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Patient Preference and Adherence 2023Poor antidiabetic medication adherence remains a great barrier to effective diabetes self-management among aging adults. This study investigates the mediation and...
PURPOSE
Poor antidiabetic medication adherence remains a great barrier to effective diabetes self-management among aging adults. This study investigates the mediation and moderation effects of self-efficacy on the relationship between medication beliefs and adherence in elderly patients with type 2 diabetes.
METHODS
This cross-sectional study evaluated a sample of 309 hospitalized elderly patients who completed the assessment of medication beliefs, self-efficacy for medication uses and medication adherence in a tertiary hospital in Shanghai, China. A bootstrapping sampling method and hierarchical moderator regression analysis were used to verify the hypothesis of mediation and moderation effects of self-efficacy on the relationship between medication beliefs and adherence.
RESULTS
Self-efficacy for medication use acted as a moderator (=-0.063, =-2.215, =0.028) and partial mediator (CI=4.5-16.63, =0.001; CI=1.524-5.323, =0.014; CI=2.151-11.817, =0.001) on the relationship between general harm medication beliefs and medication adherence. Participants with lower general harm medication beliefs may develop higher self-efficacy, which, in turn, results in a higher level of medication adherence, and higher self-efficacy may attenuate the negative effect of high general harm medication beliefs on medication adherence.
CONCLUSION
Self-efficacy for medication use not only mediated the relationship between general harm beliefs about medication and medication adherence, but moderated it negatively. The findings of this study indicate an opportunity to improve the prognosis of elderly Chinese patients with type 2 diabetes through improved medication adherence by strengthening factors such as self-efficacy for appropriate medication use and general harm beliefs about medication.
PubMed: 36713972
DOI: 10.2147/PPA.S382362 -
Schizophrenia Research Aug 2023A large body of evidence has established a tight relation between traumatic experiences (TEs) and psychotic-like experiences (PLEs). Nevertheless, more comprehensive...
BACKGROUND
A large body of evidence has established a tight relation between traumatic experiences (TEs) and psychotic-like experiences (PLEs). Nevertheless, more comprehensive models involving multiple interactions of serial or parallel mediations and moderations still need to be elucidated. Among the many potential mediators or moderators, insecure attachment and resilience play a key role in the association of stress with PLEs. Hence, we aim to explore the complex pathways that lead from different types of TEs to PLEs, involving attachment and resilience modeled as mediators or moderators.
METHODS
One thousand ten high school students completed the International Trauma Exposure Measure (ITEM), the 11-item Resilience Scale for Adults (RSA-11), the 16-item Prodromal Questionnaire (iPQ-16), and the Relationship Questionnaire (RQ). A path analysis was conducted to assess mediation and moderation.
RESULTS
The final model showed that the impact of childhood TEs on PLEs was mediated by a pathway through anxious-insecure attachment styles (i.e., fearful and preoccupied, respectively, 8.75 % and 8.53 % of the total effect) and personal resilience resources. Conversely, the avoidant-insecure attachment was associated with lower interpersonal resilience (b = 0.14 [0.08, 0.20]), which in turn moderated the impact of recent TEs on PLEs (interaction term b = 0.34 [0.21, 0.47]).
CONCLUSIONS
Our model examines a complex model that includes factors buffering the effect of traumatic experiences on PLEs. Our results highlight the importance of insecure-anxious attachment to personal resilience resources and of insecure-avoidant attachment to interpersonal resilience as potential targets for clinical practice.
Topics: Adult; Humans; Psychotic Disorders; Surveys and Questionnaires; Anxiety; Fear
PubMed: 37473666
DOI: 10.1016/j.schres.2023.07.005 -
BMC Public Health Apr 2020To elucidate the populations and conditions where screen-based sedentary behaviors (SB) and internalizing symptoms are coupled, this review synthesized the evidence for...
BACKGROUND
To elucidate the populations and conditions where screen-based sedentary behaviors (SB) and internalizing symptoms are coupled, this review synthesized the evidence for factors that may moderate the associations between screen-based SB, depressive symptoms, and anxiety symptoms among youth.
METHODS
Two independent researchers conducted a systematic literature search of the Medline, psycINFO, and Scopus electronic databases in late 2018 for observational studies assessing moderators of the association between screen-based SB and depressive and anxiety symptoms. Studies among children and adolescents were eligible if moderation was assessed by statistical test (interaction) or stratification; and a narrative synthesis of eligible studies was conducted in accordance with PRISMA guidelines.
