Negative Illness Perceptions Research Articles

Pain in Biologic-Treated Rheumatoid Arthritis Patients: The Role of Illness Perception Before and After the COVID-19 Pandemic.

We aimed to assess the role of the COVID-19 pandemic in the association of clinical, physical, and psychological factors with pain in Rheumatoid Arthritis (RA) patients. We included 103 RA patients (81.6% females; mean age 56.1±13.8years). Patients filled out the VAS-pain, GAD-7, PHQ-9, MFI-20, and B-IPQ. Paired sample t-tests, correlations, and multiple regression analyses were used to analyse the data. Our results showed significantly worsened pain in the data collected post-pandemic (p≤0.05). Pre-pandemic, the final regression models showed an association between functional disability (β=0.24; p≤0.05), illness perception (β=0.34; p≤0.05) and pain. In post-pandemic models, significant associations were found between fatigue (β=0.33; p≤0.01) and illness perception (β=0.36; p≤0.01) with pain. Positive illness perception was able to alleviate the associations between fatigue and depression with pain before and after the pandemic. Findings indicate that patients with RA may have been negatively affected by the COVID-19 pandemic given their vulnerability. Even though pharmacological treatment was not interrupted, post-pandemic results showed significantly higher levels of experienced pain. Therefore, in addition to biological therapy, non-pharmacological interventions, including psychological support aimed at diminishing negative illness perception, may be beneficial in reducing RA-related pain, especially when dealing with a crisis.

Correlation between illness perceptions and self-reported degree-of-worry in somatic ill patients in emergency care: a Danish cross-sectional study.

The study aimed to investigate the correlation between illness perceptions and self-reported degree-of-worry (DOW) in patients presenting to the emergency department with acute somatic illness. A cross-sectional survey study collected data from a survey on DOW, the Brief-illness Perception Questionnaire (B-IPQ) and demographics. An emergency department at a university hospital in the Capital Region of Denmark. 944 patients (≥18 years) presenting to the emergency department with acute somatic illness. Data collection was conducted during day and evening shifts on weekdays from 13 January to 19 December 2020. Correlations between B-IPQ scores and DOW, including (1) the total B-IPQ score, (2) emotional representations (emotion and illness concern combined) and (3) the single items, respectively. Secondary analysis: linear relationships between the single B-IPQ items and DOW. Analyses included the variables sex, age, reason for contact, self-reported comorbidity, employment, highest educational attainment, cohabitation status and region of origin. The study found moderate correlations between the total illness perceptions score and DOW of 0.47 (95% CI 0.42 to 0.52) and emotional representations and DOW of 0.57 (95% CI 0.52 to 0.61). Linear regression showed the largest and most significant changes in DOW with an increasing score of the B-IPQ items for consequence, illness concern and emotion. Illness perceptions overall and perceptions of consequences of symptoms, illness concern and emotional representations are correlated with patients' DOW, with increasing DOW related to more negative illness perceptions. This finding contributes to insight into how illness perceptions are related to illness worry when presenting to the emergency department. Incorporating the novel DOW scale may aid triage and clinical encounters in the emergency department. ClinicalTrails.gov reference: NCT04226040.

S1250 Negative Illness Perceptions Are Associated With Clinical Disease Activity in Adult Patients With Inflammatory Bowel Disease

S1250 Negative Illness Perceptions Are Associated With Clinical Disease Activity in Adult Patients With Inflammatory Bowel Disease

Association between Type D personality, illness perception, and coping strategies in patients undergoing open-heart surgery.

A combination of social inhibition and negative affectivity characterizes Type D personality. Type D, or distressed personality, is an established risk factor for the development and prognosis of coronary heart disease. It occurs in approximately 1 in 4 patients with coronary heart disease. This study aimed to investigate the relationship between Type D personality, illness perception, and coping strategies in patients undergoing open-heart surgery. This retrospective and cross-sectional study was conducted in a university hospital psychiatry and cardiovascular surgery clinics between February 2022 and April 2022. Seventy-one volunteered patients over the age of 18 who underwent open-heart surgery in the cardiovascular surgery clinic were included in the study. Cardiovascular surgeons recorded the sociodemographic and clinical data of the patients and referred them to the psychiatry clinic for further evaluation. Subsequently, patients underwent psychiatric evaluation and were assessed using the Type D Personality Scale, Coping Attitudes Assessment Scale, Hospital Anxiety and Depression Scale, and Illness Perception Questionnaire. According to this study, individuals with Type D personality tended to have higher scores on the Hospital Anxiety and Depression Scale. Analysis of the subdimensions of the Stress Coping Styles Scale revealed that individuals with Type D personalities showed a significantly lower optimistic approach and a considerably higher helpless approach. In terms of the subdimensions of the Illness Perception Questionnaire, it was found that individuals with Type D personality had a statistically lower treatment control approach and a statistically higher emotional representations approach. Identifying Type D personality traits in patients undergoing open-heart surgery can help manage negative illness perceptions through effective coping mechanisms.

