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Rasmussen AN, Guise A, Overgaard C. The role of social support in the experience of life with ischemic heart disease for socially disadvantaged patients: A qualitative study. Chronic Illn 2023; 19:354-367. [PMID: 34870487 DOI: 10.1177/17423953211065005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Ischemic heart disease (IHD) displays wide social inequalities that are often explained with reference to lifestyle factors. However, research indicates that social support may also play an important role in social inequality in IHD. This study aims to explore the role of social support in the experience of life with IHD for socially disadvantaged patients. METHODS The study was conducted as a critical hermeneutic qualitative study in Denmark between October 2018 and August 2019. Data consist of in-depth qualitative interviews with 30 socially disadvantaged patients with IHD. RESULTS The findings showed a notable difference between the participants who were engaged in close and supportive social relationships and those who were not. Life with IHD for those who lacked supportive relationships tended to be marked by feelings of chaos, powerlessness and meaninglessness. Contrarily, those who were engaged in supportive relationships received help to navigate their life with illness, reconcile with what had happened to them, feel empowered, and gain a sense of meaning in their life.Discussion: Social support from close social relationships appears to be crucial for socially disadvantaged ischemic heart patients, and should be encouraged and facilitated in healthcare and interventions targeting this patient group.
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Affiliation(s)
- Amanda Nikolajew Rasmussen
- Department of Health Science and Technology, 1004Aalborg University, Niels Jernes Vej 14, 9220 Aalborg Øst, Denmark
| | - Andrew Guise
- Population Health Sciences, 4616King's College London, Great Maze Pond, London SE1 1UL, UK
| | - Charlotte Overgaard
- Department of Health Science and Technology, 1004Aalborg University, Niels Jernes Vej 14, 9220 Aalborg Øst, Denmark
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Aierken A, Ding X, Pan Y, Chen Y, Li Y. Association between dependency on community resources and social support among elderly people living in rural areas in China: a cross-sectional study. BMC Geriatr 2022; 22:589. [PMID: 35842579 PMCID: PMC9288718 DOI: 10.1186/s12877-022-03247-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 06/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of dependency personality disorder (DPD) is high among elderly people living in rural areas. This study aims to explore the association between dependency on community resources and social support among elderly individuals living in rural areas. METHODS A cross-sectional study was conducted in 26 locations in China. A total of 1160 participants aged ≥ 60 years were selected using a complex multistage sampling design. All data were obtained using questionnaires via face-to-face interviews. DPD was measured using the Minnesota Multiphasic Personality Inventory-II in the standardized Chinese version. Self-efficacy was assessed using the Chinese version of the General Self-Efficacy Scale. Social support was measured using the Chinese version of the questionnaires of the Older American Resources and Services scale. Community services and resources comprised 44 items. The association between DPD and levels of social support and self-efficacy was evaluated using a logistic regression model. The association between social support and self-efficacy was assessed using analysis of covariance. RESULTS Univariate analysis results showed that elderly people living in rural areas had higher DPD scores and lower levels of self-efficacy compared with those living in urban areas (P < 0.001). Logistic regression analysis showed that DPD was positively associated with the received frequencies of community health service, contracted family doctor services, and regular lectures on health knowledge among the elderly people with odd ratios of 1.58 (P < 0.001), 2.03 (P = 0.013), and 2.67 (P = 0.005), respectively. Logistic regression analysis showed significant interaction between social support and self-efficacy effect on DPD was found in the additive model (P < 0.001). CONCLUSION DPD was associated mainly with the community resources among elderly people living in rural areas. Social support and self-efficacy were commonly associated with DPD through a synergistic effect. These results suggest that DPD among elderly people may be reduced through effective social support to directly and indirectly promote the elderly's use of community resources and improve their self-efficacy.
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Affiliation(s)
- Ayizuhere Aierken
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, 310058, Zhejiang, China
| | - XiWen Ding
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, 310058, Zhejiang, China
| | - YiYang Pan
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, 310058, Zhejiang, China
| | - Yuan Chen
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, 310058, Zhejiang, China
| | - Ying Li
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, 310058, Zhejiang, China.
