Illness perceptions and self efficacy beliefs in adolescents and young adults with insulin dependent diabetes mellitus

Abstract

The study examined the role of illness perceptions and self-efficacy in diabetic regimen adherence and metabolic control among young patients with Insulin Dependent Diabetes Mellitus (IDDM). Sixty-four outpatients with Insulin Dependent Diabetes completed measures of illness perceptions, generalised and diabetes specific self-efficacy and a self-report measure of adherence. Metabolic control (HbAlc) was also assessed. Control, identity and consequences components of illness perceptions were significantly correlated with self-efficacy expectancies. Control beliefs were consistently associated with self-reported adherence across all treatment aspects and accounted for 39% of the predicted variance in total adherence. The associations of the other psychological predictors examined, varied depending on the regimen area. Multiple regression analysis showed that 30.8% of the variance in HbAlc assays was explained by patients' diabetes specific self-efficacy, consequences and identity. Our findings suggest that patients' beliefs are useful predictors of physiological and behavioural outcomes in diabetes self-management and should thus be the focus of routine clinical assessments and future interventions.     

Acceptance,well-being and goals in adolescents with chronic illness: a daily process analysis

Objective: The main aim of this study was to investigate the relationship between acceptance and well-being in adolescents with chronic illness from a daily process perspective. Furthermore, we explored the role of daily experienced interference and facilitation of life goals by treatment goals as mediating mechanisms.

Methods: Thirty-eight adolescents with cystic fibrosis (CF) or diabetes completed questionnaires assessing acceptance, negative life events and goal-related self-efficacy. Furthermore, an online diary assessing daily mood, daily experienced interference and facilitation of life goals by treatment goals was completed during three consecutive weeks.

Results: Acceptance of illness was positively related to daily well-being, but unrelated to daily goal interference and facilitation. Furthermore, daily goal interference and facilitation were unrelated to same-day and next-day well-being.

Conclusion: This study suggests that acceptance of illness plays an important role in the daily mood of adolescents with CF and diabetes. This relationship, however, was not mediated by daily experienced interference and facilitation of life goals by treatment goals. Further research is needed to determine whether interventions promoting acceptance are beneficial for adolescents with CF and diabetes.     

A Reply to the Commentaries of Drs DiBenedetto and Pakenham

This commentary addresses some of the cogent responses offered by Drs. DiBenedetto and Pakenham and the idea of an alternative approach to addressing the self‐care needs of our profession.     

Religious belief,age, and sexual orientation on attributions of younger and older gay and heterosexual men

Using 4 vignettes and 20 response items, this exploratory study investigated attributions about older or younger gay or heterosexual men with a history of multiple sex partners, substance abuse, and legal problems. The character is diagnosed with a terminal illness and two options for care: no treatment or an aggressive treatment protocol with a small chance of recovery. When controlling for respondents’ (N?=?324) religious identification, frequency of attendance at religious services, and ethno-cultural identification, a General Linear Model was significant (F?=?57.014, df?=?20, p?<?.001). Differences in the vignette responses centred on perceptions of quality of life, the character's lifestyle, and suicide.     

Psychotherapy and its alternatives: Commentary on a critique

In this commentary, Michael Rustin reviews the articles in the symposium, outlining their main aims and arguments. He goes on to provide some critical reflections, asking questions about the key concept of the ‘therapeutic state’. He notes that little attention is given to psychoanalytic or other psychological theories of the mind, as distinct from the biological models which are the main object of criticism in the symposium. He argues that just as it is justifiable and useful to take account of theories of the mind in considering issues of mental health and therapy, so it is desirable also to take account of the structures of society which have responsibility for generating conditions of mental well- or ill-being, and to reflect on how these may be changed. The commentary argues that the counter-cultural and somewhat ‘post-modern’ critical approach which informs the symposium can only form part of a sufficient response to the problems which the symposium identifies.     

Futility in Chronic Anorexia Nervosa: A Concept Whose Time Has Not Yet Come

Comparatively little scholarly attention has been given to the question of futility in chronic psychiatric disorders, with the exception of a small body of work on so-called end-stage anorexia nervosa (AN). A review of this literature provides the background for a critical examination of whether the concept of futility has any clinically meaningful, ethically justifiable, and legally defensible application to AN. In this article, the arguments for and against futility judgments in AN are analyzed with special emphasis on determinations of capacity in this serious mental illness. Parallels between the futility disputes in medical and psychiatric disorders, where applicable, will be drawn to further illuminate whether or not the concept that continued psychiatric treatment for AN is ever truly futile.     

Consumer Perspectives of Participation in Vocational Programs by Individuals With Serious Mental Illness: Two Phenomenological Studies

Engagement in worker roles presents significant challenges for individuals with serious mental illnesses. Evolution of vocational rehabilitation programs has yielded evidence-based support for supported employment models. This research presents a phenomenological study of consumer viewpoints concerning participation in earlier vocational rehabilitation programs, followed by a study of supported employment participation perspectives. Initial study themes of Chaos: Living with Disruptions, Mixed Blessings: Vocational Rehabilitation Program, Feelings of Discrepancy, and Searching for Order were reinforced by follow-up study themes of Positive Feelings of Worker Satisfaction and Managing Self/Illness. Consumers identified success in employment outcomes, if able to balance illness and work demands.     

老年肺栓塞临床诊治进展

急性肺栓塞在老年患者中属于高发疾病,并可能严重危及生命,其危险因素、临床表现常因基础疾病的掩盖而造成误诊或漏诊。当患者出现特异性较高的易患因素及晕厥表现,应高度警惕肺栓塞的发生,并根据临床具体条件确定诊查策略,选择合适的诊断手段,尽早确定或排除诊断。抗凝治疗仍是所有肺栓塞患者的基本治疗方法,当血流动力学不稳定时,可以考虑启动溶栓治疗。老年肺栓塞的治疗更强调个体化施治以最大限度地提高治疗收益,降低治疗风险。