Nursing, Kosin University, Busan 49104, Korea;
| | - Heeran J. Cho
- Department of Health Administration, Yonsei University, Seoul 03021, Korea
| | - Sunghwan Cho
- School of Social Work, Virginia Commonwealth University, Richmond, VA 23284, USA;
| | - Juhyun Ryu
- Graduate School of Social Welfare, Yonsei University, Seoul 03722, Korea; (J.R.); (S.K.)
| | - Sunghee Kim
- Graduate School of Social Welfare, Yonsei University, Seoul 03722, Korea; (J.R.); (S.K.)
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OUP accepted manuscript. Eur J Prev Cardiol 2022; 29:1124-1141. [DOI: 10.1093/eurjpc/zwac006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/25/2021] [Accepted: 01/04/2022] [Indexed: 11/12/2022]
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Zhou Y, Huo Q, Du S, Shi X, Shi Q, Cui S, Feng C, Du X, Wang Y. Social Support and Self-Efficacy as Mediating Factors Affecting the Association Between Depression and Medication Adherence in Older Patients with Coronary Heart Disease: A Multiple Mediator Model with a Cross-Sectional Study. Patient Prefer Adherence 2022; 16:285-295. [PMID: 35153475 PMCID: PMC8824789 DOI: 10.2147/ppa.s337634] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 01/13/2022] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Medication non-adherence is a major public health issue. Recent evidence suggests that depression, inadequate social support, and lower levels of self-efficacy are associated with poor medication adherence. However, the mechanism underlying the association among depression, social support, self-efficacy and medication adherence is unclear. This study aims to examine the mediating role of social support and self-efficacy between depression and medication adherence in older patients with coronary heart disease. PATIENTS AND METHODS Data were collected from 238 hospitalized older patients with coronary heart disease. Depression, social support, self-efficacy, and medication adherence were assessed using structured questionnaires. A serial multiple mediation model was tested using the PROCESS macro for SPSS. RESULTS A total of 238 older patients with CHD with a mean age of 70.5 years were involved in this cross-sectional study. Depression was negatively correlated with medication adherence in older patients with coronary heart disease. Social support and self-efficacy were positively associated with medication adherence, and fully mediated the relationship between depression and medication adherence. Three mediation paths were included in the model: (a) social support, (b) chain combination of social support and self-efficacy, and (c) self-efficacy. CONCLUSION Social support and self-efficacy explain the association of depression and medication adherence in older CHD patients and may be the keys target for enhanced intervention to improve medication adherence in older CHD patients with depression.
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Affiliation(s)
- Yi Zhou
- School of Nursing, Hebei University, Baoding, Hebei, People’s Republic of China
| | - Qiwen Huo
- School of Nursing, Hebei University, Baoding, Hebei, People’s Republic of China
| | - Shaoying Du
- School of Nursing, Hebei University, Baoding, Hebei, People’s Republic of China
| | - Xiaoyang Shi
- School of Nursing, Hebei University, Baoding, Hebei, People’s Republic of China
| | - Qisong Shi
- Department of Cardiovascular Medicine, The Second Hospital of Baoding, Baoding, Hebei, People’s Republic of China
| | - Shanshan Cui
- Department of General Medicine, Affiliated Hospital of Hebei University, Baoding, Hebei, People’s Republic of China
| | - Cuina Feng
- Department of Cardiovascular Medicine, Affiliated Hospital of Hebei University, Baoding, Hebei, People’s Republic of China
| | - Xiaojing Du
- School of Nursing, Hebei University, Baoding, Hebei, People’s Republic of China
| | - Yan Wang
- School of Nursing, Hebei University, Baoding, Hebei, People’s Republic of China
- Correspondence: Yan Wang, School of Nursing, Hebei University, 342 Yuhuadong Road, Baoding, Hebei, 071000, People’s Republic of China, Tel/Fax +86 3125075605, Email
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Association of functional disability and treatment modalities with perceived effectiveness of treatment among adults with depression: a cross-sectional study. Disabil Health J 2021; 15:101264. [DOI: 10.1016/j.dhjo.2021.101264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 11/19/2022]
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Xu C, Shi Y, Yu X, Chang R, Wang H, Chen H, Wang R, Liu Y, Liu S, Cai Y, Ni Y, Wang S. The syndemic condition of psychosocial problems related to depression among sexually transmitted infections patients. PeerJ 2021; 9:e12022. [PMID: 34616597 PMCID: PMC8462369 DOI: 10.7717/peerj.12022] [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: 04/21/2021] [Accepted: 07/29/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The prevalence of depression in sexually transmitted infections (STIs) patients is much higher than general public. However, studies focusing on comprehensive psychosocial effects on depression among STIs patients are limited. This study aimed to examine association of multiple psychosocial syndemic conditions with depression among STIs patients in Shanghai, China. METHODS We conducted a cross-sectional study and recruited 910 STIs patients from Shanghai Skin Disease Hospital. Participants self-reported their demographics and themselves completed the scales of depression, self-esteem, loneliness, social support, entrapment, defeat and interpersonal needs. Logistic regressions were performed to detect the possible contributing psychosocial factors for depression and to verify the syndemic conditions of psychosocial problems. RESULTS Of the STIs patient sample, the prevalence of depression was 17.9%. Multivariable analysis showed low-level self-esteem (odds ratio [ORm]: 2.18, 95% CI [1.19-4.00]) and social support (ORm: 2.18, 95% CI [1.37-3.46]), high-level entrapment (ORm: 6.31, 95% CI [3.75-10.62]) and defeat (ORm: 2.60, 95% CI [1.51-4.48]) increased the risk of depression. Psychosocial syndemic conditions magnified effect in fusing depression (adjusted odds ratio [AOR]: 11.94, 95% CI [7.70-18.53]). Participants with more than 4 psychosocial problems were about 22 times more likely to have depression (AOR: 22.12, 95% CI [13.19-37.09]). CONCLUSIONS The psychosocial problems syndemic magnifying the risk of depression was confirmed and psychosocial interventions to prevent depression is needed among STIs patients.
