Practical strategies to manage obesity in type 2 diabetes.

The rising phenomenon of obesity, a major risk factor for the development and progression of type 2 diabetes, is a complex and multifaceted issue that requires a comprehensive and coordinated approach to be prevented and managed. Although novel pharmacological measures to combat obesity have achieved unprecedented efficacy, a healthy lifestyle remains essential for the long-term success of any therapeutic intervention. However, this requires a high level of intrinsic motivation and continued behavioural changes in the face of multiple metabolic, psychological and environmental factors promoting weight gain, particularly in the context of type 2 diabetes. This review is intended to provide practical recommendations in the context of a holistic, person-centred approach to weight management, including evidence-based and expert recommendations addressing supportive communication, shared decision-making, as well as nutritional and pharmacological therapeutic approaches to achieve sustained weight loss.

Ethnic socialisation profiles and depression among ethnic minority adolescents in China: a person-centred approach.

BACKGROUND: Ethnic socialisation plays a vital role in the development of ethnic minority adolescents. However, the generalizability of research findings beyond the context of immigrant societies in the United States remains unclear. METHODS: Utilising a person-centred approach, this study analysed a sample of 2,600 ethnic minority adolescents in China (55.8% female, Mage = 14.93 ± 1.82) to explore ethnic socialisation patterns, and their correlations with depression. RESULTS: Latent profile analysis revealed four distinct ethnic socialisation profiles: low-frequency, moderate-frequency, high-frequency and proactive integration orientation. Adolescents with the high-frequency profile displayed the highest levels of depression, followed by those with the moderate-frequency profile, whereas adolescents with the low-frequency and proactive integration orientation profiles showed a lower risk of depression. CONCLUSIONS: Within the sociocultural context of China, ethnic minority families' ethnic socialisation practices demonstrate unique characteristics. Various ethnic socialisation messages are integrated in diverse patterns to exert influence on adolescents.

Identifying profiles of actual and perceived motor competence measured with aligned instruments: Differences in (enjoyment of) physical fitness.

A person-centred approach was used to examine whether children with various actual and perceived motor competence (AMC and PMC) profiles differ in (enjoyment of) physical fitness (PF). The strength of the relationship between AMC and PMC was also assessed through aligned assessment tools. A sample of 287 7-11-year-old children (47.40% boys, Mage = 8.92 ± .78 years) was assessed on AMC with the KörperkoordinationsTest für Kinder (KTK3), and on PF with six validated fitness tests. Animated videos fully aligned with the AMC- and PF-tests were used to assess children's PMC and enjoyment of PF, respectively. Cluster analyses identified one convergent (i.e. high AMC-high PMC) and three partially convergent AMC-PMC profiles (i.e. low AMC-high PMC). Furthermore, children with relatively high AMC (i.e. high-average profile) reported higher PF (F = 30.99, p < .001), while children with relatively high PMC (i.e. average-high profile) reported higher enjoyment of PF (F = 9.02, p < .001). The correlation between AMC and PMC was significant but weak (r = .16). Overall, it seems important to invest in both children's AMC and PMC as they may support a higher (enjoyment of) PF, potentially leading to higher PA-levels.

When it comes to physical fitness, actual motor competence rather than perceived motor competence seemed to play the biggest role. As extra high perceived motor competence did not add additional benefits in terms of physical fitness, there might have been a ceiling effect of perceived motor competence.When looking at enjoyment of physical fitness, perceived motor competence seemed to be a more important factor than actual motor competence. However, profile analyses revealed that a relatively high perceived motor competence score may not fully compensate the loss of enjoyment in physical fitness when children's actual motor competence is relatively low.

Stress dimensions, patterns of coping, and psychopathological risk among nurses: a person-centred approach.

