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Yazdanpanah F, Jackson AC, Sanaie N, Sharifi F, Shamshirgaran SM, Bahramnezhad F. The epidemiology and treatment outcomes of COVID-19 patients admitted to an intensive care unit in an Iranian hospital in Neyshabur city. Health Sci Rep 2024; 7:e2049. [PMID: 38655427 PMCID: PMC11035379 DOI: 10.1002/hsr2.2049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/26/2024] Open
Abstract
Background and Aims The COVID-19 pandemic and the infection of numerous individuals from diverse societies have emerged as major global challenges. Given the limited resources in intensive care units, effective bed management and resource allocation require a deep understanding of the disease. This study aimed to assess the epidemiology and treatment outcomes of COVID-19 patients admitted to an intensive care unit in an Iranian hospital in Neyshabur city. Methods This cross-sectional study was conducted on COVID-19 patients hospitalized in intensive care units in Razavi Khorasan, Iran in 2021. Census sampling was used to include all intensive care units. Of the initial 480 cases, 54 cases were excluded based on the exclusion criteria, leaving 426 cases for the study. Data were collected with the help of a data collection form that was designed by the researcher and its content validity and reliability were measured with Cronbach's alpha coefficient (α = 89%.). Data were analyzed with SPSS version 20 software. Descriptive and inferential statistics were used to analyze the data. Mean, standard deviation, and interquartile range indicators were used for descriptive statistics, and absolute frequency and relative frequency (percentage) were used to show numbers and ratios. Results The mean (SD) age of the patients was 66.33 (15.05) years, and 49.3% were female. The results showed that arterial blood oxygen saturation, respiratory rate, and Alzheimer's disease were significant variables for predicting mortality. Furthermore, arterial blood oxygen saturation, respiratory rate, and the need for transfusion of blood products were significant variables in predicting hospitalization and the risk of acute respiratory distress syndrome (ARDS). Conclusion This study demonstrated that arterial blood oxygen saturation, respiratory rate, and Alzheimer's disease are crucial variables for predicting death. Furthermore, arterial blood oxygen saturation and respiratory rate are significant factors in predicting the risk of ARDS.
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Affiliation(s)
- Farzaneh Yazdanpanah
- Department of Critical Care Nursing, School of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
| | - Alun C. Jackson
- Australian Centre for Heart HealthMelbourneAustralia
- Faculty of HealthDeakin UniversityGeelongAustralia
- Centre on Behavioural HealthHong Kong UniversityHong KongChina
| | - Neda Sanaie
- Department of Medical Surgical Nursing, School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrine Population Sciences Institute, Endocrinology and Metabolism Research InstituteTehran University of Medical SciencesTehranIran
| | - Seyed Morteza Shamshirgaran
- Department of Epidemiology and Statistics Faculty of Health SciencesNeyshabur University of Medical SciencesNeyshaburIran
| | - Fatemeh Bahramnezhad
- Department of Critical Care Nursing, School of Nursing & Midwifery, Nursing and Midwifery Care Research CenterTehran University of Medical SciencesTehranIran
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Le Grande MR, Salvacion M, Shwaita L, Murphy BM, Jackson AC, Alvarenga ME. Does coping style mediate the relationship between knowledge and psychosocial outcomes in women with atrial fibrillation? Front Psychiatry 2024; 15:1328111. [PMID: 38585480 PMCID: PMC10995340 DOI: 10.3389/fpsyt.2024.1328111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/11/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction In patients affected by atrial fibrillation (AF) disease-specific knowledge and coping style may be associated with psychosocial well-being. This study aimed to determine if coping style (problem-focused, emotion-focused, avoidance-focused) mediated the relationship between patient knowledge and three psychosocial outcomes (anxiety, depression and life satisfaction). Methods In 2021 a total of 188 women with reported AF, and ages ranging from 18 to 83 years (mean 48.7, sd 15.5 years), completed an online questionnaire consisting of sociodemographic, clinical and AF knowledge questions and psychosocial instruments (Anxiety and depression, the Hospital Anxiety and Depression (HADS) scale; life satisfaction, Satisfaction With Life Scale (SWLS); and coping style (Brief COPE). Using Jamovi statistical software three individual mediational models (for anxiety, depression and life satisfaction) were constructed assessing the direct and indirect relationships between knowledge, coping style and each psychosocial outcome. Age was a covariate in each model. Results The mediation analyses demonstrated significant direct negative associations between AF knowledge and HADS anxiety and depression and positive associations with SWLS. There were also direct associations between each of the three coping styles and the three psychosocial outcomes. There were significant indirect effects of coping style between AF knowledge and each of the three outcomes confirming partial mediation effects. Discussion These findings highlight the crucial role of coping style in mediating the association between AF knowledge and psychosocial outcomes. As such, interventions aimed at increasing patient knowledge of AF may be more effective if adaptive problem-solving coping strategies are also demonstrated to these patients. Additionally, modification of maladaptive coping strategies as part of the psychological management of patients with AF is highly recommended.
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Affiliation(s)
- Michael R. Le Grande
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Marielle Salvacion
- Institute of Health and Wellbeing, Federation University, Berwick, VIC, Australia
| | - Lubab Shwaita
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Faculty of Science, Engineering and Built Environment, Deakin University, Burwood, VIC, Australia
| | - Barbara M. Murphy
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Alun C. Jackson
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
- Centre on Behavioral Health, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Marlies E. Alvarenga
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Institute of Health and Wellbeing, Federation University, Berwick, VIC, Australia
- Victorian Heart Institute, Clayton, VIC, Australia
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
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Khanipour-Kencha A, Jackson AC, Sharifi F, Bahramnezhad F. Death Anxiety in Patients with a History of Coronary Artery Bypass Graft Surgery During the COVID-19 Pandemic: The Role of Spiritual Well-Being and Coping Strategies. J Relig Health 2024:10.1007/s10943-024-02003-w. [PMID: 38430384 DOI: 10.1007/s10943-024-02003-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/12/2024] [Indexed: 03/03/2024]
Abstract
Patients who have previously undergone coronary artery bypass surgery (CABG) were prone to death anxiety during the COVID-19 pandemic. It appears that spiritual well-being and appropriate coping strategies may mitigate the harmful effects of death anxiety. Therefore, this study aimed to determine the level of death anxiety in patients with CABG during the COVID-19 pandemic and investigate the relationship between spiritual well-being, coping strategies and death anxiety.This cross-sectional study was conducted on 100 patients with CABG history in Tehran from June 2021 to February 2022. The face-to-face questionnaire, containing questions on demographics, Templer's death anxiety scale, the spiritual well-being questionnaire, and the ways of coping questionnaire was administered to collect data. Statistical analysis was performed using descriptive-analytical statistics, correlation tests, and logistic regression models.Participants' mean age was 55.59 ± 12.78 years. The mean death anxiety score was 10.00 ± 2.16, with 87% of participants reporting high levels and 13% reporting low levels of death anxiety. Based on the results, there was a significant negative correlation between death anxiety and coping strategies, as well as subscales of distancing, seeking social support, accepting responsibility, and planful problem-solving. Logistic regression showed that with the increase in the score of spiritual well-being, the odds of having high levels of death anxiety decreased (p < 0.05). Furthermore, increasing the total score of coping strategies, and the score of self-controlling, seeking social support, accepting responsibility, and planful problem-solving, significantly reduced the odds of high levels of death anxiety (p < 0.05).The study showed that patients with a CABG history experienced high death anxiety during the COVID-19 pandemic. According to the findings, spiritual well-being and coping strategies, especially self-controlling, seeking social support, accepting responsibility, and planful problem-solving, may reduce the odds of severe death anxiety. These should be considered as effective targets for psychological intervention in these patients.
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Affiliation(s)
- Ali Khanipour-Kencha
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- Student's Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alun C Jackson
- Australian Centre for Heart Health, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- Graduate School of Education, University of Melbourne, Melbourne, Australia
- Centre on Behavioral Health, Hong Kong University, Pok Fu Lam, Hong Kong
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology & Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bahramnezhad
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Nosrat ST., Tohid Sq, Tehran, 141973317, Iran.
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Spence K, Merkouris SS, Jackson AC, Wade AJ, Dowling NA. Negative and positive mental health characteristics of affected family members: Findings from a cross-sectional Australian general population gambling study. Addict Behav 2024; 155:107998. [PMID: 38598904 DOI: 10.1016/j.addbeh.2024.107998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/13/2024] [Accepted: 02/21/2024] [Indexed: 04/12/2024]
Abstract
Despite the impact of problem gambling on affected family members (AFMs), there are limited large-scale population level studies identifying the negative mental health (NMH) and positive mental health (PMH) characteristics of AFMs. Furthermore, no study has explored whether PMH characteristics are protective in the relationships between AFM status and NMH characteristics. This study involved secondary data analysis from the Third Social and Economic Impact Study of Gambling in Tasmania. Using a subsample of 1,869 adults (48.30 % male; meanage = 48.48; 4.67 % AFMs), this study aimed to explore whether: (1) AFM status is associated with NMH (depression, anxiety, panic, post-traumatic stress disorder, social anxiety, binge drinking, tobacco use, and drug use symptoms) and PMH (quality of life [QOL], personal growth/autonomy, interpersonal/social skills, coping skills) characteristics after separately controlling for sociodemographic, problem gambling severity, and other NMH characteristics; (2) PMH characteristics moderate (buffer) the relationships between AFM status and NMH characteristics; and (3) gender influences these relationships. AFM status, defined as exposure to family member gambling problems, significantly positively predicted NMH characteristics (depression, anxiety, panic, PTSD, and tobacco use symptoms) and negatively predicted QOL (physical, social) and planning coping. The strength of these relationships generally attenuated after controlling for various covariates. Gender did not moderate these relationships. Religious coping exacerbated the relationship between AFM status and panic disorder symptoms. These findings can inform the development of intervention initiatives for family members exposed to gambling problems. Future population-representative research is required using a range of affected other types, longitudinal study designs, and more comprehensive measures.
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Affiliation(s)
- K Spence
- School of Psychology, Deakin University, Geelong, Australia.
| | - S S Merkouris
- School of Psychology, Deakin University, Geelong, Australia.
| | - A C Jackson
- Melbourne School of Psychological Sciences, University of Melbourne, Australia; Faculty of Education, University of Melbourne, Australia.
| | - A J Wade
- Centre for International Research on Education Systems, Mitchell Institute, Victoria University, Australia.
| | - N A Dowling
- School of Psychology, Deakin University, Geelong, Australia.
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Rogerson MC, Jackson AC, Navaratnam HS, Le Grande MR, Higgins RO, Clarke J, Murphy BM. Behavioural and psychological telehealth support for people with cardiac conditions: randomized trial of the 'back on track' self-management programme. Eur J Cardiovasc Nurs 2024; 23:42-54. [PMID: 36989400 DOI: 10.1093/eurjcn/zvad034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023]
Abstract
AIMS Behaviour modification and mood management are essential to recovery after a cardiac event. Recent times have seen a major shift to remote delivery of cardiac services. This study assessed behavioural and psychological outcomes of the Back on Track online self-management programme, comparing the programme undertaken alone (self-directed) vs. with telephone support (supported). Relevance for people with depression was also assessed. METHODS AND RESULTS Participants with cardiac conditions (n = 122) were randomly assigned to self-directed or supported groups and given access to the online programme for 2 months. The programme addressed depression, anxiety, physical activity, and healthy eating. Supported group participants also received two telephone sessions facilitated by a trained counsellor to further enhance their self-management skills and engagement with the online modules. The Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Active Australia Survey and Diet Quality Tool were administered at baseline, 2, and 6 months. χ2 tests were used to compare self-directed and supported groups. Cochrane's Q tests assessed changes over time in depression, anxiety, and physical activity (PA) and healthy diet guideline achievement. Participants in both groups showed reduced depression rates (self-directed, P < 0.05) and increased PA after programme completion (both groups, P < 0.05). Amongst those classified as depressed at baseline, significantly fewer were classified as depressed over time (P < 0.001) and significantly more were achieving the PA guidelines (P < 0.01) compared to those who were not depressed at baseline. CONCLUSIONS The Back on Track telehealth programme was effective in assisting with behavioural and emotional recovery after a cardiac event. The programme may be particularly beneficial for those who are depressed early in their recovery period. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12620000102976.
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Affiliation(s)
- Michelle C Rogerson
- Australian Centre for Heart Health, 75-79 Chetwynd St, PO Box 2137, North Melbourne, VIC 3051, Australia
| | - Alun C Jackson
- Australian Centre for Heart Health, 75-79 Chetwynd St, PO Box 2137, North Melbourne, VIC 3051, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
- Centre on Behavioral Health, University of Hong Kong, Pokfulam, Hong Kong
- PRC Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Hema S Navaratnam
- Australian Centre for Heart Health, 75-79 Chetwynd St, PO Box 2137, North Melbourne, VIC 3051, Australia
| | - Michael R Le Grande
- Australian Centre for Heart Health, 75-79 Chetwynd St, PO Box 2137, North Melbourne, VIC 3051, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Rosemary O Higgins
- Australian Centre for Heart Health, 75-79 Chetwynd St, PO Box 2137, North Melbourne, VIC 3051, Australia
- Department of Psychology, Deakin University, Geelong, Australia
- Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia
| | - Joanne Clarke
- Australian Centre for Heart Health, 75-79 Chetwynd St, PO Box 2137, North Melbourne, VIC 3051, Australia
| | - Barbara M Murphy
- Australian Centre for Heart Health, 75-79 Chetwynd St, PO Box 2137, North Melbourne, VIC 3051, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
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Murphy BM, Rogerson MC, Le Grande MR, Hesselson S, Iismaa SE, Graham RM, Jackson AC. Psychosocial and lifestyle impacts of spontaneous coronary artery dissection: A quantitative study. PLoS One 2024; 19:e0296224. [PMID: 38181032 PMCID: PMC10769080 DOI: 10.1371/journal.pone.0296224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/07/2023] [Indexed: 01/07/2024] Open
Abstract
INTRODUCTION Recent studies suggest that acute myocardial infarction due to spontaneous coronary artery dissection (SCAD) carries significant psychosocial burden. This survey-based quantitative study builds on our earlier qualitative investigation of the psychosocial impacts of SCAD in Australian SCAD survivors. The study aimed to document the prevalence and predictors of a broad range of psychosocial and lifestyle impacts of SCAD. METHOD Australian SCAD survivors currently enrolled in the Victor Chang Cardiac Research Institute genetics study were invited to participate in an online survey to assess the psychosocial impacts of SCAD. Participants completed a questionnaire, developed using findings from our earlier qualitative research, which assessed 48 psychosocial and five lifestyle impacts of SCAD. Participants also provided demographic and medical data and completed validated measures of anxiety and depression. RESULTS Of 433 SCAD survivors invited to participate, 310 (72%) completed the questionnaire. The most common psychosocial impacts were 'shock about having a heart attack' (experienced by 87% respondents), 'worry about having another SCAD' (81%), 'concern about triggering another SCAD' (77%), 'uncertainty about exercise and physical activity' (73%) and 'confusion about safe levels of activity and exertion' (73.0%) and 'being overly aware of bodily sensations' (73%). In terms of lifestyle impacts, the SCAD had impacted on work capacity for almost two thirds of participants, while one in ten had sought financial assistance. The key predictors of psychosocial impacts were being under 50, current financial strain, and trade-level education. The key predictors of lifestyle impacts were being over 50, SCAD recurrence, trade-level education, and current financial strain. All psychosocial impacts and some lifestyle impacts were associated with increased risk of anxiety and/or depression. CONCLUSION AND IMPLICATIONS This quantitative study extends our previous qualitative investigation by documenting the prevalence of each of 48 psychosocial and five lifestyle impacts identified in our earlier focus group research, and by providing risk factors for greater SCAD impacts. The findings suggest the need for supports to address initial experiences of shock, as well as fears and uncertainties regarding the future, including SCAD recurrence and exercise resumption. Support could be targeted to those with identified risk factors. Strategies to enable SCAD survivors to remain in or return to the paid workforce are also indicated.
