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Zhu J, Zhang S, Zhu Z, Wang J, Kang T, Li X, Zhao Y, Zhu L. Knowledge, attitude and practice towards insomnia and sleep hygiene among patients with chronic insomnia in Northwest China in 2023: a cross-sectional survey. BMJ Open 2024; 14:e083100. [PMID: 38910008 PMCID: PMC11328641 DOI: 10.1136/bmjopen-2023-083100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/25/2024] Open
Abstract
OBJECTIVES To investigate the knowledge, attitude and practice (KAP) towards insomnia and sleep hygiene among patients with chronic insomnia. DESIGN Web-based cross-sectional survey. SETTING Shaanxi Provincial People's Hospital (northwest China) between January 2023 and May 2023. PARTICIPANTS Patients with chronic insomnia. PRIMARY AND SECONDARY OUTCOME MEASURES Demographic characteristics and KAP towards insomnia and sleep hygiene were collected by distributing a questionnaire developed by the authors. RESULTS A total of 613 people participated in this study, with a Mean Knowledge Score of 7.63±2.56 (total score of 12), a Mean Attitude Score of 48.39±6.643 (total score of 70) and a Mean Practice Score of 42.37±8.592 (total score of 70). Knowledge was significantly correlated with attitude (r=0.447, p<0.001) and practice (r=0.327, p<0.001), and attitude was significantly correlated with practice (r=0.486, p<0.001). Multivariable logistic regression showed that higher knowledge (OR=1.181 (1.062-1.314), p=0.002) and better attitude (OR=1.171 (1.124-1.221), p<0.001) were independently associated with good practice. According to the structural equation modelling analysis, knowledge directly influenced practice (β=0.457, p=<0.001) and attitude (β=1.160, p=<0.001), while attitude influenced practice (β=0.550, p=<0.001). CONCLUSION The KAP towards insomnia and sleep hygiene among patients with chronic insomnia in Northwest China in 2023 was moderate, with better practice showing signs of being influenced by better knowledge and more positive attitudes.
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Affiliation(s)
- Jing Zhu
- Department of Anesthesiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
- Xi'an Medical University, Xi'an, Shaanxi, China
| | - Shiping Zhang
- Department of Anesthesiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
- Xi'an Medical University, Xi'an, Shaanxi, China
| | - Zhibo Zhu
- Department of Medical Equipment, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Jinghua Wang
- Department of Anesthesiology, The 305 Hospital of PLA, Beijing, China
| | - Tao Kang
- Department of Anesthesiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
- Xi'an Medical University, Xi'an, Shaanxi, China
| | - Xin Li
- Department of Anesthesiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
- Xi'an Medical University, Xi'an, Shaanxi, China
| | - Yikang Zhao
- Department of Anesthesiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
- Xi'an Medical University, Xi'an, Shaanxi, China
| | - Lijuan Zhu
- Department of Anesthesiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
- Xi'an Medical University, Xi'an, Shaanxi, China
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Nam H, Jeon HE, Kim WH, Joa KL, Lee H. Effect of maximal-intensity and high-intensity interval training on exercise capacity and quality of life in patients with acute myocardial infarction: a randomized controlled trial. Eur J Phys Rehabil Med 2024; 60:104-112. [PMID: 37906165 PMCID: PMC10938035 DOI: 10.23736/s1973-9087.23.08094-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/02/2023] [Accepted: 10/11/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND An increase in V̇O2max is important for acute myocardial infarction morbidity, and recurrence rate and intensity have been suggested as important factors in improving V̇O2max. AIM The aim of this study was to compare the effects of maximal-intensity interval training (MIIT) and high-intensity interval training (HIIT) on exercise capacity and health-related Quality of Life (HRQoL) in patients with acute myocardial infarction (MI) at low and moderate cardiac risk in cardiac rehabilitation (CR). This study secondarily aimed to compare the effects of hospital-based phase II CR and usual care. DESIGN This study is a randomized controlled trial. SETTING Outpatient Rehabilitation Setting. POPULATION Fifty-nine patients with acute MI were randomly assigned to the MIIT (N.=30) or HIIT (N.=29) group, and 32 to the usual care group. METHODS Twice a week, an intervention was conducted for nine weeks in all groups. The maximum oxygen intake (V̇O2max) and MacNew Heart Disease HRQoL were evaluated before and after intervention. RESULTS A significant interaction was observed between time and group for V̇O2max (P<0.001). The MIIT group showed greater improvement than those exhibited by the HIIT and usual care groups (P<0.05). Similarly, a significant time and group interaction was observed on the MacNew Global, Physical, and Emotional scales (P<0.05), but not on the social scale (P>0.05). CONCLUSIONS Compared to HIIT and usual care, MIIT significantly increased the V̇O2max and was as safe as HIIT in patients with acute MI with low and moderate cardiac risk in CR. Additionally, MIIT and HIIT were superior to usual care in terms of improving the HRQoL. CLINICAL REHABILITATION IMPACT Our results suggest that increased intensity in phase II CR could result in better outcomes in terms of V̇O2max increment in patients with acute MI and low and moderate cardiac risk in CR.
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Affiliation(s)
- Hoon Nam
- College of Health Science, Department of Physical Therapy, Gachon University, Incheon, Korea
- School of Medicine, Department of Physical and Rehabilitation Medicine, Inha University, Incheon, Korea
| | - Hyeong-Eun Jeon
- School of Medicine, Department of Physical and Rehabilitation Medicine, Inha University, Incheon, Korea
| | - Won-Hyoung Kim
- School of Medicine, Department of Psychiatry, Inha University, Incheon, Korea
| | - Kyung-Lim Joa
- School of Medicine, Department of Physical and Rehabilitation Medicine, Inha University, Incheon, Korea -
| | - Haneul Lee
- College of Health Science, Department of Physical Therapy, Gachon University, Incheon, Korea
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Guo H, Li P, Zhao J, Xin Q, Miao Y, Li L, Li X, Wang S, Mo H, Zeng L, Ju Z, Liu Z, Shen X, Cong W. Sheng Mai Yin shows anti-fatigue, anti-hypoxia and cardioprotective potential in an experimental joint model of fatigue and acute myocardial infarction. JOURNAL OF ETHNOPHARMACOLOGY 2024; 319:117338. [PMID: 37890804 DOI: 10.1016/j.jep.2023.117338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cardiovascular disease (CVD) and fatigue are two common diseases endangering human life and health that may interact and reinforce one another. Myocardial infarction survivors frequently experience fatigue, and acute myocardial infarction (AMI) is one of the most common cardiovascular diseases that cause fatigue-induced sudden death. Sheng Mai Yin (SMY), a Chinese medicine prescription, is traditionally used for the treatment of diabetes and cardiovascular disease, and has been demonstrated to reduce fatigue and safeguard cardiac function. AIM OF THE STUDY This study aims to investigate the effects and underlying mechanisms of SMY in treating fatigue and AMI. MATERIALS AND METHODS The pharmacological mechanisms of SMY in treating fatigue and AMI were predicted by bioinformatics and network pharmacology methods. After administering SMY at high, medium and low doses, the swimming time to exhaustion, hemoglobin level, serological parameters and hypoxia tolerance time were detected in C57BL/6N mice, and the left ventricular ejection fractions (LVEF), left ventricular fractional shortening (LVFS), grasp strength, cardiac histopathology, serological parameters and the expression of PINK1 and Parkin proteins were examined in Wistar rats. RESULTS 371 core targets for SMY and 282 disease targets for fatigue and AMI were obtained using bioinformatics and network pharmacology methods. Enrichment analysis of target genes revealed that SMY might interfere with fatigue and AMI through biological processes such as mitochondrial autophagy, apoptosis, and oxidative stress. For in vivo experiments, SMY showed significant anti-fatigue and hypoxia tolerance effects in mice; It also improved the cardiac function and grasp strength, decreased their cardiac index, myocardial injury and fibrosis degree, and induced serological parameters levels and the expression of PTEN-induced putative kinase 1 (PINK1) and Parkin proteins in myocardium, suggesting that SMY may exert cardioprotective effects in a joint rat model of fatigue and AMI by inhibiting excessive mitochondrial autophagy. CONCLUSION This study revealed the anti-fatigue, anti-hypoxia and cardioprotective effects of SMY in a joint model of fatigue-AMI, and the pharmacological mechanism may be related to the inhibition of mitochondrial autophagy in cardiomyocytes through the PINK1/Parkin pathway. The discoveries may provide new ideas for the mechanism study of traditional Chinese medicine, especially complex prescriptions, in treating fatigue and AMI.
