Patient engagement, quality of life and chronic pain: A cross-sectional study on endometriosis
Endometriosis is a chronic condition affecting approximately 1 in 10 women of childbearing age, significantly impacting their daily lives, mental health, and quality of life. This study explores the relationship between chronic pain, patient engagement, and quality of life among women with endometriosis. Utilizing a sample of 354 women the study employed the WHOQOL-BREF, Patient Health Engagement Scale, and Numerical Pain Rating Scale to measure QoL, engagement, and pain intensity, respectively. Results indicated significant correlations between chronic pain and reduced QoL, as well as between higher patient engagement and improved QoL. Structural equation modeling revealed that patient engagement partially mediates the negative impact of chronic pain on QoL, suggesting that active involvement in health management can mitigate some adverse effects of chronic pain. These findings underscore the importance of patient engagement in enhancing QoL and managing endometriosis, highlighting the need for tailored interventions to foster proactive health management among affected women.
Health anxiety and related factors among the rural population: A cross-sectional study in China
This study investigated the prevalence and correlates of health anxiety among rural populations in China, due to the unique socio-economic challenges in these areas, such as limited healthcare access. A sample of rural residents ( = 909) was analyzed to identify key predictors of health anxiety, such as age, education level, living type, anxiety sensitivity, and perceived information overload. Results indicated that older individuals and those with lower educational levels exhibited significantly higher levels of health anxiety. Furthermore, living alone was associated with increased health anxiety, while anxiety sensitivity and perceived information overload were found to exacerbate anxiety levels. These findings highlight the critical need for tailored interventions aimed at mitigating health anxiety in rural areas, thereby contributing to improved mental health outcomes and overall well-being.
Exploring social, cultural and environmental factors that influence attitudes to exercise among people with Parkinson's disease: A qualitative study
Exercise is recommended for people with Parkinson's (PwP) but clinical exercise-based interventions are generally ineffective. Social, cultural and environmental factors can influence exercise behaviours, but these topics are under-researched. We interviewed 18 PwP using a narrative approach to identify factors influencing their exercise behaviours throughout their lives. Thematic analysis identified three themes: (1) Why I exercise, (2) What helps and (3) Exercise with Parkinson's. Participants had consistent core motivations to exercise: mood and well-being, body image, competition, and camaraderie. Having active partners, supportive work, and varied exercise options were among the important facilitators of long-term exercise. Participants believed strongly in the benefits of exercise for Parkinson's, but experienced guilt about not exercising enough and frustration when symptoms made it harder to continue. This study illustrates how narrative interviews can reveal important social, cultural and environmental influences on exercise behaviour, offering potential to develop more individualised and effective exercise interventions.
Understanding the public's decision-making about seasonal flu vaccination during a pandemic: Application of the precaution adoption process model
Understanding the behavioural factors influencing flu vaccination is crucial for mitigating seasonal infection outbreaks. This study utilised the Precaution Adoption Process Model (PAPM) to examine the public's decision-making about seasonal flu vaccination through an online cross-sectional survey with 2004 participants in England, UK. Results showed varying stages of decision-making: 7% in Stage 2 (unengaged), 10% in Stage 3 (undecided), 7% in Stage 4 (decided not to vaccinate), 39% in Stage 5 (decided to vaccinate) and 38% in Stage 6 (vaccinated). Regression modelling revealed factors common across stages and unique to certain stages, such as flu vaccination history distinguishing those who received the vaccine. Vaccine knowledge (Stage 2), perceived benefits (Stage 4), perceived control and fear of needles (Stage 5) were uniquely associated with specific PAPM stages. The study discusses policy implications for integrating these findings to improve flu vaccination uptake, highlighting the importance of tailored strategies based on decision-making stages.
