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Al-Maskari A, Al-Zaabi G, AL-Mamari HA, Al-mawali M, Nadar SK. Psychological impact of first admission with cardiovascular disease in a tertiary hospital in Oman. J Taibah Univ Med Sci 2024; 19:28-34. [PMID: 37868102 PMCID: PMC10585295 DOI: 10.1016/j.jtumed.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/05/2023] [Accepted: 08/30/2023] [Indexed: 10/24/2023] Open
Abstract
Background and objectives Cardiovascular diseases (CVD) are associated with substantial psychological effects that can adversely influence long term prognosis. The aim of this study was to determine the psychological effect of the first hospital admission for acute coronary syndrome (ACS) or congestive heart failure (CHF) in an adult Omani population. Methods This cross-sectional questionnaire based study used the Hospital Anxiety and Depression Scale. Patients were recruited from the in-patient cardiology and medical wards of our institution. Patients with a prior hospital admission for CHF and ACS were excluded. The questionnaire was administered between days 3 and 7 after admission once patients were clinically stable. Results The study included 116 patients (mean age 60.3 + 13.8 years; 78 (67.8%) men), comprising 52 patients with ACS and 64 patients with CHF. Based on the scores, a total of 45 (38.8%) patients had moderate to severe anxiety, and 32 (27.6%) had moderate to severe depression. Patients with severe anxiety tended to be younger, and no other factors predicted anxiety or depression. The proportion of patients with severe depression was higher among patients with CHF (31.4%), and no other differences were observed between patients with ACS or CHF. Conclusion A substantial proportion of patients admitted to our institution in Oman with CVD had severe anxiety and depression. Treating physicians and caregivers should be more open to identifying these patients, and steps should be taken to address their psychological wellbeing along with the medical management of their illness.
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Affiliation(s)
- Ahmed Al-Maskari
- Department of Nursing, Directorate of Nursing, Sultan Qaboos University Hospital, Muscat, Oman
| | - Ghanima Al-Zaabi
- Department of Nursing, Directorate of Nursing, Sultan Qaboos University Hospital, Muscat, Oman
| | - Hafsa A. AL-Mamari
- Department of Medicine, College of Medicine and Health Science, Sultan Qaboos University, Muscat, Oman
| | - Manar Al-mawali
- Department of Medicine, College of Medicine and Health Science, Sultan Qaboos University, Muscat, Oman
| | - Sunil K. Nadar
- Department of Cardiology, Sultan Qaboos University Hospital, Muscat Oman
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Dong X, He D, Zhang Y, Zhao Q, Zhang X, Fan X. Dyadic Associations Between Burden and Depressive Symptoms Among Patients With Heart Failure and Their Caregivers: The Mediating Role of Perceived Stress. J Cardiovasc Nurs 2023; 38:517-527. [PMID: 37816079 DOI: 10.1097/jcn.0000000000000974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Depressive symptoms are prevalent in patients with heart failure and their family caregivers. Given the interpersonal interactions between dyadic individuals with intimate relationship, it is essential to consider the dyads as a unit when exploring the factors associated with depressive symptoms in heart failure patient-caregiver dyads. OBJECTIVE The aims of this study were to explore the dyadic effects of burden on depressive symptoms in heart failure patient-caregiver dyads and investigate whether perceived stress acts as a mediator in these relationships. METHODS In this cross-sectional study, 237 heart failure patient-caregiver dyads were recruited from 3 hospitals in China between November 2018 and June 2019. Symptom burden, caregiving burden, perceived stress, and depressive symptoms were assessed using self-report questionnaires. The actor-partner interdependence model and actor-partner interdependence mediation model were used to analyze the data. RESULTS Patients' symptom burden had an actor effect on their own depressive symptoms and a partner effect on their caregivers' depressive symptoms. Similarly, caregivers' caregiving burden had an actor effect on their own depressive symptoms and a partner effect on patients' depressive symptoms. The actor effects between burden and depressive symptoms were partially mediated by their own perceived stress in heart failure patient-caregiver dyads. Furthermore, the partner effect between caregivers' caregiving burden and patients' depressive symptoms was completely mediated by patients' perceived stress. CONCLUSIONS Patients' symptom burden and caregivers' caregiving burden aggravated their depressive symptoms by increasing their own perceived stress. Moreover, patients' symptom burden led to caregivers' depressive symptoms, and caregivers' caregiving burden contributed to patients' depressive symptoms through patients' perceived stress. These interdependent relationships suggest that dyadic interventions focused on reducing burden and perceived stress may be beneficial for relieving depressive symptoms in heart failure patient-caregiver dyads.
