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Emamzadehashemi KR, Khanghah AG, Azizi A, Paryad E, Noveiri MJS. Quality of life and activities of daily living one year after Coronary Artery Bypass Graft (CABG) surgery: a cross-sectional study. J Cardiothorac Surg 2024; 19:367. [PMID: 38915074 DOI: 10.1186/s13019-024-02848-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 06/14/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Daily activities have been recommended to minimize the long-term complications of coronary artery bypass as one of the strategies to return to the normal activity level, the effectiveness of which needs further investigation. This study aims to determine the quality of life and activities of daily living one year after CABG. METHODS This cross-sectional study was performed on 206 patients who had undergone CABG for more than one year in 2018 in the north of Iran. The research instrument was a questionnaire including five sections, Data were analyzed using descriptive statistics and Chi2, Mann-Whitney U, Kruskal-Wallis tests, and a Logistic regression model. RESULT The mean score of quality of life was 31.7 ± 2.04 of 12 to 48 possible scores. About Activities of Daily Living results showed 99.5% and 84.7% of the samples needed help with many of these activities respectively. The mean score of quality of life was significantly different based on sex (p < 0.018) and instrumental activity of daily living (p < 0.0001). A logistic regression model was used to determine the factors related to quality of life. The final model showed cross-clamp duration (OR = 0.33,p = 0.014), length of stay(LOS)in the intensive care unit(OR = 0.42,p = 0.05), and instrumental activities of daily living (OR = 0.08,p = 0.001) predicted patients' quality of life one year after coronary artery bypass grafting. CONCLUSION Although more than half of the samples had a good average quality of life score, due to the lack of definitive treatment for coronary artery disease, it is suggested to consider predictive variables to help plan to improve the quality of life of these patients.
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Affiliation(s)
- Khashayar Rezvani Emamzadehashemi
- Department of Neurosurgery, Faculty of Medicine, Imam Khomeini Hospital, Urmia University of Medical Sciences, Guilan University of Medical Sciences, Rasht, Iran
| | - Atefeh Ghanbari Khanghah
- Social Determinants of Health Research Center (SCHRC), School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
- Nursing and Midwifery Faculty of Guilan University of Medical Sciences, Daneshjoo Ave, Rasht, Iran
| | - Ali Azizi
- School of Nursing and Midwifery, Guilan University of Medical Sciences (GUMS), Rasht, Iran
| | - Ezzat Paryad
- School of Nursing and Midwifery, Guilan University of Medical Sciences (GUMS), Rasht, Iran
- Cardiovascular Diseases Research Center, GI Cancer Screening and Prevention Research Center (GCSPRC), Department of Nursing (Medical-Surgical), Rasht, Iran
| | - Marzieh Jahani Sayad Noveiri
- Department of Medical Surgery, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
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Clifford C, Girdauskas E, Klotz SGR, Kurz S, Löwe B, Kohlmann S. Patient-centered evaluation of an expectation-focused intervention for patients undergoing heart valve surgery: a qualitative study. Front Cardiovasc Med 2024; 11:1338964. [PMID: 38426119 PMCID: PMC10902160 DOI: 10.3389/fcvm.2024.1338964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/30/2024] [Indexed: 03/02/2024] Open
Abstract
Objective Randomized controlled trials demonstrate the effectiveness of expectation-focused interventions in improving recovery outcomes following cardiac surgery. For dissemination in routine health care, it is important to capture the perspective of affected individuals. This qualitative study explores the perceived benefits and intervention-specific needs of patients who received expectation-focused intervention in the context of heart valve surgery. In addition, it explores potential barriers and adverse effects. Methods As part of an Enhanced Recovery After Surgery (ERAS) program within a multicentered randomized controlled trial, patients undergoing minimally invasive heart valve surgery received an intervention focused on their expectations. Six weeks after the intervention, semi-structured interviews were conducted with 18 patients to assess its feasibility, acceptance, barriers, benefits, and side effects. The transcribed interviews were analyzed using qualitative content analysis. Results The results indicate that both the intervention and the role of the patient and psychologist are key aspects in evaluating the expectation-focused intervention. Five key themes emerged from the patients' perspective: personal needs, expectations and emotions, relationship, communication, and individuality. Patients valued the preparation for surgery and recovery and the space for emotions. Establishing a trustful relationship and addressing stigmatization were identified as primary challenges within the intervention. Conclusion Overall, patients experienced the expectation-focused intervention as helpful and no adverse effects were reported. Perceived benefits included enhanced personal control throughout the surgery and recovery, while the potential barrier of stigmatization towards a psychologist may complicate establishing a trustful relationship. Addressing personal needs, as a relevant topic to the patients, could be achieved through additional research to identify the specific needs of different patient subgroups. Enhancing the expectation-focused intervention could involve the implementation of a modular concept to address individual needs better.
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Affiliation(s)
- Caroline Clifford
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Evaldas Girdauskas
- Department of Cardiothoracic Surgery, University Medical Center Augsburg, Augsburg, Germany
| | - Susanne G. R. Klotz
- Department of Physiotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Saskia Kurz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sebastian Kohlmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Kane NS, Hassabelnaby R, Sullivan NL, Graff F, Litke DR, Quigley KS, Pigeon WR, Rath JF, Helmer DA, McAndrew LM. Veteran Beliefs About the Causes of Gulf War Illness and Expectations for Improvement. Int J Behav Med 2024; 31:169-174. [PMID: 36973578 DOI: 10.1007/s12529-023-10166-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Individuals' beliefs about the etiology of persistent physical symptoms (PPS) are linked to differences in coping style. However, it is unclear which attributions are related to greater expectations for improvement. METHOD AND RESULTS A cross-sectional regression analysis (N = 262) indicated that Veterans with Gulf War Illness (GWI) who attributed their GWI to behavior, (e.g., diet and exercise), had greater expectations for improvement (p = .001) than those who attributed their GWI to deployment, physical, or psychological causes (p values > .05). CONCLUSIONS Findings support the possible clinical utility of exploring perceived contributing factors of PPS, which may increase perceptions that improvement of PPS is possible. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02161133.
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Affiliation(s)
- Naomi S Kane
- Department of Veterans Affairs, War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange, NJ, USA.
- VA Ann Arbor Healthcare System, Ann Arbor, USA.
- Department of Psychiatry, Michigan Medicine, 2215 Fuller Road (116C), Ann Arbor, MI, 48105-2103, USA.
| | - Raghad Hassabelnaby
- Department of Veterans Affairs, War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange, NJ, USA
- William Paterson University, Wayne, NJ, USA
| | - Nicole L Sullivan
- Department of Veterans Affairs, War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange, NJ, USA
| | - Fiona Graff
- Department of Veterans Affairs, War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange, NJ, USA
| | - David R Litke
- Department of Veterans Affairs, War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange, NJ, USA
- Department of Rehabilitation Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Karen S Quigley
- Department of Veteran Affairs, Bedford Memorial Hospital, Bedford, MA, USA
- Northeastern University, Boston, MA, USA
| | - Wilfred R Pigeon
- Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY, USA
- Department of Psychiatry, University of Rochester, Rochester, NY, USA
| | - Joseph F Rath
- Department of Rehabilitation Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Drew A Helmer
- Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Lisa M McAndrew
- Department of Veterans Affairs, War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange, NJ, USA
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4
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Karanasios S, Martzoukos N, Zampetakis N, Paleta D, Sampsonis T, Vasilogeorgis I, Gioftsos G. Cross-Cultural Adaptation and Measurement Properties of the Expectations for Treatment Scale (ETS) for Greek-Speaking Patients. Cureus 2023; 15:e46457. [PMID: 37927658 PMCID: PMC10623487 DOI: 10.7759/cureus.46457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Patients' treatment expectations are key factors influencing the health outcomes in various medical conditions. Using validated measures to capture these expectations has been strongly suggested to improve the prognosis of the health outcome and promote research investigations. The Expectations for Treatment Scale (ETS) is a well-established questionnaire designed to accurately measure treatment expectations in patients with low back pain; however, it is not available in Greek yet. We aimed to translate and cross-culturally adapt the ETS in Greek (ETS-Gr) and evaluate its reliability and validity in a Greek-speaking population with musculoskeletal disorders. Methods We followed published recommendations for the translation and cross-cultural adaptation process of the scale. Face and content validity were evaluated using interviews with patients and experts. Internal consistency, test-retest reliability, and measurement error were evaluated in 52 patients with musculoskeletal conditions. Results During forward and backward translation minor linguistic discrepancies were detected and effectively adapted for Greek-speaking patients. The ETS-Gr presented a high level of content validity (item content validity index: 0.88-1; and average scale content validity index: 0.90), acceptable internal consistency (Cronbach's alpha: 0.84), and excellent test-retest reliability (intraclass correlation coefficient: 0.96, 95% confidence interval: 0.93-0.98). Conclusions The ETS-Gr is a short, reliable, and valid instrument to measure pre-treatment expectations in patients with musculoskeletal disorders. Future investigations including other medical conditions are required.
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Affiliation(s)
| | | | | | - Danai Paleta
- Physiotherapy, University of West Attica, Athens, GRC
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Kang W, Malvaso A. Personality Traits Predict Self-Rated Health (SRH) in Coronary Heart Disease (CHD) Patients and Healthy Controls. Healthcare (Basel) 2023; 11:healthcare11111645. [PMID: 37297784 DOI: 10.3390/healthcare11111645] [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: 05/18/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVE The objective of the present study is to examine the association between Big Five personality traits and self-rated health (SRH) among individuals with coronary heart disease (CHD), and to compare this relationship with that of healthy control participants, which is of importance as SRH can be a determinant of outcomes. METHODS The current study used data from 566 participants with CHD with a mean age of 63.00 (S.D. = 15.23) years old (61.13% males) and 8608 age- and sex-matched healthy controls with a mean age of 63.87 (S.D.= 9.60) years old (61.93% males) from the UKHLS. The current study used predictive normative modelling approaches, one-sample t tests, a hierarchical regression, and two multiple regressions. RESULTS The current study found that CHD patients have significantly lower Conscientiousness (t(565) = -3.84, p < 0.001, 95% C.I. [-0.28, -0.09], Cohen's d = -0.16) and SRH (t(565) = -13.83, p < 0.001, 95% C.I. [-0.68, -0.51], and Cohen's d = -0.58) scores compared to age and sex-matched healthy controls. Moreover, health status (controls vs. CHD patients) moderated the links between Neuroticism, Extraversion and SRH. Specifically, Neuroticism (b = -0.03, p < 0.01, 95% C.I. [-0.04, -0.01]), Openness (b = 0.04, p < 0.001, 95% C.I. [0.02, 0.06]), and Conscientiousness (b = 0.08, p < 0.001, 95% C.I. [0.06, 0.10]) were significant predictors of SRH in healthy controls, whereas Conscientiousness (b = 0.08, p < 0.05, 95% C.I. [0.01, 0.16]) and Extraversion (b = -0.09, p < 0.01, 95% C.I. [-0.15, -0.02]) were significant predictors of SRH in CHD patients. CONCLUSION Based on the close associations between personality traits and SRH, and the subsequent impact on patient outcomes, the results of this study should be taken into consideration by clinicians and health professionals when developing tailored treatment and intervention programs for their patients.
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Affiliation(s)
- Weixi Kang
- UK DRI Care Research and Technology Centre, Department of Brain Sciences, Imperial College London, London W12 0BZ, UK
| | - Antonio Malvaso
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
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Darsin Singh SK, Ahmedy FB, Noor ABYA, Abdullah KL, Abidin IZ, Suhaimi AB. Changes in Perception of Illness during Cardiac Rehabilitation Programme among Patients with Acute Coronary Syndrome: A Longitudinal Study. Healthcare (Basel) 2023; 11:healthcare11030311. [PMID: 36766886 PMCID: PMC9914116 DOI: 10.3390/healthcare11030311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/21/2023] Open
Abstract
Little is known about the changes in perception of illness among patients with the acute coronary syndrome (ACS) during cardiac rehabilitation programme (CRP). The purpose of this study is to determine changes in perception of illness with ACS patients during CRP to evaluate the association of patients' characteristics with the perception of illness at the end of Phase II of CRP. A descriptive longitudinal study was conducted among 450 patients who attended 8-weeks of Phase II CRP at 2 public hospitals in Malaysia and perception of illness was assessed using Brief Illness Perception Questionnaire (BIPQ). The assessment was conducted before Phase II (T0), during the 4th session (T1), and at the end of right after the 8th session (T2). One-way repeated measures of ANOVA analysed the changes of perception at T1 and T2 while logistic regression analysis evaluated the association of patients' characteristics with the perception of illness at T2. Perception of illness changed during and after CRP from T0 to T1, and T1 to T2 (p < 0.001). The patient viewed ACS as an illness that changed from being more acute to a chronic condition as the sessions progressed. Previous history of acute myocardial infarction (OR = 2.380, 95% CI 1.46, 5.49) and angioplasty intervention were both found to be associated with the perception of illness (OR = 3.857, 95% CI 1.55, 9.61). Perception of illness changed during CRP and these changes are associated with patients' previous history of cardiac events. Phase II can be viewed as the second window of opportunity for healthcare professionals to intervene early in modifying the perception of illness.