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Affiliation(s)
- Barbara M. Murphy
- Australian Centre for Heart Health, Melbourne, Victoria, Australia
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Michael R. Le Grande
- Australian Centre for Heart Health, Melbourne, Victoria, Australia
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Siiri E. Iismaa
- Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia
- St Vincent’s Hospital, Sydney, New South Wales, Australia
| | - Robert M. Graham
- Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia
- St Vincent’s Hospital, Sydney, New South Wales, Australia
| | - Alun C. Jackson
- Australian Centre for Heart Health, Melbourne, Victoria, Australia
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Centre on Behavioral Health, University of Hong Kong, Pokfulam, Hong Kong
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Le Grande MR, Murphy B, Kerr D, Beauchamp A, Driscoll A, Jackson AC. Barriers and enablers to screening, management and referral of sleep disorders in patients attending cardiac rehabilitation: A qualitative descriptive study. J Adv Nurs 2024; 80:136-149. [PMID: 37401808 DOI: 10.1111/jan.15765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 05/30/2023] [Accepted: 06/21/2023] [Indexed: 07/05/2023]
Abstract
AIMS To examine healthcare professional's knowledge about assessment and management of sleep disorders for cardiac patients and to describe the barriers to screening and management in cardiac rehabilitation settings. DESIGN A qualitative descriptive study. Data were collected via semi-structured interviews. METHODS In March 2022, a total of seven focus groups and two interviews were conducted with healthcare professionals who currently work in cardiac rehabilitation settings. Participants included 17 healthcare professionals who had undertaken cardiac rehabilitation training within the past 5 years. The study adheres to the consolidated criteria for reporting qualitative research guidelines. An inductive thematic analysis approach was utilized. RESULTS Six themes and 20 sub-themes were identified. Non-validated approaches to identify sleep disorders (such as asking questions) were often used in preference to validated instruments. However, participants reported positive attitudes regarding screening tools provided they did not adversely affect the therapeutic relationship with patients and benefit to patients could be demonstrated. Participants indicated minimal training in sleep issues, and limited knowledge of professional guidelines and recommended that more patient educational materials are needed. CONCLUSION Introduction of screening for sleep disorders in cardiac rehabilitation settings requires consideration of resources, the therapeutic relationship with patients and the demonstrated clinical benefit of extra screening. Awareness and familiarity of professional guidelines may improve confidence for nurses in the management of sleep disorders for patients with cardiac illness. IMPACTS The findings from this study address healthcare professionals' concerns regarding introduction of screening for sleep disorders for patients with cardiovascular disease. The results indicate concern for therapeutic relationships and patient management and have implications for nursing in settings such as cardiac rehabilitation and post-cardiac event counselling. REPORTING METHOD Adherence to COREQ guidelines was maintained. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution as this study explored health professionals' experiences only.
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Affiliation(s)
- Michael R Le Grande
- Australian Centre for Heart Health, North Melbourne, Victoria, Australia
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Barbara Murphy
- Australian Centre for Heart Health, North Melbourne, Victoria, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Debra Kerr
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Alison Beauchamp
- Australian Centre for Heart Health, North Melbourne, Victoria, Australia
- Department of Medicine-Western Health, The University of Melbourne, Melbourne, Victoria, Australia
- School of Rural Health, Monash University, Warragul, Victoria, Australia
| | - Andrea Driscoll
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Alun C Jackson
- Australian Centre for Heart Health, North Melbourne, Victoria, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Centre on Behavioural Health, Hong Kong University, Pok Fu Lam, Hong Kong
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Murphy BM, Higgins RO, Jackson AC. Incidence and impacts of post-cardiac event mental health problems. Aust J Gen Pract 2023; 52:781-786. [PMID: 37935151 DOI: 10.31128/ajgp-05-23-6828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
BACKGROUND Acute cardiac events confer an increased risk of mental health problems, which compromise physical recovery and increase the risk of recurrence and premature mortality. OBJECTIVE This paper provides an overview of the nature, prevalence, predictors and impacts of post-cardiac event mental health problems, and outlines the benefits of mental health screening, effective treatments for mental health problems and the role of general practitioners (GPs) in the identification and management of mental health problems in cardiac patients. DISCUSSION Post-event mental health problems are common, yet gaps exist in their identification and management in acute inpatient, cardiac rehabilitation and primary care settings. Effective screening tools and treatment options are available and have been shown to improve not only mental health, but also cardiovascular outcomes. GPs are well placed to contribute to the identification and management of post-event mental health problems provided they are equipped with adequate information about treatment and referral options.
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Affiliation(s)
- Barbara M Murphy
- PhD, BA (Hons), Associate Director, Australian Centre for Heart Health, Melbourne, Vic; Honorary Senior Fellow, Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Vic
| | - Rosemary O Higgins
- DPysch, GradDipHealth, Health Psychologist, Australian Centre for Heart Health, Melbourne, Vic; Honorary Associate Professor, Physiotherapy Department, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Vic
| | - Alun C Jackson
- MSc, PhD, FCSANZ, FESC, Director, Australian Centre for Heart Health, Melbourne, Vic; Honorary Professorial Fellow, Melbourne School of Psychological Sciences and Melbourne Graduate School of Education, The University of Melbourne, Melbourne, Vic; Honorary Professor, Centre on Behavioural Health, University of Hong Kong, Hong@Kong, SAR@China
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Murphy BM, Rogerson MC, Hesselson S, Iismaa SE, Hoover V, Le Grande M, Graham RM, Jackson AC. Prevalence of Anxiety, Depression, and Distress in SCAD and Non-SCAD AMI Patients: A Comparative Study. J Cardiopulm Rehabil Prev 2023; 43:338-345. [PMID: 36892564 PMCID: PMC10467813 DOI: 10.1097/hcr.0000000000000782] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
PURPOSE Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute myocardial infarction (AMI), particularly in younger women without classic cardiac risk factors. Spontaneous coronary artery dissection is considered to be particularly stressful; however, few studies have quantified SCAD survivor stress levels. This study compared anxiety, depression, and distress levels in SCAD and non-SCAD AMI patients. METHOD A sample of 162 AMI (35 [22%] SCAD) patients was recruited from hospitals and via social media, in Australia and the United States. All had had their AMI in the past 6 mo. Participants completed an online questionnaire comprising the Generalized Anxiety Disorder-2 (GAD2), Patient Health Questionnaire-2 (PHQ2), Kessler-6 (K6), and Cardiac Distress Inventory (CDI). T-tests, χ 2 tests, Mann-Whitney tests, and analysis of covariance were used to compare SCAD and non-SCAD samples. Logistic regression was used to identify the unique predictors of anxiety, depression, and distress, controlling for relevant confounders. RESULTS Patients with SCAD were more commonly female and significantly younger than non-SCAD patients. Patients with SCAD scored significantly higher on the GAD2, PHQ2, K6, and CDI and a significantly larger proportion was classified as anxious, depressed, or distressed using these instruments. In logistic regression, together with mental health history, having had a SCAD-AMI predicted anxiety, depression, and distress, after controlling for female sex, younger age, and other confounding variables. CONCLUSION This study supports the view that anxiety, depression, and distress are more common after SCAD-AMI than after traditional AMI. These findings highlight the psychosocial impacts of SCAD and suggest that psychological support should be an important component of cardiac rehabilitation for these patients.
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Affiliation(s)
- Barbara M. Murphy
- Australian Centre for Heart Health, Melbourne, Victoria, Australia (Drs Murphy, Rogerson, and Jackson and Mr Le Grande); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia (Drs Murphy and Jackson and Mr Le Grande); Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia (Drs Hesselson, Iismaa, and Graham); St Vincent's Clinical School, University of New South Wales, Sydney, Australia (Drs Iismaa and Graham); Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California (Dr Hoover); and Centre on Behavioral Health, University of Hong Kong, Pokfulam, HongKong, China (Dr Jackson)
| | - Michelle C. Rogerson
- Australian Centre for Heart Health, Melbourne, Victoria, Australia (Drs Murphy, Rogerson, and Jackson and Mr Le Grande); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia (Drs Murphy and Jackson and Mr Le Grande); Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia (Drs Hesselson, Iismaa, and Graham); St Vincent's Clinical School, University of New South Wales, Sydney, Australia (Drs Iismaa and Graham); Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California (Dr Hoover); and Centre on Behavioral Health, University of Hong Kong, Pokfulam, HongKong, China (Dr Jackson)
| | - Stephanie Hesselson
- Australian Centre for Heart Health, Melbourne, Victoria, Australia (Drs Murphy, Rogerson, and Jackson and Mr Le Grande); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia (Drs Murphy and Jackson and Mr Le Grande); Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia (Drs Hesselson, Iismaa, and Graham); St Vincent's Clinical School, University of New South Wales, Sydney, Australia (Drs Iismaa and Graham); Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California (Dr Hoover); and Centre on Behavioral Health, University of Hong Kong, Pokfulam, HongKong, China (Dr Jackson)
| | - Siiri E. Iismaa
- Australian Centre for Heart Health, Melbourne, Victoria, Australia (Drs Murphy, Rogerson, and Jackson and Mr Le Grande); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia (Drs Murphy and Jackson and Mr Le Grande); Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia (Drs Hesselson, Iismaa, and Graham); St Vincent's Clinical School, University of New South Wales, Sydney, Australia (Drs Iismaa and Graham); Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California (Dr Hoover); and Centre on Behavioral Health, University of Hong Kong, Pokfulam, HongKong, China (Dr Jackson)
| | - Valerie Hoover
- Australian Centre for Heart Health, Melbourne, Victoria, Australia (Drs Murphy, Rogerson, and Jackson and Mr Le Grande); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia (Drs Murphy and Jackson and Mr Le Grande); Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia (Drs Hesselson, Iismaa, and Graham); St Vincent's Clinical School, University of New South Wales, Sydney, Australia (Drs Iismaa and Graham); Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California (Dr Hoover); and Centre on Behavioral Health, University of Hong Kong, Pokfulam, HongKong, China (Dr Jackson)
| | - Michael Le Grande
- Australian Centre for Heart Health, Melbourne, Victoria, Australia (Drs Murphy, Rogerson, and Jackson and Mr Le Grande); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia (Drs Murphy and Jackson and Mr Le Grande); Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia (Drs Hesselson, Iismaa, and Graham); St Vincent's Clinical School, University of New South Wales, Sydney, Australia (Drs Iismaa and Graham); Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California (Dr Hoover); and Centre on Behavioral Health, University of Hong Kong, Pokfulam, HongKong, China (Dr Jackson)
| | - Robert M. Graham
- Australian Centre for Heart Health, Melbourne, Victoria, Australia (Drs Murphy, Rogerson, and Jackson and Mr Le Grande); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia (Drs Murphy and Jackson and Mr Le Grande); Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia (Drs Hesselson, Iismaa, and Graham); St Vincent's Clinical School, University of New South Wales, Sydney, Australia (Drs Iismaa and Graham); Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California (Dr Hoover); and Centre on Behavioral Health, University of Hong Kong, Pokfulam, HongKong, China (Dr Jackson)
| | - Alun C. Jackson
- Australian Centre for Heart Health, Melbourne, Victoria, Australia (Drs Murphy, Rogerson, and Jackson and Mr Le Grande); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia (Drs Murphy and Jackson and Mr Le Grande); Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia (Drs Hesselson, Iismaa, and Graham); St Vincent's Clinical School, University of New South Wales, Sydney, Australia (Drs Iismaa and Graham); Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California (Dr Hoover); and Centre on Behavioral Health, University of Hong Kong, Pokfulam, HongKong, China (Dr Jackson)
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10
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Le Grande MR, Murphy BM, Rogerson MC, Ski CF, Amerena J, Smith JA, Hoover V, Alvarenga ME, Higgins RO, Thompson DR, Jackson AC. Development of a short form of the Cardiac Distress Inventory. BMC Cardiovasc Disord 2023; 23:408. [PMID: 37596516 PMCID: PMC10439557 DOI: 10.1186/s12872-023-03439-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/08/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Cardiac distress may be viewed as a persistent negative emotional state that spans multiple psychosocial domains and challenges a patient's capacity to cope with living with their heart condition. The Cardiac Distress Inventory (CDI) is a disease-specific clinical assessment tool that captures the complexity of this distress. In busy settings such as primary care, cardiac rehabilitation, and counselling services, however, there is a need to administer briefer tools to aid in identification and screening. The aim of the present study was to develop a short, valid screening version of the CDI. METHODS A total of 405 participants reporting an acute coronary event in the previous 12 months was recruited from three hospitals, through social media and by direct enrolment on the study website. Participants completed an online survey which included the full version of the CDI and general distress measures including the Kessler K6, Patient Health Questionnaire-4, and Emotion Thermometers. Relationship of the CDI with these instruments, Rasch analysis model fit and clinical expertise were all used to select items for the short form (CDI-SF). Construct validity and receiver operating characteristics in relation to the Kessler K6 were examined. RESULTS The final 12 item CDI-SF exhibited excellent internal consistency indicative of unidimensionality and good convergent and discriminant validity in comparison to clinical status measures, all indicative of good construct validity. Using the K6 validated cutoff of ≥ 18 as the reference variable, the CDI-SF had a very high Area Under the Curve (AUC) (AUC = 0.913 (95% CI: 0.88 to 0.94). A CDI-SF score of ≥ 13 was found to indicate general cardiac distress which may warrant further investigation using the original CDI. CONCLUSION The psychometric findings detailed here indicate that the CDI-SF provides a brief psychometrically sound screening measure indicative of general cardiac distress, that can be used in both clinical and research settings.