BACKGROUND: Nurses are increasingly demanded to achieve gold-standards of care with fewer resources. Dealing effectively with stress experienced in their daily-work-life is thus crucial. This study is based on the Demands-Resources-and-Individual-Effects (DRIVE) Nurses Model and applied the person-centred approach with a twofold objective: 1. to identify patterns of coping strategies (Problem-Focused; Seek-Advice; Self-Blame; Wishful-Thinking; Escape/Avoidance) adopted by nurses to deal with perceived stress; 2. to explore potential differences in perceived Demands (Effort), Resources (Rewards, Job-Control, Social-Support), and Psychopathological Symptoms (Anxiety, Phobic-Anxiety, Obsessive-Compulsive, Somatization, Depression, Interpersonal-Sensitivity, Hostility, Psychoticism, Paranoid-Ideation) according to the emerged patterns. METHOD: This cross-sectional study was reported by using the STROBE Checklist. Overall, 265 nursing professionals completed self-report measures. Non-hierarchical k-means-cluster-analysis was employed to derive patterns of coping. MANOVAs were used to test differences in Demands, Resources, and Psychopathological Symptoms according to the emerged patterns. RESULTS: Three stable and meaningful patterns of coping were identified and labelled as Active/Solution-Oriented, Dysregulated/Emotion-focused, and Passive/Disengaged. Nurses belonging to Dysregulated/Emotion-focused group emerged to be at higher risk (higher effort/psychopathological suffering; lower resources) - followed by Passive/Disengaged group - in comparison with nurses belonging to Active/Solution-Oriented group. CONCLUSION: Fostering nurses' awareness of their latent coping patterns and supporting active approaches/emotional regulation strategies for stress management should represent a key goal when defining interventions promoting nurses' health within/beyond the healthcare settings.

Organisational and leadership skills towards healthy workplaces: an interview study with registered nurses in Sweden.

BACKGROUND: According to shortage of registered nurses, organisational and leadership aspects grounded in person-centrered approach, are highlighted to ensure high quality of care. Therefore, it is interesting to develop knowledge regarding registered nurses working environment. AIM: The aim of the study was to investigate registered nurses' reason to end their employment at a university hospital setting (internal medicine, emergency department). METHOD: Qualitative content analysis with an inductive methodological approach was used to analyse registered nurses' experiences regarding their former employment. Inclusion criteria; all nurses (n = 55) who ended employment during one year (first of July 2020-30th of June 2021) were invited, and 38 semi-structured interviews were conducted. RESULTS: Three categories were identified: Limited organisational support, Lack of visible leadership, and Limited healthy working environment, followed by six subcategories: Longing for organisational support, Being a tile in a box, Need for professional relationship, Limitation of supportive leadership, Imbalance of work versus personal life, and Ethical stress. CONCLUSION: To improve registered nurses working environment and commitment to work, balance between time at work and personal life is significant. Therefore, organisational support and leadership skills grounded in a person-centred approach are crucial to develop a healthy working environment. A person-centred leadership could improve collaboration and shared decision-making in partnership with those involved, managers, nurses, and team members.

"Connectedness" between people with intellectual disabilities and challenging behaviour and support staff: Perceptions of psychologists and support staff.

The tacit practical knowledge of psychologists and support staff to foster a real connection between support staff and people with intellectual disabilities and challenging behaviour was explored. Therefore, six dyads comprising individuals with intellectual disabilities and challenging behaviour and their support staff were video recorded during joint engagement in an activity. To tap into the implicit knowledge of professionals about when staff have 'a real connection' with a person with an intellectual disability, 10 psychologists and 10 support staff were asked to pinpoint these moments in the pre-recorded video compilation. They also shared their interpretations about what they considered to be a real connection. The results displayed that participants designated real connections as occurring when they noticed concrete interactions taking place. Based on thematic analysis of the data, four themes were identified that encapsulated what professionals deemed to be a real connection. In conclusion: joint engagement in an activity appears to be a context that fosters opportunities for real connection. Furthermore, support staff should adopt a sensitive attitude and create a safe atmosphere, to establish real connections.

Barriers and facilitators for isoniazid preventive therapy (IPT) administration in children under 5 years of age in the Dominican Republic.