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Affiliation(s)
- Hao Guo
- Institute of Basic Medical Sciences, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Pengqi Li
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100091, China; National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Beijing, 100091, China
| | - Jun Zhao
- Traditional Chinese Medicine Department, The Affiliated Hospital of Qingdao University, Qingdao, 266000, China
| | - Qiqi Xin
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100091, China; National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Beijing, 100091, China
| | - Yu Miao
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100091, China; National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Beijing, 100091, China
| | - Li Li
- Chenland Research Institute, Irvine, CA, 92614, USA
| | - Xin Li
- Chenland Research Institute, Irvine, CA, 92614, USA
| | | | - Hui Mo
- Macao Health Bureau, Macao, 999078, China
| | - Li Zeng
- Macau University of Science and Technology, Macao, 999078, China
| | - Zhenyu Ju
- Key Laboratory of Regenerative Medicine of Ministry of Education, Institute of Aging and Regenerative Medicine, Jinan University, Guangzhou, 510632, China
| | - Zimin Liu
- Chenland Research Institute, Irvine, CA, 92614, USA.
| | - Xiaoxu Shen
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100091, China.
| | - Weihong Cong
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100091, China; National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Beijing, 100091, China.
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Gökçe E, Arslan S, İşler A. Correlation of plasma metabolites and comorbid illnesses with poor sleep quality in patients with coronary heart disease. Sleep Breath 2023; 27:2249-2255. [PMID: 37103681 DOI: 10.1007/s11325-023-02835-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 04/08/2023] [Accepted: 04/14/2023] [Indexed: 04/28/2023]
Abstract
PURPOSE This study aimed to examine the relationship between plasma metabolites (biochemical parameters) and comorbid illnesses with sleep quality in individuals with coronary heart disease (CHD). METHODS This descriptive cross-sectional study was conducted between 2020 and 2021 at a university hospital. Hospitalized patients with a diagnosis of CHD were analyzed. The Personal Information Form' and Pittsburgh Sleep Quality Index (PSQI) were used to collect data. Laboratory findings including plasma metabolites were examined. RESULTS Of 60 hospitalized patients with CHD, 50 (83%) had poor sleep quality. A positive and statistically significant correlation was found between the plasma metabolite blood urea nitrogen and poor sleep quality (r = 0.399; p = 0.002). The presence of CHD and additional chronic diseases (especially diabetes mellitus, hypertension, and chronic kidney disease) are important parameters associated with the risk of poor sleep quality (p = 0.040 < 0.05). CONCLUSION Increases in blood urea nitrogen level in individuals with CHD are associated with worse sleep quality. Additional chronic diseases coexisting with CHD correlate with increased risk of poor sleep quality.
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Affiliation(s)
- Esma Gökçe
- Department of Vocational School of Health Services, Toros University, Mersin, Turkey.
| | - Sevban Arslan
- Department of Nurses, Faculty of Health Science, Çukurova University, Adana, Turkey
| | - Arzu İşler
- Department of Cardiology, Çukurova University, Adana, Turkey
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Horne CE, Abel WM, Crane PB. Fatigue, Stress, and Blood Pressure Medication Adherence by Race After Myocardial Infarction. J Nurse Pract 2023; 19:104757. [PMID: 37810177 PMCID: PMC10552602 DOI: 10.1016/j.nurpra.2023.104757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Fatigue and stress may affect medication adherence. This study explored fatigue, stress, and blood pressure (BP) medication adherence in Black and White adults (N= 152) who had experienced a myocardial infarction. Over half of the sample (55%) reported fatigue as moderate to severe. The regression model explained up to 40% of the variance (p < .001) with fatigue and race significantly predicting adherence. Black participants reported fatigue causing distress (r =.40), and White participants reported greater association of fatigue severity-related BP medication adherence (r =.49). Our findings support considering racial differences when evaluating fatigue associated with BP medication adherence.
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Affiliation(s)
- Carolyn E Horne
- School of Nursing, The University of North Carolina, Charlotte, NC
| | - Willie M Abel
- School of Nursing, The University of North Carolina, Charlotte, NC
| | - Patricia B Crane
- School of Nursing, The University of North Carolina, Charlotte, NC
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Gutlapalli SD, Pu J, Zaidi MF, Patel M, Atluri LM, Gonzalez NA, Sakhamuri N, Athiyaman S, Randhi B, Penumetcha SS. The Significance of Sleep Disorders in Post-myocardial Infarction Depression. Cureus 2022; 14:e30899. [DOI: 10.7759/cureus.30899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
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Abstract
BACKGROUND As recurrent myocardial infarctions (MIRs) constitute almost a third of the annual incidence of myocardial infarction, identifying the traditional and novel variables related to MIR is important. OBJECTIVE The aim of this study was to examine modifiable cardiac risks, adiposity, symptoms associated with inflammation (fatigue, depression, sleep) and inflammatory cytokines, and MIR by sex and race. METHODS Using a cross-sectional descriptive design, we recruited a convenience sample of adults (N = 156) discharged with first myocardial infarction or had MIR in the last 3 to 7 years. Surveys measured demographics, cardiac risk factors, depression, sleep, and fatigue. Anthropometric measures and cytokines tumor necrosis factor-α, interleukin-6, and high-sensitivity C-reactive protein (hsCRP) were obtained. A maximum likelihood regression was calculated to predict MIR. RESULTS The sample included 57% male and 30% Black participants, and the mean (SD) age was 65 (12) years. The hsCRP was the only cytokine related to symptoms: fatigue ( r = 0.309, P < .001) and depression ( r = 0.255, P = .002). An MIR was not associated with race despite White participants reporting better sleep ( t146 = -3.25, P = .002), lower body mass index ( t154 = -3.49, P = .001), and fewer modifiable risk factors ( t152 = -2.05, P = .04). An MIR was associated with being male, higher hsCRP and tumor necrosis factor-α levels ( P < .001), and higher inflammatory symptoms of fatigue ( P = .04), depression ( P = .01), and poor sleep ( P < .001). CONCLUSION Further examination of biomarkers to understand the mechanisms associated with inflammatory symptoms of fatigue, depression, and poor sleep and MIR is needed.