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Affiliation(s)
- Michael R Le Grande
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Barbara M Murphy
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | | | - Chantal F Ski
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Integrated Care Academy, University of Suffolk, Ipswich, UK
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - John Amerena
- Barwon Health, Geelong, VIC, Australia
- Deakin School of Medicine, University Hospital Geelong, Geelong, VIC, Australia
| | - Julian A Smith
- Department of Cardiothoracic Surgery, Monash Health, Clayton, VIC, Australia
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
- Victorian Heart Institute, Clayton, VIC, Australia
| | - Valerie Hoover
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Marlies E Alvarenga
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Victorian Heart Institute, Clayton, VIC, Australia
- Institute of Health and Wellbeing, Federation University, Berwick, VIC, Australia
- Monash Health & Department of Medicine, Monash University, Clayton, VIC, Australia
| | - Rosemary O Higgins
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Department of Physiotherapy, University of Melbourne, Parkville, VIC, Australia
| | - David R Thompson
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Alun C Jackson
- Australian Centre for Heart Health, Melbourne, VIC, Australia.
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia.
- Centre on Behavioral Health, University of Hong Kong, Hong Kong, China.
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11
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Asadi Z, Jackson AC, Moradpour F, Cheraghi MA, Sharifi F, Bahramnezhad F. Investigating the Relationship Between Spiritual Health, Meaning in Life, and Death Attitudes among COVID-19 Patients Discharged from ICUs: A Cross-Sectional Study in Iran. J Relig Health 2023:10.1007/s10943-023-01834-3. [PMID: 37329378 DOI: 10.1007/s10943-023-01834-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/09/2023] [Indexed: 06/19/2023]
Abstract
The COVID-19 pandemic has been shown to affect both physical and mental health. Because of this mental health burden, it is important to pay attention to issues such as the relationship between spiritual health, death attitudes and meaning in life - all issues made more prominent during the pandemic. This study was conducted to determine the correlation between these three factors - spiritual health, meaning in life, and death attitudes, among patients with COVID-19 discharged from the intensive care units of hospitals affiliated with Tehran University of Medical Sciences, Tehran, Iran.This cross-sectional, descriptive-analytical study was conducted between April 2020 and August 2021 with 260 participants. The data collection instruments were a demographic characteristics questionnaire, Polotzin and Ellison's Spiritual Health Questionnaire, The Meaning in Life Questionnaire (MLQ), and Death Attitude Profile-Revised (DAP-R).The correlation between meaning in life, spiritual health, and death attitudes was determined by Spearman's correlation coefficient. The research results showed that there is an inverse and significant correlation between spiritual health and death attitudes (p = 0.01); an inverse, but insignificant correlation between existential health and subscales of death attitudes, except for the subscales of approach acceptance and neutral acceptance (p > 0.05); and an inverse, but insignificant, correlation between spiritual health and death attitudes, (p > 0.05). In addition, there was an inverse and significant correlation between the presence of meaning in life and escape acceptance (p = 0.002); an inverse and significant correlation between the search for meaning in life and neutral acceptance (p = 0.007); and an inverse and significant correlation between the meaning in life and death attitudes (p = 0.04). Besides, the findings showed an inverse but insignificant correlation between all spiritual health subscales and the meaning in life subscales (p > 0.05). Spiritual health has an inverse correlation with death attitudes.Also, there is an inverse correlation between the total score of spiritual health and death attitudes. Regarding the subscales of spiritual health, there is an inverse correlation between existential health and death attitudes subscales, except for approach acceptance and neutral acceptance. Also, the results showed an inverse and significant correlation between meaning in life and death acceptance and avoidance subscales, and there was an inverse and significant correlation between the meaning in life and death attitudes. Finally, the increase in spiritual health reduces patients' risks of thinking about death. The research results double the significance of the role of nurses, especially those dealing with critically ill patients and those who have experienced severe disease conditions.
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Affiliation(s)
- Zahra Asadi
- Department of Critical Care Nursing, School of Nursing and Midwifery, Nursing, Tehran University of Medical Sciences, Tehran, Iran
| | - Alun C Jackson
- Australian Centre for Heart Health, Melbourne, Australia
- Faculty of Health, Deakin University, Geelong, Australia
- Centre on Behavioral Health, Hong Kong University, Hong Kong, Hong Kong, PRC
| | - Fatemeh Moradpour
- Department of Critical Care Nursing, School of Nursing and Midwifery, Nursing, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Cheraghi
- Department of Nursing management, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Endocrinology and Metabolism Research Center Clinical Sciences Institute Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bahramnezhad
- School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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12
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Hosseini A, Jackson AC, Chegini N, Dehghan MF, Mazloum D, Haghani S, Bahramnezhad F. The effect of an educational app on hemodialysis patients' self-efficacy and self-care: A quasi-experimental longitudinal study. Chronic Illn 2023; 19:383-394. [PMID: 35179394 DOI: 10.1177/17423953211073365] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Adequate self-care and exploring ways to improve it is imperative for patients with hemodialysis in order to meet the challenges arising from hemodialysis. This study aimed to determine the effect of an educational app on patients with hemodialysis' self-efficacy and self-care. METHODS The present study is a quasi-experimental longitudinal single-group study, carried out from October 2020 to March 2021 with the participation of 60 Patients with hemodialysis. Simple random sampling was used to sample patients. The intervention included an educational application, and participants completed questionnaires on self-efficacy and self-care performance at four points including baseline and at one, three, and six-month intervals post- intervention. Two-way ANOVA with repeated measures was used to examine the impact of the intervention. Bonferroni's posthoc test was also used for in-class calculation and comparison of changes over various periods. RESULTS The results of this study showed that the self-care performance of patients at different times was statistically significant (P <0.001). Also, the results showed that the mean total score of self-efficacy in the second period compared to the first was significantly improved (P <0.001). But the trend of changes in the third period compared to the second and the fourth to the third was not significant (p = 0.1 and p = .82). Also, a significant change was observed in the fourth period compared to the first (p = .029). CONCLUSIONS The study showed that education through a mobile app can result in significant improvements in these patients' self-care behaviors and self-efficacy over time. The educational intervention should be provided to patients with hemodialysis over a several-month period to allow for proper integration of the learning.
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Affiliation(s)
- Amin Hosseini
- School of Nursing and Midwifery, Department of Medical Surgical Nursing, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, School of Nursing and Midwifery, 48439Tehran University of Medical Sciences, Tehran, Iran
| | - Alun C Jackson
- Australian Centre for Heart Health, Melbourne, Australia.,Faculty of Health, 95522Deakin University, Geelong, Australia.,Centre on Behavioural Health, Hong Kong University, Hong Kong, PRC
| | - Najmeh Chegini
- Students' Scientific Research Center, School of Nursing and Midwifery, 48439Tehran University of Medical Sciences, Tehran, Iran
| | | | - Danyal Mazloum
- Students' Scientific Research Center, School of Nursing and Midwifery, 48439Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Haghani
- School of Nursing and Midwifery, Department of Medical Surgical Nursing, 440827Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bahramnezhad
- Department of ICU and Nursing Management, School of Nursing & Midwifery, Nursing and Midwifery Care Research Center, 48439Tehran University of Medical Sciences, Tehran, Iran.,Spiritual Health Group, Research Center of Quran, Hadith and Medicine, 48439Tehran University of Medical Sciences, Tehran, Iran
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13
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Murphy BM, Navaratnam HS, Le Grande MR, Higgins RO, Rogerson MC, Elliott P, Worcester MUC, Jackson AC. Cognitive Behavioral Therapy Enhances Survival in Cardiac Patients Aged Under 60: 14-YEAR OUTCOMES OF THE BEATING HEART PROBLEMS PROGRAM TRIAL. J Cardiopulm Rehabil Prev 2023; 43:170-178. [PMID: 36862021 DOI: 10.1097/hcr.0000000000000753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
PURPOSE To optimize recovery and improve prognosis, people who have had an acute cardiac event (ACE) need support to manage their cardiac risk. In 2008, we conducted a randomized controlled trial (RCT) of Beating Heart Problems (BHP) , an 8-wk group program based on cognitive behavioral therapy (CBT) and motivational interviewing (MI), designed to improve behavioral and mental health. This study investigated 14-yr mortality status for RCT participants in order to evaluate the survival impact of the BHP program. METHODS In 2021, mortality data on 275 participants from the earlier RCT were obtained from the Australian National Death Index. Survival analysis was undertaken to investigate differences in survival for participants in the treatment and control groups. RESULTS Over the 14-yr follow-up period, there were 52 deaths (18.9%). For those aged <60 yr, there was a significant survival benefit to program participation, with 3% deaths in the treatment group and 13% deaths in the control group ( P = .022). For those aged ≥60 yr, the death rate was identical in both groups (30%). Other significant predictors of mortality included older age, higher 2-yr risk score, lower functional capacity, lower self-rated health, and having no private health insurance. CONCLUSIONS Participation in the BHP conferred a survival benefit for patients aged <60 yr but not for participants overall. The findings highlight the long-term benefit of behavioral and psychosocial management of cardiac risk through CBT and MI for those who are younger at the time of their first ACE.
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Affiliation(s)
- Barbara M Murphy
- Australian Centre for Heart Health, Melbourne, Victoria, Australia (Drs Murphy, Higgins, Rogerson, Worcester, and Jackson, Ms Navaratnam, and Mr Le Grande); Faculty of Health (Drs Murphy and Jackson and Mr Le Grande) and Department of Psychology (Dr Higgins), Deakin University, Geelong, Australia; Centre for Behaviour Change (Mr Le Grande), School of Psychological Sciences (Drs Murphy and Jackson), and Department of Physiotherapy (Dr Higgins) and Phoenix Australia Centre for Posttraumatic Mental Health (Dr Elliott), University of Melbourne, Melbourne, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia (Dr Worcester); and Centre on Behavioral Health, University of Hong Kong, Pokfulam, Hong Kong (Dr Jackson)
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14
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Liu T, Jackson AC, Menahem S. Adolescents and Adults With Congenital Heart Disease: Why Are They Lost to Follow-Up? World J Pediatr Congenit Heart Surg 2023; 14:357-363. [PMID: 36823988 DOI: 10.1177/21501351221149897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Almost 90% of infants with congenital heart disease (CHD) now reach adulthood but require long-term surveillance to recognize and manage residual and/or evolving lesions. Yet many are lost to follow-up. A scoping review identified four specific domains that pose barriers to consistent follow-up. There are multiple issues associated with transition from pediatric to adult care which included-the lack of a seamless transfer, the establishment of a new trusting relationship, promoting the right balance of patient autonomy and addressing knowledge gaps. Additional issues related to logistic problems of time, distance, cost, and the availability of specialized care, are further compounded by the psychosocial factors and the heterogeneity of the cardiac abnormality affecting our patients. Further study of all these issues is warranted to improve ongoing engagement.
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Affiliation(s)
- Tianwei Liu
- Department of Medical Education, University of Melbourne, Melbourne, Australia
| | - Alun C Jackson
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, Australia.,Australian Centre for Heart Health, Melbourne, Australia
| | - Samuel Menahem
- Australian Centre for Heart Health, Melbourne, Australia.,Department of Paediatrics and School of Clinical Sciences, Monash University, Clayton, Australia.,Murdoch Children's Research Institute, University of Melbourne, Melbourne, Australia
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15
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Hoseini Azizi T, Dehghan Nayeri N, Jackson AC, Bahramnezhad F. Mixed-methods study protocol for exploring the perception of nurses' resilience in the COVID-19 pandemic: Designing, implementing and evaluation of intervention. Nurs Open 2023; 10:4111-4119. [PMID: 36790876 PMCID: PMC10170888 DOI: 10.1002/nop2.1627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 12/21/2022] [Accepted: 01/13/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND While the necessity for interventions to build resilient nurses in the COVID-19 pandemic is recognized, there is disagreement about the effective methods for achieving this. AIM We present our research protocol that describes plans to design and test an interventional program for promoting nurses' resilience. DESIGN This sequential exploratory interventional mixed-methods study is conducted in three phases (qualitative, intervention design, and quantitative). METHODS It was funded from May 2021 for 24 months. In phase 1, we explored strategies for promoting resilience in the COVID-19 pandemic from nurses' perspectives (through semi-structured interviews). In phase 2, we will design an interventional program for promoting nurses' resilience (using the qualitative phase and literature review results). We will assess the program's effectiveness on nurses' resilience in a randomized controlled trial in phase 3. DISCUSSION Given the different experiences of nurses of resilience in COVID-19, our innovative program can guide future research to enhance nurses' resilience based on specific situations.
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Affiliation(s)
- Tooba Hoseini Azizi
- Department of Critical Care Nursing and Management, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.,School of Nursing, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Nahid Dehghan Nayeri
- School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alun C Jackson
- Australian Centre for Heart Health, Victoria, Melbourne, Australia.,Centre on Behavioural Health, Hong Kong University, Hong Kong, PRC
| | - Fatemeh Bahramnezhad
- School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Spiritual Health Group, Research Center of Quran, Hadith and Medicine, Tehran University of Medical Sciences, Tehran, Iran
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16
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Hosseini A, Jackson AC, Bahramnezhad F. Ethical Considerations in Interventional Studies: A Systematic Review Ethics and Interventional Study. ACTA 2023. [DOI: 10.18502/acta.v60i10.11550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Interventional studies are necessary to gain new knowledge in medical sciences; they can also be associated with several risks and impose high costs on patients and healthy people, and ethical considerations must be considered, as well. Understanding the ethical challenges and issues of interventional studies is essential. Using placebo, ethical consent, and clinical trials in specific groups are some of these challenges. This systematic review study was conducted to determine ethical considerations in interventional studies with an emphasis on the four ethical principles, including autonomy, non-maleficence principle, beneficence, and justice. Researchers in interventional studies should pay attention to ethics and take the necessary steps in line with these four biological principles.