INTRODUCTION: Throughout the world tuberculosis (TB) is the second leading cause of death due to an infectious agent. The World Health Organization promotes Isoniazid Preventive Therapy (IPT) in children under 5 years who are contacts of persons diagnosed with smear-positive pulmonary TB (SPPTB). In 2019, 33% of children identified as contacts received IPT globally, while in the Americas 11 countries reached coverages ≥ 75%, only 35% did so in the Dominican Republic (DR). The aim of this study was to identify barriers and facilitators for IPT administration in children under 5 in the Area IV Directorate of Health of the DR's National District. METHODS: Descriptive study, using mixed methods and sequential explanatory approach. We characterized children under 5 years who were contacts of a person with SPPTB. Later, semi-structured interviews and content analysis allowed identification of barriers and facilitators for IPT administration in children who were contacts of a person diagnosed with SPPTB, as perceived by relatives and health system personnel. RESULTS: A total of 238 children were identified as contacts of 174 persons with SPPTB: 36% of these received IPT while no data on IPT administration was found for 11% of them. The proportion of children who had a tuberculin skin test (TST) done was < 20%. However, those who had the test done had a greater opportunity to receive IPT (OR: 8.12, CI 95%: 1.60-41.35). Barriers identified include socioeconomic conditions of children and families, stigma, lack of information in clinical and follow-up records, lack of coordination between public and private providers and lack of coherence within national regulations. Facilitators include home based care of persons with TB and their contacts, transfer of treatment to a health centre near household, isoniazid availability, provision of information by health-workers and economic support for food and transportation. CONCLUSIONS: Incomplete data, lack of use of TST to rule out active TB, socioeconomic and cultural conditions, were barriers for IPT administration. Implementation of a person centred approach to care was found to be the main facilitator for IPT uptake. Administration of IPT depends predominantly on modifiable health system factors. This allows rapid identification of strategies to improve IPT administration.

An exploration of person-centred approach in end-of-life care policies in England and Japan.

BACKGROUND: Increasing evidence has suggested that a person-centred approach (PCA) is beneficial not only for improving care outcomes but also for mitigating the pressure on public health systems. However, policy implementation gaps have prevented the translation of this complex framework into useful practical, ethical and moral stances for end-of-life care (EOLC). This article aims to explore the meaning and implications of person-centredness in EOLC policy discourses. METHODS: By perceiving policy documents as a medium embodied with socio-political and cultural norms, we analysed how PCA in EOLC is constructed within specific socio-cultural contexts and the implications of these contexts on resultant care. Focusing on England and Japan, we conducted a critical policy analysis to examine and compare key policy and legal documents released between 2000 and 2019 in these two post-industrial and socio-culturally distinctive countries. RESULTS: Our analysis found that the PCA is mobilised in policy discourses primarily through three interconnected dimensions: individual, relational and existential. While acknowledging that both countries have developed varied policy and legal mechanisms to emphasise holistic and integrated care with respect to these three dimensions, we also identified significant gaps in the pol icies both within and between England and Japan. They include ambiguity in defining patients' best interests, fragmented support for social and family care and the neglect of existential needs. CONCLUSIONS: This cross-cultural analysis has revealed the complex nature of discourses around PCA in English and Japanese EOLC policies, which often concentrate on the multifaceted aspects of experiences as one approaches the end of life. Despite this, we argue that a more holistic construction of PCA is needed in EOLC policies not only in England and Japan but also more broadly, to encapsulate the richness of end-of-life experiences.

Identifying actual and perceived motor competence based profiles among children.

This study aimed to develop motor competence (MC) profiles in children based on their actual and perceived MC, and to investigate differences in physical activity (PA) behaviour and motivation towards PA between profiles. Two hundred and sixteen British children (7-10 years) took part in this study. Perceived motor competence (PMC) was assessed using the pictorial scale of movement competence. MC was assessed using process-oriented and product-oriented measures. A validated questionnaire assessed motivation towards PA and an objective measure of PA was employed. K-means cluster analysis was used to create profiles. Differences in PA and motivation towards PA were examined using ANCOVAs. Four groups of divergent and convergent levels were identified based on the contribution of either product or process MC with PMC. Motivation towards PA differed by profiles that included actual-process and PMC. Children with high actual process and high PMC had significantly higher levels of autonomous motivation than children with high actual process but low PMC. No significant differences were found between PA levels and profiles. Developing the quality and execution of actual motor competence (AMC) and PMC is key to stimulate motivation towards PA. Furthermore, maintaining AMC and PMC simultaneously may be imperative to children's future PA behaviour.

How technology-enhanced experiential e-learning can facilitate the development of person-centred communication skills online for health-care students: a qualitative study.