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Cui P, Chen Y, Li Y, Wali N, Li Y. The role of social support in the association between dependency and important risk factors among the elderly. Psychogeriatrics 2021; 21:317-323. [PMID: 33749093 DOI: 10.1111/psyg.12671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/14/2020] [Accepted: 02/08/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study aimed to assess the association between social resources and dependency, and explored the effect of social support in modifying important risk factors for dependency among the elderly. METHODS This was a population-based cross-sectional study. A total of 950 participants aged ≥60 years were selected using a complex multistage sampling design from 22 locations in China. All data were collected using questionnaires by face-to-face interviews. Dependency was assessed using the Minnesota Multiphasic Personality Inventory-II, and social resource status with the Chinese version of the Older American Resources and Services (OARS) questionnaire. Logistic regression analysis was used to evaluate the association between dependency and social resources. Analysis of covariance was performed to evaluate the effect of social support on modifications of important risk factors for dependency. RESULTS A total of 913 participants were included in the analysis, and 10.3% of the males and 14.4% of the females were identified as in dependency. The results of logistic regression analysis showed a significant negative association between the levels of social resources and dependency. The odds ratio was 0.78 (95% confidence interval, 0.73-0.84) after adjusting for important confounding factors. The results of analysis of covariance showed differences in the mean dependency scores between different groups defined by chronic disease status and social support level. CONCLUSIONS Levels of social resources were negatively associated with dependency. Our results suggest that social support has both a direct effect on dependency and an indirect effect through modifying chronic disease status and individual income.
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Affiliation(s)
- PingYu Cui
- Department of Social Medicine, School of Public Health, Zhejiang University, Hangzhou, China
| | - Yuan Chen
- Department of Social Medicine, School of Public Health, Zhejiang University, Hangzhou, China
| | - YaXing Li
- Department of Social Medicine, School of Public Health, Zhejiang University, Hangzhou, China
| | - Nuremaguli Wali
- Department of Social Medicine, School of Public Health, Zhejiang University, Hangzhou, China
| | - Ying Li
- Department of Social Medicine, School of Public Health, Zhejiang University, Hangzhou, China
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Li Y, Pan Y, Chen Y, Cui P. Important Dependency-Associated Community Resources among Elderly Individuals with a Low Level of Social Support in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052754. [PMID: 33803141 PMCID: PMC7967261 DOI: 10.3390/ijerph18052754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 03/02/2021] [Indexed: 11/16/2022]
Abstract
Background: The prevalence of dependency personality disorder is high among elderly individuals with a low level of social support. The objective of this study was to explore the dependency associated with important community resources among elderly individuals with a low level of social support from the perspective of resource demand. Methods: The population-based cross-sectional study was conducted in 22 locations in China. A total of 950 participants aged ≥60 years were selected using a complex multistage sampling design. All the data were collected using questionnaires via face-to-face interviews. The dependency was assessed using the standardized Chinese version of the Minnesota Multiphasic Personality Inventory-II. Community resources were assessed using 43 items. Logistic regression analysis was used to evaluate the association between dependency and important community resources. Results: Bivariate analysis showed that the level of social support was negatively associated with levels of income (p < 0.001) and education (p = 0.008) and was positively associated with social communication and interactions (p < 0.001). The logistic regression analysis showed that the emergency call or survival monitoring system (ECSMS) was the most important community resource that was significantly associated with the levels of dependency; the odds ratio was 2.64 (95% CI, 1.07–3.91; p = 0.031) among elderly individuals with a low level of social support. Conclusions: The levels of dependency were most significantly associated with the ECSMS among elderly individuals with a low level of social support. Our results suggest that improving the ECSMS can be the main problem in the development of community resources.