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17
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Jackson AC, Grande MRL, Rogerson MC, Ski CF, Amerena J, Smith JA, Hoover V, Alvarenga ME, Higgins RO, Thompson DR, Murphy BM. The cardiac distress inventory: A new measure of psychosocial distress associated with an acute cardiac event. BMC Cardiovasc Disord 2022; 22:460. [PMID: 36329396 PMCID: PMC9633013 DOI: 10.1186/s12872-022-02897-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Background Many challenges are posed by the experience of a heart attack or heart surgery which can be characterised as ‘cardiac distress’. It spans multiple psychosocial domains incorporating patients’ responses to physical, affective, cognitive, behavioural and social symptoms and experiences related to their cardiac event and their recovery. Although some measures of the psychological and emotional impacts of a cardiac event exist, none provides a comprehensive assessment of cardiac distress. To address this gap, the study aimed to develop a Cardiac Distress Inventory (CDI) using best practice in instrument design. Method An item pool was generated through analysis of cognate measures, mostly in relation to other health conditions and through focus group and individual review by a multidisciplinary development team, cardiac patients, and end-users including cardiac rehabilitation co-ordinators. The resulting 144 items were reduced through further reviews to 74 for testing. The testing was carried out with 405 people recruited from three hospitals, through social media and by direct enrolment on the study website. A two-stage psychometric evaluation of the 74 items used exploratory factor analysis to extract the factors followed by Rasch analysis to confirm dimensionality within factors. Results Psychometric analysis resulted in the identification of 55 items comprising eight subscales, to form the CDI. The subscales assess fear and uncertainty, disconnection and hopelessness, changes to roles and relationships, overwhelm and depletion, cognitive challenges, physical challenges, health system challenges, and death concerns. Validation against the Kessler 6 supports the criterion validity of the CDI. Conclusion The CDI reflects a nuanced understanding of cardiac distress and should prove to be a useful clinical assessment tool, as well as a research instrument. Individual subscales or the complete CDI could be used to assess or monitor specific areas of distress in clinical practice. Development of a short form screening version for use in primary care, cardiac rehabilitation and counselling services is warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02897-y.
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Affiliation(s)
- Alun C Jackson
- Australian Centre for Heart Health, Melbourne, VIC, Australia. .,Centre on Behavioral Health, University of Hong Kong, Hong Kong SAR, China.
| | - Michael R Le Grande
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | | | - Chantal F Ski
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Integrated Care Academy, University of Suffolk, Ipswich, UK.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - John Amerena
- Barwon Health, Geelong, VIC, Australia.,Deakin School of Medicine, University Hospital Geelong, Geelong, VIC, Australia
| | - Julian A Smith
- Department of Cardiothoracic Surgery, Monash Health, Clayton, VIC, Australia.,Department of Surgery, School of Clinical Sciences at Monash Health), Monash University, Clayton, VIC, Australia
| | - Valerie Hoover
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Marlies E Alvarenga
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Institute of Health and Wellbeing, Federation University, Berwick, VIC, Australia.,Victorian Heart Institute, Clayton, VIC, Australia.,Monash Health & Department of Medicine, Monash University, Clayton, VIC, Australia
| | - Rosemary O Higgins
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Department of Physiotherapy, University of Melbourne, Parkville, VIC, Australia
| | - David R Thompson
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.,School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Barbara M Murphy
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
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18
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Murphy BM, Rogerson MC, Hesselson S, Iismaa SE, Graham RM, Jackson AC. Psychosocial impacts of spontaneous coronary artery dissection: A qualitative study. PLoS One 2022; 17:e0273978. [PMID: 36067201 PMCID: PMC9447895 DOI: 10.1371/journal.pone.0273978] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 08/18/2022] [Indexed: 12/17/2022] Open
Abstract
Spontaneous coronary artery dissection (SCAD) is an increasingly recognised cause of acute myocardial infarction, particularly in younger women without classic cardiac risk factors. While recent quantitative studies have noted high anxiety and depression in SCAD survivors, the full range and extent of psychosocial impacts of SCAD is unknown. The present study used a qualitative approach to investigate the psychosocial impacts of SCAD in Australian SCAD survivors. Focus group participants were recruited as part of a larger study of SCAD survivors currently being undertaken by the Victor Chang Cardiac Research Institute. Thirty SCAD survivors participated in one of seven online focus groups, conducted using a semi-structured format. Focus group duration was 1.5 hours. Each was digitally recorded and transcribed. Data were analyzed thematically according to recommended guidelines. One over-arching theme, five main themes and 26 sub-themes were identified. The over-arching theme related to lack of information, while the five main themes related to emotional impacts, issues with self-management, issues with family, impacts on work life, and the need for psychosocial support. The ‘emotional impacts’ theme comprised 11 sub-themes, namely shock and disbelief, confusion and uncertainty, unfairness, fear and anxiety, loss and grief, isolation and loneliness, guilt, invalidation and embarrassment, depression, vulnerability, and frustration. Findings are discussed in light of relevant psychological theories. This qualitative study extends previous quantitative investigations of SCAD survivors by providing an in-depth understanding of the complex, inter-related and highly distressing impacts of SCAD. The findings point to the urgent need for a coherent approach to information provision, the development and delivery of SCAD-specific cardiac rehabilitation programs, and the provision of psychosocial support programs for SCAD survivors.
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Affiliation(s)
- Barbara M. Murphy
- Australian Centre for Heart Health, Melbourne, Victoria, Australia
- Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
- * E-mail:
| | | | | | - Siiri E. Iismaa
- Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia
- St Vincent’s Clinical School, University of New South Wales, Sydney, Australia
| | - Robert M. Graham
- Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia
- St Vincent’s Clinical School, University of New South Wales, Sydney, Australia
| | - Alun C. Jackson
- Australian Centre for Heart Health, Melbourne, Victoria, Australia
- Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Center on Behavioral Health, University of Hong Kong, Pokfulam, Hong Kong
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19
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Parchami F, Jackson AC, Sharifi F, Parsapoor A, Bahramnezad F. Written and computer simulation on the moral sensitivity of nurses. Nurs Ethics 2022; 29:1739-1749. [PMID: 35801307 DOI: 10.1177/09697330221109945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Moral sensitivity is the first step towards ethical decision-making. This sensitivity should form a basic attitude in healthcare team members, particularly nurses, toward providing effective and ethical care. This is highlighted in intensive care units (ICUs) where close attention should be paid to patient rights and moral or ethical decision-making.Objective: The present study aimed at determining and comparing the effect of written simulation and computer simulation of a virtual patient on the development of moral sensitivity of ICU nurses.Research design: Randomized controlled trial with one control arm and two experimental arms.Participants and content: This study involved 204 ICU nurses working in hospitals affiliated to Tehran University of Medical Sciences, Tehran, Iran, from 2019 to 2021 using a random allocation method. The participants were allocated to three groups comprising virtual patient computer simulation, written simulation, and the no simulation control group. After training based on a Patient Rights Charter, five scenarios, with themes reflecting the clauses of the Patient's Rights Charter, were written as a computer program and text for the computer simulation and written simulation groups, respectively. Finally, nurses' moral sensitivity was assessed using the Lützén moral sensitivity questionnaire as pre- and post-tests (immediately and 2 months after the intervention).Ethical considerations: Ethical permission was obtained for the study. All the participants signed the informed consent before the study onset.Results: The study results showed a significant difference in moral sensitivity among the three groups before the intervention (p = 0.003). Immediately after the intervention compared to pre-intervention, the three groups showed no significant differences in this regard (p = 0.056), however a significant difference among the three groups was found 2 months post-intervention (p < 0.001).
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Affiliation(s)
- Faezeh Parchami
- School of Nursing and Midwifery, 48439Tehran University of Medical Sciences, Tehran, Iran
| | - Alun C Jackson
- Australian Centre for Heart Health, Melbourne, VIC, Australia; Faculty of Health, Deakin University, Geelong, VIC, Australia; Centre on Behavioural Health, Hong Kong University, Hong Kong, PRC, China
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Research Institute, 48439Tehran University of Medical Sciences, Tehran, Iran
| | | | - Fatemeh Bahramnezad
- School of Nursing & Midwifery, Nursing and Midwifery Care Research Center, Spiritual Health Group, Research Center of Quran, Hadith and Medicine,48439 Tehran University of Medical Sciences, Tehran, Iran
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Abstract
The diagnosis of potentially fatal diseases, such as COVID-19, may cause many critical reactions in dying patients and their relatives. Grief and fear of anticipatory death are natural, especially in the case of COVID-19. Although several studies have been conducted on anticipatory grief (AG) caused by cancer and dementia, the outbreak of COVID-19 could potentially intensify the AG rate among dying patients, their families and healthcare professionals. Therefore, mental health support, palliative and psychiatric care, and similar strategies should be taken into account when planning the treatment process and allocating resources during the COVID-19 pandemic. This commentary highlights the importance of addressing anticipatory grief during the COVID-19 pandemic and provides some recommendations for grief management for healthcare professionals.
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Affiliation(s)
- Ali Khanipour-Kencha
- Master's Student, Medical Surgical Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Alun C Jackson
- Director, Australian Centre for Heart Health, Honorary Professor, Faculty of Health, Deakin University, Honorary Professorial Fellow, Melbourne Graduate School of Education, University of Melbourne, and Honorary Professor, Centre on Behavioral Health, Hong Kong University
| | - Fatemeh Bahramnezhad
- Assistant Professor, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran, and Spiritual Health Group, Research Center of Quran, Hadith and Medicine, Tehran University of Medical Sciences, Tehran, Iran
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21
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Jackson AC, Rogerson MC, Amerena J, Smith J, Hoover V, Alvarenga ME, Higgins RO, Grande MRL, Ski CF, Thompson DR, Murphy BM. Unraveling the Complexity of Cardiac Distress: A Study of Prevalence and Severity. Front Psychiatry 2022; 13:808904. [PMID: 35432039 PMCID: PMC9009040 DOI: 10.3389/fpsyt.2022.808904] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 02/23/2022] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION While much research attention has been paid to anxiety and depression in people who have had a recent cardiac event, relatively little has focused on the broader concept of cardiac distress. Cardiac distress is a multidimensional construct that incorporates but extends beyond common mood disorders such as anxiety and depression. In the present study we assessed the prevalence, severity and predictors of a broad range of physical, affective, cognitive, behavioral and social symptoms of cardiac distress. This is the first study to investigate cardiac distress in this comprehensive way. METHOD A sample of 194 patients was recruited from two hospitals in Australia. Eligible participants were those who had recently been hospitalized for an acute cardiac event. Data were collected at patients' outpatient clinic appointment ~8 weeks after their hospital discharge. Using a questionnaire developed through a protocol-driven 3-step process, participants reported on whether they had experienced each of 74 issues and concerns in the past 4 weeks, and the associated level of distress. They also provided sociodemographic and medical information. Regression analyses were used to identify risk factors for elevated distress. RESULTS Across the 74 issues and concerns, prevalence ratings ranged from a high of 66% to a low of 6%. The most commonly endorsed items were within the domains of dealing with symptoms, fear of the future, negative affect, and social isolation. Common experiences were "being physically restricted" (66%), "lacking energy" (60%), "being short of breath" (60%), "thinking I will never be the same again" (57%), and "not sleeping well" (51%). While less prevalent, "not having access to the health care I need," "being concerned about my capacity for sexual activity," and "being unsupported by family and friends" were reported as highly distressing (74, 64, and 62%) for those experiencing these issues. Having a mental health history and current financial strain were key risk factors for elevated distress. CONCLUSION AND IMPLICATIONS Specific experiences of distress appear to be highly prevalent in people who have had a recent cardiac event. Understanding these specific fears, worries and stressors has important implications for the identification and management of post-event mental health and, in turn, for supporting patients in their post-event cardiac recovery.
