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Wasilewski M, Vijayakumar A, Szigeti Z, Sathakaran S, Wang KW, Saporta A, Hitzig SL. Barriers and Facilitators to Delivering Inpatient Cardiac Rehabilitation: A Scoping Review. J Multidiscip Healthc 2023; 16:2361-2376. [PMID: 37605772 PMCID: PMC10440091 DOI: 10.2147/jmdh.s418803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/20/2023] [Indexed: 08/23/2023] Open
Abstract
Objective The purpose of this scoping review was to summarize the literature on barriers and facilitators that influence the provision and uptake of inpatient cardiac rehabilitation (ICR). Methods A literature search was conducted using PsycINFO, MEDLINE, EMBASE, CINAHL and AgeLine. Studies were included if they were published in English after the year 2000 and focused on adults who were receiving some form of ICR (eg, exercise counselling and training, education for heart-healthy living). For studies meeting inclusion criteria, descriptive data on authors, year, study design, and intervention type were extracted. Results The literature search resulted in a total of 44,331 publications, of which 229 studies met inclusion criteria. ICR programs vary drastically and often focus on promoting physical exercises and patient education. Barriers and facilitators were categorized through patient, provider and system level factors. Individual characteristics and provider knowledge and efficacy were categorized as both barriers and facilitators to ICR delivery and uptake. Team functioning, lack of resources, program coordination, and inconsistencies in evaluation acted as key barriers to ICR delivery and uptake. Key facilitators that influence ICR implementation and engagement include accreditation and professional associations and patient and family-centred practices. Conclusion ICR programs can be highly effective at improving health outcomes for those living with CVDs. Our review identified several patient, provider, and system-level considerations that act as barriers and facilitators to ICR delivery and uptake. Future research should explore how to encourage health promotion knowledge amongst ICR staff and patients.
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Affiliation(s)
- Marina Wasilewski
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, Ontario, Canada
| | - Abirami Vijayakumar
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
| | - Zara Szigeti
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
| | - Sahana Sathakaran
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Kuan-Wen Wang
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Adam Saporta
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
| | - Sander L Hitzig
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
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Sopek Merkaš I, Lakušić N, Sonicki Z, Koret B, Vuk Pisk S, Filipčić I. Prevalence of posttraumatic stress disorder following acute coronary syndrome and clinical characteristics of patients referred to cardiac rehabilitation. World J Psychiatry 2023; 13:376-385. [PMID: 37383282 PMCID: PMC10294131 DOI: 10.5498/wjp.v13.i6.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/04/2023] [Accepted: 05/25/2023] [Indexed: 06/19/2023] Open
Abstract
BACKGROUND Studies have demonstrated that patients who have experienced acute coronary syndrome (ACS) have an increased risk of developing posttraumatic stress disorder (PTSD) and experiencing worse survival outcomes than those who do not develop PTSD. Nevertheless, the prevalence rates of PTSD following ACS vary widely across studies, and it is noteworthy that in most cases, the diagnosis of PTSD was based on self-report symptom questionnaires, rather than being established by psychiatrists. Additionally, the individual characteristics of patients who develop PTSD after ACS can differ widely, making it difficult to identify any consistent patterns or predictors of the disorder.
AIM To investigate the prevalence of PTSD among a large sample of patients undergoing cardiac rehabilitation (CR) after ACS, as well as their characteristics in comparison to a control group.
METHODS The participants of this study are patients who have experienced ACS with or without undergoing percutaneous coronary intervention and are enrolled in a 3-wk CR program at the largest CR center in Croatia, the Special Hospital for Medical Rehabilitation Krapinske Toplice. Patient recruitment for the study took place over the course of one year, from January 1, 2022, to December 31, 2022, with a total of 504 participants. The expected average follow-up period for patients included in the study is about 18 mo, and currently ongoing. Using self-assessment questionnaire for PTSD criteria and clinical psychiatric interview, a group of patients with a PTSD diagnosis was identified. From the participants who do not have a PTSD diagnosis, patients who would match those with a PTSD diagnosis in terms of relevant clinical and medical stratification variables and during the same rehabilitation period were selected to enable comparability of the two groups.
