COVID-19 vaccine safety in Scotland - background rates of adverse events of special interest.

OBJECTIVES: Mass COVID-19 vaccination commenced in December 2020 in Scotland. Monitoring vaccine safety relies on accurate background incidence rates (IRs) for health outcomes potentially associated with vaccination. This study aimed to quantify IRs in Scotland of adverse events of special interest (AESI) potentially associated with COVID-19 vaccination. STUDY DESIGN AND METHODS: IRs and 95% confidence intervals (CIs) for 36 AESI were calculated retrospectively for the pre-COVID-19 pandemic period (01 January 2015-31 December 2019) and the COVID-19 pandemic period (01 April 2020-30 November 2020), with age-sex stratification, and separately by calendar month and year. Incident cases were determined using International Classification of Diseases-10th Revision (ICD-10)-coded hospitalisations. RESULTS: Prepandemic population-wide IRs ranged from 0.4 (0.3-0.5 CIs) cases per 100,000 person-years (PYRS) for neuromyelitis optica to 478.4 (475.8-481.0 CIs) cases per 100,000 PYRS for acute renal failure. Pandemic population-wide IRs ranged from 0.3 (0.2-0.5 CIs) cases per 100,000 PYRS for Kawasaki disease to 483.4 (473.2-493.7 CIs) cases per 100,000 PYRS for acute coronary syndrome. All AESI IRs varied by age and sex. Ten AESI (acute coronary syndrome, acute myocardial infarction, angina pectoris, heart failure, multiple sclerosis, polyneuropathies and peripheral neuropathies, respiratory failure, rheumatoid arthritis and polyarthritis, seizures and vasculitis) had lower pandemic than prepandemic period IRs overall. Only deep vein thrombosis and pulmonary embolism had a higher pandemic IR. CONCLUSION: Lower pandemic IRs likely resulted from reduced health-seeking behaviours and healthcare provision. Higher IRs may be associated with SARS-CoV-2 infections. AESI IRs will facilitate future vaccine safety studies in Scotland.

The psychological well-being and self-efficacy of carers of children with disabilities following attendance on a simple massage training and support programme: a 12-month comparison study of adherers and non-adherers.

OBJECTIVES: The Training and Support Programme (TSP) is an 8-week programme in which carers of children with disabilities receive instruction in simple massage techniques to use with their child. The aims of the present study were firstly to compare, adherers and non-adherers on measures of psychological well-being and self-efficacy and secondly, to examine whether, for adherers, the positive benefits of attending the TSP reported immediately after the Programme were maintained at 12-month follow-up. DESIGN: Eighty-two carers took part in the study. Data were collected 12-months after completion of the TSP by self-report questionnaires mailed to carers. For comparisons between adherers and non-adherers at 12-month follow-up a between-groups design was used. For comparisons over time, a within-subjects design was used. RESULTS: Adherers had significantly higher levels of self-efficacy for managing their child's psychosocial well-being, self-efficacy for carrying out the massage, and significantly better psychological well-being at follow-up compared to non-adherers. Furthermore, there were no significant differences over time on self-efficacy for managing their child's psychosocial well-being, self-efficacy for giving massage and levels of anxiety and depression at 12-month follow-up for adherers, suggesting that their improvements noted immediately post-programme were maintained at follow-up. Significant decreases on self-efficacy and depression were noted for non-adherers and there was a trend towards deterioration in anxious mood. CONCLUSION: In conclusion, the present study suggests that the positive benefits the TSP has for carers of children with disabilities can be maintained if carers continue to practise the massage at home with their child.

Educational preferences, psychological well-being and self-efficacy among people with rheumatoid arthritis.

As a basis for developing interventions to meet the psycho-educational needs of rheumatoid arthritis (RA) outpatients attending a regional hospital have been investigated. Specifically, patients' preferences for interventions addressing education (e.g. the disease and its treatment), self-management (e.g. pain-management, exercise) and the consequences (e.g. emotions, impact on work, family relationships) of RA were examined. In addition, psychological well-being and self-efficacy were examined. Results showed that patients preferred education about the disease and its treatment to be delivered on a one-to-one basis by health professionals. Similarly, emotional issues were believed to be best dealt with one-to-one although this could be with a similar other (i.e. a patient). Group interventions were the preferred format for self-management, exercise and relationship issues, whereas videos were thought to be useful for demonstrating use of aids and how other families cope. None of the participants would welcome computer-based interventions. Psychological well-being (e.g. depression, anxiety) remained stable over a 12-month period. Both physical and psychological health status were correlated with arthritis self-efficacy. The implications of these findings are discussed in relation to development of interventions to better meet the psycho-educational needs of outpatients with RA.