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Affiliation(s)
- Willie M. Abel
- School of Nursing, The University of North Carolina at
Charlotte
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Effect of Sleep Intervention Programs during Cardiac Rehabilitation on the Sleep Quality of Heart Patients. SLEEP DISORDERS 2022; 2022:8269799. [PMID: 35368746 PMCID: PMC8970947 DOI: 10.1155/2022/8269799] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/03/2022] [Accepted: 03/07/2022] [Indexed: 11/24/2022]
Abstract
Materials and Methods In this quasi-experimental study with unequal control group design, 35 individuals participated in the cardiac rehabilitation program as the experimental group and 35 served as the control group. The program included 12 weeks of exercise, 3 sessions per week, 3 sessions of training programs each lasting for 45 minutes, and a special two-session sleep improvement program. Data were collected using the Pittsburgh Sleep Quality Index and analysed with descriptive and inferential statistical methods. Results There were not any significant differences between the two groups in age, sex, marital status, smoking, and indication for cardiac rehabilitation (P > 0.05). The scores of sleep quality of patients were 9.2 ± 1.58 before and 4.40 ± 1.14 after intervention in the experimental group and 9.02 ± 2.56 before and 7.48 ± 1.86 after intervention in the control group. There was no significant difference between the two groups before intervention (P = 0.73). yet there was a significant difference after intervention (P = 0.0001). In addition, scores of sleep quality of patients were significantly different in the experimental and control groups before and after intervention (P = 0.0001). Conclusion Findings indicated that the quality of sleep of cardiac patients improved after the sleep intervention program during the cardiac rehabilitation program. Therefore, it is suggested to implement sleep improvement programs for cardiac patient care as an effective, easy, and feasible technique. In addition, it is necessary to pay more attention to the sleep improvement program in cardiac rehabilitation. Trial Registration. The trial was retrospectively registered on https://en.irct.ir/trial/50799 on 14 September 2020 (14.09.2020) with registration number IRCT20140307016870N6.
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Sexual Function, Anxiety, Depression and Coping After Myocardial Infarction: An Exploratory Study. SEXUALITY AND DISABILITY 2022; 40:77-89. [PMID: 36712231 PMCID: PMC9881546 DOI: 10.1007/s11195-021-09715-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background Myocardial infarction (MI) may decrease sexual function and satisfaction in men and can be influenced by anxiety, depression, and sexual fear. However, few studies have examined short-term changes in sexual function over time in a post-MI population. This study aimed to longitudinally describe changes in sexual function and satisfaction in a sample of men post-MI. Methods Eighteen patients were recruited from a Midwestern hospital. Surveys were mailed two weeks and three months post discharge. Sexual function was measured with the Male Sexual Function Index. Other variables collected included sexual fear (Multidimensional Sexuality Questionnaire), anxiety and depressive symptoms (Patient-Reported Outcomes Measurement Information System Anxiety and Depression 4a), and use of coping strategies (Coping Strategy Indicator). Results Sexual function scores increased in the entire sample from 8.9 (SD 7.3) at two weeks to 14.6 (SD 8.9) at three months (18.8% improvement, p=0.04). Men who were sexually active improved their scores by 27.3% (p=0.01), while those who were not sexually active decreased their scores by 2.3% (p=0.5). Depressive symptoms and anxiety scores were low and largely stable across timepoints, though there were some improvements among men who were sexually active compared to those who were not. Decreased utilization of avoidance coping strategies was reported in sexually active versus inactive men. Conclusion While sexual function improved within a short-time period post discharge among sexually active men post-MI, further research is needed with a larger sample to understand these changes across a longer period. Additional research is also warranted to examine any potential influence of psychosocial predictors.
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Prevalence of Moderate to Severe Anxiety Symptoms among Patients with Myocardial Infarction: a Meta-Analysis. Psychiatr Q 2022; 93:161-180. [PMID: 34013389 DOI: 10.1007/s11126-021-09921-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2021] [Indexed: 10/21/2022]
Abstract
This study attempted to synthesize the evidence on the prevalence of moderate to severe anxiety symptoms among myocardial infarction (MI) patients to offer a reliable and accurate estimate on the number of MI patients suffering from moderate to severe anxiety symptoms. Comprehensive electronic searches (PubMed, Embase and Web of Science) were performed from their inception to February 2021. Between-study heterogeneity was analyzed using the Cochran's Q test and [Formula: see text] statistic, and if it was high across the eligible studies, meta-regression and subgroup analyses were conducted to examine the source of heterogeneity. Publication bias and the robustness of the pooled results were also examined. A total of 18 eligible studies covering 8,532 MI patients were included, of which 3,443 were identified with moderate to severe anxiety symptoms. Between-study heterogeneity was high ([Formula: see text]=98.8%) with the reported prevalence ranging from 9.6% to 69.17%, and the pooled prevalence was 38.08% (95% confidence interval: 28.82-47.81%) by a random-effects model. Meta-regression analyses indicated that publication year (β = -0.014) was significant moderators contributing 16.11% to the heterogeneity. Subgroup analyses indicated that studies using the anxiety subscale of Brief Symptom Inventory to assess anxiety were homogenous ([Formula: see text]=0.0). Furthermore, the pooled prevalence of moderate to severe anxiety symptoms varied significantly by geographic region, instrument used to assess anxiety, methodological quality, sex, education level, a history of previous MI and hypercholesterolemia. Additionally, the results of Egger's linear test (t = -0.630) and Begg's rank test (z = -0.190) indicated no evidence of publication bias, and the sensitivity of the pooled results was low. Nearly two fifth of MI patients suffered from moderate to severe anxiety symptoms, which emphasizes the importance of early identification of anxiety symptoms after MI, as well as the need of implementing psychological interventions for those with elevated anxiety symptoms.
