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The purpose of this study was to explore the existing literature on the relationship between depressive symptoms and executive function in patients with type 1 diabetes (T1DM) across the lifespan. The scoping review followed the PRISMA protocol by using three databases: PubMed, CINAHL, and PsycINFO on May 14, 2023. Primary research that included reported executive function and the association with depressive symptoms was included in the review. Of 1470 de-duplicated publications identified, nine articles were included in the review. Five studies evaluated the T1DM population, while four studies evaluated T1DM and type 2 diabetes (T2DM) as an aggregate result. Three studies indicated an association between depressive symptoms and executive function in adults with T1DM, and four studies indicated an association between depressive symptoms and executive function in adults with either T1DM or T2DM. In general, participants who reported depressive symptoms also exhibited poor executive function. However, two studies did not find an association between depressive symptoms and executive function. In summary, the seven studies in this review suggest that individuals with T1DM who report depressive symptoms are at a higher risk of poor executive function; a clear association between depressive symptoms and executive function in individuals with T1DM remains inconclusive. There is a need to explore this relationship in the future. • Study results linking depressive symptoms and executive function were mixed. • Depressive symptoms may impair executive function. • Future studies should include both type 1 and type 2 in the analysis. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine anxiety and depressive symptoms in adolescents with type 1 diabetes (T1D) to determine differences based on grade level and disease duration. We conducted a secondary data analysis of adolescents with T1D, which included demographic characteristics, general anxiety symptoms, and depressive symptoms. Of the 147 adolescents included in the analysis, 32% (n =47) were in middle school and 68% (n =100) were in high school. Most had been diagnosed with diabetes for less than 3 years (67.3%, n =99). When controlling for covariates, middle schoolers were more likely to report clinically significant depressive symptoms compared to their high school peers (β = 0.83, p = 0.008). Younger adolescents may be at a higher risk of a clinically significant symptom burden from depression and should be screened regularly. Future research should include tailoring psychosocial interventions specifically to an adolescent's age and disease duration. [ABSTRACT FROM AUTHOR]

Background: Promoting civility in nursing education can be accomplished with civility teams, assessing perceptions of civility and developing initiatives to address areas needing improvement. Problem: There is a lack of information about the effectiveness of civility teams in nursing education, leading to uncertainty on how to develop and assess civility teams. Approach: This article discusses how 1 school of nursing implemented a civility team and used the Clark Healthy Work Environment Inventory to assess the impact of the team. Outcomes: The civility team used the inventory responses from 110 team members to establish civility action items. One year later, the inventory was repeated, and the responses from 122 team members were used to evaluate the impact of the civility action items. Conclusion: This program evaluation indicates an effective way for nursing programs to develop civility initiatives using a validated assessment tool to create and evaluate civility action items. [ABSTRACT FROM AUTHOR]

• The SCCOPDI is a valid and reliable tool in a United States population with COPD. • Participants demonstrated less than desirable scores for adequacy of self-care. • Future research should confirm the SCCOPDI is valid and reliable in the United States. High quality self-care among individuals with chronic obstructive pulmonary disease (COPD) promotes better outcomes, however, there are few validated self-care measures that are psychometrically sound to be used in research. The purpose of this study is to examine the psychometric properties of the Self-Care in Chronic Obstructive Pulmonary Disease Inventory (SC-COPDI) in an English-speaking population in the United States. Factorial validity, construct validity and reliability of the SCCOPDI were examined using components analysis via principal components analysis, hypothesis testing via multivariate linear regression, Cronbach's alpha, and split-half reliability. The SCCOPDI demonstrated strong evidence of validity and reliability on par with the SCCOPDI's original construction. Component analysis produced item loadings consistent with the theoretical underpinnings of the instrument. Reliability metrics yielded good internal consistency across all subscales of the SCCOPDI. The SCCOPDI is a valid and reliable instrument to measure self-care in people with COPD. [ABSTRACT FROM AUTHOR]