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Affiliation(s)
- Sukhbeer Kaur Darsin Singh
- Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia
- Department of Nursing Science, Faculty of Medicine, Universiti of Malaya, Kuala Lumpur 50603, Wilayah Persekutuan, Malaysia
| | - Fatimah Binti Ahmedy
- Department of Medical Education, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia
- Correspondence: (F.B.A.); (A.B.Y.A.N.)
| | - Abqariyah Binti Yahya Ahmad Noor
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti of Malaya, Kuala Lumpur 50603, Wilayah Persekutuan, Malaysia
- Correspondence: (F.B.A.); (A.B.Y.A.N.)
| | - Khatijah Lim Abdullah
- Department of Nursing, School of Medical and Life Sciences, Sunway University, Subang Jaya 47500, Selangor, Malaysia
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Imran Zainal Abidin
- Deparment of Medicine, Faculty of Medicine, Universiti of Malaya, Kuala Lumpur 50603, Wilayah Persekutuan, Malaysia
| | - Anwar Bin Suhaimi
- Department of Rehabilitation Medicine, Faculty of Medicine, Universiti of Malaya, Kuala Lumpur 50603, Wilayah Persekutuan, Malaysia
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Horn N, Gärtner L, Rastan AJ, Andrási TB, Lenz J, Böning A, Salzmann-Djufri M, Puvogel U, Genovese M, Kus S, Rief W, Salzmann S. Preoperative optimization of cardiac valve patients' expectations: Study protocol of the randomized controlled ValvEx-trial. Front Cardiovasc Med 2023; 10:1105507. [PMID: 36937912 PMCID: PMC10018216 DOI: 10.3389/fcvm.2023.1105507] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/14/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Complete recovery after surgery depends on psychological factors such as preoperative information, expectations, and surgery-associated anxiety. Prior studies have shown that even a short preoperative psychological intervention aiming at optimized expectations (EXPECT) can improve postoperative outcomes in coronary artery bypass patients. However, this intervention may benefit only a small subgroup of heart surgery patients since implementing preoperative psychological interventions into the daily clinical routine is difficult due to the additional time and appointments. It is unclear whether the EXPECT intervention can be shortened and whether heart valve patients would also benefit from interventions that optimize patients' expectations. The multicenter ValvEx trial aims (i) to adapt an effective preoperative psychological intervention (EXPECT) to make it brief enough to be easily integrated into the preoperative routine of heart valve patients and (ii) to examine if the adapted preoperative psychological intervention improves the subjectively perceived illness-related disability (PDI) up to 3 months after surgery. Materials and analysis In two German university hospitals, N = 88 heart valve patients who undergo heart surgery are randomized into two groups [standard of care (SOC) vs. standard of care plus interventional expectation manipulation (SOC and EXPECT)] after baseline assessment. Patients in the EXPECT group additionally to standard of care participate in the preoperative psychological intervention (30-40 min), focusing on optimizing expectations and have two booster-telephone calls (4 and 8 weeks after the surgery, approx. 15 min). Both groups have assessments again on the evening before the surgery, 4 to 6 days, and 3 months after the surgery. Discussion The trial demonstrates excellent feasibility in the clinical routine and a high interest by the patients. Ethics and dissemination The Ethics Committees of the Department of Medicine of the Philipps University of Marburg and the Department of Medicine of the University of Giessen approved the study protocol. Study results will be published in peer-reviewed journals and presented at congresses. Clinical trial registration ClinicalTrials.gov, identifier NCT04502121.
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Affiliation(s)
- Nicole Horn
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
- *Correspondence: Nicole Horn,
| | - Laura Gärtner
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Ardawan J. Rastan
- Department of Cardiovascular Surgery, Heart Center, Philipps University of Marburg, Marburg, Germany
| | - Térezia B. Andrási
- Department of Cardiovascular Surgery, Heart Center, Philipps University of Marburg, Marburg, Germany
| | - Juliane Lenz
- Department of Cardiovascular Surgery, Heart Center, Philipps University of Marburg, Marburg, Germany
| | - Andreas Böning
- Department of Cardiovascular Surgery, Justus Liebig University, Giessen, Germany
| | | | - Ulrike Puvogel
- Department of Cardiovascular Surgery, Justus Liebig University, Giessen, Germany
| | - Maria Genovese
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Sibel Kus
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Winfried Rief
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Stefan Salzmann
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
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Salzmann S, Laferton JAC, Shedden-Mora MC, Horn N, Gärtner L, Schröder L, Rau J, Schade-Brittinger C, Murmann K, Rastan A, Andrási TB, Böning A, Salzmann-Djufri M, Löwe B, Brickwedel J, Albus C, Wahlers T, Hamm A, Hilker L, Albert W, Falk V, Zimmermann T, Ismail I, Strauß B, Doenst T, Schedlowski M, Moosdorf R, Rief W. Pre-surgery optimization of patients' expectations to improve outcome in heart surgery: Study protocol of the randomized controlled multi-center PSY-HEART-II trial. Am Heart J 2022; 254:1-11. [PMID: 35940247 DOI: 10.1016/j.ahj.2022.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 06/15/2023]
Abstract
The PSY-HEART-I trial indicated that a brief expectation-focused intervention prior to heart surgery improves disability and quality of life 6 months after coronary artery bypass graft surgery (CABG). However, to investigate the clinical utility of such an intervention, a large multi-center trial is needed to generalize the results and their implications for the health care system. The PSY-HEART-II study aims to examine whether a preoperative psychological intervention targeting patients' expectations (EXPECT) can improve outcomes 6 months after CABG (with or without heart valve replacement). EXPECT will be compared to Standard of Care (SOC) and an intervention providing emotional support without targeting expectations (SUPPORT). In a 3-arm multi-center randomized, controlled, prospective trial (RCT), N = 567 patients scheduled for CABG surgery will be randomized to either SOC alone or SOC and EXPECT or SOC and SUPPORT. Patients will be randomized with a fixed unbalanced ratio of 3:3:1 (EXPECT: SUPPORT: SOC) to compare EXPECT to SOC and EXPECT to SUPPORT. Both psychological interventions consist of 2 in-person sessions (à 50 minute), 2 phone consultations (à 20 minute) during the week prior to surgery, and 1 booster phone consultation post-surgery 6 weeks later. Assessment will occur at baseline approx. 3-10 days before surgery, preoperatively the day before surgery, 4-6 days later, and 6 months after surgery. The study's primary end point will be patients' illness-related disability 6 months after surgery. Secondary outcomes will be patients' expectations, subjective illness beliefs, quality of life, length of hospital stay and blood sample parameters (eg, inflammatory parameters such as IL-6, IL-8, CRP). This large multi-center trial has the potential to corroborate and generalize the promising results of the PSY-HEART-I trial for routine care of cardiac surgery patients, and to stimulate revisions of treatment guidelines in heart surgery.
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Affiliation(s)
- Stefan Salzmann
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany.
| | | | - Meike C Shedden-Mora
- Department of Psychology, Medical School Hamburg, Hamburg, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nicole Horn
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Laura Gärtner
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Lara Schröder
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Jörn Rau
- Coordination Center for Clinical Trials (KKS), University of Marburg, Marburg, Germany
| | | | - Kirsten Murmann
- Coordination Center for Clinical Trials (KKS), University of Marburg, Marburg, Germany
| | - Ardawan Rastan
- Department for Cardiovascular Surgery, Heart Center, Philipps University of Marburg, Marburg, Germany
| | - Térezia B Andrási
- Department for Cardiovascular Surgery, Heart Center, Philipps University of Marburg, Marburg, Germany
| | - Andreas Böning
- Department of Cardiovascular Surgery, University Hospital Giessen, Giessen, Germany
| | | | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Brickwedel
- Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Hamburg, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
| | - Thorsten Wahlers
- Department of Cardiothoracic Surgery, University Hospital of Cologne, Cologne, Germany
| | - Alfons Hamm
- Department of Physiological and Clinical Psychology/ Psychotherapy, University of Greifswald, Greifswald, Germany
| | - Lutz Hilker
- Department of Cardiovascular Surgery, Clinic Karlsburg, Heart and Diabetes Center Mecklenburg-Western Pommerania, Karlsburg, Germany
| | | | - Volkmar Falk
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
| | - Tanja Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Issam Ismail
- Division of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Bernhard Strauß
- Institute of Psychosocial Medicine, Psychotherapy, and Psychooncology, University Hospital Jena, Germany
| | - Torsten Doenst
- Jena University Hospital, Friedrich-Schiller-University of Jena, Jena, Germany
| | - Manfred Schedlowski
- Institute of Medical Psychology and Behavioral Immunobiology, University Clinic Essen, Essen, Germany, and Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institute, Stockholm, Sweden
| | - Rainer Moosdorf
- Department for Cardiovascular Surgery, Heart Center, Philipps University of Marburg, Marburg, Germany
| | - Winfried Rief
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
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Association between cognitive representation of illness and the outcome of patients with premature coronary artery disease. J Psychosom Res 2022; 162:111019. [PMID: 36087351 DOI: 10.1016/j.jpsychores.2022.111019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 07/24/2022] [Accepted: 08/20/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess whether illness perception (IP) in overall and each of its three dimensions (cognitive, emotional and comprehension) have an independent prognostic value in men and women with premature coronary artery disease (CAD). METHODS In a prospective cohort, 778 patients (370 men and 408 women) with premature CAD(diagnosed in men aged<45 y and women aged<55 y), who had completed brief illness perception questionnaire were followed up for 4 years. Outcome event was defined as composite of all-cause mortality, nonfatal myocardial infarction(MI), repeated revascularization or/and stroke. Analysis was performed for men and women separately. High scores for each item of illness perception indicate positive perception. RESULTS Among men, 90 patients (24.3%) experienced events: 14(3.8%) death, 23(6.2%) nonfatal MI, 9(2.4%) strokes, and 44(11.9%) revascularization. Men with and without event showed no difference regarding the traditional risk factors, depression and anxiety symptoms. Among women, 72(17.6%) had events: 11(2.7%) death, 23(5.6%) nonfatal MI, 7(1.7%) strokes and 31(7.6%) revascularization; who had a lower education, more severe CAD, and more depressive symptoms. After adjustments for potential confounders, overall IP and only its cognitive dimension were significantly associated with the outcome in women:1-score increase in the women's cognitive perception resulted in an 18% decrease in the event (HR = 0.82, 95% CI:0.72 to 0.95; P = 0.007). In the men, this effect remained nonsignificant either for IP or its dimensions. CONCLUSIONS Positive cognitive representation of illness was predictive of a decreased likelihood of mortality and/or cardiovascular events in women with premature CAD. Interventional studies are needed to confirm the results.
