Understanding the Coping Process from a Self-Determination Theory Perspective

Purpose: To explore conceptual links between the Cognitive-Motivational-Relational Theory of coping (Lazarus, 1991) and Self-Determination Theory of motivation (Deci & Ryan, 1985) Method: We present a very brief overview of the two theories. We also discuss how components from the two theories can be examined together to facilitate research in the health/exercise domain. To this effect, we offer a preliminary integrated model of stress, coping and motivation, based on the two aforementioned theories, in an attempt to illustrate and instigate research on how motivational factors are implicated in the coping process. Conclusion: We believe that the proposed model can serve as a platform for generating new research ideas which, besides their theoretical relevance, may have important applied implications

Psychological needs and the prediction of exercise-related cognitions and affect among an ethnically diverse cohort of adult women

Previous research has highlighted a need for identifying the psychological strategies which best maximize the affective responses to exercise (e.g., Blanchard, Rodgers, & Gauvin, 2004). The present study compared the effects on affective responses of using different imagery types while exercising. Participants (N = 75, mean age = 20.2 years, SD = 1.33) were randomly assigned to 1 of 3 imagery conditions (i.e., enjoyment imagery, energy imagery, or technique imagery). Affect was recorded before and after 20 min of moderate intensity cycle ergometry (50% Heart Rate Reserve) using the Exercise-Induced Feeling Inventory (EFI; Gauvin & Rejeski, 1993) and the Feeling Scale (Hardy & Rejeski, 1989). Controlling for affect reported before the exercise bout, the enjoyment imagery group reported significantly higher levels of postexercise valence than the energy and technique imagery groups and higher revitalization than the technique imagery group. These findings indicate that enjoyment imagery could be used to further improve the affective benefits associated with exercise

Helping Your Clients and Patients Take Ownership over their Exercise: Fostering Exercise Adoption, Adherence and Associated Well-Being

LEARNING OBJECTIVE: • This feature article emphasizes the need for physical activity and exercise interventions to be developed and delivered in accordance with psychological theory. Pulling from a contemporary theory of human motivation called Self-determination Theory, this article demonstrates how delivering an exercise message, consultation, or program in an autonomy-supportive, well-structured, and interpersonally involved way may benefit participants' attempts to become and stay more active. Practical strategies that may be used by a health and fitness professional to create an autonomy-supportive, well-structured, and interpersonally involved exercise environment also are presented

Promoting healthy eating in pregnancy: What kind of support services do women say they want?

Aim: To identify characteristics of the services and support women want to enable them to eat healthily during pregnancy to make a potential future service acceptable to this population. Background: An unhealthy diet during pregnancy may have a significant influence on pregnancy outcome, either directly through nutrient deficiencies or indirectly through maternal weight gain. Many pregnant women in the United Kingdom gain too much weight in pregnancy, and this weight gain may lead to an increased risk of preeclampsia, gestational diabetes and having an obese child. Thus, there is a need for interventions aimed at improving healthy eating in pregnancy. It is crucial in developing successful interventions to understand how participation can be maximised by optimising intervention acceptability. Methods: Four focus groups were conducted; two with prenatal women (n = 9) and two with postnatal women (n = 14). Discussion focused on identifying relevant characteristics of a service targeting prenatal and postnatal women's eating to ensure that a future service was acceptable to the women. Findings: The participants’ responses were clustered into three broad themes: (1) early information leading to routine formation of healthier eating habits, (2) the delivery of practical sessions to increase information and (3) health professionals providing support and signposting to services. The participants reported wanting a practical service held in a convenient location, preferably led by women who have been pregnant themselves. The participants also reported wanting to be offered this service in pregnancy to help them get into a routine before they gave birth. Several suggestions for how this service should be marketed were mentioned, including through midwives and the internet. This research provides practical information for how to design support for prenatal women to increase their knowledge and practical skills regarding eating healthily during their pregnancy

Examining exercise dependence symptomatology from a self-determination perspective

Background: Based on the theoretical propositions of Self-Determination Theory (SDT; Deci & Ryan, 1985) this study examined whether individuals classified as “nondependent-symptomatic” and “nondependent-asymptomatic” for exercise dependence differed in terms of the level of exercise-related psychological need satisfaction and self-determined versus controlling motivation they reported. Further, we examined if the type of motivational regulations predicting exercise behaviour differed among these groups. Methods: Participants (N = 339), recruited from fitness, community, and retail settings, completed measures of exercise-specific psychological need satisfaction, motivational regulations, exercise behaviour and exercise dependence. Results: Individuals who were nondependent-symptomatic for exercise dependence reported higher levels of competence need satisfaction and all forms of motivational regulation, compared to nondependent-asymptomatic individuals. Introjected regulation approached significance as a positive predictor of strenuous exercise behaviour for symptomatic individuals. Identified regulation was a positive predictor of strenuous exercise for asymptomatic individuals. Conclusions: The findings reinforce the applicability of SDT to understanding engagement in exercise

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570