Emotion regulation in patients with heart failure: Its relationship with depressive symptoms and rehospitalization

A retrospective analysis of empathy-centric care strategies on negative emotional states and expectation levels in acute heart failure patients

The objective of this research was to evaluate the impact of an empathy-centered care approach on the intensity of negative emotional states and levels of expectation in patients experiencing acute heart failure. A retrospective analysis was conducted on the clinical data of 106 patients presenting with emergent heart failure. The patients were bifurcated into a control group (53 patients) and an intervention group (53 patients) based on their respective care management plans. Following the intervention, the intervention group demonstrated decreased values in left ventricular end-systolic diameter and left ventricular end-diastolic diameter, and increased left ventricular ejection fraction compared to the control group (P < .05). Additionally, the 6-minute walk test used for cardiopulmonary rehabilitation and the 30 seconds sit-to-stand exercise revealed superior results in the intervention group (P < .05). Positive scores on the Positive Negative Affect Scale, the various dimensions of the Herth Hope Index Scale, the Psychological Resilience Scale, and the Chinese Cultural Modified Minnesota Living with Heart Failure Questionnaire were notably higher in the intervention group, whereas negative scores on the Positive Negative Affect Scale and scores on the Self-Assessment Scale of Anxiety were comparatively lower than those in the control group (P < .05). Implementing an empathy-based care approach can bolster cardiac function, augment functional fitness, mitigate negative emotional states, elevate expectation levels, enhance psychological resilience, improve quality of life, and decrease complication rates in patients with acute heart failure.

First results from post-COVID inpatient rehabilitation

Background

COVID-19 is associated with various symptoms and psychological involvement in the long term. In view of the multifactorial triggering and maintenance of the post-COVID syndrome, a multimodal therapy with somatomedical and psychotherapeutic content is expedient. This paper compares the psychological stress of post-COVID patients and their course in rehabilitation to psychosomatic and psychocardiological patients.

Method

Observational study with control-groups and clinical, standardized examination: psychological testing (BDI-II, HELATH-49), 6-MWT as somatic parameter, two measurement points (admission, discharge). Sample characteristics, including work related parameters, the general symptom-load and the course of symptoms during rehabilitation are evaluated.

Results

At admission in all measures post-COVID patients were significantly affected, but less pronounced than psychosomatic or psychocardiological patients (BDI-II post-COVID = 19.29 ± 9.03, BDI-II psychosomatic = 28.93 ± 12.66, BDI-II psychocardiology = 24.47 ± 10.02). During rehabilitation, in all complaint domains and sub-groups, symptom severity was significantly reduced (effect sizes ranging from d = .34 to d = 1.22). Medium positive effects were seen on self-efficacy (d = .69) and large effects on activity and participation (d = 1.06) in post-COVID patients. In the 6-MWT, the walking distance improved by an average of 76.43 ± 63.58 meters (d = 1.22). Not a single patient deteriorated in walking distance, which would have been a possible sign of post exercise malaise (PEM).

Conclusion

Post-COVID patients have a slighter psychological burden as psychocardiological or psychosomatic patients. Although rehabilitation is not curative, post-COVID patients benefit significantly from the interventions and there were no signs of PEM.

Emotion regulation strategies and difficulties in older adults: A systematic review

OBJECTIVES

The purpose of this systematic review was to assess the types of emotion regulation (ER) strategies used and difficulties in emotion regulation experienced by older adults, within the theoretical frameworks proposed by Gross, and by Gratz and Roemer, respectively.

METHODS

A systematic search was conducted using principal electronic scientific databases (PubMed, Scopus, and Web of Science). The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines.

RESULTS

The final number of articles included was 44. Older adults reported a higher use of adaptive ER strategies, as well as fewer difficulties in ER, compared with younger adults. Findings from this review also suggest that the use of maladaptive ER strategies can also expose older adults to psychological distress, and may affect their adaptation to negative disease-related outcomes more common in later life.

CONCLUSIONS

Older adults generally showed a greater emotional control compared with younger subjects. Adaptive control strategies, rather than maladaptive control strategies, were correlated with more positive outcomes for psychological distress and adaptation to chronic diseases.

CLINICAL IMPLICATIONS

Understanding the nature of ER processes in older adults may contribute to implement tailored interventions aimed at reinforcing adaptive ER processes.

Depression and Rehospitalization in Patients With Heart Failure After Discharge From Hospital to Home: An Integrative Review

Patients with heart failure are known to be particularly vulnerable to depression resulting in adverse health outcomes. However, there has been no literature review on current evidence regarding the relationship between depression and rehospitalization. This review aims to explore the relationship between depression and rehospitalization in patients with heart failure. A systematic review employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines included articles published between 2001 and 2019 taken from Scopus, PubMed, CINAHL, and PsycINFO databases. We identified 12 relevant studies with participants ranging from 115 to 160,169 patients. Heart failure patients with depression were more likely to be rehospitalized than those without. To explain this, few reasons have been proposed. First, depression could disrupt the regulation of autonomic nervous system, neurohormonal activation, and body’s natural rhythm. Second, depressed patients tend to have poor adherence to medication. Healthcare providers should not only focus on drug and dietary management but also on implementing effective interventions to manage depression, in order to reduce the risk of rehospitalization. Moreover, palliative care should start at the stage of heart failure diagnosis to improve quality of life, better outcomes, and lower cost of care for the patients.