Facilitators and barriers to behavior change in overweight and obesity management using the COM-B model.

Introduction: Increasing overweight and obesity rates represent one of the global public health challenges. COM-B is a theoretical model used to identify areas to target to achieve behavior change. It identifies three factors that are needed for any behavior to occur: capability, opportunity, and motivation. We aimed to assess the potential facilitators and barriers to behavior change in weight management using the COM-B. Methods: The study included 139 people with overweight and obesity (mean age 48.81 ± 14.49 years; 64.5% female; body mass index 32.64 ± 6.51 kg/m2; waist-to-height ratio 0.62 ± 0.10) from primary care settings. All participants completed the Brief Measure of Behavior Change (COM-B), the General Self-Efficacy Scale (GSE), the Rosenberg Self-esteem Scale (RSE), and the Overall Evaluation of Health (OEH). Multiple linear regression was performed to analyse the data. Results: The associations between sociodemographic and clinical variables and COM-B domains attenuated or were no longer significant when psychological resources were added to the regression models. Self-efficacy was identified as a stronger facilitator of health behavior change (p < 0.001) when compared to self-esteem (p < 0.05). No associations between automatic motivation and psychological resources were identified, however. Automatic motivation was found to be associated with higher age, being in a relationship, and better health. Discussion: Behavioral interventions for weight management should specifically target different components of COM-B. Self-efficacy and self-esteem may play a significant role in individual capabilities, opportunities, and reflective motivation and should be included in tailored public health interventions. Health programs targeting younger and single people, and people with chronic conditions may help to promote sustainable behavior change.

Social participation of rheumatoid arthritis patients: Does illness perception play a role?

OBJECTIVE: Social participation is an important aspect associated with health-related outcomes in chronic diseases. However, little is known about the factors that may affect participation in patients with rheumatoid arthritis (RA). We aimed to examine whether pain, fatigue, anxiety, depression, and illness perception are associated with social participation in patients with RA when controlled for clinical and sociodemographic variables. We also analysed the mediating role of illness perception in the association between physical and psychological variables on social participation. METHOD: We included 157 RA patients (84.7% females; mean age 56.4 ± 13.9 years) who completed the Participation Scale, Brief Illness Perception Questionaire, Generalized Anxiety Disorder Scale, Patient Health Questionnaire, 36-item Short Form Health Survey, and the Visual Analogue Scale. Multiple linear regressions and mediation analyses were used to analyze the data. RESULTS: In the final regression models, illness perception (ß = .42; p ≤ .001) and functional disability (ß = .21; p ≤ .05) were associated with social participation. Income (ß = -.18; p ≤ .05) lost its significance when physical variables were added to the model, and pain (ß = .24; p ≤ .05) and fatigue (ß = -.24; p ≤ .05) when psychological distress was added. No significant role of anxiety, depression, disease activity, or age was identified using regression analyses. Illness perception mediated the association of pain, fatigue, anxiety, and depression with social participation, and the indirect effect varied from 65% to 98%. CONCLUSIONS: Illness perceptions may significantly diminish the impacts of pain, fatigue, anxiety, and depression on social participation in individual RA patients. Therefore, RA patients could benefit from psychological interventions aimed at tackling negative illness perceptions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A cross-sectional study of multidimensional fatigue in biologic-treated rheumatoid arthritis: which variables play a role?

PURPOSE: Despite efficient biological disease-modifying antirheumatic drugs (bDMARDs) Rheumatoid Arthritis (RA) patients still suffer from high fatigue. This study aims to further our knowledge by assessing severity levels of the various fatigue dimensions and their associations with pain, sleep quality, and psychological well-being in bDMARDs treated RA patients. MATERIAL AND METHODS: The sample consisted of 146 RA patients (84.9% females; mean age 56.6 ± 13.6 years), who completed the MFI-20, SF-36, PSQI, GAD-7 and PHQ-9. Correlation analyses and multiple linear regressions were used to analyse the data. RESULTS: General fatigue was the highest reported type of fatigue, followed by physical fatigue dimensions. In the final regression model, pain and disability were significantly associated with physical fatigue (p ≤ 0.001, p ≤ 0.05, respectively) and reduced activity (p ≤ 0.01, p ≤ 0.05, respectively). Anxiety was significantly associated with mental fatigue (p ≤ 0.05) and reduced motivation (p ≤ 0.01). Regression analyses showed no significant associations between depression, sleep quality, and fatigue in any of the final models. CONCLUSIONS: Our findings indicate that effectively addressing fatigue in RA patients requires an individualized approach. This approach should acknowledge the varying degrees of fatigue across different fatigue dimensions (physical or mental), while also taking into account the patient's mental health problems, pain levels, and disability levels.

despite the high prevalence of fatigue in rheumatoid arthritis (RA), the patients reported that 79% of healthcare professionals do not assess fatigue during visits; therefore, a measure of fatigue should be a part of routine medical examinationsrehabilitation professionals should evaluate multidimensional fatigue, which seems to be more informative than a single measure of severitydevelopment and use of an effective individual non-pharmacological management program, based on an understanding of the variables associated with multidimensional fatigue may help in improving the quality of life of patients with RA.