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Carriere JS, Martel MO, Loggia ML, Campbell CM, Smith MT, Haythornthwaite JA, Edwards RR. The Influence of Expectancies on Pain and Function Over Time After Total Knee Arthroplasty. PAIN MEDICINE (MALDEN, MASS.) 2022; 23:1767-1776. [PMID: 35482515 PMCID: PMC9527599 DOI: 10.1093/pm/pnac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 03/11/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Expectancies have a well-documented influence on the experience of pain, responses to treatment, and postsurgical outcomes. In individuals with osteoarthritis, several studies have shown that expectations predict increased pain and disability after total knee replacement surgery. Despite the growing recognition of the importance of expectancies in clinical settings, few studies have examined the influence of expectancies throughout postsurgical recovery trajectories. The objective of the present study was to examine the role of presurgical expectancies on pain and function at 6-week, 6-month, and 1-year follow-ups after total knee arthroplasty. DESIGN AND PARTICIPANTS Data were collected from patients scheduled for total knee arthroplasty 1 week before surgery and then at 6 weeks, 6 months, and 1 year after surgery. Correlational and multivariable regression analyses examined the influence of expectancies on patients' perceptions of pain reduction and functional improvement at each time point. Analyses controlled for age, sex, body mass index, presurgical pain intensity and function, pain catastrophizing, anxiety, and depression. RESULTS Results revealed that expectancies significantly predicted pain reduction and functional improvement at 1-year follow-up. However, expectancies did not predict outcomes at the 6-week and 6-month follow-ups. Catastrophizing and depressive symptoms emerged as short-term predictors of postsurgical functional limitations at 6-week and 6-month follow-ups, respectively. CONCLUSIONS The results suggest that targeting high levels of catastrophizing and depressive symptoms could optimize short-term recovery after total knee arthroplasty. However, the results demonstrate that targeting presurgical negative expectancies could prevent prolonged recovery trajectories, characterized by pain and loss of function up to 1 year after total knee arthroplasty.
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Affiliation(s)
- Junie S Carriere
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Centre de Recherche Charles-Le Moyne, Université de Sherbrooke, Longueuil, Quebec, Canada
| | - Marc Olivier Martel
- Faculties of Dentistry and Medicine, McGill University, Montreal, Quebec, Canada
| | - Marco L Loggia
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Claudia M Campbell
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael T Smith
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer A Haythornthwaite
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert R Edwards
- Department of Anesthesiology, Brigham and Women’s Hospital Pain Management Center, Harvard Medical School, Chestnut Hill, Massachusetts, USA
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11
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Geuens S, Leyen K, Raymaekers K, Prikken S, Willen J, Goemans N, De Waele L, Lemiere J, Luyckx K. Illness Perceptions and Illness Identity in Adolescents and Emerging Adults With Neuromuscular Disorders. Clin Child Psychol Psychiatry 2022:13591045221125631. [PMID: 36112900 DOI: 10.1177/13591045221125631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Neuromuscular disorders (NMD) are intrusive medical conditions with implications for psychosocial development. OBJECTIVES This paper explores illness perceptions and illness identity dimensions of youth with NMD. First, we compare illness identity outcomes and illness perceptions of NMD patients with a comparison group of adolescents with type 1 diabetes mellitus (DM). Second, we report about the relationships between NMD-related variables and illness perceptions and illness identity. METHODS Scores on the Brief Illness Perception Questionnaire and the Illness Identity Questionnaire were compared between a group of NMD patients (N = 59; 12-22 years) and an age- and gender-matched group of DM patients (N = 118). NMD-related variables included time since diagnosis, prognosis, wheelchair use, and physical limitations. RESULTS Youth with NMD scored significantly higher on two of the four illness identity dimensions than youth with DM. NMD patients reported significantly less positive illness perceptions, experienced more physical symptoms, and had a lower score on understanding of their illness. Within the NMD group, wheelchair-users have a better understanding of their disease than those who are not wheelchair-bound. CONCLUSIONS The present study is the first to investigate illness identity and illness perceptions in NMD. More research is needed to provide insight in the identity formation process of the growing group of adolescents with NMDs.
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Affiliation(s)
- Sam Geuens
- Child Neurology, 60182University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, 26657KU Leuven, Leuven, Belgium
| | - Kathelijne Leyen
- School Psychology and Development in Context, 26657KU Leuven, Leuven, Belgium
| | - Koen Raymaekers
- School Psychology and Development in Context, 26657KU Leuven, Leuven, Belgium.,60182FWO Vlaanderen (Research Foundation Flanders), Leuven, Belgium
| | - Sofie Prikken
- Child Neurology, 60182University Hospitals Leuven, Leuven, Belgium.,School Psychology and Development in Context, 26657KU Leuven, Leuven, Belgium.,60182FWO Vlaanderen (Research Foundation Flanders), Leuven, Belgium
| | - Joanna Willen
- Child Neurology, 60182University Hospitals Leuven, Leuven, Belgium
| | - Nathalie Goemans
- Child Neurology, 60182University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, 26657KU Leuven, Leuven, Belgium
| | - Liesbeth De Waele
- Child Neurology, 60182University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, 26657KU Leuven, Leuven, Belgium
| | - Jurgen Lemiere
- Child Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Koen Luyckx
- School Psychology and Development in Context, 26657KU Leuven, Leuven, Belgium.,UNIBS, 60182University of the Free State, Bloemfontein, South Africa
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12
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Streith LD, Yip SJY, Brown CJ, Karimuddin AA, Raval MJ, Phang PT, Ghuman A. Effectiveness of a rectal cancer education video on patient expectations. Colorectal Dis 2022; 24:1040-1046. [PMID: 35396809 DOI: 10.1111/codi.16143] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/16/2022] [Accepted: 03/28/2022] [Indexed: 12/24/2022]
Abstract
AIM Discrepancy between patient expectations and outcomes can negatively affect patient satisfaction and quality of life. We aimed to assess patient expectations of bowel, urinary, and sexual function after rectal cancer treatments, and whether a preoperative education video changed expectations. METHODS A total of 45 patients were assessed between January 2018 and January 2021 in a tertiary care hospital in Vancouver, Canada. Patients included were rectal cancer patients who had neoadjuvant chemoradiation and were listed for low anterior resection but had not yet had surgery. Following surgical consultation but before surgery, a questionnaire assessing expectations of lifestyle after treatments was administered. Patients then watched an educational video and repeated the questionnaire to assess for changes in expectations. RESULTS Patient scores indicated expectation that control of bowel movements, urination, and sexual function would sometimes be problematic, but had a range from occasionally problematic to good function. Significant change after the video was seen in the expectation of needing medications for bowel control, and 44%-69% of individual patient answers changed from prevideo to post-video, depending on the question. The education video was scored as helpful or very helpful by 82% of patients. CONCLUSIONS Patients have varying expectations of problematic control of bowel, urinary, and sexual function following rectal cancer treatments. A pretreatment education video resulted in a trend toward changed expectations for functional outcomes in most patients. Further educational modalities for patients may provide more uniform expectations of function and increase patient satisfaction after rectal cancer treatments.
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Affiliation(s)
- Lucas D Streith
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Silas J Y Yip
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Carl J Brown
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Ahmer A Karimuddin
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Manoj J Raval
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - P Terry Phang
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Amandeep Ghuman
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
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13
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Sanders J, Bowden T, Woolfe-Loftus N, Sekhon M, Aitken LM. Predictors of health-related quality of life after cardiac surgery: a systematic review. Health Qual Life Outcomes 2022; 20:79. [PMID: 35585633 PMCID: PMC9118761 DOI: 10.1186/s12955-022-01980-4] [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: 01/06/2022] [Accepted: 04/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) is important in determining surgical success, particularly from the patients' perspective. AIMS To identify predictors for HRQoL outcome after cardiac surgery in order to identify potentially modifiable factors where interventions to improve patient outcomes could be targeted. METHODS Electronic databases (including MEDLINE, CINAHL, Embase) were searched between January 2001 and December 2020 for studies determining predictors of HRQoL (using a recognised and validated tool) in adult patients undergoing cardiac surgery. Data extraction and quality assessments were undertaken and data was summarised using descriptive statistics and narrative synthesis, as appropriate. RESULTS Overall, 3924 papers were screened with 41 papers included in the review. Considerable methodological heterogeneity between studies was observed. Most were single-centre (75.6%) prospective observational studies (73.2%) conducted in patients undergoing coronary artery bypass graft (CABG) (n = 51.2%) using a version of the SF-36 (n = 63.4%). Overall, 103 independent predictors (62 pre-operative, five intra-operative and 36 post-operative) were identified, where 34 (33.0%) were reported in more than one study. Potential pre-operative modifiable predictors include alcohol use, BMI/weight, depression, pre-operative quality of life and smoking while in the post-operative period pain and strategies to reduce post-operative complications and intensive care and hospital length of stay are potential therapeutic targets. CONCLUSION Despite a lack of consistency across studies, several potentially modifiable predictors were identified that could be targeted in interventions to improve patient or treatment outcomes. This may contribute to delivering more person-centred care involving shared decision-making to improve patient HRQoL after cardiac surgery.
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Affiliation(s)
- Julie Sanders
- St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, EC1A 7DN, UK. .,William Harvey Research Institute, Charterhouse Square, Queen Mary University of London, London, EC1M 6BQ, UK.
| | - Tracey Bowden
- School of Health Sciences, City, University of London, London, EC1V 0HB, UK
| | - Nicholas Woolfe-Loftus
- St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, EC1A 7DN, UK
| | - Mandeep Sekhon
- School of Health Sciences, City, University of London, London, EC1V 0HB, UK
| | - Leanne M Aitken
- School of Health Sciences, City, University of London, London, EC1V 0HB, UK.,School of Nursing and Midwifery, Griffith University, Nathan, QLD, 4111, Australia
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14
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Horn N, Laferton JAC, Shedden-Mora MC, Moosdorf R, Rief W, Salzmann S. Baseline depressive symptoms, personal control, and concern moderate the effects of preoperative psychological interventions: the randomized controlled PSY-HEART trial. J Behav Med 2022; 45:350-365. [PMID: 35522399 PMCID: PMC9160109 DOI: 10.1007/s10865-022-00319-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/03/2022] [Indexed: 11/06/2022]
Abstract
This study examined whether baseline (3–14 days pre-surgery) levels of (i) depressive or (ii) anxiety symptoms and (iii) illness beliefs moderate the effects of additional preoperative interventions before coronary artery bypass graft surgery on (i) depressive or (ii) anxiety symptoms and (iii) illness beliefs 1 day before surgery, 1 week and 6 months after surgery. In the PSY-HEART trial, 115 patients were assessed. They were randomized into one of three groups: 1. receiving standard medical care only (SMC), additional psychological interventions: 2. aiming to optimize patients’ expectations (EXPECT), or 3. focusing on emotional support. Patients with a higher baseline level of depressive symptoms receiving a preoperative psychological intervention indicated lower depressive symptoms 6 months after surgery compared to SMC. EXPECT increased personal control and concern levels in patients with low baseline personal control/concern 1 day before surgery. Brief preoperative psychological interventions can improve psychological outcomes in heart surgery patients. Baseline status may moderate these effects. The study has been approved by the medical ethics committee of the Philipps University of Marburg and has been pre-registered at www.clinicaltrials.gov (NCT01407055) on August 1, 2011.
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Affiliation(s)
- Nicole Horn
- Department of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Gutenbergstraße 18, 35032, Marburg, Germany.
| | - Johannes A C Laferton
- Division of Medical Psychology, Department of Medicine, Health and Medical University Potsdam, Potsdam, Germany
| | - Meike C Shedden-Mora
- Department of Psychology, Medical School Hamburg, Hamburg, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rainer Moosdorf
- Department for Cardiovascular Surgery, Heart Center, Philipps University of Marburg, Marburg, Germany
| | - Winfried Rief
- Department of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Gutenbergstraße 18, 35032, Marburg, Germany
| | - Stefan Salzmann
- Department of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Gutenbergstraße 18, 35032, Marburg, Germany
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15
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AbuRuz ME, Al-Dweik G. Depressive symptoms, perceived control and quality of life among patients undergoing coronary artery bypass graft: a prospective cohort study. BMC Nurs 2022; 21:87. [PMID: 35410251 PMCID: PMC9004116 DOI: 10.1186/s12912-022-00857-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Coronary artery bypass graft surgery (CABG) is an intervention directed toward improving the Quality of Life (QoL) for patients with coronary artery disease. Depression can affect QoL negatively among this population. Perceived control (PC) decreased the effect of anxiety on QoL, however, this effect has not been well-studies regarding depression. Therefore, the purpose of this study was to check the effect of depression on QoL among CABG patients and to determine if preoperative PC moderates this effect. METHODS This was a prospective observational cohort study conducted on a consecutive sample of 200 patients from three hospitals in Amman, Jordan. Depression Anxiety and Stress Scale, Short-Form Health Survey-36, and Arabic version of the Control Attitude Scale-Revised were used to measure depressive symptoms, QoL and PC respectively. Data were analyzed using t test and step wise multiple regression followed by simple slope analysis. RESULTS Postoperative Physical Component Summary (PCS) was better than preoperative PCS (mean ± SD: 38.2 ± 9.4 vs. 36.6 ± 9.5, P < 0.001). Postoperative Mental Component Summary (MCS) was better than preoperative MCS (mean ± SD: 44.3 ± 11.5 vs. 41.4 ± 11.4, P < 0.001). Preoperative depression was higher than postoperative depression; (mean ± SD: 12.8 ± 6.8 vs.11.1 ± 6.7, P < 0.01). Simple slope analysis was significant (simple slope = 0.41, t = 6.1, P < 0.001), indicating the moderating effect of PC. CONCLUSION Patients undergoing CABG surgery had poor QoL and high levels of depression. Perceived control moderated this relationship and improve QoL. Assessing depression levels and implantation of interventions to enhance perceived control levels prior to operation might improve QoL.