Impact of perception of illness on quality of life in juvenile systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organs, notably the skin, joints, and kidneys. The primary goal in managing SLE is to enhance patients' quality of life (QoL). Illness perception can influence QoL in patients with chronic disease. We assessed illness perception in juvenile SLE (jSLE) patients and its effect on patient's and parental QoL. Patients diagnosed with jSLE according to the SLICC 2012 criteria between January and November 2023 were included. Patients' illness perceptions were gaged using the brief illness perception questionnaire (B-IPQ), while patient's and parental QoL were evaluated using PedsQL and WHOQOL- BREF, respectively. The study comprised 32 patients and 32 parents, predominantly female (78.1%). Musculoskeletal involvement was the most common (65.6%), followed by mucocutaneous (59.4%), renal, and hematological involvement (50% each). Neuropsychiatric involvement was absent. The median SLEDAI-2K score at the last outpatient clinic visit, which was documented in the patient's file was 2 (0-18) and was not correlated with the B-IPQ score (r = 0.121, p = .51). A significant negative correlation was found between B-IPQ and patient QoL, indicating poorer QoL in patients with negative illness perceptions (r = -0.576, p < .001). No correlation was observed between parental QoL and B-IPQ (p => .05). Of note, 56.3% of patients had poor QoL, scoring below the PedsQL cut-off, while 43.8% of parents had poor QoL for general health, scoring below the WHOQOL-BREF cut-off for general health. Although disease perception did not correlate with disease activation in jSLE, it significantly impacted patient QoL. Enhancing patients' perceptions of jSLE may improve their overall QoL.

Interpersonal Processes in the Duration of Sick Leave of Workers with Chronic Diseases: A Dyadic Analysis.

Although there is increasing awareness that significant others' perceptions and behavior can affect health outcomes, the role of interpersonal processes between sick-listed workers and significant others in sick leave and return to work (RTW) has hardly been studied. This study aims to examine the associations between illness perceptions, RTW expectations, and behaviors of significant others (engagement, buffering and overprotection) with sick leave duration within dyads of sick-listed workers with chronic diseases and their significant others. We used survey data linked with sick leave registry data of 90 dyads. Pearson correlations were used to study the interdependence within dyads. Multiple linear regression analyses were conducted to examine associations between survey data of both dyad members and sick leave duration. We found moderate to strong correlations between workers and significant others, indicating interdependence within dyads regarding illness perceptions, RTW expectations and perceived significant other behaviors. Dyad members' illness perceptions (R2 = .204, p = .001) and RTW expectations (R2 = .326, p = < .001) were associated with sick leave duration, explaining respectively 12.3% and 24.5% of the variance. We found no associations between sick leave duration and active engagement, protective buffering and overprotection. This study indicates that negative illness perceptions and RTW expectations of both workers and their significant others are associated with a longer sick leave duration. Considering the interdependence within dyads, involving significant others when intervening on maladaptive illness perceptions and RTW expectations may be more effective than solely focusing on the worker's perceptions and expectations.

Illness perception and intimate relationships in patients with cervical cancer: the mediating role of dyadic coping.

A good intimate relationship (IR) can relieve the psychological distress of patients with cervical cancer and promote a sense of well-being during stressful times. Researchers have found that IR is related to illness perception (IP) and dyadic coping (DC). Therefore, this study aimed to (1) describe the IR of patients with cervical cancer, (2) identify the relationships and pathways among IP, DC and IR in patients with cervical cancer and (3) explore the mediating role of DC between IP and IR in cervical cancer patients. A total of 175 patients with cervical cancer were recruited at a tertiary hospital in China from September 2021 to January 2023. The data were collected through a general demographic and disease-related information questionnaire, the Locke-Wallace Marriage Adjustment Test, the Revised Illness Perception Questionnaire of Cervical Cancer and the Dyadic Coping Inventory. The mean score for intimate relationships was 107.78 (SD = 23.99, range 30-154). Pearson's correlation analysis revealed that intimate relationships were positively correlated with IP (personal control) and DC (stress communication, supportive DC, delegated DC and common DC) and were negatively correlated with IP (consequence, timeline acute/chronic, timeline cyclical and emotional representation) and negative DC. As for the results of the structural equation model, DC fully mediated the influencing effects of both positive and negative IP on IR. The level of IR of patients with cervical cancer in China should be improved. DC has a significant mediating effect on the link between the IP and IR.

