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Type 1 diabetes (T1D) is a chronic, complex medical condition associated with higher rates of anxiety in adolescents. Higher rates of anxiety are associated with poorer glycemic control. Although technological advancements have been made to improve self-management of glycemia, few technological interventions aim to mitigate anxiety symptoms. Adolescents frequently use technology every day for school and socialization in addition to management of glycemia. Technology has not yet been leveraged to provide evidence-based interventions, such as mindfulness, for anxiety symptoms and other psychosocial comorbidity in adolescents with T1D. We aimed to examine technology preferences in adolescents with type 1 diabetes, their experiences with mindfulness practices, and their perceived acceptability of a mobile health application delivering mindfulness training. Twenty participants aged 14 to 17 years old with T1D participated in this qualitative descriptive study. Interview transcripts were organized using the ATLAS.ti software version 8 and coded using an in vivo approach and thematic analysis. Descriptive statistics regarding participant demographics and hemoglobin A1c levels were analyzed using SAS statistical software version 9.2. Findings supported heavy technology use, limited experience with mindfulness, and positive receptivity regarding an app that delivered a mindfulness training program specifically for adolescents with T1D. Thus, a mobile health application may be a feasible and acceptable way to deliver an evidence-based psychosocial intervention to this vulnerable population. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the daily stressors experienced by adolescents with Type 1 diabetes (T1D) and the perceived impact of those stressors on their self‐management and psychological well‐being. Design and Methods: We conducted semistructured in‐depth telephone interviews using a qualitative descriptive approach with 20 adolescents aged 14–17 years with T1D and analyzed subsequent data using thematic analysis. Results: Participants who were non‐Hispanic white made up 85% of the sample, 75% identified as female and mean age was 15 years. The study identified two key themes: "the everyday stress of living with diabetes" and "managing stress and supporting psychological well‐being." Participants described heightened mental load, the impact of daily activities, stress associated with public diabetes management, and added stress due to COVID‐19. Primary mitigation techniques included family support, peer support networks, activity engagement, and personal acceptance of their condition. Practice Implications: We found that there is a compound effect that occurs with balancing daily disease management with normative activities of daily living. These data will help guide the design of new interventions and tailoring of existing interventions. Future intervention development may include physical exercise, mindfulness training, and stress reducing techniques. [ABSTRACT FROM AUTHOR]

Anxiety and depressive symptoms affect up to 80% of people with chronic obstructive pulmonary disease (COPD). To reduce this symptom burden, clinicians should target modifiable explanatory factors while accounting for nonmodifiable explanatory factors of these symptoms. The purpose of this secondary data analysis was to examine which modifiable factors explain anxiety and depressive symptoms in COPD. This secondary data analysis of 1,760 COPD patients used multiple regression to explain anxiety and depressive symptoms from sets of modifiable patient characteristics and demographic controls. Clinically significant symptoms of anxiety or depression presented in 29.6% (n = 526) of participants, and 20.6% (n = 363) had both. Significant modifiable explanatory factors of both disorder symptoms were perceived functional status, functional capacity, psychosocial impact, symptom self-management, and significant symptoms for the other. Somatic symptom burden and dyspnea explained anxiety and depressive symptoms, respectively. Addressing these modifiable factors may reduce anxiety and depressive symptoms in patients with COPD. [ABSTRACT FROM AUTHOR]

Adolescents with Type 1 diabetes experience anxiety symptoms specifically related to the self-management of diabetes. The purpose of this study is to describe the initial psychometric testing of the Anxiety Symptoms in Diabetes Scale in Adolescents (ASDS-A), a 14-item instrument designed to measure diabetes-specific anxiety. Following an in-depth qualitative study, items were identified and reviewed by experts, and remaining items were tested in 146 adolescents. A PCA indicated a single dimension (Eigenvalue, 6.106) with a Cronbach's α of.896, leaving a 14-item measure. There is strong evidence that the ASDS-A is a developing reliable and valid measure of diabetes-specific anxiety. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic profoundly impacted psychological well-being worldwide. Oncology health care professionals' (OHCPs') perceptions of psychological effects of COVID-19 among people in active cancer treatment were explored. Semi-structured interviews with a purposive sample of OHCPs actively providing care were conducted. Interviews were audio-recorded, transcribed, and coded using Atlas.ti v8 and thematic analysis. In total, 30 OHCPs participated. Most were registered nurses (70%), worked in outpatient setting (56.7%) and were in their current position 1–5 years (53.3%). Overarching themes are as follows: (a) cancer treatment disrupted due to patients' fear of exposure to COVID-19; (b) social distancing restrictions caused discontinued social support and supportive services that exacerbated psychological distress; (c) pandemic-related stressors led to overwhelmed coping skills; and (d) OHCPs played a vital role in providing emotional support and connecting patients with family/friends through technology. Behavioral health interventions should focus within the "new world of COVID-19" of reduced face-to-face support and increased online support for patients. [ABSTRACT FROM AUTHOR]

