Objective This study aimed to clarify the relationship between symptoms of depression, anxiety and health behaviors, namely, physical activity, BMI, healthy diet and medication adherence, in...Show moreObjective This study aimed to clarify the relationship between symptoms of depression, anxiety and health behaviors, namely, physical activity, BMI, healthy diet and medication adherence, in patients with non-dialysis dependent chronic kidney disease (NDD-CKD). Methods Patients with NDD-CKD (N = 460, Mage = 59, SD = 13) filled in the Patient Health Questionnaire and the Generalized Anxiety Disorder questionnaire, the Short Questionnaire to Assess Health-enhancing physical activity, and BMI data. Perceived adherence to a healthy diet was measured by factoring two questions in principal component analysis and the Simplified Medication Adherence Questionnaire was used. Hierarchical multiple regression analyses and ordinal logistic regression analyses were conducted. Adjustments were made for age, gender and covariates that correlated with health behaviors. Results Patients with symptoms of depression were less likely to be physically active (β = -.11, p = .031), perceived adherence to a healthy diet was lower (β = -.16, p = .001), and more likely to be medication non-adherent (OR = 1.08, p = .003). The relationship between symptoms of depression and BMI only showed a trend towards significance (β = .09, p = .063). Patients with symptoms of anxiety only perceived to adhere less to a healthy diet (β = -.11, p = .019). Discussion The results implicate that patients with symptoms of depression engage less in health behaviors, while patients with symptoms of anxiety only adhere less to a healthy diet. These results are important to consider to ensure a tailored approach in motivating patients towards a healthy lifestyle can be implemented.Show less
For patients with non-dialysis dependent chronic kidney disease (CKD) it is of vital importance to engage in physical activity and to adhere to a healthy diet. As a significant amount of patients...Show moreFor patients with non-dialysis dependent chronic kidney disease (CKD) it is of vital importance to engage in physical activity and to adhere to a healthy diet. As a significant amount of patients does not seem to adhere sufficiently to these self-management behaviors, the study objective was to examine psychological factors that are associated with adherence to these self-management behaviors. In this study, the univariate, direct associations between perceived control, anxiety and adherence to a healthy diet or engagement in physical activity were investigated. Specifically, this study tested whether the relationship between perceived control and the self-management behaviors was mediated by symptoms of anxiety. A cross-sectional design was used to investigate the relationships between perceived control, anxiety and the self-management behaviors. An online survey consisting of self-report measures was administered on 145 patients with non-dialysis dependent CKD that received treatment in Dutch hospitals. The Brief IPQ, GAD-7, SQUASH and questions based on nephrology guidelines were used to measure perceived control, anxiety, physical activity and adherence to a healthy diet, respectively. Cognitions of helplessness, measured with the ICQ, were used as an additional expression of low perceived control. The direct relationships were tested with a number of bivariate regression analyses and bootstrapping was used to test the mediation effect. Findings show that perceived control was directly and positively related to physical activity (b* = .18, p = .045). Cognitions of helplessness were found to be directly and positively associated with anxiety (b* = .21, p = .01). Patients did not seem to engage less in the self-management behaviors when they experienced lower levels of perceived control or more cognitions of helplessness, as a consequence of having more symptoms of anxiety. Findings suggest that patients with higher levels of perceived control, might engage in more physical activity and that patients with more cognitions of helplessness might experience increased anxiety. An important implication of these findings is that is seems necessary to design cognitive behavioral interventions that aim to enhance levels of perceived control in patients with non-dialysis dependent CKD. Theoretical and practical implications, limitations of this study and suggestions for future research are discussed.Show less