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Affiliation(s)
- Chen Xu
- Shanghai Skin Disease Hospital, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuan Shi
- Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyue Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruijie Chang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huwen Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rongxi Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yujie Liu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shangbin Liu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yang Ni
- Shanghai Skin Disease Hospital, Shanghai, China
| | - Suping Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Nakamura-Taira N, Horikawa N, Oka F, Igarashi Y, Kobayashi S, Kato S, Enomoto T, Kimura H, Watanabe Y, Kumada T, Matsuyama K, Matsuoka N, Yoshimasu H. Quasi-cluster randomized trial of a six-month low-intensity group-based resistance exercise for hemodialysis patients on depression and cognitive function: a 12-month follow-up. Health Psychol Behav Med 2021; 9:741-760. [PMID: 34484975 PMCID: PMC8409964 DOI: 10.1080/21642850.2021.1966302] [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] [Indexed: 11/05/2022] Open
Abstract
Objective This study aimed to examine the effects of a six-month group-based low-intensity resistance exercise program on depression and the cognitive function of hemodialysis patients. Method We conducted a quasi-cluster randomized, open-label controlled study from October 2017 to December 2018. Forty-two patients undergoing hemodialysis completed the trial over six months; half participated in the resistance exercise group (n = 21, mean = 74.90 years of age, SD = 2.23, 66.67% female) and the other half were in a stretching control group (n = 21, mean = 72.57 years of age, SD = 2.26, 28.57% female). Depressive symptoms and cognitive function were the primary outcome measures. Behavioral and psychological problems associated with cognitive decline (NPI-Q), subjective insomnia, and exercise self-efficacy were secondary outcomes. Outcomes were measured at baseline, three-month (mid-intervention), six-month (end of intervention), and 12-month (six months after intervention) follow-ups. Linear mixed model analyses were used to determine short-term (immediately after intervention) and long-term (six months after intervention) effects. Results In depression, cognitive function, and the NPI-Q, there were no significant effects. In subjective insomnia, a short-term group-by-time interaction in the intervention group compared to the control group was found (ES = .43). However, the effect had disappeared by the 12-month follow-up. In exercise self-efficacy, short- and long-term group-by-time interactions were found. A significant short-term increase in the resistance exercise and a significant decrease in the stretching control was observed (ES = -.83). However, the effect was weakened in the long term (ES = -.38). Conclusion The results showed that low-intensity group resistance exercise would reduce subjective insomnia and improve exercise self-efficacy, but the effect was not maintained by six months after the program. Trial registration: This study was registered on the University Hospital Medical Information Network Clinical Trials Registry (UMIN000029372). Trial registration:UMIN Japan identifier: UMIN000029372.
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Affiliation(s)
- Nanako Nakamura-Taira
- Department of Psychology, Faculty of Letters, Chuo University, Tokyo, Japan.,Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Naoshi Horikawa
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Fumie Oka
- Department of Psychiatry and Huntsman Mental Health Institute, University of Utah, UT, USA, UT, USA
| | - Yuri Igarashi
- Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, Tokyo, Japan.,Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Sayaka Kobayashi
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Shingo Kato
- Yanagihara Rehabilitation Hospital, Tokyo, Japan
| | | | | | | | | | | | | | - Haruo Yoshimasu
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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Kitsiou S, Gerber BS, Kansal MM, Buchholz SW, Chen J, Ruppar T, Arrington J, Owoyemi A, Leigh J, Pressler SJ. Patient-centered mobile health technology intervention to improve self-care in patients with chronic heart failure: Protocol for a feasibility randomized controlled trial. Contemp Clin Trials 2021; 106:106433. [PMID: 33991686 PMCID: PMC8222185 DOI: 10.1016/j.cct.2021.106433] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/09/2021] [Accepted: 05/08/2021] [Indexed: 12/25/2022]
Abstract
This randomized controlled trial aims to determine the feasibility and preliminary efficacy of a patient-centered, mobile health technology intervention (iCardia4HF) in patients with chronic Heart Failure (HF). Participants (n = 92) are recruited and randomized 1:1 to the intervention or control group. The intervention group receives a commercial HF self-care app (Heart Failure Storylines), three connected health devices that interface with the app (Withings weight scale and blood pressure monitor, and Fitbit activity tracker), and a program of individually tailored text-messages targeting health beliefs, self-care self-efficacy, HF-knowledge, and physical activity. The control group receives the same connected health devices, but without the HF self-care app and text messages. Follow-up assessments occur at 30 days and 12 weeks. The main outcome of interest is adherence to HF self-care assessed objectively through time-stamped data from the electronic devices and also via patient self-reports. Primary measures of HF self-care include medication adherence and adherence to daily weight monitoring. Secondary measures of HF self-care include adherence to daily self-monitoring of HF symptoms and blood pressure, adherence to low-sodium diet, and engagement in physical activity. Self-reported HF self-care and health-related quality of life are assessed with the Self-care Heart Failure Index and the Kansas City Cardiomyopathy Questionnaire, respectively. Hospitalizations and emergency room visits are tracked in both groups over 12 weeks as part of our safety protocol. This study represents an important step in testing a scalable mHealth solution that has the potential to bring about a new paradigm in self-management of HF.
