Exercise‐related goals and self‐efficacy as correlates of aquatic exercise in individuals with arthritis

Objective

To examine whether aquatic exercise–related goals, task self‐efficacy, and scheduling self‐efficacy are predictive of aquatic exercise attendance in individuals with arthritis. A secondary objective was to determine whether high attendees differed from low attendees on goals and self‐efficacy.

Methods

The sample comprised 216 adults with arthritis (mean age 69.21 years). Measures included exercise‐related goal difficulty and specificity, task and scheduling self‐efficacy, and 8‐week aquatic exercise attendance.

Results

Results of a multiple hierarchical regression analysis were significant (P < 0.01). Goal difficulty, specificity, and task self‐efficacy were independent predictors of attendance (P < 0.05). A significant multivariate analysis of variance (P < 0.01) indicated that high attendees had higher task and scheduling self‐efficacy and lower goal difficulty than did low attendees (P < 0.05).

Conclusion

Support for the importance of exercise‐related goal setting and self‐efficacy was demonstrated. Implications pertain to the design of interventions to impact aquatic exercise.

     

Self‐efficacy in rheumatoid arthritis: translation and test of validity,reliability and sensitivity of the Danish version of the Rheumatoid Arthritis Self‐Efficacy Questionnaire (RASE)

Objectives: To describe the translation and test of the Danish version of the original British ‘Rheumatoid Arthritis Self‐Efficacy Questionnaire’ (RASE). Methods: The questionnaire was forward and back translated by individuals with Danish and English as their respective primary languages. The questionnaire was tested by five lay‐people and in the field by 10 + five persons with rheumatoid arthritis (RA). A test‐retest was performed on 62 outpatients with RA. The sensitivity of the adapted Danish version of RASE (RASE‐DK) was finally tested on 106 outpatients with RA – before, immediately after and three months after they had participated in a short self‐management course performed by a multidisciplinary team. Results: RASE‐DK showed good face validity, but ‘relaxation’ was interpreted in various ways. Internal consistency evaluated by Cronbach's alpha was 0.91. Reliability evaluated by the intra‐class correlation coefficient (ICC) was 0.88. A Bland–Altman plot showed good agreement. RASE‐DK, like the original English version of RASE, was not associated with disease activity (Disease Activity Score, DAS‐28) or disability (Health Assessment Questionnaire, HAQ), and correlated significantly with the Arthritis Self‐Efficacy Scale (ASES) subscales ‘other’ and ‘pain’, and total ASES. RASE‐DK showed a highly significant change, from baseline to immediately after participation in the short course (p < 0.001). The effect faded during the following three months. Conclusion: RASE‐DK met the appropriate standards for validity, reliability and sensitivity, and is appropriate for use in Denmark. However, the concept of self‐efficacy may be too abstract for a few individuals, and relaxation is interpreted in various ways by the Danish patients. Copyright © 2010 John Wiley & Sons, Ltd.     

Self‐monitoring has potential for home exercise programmes in patients with haemophilia

Haemophiliacs who have had to keep a physically inactive lifestyle due to bleeding during childhood are likely to have little motivation for exercise. The purpose of this study is to clarify the effectiveness of the self‐monitoring of home exercise for haemophiliacs. A randomized controlled trial was conducted with intervention over 8 weeks at four hospitals in Japan. Subjects included 32 male outpatients aged 26–64 years without an inhibitor who were randomly allocated to a self‐monitoring group and a control group. Individual exercise guidance with physical activity for improvement of their knee functions was given to both groups. The self‐monitoring materials included an activity monitor and a feedback system so that the self‐monitoring group could send feedback via the Internet and cellular phone. The self‐monitoring was performed by checking exercise adherence and physical activity levels, bleeding history and injection of a coagulation factor. Both groups showed significant improvements in exercise adherence (P < 0.001) and physical function such as the strength of knee extension (P < 0.001), range of knee extension (P < 0.001), range of ankle dorsiflexion (P < 0.01), a modified Functional Reach (P < 0.05) and 10 metre gait time (P < 0.01). In particular, improvements in exercise adherence (P < 0.05), self‐efficacy (P < 0.05), and strength of knee extension (P < 0.05) were significant in the self‐monitoring group compared with those in the control group. No increase in bleeding frequency and pain scale was noted. The self‐monitoring of home exercise for haemophilic patients is useful for the improvement of exercise adherence, self‐efficacy and knee extension strength.     