Psychological well-being in people with multiple sclerosis and its association with illness perception and self-esteem.

BACKGROUND: Illness perception and self-esteem were found to improve adjustment to disease in many chronic conditions. However, so far, little is known about the role of illness-appraisal and self-appraisal factors in psychological well-being in people with multiple sclerosis (MS). Thus, we aimed to assess the association between illness perception, self-esteem and psychological well-being in people with MS while controlling for sociodemographic variables, clinical variables, and sleep-related problems. METHODS: The General Health Questionnaire-28, the Brief Illness Perception Questionnaire, the Rosenberg Scale of Self-esteem, the Expanded Disability Status Scale, the Pittsburgh Sleep Quality Index, and the Multidimensional Fatigue Inventory were used. Multiple linear regressions and mediation analyses were utilized to analyse the data. RESULTS: Positive illness perception (p<0.001) and self-esteem (p<0.05) were significantly associated with psychological well-being in MS. Low income (p<0.05) and sleep-related problems (p<0.001) were significantly associated with lower level of psychological well-being in people with MS. Positive illness perception and self-esteem were able to diminish the association between low income (p>0.05), poor sleep quality (p<0.01), fatigue (p>0.05), and low level of psychological well-being. Self-esteem also mediated the association between illness perception and psychological well-being. DISCUSSION: People with MS may benefit from psychological support aimed at promoting self-esteem and diminishing negative illness perception.

Self-management, self-esteem and their associations with psychological well-being in people with multiple sclerosis.

BACKGROUND: Optimal self-management seem to be protective factor of health-related quality of life and psychological well-being in many chronic conditions. However, the results in people with multiple sclerosis (MS) are still inconclusive. Thus, the aim of this study is to assess the associations between self-management, self-esteem and psychological well-being in people with MS when controlled for sociodemographic and clinical variables. METHODS: A total of 165 people with MS filled in The Multiple Sclerosis Self-Management Scale, Rosenberg Self-Esteem scale, and General Health Questionnaire-28, to assess main variables under study. Functional status was measured by Kurtzke disability Status Scale. RESULTS: We found significant associations between self-esteem and somatic symptoms, anxiety/insomnia, social dysfunction and severe depression. Explained variance of the models ranged from 16% to 38% for somatic symptoms and severe depression, respectively. Self-management significantly contributed to the explained variance in all models sans GHQ social dysfunction. Self-esteem was significant contributor to overall variance in all models. DISCUSSION: According to our results, self-management and self-esteem were found to be associated with multiple domains of psychological well-being. These findings may be used in neurological practice, to help people with MS who report psychological distress in one or more domains.

Posttraumatic growth after earthquake: A systematic review and meta-analysis.

BACKGROUND: Posttraumatic growth (PTG) represents a positive personal change after adverse events, such as natural disasters, including earthquake. However, the association between exposure to earthquake and level of PTG is still unknown. Thus, the aim of this systematic review and meta-analyses (MA) is to assess the level of PTG in people exposed to earthquake. METHODS: Studies were identified via Scopus, PsycInfo, Web of Science, PubMed, EMBASE, ProQuest, Cochran Library, Ovid, Google Scholar, OpenGrey, congress, and conferences research papers. The level of PTG was presented as mean and standard deviation. Subgroup analyses were conducted to control for the amount of time that had passed since stressor onset and age of the study population. The meta-regression was used to explore the sources of between-study heterogeneity, including sample size and age. RESULTS: The MA of all 21 studies using no restrictions related to age and time of the PTG measurement since traumatic event showed low level of PTG (41.71; 95%CI = 34.26; 49.16, I2: 62.44%, p: .000). Subgroup analyses controlled for the age demonstrated that level of PTG was higher in adults (49.47; 95% CI = 42.35; 56.58, I2: 0%, p = .466) when compared to children and adolescents (35.38; 95% CI = 23.65; 47.11, I2: 69.09%, p < .00). Moreover, the pooled weight mean of PTG measured 1 year and less than 1 year since the earthquake varied between medium (46.04; 95%CI = 34.45; 57.63, I2:51.2%, p: .037) and high (59.03; 95%CI = 41.46; 76.41, I2: 0%, p: .990) levels, respectively. CONCLUSION: The results of our MA showed low level of PTG in earthquake survivors. However, the mean value of PTG in adults was higher when compared to children and adolescents. In addition, the mean PTG was found to decrease over time since traumatic events.