'It's that camaraderie': Experiences of a Long-COVID peer support group for staff working in health, social care and emergency services
Health, social care and emergency services staff, continue to feel the impact of Long-COVID. Using quantitative and qualitative methods, this study aims to evaluate the experience of UK health and social care staff who participated in a virtual Long-COVID peer support group between May 2021 and May 2023. The outcome measures (SWEMWBS and PHQ9) show an improvement in post-group scores, suggesting participation in the peer support group is linked to improved wellbeing. Thematic analysis identified five key themes: . This evaluation shows how peer support groups provided space for reciprocity and the positive outcomes associated with this. This evaluation highlights the importance of co-produced, needs-based services providing Long-COVID peer support.
Personality and social determinants of health predict adolescent comfort and honesty reporting sports-related concussion symptoms
Proper diagnosis is essential in mitigating risk associated with sports-related concussion (SRC); however, 50% of SRCs remain undiagnosed due to unreported symptoms. The current study aimed to identify the clinically-relevant, attainable personality and social determinants of health variables that are associated with honesty and comfortability reporting symptoms in 317 adolescents ( = 17.8, SD = 0.97, female = 55.0%, white racial identity = 81.4%). Three variables emerged as significantly associated with symptom disclosure outcomes. Openness to experience was positively associated with comfort and honesty in symptom disclosure, while impulsivity and pressure to continue playing were negatively associated with these outcomes. Importantly, increased pressure to continue playing was the most salient factor associated with symptom disclosure. These results underscore the importance of considering these specific variables when tailoring SRC intervention and prevention efforts at the individual, environmental, and systemic levels.
"I am the mother of the kind of child you dread having": Experiences of living with chronic sorrow among parents with a disabled child
Chronic sorrow involves parents' enduring grief due to their child's disability. This stems not only from the recurring painful reality parents face, which differs from the life they had hoped for their children, families, and themselves but from also being confronted with societal and personal norms and expectations they cannot meet. There is a lack of research on the lived experiences of parents' chronic sorrow. An Interpretative Phenomenological Analysis (IPA) study involving six parents with severely disabled children explored what it is like for parents to confront being "different." Besides sorrow, the parents experienced intense ambiguity, guilt, and uncertainty while navigating societal expectations and their own perceptions of their children. Their ideas of parenthood and their self-identity as parents proved central to their strategies. This study provides insight into the intricacies of this particular aspect of chronic sorrow in parents, with relevance for research and practice.
The roles of self-compassion and social support on the maternal adjustment to a child's hip dysplasia
Parenthood can be challenging when facing a child's chronic illness such as developmental dysplasia of the hip (DDH). Although social support is known as a protective factor for the caregiver's mental health, the role of self-compassion is less explored. This study, conducted in Portugal, explored whether self-compassion and social support mediate the relationship between mothers' psychological adjustment and perception of their child's illness. Ninety-four mothers of children with DDH completed questionnaires on illness perception, self-compassion, perceived social support, and psychological distress. Results suggested that self-compassion and social support mediated the relationship between mothers' overall negative perception of the children's illness and psychological distress. The final model accounted for 50% of the variance of depressive symptoms, 40% of anxiety, and 63% of perceived stress. This study highlights the potential value of encouraging mothers to seek social support when facing their child's DDH diagnosis. Promoting self-compassion may be important in clinical intervention.
Psychological factors in diabetes-related foot complications: A cohort study
Living with diabetes has been linked with an increased prevalence of psychological distress. Psychological problems may interfere diabetes-related foot complication (DRFC) self-management. We aimed to characterise psychological functioning in DRFC, and identify clinical factors that may be associated with psychological problems. Eighty-one participants ( = 62.8, SD = 11.3, range = 30-87) with DRFC were recruited from The Royal Melbourne Hospital. Each participant completed a battery of psychological questionnaires. DRFC participants endorsed an elevated prevalence of depression, anxiety, post-traumatic stress and diabetes distress. There were also maladaptive personality traits, differences in emotion regulation skills and negative illness perceptions. Previous mental health disorder, higher HbA1C levels and diabetes-related complications were also associated with greater psychological symptoms. Elevated prevalence of psychological symptoms is apparent in DRFC. Our study highlights the need to use targeted interventions to address psychological difficulties to help DRFC patients cope better with their condition.
