Różnice płciowe w przystosowaniu do insulinoterapii u chorych na cukrzycę typu 2

Background: This study aims to investigate if there aregender differences in cognitive, behavioral and emotional response to switching over to insulin treatmentin adults with type 2 diabetes.Material and methods: Cognitive appraisal (questionnaire KOS), coping strategies (CHIP) and emotions (PANAS) were assessed among 278 patients (F = 148,M = 130) one month after conversion to insulin treatment.Results: Results showed that women reported morenegative appraisal, instrumental- and emotion-oriented behaviors than did men. There’s no differences inemotions. In addition, patients generally expressed stronger perception of their health condition in termsof challenge, more emotion-oriented coping strategies and higher levels of negative emotions.Conclusions: Gender differences play an important antrole in adjustment to insulin treatment.Wstęp: Celem badania było określenie istotnych różnic międzypłciowych w zakresie oceny poznawczej, strategii radzenia sobie oraz emocji pojawiających się w reakcji na wprowadzenie insulinoterapii u chorychz cukrzycą typu 2.Materiał i metody: Badaniami kwestionariuszowymi objęto 278 osób (K = 148, M = 130), które miesiąc wcześniej rozpoczęły insulinoterapię. Zastosowano kwestionariusze KOS (ocena poznawcza), CHIP (strategie radzenia sobie z chorobą) oraz PANAS (negatywne i pozytywne emocje).Wyniki: Wykazano istotne znaczenie płci dla oceny zmiany leczenia i zachowań podejmowanych w jej obliczu. Kobiety istotnie częściej postrzegały insulinoterapię w kategoriach zagrożenia, podejmowały działania ukierunkowane na poradzenie sobie z chorobą oraz regulujące emocje. Nie odnotowano różnic w zakresie odczuwanych emocji. Analizy wykazały, że pacjenci, bez względu na płeć, najczęściej oceniali swoją sytuację zdrowotną w kategoriach Wyzwania/aktywności, odczuwali negatywne emocje i radzili sobie poprzez koncentrowanie się na tych emocjach.Wnioski: Rezultaty badania wskazują, że w praktyce klinicznej przy wprowadzaniu insulinoterapii należałoby uwzględnić różnice międzypłciowe

The role of temperament in the changes of coping in Type 2 diabetes: direct and indirect relationships

The paper investigates whether the changes in cognitive appraisal and coping strategies related to initiation of insulin treatment onset mediate the effect of temperament on changes in positivity ratio among diabetic patients. Temperament, cognitive appraisal, coping strategies and positivity ratio (ratio of positive to negative affect) were assessed among 278 patients: just before conversion to insulin therapy and then one month later. Mediation analysis indicated that endurance and briskness were directly connected to changes in positivity ratio, whilst the effect of perseveration on positivity ratio was indirect via changes in negative appraisal, emotion- and problem-focused coping. The results confirm the stressful nature of the initiation of insulin treatment, and the assumptions of Lazarus’ model of stress and regulative role of temperament

Personality, cognitive appraisal and labor pain

Background The theories focusing on the central neural mechanisms also pointed to the role of psychological factors in shaping painful sensations. The aim of the study was to explore direct and indirect effects of personality and cognitive appraisal of childbirth on experienced labor pain. Participants and procedure Labor pain was assessed twice by forty-five childbearing women aged 18-45 (M = 28.31, SD = 5.20; 23 participants were primiparous): on admission to the obstetrics clinic and two days postpartum. On the first occasion, experienced and anticipated pain (VAS) and cognitive appraisal of labor (KOS) were measured, while the second assessment included rating of pain in the second stage of labor (VAS) and personality traits (NEO-FFI). Results Mediation analyses indicated indirect effects of conscientiousness on pain at the first stage of labor via challenge appraisal and of neuroticism and conscientiousness on recalled second stage labor pain intensity via threat/loss appraisal. Irrespective of personality traits, correlations were found between pain and cognitive appraisal in terms of threat/loss and challenge. Conclusions The findings showed the importance of conscientiousness and positive appraisal of labor for diminishing the experienced and memory for labor pain. Such positive appraisals can be reinforced in prenatal classes or trained with the support of close persons

Temperament a efektywność radzenia sobie z chorobą. mediująca rola oceny poznawczej i strategii zaradczych

Zmienne podmiotowe i radzenie sobie są predyktorami emocjonalnych rezultatów konfrontacji z sytuacją stresową. Celem pracy było zbadanie pośredniczącej roli oceny poznawczej i strategii zaradczych w relacji temperamentu i bilansu afektywnego u osób chorujących na cukrzycę typu 2. Badaniami objęto 278 osób. Pomiaru zmiennych dokonano dwukrotnie: miesiąc przed i miesiąc po rozpoczęciu insulinoterapii. Zastosowano kwestionariusz FCZ-KT, KOS, CISS-S oraz PANAS. W toku analizy mediacji dokonanej metodą bootstrappingu stwierdzono całkowitą mediację pomiędzy temperamentem a bilansem afektywnym, choć ostatecznie jedynie model wytrzymałości okazał się być istotny. Ponadto, wskazano na odmienność regulacyjnych funkcji poszczególnych cech temperamentu

Optimism, pain coping strategies and pain intensity among women with rheumatoid arthritis

