Validation of the integrative model of adjustment to chronic conditions: Applicability to adult-onset epilepsy

Adapting to life with adult-onset epilepsy is a challenge and there is a need for better interventions to support people, who have difficulty with psychosocial adjustment to the condition. The integrative model of adjustment to chronic conditions was developed for type 2 diabetes. This study aimed to demonstrate the applicability of the model to adult-onset epilepsy and thus make an original contribution to the development of relevant interventions. Qualitative data from a previous phenomenological study on the experience of adult-onset epilepsy were mapped onto the integrative model of adjustment to chronic conditions using framework analysis. Ten of the original 39 datasets were selected. All 10 datasets were from females diagnosed with epilepsy within 5 years before participation in the original study. The results demonstrated applicability of the integrative model of adjustment to chronic conditions after minor revisions to the model. These findings support further development of the integrative model of adjustment to chronic conditions for use as a clinical intervention for people with adult-onset epilepsy.

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Proposal of an integrative model of adjustment to chronic conditions: An understanding of the process of psychosocial adjustment to living with type 2 diabetes

Journal of Health Psychology ◽

10.1177/1359105316664131 ◽

2016 ◽

Vol 23 (8) ◽

pp. 1063-1074 ◽

Cited By ~ 4

Author(s):

Lis D Hammond ◽

Sarah Hirst-Winthrop

Keyword(s):

Type 2 Diabetes ◽

Grounded Theory ◽

Focus Groups ◽

Psychosocial Adjustment ◽

Chronic Conditions ◽

Chronic Condition ◽

Personal Narratives ◽

Integrative Model ◽

Individual Interviews

Psychosocial adjustment to living with a chronic condition was explored in this grounded theory study, focusing on type 2 diabetes. Despite a range of relevant theories, there is limited understanding of the process of adjustment. The study aimed to address this issue. That was achieved through collecting and analysing personal narratives using individual interviews and focus groups. This allowed for the development of a normative integrative model of adjustment to chronic conditions based on biopsychosocial principles. The integrative model of adjustment to chronic condition has the potential to lead to improved understanding of adjustment processes.

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Type 1 Diabetes-related Autoantibodies in Different Forms of Diabetes

Current Diabetes Reviews ◽

10.2174/1573399814666180730105351 ◽

2019 ◽

Vol 15 (3) ◽

pp. 199-204 ◽

Cited By ~ 7

Author(s):

Elin Pettersen Sørgjerd

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Autoimmune Diabetes ◽

Acid Decarboxylase ◽

Adult Onset ◽

Latent Autoimmune Diabetes ◽

Childhood Type 1 Diabetes ◽

Childhood Type

Autoantibodies against Glutamic Acid Decarboxylase (GADA), insulinoma antigen-2 (IA- 2A), insulin (IAA) and the most recently Zinc Transporter 8 (ZnT8A) are one of the most reliable biomarkers for autoimmune diabetes in both children and adults. They are today the only biomarkers that can distinguish Latent Autoimmune Diabetes in Adults (LADA) from phenotypically type 2 diabetes. As the frequency of autoantibodies at diagnosis in childhood type 1 diabetes depends on age, GADA is by far the most common in adult onset autoimmune diabetes, especially LADA. Being multiple autoantibody positive have also shown to be more common in childhood diabetes compared to adult onset diabetes, and multiple autoantibody positivity have a high predictive value of childhood type 1 diabetes. Autoantibodies have shown inconsistent results to predict diabetes in adults. Levels of autoantibodies are reported to cause heterogeneity in LADA. Reports indicate that individuals with high levels of autoantibodies have a more type 1 diabetes like phenotype and individuals with low levels of autoantibody positivity have a more type 2 diabetes like phenotype. It is also well known that autoantibody levels can fluctuate and transient autoantibody positivity in adult onset autoimmune diabetes have been reported to affect the phenotype.