The influence of stress, social support and feminine values on the health behaviour of women in Hong Kong
The relationship between feminine values, cultural values, stress, social support and health behaviour among women in Hong Kong was examined in a sample of 306 women aged 18-61 years ( = 34.77, SD = 10.43). Older age and weaker identification with Chinese cultural values were predictive of engagement with risky health behaviour, older age was also associated with lower perceived levels of stress. Further post-hoc analysis explored the mediating effect of Chinese values and stress on the relationship between feminine values and health behaviour, Chinese values and stress fully mediated the relationship between feminine values and engagement with risky health behaviour. Experiencing high levels of stress did not necessarily lead to engagement in health compromising behaviour. Incorporating cultural values into health promotion campaigns may be one approach to better engagement in health promotion behaviour.
The psychological impact of living with peritoneal mesothelioma: An interpretative phenomenological analysis
Peritoneal mesothelioma is a rare life-limiting cancer that is likely to have an extremely negative impact on mental health; however, no studies to date have explored the impact and needs of those living with the condition. Ten individuals diagnosed with peritoneal mesothelioma (eight women, two men) participated in interviews and could share and discuss photographs to convey their illness experiences. Data analysis was informed by 'Interpretative Phenomenological Analysis'. Two themes are presented: 'Experiences of Care' and 'Psychological Distress'. Individuals experienced a lengthy diagnostic journey with little follow-up support. Women also reported negative impacts on body image due to abdominal swelling and scaring, diminished sexual ability and loss of fertility. Individuals recalled vivid feelings of anxiety and post-traumatic stress, and tried to cope by compartmentalising their fears and modifying diets. These findings demonstrate the need to further signpost services, help individuals manage gendered issues, and alleviate feelings of anxiety.
Deep Brain Stimulation Impairment Scale in Brazilian Portuguese: Cross-cultural adaptation and content validity
Parkinson's disease has exhibited the most rapid increase in prevalence among neurodegenerative disorders over the past 25 years. With the expanding availability of its surgical interventions and the controversial side effects identified in the literature, it is urgent to develop instruments for discerning subtle changes in patients' biopsychosocial functioning. Therefore, the primary objective of this study was to culturally adapt the Deep Brain Stimulation Impairment Scale (DBS-IS) into Brazilian Portuguese and evaluate its content validity. The final version of the DBS-IS in Brazilian Portuguese comprises 19 Likert items and yielded an S-CVI of 0.97, indicating robust content validity. Given the escalating number of Parkinson's disease diagnoses annually in Brazil, this tool may prove beneficial for practitioners and could also contribute to clarifying some of the apparent disparities among users of brain stimulation therapies worldwide and in Brazil.
Prevalence and intervention strategies of health misinformation among older adults: A meta-analysis
The rapid expansion of the Internet and social media has intensified the spread of health misinformation, posing significant risks, especially for older adults. This meta-analysis synthesizes evidence on the prevalence and interventions of health misinformation among older adults. Our findings reveal a high prevalence rate of 47% (95% CI [33%, 60%]), surpassing recent estimates. Offline research settings have a higher prevalence of health misinformation. Despite methodological variances, the prevalence remains consistent across different measures and development levels. Interventions show significant effectiveness (Hedges' = 0.76, 95% CI [0.25, 1.26]), with graphic-based approaches outperforming video-based ones. These results underscore the urgent need for tailored, large-scale interventions to mitigate the adverse impacts of health misinformation on older adults. Further research should focus on refining intervention strategies and extending studies to underrepresented regions and populations.