Spirituality as a Mediator Between Depressive Symptoms and Subjective Well-being in Older Adults.

As the population is aging, strategies for helping older people to maintain and promote good health and well-being are needed. This study aims to assess whether depressive symptomatology and spirituality are associated with subjective well-being in older adults when controlled for sociodemographic variables. Furthermore, the mediating role of spirituality in the association between depressive symptomatology and subjective well-being was examined. A total of 250 participants (mean age 75.91 ± 7.60) in this cross-sectional study completed the Daily Spiritual Experience Scale, the Zung's Self-rating Depression Scale, and the Personal Wellbeing Index. Multiple linear regression and mediation analyses were used to analyze the data. Subjective well-being was negatively associated with depressive symptoms and positively associated with spiritual experiences. The indirect effect of depressive symptomatology on subjective well-being via spirituality was 28.7%. The enhancement of spirituality seems to represent one of the relevant interventional strategies in prevention and treatment of depressive symptoms and well-being improvement.

Sexual functioning in patients with multiple sclerosis and its association with social support and self-esteem.

Sexual dysfunction is very commonly reported by people with multiple sclerosis (MS). However, this problem often remains under-diagnosed and under-treated. Furthermore, still very little is known about protective psychosocial factors that may help to improve sexual functioning in MS patients. Thus, we aimed to assess the associations between social support, self-esteem and sexual functioning in MS patients when controlled for clinical and sociodemographic variables. The Expanded Disability Status Scale (EDSS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Rosenberg Scale of Self-esteem (RSE) were used to assess the independent variables. Sexual functioning was assessed by the Incapacity Status Scale (ISS). We found a significant association between social support and sexual functioning (p = 0.01). However, this association attenuated (p < 0.05) when self-esteem (p < 0.01) was added to the model. Furthermore, we found that sexual dysfunction in MS patients was associated with older age (p < 0.001). Self-esteem was associated with sexual functioning more strongly compared to social support and sexual functioning, even though both of these variables were associated with sexual functioning as well. Our findings support the biopsychosocial model of treatment of sexual dysfunction in MS patients.

Fatigue and Suicidal Ideation in People With Multiple Sclerosis: The Role of Social Support.

Fatigue and poor sleep quality are among the most common patient-reported problems associated with multiple sclerosis (MS). Social support, on the other hand, is often found to be positively associated with quality of life in patients with neurological diseases. Studies also show that suicidal ideation (SI) levels in MS are elevated compared to the general population. Thus, the aim of this study is to assess the associations between fatigue, social support, and SI in patients with MS. Out of 184 MS patients asked to participate in this cross-sectional study, 156 agreed (RR 69.8%; 75% female; mean age: 39.95 ± 9.97 years). Patients filled-in the Multidimensional Fatigue Inventory-20, the Pittsburgh Sleep Quality Index, the Multidimensional Scale of Perceived Social Support and the subscale of the General Health Questionnaire-28 focused on assessing SI. Models were controlled for age, gender, disease duration, functional disability, and sleep quality. Data were analyzed using multiple linear regressions. SI was positively associated with lower sleep quality and four types of fatigue: general, mental, reduced activity, and reduced motivation (p < 0.05). Physical fatigue was not significantly associated with SI. Social support was negatively associated with SI in all models. The final models under study explained from 24.3 to 29.7% of the total variance in SI. SI yielded associations with both sleep quality and fatigue, with the exception of physical fatigue. Information provided by physicians on sleep management, and a psychosocial intervention focused on people who provide support for patients with MS (family, friends, and significant others) may reduce levels of SI.

Psychological distress in patients with obstructive sleep apnoea: The role of hostility and coping self-efficacy.

We aimed to assess whether hostility and coping self-efficacy are associated with psychological distress in obstructive sleep apnoea patients. Furthermore, we examined whether coping self-efficacy mediates the association between hostility and psychological distress. We included 150 obstructive sleep apnoea patients (Apnoea-Hypopnoea Index ⩾5; 68% male; mean age: 48.9 ± 9.5 years). Regression models showed that hostility and poor coping self-efficacy were strongly associated with psychological distress in obstructive sleep apnoea patients. All assessed coping self-efficacy dimensions mediated the association between hostility and psychological distress. Coping self-efficacy for stopping unpleasant emotions and thoughts showed the strongest association with a lower level of psychological distress.

Suicidal ideation in patients with obstructive sleep apnoea and its relationship with disease severity, sleep-related problems and social support.