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Relationship between medication adherence and psychosocial adjustment in patients with type 2 diabetes: A cross-sectional study

Nordic Journal of Nursing Research ◽

10.1177/2057158520937456 ◽

2020 ◽

Vol 40 (3) ◽

pp. 116-122

Author(s):

Duygu Kes ◽

Feray Gökdoğan

Keyword(s):

Type 2 Diabetes ◽

Psychosocial Adjustment ◽

Large City ◽

Psychosocial Care ◽

Self Report ◽

Cross Sectional ◽

Convenience Sample ◽

Adherence To Medication ◽

The Relationship

Adherence to drug treatment is a multidimensional concept. It is affected by many factors, such as physiological, psychological, family, environmental and social conditions. However, relatively little is known about the relationship between adherence to medication and psychosocial adjustment. The aim was to explore the relationship between adherence to antidiabetic drugs and the psychosocial adjustment of patients with type 2 diabetes mellitus. This cross-sectional descriptive correlational study was conducted between March and June 2018. A convenience sample of participants was recruited from seven internal disease outpatient clinics at a public tertiary hospital, located in a large city that serves as a gateway to nearby rural and urban areas in the north-west region of Turkey. Data were collected using the Adherence to Refills and Medications Scale (ARMS-7), and the Psychosocial Adjustment to Illness Scale–Self Report (PAIS–SR). This study is reported in accordance with STROBE. Pearson’s correlation analysis found a significant weak positive correlation between all domains of the PAIS–SR and the total scores on the ARMS‐7. The participants’ scores on medication refill were found to be significantly and positively correlated with all of the PAIS–SR domain scores except the sexual relationships domain. Psychosocial care could play a crucial role in improving drug regimen adherence among patients with diabetes. Therefore, nurses should integrate psychosocial care into daily practice.

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Peer support program (P-SUP) to strengthen self-management in patients with chronic conditions

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1122 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

L Giesen ◽

H Könnecke ◽

M Redaèlli ◽

D Simic ◽

M Heßbrügge ◽

...

Keyword(s):

Peer Support ◽

Support Groups ◽

Chronic Conditions ◽

Primary Outcome ◽

Hospital Admissions ◽

Self Management ◽

Artery Disease ◽

Telephone Coaching

Abstract Background Chronic care programmes (CCPs) ensure a standardised, evidence based and structured patient care. In Germany, CCPs are successful in improving quality of care and making care more patient-centred. Regarding self-management support, however, the programs only feature patient education and shared decisions on treatment goals. Peer support has proven to be a successful component in outpatient care to enhance self-management. The aim of this study is to support patients with type 2 diabetes and coronary artery disease in conducting successful self-management through a multimodal program. Methods This randomized controlled trial (RCT) is set up for 27 months and will include a study population of approximately 1800 patients, beginning in summer 2020. The primary outcome (PO) is the reduction of hospital admissions. In addition to the PO, secondary outcomes include motivational and knowledge-based aspects. Furthermore, health-competitive and health-economic data will be collected. The formative evaluation will review the processes for implementation. The central element of the intervention will be peer support groups, in which the group will participate in physical activities and educational lectures on nutrition, exercise or disease related knowledge. Additionally, a specially designed online platform, personalized feedback for patients on medical outcomes from their family doctors, and regular telephone coaching to increase intrinsic motivation and activation will be provided. Results In addition to the primary outcome (reduction of hospital admissions), increased motivation levels, improved quality of life and increased health literacy are expected. Conclusions This project, funded by the Federal Joint Committee (establishment of statutory health insurance funds and medical providers in Germany), can serve as a blueprint for future implementations of public health approaches and accessible care models for patients with chronic conditions. Key messages Peer support as a successful method to enhance self-management in patients with type 2 diabetes and coronary artery disease. A multimodal program, consisting of peer support groups, an online platform, personalized medical feedback and telephone coaching, aiming to improve quality of life in patients with chronic conditions.