Objectives: According to the biopsychosocial model of pain, it is a multidimensional phenomenon, which comprises physiological (sensation-related factors), psychological (affective) and social (socio-economic status, social support) factors. Researchers have mainly focused on phenomena increasing the pain sensation; very few studies have examined psychological factors preventing pain. The aim of the research is to assess chronic pain intensity as determined by level of optimism, and to identify pain coping strategies in women with rheumatoid arthritis (RA). Material and methods : A survey was carried out among 54 women during a 7-day period of hospitalisation. The following questionnaires were used: LOT-R (optimism; Scheier, Carver and Bridges), the Coping Strategies Questionnaire (CSQ; Rosenstiel and Keefe) and the 10-point visual-analogue pain scale (VAS). Results: The research findings indicate the significance of optimism in the experience of chronic pain, and in the pain coping strategies. Optimists felt a significantly lower level of pain than pessimists. Patients with positive outcome expectancies (optimists) experienced less pain thanks to replacing catastrophizing (negative concentration on pain) with an increased activity level. Regardless of personality traits, active coping strategies (e.g. ignoring pain sensations, coping self-statements – appraising pain as a challenge, a belief in one’s ability to manage pain) resulted in a decrease in pain, whilst catastrophizing contributed to its intensification. The most common coping strategies included praying and hoping. Employment was an important demographic variable: the unemployed experienced less pain than those who worked. Conclusions : The research results indicate that optimism and pain coping strategies should be taken into account in clinical practice. Particular attention should be given to those who have negative outcome expectations, which in turn determine strong chronic pain regardless of coping strategies. Intensification of positive outcome expectations and seeking benefits in the RA experience could therefore constitute effective techniques in the clinical therapy process

Original article The Me and My Disease Scale: measuring state hope and determining its impact on coping in patients with type 2 diabetes mellitus and myocardial infarction

Background The aim of this study was to examine the psychometric properties, factor structure, measurement invariance, internal consistency reliability and construct validity of the Me and My Disease Scale – a tool for state hope measurement for adults suffering from chronic medical conditions. Participants and procedure Two clinical groups, patients with type 2 diabetes (DM) (n = 278) just before and 1 month after introducing insulin treatment, and cardiac patients (n = 232) five days and one month after their first uncomplicated myocardial infarction (MI), participated in the study. Cognitive appraisal, emotions and depression (MI group) were measured to establish the construct validity of the scale. Results A single-factor model which consisted of 4 items was established. The structure was characterized by good measurement model fit and satisfactory indicators of reliability for the MI subgroup. A less satisfactory model fit was obtained for the DM subgroup – this may point to the impact of specific medical conditions on the scale. Furthermore, the findings indicated metric invariance for the scale. The moderate correlations between hope and cognitive appraisal, emotion and depression confirm the construct validity of the scale. Conclusions The Me and My Disease Scale is characterized by satisfactory psychometric parameters and can be used in scientific research to measure hope as a dimension of cognition and to compare the relationships between hope and other variables in medical patients. However, caution should be taken during analysis when comparing means between clinical groups

Heterogeneity of change in state affect following insulin therapy initiation in type 2 diabetic patients

The aim of the study was to explore heterogeneity of change in state affect following the introduction of insulin therapy in patients with type 2 diabetes. State affect was assessed twice among 305 patients: just before the introduction of insulin therapy and at 1-month follow-up. Latent class growth modeling showed that negative affect (NA) increased in 78% of the sample, whereas positive affect (PA) improved in only 17% of the participants. On the basis of cross-tabulation of these changes a 4-class model of emotional response to the new treatment was obtained. The largest subgroup of participants (57%) manifested “threat response”, i.e. moderate-stable PA with increase in NA. Participants in the “challenge response” subgroup (11.8%) showed increases in both NA and PA. The third class (10.2%) characterized by “no response”, had low-stable NA and moderate-stable PA. The smallest “stress response” subgroup (9.8%) showed increase in NA and high-stable PA. Gender, age and education level were significant covariates of group membership. Thus, the findings revealed heterogeneous emotional response to the new treatment, which may be of clinical relevance for improving diabetic patients’ adjustment through a more individual, person-centered approach

The role of temperament in the changes of coping in Type 2 diabetes: direct and indirect relationships

The paper investigates whether the changes in cognitive appraisal and coping strategies related to initiation of insulin treatment onset mediate the effect of temperament on changes in positivity ratio among diabetic patients. Temperament, cognitive appraisal, coping strategies and positivity ratio (ratio of positive to negative affect) were assessed among 278 patients: just before conversion to insulin therapy and then one month later. Mediation analysis indicated that endurance and briskness were directly connected to changes in positivity ratio, whilst the effect of perseveration on positivity ratio was indirect via changes in negative appraisal, emotion- and problem-focused coping. The results confirm the stressful nature of the initiation of insulin treatment, and the assumptions of Lazarus’ model of stress and regulative role of temperament

Heterogeneity of change in state affect following insulin therapy initiation in type 2 diabetic patients

The aim of the study was to explore heterogeneity of change in state affect following the introduction of insulin therapy in patients with type 2 diabetes. State affect was assessed twice among 305 patients: just before the introduction of insulin therapy and at 1-month follow-up. Latent class growth modeling showed that negative affect (NA) increased in 78% of the sample, whereas positive affect (PA) improved in only 17% of the participants. On the basis of cross-tabulation of these changes a 4-class model of emotional response to the new treatment was obtained. The largest subgroup of participants (57%) manifested “threat response”, i.e. moderate-stable PA with increase in NA. Participants in the “challenge response” subgroup (11.8%) showed increases in both NA and PA. The third class (10.2%) characterized by “no response”, had low-stable NA and moderate-stable PA. The smallest “stress response” subgroup (9.8%) showed increase in NA and high-stable PA. Gender, age and education level were significant covariates of group membership. Thus, the findings revealed heterogeneous emotional response to the new treatment, which may be of clinical relevance for improving diabetic patients’ adjustment through a more individual, person-centered approach