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Chen L, Li H, Gou X, Dong H, Yang S, Dong F, Wu J. Coping as a mediator of the relationship between kinesiophobia and illness perception in atrial fibrillation patients: A cross-sectional mediation analysis. J Adv Nurs 2024. [PMID: 38924140 DOI: 10.1111/jan.16262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/15/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Abstract
AIM(S) To explore the mediating role of coping styles in the association between illness perception and kinesiophobia in atrial fibrillation patients. DESIGN A cross-sectional survey. METHODS Between June 2021 and November 2022, data were collected using a self-designed demographic questionnaire, the Brief Illness Perception Questionnaire (BIPQ), Tampa Scale for Kinesiophobia Heart (TSK-SV Heart) and Medical Coping Modes Questionnaire (MCMQ). The sample comprised 474 atrial fibrillation patients recruited from three hospitals in China. To analyse the data, multiple linear regression models with forced entry were employed, and the mediation Mode 4 of the PROCESS macro in SPSS was implemented. RESULTS In total, 57.8% of patients exhibited a high level of kinesiophobia. Regression analyses uncovered associations between kinesiophobia and various demographic and disease characteristics, as well as assessments of both illness perception and coping styles. Path analysis results indicated that illness perception reduced kinesiophobia through the mediating effect of confrontation, while avoidance and resignation intensified kinesiophobia. The mediating factor of coping styles explained a significant 53% of the overall effect. CONCLUSIONS Coping styles mediate the relationship between illness perception and kinesiophobia, resulting in a shift in coping styles as illness perception decreases and ultimately leading to reduced kinesiophobia. IMPACT Coping styles play a mediating role in the relationship between kinesiophobia and illness perception. The results suggest healthcare providers in identifying high-risk individuals and tailoring interventions to effectively break the vicious cycle of kinesiophobia. Therefore, screening and intervening with patients showcasing heightened illness perception aims to promote a transformation in coping styles, subsequently reducing atrial fibrillation kinesiophobia. REPORTING METHOD The results of the observations were reported in adherence to the STROBE criteria. PATIENT OR PUBLIC CONTRIBUTION No patient and public involvement.
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Affiliation(s)
- Limei Chen
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Husheng Li
- Department of Nursing, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinyu Gou
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hui Dong
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shenglan Yang
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fengwei Dong
- Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jing Wu
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Striberger R, Zarrouk M, Kumlien C, Axelsson M. Illness perception, health literacy, self-efficacy, adherence and quality of life in patients with intermittent claudication - a longitudinal cohort study. BMC Nurs 2023; 22:167. [PMID: 37198627 DOI: 10.1186/s12912-023-01329-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/05/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Patients with intermittent claudication need lifelong treatment with secondary prevention to prevent cardiovascular events and progression of atherosclerotic disease. Illness perception, health literacy, self-efficacy, adherence to medication treatment, and quality of life are factors influencing patients' self-management. Knowledge of these factors could be important when planning for secondary prevention in patients with intermittent claudication. AIM to compare illness perception, health literacy, self-efficacy, adherence to treatment, and quality of life in in patients with intermittent claudication. METHODS A longitudinal cohort study was conducted with 128 participants recruited from vascular units in southern Sweden. Data were collected through medical records and questionnaires regarding illness perception, health literacy, self-efficacy, adherence to treatment, and quality of life. RESULTS In the subscales in illness perception, patients with sufficient health literacy reported less consequences and lower emotional representations of the intermittent claudication. They also reported higher self-efficacy and higher quality of life than patients with insufficient health literacy. In comparison between men and women in illness perception, women reported higher illness coherence and emotional representations associated with intermittent claudication compared to men. A multiple regression showed that both consequences and adherence were negative predictors of quality of life. When examining changes over time, a significant increase in quality of life was seen between baseline and 12 months, but there were no significant differences in self-efficacy.. CONCLUSION Illness perception differs in relation to level of health literacy and between men and women. Further, the level of health literacy seems to be of importance for patients' self-efficacy and quality of life. This illuminates the need for new strategies for improving health literacy, illness perception, and self-efficacy over time. For example, more tailored information regarding secondary prevention could be provided to strengthen self-management to further improve quality of life in patients with intermittent claudication.
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Affiliation(s)
- Rebecka Striberger
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, SE-20506, Sweden.
- Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden.
| | - Moncef Zarrouk
- Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Christine Kumlien
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, SE-20506, Sweden
- Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden
| | - Malin Axelsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, SE-20506, Sweden
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Bergsten U, Dehlin M, Klingberg E, Landgren AJ, Jacobsson LTH. Gender differences in illness perceptions and disease management in patients with gout, results from a questionnaire study in Western Sweden. BMC Musculoskelet Disord 2023; 24:300. [PMID: 37061681 PMCID: PMC10105391 DOI: 10.1186/s12891-023-06416-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/10/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND Aims were to examine gender differences in patients with gout with regard to a) self-reported gout severity, b) illness perceptions (IP), c) impact on daily activities and Quality of Life (QoL), d) advice from healthcare professionals, e) having changed dietary- or alcohol habits. METHODS Adult patients with gout identified in primary and secondary care in Sweden between 2015 and 2017 (n = 1589) were sent a questionnaire about demographics, gout disease severity, IP (using the Brief Illness Perception Questionnaire, (B-IPQ)) and disease management. T-tests, Chi square tests, ANalysis Of VAriance (ANOVA) and linear regression models were used for gender comparisons. RESULTS Eight hundred sixty-eight patients responded to the questionnaire. Women, n = 177 (20%), experienced more severe gout symptoms (p = 0.011), albeit similar frequencies of flares compared to men. Women experienced modest but significantly worse IP with regard to consequences, identity, concerns and emotional response (p < 0.05) as well as daily activities such as sleeping (p < 0.001) and walking (p = 0.042) and QoL (p = 0.004). Despite this and a higher frequency of obesity in women (38 vs 21%, P < 0.001) and alcohol consumption in men (p < 0.001), obese women had received significantly less advice regarding weight reduction (47 vs 65%, p = 0.041) compared to obese men. On the other hand, women reported having acted on dietary advice to a larger degree. CONCLUSIONS Despite only modestly worse gout severity and perception, women appear to have been given less information regarding self-management than men. These gender differences should be given attention and addressed in clinical care.
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Affiliation(s)
- Ulrika Bergsten
- Region Halland, Research and development department, Halmstad, Sweden
| | - Mats Dehlin
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden.
| | - Eva Klingberg
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden
| | - Anton J Landgren
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden
- Region Västra Götaland, Research and Development Primary Health Care, Södra Bohuslän, Gothenburg, Sweden
| | - Lennart T H Jacobsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden
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Hasan EM, Calma CL, Tudor A, Vernic C, Palade E, Tudorache E, Oancea C, Papava I. Gender Differences in Coping, Depression, and Anxiety in Patients with Non-Metastatic Lung Cancer. Cancer Manag Res 2022; 14:2041-2052. [PMID: 35757160 PMCID: PMC9231683 DOI: 10.2147/cmar.s368992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/08/2022] [Indexed: 01/10/2023] Open
Abstract
Background Depression and anxiety are prevalent issues amongst individuals suffering from thoracic cancer. Gender differences in coping with thoracic cancer have a serious impact upon the management of emotional distress. The purpose of our study has been to assess sex variations in handling anxiety and depression, including the use of coping mechanisms and their relationship with respect to anxiety and depression. Methods This cross-sectional study registered 18 women and 22 men with non-metastatic lung cancer and operated upon. Pre-operatively and at one month post-operatively, the patients were assessed by means of scales (COPE, GAD-7 and PHQ-9). Results Post-operatively, the intensity of depression and anxiety was substantially greater in males than in females (p = 0.049, p = 0.042). Male individuals tended to use coping mechanisms of humour (p = 0.009) and restraint (p = 0.029) significantly more frequently than women. Moreover, in women, depression correlated significantly with denial and behavioural deactivation (rho = 0.465, p = 0.029, respectively, rho = 0.562, p = 0.006); whilst anxiety, similarly, correlated with positive interpretation, behavioural deactivation, and use of social-emotional support (rho = 0.484, p = 0.022, respectively, rho = 0.590, p = 0.004 and rho = 0.502, p = 0.017). Furthermore, in males, depression correlated significantly with mental deactivation, use of social-instrumental and social-emotional support (rho = 0.702, p = 0.001, respectively, rho = 0.505, p=0.033, and rho = 0.773 with p < 0.001), whilst anxiety correlated significantly with mental deactivation, denial, and use of social-emotional support (rho = 0.597, p = 0.009, respectively, rho = 0.553 with p = 0.017 and rho = 0.755, p < 0.001). Conclusion There were gender divergences in the use of coping mechanisms and the level of post-surgical anxiety and depression. We found significant positive relationships between some coping mechanisms and depression/anxiety. The patient’s gender governs the coping style, which in turn has bearing upon the post-operative evolution.