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Raesi R, Shaye ZA, Saghari S, Sheikh Beig Goharrizi MA, Raei M, Hushmandi K. The impact of education through nurse-led telephone follow-up (telenursing) on the quality of life of COVID-19 patients. J Egypt Public Health Assoc 2021; 96:30. [PMID: 34748085 PMCID: PMC8574947 DOI: 10.1186/s42506-021-00093-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 10/18/2021] [Indexed: 12/14/2022]
Abstract
Background The widespread prevalence of COVID-19 has disrupted the social life, physical function, and daily activities of patients, leading to reduced quality of their lives. Because of the nature of this disease and its comprehensive impact on patients’ lives, a follow-up based on the conditions of these patients is necessary. This study was conducted to determine the impact of nurse education and telephone follow-up (telenursing) on the quality of life of COVID-19 patients. Methods This quasi-experimental study included 120 COVID-19 patients discharged from 22nd-Bahman Hospital in Khaf city and was conducted over 6 months from July 20, 2020, to December 20, 2020. The participants were selected by convenience sampling method and were assigned into two matching groups. The training was delivered through telenursing based on the quality of life criteria for 1 month in the intervention group. The controls did not receive any intervention. Both groups completed the 36-item SF health survey before and 1 month after the intervention. Results The two groups were not significantly different regarding the quality of life mean scores at baseline (p = 0.61). However, after the intervention, the mean and standard deviation of the total life quality score was significantly different between the control and intervention groups (63.62 ± 3.93 versus 72.62 ± 3.51, p <0.001). Conclusions Telenursing improves the life quality of COVID-19 patients. Through appropriate policies, health managers may put on the agenda the implementation of telenursing for COVID-19 patients.
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Affiliation(s)
- Rasoul Raesi
- Bahman Khaf Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Health Services Management, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Zahra Abbasi Shaye
- Community Medicine, Akbar Clinical Research & Development Unit, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sam Saghari
- Department of Health Services Management, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | | | - Mehdi Raei
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Kiavash Hushmandi
- Department of Food Hygiene and Quality Control, Division of Epidemiology & Zoonoses, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran.
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Yang H, Li Y, Su X, Li C. Relationship between free fatty acids, body mass index and depressive symptoms in patients with chronic heart failure. Nurs Open 2021; 8:2877-2885. [PMID: 34080794 PMCID: PMC8363406 DOI: 10.1002/nop2.877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/07/2021] [Accepted: 03/15/2021] [Indexed: 02/04/2023] Open
Abstract
AIM To explore the prevalence of depressive symptoms among patients with chronic heart failure (CHF) and analyse the relationship between free fatty acids (FFAs), body mass index (BMI) and depressive symptoms among patients with CHF. DESIGN A cross-sectional study. METHODS Questionnaires were distributed to 200 patients with CHF in the department of Cardiology at a tertiary first-class hospital in Shandong province. A total of 195 hospitalized patients completed the survey. Data collected from February 2017-November 2017 were analysed by using Pearson's correlation and multiple linear regression. The depressive status of the patients was assessed by the Zung Self-rating Depression Scale (SDS), and the relationships between FFA, BMI and depressive symptoms were analysed using SPSS 20.0. RESULTS The results showed that 71.28% CHF patients have depressive symptoms. The serum FFA level was significantly higher in CHF patients with depressive symptoms than those without depressive symptoms (p = .003), and FFA level was significantly positively correlated with the SDS score (r = .242, p = .001). The differences in SDS scores were statistically significant between two different BMI groups (p < .01), and BMI was negatively correlated with the SDS score (r = -.139, p = .040). Regression analysis showed that high FFAs (β = 0.184, p = .009) and low BMI (β = -0.116, p = .049) were risk factors for depressive symptoms in CHF patients. Gender, age, FFA and BMI were associated with depressive symptoms, accounting for 7.1% of the variance in depressive symptoms. CONCLUSIONS The prevalence of depressive symptoms in CHF patients is very high, and high FFAs and low BMI are risk factors for depressive symptoms. Targeted interventions to strengthen nutritional support in CHF patients may be benefit to improve depression-related outcomes.
