Cardiovascular risk and biopsychosocial interplay: Association among hypertension, anxiety, and emotional dysregulation-observational study in primary care setting for efficient self-care

Stressful Life Events and Heart Failure: A Mixed-Method Study to Analyze the Patient's Perspective

INTRODUCTION

The challenge in heart failure medical practice is to address the clinical and laboratory method integrations for the shared decision-making process in caring for patients and families. Furthermore, stressful life events may worsen outcomes in patients with heart failure. This study aimed to explore patient perceptions regarding cardiac care analyzing the individual needs and features of adverse life event experiences.

METHODS

A mixed-methods design was used in this study. This quantitative research focuses on clinical (medical and psychological) data. Giorgi's phenomenological method was applied to the interview analysis.

RESULTS

Qualitative analyses highlighted the role of patient-engagement strategies powered by cardiologists in a personalized approach that favors adherence to complex medical therapies. Active patient involvement and associated engagement based on cardiologists' confidence are focal points for facilitating management-therapy strategies to improve outcomes and reduce the perception of the frailty burden. The quality of therapeutic relationships with cardiologists is a key protective factor for accurate risk stratification and therapeutic decision-making in patients, addressing the potential benefits of therapeutic interventions.

CONCLUSIONS

In conclusion, the engaged patient contributes to more efficient cardiological care and the personalized patient-centered approach leads to the more efficient 'cure and care' clinical model. In adverse life events, acute psychological and physiological stress responses intensify detrimental outcomes for patients with cardiovascular disorders. Integrative management of physical risks and mental resilience factors in the development of cardiac disease appears to be strategic for patients with a positive quality of life (QoL) and clinical management of heart failure (HF).

Allostatic load modelling, lifestyle and cardiological risk factor: evidence for integrating patient profiling in the optimisation of pharmacological therapies during follow-ups in hospital setting - PLAY-UP cohort study protocol

INTRODUCTION

The allostatic load (AL) is a framework for conceptualising the physiological multisystemic impact of prolonged exposure to stress and its related side effects on mental health.Stress due to AL can influence the development and outcomes of cardiovascular diseases. AL increases the risk of coronary and peripherical artery diseases. AL emerges from the detection of emotional dimensions related to the disease, low psychosocial functioning and high rates of psychopathological signs in patients with hypertension or coronary heart disease.

METHOD AND ANALYSIS

The primary endpoint of the PLAY-UP protocol is the implementation of a multidimensional model underlying the clinical treatment of patients with cardiovascular disease through the integration of medical and psychological clinical variables.PLAY-UP is a cohort study that will last for 24 months. 200 participants will be recruited and divided into three groups: early disease, midterm disease and long disease. All patients will undergo a clinical evaluation based on the detection of biological, medical and psychological indicators and variables. The evaluation battery will comprise three types of measurements: medical, psychological and pharmacological treatments. Clinical and psychological measurements will be processed in an integrated manner through the combination of all variables examined, elaborating the Allostatic Load Index from a longitudinal time perspective. The Allostatic Load Index will be calculated by measuring the z-score.

ETHICS AND DISSEMINATION

Ethical Committee Approval was obtained from CEtRA Abruzzo Region (IT) (ID 0461499/23). The results of the present project will be published in peer-reviewed journals, disseminated electronically and in print, and presented as abstracts and/or personal communications during national and international conferences.

Examining the influence of anxiety and depression on medication adherence among patients diagnosed with acute myocardial infarction

BACKGROUND

Effective medication adherence is vital for managing acute myocardial infarction (AMI) and enhancing patient well-being. This study aimed to evaluate medication adherence levels and associated factors among AMI patients using standardized assessment tools.

METHODS

Employing a cross-sectional descriptive design, the study involved 210 patients diagnosed with acute myocardial infarction. Participants completed the General Medication Adherence Scale (GMAS), Hospital Anxiety and Depression Scale (HADS), and provided socio-demographic details.

RESULTS

The study revealed partial adherence to medications among AMI patients, with mean scores of 24.89 (± 3.64) out of 33. Notably, good adherence was observed in non-adherence due to patient behavior (mean ± SD = 11.8 ± 2.3 out of 15) and additional disease burden (mean ± SD = 8.65 ± 2.21 out of 12), while partial adherence was noted in non-adherence due to financial constraints (mean ± SD = 4.44 ± 1.34 out of 6). Patients reported mild anxiety (mean ± SD = 8.38 ± 2.81) and no depressive symptoms (mean ± SD = 7.43 ± 2.42). Multiple linear regression analysis indicated that employed status, younger age, shorter duration of MI, lower anxiety, and depression levels were associated with higher medication adherence. However, factors such as monthly income, gender, educational level, and marital status did not predict medication adherence.

CONCLUSION

The study highlights the significance of addressing anxiety and depression levels and considering socio-demographic factors when designing interventions to enhance medication adherence among AMI patients. Further research is needed to explore additional determinants of medication adherence and develop tailored interventions to improve patient outcomes post-AMI.

Emotion regulation from a virtue perspective

BACKGROUND

The ability to regulate one's emotional state is an important predictor of several behaviors such as reframing a challenging situation to reduce anger or anxiety, concealing visible signs of sadness or fear, or focusing on reasons to feel happy or calm. This capacity is referred to as emotion regulation. Deficits in this ability can adversely affect one's adaptive coping, thus are associated with a variety of other psychopathological symptoms, including but not limited to depression, borderline personality disorder, substance use disorders, eating disorders, and somatoform disorders.

METHODS

The present study examined emotion regulation in relation to the virtue-based psychosocial adaptation model (V-PAM). 595 participants were clustered based on their Difficulties in Emotion Regulation Scale (DERS) score, producing two clusters (i.e., high functioning vs. low functioning). Then, emotion regulation group membership was discriminated by using five V-PAM virtue constructs, including courage, integrity, practical wisdom, committed action, and emotional transcendence.

RESULTS

Results show that five virtues contribute to differentiating group membership. Practical wisdom was the strongest contributor, followed by integrity, emotional transcendence, committed action, and courage. Predictive discriminant analysis was conducted and 71% of cases were correctly classified. A discussion of the relationship between emotion regulation and virtues was elaborated.

CONCLUSION

The concept of virtue holds significant importance in the comprehension of an individual's capacity to regulate their emotions, meriting future study.