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Affiliation(s)
- Mohannad Eid AbuRuz
- Department of Nursing, Faculty of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - Ghadeer Al-Dweik
- Faculty of Nursing, Applied Science Private University, Amman, Jordan
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16
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Effects of Preoperative Gabapentin on Clinical Outcomes After Outpatient Midurethral Sling Placement. Female Pelvic Med Reconstr Surg 2022; 28:e39-e43. [PMID: 35272331 DOI: 10.1097/spv.0000000000001141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study aimed to evaluate transient urinary retention in women undergoing outpatient midurethral sling placement who received preoperative gabapentin (treated) versus those who did not (untreated). Secondary outcomes included unexpected admission rates, analgesic usage, time to discharge, and pain. METHODS This was a retrospective cohort study including women who underwent outpatient midurethral sling placement from 2015 to 2019. Exclusion criteria included suprapubic catheter placement, planned overnight admission, abnormal preoperative postvoid residual volume, and prolonged postoperative catheterization. Logistic regression was performed to evaluate gabapentin usage and urinary retention after adjusting for patient characteristics. RESULTS Three hundred two women met the inclusion criteria, with 19.5% experiencing urinary retention after midurethral sling placement. Women older than 65 years were more likely to have urinary retention than those aged 18-65 years (29.8% vs 17.6%, P = 0.054). Of treated participants, 26% had urinary retention versus 18% of untreated participants (P = 0.162). Adjusting for age, parity, pain, operative time, blood loss, sling type, analgesic, scopolamine patch, or hemostatic agent use, treated participants had 72% higher odds of urinary retention (adjusted odds ratio, 1.72; 95% confidence interval, 0.88-3.38; P = 0.113). There was no difference in unexpected admission, analgesic usage, time to discharge, or pain between groups. CONCLUSIONS One of 5 women had urinary retention after outpatient midurethral sling placement. Although no statistically significant difference was found in urinary retention between groups, the odds of urinary retention in the treated group were increased. Because there was no difference in pain, analgesic usage, or time to discharge between groups, investigation regarding gabapentin use for outpatient urogynecologic surgery is needed.
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17
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Löwe B, Andresen V, Van den Bergh O, Huber TB, von dem Knesebeck O, Lohse AW, Nestoriuc Y, Schneider G, Schneider SW, Schramm C, Ständer S, Vettorazzi E, Zapf A, Shedden-Mora M, Toussaint A. Persistent SOMAtic symptoms ACROSS diseases - from risk factors to modification: scientific framework and overarching protocol of the interdisciplinary SOMACROSS research unit (RU 5211). BMJ Open 2022; 12:e057596. [PMID: 35063961 PMCID: PMC8785206 DOI: 10.1136/bmjopen-2021-057596] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Persistent somatic symptoms (PSS) are highly prevalent in all areas of medicine; they are disabling for patients and costly for society. The subjective symptom burden often correlates poorly with the underlying disease severity, and patients' needs for effective treatment are far from being met. Initial evidence indicates that, in addition to disease-specific pathophysiological processes, psychological factors such as expectations, somatosensory amplification and prior illness experiences contribute to symptom persistence in functional as well as in somatic diseases. However, prospective studies investigating the transition from acute to chronic somatic symptoms, integrating pathophysiological, psychological and social factors, are scarce. A better understanding of the multifactorial mechanisms of symptom persistence is crucial for developing targeted mechanism-based interventions for effective prevention and treatment of PSS. Thus, the overall aim of the interdisciplinary SOMACROSS research unit is to identify generic and disease-specific risk factors and aetiological mechanisms of symptom persistence across a range of diseases. METHODS AND ANALYSIS Seven projects will investigate risk factors and mechanisms of symptom persistence in a total of 3916 patients across 10 medical conditions. All study designs are prospective and share common assessment points, core instruments and outcome variables to allow comparison and validation of results across projects and conditions. Research will focus on the identification of generic and disease-specific mechanisms associated with unfavourable symptom course. The development of a multivariate prediction model will facilitate the understanding of the course of PSS across diseases. ETHICS AND DISSEMINATION All individual SOMACROSS studies were approved by the ethics committees of the Medical Chambers Hamburg and Münster, Germany. Findings will be disseminated through peer-reviewed publications, scientific conferences and the involvement of relevant stakeholders, patients and the lay public. This interdisciplinary research unit will fundamentally contribute to earlier recognition of patients at risk, and to the development of prevention and tailored treatment concepts for PSS.
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Affiliation(s)
- Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Viola Andresen
- Department of Gastroenterology, Israelitic Hospital, Hamburg, Germany
| | - Omer Van den Bergh
- Research Group on Health Psychology, University of Leuven, Leuven, Belgium
| | - Tobias B Huber
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Ansgar W Lohse
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Yvonne Nestoriuc
- Department of Psychology, Helmut-Schmidt-University/University of the Armed Forces Hamburg, Hamburg, Germany
- Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gudrun Schneider
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Münster, Münster, Germany
| | - Stefan W Schneider
- Department of Dermatology and Venerology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Schramm
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Martin Zeitz Center for Rare Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sonja Ständer
- Department of Dermatology, Medical University Center Münster, Münster, Germany
| | - Eik Vettorazzi
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Antonia Zapf
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Meike Shedden-Mora
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychology, Medical School Hamburg, Hamburg, Germany
| | - Anne Toussaint
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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18
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Bubnova MG, Aronov DM, Sprikut AA, Stankevich DI, Poddubskaya EA, Persiyanova-Dubrova AL. Prehabilitation as an important stage before cardiac surgery. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2021. [DOI: 10.15829/1728-8800-2021-2998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The review discusses the preparation of patients for surgery on the heart and other organs. We considered the importance of introducing a new stage of medical and cardiology rehabilitation — prehabilitation. The results of randomized clinical trials, systematic reviews and metaanalyzes evaluating the effectiveness of respiratory techniques and physical training during the prehabilitation are presented. Particular attention is paid to the involvement of patients in prehabilitation programs before the elective coronary artery bypass grafting. Methodological problems arising in the development of prehabilitation programs are discussed.
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Affiliation(s)
- M. G. Bubnova
- National Medical Research Center for Therapy and Preventive Medicine
| | - D. M. Aronov
- National Medical Research Center for Therapy and Preventive Medicine
| | | | | | - E. A. Poddubskaya
- National Medical Research Center for Therapy and Preventive Medicine
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19
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Richards HL, Sweeney P, Corscadden R, Carr C, Rukundo A, Fitzgerald J, O’Connor C, Fortune DG. “Picture this”- Patients’ Drawings of Non-Muscle Invasive Bladder Cancer: A Novel Method to Help Understand How Patients Perceive Their Condition. Bladder Cancer 2021. [DOI: 10.3233/blc-201528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: There is a paucity of data regarding patient experiences of living with non-muscle-invasive bladder cancer (NMIBC). OBJECTIVES: To investigate patients’ beliefs about NMIBC utilising both a well-established verbal/linguistic method, the Brief Illness Perception Questionnaire (B-IPQ) in addition to a novel visual/perceptual method, that is, asking patients to draw their bladder as it is now and as they perceive it will be in the future. METHODS: Cross-sectional study of patients with NMIBC. Patients completed: (i) the B-IPQ, and (ii) 2 drawings of their bladder: as they perceived it currently and as they perceived it would look in 5 years’ time. RESULTS: A total of 118 patients completed the B-IPQ, of which 96 produced 2 bladder drawings. Forty-seven per cent of patients depicted no change in their bladder across time, 35% depicted improvements, while 18% drew their NMIBC as deteriorating between the two time points. Patients who drew their NMIBC worsening over time reported significantly stronger beliefs in the severity of current consequences from their NMIBC (F(2,94) = 9.07, p < 0.001, m = 5.68, 95% CI 4.38–6.88) and greater current concerns about their NMIBC (F(2,94) = 6.17, p < 0.01, m = 7.06, 95% CI 5.47–8.66). This was unrelated to cancer grade, cancer stage, treatment or demographic variables. CONCLUSION: This is the first study to explore beliefs about NMIBC in a sample of patients with NMIBC attending routine clinics using both a well-established and a novel method of assessing patients’ perceptions. Results highlight the usefulness of a simple non-verbal technique, in identifying patients’ concerns about the condition. Almost one fifth of patients with NMIBC may experience significant concerns about the worsening of their condition, which appear to be independent of demographic, histopathological, and treatment related variables. Further exploration of the psychological concerns of individuals with NMIBC is required in order to appropriately plan for needs led multidisciplinary approach in their care.
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Affiliation(s)
- Helen L. Richards
- Department of Clinical Psychology, Mercy University Hospital, Cork, Ireland
- Department of Uro-Oncology, Mercy University Hospital, Cork, Ireland
| | - Paul Sweeney
- Department of Uro-Oncology, Mercy University Hospital, Cork, Ireland
| | - Rebekah Corscadden
- Department of Clinical Psychology, Mercy University Hospital, Cork, Ireland
| | - Chelsea Carr
- Department of Clinical Psychology, Mercy University Hospital, Cork, Ireland
| | - Aphie Rukundo
- Department of Clinical Psychology, Mercy University Hospital, Cork, Ireland
| | - Jill Fitzgerald
- Department of Clinical Psychology, Mercy University Hospital, Cork, Ireland
| | - Charles O’Connor
- Department of Uro-Oncology, Mercy University Hospital, Cork, Ireland
| | - Dónal G. Fortune
- Department of Psychology, University of Limerick, Limerick, Ireland
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20
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Abstract
BACKGROUND Depression and pain catastrophizing are aspects of the patient's mindset that have been shown to be important in relation to the outcome of carpal tunnel release. However, other factors of the patient's mindset have been understudied, such as treatment expectations and illness perceptions. The aim of the present study was to investigate the influence of these mindset aspects on outcome of carpal tunnel release, in addition to psychological distress and pain catastrophizing. METHODS A total of 307 patients with carpal tunnel syndrome who visited outpatient hand surgery clinics and who completed online questionnaires regarding demographic and psychosocial characteristics and carpal tunnel syndrome severity were included. The patient mindset was measured with the Patient Health Questionnaire-4, the Pain Catastrophizing Scale, the Credibility Expectancy Questionnaire, and the Brief Illness Perception Questionnaire. Hierarchical linear regression models were used to examine the relation between self-reported severity 6 months after carpal tunnel release, as measured with the Boston Carpal Tunnel Questionnaire, and psychosocial aspects of mindset, adjusting for preoperative Boston Carpal Tunnel Questionnaire score, patient characteristics, and comorbidities. RESULTS Independent associations with better self-reported outcome were found for higher treatment expectations (β = -0.202; p < 0.001) and illness comprehensibility (β = -0.223; p < 0.001). The additional explained variance in Boston Carpal Tunnel Questionnaire scores by the patient's mindset was 13.2 percent (psychological distress and pain catastrophizing together, 2.1 percent; treatment expectations and illness perceptions together, 11.1 percent). CONCLUSION Treatment outcome expectations and comprehensibility of illness are both independently associated with the outcome of carpal tunnel release, showing the importance of these aspects of the patient's mindset for the outcome of carpal tunnel release. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, III.