Effects of health literacy to self‐efficacy and preventive care utilization among older adults

Aim: This study examined the relationships between health literacy, self‐efficacy and preventive care utilization among older adults in Taiwan. Methods: The data were from a longitudinal survey, “Taiwan Longitudinal Study in Aging” in 2003 and 2007. A total of 3479 participants who completed both two waves were included for analysis. Health literacy first was constructed through education, cognitive function and disease knowledge through structural equation modeling (SEM); then, the associations of health literacy to later self‐efficacy and preventive care were examined. Results: The model fit of SEM was good, indicating that the construct of health literacy was appropriate. Healthy literacy showed a moderate positive effect on self‐efficacy and a small positive effect on preventive care utilization. Conclusions: Health literacy increases self‐efficacy and utilization of preventive care. Promoting people's health knowledge and health literacy is suggested. Geriatr Gerontol Int 2013; 13: 70–76 .     

Fear of falling and falls self‐efficacy and their relationship to higher‐level competence among community‐dwelling senior men and women in Japan

Aim: This cross‐sectional study examined the relationships of fear of falling and falls self‐efficacy with higher‐level competence among community‐dwelling senior citizens in Japan. Methods: Of the 822 registered senior citizens, 731 (89%) community dwellers were requested to participate in the survey using a mailed self‐accomplished questionnaire. Data from 648 respondents with duly accomplished questionnaires were analyzed using R², the coefficient of determination, based on a multivariate regression analysis. Results: Fear of falling, low falls self‐efficacy and higher‐level functional disability were observed among respondents. Of the hypothesized relationships examined by sex, fear of falling was significantly associated with disability among male respondents and low falls self‐efficacy among both sexes. Several confounding variables were strongly associated with competence. Conclusion: While the data underscore the strategic importance of promoting higher‐level competence among the senior citizens, there is much to suggest that their competence is likely to be maintained if their fear of falling and falls self‐efficacy were modified. Programs must also consider a wide array of intervening factors. Geriatr Gerontol Int 2011; 11: 282–289.     

French adaptation of the eating disorder recovery self‐efficacy questionnaire (EDRSQ): Psychometric properties and conceptual overview

High prevalence of Eating Disorders (EDs) and poor treatment outcome rates have urged research in the assessment of EDs. Self‐efficacy is a key motivational factor in the recovery from EDs. A self‐report measure, the Eating Disorder Recovery Self‐Efficacy Questionnaire (EDRSQ), was recently developed to assess confidence in adopting healthy eating behaviours and in maintaining a realistic body image. The objectives of this study were to (a) translate the EDRSQ to French (EDRSQ‐F), (b) assess the psychometric properties of this French version, and (c) establish normative data for a non‐clinical sample. Participants were 203 undergraduate women. They completed the EDRSQ‐F and measures of ED symptoms, depression and self‐esteem. A confirmatory factor analysis (CFA) revealed a bi‐factorial structure. Both scales demonstrated evidence of reliability and theoretically consistent evidence of construct validity. Findings support the validity of the EDRSQ‐F and suggest it is a useful instrument for the assessment of EDs. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association.     

