Illness perceptions predict mortality in patients with predialysis chronic kidney disease: a prospective observational study

Background Illness perceptions have been shown to predict a range of psychosocial and clinical outcomes in kidney disease; including quality of life, distress, treatment adherence and even survival in end-stage renal disease patients on dialysis. The aim of this study was to evaluate whether illness perceptions impact mortality in incident predialysis Chronic Kidney Disease (CKD) patients. Methods Over the study period between September 2015 and June 2019, a total of 200 participants with predialysis CKD were recruited from the Nephrology Outpatient’s clinics at Mater Dei Hospital, Malta. The participants were followed up until June 2019, and the mortality information was collected. Cox proportional hazards models were used to examine the association between illness perceptions, and mortality risk, after adjustment for covariates including distress, kidney function, co-morbidity and psychological distress. Results Of the 200 cases available for analysis, there were 43 deaths. The mean survival time was 718.55 days (min. 3 days, max. 1297 days). The cumulative survival 1-year post the assessment of the Revised Illness Perceptions Questionnaire (IPQ–R) was 93%. Stronger identity beliefs (HR = 1.199, 95% CI: 1.060–1.357, p = 0.004), perceptions of a chronic timeline (HR = 1.065, 95% CI: 1.003–1.132, p = 0.041), personal control beliefs (HR = 0.845, 95% CI: 0.748–0.955, p = 0.007) and perceptions of control over the treatment (HR = 0.812, 95% CI: 0.725–0.909, p = 0.000) demonstrated a significant association with mortality after controlling covariates. In a subsequent saturated model, perceived identity, chronic timeline and treatment control perceptions remained significant predictors of mortality, together with serum albumin, comorbidities and urea. Conclusions CKD patients’ perceptions of treatment control, perceptions of a chronic timeline and perceived illness identity predict survival independently of clinical prognostic factors, including kidney function and co-morbidity. Illness perceptions are important and potentially modifiable risk factors in CKD. Further studies are required to test whether the assessment and the implementation of psychological interventions aimed to modify maladaptive illness perceptions influence clinical outcomes in CKD.

Impact of employees’ job control perceptions on their work-related responses in the hospitality industry

Purpose This study investigates the relationships among three types of employees’ perceived job control, employee commitment, employees’ well-being, and job performance. Design/methodology/approach The proposed relationships were investigated based on a cross-section, online, self-administered survey. Findings The results confirmed the positive role of employees’ job control perceptions on work-related responses. Practical implications Results suggested hospitality managers implement practices to improve job control perceptions of employees to enhance their well-being and job performance. Originality/value This study was the first to investigate the roles of three types of job control perceptions on employees’ well-being and commitment, based on positive organizational behavior literature and control theory. This study was also the first attempt to explore three types of job control focusing on employees’ perspectives in the hospitality industry.

The role of maternal psychosocial perceptions in parent-training programs: a preliminary randomized controlled trial

Parent–child interaction is critical for early language and literacy development. Parent training programs have proliferated to support early interactions. However, many environmental and psychosocial factors can impact the quality of parent–child language and literacy interactions as well as training program outcomes. This preliminary randomized controlled trial examined maternal perceived self-efficacy and locus of control during a language and literacy parent training program. Thirty mother–child dyads (mother age 21–40; children 2;6–4;0) were assigned in parallel to the training or control group. The training was efficacious for mothers and children – training-group dyads made significantly greater gains in maternal strategy use, responsivity, and child print awareness than the control group. Gains were maintained one month post-training. Children whose mothers had more external baseline control perceptions identified significantly fewer print targets at baseline and made greater gains than those with more internal control perceptions. Future directions and implications are discussed.

Toward a Theory of Moral Identity Development

There has been growing interest in moral identity development among moral psychologists. However, identity theorists have had little to say on this issue. In this chapter, I will attempt to bring identity theorists into the discussion by conceptualizing moral identity development in identity theory terms. I outline three phases of moral identity development that emerge within the literature. First is the pre-formative phase, which exists prior to the formation of the moral identity. Second is the formative phase, which occurs as the moral identity takes on moral meanings learned through socialization. Third is the transformative phase, which takes place as the moral identity works to control perceptions to ensure verification. As I argue, an identity theory approach to moral identity development has much to add to the current literature on the topic.