The Effects of Social and Physical Functioning and Self-Management Abilities on Well-Being Among Patients with Cardiovascular Diseases,Chronic Obstructive Pulmonary Disease,and Diabetes

To increase our understanding of relationships between well-being and social/physical functioning and self-management abilities (SMAs) among chronically ill patients. The cross-sectional questionnaire-based study included 1,254 patients with cardiovascular diseases, 725 with chronic obstructive pulmonary disease, and 253 with diabetes (total, 2232/4200; 53 % response rate). Social and physical functioning correlated significantly with SMAs and well-being (all p?≤?0.001). After controlling for background characteristics, multiple regression showed that social and physical functioning were still related to SMAs (β?=?0.32–0.12; both p?≤?0.001) and well-being (β?=?0.39–0.14; both p?≤?0.001). The strengths of relationships between well-being and social (β?=?0.39 vs. 0.20) and physical (β?=?0.14 vs. 0.07) functioning declined significantly (both p?≤?0.001) when the SMA mediator was included in the equation. SMAs of chronically ill are related to their social and physical functioning. We found indications that chronically ill patients reporting lower levels of social and physical functioning are worse self-managers than are those with higher levels of functioning. Furthermore, SMAs may mediate the relationships between social and physical functioning and well-being. Self-management interventions aiming to enhance SMAs more broadly than traditional interventions aiming only to prevent functional decline are expected to improve SMAs and enhance well-being among chronically ill patients.     

Interpreting elliptical verb phrases

Elliptical verb phrases are anaphoric expressions whose correct interpretation depends on the exact form of the preceding text as well as its meaning. However, people are not very good at remembering surface details of what they read or hear, so how do they understand such expressions? One alternative to a linguistically based interpretation of elliptical verb phrases is to assign them meanings that are plausible, given general knowledge about the situation being described. In an experiment, subjects read passages in which context provided a plausible interpretation for an elliptical verb phrase that either was or was not at odds with the linguistically correct interpretation. There was a tendency for subjects to assign plausible, but incorrect, meanings to elliptical verb phrases. This tendency increased with the distance between the elliptical verb phrase and its antecedent. Incorrect interpretations were assigned slowly, and the speed of assignment increased with distance from the antecedent. These results suggest that people try to interpret elliptical verb phrases correctly, but that they are not always able to do so. Furthermore, they indicate that the intuition that elliptical verb phrases are easy to interpret is misleading. If text is to be comprehensible, speakers and writers must use such expressions with care.     

Behaviour therapy: Criticisms and confusions

An attempt will be made in this paper to show that the two most frequent criticisms of behaviour therapy are based on confusions. These confusions, it will be shown, are not solely the responsibility of the critics. The behaviour therapists themselves, in their writings, are partly responsible for the confusions.     

A longitudinal evaluation of a social support model of medication adherence among HIV-positive men and women on antiretroviral therapy.

Nonadherence in the management of chronic illness is a pervasive clinical challenge. Although researchers have identified multiple correlates of adherence, the field remains relatively atheoretical. The authors propose a cognitive-affective model of medication adherence based on social support theory and research. Structural equation modeling of longitudinal survey data from 136 mainly African American and Puerto Rican men and women with HIV/AIDS provided preliminary support for a modified model. Specifically, baseline data indicated social support was associated with less negative affect and greater spirituality, which, in turn, were associated with self-efficacy to adhere. Self-efficacy to adhere at baseline predicted self-reported adherence at 3 months, which predicted chart-extracted viral load at 6 months. The findings have relevance for theory building, intervention development, and clinical practice.