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Goli F, Roohafza H, Feizi A, Gholamrezaei A, Farzanegan M, Hashemi M, Kube T, Rief W. The Illness Belief Network Questionnaire: Development and Evaluation of a Psychosomatic Assessment Tool. IRANIAN JOURNAL OF PSYCHIATRY 2021; 16:177-186. [PMID: 34221044 PMCID: PMC8233563 DOI: 10.18502/ijps.v16i2.5819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: Patients’ beliefs and emotions toward an illness can influence their coping responses, illness behaviors, adherence to treatment, quality of life, and even the psychoneuroimmune responses. The aim of present study was to develop and validate a novel questionnaire assessing both rational and irrational beliefs of patients regarding their illness. Method: In a cross sectional methodological study, the items of the Illness Belief Network (IBN) were developed regarding patients and clients’ opinions about and attribution of their disease extracted from 400 clinical interviews and were coded based on Leventhal’s self-regulation model. An expert panel coded the items. A total of 400 patients with different medical conditions completed the questionnaire. Participants additionally rated the Illness Perceptions Questionnaire in its revised form (IPQ-R) to assess convergent validity. Construct validity was examined by conducting exploratory and confirmatory factor analysis. The Cronbach alpha and Intracluster Correlation Coefficient (ICC) were used for examining Internal consistency and test-retest reliability of the IBN. Results: The IBN questionnaire was finalized with 84 items, and the results of factor analysis revealed 5 factors: psychosocial causes, environmental causes, control, meaning, and consequence/timeline; extracted factors were confirmed by confirmatory factor analysis. Cronbach’s α coefficient for scale was 0.92 and it ranged from 0.79 to 0.89 for the subscales. IBN indicated excellent test-retest reliability results based on ICC 0.842(95%CI: 0.798-0.846). The correlation coefficients of all items exceeded the prespecified acceptable value of 0.40, indicating satisfactory item discriminant validity, and correlation between IBN and IPQ-R subscales were statistically significant (all p values < 0.01), indicating acceptable convergent validity. Conclusion: The IBN questionnaire is a valid and reliable phenomenological, non-judging, and clinical tool to assess patient’s rational and irrational or faith-based beliefs about the illness. This tool can be used to improve doctor-patient communication by exploring the complex nature of human thinking.
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Affiliation(s)
- Farzad Goli
- Danesh-e Tandorosti Institute, Isfahan, Iran.,Energy Medicine University, California, United States of America
| | - Hamidreza Roohafza
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Gholamrezaei
- Department of Chronic Diseases, Metabolism and Ageing, Translational Research Center for Gastrointestinal Disorders, Leuven, Belgium
| | - Mahboubeh Farzanegan
- Danesh-e Tandorosti Institute, Isfahan, Iran.,Energy Medicine University, California, United States of America
| | | | - Tobias Kube
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University of Marburg, Marburg, Germany
| | - Winfried Rief
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University of Marburg, Marburg, Germany
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22
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Trinidade A, Harman P, Stone J, Staab JP, Goebel JA. Assessment of Potential Risk Factors for the Development of Persistent Postural-Perceptual Dizziness: A Case-Control Pilot Study. Front Neurol 2021; 11:601883. [PMID: 33551961 PMCID: PMC7859446 DOI: 10.3389/fneur.2020.601883] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/29/2020] [Indexed: 12/21/2022] Open
Abstract
Objectives: (1) To assess whether neuroticism, state anxiety, and body vigilance are higher in patients with persistent postural-perceptual dizziness (PPPD) compared to a recovered vestibular patient group and a non-dizzy patient group; (2) To gather pilot data on illness perceptions of patients with PPPD. Materials and Methods: 15 cases with PPPD and two control groups: (1) recovered vestibular patients (n = 12) and (2) non-dizzy patients (no previous vestibular insult, n = 12). Main outcome measures: Scores from the Big Five Inventory (BFI) of personality traits, Generalized Anxiety Disorder - 7 (GAD-7) scale, Body Vigilance Scale (BVS), Dizziness Handicap Inventory (DHI), modified Vertigo Symptom Scale (VSS) and Brief Illness Perception Questionnaire (BIPQ). Results: Compared to non-dizzy patients, PPPD cases had higher neuroticism (p = 0.02), higher introversion (p = 0.008), lower conscientiousness (p = 0.03) and higher anxiety (p = 0.02). There were no differences between PPPD cases and recovered vestibular patients in BFI and GAD-7. PPPD cases had higher body vigilance to dizziness than both control groups and their illness perceptions indicated higher levels of threat than recovered vestibular patients. Conclusion: PPPD patients showed statistically significant differences to non-dizzy patients, but not recovered vestibular controls in areas such as neuroticism and anxiety. Body vigilance was increased in PPPD patients when compared with both recovered vestibular and non-dizzy patient groups. PPPD patients also exhibited elements of negative illness perception suggesting that this may be the key element driving the development of PPPD. Large scale studies focusing on this area in the early stages following vestibular insult are needed.
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Affiliation(s)
- Aaron Trinidade
- Southend University Hospital NHS Foundation Trust, Southend-on-Sea, United Kingdom
| | - Paula Harman
- Southend University Hospital NHS Foundation Trust, Southend-on-Sea, United Kingdom
| | - Jon Stone
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Joel A Goebel
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
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23
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Paranjpe MD, Chin AC, Paranjpe I, Reid NJ, Duy PQ, Wang JK, O'Hagan R, Arzani A, Haghdel A, Lim CC, Orhurhu V, Urits I, Ngo AL, Glicksberg BS, Hall KT, Mehta D, Cooper RS, Nadkarni GN. Self-reported health without clinically measurable benefits among adult users of multivitamin and multimineral supplements: a cross-sectional study. BMJ Open 2020; 10:e039119. [PMID: 33148746 PMCID: PMC7643504 DOI: 10.1136/bmjopen-2020-039119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Multiple clinical trials fail to identify clinically measurable health benefits of daily multivitamin and multimineral (MVM) consumption in the general adult population. Understanding the determinants of widespread use of MVMs may guide efforts to better educate the public about effective nutritional practices. The objective of this study was to compare self-reported and clinically measurable health outcomes among MVM users and non-users in a large, nationally representative adult civilian non-institutionalised population in the USA surveyed on the use of complementary health practices. DESIGN Cross-sectional analysis of the effect of MVM consumption on self-reported overall health and clinically measurable health outcomes. PARTICIPANTS Adult MVM users and non-users from the 2012 National Health Interview Survey (n=21 603). PRIMARY AND SECONDARY OUTCOME MEASURES Five psychological, physical, and functional health outcomes: (1) self-rated health status, (2) needing help with routine needs, (3) history of 10 chronic diseases, (4) presence of 19 health conditions in the past 12 months, and (5) Kessler 6-Item (K6) Psychological Distress Scale to measure non-specific psychological distress in the past month. RESULTS Among 4933 adult MVM users and 16 670 adult non-users, MVM users self-reported 30% better overall health than non-users (adjusted OR 1.31; 95% CI 1.17 to 1.46; false discovery rate adjusted p<0.001). There were no differences between MVM users and non-users in history of 10 chronic diseases, number of present health conditions, severity of current psychological distress on the K6 Scale and rates of needing help with daily activities. No effect modification was observed after stratification by sex, education, and race. CONCLUSIONS MVM users self-reported better overall health despite no apparent differences in clinically measurable health outcomes. These results suggest that widespread use of multivitamins in adults may be a result of individuals' positive expectation that multivitamin use leads to better health outcomes or a self-selection bias in which MVM users intrinsically harbour more positive views regarding their health.
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Affiliation(s)
- Manish D Paranjpe
- Health Sciences and Technology, Harvard Medical School, Boston, Massachusetts, USA
| | - Alfred C Chin
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, USA
| | - Ishan Paranjpe
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Phan Q Duy
- Medical Scientist Training Program, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jason K Wang
- Health Sciences and Technology, Harvard Medical School, Boston, Massachusetts, USA
| | - Ross O'Hagan
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Artine Arzani
- Weill Cornell Medical College, New York City, New York, USA
| | | | - Clarence C Lim
- Texas A&M University System Health Science Center College of Medicine, Bryan, Texas, USA
| | - Vwaire Orhurhu
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Pain Division, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ivan Urits
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Pain Division, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Anh L Ngo
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Benjamin S Glicksberg
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Kathryn T Hall
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Darshan Mehta
- Harvard Medical School, Boston, Massachusetts, USA
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States
| | | | - Girish N Nadkarni
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Icahn School of Medicine at Mount Sinai, New York City, New York, USA
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Abstract
PURPOSE OF REVIEW To review the current state of preoperative psychological preparation to improve outcomes after cardiac surgery. RECENT FINDINGS Preoperative psychosocial factors are associated with short- and long-term outcomes after cardiac surgery. There are several approaches to optimize patients' preoperative psychological status with promising effects on postoperative outcomes (e.g., less complications, improved quality of life). Preoperative psychological preparation often aims to improve patients' knowledge or social support and to modify and optimize expectations and illness beliefs. Preoperative psychological preparation is gaining importance for cardiac surgery. However, patients' psychological status still does not get as much attention as it deserves. Preoperative psychological preparation seems to have positive effects on postoperative outcomes. Since overall evidence is still weak, further studies are warranted to understand which intervention works best for whom and why.
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Affiliation(s)
- Stefan Salzmann
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Gutenbergstraße 18, 35032 Marburg, Germany
| | | | - Marcel Wilhelm
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Gutenbergstraße 18, 35032 Marburg, Germany
| | - Frank Euteneuer
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Gutenbergstraße 18, 35032 Marburg, Germany
- Department of Psychology, Clinical Psychology and Psychotherapy, Medical School Berlin, Berlin, Germany
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25
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Callus E, Pagliuca S, Bertoldo EG, Fiolo V, Jackson AC, Boveri S, De Vincentiis C, Castelvecchio S, Volpe M, Menicanti L. The Monitoring of Psychosocial Factors During Hospitalization Before and After Cardiac Surgery Until Discharge From Cardiac Rehabilitation: A Research Protocol. Front Psychol 2020; 11:2202. [PMID: 33117210 PMCID: PMC7550819 DOI: 10.3389/fpsyg.2020.02202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 08/05/2020] [Indexed: 01/07/2023] Open
Abstract
Introduction: There is considerable evidence that psychosocial factors contribute to the etiology and prognosis of cardiac illness. Currently, in Italy, psychologists are only obligatory in the cardiac rehabilitation setting, although there are indications that patients could be experiencing distress also during other moments of hospitalization, such as on admission for cardiac surgery. Objective and Methods: The objective of this protocol is to gain more information about cardiac patients, specifically during the various moments of hospitalization for cardiac surgery, by collecting data at admission before cardiac surgery (t0), at admission to cardiac rehabilitation (t1), and at discharge (t2) at the Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato hospital. A psychosocial questionnaire was constructed after consulting the relevant national and international guidelines. Patients admitted for cardiac surgery and attending a rehabilitation program will be evaluated by acquiring data about their civil status, religiosity, education and work capacity, social condition (including the presence and quality of intimate relationships and support received), previous psychological and psychiatric histories, psychological status, lifestyle (including questions on nutrition, smoking, alcohol, and substance abuse), adherence to therapy, quality of life (QoL), health perception, anxiety, and depression at t0. Health perception, anxiety, and depression are also measured at t1 and t2. Discussion and Conclusion: This study is an attempt to identify the recommended psychosocial variables which need to be monitored during cardiac patients' hospitalization for cardiac surgery, through to the completion of cardiac rehabilitation. After implementing this study at the IRCCS Policlinico San Donato, attempts will be made to create studies on a national and international level to generate more evidence regarding these variables, in order to create tailor-made interventions for these patients during these specific and delicate moments.
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Affiliation(s)
- Edward Callus
- Clinical Psychology Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Silvana Pagliuca
- Clinical Psychology Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | | | - Valentina Fiolo
- Clinical Psychology Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | | | - Sara Boveri
- Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Carlo De Vincentiis
- Department of Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | | | - Marianna Volpe
- Department of Cardiac Rehabilitation, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Lorenzo Menicanti
- Department of Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
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26
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Abo-Rass F, Shinan-Altman S, Werner P. Health-related quality of life among Israeli Arabs diagnosed with depression: the role of illness representations, self-stigma, self-esteem, and age. J Affect Disord 2020; 274:282-288. [PMID: 32469817 DOI: 10.1016/j.jad.2020.05.125] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/13/2020] [Accepted: 05/17/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Studies that examined health-related quality of life (HRQoL) and related factors among people diagnosed with depression, have only focused on sociodemographic and clinical factors. This study examined the contribution of illness representations (IRs), self-stigma, self-esteem, and age group (younger adults aged 18 to 64 and older adults aged 65+) to HRQoL among Israeli Arabs diagnosed with depression. METHODS A convenience sample of 160 Israeli Arabs with depression completed measures of cognitive and emotional IRs, self-stigma, self-esteem, HRQoL, and sociodemographic and health characteristics. RESULTS Participants reported low levels of HRQoL, with the older adults reporting significantly lower levels of HRQoL in comparison to those reported by the younger adults. Low levels of HRQoL were significantly associated with negative cognitive and emotional IRs, high levels of self-stigma, and low levels of self-esteem. Cognitive IRs, self-stigma, self-esteem, and age group were found to be the main determinants of HRQoL. LIMITATIONS Limitations of the study include use of a cross-sectional design among culturally homogeneous sample. This limits the generalizability of our results and conclusions, and prevented us from determining causal relationships. CONCLUSIONS This study emphasizes the role of cognitive IRs, self-stigma, and self-esteem, as well as age, in the HRQoL of individuals diagnosed with depression. Intervention programs should be mindful of these determinants in order to improve the HRQoL of individuals diagnosed with depression.