RESULTS
Seventy empirical studies (46 cross-sectional, 19 longitudinal, and 5 both) of 13 different moderating variables of screen-based SB-internalizing symptom associations met the eligibility criteria. Of these, 40 studies were of depressive symptoms, 2 were of anxiety symptoms, and 28 studies assessed symptoms of both. The most consistent evidence of moderation was for screen-type, such that TV viewing was not as strongly associated with internalizing symptoms compared to other forms of screen-based SB. There was also inconsistent evidence for physical activity buffering screen-based SB-internalizing symptom associations and for female sex amplifying screen-based SB-internalizing symptom associations. In general, the body of evidence for anxiety symptoms was more limited than that for depressive symptoms, and were therefore more inconsistent.
CONCLUSIONS
Screen-type, physical activity, and sex may influence the magnitude of screen-based SB-internalizing symptom coupling; highlighting potential sources of heterogeneity of screen-based SB-internalizing symptom associations. Additional studies aimed at understanding potential mechanistic explanations for the above moderators are needed prior to the development of tailored intervention strategies designed to decouple screen-based SB and internalizing symptoms among youth.
Topics: Adolescent; Anxiety; Child; Depression; Humans; Risk Factors; Screen Time; Sedentary Behavior
PubMed: 32272906
DOI: 10.1186/s12889-020-08572-1 -
Frontiers in Public Health 2022Swift social and economic environmental changes such as those associated with the COVID-19 pandemic have led to decreased job security. Although numerous previous...
Job insecurity during the COVID-19 pandemic and counterproductive work behavior: The sequential mediation effects of job stress and organizational identification and the buffering role of corporate social responsibility.
Swift social and economic environmental changes such as those associated with the COVID-19 pandemic have led to decreased job security. Although numerous previous studies have examined the influence of job insecurity on employee perceptions, attitudes, and behaviors, the link between job insecurity and negative behavior and its underlying or intermediating mechanisms remain underexplored. The significance of an organization's positive behaviors, which fall under the umbrella of corporate social responsibility (CSR), also deserves more attention. To address these gaps, we examined both the mediator and the moderator in the association between job insecurity and negative employee behavior by establishing a moderated sequential mediation model. We hypothesized that the levels of employee job stress and organizational identification sequentially mediate the relationship between job insecurity and counterproductive work behavior as a representative negative behavior. We also hypothesized that CSR activities play a buffering role that moderates the influence of job insecurity on job stress. We used three-wave time-lagged data collected from 348 employees in South Korean organizations to demonstrate that job stress and organizational identification sequentially mediate the relationship between job insecurity and counterproductive work behavior, and that CSR activities function as a buffering factor that decreases the influence of job insecurity on job stress. The results of this research suggest that the levels of job stress and organizational identification (as sequential mediators) as well as CSR activities (as a moderator) are underlying mechanisms in the link between job insecurity and counterproductive work behavior.
Topics: Humans; COVID-19; Pandemics; Asian People; Occupational Stress; Employment
PubMed: 36876229
DOI: 10.3389/fpubh.2022.1037184 -
Journal of Applied Statistics 2022Third variable effect refers to the effect from a third variable that explains an observed relationship between an exposure and an outcome. Depending on whether there is...
Third variable effect refers to the effect from a third variable that explains an observed relationship between an exposure and an outcome. Depending on whether there is causal relationship, typically, a third variable takes the format of a mediator or a confounder. A moderation effect is a special case of the third-variable effect, where the moderator and other variables have an interactive effect on the outcome. In this paper, we extend the R package 'mma' for moderation analysis so that third-variable effects can be reported at different levels of the moderator. The proposed moderation analysis use tree-structured models to automatically detect moderation effects and can handle both categorical and numerical moderators. We propose algorithms and graphical methods for making inference on moderation effects and illustrate the method under different scenarios of moderation effects. Finally, we apply the proposed method to explore the trend of racial disparities in the use of Oncotype DX recurrence tests among breast cancer patients. We found that the unexplained racial differences in using the tests have decreased from 2010 to 2015.
PubMed: 36340886
DOI: 10.1080/02664763.2021.1968358 -
PloS One 2022Evidence has shown that the Five precepts significantly affect the relationship between attachment and resilience; however, little is known whether observing the Five...
PURPOSE
Evidence has shown that the Five precepts significantly affect the relationship between attachment and resilience; however, little is known whether observing the Five Precepts would help reduce depressive symptoms among those who experience risks. The aim of this study was to examine the moderating role of the Five Precepts in the mediation model relationship among neuroticism, perceived stress, and depression.
PATIENTS AND METHODS
The study employed a cross-sectional survey design and data were collected from the end of 2019 to September 2022 in Thailand. In all, 644 general participants completed questionnaires on the Neuroticism Inventory (NI), the 10-item Perceived Stress Scale (PSS), Depression Subscale, and the Five-Precept Subscale of the Inner Strength-based Inventory (SBI-PP). Mediation and moderation analyses with 5000 bootstrapping methods were used.