Comparison of knowledge and psychological well-being between patients with a short disease duration (< or = 1 year) and patients with more established rheumatoid arthritis (> or = 10 years duration).

Patients with rheumatoid arthritis (RA) of short disease duration (i.e. < or = 1 year) compared with patients of longer disease duration (i.e. > or = 10 years) in terms of RA knowledge, symptoms of anxiety, symptoms of depression and disease acceptance. In addition, the predictors of psychological distress (i.e. symptoms of anxiety and depression) were examined. Data were collected by self-administered questionnaires. As expected, patients with more established disease were significantly older and had more physical dysfunction. However, there were no statistically significant differences on anxiety, depression, acceptance of illness, pain or knowledge about RA. The need for education regarding RA and its implications was expressed by all participants regardless of disease duration. Illness acceptance beliefs were identified as significant predictors of both anxiety and depression.

Does arthritis influence perceived ability to fulfill a parenting role? Perceptions of mothers, fathers and grandparents.

The presence of a painful, disabling chronic disease may have implications for perceived ability to fulfill a parenting role. The purpose of this research was to examine the realities of parenting from the perspectives of mothers, fathers and grandparents with arthritis using a combination of methods: a cross sectional survey and in-depth focus group discussions. There was consensus that pain, fatigue and restricted physical functioning combined to interfere with the parenting role. Overall, approximately 35% of the sample had experienced difficulties attributed to arthritis. A gender difference emerged with women reporting more difficulties in relation to caring for babies and toddlers, whereas men reported more problems as children grew older. Key themes concerned: physical limitations; practical and caring issues; social factors; emotional response; hereditary risks and safety issues. Perceived inability to fulfill parenting roles resulted in feelings of frustration, guilt, anger and depression. A number of positive outcomes were mentioned including children's increased awareness of the needs of others. Limitations of the methodological approach adopted are discussed.

Psychometric properties of the Rosenberg Self-esteem Scale among people with arthritis.

After 30 years of use the factor structure of the Rosenberg Self-esteem Scale remains the subject of debate. Most studies have focused on school-aged or undergraduate students. There are few psychometric data for older people or for those with disabilities. This study compared the factor structures of the Rosenberg Self-esteem Scale among 117 adults with arthritis and 185 undergraduate students. A two-factor solution provided the best fit for both samples, although the item content of the factors differed slightly. Further investigation is required to assess whether the difference is due to age or the presence of physical disability. Nonetheless, the scale discriminated well between students and adults with arthritis.

Being a parent or grandparent with back pain, ankylosing spondylitis or rheumatoid arthritis: a descriptive postal survey.

Research that explores being a parent or grandparent with musculoskeletal problems has been fairly limited to date. The aim of this study was to describe the experience of parenting in the context of back pain (BP), ankylosing spondylitis (AS) and rheumatoid arthritis (RA), with a particular focus on the extent and nature of childcare experiences and to compare these experiences across the three groups. In addition, the possible reasons for these reported experiences, the availability of advice and support and the development of strategies for coping were explored using a cross-sectional descriptive survey. A total of 448 participants was recruited from relevant charitable organizations and the National Health Service (280 with BP, 106 with AS and 62 with RA). A combination of opportunistic and random sampling was used. Quantitative data were analysed with appropriate descriptive and inferential statistics using Statistical Package for the Social Sciences (SPSS version 10). Qualitative data were analysed using content analysis. Results indicate that a high proportion of all groups experienced a wide range of difficulties with parenting (81% BP, 77% AS, 97% RA). The most prevalent problems were similar for all three groups: lifting baby/child from the floor or cot, encouraging children/grandchildren to help with domestic chores and keeping up (in terms of energy) with children/grandchildren. However, the RA group reported having greater difficulties than the other two groups. Very little advice was offered to participants with parenting difficulties which may indicate a gap in service provision. However, a wide range of strategies for coping were described by respondents. The study highlighted a need for healthcare professionals to develop a greater awareness of parenting issues and to provide opportunities for these issues to be addressed.