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Affiliation(s)
- Spyros Kitsiou
- Department of Biomedical & Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America.
| | - Ben S Gerber
- Division of Academic Internal Medicine and Geriatrics, Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Mayank M Kansal
- Division of Cardiology, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Susan W Buchholz
- College of Nursing, Michigan State University, East Lansing, MI, United States of America
| | - Jinsong Chen
- College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Todd Ruppar
- Department of Adult Health and Gerontological Nursing, College of Nursing, Rush University, Chicago, IL, United States of America
| | - Jasmine Arrington
- Department of Biomedical & Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Ayomide Owoyemi
- Department of Biomedical & Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Jonathan Leigh
- Department of Biomedical & Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America; Division of Cardiology, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Susan J Pressler
- School of Nursing, Indiana University, Bloomington, IN, United States of America
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Jalali N, Taghavi Kojidi H, Badrfam R, Zandifar A. The relationship between personality disorder, depression and eating disorder with treatment adherence in patients with type 2 diabetes; a cross-sectional study in diabetic patients in Iran. J Diabetes Metab Disord 2021; 20:153-159. [PMID: 34178827 DOI: 10.1007/s40200-020-00722-x] [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: 10/05/2020] [Accepted: 12/28/2020] [Indexed: 10/22/2022]
Abstract
Purpose Adherence to treatment is of great importance in patients with diabetes mellitus due to its necessity and benefits. The purpose of this study was to evaluate the relationship between personality disorder, depression and eating disorder with appropriate treatment acceptance and follow-up in patients with type 2 diabetes. Methods This cross-sectional study was performed in Imam Ali Medical Education Center in Karaj city of Alborz province of Iran. A total of 1320 patients were evaluated and were screened according to the inclusion criteria, including type 2 diabetes and those over 18 years of age. Finally, considering the exclusion criteria, 600 patients with type 2 diabetes were included in the study. Patients were divided into 4 groups. 150 patients with type 2 diabetes in the control group, 150 patients with type 2 diabetes with major depressive disorder, 150 patients with type 2 diabetes with personality disorder and 150 patients with type 2 diabetes and eating disorder were studied. Questionnaires used in the study included Hamilton Depression Rating Scale(HAM-D) for depression, Minnesota Multiphasic Personality Inventory II (MMPI II) questionnaire for personality disorders and Eating Disorder Diagnostic Scale(EDDS) for eating disorder. The Murisky questionnaire also assessed adherence to treatment in patients, which included 8 questions. Scores measure the degree of adherence to treatment. Results 600 patients with type 2 diabetes were studied. Patients were divided into 4 groups (each group consisting of 150 patients) of control, depression, personality disorder and eating disorder. Mean age, sex, marital status and duration of diabetes were not significantly different in the study groups (P > 0.05). The mean Murisky score in patients with depression and personality disorder was significantly lower than the control group (P < 0.05) but the mean Murisky score in patients with eating disorder was not significantly different (P > 0.05). Patients with depression, paranoid, schizotypal, antisocial, borderline, avoidant and dependent personality disorder had less adherent to treatment than the control group. Conclusions Early psychiatric evaluation of patients with diabetes and identification of possible disorders can help improve diabetes control.
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Affiliation(s)
- Negar Jalali
- Imam Ali Hospital, Alborz University of Medical Sciences, Karaj, Alborz Iran
| | - Habibeh Taghavi Kojidi
- Department of Internal Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Rahim Badrfam
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Atefeh Zandifar
- Imam Ali Hospital, Alborz University of Medical Sciences, Karaj, Alborz Iran
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The Combined Effect of Psychological and Relational Aspects on Cardiac Patient Activation. J Clin Psychol Med Settings 2021; 27:783-794. [PMID: 31630348 DOI: 10.1007/s10880-019-09670-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The literature assumes that activating patients in the treatment is associated with positive health-related outcomes, such as clinical indicators in the normal range, high medication adherence, and low emergency department utilization. In the cardiac population, patient activation, that is the patient's knowledge, skills, confidence, and behaviors needed for managing one's own health and health care, has been less investigated. In addition, limited attention has been given to the role of the partner as an informal caregiver. However, the patient in the care process is rarely alone, and the partner may play a key role in this process. The goal of this dyadic study (N = 100 heterosexual couples with one partner suffering from an acute cardiac event) is to analyze how individual factors (patients' anxiety, depression, medication adherence, pessimistic perception of illness) and the couple's relationship functioning (e.g., different kinds of partner support and dyadic coping) are associated with patient activation. The results showed that patient activation is not a mere question of age. It is positively related to medication adherence and to the partner's support patient activation. It is negatively correlated with the patient's psychological distress, pessimistic perception of illness, and to the partner's hostility. The need for a dyadic approach to both research and intervention with this population is discussed.
