Journal Articles

Abstract:

This study evaluated the mediating role of self-efficacy, coping, depression and anxiety on the relationship between illness perceptions and quality of life in stroke survivors (n = 72; 32 females; mean [SD] age 65.09 [14.14] years; male mean [SD] age 69.83 [11.81]). Illness perceptions (Brief Illness Perceptions Questionnaire; BIPQ), coping styles (Carver Brief-COPE scale; B-COPE), depression/anxiety (Hospital Anxiety and Depression Scale; HADS), self-efficacy (General Self-Efficacy Scale; GSE) and quality of life (Assessment of quality of life; AQOL-6D) were analysed. Correlation analyses showed illness perception, maladaptive coping, self-efficacy, depression and anxiety to have a significant negative relationship with quality of life. Mediation analyses showed that while maladaptive coping and self-efficacy did not mediate the relationship between illness perception and quality of life, depression and anxiety did. The final model explained 76.74% of the variance in quality of life. Although based on a relatively small sample size, these results provide evidence for the important role of psychosocial factors in quality of life in post-stroke cohorts.

URL: https://doi.org/10.1007/s10880-020-09700-0  

Abstract:

Background and Purpose: Stroke can have a devastating impact on the mental and physical health of stroke survivors and their carers. We aimed to evaluate the effectiveness of a novel psychosocial intervention designed to improve health outcomes in both groups.

Methods: We conducted a randomized controlled trial of a personalized psychosocial intervention (eight 1-hour weekly sessions plus one booster) compared to usual care for adult stroke survivors and carers. Participants recruited from hospital services and community referrals completed questionnaires at baseline, 3, 6, and 12 months. Primary outcomes were quality of life and self-efficacy; secondary outcomes were depressive and anxiety symptoms, coping, illness perception, work and social adjustment, carer strain, and carer satisfaction. Mixed-effect model repeated measures analysis between groups and across time was conducted.

Results: Of the 173 participants recruited (89 stroke survivors; 84 carers), a total of 137 participants – 73 stroke survivors (intervention n = 42; usual care n = 31) and 64 carers (intervention n = 35; usual care n = 29) – underwent analysis up to 12 months. No statistically significant differences were found in the primary outcomes between groups over time, though a significant improvement in carer satisfaction was found at 6 months in the intervention group compared to the usual care group.

Conclusion: A personalized psychosocial intervention resulted in a significant improvement in carer satisfaction at 6 months but in no other outcomes. A lack of available services and barriers to social engagement may have impeded the effectiveness of this intervention.

URL: https://doi.org/10.1080/10749357.2020.1738677

Abstract:

This study evaluated the mediating role of self-efficacy, coping, depression and anxiety on the relationship between illness perceptions and quality of life in stroke survivors (n = 72; 32 females; mean [SD] age 65.09 [14.14] years; male mean [SD] age 69.83 [11.81]). Illness perceptions (Brief Illness Perceptions Questionnaire; BIPQ), coping styles (Carver Brief-COPE scale; B-COPE), depression/anxiety (Hospital Anxiety and Depression Scale; HADS), self-efficacy (General Self-Efficacy Scale; GSE) and quality of life (Assessment of quality of life; AQOL-6D) were analysed. Correlation analyses showed illness perception, maladaptive coping, self-efficacy, depression and anxiety to have a significant negative relationship with quality of life. Mediation analyses showed that while maladaptive coping and self-efficacy did not mediate the relationship between illness perception and quality of life, depression and anxiety did. The final model explained 76.74% of the variance in quality of life. Although based on a relatively small sample size, these results provide evidence for the important role of psychosocial factors in quality of life in post-stroke cohorts.

URL: https://doi.org/10.1080/13548506.2019.1695865

Abstract:

Irritable bowel syndrome (IBS) affects up to 20% of the global population and is associated with impaired health-related quality of life (HRQoL). This systematic review and meta-analysis aimed to investigate differences in HRQoL of those with IBS compared with healthy controls and to examine whether HRQoL improves following psychological intervention. Online databases were searched for articles from 2002 to 2017. Studies were screened and data extracted according to predetermined criteria. A total of 4,154 citations were identified from which 36 were eligible for inclusion. Eight studies compared HRQoL of those with IBS (n = 822) with that of healthy individuals (n = 3,809). Those with IBS suffered significant impairment across all HRQoL domains compared with healthy individuals, with the majority of effects (Cohen’s d) being moderate to large. Twenty-eight studies investigated HRQoL in IBS following psychological intervention (n = 1,308) relative to controls (n = 1,006). All HRQoL domains improved with large effects following treatment; however, maintenance of these effects was inconsistent. Those with IBS experience poorer HRQoL than the wider community; nevertheless, psychological interventions are associated with improved HRQoL across all domains. High-quality studies are needed to better inform gastroenterological nurses of which interventions are most efficacious in alleviating the burden of IBS, and which IBS subpopulations would benefit.

URL: https://doi.org/10.1097/SGA.0000000000000530

Abstract:

Background: Quality of care in inflammatory bowel disease (IBD) has received much attention internationally; however, the available surveys focus on health professionals rather than patients.

Aims: To assess the experiences of healthcare for people living with IBD against established Australian IBD Standards.

Methods: An online cross-sectional survey was conducted with Australians ≥16 years old recruited via Crohn’s & Colitis Australia membership, public and private clinics and the Royal Flying Doctor Service. Participants completed a questionnaire incorporating items addressing the Australian IBD Standards 2016, the Picker Patient Experience Questionnaire, IBD Control Survey and the Manitoba Index.