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Metabolomics and psychological features in fibromyalgia and electromagnetic sensitivity. Sci Rep 2020; 10:20418. [PMID: 33235303 PMCID: PMC7686375 DOI: 10.1038/s41598-020-76876-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 10/30/2020] [Indexed: 12/29/2022] Open
Abstract
Fibromyalgia (FM) as Fibromyalgia and Electromagnetic Sensitivity (IEI-EMF) are a chronic and systemic syndrome. The main symptom is represented by strong and widespread pain in the musculoskeletal system. The exact causes that lead to the development of FM and IEI-EMF are still unknown. Interestingly, the proximity to electrical and electromagnetic devices seems to trigger and/or amplify the symptoms. We investigated the blood plasma metabolome in IEI-EMF and healthy subjects using 1H NMR spectroscopy coupled with multivariate statistical analysis. All the individuals were subjected to tests for the evaluation of psychological and physical features. No significant differences between IEI-EMF and controls relative to personality aspects, Locus of Control, and anxiety were found. Multivariate statistical analysis on the metabolites identified by NMR analysis allowed the identification of a distinct metabolic profile between IEI-EMF and healthy subjects. IEI-EMF were characterized by higher levels of glycine and pyroglutamate, and lower levels of 2-hydroxyisocaproate, choline, glutamine, and isoleucine compared to healthy subjects. These metabolites are involved in several metabolic pathways mainly related to oxidative stress defense, pain mechanisms, and muscle metabolism. The results here obtained highlight possible physiopathological mechanisms in IEI-EMF patients to be better defined.
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Depression anticipates patients at risk of poor exercise stress test performance after percutaneous coronary angioplasty: A short-term longitudinal study. Gen Hosp Psychiatry 2020; 67:10-18. [PMID: 32889363 DOI: 10.1016/j.genhosppsych.2020.08.009] [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: 06/12/2020] [Revised: 08/03/2020] [Accepted: 08/20/2020] [Indexed: 12/14/2022]
Abstract
AIMS The exercise stress test is commonly used to assess physical capacity and recovery in coronary artery disease (CAD) patients after percutaneous transluminal coronary angioplasty (PTCA). Despite depressive symptoms have been consistently associated with adverse outcomes in CAD patients, they are rarely considered as risk factors of poor exercise test. The present study investigated the influence of depressive symptoms, along with anxiety, sleep problems and perceived health on exercise test in PTCA patients. METHODS One hundred and sixty-five patients who underwent PTCA completed the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory, the Sleep Condition Index and the 12-item Short-Form Health Survey and, after 20 days, underwent exercise stress test. RESULTS Higher BDI-II scores significantly predicted lower maximal workload measured in metabolic equivalents (METs; β = -0.13; p = .030), shorter total exercise duration (β = -5.23; p = .034) and the inability to reach maximum heart rate during exercise test (OR = 1.07; p = .032), even after controlling for relevant sociodemographic and biomedical risk factors. CONCLUSIONS Depressive symptoms specifically predicted worse exercise stress test performance in patients after PTCA, controlling for common risk factors. Focusing on the assessment of depressive symptoms, in addition to sociodemographic and biomedical risk factors, is essential to anticipate patients at risk of poor physical capacity after PTCA.
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Gecaite-Stonciene J, Bunevicius A, Burkauskas J, Brozaitiene J, Neverauskas J, Mickuviene N, Kazukauskiene N. Validation of the Multidimensional Fatigue Inventory with Coronary Artery Disease Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218003. [PMID: 33143183 PMCID: PMC7662819 DOI: 10.3390/ijerph17218003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Fatigue is a common distressing symptom in patients with coronary artery disease (CAD). The Multidimensional Fatigue Inventory (MFI) is used for measuring fatigue in various clinical settings. Nevertheless, its multidimensional structure has not been consistent across studies. Thus, we aimed to psychometrically evaluate the MFI in patients with CAD. METHODS In sum, 1162 CAD patients completed questionnaires assessing their subjective fatigue level (MFI-20), mental distress symptoms (HADS, STAI), and health-related quality of life (SF-36). Participants also completed exercise capacity (EC) testing. RESULTS Confirmatory factor analysis of the four-factor model, showed acceptable fit (CFI = 0.905; GFI = 0.895; NFI = 0.893, RMSEA = 0.077). After eliminating four items, confirmatory factor analysis testing showed improvement in the four-factor model of the MFI-16 (CFI = 0.910; GFI = 0.909; NFI = 0.898, RMSEA = 0.077). Internal consistency values were adequate for the total score and four MFI-16 subscales: General fatigue, physical fatigue, reduced activity, and mental fatigue with Cronbach's α range: 0.60-0.82. The inadequate value (Cronbach's α = 0.43) was received for the subscale of reduced motivation in both MFI-20 and MFI-16. Correlations between the MFI-16 and HADS, STAI, SF-36, and EC measures were statistically significant (all p's < 0.001). CONCLUSIONS The Lithuanian version of the modified MFI of 16 items showed good factorial structure and satisfactory psychometric characteristics, except for reduced motivation subscale.
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Antonio DADF, Muller AG, Butcher RDCGES. Reliability and viability of using the Multidimensional Fatigue Inventory-20 in patients with chronic coronary artery disease. Rev Esc Enferm USP 2019; 53:e03511. [PMID: 31800808 DOI: 10.1590/s1980-220x2018029203511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 04/11/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To verify the reliability and viability estimates of using the translated and adapted version of the Multidimensional Fatigue Inventory-20 for use in Brazil in patients with chronic coronary artery disease. METHOD A methodological study. The instrument was answered by the participants without the help of the researchers. Filling time was recorded, and facilities and difficulties were documented. The viability of use was analyzed through acceptability, practicality, ceiling and floor effects. Reliability was estimated by internal consistency. RESULTS The sample consisted of 201 participants. The mean fatigue score was 51.9 + 14.0. There was a small rate of unanswered items (0.65%), although 30.3% of participants requested some clarification after reading the instructions; 37.3% reported that they had doubts when answering the items, especially number 19. The response time was 4.8 + 1.9 minutes. There were no ceiling or floor effects. The reliability estimate was adequate. CONCLUSION The instrument needs adjustments to the wording of the instructions and some items, although it has good acceptability and reliability estimates.