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Current Perspectives on Management of Type 2 Diabetes in Youth

Children ◽

10.3390/children8010037 ◽

2021 ◽

Vol 8 (1) ◽

pp. 37

Author(s):

Sachi Singhal ◽

Seema Kumar

Keyword(s):

Type 2 Diabetes ◽

Severe Obesity ◽

Rapid Development ◽

Adult Onset ◽

Socioeconomically Disadvantaged ◽

Lifestyle Modifications ◽

First Line ◽

Diabetes In Youth ◽

First Line Treatment

The prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents is on the rise, and the increase in prevalence of this disorder parallels the modern epidemic of childhood obesity worldwide. T2DM affects primarily post-pubertal adolescents from ethnic/racial minorities and those from socioeconomically disadvantaged backgrounds. Youth with T2DM often have additional cardiovascular risk factors at diagnosis. T2DM in youth is more progressive in comparison to adult onset T2DM and shows lower rates of response to pharmacotherapy and more rapid development of diabetes-related complications. Lifestyle modifications and metformin are recommended as the first-line treatment for youth with T2DM in the absence of significant hyperglycemia. Assessment of pancreatic autoimmunity is recommended in all youth who appear to have T2DM. Pharmacotherapeutic options for youth with T2DM are limited at this time. Liraglutide, a GLP-1 agonist, was recently approved for T2DM in adolescents 10 years of age and older. Several clinical trials are currently underway with youth with T2DM with medications that are approved for T2DM in adults. Bariatric surgery is associated with excellent rates of remission of T2DM in adolescents with severe obesity and should be considered in selected adolescents.

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A School Nurse Application of the ECHO Model

The Journal of School Nursing ◽

10.1177/1059840519861748 ◽

2019 ◽

pp. 105984051986174

Author(s):

Suzuho Shimasaki ◽

Pamela Brunner Nii ◽

Lisa Davis ◽

Erin Bishop ◽

Cari Berget ◽

...

Keyword(s):

Diabetes Care ◽

Chronic Conditions ◽

Type I Diabetes ◽

Models Of Care ◽

School Nurses ◽

Type I ◽

Colorado School ◽

Childhood Diseases ◽

Survey Results

Type I diabetes (T1D) is one of the most common childhood diseases and Type 2 diabetes (T2D) is increasing at alarming rates. Given that children spend a great percentage of their time in school, this setting is a critical environment for models of care that lead to better management of this and other health conditions. The School Nurses Managing Diabetes Care ECHO was offered to Colorado school nurses to build their capacity in providing evidence-based management of T1D. The purpose of this effort was to (1) determine whether or not the model could be used as a tool of collaboration and dissemination for school nurses across Colorado and (2) assess the effectiveness of the “School Nurses Managing Diabetes Care” ECHO learning series. Post-series survey results demonstrated a 25% increase in self-efficacy ratings, moving learners from “average among my peers” toward “competent.” Additionally, all respondents planned to make one or more practice changes to improve care for students with T1D. Expanding the use of the ECHO model to implement intensive management of children and youth with T1D is critically important as rates of this and other chronic conditions continue to increase.

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Relative contribution of type 1 and type 2 diabetes loci to the genetic etiology of adult-onset, non-insulin-requiring autoimmune diabetes

BMC Medicine ◽

10.1186/s12916-017-0846-0 ◽

2017 ◽

Vol 15 (1) ◽

Cited By ~ 45

Author(s):

Rajashree Mishra ◽

◽

Alessandra Chesi ◽

Diana L. Cousminer ◽

Mohammad I. Hawa ◽

...

Keyword(s):

Type 2 Diabetes ◽

Autoimmune Diabetes ◽

Adult Onset ◽

Genetic Etiology ◽

Relative Contribution

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Structural Lesions on Kidney Biopsy in Youth-Onset and Adult-Onset Type 2 Diabetes

10.2337/figshare.17069885 ◽

2022 ◽

Author(s):

Helen C. Looker ◽

Laura Pyle ◽

Tim Vigers ◽

Cameron Severn ◽

Pierre Saulnier ◽

...