Examining healthcare professional delivery of health behaviour change interventions during a public health emergency: A multi-professional survey among NHS healthcare professionals
This study aimed to assess the extent to which healthcare professional characteristics and perceptions of major stressors during a public health emergency were associated with delivering health behaviour change interventions. A survey was administered in 2022 to a representative sample of 1008 healthcare professionals working in the UK's National Health Service (NHS). Data were analysed using descriptive statistics and hierarchical linear regression. Older respondents, higher levels of job satisfaction, being a nurse or health visitor, and reporting higher levels of perceived impacts of the COVID-19 public health emergency were associated with higher prevalence of delivering interventions. Higher levels of emotional job stress were associated with greater time spent delivering interventions (but not with a higher prevalence of contacts involving intervention delivery). Interventions targeted at younger healthcare professionals, those reporting lower job satisfaction, and healthcare professionals other than nurses or health visitors would be particularly beneficial.
Perspectives on weight change and antiretroviral therapy from people living with HIV in New York City: A qualitative study
Some people living with HIV experience weight gain or loss after initiating or switching antiretroviral therapy (ART) regimens. There is limited research on how perceptions of weight change affect health behaviors in this population. We interviewed 61 people living with HIV (aged 23-65; 51% cisgender men, 36% cisgender women, 13% transgender/nonbinary; 87% Black and/or Hispanic) in New York City about their feelings about weight change. Using an inductive thematic approach, we identified four themes: weight changes were attributed to external and internal factors; weight management was seen as an individual responsibility; feeling in control of one's health was linked to body image satisfaction; and one's sense of control related to health behaviors in divergent ways. Low perceived control could interfere with recommended behaviors, but some long-term survivors focused on controlling what they could. Healthcare providers should consider HIV patients holistically and be aware of ART's impact in their daily lives.
Maintaining a sense of normality with the help of others: Lived experiences of facilitators and barriers to Lupus adjustment
Systemic lupus erythematosus (SLE) has a high detrimental impact on individuals' quality of life. Identifying key factors associated with SLE adjustment is crucial for intervention development, yet there is no previous research exploring the perspectives of individuals with SLE regarding illness adjustment' facilitating or hindering factors. In this qualitative study, 16 individual semi-structured interviews with Portuguese adults with SLE (13 women) were conducted to explore perceived facilitators and barriers to illness adjustment. A reflexive thematic analysis revealed that efforts toward maintaining a normal life, optimism, keeping engaged in meaningful activities, accessing reliable illness-related information, and having supportive relationships were core facilitators of SLE adjustment. Main barriers included inability to maintain normality, engaging in excessive activity, pessimism, being unsupported or stigmatized, and not having access to reliable illness-related information. These findings unveil potential targets for psychosocial and behavioral interventions aimed at enhancing the quality of life for individuals with SLE.
Key factors for inappropriate supplement intake in risk-taking users: An exploratory sequential mixed-methods pilot study in Japan
This study identified the control factors of inappropriate supplement intake to support public agencies in preventing health problems. We used an exploratory sequential mixed-method design with the integrated behavioral model (IBM). Control factors in the IBM were identified with 95 participants. The highest impact behavioral change was established for the following two out of 19 control factors: "I trust others' blogs as a source of information when they post the bad as well as the good" ( = -0.324, < 0.001) and "I can control any health problems by adjusting the amount and frequency of my supplement intake" ( = -0.308, < 0.001). The findings suggest that when providing safety information on supplement use, it is important to: (1) disseminate information to online communities of supplement users who share knowledge based on real experiences and (2) effectively demonstrate the risks associated with continued supplementation.
Exploring personality correlates of falsification of COVID-19 lateral flow tests through vignettes
Regular testing using rapid antigen lateral flow tests (LFTs) was an important prevention strategy during the COVID-19 pandemic. However, falsification of home LFTs was a concern. Using a large quota-representative sample of adults ( = 1295) in England, we conducted a vignette survey consisting of four hypothetical scenarios of LFT falsification behaviours (FBs) to examine whether prosocial personality traits were associated with attitudes towards and intentions for falsifying home LFTs during the pandemic. Results show that higher levels of affective empathy for people vulnerable to COVID-19 and Honesty-Humility from the HEXACO model of Personality are associated with non-acceptability of LFT FBs and intentions to not engage with them. However, affective empathy explained more of the variation compared to the facet-level measures of Honesty-Humility for both attitude and intention. Public health communications aimed at encouraging personal protective behaviours should consider the role of empathy and prosocial messages.