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Affiliation(s)
- Ying Li
- Correspondence: ; Tel.: +86-0571-(8820)-8590; Fax: +86-0571-(8795)-2233
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Ahmad K, Chen EW, Nazir U, Cotts W, Andrade A, Trivedi AN, Erqou S, Wu W. Regional Variation in the Association of Poverty and Heart Failure Mortality in the 3135 Counties of the United States. J Am Heart Assoc 2019; 8:e012422. [PMID: 31480884 PMCID: PMC6818020 DOI: 10.1161/jaha.119.012422] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 07/05/2019] [Indexed: 12/30/2022]
Abstract
Background There is significant geographical variation in heart failure (HF) mortality across the United States. County socioeconomic factors that influence these outcomes are unknown. We studied the association between county socioeconomic factors and HF mortality and compared it with coronary heart disease (CHD) mortality. Methods and Results This is a cross-sectional analysis of socioeconomic factors and mortality in HF and CHD across 3135 US counties from 2010 to 2015. County-level poverty, education, income, unemployment, health insurance status, and cause-specific mortality rates were collected from the Centers for Disease Control and Prevention and US Census Bureau databases. Poverty had the strongest correlation with both HF and CHD mortality, disproportionately higher for HF (r=0.48) than CHD (r=0.24). HF mortality increased by 5.2 deaths/100 000 for each percentage increase in county poverty prevalence in a frequency-weighted, demographic-adjusted, multivariate regression model. The greatest attenuation in the poverty regression coefficient (66.4%) was seen after adjustment for prevalence of diabetes mellitus and obesity. Subgroup analysis by census region showed that this relationship was the strongest in the South and weakest in the Northeast (6.1 versus 1.4 deaths/100 000 per 1% increase in county poverty in a demographics-adjusted model). Conclusions County poverty is the strongest socioeconomic factor associated with HF and CHD mortality, an association that is stronger with HF than with CHD and varied by census region. Over half of the association was explained by differences in the prevalence of diabetes mellitus and obesity across the counties. Health policies targeting improvement in these risk factors may address and possibly minimize health disparities caused by socioeconomic factors.
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Affiliation(s)
- Khansa Ahmad
- Division of Cardiology, Providence Veterans Affairs Medical Center and the Warren Alpert Medical School at Brown UniversityProvidenceRI
| | - Edward W. Chen
- Division of Cardiology, Providence Veterans Affairs Medical Center and the Warren Alpert Medical School at Brown UniversityProvidenceRI
| | - Umair Nazir
- Division of Cardiology, Providence Veterans Affairs Medical Center and the Warren Alpert Medical School at Brown UniversityProvidenceRI
| | - William Cotts
- Division of Cardiology, Providence Veterans Affairs Medical Center and the Warren Alpert Medical School at Brown UniversityProvidenceRI
| | - Ambar Andrade
- Division of Cardiology, Providence Veterans Affairs Medical Center and the Warren Alpert Medical School at Brown UniversityProvidenceRI
| | - Amal N. Trivedi
- Division of Cardiology, Providence Veterans Affairs Medical Center and the Warren Alpert Medical School at Brown UniversityProvidenceRI
| | - Sebhat Erqou
- Division of Cardiology, Providence Veterans Affairs Medical Center and the Warren Alpert Medical School at Brown UniversityProvidenceRI
| | - Wen‐Chih Wu
- Division of Cardiology, Providence Veterans Affairs Medical Center and the Warren Alpert Medical School at Brown UniversityProvidenceRI
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Wang W, Lim JY, Lopez V, Wu VX, Lee CH, He HG, Jiang Y. The effect of a self-help psychoeducation programme for people with coronary heart disease: A randomized controlled trial. J Adv Nurs 2018; 74:2416-2426. [PMID: 29992600 DOI: 10.1111/jan.13793] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/30/2018] [Accepted: 05/09/2018] [Indexed: 12/17/2022]
Abstract
AIM To examine the effect of a self-help psychoeducation program for people with coronary heart disease in Singapore. BACKGROUND Cardiac rehabilitation has shown benefits for mitigating many cardiac risk factors and can lead to improvement in health-related quality of life and psychological well-being in people with heart disease. However, traditional hospital-based cardiac rehabilitation faces substantial challenges. A self-management cardiac rehabilitation program offers an avenue to increase uptake and empowers patients to manage their condition at home. DESIGN A two-arm, randomized controlled trial. METHODS A total of 129 patients with coronary heart disease were recruited from an outpatient clinic in a public hospital in Singapore from April 2015-January 2016. They were randomly assigned to the intervention group or the control group. Participants in the intervention group received the 4-week home-based self-help psychoeducation program. Outcomes were measured at baseline and at 4 weeks and 16 weeks from the baseline. RESULTS There were no significant differences in health-related quality of life, psychological status (i.e., perceived stress level, anxiety, and depression levels), or cardiac physiological risk parameters between the intervention and the control groups immediately after the program or at different time points. There was also no significant difference in unplanned health service use at the 16 week posttest point between the two groups. CONCLUSIONS This study did not find any significant effect of our program on outpatients with coronary heart disease. Nonetheless, findings on participant characteristics may offer healthcare professionals valuable insights to help facilitate future development of an effective cardiac rehabilitation program catered to outpatients with coronary heart disease. TRIAL REGISTRATION The study has been registered with ISRCTN registry. The trial registration number is ISRCTN15839687.
