同伴支持对社区独居代谢综合征患者自我效能和生存质量的影响

目的：探讨同伴支持对社区独居代谢综合征患者自我效能和生存质量的影响。方法采取便利抽样方法选取2013年3—6月哈尔滨市某社区服务中心站的6个社区的独居代谢综合征患者90例作为研究对象,随机分为对照组和观察组,每组45例,对照组患者不接受同伴支持干预,观察组患者接受同伴支持,采用自我护理能力测定表( ESCA)、生活质量量表( QOL)评价两组干预效果。结果干预后,观察组患者自我效能总分为(126.98±10.13)分,对照组患者为(108.56±9.75)分,两组比较差异有统计学意义(t=5.954,P<0.05);干预后观察组患者总体生存质量为(42.62±5.86)分,对照组患者为(34.76±5.15)分,两组比较差异有统计学意义(t=3.543,P<0.05)。结论同伴支持对社区独居代谢综合征患者自我效能和生存质量均有积极改善效果,值得推广。     

1 + 1 = 3? The systematic development of a theoretical and evidence-based tailored multimedia intervention to improve medication adherence

ObjectiveTo describe the development of a theoretical and evidence-based tailored multimedia intervention to improve medication intake behavior in patients with inflammatory bowel disease (IBD). The intervention integrates interpersonal and technology-mediated strategies with the expectation that this will work synergistically.MethodsThe development followed the Medical Research Council's framework. Three literature reviews and three pre-tests among 84 IBD patients and eight nurses were conducted to guide the development of the intervention. A feasibility study was carried out among four nurses and 29 patients.ResultsThe components include: (1) an online preparatory assessment (OPA); (2) tailored interpersonal communication; and (3) tailored text messaging. To support the development, the feasibility was tested. Results indicated that the OPA was comprehensive and could be a helpful tool for both patients and nurses to prepare for the consultation. The training was evaluated as being instructive and applicable with a mean mark of 8.5. Of the developed messages, 65.6% received positive evaluations and were used in the intervention.ConclusionBy applying the framework, we were able to describe the logic behind the development of a tailored multimedia intervention to improve medication intake behavior.Practice implicationsThis study could serve as a guide for the development of other health interventions.     

Self-efficacy for temptations is a better predictor of weight loss than motivation and global self-efficacy: Evidence from two prospective studies among overweight/obese women at high risk of breast cancer

Objectives

Identifying predictors of weight loss could help to triage people who will benefit most from programs and identify those who require additional support. The present research was designed to address statistical, conceptual and operational difficulties associated with the role of self-efficacy in predicting weight loss.

Methods

In Study 1, 115 dieting overweight/obese women at high risk of breast cancer were weighed and completed questionnaires assessing motivation, global self-efficacy and self-efficacy for temptations. The main outcome measure was weight, measured 3-months post-baseline. Study 2 was identical (n = 107), except changes in psychological variables were computed, and used to predict weight 6-months post-baseline.

Results

In Study 1, self-efficacy for temptations was a significant predictor of weight loss at 3-month follow-up. In Study 2, improved self-efficacy for temptations between baseline and four-weeks was predictive of lower weight at 6 months.

Conclusion

The key finding was that self-efficacy for temptations, as opposed to motivation and global self-efficacy, was predictive of subsequent weight loss.

Practice implications

The implication is that augmenting dieters’ capability for dealing with temptations might boost the impact of weight loss programs.     

自我效能理论在代谢综合征患者血糖控制中的应用

目的探讨自我效能理论对代谢综合征患者血糖控制的影响。方法选取100例代谢综合征高血糖患者按照随机、开放、对照、平行方法分为对照组与实验组各50例,对照组给予内分泌常规治疗,实验组在常规治疗的基础上进行增强自我效能健康宣教,比较两种方法对患者血糖控制的影响。结果3个月后实验组的自我效能评分、糖化血红蛋白及空腹血糖的控制优于对照组（ P＜0.01或＜0.05）;两组患者餐后2 h血糖控制差异无统计学意义（ P＞0.05）。结论在代谢综合征高血糖患者治疗过程中应用自我效能理论,可以有效改善血糖控制。     

The impact of self-efficacy,alexithymia and multiple traumas on posttraumatic stress disorder and psychiatric co-morbidity following epileptic seizures: A moderated mediation analysis

