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Guided by theories of communicative disenfranchisement (TCD) and memorable messages (ToMM), this study analyzes 60 open-ended survey responses detailing experiences of grief following the onset of invisible, physical illness (e.g., chronic overlapping pain conditions, autoimmune rheumatic diseases). Employing reflexive thematic analysis, we identify (1) illness-related losses that are disenfranchised by discourses surrounding grief and (2) opportunities to enfranchise these losses via memorable messages. Situated at two points in time, before and after the onset of illness, we identify disenfranchised losses as what once was (e.g., physical [in]dependence, relational connection, images of self, and trust in institutions) and what will never be (e.g., family planning and career dreams). Next, we identify opportunities to disrupt this disenfranchisement through memorable messages of presence (e.g., nonverbal acknowledgment and verbal expressions of belief) and finding the fit (e.g., physical restructuring and community connection). In doing so, we extend theoretical understanding of both memorable messages, in the form that they can take (of experience) and as points of (dis)enfranchisement, and communicative (dis)enfranchisement. This study contributes to a growing body of health communication research on disenfranchising experiences in chronic illness by highlighting a resulting experience of illness not often talked about – illness-related loss and its grief process. Theoretical and practical implications, as well as limitations and future directions, are discussed. [ABSTRACT FROM AUTHOR]

This study aims to understand the impact of chronic conditions on perceived health and well-being among rural, community-dwelling older adults and to identify the barriers and supports impacting the perceived health and well-being among this population. A convergent mixed-methods design was conducted using the Pizzi Health and Wellness Assessment (PHWA) and semi-structured interviews. Participants' feelings about their health on the PHWA highlighted positive familial (M = 9.67, SD = 1), social (M = 8.67, SD = 1.12), occupational (M = 8.67, SD = 1.94), and spiritual (M = 8.56, SD = 2.13) health. Qualitative analysis revealed overarching themes: the impact of rural living and factors affecting health and well-being. Community-dwelling older adults with chronic conditions perceived their health and well-being as impacted by benefits and barriers of rural living. Positive perceptions of health and well-being were connected to family and social support, spirituality, and meaningful occupations. [ABSTRACT FROM AUTHOR]

Background: Hope is an important resource that helps patients and families thrive during difficult times. Although several studies have highlighted the importance of hope in different contexts, its specific manifestations in the realm of advanced chronic illness need further exploration. In this study, we sought to elucidate the intricate interplay between the construct of hope and the lived experience of advanced chronic illness within patient-caregiver dyads. Our objectives were (a) to explore the dyadic experience of hope as a changing dynamic over time for patients living with advanced chronic illness and their informal caregivers and (b) to evaluate variations of hope and symptom burden across time. Methods: We conducted a longitudinal mixed-methods study with a convergent design between December 2020 and April 2021. Patients living with advanced chronic illness and informal caregivers participated as a dyad (n = 8). The Herth Hope Index scale was used to measure dyads' level of hope and the Edmonton Symptom Assessment System was used to measure patients' symptom burden. Descriptive statistics were undertaken. A thematic analysis as described by Braun and Clarke was conducted to analyze dyadic interview data. Dyads' experience of hope was described by using the six dimensions of hope in the Model of Hope of Dufault and Martocchio. Results: Dyadic scores of hope and patients' symptom burden were stable over time. The constructs of hope in dyads included "Living one day at the time," "Having inner force/strength," and "Maintaining good health." Changes in patterns of hope were captured for each dyad in their transition over time. Data converged for all dyads except one. Conclusions: The findings of our study show a constant presence of hope even in the face of adversity. Healthcare professionals must find ways to promote hope in dyads of patients living with advanced chronic diseases. Nurses play a pivotal role; dyadic interviews should be promoted to create a safe space for both patients and informal caregivers in order to share experiences. More research is needed to address patients' and informal caregivers' hope in chronic illness because current hope-based interventions primarily target cancer diagnoses. [ABSTRACT FROM AUTHOR]

Background: Palliative extubation (PE) is the cessation of mechanical ventilation (MV) during terminal illness. Although PE is widely practiced in many countries, it remains illegal in others. Attitudes toward PE of patients at the highest risk for MV were scarcely explored before. Objective: To assess the attitudes of patients with advanced chronic illnesses (ACI) toward PE and other end-of-life decisions in a country where PE is illegal. Design: A prospective observational study using questionnaire-based interviews. Setting/Subjects: Patients with ACI hospitalized between 2021 and 2022 in a large tertiary center. Attitudes toward PE and mechanical ventilation were evaluated. Predictors for favoring/opposing PE were analyzed using multivariate logistical regression models. Results: A total of 152 (40% female, 75 ± 11 years) patients were included. The most common ACIs were advanced heart failure (32%), metastatic malignancy (32%), and chronic obstructive pulmonary disease (22%). Around 132 patients (87%) supported the legalization of PE, and their main reason was to avoid pain and suffering (87%). Legalization of PE would change the decision to avoid mechanical intubation in 34% of the cases. Most patients thought that the decision to perform PE should be made by the patient's physician and primary caregiver collaboratively (64%). Religious observance was an independent predictor for opposing PE (adjusted odds ratio 0.18; 95% confidence interval 0.06–0.59; p < 0.01), whereas the type of ACI was not. Conclusion: Most admitted patients with ACIs support the legalization of PE. Such policy change could have major impact on patients' end-of-life preferences. At-risk patients should be the focus of future studies in this area. [ABSTRACT FROM AUTHOR]

This methodological paper connects posthuman conceptualizations of voice with artistic research and examines whether it opens toward different registers and levels of embodied and aesthetic forms of knowing that cut across normative accounts of what it means to know. We start from what Patti Lather calls 'a praxis of stuck places' and ask how to give voice to experiences such as chronic illness and pain, while at the same time disrupting representational forms of illness and pain. To investigate this, we first critically engage with the popular genre of the health diary and its representational form. Secondly, we explore how Lisa A. Mazzei concept of 'voice without subject' can support us in disrupting the normative and representational production of voice, while working with a failing voice. Finally, we analyze the sound installation, A Borrowed Diary —made by M. Broeckmeyer, and explore how it opens up alternative approaches to voice and chronic pain. We will argue that making 'voice without subject' work, touch, and resonate can impact the lives of people who often remain unheard, in that it acknowledges experiences and expressions that are mostly not validated. Creating with 'voice without subject' makes tangible how personal experiences, however, temporarily, contribute to the bigger picture of how we look at and listen to people with illnesses and/or disabilities. [ABSTRACT FROM AUTHOR]