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Johansson P, Lundgren J, Andersson G, Svensson E, Mourad G. Internet-based cognitive behavioural therapy and association to self-efficacy, depressive symptoms and physical activity: A secondary analysis of a randomized controlled trial in patients with cardiovascular disease (Preprint). JMIR Cardio 2021; 6:e29926. [PMID: 35657674 PMCID: PMC9206200 DOI: 10.2196/29926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/05/2022] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions Trial Registration
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Affiliation(s)
- Peter Johansson
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
- Unit of Internal Medicine, Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping Univerisity, Norrköping, Sweden
| | - Johan Lundgren
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | | | - Ghassan Mourad
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
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Achilleos M, Merkouris A, Charalambous A, Papastavrou E. Medication adherence, self-efficacy and health literacy among patients with glaucoma: a mixed-methods study protocol. BMJ Open 2021; 11:e039788. [PMID: 33472775 PMCID: PMC7818806 DOI: 10.1136/bmjopen-2020-039788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION As the world population ages, glaucoma is becoming an increasingly significant cause of blindness. A key component in the management of glaucoma is the use of prescribed medications and the adherence to treatment. However, there is evidence of low adherence to prescribed medication in chronic diseases, such as glaucoma. This study aims to explore the level of medication adherence, self-efficacy, social support and health literacy among the patients with glaucoma and to determine if there are any correlations between them. The ultimate aim is to use the information to develop an educational programme for patients with glaucoma at a later stage. METHODS AND ANALYSIS This is a mixed-methods study which includes two stages: a descriptive study (stage 1) and focus group discussions (stage 2). SAMPLE Patients with glaucoma or ocular hypertension, using at least one kind of drops, from two ophthalmology clinics. Selected measures include: The Glaucoma Treatment Compliance Assessment Tool, The European Health Literacy Survey Questionnaire, The Glaucoma Medication Self-Efficacy Questionnaire and The Multidimensional Scale of Perceived Social Support. Two focus groups will be used for the collection of qualitative data, aiming to enrich the study with the patients' experiences. The data will be analysed with SPSS, using descriptive and inferential statistics for stage 1 whereas content analysis will be used for the data from the focus group discussions (stage 2). ETHICS AND DISSEMINATION Permission to conduct the study was received from the National Bioethics Committee and the board of management of the two ophthalmology clinics. All participants will be informed fully on the purpose and methods of the study. Consent forms will be signed and at any time participants will have the right to withdraw. Confidentiality and the protection of data will be respected at all times.
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Affiliation(s)
- Maria Achilleos
- Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Anastasios Merkouris
- Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Andreas Charalambous
- Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
- Nursing, Turun Yliopisto, Turku, Finland
| | - Evridiki Papastavrou
- Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
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Vásquez E, O’Malley I, Cruz-Gonzalez M, Velásquez E, Alegría M. The Impact of Social Support on Treatment Participation and Completion in a Disability Prevention Intervention for Older Adults. J Aging Health 2021; 33:557-564. [PMID: 33729038 PMCID: PMC9923629 DOI: 10.1177/0898264321999897] [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] [Indexed: 12/22/2022]
Abstract
Objectives: This study evaluates the role of emotional and instrumental social support on treatment participation and completion using the Positive Minds-Strong Bodies (PMSB) disability prevention program. Methods: Data from a multisite randomized controlled trial of the PMSB program for older adults (≥60 years) with physical impairment and mild to severe depression and/or anxiety were used. Participants were randomly assigned to receive 10 sessions of cognitive behavior therapy (CBT) plus 36 sessions of group exercise or usual care. Results: Adjusting for covariates, higher levels of emotional social support at baseline were associated with increased odds of completing the recommended number of CBT sessions (6 or more, OR = 2.58, p = .030), attending 5.56 more exercise sessions (p = .006), and increased odds of completing the recommended exercise sessions (25 or more, OR = 2.37, p = .047). Discussion: Emotional social support appears to increase dosage in a disability prevention program.
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Affiliation(s)
- Elizabeth Vásquez
- Department of Epidemiology & Biostatistics, School of Public Health, University at Albany (SUNY), Rensselaer, NY, USA
| | - Isabel O’Malley
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Mario Cruz-Gonzalez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Esther Velásquez
- Ariadne Labs, Brigham and Women’s Hospital, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA,Department of Medicine, Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Castillo-Mayén R, Luque B, Gutiérrez-Domingo T, Cuadrado E, Arenas A, Rubio S, Quintana-Navarro GM, Delgado-Lista J, Tabernero C. Emotion regulation in patients with cardiovascular disease: development and validation of the stress and anxiety regulation strategies scale (STARTS). ANXIETY STRESS AND COPING 2020; 34:349-364. [PMID: 33380227 DOI: 10.1080/10615806.2020.1866173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND OBJECTIVES Anxiety and stress influence the onset and prognosis of cardiovascular disease (CVD), but little is known about what CVD patients do when experiencing stress/anxiety. This study aimed to identify the behavioral strategies CVD patients use to regulate these emotions. DESIGN Instrumental and longitudinal. METHODS A theoretically-guided scale, the Stress and Anxiety Regulation Strategies (STARTS), was developed considering the target population's characteristics. CVD patients were recruited at three different points (NT1 = 721, NT2 = 566, NT3 = 311). RESULTS At T1 exploratory factor analysis was conducted (random sample 1). The validity of the most parsimonious three-factor solution was subsequently found via confirmatory factor analysis at T1 (random sample 2), T2, and T3, revealing good and stable model fit. The factors represented strategies differentiated by the type and level of activity required (passive, intellectual, and physical strategies). The scale showed good test-retest reliability and internal consistency. Correlation and regression analyses with positive and negative affect, psychological wellbeing (stress, anxiety, depression), and cardiac self-efficacy provided evidence for the validity of STARTS score. Physical and passive strategies showed opposite patterns. CONCLUSIONS The scale shows adequate psychometric properties for assessing the strategies used by CVD patients to regulate stress and anxiety.