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Affiliation(s)
- Fareeda Abo-Rass
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | | | - Perla Werner
- Department of Community Mental Health, University of Haifa, Haifa, Israel.
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27
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Alberts J, Löwe B, Glahn MA, Petrie K, Laferton J, Nestoriuc Y, Shedden-Mora M. Development of the generic, multidimensional Treatment Expectation Questionnaire (TEX-Q) through systematic literature review, expert surveys and qualitative interviews. BMJ Open 2020; 10:e036169. [PMID: 32819942 PMCID: PMC7440833 DOI: 10.1136/bmjopen-2019-036169] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE Patients' expectations-as a central mechanism of placebo and nocebo effects-are an important predictor of health outcomes. However, the lack of a way to assess expectations across different settings restricts progress in understanding the role of expectations and to quantify their importance in medical and psychological treatments. The aim of this study was to develop a theory-based, generic, multidimensional measure assessing patient expectations of medical and psychological treatments. DESIGN The Treatment Expectation Questionnaire (TEX-Q) was developed based on the integrative model of expectations and a systematic literature review of treatment expectation scales. After creating a comprehensive item pool, the scale was further refined by use of expert ratings and patient interviews. SETTING Patients were recruited in primary care at two hospitals in Hamburg, Germany. PARTICIPANTS 13 scientific experts participated in the expert survey. 11 patients waiting for psychological or surgical treatments participated in the qualitative interviews. RESULTS The 2×2×2 multidimensional structure of the TEX-Q assesses two expectation constructs (probabilistic vs value-based) across two outcome domains with two valences (direct benefits and adverse events, broader positive and negative impact), plus process and behavioural control expectations. We examined 583 items from 38 scales identified in the systematic review and developed 78 initial items. Content validity was then rated by experts according to item fit and comprehensibility. The best 53 items were further evaluated for comprehensibility, acceptability, phrasing preference and understanding by interviewing patients prior to treatment using the 'think aloud' technique. This resulted in a first 35-item version of the TEX-Q. CONCLUSIONS The TEX-Q is a generic, multidimensional measure to assess patient expectations of medical and psychological treatments and allows comparison of the impact of multidimensional expectations across different conditions. The final TEX-Q will be available after psychometric validation.
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Affiliation(s)
- Jannis Alberts
- Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Löwe
- Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maja Alicia Glahn
- Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Keith Petrie
- Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Johannes Laferton
- Clinical Psychology and Psychotherapy, Psychologische Hochschule Berlin, Berlin, Germany
| | - Yvonne Nestoriuc
- Department of Clinical Psychology, Helmut Schmidt University, University of the Federal Armed Forces, Hamburg, Germany
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Meike Shedden-Mora
- Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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28
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Kube T, Rozenkrantz L. When Beliefs Face Reality: An Integrative Review of Belief Updating in Mental Health and Illness. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2020; 16:247-274. [DOI: 10.1177/1745691620931496] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Belief updating is a relatively nascent field of research that examines how people adjust their beliefs in light of new evidence. So far, belief updating has been investigated in partly unrelated lines of research from different psychological disciplines. In this article, we aim to integrate these disparate lines of research. After presenting some prominent theoretical frameworks and experimental designs that have been used for the study of belief updating, we review how healthy people and people with mental disorders update their beliefs after receiving new information that supports or challenges their views. Available evidence suggests that both healthy people and people with particular mental disorders are prone to certain biases when updating their beliefs, although the nature of the respective biases varies considerably and depends on several factors. Anomalies in belief updating are discussed in terms of both new insights into the psychopathology of various mental disorders and societal implications, such as irreconcilable political and societal controversies due to the failure to take information into account that disconfirms one’s own view. We conclude by proposing a novel integrative model of belief updating and derive directions for future research.
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Affiliation(s)
- Tobias Kube
- Program in Placebo Studies, Harvard Medical School/Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Koblenz-Landau
| | - Liron Rozenkrantz
- Program in Placebo Studies, Harvard Medical School/Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology
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29
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Caspi-Avissar N, Grosman-Rimon L, Gohari J, Arazi M, Granot D, Ghanim D, Carasso S, Shalabi A, Sudarsky D, Eilat-Adar S, Kinany W, Amir O, Kachel E. Clinical, Surgical, and Sociopsychological Factors and Depression After Cardiothoracic Surgery. Ann Thorac Surg 2020; 111:1064-1070. [PMID: 32707196 DOI: 10.1016/j.athoracsur.2020.05.130] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/27/2020] [Accepted: 05/22/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Depression is highly prevalent in cardiac surgical patients and is associated with mortality. The objectives of the study were to evaluate depression scores longitudinally pre- and postoperatively and to examine the association between postoperative depression scores and clinical, surgical, and sociopsychological factors. METHODS Depression scores were assessed using the Center for Epidemiological Study of Depression (CES-D) in 100 cardiac surgical patients who underwent cardiac surgery preoperatively, during hospitalization, and at 2 and 6 week after discharge. Clinical, surgical, and sociopsychological predictors of depression scores were recorded. RESULTS The average depression scores significantly increased from preoperative levels (14.9 ± 1.07) to during hospitalization (21.5 ± 1.05) and decreased at both 2 weeks (15.8 ± 1.07) and 6 weeks after discharge (14.0 ± 1.06), as compared with scores during hospitalization (P < .001). The percentage of patients who scored CES-D > 16 increased significantly from preoperative (39%) to hospitalization (71%) and decreased gradually at 2 weeks (45%) and 6 weeks (37%) after discharge (P < .001). Significant predictors of high postoperative CES-D scores were female gender, ejection fraction < 50%, and high preoperative CES-D scores. CONCLUSIONS High depression scores after cardiac surgery suggest that perioperative screening and management of depression after surgery are necessary and may improve outcomes of these patients who are at high risk for depression. Further understanding of the factors that contribute to high depression scores is required to facilitate clinical intervention.
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Affiliation(s)
- Noa Caspi-Avissar
- Department of Cardiology and Cardiac Surgery, Poriya Medical Center, Tiberias, Israel
| | - Liza Grosman-Rimon
- Department of Cardiology and Cardiac Surgery, Poriya Medical Center, Tiberias, Israel; The Academic College at Wingate, Wingate Institute, Netanya, Israel
| | - Jacob Gohari
- Department of Cardiology and Cardiac Surgery, Poriya Medical Center, Tiberias, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Mattan Arazi
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Department of Cardiac Surgery, Sheba Medical Centre, Tel Hashomer, Israel
| | - Dina Granot
- Department of Cardiology and Cardiac Surgery, Poriya Medical Center, Tiberias, Israel
| | - Diab Ghanim
- Department of Cardiology and Cardiac Surgery, Poriya Medical Center, Tiberias, Israel; The Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel
| | - Shemy Carasso
- Department of Cardiology and Cardiac Surgery, Poriya Medical Center, Tiberias, Israel; The Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel
| | - Amjad Shalabi
- Department of Cardiology and Cardiac Surgery, Poriya Medical Center, Tiberias, Israel
| | - Doron Sudarsky
- Department of Cardiology and Cardiac Surgery, Poriya Medical Center, Tiberias, Israel
| | - Sigal Eilat-Adar
- The Academic College at Wingate, Wingate Institute, Netanya, Israel
| | - Wadi Kinany
- Department of Cardiology and Cardiac Surgery, Poriya Medical Center, Tiberias, Israel
| | - Offer Amir
- The Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel; Department of Cardiology, The Heart Institute, Hadassah Medical Center, Jerusalem, Israel
| | - Erez Kachel
- Department of Cardiology and Cardiac Surgery, Poriya Medical Center, Tiberias, Israel; Department of Cardiac Surgery, Sheba Medical Centre, Tel Hashomer, Israel; The Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel.
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30
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Wytrychiewicz K, Pankowski D, Janowski K, Benoit CE, Bargiel-Matusiewicz K, Pisula E, Walicka M. The role of beliefs about the impact of illness on fertility and close relationships for psychopathological symptoms in women treated for hypothyroidism. J Clin Psychol 2020; 76:2314-2328. [PMID: 32592617 DOI: 10.1002/jclp.23011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 11/05/2022]
Abstract
OBJECTIVE As demonstrated in a pilot study, hypothyroidism has a highly stressful impact on some areas of functioning. This study aims to evaluate the connection between illness-related beliefs (IRBs) and the impact of hypothyroidism on fertility and close relationships, which were the strongest stressors, and the level of depressive, anxiety, and anger symptoms. METHODS Two hundred and thirteen women being treated for hypothyroidism took part in an online survey and completed the modified Hospital Anxiety and Depression Scale, Hypothyroidism Symptoms Severity rating scales, and a measure of IRBs. Other relevant clinical data were also collected. RESULT Mean levels of thyroid-stimulating hormone indicated that the women were euthyroid. Four groups of participants were identified based on IRBs. The group holding a strong IRB about the negative impact of illness only on close relationships scored significantly higher on depressive symptoms than women in the other groups. The group holding strong IRBs about the negative impact of illness on both close relationships and fertility scored significantly higher on anxiety symptoms than the women in the other groups. Regression analysis showed that IRBs about the negative impact of hypothyroidism predicted anxiety, depressive, and anger symptoms. CONCLUSIONS Negative IRBs about the impact of illness on fertility and close relationships contribute to increased levels of emotional distress symptoms in women being treated for hypothyroidism.
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Affiliation(s)
- Kinga Wytrychiewicz
- Faculty of Psychology, University of Warsaw, Warsaw, Poland.,Faculty of Psychology, University of Economics and Human Sciences in Warsaw, Warsaw, Poland
| | - Daniel Pankowski
- Faculty of Psychology, University of Warsaw, Warsaw, Poland.,Faculty of Psychology, University of Economics and Human Sciences in Warsaw, Warsaw, Poland
| | - Konrad Janowski
- Faculty of Psychology, University of Economics and Human Sciences in Warsaw, Warsaw, Poland
| | - Charles E Benoit
- Faculty of Psychology, University of Economics and Human Sciences in Warsaw, Warsaw, Poland
| | | | - Ewa Pisula
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Magdalena Walicka
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland
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31
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Rodrigues FB, Ferreira JJ. Strategies to minimize placebo effects in research investigations. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 153:49-70. [PMID: 32563293 DOI: 10.1016/bs.irn.2020.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Placebo-controlled trials are the research standard to evaluate new interventions for which there is no standard of care. While lessening performance and detection bias, such design provides a direct mode of comparison against the probed intervention. Still, using placebo arms may pose new challenges to the design, conduct and analysis of clinical trials. This is particularly relevant in circumstances of non-additivity between the therapeutic and the placebo effects, if the outcome of interest has floor or ceiling effects, or when the predicted effect size of the intervention is large and leads to small sample sizes. There are several possible strategies to mitigate the confounding effects of the placebo, each relevant to specific clinical trial designs. This chapter puts into context the new challenges created by the placebo effect, discusses possible ways around them, and explores the future of the field.
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Affiliation(s)
- Filipe B Rodrigues
- UCL Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal; Instituto de Medicina Molecular, Lisbon, Portugal
| | - Joaquim J Ferreira
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal; Instituto de Medicina Molecular, Lisbon, Portugal; CNS-Campus Neurológico Sénior, Torres Vedras, Portugal.
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Schmacke N. [Homeopathy: insubstantial doctrine of salvation]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:541-547. [PMID: 32246158 DOI: 10.1007/s00103-020-03125-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Homeopathy is one of the frequently used alternative healing methods in Germany. This article is intended to discuss and analyze why homeopathy should not be part of medicine and should rather be understood as a concept of belief that lies outside of scientific methods. The clinical, legal, and political dimensions of the homeopathy debate are explained. Finally, the question of the legitimacy of placebo applications is discussed in light of the demand for patient-centered medicine.
