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Paula da Silva Ramos A, Fernandes de Souza Ribeiro J, Lima Trajano ET, Aurélio Dos Santos Silva M, Alexsandra da Silva Neto Trajano L. Hospitalized Women Have Anxiety and Worse Mental Health Scores than Men. Psychol Rep 2023; 126:2266-2279. [PMID: 35465784 DOI: 10.1177/00332941221088967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
This study aimed to assess the levels of anxiety, depression, and quality of life in hospitalized men and women using the Hospital Anxiety and Depression Scale (HADS), Beck's Anxiety Inventory (BAI), and Short Form-36 Health Survey Questionnaire (SF-36). 60 patients of both sexes were recruited from at the outpatient department of the Hospital Universitário de Vassouras (HUV). The HADS-Anxiety (HADS-A) and BAI questionnaires were used to assess anxiety; the HADS-Depression (HADS-D) questionnaire to assess levels of depression, and the SF-36 to assess the quality of life. The results indicated that hospitalized women had higher levels of anxiety when compared to men. No difference was observed in the levels of depression between men and women. Regarding quality of life, women showed more deterioration in general and mental health compared to men. Thus, the findings suggest that hospitalized women have higher levels of anxiety when compared to men and that this increase can lead to worse general and mental health. Professionals should be aware of possible psychological changes in hospitalized women as they can affect the overall quality of life.
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Kornfield R, Lattie EG, Nicholas J, Knapp AA, Mohr DC, Reddy M. "Our Job is to be so Temporary": Designing Digital Tools that Meet the Needs of Care Managers and their Patients with Mental Health Concerns. PROCEEDINGS OF THE ACM ON HUMAN-COMPUTER INTERACTION 2023; 7:302. [PMID: 38094872 PMCID: PMC10718568 DOI: 10.1145/3610093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Digital tools have potential to support collaborative management of mental health conditions, but we need to better understand how to integrate them in routine healthcare, particularly for patients with both physical and mental health needs. We therefore conducted interviews and design workshops with 1) a group of care managers who support patients with complex health needs, and 2) their patients whose health needs include mental health concerns. We investigate both groups' views of potential applications of digital tools within care management. Findings suggest that care managers felt underprepared to play an ongoing role in addressing mental health issues and had concerns about the burden and ambiguity of providing support through new digital channels. In contrast, patients envisioned benefiting from ongoing mental health support from care managers, including support in using digital tools. Patients' and care managers' needs may diverge such that meeting both through the same tools presents a significant challenge. We discuss how successful design and integration of digital tools into care management would require reconceptualizing these professionals' roles in mental health support.
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Relationship Between Resilience and Perceived Control After Acute Coronary Syndrome: A Prospective Study. J Cardiovasc Nurs 2023; 38:E20-E30. [PMID: 35297392 DOI: 10.1097/jcn.0000000000000898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Patients with acute coronary syndrome report poor health-related quality of life and decreased levels of perceived control. Perceived control is a person's belief that they can cope with negative events. Resilience is an adaptation that gives people the capacity to recover from difficult situations, and higher levels of resilience may impact recovery after an acute event. OBJECTIVE The aim of this study was to analyze the relationship between resilience, perceived control, and health outcomes of patients hospitalized with acute coronary syndrome within 6 months of discharge. METHODS Data were collected prospectively from adult patients hospitalized with acute coronary syndrome in 3 university hospitals in the Tokyo Metropolitan area, Japan. All data were collected between December 2015 and December 2019. The Sukemune-Hiew Resilience Test (part 1) was used to measure resilience, which includes 3 domains of social support, self-efficacy, and sociality. The Control Attitudes Scale-Revised was used to measure perceived control. Linear regression and path analysis were used to statistically analyze the relationship among variables. RESULTS Higher resilience, especially self-efficacy, was associated with higher perceived control during admission. Higher resilience, especially social support, during admission was associated with perceived control at 6 months after adjusting for income and education. Higher resilience during admission was associated with better perceived control at 3 months, which was associated with better health outcomes at 6 months. Higher income and lower depression were related to higher resilience. CONCLUSIONS Nurses should make sure patients with depression, low income, and low social support are connected with appropriate treatment and social support resources.
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Liu F, Han J, Wang Y, Jin Y. The Later Status and Impact Factors of Physical Activity among Patients after Percutaneous Coronary Intervention in China. Am J Health Behav 2022; 46:654-663. [PMID: 36721281 DOI: 10.5993/ajhb.46.6.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Objectives: In this study, we investigated the physical activity status and impact factors in patients after percutaneous coronary intervention in China. Methods: This cross-sectional survey was conducted from January to October 2019. A total of 260 participants were recruited in the cardiovascular department who had successfully undergone percutaneous coronary intervention after one year for physical re-examination at 2 hospitals in Henan Province. They were investigated using 5 questionnaires - the International Physical Activity Questionnaire-Long Form, the Exercise Self-efficacy Questionnaire, the Multi-dimensional Fatigue Scale, the Social Support Rating Scale, and the Hospital Anxiety and Depression scale. Results: After percutaneous coronary intervention, most patients were at low and moderate intensity physical activity and 60.8% of patients did not meet the recommended amount of guidelines. Through the analysis of the influencing factors of physical activity in patients with coronary heart disease stent implantation, the status of physical activity was affected by the NYHA classification, LVEF, exercise self-efficacy, fatigue, and social support. Conclusions: The level of physical activity of patients after percutaneous coronary intervention needs to be improved further. In clinical practice, nursing practitioners should strengthen the health education of patients' exercise rehabilitation to improve the level of physical activity and reduce the occurrence of cardiovascular events.