Clinically suspect arthralgia and rheumatoid arthritis: patients’ perceptions of illness

ObjectivesClinically suspect arthralgia (CSA) is an at-risk stage of rheumatoid arthritis (RA), in which patients experience symptoms and physical limitations. Perceptions of CSA-patients have remained largely unknown. Therefore, we aimed to map perceptions of CSA-patients and compare these to RA-patients. Additionally, we studied changes in perceptions in CSA over time. MethodsThree hundred and ninety-nine consecutively included CSA-patients from the Leiden and Rotterdam CSA-cohorts and 100 recently diagnosed RA-patients from the Leiden Early Arthritis Clinic were included. Patients’ illness perceptions (IP) were assessed using the Brief Illness Perception Questionnaire (BIPQ), consisting of 8 questions (scale 0–10; higher score indicating more negative IP) covering cognitive, emotional and comprehensibility domains, and one open question about causes of disease. IP were measured at baseline in both populations and during 2years follow-up in the CSA-cohorts. ResultsTotal BIPQ-scores were comparable at CSA-presentation and RA-diagnosis (40±11 and 40±10; range 0–80). Comparing dimensions separately revealed that CSA-patients were less worried about physical complaints compared to RA-patients. However, CSA-patients were more negative about expected treatment-effect on symptoms. IP over time in CSA improved in patients without development of clinical arthritis (from 38±11 to 34±14; P=0.005) but remained similar in CSA-patients who progressed to arthritis/RA (mean 40 at both timepoints). CSA-patients mainly perceived physical strain and heredity as causes of their complaints. ConclusionsAlthough CSA-patients have not developed clinical arthritis, illness perceptions at CSA-presentation and RA-diagnosis are equally severe. Knowledge on worries and expectations may contribute to improving patient-contact and care in patients at risk of RA.

Factors associated with having previously received a diagnosis of fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome: A cross sectional DanFunD study

ObjectivesFibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome are highly prevalent conditions and part of the functional somatic syndromes (FSS) diagnosis, that are classified under the unifying umbrella term functional somatic disorder (FSD). Multiple factors are associated with FSD symptom development; However, few studies have explored these associations in relation to the diagnosis status. This study aims to examine associations with a previously received FSS diagnosis from a physician in participants fulfilling the FSD diagnostic criteria in a population-based sample. MethodsThis research employs a comprehensive observational approach using a cross sectional design with data from the DanFunD part two cohort. Information about received FSS diagnoses was obtained from self-reported questionnaires. Participants fulfilling the FSD diagnostic criteria were identified with both self-reported questionnaires and diagnostic interviews. Validated questionnaires were used to assess the examined factors. Results1704 cases fulfilled the diagnostic criteria for an FSD according to questionnaires or interviews in the DanFunD study. In participants fulfilling the diagnostic criteria, having previously received an FSS diagnosis by a physician was strongly associated with female sex, negative illness perceptions and poor health-related quality of life for questionnaire and interview-based diagnoses. Less consistent associations were observed for lower socioeconomic status, anxiety, and adverse life events. ConclusionPreviously received FSS diagnoses showed associations with multiple factors with a particular strong association with female sex and poor health related quality of life.