Background: The wounded healer concept refers to healthcare providers who, in the past, have had similar experiences to those of their clients and now draw on these challenging experiences to assist their clients. This study explored the positive traits of nurses with chronic cardiovascular diseases who transitioned to wounded healers. Methods: A qualitative content analysis study was conducted within hospitals in Tehran, Iran, between November 2023 and March 2024. Sampling was conducted using a purposive sampling method in accordance with the study objectives and inclusion criteria. The data were collected through semi-structured face-to-face interviews. Twenty-three participants, comprising 16 females and 7 males, participated in the interviews. Data analysis was conducted by employing a qualitative content analysis approach, including creating codes, subcategories, generic categories, and main categories. MAXQDA v20 software was utilized to facilitate the analysis process. Results: The data analysis revealed one main category that aligned with the research question: the positive traits of a wounded healer nurse, consisting of three generic categories: (1) traits related to interpersonal and professional relationships; (2) traits related to the professional dimension; and (3) traits related to the personal dimension. wounded healer nurses demonstrate positive traits that enhance patient care. Conclusions: The findings of this study have important implications for nursing practice and education. By identifying the positive traits exhibited by nurses as wounded healers affected by chronic cardiovascular diseases, nursing programs can emphasize and strengthen these qualities to convert challenges into opportunities and bridge the theory-practice gap. [ABSTRACT FROM AUTHOR]

Aim: To examine the effects of spousal support and parent–nurse partnership on caregiver burden of parents of children with chronic disease. Background: With the trend of increasing the global number of children with chronic diseases, the parental caregiver burden has become increasingly prevalent. Design: Cross‐sectional study. Methods: The study participants included 115 parents of children diagnosed with chronic disease at a general hospital in South Korea. The study duration was 4 June 2021–30 April 2022. Self‐reported measures included the parent–nurse partnership scale, the Korean version of the Parenting Alliance Inventory and the family caregiver burden scale. T‐tests, ANOVA, Pearson's correlation coefficients and hierarchical linear multiple regression were conducted using IBM SPSS version 26.0. This study followed STROBE guideline. Results: Parental caregiver burden was significantly negatively associated with spousal support and parent–nurse partnership. Factors significantly influencing caregiver burden were parental alcohol consumption; child's inherited metabolic disease, cardiovascular disease, disease relating to haematological tumours or kidney disease diagnosis; child's health perceived as poor by parents; child's dependency perceived as high by parents; hospitalization recency; and low spousal support. These factors accounted for 65% of caregiver burden. Conclusion: Parental caregiver burden was related to spousal support and parent–nurse partnership, but the primary factor affecting caregiver burden was spousal support. Relevance to clinical practice: The results highlighted the role of healthcare professionals in educating parents of children with chronic diseases to facilitate spousal support and have implications for nursing and community‐based interventions to reduce parental caregiver burden. Furthermore, they underlined that policymakers and other stakeholders should pay attention to the parental caregiver burden through government‐based, family‐centered strategies. Patient or public contribution: Parents of children with chronic disease were recruited to perform the self‐administered survey in the phase of data collection. [ABSTRACT FROM AUTHOR]

In the realm of healthcare, the significance of social connections cannot be overstated. Beyond the traditional focus on pharmacological interventions and medical procedures, recognizing and nurturing positive social relationships has emerged as a fundamental aspect of lifestyle medicine. This article delves into the multifaceted nature of social connections and their profound impact on health outcomes, particularly in the context of chronic diseases like hypertension, mental health disorders, heart disease, and dementia. Moreover, it explores strategies for healthcare practitioners, with a special emphasis on pharmacists, to foster positive connections with patients, thereby enhancing shared decision-making, self-management, and overall well-being. [ABSTRACT FROM AUTHOR]

"Lifestyle medicine (LM) is an evidence-based therapeutic intervention delivered by clinicians trained and certified in this specialty to prevent, treat, and often reverse chronic disease". Eighty percent of the conditions primary care physicians routinely encounter in their offices, e.g., diabetes mellitus, hypertension, COPD, cardiovascular disease, have root causes in poor lifestyle choices such as smoking, insufficient sleep, being sedentary, or eating highly processed foods. Lifestyle is the foundation of most chronic disease management guidelines aimed at reducing morbidity and mortality. Studies have shown that changes in lifestyle can be achieved and link almost directly to reduction in risk for chronic illness. Primary care physicians are ideally positioned to incorporate LM into their practices. It is important to recognize and find solutions to the many barriers to implementing LM at the patient, physician, and system level. There is an urgent need to increase opportunities for practicing physicians to increase their knowledge and skills related to LM and include this in medical school and residency curricula. Many resources exist that can provide the necessary training for seasoned physicians and students/residents to become competent in practicing LM and address barriers to implementing LM. LM has the potential to revolutionize clinical practice by placing a greater emphasis on disease prevention and the role of healthy lifestyle behaviors in disease management. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has determined a considerable increase in psychological distress worldwide. Compared with the general population, patients with chronic conditions experience higher stress levels due to the increased risk of worse health outcomes from COVID‐19 infection. Worries and fear of contagion could cause them to avoid going to their health facilities for medical examinations, which results in higher risks of morbidity and mortality. The present study aimed to develop and validate the Psychological Consequences of a Pandemic Event (PCPE) self‐report questionnaire, and to assess the psychological effects of exposure to a pandemic on mood and on treatment adherence appropriate for patients with chronic diseases. Data were analysed with Rasch analysis after an Exploratory Factor Analysis and a Confirmatory Factor Analysis. We identified a final set of 10 items, divided into two independent factors labelled "pandemic‐related anxiety" and "confidence in care". Finally, we transformed the raw scores of both factors into two interval scales (two rulers) that met the requirements of the fundamental measurement. The PCPE questionnaire has demonstrated to be a short and easy‐to‐administer measure, with valid and reliable psychometric properties, capable of assessing pandemic‐related anxiety and confidence in care in patients with chronic clinical conditions. [ABSTRACT FROM AUTHOR]

Students who identify with a chronic physical condition are a growing population and their conditions may be associated with poor mental well-being. To compare suicidal ideation prevalence between Canadian school-attending young adults with and without a chronic physical condition. We hypothesized that students living with a chronic condition have a higher likelihood of experiencing suicidal ideation. A cross-sectional study was conducted using a nationally representative sample of 2297 Canadian school-attending young adults (ages 15-29 years) from the 2012-13 Canadian Community Health Survey—Mental Health (CCHS-MH). Survey-weighted logistic regression and sensitivity analyses were performed to estimate the likelihood of experiencing suicidal ideation between students with and without a chronic physical condition. Approximately 14.3% (n = 329) students experienced suicidal ideation at some point. Students living with a physical chronic condition demonstrated 1.65 (95% CI: 1.14, 2.39) times higher odds of experiencing suicidal ideation, compared to students not living with a chronic physical condition. Suicide prevention and health promotion are important considerations for campus health providers and administrators when planning services and accommodations for students living with chronic physical conditions. [ABSTRACT FROM AUTHOR]

The Revised Illness Perception Questionnaire (IPQ-R) assesses patients' perspectives of their illnesses. Original psychometric testing occurred in limited populations. The purpose of this reliability generalization meta-analysis was to: (1) estimate internal consistency reliability of each IPQ-R subscale, and (2) test moderators of these estimates. Web of Science was searched in July 2022 for articles citing the original IPQ-R paper that reported IPQ-R reliability data. Cronbach's alphas (⍺) were pooled for each IPQ-R subscale using inverse variance weighting and DerSimonian and Laird estimation. Sixty-six studies met criteria. Overall pooled ⍺ estimates were acceptable: 0.71–0.87. Treatment control reliability was reduced among cardiac (⍺ = 0.68), diabetes/kidney disease (⍺ = 0.63), and mixed/other (⍺ = 0.66) samples; cyclical reliability was reduced in cancer (⍺ = 0.65) samples. Age, gender, and race were also significant moderators. Subscale reliability varied based on sample characteristics. Adapting IPQ-R subscales to account for sample variation could improve measurement of illness perception constructs. [ABSTRACT FROM AUTHOR]