RESULTS A total of 507 patients who were enrolled in the CR program were approached to participate in the study. Three patients declined to participate in the study. The screening PTSD Checklist-Civilian Version questionnaire was completed by 504 patients. Out of the total sample of 504 patients, 74.2% were men (n = 374) and 25.8% were women (n = 130). The mean age of all participants was 56.7 years (55.8 for men and 59.1 for women). Among the 504 participants who completed the screening questionnaire, 80 met the cutoff criteria for the PTSD and qualified for further evaluation (15.9%). All 80 patients agreed to a psychiatric interview. Among them, 51 patients (10.1%) were diagnosed with clinical PTSD by a psychiatrist according to Diagnostic and Statistical Manual of Mental Disorders criteria. Among the variables analyzed, there was a noticeable difference in the percentage of theoretical maximum achieved on exercise testing between the PTSD and non-PTSD groups. Non-PTSD group achieved a significantly higher percentage of their maximum compared to the PTSD group (P = 0.035).
CONCLUSION The preliminary results of the study indicate that a significant proportion of patients with PTSD induced by ACS are not receiving adequate treatment. Furthermore, the data suggest that these patients may exhibit reduced physical activity levels, which could be one of the possible underlying mechanisms in observed poor cardiovascular outcomes in this population. Identifying cardiac biomarkers is crucial for identifying patients at risk of developing PTSD and may derive benefits from personalized interventions based on the principles of precision medicine in multidisciplinary CR programs.
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Affiliation(s)
- Ivana Sopek Merkaš
- Department of Cardiology, Special Hospital for Medical Rehabilitation Krapinske Toplice, Krapinske Toplice 49217, Croatia
| | - Nenad Lakušić
- Department of Cardiology, Special Hospital for Medical Rehabilitation Krapinske Toplice, Krapinske Toplice 49217, Croatia
- Department of Clinical Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, Osijek 31000, Croatia
- Department of Internal Medicine, Family Medicine and History of Medicine, Faculty of Medicine Osijek, J. J. Strossmayer University of Osijek, Osijek 31000, Croatia
| | - Zdenko Sonicki
- Department of Medical Statistics, Epidemiology, and Medical Informatics, School of Public Health Andrija Stampar, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
| | - Barbara Koret
- Department of Psychiatry, Clinic for Psychiatry “Sveti Ivan”, Zagreb 10000, Croatia
| | - Sandra Vuk Pisk
- Department of Psychiatry, Clinic for Psychiatry “Sveti Ivan”, Zagreb 10000, Croatia
- Department of Psychiatry and Neurology, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, Osijek 31000, Croatia
| | - Igor Filipčić
- Department of Psychiatry, Clinic for Psychiatry “Sveti Ivan”, Zagreb 10000, Croatia
- Department of Psychiatry and Neurology, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, Osijek 31000, Croatia
- Department of Psychiatry and Psychological Medicine, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
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Nuraeni A, Suryani S, Trisyani Y, Sofiatin Y. Efficacy of Cognitive Behavior Therapy in Reducing Depression among Patients with Coronary Heart Disease: An Updated Systematic Review and Meta-Analysis of RCTs. Healthcare (Basel) 2023; 11:healthcare11070943. [PMID: 37046869 PMCID: PMC10094182 DOI: 10.3390/healthcare11070943] [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: 01/20/2023] [Revised: 03/19/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
PURPOSE The aim of this review is to identify the efficacy of cognitive behavior therapy (CBT) and the characteristics of CBT therapy that effectively improve depression among patients with coronary heart disease (CHD). METHODS Studies that assessed CBT efficacy in decreasing depression among CHD patients with randomized controlled trials (RCTs) were searched through PsycINFO, PubMed, CINAHL, Academic Search Complete, Scopus, and Google Scholar. Two reviewers independently screened and critically appraised them using the Cochrane risk-of-bias tool. The fixed- and random-effect models were applied to pool standardized mean differences. RESULTS Fourteen RCTs were included in the quantitative analysis. Depression was significantly lower in the CBT group (SMD -0.37; 95% CI: -0.44 to -0.31; p < 0.00001; I2 = 46%). Depression in the CBT group was significantly lower in the short-term follow-up (SMD -0.46; 95% CI: -0.69 to -0.23; p < 0.0001; I2 = 52%). Moreover, the subsequent therapy approaches were effective in reducing depression, including face-to-face and remote CBT, CBT alone or combination therapy (individual or mixed with a group), and frequent meetings. CONCLUSIONS CBT therapy effectively reduces depression, particularly in short-term follow-up. The application of CBT therapy in CHD patients should consider these findings to increase the efficacy and efficiency of therapy. Future research is needed to address generalizability.