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Affiliation(s)
- Hua Yang
- Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yan Li
- Supply Room of Affiliated Hospital of Shandong, University of Traditional Chinese Medicine, Jinan, China
| | - Xing Su
- Department of Cardiology, Affiliated Hospital of Jining Medical University, Jining, China
| | - Chao Li
- Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
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Assessing the Determinants of the Wish to Die among the Elderly Population in Ghana. Geriatrics (Basel) 2021; 6:geriatrics6010032. [PMID: 33807000 PMCID: PMC8006009 DOI: 10.3390/geriatrics6010032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/01/2021] [Accepted: 03/21/2021] [Indexed: 11/17/2022] Open
Abstract
Background: A wish to die is common in elderly people. Concerns about death wishes among the elderly have risen in Ghana, where the ageing transition is comparable to other low-and middle-income countries. However, nationally representative research on death wishes in the elderly in the country is not readily available. Our study aimed to assess the determinants of the wish to die among the elderly in Ghana. Methods: We analysed data from the World Health Organisation Global Ageing and Adult Health Survey, Wave 1 (2007–2008) for Ghana. Data on the wish to die, socio-demographic profiles, health factors and substance abuse were retrieved from 2147 respondents aged 65 and above. Ages of respondents were categorised as 65–74 years; 75–84 years; 85+ to reflect the main stages of ageing. Logistic regression models were fitted to assess the association between these factors and the wish to die. Results: Age, sex, place of residence, education, body mass index, hypertension, stroke, alcohol consumption, tobacco use, income, diabetes, visual impairment, hopelessness and depression had statistically significant associations with a wish to die. Older age cohorts (75–84 and 85+) were more likely to have the wish to die (AOR = 1.05, CI = 1.02–1.16; AOR = 1.48, CI = 1.22–1.94), compared to younger age cohorts (65–74 years). Persons who felt hopeless had higher odds (AOR = 2.15, CI = 2.11–2.20) of experiencing the wish to die as compared to those who were hopeful. Conclusions: In view of the relationship between socio-demographic (i.e., age, sex, education and employment), hopelessness, anthropometric (body mass index), other health factors and the wish to die among the elderly in Ghana, specific biopsychosocial health promotion programmes, including timely identification of persons at risk, for appropriate intervention (e.g., psychotherapy, interpersonal support, alcohol-tobacco cessation therapy, clinical help) to promote their wish for a longer life is needed.
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Neuropsychological Assessment and Screening in Heart Failure: a Meta-Analysis and Systematic Review. Neuropsychol Rev 2021; 31:312-330. [PMID: 33428163 DOI: 10.1007/s11065-020-09463-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 10/12/2020] [Indexed: 01/03/2023]
Abstract
A variety of neuropsychological changes secondary to heart failure have been documented in the literature. However, what remains unclear are which neuropsychological abilities are the most impacted by heart failure and what tests have the sensitivity to measure that impact. Eight databases were searched for articles that examined the neuropsychological functioning of patients with heart failure. Some of the inclusion criteria were articles had to have a heart failure group with a demographically comparable control group and standardized neuropsychological testing. Exclusion criteria included articles with a heart failure group with any other type of major organ failure, or comparisons that were between different classes of heart failure rather than between a heart failure and non-heart failure group. A total of 33 articles met the inclusion criteria (total heart failure sample n = 8900) and provided effect size data for 20 neuropsychological domains. All observed domain-level differences between heart failure and non-heart failure groups were statistically significant, except for simple motor functioning and confrontation naming. The greatest differences in performance were in executive functioning, global cognition, complex psychomotor speed, and verbal memory. The highest effect sizes came from Trail-Making Test-Part B, CAMCOG, Symbol Digit Modality Test, and California Verbal Learning Test. The neuropsychological patterns of heart failure suggested diffuse cognitive involvement, with higher-level processes being most affected. It is important to track neurocognition in this clinical population since neuropsychological impairment is prevalent, and screening measures appear to be reliable. Such screening and further assessment would inform future medical treatment and may improve patient care management.