Objective: Although Ireland has one of the highest levels of well‐being in Europe, having a health condition has been found to have a direct negative impact. The aim of this study is to evaluate the current situation and the experiences of patients with epidermolysis bullosa (EB), a rare genetic skin disease, and their relatives living in Ireland, with a focus on burdens and helpful practices. Methods and Measures: In a mixed‐methods design, a series of standardised questionnaires were combined with open‐ended questions. Via an online survey, data from n = 59 EB patients and relatives of EB patients living in Ireland were collected. Results: EB affects both the patients and their relatives. Burdens were found in relation to the visibility of EB, the degree of severity, the current health status, reduced mobility, the financial impact of EB, the psychosocial impact and personal and social resources. The paper also analyses existing resources and highlights opportunities for support and needs of improvement. Conclusion: Quality of life with EB is influenced by somatic symptoms and the psychosocial burden. Individual helpful practices in dealing with this rare disease can be considered as mediators, but they need to be supported by structural and healthcare improvements. Patient or Public Contribution: The perspective of EB patients, their relatives and EB experts were taken into account in the development of the study design via two feedback loops with the EB patient organisations DEBRA Ireland and DEBRA Austria. The design was adapted accordingly. Additionally, by including open‐ended questions, patients and relatives could contribute their individual perspectives and add insights into their lives with EB that might not have been captured with the structured online survey alone. [ABSTRACT FROM AUTHOR]

Background: People living with human immunodeficiency virus (HIV) are disproportionately impacted by socioeconomic deprivation and are at increased risk of developing other long‐term conditions (LTCs). These illnesses require transformative action to tackle the adverse effects on their health. Data on lived experiences of LTCs among people living with HIV of Black African and Black Caribbean ethnicities are sparse, and how people with LTCs are impacted by social determinants of health (SDoH). Methods: Through a phenomenological study design this qualitative study, conducted in 2022, comprised four focus group discussions (FGDs) with 20 people of Black ethnicities living with HIV were purposively invited from a community organisation (CO) in London, including four semistructured interviews with CO staff. Following transcription, qualitative data were analysed thematically and measures to validate the findings were implemented. Results: The findings are presented in terms of the following four levels of SDoH: (1) individual determinants (such as the impact of SDoH on lifestyle modification and self‐management); (2) interpersonal determinants (such as positive experiences of accessing healthcare for LTCs); (3) clinical determinants (such as care pathway barriers) and (4) systemic determinants (such as systemic barriers related to race/ethnicity). Conclusions: It is necessary to provide ongoing and interactive education to community members who live with HIV, focusing on risks and management of LTCs. Additionally, individuals would benefit from support to navigate increasingly complex and fragmented health services. Health Service staff require cultural competence when caring for patients of Black African and Black Caribbean ethnicities with complex health and psychosocial needs. Patient or Public Contribution: The research team collaborated with an HIV CO in South London from the very start of the project to agree the study design and learn about the realities of their daily lived experiences. Community collaborators helped to develop the semistructured interview and FGD topic guides, and were directly involved in the data gathering, analysis and validation. [ABSTRACT FROM AUTHOR]

Falls are a leading cause of morbidity and mortality among adults aged 65 years and older (older adults) and are increasingly recognized as a chronic condition. Yet, fall-related care is infrequently provided in a chronic care context despite fall-related death rates increasing by 41% between 2012 and 2021. One of the many challenges to addressing falls is the absence of fall-focused chronic disease management programs, which improve outcomes of other chronic conditions, like diabetes. Policies, information systems, and clinical-community connections help form the backbone of chronic disease management programs, yet these elements are often missing in fall prevention. Reframing fall prevention through the Expanded Chronic Care Model (ECCM) guided by implementation science to simultaneously support the uptake of evidence-based practices could help improve the care of older adults at risk for falling. The ECCM includes seven components: (1) self-management/develop personal skills, (2) decision support, (3) delivery system design/re-orient health services, (4) information systems, (5) build healthy public policy, (6) create supportive environments, and (7) strengthen community action. Applying the ECCM to falls-related care by integrating health care delivery system changes, community resources, and public policies to support patient-centered engagement for self-management offers the potential to prevent falls more effectively among older adults. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to explore the expectations of and experiences with the public healthcare system of domestic partners of people with Parkinson's disease (PD) in Denmark and Norway. Methods: A qualitative exploratory design was applied. The sample consisted of 14 people from Denmark (n = 9) and Norway (n = 5) living with a partner with PD. Semi-structured individual interviews were conducted between June and September 2020, digitally recorded, transcribed verbatim and analysed using a reflexive thematic analysis approach combining inductive and deductive approaches. Results: The main themes were 'negotiating systems of support' and 'balancing being both a partner and a family carer'. Partners take responsibility for the people with whom they live and attempt to fill gaps in the public healthcare system. The most frequently described needs were more information, service coordination as the illness progressed and acknowledgement of the complex role. Discussion: A recommendation for practice is recognition of the complex roles of partners to people with PD and reaching out to both regularly to determine needs. This may enhance the collaboration between partner carers, people with PD and healthcare providers, ensure sustainability of the system and optimise living with PD in the family. [ABSTRACT FROM AUTHOR]

Background: Chronic disease (CD) accounts for more than half of the overall global disease burden and physical activity (PA) is an established evidence-based strategy for the prevention and management of CD. Global policy emphasises the value of embedding PA into primary healthcare, highlighting the positive effects on PA behaviour. However, there is limited implementation of PA protocols in primary care, and research is needed to guide its integration into routine practice. The voice of the patient is underrepresented in the literature, resulting in the absence of critical insights into determinants of PA promotion in primary care. The purpose of the research was to identify the perspectives of people at risk of or living with CD on the determinants of PA promotion in primary care and to map these determinants across the six COM-B constructs. Methods: Semi-structured interviews (n = 22), guided by the COM-B model were conducted with people aged 35–60 years, at risk of or living with CD and not meeting the PA guidelines. A hybrid analytic approach of thematic inductive and deductive analysis was applied to the participant transcripts guided by a COM-B informed coding framework. Results: In total, 37 determinants across constructs related to capability, opportunity and motivation were prominent, examples include; physical capability constraints, the conflation of exercise with weight management, credibility of the health services in PA advice, communication styles in PA promotion, expectations of tailored support for PA, social support, accessibility, and integration of PA into routine habits. Conclusion: Exploring the determinants of PA promotion through the lens of the COM-B model facilitated a systematic approach to understanding the primary care user perspective of the healthcare professional (HCP) broaching the topic of PA. Findings emphasise the value of HCPs being supported to broach the issue of PA in a therapeutic and patient-centred manner using diverse and flexible approaches, while highlighting the importance of tailored, accessible PA opportunities that build self-efficacy and foster social support. The research provides valuable learnings to support PA promotion and the development of strategies in primary care through encompassing the perspective of those living with or at risk of CD. [ABSTRACT FROM AUTHOR]