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Affiliation(s)
- Aan Nuraeni
- Doctoral Program, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, Indonesia
- Department of Critical Care and Emergency Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung 45363, Indonesia
| | - Suryani Suryani
- Department of Mental Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung 45363, Indonesia
| | - Yanny Trisyani
- Department of Critical Care and Emergency Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung 45363, Indonesia
| | - Yulia Sofiatin
- Department of Epidemiology, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, Indonesia
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Barriault S, Jbilou J, Charbonneau A, Greenman PS, Grenier J, Chomienne MH. Relationship satisfaction and psychological wellbeing in men having participated in the MindTheHeart® psychoeducation intervention after an acute coronary syndrome. Health Psychol Open 2023; 10:20551029231179165. [PMID: 37273832 PMCID: PMC10233598 DOI: 10.1177/20551029231179165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
This study investigated the associations of relationship satisfaction, depression, and anxiety post-acute coronary syndrome in a sample of men having completed an early, couple-focused, and men-tailored psychoeducation intervention. A baseline sample of 50 male patients were followed over a 12-month period and completed the Couples Satisfaction Index and the Depression, Anxiety and Stress Scale. Results revealed a significant improvement in depression symptoms from T0 to T1, during which all participants completed the MindTheHeart® psychoeducation intervention. In addition, a hierarchical regression analysis showed that relationship satisfaction is an important predictor of this improvement in depression symptoms. Our preliminary findings point to the consideration of life partners in post-ACS interventions and encourage the exploration of this clinical approach in future research.
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Affiliation(s)
| | - Jalila Jbilou
- Université de Moncton, Moncton, NB, Canada
- Centre de Formation Médicale du
Nouveau-Brunswick, Moncton, NB, Canada
| | | | | | - Jean Grenier
- University of Ottawa, Ottawa, ON, Canada
- Institut du Savoir Montfort, Ottawa, ON, Canada
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Lim GEH, Tang A, Chin YH, Yong JN, Tan D, Tay P, Chan YY, Lim DMW, Yeo JW, Chan KE, Devi K, Ong CEC, Foo RSY, Tan HC, Chan MY, Ho R, Loh PH, Chew NWS. A network meta-analysis of 12,116 individuals from randomized controlled trials in the treatment of depression after acute coronary syndrome. PLoS One 2022; 17:e0278326. [PMID: 36449499 PMCID: PMC9710843 DOI: 10.1371/journal.pone.0278326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Post-acute coronary syndrome (ACS) depression is a common but not well understood complication experienced by ACS patients. Research on the effectiveness of various therapies remains limited. Hence, we sought to conduct a network meta-analysis to assess the efficacy of different interventions for post-ACS depression in improving patient outcomes. METHODS AND FINDINGS Three electronic databases were searched for randomised controlled trials describing different depression treatment modalities in post-ACS patients. Each article was screened based on inclusion criteria and relevant data were extracted. A bivariate analysis and a network meta-analysis was performed using risk ratios (RR) and standardized mean differences (SMD) for binary and continuous outcomes, respectively. A total of 30 articles were included in our analysis. Compared to standard care, psychosocial therapy was associated with the greatest reduction in depression scores (SMD:-1.21, 95% CI: -1.81 to -0.61, p<0.001), followed by cognitive behavioural therapy (CBT) (SMD: -0.75, 95% CI: -0.99 to -0.52, p<0.001), antidepressants (SMD: -0.73, 95% CI: -1.14 to -0.31, p<0.001), and lastly, combination therapy (SMD: -0.15, 95% CI: -0.28 to -0.03, p = 0.016). No treatment modalities was found to be more effective in reducing depression scores when compared to one another. Additional analysis showed that these treatment modalities did not have significant impact on the overall mortality, cardiac mortality and recurrent myocardial infarction. CONCLUSION This network meta-analysis found that the treatment effect of the various psychological modalities on depression severity were similar. Future trials on psychological interventions assessing clinical outcomes and improvement in adherence to ACS-specific interventions are needed.