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Molano-Barrera D, González-Consuegra R. Factores deteriorantes de la calidad de vida en insuficiencia cardiaca: revisión integrativa. DUAZARY 2021. [DOI: 10.21676/2389783x.3889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
La insuficiencia cardiaca es una enfermedad que aumenta la morbimortalidad, deteriora la calidad de vida de la persona que la padece e impacta negativamente en el sistema de salud. El propósito de esta revisión es explorar la literatura para determinar qué condiciones biopsicosociales del individuo pueden ser factores deteriorantes de la calidad de vida relacionada con la salud en esta población. Se realizó una revisión integrativa a partir de artículos publicados entre el 2014 y el 2018, en idioma español e inglés, los cuales se obtuvieron de la revisión de las bases de datos Ovid, Scopus, Scielo, Science direct, Redalyc, Lilacs, Dialnet y Pubmed, utilizando los descriptores de consulta Mesh: quality of life and heart failure. Se incluyeron en la revisión 24 artículos, en los cuales se identificaron 24 factores deteriorantes que fueron clasificados en las dimensiones biopsicosociales del individuo. Determinar la presencia de estos factores permite al profesional de salud obtener elementos claves para el establecimiento de un plan de atención individualizado que genere un impacto positivo en la condición de salud y en la calidad de vida de la persona. Esto exige un mayor desarrollo investigativo que permita conocer este fenómeno en el contexto colombiano y latinoamericano.
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Yu X, Dong Y, Li Z, Fang Y, Wu S, Wang C, He S. Work Stress and General Trust: The Mediating Effect of Depression and the Moderating Effect of the OXTR Gene rs53576. J Affect Disord 2020; 272:283-288. [PMID: 32553369 DOI: 10.1016/j.jad.2020.03.160] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 02/19/2020] [Accepted: 03/29/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Work stress has been proved to be linked to depression, and both can decrease general trust. Likewise, OXTR gene is currently the gene that is most closely associated with trust. However, few empirical studies have explored the significant role of gene-environment interactions on general trust. In this study, we explored the mediating role of depression in the relationship between work stress and general trust, and the moderating role of the OXTR rs 53576 in the mediation model. METHODS 364 healthy Han Chinese faculties were recruited from one university in Beijing. Work stress, depression, and general trust were assessed using the House and Rizzo's Work Stress Scale, Self-Rating Depression Scale (SDS), and the General Trust Questionnaire, respectively. Blood samples were collected for OXTR rs53576 genotyping. RESULTS Depression mediated the relationship between work stress and general trust. In the mediation model, OXTR rs53576 could only moderated the direct path from work stress to general trust. For AA and GA individuals, depression completely mediated the relationship between work stress and general trust. For GG individuals, depression partly mediated the relationship between work stress and general trust. LIMITATIONS This study used a cross-sectional design, only considered Han Chinese faculties, and the role of other genes should be explored. CONCLUSIONS Depression has a mediating effect between work stress and general trust. The general trust levels of GG genotype individuals are more prone to be affected by work stress than AA and GA individuals.