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Affiliation(s)
| | - Amanda Gabriela Muller
- Universidade de São Paulo, Escola de Enfermagem; Hospital Universitário, São Paulo, SP, Brasil
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Strömbäck U, Engström Å, Wälivaara BM. Realising the seriousness – The experience of suffering a second myocardial infarction: A qualitative study. Intensive Crit Care Nurs 2019; 51:1-6. [DOI: 10.1016/j.iccn.2018.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 11/20/2018] [Accepted: 12/09/2018] [Indexed: 12/13/2022]
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Feng L, Li L, Liu W, Yang J, Wang Q, Shi L, Luo M. Prevalence of depression in myocardial infarction: A PRISMA-compliant meta-analysis. Medicine (Baltimore) 2019; 98:e14596. [PMID: 30813183 PMCID: PMC6407970 DOI: 10.1097/md.0000000000014596] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Depression is common in the aftermath of myocardial infarction (MI) and may not only lead to impaired long-term quality of life, but also cause increased mortality among patients with MI. The reported prevalence of depression among patients with MI varied considerably across studies, for which a pooled prevalence was obtained in the only 1 meta-analysis conducted in March 2004. Subsequently, numerous relevant studies have been published, indicating the need for an update on the pooled prevalence. Therefore, this study was aimed at updating the pooled prevalence of depression among patients with MI. METHODS A comprehensive literature search in 3 electronic databases, PubMed, Embase, and PsycINFO, was performed in April 2018. The heterogeneity across studies was examined by the Cochran's Q test and quantified by the I statistic. If significant heterogeneity was observed, meta-regression analyses and subgroup analyses were performed to identify the source of heterogeneity. Publication bias was assessed by a funnel plot and verified by the Egger's and Begg's tests. RESULTS Nineteen eligible studies conducted in 10 countries were included, which consisted of 12,315 patients with MI, among whom 3818 were identified with depression. High heterogeneity was observed across the eligible studies (I = 98.4%), with the reported prevalence of depression ranging from 9.17% to 65.88%. The pooled prevalence of depression among patients with MI was 28.70% (95% CI: 22.39-35.46%) by a random effects model. Subgroup analyses showed that the pooled prevalence differed significantly by region, tool used to identify depression, study quality, sex, race, anterior MI, and diabetes status (P < .05). Meta-regression analyses did not identify any moderators of heterogeneity, and the heterogeneity was high within most subgroups. Nonetheless, for unmarried subjects, the heterogeneity was low (I = 19.5). The Egger's test and the Begg's test indicated no evidence of publication bias (P > .05). CONCLUSIONS Given the high pooled prevalence of depression found in this study and the association between depression and adverse health outcomes among patients with MI, more psychological resources including early assessment and effective treatment of depression should be allocated to patients with MI.
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Affiliation(s)
- Limin Feng
- Department of Cardiology, The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Lifeng Li
- Department of Traditional Chinese Medicine, Tianjin Public Security Hospital, Tianjin
| | - Wennan Liu
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin
| | - Jianzhou Yang
- Department of Preventive Medicine, Changzhi Medical College, Changzhi, Shanxi
| | - Qing Wang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin
| | - Le Shi
- Department of Cardiology, Traditional Chinese Medicine Hospital of Tianjin Beichen District, Tianjin, China
| | - Mingchi Luo
- Department of Cardiology, The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin
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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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Norman J, Fu M, Ekman I, Björck L, Falk K. Effects of a mindfulness-based intervention on symptoms and signs in chronic heart failure: A feasibility study. Eur J Cardiovasc Nurs 2017. [PMID: 28639841 PMCID: PMC5751854 DOI: 10.1177/1474515117715843] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Aims: Despite treatment recommended by guidelines, many patients with chronic heart failure remain symptomatic. Evidence is accumulating that mindfulness-based interventions (MBIs) have beneficial psychological and physiological effects. The aim of this study was to explore the feasibility of MBI on symptoms and signs in patients with chronic heart failure in outpatient clinical settings. Methods: A prospective feasibility study. Fifty stable but symptomatic patients with chronic heart failure, despite optimized guideline-recommended treatment, were enrolled at baseline. In total, 40 participants (median age 76 years; New York Heart Association (NYHA) classification II−III) adhered to the study. Most patients (n=17) were randomized into MBI, a structured eight-week mindfulness-based educational and training programme, or controls with usual care (n=16). Primary outcome was self-reported fatigue on the Fatigue severity scale. Secondary outcomes were self-reported sleep quality, unsteadiness/dizziness, NYHA functional classification, walking distance in the six-minute walk test, and heart and respiratory rates. The Mann–Whitney U test was used to analyse median sum changes from baseline to follow-up (week 10±1). Results: Compared with usual care (zero change), MBI significantly reduced the self-reported impact of fatigue (effect size −8.0; p=0.0165), symptoms of unsteadiness/dizziness (p=0.0390) and breathlessness/tiredness related to physical functioning (NYHA class) (p=0.0087). No adverse effects were found. Conclusions: In stable but symptomatic outpatients with chronic heart failure, MBI alleviated self-reported symptoms in addition to conventional treatment. The sample size is small and further studies are needed, but findings support the role of MBI as a feasible complementary option, both clinically and as home-based treatment, which might contribute to reduction of the symptom burden in patients diagnosed with chronic heart failure.
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Affiliation(s)
- Jonna Norman
- 1 Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,2 The Gothenburg University Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, Gothenburg, Sweden
| | - Michael Fu
- 3 Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Inger Ekman
- 1 Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,2 The Gothenburg University Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, Gothenburg, Sweden
| | - Lena Björck
- 1 Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,3 Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kristin Falk
- 1 Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,2 The Gothenburg University Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, Gothenburg, Sweden
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Rouleau CR, Toivonen K, Aggarwal S, Arena R, Campbell TS. The association between insomnia symptoms and cardiovascular risk factors in patients who complete outpatient cardiac rehabilitation. Sleep Med 2017; 32:201-207. [DOI: 10.1016/j.sleep.2017.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 12/29/2016] [Accepted: 01/04/2017] [Indexed: 12/21/2022]
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Nilsson U. Effectiveness of music interventions for women with high anxiety during coronary angiographic procedures: a randomized controlled. Eur J Cardiovasc Nurs 2017; 11:150-3. [DOI: 10.1016/j.ejcnurse.2010.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ulrica Nilsson
- Centre for Health Care Sciences, Örebro County Council, Sweden
- Department of Nursing, Umeå University, Umeå, Sweden
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Srivastava P, Gupta R, Chari D, Rawat A, Goel D. Comparison of prevalence of obstructive sleep apnea, restless legs syndrome, and poor sleep quality in patients with coronary artery disease and depression. SOMNOLOGIE 2016. [DOI: 10.1007/s11818-016-0053-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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The Association Between Insomnia Symptoms and Mood Changes During Exercise Among Patients Enrolled in Cardiac Rehabilitation. J Cardiopulm Rehabil Prev 2015; 35:409-16. [DOI: 10.1097/hcr.0000000000000138] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yang PL, Huang GS, Tsai CS, Lou MF. Sleep Quality and Emotional Correlates in Taiwanese Coronary Artery Bypass Graft Patients 1 Week and 1 Month after Hospital Discharge: A Repeated Descriptive Correlational Study. PLoS One 2015; 10:e0136431. [PMID: 26291524 PMCID: PMC4546334 DOI: 10.1371/journal.pone.0136431] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 08/03/2015] [Indexed: 12/16/2022] Open
Abstract
Background Poor sleep quality is a common health problem for coronary artery bypass graft patients, however few studies have evaluated sleep quality during the period immediately following hospital discharge. Purpose The aim of this study was to investigate changes in sleep quality and emotional correlates in coronary artery bypass graft patients in Taiwan at 1 week and 1 month after hospital discharge. Methods We used a descriptive correlational design for this study. One week after discharge, 87 patients who had undergone coronary artery bypass surgery completed two structured questionnaires: the Pittsburgh Sleep Quality Index and the Hospital Anxiety and Depression Scale. Three weeks later (1 month after discharge) the patients completed the surveys again. Pearson correlations, t-tests, ANOVA and linear multiple regression analysis were used to analyze the data. Results A majority of the participants had poor sleep quality at 1 week (82.8%) and 1 month (66.7%) post-hospitalization, based on the global score of the Pittsburgh Sleep Quality Index. Despite poor sleep quality at both time-points the sleep quality at 1 month was significantly better than at 1-week post hospitalization. Poorer sleep quality correlated with older age, poorer heart function, anxiety and depression. The majority of participants had normal levels of anxiety at 1 week (69.0%) and 1 month (88.5%) as measured by the Hospital Anxiety and Depression Scale. However, some level of depression was seen at 1 week (78.1%) and 1 month (59.7%). Depression was a significant predictor of sleep quality at 1 week; at 1 month after hospital discharge both anxiety and depression were significant predictors of sleep quality. Conclusion Sleep quality, anxiety and depression all significantly improved 1 month after hospital discharge. However, more than half of the participants continued to have poor sleep quality and some level of depression. Health care personnel should be encouraged to assess sleep and emotional status in patients after coronary artery bypass surgery and offer them appropriate management strategies to improve sleep and reduce anxiety and depression.