BACKGROUND: The COVID-19 pandemic brought a new challenge to medical education-health-care students had fewer opportunities to interact with and treat real patients in clinical settings. Interpersonal communication skills are often developed through human interaction and communication in person, and few studies have proposed feasible digital solutions to develop learners' communication skills. Consequently, understanding how medical teachers facilitate and implement online training programmes, with feasible instruments, to enhance students' learning effectiveness when in-person training is not possible is critical. METHODS: By using a convenience sampling method, we recruited 26 health-care students from seven medical schools in Taiwan. Through semistructured interviews and the thematic analysis technique, we analysed the latent learning factors from the experience of implementing the technology-enhanced experiential e-learning tool 'mPath'. RESULTS: Three themes were generated: A) transferring theory into practice, B) increasing authenticity with analytical features, and C) maintaining autonomy with nondirective learning. The features accessibility, flexibility, intractability, and visualisation with the characteristics of remote accessibility and flexibility, repetition and retrospect, feedback requesting, and visualised analytical reports were considered to enhance learning outcomes. CONCLUSION: This study indicated how online training using technology could develop the participants' person-centred communication skills and what features influenced the learning outcomes of social distancing. mPath may be a feasible online learning approach and has provided inspiration for developing health-care students' communication skills when in-person training is not possible.

Dental hygienists' biopsychosocial beliefs and giving autonomy support in treatment of patients: A self-determination theory perspective.

OBJECTIVES: Self-determination theory posits that managers' autonomy-supportive behaviour and employees' autonomy causality orientation are motivation constructs to explain internalization of values, functioning and wellness at work. Hypothesis 1 tested whether profiles comprising perceived dental clinic managers' autonomy-supportive, as opposed to their controlling interpersonal style, and dental hygienists' autonomy, as opposed to their control and impersonal, causality orientations at baseline, would be positively related to dental hygienists' biopsychosocial (BPS) beliefs and giving autonomy support in treatment of patients after 18 months. Hypothesis 2 tested whether dental hygienists' BPS beliefs in treatment of patients will be positively associated with their autonomy-supportive behaviour given to patients after 18 months. MATERIAL AND METHODS: A prospective cohort design with 299 (Mage  = 42.71; SDage  = 12.62) dental hygienists completed an online survey at baseline and after 18 months. RESULTS: Latent profile and correlational analyses supported the hypotheses. Effect sizes were moderate to large. CONCLUSIONS: Both perceived managerial styles and dental hygienists' causality orientations are important for dental hygienists' BPS beliefs and autonomy-supportive behaviours when working with dental patients.

COVID-19 fear, stress, sleep quality and coping activities during lockdown, and personality traits: A person-centered approach analysis.

COVID-19 has impacted the world on a psychological level. With cases continuing to rise, understanding mental health and vulnerability factors are vital for researchers and mental health professionals to address. This study examines personality factors-using a person-centered approach compared to the majority of studies that use a variable-centered approach-to investigate the psychological impacts of COVID-19 on people's fear, stress, sleep quality and activities during lockdown. The study, conducted among a Bangladeshi sample from April 17 to 20, 2020, contained n = 521 participants. Latent profile analysis identified three personality profiles - maladaptive, adaptive, and highly adaptive. Results indicated that participants with a highly adaptive personality profile exhibited lower COVID-19 fear and perceived stress as well as better sleep quality compared to the other personality profiles. Our findings yield support for person-centered approaches to personality in relation to COVID-19 experiences, which can be beneficial for researchers and mental health professionals alike in understanding these psychological interworkings.

Exploring identity and personal meanings in psychosis using the repertory grid technique: A systematic review.