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Affiliation(s)
- Rosario Castillo-Mayén
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain.,Department of Psychology, University of Córdoba, Córdoba, Spain
| | - Bárbara Luque
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain.,Department of Psychology, University of Córdoba, Córdoba, Spain
| | - Tamara Gutiérrez-Domingo
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain.,Department of Psychology, University of Córdoba, Córdoba, Spain
| | - Esther Cuadrado
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain.,Department of Psychology, University of Córdoba, Córdoba, Spain
| | - Alicia Arenas
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain.,Department of Social Psychology, University of Seville, Seville, Spain
| | - Sebastián Rubio
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain.,Department of Specific Didactics, University of Córdoba, Córdoba, Spain
| | - Gracia María Quintana-Navarro
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain.,Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, Spain.,CIBER Fisiopatologia de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Javier Delgado-Lista
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain.,Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, Spain.,CIBER Fisiopatologia de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Medicine (Medicine, Dermatology and Otorhinolaryngology), University of Córdoba, Córdoba, Spain
| | - Carmen Tabernero
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain.,Instituto de Neurociencias de Castilla y León (INCYL), University of Salamanca, Salamanca, Spain
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Yu DSF, De Maria M, Barbaranelli C, Vellone E, Matarese M, Ausili D, Rejane RSE, Osokpo OH, Riegel B. Cross-cultural applicability of the Self-Care Self-Efficacy Scale in a multi-national study. J Adv Nurs 2020; 77:681-692. [PMID: 33295675 DOI: 10.1111/jan.14617] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/24/2020] [Accepted: 10/08/2020] [Indexed: 12/15/2022]
Abstract
AIM The Self-Care Self-Efficacy Scale (SCSES) was newly developed as a self-report measure for self-care self-efficacy for chronic illness. This study investigated its measurement equivalence (ME) in different cultural groups, including United States, China (Hong Kong), Italy, and Brazil. DESIGN A multi-national study for cross-cultural validation of the Scale. METHODS From January 2015 - December 2018, investigators recruited 957 patients (United State: 200; Hong Kong: 300; Italy: 285; and Brazil: 142) with chronic illness from inpatient and outpatient settings. The SCSES was administered and clinical and demographic data were collected from participants. Based on the Meredith framework, multi-group confirmatory factor analysis evaluated the configural, metric, scalar, and strict invariance of the scale across the four populations through a series of nested models, with evaluation of reliability and coherence of the factor solution. RESULTS The mean ages of the groups ranged from 65-77 years, 56.4% was male. The Cronbach's alpha coefficients of the single-factor SCSES were 0.93, 0.89, 0.92, and 0.90 for the United States, China (Hong Kong), Italy, and Brazil, respectively. Three of the four levels of ME were partially or totally supported. The highest level achieved was partial scalar invariance level (χ2 [52] = 313.4, p < 0.001; RMSEA = 0.067; 95% CI = 0.056-0.077; CFI = 0.966; TLI = 0.960, SRMR = 0.080). CONCLUSION Patients from the four countries shared the same philosophical orientation towards scale items, although some of the items contributed differently to represent the concept and participants shared the same schemata for score interpretation. IMPACT Self-efficacy is important in producing effective and sustainable self-care behavioural changes. Cultural ideation shapes the ways individuals interpret and report their self-care self-efficacy. The study findings support cross-cultural and cross-national utility of the SCSES for research on self-care across United States, China (Hong Kong), Italy, and Brazil.
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Affiliation(s)
- Doris Sau-Fung Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulum, Hong Kong
| | - Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Claudio Barbaranelli
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Maria Matarese
- Research Unit of Nursing Science, Campus Bio-medico University of Rome, Rome, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, Università degli Studi di Milano-Bicocca, Milano, Italy
| | | | | | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.,Australian Catholic University, Mary Mackillop Institute for Health Research, Melbourne, Vic, Australia
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Mrug S, Orihuela C, Rahn E, Mudano A, Foster J, Saag K, Gaffo A. Depressive Symptoms and the Effectiveness of a Urate‐Lowering Therapy in a Clinical Trial. ACR Open Rheumatol 2020; 2:710-714. [PMID: 33216463 PMCID: PMC7738799 DOI: 10.1002/acr2.11192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/30/2020] [Indexed: 11/08/2022] Open
Abstract
Objective Methods Results Conclusion
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Affiliation(s)
| | | | | | | | | | | | - Angelo Gaffo
- University of Alabama at Birmingham and Birmingham VA Medical Center Birmingham Alabama
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Irani E, Moore SE, Hickman RL, Dolansky MA, Josephson RA, Hughes JW. The Contribution of Living Arrangements, Social Support, and Self-efficacy to Self-management Behaviors Among Individuals With Heart Failure: A Path Analysis. J Cardiovasc Nurs 2020; 34:319-326. [PMID: 31058704 PMCID: PMC6557687 DOI: 10.1097/jcn.0000000000000581] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Living arrangements, social support, and self-efficacy have significant implications for self-management science. Despite the theoretical linkages among the 3 concepts, there is limited empirical evidence about their interplay and the subsequent influence on heart failure (HF) self-management. OBJECTIVE The aim of this study was to validate components of the Individual and Family Self-management Theory among individuals with HF. METHODS This is a secondary analysis of cross-sectional data generated from a sample of 370 individuals with HF. A path analysis was conducted to examine the indirect and direct associations among social environment (living arrangements), social facilitation (social support) and belief (self-efficacy) processes, and self-management behaviors (HF self-care maintenance) while accounting for individual and condition-specific factors (age, sex, race, and HF disease severity). RESULTS Three contextual factors (living arrangements, age, and HF disease severity) had direct associations with perceived social support and self-efficacy, which in turn were positively associated with HF self-management behaviors. Living alone (β = -.164, P = .001) was associated with lower perceived social support, whereas being an older person (β = .145, P = .004) was associated with better support. Moderate to severe HF status (β = -.145, P = .004) or higher levels of perceived social support (β = .153, P = .003) were associated with self-efficacy. CONCLUSIONS Our results support the Individual and Family Self-management Theory, highlighting the importance of social support and self-efficacy to foster self-management behaviors for individuals with HF. Future research is needed to further explore relationships among living arrangements, perceived and received social support, self-efficacy, and HF self-management.