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Affiliation(s)
- Pei-Lin Yang
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
| | - Guey-Shiun Huang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chien-Sung Tsai
- Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Meei-Fang Lou
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
- * E-mail:
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Kim JM, Stewart R, Bae KY, Kang HJ, Kim SW, Shin IS, Hong YJ, Ahn Y, Jeong MH, Yoon JS. Correlates and Escitalopram Treatment Effects on Sleep Disturbance in Patients with Acute Coronary Syndrome: K-DEPACS and EsDEPACS. Sleep 2015; 38:1105-11. [PMID: 25581916 DOI: 10.5665/sleep.4822] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 12/07/2014] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES To investigate the correlates of sleep disturbance and to assess escitalopram treatment effects of depression on sleep disturbance in patients with acute coronary syndrome (ACS). DESIGN A cross-sectional study in patients with ACS within 2 w post-ACS, and a 24-w double-blind controlled trial of escitalopram against placebo for patients with ACS who have comorbid depressive disorders. SETTING A university hospital in South Korea. PARTICIPANTS There were 1,152 patients with ACS who were consecutively recruited. Of 446 patients with comorbid depressive disorders, 300 were randomized to the trial. MEASUREMENTS AND RESULTS Sleep disturbance was evaluated by the Leeds Sleep Evaluation Questionnaire. Demographic and clinical characteristics were assessed, including cardiovascular risk factors, current cardiac status, and depressive symptoms. Depressive symptoms were most strongly and consistently associated with sleep disturbance. In addition, older age, female sex, hypertension, and more severe ACS status were associated with certain aspects of sleep disturbance. Escitalopram was significantly superior to placebo for improving sleep disturbance over the 24-w treatment period. These effects were substantially explained by improvement in depressive symptoms. CONCLUSIONS Depression screening is indicated in patients with acute coronary syndrome with sleep disturbance. Successful treatment of depression has beneficial effects on sleep outcomes in these patients. CLINICAL TRIALS INFORMATION ClinicalTrial.gov identifier for the 24-w drug trial, NCT00419471.
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Affiliation(s)
- Jae-Min Kim
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | | | - Kyung-Yeol Bae
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hee-Ju Kang
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Il-Seon Shin
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jin-Sang Yoon
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
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Sepahvand E, Jalali R, Mirzaei M, Kargar Jahromi M. Association between short sleep and body mass index, hypertension among acute coronary syndrome patients in coronary care unit. Glob J Health Sci 2014; 7:134-9. [PMID: 25948448 PMCID: PMC4802147 DOI: 10.5539/gjhs.v7n3p134] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 10/09/2014] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Patients with coronary diseases admitted to special care unit often suffer from sleep disorders, which may cause physiological changes and adversely affect patient's health. The relationship between sleep disorders and obesity is an important factor in studies on sleep disorders and other chronic diseases in all groups, including cardiovascular diseases. Understanding this relationship may increase the chance of progress in effective medical interventions in sleep disorders and obesity. This study was designed to evaluate the association between short sleep and Body Mass Index (BMI), hypertension among acute coronary syndrome patients. MATERIALS & METHODS In this descriptive analytical study, 221 coronary patients admitted to coronary care unit and general wards were investigated. Data were collected through a researcher-made questionnaire whose validity and reliability had been confirmed. Data were analyzed with SPSS-16 software. RESULTS A total of 221 patients with acute coronary diseases (including myocardial infarction and angina pectoris) with a mean age of 61.27 years were studied, of whom 61.5% were male and 38.5% were female. A significant association was observed between short sleep and higher BMI (P=0.000). About half the patients (49.3%) had a history of hypertension, and sleep disorders were also significantly related to hypertension (P=0.006). DISCUSSION In this study, sleep disorders were patients' main complaint. Researchers found that patients with less than 5 hours or more than 9 hours sleep at night were more likely to have hypertension compared to patients that slept 7-8 hours. Lack of sleep affects metabolism, and daily energy expenditure reduces with increased immobility. In this study, a significant relationship was observed between BMI and sleep duration among hospitalized patients in coronary care unit (P=0.000), and sleep disorders increased with higher BMI. Short of sleep increases sympathetic tonus, cortisol level, and activation of inflammatory pathways, impairing glucose metabolism and contributing to overweigh, increased visceral fat. CONCLUSION Our findings suggest that poor sleep quality, is related to higher BMI and hypertension among acute coronary syndrome patients.
