BJHP- continuing to increase the profile of health psychology research

Editoria

Psychological Distress in Women Living with Polycystic Ovary Syndrome (PCOS): The Role of Illness Perceptions

Introduction: Polycystic ovary syndrome (PCOS) is an endocrine and metabolic condition linked to increased risk of anxiety and depression (psychological distress). This study examined the relationship between illness perceptions and psychological distress in women living with PCOS. Methods: We used a cross-sectional survey to assess psychological distress (Hospital Anxiety and Depression Scale) and illness perceptions (Illness Perception Questionnaire-Revised) in women living with PCOS in the UK (N = 487). Hierarchical multiple linear regression tested the associations between illness perceptions and psychological distress, adjusting for age, years since PCOS diagnosis, education, body mass index, current depression, and current anxiety disorder. Results: In the fully adjusted regression model, illness perceptions explained 18.6% of the variance in psychological distress, F(7,458) = 21.0, p < .001. Reporting more symptoms (B = 0.226), higher perceived consequences (B = 0.204), lower personal control (B = –0.184), and lower illness coherence (B = –0.127) were significantly associated with higher psychological distress (all p < .001). Conclusions: Illness perceptions may play an important role in psychological distress, even after adjusting for relevant demographics and clinical characteristics. Our findings highlight key areas where researchers and clinicians could develop targeted self-management interventions for women with PCOS, focused on altering maladaptive illness perceptions to reduce psychological burden

Brief report: Self-compassion, physical health and the mediating role of health-promoting behaviours.

To test the hypothesis that self-compassion predicts better physical health and that this is partially mediated through health-promoting behaviours, 147 adults completed self-report measures of self-compassion, health-promoting behaviours and physical health. Self-compassion and health-promoting behaviours were negatively associated with physical symptom scores. Self-compassion was positively associated with health-promoting behaviours. A bootstrapped mediation model confirmed a significant direct effect of self-compassion on physical health through health-promoting behaviours (R(2) = 0.13, b = -8.98, p = 0.015), which was partially mediated through health-promoting behaviours (R(2) = 0.06, b = -3.16, 95 per cent confidence interval [-6.78, -0.86]). Findings underscore the potential health-promoting benefits of self-compassion

Distinct Illness Representation Profiles Are Associated with Anxiety in Women Testing Positive for Human Papillomavirus

Background: Testing positive for human papillomavirus (HPV) at cervical cancer screening has been associated with heightened anxiety. To date, the cognitive determinants of heightened anxiety remain unclear, making it difficult to design effective interventions. Purpose: This study investigated latent illness representation profiles in women testing positive for HPV with no abnormal cells (normal cytology) and explored associations between these profiles and anxiety. Methods: Women aged 24–66 (n = 646) who had tested HPV-positive with normal cytology at routine HPV primary screening in England completed a cross-sectional survey shortly after receiving their result. Results: Latent profile analysis identified three distinct profiles of illness representations (termed “adaptive,” “negative,” and “negative somatic”), which differed significantly in their patterns of illness perceptions. Hierarchal linear regression revealed that these latent illness representation profiles accounted for 21.8% of the variance in anxiety, after adjusting for demographic and clinical characteristics. When compared with adaptive representations (Profile 1), women with negative representations (Profile 2) and negative somatic representations (Profile 3) had significantly higher anxiety, with clinically meaningful between-group differences (mean difference [MD] = 17.26, confidence interval [CI]: 14.29–20.22 and MD = 13.20, CI: 9.45–16.96 on the S-STAI-6, respectively). Conclusion: The latent illness representation profiles identified in this study provide support for the role of negative beliefs contributing to anxiety in women testing HPV-positive with normal cytology. Characteristics specific to subgroups of highly anxious women (Profiles 2 and 3) could be used by policymakers to target information in routine patient communications (e.g., test result letters) to reduce unnecessary burden. Future research should adopt longitudinal designs to understand the trajectory of illness representations from HPV diagnosis through to clearance versus persistence

Usability and experience testing to refine an online intervention to prevent weight gain in new kidney transplant recipients

