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Associations of Illness Perception, Resignation Coping, and Social Support With Self-Regulatory Fatigue in Patients With Type 2 Diabetes: A Cross-Sectional Study.

AIMS: To examine the associations among illness perception, resignation coping, social support, and self-regulatory fatigue (SRF) in patients with Type 2 diabetes mellitus. The study specifically explores whether resignation coping and social support exhibit indirect associations with SRF in the context of illness perception. DESIGN: A cross-sectional study. METHODS: From November 2024 to October 2025, a convenience sample of 302 adult patients with T2DM was recruited from a tertiary general hospital in China. Participants completed validated instruments with established psychometric properties, namely the Brief Illness Perception Questionnaire, the Medical Coping Modes Questionnaire, the Perceived Social Support Scale, and the Self-Regulatory Fatigue Scale. Statistical analyses included Spearman correlation and serial mediation analysis using the PROCESS Macro (Model 6) with bias-corrected bootstrapping. RESULTS: SRF was positively correlated with negative illness perception (r&#x2009;=&#x2009;0.579, p&#x2009;<&#x2009;0.01) and resignation coping (r&#x2009;=&#x2009;0.612, p&#x2009;<&#x2009;0.01), and negatively correlated with social support (r&#x2009;=&#x2009;-0.598, p&#x2009;<&#x2009;0.01). Serial mediation analysis revealed that illness perception was associated with SRF through indirect pathways involving resignation coping and social support. Resignation coping and social support mediated the association between illness perception and self-regulatory fatigue, both individually and sequentially. CONCLUSIONS: Negative illness perception correlates with higher SRF. This observed correlation is additionally linked to indirect pathways involving resignation coping and lower social support. Collectively, these findings highlight a pattern of interrelated cognitive (illness perception), behavioural (resignation coping), and resource (social support) factors that are associated with self-regulatory fatigue in this cross-sectional study. IMPLICATIONS FOR THE PROFESSION: The findings offer a clear, evidence-based framework for nursing practice. They highlight the potential value of integrated assessment and intervention that simultaneously addresses patients' illness beliefs, maladaptive coping strategies, and social support systems, which are associated with lower SRF and better diabetes self-management. REPORTING METHOD: This study adheres to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION: Patients participated solely as research participants by providing survey data. They were not involved in the study design, implementation, data analysis, interpretation, or manuscript preparation. All patients provided written informed consent prior to questionnaire completion.

Humans↗

Some thoughts on the perception of ultrasonics by man.

After a short specification of the ultrasonic transmitter device by which the test frequencies of 20,40,60 and 100 kHz could be emitted by means of a transmitter fixed to the forehead of the subject with constant pressure, the mean perception threshold for ultrasonics is described, which had been recorded by using the wide-band noise of the audiometer MA 30. Both curves do not differ considerably so that ultrasonic investigations can be carried out in the presence of working noise without producing wrong measurement results. A comparison of perception between ultrasonic frequencies and audio frequencies in the hearing range showed that ultrasonics produce, independent of the stimulation frequency, the same sensory impression as a sound at a frequency of about 12 or 13 kHz. Applying this method to hard of hearing subjects with noise induced hearing damages and deaf subjects had the following results: 1. Subjects with noise induced hearing damages very early have a raised perception threshold for ultrasonics. There was no correlation between the extent of the auditory threshold (the shift of the threshold) and the perception threshold of ultrasonics. 2. Deaf people almost without exception are not able to perceive ultrasonics. 3. With hard of hearing of the inner ear of different genesis ultrasonic perception is varying. There was no particular raise of the ultrasonic perception threshold with hereditary hard of hearing of the inner ear. 4. On the basis of the results the question is discussed in which section of the auditory system ultrasonic perception occurs. In the opinion of the authors the origin of perception might be in the organ of Corti itself. An unambiguous proof, however, could not be found so far. At present the procedure of investigation does not yet allow an application in practical diagnostics of ear specialists.

Adolescent↗

Anxiety induced by cardiac perceptions in patients with panic attacks: a field study.