Coping Mechanisms and Illness Perception Associated with Health-Related Quality of Life of Prostate Cancer Patients in Ogun State

Background: The second most common malignancy in men globally is prostate cancer. Moreover, one of the regions with the highest estimated death rates from prostate cancer is sub-Saharan Africa. Similarly, the leading cause of cancer-related mortality among Nigerian men is prostate cancer. However, negative illness perceptions, including worry about the disease and the severity of symptoms, have been linked to poorer prognosis among cancer patients. Generally, cancer patients adopt various coping mechanisms to deal with these stressors. Meanwhile, little is known about the health-related quality of life of prostate cancer patients in this region, regarding their coping mechanisms and illness perception. Therefore, this study examined, coping mechanisms and illness perceptions associated with health-related quality of life among prostate cancer patients in Ogun State, Nigeria. Methods: This cross-sectional study employed the Purposive sampling technique. Correlation analysis was used to determine the association between coping mechanisms, illness perception, and the health-related quality of life of participants. Results: The association between illness perception and health-related quality of life was positively correlated and statistically significant (r=.547, p=.000). However, in the association between coping mechanism and health-related quality of life; problem-focused coping and health-related quality of life were found to be positively correlated and statistically significant (r=.228, p=.000); emotion-focused coping and health-related quality of life were found to be positively correlated and statistically significant (r=.388, p=.000); while avoidant coping and health-related quality of life were found to be negatively correlated (r= -0.192, p=.000). Conclusion: This study found that a higher illness perception score correlated with a higher health-related quality of life score. Also, a higher problem-focused and emotion-focused coping mechanism score correlated with a higher health-related quality of life score. While a higher avoidant coping score inversely correlated to a lower health-related quality of life score.

Association between illness perception and social alienation among maintenance hemodialysis patients: The mediating role of fear of progression.

This study aimed to investigate the mediating role of fear of progression on illness perception and social alienation among maintenance hemodialysis (MHD) patients. MHD is frequently accompanied by increased pain and complications such as itchy skin, chronic fatigue, and muscle spasms. Cardiovascular disease rates are also elevated among MHD patients, which can heighten their anxiety regarding prognosis and treatment discomfort. This chronic fear may severely impact social functioning, leading patients to withdraw from interpersonal interactions and experience heightened helplessness and loneliness. Further investigation is necessary to understand the factors behind the high level of social alienation in MHD patients and their underlying mechanisms. A cross-sectional study guided by the STROBE. A convenience sample of 230 MHD patients were enrolled from January to May 2023. Data including demographic and clinical characteristics, illness perception, fear of progression, and social alienation were collected. Descriptive analysis and Pearson correlations were conducted using IBM SPSS version 25.0. The mediating effect was analyzed using Model 4 of the PROCESS macro for SPSS, with the Bootstrap method employed to assess its significance. The score of social alienation in MHD patients was high, with illness perception and fear of progression both significantly correlated with social alienation. In the mediating effects model, illness perception can predict social alienation in MHD patients, and fear of progression use plays a part in mediating the process by which illness perception affects social alienation. The Kappa Squared (κ2) value of 21.9%, suggests a medium effect size. Illness perception directly predicts social alienation in MHD patients and exerts an indirect effect through the mediating role of fear of progression. Suggests that healthcare professionals should concentrate on MHD patients with high negative illness perceptions to alleviate their fear of progression, thereby decreasing the level of social alienation and enhancing their integration into society.

Predicting symptom response and quality of life to the low FODMAP diet in irritable bowel syndrome: a 6-month longitudinal study

The low fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diet is recommended as a first line therapeutic management strategy for irritable bowel syndrome (IBS)(1). The low FODMAP diet is supported by meta-analytical evidence(2), and demonstrates acceptability and effectiveness for improving symptoms and quality of life (QoL) in 50-75% of individuals with IBS. However, a subset of individuals (25-50%) do not respond to the diet(3). The identification of individual-level predictors of treatment response across all three phases of the low FODMAP diet is currently lacking. The study aims were to assess psychological predictors of symptom and QoL response to the low FODMAP diet in patients with IBS. Adults with IBS underwent a three-phase low FODMAP diet, guided by individualised dietetic education. Predictor variables included levels of depressive, anxiety, and extraintestinal somatic symptoms, stress, treatment beliefs and expectations, behavioural avoidance, and illness perceptions. Symptom severity and QoL were the main outcomes. Questionnaires assessing psychological predictors, symptoms and QoL were administered at five points: pre-dietitian (week 0), post-dietitian, end of elimination (week 5), end of reintroduction (week 13), and end of personalisation (week 25) phases. Latent class growth analysis was used to identify classes of response trajectories for symptoms. Linear mixed models were used to test the effect of baseline psychological scores on symptoms and QoL over time. Cross lagged panel models determined the directional predictive relationship between psychological predictors and symptom severity. 112 participants (89% F) median age 30 ± 17 years were included. There were three classes of symptom response trajectories, including ‘non-improvers’ (21.3% of participants) with high initial symptom severity and minimal improvement, ‘improvers’ (22.5% of participants) with low initial symptom severity and significant improvement, and an ‘intermediate’ group (56.2% of participants) with moderate initial symptom severity and significant improvement. Higher treatment beliefs predicted a stronger initial symptom response (effect on linear slope p = 0.036). Lower gut-specific anxiety, as well as higher levels of personal and treatment control at baseline predicted a stronger reduction in IBS symptom severity and improved QoL from week 0 to week 25. Participants with higher levels of baseline psychological symptoms and negative illness perceptions (i.e., lower emotional representations) predicted a stronger initial and later QoL response (effect on linear (p = 0.006) and quadratic (p = 0.049) slopes). Increased cyclical time beliefs predicted poorer initial and later QoL response (effect on linear (p = 0.015) and quadratic (p = 0.029) slopes). Individuals experiencing lower to mid-range symptom severity at baseline had greater improvement with the low FODMAP diet. Lower anxiety, positive illness views and higher treatment beliefs predict better QoL and symptom response. Personalised strategies are crucial for optimising low FODMAP diet effectiveness in IBS.