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Affiliation(s)
| | - Crenguta Livia Calma
- Department of Functional Sciences, Center of Immuno-Physiology (CIFBIOTEH), "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Anca Tudor
- Department of Functional Sciences, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Corina Vernic
- Department of Functional Sciences, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Emanuel Palade
- Department of Cardiovascular and Thoracic Surgery, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Thoracic Surgery, "Leon Daniello" Pneumophtysiology Hospital, Cluj-Napoca, Romania
| | - Emanuela Tudorache
- Department of Infectious Diseases, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Cristian Oancea
- Department of Infectious Diseases, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Ion Papava
- Department of Neuroscience, NEUROPSY - COG Center for Cognitive Research in Neuropsychiatric Pathology, "Victor Babes," University of Medicine and Pharmacy, Timișoara, Romania
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Zuchowski M, Chilcot J. Illness Perceptions in Hypertrophic Cardiomyopathy (HCM) Patients and Their Association With Heart-Focussed Anxiety. Heart Lung Circ 2021; 30:496-506. [DOI: 10.1016/j.hlc.2020.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/18/2020] [Accepted: 08/09/2020] [Indexed: 10/23/2022]
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Friedrich O, Kunschitz E, Pongratz L, Wieländer S, Schöppl C, Sipötz J. Classification of illness attributions in patients with coronary artery disease. Psychol Health 2021; 36:1368-1383. [PMID: 33410711 DOI: 10.1080/08870446.2020.1851688] [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: 10/22/2022]
Abstract
OBJECTIVE To examine patient-reported causal attributions in patients with coronary artery disease and classify them according to attribution theory. DESIGN Patients with angiographically verified coronary artery disease (n = 459) were asked to report causal attributions by answering the respective open-ended item of the Brief Illness Perception Questionnaire. MAIN OUTCOME MEASURES Groups resulting from classifications were characterised with regard to sociodemographic and clinical variables, Quality of Life (SF-12), depression (PHQ-9), anxiety (GAD-7), and illness perception (BIPQ). RESULTS Stress emerged as the single most important attribution followed by various behavioural factors and genetic predisposition. There was a remarkable mismatch between the presence of modifiable risk factors (smoking, obesity) and patient-reported illness attributions. Based on the results of the descriptive categorisation of illness attributions we developed a transparent, easily reproducible scheme for dimensional classification of the fifteen most common responses according to attribution theory. The classification resulted in four groups: Behaviour/Emotional State, Past Behaviour/Emotional State, Physical/Psychological Trait and External. CONCLUSION We found a pattern of illness attributions largely in line with previous trials. The dimensional classification resulted in four groups and highlighted potential entry points for physician-patient communication aimed at establishing beneficial disease self-management.
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Affiliation(s)
- Oliver Friedrich
- Karl Landsteiner Institute for Scientific Research in Clinical Cardiology, Hanusch Hospital, Vienna, Austria
| | - Evelyn Kunschitz
- Karl Landsteiner Institute for Scientific Research in Clinical Cardiology, Hanusch Hospital, Vienna, Austria.,II. Medical Department for Cardiology, Hanusch Hospital, Vienna, Austria
| | - Lisa Pongratz
- II. Medical Department for Cardiology, Hanusch Hospital, Vienna, Austria
| | - Sophia Wieländer
- II. Medical Department for Cardiology, Hanusch Hospital, Vienna, Austria
| | - Christine Schöppl
- II. Medical Department for Cardiology, Hanusch Hospital, Vienna, Austria
| | - Johann Sipötz
- Karl Landsteiner Institute for Scientific Research in Clinical Cardiology, Hanusch Hospital, Vienna, Austria.,II. Medical Department for Cardiology, Hanusch Hospital, Vienna, Austria
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Shiloh S, Levy S, Heruti I, Avitsur R. Health-related quality of life after injury: examining the roles of perceived daily-life stress and injury perceptions. Qual Life Res 2020; 29:3053-3063. [PMID: 32535863 DOI: 10.1007/s11136-020-02548-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The present study aimed to examine the effects of injury perceptions and perceived daily stress on health-related quality of life (HRQL) of individuals affected by a physical injury. METHODS Two hundred and forty injured individuals completed questionnaires assessing HRQL (Medical Outcome Health Survey short-form 36), perceived daily-life stress (Perceived Stress Scale), and injury perceptions (Brief-InjPQ). RESULTS The direct effects of stress on HRQL scores were not moderated by gender. Emotional representation of the injury significantly mediated the links between PSS and all HRQL subscales only among women, but not among men. However, the mediation of the HRQL total score by emotional representations was significant for both genders. In addition, treatment control perceptions of the injury mediated the link between PSS and self-assessed health among men but not women, and injury-self perceptions mediated the link between PSS and physical functioning among men but not women. CONCLUSION These findings underscore the importance of perceived daily stress, gender, and injury perceptions as key factors for explaining variance in HRQL following injury. In addition to their conceptual contributions, the findings have clinical implications for treating injured populations.
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Affiliation(s)
- Shoshana Shiloh
- The School of Psychological Sciences, The Gordon Faculty of Social Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Sigal Levy
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, PO Box 8401, 68114, Tel Aviv, Israel
| | - Irit Heruti
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, PO Box 8401, 68114, Tel Aviv, Israel.,Department of Psychology, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel
| | - Ronit Avitsur
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, PO Box 8401, 68114, Tel Aviv, Israel.
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Illness perception in overweight and obese patients with cardiovascular diseases. Eat Weight Disord 2020; 25:69-78. [PMID: 29726000 DOI: 10.1007/s40519-018-0506-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/15/2018] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE This study explored the relationship of illness perception with different aspects of cardiac anxiety, general anxiety and depression in a sample of male and female overweight and obese patients with cardiovascular diseases (CVD). STUDY DESIGN The clinical sample included 165 adults (113 males) aged from 32 to 89 years. The patients were admitted to the Department of Cardiology and Cardiac Rehabilitation for a major cardiovascular event, acute myocardial infarction or myocardial revascularization. MEASUREMENTS Psychological measurement included questionnaires of illness perception, cardiac anxiety, general anxiety and depression. RESULTS AND CONCLUSIONS Illness perception and cardiac anxiety in patients with CVD were associated with anxiety and depression. Regression analysis showed that illness perception accounts for a significant proportion of the variance in both anxiety and depression for males, but not for females. Gender-specific interrelations between perceptions of CVD and indices of mental health have an implication for interventions to maximize the effect of therapy with these patients. LEVEL OF EVIDENCE Level V, Descriptive study.
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I am a total failure: associations between beliefs and anxiety and depression in patients with inflammatory bowel disease with poor mental quality of life. Behav Cogn Psychother 2019; 48:91-102. [PMID: 31423955 DOI: 10.1017/s1352465819000444] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND According to cognitive behavioural theory, cognitive factors (i.e. underlying general dysfunctional beliefs and (situation) specific illness beliefs) are theorized to lead to outcomes like anxiety and depression. In clinical practice, general dysfunctional beliefs are generally not tackled directly in short-term-therapy. AIMS The goal of the present study was to investigate the associations of general versus specific illness beliefs on anxiety and depressive symptoms and psychiatric disorders among a subgroup of patients with inflammatory bowel disease (IBD) with poor mental quality of life (QoL). METHOD This study concerns cross-sectional data, collected at baseline from a randomized clinical trial. One hundred and eighteen patients, recruited at four Dutch hospitals, with poor QoL (score ≤23 on the mental health subscale of the Short-Form 36-item Health-Survey; SF-36) were included. General dysfunctional beliefs were measured by the Dysfunctional Attitude Scale (DAS), specific illness beliefs by the Illness Perceptions Questionnaire-Revised (IPQ-R), anxiety and depressive symptoms by the Hospital Anxiety and Depression Scale (HADS), and psychiatric disorders by the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I). RESULTS Univariate analyses showed associations between the level of anxiety and/or depression and general dysfunctional beliefs and four specific illness beliefs (consequences, personal control, emotional representations and treatment control). Among patients with IBD with psychiatric disorders, only the DAS was significantly associated with anxiety and depression (DAS added to IPQ-R and IPQ-R added to DAS). CONCLUSIONS Psychological interventions may have to target general dysfunctional beliefs of patients with IBD with co-morbid psychiatric disorders to be effective. These patients with IBD are especially in need of psychological treatment.
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Lukoševičiūtė J, Šmigelskas K. Illness Perception and Its Changes During Six Months After Cardiac Rehabilitation. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2019. [DOI: 10.1027/2512-8442/a000034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Illness perception is a concept that reflects patients' emotional and cognitive representations of disease. This study assessed the illness perception change during 6 months in 195 patients (33% women and 67% men) with acute coronary syndrome, taking into account the biological, psychological, and social factors. At baseline, more threatening illness perception was observed in women, persons aged 65 years or more, with poorer functional capacity (New York Heart Association [NYHA] class III or IV) and comorbidities ( p < .05). Type D personality was the only independent factor related to more threatening illness perception (βs = 0.207, p = .006). At follow-up it was found that only self-reported cardiovascular impairment plays the role in illness perception change (βs = 0.544, p < .001): patients without impairment reported decreasing threats of illness, while the ones with it had a similar perception of threat like at baseline. Other biological, psychological, and social factors were partly associated with illness perception after an acute cardiac event but not with perception change after 6 months.
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Affiliation(s)
- Justė Lukoševičiūtė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Kastytis Šmigelskas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Health Psychology, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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11
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Wisting L, Rø A, Skrivarhaug T, Dahl-Jørgensen K, Rø Ø. Disturbed eating, illness perceptions, and coping among adults with type 1 diabetes on intensified insulin treatment, and their associations with metabolic control. J Health Psychol 2019; 26:688-700. [DOI: 10.1177/1359105319840688] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
This study investigated associations between psychological aspects and metabolic control among adults with type 1 diabetes ( n = 282). Linear regression analyses demonstrated that the illness perception personal control and the coping strategy seeking emotional social support explained 23.2 percent of the variance in hemoglobin A1c among females ( β = 0.40, p < 0.001 and β = −0.22, p < 0.01, respectively). Among males, only personal control remained significant, explaining 13.9 percent of the variance in hemoglobin A1c ( β = 0.37, p < 0.001). The associations between psychological correlates and hemoglobin A1c indicate that addressing such aspects clinically may facilitate metabolic control, thereby potentially contributing to reduce the risk of complications.
