Factors related to perceived control and health-related quality of life of patients after acute coronary syndrome during admission and after discharge

Association Between Perceived Control and Acute Coronary Syndrome Symptom Severity: A Prospective Cohort Study

AIM

To determine whether there are differences in patterns of symptom severity in three major ACS symptoms (i.e., chest pain, fatigue, and dyspnoea) over the days of CCU stay between patients with higher and lower levels of perceived control.

DESIGN

A prospective cohort study with 3 days of follow-up.

METHODS

Hundred and thirty-five patients were followed prospectively for 3 days, collecting data on (1) perceived control, using the Arabic version of the Controlled Attitude Scale (CAS-R); and (2) symptom severity, using a symptoms diary. A mixed repeated measure design ANOVA was used for data analysis.

RESULTS

Comparative analysis of the high- and low-perceived control groups revealed that there was a significant reduction in chest pain, fatigue, and dyspnoea symptom severity over the course of the 3 days for both groups. Compared to the low-perceived control group, the high-perceived control group had significantly lower chest pain on day 3, fatigue on days 2 and 3, and dyspnoea on all days.

CONCLUSION

Patients with high levels of perceived control have lower levels of symptom severity than those with low perceived control. Interventions to improve perceived control among this population are highly recommended.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Personal mastery and quality of life in patients with atrial fibrillation after radiofrequency ablation: The mediating role of health promoting behavior

BACKGROUND

Improving quality of life is vital for patients with atrial fibrillation (AF) after radiofrequency ablation. Quality of life can be affected not only by personal mastery but also by health promoting behavior as previously studied. However, it remains unclear whether health promoting behavior mediates the relationship between personal mastery and quality of life.

OBJECTIVES

To explore whether health promoting behavior mediates the relationship between personal mastery and quality of life in patients with AF after radiofrequency ablation.

METHODS

A cross-sectional design and convenience sampling were conducted at a tertiary hospital in China. Self-reported questionnaires were used to assess personal mastery, health promoting behavior and quality of life. SPSS and AMOS software were used for statistical analysis.

RESULTS

A total of 202 patients with AF after radiofrequency ablation were enrolled (mean age 58.28 ± 12.70 years). The scores for personal mastery and quality of life were 22.52 ± 2.53 points and 62.58 ± 8.59 points, respectively, indicating a limited level. The health promoting behavior exhibited a moderate level, with scores averaging 103.82 ± 8.47 points. There was a positive correlation between the three variables (all P < 0.05). Health promoting behavior played a partial mediating role in the relationship between personal mastery and quality of life in patients with AF after radiofrequency ablation, accounting for 44.79 % of the total effect.

CONCLUSIONS

In order to improve quality of life and prognosis, it is necessary to consider enhancing personal mastery and increasing patient compliance with health promoting behavior, which are important ways to improve their quality of life.

Relationship Between Resilience and Perceived Control After Acute Coronary Syndrome: A Prospective Study

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.

Healthcare graduate students' perceived control and preventive behavior for COVID-19 in Japan and the United States: A cross-sectional study

Background

Both individual and policy level perceived control are known to be positively related to preventive behavior, and both may differ among healthcare graduate students with different cultural backgrounds. This study compared the preventive health behavior and perceived control among domestic and international healthcare graduate students in Japan and the United States during the COVID-19 pandemic, and analyzed factors associated with preventive health behavior and perceived control.

Methods

The study used a self-administered online survey, conducted at two universities in Japan and one university in the United States. The survey included sociodemographic data and scales of preventive health behaviors, perceived control (policy level), and perceived health competence (individual level). Association among variables were analyzed using structural equation modeling.

Results

A total of 610 students (485 domestic and 125 international) in Japan and 231 students (220 domestic and 11 international) in the United States completed the survey. Participants' average age was 31.3 years, and 67.0% were female. Model fit of structural equation modeling was good (χ2 = 9.419, P = 0.151, comparative fit index = 0.995, RMSEA = 0.026). Japanese students had better preventive health behavior than American (β = -0.407, P < 0.001) and international students in both countries (β = -0.112, P < 0.001). However, Japanese students had significantly lower perceived control than American students (β = 0.346, P < 0.001) and international students in both countries (β = 0.188, P < 0.001). Overall higher perceived control (β = 0.175, P < 0.001) and being female (β = 0.141, P < 0.001) were significantly associated with better preventive behavior. Although higher perceived control was related to higher perceived health competence (β = 0.295, P < 0.001), perceived health competence was not associated with preventive behavior (β = 0.025, P = 0.470). Religion was not associated with perceived control or preventive behavior.

Conclusion

Nationality was identified as the main factor associated with both perceived control and preventive behavior. Policy level perceived control was more strongly associated with preventive health behavior than individual level perceived health competence. Further investigations in the contribution of specific cultural dimensions associated with perceived control and preventive behaviors are recommended.

Factors related to perceived control and health-related quality of life of patients after acute coronary syndrome during admission and after discharge

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.