Navigating the food environment: Experiences of reduced calorie interventions to manage Type 2 Diabetes Mellitus
Research into achieving Type 2 Diabetes Mellitus remission through weight loss efforts has grown steadily in the past decade. Most of this research has focused on the effectiveness of weight loss as a method to achieve remission, rather than considering individuals experiences of engaging with such change. This paper aims to review the qualitative research on individuals' experience of proposed dietary modifications with a weight loss focus. Six databases were searched for qualitative and mixed-methods research studies, and studies were subject to analysis following Thomas and Hardin's guidelines. The search yielded 2945 results, of which 47 were reviewed in full, and nine were included for analysis. Four analytical themes were identified; variability in support; choosing dietary change; re-negotiating the food relationship; and looking beyond weight loss. Providing tailored nutritional information that is comprehensible and culturally appropriate must be the premise of the interventions offered. Supporting patients to understand their relationship with food and identify meaningful goals beyond weight loss is an important starting point.
Are health protective behaviors promoted by anticipated regret?
Several factors influence the adoption of health-protective behaviors, including anticipatory affective reactions like regret. The ability to anticipate regret matures with age, allowing individuals to make increasingly risk-averse decisions. This study examined the relationship between age and the adoption of health-protective behaviors to limit the spread of a virus from adolescence to adulthood, and the mediating effect of anticipated regret. A total of 410 French participants, aged 14-58, reported their compliance with health-protective behaviors (e.g., using surgical masks, handwashing, social distancing), along with their anticipated regret in the event of non-adherence to such behaviors leading to the contamination of themselves or others. The findings revealed that both the adoption of these behaviors and anticipated regret increased with age. Moreover, anticipated regret mediated the effect of age on health-protective behavior, encouraging higher compliance with preventive measures and reducing risk-taking.
Efficacy of positive expressive writing in reducing depression and social anxiety symptoms among schoolchildren during COVID-19: A randomized controlled trial
The COVID-19 pandemic harmed children's mental health, and limited therapy access exacerbates the issue. We studied positive expressive writing (EW) as a psychological intervention for teachers to reduce depression and social anxiety symptoms among schoolchildren. Altogether, 165 Chinese schoolchildren aged 10-15 were randomly assigned to positive EW, memory EW, or control group. EW groups wrote for 10 minutes weekly for 7 weeks about people and things they felt grateful for (positive EW) or memorable in the past week. The control group continued with regular weekly class meetings. All groups measured depression and social anxiety before and after the intervention. Positive EW significantly reduced depression and social anxiety symptoms compared to the control condition (both Cohen's = -0.45) and reduced social anxiety symptoms compared to memory EW (Cohen's = -0.32). Therefore, teachers can implement positive EW to support schoolchildren's mental health recovery during and after disasters.
Improving processing fluency to encourage family health information seeking: The mediating role of communication efficacy
Drawing from the metacognitive literature, this experimental study examines how the relative ease of retrieving information (i.e. processing fluency) impacts individuals' efficacy about engaging in family health discussions and interpersonal information seeking intention across two health topics: family organ donation status and family health history. Participants ( = 609) were randomly assigned to one of three conditions. Those in the easy retrieval task condition (versus a difficult or no task control), who were asked to recall information regarding two (versus six or zero) family members, reported greater processing fluency. Moreover, those who reported greater fluency also reported higher communication efficacy, and a greater intention to seek out family health information. Practically, this study highlights how metacognitive strategies may be used in healthcare settings to motivate patient information seeking. For example, it may be advantageous to start by collecting information for relatively few diseases/family members and slowly build a family history over time.