The influence of cultural orientation,alcohol expectancies and self‐efficacy on adolescent drinking behavior in Beijing

Objective We hypothesized that the drinking behavior of adolescents in China is influenced by expectancies and self‐efficacy and that adolescents' cultural orientation towards western versus traditional Chinese values influences expectancies, self‐efficacy and drinking behavior, with western values leading to more dysfunctional patterns of beliefs and drinking, and that these beliefs are influenced by students' gender and school environment. Methods A total of 1020 high school students from Beijing completed the Chinese Adolescent Alcohol Expectancy, the Chinese Cultural Orientation and the Chinese Self‐regulation Self‐efficacy questionnaires. Results Results generally confirmed our hypotheses. Higher negative expectancies and higher self‐efficacy reduced the likelihood of drinking significantly. Higher positive expectancies increased the likelihood of regular drinking but not occasional drinking. Having western cultural orientation increased the likelihood of drinking. Higher levels of western cultural orientation also increased positive expectancies, lowered negative expectancies and lowered self‐efficacy. Having more western (less traditional) views towards traditional Chinese values decreased positive and negative expectancies. Gender influenced beliefs, with males having higher positive and lower negative expectancies, lower self‐efficacy and more traditional cultural orientation. Students in key and general schools had less traditional cultural orientation and key school students had higher self‐efficacy. Conclusions Results indicate that cultural orientation influences adolescent drinking and this influence is mediated partially through cultural orientation influences on adolescent drinking expectancies and self‐efficacy. Having more western and less traditional Chinese cultural orientation leads to more drinking, lower self‐efficacy for regulating drinking and more risk‐promoting alcohol expectancies.     

Validity and reliability of the Turkish version of the Diabetes Self-Care Scale

The purpose of this study was to evaluate the validity and reliability of the Turkish version of the Diabetes Self-Care Scale. Self-care in diabetes is influenced by various factors, and it is important that the diabetes healthcare providers evaluate the efficacy of self-care activities. Accurate and careful measurements of diabetes self-care activities/levels provide important information both for healthcare providers and researchers to enable deeper understanding of appropriate management of and attitude towards self-care in patients with diabetes. Language properties of a Turkish adaptation of the Diabetes Self-Care Scale were ensured with the translation-backtranslation method, content validity by soliciting specialist opinions. Reliability, consistency over time (test-retest reliability), item-total item correlation analysis, and internal consistency were also analyzed. Data were collected between May and July 2007. The Cronbach’s alpha reliability coefficient was 0.81. The Diabetes Self-care Scale is a valid and reliable scale to evaluate self-care activities of diabetics.     

Validity of self‐administered quality of well‐being scale in musculoskeletal disease

Objective

To evaluate the self‐administered Quality of Well‐Being (QWB‐SA) Scale for patients with rheumatic diseases.

Methods

Family medicine patients (n = 562) and rheumatology patients (n = 334) were assessed using the following tools: QWB‐SA, Health Assessment Questionnaire (HAQ), Arthritis Impact Measurement Scales (AIMS), and Rapid Assessment of Disease Activity in Rheumatology (RADAR).

Results

Patients with arthritis had significantly lower QWB‐SA scores and significantly higher HAQ scores than family medicine patients with and without adjustment for covariates. The QWB‐SA was significantly associated with quartiles from the RADAR, AIMS, and HAQ, providing evidence for the validity of the generic measure in patients with arthritis. Discriminant function analysis was used to create an arthritis‐specific scoring system for the QWB‐SA. Analyses demonstrated systematic relationships between the Quality of Well‐Being arthritis composite and the disease‐specific RADAR, AIMS, and HAQ.

Conclusions

Evidence supports the validity of the QWB‐SA for patients with rheumatic diseases. QWB‐SA items can be used to calculate an arthritis‐specific score. The QWB‐SA can be used to gain generic information for cost‐utility analysis and disease‐specific outcomes information for patients with arthritis.