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Affiliation(s)
- Elliane Irani
- Elliane Irani, PhD, RN Postdoctoral Fellow, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. Scott Emory Moore, PhD, APRN, AGPCNP-BC Assistant Professor, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. Ronald L. Hickman, PhD, RN, ACNP-BC, FNAP, FAAN Associate Professor and Associate Dean for Research, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. Mary A. Dolansky, PhD, RN, FAAN Associate Professor, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. Richard A. Josephson, MS, MD Professor, School of Medicine, Case Western Reserve University; and Director of Cardiovascular and Pulmonary Rehabilitation, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio. Joel W. Hughes, PhD Professor, Department of Psychological Sciences, Kent State University, Ohio
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Williams T, Evans L, Robertson A, Hardy L, Roy S, Lewis D, Glendinning F. The Role of Optimism and Psychosocial Factors in Athletes Recovery From ACL Injury: A Longitudinal Study. Front Sports Act Living 2020; 2:116. [PMID: 33345105 PMCID: PMC7739731 DOI: 10.3389/fspor.2020.00116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/07/2020] [Indexed: 11/26/2022] Open
Abstract
Despite a growing interest into the role of psychosocial factors during the recovery period following sports injuries, there remains a paucity of longitudinal studies examining the indirect relationships between psychosocial factors, psychological responses, and recovery outcomes. The purpose of this study was to construct and test a conceptual model which examined the indirect relationships between optimism, psychosocial factors, rehabilitation adherence, and perceived knee function up to 12 months post anterior cruciate ligament (ACL) surgery. A prospective, longitudinal, and repeated measures design was employed, wherein 81 injured athletes (Mage 26.89, SD = 7.52) completed measures of optimism, psychosocial factors, rehabilitation adherence, and perceived knee function on seven occasions (pre-surgery to 1 year post-surgery). Bayesian structural equation modeling evaluated the hypothesized indirect relationships proposed within the conceptual model. The main findings from this study was empirical support for a time-ordered, conceptual model which demonstrated that pre-surgery optimism had a significant overall indirect effect on perceived knee function at 12 months post-surgery (sum of indirect; αβ = 0.08, post. SD = 0.05, CI [0.01, 0.04]), as well as a specific indirect effect through secondary appraisal at 1 month post-surgery, efficacy at 2 months post-surgery, and rehabilitation adherence at 6 months post-surgery (αβ = 0.03, post. SD = 0.03, CI [0.00, 0.10]). Collectively, this study provides support for a number of previously hypothesized, but not empirically examined, indirect relationships between optimism, psychosocial factors and recovery outcomes. In doing so, we provide a conceptual model which has the potential to help guide individualized treatment recommendations, as well as identify individuals at risk of compromised recovery outcomes following ACL surgery.
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Affiliation(s)
- Tom Williams
- School of Health, Sport and Professional Practice, University of South Wales, Pontypridd, United Kingdom
| | - Lynne Evans
- School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Angus Robertson
- Cardiff Sports Orthopaedics LLP, Spire Cardiff Hospital, Cardiff, United Kingdom
| | - Lew Hardy
- School of Sport, Health and Exercise Sciences, Bangor University, Gwynedd, United Kingdom
| | - Stuart Roy
- Cardiff Sports Orthopaedics LLP, Spire Cardiff Hospital, Cardiff, United Kingdom
| | - Daniel Lewis
- Cardiff Sports Orthopaedics LLP, Spire Cardiff Hospital, Cardiff, United Kingdom
| | - Freya Glendinning
- School of Sport, Health and Exercise Sciences, Bangor University, Gwynedd, United Kingdom
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Adherence to Hypertension Medications and Lifestyle Recommendations among Underserved African American Middle-Aged and Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186538. [PMID: 32911772 PMCID: PMC7558819 DOI: 10.3390/ijerph17186538] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/01/2020] [Accepted: 09/02/2020] [Indexed: 01/13/2023]
Abstract
Background: For African American middle-aged and older adults with hypertension, poor adherence to medication and lifestyle recommendations is a source of disparity in hypertension outcomes including higher rates of stroke in this population relative to whites. Aims: To study demographic, social, behavioral, cognitive, and medical predictors of adherence to medication and lifestyle recommendations among underserved African American middle-aged and older adults with hypertension. Methods: This was a community-based cross-sectional survey in South Los Angeles with 338 African American middle-aged and older adults with hypertension who were 55 years or older. Age, gender, continuity of care, comorbidity, financial difficulty, self-rated health, depression, educational attainment, adherence knowledge, and adherence worries were the independent variables. Data was analyzed using linear regression with two outcomes, namely, adherence to medication (measured by the first 9 items of the Blood Pressure Self-Care Scale) and adherence to lifestyle recommendations (measured by the second 9 items of the Blood Pressure Self-Care Scale). Results: There were about twice more females than males, with a total mean age of 70 years (range 55–90 years). Various demographic, social, behavioral, and medical factors predicted adherence to medication but not adherence to lifestyle recommendations. Females with hypertension with higher continuity of care, less financial strain, higher knowledge, less negative general beliefs, and concerns about antihypertensive medications had higher adherence to antihypertensive medications. The presence of depressive symptoms, reduced knowledge, and disease management worries were associated with a reduced adherence to lifestyle recommendations. Conclusions: There seem to be fewer demographic, social, behavioral, cognitive, and medical factors that explain adherence to lifestyle recommendations than adherence to medication in economically disadvantaged underserved African American middle-aged and older adults with hypertension. More research is needed on factors that impact adherence to lifestyle recommendations of African American middle-aged and older adults with hypertension.