Social participation of rheumatoid arthritis patients: Does illness perception play a role?

Social participation is an important aspect associated with health-related outcomes in chronic diseases. However, little is known about the factors that may affect participation in patients with rheumatoid arthritis (RA). We aimed to examine whether pain, fatigue, anxiety, depression, and illness perception are associated with social participation in patients with RA when controlled for clinical and sociodemographic variables. We also analysed the mediating role of illness perception in the association between physical and psychological variables on social participation. We included 157 RA patients (84.7% females; mean age 56.4 ± 13.9 years) who completed the Participation Scale, Brief Illness Perception Questionaire, Generalized Anxiety Disorder Scale, Patient Health Questionnaire, 36-item Short Form Health Survey, and the Visual Analogue Scale. Multiple linear regressions and mediation analyses were used to analyze the data. In the final regression models, illness perception (β = .42; p ≤ .001) and functional disability (β = .21; p ≤ .05) were associated with social participation. Income (β = -.18; p ≤ .05) lost its significance when physical variables were added to the model, and pain (β = .24; p ≤ .05) and fatigue (β = -.24; p ≤ .05) when psychological distress was added. No significant role of anxiety, depression, disease activity, or age was identified using regression analyses. Illness perception mediated the association of pain, fatigue, anxiety, and depression with social participation, and the indirect effect varied from 65% to 98%. Illness perceptions may significantly diminish the impacts of pain, fatigue, anxiety, and depression on social participation in individual RA patients. Therefore, RA patients could benefit from psychological interventions aimed at tackling negative illness perceptions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Effect of the Symptom Level on the Illness Perception in Individuals Undergoing Hemodialysis

Purpose: This research was conducted to identify the effect of the symptom level on the illness perception in individuals undergoing hemodialysis. Material and Methods: The study was performed with 240 participants who had the hemodialysis procedure in dialysis units of hospitals and one private dialysis center in a province and satisfied the criteria to be included in the research. Results: In the study, it was found that nearly all patients experienced symptoms such as itching, numbness/tingling in the feet, feeling tired and dry skin. In the sample group that had a negative illness perception, it was found that the symptoms experienced alongside the hemodialysis procedure affected the illness perception, and there was a moderately positive relationship between these two variables. Conclusions: In this context, it was recommended that the frequency and the severity of symptoms of patients undergoing hemodialysis be regularly followed and these patients’ illness perception levels be evaluated. Key words: Illness perception, hemodialysis, symptom

Anxiety in Polish adult patients with inborn errors of immunity: a cross-sectional study.