Type 1 Diabetes (T1D) is a complex chronic condition that impacts physiologic and psychosocial outcomes in adolescents. Adolescents with T1D experience anxiety and depressive symptoms at 2 to 3 times the rate of the general adolescent population. Anxiety and depressive symptoms negatively impact disease management. Cognitive behavioral therapy (CBT) is considered the gold standard therapeutic technique for treating anxiety and depressive symptoms. The aim of this integrative review was to examine and synthesize the extant literature exploring the effect of CBT on physiologic and psychosocial outcomes in adolescents with T1D. Electronic databases were searched with the terms "type 1 diabetes" and "cognitive behavioral therapy." Studies were included if they were published between 2000 and 2020, evaluated a pediatric population (≤18 years of age), and included individuals with diagnosed T1D. 475 articles were identified in our initial search, and after removal of duplicates 353 articles remained. 339 did not meet inclusion criteria. A total of 14 papers met inclusion criteria. All studies included CBT, but differed in delivery methods. Several studies demonstrated evidence of the feasibility and acceptability; however, there were mixed results regarding improvement of physiologic and psychosocial outcomes. CBT is a feasible and acceptable intervention in adolescents with T1D. It may be a method of improving psychologic and psychosocial outcomes for this high-risk population. In adolescents with T1D, screening and treatment for psychosocial comorbidities should occur regularly at endocrinology visits. CBT can be operationalized to fill this gap. • Cognitive Behavioral Therapy (CBT) was feasible and acceptable in adolescents with T1D. • CBT shows promise in improving diabetes management outcomes. • CBT improves self-efficacy, stress, and quality of life. • Online delivery of CBT was effective in adolescents with T1D. [ABSTRACT FROM AUTHOR]

Short sleep duration and quality are problems for many youth, and are associated with difficulties in executive function. Our purpose was to describe subjective and objective sleep characteristics and their associations with executive function, stress and coping, adjustment, and self-management in youth with type 1 diabetes (T1D). Youth with T1D (N = 40; mean age, 13.4 ± 1.9 years; 60% female; 77.1% non-Hispanic white; diabetes duration, 7.1 ± 4.6 years; and hemoglobin A1c, 8.2 ± 1.2%) wore an actigraph and a continuous glucose monitor for 3–7 days and completed questionnaires. Descriptive and bivariate analyses were conducted. Sleep variability was associated with stress and depressive symptoms, as well as more glucose variability. Consistent rest-activity rhythm timing was associated with fewer trait anxiety symptoms. Robust rhythms were associated with better diabetes self-management. Providers should routinely assess sleep habits in youth, especially those with T1D. Improving consistency in sleep timing and sleep duration may be a potential therapeutic target to improve diabetes clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: An estimated 6.5 million American adults live with heart failure (HF). Elevated anxiety symptoms may worsen HF symptoms and contribute to decreases in overall quality of life (QOL). Mindfulness has been associated with better psychological health with lower levels of anxiety symptoms. Mindfulness may be a modifiable target for reducing anxiety symptoms and increasing QOL in patients with HF. Objective: The objective of this study is to examine the relationships among anxiety symptoms, dispositional mindfulness, and QOL in patients with symptomatic HF. Methods: In this cross-sectional study, we conducted a secondary analysis of baseline data from 70 participants. We performed descriptive statistics, bivariate Pearson correlations, and multiple linear regression. Results: The sample included 70 individuals with a mean age of 65 ± 10.5 years, 89% male, mean left ejection fraction of 45.7 ± 13.6, mean total QOL of 36.9 ± 21.7, mean total mindfulness of 82.2 ± 12.8, and mean anxiety of 4.8 ± 2.9. In multiple regression analyses, total mindfulness was significantly associated with lower anxiety (β = -0.491, P < .01), greater observational mindfulness was significantly associated with lower anxiety (β = -0.377, P < .01), and greater nonreactivity to inner experience was significantly associated with lower anxiety (β = -0.320, P < .05). Lower anxiety was associated with greater total QOL (β = 0.488, P < .01), greater physical QOL (β = 0.381, P < .01), and greater emotional QOL (β = 0.639, P < .01). Conclusions: Mindfulness may be a way of improving both anxiety symptoms and QOL in this population. [ABSTRACT FROM AUTHOR]

Problem Mental health conditions are prevalent in youth with type 1 diabetes (T1D). Anxiety symptoms and depressive symptoms are highly correlated and are two of the most prevalent mental health conditions in youth in the general population. The detrimental effect of depressive symptoms in youth with T1D has been well documented, but the effects of anxiety symptoms are not well understood. Eligibility criteria Studies were included if they were published between 1990 and 2015, and evaluated anxiety symptoms in a population of youth with T1D. Sample A total of 20 studies were identified from a sample of 338 papers. Results Anxiety symptoms were prevalent in youth with T1D. Anxiety symptoms were associated with higher glycosylated hemoglobin (HbA1c) levels, poorer self-management and coping behaviors, depressive symptoms, fear of hypoglycemia, and lower blood glucose monitoring frequency. State anxiety and trait anxiety symptoms affected health outcomes differently. Girls were at a higher risk of anxiety symptoms than boys. Conclusions Anxiety symptoms in youth with T1D have detrimental effects on health outcomes, including self-management, quality of life, and HbA1c. Implications Future research should aim to improve our current screening and treatment practices. [ABSTRACT FROM AUTHOR]