In panic disorder bodily sensations appear to play an important role as a trigger for anxiety. In our psychophysiological model of panic attacks we postulate the following vicious circle: individuals with panic attacks perceive even quite small increases in heart rate and interpret these changes as being catastrophic. This elicits anxiety and a further increase in heart rate. To evaluate this model we conducted a field study of 28 subjects with panic attacks and 20 healthy controls. A 24 hr ambulatory ECG was recorded and the subjects were instructed to report any cardiac perceptions during this period and to rate the anxiety elicited by these perceptions. The incidence of cardiac perceptions was about the same in both groups, but only subjects with panic attacks reported anxiety associated with such perceptions. Analysis of the ECGs revealed that in both groups heart rate accelerations preceded cardiac perceptions. Following cardiac perceptions, the healthy controls showed a heart rate deceleration, whereas the subjects with panic attacks had a further acceleration. This heart rate increase after cardiac perceptions was positively related to the level of anxiety elicited by the perceptions. These results provide clear evidence in support of the vicious circle model of panic attacks.

Adult↗

A hemispheric asymmetry for the unconscious perception of emotion.

Previous research has demonstrated that hemispheric asymmetries for conscious visual perception do not lead to asymmetries for unconscious visual perception. These studies utilized emotionally neutral items as stimuli. The current research utilized both emotionally negative and neutral stimuli to assess hemispheric differences for conscious and unconscious visual perception. Conscious perception was measured using a subjective measure of awareness reported by participants on each trial. Unconscious perception was measured by an "exclusion task," a form of word-stem-completion task. Consistent with predictions, negative stimuli were consciously perceived most often when presented to the right hemisphere. Negative stimuli presented to the right hemisphere showed no evidence of unconscious perception, suggesting that the hemispheric asymmetry for the conscious perception of negative information occurs at the expense of unconscious perception.

Adult↗

Psychological distress in women at increased risk for breast cancer: the role of risk perception.

The magnetic resonance imaging screening (MRISC) study evaluates a surveillance programme for women with a hereditary risk for breast cancer. The psychological burden of surveillance in these women may depend on inaccurate risk perceptions. To examine differences in risk perceptions between three predefined risk categories and associations with psychological distress. BC-specific distress, general distress, and RP (cognitive and affective) were assessed, two months before a surveillance appointment. Cumulative lifetime risk (CLTR) of developing breast cancer was trichotomised into: (1) CLTR of 60-85% (mutation carriers), (2) CLTR of 30-50%, and (3) CLTR of 15-30%. In a total group of 351 women (mean age 40.5 years, range 21-63 years) the three risk categories significantly differed in their accuracy of assessing cognitive risk perceptions. In category 1, 60% had an accurate risk perceptions, in category 2, 43.7% and in category 3, 33.3%. Overestimators reported significantly more breast cancer-specific distress. After adding affective risk perception to the model, this effect disappeared. Affective risk perceptions showed significant associations with breast cancer-specific and general distress. Affective risk perception is a more important determinant for psychological distress than cognitive risk perception. This knowledge should be used during surveillance appointments in order to improve and individualise support for these women.

Adult↗

Do illness perceptions predict attendance at cardiac rehabilitation and quality of life following myocardial infarction?

OBJECTIVE: The aim of this study was to examine the extent to which illness perceptions predict attendance at cardiac rehabilitation and quality of life following myocardial infarction (MI). METHODS: The illness perceptions of 194 MI patients were assessed whilst the patients were still in hospital following an MI. The mean age was 63.3 years (S.D. = 10.6), and 142 of the patients were men. Cardiac rehabilitation attendance and quality of life were assessed via a postal questionnaire 6 months later. RESULTS: In contrast to previous work reported in this area, illness perceptions were not significantly associated with attendance at cardiac rehabilitation. Illness perceptions measured within 24 h of an acute MI were predictive of quality of life 6 months later. CONCLUSION: Previous reports may have overestimated the extent to which illness perceptions predict attendance at cardiac rehabilitation. The relationship between illness perceptions and quality of life at 6 months suggests that interventions to alter illness perceptions, especially perceptions of consequences, may be useful in improving health-related quality of life (HRQoL) following an MI.