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Affiliation(s)
- Grace En Hui Lim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Ansel Tang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yip Han Chin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- * E-mail: (NWSC); (YHC)
| | - Jie Ning Yong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Darren Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Phoebe Tay
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yu Yi Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Denzel Ming Wei Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jun Wei Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kai En Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kamala Devi
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Colin Eng Choon Ong
- Department of Emergency Medicine, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Roger S. Y. Foo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
| | - Huay-Cheem Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
| | - Mark Y. Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute of Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| | - Poay Huan Loh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
| | - Nicholas W. S. Chew
- Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
- * E-mail: (NWSC); (YHC)
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Farhane‐Medina NZ, Castillo‐Mayén R, Tabernero C, Rubio SJ, Gutiérrez‐Domingo T, Cuadrado E, Arenas A, Luque B. Effectiveness of an eHealth intervention to improve subjective well-being and self-efficacy in cardiovascular disaease patients: A pilot non-randomized controlled trial. Nurs Open 2022; 10:1503-1516. [PMID: 36208471 PMCID: PMC9912451 DOI: 10.1002/nop2.1400] [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: 01/12/2022] [Revised: 06/03/2022] [Accepted: 09/14/2022] [Indexed: 02/11/2023] Open
Abstract
AIM To evaluate the effectiveness of a multicomponent, eHealth-based self-efficacy intervention to promote subjective well-being and self-efficacy in patients with cardiovascular disease, exploring sex differences. DESIGN A pilot study of a two-arm non-randomized controlled trial. METHODS Forty-two cardiovascular patients (31% women) participated in the study. The experimental group received a personalized psychoeducational session and a 14-days eHealth intervention. Subjective well-being (positive and negative affect) and self-efficacy (chronic and cardiac) were assessed at baseline, post-psychoeducational session, post-eHealth intervention and at two follow-ups. RESULTS The levels of the experimental group in positive affect, at post-eHealth and follow-up 1, and self-efficacy, at post-eHealth, and both follow-ups, were statistically significantly higher compared to the control group (all ps < .05). When considering sex, the intervention was effective only for men. The results highlight the potential of eHealth interventions for cardiac patients and underline the importance of considering a gender perspective in their treatment.
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Affiliation(s)
- Naima Z. Farhane‐Medina
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC)CórdobaSpain,Department of PsychologyUniversity of CordobaCórdobaSpain
| | - Rosario Castillo‐Mayén
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC)CórdobaSpain,Department of PsychologyUniversity of CordobaCórdobaSpain
| | - Carmen Tabernero
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC)CórdobaSpain,Instituto de Neurociencias de Castilla y León (INCYL)University of SalamancaSalamancaSpain
| | - Sebastián J. Rubio
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC)CórdobaSpain,Department of Specific DidacticsUniversity of CordobaCórdobaSpain
| | - Tamara Gutiérrez‐Domingo
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC)CórdobaSpain,Department of PsychologyUniversity of CordobaCórdobaSpain
| | - Esther Cuadrado
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC)CórdobaSpain,Department of PsychologyUniversity of CordobaCórdobaSpain
| | - Alicia Arenas
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC)CórdobaSpain,Department of Social PsychologyUniversity of SevilleSevilleSpain
| | - Bárbara Luque
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC)CórdobaSpain,Department of PsychologyUniversity of CordobaCórdobaSpain
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Farhane-Medina NZ, Castillo-Mayén R, Luque B, Rubio SJ, Gutiérrez-Domingo T, Cuadrado E, Arenas A, Tabernero C. A Brief mHealth-Based Psychological Intervention in Emotion Regulation to Promote Positive Subjective Well-Being in Cardiovascular Disease Patients: A Non-Randomized Controlled Trial. Healthcare (Basel) 2022; 10:healthcare10091640. [PMID: 36141252 PMCID: PMC9498759 DOI: 10.3390/healthcare10091640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 11/30/2022] Open
Abstract
The emotional impact that a cardiovascular disease may have on a person’s life can affect the prognosis and comorbidity of the disease. Therefore, emotion regulation is most important for the management of the disease. The aim of this study was to analyze the effectiveness of a brief mHealth psychological intervention in emotion regulation to promote positive subjective well-being in cardiovascular disease patients. The study sample (N = 69, 63.7 ± 11.5 years) was allocated to either the experimental group (n = 34) or control group (n = 35). The intervention consisted of a psychoeducational session in emotion regulation and an mHealth-based intervention for 2 weeks. Positive subjective well-being as a primary outcome and self-efficacy to manage the disease as a secondary outcome were assessed at five time points evaluated over a period of 6 weeks. The experimental group showed higher improvement in positive subjective well-being and self-efficacy for managing the disease compared to the control group over time. The experimental group also improved after the intervention on all outcome measures. Brief mHealth interventions in emotion regulation might be effective for improving positive subjective well-being and self-efficacy to manage the disease in cardiovascular patients.
