Diabetes has a significant negative impact on mental health and quality of life (QoL). Underpinned by the Common Sense Model (CSM) the mediating role of coping patterns, self-efficacy, anxiety and depression symptoms on the relationship between illness perceptions and QoL in patients diagnosed with diabetes was evaluated. A total of 115 participants with diabetes (56, Type 1; 59, Type 2), 51% female and average age of 52.69 (SD=15.89) in Australia completed self-report measures of illness perceptions and psychological wellbeing. Baseline measures included illness perceptions, coping styles, psychological distress (anxiety and depression symptoms), self-efficacy, and quality of life.Mediating relationships were measured using structural equation modelling. A model of good fit was identified explaining 51% of variation in QoL. Illness perceptions directly influenced QoL, maladaptive coping, self-efficacy, and anxiety symptoms. The relationship between: illness perceptions and QoL was partially mediated by anxiety; illness perceptions and depression was fully mediated by maladaptive coping and self-efficacy; and self-efficacy and QoL was partially mediated by depressive symptoms. Findings provide validation of the CSM in a diabetes cohort. Psychological interventions likely to have most benefit on psychological distress and QoL are those targeting mediating psychological processes, including maladaptive coping and self-efficacy.
BackgroundStroke is a leading cause of disability and distress, and often profoundly affects the quality of life of stroke survivors and their carers. With the support of carers, many stroke survivors are returning to live in the community despite the presence of disability and ongoing challenges. The sudden and catastrophic changes caused by stroke affects the mental, emotional and social health of both stroke survivors and carers. The aim of this study is to evaluate a Stroke and Carer Optimal Health Program (SCOHP) that adopts a person-centred approach and engages collaborative therapy to educate, support and improve the psychosocial health of stroke survivors and their carers.MethodsThis study is a prospective randomised controlled trial. It will include a total of 168 stroke survivors and carers randomly allocated into an intervention group (SCOHP) or a control group (usual care). Participants randomised to the intervention group will receive nine (8 + 1 booster) sessions guided by a structured workbook. The primary outcome measures for stroke survivors and carers will be health-related quality of life (AQoL-6D and EQ-5D) and self-efficacy (GSE). Secondary outcome measures will include: anxiety and depression (HADS); coping (Brief COPE); work and social adjustment (WSAS); carer strain (MCSI); carer satisfaction (CASI); and treatment evaluation (TEI-SF and CEQ). Process evaluation and a health economic cost analysis will also be conducted.DiscussionWe believe that this is an innovative intervention that engages the stroke survivor and carer and will be significant in improving the psychosocial health, increasing independence and reducing treatment-related costs in this vulnerable patient-carer dyad. In addition, we expect that the intervention will assist carers and stroke survivors to negotiate the complexity of health services across the trajectory of care and provide practical skills to improve self-management.Trial registrationACTRN12615001046594. Registered on 7 October 2015.
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