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Affiliation(s)
- Fangli Liu
- Fangli Liu, College of Nursing and Health, Henan University, Kaifeng, China;,
| | - Jingyi Han
- Jingyi Han, Nursing Department, Nanyang Center Hospital, Nanyang, China
| | - Yingying Wang
- Yingying Wang, College of Nursing and Health, Henan University, Kaifeng, China
| | - Yongping Jin
- Yongping Jin, College of Nursing and Health, Henan University, Kaifeng, China
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Pathways to reduced overnight hospitalizations in older adults: Evaluating 62 physical, behavioral, and psychosocial factors. PLoS One 2022; 17:e0277222. [DOI: 10.1371/journal.pone.0277222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 10/24/2022] [Indexed: 11/12/2022] Open
Abstract
As our society ages and healthcare costs escalate, researchers and policymakers urgently seek potentially modifiable predictors of reduced healthcare utilization. We aimed to determine whether changes in 62 candidate predictors were associated with reduced frequency, and duration, of overnight hospitalizations. We used data from 11,374 participants in the Health and Retirement Study—a national sample of adults aged >50 in the United States. Using generalized linear regression models with a lagged exposure-wide approach, we evaluated if changes in 62 predictors over four years (between t0;2006/2008 and t1;2010/2012) were associated with subsequent hospitalizations during the two years prior to t2 (2012–2014 (Cohort A) or 2014–2016 (Cohort B)). After robust covariate-adjustment, we observed that changes in some health behaviors (e.g., those engaging in frequent physical activity had 0.80 the rate of overnight hospital stays (95% CI [0.74, 0.87])), physical health conditions (e.g., those with cancer had 1.57 the rate of overnight hospital stays (95% CI [1.35, 1.82])), and psychosocial factors (e.g., those who helped friends/neighbors/relatives 100–199 hours/year had 0.73 the rate of overnight hospital stays (95% CI [0.63, 0.85])) were associated with subsequent hospitalizations. Findings for both the frequency, and duration, of hospitalizations were mostly similar. Changes in a number of diverse factors were associated with decreased frequency, and duration, of overnight hospitalizations. Notably, some psychosocial factors (e.g., informal helping) had effect sizes equivalent to or larger than some physical health conditions (e.g., diabetes) and health behaviors (e.g., smoking). These psychosocial factors are mostly modifiable and with further research could be novel intervention targets for reducing hospitalizations.
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Abstract
Depression is a well-known risk factor for adverse cardiovascular outcomes in patients with cardiovascular diseases. The prevalence of depression in patients with cardiovascular diseases has been reported to be approximately 20 %. A two-step depression screening protocol using the 2-item Patient Health Questionnaire (PHQ-2) and the 9-item Patient Health Questionnaire (PHQ-9) is recommended for patients with cardiovascular diseases. Cardiovascular diseases and depression share a common pathology, including increased activity of the sympathetic nervous system, hyperactivity of hypothalamic-pituitary-adrenal axis, and inflammation. Psychosocial and environmental factors are also associated with depression and cardiovascular outcomes. Randomized controlled trials of antidepressant treatment for patients with depression and cardiovascular diseases have shown no advantage regarding cardiovascular outcomes. However, improvement in depressive symptoms, regardless of the method, may lead to a reduction in subsequent cardiovascular events. A collaborative approach between cardiologists and psychiatrists is recommended to manage depression in patients with cardiovascular diseases. Future research should identify more specific targets for treating patients with cardiovascular diseases, involve collaboration with professionals across fields, and establish community support systems.
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Mattioli AV, Coppi F, Nasi M, Gallina S. Stress and cardiovascular risk burden after the pandemic: current status and future prospects. Expert Rev Cardiovasc Ther 2022; 20:507-513. [PMID: 35727895 DOI: 10.1080/14779072.2022.2092097] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The recent COVID-19 pandemic has induced an increase in anxiety, stress, and depression in the world population, prompting a reevaluation of these well-known risk factors on cardiovascular burden. AREAS COVERED This short report analyzes the impact of the pandemic on stress and depression, highlighting how the phenomenon has particularly affected women and highlights the strategies that can be undertaken after the pandemic to reduce stress and depression. We have analyzed the pandemic because it has completely changed the scenario of cardiovascular risk factors with an important increase in socio-economic stressors. EXPERT OPINION It is still difficult to assess the damage produced on cardiovascular risk just as it is almost impossible to predict how the overwhelming and important increase in Long-Covid Syndromes will impact the population. Strong action is needed to support critical situations and to implement social campaigns aimed at restoring healthy lifestyles. Physical activity can be an easy and inexpensive tool to help cope with stress and depression.
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Affiliation(s)
- Anna Vittoria Mattioli
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Milena Nasi
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti, Italy
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Liu Y, Han Y, Wang X, Chen Y, Mo Q, Li L, Wang Y, Fan J, Yang Y, Soondrum T, Zhu X. Psychometric properties of the Chinese version of the Courtauld Emotional Control Scale in women newly diagnosed with breast cancer. Qual Life Res 2021; 31:865-876. [PMID: 34328583 DOI: 10.1007/s11136-021-02953-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Emotional control, the attempt to suppress the expression of negative effects, is an essential factor in the prevalence of psychological distress in women with breast cancer. The Courtauld Emotional Control Scale (CECS) is a commonly used self-report tool for assessing emotional suppression in both clinical and general groups. This study aimed to validate the Chinese version of the Courtauld Emotional Control Scale (CECS) in women newly diagnosed with breast cancer. METHODS The study involved 680 women newly diagnosed with breast cancer aged 25 to 76 (mean age = 48.19, standard deviation (SD) = 8.57) from Changsha (China). Data analysis included Cronbach's alpha coefficients, the intraclass correlation coefficient (ICC), Pearson's correlations, Independent-Samples T test, confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were conducted to determine the optimal model. For the best fitting model stability was assessed with tests for invariance across age, educational level, and employment status. RESULTS Internal consistency (α = 0.987) and test-retest reliability (ICC = 0.715) of the CECS were presented. Results confirm the structure of the Chinese version of the CECS with 21 items divided into three dimensions, anger suppression (CECS_AG), depression suppression (CECS_MD), and anxiety suppression (CECS_AX). Convergent and known-groups validity were acceptable. Additionally, this model remained invariant across age, educational levels, and employment status. CONCLUSIONS The Chinese version of the CECS has good psychometric properties in terms of reliability and validity, remaining invariant across age, educational levels, and employment status in women newly diagnosed with breast cancer.
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Affiliation(s)
- Yao Liu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
- Medical Psychological Institute of Central South University, Changsha, China
| | - Yan Han
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
| | - Xiang Wang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
| | - Yaoxin Chen
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
| | - Qingqian Mo
- Department of Clinical Psychology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Lingyan Li
- School of Nursing, Nanchang University, Nanchang, China
| | - Yuping Wang
- School of Humanities and Social Science, Xi'an Jiaotong University, Xi'an, China
| | - Jie Fan
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
| | - Yanjie Yang
- School of Public Health, Harbin Medical University, Harbin, China
| | - Tamini Soondrum
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
| | - Xiongzhao Zhu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China.
- Medical Psychological Institute of Central South University, Changsha, China.