RESULTS
Among all, 74.2% were female, and the mean age totalled 28.28 years (SD = 10.6). SBI-PP was shown to have a moderation effect on the relationship between NI, PSS and depressive symptoms. The moderating effect between SBI-PP and PSS was significant, whereas SBI-PP and NI was not. The index of moderated mediation from the Five Precepts was significant (b = -0.019 (95%CI -0.029, -0.009)). The moderated mediation model increased the percent variance explaining depressive symptoms to 47.6%, compared with 32.6% from the mediation model alone.
CONCLUSION
Observing the Five Precepts offers evidence that it buffers the effect of perceived stress on depression. People with high levels of observing the Five Precepts are less likely to develop depressive symptoms. Implications as well as possible future research are discussed.
Topics: Humans; Female; Male; Buddhism; Neuroticism; Cross-Sectional Studies; Depression; Stress, Psychological
PubMed: 36449445
DOI: 10.1371/journal.pone.0277351 -
BMC Geriatrics Jan 2022While depressive symptoms are recognized as major mental health problems in later life, there is a lack of study in examining potential moderators in the association...
BACKGROUND
While depressive symptoms are recognized as major mental health problems in later life, there is a lack of study in examining potential moderators in the association between intergenerational support and depressive symptoms, especially in social contexts with low socioeconomic status and inadequate formal public support. This study set out to examine the association between intergenerational support and depressive symptoms among older adults in rural Northeast China, and the potential moderating roles of age, living alone, and number of chronic diseases on this link.
METHODS
A quota sampling approach was used to recruit 448 respondents aged 60 and above from rural Chinese communities. Depressive symptoms were the dependent variable. Intergenerational emotional, instrumental, and financial support were the main independent variables. Age, living alone, and number of chronic diseases were the moderators. Multiple linear regression models with interaction terms were conducted to test the proposed model.
RESULTS
The results showed that intergenerational emotional support was significantly associated with depressive symptoms in older adults when instrumental and financial support and covariates were controlled (β = -0.196, p < .001). Age was found to have a significant moderating effect on the relationship between intergenerational instrumental support and depressive symptoms (β = -0.118, p < .05). Among older respondents aged 74.51 years and older, instrumental support was positively associated with depressive symptoms, but this association was not significant for younger respondents. Furthermore, living alone and number of chronic diseases suffered moderated the association between intergenerational financial support and depressive symptoms, which was statistically significant only for those living alone and with more chronic diseases (interaction term between living alone and intergenerational financial support: β = -0.082, p < .05; interaction term between number of chronic diseases and intergenerational financial support: β = -0.088, p < .05.
CONCLUSIONS
The findings not only highlight the important role of intergenerational support in promoting mental health in later life in rural Chinese contexts, but also identify within-population heterogeneity in the identified associations. Policy and intervention implications are discussed.
Topics: Age Distribution; Aged; China; Chronic Disease; Depression; Home Environment; Humans; Intergenerational Relations; Middle Aged; Risk Factors; Rural Population; Social Support
PubMed: 35086485
DOI: 10.1186/s12877-021-02738-1 -
Frontiers in Sports and Active Living 2022The results from the physical training and cancer randomized controlled trial (Phys-Can RCT) indicate that high intensity (HI) strength and endurance training during...
Exploring Moderators of the Effect of High vs. Low-to-Moderate Intensity Exercise on Cardiorespiratory Fitness During Breast Cancer Treatment - Analyses of a Subsample From the Phys-Can RCT.
INTRODUCTION
The results from the physical training and cancer randomized controlled trial (Phys-Can RCT) indicate that high intensity (HI) strength and endurance training during (neo-)adjuvant cancer treatment is more beneficial for cardiorespiratory fitness (CRF, measured as peak oxygen uptake [VOpeak]) than low-to-moderate intensity (LMI) exercise. Adherence to the exercise intervention and demographic or clinical characteristics of patients with breast cancer undergoing adjuvant treatment may moderate the exercise intervention effect on VOpeak. In this study, the objective was to investigate whether baseline values of VOpeak, body mass index (BMI), time spent in moderate- to vigorous-intensity physical activity (MVPA), physical fatigue, age, chemotherapy treatment, and the adherence to the endurance training moderated the effect of HI vs. LMI exercise on VOpeak.
MATERIALS AND METHODS
We used data collected from a subsample from the Phys-Can RCT; women who were diagnosed with breast cancer and had a valid baseline and post-intervention VOpeak test were included ( = 255). The exercise interventions from the RCT included strength and endurance training at either LMI, which was continuous endurance training at 40-50% of heart rate reserve (HRR), or at HI, which was interval training at 80-90% of HRR, with similar exercise volume in the two groups. Linear regression analyses were used to investigate moderating effects using a significance level of < 0.10. Statistically significant interactions were examined further using the Johnson-Neyman (J-N) technique and regions of significance (for continuous variables) or box plots with adjusted means of post-intervention VOpeak (for binary variables).