Introduction: Chronic physical disease (CPD) makes life filled with many negative events in adolescents, but not all adolescents experiencing negative life events proceed to develop emotional distress, only those with low emotional distress tolerance (EDT). A valid and reliable scale to measure EDT in CPD adolescents is important for caring for their emotional distress. Therefore, the purpose of this study is to translate the 15‐item English version Distress Tolerance Scale (DTS) into a Chinese version and then validate the scale for measuring EDT of adolescents with CPD. Methods: The 15‐item English version DTS was translated into a Chinese version using the translation guidelines for cross‐cultural research. Two cohorts of adolescents with CPD were recruited from four hospitals in southern Taiwan, with the first cohort including 124 adolescents with CPD employed to conduct exploratory factor analysis, corrected item‐total correlation and reliability testing, while the second cohort, consisting of 238 adolescents with CPD, was utilized to examine confirmatory factor analysis and concurrent validity. Results: The two‐factor nine‐item Chinese version DTS for Adolescents with CPD (C‐DTS‐A) was developed. Lower scores of the C‐DTS‐A were significantly associated with higher diabetes distress, poorer self‐management, and worse glycaemic control; their correlation coefficients sequentially were −.40,.17 and −.23. Cronbach's α and the test–retest reliability of the two‐factor C‐DTS‐A ranged from.81 to.87 and from.79 to.89, respectively. Conclusion: The two‐factor nine‐item C‐DTS‐A with good cross‐cultural translation quality was a reliable and valid scale to assess EDT for adolescents with CPD. [ABSTRACT FROM AUTHOR]

Chronic migraines result in debilitating pain requiring complex and multifaceted daily management, including acting purposefully to attenuate symptoms and decrease impairment. Experiencing migraines may be more psychologically challenging for adolescent and young adult (AYA) women due to complex and recurrent stressors. This study examined the relationships between illness specific cognitive appraisal mechanisms (i.e., illness uncertainty and illness intrusiveness) and psychological adjustment (i.e., anxious and depressive symptoms) in AYA women with self-reported chronic migraines. AYA women (N = 74, Mage = 20.19, SD = 3.41) with chronic migraines completed measures of illness uncertainty, illness intrusiveness, anxious, and depressive symptoms. Two hierarchical regression analyses indicated that illness uncertainty (B =.44, p <.001) and intrusiveness (B =.27, p =.026) significantly predicted anxious, F(4, 68) = 12.83, p <.001, and depressive symptoms, F(4, 68) = 8.48, p <.001, B =.31, p =.021 and B =.27, p =.037. Greater illness uncertainty and illness intrusiveness were associated with greater anxious and depressive symptoms. Thus, it may be that AYA women who experience chronic migraines have increased perceptions of ambiguity, unpredictability, and disruption to their life that significantly contribute to their psychological adjustment outcomes. This study demonstrates a need for health education on the role of illness related cognitive appraisal mechanisms for AYA women with chronic migraines. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) [ABSTRACT FROM AUTHOR]

Copyright of ESTUDAM Public Health Journal is the property of ESTUDAM Public Health Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Older adults often delay seeking professional help, particularly for mental health problems. This is of great concern for older adults with chronic diseases, who are at risk of mental health declines. This study explored barriers to help-seeking among older adults with chronic diseases and identified factors that influence older adults' perceptions of such barriers. This was a cross-sectional study with 106 adults ≥65 years, diagnosed with cardiovascular disease, respiratory disease, and/or type 2 diabetes. Demographic variables and barriers to help-seeking were measured using self-report questionnaires. The most common barriers to help-seeking were wondering whether the mental health problem is significant enough to warrant treatment (51.9%) and not having a regular primary health care provider to speak with (39.6%). Participants who had sought help in the past had less endorsement of these barriers than those who had never sought help. Many older adults with chronic diseases have difficulties knowing when to seek help, and apprehensions about disclosing mental health concerns. Integrated intervention is needed involving the community (e.g., reduce stigma), older adults with chronic diseases (e.g., increase mental health literacy), and physicians (e.g., increase training in ageing and mental health) to alleviate common barriers to help-seeking in this population. What is already known about this topic: Adults aged 65 years and older with chronic diseases are at risk of mental health problems. Many older adults do not seek mental health help or delay seeking help, thus mental health problems often go undiagnosed and untreated. Attitudes and beliefs towards help-seeking influence whether older adults are willing to engage mental health-related services. What this topic adds: The most common barriers to mental health help-seeking among older adults with chronic diseases are perceived need and fears around disclosing mental health concerns. Past use of mental health services, gender, marital status, number of chronic diseases, and quality of life influence perceived barriers to mental health help-seeking. Greater education for older adults and primary health care providers to increase mental health literacy and reduce stigma is likely to alleviate barriers to care and increase mental health help-seeking in this population. [ABSTRACT FROM AUTHOR]

This paper describes the Wellness in Chronic Care (WCC) model, an innovative integrative clinical intervention method aimed at helping social workers manage the care of patients living with chronic illnesses and their families. The goal is to propose appropriate clinical responses to the changing reality of the health system. This new reality poses new challenges that require caregivers (social work practitioners and family members) to develop suitable skills and expertise. The intervention method we developed offers a new paradigm that entails partnership and the need to assume responsibility in decision-making while coping with the illness over time. The intervention provides practical tools and methods for coping and managing the illness. These factors have contributed to building a specifically tailored intervention program for patient and family care to achieve an effective and meaningful wellbeing. An assessment of the training program of the intervention model and its implementation is presented. The model was found to be essential yet some found it difficult to make the needed changes. [ABSTRACT FROM AUTHOR]

Background: Cancer threat is relevant to age, and the threat of a foreshortened life coupled with a lengthy treatment process negatively affects middle‐aged and older adults. Understanding the coping throughout the cancer experience in middle‐aged and older cancer survivors will help develop supportive care to promote their physiological and psychological coping effects. Objectives: To explore the cancer coping experiences of middle‐aged adults aged 40–59 and older adults over 60. Design: A descriptive phenomenological study was employed. Methods: Face‐to‐face, in‐depth, semistructured interviews were conducted with 22 oncology patients in a tertiary university hospital aged 40 or above from August to October 2023. The interview data were analyzed using thematic analysis procedures. Results: Five themes and 13 subthemes were formed through analysis: acceptance of cancer (considering cancer as chronic, believing in fate and attributing cancer to karma); having different information needs (desired to be truthfully informed, information‐seeking behaviour, information avoidance behaviour); getting families involved (developing dependent behaviours, feeling emotional support, family members suffering worse); striving to maintain positive psychological state (positive thinking, seeking peer support) and negative experience (undesirable, low self‐esteem). Conclusion: Our study reveals that cancer survivors' attitudes towards having cancer have changed from a death sentence to a more positive perception of a chronic disease. Supportive programmes for developing coping strategies should consider the cultural traditions and religious beliefs, different information needs, involvement of family and promoting a positive psychological state while avoiding negative factors. Patient or Public Contribution: Participants with experience of coping with cancer were involved in the semistructured interview. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article focuses on Drew Leder's book, The Healing Body, which provides a practical and philosophically grounded guide to understanding and managing illness and aging. Topics include the book's role as an introduction to phenomenology of health, its exploration of individual and systemic aspects of suffering, and the presentation of twenty healing strategies based on phenomenological features of embodiment.