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Kondo A, Oki T, Otaki A, Abuliezi R, Eckhardt AL. Factors related to perceived control and health-related quality of life of patients after acute coronary syndrome during admission and after discharge. Jpn J Nurs Sci 2021; 18:e12404. [PMID: 33448141 PMCID: PMC8248406 DOI: 10.1111/jjns.12404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/20/2020] [Accepted: 12/04/2020] [Indexed: 11/26/2022]
Abstract
Aim To explore the relationship between demographic factors, acute coronary syndrome‐related factors, perceived control and health‐related quality of life during admission, 3 months and 6 months after discharge, in patients with acute coronary syndrome. Methods Participants were recruited for this longitudinal study after admission for acute coronary syndrome in three university hospitals in the Tokyo metropolitan area, Japan. Self‐administered questionnaires included demographic data, perceived control, health‐related quality of life, acute coronary syndrome symptoms, fatigue, depression and anxiety. Results Participants (N = 137) had an average age of 62.8 (SD 11.6) years and 80.3% were male. As a result of Path analysis, higher perceived control (β = 0.258, p = .001), lower anxiety (β = −0.226, p = .009) and lower fatigue (β = −0.231, p = .010), were significantly related to better health‐related quality of life (General health). Only annual income was significantly related to perceived control (β = 0.187, p = .029). Eighty‐two (59.9%) participants at 3 months and 54 (39.4%) participants at 6 months completed the questionnaires. Perceived control (F = 7.074, p = .001) and General health (χ2 = 10.22, p = .006) significantly increased over the 6 months. Perceived control during admission was significantly related with health‐related quality of life at 3 months. Perceived control at 3 months was significantly related with health‐related quality of life at 6 months. Conclusion Perceived control was an important factor for health‐related quality of life of the Japanese patients with acute coronary syndrome. It is necessary to investigate whether nursing interventions to enhance perceived control lead to improvement of health‐related quality of life.
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Affiliation(s)
- Akiko Kondo
- International Nursing Development, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomomi Oki
- School of Nursing and Rehabilitation Sciences, Showa University, Tokyo, Japan
| | - Amane Otaki
- School of Nursing and Rehabilitation Sciences, Showa University, Tokyo, Japan
| | - Renaguli Abuliezi
- International Nursing Development, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ann L Eckhardt
- School of Nursing, Illinois Wesleyan University, Bloomington, Illinois, USA
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Karlsen HR, Matejschek F, Saksvik-Lehouillier I, Langvik E. Anxiety as a risk factor for cardiovascular disease independent of depression: A narrative review of current status and conflicting findings. Health Psychol Open 2021; 8:2055102920987462. [PMID: 33489304 PMCID: PMC7809320 DOI: 10.1177/2055102920987462] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
The aim of this paper is to summarise and evaluate the empirical support for the association between anxiety and cardiovascular disease (CVD) and to address challenges related to method and study design. We review results from meta-analyses and more recent findings on the association of anxiety and the risk of CVD. Depression and anxiety are often listed as psychosocial risk markers of CVD, but the role of anxiety as a risk factor for CVD has not received the same evidential support as the effects of depression. Through a narrative review we identified six meta-analyses as well as 15 recent large studies of anxiety and CVD that we summarise. Some of the conflicting findings may be artefacts of study design or population the sample is drawn from. Researchers should take care to be population specific, measurement specific and outcome specific, and to control for comorbid depression.
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Affiliation(s)
| | | | | | - Eva Langvik
- Norwegian University of Science and Technology, Norway
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Li L, Peng T, Liu R, Jiang R, Liang D, Li X, Ni A, Ma H, Wei X, Liu H, Zhang J, Li H, Pang J, Ji Y, Zhang L, Cao Y, Chen Y, Zhou B, Wang J, Mao X, Yang L, Fang J, Shi H, Wu A, Yuan Y. Development of the psychosomatic symptom scale (PSSS) and assessment of its reliability and validity in general hospital patients in China. Gen Hosp Psychiatry 2020; 64:1-8. [PMID: 32070913 DOI: 10.1016/j.genhosppsych.2020.01.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 01/07/2020] [Accepted: 01/28/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To develop and verify the Psychosomatic Symptom Scale (PSSS) among psychosomatic patients and the cut-off value of PSSS in distinguishing psychosomatic patients from health controls. METHODS The PSSS was drafted by an expert workgroup. 996 patients and 366 controls from 14 general hospitals in China were recruited to complete PSSS, Patient Health Questionnaire-15 (PHQ-15) and Symptom Checklist-90 (SCL-90). Student's t-test, Kruskal-Wallis test, Cronbach's α, Spearman's correlation, and confirmatory factor analysis (CFA) were used to verify the PSSS. Receiver operating characteristic (ROC) analyses were used to determine the cut-off value. RESULTS Cronbach α of PSSS was 0.907. The PSSS was significantly correlated with SCL-90 somatization subscale (r = 0.682, P < 0.001) and PHQ-15 (r = 0.724, P < 0.001). CFA supported the theoretical two-factor structure of the PSSS, with comparative fit index (CFI) = 0.979, Tucker-Lewis index (TLI) = 0.977, root mean square error of approximation (RMSEA) = 0.039 (90% CI: 0.035-0.042), and standardized root mean residual (SRMR) = 0.054. As the sum score of PSSS was significantly higher in female, cut-off values were determined as 11 in females and 10 in males respectively. CONCLUSIONS The PSSS is a reliable and valid instrument for measuring psychosomatic symptoms.
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Affiliation(s)
- Lei Li
- Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China; Department of Clinical Psychology, The Forth People's Hospital of Lianyungang, Lianyungang, China
| | - Tianci Peng
- School of Information Science and Engineering, Southeast University, Nanjing, China
| | - Rui Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China; School of Information Science and Engineering, Southeast University, Nanjing, China
| | - Ronghuan Jiang
- Department of Psychological Medicine, Chinese PLA General Hospital, Beijing, China
| | - Dongfeng Liang
- Department of Rheumatism, Chinese PLA General Hospital, Beijing, China
| | - Xiangping Li
- Department of Cardiovascular Medicine, the Second Xiangya Hospital, Central South University, Changsha, China
| | - Aihua Ni
- Department of Clinical Psychology, Hebei Provincial People's Hospital, Shijiazhuang, China
| | - Huan Ma
- Department of Clinical Psychology, Hebei Provincial People's Hospital, Shijiazhuang, China
| | - Xianwen Wei
- Department of Neurology, Puer People's Hospital, Puer, China
| | - Hanxiang Liu
- Department of Neurology, Puer People's Hospital, Puer, China
| | - Jing Zhang
- Department of Cardiovascular Medicine, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Hengfen Li
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jianyue Pang
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yunxin Ji
- Department of Psychosomatics, Ningbo First Hospital, Ningbo, China
| | - Li Zhang
- Department of Psychosomatics, Ningbo First Hospital, Ningbo, China
| | - Yin Cao
- Department of Neurology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Yun Chen
- Department of Neurology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Bo Zhou
- The Center of Psychosomatic Medicine, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu, China
| | - Jinny Wang
- The Center of Psychosomatic Medicine, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu, China
| | - Xueqin Mao
- Department of Psychology, Qilu Hospital, Shandong University, Jinan, China
| | - Lejin Yang
- Department of Psychology, Qilu Hospital, Shandong University, Jinan, China
| | - Jianqun Fang
- Mental Health Center, The General Hospital of Ningxia Medical University, Yinchuan, China
| | - Honglan Shi
- Mental Health Center, The General Hospital of Ningxia Medical University, Yinchuan, China
| | - Aiqin Wu
- Department of Clinical Psychology, The First Affiliated Hospital of Soochow University, SuZhou, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China.