Type 1 diabetes (T1D), type 2 diabetes, and prediabetes are increasing in incidence. Adolescents and young adults with diabetes experience psychosocial comorbidities at an increased incidence. As such, exploring interventions that can improve psychosocial and glycemic outcomes are needed. The purpose of this integrative review is to examine and synthesize the literature on mindfulness in adolescents and young adults with type 1 or type 2 diabetes or prediabetes. Four databases were searched during May 2021. Included studies were published between 2000 and 2021, evaluated adolescents and young adults, diagnosed with type 1 or type 2 diabetes or prediabetes. Studies were excluded if they were not in English; not original research; evaluated complementary/alternative therapies as a group. To assess for risk of bias, the National Institutes of Health quality assessment tools and the Cochrane Collaboration's tool were utilized. Whittemore and Knafl's (2005) method for conducting an integrative review was utilized to synthesize results. We identified 137 articles in our initial search and 74 articles remained after removing for duplicates. Ten articles were included in the review, with 5 including adolescents and young adults with T1D and 5 including adolescents and young adults with prediabetes. No studies evaluated mindfulness in adolescents and young adults with type 2 diabetes. Mindfulness is an acceptable intervention in adolescents and young adults with T1D and prediabetes, resulting in positive psychosocial and glycemic outcomes. There were issues with feasibility of the intervention and mobile health technology delivery methods should be evaluated. • Stress/quality of life may improve with mindfulness in adolescents and young adults with type 1 diabetes and prediabetes. • Anxiety symptoms may also improve with mindfulness in adolescents and young adults with type 1 diabetes. • Mindfulness may result in clinically significant changes to glycemic outcomes in adolescents and young adults. [ABSTRACT FROM AUTHOR]

This research abstract was the winner of the 2022 NAPNAP Research Poster Award. Clinical Research Podium Presentations: Research on Adolescents: Depression, Diabetes, Drugs . Presented at NAPNAP's 43rd National Conference on Pediatric Health Care, April 29th, 2022 The purpose of this secondary data analysis was to examine anxiety and depressive symptoms in adolescents with Type 1 diabetes (T1D) to determine differences based on school grade level and disease duration. T1D is one of the most prevalent chronic conditions in children and adolescents worldwide; its incidence is rising 3% per year. Over 200,000 youth under the age of 18 in the United States are currently living with T1D. The chronic nature of T1D, combined with the demands of the daily treatment regimen, increase the risk of mental health comorbidity, particularly anxiety and depressive symptoms. Anxiety and depressive symptoms are 2 to 3 times more prevalent in adolescents with T1D than in the general adolescent population and are associated with out-of-range glycemic control, severe hypoglycemia, and ketoacidosis. Reducing the burden of anxiety and depressive symptoms may be a key part of improving glycemic control and reducing long-term complications in this high-risk population. After obtaining IRB approval, we conducted a secondary data analysis of baseline data collected from a previous research study validating a measure of diabetes-specific anxiety. The data set included the following self-report measures: demographic characteristics (age, race/ethnicity, disease duration, insulin pump use), general anxiety symptoms (Generalized Anxiety Disorders 7), and general depressive symptoms (Patient Health Questionnaire 2). Data was electronically collected through REDCap. We conducted descriptive statistics, bivariate, and multivariate analyses. A total of 147 adolescents aged 13-17 years old (M=14.5+1.26 years) were included in the analysis. Of these adolescents, 32% (n=47) were in middle school (grades 6 to 8) and 68% (n=100) were in high school (grades 9 to 12). Most participants (67.3%, n=99) had been diagnosed with diabetes for less than 3 years, with 41.4% (n=41) of these in middle school and 58.6% (n=58) of these in high school. Mean general anxiety scores were 9.78+5.13, indicating mild to moderate anxiety symptoms, and mean depressive symptom scores were 2.75+1.76, where scores above 3 indicate major depressive disorder likely. When controlling for demographic covariates and length of time since diagnosis, middle schoolers were more likely to report clinically significant depressive symptoms compared to their high school peers. However, this relationship was not seen with general anxiety symptoms. Without controlling for grade level, participants with less time since diagnosis were more likely to report clinically significant anxiety symptoms. The results of this secondary data analysis highlight the importance of screening and treatment for anxiety and depression in adolescents with T1D. Younger adolescents may be at a higher risk of a clinically significant symptom burden from depression and therefore should be closely screened at regular clinic visits. Adolescents newly diagnosed with T1D may be at a higher risk of suffering from anxiety symptoms than those who have been living with T1D for several years. Future research should be aimed at tailoring psychosocial interventions with particular attention to an adolescent's age and disease duration. [ABSTRACT FROM AUTHOR]