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Affiliation(s)
- Line Wisting
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway
- Oslo Diabetes Research Centre, Norway
| | - Astrid Rø
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
| | - Torild Skrivarhaug
- Oslo Diabetes Research Centre, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
- The Norwegian Diabetic Centre, Oslo, Norway
- Department of Paediatric and Adolescent Medicine, Oslo University Hospital, Norway
| | - Knut Dahl-Jørgensen
- Oslo Diabetes Research Centre, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
- The Norwegian Diabetic Centre, Oslo, Norway
- Department of Paediatric and Adolescent Medicine, Oslo University Hospital, Norway
| | - Øyvind Rø
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway
- Institute of Clinical Medicine, Mental Health and Addiction, University of Oslo, Norway
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Groeneveld IF, van der Pas SL, Meesters JJL, Schuurman JM, van Meijeren-Pont W, Jagersma E, Goossens PH, Kaptein AA, Vliet Vlieland TPM. Illness perceptions of stroke survivors: Predictors and changes over time - A 1 year follow-up study. J Psychosom Res 2019; 116:54-61. [PMID: 30654994 DOI: 10.1016/j.jpsychores.2018.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/11/2018] [Accepted: 10/31/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To describe the illness perceptions (IP) of stroke patients in the first year post stroke; to identify patient clusters with comparable IP trajectories and determine their associations with health. METHODS This prospective study included consecutive stroke patients after medical rehabilitation. Three and 12 months post stroke they completed the Brief Illness Perception Questionnaire (B-IPQ) and questionnaires on physical and mental health. All eight IP and their changes over time were described. Clusters of patients with comparable IP trajectories were constructed by k-means clustering, with subsequent comparison of patient characteristics. Multivariable logistic regression analyses were conducted to determine the association between IP clusters and 12-month mental health. RESULTS Hundred-and-eighty-four patients were included (men n = 107 [58.2%]; mean age 61.1 [SD 12.7] years). At 3 months, the scores of the IP coherence (mean 3.0, SD 2.3) and treatment control (mean 3.2, SD 2.5) were lowest (best), and consequences (mean 6.1, SD 2.8) and anticipated timeline (mean 6.0, SD 2.7) were highest (worst). At 12 months, the timeline and treatment control scores had significantly worsened. Three clusters of the trajectories of IP were identified, and designated as 'favourable', 'average', and 'unfavourable'. The unfavourable cluster was significantly associated with worse physical and mental health at 3 months (unadjusted) and depressive symptoms at 12 months. CONCLUSION Stroke patients' IP partly changed between 3 and 12 months post stroke. Patients with an unfavourable IP trajectory had a higher chance of depressive symptoms at 12 months. Illness perceptions could be considered as an additional target of treatment.
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Affiliation(s)
- I F Groeneveld
- Rijnlands Rehabilitation Centre, Leiden, the Netherlands; Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands.
| | - S L van der Pas
- Medical Statistics, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands; Mathematical Institute, Leiden University, the Netherlands
| | - J J L Meesters
- Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
| | | | - W van Meijeren-Pont
- Rijnlands Rehabilitation Centre, Leiden, the Netherlands; Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
| | - E Jagersma
- Sophia Rehabilitation, The Hague, the Netherlands
| | - P H Goossens
- Rijnlands Rehabilitation Centre, Leiden, the Netherlands; Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
| | - A A Kaptein
- Department of Medical Psychology, Leiden University Medical Center, Leiden, the Netherlands
| | - T P M Vliet Vlieland
- Rijnlands Rehabilitation Centre, Leiden, the Netherlands; Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
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Kristoffersen ES, Lundqvist C, Russell MB. Illness perception in people with primary and secondary chronic headache in the general population. J Psychosom Res 2019; 116:83-92. [PMID: 30654999 DOI: 10.1016/j.jpsychores.2018.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 12/02/2018] [Accepted: 12/02/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Chronic headache (headache ≥15 days/month) is a leading cause of disability. Illness perception, beliefs and cognitive models are likely central for patient understanding of their chronic pain condition and are associated with treatment outcome. However, these factors are insufficiently described in chronic headache. OBJECTIVE To describe illness perception, and to explore the effect of background variables and headache characteristics on illness perceptions in primary and secondary chronic headaches in the general population. METHODS 30,000 persons aged 3044 from the general population were screened for chronic headache by a mailed questionnaire. Those with self-reported chronic headache were interviewed by headache specialists. The questionnaire response rate was 71%, and the interview participation rate was 74%. The International Classification of Headache Disorders III was applied. Illness perception was assessed by the Revised Illness Perception Questionnaire (IPQ-R). The statistical approach was exploratory. RESULTS 405 of the 516 eligible participants (78%) completed the IPQ-R. Confirmatory factor analysis showed good internal validity in chronic headache. People believed their chronic headache to be long-lasting, with negative life consequences including emotional distress. Severe headache-related disability was associated with more perception of chronicity, more perceived consequences, emotional load and illness identity and less illness coherence. People with secondary chronic headache scored significantly higher on chronicity and life consequences, and had less personal control than those with primary chronic headache. CONCLUSION Chronic primary and secondary headache is associated with a high symptom burden and chronicity with large perceived negative consequences for daily living, suggesting multidisciplinary management may be necessary.
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Affiliation(s)
- Espen Saxhaug Kristoffersen
- Head and Neck Research Group, Research Centre, Akershus University Hospital, Lørenskog, Norway; Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
| | - Christofer Lundqvist
- Head and Neck Research Group, Research Centre, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Nordbyhagen, Norway; HØKH, Research Centre, Akershus University Hospital, Lørenskog, Norway; Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Michael Bjørn Russell
- Head and Neck Research Group, Research Centre, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Nordbyhagen, Norway
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Marogna C, Russo SE, Caccamo F, Pinton A, Sava V, Carlon R. The perception of the illness and the self-efficacy in the management of emotions in cardiac patients. ACTA ACUST UNITED AC 2018; 21:310. [PMID: 32913765 PMCID: PMC7451379 DOI: 10.4081/ripppo.2018.310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 10/04/2018] [Indexed: 11/26/2022]
Abstract
Cardiac rehabilitation is the sum of psychological, physical and social treatments that are offered to cardiac patients to maintain or regain an active position in society. This study wants to evaluate changes in the perception of the illness and in the self-efficacy of the management of positive and negative emotions in patients who went through cardiac rehabilitation. Sixty-seven patients (20 females, 47 males) were selected within the cardiac rehabilitation unit in the Hospital of Cittadella (Italy). Illness Perception Questionnaire - revised version and the Scale for the self-efficacy of the management of positive and negative emotions were submitted at the beginning and at the end of the rehabilitation program. One-way analyses-of-variance were performed to evaluate different answers in questionnaires between pre- and post-evaluation, and to explore gender differences. A significant change was found in the perception of duration of illness, perceived as permanent and longer after the cardiac rehabilitation program. Furthermore, at the end of the cardiac rehabilitation program men perceived the illness more chronic than women, even if they are less worried and anxious. Intensive cardiac rehabilitation has a great emotional impact on cardiac patients, influencing their perception and management of the illness. Working on emotions, through psychological groups, helps patients change their beliefs by offering them a different perspective to approach the illness.
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Affiliation(s)
- Cristina Marogna
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua
| | - Sofia Elena Russo
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua
| | - Floriana Caccamo
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua
| | - Alessandro Pinton
- UOA of Cardiology, Rehabilitation Cardiology, ASSL 6 "Euganea", Presidio Hospital of Cittadella (PD), Italy
| | - Vito Sava
- UOA of Cardiology, Rehabilitation Cardiology, ASSL 6 "Euganea", Presidio Hospital of Cittadella (PD), Italy
| | - Roberto Carlon
- UOA of Cardiology, Rehabilitation Cardiology, ASSL 6 "Euganea", Presidio Hospital of Cittadella (PD), Italy
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Rahimi Kordshooli K, Rakhshan M, Ghanbari A. The Effect of Family-Centered Empowerment Model on the Illness Perception in Heart Failure Patients: a Randomized Controlled Clinical Trial. J Caring Sci 2018; 7:189-195. [PMID: 30607359 PMCID: PMC6311623 DOI: 10.15171/jcs.2018.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 07/21/2018] [Indexed: 01/16/2023] Open
Abstract
Introduction: Heart failure is a chronic medical condition that, despite the existing therapies, involves different aspects of an individual's life (such as self-care capability). Illness perception is one of the most important variables which seem to improve the self-efficacy skills in chronic diseases such as heart failure. Therefore, this study aimed to investigate the effect of family-centered empowerment model on the perception of the illness in heart failure patients. Methods: This interventional study was performed on 70 heart failure patients, assigned into control and experimental groups, admitted to the heart clinic of Hazrate Fatemeh hospital in Shiraz. After the convenience sampling, the patients were divided into two control and intervention groups by block randomization method. For experimental group, the family-centered empowerment modeling was done in 5 sessions. The research materials included demographic information and Brief illness perception questionnaires (B-IPQ). Data were analyzed using SPSS v.13 software. The statistical tests included Wilcoxon, Man-Whitney, and Independent t-test. P value less than 0.05 was considered as significant. Results: In this study, both control and experimental groups were homogeneous with demographic information. Before the intervention in different dimensions of illness perception, all of the values in both groups were the same; However, after the intervention, a significant difference was observed in all of the dimensions of illness perception, except for Time line; so that the most and the least changes were related to the concern (1.09 (0.61) vs 3 (0.93)), and identity dimensions (0.97 (0.61) vs 2.11 (0.67)), respectively. Conclusion: On the basis of the above, it can be concluded that this model modifies the illness perceptions in heart failure patients. Cardiac nurses should consider family- based empowerment model as a treatment for heart failure patients.