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Chen AMH, Yehle KS, Plake KS, Rathman LD, Heinle JW, Frase RT, Anderson JG, Bentley J. The role of health literacy, depression, disease knowledge, and self-efficacy in self-care among adults with heart failure: An updated model. Heart Lung 2020; 49:702-708. [PMID: 32861889 DOI: 10.1016/j.hrtlng.2020.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/07/2020] [Accepted: 08/10/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Patients with inadequate health literacy and heart failure face high healthcare costs, more hospitalizations, and greater mortality. To address these negative consequences, patients need to improve heart failure self-care. Multiple factors may influence self-care, but the exact model by which they do so is not fully understood. OBJECTIVES The objective of this study was to examine a model exploring the contribution of health literacy, depression, disease knowledge, and self-efficacy to the performance of heart failure self-care. METHODS Using a cross-sectional design, patients were recruited from a heart failure clinic and completed validated assessments of their cognition, health literacy, depression, knowledge, self-efficacy and self-care. Patients were separated into two groups according to their health literacy level: inadequate/marginal and adequate. Differences between groups were assessed with an independent t-test. Hypothesized paths and mediated relationships were estimated and tested using observed variable path analysis. RESULTS Participants (n = 100) were mainly male (67%), white (93%), and at least had a high school education (85%). Health literacy was associated with disease knowledge (path coefficient=0.346, p = 0.002), depression was negatively associated with self-efficacy (path coefficient=-0.211, p = 0.037), self-efficacy was positively associated with self-care (path coefficient=0.402, p<0.0005), and there was evidence that self-efficacy mediated the link between depression and self-care. There was no evidence of: mediation of the link between health literacy and self-care by knowledge or self-efficacy; positive associations between knowledge and self-efficacy or self-care; or mediation of the disease knowledge and self-care relationship by self-efficacy. Further, depression was associated with self-care indirectly rather than also directly as hypothesized. CONCLUSIONS Self-efficacy and depression are associated with heart failure self-care. Data generated from the model suggest that healthcare professionals should actively engage all patients to gain self-efficacy and address depression to positively affect heart failure self-care.
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Affiliation(s)
- Aleda M H Chen
- Assistant Dean and Associate Professor, Cedarville University School of Pharmacy, 251N. Main St., Cedarville, OH 45314, USA.
| | - Karen S Yehle
- Professor Emerita, Purdue University, School of Nursing, 502N. University Street, West Lafayette, IN, 47907, USA.
| | - Kimberly S Plake
- Associate Head of Professional Education, Associate Professor, Director, Purdue University Academic and Ambulatory Care Fellowship Program, Faculty Associate, Center for Aging and the Life Course, 575 Stadium Mall Dr., West Lafayette, IN, 47907, USA.
| | - Lisa D Rathman
- Heart Failure Nurse Practitioner, The Heart Group of Lancaster General Health/PENN Medicine, 217 Harrisburg Ave, Suite 100, Lancaster, PA 17603, USA.
| | - J Wes Heinle
- At time of project: Research Assistant, The Heart Group of Lancaster General Health/PENN medicine, 217 Harrisburg Ave, Suite 100, Lancaster, PA 17603, USA
| | - Robert T Frase
- Graduate Student, Purdue University, Department of Sociology, 700W. State Street, West Lafayette, IN 47907, USA.
| | - James G Anderson
- Purdue University, Department of Medical Sociology and Health Communication, 700W. State Street, West Lafayette, IN 47907, USA.
| | - John Bentley
- Department of Pharmacy Administration, University of Mississippi School of Pharmacy, Faser Hall 225, University, MS, 38677, USA.
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Eindor- Abarbanel A, Naftali T, Ruhimovich N, Bar-Gil Shitrit A, Sklerovsky-Benjaminov F, Konikoff F, Matalon S, Shirin H, Milgrom Y, Ziv-Baran T, Broide E. Important relation between self-efficacy, sense of coherence, illness perceptions, depression and anxiety in patients with inflammatory bowel disease. Frontline Gastroenterol 2020; 12:601-607. [PMID: 34917318 PMCID: PMC8640387 DOI: 10.1136/flgastro-2020-101412] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/03/2020] [Accepted: 07/19/2020] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Anxiety and depression are common disturbances in patients with inflammatory bowel diseases (IBD), and were found to impact the disease course. Illness perceptions (IPs), self-efficacy (SE) and sense of coherence (SOC) are important psychological functions, used by the individual to cope with his chronic disease. AIMS to investigate the association of IP, SE and SOC on anxiety and depression among patients with IBD. PATIENTS AND METHODS Patients filled questionnaires including: demographic, socioeconomic and clinical features. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale. IP, SE and SOC were assessed using the Brief Illness perception Questionnaire, IBD-SE and SOC scales. RESULTS The study sample consisted of 299 patients with IBD, median age 34.15, 63% females, 70.9% had Crohn's disease, filled the questionnaires. In the multivariate analysis, lower results in IP, SE and SOC were found to be associated with significantly increase anxiety (OR 8.35, p<0.001; OR 4.18, p=0.001; OR 4.67, p<0.001, respectively) and depression (OR 15.8, p=0.001; OR 10.99, p=0.029; OR 6.12, p=0.014. CONCLUSIONS Anxiety and depression are associated with IP, SE and SOC in patients with IBD. Clinicians should be aware of this impact, recognise their patients' psychological abilities to cope with the disease and improve those abilities, when needed, in order to achieve a better coping with the disease and to prevent the development of anxiety and depression.