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Affiliation(s)
- Alun C Jackson
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Center on Behavioral Health, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Behavioral Health, University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | | | - John Amerena
- Barwon Health, Geelong, VIC, Australia.,Deakin School of Medicine, University Hospital Geelong, Geelong, VIC, Australia
| | - Julian Smith
- Department of Cardiothoracic Surgery, Monash Health, Melbourne, VIC, Australia.,Department of Surgery, School of Clinical Sciences, Monash Health, Melbourne, VIC, Australia
| | - Valerie Hoover
- Psychiatry and Behavioral Sciences, Stanford Women's Heart Health Clinic, Stanford, CA, United States
| | - Marlies E Alvarenga
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,School of Health and Life Sciences, Federation University Australia, Berwick, VIC, Australia.,Victorian Heart Institute, Melbourne, VIC, Australia.,Monash Health & Department of Medicine, Monash University, Melbourne, VIC, Australia
| | - Rosemary O Higgins
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Department of Psychology, Deakin University, Geelong, VIC, Australia.,Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia
| | - Michael R Le Grande
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Centre for Behaviour Change, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Chantal F Ski
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Integrated Care Academy, University of Suffolk, Ipswich, United Kingdom.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - David R Thompson
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.,School of Nursing and Midwifery, Queen's University Belfast, Belfast, United Kingdom
| | - Barbara M Murphy
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Center on Behavioral Health, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Department of Psychology, University of Melbourne, Melbourne, VIC, Australia
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22
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Rogerson MC, Jackson AC, Navaratnam HS, Le Grande MR, Higgins RO, Clarke J, Murphy BM. Getting "Back on Track" After a Cardiac Event: Protocol for a Randomized Controlled Trial of a Web-Based Self-management Program. JMIR Res Protoc 2021; 10:e34534. [PMID: 34941550 PMCID: PMC8738993 DOI: 10.2196/34534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/15/2021] [Indexed: 11/28/2022] Open
Abstract
Background After a cardiac event, a large majority of patients with cardiac conditions do not achieve recommended behavior change targets for secondary prevention. Mental health issues can also impact the ability to engage in health behavior change. There is a need for innovative, flexible, and theory-driven eHealth programs, which include evidence-based strategies to assist patients with cardiac conditions with their recovery, especially in behavioral and emotional self-management. Objective The aim of this study is to determine the short- and longer-term behavioral and emotional well-being outcomes of the Back on Track web-based self-management program. In addition, this study will test whether there is enhanced benefit of providing one-on-one telephone support from a trained lifestyle counselor, over and above benefit obtained through completing the web-based program alone. Methods People who have experienced a cardiac event in the previous 12 months and have access to the internet will be eligible for this study (N=120). Participants will be randomly assigned to one of the two study conditions: either “self-directed” completion of the Back on Track program (without assistance) or “supported” completion of the Back on Track program (additional 2 telephone sessions with a lifestyle counselor). All participants will have access to the web-based Back on Track program for 2 months. Telephone sessions with the supported arm participants will occur at approximately 2 and 6 weeks post enrollment. Measures will be assessed at baseline, and then 2 and 6 months later. Outcome measures assessed at all 3 timepoints include dietary intake, physical activity and sitting time, smoking status, anxiety and depression, stage of change, and self-efficacy in relation to behavioral and emotional self-management, quality of life, and self-rated health and well-being. A demographic questionnaire will be included at baseline only and program acceptability at 2 months only. Results Recruitment began in May 2020 and concluded in August 2021. Data collection for the 6-month follow-up will be completed by February 2022, and data analysis and publication of results will be completed by June 2022. A total of 122 participants were enrolled in this study. Conclusions The Back on Track trial will enable us to quantify the behavioral and emotional improvements obtained and maintained for patients with cardiac conditions and, in particular, to compare two modes of delivery: (1) fully self-directed delivery and (2) supported by a lifestyle counselor. We anticipate that the web-based Back on Track program will assist patients in their recovery and self-management after an acute event, and represents an effective, flexible, and easily accessible adjunct to center-based rehabilitation programs. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12620000102976; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378920&isReview=true International Registered Report Identifier (IRRID) DERR1-10.2196/34534
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Affiliation(s)
| | - Alun C Jackson
- Australian Centre for Heart Health, North Melbourne, Australia.,Faculty of Health, Deakin University, Geelong, Australia.,Centre on Behavioral Health, University of Hong Kong, Pokfulam, China
| | | | | | - Rosemary O Higgins
- Australian Centre for Heart Health, North Melbourne, Australia.,Department of Psychology, Deakin University, Geelong, Australia.,Department of Physiotherapy, University of Melbourne, Melbourne, Australia
| | - Joanne Clarke
- Australian Centre for Heart Health, North Melbourne, Australia
| | - Barbara M Murphy
- Australian Centre for Heart Health, North Melbourne, Australia.,Faculty of Health, Deakin University, Geelong, Australia.,Department of Psychology, University of Melbourne, Melbourne, Australia
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Ghorbani B, Jackson AC, Noorchenarboo M, Mandegar MH, Sharifi F, Mirmoghtadaie Z, Bahramnezhad F. Comparing the Effects of Gamification and Teach-Back Training Methods on Adherence to a Therapeutic Regimen in Patients After Coronary Artery Bypass Graft Surgery: Randomized Clinical Trial. J Med Internet Res 2021; 23:e22557. [PMID: 34890346 PMCID: PMC8709912 DOI: 10.2196/22557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/06/2020] [Accepted: 03/05/2021] [Indexed: 12/28/2022] Open
Abstract
Background Patients undergoing coronary artery bypass graft surgery (CABGS) may fail to adhere to their treatment regimen for many reasons. Among these, one of the most important reasons for nonadherence is the inadequate training of such patients or training using inappropriate methods. Objective This study aimed to compare the effect of gamification and teach-back training methods on adherence to a therapeutic regimen in patients after CABGS. Methods This randomized clinical trial was conducted on 123 patients undergoing CABGS in Tehran, Iran, in 2019. Training was provided to the teach-back group individually. In the gamification group, an app developed for the purpose was installed on each patient’s smartphone, with training given via this device. The control group received usual care, or routine training. Adherence to the therapeutic regimen was assessed using a questionnaire on adherence to a therapeutic regimen (physical activity and dietary regimen) and an adherence scale as a pretest and a 1-month posttest. Results One-way analysis of variance (ANOVA) for comparing the mean scores of teach-back and gamification training methods showed that the mean normalized scores for the dietary regimen (P<.001, F=71.80), movement regimen (P<.001, F=124.53), and medication regimen (P<.001, F=9.66) before and after intervention were significantly different between the teach-back, gamification, and control groups. In addition, the results of the Dunnett test showed that the teach-back and gamification groups were significantly different from the control group in all three treatment regimen methods. There was no statistically significant difference in adherence to the therapeutic regimen between the teach-back and control groups. Conclusions Based on the results of this study, the use of teach-back and gamification training approaches may be suggested for patients after CABGS to facilitate adherence to the therapeutic regimen. Trial Registration Iranian Registry of Clinical Trials IRCT20111203008286N8; https://en.irct.ir/trial/41507
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Affiliation(s)
- Banafsheh Ghorbani
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Alun C Jackson
- Australian Centre for Heart Health, Melbourne, Australia.,Faculty of Health, Deakin University, Geelong, Australia.,Centre on Behavioural Health, Hong Kong University, Hong Kong, China
| | | | - Mohammad H Mandegar
- Department of Cardiac Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Fatemeh Bahramnezhad
- School of Nursing & Midwifery, Nursing and Midwifery Care Research Center, Spiritual Health Group, Research Center of Quran, Hadith and Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Bahramnezhad F, Sanaie N, Jackson AC, Shariati E, Atashzadeh-Shoorideh F. The of effect of partnership-based education on adherence to the treatment plans in open heart surgery. J Educ Health Promot 2021; 10:353. [PMID: 34761039 PMCID: PMC8552276 DOI: 10.4103/jehp.jehp_1463_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 03/30/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Adherence to the treatment plans is one of the most effective conducts to prevent and reduce postoperative side effects. Partnership-based education is one of the most efficient ways to shape health behaviors. The aim of the present study was to determine the effect of partnership-based education on adherence to the treatment plans in open heart surgery. MATERIALS AND METHODS This quasi-experimental study was conducted in 2019-2020 on the patients undergoing open heart surgery in Tehran (Capital of Iran). Sampling was done in one educational hospital. A total of 86 patients and their caregivers participated in the study. Sampling was done nonrandomly by tossing a coin, and patients were allocated into the odd week in the intervention group and the even week in the control group (n = 43 in each group), and data were collected before and after intervention using the Treatment Adherence Questionnaire concerning dietary, physical activity, and medication aspects. The educational intervention was carried out after the pretest analysis in five 20-45 min sessions (two individual and three group educations). Data were analyzed with Chi-square, independent t-test, and paired t-test using SPSS 19 at a significance level of P < 0.05. RESULTS Patients and caregivers in both groups did not have a significant difference in terms of demographic variables (P > 0. 05). In addition, there was no significant difference in the mean of dietary, physical activity, and medication plans before the intervention in both groups; however, after the intervention, the mean of the three aspects in the intervention group was significantly higher than that of control (P < 0.001). CONCLUSION Implementing partnership-based education with participation of patients and caregivers is influential in improving patients' adherence to the treatment plans and it is recommended as a clinical dynamic educational strategy.
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Affiliation(s)
- Fatemeh Bahramnezhad
- Department of Critical Care Nursing, School of Nursing and Midwifery, Nursing and Midwifery Care Research Centre, Spiritual Health Group, Research Center of Quran, Hadith and Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Sanaie
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alun C. Jackson
- Australian Centre for Heart Health, Melbourne Australia
- Faculty of Health, Deakin University, Geelong Australia
- Honorary Professor, Centre on Behavioural Health, Hong Kong University, Hong Kong
| | - Esmail Shariati
- Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Foroozan Atashzadeh-Shoorideh
- Department of Psychiatric Nursing and Management, School of Nursing and Midwifery, Shahid Labbafinezhad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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25
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Asgari P, Jackson AC, Esmaeili M, Hosseini A, Bahramnezhad F. Nurses' experience of patient care using extracorporeal membrane oxygenation. Nurs Crit Care 2021; 27:258-266. [PMID: 34350667 DOI: 10.1111/nicc.12684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 06/22/2021] [Accepted: 07/03/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Extracorporeal membrane oxygenation (ECMO) is an advanced form of temporary life support, to aid respiratory and/or cardiac function, which diverts venous blood through an extracorporeal circuit and returns it to the body after gas exchange through a semipermeable membrane. It may be used for oxygenation, carbon dioxide removal, and hemodynamic support. ECMO has been available to patients in Iran for only about 4 years. Because nurses do not widely use ECMO in Intensive Care Units (ICUs), for many it is still a unique experience and more needs to be understood about that experience in order to support nurses in that role. AIM This study aimed to explore Iranian nurses' experience of caring for patients receiving ECMO. METHODS This interpretive phenomenological study was conducted in Iran in 2019. Semi-structured interviews were conducted in Farsi to collect data from 18 nurses who had cared for patients receiving ECMO. The interviews continued until data saturation, and thematic analysis of the interview transcripts was undertaken. RESULTS Following thematic analysis, three main themes of "running on a suspension bridge," "sense of duality," and "bewilderment in the mirage of hope," and with seven sub-themes, emerged. CONCLUSION Based on the results of this study, it is proposed that caring for patients receiving ECMO is a source of emotional turmoil for nurses. Nurses are constantly thinking about whether their patients receiving ECMO are recovering or dying, and the nature of this care may lead to stress and burnout. Therefore, it is recommended that these nurses receive counselling and psychological support. RELEVANCE TO CLINICAL PRACTICE Nurses are able to provide comprehensive and holistic patient care when they enjoy good physical and mental health themselves. To prevent distress in nurses and to provide safe care for the patient receiving ECMO, provision of psychological support for these nurses is recommended.
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Affiliation(s)
- Parvaneh Asgari
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Alun C Jackson
- Australian Centre for Heart Health, Melbourne, Victoria, Australia.,Faculty of Health, Deakin University, Geelong, Victoria, Australia.,Centre on Behavioural Health, Hong Kong University, Hong Kong, PR China
| | - Maryam Esmaeili
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.,Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Hosseini
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bahramnezhad
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.,Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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26
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Dowling NA, Oldenhof E, Cockman S, Suomi A, Merkouris SS, Jackson AC. Problem Gambling and Family Violence: Factors Associated With Family Violence Victimization and Perpetration in Treatment-Seeking Gamblers. J Interpers Violence 2021; 36:7645-7669. [PMID: 30894040 DOI: 10.1177/0886260519835877] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Although problem gambling and family violence are related, there is little available research exploring the factors associated with this relationship. The primary aim was to predict family violence (victimization and perpetration) in a sample of treatment-seeking gamblers by gambling indices (gambling symptom severity, gambling time spent, gambling frequency, gambling expenditure), psychological distress, post-traumatic stress disorder (PTSD) symptoms, gambling coping motives, alcohol and drug use, gambling-related legal consequences, work and social adjustment, impulsivity, and gender. A secondary aim was to explore the degree to which these factors moderate the relationship between gambling symptom severity and family violence. Participants (n = 141) were consecutively recruited gamblers presenting to a gambling counseling service. The prevalence of family violence was 25.5%, with 18.4% reporting victimization and 19.1% reporting perpetration. Intimate partners and parents were most likely to be both perpetrators and victims of family violence. Victimization was significantly predicted by psychological distress, symptoms of PTSD, and gambling-related legal consequences, while perpetration was significantly predicted by gambling symptom severity, gambling-related legal consequences, and impulsivity. The association between gambling symptom severity and victimization was significant only for gamblers with low levels of gambling coping motives and moderate or high levels of alcohol use. These findings provide further support for routine screening in problem gambling and family violence services, particularly those who report gambling-related legal consequences; highlight the need for prevention and intervention programs to lower the co-occurrence of these behaviors; and suggest that reducing psychological distress, symptoms of PTSD, alcohol use, and impulsivity may be important in these efforts.
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Affiliation(s)
- Nicki A Dowling
- Deakin University, Geelong, Victoria, Australia
- University of Melbourne, Parkville, Victoria, Australia
| | | | - Sue Cockman
- University of Melbourne, Parkville, Victoria, Australia
| | - Aino Suomi
- University of Melbourne, Parkville, Victoria, Australia
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27
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Asgari P, Jackson AC, Khanipour-Kencha A, Bahramnezhad F. A Resilient Care of the Patient With COVID-19: A Phenomenological Study. Int Q Community Health Educ 2021; 43:272684X211033454. [PMID: 34304613 DOI: 10.1177/0272684x211033454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study a utilized phenomenological hermeneutic design. Fourteen Iranian family caregivers of patients with COVID-19 who were isolated at home were included in the study using purposive sampling. In-depth unstructured interviews were conducted via WhatsApp. Sampling continued until data saturation. Interviews were transcribed and analyzed using Van Manen's approach. Three primary themes and eight subthemes emerged. The primary themes included: "captured in a whirlpool of time", "resilient care' and "feeling helpless". It seems that the families of patients with COVID-19 attempt to resist the pressures of this disease with religious practices and problem solving. However, due to the nature of the disease and its severity, they sometimes feel ashamed or lonely and are afraid of losing their loved ones. It is recommended that psychiatric nurses should develop programs in the form of comprehensive spiritual care packages or psychological support and utilize multiple media channels to deliver these.
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Affiliation(s)
- Parvaneh Asgari
- School of Nursing and Midwifery, 48439Tehran University of Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Alun C Jackson
- Australian Centre for Heart Health, Melbourne Australia
- Faculty of Health, Deakin University, Geelong, Australia
- Centre on Behavioural Health, Hong Kong University, Hong Kong, PRC
| | - Ali Khanipour-Kencha
- School of Nursing and Midwifery, 48439Tehran University of Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bahramnezhad
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- Spiritual Health Group, Research Center of Quran, Hadith and Medicine, , Tehran University of Medical Sciences, Tehran, Iran
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28
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Ofori Dei SM, Christensen DR, Awosoga OA, Lee BK, Jackson AC. Correction to: A Composite Measure of Gambling Exposure: Availability, Accessibility or Both? J Gambl Stud 2021; 37:1311. [PMID: 33835402 DOI: 10.1007/s10899-021-10026-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S M Ofori Dei
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada
| | - D R Christensen
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada. .,Melbourne Graduate School of Education, University of Melbourne, Melbourne, Australia.
| | - O A Awosoga
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada
| | - B K Lee
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada
| | - A C Jackson
- Australian Centre for Heart Health, North Melbourne, Australia.,Faculty of Health, Deakin University, North Melbourne, Australia.,Melbourne Graduate School of Education, University of Melbourne, Melbourne, Australia.,Centre on Behavioral Health, University of Hong Kong, Hong Kong, China
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29
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Murphy BM, Zaman S, Tucker K, Alvarenga M, Morrison-Jack J, Higgins R, Le Grande M, Nasis A, Jackson AC. Enhancing the appeal of cardiac rehabilitation for women: development and pilot testing of a women-only yoga cardiac rehabilitation programme. Eur J Cardiovasc Nurs 2021; 20:633-640. [PMID: 33748850 DOI: 10.1093/eurjcn/zvab008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/14/2020] [Accepted: 01/20/2021] [Indexed: 11/13/2022]
Abstract
AIMS Despite its demonstrated benefits, cardiac rehabilitation (CR) attendance, and completion is suboptimal, particularly in women. The aims of this study were (i) to develop and pilot test a women-only yoga-based CR programme (the Women's Yoga CR Programme; WYCRP); (ii) to investigate programme acceptability; and (iii) to investigate attendance and completion of the WYCRP and continuation to Phase III community-based CR. METHODS AND RESULTS Women eligible for CR at a tertiary hospital in Melbourne, Australia were recruited. Over a 6-month period in 2019, they were offered the WYCRP or usual CR. The WYCRP involved attendance at a 1-h yoga session following the usual 1-h mixed-sex education session, over a 7-week period. Participants completed pre- and post-programme questionnaires and attended focus groups to assess programme acceptability. Rates of attendance, completion, and continuation for the WYCRP were recorded and compared to those for the standard CR programme offered in 2018. In total, 27 women were eligible for the study and attended the initial CR assessment. Of those, 22 (81%) attended the WYCRP, 1 (4%) attended usual CR, and 4 (15%) did not attend CR. Ratings of programme acceptability were consistently positive; qualitative comments highlighted both physical and emotional benefits. While attendance at the WYCRP was not significantly higher than for usual CR the previous year (81% vs. 76%; P = 0.40), CR completion, and continuation were (95% vs. 56%; P = 0.02, and 72% vs. 12%; P < 0.001, respectively). CONCLUSION This pilot study has demonstrated that women-only yoga-based CR is appealing to women and can improve women's CR completion and continuation. These preliminary findings support further development of women-only and yoga-based CR options.
