Davide Mazzoni

Psychosocial Predictors and HIV-Related Behaviors of Old Adults Versus Late Middle-Aged and Younger Adults

Objective: We investigated the psychosocial predictors and HIV-related behaviors of old adults versus late middle-aged and younger adults. Method: A demographically representative sample of residents in Italy aged 18 to 75 years (n = 2,018) was subdivided into three age groups: (a) younger adults (18-49 years), (b) late middle-aged adults (50-59 years), and (c) old adults (60-75 years). Interviews were conducted using computer-assisted telephone survey methodology. Results: Despite reporting similar levels of sexual risk behaviors, late middle-aged and old adults were less likely to use condoms and to have ever had an HIV test. The levels of HIV/AIDS knowledge, risk perception, perceived behavioral control, and behavioral intentions toward condom use were lower among old adults compared with younger adults. Old adults were less likely to have discussed HIV/AIDS with friends, relatives, or health professionals. Discussion: Old adults should be included in prevention efforts targeting knowledge, perceptions, and intentions toward condom use. Future studies should be cautious when overgeneralizing the results to all individuals aged 50 and older.

Problematic Social Support From Patients’ Perspective: The Case of Systemic Lupus Erythematosus

Several studies demonstrated the importance of psychosocial factors, like social support, for understanding the experience of people with Systemic Lupus Erythematosus (SLE). Less information is available on “problematic support”; that is, instances of support that are perceived as non-supportive, even though the provider’s actions may be well intended. Aim of this qualitative study was to explore the experiences of problematic support from SLE patients’ perspective. Nine women with SLE were interviewed and transcripts were analyzed through qualitative content analysis. Three main types of problematic social support were indentified. Oppressive support describes social support offers characterized by excessive worries and unwanted advices. Support denying the illness is characterized by a neglect of the disease or of its consequences. Support based on divergent illness representations is perceived as not punctual and not in line with patients’ actual clinical condition. This study confirms the complexity of providing useful support to SLE patients and suggest that also people living close to patients should represent a target of interventions.

Perceived behavioural control, subjective norms, attitudes and intention to use condom: A longitudinal cross-lagged design

Based on the Theory of Planned Behaviour (TPB), the purpose of this investigation was to examine the directionality of the association among condom use, intention, attitudes, subjective norms and perceived behavioural control. The present study investigated the nature of these relationships using a longitudinal cross-lagged design applied to data from a cohort of 958 randomly selected Italian adults. Using structural equation modelling, two cross-lagged panel analyses revealed reciprocal relationships between intention and attitudes and between intention and condom use. Contrary to expectations, baseline subjective norms and perceived behavioural control did not predict subsequent intention to use condom when controlled for the autoregressive effect of intention at T1 on the same variable at T2. Also, perceived behavioural control at T1 did not influence condom use at T2 after controlling for the effect of baseline intention. The possibility of reciprocity was also tested for all relations and significant results were found. The moderation effect of perceived behavioural control on the relationship between intention and condom use was not significant. The differences in age, gender and partnership status were taken into account in the analyses.

Explaining offline and online civic engagement intentions between Italian and migrant youth / Análisis de las intenciones de participación cívica virtual y presencial entre jóvenes italianos y emigrantes

Abstract The aim of the study was to assess the role of some psychosocial factors in explaining offline and online civic engagement intentions in a sample of Italian and second generation migrant (Albanian and Moroccan) adolescents and young adults living in Italy. The theoretical model was an extended version of the Theory of Planned Behaviour including past experience. The sample included 598 adolescents and young adults (M = 19.32, SD = 3.17). Two hundred were Italian (88 males, 44.0%), 197 migrants of Albanian origin (130 males, 66%) and 201 migrants of Moroccan origin (116 males, 57.7%). Moroccan youth reported higher levels of both past civic engagement and future intentions than Albanian and Italian peers. Perceived effectiveness of civic engagement and past experience are consistently associated with stronger intentions to engage in the future (offline and online) in all groups. Internal efficacy plays a limited role, whereas the role of subjective norms differs according to the group and the source of normative influence (parents, peers).AbstractThe aim of the study was to assess the role of some psychosocial factors in explaining offline and online civic engagement intentions in a sample of Italian and second generation migrant (Albanian and Moroccan) adolescents and young adults living in Italy. The theoretical model was an extended version of the Theory of Planned Behaviour including past experience. The sample included 598 adolescents and young adults (M = 19.32, SD = 3.17). Two hundred were Italian (88 males, 44.0%), 197 migrants of Albanian origin (130 males, 66%) and 201 migrants of Moroccan origin (116 males, 57.7%). Moroccan youth reported higher levels of both past civic engagement and future intentions than Albanian and Italian peers. Perceived effectiveness of civic engagement and past experience are consistently associated with stronger intentions to engage in the future (offline and online) in all groups. Internal efficacy plays a limited role, whereas the role of subjective norms differs according to the group and the sourc...