Aged↗

Diurnal fluctuation of time perception under 30-h sustained wakefulness.

Previous studies have reported that time perception in humans fluctuates over a 24-h period. Behavioral changes seem to affect human time perception, so that the fluctuation in human time perception may be the result of such changes due to self-determined activities. Recently, we carried out a study in which a healthy human cohort was asked to perform simultaneously loaded cognitive tasks under controlled conditions, and found that time perception decreased linearly from morning to evening. In addition, the variations in time perception were not a consequence of behavioral changes. It remains to be elucidated whether diurnal variations in time perception are a consequence of circadian rhythm or of some homeostatic changes that are attributable to accumulated wake time. The effects of circadian rhythm on time perception were investigated in eight healthy young male volunteers by conducting 10-s time production tasks under 30-h constant-routine conditions. Core body temperature and serum melatonin and cortisol levels were measured during the course of the study. Produced time exhibited a diurnal variation and was strongly correlated with circadian variations in core body temperature and serum melatonin levels. These results suggest that human short-term time perception is under the influence of the circadian pacemaker.

Adult↗

A binocular rivalry study of motion perception in the human brain.

The relationship between brain activity and conscious visual experience is central to our understanding of the neural mechanisms underlying perception. Binocular rivalry, where monocular stimuli compete for perceptual dominance, has been previously used to dissociate the constant stimulus from the varying percept. We report here fMRI results from humans experiencing binocular rivalry under a dichoptic stimulation paradigm that consisted of two drifting random dot patterns with different motion coherence. Each pattern had also a different color, which both enhanced rivalry and was used for reporting which of the two patterns was visible at each time. As the perception of the subjects alternated between coherent motion and motion noise, we examined the effect that these alternations had on the strength of the MR signal throughout the brain. Our results demonstrate that motion perception is able to modulate the activity of several of the visual areas which are known to be involved in motion processing. More specifically, in addition to area V5 which showed the strongest modulation, a higher activity during the perception of motion than during the perception of noise was also clearly observed in areas V3A and LOC, and less so in area V3. In previous studies, these areas had been selectively activated by motion stimuli but whether their activity reflects motion perception or not remained unclear; here we show that they are involved in motion perception as well. The present findings therefore suggest a lack of a clear distinction between 'processing' versus 'perceptual' areas in the brain, but rather that the areas involved in the processing of a specific visual attribute are also part of the neuronal network that is collectively responsible for its perceptual representation.

Adult↗

Monosyllable speech perception of Japanese hearing aid users with prelingual hearing loss: implications for surgical indication of cochlear implant.

OBJECTIVE: The monosyllable speech perception ability after years of educational intervention was compared between prelingually deafened pediatric hearing aid users and their cochlear implant counterparts. DESIGN: An open-set monosyllabic speech perception test was conducted on all subjects. The test required subjects to indicate a corresponding Japanese character to that spoken by the examiner. Fifty-two subjects with prelingual hearing impairment (47 hearing aid users and 5 cochlear implant users) were examined. RESULTS: Hearing aid users with average pure-tone thresholds less than 90 dB HL demonstrated generally better monosyllable perception than 70%, which was equivalent or better performance than that of the cochlear implant group. Widely dispersed speech perception was observed within the 90-99 dB HL hearing-aid user group with most subjects demonstrating less than 50% speech perception. In the cluster of >100 dB HL, few cases demonstrated more than 50% in speech perception. The perception ability of the vowel part of each mora within the cochlear implant group was 100% and corresponding to that of hearing aid users with moderate and severe hearing loss. CONCLUSION: Hearing ability among cochlear implant users can be comparable with that of hearing aid users with average unaided pure-tone thresholds of 90 dB HL, after monosyllabic speech perception testing was performed.

Adolescent↗

[Classification and mechanisms of body perceptions in the amputees].