Current research and clinical practice in person-centred approaches highlight the importance of self, identity, and personal meanings in psychosis. Previous research has focused on dimensions of self, but less attention has been paid to the personal meanings involved in identity. The personal construct theory framework and the repertory grid technique (RGT) allow the study of identity and personal meanings within person-centred approaches of psychopathology and treatment in psychosis, as suggested by studies that began more than 40 years ago. However, their contributions have not yet been reviewed. We aimed to systematically review the evidence for the role of identity and personal meanings in psychotic disorders. We performed a systematic search using personal construct and RGT terms in PsycINFO, Web of Science, PubMed, EBSCO, Scopus, and Google Scholar. After identifying 2,574 articles, 15 were included. Nine studies followed an idiographic assessment, and six were nomothetic. Patients reported their subjective experience of isolation in terms of high self-ideal discrepancy and high perceived discrepancy with their significant others, which some studies associated with a lower degree of recovery or with the way in which positive symptoms were construed. Self-fragmentation either decreased with interventions or was associated with recovery. Evidence regarding interpersonal construing was less consistent, but there was a tendency for patients to show a more rigid cognitive structure than controls. To conclude, we found some evidence that self-discrepancies, fragmentation of self, and interpersonal construing are affected in psychosis and potentially modifiable through psychotherapy.

The importance of communication in sustaining hope at the end of life.

How can health professionals, especially those working in busy environments, foster hope and communicate effectively and therapeutically with patients at the end of their lives? Many authors agree that failure to comprehend the essence of what patients are communicating, either verbally or non-verbally, can adversely affect the level of support that health professionals can offer, and risks increasing patients' suffering and isolation, leaving them feeling hopeless. Anxiety and fear frequently invoke hopelessness and often cause patients to reject advice and important information given by clinicians. This article focuses on the importance of therapeutic communication in sustaining hope for patients at the end of life.

Multiple social identities and well-being: Insights from a person-centred approach.

Recent research on social identity and identity integration suggests that individuals who have multiple identities and who also successfully integrate them are better adjusted. We combine predictions from these studies and examine how social identification, together with identity integration, are related to psychological well-being using a person-centred approach. A first study (N = 2705) showed that the identity configuration characterized by high levels of identification with organization and gender, as well as the perception that these identities are well integrated, is associated with the highest level of well-being. Conversely, the identity configuration characterized by low scores on gender and organization identifications and low levels of identity integration was associated with the lowest levels of well-being. These findings were replicated in a second study (N = 8987) where organization and age-group identification were analysed. We discuss the implications of these findings for the literatures on multiple social identities, identity integration and organizational climate.

Profiles of well-being and their associations with self-forgiveness, forgiveness of others, and gratitude among patients with rheumatic and musculoskeletal diseases.

OBJECTIVES: Patients with rheumatic and musculoskeletal diseases (RMDs) often experience poor well-being. Common limitations of the studies on this topic involve using variable-centred and deficit-based approaches. In this study, we used the person-centred approach to identify profiles of positive (life satisfaction and health status) and negative (depression, anxiety, fatigue, and stress) indicators of well-being among patients with RMDs. Moreover, we tested self-forgiveness, forgiveness of others, gratitude, and sociodemographics as contributors to latent profile membership. DESIGN: A cross-sectional questionnaire survey. METHODS: Using a latent profile analysis, we investigated well-being profiles among 892 patients with RMDs (759 patients with arthritis and 133 with fibromyalgia [FM]) and examined the correlates of latent profile membership. RESULTS: We identified four profiles of well-being: (1) 'life dissatisfaction' (9.2%), (2) 'high well-being' (43.4%), (3) 'suboptimal well-being' (35.2%), and (4) 'very poor well-being' (12.2%). Members of Profile 2 had higher levels of self-forgiveness and gratitude than members of the remaining profiles, had higher levels of forgiveness of others than Profile 3, and were older than members of Profile 4. Moreover, members of Profile 2 had a higher proportion of patients with arthritis relative to those with FM than all other profiles and men to women than Profile 4. CONCLUSIONS: Patients with RMDs are heterogeneous in terms of well-being. Self-forgiveness, gratitude, and forgiveness of others may serve as psychological capital that enhances patients' well-being. Special attention should be paid to patients with FM, women, and younger patients since they can be especially susceptible to poor well-being.

Assessing understandings and perceptions of HIV cure among peer navigators and treatment officers in Australia.

HIV community peer navigators and treatment officers are important sources of information and guidance for people living with HIV. We conducted an anonymous online survey with members of the treatment outreach network of the Australian National Association of People Living with HIV. The survey explored understandings and acceptance of HIV cure research and was disseminated before and following an interactive workshop on HIV cure. We demonstrated an improvement in understandings of HIV cure science and increased willingness to participate in interventional clinical trials after the workshop. Concerns around interrupting HIV treatment and detrimental impacts on health were identified as barriers to participation. Altruism was a motivator to enrol in HIV cure trials, along with endorsement from a trusted member of community.