Data availability statement: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. Consent was not given for the full publication of transcripts.Supporting information is available online at: https://bpspsychub.onlinelibrary.wiley.com/doi/full/10.1111/bjhp.12471#support-information-section .Copyright © 2020 The Authors. Objectives Weight gain in the first year following kidney transplantation increases the risk of adverse health outcomes. Currently, there is no recognized intervention available to prevent weight gain after kidney transplantation. An online kidney transplant-specific resource, entitled Exercise in Renal Transplant Online (ExeRTiOn), has been co-created by a multi-professional team, including patients, to assist with weight prevention. This study aimed to evaluate patient and health care professional usability and experience of the ExeRTiOn online resource. Design Qualitative study utilizing ‘Think-Aloud’ and semi-structured interviews. Methods Participants (n = 17) were purposively sampled to include new kidney transplant recipients (n = 11) and transplant health care professionals (n = 6). Kidney transplant recipient participants were from a spread of physical activity levels based on scores from the General Practice Physical Activity Questionnaire (GPPAQ). ‘Think-Aloud’ interviews assessed the usability of ExeRTiOn. Semi-structured interviews explored participants’ experience of ExeRTiOn, weight gain, and physical activity. The data set were analysed thematically. Participant characteristics, including login data and self-reported body weight, were collected. Results Data analyses identified valued intervention content and usability aspects which were summarized by two themes. The first theme ‘You need to know how to manage yourself’ included subthemes: (1) the resource filled a guidance gap, (2) expert patient content resonated, and (3) the importance of goal setting and monitoring progress. The second theme ‘room for improvement’ included subthemes: (2) web support and (2) content and operational change suggestions. Conclusions Results have allowed for identification of potential areas for resource refinement. This has facilitated iterative enhancement of ExeRTiOn in preparation for a randomized controlled feasibility trial.Kidney Research UK Allied Health Professional PhD Fellowship; National Institute for Health Research/Health Education England (NIHR/HEE) Clinical Lectureship; KCH NIHR Clinical Research Facility; Kidney Research UK

Do Exercise, Physical Activity, Dietetic, or Combined Interventions Improve Body Weight in New Kidney Transplant Recipients? A Narrative Systematic Review and Meta-Analysis

Data Availability Statement: Data is contained within the article or Supplementary Material. The data presented in this study are available in this article and included Supplementary Material.Supplementary Materials: Available at: https://www.mdpi.com/2673-8236/1/2/14/s1?version=1633165351 (ZIP-Document, 999 KiB) The following are available online at www.mdpi.com/article/10.3390/kidneydial1020014/s1, Figure S1: Risk-of-bias plots for Non-RCTs (n = 6), Table S1: PRISMA checklist, Table S2: Search strategy, Table S3: Screening form, Table S4: Detailed sample characteristics, Table S5: Study characteristics of non-RCTs, Table S6: Details of intervention nonRCTs (n = 6), Table S7: Sensitivity analysis.Copyright: © 2021 by the authors. Weight gain within the first year of kidney transplantation is associated with adverse outcomes. This narrative systematic review and meta-analysis examines the effect of exercise, physical activity, dietary, and/or combined interventions on body weight and body mass index (BMI) within the first year of kidney transplantation. Seven databases were searched from January 1985 to April 2021 (Prospero ID: CRD42019140865), using a ‘Population, Intervention, Controls, Outcome’ (PICO) framework. The risk-of-bias was assessed by two reviewers. A random-effects meta-analysis was conducted on randomized controlled trials (RCTs) that included post-intervention body weight or BMI values. Of the 1197 articles screened, sixteen met the search criteria. Ten were RCTs, and six were quasi-experimental studies, including a total of 1821 new kidney transplant recipients. The sample sizes ranged from 8 to 452. Interventions (duration and type) were variable. Random-effects meta-analysis revealed no significant difference in post-intervention body weight (−2.5 kg, 95% CI −5.22 to 0.22) or BMI (−0.4 kg/m2, 95% CI −1.33 to 0.54). Despite methodological variance, statistical heterogeneity was not significant. Sensitivity analysis suggests combined interventions warrant further investigation. Five RCTs were classified as ‘high-risk’, one as ‘some-concerns’, and four as ‘low-risk’ for bias. We did not find evidence that dietary, exercise, or combined interventions led to significant changes in body weight or BMI post kidney transplantation. The number and quality of intervention studies are low. Higher quality RCTs are needed to evaluate the immediate and longer-term effects of combined interventions on body weight in new kidney transplant recipients.Kidney Research UK PhD Grant (AHPF_001_20171122); NIHR Advanced Research Fellowship (ICA-CL-2017-03-020); National Institute for Health Research (NIHR) (DRF-2017-10-105)

A confirmatory factor analysis and validation of the forms of self-criticism/reassurance scale