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O'Donovan CE, Skinner JR, Broadbent E. Perceptions of Risk of Cardiac Arrest in Individuals Living With a Cardiac Inherited Disease: Are the Doctor and the Patient on the Same Page? Heart Lung Circ 2019; 29:851-858. [PMID: 31501048 DOI: 10.1016/j.hlc.2019.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 04/14/2019] [Accepted: 07/15/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Risk perceptions influence patient engagement with treatment recommendations, yet it is unknown whether patients with a cardiac inherited disease (CID) hold accurate risk perceptions. The study aimed to examine whether CID patients' and clinician's risk perceptions correlate and factors associated with patient perceptions. METHODS 202 CID patients (of 618 [36%]) participated in a postal survey assessing perceived risk of aborted cardiac arrest or sudden cardiac death (ACA/SCD). Median age was 53 (16 to 83 years); 86 had Long QT Syndrome (LQTS), 69 had hypertrophic cardiomyopathy, 12 had dilated cardiomyopathy, and 27 had 'other'. Clinical and genetic characteristics were collected from the CID registry; clinical estimate of 5-year risk was determined for LQTS participants (n = 77) using a combination of cardiac arrest or syncope history, maximal QTc length, age, sex and genotype. RESULTS Patients' risk perceptions of ACA/SCD ranged from 0 to 100%, (median 20%). Greater risk perceptions were associated with: non-New Zealand (NZ) Europeans (p < 0.01), probands (p < 0.05), reporting more physical symptoms (including those unrelated to CID) (p < 0.01), and more symptoms of anxiety (p < 0.05). Median risk assessment by LQTS patients was 15%, and by the clinician was 4.5%. No association was found between patient and clinician assessments of risk (rs = 0.13, ns), 56% of LQTS patients overestimated their risk, 14% underestimated and 30% were accurate. CONCLUSION Cardiac inherited disease patients' risk perceptions correlate poorly with those of the clinician. Patients overestimating risk tend to have physical symptoms usually unrelated to their CID, and underlying anxiety. Techniques to better communicate risk are needed.
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Affiliation(s)
- Claire E O'Donovan
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Jonathan R Skinner
- Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand; Department of Paediatrics Child and Youth Health, The University of Auckland, Auckland, New Zealand.
| | - Elizabeth Broadbent
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
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AbuRuz ME. Patients with ST segment elevation myocardial infarction: moderating effect of perceived control on the relationship between depression and in-hospital complications. BMC Cardiovasc Disord 2019; 19:143. [PMID: 31195992 PMCID: PMC6567480 DOI: 10.1186/s12872-019-1126-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/06/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Cardiovascular diseases remain the top global killer, with nearly 80% of related mortalities occurring in developing countries. Over half of cardiovascular diseases' mortality is due to coronary heart disease, which is commonly linked to acute myocardial infarction. Psychological factors (i.e., depression and anxiety) after acute myocardial infarction are associated with higher levels of complications and mortality. Perceived control moderated the effect of anxiety on complications in different cardiac populations, but impacts on depression and complications after acute myocardial infarction are not well studied. This study explores the moderating effect of perceived control on the relationship between depression and complications after ST segment elevation myocardial infarction. METHODS Three hundred patients with a confirmed diagnosis of ST segment elevation myocardial infarction participated in this prospective observational study. Patients answered socio-demographic data, the depression subscale of the Hospital Anxiety and Depression Scale (HADS), and the Control Attitude Scale-Revised (CAS-R) questionnaires. In-hospital complications and all other necessary data were extracted from medical records after discharge. Data were analyzed using logistic regression. RESULTS 24% developed at least one complication. Patients with high depression scores (8-21) were more likely to develop complications (χ2 = 34.15, p < .001) than those with low depression scores (0-7). Patients with high levels of perceived control had lower levels of depression than those with low perceived control (mean [SD], 9.47 [6.43] vs. 12.31 [6.66], p < .001). The results of logistic regression showed that perceived control moderated the association between depression and complications, since depression scores, perceived control scores, and the interaction between depression and perceived control were significant predictors of complications. Participants with high depression and low perceived control had the highest rate of complications (31.5% vs. 15.4%, P < .001). CONCLUSIONS Depression increased complications after ST segment elevation myocardial infarction. Perceived control moderated this relationship. Assessment of depression and enhancement of perceived control in patients with acute myocardial infarction can decrease complications and improve outcomes.
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Affiliation(s)
- Mohannad Eid AbuRuz
- Clinical Nursing Department, Faculty of Nursing, Applied Science Private University, Po Box 142 Shafa Badarn, postal code, Amman, 11934, Jordan.
