Elvira Cicognani

Health-related quality of life in systemic lupus erythematosus: a longitudinal study on the impact of problematic support and self-efficacy:

Objectives: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease which can affect any organ in the body, reducing patients health-related quality of life (HR-QOL). Psychosocial research on SLE is quite recent and is mostly based on qualitative and cross-sectional evidence. Some studies suggest that a protective role is played by perceived self-efficacy in the management of the disease, while a detrimental role is played by problematic social interactions. Methods: In a longitudinal study, we tested the independent contribution of self-efficacy and problematic social support, in predicting patients HR-QOL after 11 months. An online questionnaire was completed by 162 participants with SLE, the second questionnaire after 11 months. Results: Controlling for corticosteroids and hydroxychloroquine use, self-efficacy in the management of the disease at Time 1 showed a significant and positive effect on HR-QOL at Time 2, while problematic social support (denying/uninformed) showed a negative effect. Conclusions: HR-QOL of SLE patients is influenced by self-efficacy in the management of the disease and problematic support. Specific attention should be paid to the quality of patients social relationships and their perceived efficacy in the management of the disease in focused interventions as in daily clinical practice.

Psychometric Properties of a Multidimensional Scale of Sense of Community in the School

Sense of community in the school has been associated with a range of important outcomes for students. However, there are currently no standard definitions of sense of community in the school with corresponding measures with established psychometric properties. To fill this gap, the main aim of the present study was to propose a model of sense of community in the school, its operationalization and to examine its key psychometric properties (factorial structure, reliability, differential item functioning, differential test functioning of the scale and discriminant, convergent, and criterion validity). Participants were 1,076 students from 22 public middle schools and 724 students from 22 public high schools located in the Italian city of Genoa and its province. To test the dimensionality of the scale, we conducted exploratory and confirmatory factor analysis under the Item Response Theory paradigm. Exploratory factor analysis confirmed three dimensions: Membership, Emotional connection, and Opportunities. A confirmatory factor analysis revealed that the bifactor model exhibited the largest improvement in fit. Cronbach’s alpha, omega total, and omega hierarchical indicated a good reliability for the measure. Internal consistency was satisfactory, considering Cronbach’s alpha and omega. Analysis of differential item/test functioning of the scale showed that girls and boys as well as students attending middle school and those attending high school responded in largely similar ways to the measure. Finally, the instrument demonstrated good discriminant, convergent, and criterion validity. Together, these findings indicate that our theory driven model of sense of community in the school is valid and that the instrument is a reliable measure for assessing sense of community in the school.

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 39.66u2009years. 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.

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.

Communication of health risks from exposure to depleted uranium (DU) in Italy: a case study

The potential effects of depleted uranium (DU) on the health of military personnel, civilians and on the environment have been the focus of considerable debate in the last two decades. In Italy, the issue came to the attention of the public when some soldiers developed cancer after participating in peace missions in the Balkans in the second half of the nineties. In this case study, we draw on theoretical perspectives on risk and crisis communication to examine how communication strategies on DU risk lead to the creation of a ‘DU case’ in Italy, through the amplification of public perception of risk. In-depth interviews were conducted with experts, policy-makers, journalists and members of associations of soldiers and families of victims (nu2009=u200930) and were qualitatively analysed. The findings indicate the presence of three temporal phases through which the ‘DU case’ unfolded, characterized by different forms of communication, which influenced risk responses by amplification effects. A chain of communication errors could be identified, which explains the ineffectiveness of the initial responses of public authorities to the risk event, leading to a crisis that persisted for some years. The media played a central role in communication in all phases of the crisis. The findings have several implications for the improvement of the public responses to this type of risk.

“Is it your concern?” perceived similarity and identification with the characters of the 2012–2013 Italian media campaign against AIDS

ABSTRACT The 2012–13 Italian national campaign against HIV/AIDS was based on a video primarily targeted to women, youth, migrants, and gay men. Its conceptual basis was to encourage preventive behaviors by promoting people’s perceived similarity and identification with the video characters and communicating the message that AIDS is everyone’s concern. The aim of this study was to investigate how people belonging to the target groups reacted to the video and, more specifically, their comprehension of the message, their perceived similarity and identification with the characters, and the perceived efficacy of the video. Fourteen focus groups were conducted with 130 participants. Transcripts were analyzed through qualitative content analysis. Results showed that the core message was adequately understood. Participants perceived themselves as partially similar to the video characters but they did not strongly identify with them. Most participants did not consider the video as effective. Peculiarities of the four target groups are discussed.

Positive and problematic support, stress and quality of life in patients with systemic lupus erythematosus

ABSTRACT Background and Objectives: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. Previous studies showed that perceived social support has an important role in enhancing patients quality of life (QOL). However, the precise mechanisms through which social support exerts such an effect are not completely understood. The aim of this paper is to test two alternative models explaining the relationship between social support (positive and problematic) and two dimensions of QOL: Health-Related (HR-QOL) and Non-Health-Related (NHR-QOL). Design: Model A (mediation) hypothesized that positive support would reduce stress while problematic support would increase stress), and that this in turn would reduce QOL. Model B (moderation) hypothesized that the effect of support on QOL would be moderated by the experience of stress in that more stressed individuals would show stronger effects. Methods: Three hundred and forty-four Italian patients with SLE completed an online questionnaire. Results: Stress partially mediated the relationship between support and QOL dimensions (either HR-QOL and NHR-QOL) thus supporting Model B. As hypothesized, positive support reduced stress, while problematic support increased stress. Conclusions: These findings help to explain the complex relationship between social support, stress and QOL in patients with SLE.