Keyword(s):

Type 2 Diabetes ◽

Kidney Disease ◽

Age Of Onset ◽

Tissue Injury ◽

Kidney Tissue ◽

Glomerular Sclerosis ◽

Oral Glucose ◽

Adult Onset ◽

Pima Indians

Objective: Type 2 diabetes (T2D) is a leading cause of end stage kidney disease (ESKD) worldwide. Recent studies suggest a more aggressive clinical course of diabetic kidney disease (DKD) in youth-onset than adult-onset T2D. We compared kidney structural lesions in youth- and adult-onset T2D to determine if youth-onset was associated with greater early tissue injury. Methods: Quantitative microscopy was performed on kidney tissue obtained from research kidney biopsies in 161 Pima Indians (117 women, 44 men) with T2D. Onset of T2D was established by serial oral glucose tolerance testing and participants were stratified as youth-onset (<25 years) or adult-onset (≥25 years). Associations between clinical and morphometric parameters and age of onset were tested using linear models. Results: At biopsy, the 52 participants with youth-onset T2D were younger than the 109 with adult-onset T2D (39.1±9.9 vs. 51.4±10.2 years, p<0.0001), but their diabetes duration was similar (19.3±8.1 vs. 17.0±7.8 years, p=0.09). Median urine albumin-to-creatinine ratio was higher in the youth-onset group (58 [25th-75th percentile, 17-470] vs. 27 [13-73] mg/g, p=0.02). Youth-onset participants had greater glomerular basement membrane (GBM) width (552±128 nm vs. 490±114nm, p=0.002) and mesangial fractional volume (0.31±0.10 vs. 0.27±0.08, p=0.001) than adult-onset participants. Percentage glomerular sclerosis, glomerular volume, mesangial fractional volume, and GBM width were also inversely associated with age of diabetes onset as a continuous variable. Conclusion: Younger age of T2D onset strongly associates with more severe kidney structural lesions. Studies are underway to elucidate the pathways underlying these associations.

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Education for type 2 diabetes mellitus self-care: from compliance to empowerment

Interface - Comunicação Saúde Educação ◽

10.1590/s1414-32832009000300009 ◽

2009 ◽

Vol 13 (30) ◽

pp. 93-106 ◽

Cited By ~ 12

Author(s):

Antonio Pithon Cyrino ◽

Lilia Blima Schraiber ◽

Ricardo Rodrigues Teixeira

Keyword(s):

Social Sciences ◽

Chronic Conditions ◽

Self Care ◽

Self Management ◽

Degenerative Diseases ◽

Cognitive Autonomy ◽

The Social ◽

Transmission Of Information ◽

Traditional Approaches

Through a critical review of the literature on education for diabetes self-care and self-management, it was sought to point out the inappropriateness of traditional approaches towards compliance with treatment and transmission of information, considering the complexity of self-care under chronic conditions. The influence of the social sciences on the field of studies on chronic degenerative diseases in general, and diabetes in particular, was explored. From this perspective, it can be recognized that the fields of anthropology and sociology have been incorporated into research focusing more on individuals as patients, and on the experience gained through this process. Recently, there has been a slight change within the field of health education research relating to diabetes, with the introduction of strategies that seek to value the experience and autonomy of patients as self-care agents. This paper discusses the strategy for empowerment in education for diabetes self-care and self-management, as a dialogue-focused practice that respects patients' moral and cognitive autonomy.

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Genetic Rhabdomyolysis within the Spectrum of the Spinocerebellar Ataxia Type 2 Responsive to Pregabalin

10.21203/rs.3.rs-125754/v1 ◽

2021 ◽

Author(s):

Fabian Rossi ◽

Joe Ma ◽

Nina Tsakadze ◽

Lourdes Benes-Lima ◽

Julio Araque Gonzalez ◽

...

Keyword(s):

Cerebellar Ataxia ◽

Spinocerebellar Ataxia ◽

Clinical Presentation ◽

Spinocerebellar Ataxia Type ◽

Adult Onset ◽

Spinocerebellar Ataxia Type 2 ◽

First Report ◽

Recurrent Rhabdomyolysis

Abstract BackgroundSpinocerebellar Ataxia type 2 is a slowly progressive adult onset ataxia with a broad clinical presentation. Case presentationWe describe a man with Spinocerebellar Ataxia type 2 with chronic, severe, and recurrent rhabdomyolysis, as part of the cerebellar ataxia genetic spectrum. Initially rhabdomyolysis was refractory to multiple medications, but entirely resolved and remained in chronic remission with pregabalin. ConclusionThis is the first report of Spinocerebellar Ataxia type 2 associated with chronic, severe, recurrent rhabdomyolysis as part of its genetic phenotype responsive to pregabalin.

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