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Theeke L, Carpenter RD, Mallow J, Theeke E. Gender differences in loneliness, anger, depression, self-management ability and biomarkers of chronic illness in chronically ill mid-life adults in Appalachia. Appl Nurs Res 2019; 45:55-62. [DOI: 10.1016/j.apnr.2018.12.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 12/04/2018] [Indexed: 12/20/2022]
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15
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Value of ATRIA risk score and gender in predicting adverse events in patients with myocardial infarction. Anatol J Cardiol 2018; 20:370-371. [PMID: 30504743 PMCID: PMC6287440 DOI: 10.14744/anatoljcardiol.2018.25483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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16
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The Effectiveness of Schema Therapy Integrated with Rehabilitation on Cognitive Emotion Regulation and Existential Anxiety in Patients with Congestive Heart Failure. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2018. [DOI: 10.1007/s10879-018-9390-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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17
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Altino DM, Nogueira-Martins LA, Gonçalves MAB, Barros ALBLD, Lopes JDL. Impact of anxiety and depression on morbidity and mortality of patients with coronary syndrome. Rev Bras Enferm 2018; 71:3048-3053. [DOI: 10.1590/0034-7167-2017-0709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 05/25/2018] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: Evaluate the impact of anxiety and depression on morbidity and mortality of patients with acute coronary syndrome. Method: Retrospective cohort study, with follow-up of two years, conducted with 94 patients. The morbidity and mortality (readmission, myocardial revascularization, and death) was evaluated immediately after discharge and after one and two years. Anxiety and depression were evaluated by the State-Trait Anxiety Inventory and by Beck’s Depression Inventory. The Kaplan-Meier estimator and the Logrank test were used. The significance level adopted was 0.05. Results: We observed that 76.6% of the patients did not present symptoms of depression or had mild signs, while 78.8% had low to moderate anxiety. The symptoms of depression and anxiety were not related to morbidity (need for MR p=0.098 and 0.56, respectively; readmission p=0.962 and 0.369, respectively) and mortality (p=0.434 and 0.077, respectively). Conclusion: No relationship was found between levels of anxiety and depression with the morbidity and mortality of patients.
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Mohammadi SY, Ahmadi S. Effectiveness of progressive relaxation and emotional regulation on quality of life of heart patients. THE JOURNAL OF QAZVIN UNIVERSITY OF MEDICAL SCIENCES 2018. [DOI: 10.29252/qums.22.5.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Şahan E, Eroğlu MZ, Karataş MB, Mutluer B, Uğurpala C, Berkol TD. Death anxiety in patients with myocardial infarction or cancer. Egypt Heart J 2018; 70:143-147. [PMID: 30190638 PMCID: PMC6123246 DOI: 10.1016/j.ehj.2018.04.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 04/16/2018] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE The aim of this study was to find out the level of death anxiety among 3 groups: patients with acute myocardial infarction, patients with cancer and healthy individuals in two training and research hospitals; also to evaluate its relationship with several sociodemographic and clinical variables. MATERIALS AND METHOD This study was conducted with one hundred and eighty persons (108 male, 72 female) who have been referred to cardiology or oncology departments and the healthy individuals. Participants completed sociodemographic and clinical data form, State and Trait Anxiety Inventory (STAI-I, STAI-II), Thorson Powell Death Anxiety Scale (TPDAS), Death Depression Scale (DDS). RESULTS Participants included in the present study were 40% female with an average age of 53.48 for whole group. The mean TPDAS score for patients with AMI was 51.60 ± 16.40, for patients with cancer 37.10 ± 10.23 and for healthy individuals 43.40 ± 13.35. In AMI group there were positive correlations between STAI-I and TPDAS, DDS scores and also between STAI-II and DDS. In cancer group positive correlations were between STAI-I, II and TPDAS, DDS. TPDAS and DDS were positively correlated in all three groups. Women and participants who were unemployed scored higher on DDS. CONCLUSION In this study patients with AMI had higher death anxiety than patients with cancer or healthy individuals. Generally death anxiety was related with education, employment and socioeconomic status. Prospective studies carefully searching for different variables in different medical groups would reveal and help us to understand the importance of death anxiety and its impact on courses of physical and mental disorders.
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Affiliation(s)
- Ebru Şahan
- Department of Psychiatry, Bezmialem Vakif University, Istanbul, Turkey
| | - Meliha Zengin Eroğlu
- Department of Psychiatry, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Baran Karataş
- Department of Cardiology, Dr. Siyami Ersek Training and Research Hospital, Istanbul, Turkey
| | - Başak Mutluer
- Department of Psychiatry, Bakırkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Can Uğurpala
- Department of Psychiatry, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
| | - Tonguç Demir Berkol
- Department of Psychiatry, Bakırkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
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AbuRuz ME. Perceived control moderates the relationship between anxiety and in-hospital complications after ST segment elevation myocardial infarction. J Multidiscip Healthc 2018; 11:359-365. [PMID: 30100731 PMCID: PMC6067526 DOI: 10.2147/jmdh.s170326] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose Anxiety is a common psychological response after acute myocardial infarction and might be associated with higher levels of in-hospital complications. Perceived control might moderate this relationship, but the effect of this method has not been checked in developing countries. Therefore, the objectives of this study were as follows: 1) to check if anxiety was an independent predictor of in-hospital complications after acute myocardial infarction; and 2) to check if perceived control moderates the relationship between anxiety and in-hospital complications after acute myocardial infarction. Patients and methods This was a prospective observational study among 500 patients with a confirmed diagnosis of ST segment elevation myocardial infarction recruited from three private hospitals in Amman, Jordan. Anxiety was measured by the Anxiety subscale of Hospital Anxiety and Depression Scale, and perceived control was measured by the Arabic version of the Control Attitude Scale-Revised. Results One hundred and forty patients (28%) developed at least one complication during hospitalization. Two hundred and fifty-five patients had low anxiety scores (≤7), and 245 patients had high anxiety scores (≥8). Patients with high levels of perceived control had lower levels of anxiety (mean [SD]; 5.3 [3.6] vs 14.1 [6.3], P<0.001) than those with low perceived control. In logistic regression, anxiety was an independent predictor of in-hospital complications after controlling for sociodemographic and clinical variables (odds ratio: 1.24, 95% CI, 1.08–1.41, P<0.01). Moreover, the interaction of anxiety and perceived control was a significant predictor of complications. Conclusion Anxiety was associated with increased risk of in-hospital complications after acute myocardial infarction independent of sociodemographic and clinical variables. Perceived control had a moderating effect for this association since the combination of low perceived control and high anxiety scores was associated with the greatest risk for complications. Supporting patients’ levels of perceived control can decrease complications, morbidities, and mortality after acute myocardial infarction.