Patients with inborn errors of immunity (IEI) experience recurrent infections, autoimmunity, and malignancies. Owing to repeated medical procedures, the need for constant treatment and surveillance, and the unpredictable course of the disease, patients with IEI are prone to develop mental health disorders, including anxiety. In this study, we aimed to assess the prevalence and level of anxiety symptoms in adult Polish patients with IEI and explore the determinants of anxiety in this group of patients. Data from 105 Polish patients with IEI were collected via the hospital anxiety and depression scale (HADS), brief illness perception questionnaire (B-IPQ), illness cognition questionnaire (ICQ), Pittsburgh sleep quality index (PSQI), and a questionnaire on general health and demographic data. For statistical analyses of data, the normality of distribution of quantitative data was assessed, and internal consistency of tests was investigated using Cronbach's alpha coefficient; moreover, we performed the analysis of correlations and between-group differences, and path analysis to explore causal relationships. Significance was considered at p < 0.050. Thirty-eight (36.2%) patients had anxiety symptoms (HADS-A ≥ 8); 14 (13.3%) patients had severe anxiety (score ≥ 11), and 24 (22.9%) had moderate anxiety (score of 8-10). Patients with poor sleep quality, higher pain frequency, younger age, and no fixed income had higher anxiety scores than others. Emotional and cognitive representations of illness were positively correlated with anxiety levels. Intense anxiety was related to more negative illness perception, higher helplessness, lower illness acceptance, and lower perceived benefits. Anxiety is common in patients with IEI. However, results indicate that it is not related to a more severe course of IEI or several comorbidities, whereas, pain frequency and poor sleep quality were identified to be important clinical factors for anxiety. Because anxiety was related to negative illness perception, psychological therapy may apply to this group of patients.

Examining interactions of illness perceptions, avoidance behavior and patient status in predicting quality of life among people with irritable bowel syndrome

ABSTRACT Background: Illness perceptions (IPs) and avoidance behavior both predict quality of life (QoL) in people with irritable bowel syndrome (IBS). This study examined whether the effects of IPs on QoL are mediated by avoidance behaviors, and whether this mediation is moderated by participant treatment-seeking status. Methods: People with self-reported IBS (n = 253) answered a survey assessing QoL, IPs, avoidance behaviors, and treatment-seeking status. Moderated-mediation analyses investigated the paths from IPs through avoidance behaviors to QoL, with treatment-seeking status entered as a moderator. Results: The final moderated mediation model included the IPs consequences, timeline and emotional representations as independent variables and avoidance behavior and depressive reactions as mediators. This model explained 68.6% of the variance in QoL. Among treatment-seeking participants five significant mediation effects were found, whereas only one significant mediation effect was found among participants who did not report seeking treatment. Conclusions: IPs seem to drive avoidant behavioral responses to IBS symptoms, which in turn predict reductions in QoL. These relationships seem more pronounced among people who seek treatment for their symptoms. In practice, health care practitioners might help improve the QoL of people with IBS by preventing or remedying the development of negative IPs and avoidance behaviors.

Prevalence and Correlators of Diabetes Distress in Adults with Type 2 Diabetes: A Cross-Sectional Study.

To address the prevalence of diabetes distress (DD) and its correlators in adults with type 2 diabetes. During 2021 and 2022, we conducted a cross-sectional study in three Class A tertiary comprehensive hospitals in China, and received 947 participants who completed a printed survey covering DD, demographic, diabetic, physiological, and psychosocial factors. We used Jonckheere-Terpstra, chi-square, and Fisher's exact tests to assess intergroup differences between different levels of DD. We used ordinal logistic regression analysis to analyze correlators of DD further. The prevalence of DD was 34.64%. In univariate analysis, those with lower satisfaction with financial status, longer durations of diabetes, more complications, higher glycemia, more severe insomnia, treatment by medications only, poorer lifestyle interventions, fewer self-care activities, more types and frequencies of insulin injections, and spending more money and time on treatment were susceptible to DD. Type D personality, negative illness perceptions, negative coping styles, and psychological effects of major life events were related to higher DD. Hope, self-efficacy, positive coping styles, and social support can reduce DD. In ordinal logistic regression analysis, hypoglycemic episode (β=-1.118, p=0.019, "have hypoglycemic" as reference) and Brief Illness Perception Questionnaire (β=0.090, p<0.001) were significant positive correlators for DD, while diet intervention (β=0.803, p=0.022, "have diet intervention" as reference), money spent on diabetes treatment (β<-0.001, p=0.035), and SES (β=-0.257, p<0.001) were significant negative correlators. More than one-third of Chinese adults with type 2 diabetes experience moderate or high levels of DD. DD was associated with financial, diabetic, physiological, and psychosocial status.

Psychosocial markers of pre-hospital delay in patients with diabetic foot: A cross-sectional survey.