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Affiliation(s)
- Khadijeh Rahimi Kordshooli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahnaz Rakhshan
- Department of Medical-Surgical Nursing, Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Ghanbari
- Research Center of Anesthesiology and Critical Care, Shiraz University of Medical Sciences, Shiraz, Iran
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Psychological Profile in Coronary Artery By-Pass Graft Patients vs. Valve Replacement Patients Entering Cardiac Rehabilitation after Surgery. Sci Rep 2018; 8:14381. [PMID: 30258180 PMCID: PMC6158272 DOI: 10.1038/s41598-018-32696-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 09/13/2018] [Indexed: 11/16/2022] Open
Abstract
Anxiety and depression are thought to influence the genesis of ischemic diseases and not of valvular diseases, but little is known on the psychological profile of cardiac patients after surgery. Aim of this study was to investigate differences in disease experience and mood between patients undergoing cardiac rehabilitation after coronary artery by-pass graft (CABG) or after valve replacement (VR). We studied 1,179 CABG and 737 VR patients who completed the Illness Behaviour Questionnaire and the Hospital Anxiety and Depression Scale after surgery. We tested the independent effect of the type of surgery by multivariate analysis and between-group differences in prevalence of clinically relevant scores. Relevant scores in the psychosomatic concern scale were more frequent in CABG than in VR patients. After correction by age, sex, education and marital status, scores of disease conviction and psychosomatic concern were higher in CABG patients, scores of denial were higher in VR patients. Unexpectedly, anxiety and depression scores did not differ between groups. Results suggest providing psychological support for anxiety and depression to both VR and CABG patients during cardiac rehabilitation, and planning differentiated interventions of cardiac rehabilitation and secondary prevention tailored to the specific psychological reactions of CABG and VR patients.
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Malhotra C, Sim D, Jaufeerally F, Finkelstein EA. Associations between understanding of current treatment intent, communication with healthcare providers, preferences for invasive life-sustaining interventions and decisional conflict: results from a survey of patients with advanced heart failure in Singapore. BMJ Open 2018; 8:e021688. [PMID: 30232107 PMCID: PMC6150135 DOI: 10.1136/bmjopen-2018-021688] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To make informed choices about use of future invasive life-sustaining interventions (ILSI), patients with congestive heart failure (CHF) need to correctly understand the intent of their current treatments. However, healthcare providers may be wary of having these discussions due to fear of distressing patients. In this study, we assessed whether patients who understand their treatment intent are less willing to undergo ILSI and are indeed more psychologically distressed. DESIGN, PARTICIPANTS AND OUTCOMES As part of a cross-sectional survey conducted prior to randomising patients for a trial, we asked 282 patients with advanced CHF (New York Heart Association Class III and IV) whether they believe their existing treatments would cure their heart condition, their willingness to undergo ILSI and assessed their anxiety and depression using the Hospital Anxiety and Depression Scale. RESULTS Approximately half of patients reported a willingness to undergo ILSI if needed. Only 22% knew that their current treatments were not curative. These patients were far less willing to undergo ILSI (OR 0.28, 95% CI 0.15 to 0.56) and were not at a greater risk of having clinically significant anxiety (OR 0.72, 0.34 to 1.54) and depression (OR 0.70, 0.33 to 1.47) compared with those who did not understand their current treatment intent. CONCLUSIONS Improving patients' understanding of the intent of their current treatments can help patients make informed choices about ILSI. TRIAL REGISTRATION NUMBER NCT02299180; Pre-results.
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Affiliation(s)
- Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
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18
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Die Bedeutung subjektiver Krankheitsvorstellungen in der Gesundheitsversorgung am Beispiel von Menschen mit (türkischem) Migrationshintergrund. Ethik Med 2018. [DOI: 10.1007/s00481-018-0499-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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19
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Arat S, De Cock D, Moons P, Vandenberghe J, Westhovens R. Modifiable correlates of illness perceptions in adults with chronic somatic conditions: A systematic review. Res Nurs Health 2018; 41:173-184. [PMID: 29315678 DOI: 10.1002/nur.21852] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 12/01/2017] [Indexed: 11/11/2022]
Abstract
When individuals become ill, they want to understand and give meaning to their illness. The interpretation of this illness experience, or illness perception, is influenced by a range of individual, contextual, and cultural factors. Some of these factors may be modifiable by nursing interventions. The purpose of this systematic review was to investigate which modifiable factors were correlated with illness perceptions across studies of adults with different chronic somatic diseases. Using search terms tailored to each of four electronic databases, studies retrieved were reviewed by two independent evaluators, and each relevant article was assessed for methodological quality. Results were standardized by calculating correlation coefficients. Fifteen papers on illness perceptions in a variety of chronic diseases met the inclusion criteria. All used standardized measures of illness perceptions. We identified five groups of modifiable correlates of illness perceptions: illness-related factors, psychosocial factors, medication beliefs, information provision and satisfaction with information received, and quality of care. Our findings add to the knowledge of modifiable factors correlated with illness perceptions, including the importance of illness-related factors and psychosocial factors such as anxiety and depression. Knowledge of these correlates can facilitate understanding of patients' illness perceptions and might be useful in tailoring patient education programs.
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Affiliation(s)
- Seher Arat
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium
| | - Diederik De Cock
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium.,Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Philip Moons
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.,Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Joris Vandenberghe
- Department of Psychiatry, University Hospitals Leuven, Leuven, Belgium.,Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - René Westhovens
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium.,Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium
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20
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Ammouri AA, Kamanyire JK, Abu Raddaha AH, Achora S, Obeidat AA. Another Chance at Life: Jordanian Patients' Experience of Going Through a Myocardial Infarction. Res Theory Nurs Pract 2017; 31:334-348. [PMID: 29137693 DOI: 10.1891/1541-6577.31.4.334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Myocardial infarction (MI) is a life-threatening health condition that has physical, spiritual, emotional, and social changes. Understanding feelings and thoughts of patients who suffered MI attacks is essential to recovery. Among Jordanian patients who suffered an acute attack of MI, the aim of the study was to describe the experiences and the varied meanings that they assign to their experiences. METHODS A qualitative hermeneutic phenomenological research design was used. Five participants were engaged in in-depth semistructured interviews. The participants were identified using a purposeful sampling technique, after being admitted at a coronary care unit in a university hospital located in Amman, the capital city of Jordan. The hospital provides a full range of cardiovascular medical and surgical care for patients admitted from different socioeconomic levels. Transcribed data were analyzed following inductive qualitative content analysis method. RESULTS The experience of MI was a traumatizing event characterized by life-threatening symptoms, and participants feared they would not come back home. However, cultural values and religiosity among the Jordanian patients played a major role in facilitating their positive coping during and after the MI attack. The participants' recount of their experience was summed-up into 5 major themes: frightening experience, needed support, religiosity, experiencing changes, and lifestyle modifications. After the MI attack, most of the participants felt that they had given another chance to live, showing a pressing need to make healthier lifestyle modifications to avoid another MI attack. IMPLICATIONS FOR PRACTICE Health care workers should need not only pay attention on physical and physiological caring aspects but should also consider other patients' needs, while supporting the patients and their family members.
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21
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Miglioretti M, Meroni C, Baiardo G, Savioli G, Velasco V. The perceptions of the causes of cardiac diseases: a taxonomy. Psychol Health 2017; 33:537-554. [DOI: 10.1080/08870446.2017.1380810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
| | - Claudia Meroni
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Giacomo Baiardo
- Psychological Unit, Cardiovascular Institute of Camogli, Ruta di Camogli (GE), Italy
| | - Gaia Savioli
- Psychological Unit, Cardiovascular Institute of Camogli, Ruta di Camogli (GE), Italy
| | - Veronica Velasco
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
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22
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Rassart J, Apers S, Kovacs AH, Moons P, Thomet C, Budts W, Enomoto J, Sluman MA, Wang JK, Jackson JL, Khairy P, Cook SC, Subramanyan R, Alday L, Eriksen K, Dellborg M, Berghammer M, Johansson B, Rempel GR, Menahem S, Caruana M, Veldtman G, Soufi A, Fernandes SM, White KS, Callus E, Kutty S, Luyckx K. Illness perceptions in adult congenital heart disease: A multi-center international study. Int J Cardiol 2017; 244:130-138. [DOI: 10.1016/j.ijcard.2017.06.072] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 06/01/2017] [Accepted: 06/19/2017] [Indexed: 01/02/2023]
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23
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Princip M, Scholz M, Meister-Langraf RE, Barth J, Schnyder U, Znoj H, Schmid JP, Thayer JF, von Känel R. Can Illness Perceptions Predict Lower Heart Rate Variability following Acute Myocardial Infarction? Front Psychol 2016; 7:1801. [PMID: 27917140 PMCID: PMC5114266 DOI: 10.3389/fpsyg.2016.01801] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 11/01/2016] [Indexed: 12/19/2022] Open
Abstract
Objective: Decreased heart rate variability (HRV) has been reported to be a predictor of mortality after myocardial infarction (MI). Patients' beliefs and perceptions concerning their illness may play a role in decreased HRV. This study investigated if illness perceptions predict HRV at 3 months following acute MI. Methods: 130 patients referred to a tertiary cardiology center, were examined within 48 h and 3 months following acute MI. At admission, patients' cognitive representations of their MI were assessed using the German version of the self-rated Brief Illness Perception Questionnaire (Brief IPQ). At admission and after 3 months (follow-up), frequency and time domain measures of HRV were obtained from 5-min electrocardiogram (ECG) recordings during stable supine resting. Results: Linear hierarchical regression showed that the Brief IPQ dimensions timeline (β coefficient = 0.29; p = 0.044), personal control (β = 0.47; p = 0.008) and illness understanding (β = 0.43; p = 0.014) were significant predictors of HRV, adjusted for age, gender, baseline HRV, diabetes, beta-blockers, left ventricular ejection fraction (LVEF), attendance of cardiac rehabilitation, and depressive symptoms. Conclusions: As patients' negative perceptions of their illness are associated with lower HRV following acute MI, a brief illness perception questionnaire may help to identify patients who might benefit from a specific illness perceptions intervention.