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Affiliation(s)
- Mohannad Eid AbuRuz
- Clinical Nursing Department, College of Nursing, Applied Science Private University, Amman, Jordan,
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21
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Su SF, He CP. Type D Personality, Social Support, and Depression Among Ethnic Chinese Coronary Artery Disease Patients Undergoing a Percutaneous Coronary Intervention: An Exploratory Study. Psychol Rep 2018; 122:988-1006. [PMID: 29848215 DOI: 10.1177/0033294118780428] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigated the relationships between Type D personality, depression, and social support among ethnic Chinese coronary artery disease (CAD) patients undergoing percutaneous coronary interventions. Type D personality is associated with CAD, and may increase patients' depression and mortality rate. However, very few studies have explored the relationships between depression and social support among ethnic Chinese Type D CAD patients. A longitudinal, repeated-measures design was used; 105 Taiwanese CAD patients undergoing a percutaneous coronary intervention were recruited between January and December 2015. A demographic questionnaire, Type D Scale, ENRICHD Social Support Inventory, and Patient Health Questionnaire-9 were completed by 102 participants (mean age = 64.42, SD = 13.67 years) at hospitalization, and at the second week and third month after discharge. Data were analyzed using t tests and a generalized estimating equation. Results indicated that 46.7% of participants who had Type D personality had lower social support and higher depression than did the remaining (non-Type D) participants. At two weeks after discharge, the improvement in social support was higher among Type D patients than non-Type D participants; the same was true for depression at two weeks and three months after discharge each. Type D Taiwanese CAD patients showed lower perceived social support and higher depression during hospitalization than did non-Type D participants. Furthermore, the more social support patients received at home, the lower was their depression. Health-care providers should provide continuous mental health care, conduct early screening of mental health issues, and ensure that patients receive sufficient social support to reduce depression.
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Affiliation(s)
- Shu-Fen Su
- Department of Nursing, National Taichung University of Science and Technology, Taichung, Taiwan, R.O.C
| | - Chung-Ping He
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
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22
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Oncel CR, Kucuk M. Value of CHA2DS2-VASc score and gender in predicting PCI outcomes in ST segment elevation myocardial infarction. Acta Cardiol 2018; 73:210. [PMID: 28730926 DOI: 10.1080/00015385.2017.1351236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Murathan Kucuk
- Department of Cardiology, Akdeniz University Medical Faculty, Antalya, Turkey
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Kindermann I, Wedegärtner SM, Mahfoud F, Weil J, Brilakis N, Ukena J, Ewen S, Linz D, Fahy M, Mancia G, Böhm M. Improvement in health-related quality of life after renal sympathetic denervation in real-world hypertensive patients: 12-month outcomes in the Global SYMPLICITY Registry. J Clin Hypertens (Greenwich) 2017; 19:833-839. [PMID: 28480523 DOI: 10.1111/jch.13007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 01/27/2017] [Accepted: 02/13/2017] [Indexed: 01/21/2023]
Abstract
Renal denervation has been shown to reduce blood pressure in patients with uncontrolled hypertension, but less is known about its impact on quality of life. This analysis evaluated 12-month blood pressure and quality of life outcomes in 934 patients from the Global SYMPLICITY Registry who completed the EuroQoL five-dimensions three-level questionnaire (EQ-5D-3L). At baseline, 32% of patients reported anxiety/depression and 48% reported pain/discomfort. At 12 months (n=496), office and 24-hour ambulatory systolic blood pressure were reduced by 13.9±26.6 and 7.7±19.3 mm Hg, respectively, and 8% (P<.001) more patients reported no problems in anxiety/depression. Furthermore, numerically more patients reported no problems in pain/discomfort (4%, P=.08). Perceived health-related quality of life (visual analog scale) improved from baseline to 12 months (68±18 vs 73±17, P<.001), and the improvement was largest among patients with severe anxiety/depression at baseline (50±24 vs 64±22, P=.005 [n=32]). In this analysis, renal denervation was associated with a significant improvement in health-related quality of life, particularly anxiety/depression.
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Affiliation(s)
- Ingrid Kindermann
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Universität des Saarlandes, Homburg, Germany
| | - Sonja Maria Wedegärtner
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Universität des Saarlandes, Homburg, Germany
| | - Felix Mahfoud
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Universität des Saarlandes, Homburg, Germany.,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Joachim Weil
- Medizinische Klinik II, Sana Kliniken Lübeck GmbH, Lübeck, Germany
| | | | - Julia Ukena
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Universität des Saarlandes, Homburg, Germany
| | - Sebastian Ewen
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Universität des Saarlandes, Homburg, Germany
| | - Dominik Linz
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Universität des Saarlandes, Homburg, Germany
| | - Martin Fahy
- Clinical Research, Medtronic, Santa Rosa, CA, USA
| | | | - Michael Böhm
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Universität des Saarlandes, Homburg, Germany
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Savoy C, Van Lieshout RJ, Steiner M. Is plasminogen activator inhibitor-1 a physiological bottleneck bridging major depressive disorder and cardiovascular disease? Acta Physiol (Oxf) 2017; 219:715-727. [PMID: 27246986 DOI: 10.1111/apha.12726] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 04/29/2016] [Accepted: 05/30/2016] [Indexed: 12/16/2022]
Abstract
Major depressive disorder (MDD) is estimated to affect one in twenty people worldwide. MDD is highly comorbid with cardiovascular disease (CVD), itself one of the single largest causes of mortality worldwide. A number of pathological changes observed in MDD are believed to contribute to the development of cardiovascular disease, although no single mechanism has been identified. There are also no biological markers capable of predicting the future risk of developing heart disease in depressed individuals. Plasminogen activator inhibitor-1 (PAI-1) is a prothrombotic plasma protein secreted by endothelial tissue and has long been implicated in CVD. An expanding body of literature has recently implicated it in the pathogenesis of major depressive disorder as well. In this study, we review candidate pathways implicating MDD in CVD and consider how PAI-1 might act as a mediator by which MDD induces CVD development: chiefly through sleep disruption, adiposity, brain-derived neurotrophic factor (BDNF) metabolism, systemic inflammation and hypothalamic-pituitary-adrenal (HPA)-axis dysregulation. As both MDD and CVD are more prevalent in women than in men, and incidence of either condition is dramatically increased during reproductive milestones, we also explore hormonal and sex-specific associations between MDD, PAI-1 and CVD. Of special interest is the role PAI-1 plays in perinatal depression and in cardiovascular complications of pregnancy. Finally, we propose a theoretical model whereby PAI-1 might serve as a useful biomarker for CVD risk in those with depression, and as a potential target for future treatments.
