Changes in well-being after myocardial infarction: Does coping matter?

Effectiveness of Mindfulness and Positive Strengthening mHealth Interventions for the Promotion of Subjective Emotional Wellbeing and Management of Self-Efficacy for Chronic Cardiac Diseases

Intervention in health prevention and treatment via mobile phones is becoming a key element on health promotion. Testing the efficacy of these mobile health (mHealth) psychological interventions for cardiovascular health is necessary as it is a chronic pathology, and it can influence the affective and cognitive states of patients. This research aimed to analyze the effectiveness of two brief psychological interventions-mindfulness and positive strengthening-to promote subjective emotional wellbeing and disease management self-efficacy using mHealth. This was a three-arm intervention and feasibility study, with a pre-post design and three follow-up measures with 105 patients (93 completed all phases) with cardiovascular diseases. Group 1 and 2 received the mindfulness or strengthening intervention, and Group 3 was the control group. The positive-negative affect and management self-efficacy for chronic and cardiovascular diseases were analyzed over time, while anxiety and depression levels were assessed at the beginning of the study. The results showed that mindfulness and positive strengthening interventions both had a positive effect on participants' affective state and management self-efficacy for the disease in comparison with the control group over time, even after controlling for baseline anxiety and depression levels. Positive strengthening seems to be more effective for improving cardiac self-efficacy, while mindfulness practice was significantly more effective at reducing negative affect at the first face-to-face evaluation.

Predictors of sexual function among men after myocardial infarction: a pilot study

Background

Sexual dysfunction often persists among men post-myocardial infarction (MI). While some cross-sectional and longitudinal research has been conducted, there are still no known modifiable targets for intervention. This pilot study aimed to model hypothesized predictive factors of higher sexual function in a cohort of men post-MI.

Methods

In a longitudinal study design, sexual function (Male Sexual Function Index), sexual fear (Multidimensional Sexuality Questionnaire), anxiety and depressive symptoms (Patient-Reported Outcomes Measurement Information System), and utilization of coping strategies (Coping Strategy Indicator) data were collected at two weeks and three months post discharge for MI. Spearman correlations were estimated to examine associations among MSFI scores with the selected predictors at two weeks and three months. Linear regression models were conducted for sexual function while controlling for age.

Results

Fourteen men post-MI were analyzed. The average age of the sample was 59.79 years, 78.6% were married, and all were self-reported White race. Sexual fear and utilization of problem-solving and support-seeking coping strategies were moderately correlated with MSFI scores at three months. Increased use of problem-solving and support-seeking coping strategies were associated with increased sexual function at three months (support-seeking coping 1.47, p<0.01; problem-solving coping 0.95, p=0.02).

Conclusions

Based on these preliminary findings, utilization of coping strategies may predict increased function score over three months. However, additional studies are needed to further examine these hypothesized relationships with a larger more diverse sample. Additional studies are needed of predictors of sexual function among women post-MI.

Prevalence and influencing factors of chronic post-traumatic stress disorder in patients with myocardial infarction, transient ischemic attack (TIA) and stroke - an exploratory, descriptive study

BACKGROUND

Cardio- and cerebrovascular events such as myocardial infarction (MI), stroke and transient ischemic attack (TIA) are leading causes of death and disability and have also been associated with poor mental outcomes. In addition, cardio- and cerebrovascular events may pose the risk of experiencing a sudden traumatic occurrence of symptoms during ictus and thus contribute to high rates of PTSD as well as high rates of subsequent depression and anxiety. Moreover, MI, TIA and stroke survivors with PTSD, depressive and anxiety symptoms may have poorer health-related quality of life (HRQoL) and poorer disease prognosis than patients who do not develop psychiatric symptoms after ictus. However, data on the prevalence of PTSD, anxiety and depression, as well as the HRQoL, coping strategies and potential risk factors for development of PTSD in these patients, are rare.

METHODS

In an exploratory, descriptive study we interviewed 112 patients (54 MI, 18 TIA, 40 stroke; mean age: 69.5 years, 55.4% males) from three general physician practices and used psychometric self-assessment tools to determine the occurrence of PTSD and psychosomatic comorbidity, anxiety and depression and to assess HRQoL and coping strategies. We evaluated disease severity and compared the patient groups to each other. Moreover, we assessed psychological outcome differences between patients with or without PTSD after ictus.