OBJECTIVE: Amputees can experience several types of physical illusions and phantom limb phenomenon. The objective was to establish a synthetic classification of theses perceptions. METHOD: Prospective study in 75 amputees (group 1: amputation (n = 60), group 2: congenital defect). The subjects were asked first to report their perceptions spontaneously and then to detail the perception, if exist, of the missing limb: form recognition, posture, movement, reminiscence of a lost limb. RESULTS: Different types of perception were described besides the perception of the real state : normal, deformed or commemorative phantom limb and illusion of a normal body. DISCUSSION: Whatever the model (i.e.: neuro-matrix) which support the construction of the scheme and the body image, the representations related to identified perceptions, use various innate, autobiographic and identity frames of references as well as instantaneous peripheral information, treated by reorganized cerebral structures. Each type of perception is related to a particular representation pattern. CONCLUSION: This approach, in accordance with the literature, offers a better understanding of the differences between amelic and amputated subjects and of their perception of any prosthetic equipment.

Amputees↗

Perceptions of physicians and patients with organic and functional gastrointestinal diagnoses.

BACKGROUND AND AIMS: We studied patient after-hours telephone calls to gastrointestinal (GI) fellows at a university program to determine requests made, physicians' responses, and perceptions of patients and physicians to these requests. METHODS: During a 4-month period, 4 GI fellows taking call were asked about reasons for patient-initiated after-hours telephone calls, actions taken, and their perceptions about the nature of the request, the illness impact, and their role in the care administered. Patients were telephoned within 1 week and asked the same questions about their perceptions of the call. RESULTS: Patients (N = 102) made 103 telephone calls, averaging 8.7 minutes, for symptoms (56%), procedure-related concerns (19%), and medications (18%). Physicians usually referred the patient to the clinic or emergency room (40%) or provided discussion and reassurance (36%). Patients' perceptions differed from physicians' perceptions: patients believed their problems to be more severe and more disabling and requests were more reasonable than perceived by the physician. Furthermore, their interactions with physicians (physician helpfulness, satisfaction with the recommendation, and likeability of the physician) were more positive than believed by physicians. Physicians believed phone calls from patients with functional disorders were less serious and less reasonable, that these patients were less disabled, and also that these patients were less liked than patients with an organic diagnosis. CONCLUSIONS: In this study, physicians carried a lower perception of the importance of telephone requests, the impact of the disorder, and their perceived helpfulness to patients than did patients making these requests. Physician perceptions were significantly lower for all these factors for patients with functional GI diagnoses. Additional studies are needed to understand the reasons for differing perceptions between physicians and patients.

Adolescent↗

Motion coherence affects human perception and pursuit similarly.

Pursuit and perception both require accurate information about the motion of objects. Recovering the motion of objects by integrating the motion of their components is a difficult visual task. Successful integration produces coherent global object motion, while a failure to integrate leaves the incoherent local motions of the components unlinked. We compared the ability of perception and pursuit to perform motion integration by measuring direction judgments and the concomitant eye-movement responses to line-figure parallelograms moving behind stationary rectangular apertures. The apertures were constructed such that only the line segments corresponding to the parallelogram's sides were visible; thus, recovering global motion required the integration of the local segment motion. We investigated several potential motion-integration rules by using stimuli with different object, vector-average, and line-segment terminator-motion directions. We used an oculometric decision rule to directly compare direction discrimination for pursuit and perception. For visible apertures, the percept was a coherent object, and both the pursuit and perceptual performance were close to the object-motion prediction. For invisible apertures, the percept was incoherently moving segments, and both the pursuit and perceptual performance were close to the terminator-motion prediction. Furthermore, both psychometric and oculometric direction thresholds were much higher for invisible apertures than for visible apertures. We constructed a model in which both perception and pursuit are driven by a shared motion-processing stage, with perception having an additional input from an independent static-processing stage. Model simulations were consistent with our perceptual and oculomotor data. Based on these results, we propose the use of pursuit as an objective and continuous measure of perceptual coherence. Our results support the view that pursuit and perception share a common motion-integration stage, perhaps within areas MT or MST.

Humans↗

Speech perception for adults who use hearing aids in conjunction with cochlear implants in opposite ears.

