Developing a spouse version of the Illness Perception Questionnaire-Revised (IPQ-R) for husbands of women with rheumatoid arthritis

A husband’s beliefs about his wife’s rheumatoid arthritis (RA) may be important to his provision of support and well-being. We adapted seven subscales of the Illness Perception Questionnaire-Revised to assess husbands’ beliefs about their wives’ RA. We recruited 190 couples (average years married = 22; average years with RA = 14) from community settings to complete surveys assessing illness perceptions, psychosocial and illness variables at baseline and four-month followup. We conducted exploratory factor analyses, calculated Cronbach’s alphas for each factor, and examined construct validity. This process yielded six parallel wife and husband subscales assessing beliefs about the (a) timeline, (b) consequences and (c) cyclical nature of RA, and women’s RA (d) emotional responses, (e) control and (f) illness coherence. All items loaded above 0.50 on their respective factors and Cronbach’s alphas ranged from 0.72 to 0.86. Subscales were inter-related in a manner consistent with previous research and husbands’ beliefs were related to a variety of illness and adjustment variables. The factor structure was replicated in the same sample at follow-up (n = 165). This study introduces an instrument to assess spouse beliefs about RA that may help to elucidate the role of spousal relationships in illness adaptation

Gist and verbatim communication concerning medication risks/benefits

To describe the information about medication risks/benefits that rheumatologists provide during patient office visits, the gist that patients with rheumatoid arthritis (RA) extract from the information provided, and the relationship between communication and medication satisfaction

Stop Using the Modified Work APGAR to Measure Job Satisfaction

Background. The psychometric properties of the Modified Work APGAR (MWA) scale are not established, yet researchers use this scale as an overall measure of job satisfaction. Objective. Perform psychometric analyses on the MWA scale using data from two populations. Methods. A landmark occupational cohort and a clinical cohort are populations with low back pain studied. The first five items of the MWA scale measure social support from coworkers, one item measures dissatisfaction with job tasks, and the sixth item measures lack of social support from a supervisor. Exploratory principal components analyses were conducted in both cohorts. Results. In both cohorts, the first five items of the MWA scale loaded consistently onto one factor, social support from coworkers subscale. Conclusions. Unless researchers are interested in measuring social support from coworkers only, future studies should use other reliable and valid instruments to measure a broad range of psychosocial work characteristics

Measuring Concurrency Attitudes: Development and Validation of a Vignette-Based Scale

Concurrent sexual partnerships (partnerships that overlap in time) may contribute to higher rates of HIV transmission in African Americans. Attitudes toward a behavior constitute an important component of most models of health-related behavior and behavioral change. We have developed a scale, employing realistic vignettes that appear to reliably measure attitudes about concurrency in young African American adults

Associations Between Patient Characteristics and the Amount of Arthritis Medication Information Patients Receive

Little is known about factors associated with receipt of medication information among arthritis patients. This study explores information source receipt and associations between demographic and clinical/patient characteristics and the amount of arthritis medication information patients receive. Adult patients with osteoarthritis (OA) or rheumatoid (RA) arthritis (n = 328) completed an online cross-sectional survey. Patients reported demographic and clinical/patient characteristics and the amount of arthritis medication information received from 15 information sources. Bivariate and multivariable linear regression analyses were used to investigate whether those characteristics were associated with the amount of medication information patients received. Arthritis patients received the most information from health professionals followed by printed materials, media sources, and interpersonal sources. Greater receipt of information was associated with greater medication adherence, taking more medications, greater medication-taking concerns, more satisfaction with doctor medication-related support, and Black compared to White race. RA patients reported receiving more information compared to OA patients, and differences were found between RA patients and OA patients in characteristics associated with more information receipt. In conclusion, arthritis patients received the most medication information from professional sources, and both positive (e.g., greater satisfaction with doctor support) and negative (e.g., more medication taking concerns) characteristics were associated with receiving more medication information

Examining whether the information-motivation-behavioral skills model predicts medication adherence for patients with a rare disease.

The information-motivation-behavioral skills (IMB) model has been used to explain and promote medication adherence among patients with diabetes and HIV. The objective of this study was to examine whether the IMB model predicted medication adherence among vasculitis patients. Adult vasculitis patients (n=228) completed online questionnaires at baseline and 3-month follow-up. Linear regressions were calculated to determine the direct effects of information and motivation on medication adherence (P<0.05). A mediation analysis using a bootstrapping approach was used to test whether behavioral skills significantly mediated the effect of information and motivation on medication adherence. Participants reported high levels of information (M=4.0; standard deviation [SD]=0.68), moderate levels of motivation (M=2.7; SD=1.00), and high levels of behavioral skills (M=4.1; SD=0.74). In the regression model, only behavioral skills (B=0.38; P<0.001) were significantly associated with medication adherence; however, mediation analysis revealed that behavioral skills significantly mediated the effects of information and motivation on medication adherence. The results support the IMB-hypothesized relationships between information, motivation, behavioral skills, and medication adherence in our sample. Findings suggest that providers should work with vasculitis patients to increase their medication-related skills to improve medication adherence

Predictors of medication non-adherence for vasculitis patients

The primary purpose of this article is to document whether demographic, clinical, regimen-related, intrapersonal, and interpersonal factors predict medication non-adherence for vasculitis patients. A secondary purpose is to explore whether adherence varies by medication type and whether patients experienced drug-related side effects. Vasculitis patients (n=228) completed online baseline and 3-month follow-up surveys. Demographic (age, gender, education, race, marital status, and insurance status), clinical (perceived vasculitis severity, disease duration, vasculitis type, and relapse/remission status), regimen-related (experience of side effects), intrapersonal (depressive symptoms), and interpersonal (adherence-related support from family and friends) factors were measured at baseline. Medication non-adherence was assessed at follow-up using the Vasculitis Self-Management Survey medication adherence sub-scale (α=0.89). Variables that significantly correlated (p<0.05) with non-adherence were included in a linear regression model to predict non-adherence. Younger age (r=−0.23, p<0.001), female sex (r=0.16, p<0.05), experience of side effects (r=0.15, p<0.05), and more depressive symptoms (r=0.22, p< 0.001) were associated with more medication non-adherence, In the regression model, younger age (β=−0.01, p=0.01) and more depressive symptoms (β=0.01 p=0.02) predicted worse adherence. For six out of eight vasculitis medication types, patients who experienced side effects were less adherent than patients who did not experience side effects. Multiple factors are associated with medication non-adherence for vasculitis patients. Providers should discuss medication adherence and drug-related side effects with vasculitis patients. Providers may want to particularly target younger patients and patients with clinical signs of depression

The effect of conflicting medication information and physician support on medication adherence for chronically ill patients

This article explores the effect of conflicting information, defined as contradictory information about medication topics from different sources, on medication adherence in a sample of chronically ill patients. We specifically investigate whether conflicting information and physician support directly affect medication adherence or whether the effect is mediated by adherence self-efficacy and outcome expectations for medications

Development and initial evaluation of a measure of self-management for adults with antineutrophil cytoplasmic antibody-associated small-vessel vasculitis

To develop a measure of illness self-management for adults living with antineutrophil cytoplasmic antibody (ANCA)–associated small-vessel vasculitis (ANCA-SVV) and to gather evidence of its reliability and validity