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Affiliation(s)
- Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jian Yang Lim
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Violeta Lopez
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Chi-Hang Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying Jiang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Botes R, Vermeulen KM, Gerber AM, Ranchor AV, Buskens E. Functioning and quality of life in Dutch oldest old with diverse levels of dependency. Patient Prefer Adherence 2018; 12:2187-2196. [PMID: 30410314 PMCID: PMC6199227 DOI: 10.2147/ppa.s175388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Frequently, a questionnaire like the EQ-5D is applied to investigate elderly health-related quality of life (HRQoL), but current literature suggests that inputs that go beyond these traditional health aspects might be of importance. The capability approach is a different method, which integrates several non-health-related factors to define the well-being of the oldest old. OBJECTIVE We propose to investigate the differences in oldest old functionings and quality of life (QoL), given different levels of dependency, using both a utility-based (EQ-5D+C) and capability-based (Currently Achieved Functioning) questionnaire. METHODS We interviewed 99 Dutch elderly, living in the Groningen, Veendam, and Hoogeveen areas. The average age of the elderly was 80 years, who were living independently, still looking after themselves; living semi-dependently with moderate care; or living in a nursing home requiring consistent care. RESULTS The utility score for the dependent group is the lowest of all three groups, across the diseases investigated in this study. The respective average utility scores calculated for the dependent, semi-dependent, and independent subgroups were 0.56 (SD ±0.10); 0.84 (SD ±0.11), and 0.69 (SD ±0.13). Mobility and pain were reported to be the major domains where problems appeared across the three groups. Additionally, dependent elderly experience deficits in the role and control functionings while the other two subgroups experience deficits in pleasure and security. CONCLUSION The results suggest that it is important to take note of the achievability of functionings and HRQoL, in addition to care dependency, to obtain QoL and well-being outcomes of the oldest old.
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Affiliation(s)
- Riaan Botes
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands,
| | - Karin M Vermeulen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands,
| | - Antonie M Gerber
- Department of Basic Medical Sciences (G25), University of the Free State, Basic Medical Sciences, Bloemfontein, South Africa
| | - Adelita V Ranchor
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Erik Buskens
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands,
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Mollon L, Bhattacharjee S. Health related quality of life among myocardial infarction survivors in the United States: a propensity score matched analysis. Health Qual Life Outcomes 2017; 15:235. [PMID: 29202758 PMCID: PMC5716338 DOI: 10.1186/s12955-017-0809-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/23/2017] [Indexed: 12/30/2022] Open
Abstract
Background Little is known regarding the health-related quality of life among myocardial infarction (MI) survivors in the United States. The purpose of this population-based study was to identify differences in health-related quality of life domains between MI survivors and propensity score matched controls. Methods This retrospective, cross-sectional matched case-control study examined differences in health-related quality of life (HRQoL) among MI survivors of myocardial infarction compared to propensity score matched controls using data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) survey. Propensity scores were generated via logistic regression for MI survivors and controls based on gender, race/ethnicity, age, body mass index (BMI), smoking status, and comorbidities. Chi-square tests were used to compare differences between MI survivors to controls for demographic variables. A multivariate analysis of HRQoL domains estimated odds ratios. Life satisfaction, sleep quality, and activity limitations were estimated using binary logistic regression. Social support, perceived general health, perceived physical health, and perceived mental health were estimated using multinomial logistic regression. Significance was set at p < 0.05. Results The final sample consisted of 16,729 MI survivors matched to 50,187 controls (n = 66,916). Survivors were approximately 2.7 times more likely to report fair/poor general health compared to control (AOR = 2.72, 95% CI: 2.43–3.05) and 1.5 times more likely to report limitations to daily activities (AOR = 1.46, 95% CI: 1.34–1.59). Survivors were more likely to report poor physical health >15 days in the month (AOR = 1.63, 95% CI: 1.46–1.83) and poor mental health >15 days in the month (AOR = 1.25, 95% CI: 1.07–1.46) compared to matched controls. There was no difference in survivors compared to controls in level of emotional support (rarely/never: AOR = 0.75, 95% CI: 0.48–1.18; sometimes: AOR = 0.73, 95% CI: 0.41–1.28), hours of recommended sleep (AOR = 1.14, 95% CI: 0.94–1.38), or life satisfaction (AOR = 1.62, 95% CI: 0.99–2.63). Conclusion MI survivors experienced lower HRQoL on domains of general health, physical health, daily activity, and mental health compared to the general population.