Objective: Cancer diagnosis and treatment can significantly affect women's sexual health and intimacy, leading to diminished quality of life in survivorship. The perspectives and experiences of women of color (WOC) with cancer are critical to inform comprehensive, inclusive sexual wellbeing care in survivorship. The purpose of this systematic review is to summarize contemporary literature describing sexual wellbeing experiences of WOC treated for cancer.Methods: A comprehensive search of CINAHL, PubMed, Embase and PsycInfo and Scopus identified studies that addressed sex and intimacy of U.S. WOC treated for cancer published in the last 15 years. The authors identified emergent themes from the literature through thematic content analysis.Results: Eighteen studies (10 qualitative, 8 quantitative) met the inclusion criteria, all with breast or gynecologic cancer samples. Studies include African American (13), Asian American (3), and Latina (10) women, as well as Non-Hispanic Whites and 'other' race/ethnicity women. Overarching themes identified were: 1) impacts of treatment on sexual health and body image, 2) process of accepting and overcoming, 3) value of an engaged and supportive partner, and 4) current clinical practice and barriers to sexual health care.Conclusions: WOC experience changes in sex and intimacy after cancer treatment, and experiences of sexual function, sexual communication, and sexual healthcare are often shaped by sociocultural experiences. An understanding of WOC's sexual health and intimacy after cancer treatment can inform inclusive, culturally responsive sexual health interventions. [ABSTRACT FROM AUTHOR]

Self-care improves quality of life, and reduces exacerbations and mortality risk in people with chronic obstructive pulmonary disease (COPD). The purpose of this report is to describe the development and testing of the feasibility and acceptability of a digital, educational self-care intervention designed to improve self-care ability, adherence, knowledge, somatic symptoms, anxiety, and depressive symptoms. This pilot study was a quasi-experimental, repeated measures design. Self-care behaviors were identified, and educational modules were developed and built into a web-based platform. Twenty participants were enrolled to determine feasibility, acceptability, and preliminary efficacy. The intervention was deemed acceptable and feasible as evidenced by > 95% completion rates and high degree of participation. Overall, the intervention was well received and is feasible for future home-based interventions in those with COPD. Results included significant improvements in adherence and knowledge, and significant associations between self-care ability, adherence, and depressive symptoms. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this exploratory pilot study was to examine the associations of state and trait anxiety with glycemic control, self-management, and diabetes-specific quality of life (QOL) in youth 10 to 16 years of age with type 1 diabetes (T1D). Methods: Bivariate Pearson correlations and multiple linear regression modeling were conducted to examine the relationship among anxiety symptoms, hemoglobin A1C (A1C), self-management, QOL, and covariates. Results: A sample of 67 adolescents was 50.7% female, and 87.1% were non-Hispanic white, with a mean ± SD age of 13.4 ± 1.85 years and an A1C of 8.3% ± 1.2% (67 mmol/mol). Higher state anxiety was correlated with older age. Better self-management was correlated with lower trait anxiety and lower state anxiety. Higher state and trait anxiety were associated with poorer self-management. Higher state anxiety was associated with higher A1C. Higher trait anxiety was associated with poorer diabetes-specific QOL. Conclusions: State and trait anxiety may differentially affect diabetes outcomes. State anxiety may be a modifiable target for physiologic (A1C) and psychosocial (QOL) outcomes in youth with T1D, while trait anxiety may be a modifiable target for psychosocial outcomes (QOL). Anxiety symptoms should be assessed at regular clinic visits. Interventions to improve anxiety symptoms may in turn improve physiologic and psychosocial outcomes. [ABSTRACT FROM AUTHOR]