Results: Complete data were provided by 731 respondents (71.5% female, median age 46 years, ranging from 16 to 84 years). While the majority (74.8%) were satisfied with their IBD healthcare, the care reported did not meet the Australian IBD Standards. Overall, 32.4% had access to IBD nurses, 30.9% to a dietician and 12% to a psychologist in their treating team. Participants managed by public IBD clinics were most likely to have access to an IBD nurse (83.7%), helpline (80.7%) and research trials (37%). One third of respondents reported waiting >14 days to see a specialist when their IBD flared. Participants received enough information, mostly from medical specialists (88.8%) and IBD nurses (79.4%). However, 51% wanted to be more involved in their healthcare.

Conclusions: These data show discordance between expectations of patients and national standards with current levels of service provision, which fail to deliver equitable and comprehensive IBD care.

URL: https://doi.org/10.1111/imj.14683

Abstract:

This article reviews the differences and similarities in medication adherence between adolescent and adult cohorts with inflammatory bowel disease. The review covers the rates of medication adherence, as well as predictors, consequences, and related interventions. Rates of adherence were more favorable among adolescents (65%-90%) than among adults (55%-70%). Major risk factors for poor adherence in adolescents include low medication knowledge, not establishing good medication habits initially, and peer victimization with low social support. For adults, nonadherence is more frequently unintentional (e.g., forgetting) and occurs more often in the context of a poor-quality patient-physician relationship, low medication knowledge, infrequent/missed appointments, busy lifestyle, and concurrent mental health concerns. Nonadherence to medication is associated with worsening of symptoms and risk of relapse in adults and adolescents. Nurses can play a significant role in influencing adherence to medication in patients with inflammatory bowel disease. In particular, nurses can help to impart knowledge on the importance of medication and identify factors that may help or hinder an individual in terms of adherence. Based on the current review, implications for practice and recommendations for nurses to promote medication adherence across both adolescent and adult cohorts are provided. Limitations of the currently available evidence and suggestions for future research are discussed.

URL: https://doi.org/10.1097/SGA.0000000000000467

Abstract

The current research investigates the development and validation of the Bladder and Bowel Incontinence Phobia Severity Scale (BBIPSS). Over two studies, two independent samples consisting of university students and respondents from the general public were used to validate the scale (study 1 n = 226; study 2 n = 377). A 15-item, two-factor model was confirmed in study 2 where strong construct (convergent and divergent) validity was demonstrated. The BBIPSS did not display significant correlations with openness and gender (divergent validity) and displayed significant correlations with depression, anxiety and stress scores (DASS), alongside paruresis and parcopresis scores (SBBS; convergent validity) and the BoBCAtS. The BBIPSS also demonstrated strong test-retest reliability (bladder r = 0.89; bowel r = 0.86) in a small sample of adults (n = 13). Overall, this scale provides researchers and clinicians with a reliable and psychometrically valid assessment tool to measure bladder and bowel incontinence phobia severity.  

URL: https://doi.org/10.1891/0889-8391.33.4.271

Abstract

To date, research exploring the socio-cognitive processes associated with paruresis and parcopresis symptomology is lacking. The current study aimed to investigate how the socio-cognitive processes dysfunctional attitudes (DAs) and fear of negative and positive evaluation (FNE and FPE respectively) relate to paruresis and parcopresis symptomology. In total, 254 undergraduate students (74.0% female; mean age = 31.67 years) completed a cross-sectional online study. A structural equation model indicated the data fit reasonably well (χ2 p value = .209, CMIN/df = 1.514, CFI = .995, TLI = .983, RMSEA = .045, SRMR = .0272), with FPE mediating the relationship between DAs and paruresis symptom severity (p = .001) along with parcopresis symptom severity (p = .001). However, secondary analyses identified that FPE and FNE act as mediators between DAs and paruresis and parcopresis symptom severity when placed in separate models. This is the first study to provide evidence that the psychosocial-cognitive processes DAs and fear of evaluation play an important role in paruresis and parcopresis symptomology. Although this research should be replicated, the current study provides evidence that DAs, and FPE are important contributory factors in paruresis and parcopresis symptoms. 

URL: https://link.springer.com/article/10.1007/s12144-019-0125-7

Abstract:

Background and aims: The aim of this paper was to undertake a systematic review of the research utilizing the Common Sense Model (CSM) involving IBD cohorts to explain the psychosocial processes, including illness perceptions and coping styles, that underpin patient reported outcomes (PROs) – psychological distress (PD) and quality of life (QoL).

Methods: Adult studies were identified through systematic searches of 8 bibliographic databases run in August 2020 including Medline, Embase, and PsychINFO. No language or year limits were applied.

Results: Of 848 records identified, 516 were selected with seven studies evaluating the CSM mediating pathways for final review (n = 918 adult participants). Consistent with the CSM, illness perceptions were associated with PD and QoL in six and five studies respectively. Illness perceptions acted as mediators, at least partially, on the relationship between IBD disease activity and PD and/or QoL in all seven studies. Coping styles, predominantly maladaptive-based coping styles, were found to act as mediators between illness perceptions and PD and/or QoL in five studies. Perceived stress was identified in one study as an additional psychosocial process that partially explained the positive influence of illness perceptions on PD, and a negative impact on QoL. Five studies were classified as high quality and two as moderate.

Conclusions: The CSM can be utilised in IBD cohorts to evaluate key psychosocial processes that influence PROs. Future research should explore additional psychosocial processes within the CSM and evaluate the efficacy of targeting CSM processes to promote psychological well-being and QoL in IBD cohorts.

URL: https://doi.org/10.1016/j.jpsychores.2020.110283