This study investigated the incidence of posttraumatic stress disorder (PTSD) and psychiatric co-morbidity following epileptic seizure, whether alexithymia mediated the relationship between self-efficacy and psychiatric outcomes, and whether the mediational effect was moderated by the severity of PTSD from other traumas. Seventy-one (M=31, F=40) people with a diagnosis of epilepsy recruited from support groups in the United Kingdom completed the Posttraumatic Stress Diagnostic Scale, the Hospital Anxiety and Depression Scale, the Toronto Alexithymia Scale-20 and the Generalized Self-Efficacy Scale. They were compared with 71 people (M=29, F=42) without epilepsy. For people with epilepsy, 51% and 22% met the diagnostic criteria for post-epileptic seizure PTSD and for PTSD following one other traumatic life event respectively. For the control group, 24% met the diagnostic criteria for PTSD following other traumatic life events. The epilepsy group reported significantly more anxiety and depression than the control. Partial least squares (PLS) analysis showed that self-efficacy was significantly correlated with alexithymia, post-epileptic seizure PTSD and psychiatric co-morbidity. Alexithymia was also significantly correlated with post-epileptic seizure PTSD and psychiatric co-morbidity. Mediation analyses confirmed that alexithymia mediated the path between self-efficacy and post-epileptic seizure PTSD and psychiatric co-morbidity. Moderated mediation also confirmed that self-efficacy and PTSD from one other trauma moderated the effect of alexithymia on outcomes. To conclude, people can develop posttraumatic stress disorder symptoms and psychiatric co-morbidity following epileptic seizure. These psychiatric outcomes are closely linked with their belief in personal competence to deal with stressful situations and regulate their own functioning, to process rather than defend against distressing emotions, and with the degree of PTSD from other traumas.     

Identifying predictors of resilience at inpatient and 3-month post-spinal cord injury

Objectives

To identify (1) changes in psychosocial factors, (2) relationships between psychosocial factors, and (3) significant predictors of resilience in adults with spinal cord injury (SCI) during inpatient rehabilitation and at 3-month post-discharge.

Design

Cross sectional with convenience sample based on inclusion/exclusion criteria.

Setting

Inpatient rehabilitation hospital and community-based follow-up.

Participants

Individuals with a SCI.

Interventions

Not applicable.

Outcome measures

Demographic, resilience, self-efficacy for managing a chronic health issue, depression, social roles/activity limitations, and pain.

Results

The final sample consisted of 44 respondents (16 women and 28 men). Results of repeated measure analyses of variance indicated no significant changes in variables between inpatient and 3-month follow-up. Bivariate correlations revealed associations between resilience and self-efficacy at inpatient (r = 0.54, P < 0.001), and resilience and depression (r = −0.69, P < 0.001) and self-efficacy (r = 0.67, P < 0.001) at 3-month follow-up. Hierarchical regression analyses a significant model predicting resilience at inpatient stay (R = 0.61; adjusted R² = 0.24, P = 0.023), and at 3-month follow-up (R = 0.83; adjusted R² = 0.49, P = 0.022). Self-efficacy was the strongest predictor at inpatient stay (β = 0.46, P  =  0.006) and depression was strongest at 3-month follow-up (β = −0.80, P = 0.007).

Conclusion

Results suggest that although resilience appears to be stable from inpatient to 3-month follow-up, different factors are stronger predictors of resilience across time. Based on current results, an assessment of self-efficacy during inpatient rehabilitation and an identification of depression at 3-month follow-up may be important factors to help identify those at risk of health issues overtime.     

健康教育模式的建立对乳腺癌患者创伤后成长及自我效能的影响

目的 探讨健康教育模式的建立对乳腺癌患者创伤后成长及自我效能的影响.方法 选取2013年12月至2015年5月收治的乳腺癌患者124例,依照入院先后顺序依次交替归属为对照组和研究组,每组各62例,分别接受常规护理和医护共同参与的健康教育.采用创伤后成长评定量表(PTG)、Jalowies应对方式量表及自我效能量表比较2组患者的干预效果.结果 干预后,观察组患者PTG评分、Jalowies应对方式及自我效能评分均优于对照组,差异有统计学意义(P<0.05).结论 健康教育模式的建立能使乳腺癌患者积极应对疾病,合理调节负性情绪,从而提高自我效能,促进创伤后成长.     

Received social support, self-efficacy, and finding benefits in disease as predictors of physical functioning and adherence to antiretroviral therapy

OBJECTIVE: The study investigated whether received social support, self-efficacy, and finding benefits in disease are related to physical functioning and adherence to antiretroviral medication among men and women infected with HIV. METHODS: Data were collected among 104 patients of three HIV clinics in India. The measures included general self-efficacy scale, Berlin social support scales, questionnaire on taking antiretroviral medication, and SF-20 (physical functioning). RESULTS: The results of path analysis and mediation analysis revealed that finding benefits and self-efficacy were directly related to both adherence and physical functioning. Additionally, finding benefits mediated the relation between patients' self-efficacy and adherence as well as physical functioning. Although received support was unrelated to adherence directly, effects of received support on adherence were mediated by self-efficacy. CONCLUSIONS: Besides personal and social resources, benefit finding was related to better adherence to antiretroviral medication. PRACTICE IMPLICATIONS: Identifying patients receiving low social support, with weak general self-efficacy and finding no benefits in being diagnosed with HIV may help to elicit those people who are at risk for poorer adherence and physical functioning.     

Quality of life and psychological well-being in the early stages of multiple sclerosis (MS): Importance of adopting a biopsychosocial model

Background

Reductions in quality of life (QOL) exist among individuals with multiple sclerosis (MS).