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Affiliation(s)
- Xiaoqi Yu
- Department of Psychology, Renmin University of China, 59# Zhongguancun Street, Haidian District, Beijing 100872, China
| | - Yan Dong
- Department of Psychology, Renmin University of China, 59# Zhongguancun Street, Haidian District, Beijing 100872, China.
| | - Zheneng Li
- Department of Psychology, Renmin University of China, 59# Zhongguancun Street, Haidian District, Beijing 100872, China
| | - Yuan Fang
- Department of Psychology, Renmin University of China, 59# Zhongguancun Street, Haidian District, Beijing 100872, China
| | - Shuang Wu
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, 5# Yiheyuan Road, Haidian District, Beijing, 100871
| | - Chao Wang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, 5# Yiheyuan Road, Haidian District, Beijing, 100871
| | - Shuchang He
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, 5# Yiheyuan Road, Haidian District, Beijing, 100871.
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Chen C, Fang W, An Y, Wang L, Fan X. The multiple mediating effects of illness perceptions and coping strategies on the relationship between physical symptoms and depressive symptoms in patients with heart failure. Eur J Cardiovasc Nurs 2019; 19:125-133. [DOI: 10.1177/1474515119864759] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: Depressive symptoms are prevalent and cause poor health outcomes in patients with heart failure. Studies show that the physical symptoms of heart failure are associated with depressive symptoms. However, little is known about the underlying mechanisms of this relationship. Aims: The purpose of our study was to examine the associations between physical symptoms, illness perceptions, coping strategies and depressive symptoms and to test the multiple mediation effects of illness perceptions and coping strategies on the relationship between physical symptoms and depressive symptoms in patients with heart failure. Methods: Physical symptoms, illness perceptions, coping strategies and depressive symptoms were assessed using self-reported questionnaires among 302 patients (64.2±11.9 years, 54% male) with heart failure in a tertiary general hospital. A serial multiple mediation model was tested using the PROCESS macro for SPSS. Results: Depressive symptoms were positively correlated with physical symptoms ( r=0.487, p<0.01), illness perceptions ( r=0.499, p<0.01) and acceptance–resignation coping ( r=0.580, p<0.01). The relationship between physical symptoms and depressive symptoms was mediated by illness perceptions (indirect effect: 0.036, confidence interval (0.014, 0.059)) and by acceptance-resignation (indirect effect: 0.034, confidence interval (0.019, 0.053)), respectively, and by these two in serial (indirect effect: 0.021, confidence interval (0.013, 0.033)). Conclusion: Patients with heart failure who have more physical symptoms are vulnerable to the development of depression. Healthcare providers should implement interventions focused on changing illness perceptions and reducing acceptance–resignation coping to relieve depressive symptoms.
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Affiliation(s)
- Cancan Chen
- School of Nursing, Shandong University, Jinan, PR China
| | - Wenjie Fang
- School of Humanities, Shandong Management University, Jinan, PR China
| | - Yan An
- School of Nursing, Shandong University, Jinan, PR China
| | - Lyu Wang
- School of Nursing, Shandong University, Jinan, PR China
| | - Xiuzhen Fan
- School of Nursing, Shandong University, Jinan, PR China
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Carneiro-Barrera A, Díaz-Román A, Guillén-Riquelme A, Buela-Casal G. Weight loss and lifestyle interventions for obstructive sleep apnoea in adults: Systematic review and meta-analysis. Obes Rev 2019; 20:750-762. [PMID: 30609450 DOI: 10.1111/obr.12824] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 11/27/2018] [Accepted: 11/28/2018] [Indexed: 12/17/2022]
Abstract
Lifestyle interventions addressing diet, exercise-training, sleep hygiene, and/or tobacco/alcohol cessation are recommended in the management of obstructive sleep apnoea (OSA). Yet their effectiveness on this condition still requires further research. This systematic review and meta-analysis was aimed at establishing (a) the effectiveness of lifestyle interventions on apnoea-hypopnoea index (AHI), oxygen desaturation index (ODI), excessive daytime sleepiness (EDS), and secondary OSA measures among adults, and (b) which intervention characteristics may drive the greatest improvements. A systematic search of studies was conducted using CINAHL, ProQuest, Psicodoc, Scopus, and Web of Science, from inception to April 2018. Standardized mean differences were calculated using the inverse variance method and random-effects models. The meta-analyses of 13 randomized controlled trials and 22 uncontrolled before-and-after studies (1420 participants) revealed significant reductions on AHI (d = -0.61 and -0.46, respectively), ODI (d = -0.61 and -0.46) and EDS (d = -0.41 and -0.49). Secondary OSA outcomes were also improved after interventions. However, effectiveness of interventions differed depending on their components, OSA severity, and gender. Thus, until future research further supports the differential effectiveness among lifestyle interventions on OSA, those addressing weight loss through diet and exercise-training may be the most effective treatments for male patients with moderate-severe OSA.