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Optimal Timing for Initiation of Biofeedback-Assisted Relaxation Training in Hospitalized Coronary Heart Disease Patients With Sleep Disturbances. J Cardiovasc Nurs 2014; 29:367-76. [DOI: 10.1097/jcn.0b013e318297c41b] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Lei H, Xu J, Cheng LJ, Guo Q, Deng AM, Li YS. An increase in the cerebral infarction area during fatigue is mediated by il-6 through an induction of fibrinogen synthesis. Clinics (Sao Paulo) 2014; 69:426-32. [PMID: 24964308 PMCID: PMC4050324 DOI: 10.6061/clinics/2014(06)10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 12/11/2013] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Our study aimed to investigate the impact of fatigue on the severity of stroke and to explore the underlying mechanisms. METHODS Fatigued male rats underwent middle cerebral artery occlusion and the infarcted brain area was determined. Then, coagulation parameters were assessed in the fatigued group and a control group. In addition, the level of fibrinogen was determined in rats deprived of sleep for various numbers of days. To study whether interleukin-6 was involved in fibrinogen synthesis during fatigue, we also measured levels of interleukin-6 in rats deprived of sleep for various numbers of days. Furthermore, brain injury by middle cerebral artery occlusion was measured in wild-type mice, interleukin-6-/- mice and wild-type mice treated with bezafibrate. RESULTS More severe cerebral infarction was observed in the fatigued rats, resulting in an infarct ratio of 23.4%. The infarct ratio was significantly increased in the fatigued rats compared with that in the control group (8%, p<0.05). The level of fibrinogen was increased significantly in the fatigued rats compared with that in the control group. In addition, a marked reduction in fibrinogen level was observed in the fatigued interleukin-6-/- mice compared to their wild-type counterparts, whereas no difference was observed between fatigued wild-type mice and interleukin-6-/- rats treated with recombinant human interleukin-6. The reduction in brain injury due to middle cerebral artery occlusion during fatigue was observed in interleukin-6-/- mice and wild-type mice treated with bezafibrate. CONCLUSION Fatigue could increase stroke severity and was associated with the interleukin-6-induced expression of fibrinogen.
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Affiliation(s)
- Hong Lei
- Institute for Drug and Instrument Control of Beijing Military Area Command, , Beijing, China
| | - Jian Xu
- Department of Laboratory Medicine, Chang Hai Hospital, Second Military Medical University, Shanghai, China
| | - Li-Juan Cheng
- Institute for Drug and Instrument Control of Beijing Military Area Command, , Beijing, China
| | - Qi Guo
- Institute for Drug and Instrument Control of Beijing Military Area Command, , Beijing, China
| | - An-Mei Deng
- Department of Laboratory Medicine, Chang Hai Hospital, Second Military Medical University, Shanghai, China
| | - Yong-Shen Li
- Institute for Drug and Instrument Control of Beijing Military Area Command, , Beijing, China
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Development and Validation of Sleep Disturbance Questionnaire in Patients with Acute Coronary Syndrome. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2014; 2014:978580. [PMID: 27382631 PMCID: PMC4897318 DOI: 10.1155/2014/978580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Revised: 07/27/2014] [Accepted: 07/28/2014] [Indexed: 11/17/2022]
Abstract
Background and Objectives. Severe sleep disturbance is a common problem among patients in cardiac care units (CCUs). There are questionnaires to measure sleep disturbances. Therefore, the present study seeks to design a valid and reliable questionnaire to assess sleep disturbance in patients with acute coronary syndrome (ACS) hospitalized in CCUs. Materials and Methods. In the present methodological research, items of the questionnaire were extracted through a systematic review. The validity and reliability of the questionnaires was assessed by face validity, content validity, construct validity, Cronbach's alpha coefficient, and test-retest methods. Results. Factor analysis provided a questionnaire of 23 items on 5 dimensions of sleep disturbance in coronary patients: “sleep onset and continuity disorder,” “disorder in daytime functioning,” “sleep disturbance caused by environmental factors,” “sleep disturbance as a result of cardiac diseases,” and “respiratory disorders during sleep.” Furthermore, test-retest analysis showed a reliability correlation coefficient of r = 0.766 and α Cronbach's reliability (α = 0.855). Conclusion. Sleep disturbance questionnaire for patients with ACS hospitalized in coronary care unit (CCU) was identified in 5 dimensions and assessed for validity and reliability. To control and improve the sleep quality of CCU hospitalized patients, we need to identify and remove predisposing factors.
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Holliday EG, Magee CA, Kritharides L, Banks E, Attia J. Short sleep duration is associated with risk of future diabetes but not cardiovascular disease: a prospective study and meta-analysis. PLoS One 2013; 8:e82305. [PMID: 24282622 PMCID: PMC3840027 DOI: 10.1371/journal.pone.0082305] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 10/22/2013] [Indexed: 11/24/2022] Open
Abstract
Epidemiologic studies have observed association between short sleep duration and both cardiovascular disease (CVD) and type 2 diabetes, although these results may reflect confounding by pre-existing illness. This study aimed to determine whether short sleep duration predicts future CVD or type 2 diabetes after accounting for baseline health. Baseline data for 241,949 adults were collected through the 45 and Up Study, an Australian prospective cohort study, with health outcomes identified via electronic database linkage. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals. Compared to 7h sleep, <6h sleep was associated with incident CVD in participants reporting ill-health at baseline (HR=1·38 [95% CI: 1·12-1·70]), but not after excluding those with baseline illness and adjusting for baseline health status (1·03 [0·88-1·21]). In contrast, the risk of incident type 2 diabetes was significantly increased in those with <6h versus 7h sleep, even after excluding those with baseline illness and adjusting for baseline health (HR=1·29 [1·08-1·53], P=0.004). This suggests the association is valid and does not simply reflect confounding or reverse causation. Meta-analysis of ten prospective studies including 447,124 participants also confirmed an association between short sleep and incident diabetes (1·33 [1·20-1·48]). Obtaining less than 6 hours of sleep each night (compared to 7 hours) may increase type 2 diabetes risk by approximately 30%.
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Affiliation(s)
- Elizabeth G. Holliday
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health and Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia
- * E-mail:
| | - Christopher A. Magee
- Centre for Health Initiatives, University of Wollongong, Wollongong, New South Wales, Australia
| | - Leonard Kritharides
- Department of Cardiology, Concord Repatriation General Hospital, The University of Sydney, Sydney, New South Wales, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
- The Sax Institute, Sydney, New South Wales, Australia
| | - John Attia
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health and Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia
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Abstract
Posttraumatic stress disorder (PTSD) is an anxiety disorder initiated by exposure to a traumatic event and characterized by intrusive thoughts about the event, attempts to avoid reminders of the event, and physiological hyperarousal. In a number of large prospective observational studies, PTSD has been associated with incident cardiovascular disease (CVD) and mortality. Also, in recent years, a number of studies have shown that cardiovascular events can themselves cause PTSD in more than 1 in 8 patients with acute coronary syndrome. Further, a few small studies suggest that PTSD secondary to an acute CVD event then places patients at increased risk for subsequent CVD events and mortality. In this article, we review the evidence for a link between PTSD and CVD, and discuss potential mechanisms for that association as well as future directions for research.
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Affiliation(s)
- Donald Edmondson
- Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY 10032, USA.