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Affiliation(s)
- C. Savoy
- Women's Health Concerns Clinic; St. Joseph's Healthcare; Department of Psychiatry and Behavioural Neurosciences; McMaster University; Hamilton ON Canada
- McMaster Integrated Neuroscience Discovery and Study Program; McMaster University; Hamilton ON Canada
| | - R. J. Van Lieshout
- Women's Health Concerns Clinic; St. Joseph's Healthcare; Department of Psychiatry and Behavioural Neurosciences; McMaster University; Hamilton ON Canada
- McMaster Integrated Neuroscience Discovery and Study Program; McMaster University; Hamilton ON Canada
| | - M. Steiner
- Women's Health Concerns Clinic; St. Joseph's Healthcare; Department of Psychiatry and Behavioural Neurosciences; McMaster University; Hamilton ON Canada
- McMaster Integrated Neuroscience Discovery and Study Program; McMaster University; Hamilton ON Canada
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Brinks J, Fowler A, Franklin BA, Dulai J. Lifestyle Modification in Secondary Prevention: Beyond Pharmacotherapy. Am J Lifestyle Med 2017; 11:137-152. [PMID: 30202327 PMCID: PMC6125029 DOI: 10.1177/1559827616651402] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 04/19/2016] [Accepted: 05/04/2016] [Indexed: 12/17/2022] Open
Abstract
Despite significant advances in medical technology and pharmacology, cardiovascular disease (CVD) remains a major contributor to health care expenses and the leading cause of death in the United States. Patients with established CVD and their health care providers are challenged with achieving cardiovascular risk reduction to decrease the likelihood of recurrent cardiovascular events. This "secondary prevention" can be achieved, in part, through adherence to prescribed pharmacotherapies that favorably modify major coronary risk factors (ie, hypertension, hypercholesterolemia, diabetes, and obesity). However, lifestyle modification can also be helpful in this regard, providing independent and additive benefits to the associated reductions in cardiovascular morbidity and mortality. Accordingly, physicians and other health care providers should routinely counsel their coronary patients to engage in structured exercise and increased lifestyle physical activity, consume a heart-healthy diet, quit smoking and avoid secondhand smoke, and purposefully address psychosocial stressors that may elevate cardiovascular risk. These lifestyle interventions, either as an adjunct to medication therapy or independently in those patients where medications may be poorly tolerated, cost prohibitive, or ineffective, can significantly decrease cardiovascular mortality and the risk of recurrent cardiac events.
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Affiliation(s)
- Jenna Brinks
- Jenna Brinks, MS, Manager, Preventive Cardiology and Cardiac Rehabilitation, William Beaumont Hospital, Beaumont Health Center, Cardiac Rehabilitation, 4949 Coolidge Highway, Royal Oak, MI 48073, USA; e-mail:
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27
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Ghaffari S, Pourafkari L, Tajlil A, Bahmani-Oskoui R, Nader ND. Is female gender associated with worse outcome after ST elevation myocardial infarction? Indian Heart J 2016; 69 Suppl 1:S28-S33. [PMID: 28400036 PMCID: PMC5388020 DOI: 10.1016/j.ihj.2016.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 10/04/2016] [Accepted: 12/11/2016] [Indexed: 12/26/2022] Open
Abstract
Objectives To investigate the impact of gender in outcomes of patients with ST segment myocardial infarction in a setting with limited access to primary percutaneous coronary intervention Methods In 1017 consecutive patients hospitalized with ST segment myocardial infarction during years 2008–2013, distribution of risk factors, therapeutic methods, heart failure and in-hospital mortality were compared between males and females. Association of gender and primary outcomes was determined after adjustment for confounding factors. Results Females were significantly older (66 ± 12.1 years vs. 59.5 ± 12.7 years, p < 0.001). Prevalence of hypertension, hyperlipidemia and diabetes was significantly higher in females (72.2% vs. 39%, p < 0.001, 36.1% vs. 20.3%, p < 0.001, 46.5% vs. 32.1%, p < 0.001, respectively). Presentation delay was similar in males and females. Females received reperfusion therapy more than males (63.2%vs. 55.8%, p = 0.032). Development of heart failure and in-hospital mortality were significantly higher in females (36.5% vs. 27.2%, p = 0.003 and 19.4% vs. 12.1%, p = 0.002, respectively). However in multivariate analysis, female gender was not independently associated with increased rate of heart failure and in-hospital mortality Conclusion In a center with low rate of primary percutaneous coronary intervention, crude rates of heart failure and in-hospital mortality are higher in females; however, the association is lost after adjustment for baseline characteristics
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Affiliation(s)
- Samad Ghaffari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leili Pourafkari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Anesthesiology Department, University at Buffalo, Buffalo, NY, United States
| | - Arezou Tajlil
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roza Bahmani-Oskoui
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nader D Nader
- Anesthesiology Department, University at Buffalo, Buffalo, NY, United States.
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Pederson JL, Warkentin LM, Majumdar SR, McAlister FA. Depressive symptoms are associated with higher rates of readmission or mortality after medical hospitalization: A systematic review and meta-analysis. J Hosp Med 2016; 11:373-80. [PMID: 26824220 PMCID: PMC5066695 DOI: 10.1002/jhm.2547] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 12/01/2015] [Accepted: 12/21/2015] [Indexed: 12/02/2022]
Abstract
Depressive symptoms during a medical hospitalization may be an overlooked prognostic factor for adverse events postdischarge. Our aim was to evaluate whether depressive symptoms predict 30-day readmission or death after medical hospitalization. We conducted a systematic review of studies that compared postdischarge outcomes by in-hospital depressive status. We assessed study quality and pooled published and unpublished data using random effects models. Overall, one-third of 6104 patients discharged from medical wards were depressed (interquartile range, 27%-40%). Compared to inpatients without depression, those discharged with depressive symptoms were more likely to be readmitted (20.4% vs 13.7%, risk ratio [RR]: 1.73, 95% confidence interval [CI]: 1.16-2.58) or die (2.8% vs 1.5%, RR: 2.13, 95% CI: 1.31-3.44) within 30 days. Depressive symptoms were common in medical inpatients and are associated with an increased risk of adverse events postdischarge. Journal of Hospital Medicine 2016;11:373-380. © 2016 The Authors Journal of Hospital Medicine published by Wiley Periodicals, Inc. on behalf of Society of Hospital Medicine.