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Affiliation(s)
- Mary Princip
- Department of Neurology, Inselspital, Bern University Hospital, and University of BernBern, Switzerland; Psychosomatic Research Group, Department of Clinical Research, University of BernBern, Switzerland; Department of Cardiology, Inselspital, Bern University HospitalBern, Switzerland
| | - Marco Scholz
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern Bern, Switzerland
| | - Rebecca E Meister-Langraf
- Department of Neurology, Inselspital, Bern University Hospital, and University of BernBern, Switzerland; Psychosomatic Research Group, Department of Clinical Research, University of BernBern, Switzerland; Clienia Schlössli AG, Private Psychiatric and Psychotherapy ClinicOetwil am See, Switzerland
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zurich Zurich, Switzerland
| | - Ulrich Schnyder
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich Switzerland
| | - Hansjörg Znoj
- Division of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Bern Bern, Switzerland
| | - Jean-Paul Schmid
- Cardiology Clinic, Tiefenauspital, Bern University Hospital Bern, Switzerland
| | - Julian F Thayer
- Department of Psychology, Ohio State University Columbus Columbus, OH, USA
| | - Roland von Känel
- Department of Neurology, Inselspital, Bern University Hospital, and University of BernBern, Switzerland; Psychosomatic Research Group, Department of Clinical Research, University of BernBern, Switzerland; Department of Psychosomatic Medicine, Clinic BarmelweidBarmelweid, Switzerland
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24
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Al-Smadi AM, Ashour A, Hweidi I, Gharaibeh B, Fitzsimons D. Illness perception in patients with coronary artery disease: A systematic review. Int J Nurs Pract 2016; 22:633-648. [PMID: 27687787 DOI: 10.1111/ijn.12494] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 08/19/2016] [Accepted: 08/30/2016] [Indexed: 11/28/2022]
Abstract
The aim of this study was to conduct a systematic review that investigates the differences in illness perception with age and gender in patients diagnosed with coronary artery disease. Previous studies show some discrepancies regarding the influence of age and gender on the specific dimensions of coronary artery disease patients' illness perception. A systematic review using a narrative synthesis process included preliminary synthesis, exploration of relationships and assessment of the robustness of the synthesis and findings was conducted. Search terms were used to identify research studies published between 1996 and December 2014 across four key databases: CINAHL, Medline, PsycINFO and Web of Science. A total of 14 studies met the inclusion criteria of the review. The review found that men had a stronger perception that their own behaviour had caused their illness than women. In addition, older patients had lower perceptions of the consequences and chronicity of their illness. This analysis concludes that some dimensions of illness perception vary according to age and gender of patients with coronary artery disease. These differences should be taken into consideration, particularly when providing health education and cardiac rehabilitation.
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Affiliation(s)
| | | | - Issa Hweidi
- Jordan University of Science and Technology, Irbid, Jordan
| | | | - Donna Fitzsimons
- University of Ulster and Belfast Health and Social Care Trust, Belfast, UK
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25
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Fatima Y, Doi SA, O'Callaghan M, Williams G, Najman JM, Mamun AA. Parent and adolescent reports in assessing adolescent sleep problems: results from a large population study. Acta Paediatr 2016; 105:e433-9. [PMID: 26991850 DOI: 10.1111/apa.13404] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 12/28/2015] [Accepted: 03/11/2016] [Indexed: 11/30/2022]
Abstract
AIM To compare parent and adolescent reports in exploring adolescent sleep problems and to identify the factors associated with adolescent sleep problem disclosures. METHODS Parent (n = 5185) and adolescent reports (n = 5171, age=13.9 ± 0.3 years), from a birth cohort were used to explore adolescent sleep problems. Kappa coefficients were used to assess the agreement, whereas, conditional agreement and disagreement ratios were used to identify the optimal informant. Logistic regression analysis was used to determine the factors affecting adolescent sleep problem disclosure. RESULTS Parental reports identified only about one-third of the sleep problems reported by adolescents. Whereas adolescent reports identified up to two-thirds of the sleep problems reported by parents. Combined reports of parents and adolescent did not show any considerable difference from the adolescent report. Adolescent and parent health, maternal depression, and family communication were significantly associated with adolescents sleep problem disclosures. CONCLUSION Adolescent reports could be used as the preferred source to explore adolescent sleep problems. Parental reports should be used when parents as observers are more reliable reporters, or where adolescents are cognitively unable to report sleep problems. Additionally, the impact of poor health, maternal depression and family communication on sleep problems disclosure should be considered for adolescent sleep problem diagnosis.
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Affiliation(s)
- Yaqoot Fatima
- School of Public Health; The University of Queensland; Brisbane Queensland Australia
- Mount Isa Centre for Rural and Remote Health; James Cook University; Mount Isa Queensland Australia
| | - Suhail A.R. Doi
- Research School of Population Health; Australian National University; Canberra ACT Australia
- College of Medicine; Qatar University; Doha Qatar
- School of Agricultural; Computing and Environmental Sciences; University of Southern Queensland; Toowoomba Queensland Australia
| | - Michael O'Callaghan
- School of Medicine; The University of Queensland; Brisbane Queensland Australia
| | - Gail Williams
- School of Public Health; The University of Queensland; Brisbane Queensland Australia
| | - Jake M. Najman
- School of Public Health; The University of Queensland; Brisbane Queensland Australia
- School of Social Science; The University of Queensland; Brisbane Queensland Australia
| | - Abdullah Al Mamun
- School of Public Health; The University of Queensland; Brisbane Queensland Australia
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Waring ME, McManus DD, Lemon SC, Gore JM, Anatchkova MD, McManus RH, Ash AS, Goldberg RJ, Kiefe CI, Saczynski JS. Perceiving one's heart condition to be cured following hospitalization for acute coronary syndromes: Implications for patient-provider communication. PATIENT EDUCATION AND COUNSELING 2016; 99:455-461. [PMID: 26519237 PMCID: PMC4779389 DOI: 10.1016/j.pec.2015.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 08/28/2015] [Accepted: 10/11/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE We examined the proportion of patients perceiving their heart condition to be cured following hospitalization for ACS and identified characteristics associated with these perceptions. METHODS We conducted a prospective cohort study of adults hospitalized with ACS (N=396). Patient interviews during hospitalization and one week post-discharge provided demographic and psychosocial characteristics. Medical records provided clinical characteristics. At one week, patients who rated "My heart condition is cured" as "definitely true" or "mostly true" were considered to perceive their heart condition cured. RESULTS Participants were aged 60.7 (SD:11.0) years, 26.5% female, and 89.0% non-Hispanic white; 16.7% had unstable angina, 59.6% NSTEMI, and 23.7% STEMI. One week post-discharge, 30.3% perceived their heart condition to be cured. Characteristics associated with cure perceptions were older age (OR=2.2; 95% CI: 1.2-4.0 for ≥65 years vs <55 years), male sex (OR=2.4; 95%CI: 1.3-4.2), history of hypertension (OR=1.8; 95%CI: 1.1-3.1), history of stroke (OR=4.2; 95%CI: 1.1-16.7), no history of CHD (OR=2.8; 95%CI: 1.6-4.9), and receipt of CABG during hospitalization (OR=4.8, 95%CI: 1.9-12.0 vs medical management). CONCLUSION One week post-discharge, 3 in 10 patients perceived their heart condition to be cured. PRACTICE IMPLICATIONS Conversations with patients should frame ACS as a chronic disease and dispel cure perceptions.
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Affiliation(s)
- Molly E Waring
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA.
| | - David D McManus
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA; Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01605, USA; Meyers Primary Care Institute, 425 Lake Avenue North, Worcester, MA 01605, USA.
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01605, USA.
| | - Joel M Gore
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01605, USA.
| | - Milena D Anatchkova
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA; Evidera, 430 Bedford Street, Suite 300, Lexington Office Park, Lexington, MA 02420, USA.
| | - Richard H McManus
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA.
| | - Arlene S Ash
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA.
| | - Robert J Goldberg
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA.
| | - Catarina I Kiefe
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA.
| | - Jane S Saczynski
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA; School of Pharmacy, Northeastern University, 360 Huntington Avenue, R218 TF, Boston, MA 02115, USA.
