Examining a Conceptual Model of Maternal and Paternal Warmth, Emotion Regulation and Social Competence among Preadolescent Children in Malaysia

Although parental warmth has been shown to be related to children’s social competence, the mediating role of preadolescent children’s emotion regulation in this context has been less explored, particularly in Asian cultures. Thus, this study examined the role of emotion regulation as a mediator in the relationship between parental warmth (i.e., paternal and maternal warmth) and social competence among preadolescent children in Malaysia. Preadolescent children (N = 720; Mage = 10.95; SD = 0.59; 58.8% female) completed self-administered questionnaires. Results of correlation analysis showed that higher levels of paternal and maternal warmth were associated with greater emotion regulation in preadolescent children and a greater level of social competence. However, analysis of structural equation modeling revealed that emotion regulation significantly mediated only the relationship between maternal warmth and social competence. These findings underscored the importance of maternal warmth in promoting Malaysian preadolescent children’s social competence as well as their emotion regulation as a mediating pathway. This study also highlights the direct effect of paternal warmth on preadolescents’ social competence. Theoretical and practical implications of this study are discussed

Utility of the Morisky Medication Adherence Scale in gout: a prospective study [Corrigendum]

Tan CSL, Teng GG, Chong KJ, et al. Patient Prefer Adherence. 2016;10:2249–2457.On page 2452, Table 2, the copyright statement “Use of the ©MMAS is protected by US copyright laws. Permission for use is required. A license agreement is available from: Donald E. Morisky, 14725 NE 20th St Bellevue, WA 98007, USA; [email protected],53,54” was not included in the Note section. Read the original article&nbsp

Utility of the Morisky Medication Adherence Scale in gout: a prospective study

CSL Tan,1 GG Teng,1,2 KJ Chong,2 PP Cheung,1,2 AYN Lim,1,2 HL Wee,3,4 A Santosa1,2 1University Medicine Cluster, Division of Rheumatology, National University Health System, 2Department of Medicine, Yong Loo Lin School of Medicine, 3Department of Pharmacy, Faculty of Science, 4Saw Swee Hock School of Public Health, National University of Singapore, Singapore Background: The outcomes of any chronic illness often depend on patients’ adherence with their treatment. A tool is lacking to assess adherence in gout that is standardized, allows real-time feedback, and is easy to understand.Objective: We set out to evaluate the utility of the 8-item Morisky Medication Adherence Scale (MMAS-8) in monitoring medication adherence in a multiethnic Asian gout cohort on urate-lowering therapy (ULT).Methods: This cohort study recruited patients with gout where baseline and 6-monthly clinical data, self-report of adherence, and health status by Gout Impact Scale (GIS) and EuroQoL-5 dimension 3 levels were collected. Those who received at least 9 months of ULT were analyzed. Convergent and construct validities of MMAS-8 were evaluated against medication possession ratio (MPR) and known groups, clinical outcomes, and patient-reported outcomes. Internal consistency and test–retest reliability were assessed using Cronbach’s alpha and intraclass correlation coefficient (ICC), respectively.Results: Of 91 patients, 92.3% were male, 72.5% Chinese with mean age 53.5 years. MMAS-8 (mean 6.17) and MPR (mean 96.3%) were poorly correlated (r=0.069, P=0.521). MMAS-8 did not differ between those who did or did not achieve target serum urate (SU) <360 µmol/L (P=0.852); or among those whose SU improved, stagnated, or worsened during follow-up (P=0.777). Adherence was associated with age (β=0.256, P=0.015) and education level (P=0.011) but not comorbidities, polypharmacy, or flare frequency. Concerns for medication side effects and anxiety or depression were associated with lower MMAS-8 (P<0.005). Internal consistency was acceptable (α=0.725) and test–retest reliability was satisfactory (ICC =0.70, 95% confidence interval [CI] 0.36–0.88).Conclusion: MMAS-8 had limited construct validity in assessing medication adherence to ULT in our gout patients. Nevertheless, it identified patients bothered or worried about ULT side effects, and those with underlying anxiety or depression, for whom targeted education and coping support may be useful. Keywords: gout, 8-item Morisky Medication Adherence Scale, MMAS-8, serum urate, urate-lowering therapy, Singapor