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Affiliation(s)
- Lea Mollon
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, 1295 North Martin Avenue, Tucson, AZ, 85721, USA
| | - Sandipan Bhattacharjee
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, 1295 North Martin Avenue, Tucson, AZ, 85721, USA.
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Wang W, Jiang Y, Lee CH. Independent predictors of physical health in community-dwelling patients with coronary heart disease in Singapore. Health Qual Life Outcomes 2016; 14:113. [PMID: 27464673 PMCID: PMC4963936 DOI: 10.1186/s12955-016-0514-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 07/23/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Patients with coronary heart disease (CHD) experienced poor physical health which was found to be associated with higher hospital readmission rates and increased mortality. The study aimed to identify the independent predictors of physical health in Singaporean patients with CHD. METHODS A consecutive sample of 129 patients with CHD was recruited from the medical heart clinic of a tertiary public hospital in Singapore. A set of questionnaires including the Short Form 12-item health survey version 2, Perceived Stress Scale, Hospital Anxiety and Depression Scale, and Cardiac Self-Efficacy Scale were used to measure the study outcomes. The patients' socio-demographic and clinical data were also collected. RESULTS A multivariate linear regression analysis indicated that depression (B = -0.766, p < 0.05) and self-efficacy for maintaining function (B = 2.351, p < 0.05) remained significant while the other variables were adjusted and identified as the independent predictors of physical health in Singaporean patients with CHD. CONCLUSIONS This study has shed some light on the key factors influencing the physical health of Singaporean patients with CHD. The finding suggests tailored interventions that target mitigating a patient's depression and promote self-efficacy for maintaining function may be helpful in improving patients' physical health and quality of life.
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Affiliation(s)
- Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11, 10 Medical Drive, Singapore, 117597, Singapore.
| | - Ying Jiang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11, 10 Medical Drive, Singapore, 117597, Singapore
| | - Chi-Hang Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Socioeconomic status, cognitive-emotional factors, and health status following myocardial infarction: testing the Reserve Capacity Model. J Behav Med 2014; 38:110-21. [PMID: 25022863 DOI: 10.1007/s10865-014-9583-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 06/19/2014] [Indexed: 01/24/2023]
Abstract
Health disparities by socioeconomic status (SES) exist for many outcomes, including patients' subjective health status after myocardial infarction (MI). The Reserve Capacity Model (RCM), a theoretical means to understand such disparities, was tested to examine the possible mediating effects of cognitive-emotional factors on the association between SES and health status. Data from 2,348 post-MI patients in PREMIER were used. Indicators of SES were collected during hospitalization via personal interviews, while participants completed measures of stress and reserves at 1 month, depressive symptoms at 6 months, and health status at 1 year through telephone interviews. Structural equation model results provide partial support for the RCM, as cognitive-emotional factors partially mediated the association between SES and mental health status. For physical health status, results supported direct rather than indirect effects of SES. Findings suggest psychosocial interventions with patients of low SES will have their greatest effects on appraisals of psychological health status.