The Problematic Support Scale: A validation among patients with systemic lupus erythematosus:

The aim of the study was to develop and to assess the psychometric properties of the Problematic Support Scale, among patients with systemic lupus erythematosus. An online questionnaire was filled in by 344 systemic lupus erythematosus patients with a mean age of 39.66 years. Explorative factor analysis, later validated by confirmative factor analysis, showed the emergence of a two-factor structure in types of support provided: denying/uninformed support and oppressive support. Denying/uninformed support includes offers of support that neglect the disease manifestations and consequences. Oppressive support describes social support offers which are perceived as excessive and oppressive. Results confirm previous qualitative evidence and demonstrate good reliability and concurrent validity of the Problematic Support Scale. Theoretical and methodological implications for the study of social support are discussed.

Evaluating the Persuasiveness of an HIV Mass Communication Campaign Using Gain-Framed Messages and Aimed at Creating a Superordinate Identity

ABSTRACT This research assesses the coverage and impact of “United Against AIDS,” the 2012–2013 Italian National HIV/AIDS prevention campaign to promote safer sex behavior and voluntary HIV counseling and testing. The campaign used gain-framed messages and aimed at creating a superordinate identity. We conducted two studies. The first study employed a quasi-experimental design involving three groups of participants: general population (n = 858), men who have sex with men (MSM; n = 109), and migrants (n = 211). In the second study, we carried out a time-series design to analyze the archival data of the Italian National AIDS Help-Line. Exposure to the campaign was reported by 78.3%, 67.5%, and 57.8% of the general population, MSM, and migrant respondents, respectively. The probability of having unprotected sexual intercourse with multiple partners decreased significantly in the subsample of the general populations that was exposed to the campaign (compared to the nonexposed participants), but the same effect was not found among MSM and migrant participants. The probability of having unprotected sexual intercourse with someone of unknown HIV status decreased after the campaign in the exposed MSM subsample (compared to the nonexposed participants), but the same effect was not found among the general population and migrant participants. In addition, the probability of undertaking HIV testing increased significantly in the exposed participants belonging to the general population but not among MSM and migrant participants. Time-series analysis revealed that the number of calls at the Italian National AIDS Help-Line significantly increased during the campaign. This research provides evidence that the effect of the campaign was complex and varied across participants.

Patients' participation in research projects as partners

Sir, The authors of this letter are an international group of patients who are currently involved in scientific research projects at European level. The aim of this letter is to briefly review the state of the art and to open the discussion about the implications of patients’ involvement in research as partners. Patients can be involved in research in many ways. For example, they can participate as objects of research in randomized controlled studies, or as respondents to questionnaires and interviews. The role of the patient as a research partner is emerging. Patient research partners are patients who join research teams on an equal basis with professional researchers, adding the benefit of their experiential knowledge to any phase of the project. Recent literature shows that the rationale for actively involving patients in research as partners is mostly based on ethical arguments (i.e. in a democracy patients have the right to speak for themselves), content (the experience-based knowledge makes research outcomes more relevant and fit better with the context of daily life), political/strategic (legitimacy and chances for implementation increase). Finally, patients’ involvement may also enhance their sense of empowerment. Mostly for these reasons, in the recent years some scientific organizations have started defining recommendations for patients’ involvement from the beginning of projects and establishing a network of specifically trained research partners. To our knowledge, at least seven European patients with lupus, including some of us, are currently involved as partners in international projects covering different research areas. The contribution of patients in research projects is often largely appreciated. With specific regards to lupus patients, where possible, their contribution has also been recognized in some projects as co-authorship in presentations at international conferences and in journals. Despite this enthusiasm, we must recognize, also from our personal experience, that patients’ involvement in research as individuals is not easy and it still remains a novelty. To our knowledge, in the recent years no published article in the Lupus journal has been devoted to this issue. In order to optimize the participation of lupus patients, more support and training opportunities are desirable. We hope that this brief letter will open the debate about the role, opportunities and challenges of the involvement of lupus patients in research.