Objective: Several studies have used the Forms of Self-Criticism/Reassurance Scale (FSCRS; Gilbert, Clarke, Hempel, Miles, & Irons, 2004) when exploring the role of emotion regulation in psychopathology. However, psychometric evaluation of the FSCRS is limited. The present study sought to confirm the factor structure of the FSCRS based on theoretical and empirical grounds in a large sample of the general population. / Method: The FSCRS was completed by a large sample of men and women (N= 1,570) as part of an online survey. The data were randomly split in order to perform both independent exploratory (EFA) and confirmatory factor analyses (CFA). One-, two- and three-factor solutions were examined. / Results: A three-factor model of reassured-self (RS) and the two types of self-criticism, inadequate-self (IS), and hated-self (HS), proved to be the best-fitting measurement model in this sample (χ2= 800.3, df= 148, p < .001; CFI [comparative fit index]= .966, TLI [Tucker Lewis index]= .961, RMSEA [root mean square error of the approximation]= .074). Although very similar to the original questionnaire, there were some differences in terms of the items that were retained. Validity was confirmed with the shortened FSCRS showing the same associations with mood and sex as the original version of the FSCRS. / Conclusion: A three-factor model (RS, IS and HS) provided the best-fitting structure and confirmed the separation of different types of self-criticism. Future research should explore the degree to which these separable aspects of self-criticism are theoretically and clinically meaningful and to identify the role of self-reassurance in ameliorating their effects

Easier, but not easy: Testing a grounded theory of breastfeeding experiences among women with larger birthweight infants

Objective: Grounded Theory has previously been used to explore breastfeeding practices amongst average birthweight infants and these working hypotheses can be ‘tested’ in new contexts. A pre-existing Grounded Theory was applied to the context of women who gave birth to larger birthweight infants (≥4,000 g) to understand whether perceptions and practices of infant feeding were distinct. Design: A nested qualitative study analysed data from N = 10 women with a larger birthweight infant (≥4,000 g). Face-to-face, semi-structured interviews were audio-recorded and transcribed verbatim. Grounded Theory methodology was used to analyse data. Results: A pre-existing Grounded Theory of breastfeeding experiences derived from women with average birthweight infants did not hold true among women with larger birthweight infants. An alternative Grounded Theory was therefore proposed comprised of three discrete themes: Infant Ability to Breastfeed; Attenuating Maternal Concerns; and Reality of Breastfeeding. Conclusions: Larger infant birthweight is potentially a protective factor against breastfeeding latch and lactation difficulties. It is associated with alleviating maternal concerns, helping to reduce disparities between expectations of breastfeeding and reality, but does not alleviate the demands breastfeeding places on women. Healthcare professionals help to attenuate women’s concerns, however the support needs for women with larger birthweight infants may not differ from existing care recommendations

Perceptions of risk in pregnancy with chronic disease: A systematic review and thematic synthesis

Background Women with chronic disease are at increased risk of adverse pregnancy outcomes. Pregnancies which pose higher risk, often require increased medical supervision and intervention. How women perceive their pregnancy risk and its impact on health behaviour is poorly understood. The aim of this systematic review of qualitative literature is to evaluate risk perceptions of pregnancy in women with chronic disease. Methods Eleven electronic databases including grey literature were systematically searched for qualitative studies published in English which reported on pregnancy, risk perception and chronic disease. Full texts were reviewed by two researchers, independently. Quality was assessed using the Critical Appraisal Skills Programme Qualitative checklist and data were synthesised using a thematic synthesis approach. The analysis used all text under the findings or results section from each included paper as data. The protocol was registered with PROSPERO. Results Eight studies were included in the review. Three themes with sub-themes were constructed from the analysis including: Information Synthesis (Sub-themes: Risk to Self and Risk to Baby), Psychosocial Factors (Sub-themes: Emotional Response, Self-efficacy, Healthcare Relationship), and Impact on Behaviour (Sub-themes: Perceived Risk and Objective Risk). Themes fitted within an overarching concept of Balancing Act. The themes together inter-relate to understand how women with chronic disease perceive their risk in pregnancy. Conclusions Women's pregnancy-related behaviour and engagement with healthcare services appear to be influenced by their perception of pregnancy risk. Women with chronic disease have risk perceptions which are highly individualised. Assessment and communication of women's pregnancy risk should consider their own understanding and perception of risk. Different chronic diseases introduce diverse pregnancy risks and further research is needed to understand women's risk perceptions in specific chronic diseases