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Affiliation(s)
| | - Amparo Díaz-Román
- Mind, Brain, and Behaviour Research Centre, CIMCYC, University of Granada, Granada, Spain
| | | | - Gualberto Buela-Casal
- Mind, Brain, and Behaviour Research Centre, CIMCYC, University of Granada, Granada, Spain
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Health-related quality of life in ischaemic stroke survivors after carotid endarterectomy (CEA) and carotid artery stenting (CAS): confounder-controlled analysis. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2019; 15:226-233. [PMID: 31497056 PMCID: PMC6727227 DOI: 10.5114/aic.2019.84441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/29/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction Atherosclerotic carotid artery stenosis (CS)-related strokes are a significant overall stroke burden contributor. Aim To evaluate the effect of surgical (carotid endarterectomy – CEA) vs. percutaneous (neuroprotected carotid artery stenting – CAS) carotid revascularization on health-related quality of life (HRQoL) in stroke survivors: analysis controlled for major HRQoL determinants beyond strokes. Material and methods Our database of 856 carotid revascularization procedures (48.7% symptomatic CS) performed over 3 years showed 42 pairs (CEA-CAS) of right hemispheric stroke patients matched for age, sex, marital and educational status, hyper-tension, heart failure and diabetes, who underwent uneventful carotid revascularization, experienced no major adverse clinical events, and completed the Short Form Outcome Study (SF-36) questionnaire within 7 days before, 14 days after, 6 months after, and 12 months after carotid revascularization. Results Baseline HRQoL was low and similar in both groups (30.8 ±4.6% vs. 29.1 ±3.9%, p = 0.68; data given for CEA vs. CAS). National Institute of Health Stroke Scale chronic severity was 5.4 ±2.8 vs. 5.9 ±3.1 (p = 0.44). Revascularization was associated with a major HRQoL improvement, that was significantly greater in CAS (60.4 ±9.2% vs. 71.5 ±6.2%, p < 0.001). At 6 months the CEA-CAS difference was narrower (70.7 ±9.7% vs. 74.6 ±5.9%, p = 0.026), becoming statistically insignificant at 12 months (72.6 ±6.7% vs. 75.1 ±5.1%, p = 0.062). The early CEA-CAS difference was driven by less bodily pain and better physical functioning/role-physical plus better role-emotional and higher general well-being scores in CAS (p < 0.05). Conclusions Carotid revascularization has a major positive impact on stroke survivor patient-reported HRQoL. The improvement is initially greater in CAS, with the remaining difference small at 12 months and statistically insignificant.
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Lee JK, Won MH, Son YJ. Combined Influence of Depression and Physical Frailty on Cognitive Impairment in Patients with Heart Failure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:ijerph16010066. [PMID: 30591673 PMCID: PMC6338900 DOI: 10.3390/ijerph16010066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 12/20/2018] [Accepted: 12/21/2018] [Indexed: 12/18/2022]
Abstract
Cognitive impairment is a prevalent condition and important barrier to self-care behaviors in patients with heart failure (HF). HF patients with depression or physical frailty are more likely to have reduced cognitive function. However, it remains unclear if combined depression and physical frailty increased the risk of cognitive impairments among HF populations. This study aimed to identify the influence of combined depression and physical frailty on cognitive impairments in HF. This cross-sectional study was included 289 patients with HF in outpatient cardiology clinics at a tertiary care university hospital in Cheonan, South Korea. We obtained patients’ characteristics including depression, physical frailty, and cognitive function with Korean validated tools using a face-to-face interview. The prevalence rate of cognitive impairment was approximately 27.3% in HF outpatients. We found that the combined influence of depression and physical frailty increased the risk of cognitive impairments in both unadjusted (odds ratio (OR) 4.360; 95% confidence interval (CI) (2.113, 8.994)) and adjusted models (OR 3.545; 95% CI (1.448, 8.681)). Our findings highlight that healthcare professionals need to be more aware of the vulnerable population who suffer from both depression and physical frailty at the same time. Future prospective studies should examine the causal relationships among depression, physical frailty and cognitive impairment during the HF illness trajectories.
