Validation of the Patient Activation Measure in a Multiple Sclerosis Clinic Sample and Implications for Care

Purpose. Patient engagement in multiple sclerosis (MS) care can be challenging at times given the unpredictable disease course, wide range of symptoms, variable therapeutic response to treatment and high rates of patient depression. Patient activation, a model for conceptualising patients’ involvement in their health care, has been found useful for discerning patient differences in chronic illness management. The purpose of this study was to validate the patient activation measure (PAM-13) in an MS clinic sample. Methods. This was a survey study of 199 MS clinic patients. Participants completed the PAM-13 along with measures of MS medication adherence, self-efficacy, depression and quality of life. Results. Results from Rasch and correlation analyses indicate that the PAM-13 is reliable and valid for the MS population. Activation was associated with MS self-efficacy, depression and quality of life but not with self-reported medication adherence. Also, participants with relapse-remitting MS, current employment, or high levels of education were more activated than other subgroups. Conclusions. The PAM-13 is a useful tool for understanding health behaviours in MS. The findings of this study support further clinical consideration and investigation into developing interventions to increase patient activation and improve health outcomes in MS

Perceptions of Caregiver Distress, Health Behaviors, and Provider Health-Promoting Communication and their Relationship to Stress Management in MS Caregivers

This study applied the Stress/Health Model to examine a novel approach for promoting stress management among 67 caregivers of persons with multiple sclerosis, who often face unique caregiving challenges. Hierarchical regressions indicated that caregiver distress (i.e., emotional burden) and engagement in other health-promoting activities (i.e., controlling alcohol use) were the best predictors of caregiver stress management. Communication with the MS care recipient’s health provider about caregiver engagement in health-promoting activities was associated with caregiver stress management, but not significantly more so than explained by the other factors (i.e., caregiver distress and engagement in health-promoting behaviors). A more controlled study would be indicated to further explain how to encourage, within the medical setting, caregiver engagement in self-care activities

Implementing an LGBTQ Training for Teen Pregnancy Prevention Facilitators

Teen pregnancy and sexually transmitted infections remain a major health concern and are linked to a number of poor outcomes. Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth are particularly at risk for these issues. Although evidence-based teen pregnancy prevention (TPP) programs exist, they are not necessarily tailored to meet the needs of LGBTQ youth. This paper reports on the development and implementation of a LGBTQ training for TPP facilitators working for the Augusta Partnership for Children in Augusta, GA. The four-hour workshop covered a range of topics including terminology, identity, intersectionality, and risk/resilience factors through a combination of lecture, video clips, and interactive activities. The training was well-received with most facilitators rating the training as excellent on satisfaction surveys completed one-week after the training. Qualitative comments were also largely positive; areas for improvement included discussion of the legal context around LGBTQ issues and the impact of race on LGBTQ issues. Future work is needed to expand on these findings by examining the impact of such trainings on TPP program implementation and, ultimately, on LGBTQ youth

Implementing an LGBTQ Training for Teen Pregnancy Prevention Facilitators

Teen pregnancy and sexually transmitted infections remain a major health concern and are linked to a number of poor outcomes. Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth are particularly at risk for these issues. Although evidence-based teen pregnancy prevention (TPP) programs exist, they are not necessarily tailored to meet the needs of LGBTQ youth. This paper reports on the development and implementation of a LGBTQ training for TPP facilitators working for the Augusta Partnership for Children in Augusta, GA. The four-hour workshop covered a range of topics including terminology, identity, intersectionality, and risk/resilience factors through a combination of lecture, video clips, and interactive activities. The training was well-received with most facilitators rating the training as excellent on satisfaction surveys completed one-week after the training. Qualitative comments were also largely positive; areas for improvement included discussion of the legal context around LGBTQ issues and the impact of race on LGBTQ issues. Future work is needed to expand on these findings by examining the impact of such trainings on TPP program implementation and, ultimately, on LGBTQ youth

Physician–Patient Communication About Sexual Functioning in Patients with Multiple Sclerosis

Sexual dysfunction is quite common among individuals with multiple sclerosis (MS); however, severity of dysfunction alone does not account for the tremendous variation in sexual satisfaction across individuals living with MS. Individual characteristics, relationships with intimate partners, and environmental factors all likely contribute to the multidimensional experience of sexual satisfaction. Health care provider variables, including how one communicates with providers about sexual concerns, may also be influential. The purpose of this study was to examine factors that are associated with patients’ sex-related communications with their MS physicians and to overall patient sexual satisfaction. Individuals in an MS clinic (n = 73) completed a survey packet which included measures of physical and mental health, sexual dysfunction, sexual satisfaction, sex communication, health care provider relationships, and health care satisfaction. Findings suggest that while more than half of patients with MS reported experiencing sexual dysfunction, only a third of patients indicated addressing their sexual concerns with their physician during the past year. Interestingly, the frequency of communication about sexual concerns was associated with satisfaction with physician variables, whereas selfefficacy for these interactions was associated with emotional health variables. These results indicate that when considering interventions to increase confidence for communication and frequency of communication that differing factors may be taken into account

Attributional Dimensions of Problem Cause and Solution and Their Relation to Coping Strategies, Problem -Solving Confidence, and Life Satisfaction

230 p.Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 2001.A measure of Brickman et al.'s (1982) model of helping/coping orientations was validated and its relation to the counseling variables: (1) problem-solving confidence, (2) coping styles, and (3) satisfaction with life was investigated. Two-hundred and fifty one participants from five environments (mental health center, health center, church, university, and Alcoholics/Narcotics Anonymous) completed the Attribution of Problems Solution Responsibility Scale (APSRS), an additional measure of attribution, and measures for each of the three aforementioned variables. Findings indicate that the APSRS has sound reliability and construct validity and is related to the counseling variables in the hypothesized manners. The APSRS has clinical implications with regard to the impact of attributions of cause and solution of problems to how individuals cope with problems and how satisfied they are with their lives.U of I OnlyRestricted to the U of I community idenfinitely during batch ingest of legacy ETD

Managing Depression and Suicidality in clients living with HIV: A roadmap for non-mental health professionals and care settings

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The Arts Therapies

(Statement of Responsibility) by Lara Michelle Stepleman(Thesis) Thesis (B.A.) -- New College of Florida, 1992(Electronic Access) RESTRICTED TO NCF STUDENTS, STAFF, FACULTY, AND ON-CAMPUS USE(Bibliography) Includes bibliographical references.(Source of Description) This bibliographic record is available under the Creative Commons CC0 public domain dedication. The New College of Florida, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.(Local) Faculty Sponsor: Callahan, Charlen

Variables Associated with Patient Activation in Persons with Multiple Sclerosis

Identifying variables associated with patient activation in the multiple sclerosis population could serve to facilitate better multiple sclerosis self-management behaviors. Using a cross-sectional survey design, 199 participants were recruited from a multiple sclerosis center in the Southeastern United States. Depression, multiple sclerosis quality of life, and multiple Sclerosis self-efficacy were all significantly correlated with patient activation. Results of a hierarchical regression indicated that patient activation was significantly related to educational attainment, depression, and self-efficacy but not to quality of life. The results suggest several possible targets for intervention to increase patient activation, including health literacy, depression symptoms, and self-efficacy for multiple sclerosis disease management