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Affiliation(s)
- Norbert Schmacke
- Institut für Public Health und Pflegeforschung, Universität Bremen, Bremen, Deutschland. .,, Bibliothekstrasse 1, 28359, Bremen, Deutschland.
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El-Haddad C, Hegazi I, Hu W. Understanding Patient Expectations of Health Care: A Qualitative Study. J Patient Exp 2020; 7:1724-1731. [PMID: 33457636 PMCID: PMC7786689 DOI: 10.1177/2374373520921692] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Understanding and measuring patient expectations of health care is central to improving patient satisfaction and delivering patient-centered care. However, most empiric research in this field has focused on measuring patient expectations for specific diseases only. Patient expectations common to a variety of settings and clinical contexts need to be better understood to design measures with wider utility. We aimed to understand how patients express and conceptualize their expectations of health care across a range of clinical contexts and conditions. Semi-structured interviews were conducted with patients presenting to a major metropolitan hospital, informed by interpretive phenomenological analysis. Sampling continued until thematic saturation. Interview topics explored the illness experience, interactions with clinicians, how patients communicated and conceptualized their expectations of health care, and the nature of these expectations. The 26 participants conceptualized and described their expectations in 3 distinct domains: (1) health outcomes, (2) individual clinicians, and (3) the health-care system. Importantly, these domains were consistent across a variety of clinical contexts, participant demographics, and medical conditions. Despite variation in expectations due to individual patient circumstances, we identified 3 conceptual domains within which expectations consistently lie. When designing measurement tools for patient expectations, we suggest incorporating questions specifically addressing the 3 domains we have identified. With such measures, clinicians and health-care providers can be empowered to provide and monitor patient-centered care with outcomes tailored to what patients desire.
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Affiliation(s)
- Carlos El-Haddad
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
| | - Iman Hegazi
- Medical Education & Academic Program, School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
| | - Wendy Hu
- Medical Education, School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
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Jarmoszewicz K, Nowicka-Sauer K, Zemła A, Beta S. Factors Associated with High Preoperative Anxiety: Results from Cluster Analysis. World J Surg 2020; 44:2162-2169. [DOI: 10.1007/s00268-020-05453-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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35
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Chiavarino C, Poggio C, Rusconi F, Beretta AAR, Aglieri S. Psychological factors and self-rated health: An observative study on cardiological patients. J Health Psychol 2019; 24:1993-2002. [DOI: 10.1177/1359105317712591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study investigated the association of illness representations, awareness of bodily states and health complaints to self-rated health in N = 150 consecutive patients with heart disease (ischaemic disease, heart failure and heart valve disease) and explored differences between ‘health optimist’ and ‘health pessimist’ patients. After controlling for medical variables, health complaints accounted for 14.2 per cent of patients’ self-rated health, and illness representations contributed for another 16.2 per cent; body awareness was not associated with self-rated health. Also, ‘optimists’ tended to see less negative consequences from their illness and perceived greater control over illness treatment compared to ‘pessimists’. Targeting symptoms and illness representations may optimize rehabilitation outcomes.
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Dehghan-Nayeri N, Shali M, Vaezi A, Navabi N, Ghaffari F. Cardiac patients' beliefs about their illness and treatment: A sequential exploratory mixed methods design. Med J Islam Repub Iran 2019; 33:98. [PMID: 31696092 PMCID: PMC6825381 DOI: 10.34171/mjiri.33.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Indexed: 12/02/2022] Open
Abstract
Background: Cardiac patients’ beliefs about illness and treatment can disturb their treatment process, treatment regimen adherence, and daily activities. Exploring these beliefs by the use of appropriate, valid, and accurate scales can be helpful in false beliefs reforming by nurses and finally, result in life quality promotion. Therefore, this study is conducted to design and psychometry a questionnaire probing about cardiac patients’ beliefs about illness and treatment. Methods: The sequential combination exploratory mixed methods design was used to develop the questionnaire format, which involved two sections: the quantitative and qualitative step. The qualitative step included probing the role of cultural beliefs about illness and treatment in two steps, including the literature and related tools review and fieldwork (semi-structured interviews with cardiac patients). Seventeen studies were checked in the literature review. Twenty-two cardiac patients were selected and interviewed by purposive sampling. The interviews continued up to the data saturation. The data analysis was conducted in both steps using conventional content analysis and textual content analysis. The quantitative step was a methodology study accomplished in two parts. The questionnaire items were formed using the data and items pool in the first part while the psychometric properties of the questionnaire were checked using face, content and construct validity and the reliability was probed using internal consistency and stability in the second part. The data were transferred into SPSS software program, version 18.0 for Windows (α<0.05). Results: 319 codes were extracted from the analyzing phase which formed 6 categories including prognosis, prevention, contexts, treatment efficiency, mentality and lifestyle as well as 9 sub-categories including understanding the danger, attitude toward disease, attitude toward treatment, society’s culture, feeling hopeless, treatment regimen ignorance, self-curing, trying to survive and physical outcomes. The items pool was formed using literature reviews and interviews. A 30-itemed questionnaire was formed after the psychometric process. The Kaiser-Meyer-Olkin (KMO) index and the Bartlett’s test of sphericity showed good results. Six components from the exploratory content analysis including prognosis, prevention, contexts, treatment efficiency, mentality, and lifestyle gained 51.7% variance totally. The interclass correlation coefficient was 0.83 in responding to the items for two times. Conclusion: This study developed a questionnaire about cardiac patients’ beliefs regarding their illness and treatment. It can be used for the educational, research, and treatment purposes as a questionnaire with short, easy, and grammatically simple items that have appropriate validity and reliability. Using this scale can be helpful in evaluating clients’ beliefs and recognize their educational needs.
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Affiliation(s)
- Nahid Dehghan-Nayeri
- School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Shali
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Atefeh Vaezi
- School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Nasrin Navabi
- Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Ghaffari
- Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Joskowiak D, Meusel D, Kamla C, Hagl C, Juchem G. Impact of Preoperative Functional Status on Quality of Life after Cardiac Surgery. Thorac Cardiovasc Surg 2019; 70:205-212. [PMID: 31499539 DOI: 10.1055/s-0039-1696953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND With increasing importance, health-related quality of life (HRQoL) has become a crucial outcome measure of cardiac surgery. The aim of this study was to assess the dynamics of HRQoL change within 12 months after surgery and to identify predictors of deterioration in physical and mental health. METHODS The cohort of this prospective study included 164 consecutive patients who underwent elective surgery. HRQoL was assessed on the basis of the Short-Form 36 questionnaire at three different times: upon admission and at 3 and 12 months after surgery. The minimal clinically important difference (MCID) was used to determine whether the surgery resulted in deterioration of HRQoL. RESULTS In general, physical and mental health status improved within the first year after cardiac surgery. However, after 12 months, 7.9 and 21.2% of patients had clinically significant poorer physical (PCS) and mental component summary (MCS) scores, based on the MCID approach. The results of multivariate analysis identified preoperative health status, age < 70 years, coronary artery bypass grafting, and a previous neurological event as predictors of deterioration in postoperative HRQoL. The greatest risks for deterioration were higher preoperative PCS and MCS scores. CONCLUSION Although we were able to demonstrate a general improvement in the HRQoL following cardiac surgery, in one-fifth of patients, there was no recovery of mental health status even after 1 year. As this effect is mainly determined by preoperative functional status, HRQoL should be an integral part of medical consultation, especially in younger patients with a positive perception of quality of life.
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Affiliation(s)
- Dominik Joskowiak
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munchen, Bayern, Germany
| | - Daniela Meusel
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munchen, Bayern, Germany
| | - Christine Kamla
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munchen, Bayern, Germany
| | - Christian Hagl
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munchen, Bayern, Germany
| | - Gerd Juchem
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munchen, Bayern, Germany
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Kube T, Meyer J, Grieshaber P, Moosdorf R, Böning A, Rief W. Patients’ pre- and postoperative expectations as predictors of clinical outcomes six months after cardiac surgery. PSYCHOL HEALTH MED 2019; 25:781-792. [DOI: 10.1080/13548506.2019.1659986] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Tobias Kube
- Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Julia Meyer
- Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Philippe Grieshaber
- Department of Adult and Pediatric Cardiovascular Surgery, Justus-Liebig-University Giessen, Gießen, Germany
| | - Rainer Moosdorf
- Department of Cardiovascular Surgery, Heart Centre, Philipps-University of Marburg, Marburg, Germany
| | - Andreas Böning
- Department of Adult and Pediatric Cardiovascular Surgery, Justus-Liebig-University Giessen, Gießen, Germany
| | - Winfried Rief
- Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
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Psychometric Characteristics of the Revised Illness Perception Questionnaire (IPQ-R) in People Undergoing Weight Loss Surgery. J Clin Psychol Med Settings 2019; 27:79-88. [PMID: 31069587 DOI: 10.1007/s10880-019-09624-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The Illness Perception Questionnaire-Revised (IPQ-R) has been used extensively across many health conditions to measure patient illness and treatment perceptions. The constructs have an association with treatment adaptation and adherence which, in turn, are considered core factors involved in bariatric surgery outcome. This study examines the factorial validity and internal reliability of a modified (IPQ-R) in bariatric surgery candidates. After wording modifications, participants (N = 310) completed the IPQ-R as part of standard pre-surgery assessments. After removal of two items, confirmatory factor analysis (CFA) supported the original 7-factor solution of the Beliefs scale, with good to marginal subscale internal consistency. Exploratory factor analysis (EFA), with two items removed only partially supported the original 5-factor Causal Attributions scale. Internal consistency was unacceptably low for two subscales. Further research is needed to generate new items which better fit the IPQ-R to this population before research can explore the relevance of illness perceptions.
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40
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Sawyer AT, Harris SL, Koenig HG. Illness perception and high readmission health outcomes. Health Psychol Open 2019; 6:2055102919844504. [PMID: 31041109 PMCID: PMC6482662 DOI: 10.1177/2055102919844504] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
This review identified associations between illness perception and health outcomes of patients with a medical diagnosis included in the Hospital Readmissions Reduction Program. Inclusion criteria were English language, use of quantitative methodology, health outcomes specified, and identifiable effect size and statistical significance of the relationship. Most of the 31 studies in this review showed that favorable illness perception has been associated with better health outcomes, while unfavorable illness perception has been associated with worse outcomes. A multifaceted approach might include behavioral, clinical, educational, and psychosocial components to improve one’s illness perception through educative, cognitive-behavioral, or psychodynamic counseling.
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41
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Kube T, Glombiewski J, Rief W. Erwartungsfokussierte psychotherapeutische Interventionen bei Personen mit depressiver Symptomatik. VERHALTENSTHERAPIE 2019. [DOI: 10.1159/000496944] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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42
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Fazlollahpour-Rokni F, Shorofi SA, Mousavinasab N, Ghafari R, Esmaeili R. The effect of inhalation aromatherapy with rose essential oil on the anxiety of patients undergoing coronary artery bypass graft surgery. Complement Ther Clin Pract 2019; 34:201-207. [DOI: 10.1016/j.ctcp.2018.11.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/15/2018] [Accepted: 11/28/2018] [Indexed: 01/24/2023]
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Petrie KJ, Rief W. Psychobiological Mechanisms of Placebo and Nocebo Effects: Pathways to Improve Treatments and Reduce Side Effects. Annu Rev Psychol 2019; 70:599-625. [PMID: 30110575 DOI: 10.1146/annurev-psych-010418-102907] [Citation(s) in RCA: 141] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Placebo effects constitute a major part of treatment success in medical interventions. The nocebo effect also has a major impact, as it accounts for a significant proportion of the reported side effects for many treatments. Historically, clinical trials have aimed to reduce placebo effects; however, currently, there is interest in optimizing placebo effects to improve existing treatments and in examining ways to minimize nocebo effects to improve clinical outcome. To achieve these aims, a better understanding of the psychological and neurobiological mechanisms of the placebo and nocebo response is required. This review discusses the impact of the placebo and nocebo response in health care. We also examine the mechanisms involved in the placebo and nocebo effects, including the central mechanism of expectations. Finally, we examine ways to enhance placebo effects and reduce the impact of the nocebo response in clinical practice and suggest areas for future research.