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Muhammad I, He HG, Kowitlawakul Y, Wang W. Narrative review of health-related quality of life and its predictors among patients with coronary heart disease. Int J Nurs Pract 2014; 22:4-14. [DOI: 10.1111/ijn.12356] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Imran Muhammad
- Ward B65 (General Medicine/Cardiology); Khoo Teck Phuat Hospital; Singapore
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Yanika Kowitlawakul
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
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12
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Wang W, Lopez V, Chow A, Chan SWC, Cheng KKF, He HG. A randomized controlled trial of the effectiveness of a self-help psychoeducation programme on outcomes of outpatients with coronary heart disease: study protocol. J Adv Nurs 2014; 70:2932-41. [DOI: 10.1111/jan.12397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2014] [Indexed: 01/01/2023]
Affiliation(s)
- Wenru Wang
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Violeta Lopez
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Aloysius Chow
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Sally Wai-Chi Chan
- School of Nursing and Midwifery; Faculty of Health and Medicine; University of Newcastle, Newcastle, NSW; Australia
| | - Karis Kin Fong Cheng
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
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Health-related quality of life and its predictors among outpatients with coronary heart disease in Singapore. Appl Nurs Res 2013; 27:175-80. [PMID: 25052181 DOI: 10.1016/j.apnr.2013.11.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 11/04/2013] [Accepted: 11/04/2013] [Indexed: 12/15/2022]
Abstract
AIMS AND BACKGROUND Coronary heart disease (CHD) is a major cause of death and disability and negatively impacts on patients' health-related quality of life (HRQoL). This study aimed to explore HRQoL and identify its predictors among outpatients with CHD in Singapore. METHODS A correlational study was conducted with a convenience sample of 106 outpatients with CHD recruited from a public hospital. HRQoL outcomes were measured using the Short Form-12 Health Survey (SF-12), Medical Outcomes Study Social Support Survey (MOS-SSS) and Hospital Anxiety and Depression Scale (HADS). RESULTS Patients reported a generally high level of HRQoL as assessed by SF-12. Those aged over 65years reported significantly higher mental health and those who were married had higher levels of education or income reported significantly higher physical health. There were significant negative correlations between physical and mental health and anxiety and depression (p<.05). Perceived social support was negatively correlated with anxiety and depression and positively correlated with mental health. Education level and depression significantly predicted physical health, while age, anxiety and depression predicted mental health. CONCLUSION Anxiety, depression, age and education are significant predictors of HRQoL in this patient population and should be assessed routinely and, where appropriate, addressed through individually-tailored interventions.
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Wang W, Thompson DR, Ski CF, Liu M. Health-related quality of life and its associated factors in Chinese myocardial infarction patients. Eur J Prev Cardiol 2012; 21:321-9. [PMID: 22767965 DOI: 10.1177/2047487312454757] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Healthcare providers are called on to assess and improve the health-related quality of life (HRQL) of patients with myocardial infarction (MI). However, there is lack of empirical data on HRQL of such individuals in mainland China. The purpose of this study is to assess HRQL and identify associated factors in hospitalized Chinese MI patients. METHODS A single group, cross-sectional design was adopted with a sample of 192 hospitalized MI patients at two teaching hospitals in Xi'an, People's Republic of China. HRQL was assessed using the Chinese Mandarin versions of the Short Form 36 health survey (SF-36), the Myocardial Infarction Dimensional Assessment Scale (MIDAS), and the Hospital Anxiety and Depression Scale (HADS). RESULTS Chinese MI patients reported poor HRQL as measured by both the generic (SF-36) and disease-specific (MIDAS) instruments. Advancing age and the presence of heart failure, anxiety, and depression were significant predictors of overall HRQL. Smoking and hypertension were significant predictors of the physical aspects of HRQL. CONCLUSIONS Assessing HRQL of hospitalized Chinese MI patients and identifying associated factors may help health professionals in the design and delivery of appropriately tailored and culturally relevant interventions to this group of patients.