Navigating women's cancer prevention: Two cross-sectional studies to investigate psychosocial antecedents of cervical and breast cancer screening attendance
Despite population-based cancer screening programmes effectively decreasing mortality, participation rates are unsatisfactory for both cervical and breast screening. This research tested an integrated theory of planned behaviour model applied to cervical cancer screening (CCS; Study 1) and breast cancer screening (BCS; Study 2) attendance. Women residing in Campania (Italy) and belonging to each screening target population joined two independent surveys (Study 1: = 332, = 41.03, SD = 11.45; Study 2: = 298, = 55.03; SD = 5.17). In both studies, screening behaviour was predicted by intention to undergo the screening, action and coping planning. Significant predictors of intention were subjective norms, perceived behavioural control and self-identity in Study 1, and subjective norms, anticipated regret and self-identity in Study 2. A mediation analysis confirmed the role of action and coping planning in the intention-behaviour relation. This model can guide forthcoming interventions and steer enhancements in healthcare access.
Psychometric evaluation of the Turkish version of the Work-Related Stress Scale: A study among search and rescue workers responding to the 2023 Kahramanmaraş earthquakes
This study evaluates the reliability and validity of the Turkish version of the Work-Related Stress Scale (WRSS) among search and rescue workers who responded to the 2023 Kahramanmaraş earthquakes. Data were collected from 275 workers between January and April 2024 using the Personal Information Form and the Turkish version of the WRSS. Language, content, and construct validity were assessed, and reliability was determined using item-total correlation, Cronbach's alpha, split-half, and test-retest methods. The scale demonstrated strong content validity with a CVI range of 0.9-1.0 and a mean CVI of 0.98. Exploratory factor analysis yielded factor loadings from 0.469 to 0.932, resulting in four factors that explained 75.3% of the variance. The reliability coefficients for the sub-dimensions ranged from 0.833 to 0.900, with an overall Cronbach's alpha of 0.913. These results indicate that the Turkish WRSS is a valid and reliable tool for assessing stress among search and rescue workers.
Characteristics and influencing factors of posttraumatic growth in young and middle-aged cancer patients: A cross-sectional latent profile analysis
This cross-sectional study aimed to examine the subgroups of posttraumatic growth (PTG) among young and middle-aged cancer patients in China and to explore influencing factors. A total of 378 young and middle-aged cancer patients aged 18-60 were selected for the study at a hospital in Shanghai, China. Latent profile analysis identified four categories of PTG among young and middle-aged cancer patients: the "predicament group" (5.9%), the "struggle group" (36.8%), the "limited growth group" (44.1%) and the "remarkable growth group" (13.2%). Age, gender, time since diagnosis, cancer site, primary/recurrence, and meaning in life significantly influenced the distribution of PTG in young and middle-aged cancer patients. Targeted interventions should be developed to enhance the level of PTG among this population, considering the specific characteristics and influencing factors within each profile.
Much more than a biological phenomenon: A qualitative study of women's experiences of brain fog across their reproductive journey
Whilst 'brain fog' is mostly considered a biological problem little is understood about an individual's experience. This qualitative study explored women's experiences of brain fog focusing on those at the start (aged 18-25; = 10) and end (aged 45-60; = 10) of their reproductive journey. Descriptive thematic analysis described three themes: (i) 'daily disruptions' describing cognitive dysfunctions and the main triggers; (ii) 'the cycle of impact' with a focus on women's emotional experiences and how these can exacerbate brain fog; (iii) 'taking control' highlighting the use of self-care, physical prompts and Hormonal Replacement Therapy (HRT) to manage brain fog. Transcending these themes was the notion of 'crisis of identity' illustrating the negative impact of brain fog on the women's sense of self with some older women describing acceptance and finding it less challenging. Brain fog is much more than a biological phenomenon and has broader implications for a woman's sense of self.