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Affiliation(s)
- Naima Z. Farhane-Medina
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14071 Córdoba, Spain
- Department of Psychology, University of Cordoba, 14071 Córdoba, Spain
| | - Rosario Castillo-Mayén
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14071 Córdoba, Spain
- Department of Psychology, University of Cordoba, 14071 Córdoba, Spain
| | - Bárbara Luque
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14071 Córdoba, Spain
- Department of Psychology, University of Cordoba, 14071 Córdoba, Spain
- Correspondence: ; Tel.: +34-957-21-89-61
| | - Sebastián J. Rubio
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14071 Córdoba, Spain
- Department of Didactics of Experimental Sciences, University of Cordoba, 14071 Córdoba, Spain
| | - Tamara Gutiérrez-Domingo
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14071 Córdoba, Spain
- Department of Psychology, University of Cordoba, 14071 Córdoba, Spain
| | - Esther Cuadrado
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14071 Córdoba, Spain
- Department of Psychology, University of Cordoba, 14071 Córdoba, Spain
| | - Alicia Arenas
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14071 Córdoba, Spain
- Department of Psychology, University of Seville, 41018 Seville, Spain
| | - Carmen Tabernero
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14071 Córdoba, Spain
- Institute of Neurosciences of Castilla y León (INCYL), University of Salamanca, 37007 Salamanca, Spain
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Wen Y, Zhang X, Lan W, Zhao S, Qi Q, Yang L. Effects of Cardiac Rehabilitation on Cardiac Function and Quality of Life in Patients with Ischemic Nonobstructive Coronary Artery Disease and Diabetes Mellitus. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3487107. [PMID: 35677096 PMCID: PMC9168191 DOI: 10.1155/2022/3487107] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/16/2022] [Accepted: 04/28/2022] [Indexed: 11/17/2022]
Abstract
Objective To investigate the effect of cardiac rehabilitation on the quality of life in patients with ischemic and nonobstructive coronary artery disease complicated with diabetes mellitus. Methods From January 2020 to June 2021, 100 patients with ischemic nonobstructive coronary heart disease complicated with diabetes were randomly divided into the control group (n = 50). The routine drug therapy observation group (50 cases) was treated with routine drugs combined with cardiac rehabilitation at 6 months for 1 course. The curative effect, cardiac function, 6 min walking distance (6MWD), cardiopulmonary exercise test (CPFT) index, SF-36 Health Status Survey Scale, and quality of life score were compared between the two groups. Results The total effective rate of the observation group was significantly higher than that of the control group (P < 0.05). After treatment, there was no significant change in cardiac function and 6MWD in the control group. The left ventricular ejection fraction and 6MWD in the observation group were significantly higher/longer than those before treatment and the control group (all P < 0.05). After treatment, the indexes of CPET in the two groups were improved in varying degrees. The forced vital capacity and oxygen uptake of anaerobic valve in the observation group were significantly higher than those in the control group (all P < 0.05). After treatment, the scores of the SF-36 in both groups were improved in varying degrees. The physiological function, general health, energy, mental health, and total scores of the observation group were significantly higher than those of the control group (all P < 0.05). Conclusion Cardiac rehabilitation can significantly improve the cardiorespiratory function, exercise ability, and quality of life in patients with ischemic and nonobstructive coronary artery disease complicated with diabetes mellitus.
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Affiliation(s)
- Yuan Wen
- Department of Cardiovascular Medicine, Wuhan Hankou Hospital, Wuhan, China 430012
| | - Xiaoli Zhang
- Department of Nephrology, Wuhan Hankou Hospital, Wuhan, China 430012
| | - Weiqun Lan
- Department of Cardiovascular Medicine, Wuhan Hankou Hospital, Wuhan, China 430012
| | - Shimin Zhao
- Department of Cardiovascular Medicine, Wuhan Hankou Hospital, Wuhan, China 430012
| | - Qiuhuan Qi
- Department of Cardiovascular Medicine, Wuhan Hankou Hospital, Wuhan, China 430012
| | - Li Yang
- Department of Endocrinology and Hematology, Wuhan Hankou Hospital, Wuhan, China 430012
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STUDY OF THE EMOTIONAL STATUS OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AND THEIR RELATIVES AT DIFFERENT STAGES OF THE PATIENT'S ROUTE. WORLD OF MEDICINE AND BIOLOGY 2022. [DOI: 10.26724/2079-8334-2022-3-81-46-50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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10