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Affiliation(s)
- Jong Kyung Lee
- College of Nursing, Dankook University, Cheonan 31116, Korea.
| | - Mi Hwa Won
- Department of Nursing, Wonkwang University, Iksan 54538, Korea.
| | - Youn-Jung Son
- Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea.
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Sanborn VE, Spitznagel MB, Crosby R, Steffen K, Mitchell J, Gunstad J. Cognitive function and quality of life in bariatric surgery candidates. Surg Obes Relat Dis 2018; 14:1396-1401. [PMID: 30049594 PMCID: PMC6165683 DOI: 10.1016/j.soard.2018.06.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 06/02/2018] [Accepted: 06/09/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Both poor quality of life (QoL) and cognitive impairment are common in persons with severe obesity. Work in other patient populations show that cognitive impairment is associated with poorer QoL, though this possibility has not been examined in bariatric surgery candidates. OBJECTIVES We sought to determine the association between cognitive performance and QoL, both total and work related, in a sample of bariatric surgery candidates. SETTING Three sites were used for data collection, including the Neuropsychiatric Research Institute in Fargo, North Dakota, Columbia University in New York, and Cornell University in New York. METHODS Sixty participants from the Longitudinal Assessment of Bariatric Surgery project were assessed at preoperative baseline. RESULTS Hierarchical regression analyses showed that poorer cognitive function was independently associated with lower total QoL and that both reported and objectively measured cognitive impairment were associated with poorer work-related QoL. CONCLUSIONS These preliminary findings suggest that cognitive impairment may contribute to poorer total and work-related QoL in bariatric surgery candidates. Future studies should examine whether interventions to improve cognitive function can improve QoL and other outcomes in this population.
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Affiliation(s)
| | | | - Ross Crosby
- Neuropsychiatric Research Institute, Fargo, North Dakota, United States
| | - Kristine Steffen
- School of Pharmacy, North Dakota State University, Fargo, North Dakota, United States
| | - James Mitchell
- Neuropsychiatric Research Institute, Fargo, North Dakota, United States
| | - John Gunstad
- Psychological Sciences, Kent State University, Kent, Ohio, United States
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14
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Nieto A, Hernández-Torres A, Pérez-Flores J, Montón F. Depressive symptoms in Friedreich ataxia. Int J Clin Health Psychol 2017; 18:18-26. [PMID: 30487906 PMCID: PMC6220911 DOI: 10.1016/j.ijchp.2017.11.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 11/22/2017] [Indexed: 12/15/2022] Open
Abstract
Background/Objective: Almost no attention has been paid to depression in Friedreich ataxia (FRDA), a highly disabling cerebellar degenerative disease. Our aim was to study the presence and the profile of depressive symptoms in FRDA and their relationship with demographic-disease variables and cognitive processing speed. Method: The study groups consisted of 57 patients with a diagnosis of FRDA. The Beck Depression Inventory-II was used to assess symptoms of depression. Speed of information processing was measured with a Choice Reaction time task. Results: The mean BDI score for patients was significantly higher than the mean score in the general population. Twenty one percent of participants scored in the moderate/severe range. A Cognitive-Affective score and a Somatic-Motivational score was calculated for each patient. Patients’ scores in both dimensions were significantly higher than the scores in the general population. Demographic and disease variables were not related with symptoms of depression, except for severity of ataxia. Depressive symptoms predict cognitive reaction times. The greater proportion of variance was explained by the Cognitive-Affective dimension. Conclusions: Our data show that both somatic-motivational and cognitive affective symptoms of depression are frequent in individuals with FRDA. In addition, depressive symptoms may influence cognition, especially, the cognitive and affective symptoms.