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Affiliation(s)
- Adi Eindor- Abarbanel
- The Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center affiliated to Sackler School of Medicine Tel Aviv University, Zriffin, Israel
| | - Timna Naftali
- Department of Gastroenterology and Hepatology, Meir Medical Center, affiliated to the Sackler School of Medicine, Tel Aviv University, Kfar Saba, Israel
| | - Nahum Ruhimovich
- Department of Gastroenterology and Hepatology, Meir Medical Center, affiliated to the Sackler School of Medicine, Tel Aviv University, Kfar Saba, Israel
| | | | - Fabiana Sklerovsky-Benjaminov
- Department of Gastroenterology and Hepatology, Meir Medical Center, affiliated to the Sackler School of Medicine, Tel Aviv University, Kfar Saba, Israel
| | - Fred Konikoff
- Department of Gastroenterology and Hepatology, Meir Medical Center, affiliated to the Sackler School of Medicine, Tel Aviv University, Kfar Saba, Israel
| | - Shay Matalon
- The Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center affiliated to Sackler School of Medicine Tel Aviv University, Zriffin, Israel
| | - Haim Shirin
- The Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center affiliated to Sackler School of Medicine Tel Aviv University, Zriffin, Israel
| | - Yael Milgrom
- Digestive diseases institute, Shaare Zedek Medical Center, Jerusalem, Jerusalem, Israel
| | - Tomer Ziv-Baran
- Department of Epidemiology and Preventive Medicine, School of Public, Tel Aviv, Israel
| | - Efrat Broide
- The Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center affiliated to Sackler School of Medicine Tel Aviv University, Zriffin, Israel
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Tatschl JM, Hochfellner SM, Schwerdtfeger AR. Implementing Mobile HRV Biofeedback as Adjunctive Therapy During Inpatient Psychiatric Rehabilitation Facilitates Recovery of Depressive Symptoms and Enhances Autonomic Functioning Short-Term: A 1-Year Pre-Post-intervention Follow-Up Pilot Study. Front Neurosci 2020; 14:738. [PMID: 32792897 PMCID: PMC7386054 DOI: 10.3389/fnins.2020.00738] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/22/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE New treatment options for depression are warranted, due to high recurrence rates. Recent research indicates benefits of heart rate variability biofeedback (HRVBF) on symptom recovery and autonomic functioning in depressed individuals. Slow-paced breathing-induced amplification of vagus nerve activity is the main element of HRVBF. Thus, the latter represents a safe and non-invasive complementary depression treatment. However, its efficacy in patients undergoing inpatient psychiatric rehabilitation receiving highly comprehensive treatments has not been evaluated. METHODS Ninety-two inpatients were randomly assigned to an intervention group (IG) or control group (CG). While the latter received the standard treatment only, adjunctive HRVBF was provided to the IG over 5 weeks. Depression severity and heart rate variability (HRV) were assessed before (pre) and after 5 weeks (post). Moreover, 1-year follow-up depression scores were available for 30 participants. RESULTS Although depression improved in both groups, the IG exhibited significantly larger improvements at post-assessment ( η p 2 = 0.065) and significant increases in resting LF-HRV (d = 0.45) and cardiorespiratory coherence (d = 0.61). No significant effects for RMSSD, SDNN, HF-HRV, or HR were found (ps > 0.05). Additionally, the IG showed a medium- to large-sized reduction in resting respiratory rate from 13.2 to 9.8 breaths per minute (p < 0.001, d = 0.86), with the CG exhibiting only a small decrease from 13.5 to 12.4 (p = 0.49; d = 0.35). While the IG exhibited significantly lower depression scores at post-assessment (p = 0.042, d = 0.79), this effect decreased during follow-up (p = 0.195, d = 0.48). CONCLUSION HRVBF as adjuvant therapy during inpatient psychiatric rehabilitation facilitated depression recovery. Additionally, amplified LF-HRV as well as cardiorespiratory coherence at rest and a decrease in resting breathing frequency was observed in the HRVBF group. These findings emphasize HRVBF's value as complementary therapy regardless of concurrent treatments. Moreover, these incremental benefits could serve as resource even after the actual training period. However, the additional antidepressant gains vanish during the long-term follow-up, indicating the need for more intense training or regular practice afterward, respectively. Thus, future studies are warranted to examine how the initial benefits of HRVBF during inpatient psychiatric rehabilitation can be preserved post discharge.
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Affiliation(s)
- Josef M. Tatschl
- Health Psychology Unit, Institute of Psychology, University of Graz, Graz, Austria
| | | | - Andreas R. Schwerdtfeger
- Health Psychology Unit, Institute of Psychology, University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
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Understanding adherence to the CardioMEMS pulmonary artery pressure monitoring system for heart failure: A qualitative study. Heart Lung 2020; 49:251-258. [DOI: 10.1016/j.hrtlng.2020.01.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 01/23/2020] [Accepted: 01/29/2020] [Indexed: 11/24/2022]
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