Context: To identify the characteristics of adolescent young carers (AYCs), studies in the literature have compared them with non‐AYCs, but without considering that in the latter group, some face the illness of a relative whereas others do not. Objectives: The aims of the study were (1) to identify the characteristics of AYCs as compared with adolescents who are not young carers but are facing the illness/disability of a relative, or adolescents not facing the illness/disability of a relative, and (2) to identify factors associated with being a carer within adolescents facing a relative illness. Methods: A total of 4000 high school students (grades 10–12, mainly aged 15–17 years, 568 identified as AYCs, 1200 as adolescents facing the illness/disability of a relative without being a carer and 2232 as adolescents not facing the illness/disability of a relative) completed a self‐reported questionnaire assessing sociodemographic characteristics, illness/disability in the family, caregiving activities (MACA‐YC18 and specific emotional support scale), quality of life (KIDSCREEN‐10) and mental health (GHQ‐12). Chi‐square tests, ANOVAs and logistic regressions were performed. Results: AYCs scored lower on the quality‐of‐life measure compared with adolescents not facing the illness/disability of a relative (p <.001) and had poorer mental health compared with adolescents facing the illness/disability of a relative without being a carer and adolescents not facing the illness/disability of a relative (p <.001). Logistic regressions showed that youth were more at risk to be an AYC when they were females (p <.001), when they had an extracurricular job (p <.001), spoke another language at home (p <.01), had siblings and were one of the oldest siblings (p <.001), and when the relative had a serious or chronic physical illness (p <.001) and lived with the youth (p <.001). Conclusions: These results highlight the importance of distinguishing AYCs, adolescents facing the illness/disability of a relative without being a carer and adolescents not facing the illness/disability of a relative to better describe AYCs, recognizing that as the level of care provided might change over time, adolescents facing the illness/disability of a relative without being a carer could become AYCs or inversely. The factors that emerged could be used by professionals to better identify AYCs. [ABSTRACT FROM AUTHOR]

Nigeria is experiencing an increasing rate of new cancer cases while marred by a weak health system. As cancer prevalence increases in Nigeria, especially among women, it is crucial to understand the experiences of female cancer survivors, given that their quality of life may be influenced by perceptions of cancer and what it means to be a cancer survivor. This study employed a qualitative descriptive method. Semi-structured interviews were conducted with a purposive sample of 30 female breast cancer survivors in Abuja, Nigeria. The three major themes were views about being a cancer survivor, cancer can be stigmatizing, and life after cancer diagnosis and therapy. We argue that cancer-related identity and cancer-related stigma are key factors with help-seeking and quality-of-life implications. Tailored interventions such as cancer health education and social support for cancer survivors may help reduce the burden of cancer in Nigeria. [ABSTRACT FROM AUTHOR]

We aimed to assess the parent-child agreement on various domains of health-related quality of life (HRQoL) in a Hungarian pediatric sample. We examined the associations of demographic, illness-specific factors and the perceived consequences of the illness with the parent-child disagreement. A cross-sectional study was carried out with child-parent pairs in a heterogeneous pediatric sample (n = 259). Child and parent versions of Kidscreen-52 and the consequences scale of the Revised Illness Perception Questionnaire (IPQ-R) were applied. We used intraclass correlation coefficients to measure agreement. We computed directional discrepancies as dyadic indexes and applied them in multinomial regression analysis to identify factors influencing agreement. Agreement between children and parents on the KIDSCREEN-52 instrument was moderate to good (ICC = 0.41 to 0.66). Significant (p < 0.005) parent-child disagreement was observed on 6 out of 10 dimensions of HRQoL: Parents rated their children's well-being lower on Physical Well-being, Psychological Well-being, Parent Relations and Home Life, Social Support and Peers, and Financial Resources scales and rated higher on Moods and Emotions compared to child-reported HRQoL. Both parent's and child's higher perceived illness consequences made disagreement significantly more likely on various domains. Direction of disagreement may draw attention to potentially vulnerable domains of the child's well-being, like moods and emotions and self-perception. [ABSTRACT FROM AUTHOR]

People affected by chronic skin conditions suffer from elevated levels of psychological distress. There is a need for evidence-based treatments that integrate medical care. Mindfulness and Self-compassion programs (MCBPs) have proven effective in chronic diseases. This systematic review aims to narratively synthesize the literature on mindfulness and self-compassion as traits and interventions in chronic skin conditions. We searched four electronic databases for mindfulness and self-compassion trials and correlational studies in chronic skin conditions. We narratively synthetized results regarding the effects of mindfulness and self-compassion, both as traits and as interventions, on psychological and disease outcomes. Thirteen studies were included in our review. Evidence from cross-sectional studies suggest that mindfulness and self-compassion are linked to lower psychological distress and better adjustment to the disease. MCBPs appear feasible for this population and can lower psychological distress, reduce disease severity and improve quality of life. Methodological issues limit conclusions on MCBP efficacy. Based on our analysis, we propose possible mechanisms that future research could explore. The integration of MCBPs in the care process of chronic skin conditions appears promising. Definitive conclusions cannot be drawn due to a lack of strong evidence. Further studies with high methodological standards are needed. [ABSTRACT FROM AUTHOR]

Aims: To determine the relationship between perception of COVID‐19, fear of COVID‐19 and self‐care management in individuals with chronic diseases during the pandemic process. Background: Individuals with chronic diseases are a sensitive group during the COVID‐19 pandemic process; it is thought that self‐care management may be adversely affected as a result of their more intense exposure to the psychological, physiological and economic effects of the pandemic. In the literature, there is no study examining the effect of perception of COVID‐19 and fear of COVID‐19 on self‐care management in individuals with chronic diseases. Design: Descriptive study. Methods: The study was conducted with 322 individuals who applied to the internal medicine outpatient clinics of a university's Health Practice and Research Center, met the inclusion criteria, agreed to participate in the study and had a chronic disease. Questionnaire form, Perception of COVID‐19 Scale (P‐COVID‐19), The Fear of COVID‐19 Scale (FCV‐19S) and Self‐Care Management Process in Chronic Illness Scale (SCMP‐G) were used to collect data. STROBE checklist was used to report the present study. Results: In the study, it can be stated that individuals with chronic diseases had a moderate to the high perception of contagiousness and dangerousness of COVID‐19, they had a moderate‐high level of fear of COVID‐19 and their self‐care care management was above moderate level. There was a significant positive correlation between P‐COVID‐19, FCV‐19S and SCMP‐G in the study. Conclusions: It was found that the perception of COVID‐19 contagiousness and the fear of COVID‐19 had a positive effect on the self‐care management of individuals with chronic diseases. Relevance to clinical practice: Determining the level of COVID‐19 perception and fear of COVID‐19 and their effects on the life of the individual, and evaluating self‐care management during the difficult pandemic process will increase the success in the holistic nursing care and management of chronic diseases. [ABSTRACT FROM AUTHOR]