Emotional awareness amplifies affective sensitivity to social support for women with breast cancer
Emotional awareness (EA) is thought to facilitate psychological health by aiding emotion regulation in oneself and garnering social support from others. This study tested these potential relationships within a one-year longitudinal study of 460 women (age 23-91 years, mean 56.4 years) recently diagnosed with breast cancer (i.e., within four months). The women completed measures of emotional awareness, social support, social stress, affective symptoms, and well-being. Linear models tested EA as a moderator of social support and stress on affective symptoms and well-being. In those with higher EA, low social support was associated with greater depression and lower optimism. There was some evidence that higher EA predicted greater depression at baseline but lower depression at nine-month follow-up. These results support the idea that EA increases sensitivity to available social support and facilitates emotional adjustment over time, suggesting that assessment of EA could help guide clinicians in identifying those at greatest risk of adverse mental health outcomes in this population.
How did slovak students perceive the COVID-19 pandemic: Insights from one of the least vaccinated EU countries
The COVID-19 pandemic brought different challenges to different populations. A less explored group was university students who generally suffered low mortality rates compared to other populations. Yet, they were affected by the psychological impact of lockdowns and limited access to education and socialization. This paper focuses on Slovakia, one of the least vaccinated EU countries. In November 2021 we conducted eight focus groups with 51 university students (45 women; 6 men; = 23.67; SD = 3.43) and analyzed the data using reflexive thematic analysis. Our results identified the development of prevailing themes associated with COVID-19. Initially, COVID-19 was perceived as unreal but brought certain secondary benefits. We also identified themes of exaggerated disease, conspiracy, resignation, frustration, or adaptation to the disease. We divided the students into three groups based on their COVID-19 vaccine stance: accepting, hesitant, and rejecting. Insights from these groups could guide better communication strategies in the future.
Psychological distress in Aotearoa New Zealand adults with type 1 diabetes
The psychological burden of type 1 diabetes (T1D) can negatively impact health outcomes. This study evaluates the prevalence of low mood (WHO-5), disordered eating (DEPS-R), diabetes distress (PAID) and fear of hypoglycaemia (HFS-II), in a sample of 250 New Zealand adults (8.4% Māori/91.6% non-Māori; 43.6% female/56.4% male) with T1D using validated tools. Māori and female patients indicated low mood, with lower median WHO-5 scores than non-Māori ( = 0.027) and males ( = 0.002). Māori were more likely to score in the clinical range on the WHO-5, DEPS-R, PAID and HFS-II (all < 0.05). HbA1c was correlated with emotional well-being ( = -0.189), diabetes distress ( = 0.223) and disordered eating ( = 0.389; all < 0.001) whilst DEPS-R correlated with age ( = -0.232) and BMI ( = 0.343; both ≤ 0.001). Thus, diabetes-related psychological distress is common in New Zealand adults with T1D, particularly for Māori, females and those with elevated HbA1c levels.
Self-efficacy and social support enable women to protect their pelvic floor health: A nonrandomized controlled trial in rural Nepal
Carrying heavy loads increases the risk of pelvic organ disorders, particularly in low-income countries. Low self-efficacy hampers adoption of pelvic-floor-protective behaviors. The enabling hypothesis suggests that social support may strengthen women's behavioral self-efficacy. A three-arm parallel non-randomized controlled trial with 300 women and their social partners experimentally examined whether self-efficacy and social support can enable women's pelvic-floor-protective behaviors in rural Nepal. Three villages received (1) self-efficacy (2) self-efficacy and social support promotion, or (3) information only control. The co-primary outcomes were reduced weight carried and using protective lifting techniques at 2-month follow-up. Self-efficacy promotion increased the use of protective lifting techniques 9% more than information only ( = 0.28). Weight was reduced by 3 kg more when additionally promoting social support compared to self-efficacy alone ( = 0.39). Self-efficacy and social support promotion enable women to better protect their pelvic floor health and may complement educational approaches to health behavior change in low-resource populations.