RESULTS
Age, as a continuous variable, and adherence, dichotomized into < or > 58% based on median, moderated the effect of HI vs. LMI on CRF ( = -0.08, 95% CI [-0.16, 0.01], = 0.06, and = 1.63, 95% CI [-0.12, 3.38], = 0.07, respectively). The J-N technique and regions of significance indicated that the intervention effect (HI vs. LMI) was positive and statistically significant in participants aged 61 years or older. Baseline measurement of CRF, MVPA, BMI, physical fatigue, and chemotherapy treatment did not significantly moderate the intervention effect on CRF.
CONCLUSION
Women with breast cancer who are older and who have higher adherence to the exercise regimen may have larger effects of HI exercise during (neo-)adjuvant cancer treatment on CRF.
PubMed: 35903402
DOI: 10.3389/fspor.2022.902124 -
Journal of Advanced Nursing Jan 2022Nursing students in Taiwan often study in interdisciplinary teams that must create healthcare products. Creativity is imperative for the students' success, but studies...
AIMS
Nursing students in Taiwan often study in interdisciplinary teams that must create healthcare products. Creativity is imperative for the students' success, but studies have not explored the relational precursors to team creativity in nursing education. Therefore, the relationship was examined between task interdependence, interaction behaviours (constructive controversy, helping behaviours and spontaneous communication) and creativity for nursing students on interdisciplinary teams in Taiwan to investigate whether high task interdependence moderates the correlations between interaction behaviours and creativity.
DESIGN
Descriptive, cross-sectional, quantitative study.
METHODS
Participants were nursing students (N = 99) attending interdisciplinary capstone courses in 2- or 4-year nursing programmes at a university for science and technology in Taiwan. Self-report questionnaires were used to collect the students' demographics and perceptions of their teams' task interdependence, interaction behaviours and creativity between January 2018 and January 2019. Pearson's correlation coefficient revealed variable associations. SPSS PROCESS macro displayed moderating effects.
RESULTS
Task interdependence had significant positive correlations with all three interaction behaviours and team creativity. Each interaction behaviour also had significant positive correlations with team creativity. High task interdependence negatively moderated the relationships between team creativity and (a) constructive controversy, and (b) spontaneous communication, but not (c) helping behaviours.
CONCLUSION
The empirically validated moderation model and study results suggest that nursing educators can foster creativity in their students by encouraging task interdependence and helping behaviours, and teaching students to build constructive controversy and spontaneous communication into their collaborative plans.
IMPACT
In Taiwan, nursing students must demonstrate creativity in interdisciplinary capstone courses. Their ability to do so requires them to cooperate with students in other disciplines who have unique skills or knowledge. This study provides insights into the relational factors that may improve creativity for nursing students on interdisciplinary teams.
Topics: Creativity; Cross-Sectional Studies; Education, Nursing; Faculty, Nursing; Humans; Students, Nursing
PubMed: 34227141
DOI: 10.1111/jan.14961 -
Frontiers in Public Health 2024Nurse turnover has become a salient issue in healthcare system worldwide and seriously compromises patient outcomes. Social support is considered an effective... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Nurse turnover has become a salient issue in healthcare system worldwide and seriously compromises patient outcomes. Social support is considered an effective contributor to alleviate nurse turnover intention (TI). However, the degree of correlation between social support and nurse TI remains elusive.
AIMS
This study aims to evaluate the strength of the effectiveness of social support on TI among nurses as well as its potential moderators.
DESIGN
This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
METHODS
To obtained qualified studies, two researchers searched Embase, PubMed, Web of science, CINAHL, CNKI, WanFang, and Chinese Medical Journal Full Text Database from inception to January 6, 2024. Meta-analysis, publication bias, and sensitivity analysis were carried out on the included studies using CMA 3.0 software, and the moderating effect was verified through meta-analysis of variance (ANOVA).
RESULTS
A total of 38 studies were obtained, involving 63,989 clinical nurses. The comprehensive effect size of the random effect model showed a significant medium negative correlation between social support and TI among nurses ( < 0.001). The sample size and TI measurement tools significantly moderated the correlation between social support and TI ( < 0.050). However, nurse department, gender, data collection time, and social support measurement tools did not moderate the correlation between the two variables.
CONCLUSION
Social support is negatively associated with TI in nurses. Nursing administrators and the medical community should fully recognize the importance of social support for nurses and take corresponding measures to enhance it, thereby reducing TI and ensuring the stability of the nursing team.
Topics: Humans; Intention; Job Satisfaction; Nurses; Personnel Turnover; Social Support
PubMed: 38903567
DOI: 10.3389/fpubh.2024.1393024