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Affiliation(s)
- Barbara M Murphy
- Australian Centre for Heart Health, 75-79 Chetwynd Street, North Melbourne, 3051, Melbourne, VIC, Australia.,Faculty of Health, Deakin University, Melbourne, VIC, Australia.,Department of Psychology, University of Melbourne, Parkville, VIC, Australia
| | - Sarah Zaman
- MonashHeart, Monash Health, Clayton, VIC, Australia.,Monash Cardiovascular Research Centre, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Kim Tucker
- Australian Centre for Heart Health, 75-79 Chetwynd Street, North Melbourne, 3051, Melbourne, VIC, Australia.,MonashHeart, Monash Health, Clayton, VIC, Australia
| | - Marlies Alvarenga
- Australian Centre for Heart Health, 75-79 Chetwynd Street, North Melbourne, 3051, Melbourne, VIC, Australia.,MonashHeart, Monash Health, Clayton, VIC, Australia
| | - Jenni Morrison-Jack
- Australian Centre for Heart Health, 75-79 Chetwynd Street, North Melbourne, 3051, Melbourne, VIC, Australia.,Ihana Yoga Centre, St Kilda, VIC, Australia
| | - Rosemary Higgins
- Australian Centre for Heart Health, 75-79 Chetwynd Street, North Melbourne, 3051, Melbourne, VIC, Australia
| | - Michael Le Grande
- Australian Centre for Heart Health, 75-79 Chetwynd Street, North Melbourne, 3051, Melbourne, VIC, Australia.,Faculty of Health, Deakin University, Melbourne, VIC, Australia
| | - Arthur Nasis
- MonashHeart, Monash Health, Clayton, VIC, Australia
| | - Alun C Jackson
- Australian Centre for Heart Health, 75-79 Chetwynd Street, North Melbourne, 3051, Melbourne, VIC, Australia.,Faculty of Health, Deakin University, Melbourne, VIC, Australia.,Centre on Behavioural Health, University of Hong Kong, Pok Fu Lam, Hong Kong
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Asgari P, Jackson AC, Bahramnezhad F. Adjustment to a New Heart: Concept Analysis Using a Hybrid Model. Iran J Nurs Midwifery Res 2021; 26:89-96. [PMID: 34036054 PMCID: PMC8132861 DOI: 10.4103/ijnmr.ijnmr_9_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/29/2020] [Accepted: 12/29/2020] [Indexed: 11/04/2022]
Abstract
Background Although the phenomenon of adjustment to a new heart in transplant recipients is very complex, very few studies have been conducted on this important issue. Therefore, no careful and clear definition exists for this concept. Materials and Methods This concept analysis was conducted in Iran in 2018 on 13 patients undergoing heart transplantation. In the theoretical phase, a conceptual framework was created according to the existing data in the literature about the phenomenon. In this study, 13 participants were selected using purposive sampling with maximum diversity.-Ž In the fieldwork phase, 20 deep and semistructured interviews were conducted with patients undergoing heart transplantation over 4 months. After data saturation, interviews were analyzed using the qualitative content analysis method proposed by Granheim and Lundman (2009). At the final analytical phase, the results of the two previous phases were integrated using a hybrid model. Results Adjustment to a new heart is a unique multiphase process in patients undergoing heart transplantation. The antecedents include the transplantation time, physical conditions, social and family support, relationship with congeners, and spiritual beliefs. The desirable consequences of adjustment to a new heart may include a new life, inner peace, and spiritual excellence, and the undesirable consequences may include psychological abuse and emotional stagnation. Conclusions According to the results, the health-care team should consider the patient as a unique client and initiate discussions before and following heart transplantation that address patients' adjustment to a new heart in all their physical, sexual, and emotional aspects.
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Affiliation(s)
- Parvaneh Asgari
- PhD Candidate in Nursing Education, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Alun C Jackson
- Australian Centre for Heart Health, Melbourne, Australia.,Faculty of Health, Deakin University, Geelong, Australia.,Honorary Professor, Centre on Behavioural Health, Hong Kong University, Hong Kong, PRC
| | - Fatemeh Bahramnezhad
- Departments of Critical Care Nursing, Nursing and Midwifery Care Research Center, Spiritual Health Group, Research Center of Quran, Hadith and Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Le Grande MR, Jackson AC, Beauchamp A, Kerr D, Driscoll A. Diagnostic accuracy and suitability of instruments that screen for obstructive sleep apnoea, insomnia and sleep quality in cardiac patients: a meta-analysis. Sleep Med 2021; 86:135-160. [PMID: 33674192 DOI: 10.1016/j.sleep.2021.02.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/29/2021] [Accepted: 02/08/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND A number of clinical guidelines recommend that all cardiac rehabilitation patients should be screened for potential sleep disorders with a validated screening instrument. There is currently no consensus on what specific tools should be used. OBJECTIVE To identify tools that are practical to use in the clinical environment and have high diagnostic accuracy. METHODS We systematically searched online databases to identify patient reported outcome instruments that have been used in published research studies to assess the likelihood of obstructive sleep apnoea (OSA) in cardiac patients. In studies that provided diagnostic data, these data were extracted and verified via an evidence-based diagnostic calculator. Where sufficient numbers of studies were available, a meta-analysis was conducted to determine pooled estimates of specificity, sensitivity and diagnostic odds ratios. Selected papers were qualitatively assessed using the Standards for Reporting Diagnostic accuracy studies (STARD). RESULTS Of the 21 instruments identified, six detected likelihood of OSA, two assessed daytime sleepiness, five assessed insomnia and eight examined sleep quality. A meta-analysis of 14 studies that assessed diagnostic accuracy of moderate OSA, revealed moderate sensitivity for the Berlin Questionnaire, Sens = 0.49 (95% CI 0.45-0.52) and good sensitivity for the Stop-BANG, Sens = 0.93 (95% CI 0.87-0.96) but poor specificity at standard cut-off criteria. CONCLUSION There are promising practical tools available to screen patients with OSA and other sleep disorders in cardiac rehabilitation settings, but specificity could be improved. Additional assessment of sleep quality may enhance prognostic ability with both OSA and insomnia screening.
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Affiliation(s)
- Michael R Le Grande
- Australian Centre for Heart Health, 75 Chetwynd Street, North Melbourne, VIC, 3051, Australia; Faculty of Health, Deakin University, Burwood, VIC, 3216, Australia; Melbourne Centre for Behaviour Change, School of Psychological Sciences, The University of Melbourne, Parkville, VIC, 3052, Australia.
| | - Alun C Jackson
- Australian Centre for Heart Health, 75 Chetwynd Street, North Melbourne, VIC, 3051, Australia; Faculty of Health, Deakin University, Burwood, VIC, 3216, Australia; Centre on Behavioural Health, Hong Kong University, Pakfulam, Hong Kong
| | - Alison Beauchamp
- Australian Centre for Heart Health, 75 Chetwynd Street, North Melbourne, VIC, 3051, Australia; Department of Medicine - Western Health, The University of Melbourne, VIC, 3052, Australia; Australian Institute for Musculoskeletal Science (AIMSS), St. Albans, VIC, 3021, Australia; School of Rural Health, Monash University, Newborough, VIC, 3825, Australia
| | - Debra Kerr
- Faculty of Health, Deakin University, Burwood, VIC, 3216, Australia
| | - Andrea Driscoll
- Faculty of Health, Deakin University, Burwood, VIC, 3216, Australia; Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Geelong, VIC, 3220, Australia
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Ofori Dei SM, Christensen DR, Awosoga OA, Lee BK, Jackson AC. The Relative and Interactive Effects of Actual and Perceived Gambling Exposure on Gambling Behaviour. J Gambl Stud 2021; 37:853-874. [PMID: 33481142 DOI: 10.1007/s10899-020-09991-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 10/22/2022]
Abstract
Actual and perceptual measures of gambling exposure are important predictors of problem gambling. This study used Zero-Inflated Poisson regression analyses to assess the relative and interactive effects of actual and perceived exposure on problem gambling risk and severity. Data from the 2008 and 2009 Social and Economic Impacts of Gambling in Alberta surveys indicated actual exposure was significantly associated with problem gambling risk while perceived exposure was significantly associated with problem gambling severity. These associations differ for gamblers from emerging and mature areas. Further, actual and perceived exposure had significant interaction effects on problem gambling severity but not on risk. Implications from these findings suggest that the prevalence of problem gambling could be reduced by restrictions on gambling opportunities.
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Affiliation(s)
- S M Ofori Dei
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada
| | - D R Christensen
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada. .,Melbourne Graduate School of Education, University of Melbourne, Parkville, Australia.
| | - O A Awosoga
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada
| | - B K Lee
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada
| | - A C Jackson
- Australian Centre for Heart Health, North Melbourne, Australia.,Faculty of Health, Deakin University, Melbourne, Australia.,Melbourne Graduate School of Education, University of Melbourne, Parkville, Australia.,Centre on Behavioural Health, University of Hong Kong, Pok Fu Lam, Hong Kong
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Dowling NA, Francis KL, Dixon R, Merkouris SS, Thomas SA, Frydenberg E, Jackson AC. "It Runs in Your Blood": Reflections from Treatment Seeking Gamblers on Their Family History of Gambling. J Gambl Stud 2020; 37:689-710. [PMID: 32671673 DOI: 10.1007/s10899-020-09959-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
There are considerable gaps in our understanding of the familial transmission of gambling problems. This convergent mixed-methods study aimed to explore the: (1) sources of heterogeneity in the familial (paternal, maternal, and sibling) transmission of gambling problems; (2) degree to which family-of-origin characteristics are associated with family-of-origin problem gambling; and (3) beliefs of gamblers about the nature of the familial transmission of problem gambling. The sample consisted of 97 treatment-seeking gamblers in Australia. One-quarter (25.5%) of participants reported that at least one family member (16.5% father, 7.5% mother, 7.6% siblings) living with them when they were growing up had a gambling problem. Most participants reported that family members with a positive history of problem gambling were biological relatives, lived with them full-time, and experienced long-term difficulties with gambling. Participants with a family history of problem gambling were young (less than 12 years of age) at the onset of parental, but not sibling, problem gambling, were women, and reported difficulties with the same gambling activity as their family member. Participants raised in families with problem gambling were more likely to report parental separation (risk ratio [RR] = 2.32) and divorce (RR = 2.83), and extreme family financial hardship (RR = 1.80), as well as low levels of paternal authoritative parenting than participants raised in non-problem gambling families. Qualitatively, both social learning and genetics were perceived to play a central role in the familial transmission of gambling problems. These findings inform theories of the familial transmission of gambling problems and the design of targeted prevention and intervention strategies.
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Affiliation(s)
- N A Dowling
- School of Psychology, Deakin University, Deakin Geelong, Geelong, Australia. .,Melbourne Graduate School of Education, University of Melbourne, Parkville, Australia.
| | - K L Francis
- Murdoch Children's Research Institute, Melbourne, Australia
| | - R Dixon
- School of Psychological Sciences, Monash University, Clayton, Australia
| | - S S Merkouris
- School of Psychology, Deakin University, Deakin Geelong, Geelong, Australia
| | - S A Thomas
- Research School in Population Health, Australian National University, Canberra, Australia.,International Primary Health Care Research Institute, Shenzhen, China
| | - E Frydenberg
- Melbourne Graduate School of Education, University of Melbourne, Parkville, Australia
| | - A C Jackson
- Melbourne Graduate School of Education, University of Melbourne, Parkville, Australia
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Affiliation(s)
- Alun C Jackson
- Australian Centre for Heart Health, Melbourne, Victoria, Australia
- Faculty of Health, Deakin University, Geelong, Victoria, Australia
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Le Grande MR, Beauchamp A, Driscoll A, Jackson AC. Prevalence of obstructive sleep apnoea in acute coronary syndrome patients: systematic review and meta-analysis. BMC Cardiovasc Disord 2020; 20:147. [PMID: 32209053 PMCID: PMC7092582 DOI: 10.1186/s12872-020-01430-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 03/12/2020] [Indexed: 12/26/2022] Open
Abstract
Background Obstructive Sleep Apnoea (OSA) has been recognised as a risk factor for cardiovascular diseases such as hypertension and cardiovascular events such as acute coronary syndrome (ACS). Since it is also known to reduce exercise tolerance, it is important to establish the prevalence of OSA in ACS patients, particularly in those who are commencing cardiac rehabilitation (CR) programs. Methods Using PRISMA guidelines a systematic search was conducted in order to identify studies that objectively measured (using polysomnography or portable monitoring) the prevalence of OSA in ACS patients following hospital admission. A data extraction table was used to summarise study characteristics and the quality of studies were independently assessed using the Joanna Briggs Institute Prevalence Critical Appraisal Tool. Meta-analysis of the selected studies was conducted in order to estimate OSA prevalence as a function of the two main methods of measurement, the severity of OSA, and timing of the OSA assessment following ACS hospital admission. Results Pooled prevalence estimates of OSA using the “gold standard” polysomnography ranged from 22% for severe OSA to 70% for mild OSA, at any time after hospital admission. Similar prevalence estimates were obtained using portable monitoring, but interpretation of these results are limited by the significant heterogeneity observed among these studies. Conclusions Prevalence of OSA following ACS is high and likely to be problematic upon patient entry into CR programs. Routine screening for OSA upon program entry may be necessary to optimise effectiveness of CR for these patients.