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Affiliation(s)
| | | | | | - Fernando Montón
- Universidad de La Laguna, Spain.,Hospital La Candelaria, Tenerife, Spain
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15
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Brandolim Becker N, Jesus SND, Viseu JN, Stobäus CD, Guerreiro M, Domingues RB. Depression and quality of life in older adults: Mediation effect of sleep quality. Int J Clin Health Psychol 2017; 18:8-17. [PMID: 30487905 PMCID: PMC6220925 DOI: 10.1016/j.ijchp.2017.10.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 10/23/2017] [Indexed: 12/11/2022] Open
Abstract
Background/Objective: Sleep insufficiency, which affects more than 45% of the world's population, has a great importance when considering older adults. Thus, this research tested a mediation hypothesis, through a path analysis, which explains how depression relates to the quality of life considering the effects of sleep quality in older adults. Method: A sample of 187 community-dwelling Portuguese older adults answered questionnaires about sociodemographic status (age, gender, highest level of education completed, family status, sports activities, health, and retirement status), quality of life, sleep quality, and depression. Descriptive and path analysis statistics were performed considering the results of the normality test. Results: The sample has health characteristics and presents adequate sleep duration. Sleep quality acted as a mediator between depression and the quality of life in older adults, considering the variation of gender and health. This suggests that it is important to establish self-care practices, namely sleep quality, to intervene in the ageing process. Conclusions: It is important to consider sleep quality associated with depression for older adults and to test interventions to minimize health impacts. Also, more researches are needed about the primary prevention in sleep quality relating to depression.
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Affiliation(s)
- Nathália Brandolim Becker
- University of Algarve, Portugal
- Corresponding author: University of Algarve, Campus de Gambelas, Building 9, Research Centre for Spatial and Organizational Dynamics, 8005-139 Faro, Portugal.
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16
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Ichikura K, Kobayashi S, Matsuoka S, Suzuki T, Nishimura K, Shiga T, Hagiwara N, Ishigooka J, Suzuki SI. Avoidance behavior associated with depressive symptoms in patients with implantable cardioverter defibrillators. Int J Clin Health Psychol 2017; 17:1-8. [PMID: 30487875 PMCID: PMC6236320 DOI: 10.1016/j.ijchp.2016.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 11/09/2016] [Indexed: 11/12/2022] Open
Abstract
Objective: Many patients with implantable cardioverter defibrillators experience depressive symptoms. In addition, avoidance behavior is a common problem among patients with implantable cardioverter defibrillators. We examined the association between avoidance behaviors and depressive symptoms in patients with implantable cardioverter defibrillators. Method: We conducted a single-center, cross-sectional study with self-completed questionnaires between May 2010 and March 2011. We measured avoidance behaviors (avoidance of places, avoidance of objects, and avoidance of situations) and depressive symptoms (using the Beck Depression Inventory, Version II) in 119 participants. An avoidance behaviors instrument was developed for this study and we confirmed its internal consistency reliability. Results: Ninety-two (77.3%) patients were aged older than 50 years, and 86 (72.3%) were men. Fifty-one (42.9%) patients reported "avoidance of places", 34 (28.6%) reported "avoidance of objects", and 63 (52.9%) reported "avoidance of activity". Avoidance behavior was associated with increased odds for the presence of depressive symptoms (OR 1.31; 95% CI 1.06-1.62). Conclusions: This was the first study to identify the relationship between avoidance behavior and depressive symptoms among patients with implantable cardioverter defibrillators; however, there are a few methodological limitations.
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Affiliation(s)
- Kanako Ichikura
- Waseda University, Japan
- Tokyo Medical and Dental University, Japan
| | - Sayaka Kobayashi
- Tokyo Women's Medical University, Japan
- Saitama Medical University, Japan
| | - Shiho Matsuoka
- Waseda University, Japan
- Tokyo Medical and Dental University, Japan
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