Telehealth in long-term neurological conditions: the potential, the challenges and the key recommendations.

Long-term neurological conditions (LTNCs) cause physical and psychological symptoms that have a significant impact on activities of daily living and quality of life. Multidisciplinary teams are effective at providing treatment for people with LTNCs; however, access to such services by people with disabilities can be difficult and as a result, good quality care is not universal. One potential solution is telehealth. This review describes the potential of telehealth to support people with LTNCs, the challenges of designing and implementing these systems, and the key recommendations for those involved in telehealth to facilitate connected services that can benefit patients, carers and healthcare professionals. These recommendations include understanding the problems posed by LTNCs and the needs of the end-user through a person-centred approach. We discuss how to work collaboratively and use shared learning, and consider how to effectively evaluate the intervention at every stage of the development process.

Prosocial behaviours under collective quarantine conditions. A latent class analysis study during the 2020 COVID-19 lockdown in Italy.

We aimed to identify the patterns of prosocial behaviours under collective quarantine conditions. Survey data were collected from a sample of Italian adults during the March May 2020 COVID-19 lockdown in Italy. Participants reported on offline and online prosocial behaviours, sense of community responsibility (SoC-R) and perceptions of community resilience. Latent class analysis (LCA) was used for data analysis. A total of 4,045 participants completed the survey, and 2,562 were eligible (72% female; mean age 38.7 years). LCA revealed four classes of prosocial behaviours: Money donors (7%), Online and offline helpers (59%), Online health information sharers (21%) and Neighbour helpers (13%). The classes were partially invariant across age groups (18-35 and 35-65 years). Being a man, having achieved a higher educational level and higher SoC-R scores were associated with belonging to the Online and offline helper class. The members of this class also reported the greatest perceptions of community resilience. The results provide insight on the multidimensionality of prosociality under collective quarantine conditions. Online and offline helpers could be targeted for promoting sustained altruism and involvement in community organisations. For the other groups, programmes should aim at eliminating barriers to help others in multiple ways. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

The application, character, and effectiveness of person-centred care with service-users, and the community within the discipline of podiatry: a scoping review.

BACKGROUND: The concept of person-centred care is embedded within healthcare policy, focusing on long-term conditions and multimorbidity. The evidence that person-centred care is being operationalised effectively across all areas of healthcare is limited. The aim of this scoping review was to explore the application, features, and effectiveness of person-centred care with service-users, carers, and the community within podiatry. METHODS: The scoping review was based upon Arksey and Malley's five stage framework. The following databases were searched between January 2010 and March 2021: AMED, CINAHL, Embase, Cochrane library, SocINDEX, British Education Index, Business Source Complete, MEDLINE (EBSCO), and the EThOS 'Global electronic thesis and dissertation' repository, Prospero, and reference lists of included papers. Primary research articles were included if they reported on a person-centred care focused intervention with podiatry. Research terms were developed, appropriate databases identified, and an initial search resulted in 622 papers which, following removal of duplicates and critical appraisal, resulted in 18 eligible papers. Data extracted involved the types of person-centred care utilised, intervention details, motivations for engaging in person-centred care interventions, and intervention barriers and challenges. RESULTS: Eighteen articles were included in the review. The main type of person-centred care utilised was patient/carer activities around self-management. None of the studies considered the role of the podiatrist as a person-centred care agent. The data on interventions generated the following themes 'service facilitated person-centred care' where a change has been made to service delivery, 'direct clinician delivery' where the intervention is delivered by the clinician with the patient present and 'patient instigated participation' where patient motivation is required to engage with an activity beyond the consultation. Outcome measures associated with quality of care and effectiveness were absent. CONCLUSION: There is a lack of congruency between the concept of person-centred care and how it is operationalised. A whole system approach that considers commissioning, organisational leadership, the role of the practitioners and patients has not been considered. There is immense scope for the podiatrist to play an important part in the personalised-care agenda, but currently research that can evidence the effectiveness of person-centred care in podiatry is absent. REVIEW REGISTRATION: Open Science Framework ( osf.io/egjsd ).