Aims: To evaluate associations of age, transition readiness and anxiety in adolescents with chronic conditions and to compare perceptions of adolescents and their parents regarding health self‐management and transition readiness. Design: Cross‐sectional international study, reported following STROBE guidelines. Methods: Adolescents and young adults (N = 512, mean age 17.7) with a chronic medical condition and their parents (N = 322) from Finland and Australia. Data were collected through surveys (between September 2017 and December 2020). Adolescents reported the duration of their condition. Age at survey was defined by the response date of the questionnaires. Validated questionnaires were used to measure transition readiness (Am I ON TRAC? for Adult Care) and anxiety related to transition of care (State–Trait Anxiety Inventory short form). Perceptions of health self‐management and transition readiness were compared in adolescent/parent dyads. Associations were explored using Spearman's correlation. Results: Duration of condition and age at survey correlated weakly with transition readiness knowledge and behaviour. Higher transition readiness knowledge scores correlated with higher behaviour scores. Higher transition readiness behaviour scores were associated with lower levels of anxiety. Adolescents were less anxious than their parents and adolescents and parents mostly agreed about health self‐management and transition readiness. Conclusion: Transition readiness should be determined by an assessment of knowledge, self‐management and psychosocial skills instead of age alone. Further research should address how well transition readiness predicts positive health outcomes after the transfer of care. Implications for Patient Care: Transition readiness and self‐management skills should be formally assessed because positive feedback may decrease the anxiety of both adolescents and their parents regarding the transfer of care. Reporting Method: We have adhered to the STROBE statement, using STROBE checklist for cross‐sectional studies. Patient or Public Involvement Statement: No patient or public involvement. Trial and Protocol Registration: ClinicalTrials.org NCT04631965. [ABSTRACT FROM AUTHOR]

Objectives The global prevalence of multimorbidity is increasing as the population ages. As individuals get older, they are likely to develop multiple chronic conditions, and nearly two-thirds of older adults in the United States are estimated to experience 2 or more chronic conditions. The present preregistered study examined whether multimorbidity was associated with longitudinal changes in health-related quality of life (i.e. anxiety, depression, and physical function) and whether these associations were moderated by sociodemographic factors (i.e. sex, race, marital status, income, insurance, and education). Methods Data come from the Health Literacy and Cognitive Function Among Older Adults Longitudinal Study (LitCog), a prospective cohort study of English-speaking older adults (N  = 900). At each measurement occasion, participants reported anxiety, depression, and physical function using the Patient Reported Outcomes Information System, chronic conditions, and sociodemographic characteristics. We employed multilevel growth models to estimate changes in health-related quality of life, with multimorbidities as a predictor and sociodemographics as covariates. Results Results indicated that individuals with multiple chronic conditions reported persistently high levels of anxiety and depression, and worse physical function. We found evidence for racial health disparities, such that individuals who identified as non-White experienced worse health-related quality of life as multimorbidities increased, relative to White participants. Discussion These results contribute to the current conversation about the long-term impacts of structural and systemic barriers experienced by minoritized groups. We further discuss the public health implications of multimorbidity in older adulthood. [ABSTRACT FROM AUTHOR]

AIM: The aim of this study was to determine the problems, perceived stress, and coping with the stress of mothers of children with chronic diseases during the pandemic. METHODS: The study was conducted with cross-sectional design. The data were gathered from the mothers of children with chronic diseases who were followed up at the endocrine outpatient clinic of a hospital in Istanbul between February 1, 2021, and May 31, 2021. The data were collected by conducting face-to-face interviews with mothers of 117 children through information form, Perceived Stress Scale (PSS), and the Coping with Stress Scale (CSS). RESULTS: It was determined that 35.9% of the mothers stated that they had problems during the pandemic since their children suffered from chronic diseases. The mean scores of the mothers were 26.88 ± 6.69 points for the PSS and 87.35 ± 11.04 points for the CSS and there was a negative and weak correlation between their scale scores (r=-.190; p < .05). CONCLUSION: It was found that families faced many different problems during the pandemic, such as the treatment and control of their children. In case of extraordinary situations such as pandemics, nurses should provide planned guidance and counseling services to children with chronic diseases and their families in order to manage the negative situations they experience. [ABSTRACT FROM AUTHOR]

Background: Extensive research has explored SLE's impact on health-related quality of life (H-QoL), especially its connection with mental wellbeing. Recent evidence indicates that depressive syndromes significantly affect H-QoL in SLE. This study aims to quantify SLE's impact on H-QoL, accounting for comorbid depressive episodes through case-control studies. Methods: A case-control study was conducted with SLE patients (meeting the ACR/EULAR 2019 criteria of age ≥ 18). The control group was chosen from a community database. H-QoL was measured with the SF-12 questionnaire, and PHQ-9 was used to assess depressive episodes. Results: SLE significantly worsened H-QoL with an attributable burden of 5.37 ± 4.46. When compared to other chronic diseases, only multiple sclerosis had a worse impact on H-QoL. Major depressive episodes had a significant impact on SLE patients' H-QoL, with an attributable burden of 9.43 ± 5.10, similar to its impact on solid cancers but greater than its impact on other diseases. Conclusions: SLE has a comparable impact on QoL to serious chronic disorders. Concomitant depressive episodes notably worsened SLE patients' QoL, exceeding other conditions, similar to solid tumors. This underscores the significance of addressing mood disorders in SLE patients. Given the influence of mood disorders on SLE outcomes, early identification and treatment are crucial. [ABSTRACT FROM AUTHOR]

Psychosocial adaptation to chronic illness and disability (CID) involves a complex interplay of the client's background factors with resilience and coping. To date, there have been few studies on psychosocial adaptation to CID in the Chinese context. To examine the predictors of psychosocial adaptation, we surveyed people with CID from community-rehabilitation settings and self-help groups (N = 224). The research questionnaire collected information on demographics, health-related factors, social support, resilience, coping strategies, psychosocial adaptation, and mental well-being. Resilience, coping strategies, health-related factors, and sex were found to be important predictors of psychosocial adaptation. Using structural equation modeling (SEM), we tested a conceptual model on how social support and health-related factors predict adjustment variables (resilience and coping strategies), which further affect psychosocial adaptation and mental well-being. All the variables are closely linked and the path coefficients are all significant. An overall fair model fit (comparative fit index [CFI] = 0.89; root mean square error of approximation [RMSEA] = 0.089) was obtained. The results provide support for the conceptual model we proposed based on health-related coping and the phase model of psychosocial adaptation. The key predictors of psychosocial adaptation and mental well-being in Chinese people with CID in Hong Kong are similar to those identified in non-Chinese studies. [ABSTRACT FROM AUTHOR]

The article focuses on chronic medical illnesses, discussing their operational definition as conditions requiring ongoing management over an extended period and encompassing various health issues, leading to the concept of multimorbidity. It mentions the prevalence of chronic conditions, especially among older adults, is highlighted, with estimates suggesting that a significant portion of the population suffers from one or more chronic conditions.