     

Six‐minute walk distance and work relationship with incremental treadmill cardiopulmonary exercise test in COPD

Introduction: Cardiopulmonary exercise testing (CPET) is increasingly used to evaluate the overall impact of the illness on patients with chronic obstructive pulmonary disease (COPD). While laboratory tests of exercise performance are costly, the 6‐min walk test (6‐MWT) can be more easily performed. Although the main outcome commonly used in this field test is the distance walked in 6 min (6‐MWD), this measure does not account for differences in body weight. Previous studies showed a good correlation between the work performed during the 6‐MWT with incremental cycling CPET, an exercise modality more associated with quadriceps fatigability and with lower peak oxygen consumption than incremental walking tests. Objective: Evaluate the correlation between the 6‐MWD and its derivative body weight–walking distance product, an estimation of the work performed during the 6‐MWT, with peak from a treadmill CPET. Methods: Thirty COPD patients [forced expiratory volume in 1 s (FEV₁) = 39 ± 13%; peak predicted] performed CPET to the limit of tolerance on a treadmill and 6‐MWT, 48 h apart.6‐MWD and work were correlated to resting and exercise functional variables. Results: The work of walking during the 6‐MWT provided greater associations with peak than observed with 6‐MWD. This was the case for FEV₁, forced vital capacity, inspiratory capacity, lung diffusion capacity for carbon monoxide, peak , carbon dioxide output, minute ventilation and double product (r = 0.57, r = 0.57, r = 0.73, r = 0.7, r = 0.75, r = 0.65, r = 0.51 and r = 0.4, respectively; all P < 0.05). Conclusion: A better association was found between the work estimated from the 6‐MWT and peak achieved during CPET, in this case with a treadmill, than the 6‐MWD alone. Please cite this paper as: Poersch K, Berton DC, Canterle DB, Castilho J, Lopes AL, Martins J, Oliveira AR and Teixeira PJZ. Six‐minute walk distance and work relationship with incremental treadmill cardiopulmonary exercise test in COPD. Clin Respir J 2013; 7: 145–152.     

Self‐care versus self‐harm: piercing,tattooing, and self‐injuring in eating disorders

Eating disordered patients seem to have a love–hate relationship with their bodies. Why do some decorate their bodies by means of tattooing and piercing, while others deliberately injure themselves and make parts of their body unattractive? We have explored this question in 101 eating‐disordered patients by means of self‐reporting questionnaires about the presence and characteristics of tattooing, piercing and self‐injuring as well as the underlying motives. Furthermore, we studied the co‐occurrence of impulsive behaviours as well as personality traits. In our patient sample, 11.9 per cent had one or more tattoos, 25.7 per cent a piercing and 64.9 per cent showed some form of self‐injurious behaviour (SIB). Tattooing and piercing are clearly driven by esthetical reasons, whereas SIB can have various explanations. All three behaviours were significantly more often linked to substance (ab)use. With respect to personality traits, piercing was positively linked to extraversion (positive affectivity) and openness, and negatively to conscientiousness. SIB, on the contrary, was positively linked to neuroticism (negative affectivity) and conscientiousness, and negatively to extraversion and openness. Tattooing did not show significant correlations with particular personality traits (probably due to the small number of tattooed patients). In summary, piercing and tattooing seem to reflect more self‐care, and might protect some patients against more self‐harm. Copyright © 2005 John Wiley & Sons, Ltd and Eating Disorders Association.     

Self‐liking and self‐competence: relationship to symptoms of anorexia nervosa

Self‐esteem has been hypothesised to play a pivotal role in the development and treatment, and outcome of anorexia nervosa (AN). Though this relationship is typically investigated by considering self‐esteem as a unitary construct, research suggests that this comprises of two related but distinct components of self‐liking and self‐competence. This study investigates the association between self‐liking, self‐competence, and symptomatology of AN through the course of a defined treatment episode in 77 women. Self‐liking was significantly associated with laxative abuse. Self‐competence was significantly associated with elevated ineffectiveness, perfectionism and interpersonal distrust. Although self‐competence and eating disturbance severity significantly improved over the treatment episode, one in three participants reported a reduced self‐like or self‐competence. Changes in both self‐competence and self‐liking at the end of treatment was associated with changes in drive for thinness. Such findings have implications for treatment models concerned with improving self‐esteem. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association.