Type 1 diabetes (T1D) is one of the most common chronic health conditions in youth in the United States, and its incidence is rising worldwide. Youth with T1D are at a high risk of psychological comorbidity, for example, anxiety, depression, and eating disorders. Psychological comorbidities, especially anxiety symptoms, have been correlated with poorer diabetes outcomes, but anxiety symptoms have not been well studied in these youth. The primary aim of this study was to describe the experience of anxiety symptoms in youth with T1D, especially as those symptoms relate to diabetes self‐management tasks. We used a qualitative descriptive approach, consisting of an in‐depth, semi‐structured interview comprising 10 open‐ended questions with follow‐up probes. The analysis was guided by the principles of thematic analysis. Demographic data, Hemoglobin A1c levels, and the State‐Trait Anxiety Inventory for Children survey data were also collected and analyzed. We identified four themes and seven sub‐themes. Participants (n = 29, ages 10–16, 55% female) reported that T1D was an extra layer of responsibility that took time away from their ability to participate fully in other aspects of their lives. Some participants were able to integrate diabetes management into their lives, while others were not. Some participants were dependent on parents and the school nurse for diabetes management. Participants described two types of anxiety symptoms, general and diabetes‐specific, and they noted that their experience of anxiety was associated with poor quality sleep, general lifestyle factors, and diabetes. [ABSTRACT FROM AUTHOR]

The onset of acute and chronic illness in children frequently triggers episodes of stress and posttraumatic stress symptoms (PTSS) in mothers. Mothers of children with type 1 diabetes (T1D) consistently report high levels of stress and PTSS. The purpose of this integrative review was to review and synthesize the published empirical research. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to conduct this integrative literature review. A total of 19 studies were identified from a sample of 128. Stress and PTSS were prevalent in mothers of youth with T1D. While PTSS was most severe at disease onset, symptoms often persisted 1 to 5 years after diagnosis. The diagnosis of T1D in a child was traumatic for mothers. Stress and PTSS in mothers adversely affected children’s health. Management of stress symptoms in mothers may lead to improved behavioral and metabolic outcomes in children. [ABSTRACT FROM AUTHOR]

Low income has been established as a risk factor for poorer outcomes in youth with type 1 diabetes; however, the effect of moderate income has not been studied. The purpose of this secondary analysis of baseline data from a multi-site study was to compare glycemic control, self-management, and psychosocial outcomes [depression, stress, and quality of life (QOL)] at different income levels in adolescents with type 1 diabetes. Youth (n = 320, mean age = 12.3 + 1.1, 55% female, 64% white, mean A1C = 8.3 ± 1.4) completed established self-management and psychosocial measures. A1C levels were collected from medical records. Caregivers reported annual family income, categorized as high (>$ 80K), moderate ($40- 80K), or low (<$ 40K). Youth from high-income families had significantly lower A1C (mean = 7.9 ± 1.2) than those from the moderate-income group (8.6 ± 1.7, p < 0.001) or the low-income group (mean A1C = 8.6 ± 1.5, p = 0.003). Youth from the high-income group reported significantly better diabetes problem solving and more self-management goals than those from the moderate- or low-income groups (both p < 0.01). Youth from the high-income group also reported significantly fewer symptoms of depression, lower levels of perceived stress, and better QOL than those in the moderate or low-income groups (all p < 0.05). Multivariate linear regression models were used to test psychological and behavioral predictors of A1C and QOL. Parents' education status (p < 0.05) and self-management activities (p < 0.01) were significant predictors of hemoglobin A1c, while income (p < 0.01) and self-management activities (p < 0.05) were significant predictors of QOL. [ABSTRACT FROM AUTHOR]

Purpose Of Review: Children and adolescents with type 1 diabetes (T1D) spend much of their waking time in the school environment. However, there is limited empirical understanding of the challenges youth face in managing their T1D at school. There is even less literature focused on potential interventions to improve health or psychological outcomes in youth with T1D in this milieu. This review seeks to summarize the recent literature on diabetes T1D management in the school setting, including recommendations for care, barriers, and targets for intervention.Recent Findings: T1D organizations recommend strong collaboration amongst families, school personnel, and health care providers to enable successful T1D management in schools. While challenges remain according to parent, child, and teacher reports, perceptions of school-based management of T1D show signs of improvement. The few existing school-based intervention studies have generally focused on educational or structural interventions to improve diabetes care. The management of T1D within the school setting is critical for overall diabetes management. While barriers to effective T1D care have been examined, a greater understanding of the impact of new diabetes technologies and well-characterized interventions is lacking in this area. [ABSTRACT FROM AUTHOR]

The poem "Alarm: Explicated" by Kaitlyn Rechenberg is presented. First Line: the walls held her in. Last Line: the inevitable.