Background. The rising life expectancy and advancements in health care have led to an upsurge in chronic diseases, highlighting the emergence of significant societal and public health challenges. Objectives. We aimed to examine the effects of the health anxiety of individuals with chronic diseases on their adjustment to their chronic diseases. Material and methods. This study was designed as observational, descriptive and cross-sectional. The population of the study consisted of individuals who had a chronic disease and were treated in a family medicine outpatient clinic for any reason between February and March 2022. The sampling method was determined to be probabilistic and sequential, and a total of 107 individuals aged 18 years and older who volunteered to participate in the study with these characteristics were included in the study. Data was collected using a questionnaire that included descriptive characteristics of the patients and researcher-generated information about the disease, as well as the Chronic Disease Adjustment Scale and the Health Anxiety Scale. Results. A statistically significant inverse relationship was found between patients' scores on the Health Anxiety Scale and scores on the Chronic Disease Adjustment Scale and the psychological and social adjustment subscales. Conclusions. With the interventions to be made on patients' health anxiety, it will be possible to adapt the patients to their chronic diseases so that regular drug use and social well-being will be possible for the patients. [ABSTRACT FROM AUTHOR]

Objective: The TARGET program for integrated, person-centered care for people with chronic conditions offers primary care (PC) professionals a set of tools and trainings to actively engage in population segmentation and person-centered needs assessments (PCNAs). A pilot study was conducted to gain insight into the program's feasibility and acceptability, and identify preconditions for successful implementation. Design and setting: Seven Dutch PC practices participated in a half-year pilot study starting in August 2020. We performed a review of the population segmentation tool, observed four training sessions and 15 PCNAs, and interviewed 15 professionals and 12 patients. Results: Regarding feasibility and acceptability, we found that the tools and trainings provided professionals with skills to use the segmentation tool and take a more coaching role in the well-appreciated PCNAs. Concerning implementation preconditions, we found that team commitment and network connections need improvement, although work pleasure increased and professionals generally wanted the program to continue. Conclusions: While the content of the TARGET program is supported by its users, the implementation process, for instance team commitment to the program, needs more attention in future upscaling efforts. [ABSTRACT FROM AUTHOR]

Online health platforms play an important role in chronic disease management. Patients participate in online health platforms to receive and provide health‐related support from each other. However, there remains a debate about whether the influence of social interaction on patient health anxiety is linearly positive. Based on uncertainty, information overload, and the theory of motivational information management, we develop and test a model considering a potential curvilinear relationship between social interaction and health anxiety, as well as a moderating effect of health literacy. We collect patient interaction data from an online health platform based on chronic disease management in China and use text mining and econometrics to test our hypotheses. Specifically, we find an inverted U‐shaped relationship between informational provision and health anxiety. Our results also show that information receipt and emotion provision have U‐shaped relationships with health anxiety. Interestingly, health literacy can effectively alleviate the U‐shaped relationship between information receipt and health anxiety. These findings not only provide new insights into the literature on online patient interactions but also provide decision support for patients and platform managers. [ABSTRACT FROM AUTHOR]

BACKGROUND/OBJECTIVES: Children with chronic medical conditions (CCMC) have high rates of mental health (MH) conditions. This study examines associations between MH educational resources during fellowship and 3 dependent variables: fellows' interest, perceived responsibility, and self-reported competence in assessing MH concerns of CCMC. METHODS: Subspecialty fellows taking the American Board of Pediatrics in-training examinations in February 2020 were invited to participate in a survey inquiring about MH educational resources. Logistic regression examined associations between MH educational resources and the 3 dependent variables, adjusting for demographics and program-level characteristics. RESULTS: Of the 97.7% (4216) fellows who responded, 3870 were included in analyses. About 37.5% reported formal MH teaching sessions; 36.7% reported on-site MH professionals engaged in teaching; 41.6% reported co-assessing patients with MH specialists; and 28.3% reported performance evaluation of their MH skills. All 4 resources were significantly and positively associated with self-reported competence in adjusted analyses, with odds ratios (OR) ranging from 1.28 (95% confidence interval (95% CI): 1.03--1.58) for formal teaching sessions to 2.14 (95% CI: 1.73--2.65) for performance evaluation. Resources were positively associated with the dependent variables in a "dose-response" pattern. Respondents who reported having all 4 educational resources compared to zero resources had an OR of 2.20 (95% CI: 1.74--2.78) for high MH interest, 3.18 (95% CI: 2.45--4.12) for high perceived responsibility, and 4.38 (95% CI: 3.43--5.60) for high self-reported competence CONCLUSIONS: Access to mental health educational resources was associated with higher interest, perceived responsibility, and self-reported competence; investing in these resources may improve fellows' skills in addressing the emotional needs of CCMC. [ABSTRACT FROM AUTHOR]

Objective : This observational, multisite cohort study explored health-related quality of life (HRQoL) in children with cleft lip and/or palate (CL/P), including interrater agreement and ratings for this group relative to clinical cutoff scores and published means for healthy and chronically ill children. Methods : Participants (338 children ages 8-10 years, 45.9% male and their parents, 82.0% female) across 6 sites completed the Pediatric Quality of Life Inventory Generic Core Scales (PedsQL). Results : Intraclass correlation revealed poor interrater agreement for most HRQoL domains. Although ratings were generally higher than those expected for children with a chronic illness, child ratings were below healthy means for school functioning, and parent proxy ratings were below healthy means for all domains except physical functioning. Lower ratings consistent with chronic illness means were found for self-reported emotional and psychosocial functioning in children with cleft lip and palate (CLP), as well as parent proxy-reported emotional, school, and psychosocial functioning for children with cleft palate (CP). Scores were most likely to be in the clinical range for children with CP for social, school, and total functioning. Conclusion : Although parent proxy report provides important information about observed functioning, poor interrater agreement indicates that both child and parent proxy reported HRQoL should be included in outcomes assessment for CL/P. HRQoL ratings may be higher for children with CL/P compared to youth with other chronic illnesses, but psychosocial functioning may be negatively impacted when compared with healthy youth, particularly for emotional, social, and school functioning in children with CLP or CP. [ABSTRACT FROM AUTHOR]

Objective: Little is known about self-concept in adolescents with physical-mental comorbidity. This study investigated whether physical-mental comorbidity was associated with self-concept in adolescents and examined if adolescent age or sex moderated the association between physical-mental comorbidity and self-concept. Methods: Study data were obtained from the Multimorbidity in Youth across the Life-course (MY LIFE), an ongoing Canadian study of adolescents with chronic physical illness who were recruited from outpatient clinics at a pediatric hospital. A total of 116 adolescents aged ≥ 10 years provided self-reports on key measures. Results: Adolescents with comorbidity (n = 48) had lower self-concept scores on the Self-Determination Questionnaire (SDQ; d = 0.62) and Self-Perception Profile for Children (SPPC; d = 0.53) vs. adolescents without comorbidity (n = 68). An age × comorbidity status interaction was found and age-stratified models were computed to investigate this moderating effect of age. Amongst older adolescents, comorbidity was associated with lower SDQ (B = -2.55, p <.001), but this association was not found among younger adolescents (B = -0.29, p =.680). A similar effect was found for SPPC among older (B = -0.48, p =.001) and younger adolescents (B = 0.03, p =.842). Adolescent sex was not found to be a moderator. Conclusions: Physical-mental comorbidity in adolescence was associated with lower self-concept and this association was moderated by age—differences between adolescents with vs. without comorbidity were greater for older adolescents and were clinically relevant. Opportunities to support positive self-perceptions for adolescents with comorbidity are warranted, especially when planning the transition from pediatric to adult health services. [ABSTRACT FROM AUTHOR]

