Optimising daily diary questionnaires about fatigue,psychological flexibility and well-being: perspectives of people with rheumatic disease

Objectives: The aim of this study was to understand the perspectives of people with rheumatic disease have about completing a pilot daily diary questionnaire on fatigue and well-being, with the objective of incorporating these perspectives into future daily studies.

Methods: Twenty-two participants with experience of rheumatic disease-related fatigue attended a focus group and/or an individual interview. Before the focus group or interview, participants completed a one-off quantitative diary about their fatigue and well-being that day. In the focus groups and interviews, participants were asked about their experience completing the questionnaire. Data were analysed using inductive thematic analysis.

Results: Three themes were identified. ‘Concerns about Misinterpretation and Ambiguity’ addressed the elements of the diary questionnaire that were confusing or unclear to participants. ‘Desire to Provide Useful and Accurate Information’ outlined participants’ uncertainty about how to report complex daily experiences. ‘Gaining Personal Insight through Diaries’ revealed the personal benefits participants gained, particularly the development of insight into their fatigue.

Conclusions: People with rheumatic disease are willing to complete a daily diary questionnaire, but emphasise it is important for diary questionnaires to have clear instructions, questionnaire items and response scales. Addressing these concerns will ensure the reliability and validity of quantitative diary data.     

Projective invariance and picture perception

Four experiments test the assumption that, in the visual perception of pictures, observers have reliable and direct access to the equivalence of shapes in projective geometry. The assumption is that perception of projective equivalence is the basis of shape constancy ('the projective thesis'). Observers matched or reproduced abstract planar shapes under conditions of rotation in the picture plane, and pictured rotation in depth. Departure from projective equivalence was assessed in each study by measuring the planar analogue of cross ratio. Projective equivalence was not found to be perceived uniformly where Euclidean equivalence was not judged uniformly, either in recognition tasks or in production tasks. When the projective thesis is put to a suitably general test, confidence in the thesis is undermined.     

Non-Accidental Knowing

Knowledge excludes luck. According to the received view, this intuition reveals that knowing is essentially modal in character. This paper demurs. Either knowledge does not exclude luck, or the entailment reveals nothing about its conceptual character. It is argued that knowledge excludes accidentality, and that this notion is not modal but causal-explanatory. There are three central tasks. The first is to explicate the concept of accident. The second is to argue that the concepts of luck and accident are “intensionally distinct,” which is to say that no member of the intension of either holds on both. The third is to argue that an anti-accident requirement on knowledge is preferable to an anti-luck analogue on abductive grounds.     

Is avoidance of illness uncertainty associated with distress during oncology treatment? A daily diary study

Objective: The aim of this study was to explore the daily relationship between illness uncertainty, avoidance of uncertainty, well-being and treatment-related distress among patients with cancer receiving treatment with curative intent. It was hypothesised that daily illness uncertainty, daily avoidance of uncertainty and daily treatment-related distress would be negatively associated with daily well-being. It was also hypothesised that daily illness uncertainty and daily avoidance of uncertainty would be positively associated with daily treatment-related distress.

Design: Thirty-one patients receiving oncology treatment with curative intent completed a daily diary for seven consecutive days. Data were analysed using multilevel modelling.

Main outcome measures: Daily illness uncertainty, avoidance of illness uncertainty, treatment-related distress and well-being.

Results: As hypothesised, on days when patients with cancer reported heightened treatment-related distress they experienced diminished well-being. And on days when patients reported more experiential avoidance of illness uncertainty, they also experienced heightened levels of treatment-related distress. No other daily associations were significant.

Conclusion: These findings indicate that patients with cancer experience day-to-day fluctuations in distress and well-being throughout oncology treatment. Avoidance of illness uncertainty-related thoughts and/or emotions are associated with daily distress, but not daily well-being.