RESULTS

The prevalence of PTSD after MI, TIA and stroke was 23.2%. The patients who developed PTSD had higher rates of depression, anxiety and maladaptive coping as well as reduced HRQoL. Adaptive coping was positively related to better mental HRQoL and negatively related to anxiety and depression. Disease severity of MI, TIA and stroke was not related to PTSD, depression, anxiety or physical HRQoL.

CONCLUSIONS

Experiencing MI, TIA or stroke means confronting a life-threatening event for those affected and, therefore, these can be regarded as traumatic events. Cerebral and cardiovascular events increase the risk of developing chronic PTSD with subsequent increased depression and anxiety and reduced HRQoL. These findings emphasize the need for early screening and diagnosis of PTSD in somatically ill patients, which should be followed by specialized treatment, as PTSD hampers overall (somatic) disease prognosis.

TRIAL REGISTRATION

German Clinical Trials Register, DRKS00021730, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021730 , registered 05/19/2020 - Retrospectively registered.

The effect of education and telephone follow-up intervention based on the Roy Adaptation Model after myocardial infarction: randomised controlled trial

BACKGROUND

Patients' lifestyle changes after myocardial infarction reduce the risk of infarction. Nursing interventions are important for the initiation and maintenance of lifestyle adaptation.

AIM

The aim of this study was to evaluate the effect of education and telephone follow-up intervention based on the Roy Adaptation Model for improving myocardial infarction patients' self-efficacy, quality of life and lifestyle adaptation.

METHOD

In this parallel, randomised controlled trial, patients were randomly allocated to a control group or an intervention group (n = 33/group). The control group received routine care, while the intervention group received routine care plus a telephone follow-up intervention, which consisted of a predischarge education programme and three telephone follow-up sessions. Data were collected before discharge, in the 12th week after discharge between April 2016 and August 2017. All outcomes were assessed at baseline and at 12 weeks, and included quality of life, coping adaptation process, self-efficacy and lifestyle changes. The CONSORT checklist was used in the study.

RESULTS

In the 12th week after discharge, patients in the intervention group had significant improvements in self-efficacy, quality of life and coping adaptation process compared with the control group. The intervention group also had more adaptation lifestyle changes concerning patients nutrition and physical activity in the 12-week follow-up.

CONCLUSION

This study demonstrated that education and telephone follow-up intervention based on Roy Adaptation Model was had positive and significant results after 12 weeks compared with usual care. The findings of this study are important for supporting nursing practice and health professionals who care for individuals with myocardial infarction to develop nursing care.

Commonalities and Differences in Psychological Adjustment to Chronic Illnesses Among Older Adults: a Comparative Study Based on the Stress and Coping Paradigm

BACKGROUND

This study aimed to validate the role of the stress and coping paradigm in the context of psychological adjustment to chronic illnesses among older adults by using the structural equation modeling technique, as well as investigating the differences in structural weights between older adults with arthritis and older adults with hypertension.

METHOD

A cross-sectional study was conducted with 325 older adults with chronic illnesses (149 hypertension, 176 arthritis), aged 60-88 years, who completed questions on perceived social support, psychological resources, threat appraisal, self-efficacy, coping strategy, depressive symptoms, and anxiety.

RESULTS

The results revealed that older adults with arthritis experienced significantly higher anxiety (t = 2.91, p < 0.01) than those with hypertension, whereas no significant difference in their depressive symptoms was observed (t = 1.61, p > 0.05). Social support, psychological resources, threat appraisal, and self-efficacy had a significant direct relationship with psychological distress (β = - 0.15, β = - 0.38, β = 0.19, β = - 0.23, respectively). Multi-group analyses showed significant differences in structural weights between older adults with hypertension and those with arthritis (Δχ² = 41.336, Δdf = 18, p < 0.01).

CONCLUSION

The stress and coping paradigm appears to be applicable for adjustment to chronic illnesses by allowing direct paths from social support, psychological resources, threat appraisal, and self-efficacy to psychological distress. The differences in structural weights may offer an intervening angle for clinical practitioners to design targeted interventions for older adults with different types of chronic illnesses.