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Affiliation(s)
- Michael R Le Grande
- Australian Centre for Heart Health, 75 Chetwynd Street, North Melbourne, VIC, 3051, Australia. .,Faculty of Health, Deakin University, Burwood, VIC, 3216, Australia. .,Melbourne Centre for Behaviour Change, School of Psychological Sciences, The University of Melbourne, Parkville, VIC, 3052, Australia.
| | - Alison Beauchamp
- Australian Centre for Heart Health, 75 Chetwynd Street, North Melbourne, VIC, 3051, Australia.,Department of Medicine -Western Health, The University of Melbourne, Parkville, VIC, 3052, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), St.Albans, VIC, 3021, Australia.,School of Rural Health, Monash University, Newborough, VIC, 3825, Australia
| | - Andrea Driscoll
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Geelong, VIC, 3220, Australia
| | - Alun C Jackson
- Australian Centre for Heart Health, 75 Chetwynd Street, North Melbourne, VIC, 3051, Australia.,Faculty of Health, Deakin University, Burwood, VIC, 3216, Australia.,Centre on Behavioural Health, Hong Kong University, Pakfulam, Hong Kong
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Jackson AC, Frydenberg E, Koey XM, Fernandez A, Higgins RO, Stanley T, Liang RPT, Le Grande MR, Murphy BM. Enhancing Parental Coping with a Child's Heart Condition: A Co-production Pilot Study. Compr Child Adolesc Nurs 2019; 43:314-333. [PMID: 31584303 DOI: 10.1080/24694193.2019.1671915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Families of children with congenital heart disease (CHD) can have difficulties coping with the stress of their child's condition and would benefit from assistance to cope better. To address the needs of these parents, the Australian Center for Heart Health/HeartKids Australia/Melbourne Graduate School of Education co-produced Family Coping Project was initiated. This project involved two systematic literature reviews, interviews with parents of children with CHD, and the development and piloting of a manualised parental coping program. The primary aims of the pilot study were to determine whether the program would: attract high needs families; enhance the coping self-efficacy of parents; and be acceptable to parents in terms of content and mode of delivery. The secondary aims were to investigate whether the program would impact on parental coping, parental stress and general stress. Parents completed pre-, post-program and 6-month follow up assessment measures, with parent stress scores being compared to stress scores reported for other chronic condition parent carer groups. Twenty-one parents participated and provided baseline data. They were found to be significantly more stressed than other parent carer groups. Eleven parents completed post-program data and 13 completed 6-month follow-up data. There was a significant increase in parents' coping self-efficacy from pre- to post-program, and from pre- to 6-months. Parents' use of productive coping styles increased significantly from pre- to post-program. The program was rated as highly acceptable in terms of content and delivery mode. The pilot provides strong evidence for upscaling the program in conjunction with individualized psychological support for parents to extend knowledge acquisition and attitude change into enhanced coping skills and demonstrated the benefits of a co-production process.
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Affiliation(s)
- Alun C Jackson
- Australian Centre for Heart Health , Melbourne, Australia.,Faculty of Health, Deakin University , Geelong, Australia.,Melbourne Graduate School of Education, University of Melbourne , Melbourne, Australia.,Centre on Behavioural Health, Hong Kong University , Hong Kong, People's Republic of China
| | - Erica Frydenberg
- Melbourne Graduate School of Education, University of Melbourne , Melbourne, Australia
| | - Xui Min Koey
- Melbourne Graduate School of Education, University of Melbourne , Melbourne, Australia
| | - Amanda Fernandez
- Melbourne Graduate School of Education, University of Melbourne , Melbourne, Australia
| | - Rosemary O Higgins
- Australian Centre for Heart Health , Melbourne, Australia.,Faculty of Health, Deakin University , Geelong, Australia.,Department of Physiotherapy, University of Melbourne , Melbourne, Australia
| | - Tracy Stanley
- HeartKids Australia Family Support Program, Royal Children's Hospital , Melbourne, Australia
| | - Rachel Pui-Tak Liang
- Melbourne Graduate School of Education, University of Melbourne , Melbourne, Australia
| | - Michael R Le Grande
- Australian Centre for Heart Health , Melbourne, Australia.,Faculty of Health, Deakin University , Geelong, Australia
| | - Barbara M Murphy
- Australian Centre for Heart Health , Melbourne, Australia.,Faculty of Health, Deakin University , Geelong, Australia.,Department of Psychology, University of Melbourne , Melbourne, Australia
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Murphy BM, Higgins RO, Le Grande M, Beauchamp A, Worcester MU, Goble AJ, Jackson AC. Impact of intensive training on health professionals’ self-efficacy in establishing, running and maintaining a cardiac rehabilitation program. ACTA ACUST UNITED AC 2019. [DOI: 10.5430/jnep.v9n7p67] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We developed an intensive five-day training program for health professionals working in cardiac rehabilitation (CR). The training covers topics related to establishing, running, maintaining and evaluating a CR program. The aim of this study was to assess the impact of the training on health professionals’ self-efficacy regarding the effective delivery of CR. From 2014 to 2018, 167 health professionals participated in one of five training programs. Participants completed a 28-item pre- and post-training self-efficacy scale. For a sub-group, self-efficacy was re-assessed 4 months later. Factor analysis was used to identify self-efficacy domains. Paired sample t-tests compared pre- and post-training self-efficacy scores; repeated measures analysis of variance investigated change over the three time points. Variations in self-efficacy across profession, role in CR, and years of CR practice were investigated. Factor analysis identified three domains: Operational aspects of CR; Medical aspects of heart disease; and Psychosocial aspects of CR. Health professionals’ self-efficacy increased significantly after training participation, across the three domains and for the total score. Effects were sustained in the 4-month follow-up. Few variations in self-efficacy trajectories by participant characteristics were identified. The study demonstrates that our health professional CR training significantly improves health professionals’ confidence in a range of areas related to establishing, running, maintaining and evaluating a CR program, with immediate improvements sustained four months later. The pattern of findings was largely consistent regardless of participants’ role and experience in CR. Findings highlight the benefits of this relatively brief intensive program on enhancing the capacity of the CR workforce.
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Abstract
Rabies is an acute neurological infection of humans and animals, caused by rabies virus and usually transmitted by animal bites. After an incubation period usually lasting weeks or longer, a variety of prodromal symptoms may occur. Encephalitic rabies (80% of cases) is associated with episodes of generalised arousal or hyperexcitability and hydrophobia, in which spasms involve the contraction of inspiratory muscles with swallowing. Paralytic rabies (in 20% of cases) is characterised by progressive lower motor neuron weakness. Laboratory investigations are important for confirming an ante mortem diagnosis of rabies. Cardiopulmonary and many other complications, including multiple organ failure, are common in aggressively managed rabies patients in critical care units. No effective therapy is available for rabies and survivors are uncommon. In contrast, preventative measures for rabies are highly effective after recognised exposures.
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Le Grande MR, Tucker G, Bunker S, Jackson AC. Validating the Short Form-12 and the development of disease-specific norms in a cohort of Australian private health insurance members. Aust J Prim Health 2019; 25:90-96. [DOI: 10.1071/py18069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 11/29/2018] [Indexed: 01/18/2023]
Abstract
Despite the large number of Australians with private health insurance (PHI), normative quality-of-life data are not available for this population. The Short Form (SF)-12 has been used to characterise the health-related quality of life of Australians in the general population, but there is debate concerning the appropriate algorithm that should be used to calculate its physical and mental component summary scores. The standard (orthogonal method) approach assumes that the mental and physical components are unrelated, whereas an alternate approach (the correlated method) assumes that the two components are related. A consecutive sample of 24957 PHI members with four major initial disease conditions were administered the SF-12 via phone and 4330 participants were followed up at a mean of 16 months after the first survey. The SF-12 was scored using both the orthogonal and correlated methods, and both scoring models were assessed for model fit and ability to discriminate between the four major disease conditions. Confirmatory factor analysis demonstrated superior model fit and improved discriminative validity when the SF-12 was scored using the correlated method instead of the default orthogonal method. Further, the correlated method demonstrated utility by producing scores that were responsive to change over time.
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Abstract
BACKGROUND AND AIMS Few studies have investigated the association between problem gambling (PG) and violence extending into the family beyond intimate partners. This study aimed to explore the association between PG and family violence (FV) in a population-representative sample. It was hypothesized that: (a) PG would be positively associated with FV, even after adjusting for sociodemographic variables and comorbidities and (b) these relationships would be significantly exacerbated by substance use and psychological distress. A secondary aim was to explore whether gender moderated these relationships. METHODS Computer-assisted telephone interviews were conducted with a population-representative sample of 4,153 Australian adults. RESULTS Moderate-risk (MR)/problem gamblers had a 2.73-fold increase in the odds of experiencing FV victimization (21.3%; 95% CI: 13.1-29.4) relative to non-problem gamblers (9.4%; 95% CI: 8.5-10.4). They also had a 2.56-fold increase in the odds of experiencing FV perpetration (19.7%; 95% CI: 11.8-27.7) relative to non-problem gamblers (9.0%; 95% CI: 8.0-10.0). Low-risk gamblers also had over a twofold increase in the odds of experiencing FV victimization (20.0%; 95% CI: 14.0-26.0) and perpetration (19.3%; 95% CI: 13.5-25.1). These relationships remained robust for low-risk gamblers, but were attenuated for MR/problem gamblers, after adjustment for substance use and psychological distress. MR/problem gamblers had a greater probability of FV victimization, if they reported hazardous alcohol use; and low-risk gamblers had a greater probability of FV perpetration if they were female. DISCUSSION AND CONCLUSION These findings provide further support for routine screening, highlight the need for prevention and intervention programs, and suggest that reducing alcohol use may be important in these efforts.
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Affiliation(s)
- Nicki A. Dowling
- School of Psychology, Deakin University, Geelong, VIC, Australia,Melbourne Graduate School of Education, University of Melbourne, Parkville, VIC, Australia,Corresponding author: Nicki A. Dowling, Associate Professor; School of Psychology, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood 3125, Geelong, VIC, Australia; Phone: +61 3 9244 5610; Fax: +61 3 9244 6858; E-mail:
| | - Carrie Ewin
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | | | | | - Aino Suomi
- Institute of Child Protection Study, Australian Catholic University, Canberra, ACT, Australia
| | - Shane A. Thomas
- Centre for Research on Ageing, Health & Wellbeing, Australian National University (ANU), Canberra, ACT, Australia,International Primary Health Care Research Institute, Shenzhen, China
| | - Alun C. Jackson
- Melbourne Graduate School of Education, University of Melbourne, Parkville, VIC, Australia
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Zhuang XY, Wong DFK, Ng TK, Jackson AC, Dowling NA, Lo HHM. Evaluating the Effectiveness of an Integrated Cognitive-Behavioural Intervention (CBI) Model for Male Problem Gamblers in Hong Kong: A Matched-Pair Comparison Design. J Gambl Stud 2018; 34:969-985. [PMID: 29357020 DOI: 10.1007/s10899-018-9747-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Very few clinical cognitive-behavioural intervention (CBI) studies were conducted with the Chinese gamblers. There is a lack of attention paid to intervening in negative emotions that may also adversely affect PGs in current CBI treatment modality. This study is the first attempt to systematically and rigorously evaluate both the short-term and longer-term effects of a culturally-attuned CBI group treatment with an emotion regulation component for a group of Chinese PGs in Hong Kong. A quasi-experimental matched-pairs design was adopted and 84 participants were allocated to the CBI (N = 42) and social activity groups (N = 42). There are 3 assessment points in the study: baseline at recruitment, post-intervention at the end of CBI and social activity groups, and at 6-month follow-up. When compared to the social activity group and after controlling for general group effects, there were significantly greater decreases in the severity of gambling, gambling-related cognitions (i.e. interpretive bias), negative psychological states (i.e. stress) and money spent on gambling in the past month in the CBI group between pre- and post-intervention and between pre-intervention and 6-month follow-up. Results also indicated that both reduction in gambling-related cognitions and negative psychological states could mediate the treatment effect of the CBI on the reduction of problematic gambling behaviours. The culturally attuned integrated CBI group treatment with an emotional regulation component appeared to be effective in treating Chinese problem gamblers in Hong Kong and the effects could be sustained at 6-month follow-up.
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Affiliation(s)
- Xiao Yu Zhuang
- Department of Social Work and Social Administration, The University of Hong Kong, The Jockey Club Tower, Pok Fu Lam Road, Hong Kong, China
| | - Daniel Fu Keung Wong
- Department of Social Work and Social Administration, The University of Hong Kong, The Jockey Club Tower, Pok Fu Lam Road, Hong Kong, China.
| | - Ting Kin Ng
- Department of Social Work and Social Administration, The University of Hong Kong, The Jockey Club Tower, Pok Fu Lam Road, Hong Kong, China
| | - Alun C Jackson
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, Australia.,Centre on Behavioural Health, University of Hong Kong, Hong Kong, China
| | - Nicki A Dowling
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, Australia.,School of Psychology, Deakin University, Geelong, Australia
| | - Herman Hay-Ming Lo
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
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Dowling NA, Shandley KA, Oldenhof E, Affleck JM, Youssef GJ, Frydenberg E, Thomas SA, Jackson AC. The intergenerational transmission of at-risk/problem gambling: The moderating role of parenting practices. Am J Addict 2017; 26:707-712. [PMID: 28881065 DOI: 10.1111/ajad.12599] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 06/28/2017] [Accepted: 07/15/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Although parenting practices are articulated as underlying mechanisms or protective factors in several theoretical models, their role in the intergenerational transmission of gambling problems has received limited research attention. This study therefore examined the degree to which parenting practices (positive parenting, parental involvement, and inconsistent discipline) moderated the intergenerational transmission of paternal and maternal problem gambling. METHODS Students aged 12-18 years (N = 612) recruited from 17 Australian secondary schools completed a survey measuring parental problem gambling, problem gambling severity, and parenting practices. RESULTS Participants endorsing paternal problem gambling (23.3%) were 4.3 times more likely to be classified as at-risk/problem gamblers than their peers (5.4%). Participants endorsing maternal problem gambling (6.9%) were no more likely than their peers (4.0%) to be classified as at-risk/problem gamblers. Paternal problem gambling was a significant predictor of offspring at-risk/problem gambling after controlling for maternal problem gambling and participant demographic characteristics. The relationship between maternal problem gambling and offspring at-risk/problem gambling was buffered by parental involvement. DISCUSSION AND CONCLUSIONS Paternal problem gambling may be important in the development of adolescent at-risk/problem gambling behaviours and higher levels of parental involvement buffers the influence of maternal problem gambling in the development of offspring gambling problems. Further research is therefore required to identify factors that attenuate the seemingly greater risk of transmission associated with paternal gambling problems. SCIENTIFIC SIGNIFICANCE Parental involvement is a potential candidate for prevention and intervention efforts designed to reduce the intergenerational transmission of gambling problems. (Am J Addict 2017;26:707-712).