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Association of late-life changes in blood pressure and cognitive status. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2016; 13:37-43. [PMID: 26918011 PMCID: PMC4753010 DOI: 10.11909/j.issn.1671-5411.2016.01.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background Disagreement exists on the association between changes in blood pressure and cognitive impairment. We aimed to examine whether 4-year changes in systolic and diastolic blood pressure (SBP and DBP) are associated with cognitive status in a representative sample of older men and women. Methods Analysis of longitudinal data from 854 participants of a population-based German sample (aged 60–87 years) was performed with standard cognitive screening and blood pressure measurements. Effects of changes in SBP and DBP (10 mmHg and 5 mmHg respectively as unit of regression effect measure) on cognitive status were evaluated using non-parametric and linear regression modeling. Results No clear associations were seen between changes in SBP or in DBP and cognitive scores. Small effects were found after stratification for sex and hypertension awareness. Specifically, larger decreases in SBP were associated with higher cognitive scores in those men aware of their hypertension (10 mmHg decrease in SBP, β = −0.26, 95% CI: −0.51 to −0.02) and men with controlled hypertension (10 mmHg decrease in SBP, β = −0.44, 95% CI: −0.92 to −0.03). Additionally larger increases in DBP were associated with higher cognitive scores in men with controlled hypertension (5 mmHg increase in DBP, β = 0.67, 95% CI: 0.19–1.15). For women aware of their hypertension, larger decreases in DBP were associated with higher cognitive scores (5 mmHg decrease in DBP, β = −0.26; 95%CI: −0.51 to −0.01). Conclusions Changes in blood pressure were only weakly associated with cognitive status. Specifically, decreases in SBP were associated with higher cognitive scores in men aware of their hypertension and especially those that were medically controlled.
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Shiloh S, Drori E, Peleg S, Banai S, Finkelstein A. Mediation and moderation of the effects of watching the angiography screen on patients. PSYCHOL HEALTH MED 2016; 21:806-18. [PMID: 26740003 DOI: 10.1080/13548506.2015.1131997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
It has been reported that allowing patients to watch the coronary angiography screen during the procedure results in psychological benefits. This study aimed to investigate the roles of illness perceptions as mediators of this outcome and to examine whether individual differences in monitoring coping style moderated these effects. The experiment compared patients who were instructed to watch the monitor screen (n = 57) with those who were not (n = 51). Questionnaires were used to measure the research variables at one day and one month after the procedure. Results showed that watching the angiography screen increased patients' personal and treatment control perceptions that mediated changes in self-assessed health, risk perceptions, negative affect, general and diet outcome expectancies, and diet and physical activity intentions. The behavior-related outcomes were moderated by monitoring coping style. These findings illustrate the significance of illness perceptions, perceived control and monitoring coping style in achieving desirable outcomes among patients undergoing coronary angiography, and reveal opportunities for interventions using medical imaging technologies.
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Affiliation(s)
- Shoshana Shiloh
- a The Gordon Faculty of Social Sciences, School of Psychological Sciences , Tel Aviv University , Tel Aviv , Israel
| | - Erga Drori
- a The Gordon Faculty of Social Sciences, School of Psychological Sciences , Tel Aviv University , Tel Aviv , Israel
| | - Shira Peleg
- a The Gordon Faculty of Social Sciences, School of Psychological Sciences , Tel Aviv University , Tel Aviv , Israel
| | - Shmuel Banai
- b Sackler Faculty of Medicine, Department of Cardiology, Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
| | - Ariel Finkelstein
- b Sackler Faculty of Medicine, Department of Cardiology, Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
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Bertolotti G, Moroni L, Burro R, Spanevello A, Pedretti RF, Giorgetti G. Shortened questionnaires to assess anxiety and depression during in-hospital rehabilitation: clinical validation and cutoff scores. Neuropsychiatr Dis Treat 2016; 12:2627-2633. [PMID: 27789951 PMCID: PMC5068471 DOI: 10.2147/ndt.s111797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND A postacute phase needs reliable routine screening instruments in order to identify the patients to be referred for a clinical interview with a psychologist. The aim of this study was to estimate the clinical cutoff scores of the anxiety and depression questionnaires and their clinical validity using a gold standard. METHODS The study involved 177 patients with pulmonary, cardiac, or neurological disease undergoing in-hospital rehabilitation. Receiver operating characteristic curves were used to determine the best concordance between questionnaire's scores and the gold standards. RESULTS There was a significant difference (P<0.001) between clinically anxious and depressed patients and nonclinical subjects. The receiver operating characteristic curve for anxiety indicated that the best area under the curve for State Anxiety Inventory is obtained with a cutoff point of 21 for males and 25 for females; for depression scores, the highest area under the curve for Depression Questionnaire-Reduced Form is obtained with a cutoff point of six for males and eight for females. CONCLUSION Using appropriate cutoff values, the State Anxiety Inventory and Depression Questionnaire-Reduced Form allow psychologists to optimize early clinical intervention strategies selecting patients with significant needs.
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Affiliation(s)
- Giorgio Bertolotti
- Psychology Unit, Salvatore Maugeri Foundation, IRCCS, Scientific Institute, Tradate
| | - Loretta Moroni
- Psychology Unit, Salvatore Maugeri Foundation, IRCCS, Scientific Institute, Tradate
| | - Roberto Burro
- Department of Human Sciences - University of Verona, Verona
| | | | | | - Giandomenico Giorgetti
- Department of Neuromotor Rehabilitation, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Tradate, Italy
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Wisting L, Bang L, Skrivarhaug T, Dahl-Jørgensen K, Rø Ø. Psychological barriers to optimal insulin therapy: more concerns in adolescent females than males. BMJ Open Diabetes Res Care 2016; 4:e000203. [PMID: 27403325 PMCID: PMC4932280 DOI: 10.1136/bmjdrc-2016-000203] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 04/18/2016] [Accepted: 05/02/2016] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The aim of this study is to investigate psychological barriers (illness perceptions, insulin beliefs, and coping strategies) to optimal insulin therapy among adolescents with type 1 diabetes (T1D), with a specific focus on gender differences and mode of treatment (insulin pump vs pen). METHODS A total of 105 males and females (12-20 years) participated in this study. The Brief Illness Perception Questionnaire, the Beliefs about Medicines Questionnaire, and the Adolescent Coping Orientation for Problem Experiences were completed. Additionally, diabetes clinical data were collected by the Norwegian Childhood Diabetes Registry. RESULTS Females had significantly more negative illness perceptions than males on all dimensions (p<0.05), with moderate-to-large effect sizes. Regarding insulin beliefs, females scored significantly higher than males on insulin concern (p<0.001), indicating more concerns about insulin. There were no significant gender differences on perceptions of insulin necessity. Finally, females scored significantly higher on the coping strategies being social and solving family problems (p<0.01), indicating more positive coping among females than males for these subscales. In terms of treatment mode, the only statistically significant difference in the psychological aspects was for the illness perception treatment control, with patients using insulin pen reporting more negative perceptions on this dimension than patients using insulin pump. CONCLUSIONS Addressing psychological aspects may be a clinically important supplement to standard somatic T1D care. The consistent finding of gender differences across the psychological measures implies that a tailored treatment approach for males and females with T1D may be warranted.
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Affiliation(s)
- Line Wisting
- Division of Mental Health and Addiction, Regional Department for Eating Disorders, Oslo University Hospital, Oslo, Norway
- Oslo Diabetes Research Centre, Oslo University Hospital, Oslo, Norway
| | - Lasse Bang
- Division of Mental Health and Addiction, Regional Department for Eating Disorders, Oslo University Hospital, Oslo, Norway
| | - Torild Skrivarhaug
- Oslo Diabetes Research Centre, Oslo University Hospital, Oslo, Norway
- Department of Pediatric Medicine, The Norwegian Childhood Diabetes Registry, Oslo University Hospital, Oslo, Norway
- Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Knut Dahl-Jørgensen
- Oslo Diabetes Research Centre, Oslo University Hospital, Oslo, Norway
- Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Øyvind Rø
- Division of Mental Health and Addiction, Regional Department for Eating Disorders, Oslo University Hospital, Oslo, Norway
- Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Joshi S, Dhungana RR, Subba UK. Illness Perception and Depressive Symptoms among Persons with Type 2 Diabetes Mellitus: An Analytical Cross-Sectional Study in Clinical Settings in Nepal. J Diabetes Res 2015; 2015:908374. [PMID: 26236749 PMCID: PMC4508465 DOI: 10.1155/2015/908374] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 05/25/2015] [Accepted: 06/21/2015] [Indexed: 01/04/2023] Open
Abstract
Background. This study aimed to assess the relationship between illness perception and depressive symptoms among persons with diabetes. Method. This was an analytical cross-sectional study conducted among 379 type 2 diabetic patients from three major clinical settings of Kathmandu, Nepal. Results. The prevalence of depressive symptoms was 44.1% (95% CI: 39.1, 49.1). Females (p < 0.01), homemakers (p < 0.01), 61-70 age group (p = 0.01), those without formal education (p < 0.01), and people with lower social status (p < 0.01) had significantly higher proportion of depressive symptoms than the others. Multivariable analysis identified age (β = 0.036, p = 0.016), mode of treatment (β = 0.9, p = 0.047), no formal educational level (β = 1.959, p = 0.01), emotional representation (β = 0.214, p < 0.001), identity (β = 0.196, p < 0.001), illness coherence (β = -0.109, p = 0.007), and consequences (β = 0.093, p = 0.049) as significant predictors of depressive symptoms. Conclusion. Our study demonstrated a strong relationship between illness perception and depressive symptoms among diabetic patients. Study finding indicated that persons living with diabetes in Nepal need comprehensive diabetes education program for changing poor illness perception, which ultimately helps to prevent development of depressive symptoms.