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Affiliation(s)
- Wenru Wang
- National University of Singapore, Singapore
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15
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Sjöström-Strand A, Ivarsson B, Sjöberg T. Primary health care resources for rehabilitation and secondary prevention after myocardial infarction - a questionnaire survey. Scand J Caring Sci 2012; 27:260-6. [PMID: 22671582 DOI: 10.1111/j.1471-6712.2012.01025.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND During the first year after a cardiac event, many patients are offered participation in a cardiac rehabilitation programme, after which the patients are often not given the opportunity to continue to attend rehabilitation and secondary prevention programmes. AIM This study describes the primary health care centres' (PHCC) resources regarding cardiac rehabilitation/secondary prevention programmes for coronary heart disease (CHD) patients in a southern Swedish region. METHOD A questionnaire containing 26 dichotomous or multiple choice questions was sent to the responsible manager of all 137 public and private PHCCs in Region Skåne. Questionnaires from 91 (66%) of the PHCCs were completed and returned. RESULT Few nurses at the PHCCs had special training regarding CHD (10%), cardiac rehabilitation (8%) or heart failure (32%). Twenty-one per cent of the physicians had special training regarding CHD. One third of the PHCCs did not offer long-term secondary prevention programmes, and few (6%) had any routines for offering socio-economic support to CHD patients. Comparison of private and public PHCCs showed that the private centres could not offer a physiotherapist (61 vs. 84%) or dietician (32 vs. 73%; p = 0.03) to the same extension as the public ones. Furthermore, the majority (91%) of PHCCs had no cooperation with patient organizations. CONCLUSIONS The PHCCs need to improve the strategies and long-term rehabilitation programmes. Furthermore, they need to focus on education programme for the staff. The result revealed that the PHCCs lack resources, strategies and long-term care programmes for CHD patients.
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Affiliation(s)
- Annica Sjöström-Strand
- Department of Cardiothoracic Surgery, Lund University and Skåne University Hospital/Lund, Lund, Sweden.
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16
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Foraker RE, Rose KM, Chang PP, McNeill AM, Suchindran CM, Selvin E, Rosamond WD. Socioeconomic status and the trajectory of self-rated health. Age Ageing 2011; 40:706-11. [PMID: 21737460 DOI: 10.1093/ageing/afr069] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND self-rated health (SRH) likely reflects both mental and physical health domains, and is assessed by asking individuals to describe their health status. Poor SRH is associated with disease incidence and subsequent mortality. Changes in SRH across time in persons with different incident diseases are uncharacterised. METHODS SRH was assessed in the Atherosclerosis Risk in Communities study via annual telephone interviews over a median of 17.6 years. Individual quadratic growth models were used for repeated measures of SRH in persons who remained disease-free during follow-up (n = 11,188), as well as among those who were diagnosed with myocardial infarction (MI; n = 1,071), stroke (n = 809), heart failure (HF; n = 1,592) or lung cancer (n = 433) and those who underwent a cardiac revascularisation procedure (n = 1,340) during follow-up. RESULTS among disease-free participants and across time, there was a trend for lowest mean SRH among persons living in low socioeconomic areas and highest mean SRH among persons living in high socioeconomic areas. Factors contributing to the decline in SRH over time included advanced age, lower educational attainment, smoking and obesity. CONCLUSION addressing factors related to poor SRH trajectories among patients pre- and post-incident disease may favourably affect health outcomes among patients regardless of type of disease.
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Affiliation(s)
- Randi E Foraker
- Division of Epidemiology, The Ohio State University, Columbus, 43210, USA.
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Barbareschi G, Sanderman R, Leegte IL, van Veldhuisen DJ, Jaarsma T. Educational Level and the Quality of Life of Heart Failure Patients: A Longitudinal Study. J Card Fail 2011; 17:47-53. [DOI: 10.1016/j.cardfail.2010.08.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Revised: 08/09/2010] [Accepted: 08/11/2010] [Indexed: 11/16/2022]
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Age trajectories of quality of life among older adults: results from the English Longitudinal Study of Ageing. Qual Life Res 2009; 18:1301-9. [PMID: 19806468 DOI: 10.1007/s11136-009-9543-6] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2009] [Indexed: 10/20/2022]
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