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Affiliation(s)
- Jenelle L. Pederson
- Division of General Internal Medicine, Faculty of Medicine and DentistryUniversity of AlbertaEdmontonCanada
| | - Lindsey M. Warkentin
- Division of Surgery, Faculty of Medicine and DentistryUniversity of AlbertaEdmontonCanada
| | - Sumit R. Majumdar
- Division of General Internal Medicine, Faculty of Medicine and DentistryUniversity of AlbertaEdmontonCanada
- Alberta Diabetes InstituteEdmontonCanada
| | - Finlay A. McAlister
- Division of General Internal Medicine, Faculty of Medicine and DentistryUniversity of AlbertaEdmontonCanada
- The Patient Health Outcomes Research and Clinical Effectiveness Unit, Faculty of Medicine and DentistryUniversity of AlbertaEdmontonCanada
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Ginzburg K, Kutz I, Koifman B, Roth A, Kriwisky M, David D, Bleich A. Acute Stress Disorder Symptoms Predict All-Cause Mortality Among Myocardial Infarction Patients: a 15-Year Longitudinal Study. Ann Behav Med 2015; 50:177-86. [DOI: 10.1007/s12160-015-9744-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Theeke LA, Mallow J, Gianni C, Legg K, Glass C. The Experience of Older Women Living with Loneliness and Chronic Conditions in Appalachia. ACTA ACUST UNITED AC 2015; 39:61-72. [PMID: 26594267 DOI: 10.1037/rmh0000029] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This phenomenological qualitative study explored the experience of living with loneliness and multiple chronic conditions for rural older women in Appalachia. The study took place in 2012 in Northern West Virginia. Participants were 14 older women who were chronically ill, community dwelling, and lonely (Score of 40 or higher on the Revised 20-item UCLA Loneliness Scale). Thematic content analysis revealed four categories that contained thirteen themes: (a) negative emotions of loneliness, which included themes of sadness, disconnection, fear, anger, and worry; (b) positive emotions when not lonely, which included themes of joy with others and pride in self; (c) loss of independence and loneliness, which included themes of functional decline contributes to loneliness, burden, and gratitude for help; and (d) ways of managing loneliness, which included remembering holidays and happier moments, staying busy, and getting out. The study contributes new knowledge about the experience of anger, fear, and worry when lonely. These emotions have not extensively been identified as significant to loneliness. Future studies exploring the links between loneliness and anger, fear, worry, and negative physical health outcomes could enhance knowledge of mechanisms by which loneliness contributes to health decline. Additionally, knowing that positive emotions such as joy are described as being linked to less lonely times could inform future work that aims to diminish loneliness and enhance positive emotional states. Finally, understanding that functional impairment is described as contributing to loneliness in this population reinforces the need to assess for and address functional limitations.
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Paine NJ, Watkins LL, Blumenthal JA, Kuhn CM, Sherwood A. Association of depressive and anxiety symptoms with 24-hour urinary catecholamines in individuals with untreated high blood pressure. Psychosom Med 2015; 77:136-44. [PMID: 25647750 PMCID: PMC5119914 DOI: 10.1097/psy.0000000000000144] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Depression and anxiety are considered risk factors for cardiovascular disease (CVD). The explanatory mechanisms, however, are still to be characterized. One proposed pathophysiological pathway is dysregulation of the autonomic nervous system, including heightened sympathetic nervous system activity. This study examined the relationship between symptoms of depression, anxiety, and sympathetic nervous system activity in individuals with untreated high blood pressure. METHODS A total of 140 participants with untreated high blood pressure (55% white, 38.5% female, mean [standard deviation] age = 45.5 [8.55] years) collected urine over a 24-hour period on 3 separate occasions. Urine samples were assayed for mean 24-hour epinephrine (EPI24) and norepinephrine excretion. Depressive symptoms were assessed using the Beck Depression Inventory, with anxiety symptoms assessed using the Spielberger State-Trait Anxiety Inventory. RESULTS Depression and anxiety scores were intercorrelated (r = 0.76, p < .001). EPI24 was positively correlated with anxiety (r = 0.20, p = .02) but not depression (r = 0.02, p = .77), whereas 24-hour urinary norepinephrine excretion was not correlated with anxiety (r = 0.10, p = .21) or with depression (r = 0.07, p = .39). Regression models, accounting for sex, age, body mass index, race, mean systolic ambulatory blood pressure, tobacco use, alcohol use, physical activity, and sleep efficiency confirmed that anxiety was associated with EPI24 excretion (p = .023) and that depressive symptoms were not (p = .54). CONCLUSIONS Anxiety was associated with heightened sympathoadrenal activity, suggesting a biological pathway through which anxiety could increase CVD risk. Anxiety and depression may confer increased CVD risk via different mechanisms.
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Affiliation(s)
- Nicola J. Paine
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710 USA
| | - Lana L. Watkins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710 USA
| | - James A. Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710 USA
| | - Cynthia M. Kuhn
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710 USA
- Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC 27710 USA
| | - Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710 USA
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Wrenn KC, Mostofsky E, Tofler GH, Muller JE, Mittleman MA. Anxiety, anger, and mortality risk among survivors of myocardial infarction. Am J Med 2013; 126:1107-13. [PMID: 24083642 PMCID: PMC3933314 DOI: 10.1016/j.amjmed.2013.07.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 07/30/2013] [Accepted: 07/31/2013] [Indexed: 12/27/2022]
Abstract
BACKGROUND Although there is evidence that anxiety and anger are associated with a higher risk of cardiovascular events, studies examining the relationship between these stressors and prognosis following myocardial infarction have been mixed. METHODS We conducted a prospective cohort study of 1968 participants (average age 60.2 years, 30.6% women) in the Determinants of Myocardial Infarction Onset Study recruited at the time of admission for myocardial infarction between 1989 and 1996. We used the state anxiety and anger subscales of the State-Trait Personality Inventory. Participants were followed for all-cause mortality through December 31, 2007 using the National Death Index. We constructed multivariable Cox proportional hazards models adjusted for demographic, behavioral, and clinical confounders and calculated hazard ratios (HR) and 95% confidence intervals (CI) to examine the relationship between high levels of anxiety and anger and all-cause mortality. RESULTS Over 10 years of follow-up, 525 participants died. Compared with those scoring lower, an anxiety score >90(th) percentile was associated with a 1.31-times (95% CI, 0.93-1.84) higher mortality rate. The association was apparent in the first 3 years (HR 1.78; 95% CI 1.08-2.93), but not thereafter. Likewise, an anger score >90(th) percentile was associated with a 1.25-times (95% CI, 0.87-1.80) higher mortality rate. The association was higher in the first 3 years (HR 1.58; 95% CI, 0.91-2.74) than in subsequent years, but it was not statistically significant during either follow-up period. CONCLUSIONS In this study of myocardial infarction survivors, a high level of anxiety was associated with all-cause mortality, with the strongest association in the first 3 years of follow-up.
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Affiliation(s)
- Katherine C Wrenn
- Department of Cardiology and Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass
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