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Affiliation(s)
- Suira Joshi
- Ministry of Health and Population, Nepal
- *Suira Joshi:
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Panzaru GM, Holman A. Type of treatment of cardiac disorders – quality of life and heart-focused anxiety: The mediating role of illness perceptions. PSYCHOL HEALTH MED 2014; 20:551-9. [DOI: 10.1080/13548506.2014.989863] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Abstract
PURPOSE Differences in the ways male and female patients confront their illness after cardiac surgery may contribute to previously observed gender differences in the outcomes of cardiac rehabilitation. The aim of this cross-sectional study was to verify whether there are gender-related differences in illness behavior (IB) soon after cardiac surgery and before entering cardiac rehabilitation. METHODS Patients (N = 1323) completed the IB Questionnaire and Hospital Anxiety and Depression Scale (HADS) 9 ± 5 (mean ± SD) days after cardiac surgery. The scores were tested for gender differences in score distributions (Mann-Whitney U test) and in prevalence of clinically relevant scores (the Pearson χ² test). Multivariate regression analyses were made with IB Questionnaire and HADS scores as independent variables, and gender, age, education, marital status, and type of surgery as predictors. RESULTS Denial was significantly (P < .01) prevalent among the men (3.6 ± 1.4) versus women (3.2 ± 1.6), whereas disease conviction (men = 2.1 ± 1.5, women = 2.5 ± 1.6), dysphoria (men = 1.5 ± 1.5, women = 2.0 ± 1.6), anxiety (men = 6.0 ± 3.6, women = 6.9 ± 3.9), and depression (men = 5.3 ± 3.8, women = 6.5 ± 4.0) were significantly more prevalent among women. The prevalences of clinically relevant scores for disease conviction, anxiety, and depression were also significantly higher in women. Multivariate analysis showed that gender predicted these scores even after the removal of confounders. CONCLUSIONS Gender differences exist in denial, disease conviction, and dysphoria, probably depending on the culturally assigned roles of men and women. As these aspects of IB may compromise treatment compliance and the quality of life, the efficacy of cardiac rehabilitation programs might be improved taking into account the different prevalences in men and women.
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Changing illness perceptions and adherence to dual antiplatelet therapy in patients with stable coronary disease. J Cardiovasc Nurs 2014; 28:573-83. [PMID: 22785086 DOI: 10.1097/jcn.0b013e31825d6060] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Platelet inhibition with dual antiplatelet therapy (DAPT) is an important component of medical management in patients with stable coronary artery disease (CAD). Dual antiplatelet therapy nonadherence is associated with increased mortality. Little is known about illness perceptions (IPs) surrounding the use of antiplatelet medications and whether they differ in stable CAD patients treated with medical and/or interventional approaches. OBJECTIVE The aim of this study was to examine temporal changes in IP scores for patients with stable CAD and examine the influence of clinical and demographic variables, IP, and depressive symptoms on adherence to DAPT. METHODS Patients (n = 180, 71.7% men; mean [SD] age, 65.1 [8.3] years) were recruited after coronary angiography and optimal medical therapy (OMT) (n = 90) or after percutaneous coronary intervention with initiation of OMT (n = 90). The Illness Perception Questionnaire-Revised and Patient Health Questionnaire-9 were administered at baseline and 30 days after treatment, with a response rate of 52.8% (n = 95) at 30 days. Adherence to DAPT (aspirin and thienopyridine) at 30 days was collected using a health history update. RESULTS Patients with stable CAD experienced shifts in IP within the first 30 days after treatment. Patients treated with OMT demonstrated increased symptoms after treatment (timeline cyclical) and reduced beliefs in the level of control provided by their prescribed regimen (treatment control, t = 3.26, P = .002). Both groups demonstrated an increase in perceived understanding of illness (illness coherence subscale) from baseline to 30 days (percutaneous coronary intervention/OMT, t = -4.43, P < .001; OMT, t = -3.74, P = .001). Chronic IPs were associated with 5.7% increased odds for improved adherence to thienopyridine agents (B = 0.509, P = .009, Exp(B) = 1.66) and 5.6% increased odds for aspirin use (B = 0.265, P = .031, Exp(B) = 1.30). Depressive symptoms were predictive of adherence for thienopyridine medications (B = 0.509, P = .009, Exp(B) = 1.66). CONCLUSIONS Illness perceptions influence adherence to DAPT in patients with stable CAD. Understanding patterns in IP after treatment may help identify the best strategies to promote a tailored approach for improving adherence to DAPT.
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Janssen V, De Gucht V, van Exel H, Maes S. Changes in illness perceptions and quality of life during participation in cardiac rehabilitation. Int J Behav Med 2014; 20:582-9. [PMID: 22941580 DOI: 10.1007/s12529-012-9260-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The beliefs patients hold about their disease and corresponding treatment have been shown to predict recovery in cardiac patients. PURPOSE However, it is not known to what extent these beliefs change during participation in cardiac rehabilitation and whether this is related to psychological indicators of outcome. METHOD Illness perceptions and health-related quality of life (HRQOL) were measured upon entry to (T0) and completion of (T1) a 3-month outpatient cardiac rehabilitation program in 158 cardiac patients. RESULTS Repeated-measures ANOVA revealed that all illness perceptions other than timeline and personal control changed significantly over the course of cardiac rehabilitation. Overall, cardiac rehabilitation patients came to view their illness as more benign. Further analysis revealed that perceiving fewer emotional consequences of the illness, gaining a better understanding, and attributing fewer symptoms to the illness at the end of cardiac rehabilitation, was related to better HRQOL. CONCLUSION Illness perceptions change during cardiac rehabilitation and these changes are associated with enhanced quality of life. Clinical trials have shown illness beliefs in cardiac patients to be modifiable during hospital admission; our results suggest that cardiac rehabilitation may provide a second window of opportunity during which illness perceptions can be actively monitored and modified if maladaptive.
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Chen SL, Lee WL, Liang T, Liao IC. Factors associated with gender differences in medication adherence: a longitudinal study. J Adv Nurs 2014; 70:2031-2040. [PMID: 24506542 DOI: 10.1111/jan.12361] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 11/21/2013] [Accepted: 01/11/2014] [Indexed: 11/30/2022]
Abstract
AIMS To examine gender differences in the medication adherence of patients with hypertension by applying a longitudinal follow-up. BACKGROUND Patient views of illness affect their adherence to therapeutic regimens. However, few studies have explored these issues by using a longitudinal design or from a gender perspective. DESIGN This study used a longitudinal, correlational design. METHODS A purposive sampling of 118 patients were recruited from cardiovascular clinics of a teaching hospital in Central Taiwan in 2007-2009. Data were collected using the Chinese Illness Perception Questionnaire-Revised and the Medication Adherence Inventory at three time points: at the first clinic visit, 6 and 12 months after the initial survey. Generalized estimating equations were calculated using the STATA software for data analysis. RESULTS The findings revealed that male patients adhere more effectively to medications than female patients do. The interaction between systolic blood pressure and gender emerged as a significant predictor of adherence. Factors associated with adherence in male patients included less causal attribution to culture, more attribution to risk factors, fewer symptoms and uncertain symptoms related to high blood pressure, lower scores for timeline-cyclical and higher scores for illness consequences and coherence. Medication adherence for female patients was significantly related to more causal attribution to balance and risk factors, less personal control and enhanced illness coherence. CONCLUSION Factors associated with adherence to antihypertensive medication were relatively gender-specific. Awareness of the differences is crucial for health professionals to provide appropriate advice for patients to cope effectively with their health threat.
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Affiliation(s)
- Shiah-Lian Chen
- Department of Nursing, National Taichung University of Science and Technology, Taiwan
| | - Wen-Lieng Lee
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tienli Liang
- Department of Nursing, Hungkuang University, Taichung, Taiwan
| | - I-Chen Liao
- Department of Nursing, Hungkuang University, Taichung, Taiwan
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Foxwell R, Morley C, Frizelle D. Illness perceptions, mood and quality of life: a systematic review of coronary heart disease patients. J Psychosom Res 2013; 75:211-22. [PMID: 23972409 DOI: 10.1016/j.jpsychores.2013.05.003] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 05/09/2013] [Accepted: 05/10/2013] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To examine published literature investigating the relationship between illness perceptions, mood and quality of life (QoL) in coronary heart disease (CHD) populations. METHODS Key databases were systematically searched (CINAHL, Medline, PsycINFO, Scopus and Web of Science) for studies matching the inclusion criteria between November 2011 and February 2012. References of included studies were examined and key authors contacted. Studies were subject to a quality control check. RESULTS 21 studies met the inclusion criteria. A synthesis of the results found that illness perceptions were correlated to and predicted QoL and mood across CHD diagnoses. Specific illness perceptions (control, coherence and timeline) were found to be important for patients that had experienced an unexpected medical event, such as myocardial infarction. CONCLUSION The results of this study provide support that illness perceptions are related to outcomes across CHD populations and disease progression, however the results do not selectively support one particular model. Recommendations are consistent with cardiac rehabilitation guidelines. Further research should focus on the systemic impact of illness perceptions.
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Affiliation(s)
- Rachel Foxwell
- Department of Clinical Psychology, University of Hull, UK.