This study aimed to (a) investigate the effect of using a hearing aid in conjunction with a cochlear implant in opposite ears on speech perception in quiet and in noise, (b) identify the speech information obtained from a hearing aid that is additive to the information obtained from a cochlear implant, and (c) explore the relationship between aided thresholds in the nonimplanted ear and speech perception benefit from wearing a hearing aid in conjunction with a cochlear implant in opposite ears. Fourteen adults who used the Nucleus 24 cochlear implant system in 1 ear participated in the study. All participants had either used a hearing aid in the nonimplanted ear for at least 75% of waking hours after cochlear implantation, and/or, hearing loss less than 90 dB HL in the low frequencies in the nonimplanted ear. Speech perception was evaluated in 3 conditions: cochlear implant alone (CI), hearing aid alone (HA), and cochlear implant in conjunction with hearing aid in opposite ears (CIHA). Three speech perception tests were used: consonant-vowel nucleus-consonant (CNC) words in quiet, City University of New York style (CUNY) sentences in coincident signal and noise, and spondees in coincidental and spatially separated signal and noise. Information transmission analyses were performed on the CNC responses. Of the 14 participants tested, 6 showed significant bimodal benefit on open-set speech perception measures and 5 showed benefit on close-set spondees. However, 2 participants showed poorer speech perception with CIHA than CI in at least 1 of the speech perception tests. Results of information transmission analyses showed that bimodal benefit (performance with CIHA minus that with CI) in quiet arises from improved perception of the low frequency components in speech. Results showed that participants with poorer aided thresholds in the mid-to-high frequencies demonstrated greater bimodal benefit. It is possible that the mid-to-high frequency information provided by the hearing aids may be conflicting with the cochlear implants.

Adult↗

Speech perception in a communicative context: an investigation using question/answer pairs.

By diminishing the role of communicative context, traditional tests of speech perception may underestimate or misrepresent the actual speech perception abilities of adults with a hearing impairment. This study investigates this contention by devising an assessment that may better simulate some aspects of "real-life" speech perception. A group of 31 participants with a severe-to-profound hearing impairment took part in a series of speech perception tests while wearing their hearing aids. The tests used question/answer or adjacency pairs, where the stimulus sentence was preceded by a question spoken by the participant. Four conditions were included: (a) where there was no initiating sentence, as in a traditional open-set speech perception test; (b) where the initiating question was neutral (e.g. "Why?"); (c) where there was a disruptive semantic relationship between the question and answer; and (d) where there was a strong contextual relationship between the question and answer. The time delay between the question and answer was also varied. Results demonstrated that in all conditions where there was a preceding question speech perception improved, and increasing the cohesion between the question and the reply improved speech perception scores. Additionally, time delay and the relatedness of the reply interacted. The effects of semantic context appeared to diminish over a 10-s period while other linguistic effects remained more constant. These results indicate the utility of simulating communicative environments within speech perception tests.

Adult↗

Parents' perceptions and use of analgesics at home after children's day surgery.

BACKGROUND: Children are found to suffer from unnecessarily severe postoperative pain following day surgery. Reasons for parents' insufficient use of analgesics may be based on misleading perceptions of children's analgesics. The purpose of this study was to describe parents' perceptions and use of analgesics for children after discharge at home. METHODS: In this survey, 840 questionnaires were given to parents, and answers from 201 mothers and 114 fathers whose children, aged 1-6 years, had undergone day surgery in 10 Finnish hospitals are presented. RESULTS: One-third (36%) of the children were assessed as having moderate or severe postoperative pain after discharge. More than three-quarters of the parents had given analgesics to the child. Analgesics were given mostly to children who were assessed to have pain and found to have several types of pain behaviour. Most of the parents had accurate perceptions of children's analgesics, but some of them had misleading perceptions of the nature and adverse effects of children's analgesics, which were related to giving analgesics to the child. Fathers, more often than mothers, seem to have such misleading perceptions. CONCLUSIONS: Parents tended to give analgesics to children who actually needed pain alleviation. Parents' perceptions of children's analgesics were mostly accurate. However, misleading perceptions of children's analgesics also exist among the parents. These misleading perceptions appear to decrease parents' use of children's postoperative pain medication.

Adult↗

[Effect of interpupillary distance on acuity of depth perception].