Religiosity is a desirable alternative coping strategy for many people when facing negative life events including age-related infirmities and stressors. Religious coping mechanisms (RCMs) have been investigated meagerly with regard to religious minorities around the world and, to the best of current knowledge, no study has been conducted on Iranian Zorostrians to explore their religious coping mechanisms in dealing with age-related chronic diseases. This qualitative research, therefore, was aimed to canvas perceptions about RCMs that are utilized by Iranian Zoroastrian older adults to deal with chronic diseases in the city of Yazd, Iran. Semi-structured interviews were conducted with purposefully selected fourteen Zoroastrian older patients and four Zoroastrian priests in 2019. The main extracted themes included performing certain religious behaviors and having sincere religion-based beliefs as employed mechanisms for better coping with their chronic diseases. Prevalent dilemmas/barriers with mitigating impact on the coping capacities in dealing with a persistent illness was another predominant identified theme. Identification of RCMs that religious and ethnic minorities are using to better confront diverse life events, such as chronic diseases, could pave the path to expand new approaches in planing sustainable disease management and proactive quality of life improvement initiatives. [ABSTRACT FROM AUTHOR]

Background and Aims: Unmet supportive care needs (SCN) refer to perceived gaps in the support parents want to manage caregiving activities for children with chronic health conditions (CHC) and the support received. This review aims to systematically identify the unmet SCN of families with children living with five common paediatric CHC and characterise the assessment tools used to measure SCN. Design: Systematic review methodology with narrative synthesis of data. Reporting followed the PRISMA statement guidelines. Method: Literature searches were conducted in electronic databases Medline complete, PsycINFO, CINHAL and EMBASE to retrieve relevant articles published between 1990 and July 2022. Eligible studies involved (i) children aged 0–18 years diagnosed with either of cancer, congenital heart disease (CHD), diabetes, asthma, renal disease and (ii) assessment of unmet SCN. Studies involving children with genetic or developmental conditions were excluded. The methodological quality of studies was assessed using JBI assessment tool. Results: Of 6223 articles screened, 34 papers were included (25 quantitative, 5 qualitative and 4 mixed design). Most papers explored unmet needs of families with cancer (n = 26). The remaining articles concerned CHD (n = 5), asthma (n = 2) and mixed CHC (n = 1, renal failure, and diabetes). Information (e.g. treatment, lifestyle, etc.) and health care (e.g. emotional support, practical services, etc.) were the most common unmet need domains across health conditions. A variety of methods and need assessments hampered comparisons between studies both across and within CHC. Conclusion: Irrespective of illness, addressing unmet informational or health care needs may help to optimise outcomes and care for children and families living with common CHC. There was considerable variation in reporting styles, study design and need assessments both within and across conditions. Relevance to Clinical Practice: Health care professionals must routinely evaluate the type, quality and quantity of psychoeducation and support that families of children with CHC want and receive. Providing nurses with more effective strategies to assess child and family needs across a broad range of domains may help to increase understanding of where further support for families is required. Patient or Public Contribution: There was no patient or public contribution to this study as it involved a systematic review of existing literature. [ABSTRACT FROM AUTHOR]

Palliative care social workers are trained to identify how trauma manifests over the course of serious and chronic illness. This expertise can guide patients and team members to ensure a trauma-informed experience of care. This paper identifies the growth of outpatient palliative care clinics as an opportunity for palliative care social workers to emphasize this clinical skill set and assume a leadership role in the implementation of trauma-informed practices early in the trajectory of serious illness. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is not the first, and certainly not the last, to strike the world. COVID-19 has conjointly been a serious concern in higher-income countries, with several European countries and over eleven million individuals in the Republic of India had been infected with COVID-19. Though some countries and regions are seeing improvements in hospitalization and death rates, COVID-19 remains a significant concern for vulnerable and underserved populations globally. The COVID-19 pandemic is unexampled and heavy, and numerous of the policy measures taken to mitigate and contain it were necessary and comprehensible. Factors associated with difficulty in accessing medicine due to the COVID-19 situation With the diversion of human resources to COVID-19 work, active case finding for TB has been postponed by a number of states in India. Though regulative authorities in many countries have approved one or a lot of COVID-19 vaccines for emergency use, necessary challenges remain in mass manufacturing and distributing vaccines in developing countries. The national authorities need to arrange for the challenges associated with the health of their population coincidental with combating the COVID-19 pandemic. It's unclear, however, whether the twin impacts of COVID-19 and also the health care disruptions have an effect on these people within the semi-permanent. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Health Academics / Sağlık Akademisyenleri Dergisi is the property of Journal of Health Academics and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

(1) Background: The elderly with chronic diseases often experience high levels of depression, which can negatively affect their family conflict coping strategies. Additionally, as the level of depression increases, self-esteem tends to decrease. This study aims to investigate whether self-esteem plays a moderating role in the relationship between depression and family conflict coping strategies among the elderly with chronic diseases. (2) Method: The subjects were 2501 older adults with chronic diseases included in the 16th Korean Welfare Panel Study. The CES-D scale, Rosenberg Self-Esteem Scale, and the tool of Family Conflict Coping Strategies were used. (3) Results: Depression was negatively correlated with self-esteem and coping strategies for family conflict, while self-esteem was positively correlated with coping strategies for family conflict. In the multiple regression model, self-esteem had a moderating effect (F = 43.20, p < 0.001). This result indicated that as self-esteem increases, the negative influence of depression on family conflict coping strategies becomes weaker (β = −0.08, t = −3.04, p = 0.002). (4) Conclusions: When addressing family conflict coping strategies in the elderly with chronic diseases, it is crucial to focus on enhancing self-esteem. Additionally, it may be beneficial to classify the elderly into groups based on their level of self-esteem. [ABSTRACT FROM AUTHOR]

Food security is an important agenda in MDG goals for people of all age groups irrespective of socio-economic strata in all developing and developed countries. For India, with increasing hunger index, provision of food security among older adults comes out to be a rising concern and matter of discussion under hunger eradication programmes and policies. The study concentrated on prevalence of food insecurity among population aged 60 and above in India and their associated health factors controlling the level of food insecurity. The data used for the research is taken from a nationally representative survey, Longitudinal Ageing Study in India (LASI), Wave I (2019–2020) with a sample of 31,464 people aged 60 and above all over India. The outcome variable of food insecurity is made with composite scores from 5 sets of questions and made a binary variable of whether the respondent is food secure or insecure. Descriptive and bivariate analysis are performed to understand the correlation between the food insecurity and associated explanatory variables, with special focus on various types of functional impairments and chronic diseases. Through binary logistic regression models, the likelihood of food insecurity under different vulnerable conditions are analysed. The result describes 10.6% of older population aged 60 years and above of India experience food insecurity especially in rural areas (12.6%). Older adults living alone, in rural areas, with poor household income, with multimorbidity and functional impairments are more susceptible to be food insecure in India. With increasing number of functional limitations, the likelihood of being food insecure increases around 1.6 times. While presence of multimorbidity increases food insecurity; individual diseases like diabetes and hypertension negatively affects food insecurity among older adults. [ABSTRACT FROM AUTHOR]