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Affiliation(s)
- Keith J Petrie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand;
| | - Winfried Rief
- Division of Clinical Psychology, University of Marburg, 35032 Marburg, Germany;
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Abstract
The expectations of patients enhance the probability of their occurrence and are thereby the main triggers for inducing placebo and nocebo responses. Strong placebo effects are not only regularly observed in pharmaceutical and non-pharmaceutical sham treatment in placebo controlled studies but also make a considerable contribution to any real treatment. The accompanying words are essential to ensure maximum impact of drugs and other forms of treatment. They should contain positive expressions instead of negations. Such a strengthening of drug therapy by placebo effects is more important than the widespread use of placebos that remains a problem because of the obligation to provide information and effective therapy and because of inherently induced side effects. Any false comments about symptoms or side effects can aggravate or induce them. Nocebo effects are not imagined but real symptoms that can definitely be harmful. They constitute a considerable proportion of the side effects requiring treatment. Awareness and knowledge is needed to prevent or neutralize them. Nocebo effects are avoidable when risk information is always directly combined with positive aspects, such as the expected benefits of the treatment or the prophylactic measures and therapeutic options for side effects. Existing negative expectations are disrupted by providing more alternative options and by leaving negative experiences in the past where they belong. Placebo and nocebo effects are strongly sensitive to the context. They are dependent on the experiences and conceptions of the individual patient, as well as on the physician-patient relationship. The latter can provide the best protection against harm from risk disclosure. In addition, the expectations of patients and their consequences are strongly affected by the expectations of the treating doctor, by fellow patients, the media and society.
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Affiliation(s)
- E Hansen
- Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Deutschland.
| | - N Zech
- Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Deutschland
| | - K Meissner
- Fachbereich Gesundheitsförderung, Hochschule Coburg, Coburg, Deutschland
- Institut für Medizinische Psychologie, Ludwig-Maximilians-Universität München, München, Deutschland
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Kwon M, Kang J. Mediating effect of illness perception on the relationship between Type D personality and health behaviors among coronary artery disease patients. Health Psychol Open 2018; 5:2055102918817228. [PMID: 30574338 PMCID: PMC6299319 DOI: 10.1177/2055102918817228] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to investigate the relationship between Type D personality and health behaviors of coronary artery disease patients and to determine the mediating effect of illness perception on this relationship. The participants were 142 coronary artery disease patients who underwent percutaneous coronary intervention in a university hospital in Korea. Type D personality, illness perception, and health behaviors were surveyed using structured questionnaires. The collected data were analyzed by a series of hierarchical multiple regressions. A total of 28.9 percent patients had Type D personality. Type D Patients were observed to have low illness perception and low health behaviors. There was a positive correlation between illness perception and health behaviors. The direct effect of Type D personality on health behaviors was significant (β = -.209, p = .013). However, the indirect effect of Type D personality on health behaviors via illness perception became low and non-significant (β = .007, p = .934). Based on the above results, it can be concluded that illness perception has a complete mediating effect on the relationship between Type D personality and health behaviors. The development of interventions that can improve illness perception is needed to improve health behaviors of Type D coronary artery disease patients.
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Affiliation(s)
- Miri Kwon
- Samsung Changwon Hospital, South Korea
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46
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Salzmann S, Laferton J, Auer C, Shedden-Mora M, Wambach K, Rief W. Patientenerwartungen optimieren: Beschreibung einer präoperativen Kurzintervention am Beispiel von Patienten vor einer Bypass-Operation. VERHALTENSTHERAPIE 2018. [DOI: 10.1159/000485430] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Princip M, Gattlen C, Meister-Langraf RE, Schnyder U, Znoj H, Barth J, Schmid JP, von Känel R. The Role of Illness Perception and Its Association With Posttraumatic Stress at 3 Months Following Acute Myocardial Infarction. Front Psychol 2018; 9:941. [PMID: 29930529 PMCID: PMC5999791 DOI: 10.3389/fpsyg.2018.00941] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/22/2018] [Indexed: 11/13/2022] Open
Abstract
Background: The aim of this study was to investigate the relationship between illness perception and posttraumatic stress disorder (PTSD) symptoms at three months following acute myocardial infarction (MI). Methods: Patients (n = 96) were examined within 48 h and 3 months after the illness episode. The brief revised illness perception questionnaire (Brief-IPQ) was used to assess patients' cognitive representation of their MI. At 3-month follow-up, the Posttraumatic Diagnostic Scale (PDS) and the Clinician-Administered PTSD Scale (CAPS) were used to assess the level of PTSD symptoms. Results: The subjective perception of the illness, including higher harmful consequences (r > 0.35, p < 0.01), higher illness concerns (r > 0.24, p < 0.05) and more emotional impairment (r > 0.23, p < 0.05), was associated with both self-rated and clinician-rated PTSD symptoms. Beliefs regarding harmful consequences after acute MI were independently associated with levels of PTSD symptoms assessed with both the self-rated PDS and CAPS interview (standardized β coefficient = 0.24; P < 0.05) adjusted for demographic factors, cognitive depressive symptoms, fear of dying during MI, factors related to study design, and illness severity. Conclusions: The findings suggest that initial perception of acute MI is significantly associated with PTSD symptoms attributable to MI at 3 months follow-up.
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Affiliation(s)
- Mary Princip
- Division of Cardiovascular Prevention, Rehabilitation and Sports Medicine, Department of Cardiology, Bern University Hospital, Inselspital and University of Bern, Bern, Switzerland
| | - Christina Gattlen
- Division of Cardiovascular Prevention, Rehabilitation and Sports Medicine, Department of Cardiology, Bern University Hospital, Inselspital and University of Bern, Bern, Switzerland
| | | | | | - Hansjörg Znoj
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jürgen Barth
- Complementary and Integrative Medicine, University of Zurich, Zurich, Switzerland
| | - Jean-Paul Schmid
- Department of Cardiology, Clinic Barmelweid, Barmelweid, Switzerland
| | - Roland von Känel
- Department of Neurology, Bern University Hospital, Inselspital and University of Bern, Bern, Switzerland.,Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
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Kube T, Rief W, Gollwitzer M, Glombiewski JA. Introducing an EXperimental Paradigm to investigate Expectation Change (EXPEC). J Behav Ther Exp Psychiatry 2018; 59:92-99. [PMID: 29253640 DOI: 10.1016/j.jbtep.2017.12.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 11/13/2017] [Accepted: 12/11/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVES Dysfunctional expectations are considered to be core features of various mental disorders. Clinical observations suggest that people suffering from mental disorders such as major depression tend to maintain dysfunctional expectations despite expectation-disconfirming evidence. Surprisingly, this clinically relevant phenomenon has not yet sufficiently been investigated in empirical studies. Therefore, we developed an experimental paradigm to investigate expectation change vs. maintenance, and the first step to test its validity is to apply it in healthy individuals. METHODS After conducting two pilot studies (n = 28; n = 37), the present study systematically examined whether it is possible to change healthy individuals' (n = 102) task-specific and generalized performance expectations through expectation-disconfirming experiences. Using a standardized instruction, we initially induced non-positive expectations regarding participants' ability to successfully work on an unknown test. Then, participants received standardized performance feedback that either confirmed or disconfirmed their expectations before assessing participants' expectations again after completing the Test for the Measure of Emotional Intelligence. RESULTS Results indicate that expectation-disconfirming feedback led to a significant change of both task-specific and generalized performance expectations. There was no expectation change in the expectation-confirming condition. LIMITATIONS As the present study examined expectation change among healthy individuals, the next step is to apply this paradigm in a clinical sample and to examine whether expectation change is less likely among people suffering from depression or other mental disorders characterized by dysfunctional expectations. CONCLUSIONS Focusing more rigorously on expectation maintenance among people with mental disorders could enable therapists to develop expectation-focused interventions aiming at enhancing expectation change.
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Affiliation(s)
- Tobias Kube
- Philipps-University of Marburg, Department of Clinical Psychology and Psychotherapy, Gutenbergstraße 18, D-35032 Marburg, Germany.
| | - Winfried Rief
- Philipps-University of Marburg, Department of Clinical Psychology and Psychotherapy, Gutenbergstraße 18, D-35032 Marburg, Germany
| | - Mario Gollwitzer
- Philipps-University of Marburg, Department of Psychological Methodology and Social Psychology, Gutenbergstraße 18, D-35032 Marburg, Germany
| | - Julia A Glombiewski
- Philipps-University of Marburg, Department of Clinical Psychology and Psychotherapy, Gutenbergstraße 18, D-35032 Marburg, Germany
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Lau JTF, Wu X, Wu AMS, Wang Z, Mo PKH. Relationships Between Illness Perception and Post-traumatic Growth Among Newly Diagnosed HIV-Positive Men Who have Sex with Men in China. AIDS Behav 2018; 22:1885-1898. [PMID: 28852886 DOI: 10.1007/s10461-017-1874-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Newly diagnosed HIV-positive men who have sex with men (NHMSM) are at high risk of mental health problems but may also develop post-traumatic growth (PTG). According to the Common Sense Model, illness perception (including both cognitive representation and emotional representation) affects coping and health-related outcomes. A cross-sectional survey was conducted to examine the associations between illness perception and PTG among 225 NHMSM in Chengdu, China. Linear regression analyses indicated that the constructs of emotional representation subscale (β = -0.49) and five cognitive representation subscales (timeline, consequence, identity, attribution to god's punishment/will, and attribution to chance/luck) (β = -0.13 to -0.37) were negative correlates of PTG, while four other constructs of cognitive representation (coherence, treatment control, personal control, and attribution to carelessness) were positive correlates (β = 0.15 to 0.51). No moderating effects were observed. The associations between five cognitive representation subscales and PTG were fully-mediated via emotional representation. The results indicate that interventions promoting PTG among NHMSM are warranted and should alter illness perception, emotional representation in particular. Future studies should clarify relationships between cognitive representation and emotional representation, and extend similar research to other health-related outcomes and HIV-positive populations.
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Mülhauser S, Bonhôte Börner M, Saner H, Zumstein-Shaha M. Auswirkung motivierender Gesprächsführung auf die Krankheitswahrnehmung bei stabiler koronarer Herzkrankheit. Eine randomisiert-kontrollierte Studie. Pflege 2018; 31:75-85. [DOI: 10.1024/1012-5302/a000595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung.Hintergrund: Koronare Herzkrankheit ist eine der häufigsten Todesursachen für Menschen > 60 Jahre. Vom Lebensstil abhängige Risikofaktoren sind wesentlich beteiligt. Kardiale Rehabilitation ist daher essenziell für eine optimale Behandlung. Leider verstehen die Betroffenen ihre Krankheit kaum. Motivierende Gesprächsführung kann die Krankheitswahrnehmung verbessern. Ziel / Methode: In einer randomisiert-kontrollierten Studie wurde die Wirksamkeit einer Intervention mit motivierender Gesprächsführung auf die Krankheitswahrnehmung untersucht. Personen mit stabiler koronarer Herzkrankheit wurden konsekutiv nach perkutaner transluminaler Koronarangioplastie (PTCA) in die Studie aufgenommen. Die Interventionsgruppe erhielt ein kurzes motivierendes Gespräch zur Erkrankung und den Risikofaktoren als Intervention. Die Kontrollgruppe erhielt die Standardbetreuung. Vor der Intervention und sechs Monate später wurden Daten zur Krankheitswahrnehmung (Illness Perception Questionnaire-Revised) erhoben. Ergebnisse: Total wurden 312 Personen (n = 148 Intervention, n = 164 Kontrollgruppe) in die Studie aufgenommen (Durchschnittsalter: 66,2 Jahre). Nach der Intervention zeigte sich eine signifikante Veränderung im Bereich der emotionalen Reaktionen auf die Erkrankung. Schlussfolgerung: Um die Krankheitswahrnehmung bei Personen mit stabiler koronarer Herzkrankheit zu verbessern, ist eine kurze Intervention mit motivierender Gesprächsführung möglicherweise wirksam. Ob eine Intensivierung der Intervention das Resultat weiter verbessert, muss noch untersucht werden.
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Affiliation(s)
- Sara Mülhauser
- Universitätsklinik für Kardiologie, Inselspital, Universitätsspital Bern
| | | | - Hugo Saner
- Universitätsklinik für Kardiologie, Inselspital, Universitätsspital Bern
| | - Maya Zumstein-Shaha
- Abteilung angewandte Forschung und Entwicklung Pflege, Departement Gesundheit, Berner Fachhochschule
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