BACKGROUND: Until today it is not really known, what kind of influence the interpupillary distance (IPD) has on depth perception. Actual literature says that haploscopic separation of pictures is of disadvantage for subjects with small IPD. This study intended to verify the influence of IPD on stereopsis in order to get valid and comparable results when testing the depth perception of different subjects. SUBJECTS AND METHODS: We examined 58 normosensoric soldiers for their stereoscopic sensation while changing their individual IPD. By using flexible flat plates of glass, the subjects' IPD could be changed infinitely variable to fix depth perception in haploscopic stereotesting. RESULTS: The variety of the interpupillary distance (IPD) of different people has to be strictly differentiated from the intraindividual changes of interpupillary distance, which, by a change of convergence, lead to a change of depth perception. A decrease in intraindividual IPD reveals an increase of depth perception. This change of perception follows, in mathematical terms, the law of logarithm. In case of intraindividual change of IPD the size of objects is also influenced. CONCLUSIONS: Using conventional stereotests, the IPD of different subjects has negligible influence on the depth perception. Different results of depth perception obtained with the help of stereoscopic examination of normosensoric subjects probably correspond with an individual and egocentric dealing with the visual localization of distances (distance between objects, size of objects, depth of objects).

Adult↗

A revised analysis of the role of efference in motion perception.

The analysis of motion perception historically has included efferent as well as afferent mechanisms to account for the perception of motion during eye movement. The application of efferent mechanisms to motion perception has been limited, however, by several illusions which are apparently inconsistent with the notion that oculomotor mechanisms contribute to motion perception. An alternative account is presented of the manner in which efference may contribute to the perception of motion. It is proposed that distinct smooth eye-movement systems contribute differentially to object motion perception. Specifically, activity in the smooth pursuit system gives rise to the perception of object motion, whereas activity in the smooth component of reflexive eye movements does not. Tracking of a moving object results in object motion perception as a result of efference in the pursuit system. However, the pursuit system may be activated to oppose the smooth component of reflexive eye movements in order to preserve fixation on a stationary object. In such cases neither the fixated object nor the eye is moving but illusory movement results from the efference in the pursuit system. A number of illusory movement phenomena are interpreted in terms of this model.

Eye Movements↗

Spontaneous musical auditory perceptions in patients who develop abrupt bilateral sensorineural hearing loss. An uninhibition syndrome?

CONCLUSIONS: Spontaneous musical auditory perceptions commonly occur in patients who develop abrupt bilateral sensorineural hearing loss. The findings in both subjects who were image tested while having these perceptions are suggestive of a biological substrate for this process and of a central locus for auditory memory seemingly located in and around area 39 of Brodmann. When an individual has abrupt bilateral sensorineural hearing loss, stored musical memory can be released and this person can have musical perceptions without an external source. It is likely that an abrupt bilateral loss of inner ear function might uninhibit neuronal groups storing auditory memory. OBJECTIVES: The objectives of this study were as follows. (1) To determine if spontaneous musical auditory perceptions occur in patients who develop abrupt bilateral severe sensorineural hearing loss (not necessarily simultaneously). (2) To determine if there is a biological substrate to the process of recalling previous auditory perceptions. (3) To compare these findings with our normal databases of unstimulated and pure tone-stimulated volunteers. (4) To establish a hypothesis for the mechanisms of these occurrences. PATIENTS AND METHODS: Thirty two patients who had had abrupt bilateral severe sensorineural hearing loss (the interval between the losses of both ears could have been years) were contacted. They were asked if they had ever had the sensation of having musical auditory perceptions without external auditory stimuli. Two of these patients were image tested with single photon computerized emission tomography (neuroSPECT) while they were having these perceptions. RESULTS: All of the 32 subjects had musical auditory perceptions following their hearing loss in the second ear or when hearing loss in both ears occurred simultaneously. The two patients who were image tested with neuroSPECT had similar findings. There was a statistically significant increase in perfusion in area 39 of Brodmann, more intense on the right side, with increased perfusion also in both frontal lobes at the middle gyrus, with bilateral hypoperfusion in area 38 of Brodmann. These findings are similar to those observed in normal volunteers stimulated with pure tones.

Acoustic Stimulation↗