Prior research has demonstrated a strong positive relationship between self-efficacy beliefs and pain tolerance. However, the pathways through which self-efficacy beliefs may be manipulated and...Show morePrior research has demonstrated a strong positive relationship between self-efficacy beliefs and pain tolerance. However, the pathways through which self-efficacy beliefs may be manipulated and affect pain tolerance are not clear. The current study aims to examine the effect that self-efficacy beliefs have on pain tolerance ratings, as assessed by a cold-pressor test (CPT). Secondly, whether self-efficacy can be altered through verbal suggestions is examined. Healthy participants (N = 17) were randomly assigned into a low self-efficacy group (Low-SE group) and a high self-efficacy (High-SE group) and participated in a CPT, after self-efficacy manipulation. Differences on pain tolerance and the manipulation check question, across the groups were examined with Analysis of Variance (ANOVA). Baseline measurements of self-efficacy were administered and analysed with ANOVA. Although participants in the High-SE group showed higher pain tolerance ratings (M = 43.23, SD = 19.09) compared to those in the Low-SE group (M = 41.58, SD = 23.36), the difference between the groups was not significant, p = .883. Participants in the High-SE group (M = 5.24, SD = 1.89) had a lower score on the manipulation check question, compared to those in the Low-SE group (M = 5.62, SD = 1.71). However, the difference was not statistically significant, p = .666. No statistically significant baseline differences have been found between the groups. Further research is needed, to determine the mechanisms through which perceived control and affective responses on pain experience may intermediate the relationship between self-efficacy and pain tolerance, while contributing to self-efficacy manipulation.Show less
eHealth could be an effective tool to reduce stress in students. Since eHealth interventions are easy to use and relatively cheap, especially unguided eHealth interventions, it is important to know...Show moreeHealth could be an effective tool to reduce stress in students. Since eHealth interventions are easy to use and relatively cheap, especially unguided eHealth interventions, it is important to know whether students want to take part in an unguided intervention as much as in a guided intervention, and which personal factors play a role in uptake. With this knowledge it might be possible to engage people that would normally not take part in an intervention. In research regarding adherence, perceived social support (PSS) and self-efficacy (SE) appear to play a role. This study focussed on guided and unguided eHealth interventions and the effect of uptake SE and PSS on uptake. We distributed a questionnaire with screenshots of an app amongst students (N = 143). They were randomly assigned to the guided or unguided condition. No effect was found of group on uptake, also PSS had no effect or interaction effect on uptake. Only a direct effect was found of uptake SE on uptake. A possible explanation for the same willingness to start in both groups is the Computers are Social Actors paradigma. Furthermore, uptake SE seems to influence uptake because in case of low levels of SE more support is needed. The results implicate that the type of intervention does not influence uptake, and that low levels of SE are related to lower levels of uptake. Further research should focus on how to increase uptake SE and the personal factors that play a role in uptake.Show less
Background: Long-term exposure to road traffic noise is associated with the prevalence of hypertension. To understand more about this exposure-response relationship, it is essential to examine this...Show moreBackground: Long-term exposure to road traffic noise is associated with the prevalence of hypertension. To understand more about this exposure-response relationship, it is essential to examine this association with baseline blood pressure measurements. However, theories of possible mechanisms explaining the chronic physiological effects of road traffic noise exposure are limited. Furthermore, the findings of epidemiological studies investigating this relationship are inconsistent and different factors seem to influence the strength of the relationship. A critical evaluation of these studies seems warranted. Purpose: This study aims to gain more theoretical and empirical insight into the association between road traffic noise and resting blood pressure measurements. Methods: Web of Science, PubMed and reference lists were used. Six articles were included, consisting of information about ten studies. A meta-analysis on the association between road traffic noise and blood pressure among adults was performed. The ten effect size estimates were based on the data of 146,339 subjects in total. Results: A 0.195 mmHg (95% CI: 0.004, 0.386) higher systolic blood pressure per 10 dB increase was found. Road traffic noise was not associated with diastolic blood pressure. However, the sensitivity analysis revealed stronger associations with diastolic blood pressure for high-quality studies and stronger associations with systolic blood pressure for nighttime noise exposure. Conclusion: Long-term exposure to road traffic noise had a significant positive association with systolic blood pressure, perhaps strongest at night, and a nonsignificant positive association with diastolic blood pressure. The significant moderating effect of study quality on diastolic blood pressure is a possible explanation for this inconsistency. Further research is required to get a more comprehensive understanding of the association between road traffic noise and blood pressure.Show less