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Muschalla B, Glatz J, Linden M. Heart-related anxieties in relation to general anxiety and severity of illness in cardiology patients. PSYCHOL HEALTH MED 2013; 19:83-92. [DOI: 10.1080/13548506.2013.774428] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Patusky KL, Caldwell B, Unkle D, Ruck B. Incorporating the treatment of medical and psychiatric disorders in the critical care area. Crit Care Nurs Clin North Am 2012; 24:53-80. [PMID: 22405712 DOI: 10.1016/j.ccell.2012.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Critical care areas are fast moving, often chaotic, and therefore confusing, even frightening, to patients attempting to understand what has happened to them. The nurse acts to mitigate these reactions by understanding the range of possibilities that can occur with patients, including potential psychiatric issues, and serving as patient advocate to ensure that appropriate treatment is initiated. Certainly there may be other psychiatric problems not described in the preceding text. The main possibilities are covered in this article. Assessing and acting early are tools the critical care nurse uses to meet patient needs and prevent behavioral problems that can interfere with life-preserving care.
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Affiliation(s)
- Kathleen L Patusky
- Graduate Programs, School of Nursing, University of Medicine & Dentistry of New Jersey, Newark, NJ 07101, USA.
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Wilkinson K, Shapiro C. Nonrestorative sleep: symptom or unique diagnostic entity? Sleep Med 2012; 13:561-9. [PMID: 22560828 DOI: 10.1016/j.sleep.2012.02.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 02/01/2012] [Accepted: 02/07/2012] [Indexed: 10/28/2022]
Abstract
Nonrestorative sleep (NRS) refers to the subjective experience of sleep as insufficiently refreshing, often despite the appearance of normal sleep according to traditionally assessed objective parameters. This has led researchers to pursue alternative physiological markers of nonrestorative or unrefreshing sleep, though much of this research remains controversial and inconclusive. This review summarizes the recent findings on NRS in the literature and discusses some of the issues inherent in current efforts to define and measure NRS. We offer a summary of recommended clinical approaches to NRS and discuss a new potential paradigm for the assessment of NRS-an approach modelled on current diagnosis of insomnia.
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Affiliation(s)
- Kate Wilkinson
- Department of Cell and Systems Biology, University of Toronto, 25 Harbord Street, Toronto, ON M5S 3G5, Canada.
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Forsberg A, Persson LO, Nilsson M, Lennerling A. The organ transplant symptom and well-being instrument - psychometric evaluation. Open Nurs J 2012; 6:30-40. [PMID: 22523527 PMCID: PMC3330362 DOI: 10.2174/1874434601206010030] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Revised: 02/18/2012] [Accepted: 02/20/2012] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND There is a need for instruments combining measurements of symptom distress and well-being in the organ transplant population. OBJECTIVES The aim of this study was to describe the development and initial psychometric evaluation of a measure of symptoms and well-being in organ transplant recipients labelled the Organ Transplant Symptom and Well-being instrument (OTSWI) and to provide descriptive data on these matters. METHOD In this cross sectional survey, the study sample (n=185) completed several measures including demographic information, the Short form- 36 items (SF-36), and the OTSWI to assess concurrent validity by exploring relationships between OTSWI and measures of health related quality of life (HRQOL). The expected scale dimensionality of the OTSWI questionnaire was examined both by the confirmatory multi-trait analysis program and by explorative principal component analysis (with oblique, varimax rotation). Scale reliability was further estimated using the Cronbach's alpha. RESULTS There were eight factors built up from twenty of the initial fifty one items and were labelled fatigue, joint and muscle pain, cognitive functioning, basic activities in daily life, sleeping problems, mood, foot pain and economy. For the remaining twenty-one items no consistent and meaningful factors could be found leading to relevant symptoms acting as single items. All eight factors had satisfying internal convergent validity as well as good item-scale discriminatory validity or 'success rate'. DISCUSSION Results support the internal consistency, reliability and concurrent validity of the OTSWI as an instrument to measure symptom distress and well-being in relation to organ transplantation. (Word count 244).
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Affiliation(s)
- Anna Forsberg
- The Sahlgrenska Academy at University of Gothenburg, Institute of Health and Caring Sciences
- The Faculty of Medicine at Lund University, Department of Health Sciences
| | - Lars-Olof Persson
- The Sahlgrenska Academy at University of Gothenburg, Institute of Health and Caring Sciences
| | - Madeleine Nilsson
- The Queen Silvia’s Children Hospital at Sahlgrenska University Hospital, Gothenburg
| | - Annette Lennerling
- The Sahlgrenska Academy at University of Gothenburg, Institute of Health and Caring Sciences
- The Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden
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Bunevicius A, Stankus A, Brozaitiene J, Girdler SS, Bunevicius R. Relationship of fatigue and exercise capacity with emotional and physical state in patients with coronary artery disease admitted for rehabilitation program. Am Heart J 2011; 162:310-6. [PMID: 21835292 DOI: 10.1016/j.ahj.2011.05.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Accepted: 05/05/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND The relationship between subjective fatigue, exercise capacity, and symptoms of depression and anxiety in patients with coronary artery disease (CAD) needs to be specified. METHODS In this cross-sectional study, a total of 1,470 (64% men; mean age 57 ± 11 years) consecutive CAD patients admitted for cardiac rehabilitation after treatment of acute cardiac events were evaluated for demographic characteristics, for past and current diagnosis and treatment, for New York Heart Association (NYHA) class, for symptoms of depression and for symptoms of anxiety using the Hospital Anxiety and Depression Scale, and for subjective fatigue using the Multidimensional Fatigue Inventory. On the next day, all patients underwent exercise capacity evaluation using a standard bicycle ergometer testing procedure. RESULTS In univariate regression analyses, there was the strongest positive association between scores on all Multidimensional Fatigue Inventory subscales and scores on the Hospital Anxiety and Depression Scale depression and anxiety subscales and between exercise capacity and NYHA class. Multivariate regression analyses revealed that symptoms of depression were the strongest positive determinants of all dimensions of subjective fatigue and, together with other significant variables, accounted for 17% to 29% of the variance. However, neither depressive nor anxious symptoms were significant determinants of exercise capacity. The association between subjective fatigue and exercise capacity and vice versa was minimal. CONCLUSION Subjective fatigue in CAD patients is strongly related to symptoms of depression and symptoms of anxiety. In contrast, exercise capacity in CAD patients is strongly related to NYHA functional class, with no relationship to symptoms of depression and anxiety.
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Affiliation(s)
- Adomas Bunevicius
- Institute of Psychophysiology and Rehabilitation of the Lithuanian University of Health Sciences, Palanga, Lithuania.
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Duarte Freitas P, Haida A, Bousquet M, Richard L, Mauriège P, Guiraud T. Short-term impact of a 4-week intensive cardiac rehabilitation program on quality of life and anxiety-depression. Ann Phys Rehabil Med 2011; 54:132-43. [DOI: 10.1016/j.rehab.2011.02.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 01/31/2011] [Accepted: 02/01/2011] [Indexed: 10/18/2022]
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