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Rakhshan M, Hassani P, Ashktorab T, Majd HA. The nature and course of illness perception following cardiac pacemaker implantation: A self-regulatory approach. Int J Nurs Pract 2013; 19:318-25. [DOI: 10.1111/ijn.12073] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Mahnaz Rakhshan
- School of Nursing & Midwifery; Shahid Beheshti University of Medical Science; Tehran; Iran
| | - Parkhideh Hassani
- School of Nursing & Midwifery; Shahid Beheshti University of Medical Science; Tehran; Iran
| | - Tahereh Ashktorab
- School of Nursing & Midwifery; Shahid Beheshti University of Medical Science; Tehran; Iran
| | - Hamid Alavi Majd
- Department of Biostatistics; Shahid Beheshti University of Medical Science; Tehran; Iran
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Vilchinsky N, Dekel R, Asher Z, Leibowitz M, Mosseri M. The role of illness perceptions in the attachment-related process of affect regulation. ANXIETY STRESS AND COPING 2013; 26:314-29. [DOI: 10.1080/10615806.2012.682649] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bennett KK, Marte RM. Patient attributions for cardiac events: predictors of physical and psychological recovery. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2013. [DOI: 10.1111/jasp.12103] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Ricardo M. Marte
- Department of Sociology/Anthropology; University of Missouri - Kansas City
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Illness Perceptions, Coping Strategies, and Symptoms Contribute to Psychological Distress in Patients With Recurrent Symptomatic Atrial Fibrillation. J Cardiovasc Nurs 2012; 27:431-44. [DOI: 10.1097/jcn.0b013e31821e7ab1] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Edelstein OE, Werner P, Dresner-Pollak R, Tordjman K, Jaffe A, Toledano Y, Vered I. Illness perceptions among osteoporotic men and women: correlates and gender differences. JOURNAL OF MENS HEALTH 2012. [DOI: 10.1016/j.jomh.2012.03.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bernal DDL, Stafford L, Bereznicki LRE, Castelino RL, Davidson PM, Peterson GM. Home medicines reviews following acute coronary syndrome: study protocol for a randomized controlled trial. Trials 2012; 13:30. [PMID: 22463733 PMCID: PMC3349589 DOI: 10.1186/1745-6215-13-30] [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] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 04/02/2012] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Despite continual improvements in the management of acute coronary syndromes, adherence to guideline-based medications remains suboptimal. We aim to improve adherence with guideline-based therapy following acute coronary syndrome using an existing service that is provided by specifically trained pharmacists, called a Home Medicines Review. We have made two minor adjustments to target the focus of the existing service including an acute coronary syndrome specific referral letter and a training package for the pharmacists providing the service. METHODS/DESIGN We will be conducting a randomized controlled trial to compare the directed home medicines review service to usual care following acute coronary syndromes. All patients aged 18 to 80 years and with a working diagnosis of acute coronary syndrome, who are admitted to two public, acute care hospitals, will be screened for enrolment into the trial. Exclusion criteria will include: not being discharged home, documented cognitive decline, non-Medicare eligibility, and presence of a terminal malignancy. Randomization concealment and sequence generation will occur through a centrally-monitored computer program. Patients randomized to the control group will receive usual post-discharge care. Patients randomized to receive the intervention will be offered usual post-discharge care and a directed home medicines review at two months post-discharge. The study endpoints will be six and twelve months post-discharge. The primary outcome will be the proportion of patients who are adherent to a complete, guideline-based medication regimen. Secondary outcomes will include hospital readmission rates, length of hospital stays, changes in quality of life, smoking cessation rates, cardiac rehabilitation completion rates, and mortality. DISCUSSION As the trial is closely based on an existing service, any improvements observed should be highly translatable into regular practice. Possible limitations to the success of the trial intervention include general practitioner approval of the intervention, general practitioner acceptance of pharmacists' recommendations, and pharmacists' ability to make appropriate recommendations. A detailed monitoring process will detect any barriers to the success of the trial. Given that poor medication persistence following acute coronary syndrome is a worldwide problem, the findings of our study may have international implications for the care of this patient group. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12611000452998.
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Affiliation(s)
- Daniel DL Bernal
- Unit for Medication Outcomes Research and Education (UMORE), School of Pharmacy, University of Tasmania (UTAS), Sandy Bay Campus, Tasmania 7001, Australia
| | - Leanne Stafford
- Unit for Medication Outcomes Research and Education (UMORE), School of Pharmacy, University of Tasmania (UTAS), Sandy Bay Campus, Tasmania 7001, Australia
| | - Luke RE Bereznicki
- Unit for Medication Outcomes Research and Education (UMORE), School of Pharmacy, University of Tasmania (UTAS), Sandy Bay Campus, Tasmania 7001, Australia
| | - Ronald L Castelino
- Unit for Medication Outcomes Research and Education (UMORE), School of Pharmacy, University of Tasmania (UTAS), Sandy Bay Campus, Tasmania 7001, Australia
| | - Patricia M Davidson
- Centre for Cardiovascular and Chronic Care, Faculty of Nursing, Midwifery and Health, University of Technology Sydney (UTS), Sydney 2007, Australia
| | - Gregory M Peterson
- Unit for Medication Outcomes Research and Education (UMORE), School of Pharmacy, University of Tasmania (UTAS), Sandy Bay Campus, Tasmania 7001, Australia
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Monirpoor N, Besharat MA, Khoosfi H, Karimi Y. The role of illness perception in predicting post-CHD depression in patients under CABG and PCI. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.sbspro.2012.01.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Poole L, Dickens C, Steptoe A. The puzzle of depression and acute coronary syndrome: reviewing the role of acute inflammation. J Psychosom Res 2011; 71:61-8. [PMID: 21767684 PMCID: PMC3143279 DOI: 10.1016/j.jpsychores.2010.12.009] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Revised: 11/12/2010] [Accepted: 12/14/2010] [Indexed: 12/27/2022]
Abstract
The relationship between depression and coronary heart disease is well-established, but causal mechanisms are poorly understood. The aim of this review is to stimulate different ways of viewing the relationship between depression and adverse outcomes following acute coronary syndrome (ACS) and coronary artery bypass graft (CABG) surgery patients. We present an argument for depression in ACS and CABG patients being a qualitatively distinct form from that observed in psychiatric populations. This is based on three features: (1) depression developing after cardiac events has been linked in many studies to poorer outcomes than recurrent depression; (2) somatic symptoms of depression following cardiac events are particularly cardiotoxic; (3) depression following an ACS does not respond well to antidepressant treatments. We propose that inflammation is a common causal process responsible in part both for the development of depressive symptoms and for adverse cardiac outcomes, and we draw parallels with inflammation-induced sickness behaviour. Clinical implications of our observations are discussed along with suggestions for further work to advance the field.
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Affiliation(s)
- Lydia Poole
- Department of Epidemiology and Public Health, University College London, London, UK.
| | | | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
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BRINK EVA, ALSÉN PIA, CLIFFORDSON CHRISTINA. Validation of the Revised Illness Perception Questionnaire (IPQ-R) in a sample of persons recovering from myocardial infarction - the Swedish version. Scand J Psychol 2011; 52:573-9. [DOI: 10.1111/j.1467-9450.2011.00901.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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John H, Hale ED, Bennett P, Treharne GJ, Carroll D, Kitas GD. Translating patient education theory into practice: developing material to address the cardiovascular education needs of people with rheumatoid arthritis. PATIENT EDUCATION AND COUNSELING 2011; 84:123-127. [PMID: 20638217 PMCID: PMC3123736 DOI: 10.1016/j.pec.2010.06.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Revised: 04/13/2010] [Accepted: 06/16/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE This paper describes the rationale and design of a theory-informed patient education programme addressing cardiovascular disease for people with rheumatoid arthritis (RA) to illustrate how theory can explicitly be translated into practice. METHODS A steering group of rheumatologists and psychologists was convened to design the programme. The Common Sense Model, the Theory of Planned Behaviour and the Stages of Change Model were used to underpin the topics and activities in the programme. User involvement was sought. The programme was formatted into a manual and the reading age of the materials was calculated. RESULTS A small group 8-week programme was designed. The structure of the patient education programme, including topics, underlying psychological theory as well as behaviour change techniques, is described. CONCLUSION This patient education programme addresses a currently unmet educational need for patients with RA and uses theory to design, not just evaluate, the programme. This will allow both enhanced interpretation of the results when the programme is implemented and replication by other units if successful. PRACTICE IMPLICATIONS The actual design and detail of education programmes merit wider dissemination to facilitate progress in the process of development and application.
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Affiliation(s)
- Holly John
- Department of Rheumatology, Dudley Group of Hospitals NHS Trust, UK.
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McCABE PAMELAJ, BARNASON SUSANA, HOUFEK JULIA. Illness Beliefs in Patients with Recurrent Symptomatic Atrial Fibrillation. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2011; 34:810-20. [DOI: 10.1111/j.1540-8159.2011.03105.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dunkel A, Kendel F, Lehmkuhl E, Hetzer R, Regitz-Zagrosek V. Causal attributions among patients undergoing coronary artery bypass surgery: gender aspects and relation to depressive symptomatology. J Behav Med 2011; 34:351-9. [PMID: 21305349 DOI: 10.1007/s10865-011-9324-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Accepted: 01/27/2011] [Indexed: 11/30/2022]
Abstract
Causal attributions made by patients for their coronary heart disease may contribute to gender differences in emotional adjustment. The purpose of this study was to determine gender differences in causal attributions and to analyze the associations between causal attributions and depressive symptomatology in patients undergoing coronary artery bypass graft (CABG) surgery. Nine hundred and seventy-nine patients (mean age 66.8 years, 19.9% women) completed a modified version of the Illness Perception Questionnaire (IPQ) and the depression module of the Patient Health Questionnaire (PHQ-9) 1-3 days before CABG-surgery and 1 year after surgery. Men were more likely to name their health behavior (men: 40.2%, women: 26.9%, P < .001) as a cause of disease, whereas women were more likely to cite destiny (women: 34.7%, men: 25.7%, P = .012). Regression analyses showed cross-sectional and longitudinal associations of attributions with depressive symptomatology which were independent of gender, sociodemographic and clinical variables. Attribution to personality and stress were associated with an increase in depressive symptomatology. Causal attributions may present a valuable approach for identifying patients at risk for depression and the implementation of targeted interventions.
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Affiliation(s)
- Anne Dunkel
- Berlin Institute of Gender in Medicine, Charité - Universitätsmedizin Berlin, Luisenstr. 65, 10117 Berlin, Germany.
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