We aimed to assess the prevalence of suicidal ideation and to examine the relationships between obstructive sleep apnoea severity, sleep-related problems, social support and suicidal ideation in obstructive sleep apnoea patients. We included 149 patients (68% male; mean age, 48.99 ± 9.57 years) with diagnosed obstructive sleep apnoea (Apnoea-Hypopnoea Index ⩾5) based on full-night polysomnography. The prevalence of suicidal ideation among obstructive sleep apnoea patients was 20.1 per cent. Structural equation modelling showed that suicidal ideation in obstructive sleep apnoea was strongly related to poor sleep quality and high fatigue levels. No relationship between social support and suicidal ideation in obstructive sleep apnoea patients was found.

Quality of life of obstructive sleep apnoea patients receiving continuous positive airway pressure treatment: A systematic review and meta-analysis.

BACKGROUND: Previous studies have shown conflicting results on the effect of continuous positive airway pressure (CPAP) on quality of life (QoL) in obstructive sleep apnoea (OSA) patients. OBJECTIVES: To evaluate the effect of CPAP on QoL in OSA patients compared to sham CPAP, placebo pills, and conservative treatment. METHODS: Studies were identified via Web of Knowledge, PubMed, PsychInfo, CINAHL, EMBASE, OpenGrey, and the Cochrane Library. Subgroup analyses and sensitivity analyses were conducted to assess the robustness of the findings. RESULTS: Meta-analysis of 13 randomised controlled trials showed no significant differences in overall and psychological QoL comparing values of CPAP treated patients with controls; however, physical QoL improved. CPAP significantly affected the overall QoL in studies with controls receiving sham CPAP, parallel design, low risk of bias, and mild OSA patients. CONCLUSION: CPAP treatment may help to improve physical symptoms of OSA, whereas impaired psychological QoL still cannot be alleviated.

Are disease severity, sleep-related problems, and anxiety associated with work functioning in patients with obstructive sleep apnoea?

Purpose: To examine whether Obstructive Sleep Apnoea severity, sleep-related problems, and anxiety are associated with work functioning in Obstructive Sleep Apnoea patients, when controlled for age, gender and type of occupation. To investigate whether anxiety moderates the associations between sleep-related problems and work functioning. Materials and methods: We included 105 Obstructive Sleep Apnoea patients (70% male; mean age 46.62 ± 9.79 years). All patients completed the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Beck Anxiety Inventory, and the Work Role Functioning Questionnaire-2.0. Results: Obstructive Sleep Apnoea-severity, poor nighttime sleep quality, and anxiety were univariately associated with impaired work functioning. Multivariate analyzes revealed that poor perceived sleep quality was more strongly associated with work functioning than sleep efficiency and daily disturbances. Anxiety was strongly associated with impaired work functioning. After adding anxiety, the explained variance in work functioning increased from 20% to 25%. Anxiety moderated the association between low and medium levels of nighttime sleep quality problems and work functioning. Conclusions: Poor perceived sleep quality and anxiety were strongly associated with impaired work functioning in Obstructive Sleep Apnoea patients. These findings may help to optimize management, standard treatment, and work functioning in people with Obstructive Sleep Apnoea when confirmed in longitudinal studies. Implications for Rehabilitation Studies show an impairment of functional status, including work functioning, in obstructive sleep apnea patients. Aside from physical disorders, obstructive sleep apnea patients often experience mental problems, such as anxiety. As many people with obstructive sleep apnea are undiagnosed, our results demonstrate to employers and healthcare professionals the need to encourage patients for obstructive sleep apnea screening, especially in the situation of impaired work functioning, increased anxiety, and poor sleep quality. The associations between obstructive sleep apnea, sleep and anxiety might increase the awareness of health professionals towards optimizing diagnostic accuracy and standard treatment.

Social support, mastery, sleep-related problems and their association with functional status in untreated obstructive sleep apnoea patients.

BACKGROUND: Social support and mastery are important aspects in the treatment of chronic diseases, however their role in connection with Obstructive Sleep Apnoea (OSA) remains unclear. OBJECTIVES: The study examined the associations between social support, mastery, sleep-related problems and functional status in untreated OSA patients. METHODS: All patients in this cross-sectional study completed the Multidimensional Scale of Perceived Social Support, the Pearlin Mastery Scale, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale and the Functional Outcomes of Sleep Questionnaire. Multiple linear regression and mediation analyses were used to analyse the data. RESULTS: Participants were 150 newly diagnosed OSA patients (Apnoea-Hypopnoea Index-AHI≥5; 68% male; mean age 48.9 ± 9.5years). Compared with social support, mastery was more strongly associated with functional status. The indirect effects of sleep-related problems on functional status via mastery varied between 17.7% and 23.3%. CONCLUSIONS: Supporting OSA patients' sense of mastery may significantly contribute to better disease management.