Health-related quality of life after solid organ transplantation: the role of sport activity

The aim of the study was to investigate the effects of sport activity on health-related quality of life (HRQoL) of solid organ transplant recipients participating in sports competitions. A group of 168 sportive transplanted patients (STP), a group of 97 nonsportive transplanted patients (NSTP), and a group of 152 sportive healthy controls (SHC) were compared on the eight scales of the SF-36 questionnaire. STP and NSTP reported significantly lower scores than SHC on the physical functioning scale. STP did not differ from SHC in the Role-Physical, General Health, and Vitality scales, while NSTP reported significantly lower scores. STP obtained higher scores than NSTP and SHC on Mental Health. Among STP, the effect of quantity of sport activity was significant on General Health and Role Emotional, with more sport activity associated with higher HRQoL. Organ failure and post-transplant therapies may have negative consequences on HRQoL. Sports activities and participation in sports competitions can reduce this impact, improving general and psychological functioning of solid organ transplant recipients.

Metaphors and representations of systemic lupus erythematosus: comment on the article by Sutanto et a.

We read with great interest the article by Sutanto and colleagues published recently in Arthritis Care & Research (1). The article was a systematic review and thematic synthesis of 46 qualitative studies that explored the experiences of adults living with systemic lupus erythematosus (SLE). This contribution is cohesive with approaches that emphasize the usefulness of synthesizing qualitative research to overcome some of the limits of single qualitative studies, bridging the gap between research and practice in health disciplines (2). However, in qualitative research and reviews, findings strictly depend on the researchers’ perspectives and questions (3). In this regard, from a social psychology perspective, we suggest that an interesting point of view for considering the growing corpus of qualitative studies is the social representation theory (4,5), with a specific focus on metaphors that patients adopt to describe their condition. In simple terms, the purpose of all representations is to make something unfamiliar familiar, and metaphors are functional to this process (6). This is mostly important for serious and complex conditions, where the challenge for clinicians is to provide clear information, and the challenge for patients is to make sense of such a largely unpredictable and fluctuating disease. In an extensive literature review, we identified the 3 main metaphors used by professionals to describe lupus-related diseases: the wolf, the monster Hydra, and the butterfly, each of which emphasizes specific disease aspects and manifestations. Regarding the wolf, the term lupus (Latin for wolf) is attributed to the thirteenth century physician Rogerius, who used the term to describe erosive facial lesions that were reminiscent of a bite from a wolf (i.e., canis lupus) (7). This metaphor emphasizes the skin involvement and appears functional to describe a quite severe disease. The second metaphor, the monster Hydra, derives from ancient Greek mythology (8). This frightening beast had an uncertain number of heads, and stories indicated that cutting off 1 head led to the growth of 2 others. Analogous with the Hydra, SLE can present itself in a multitude of guises, which are usually intermittently active (9). The successful treatment of 1 manifestation, such as arthritis, may be followed by the emergence of other clinical features, such as renal disease or skin rash (10). The third metaphor of the butterfly symbolizes the symmetric malar erythema reaction seen most often in the context of active SLE (11). However, the professionals’ perspective represents just half of the picture; which common representations of the disease are shared by patients? Are these representations related to a wild beast they can fight (like the wolf), an unbeatable, terrifying monster (like the Hydra), or a peaceful animal to live with (like the butterfly)? We suggest that future reviews of qualitative studies with SLE patients will be able to answer more specific questions, clarifying the use of representations in the light of illness severity, coping strategies, and acceptance of the disease. This kind of research will help clinicians in providing useful information to patients, but avoiding distressing or frightening disease representations (12–14).

Gender Differences in Quality of Life in Patients with Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) predominantly affects women. Clinical phenotype and outcomes in SLE may vary by sex and are further complicated by unique concerns that are dependent upon sex‐defined roles. We aimed to describe sex differences in disease‐specific quality of life (QoL) assessment scores using the Lupus Patient‐Reported Outcome (LupusPRO) tool in a large international study.