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Affiliation(s)
- Nicki A Dowling
- School of Psychology, Deakin University, Geelong, Australia.,Melbourne Graduate School of Education, University of Melbourne, Melbourne, Australia
| | | | - Erin Oldenhof
- School of Psychology, Deakin University, Geelong, Australia.,School of Psychological Sciences, Monash University, Clayton, Australia
| | - Julia M Affleck
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, Australia
| | - George J Youssef
- School of Psychology, Deakin University, Geelong, Australia.,Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Erica Frydenberg
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, Australia
| | - Shane A Thomas
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia.,International Institute for Primary Health Care Research, Shenzhen, China
| | - Alun C Jackson
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, Australia
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43
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Rogerson MC, Le Grande MR, Dunstan DW, Magliano DJ, Murphy BM, Salmon J, Gardiner PA, Jackson AC. Television Viewing Time and 13-Year Mortality in Adults With Cardiovascular Disease: Data From the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Heart Lung Circ 2017; 26:e98-e99. [PMID: 28528778 DOI: 10.1016/j.hlc.2017.03.153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 03/05/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Michelle C Rogerson
- Australian Centre for Heart Health (formerly known as the Heart Research Centre), Melbourne, Vic, Australia; Deakin University, Institute for Physical Activity and Nutrition Research, Melbourne, Vic, Australia.
| | - Michael R Le Grande
- Australian Centre for Heart Health (formerly known as the Heart Research Centre), Melbourne, Vic, Australia; Deakin University, Faculty of Health, Melbourne, Vic, Australia
| | - David W Dunstan
- Baker IDI Heart and Diabetes Institute, Melbourne, Vic, Australia; Australian Catholic University, Mary MacKillop Institute for Health Research, Melbourne, Vic, Australia; The University of Queensland, School of Public Health, Brisbane, Qld, Australia; Deakin University, School of Exercise and Nutrition Sciences, Melbourne, Vic, Australia; The University of Western Australia, School of Sport Science, Exercise and Health, Perth, WA, Australia; Monash University, Department of Medicine, Monash University, Melbourne, Vic, Australia; Monash University, Department of Epidemiology and Preventive Medicine, Melbourne, Vic, Australia
| | | | - Barbara M Murphy
- Australian Centre for Heart Health (formerly known as the Heart Research Centre), Melbourne, Vic, Australia; Deakin University, Faculty of Health, Melbourne, Vic, Australia; University of Melbourne, Department of Psychology, Melbourne, Vic, Australia; University of Newcastle School of Medicine & Public Health, Newcastle, NSW, Australia
| | - Jo Salmon
- Deakin University, Institute for Physical Activity and Nutrition Research, Melbourne, Vic, Australia
| | - Paul A Gardiner
- The University of Queensland, School of Public Health, Brisbane, Qld, Australia; The University of Queensland, Mater Research Institute, Brisbane, Queensland, Australia
| | - Alun C Jackson
- Australian Centre for Heart Health (formerly known as the Heart Research Centre), Melbourne, Vic, Australia; Deakin University, Office of the Pro Vice Chancellor (Health), Melbourne, Vic, Australia; University of Hong Kong, Centre on Behavioural Health, Hong Kong
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Abstract
Although family members of problem gamblers frequently present to treatment services, problem gambling family impacts are under-researched. The most commonly endorsed items on a new measure of gambling-related family impacts [Problem Gambling Family Impact Measure (PG-FIM: Problem Gambler version)] by 212 treatment-seeking problem gamblers included trust (62.5 %), anger (61.8 %), depression or sadness (58.7 %), anxiety (57.7 %), distress due to gambling-related absences (56.1 %), reduced quality time (52.4 %), and communication breakdowns (52.4 %). The PG-FIM (Problem Gambler version) was comprised of three factors: (1) financial impacts, (2) increased responsibility impacts, and (3) psychosocial impacts with good psychometric properties. Younger, more impulsive, non-electronic gaming machine (EGM) gamblers who had more severe gambling problems reported more financial impacts; non-EGM gamblers with poorer general health reported more increased responsibility impacts; and more impulsive non-EGM gamblers with more psychological distress and higher gambling severity reported more psychosocial impacts. The findings have implications for the development of interventions for the family members of problem gamblers.
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Affiliation(s)
- N A Dowling
- School of Psychology, Deakin University, Melbourne Burwood Campus, Building BC, 221 Burwood Highway, Burwood, VIC, 3125, Australia. .,Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia. .,School of Psychological Sciences, Monash University, Clayton, VIC, Australia. .,Centre for Gambling Research, School of Sociology, Australian National University, Canberra, ACT, Australia.
| | - A Suomi
- School of Psychology, Deakin University, Melbourne Burwood Campus, Building BC, 221 Burwood Highway, Burwood, VIC, 3125, Australia.,Centre for Gambling Research, School of Sociology, Australian National University, Canberra, ACT, Australia
| | - A C Jackson
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia
| | - T Lavis
- Student Learning Centre, Flinders University, Bedford Park, SA, Australia.,School of Medicine, Flinders University, Bedford Park, SA, Australia
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45
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Higgins RO, Rogerson M, Murphy BM, Navaratnam H, Butler MV, Barker L, Turner A, Lefkovits J, Jackson AC. Cardiac Rehabilitation Online Pilot. J Cardiovasc Nurs 2017; 32:7-13. [DOI: 10.1097/jcn.0000000000000297] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Jackson AC, Stewart H, O'Toole M, Tokatlian N, Enderby K, Miller J, Ashley D. Pediatric Brain Tumor Patients: Their Parents’ Perceptions of the Hospital Experience. J Pediatr Oncol Nurs 2016; 24:95-105. [PMID: 17332423 DOI: 10.1177/1043454206296030] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Studies have shown that admission to the hospital of a child can induce feelings of fear and helplessness in parents, challenging usual patterns of coping and parenting competence. Stress has been associated with parents’ need to establish effective communication with staff and their need for information, ready access to their children, and participation in decision making relating to their child’s care. This study of coping and adjustment was undertaken with the parents, including mothers and fathers, of children under 18 years of age diagnosed with a brain tumor, presenting at Royal Children’s Hospital, Melbourne, between 2001 and 2002 (N = 53). It was a prospective study using repeated measures over time. Participants in the study were involved in a questionnaire interview at 4 different points: at the time of diagnosis, 6 months postdiagnosis, 1 year postdiagnosis, and 2 years postdiagnosis, in which they were asked, among other things, about their experience of the hospital. The point of diagnosis was marked by a high level of dependence, with parents coping with rapid decision making and shock, and the surrender of care of their child. Parents identified high levels of information need but noted that they were often too stressed to take in information early on, and that this information need persisted up to the 2-year postdiagnosis point. More parents expressed dissatisfaction with the hospital and particularly with their interactions with the health care team at the 6-month post-diagnosis period, reflecting a possible reduction in attention given to families once they had settled into the treatment routine and the crisis of diagnosis had passed.
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Affiliation(s)
- Alun C Jackson
- University of Melbourne School of Social Work, Victoria, Australia.
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47
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Rogerson MC, Le Grande MR, Dunstan DW, Magliano DJ, Murphy BM, Salmon J, Gardiner PA, Jackson AC. Television Viewing Time and 13-year Mortality in Adults with Cardiovascular Disease: Data from the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Heart Lung Circ 2016; 25:829-36. [DOI: 10.1016/j.hlc.2016.03.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/02/2016] [Accepted: 03/03/2016] [Indexed: 10/21/2022]
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Le Grande MR, Neubeck L, Murphy BM, McIvor D, Lynch D, McLean H, Jackson AC. Screening for obstructive sleep apnoea in cardiac rehabilitation: A position statement from the Australian Centre for Heart Health and the Australian Cardiovascular Health and Rehabilitation Association. Eur J Prev Cardiol 2016; 23:1466-75. [DOI: 10.1177/2047487316652975] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 05/13/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Michael R Le Grande
- Australian Centre for Heart Health (formerly Heart Research Centre), Melbourne, Australia
- Faculty of Health, Deakin University, Melbourne, Australia
| | - Lis Neubeck
- Sydney Nursing School and Charles Perkins Centre, University of Sydney, Australia
- Australian Cardiovascular Health and Rehabilitation Association, Australia
| | - Barbara M Murphy
- Australian Centre for Heart Health (formerly Heart Research Centre), Melbourne, Australia
- Faculty of Health, Deakin University, Melbourne, Australia
- School of Psychological Sciences, University of Melbourne, Australia
- School of Medicine and Public Health, University of Newcastle, Australia
| | - Dawn McIvor
- Australian Cardiovascular Health and Rehabilitation Association, Australia
- CNC Cardiology, John Hunter Hospital, Hunter New England Health, Newcastle, Australia
| | - Dianna Lynch
- Australian Cardiovascular Health and Rehabilitation Association, Australia
- Ashford Hospital, Australia
| | - Helen McLean
- Australian Cardiovascular Health and Rehabilitation Association, Australia
- Royal Perth Hospital, Australia
| | - Alun C Jackson
- Australian Centre for Heart Health (formerly Heart Research Centre), Melbourne, Australia
- Faculty of Health, Deakin University, Melbourne, Australia
- Australian Cardiovascular Health and Rehabilitation Association, Australia
- University of Hong Kong, Centre on Behavioural Health, Hong Kong
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Murphy BM, Higgins RO, Shand L, Page K, Holloway E, Le Grande MR, Jackson AC. Improving health professionals' self-efficacy to support cardiac patients' emotional recovery: the 'Cardiac Blues Project'. Eur J Cardiovasc Nurs 2016; 16:143-149. [PMID: 27071738 DOI: 10.1177/1474515116643869] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Many patients experience the 'cardiac blues' at the time of an acute cardiac event, and one in five go on to develop severe depression. These emotional responses often go undetected and unacknowledged. We initiated the 'Cardiac Blues Project' in order to help support patients' emotional recovery. As part of the project, we developed online training in order to support health professionals in the identification and management of the cardiac blues and depression. The aim of this study was to assess the acceptability of the training and its impacts on health professionals' self-efficacy. METHOD In July 2014, a 'cardiac blues' pack of patient resources, including access to health professional online training, was mailed to 606 centres across Australia. In the first 3 months after distribution, 140 health professionals registered to undertake the online training and participated in the present study. Participants provided information via a six-item pre- and post-training self-efficacy scale and on 10 post-training acceptability items. RESULTS Health professionals' self-efficacy improved significantly after undertaking the online training across the six domains assessed and for the total score. Acceptability of the training was high across all 10 items assessed. Ratings of usefulness of the training in clinical practice were particularly favourable amongst those who worked directly with cardiac patients. CONCLUSIONS The health professional training significantly improves health professionals' confidence in identifying and managing the 'cardiac blues' and depression. Monitoring of uptake is ongoing and future studies will investigate patient outcomes.
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Affiliation(s)
- Barbara M Murphy
- 1 Australian Centre for Heart Health, Australia.,2 Faculty of Health, Deakin University, Australia.,3 Department of Psychology, University of Melbourne, Australia.,4 School of Medicine & Public Health, University of Newcastle, Australia
| | - Rosemary O Higgins
- 1 Australian Centre for Heart Health, Australia.,5 Department of Physiotherapy, University of Melbourne, Australia.,6 Department of Psychology, Deakin University, Australia.,7 Cabrini Health, Malvern, Australia
| | - Lyndel Shand
- 1 Australian Centre for Heart Health, Australia.,2 Faculty of Health, Deakin University, Australia
| | - Karen Page
- 2 Faculty of Health, Deakin University, Australia
| | | | - Michael R Le Grande
- 1 Australian Centre for Heart Health, Australia.,2 Faculty of Health, Deakin University, Australia
| | - Alun C Jackson
- 1 Australian Centre for Heart Health, Australia.,2 Faculty of Health, Deakin University, Australia.,8 Centre on Behavioural Health, Hong Kong University, Hong Kong
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Dixon RW, Youssef GJ, Hasking P, Yücel M, Jackson AC, Dowling NA. The relationship between gambling attitudes, involvement, and problems in adolescence: Examining the moderating role of coping strategies and parenting styles. Addict Behav 2016; 58:42-6. [PMID: 26905763 DOI: 10.1016/j.addbeh.2016.02.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 02/05/2016] [Accepted: 02/07/2016] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Several factors are associated with an increased risk of adolescent problem gambling, including positive gambling attitudes, higher levels of gambling involvement, ineffective coping strategies and unhelpful parenting practices. It is less clear, however, how these factors interact or influence each other in the development of problem gambling behavior during adolescence. The aim of the current study was to simultaneously explore these predictors, with a particular focus on the extent to which coping skills and parenting styles may moderate the expected association between gambling involvement and gambling problems. METHODS Participants were 612 high school students. The data were analyzed using a zero-inflated Poisson (ZIP) regression model, controlling for gender. RESULTS Although several variables predicted the number of symptoms associated with problem gambling, none of them predicted the probability of displaying any problem gambling. Gambling involvement fully mediated the relationship between positive gambling attitudes and gambling problem severity. There was a significant relationship between gambling involvement and problems at any level of problem focused coping, reference to others and inconsistent discipline. However, adaptive coping styles employed by adolescents and consistent disciplinary practices by parents were buffers of gambling problems at low levels of adolescent gambling involvement, but failed to protect adolescents when their gambling involvement was high. CONCLUSIONS These findings indicate that research exploring the development of gambling problems is required and imply that coping and parenting interventions may have particular utility for adolescents who are at risk of development gambling problems but who are not gambling frequently.
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