This study aimed to determine the psychosocial markers associated with pre-hospital delay among patients with diabetic foot (DF). This study has a cross-sectional design. The participants completed a questionnaire including pre-hospital time, demographic characteristics, Social Support Rate Scale, Brief Illness Perception Questionnaire and Type D Personality Scale-14. Bivariate and multivariate analyses were conducted to explore independent associations with pre-hospital delay. Only 1.8% (3/164) of participants arrived at the hospital for medical care in 24 h of symptom onset. Patients with low utilization of social support (p = 0.029), low negative illness perceptions (p = 0.014) and high levels of negative affectivity (p = 0.009) are likely to arrive late at the clinic. Medical staff should pay attention to identifying diabetic patients' Type D personalities and take actions to improve their social support as well as illness perception, so as to reduce the occurrence of hospital delay. Psychosocial factors play a vital role in the delay in seeking medical treatment for patients with DF. Medical staff need to improve patients' illness perception as well as self-management ability through health education. Importantly, key family members provide an emotional and psychological support system for diabetic patients. Therefore, nurses need to work with family members together to give information and psychological support during family visits. Additionally, building and maintaining trust with patients is crucial to encouraging individuals to express their concerns and worries. In this case, nurses may identify patients' negative emotions and conduct timely intervention, so as to achieve favourable outcomes. This study used a convenience sample of 164 participants with DF recruited from the wound clinic of Northern Jiangsu People's Hospital and Yangzhou Hospital of TCM in China.

Factors affecting adherence to medication, smoking cessation, and exercise in patients with peripheral artery disease

ObjectiveAdherence to peripheral artery disease (PAD) treatment reduces the risk of cardiovascular events and delays disease progression, but patients do not fully adhere to their treatment regimens. This pilot study aimed to identify the adherence levels of patients with PAD and how these are related to sociodemographics, clinical factors, and illness perceptions. MethodsPatients with PAD were recruited during outpatient appointments at a London teaching hospital between January and May 2022. Data were collected from medical records and questionnaires, including the self-reported Morinsky Medication Adherence Scale (MMAS-8) and the Brief Illness Perceptions Questionnaire (BIPQ). Descriptive statistics, χ2, independent sample tests, and one-way analysis were conducted using SPSS. ResultsA total of 105 patients participated and completed the questionnaire. Of these, 73.3% were male, with a mean age of 69.5 years. Of the patients, 41.9% and 36.2% had high antiplatelet and statin adherence, respectively, defined by an MMAS >8 score. One-quarter were current smokers, whereas only 17.1% of patients had previously attended a supervised exercise class. High adherence to antiplatelets and statins was associated with older age (P = .006 and P = .047) and previous vascular interventions (P = .004 and P = .009). Low antiplatelet adherence was linked to lower perceived control (P = .041), treatment control (P = .019), and disease understanding (P = .049). Patients perceiving their medical therapy as less effective showed lower statin adherence (P = .036). Being a current or ex-smoker was related to feeling less in control of care (P = .013). High exercise frequency was associated with lower consequences (P = .041) and identity scores (P = .031). Limited walking distance was linked to higher disease impact on daily quality of life (P < .001), lower perceived treatment effectiveness (P = .002), lower perceived personal control (P = .018), severe claudication symptoms (P < .001), and higher concerns (P = .001) and emotional distress (P < .001). ConclusionsTreatment adherence among patients with PAD is notably low. Patients’ illness perceptions play a significant role in understanding and explaining this lack of adherence. To improve treatment adherence, interventions should particularly focus on addressing and modifying negative illness perceptions.

The Perceived Meaning of Traumatic Brain Injury for Older Adults: A Longitudinal-Multiple Case Study.

The aim of this study was to explore the perceived meaning of traumatic brain injury (TBI) over the first-year postinjury among older adults and to explore if and how meaning changes. A longitudinal multiple-case study design was used. Semistructured face-to-face interviews were completed at 1 week and 1, 3, 6, and 12 months postinjury. Transcripts were analyzed using inductive thematic analysis. Fifty-five interviews were conducted with 12 participants. Four themes were identified: gratitude, vulnerability and dependence, slowing down and being more careful, and a chance for reflecting on life. Most participants' perceptions of their TBI remained either consistently positive or negative over the first-year postinjury. Nurses should elicit and support patients' positive illness perceptions regarding their brain injury, which can contribute to a higher quality of life. For those patients with negative illness perceptions, nurses should provide resources in order to support coping and resilience following brain injury. This study is the first study to explore individual perceptions over time of the meaning made from experiencing TBI among older adults. Findings can serve as a foundation for tailored supportive interventions among older adults following TBI to maximize quality of life.