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OUP accepted manuscript. Eur J Cardiovasc Nurs 2022; 21:643-654. [DOI: 10.1093/eurjcn/zvac001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/04/2021] [Accepted: 12/15/2021] [Indexed: 11/13/2022]
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Magán I, Casado L, Jurado-Barba R, Barnum H, Redondo MM, Hernandez AV, Bueno H. Efficacy of psychological interventions on psychological outcomes in coronary artery disease: systematic review and meta-analysis. Psychol Med 2021; 51:1846-1860. [PMID: 32249725 DOI: 10.1017/s0033291720000598] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND The benefits of cognitive-behavioral treatment (CBT) and positive psychology therapy (PPT) in patients with cardiovascular disease are still not well defined. We assessed the efficacy of CBT and PPT on psychological outcomes in coronary artery disease (CAD) patients. METHODS Randomized controlled trials evaluating CBT or PPT in CAD patients published until May 2018 were systematically analyzed. Primary outcomes were depression, stress, anxiety, anger, happiness, and vital satisfaction. Random effects meta-analyses using the inverse variance method were performed. Effects were expressed as standardized mean difference (SMD) or mean differences (MD) with their 95% confidence intervals (CIs); risk of bias was assessed with the Cochrane tool. RESULTS Nineteen trials were included (n = 1956); sixteen evaluated CBT (n = 1732), and three PPT (n = 224). Compared with control groups, depressive symptoms (13 trials; SMD -0.80; 95% CI -1.33 to -0.26), and anxiety (11 trials; SMD -1.26; 95% CI -2.11 to -0.41) improved after the PI, and depression (6 trials; SMD -2.08; 95% CI -3.22 to -0.94), anxiety (5 trials; SMD -1.33; 95% CI -2.38 to -0.29), and stress (3 trials; SMD -3.72; 95% CI -5.91 to -1.52) improved at the end of follow-up. Vital satisfaction was significantly increased at follow-up (MD 1.30, 0.27, 2.33). Non-significant effects on secondary outcomes were found. Subgroup analyses were consistent with overall analyses. CONCLUSION CBT and PPT improve several psychological outcomes in CAD patients. Depression and anxiety improved immediately after the intervention while stress and vital satisfaction improve in the mid-term. Future research should assess the individual role of CBT and PPT in CAD populations.
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Affiliation(s)
- Inés Magán
- Department of Psychology, Facultad de Educación y Salud, Universidad Camilo José Cela, Madrid, Spain
| | - Laura Casado
- Department of Psychology, Facultad de Educación y Salud, Universidad Camilo José Cela, Madrid, Spain
| | - Rosa Jurado-Barba
- Department of Psychology, Facultad de Educación y Salud, Universidad Camilo José Cela, Madrid, Spain
- Instituto de Investigación Biomédica del Hospital 12 de Octubre (Imas12), Madrid, Spain
| | - Haley Barnum
- Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, CT, USA
| | - Marta M Redondo
- Department of Psychology, Facultad de Educación y Salud, Universidad Camilo José Cela, Madrid, Spain
| | - Adrian V Hernandez
- Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, CT, USA
- Vicerrectorado de Investigacion, Universidad San Ignacio de Loyola (USIL), Lima, Peru
| | - Héctor Bueno
- Instituto de Investigación Biomédica del Hospital 12 de Octubre (Imas12), Madrid, Spain
- Department of Cardiology, Hospital Universitario 12 de Octubre, Madrid, Spain
- Multidisciplinary Translational Cardiovascular Research Group, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
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Cojocariu SA, Maștaleru A, Sascău RA, Stătescu C, Mitu F, Cojocaru E, Trandafir LM, Leon-Constantin MM. Relationships between Psychoeducational Rehabilitation and Health Outcomes-A Systematic Review Focused on Acute Coronary Syndrome. J Pers Med 2021; 11:jpm11060440. [PMID: 34063747 PMCID: PMC8223782 DOI: 10.3390/jpm11060440] [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: 04/23/2021] [Revised: 05/15/2021] [Accepted: 05/19/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Cardiac rehabilitation is a multidisciplinary program that includes psychoeducational support in addition to physical exercise. Psychoeducational intervention is a component that has had accelerated interest and development in recent decades. The aim was to analyze the current evidence on the effectiveness of psychoeducational interventions for patients with acute coronary syndrome (ACS). (2) Methods: We conducted a systematic search of the literature via four databases: PubMed, CENTRAL, PsycINFO, and EMBASE. We included randomized controlled trials that evaluated the effectiveness of a psychoeducational intervention compared to usual care in ACS patients. We assessed the risk of bias using a modified version of the Cochrane tool. We analyzed data regarding the population, intervention, comparator, outcomes, and timing. (3) Results: We identified 6248 studies. After a rigorous screening, we included in the analysis 11 articles with a total of 3090 participants. Major adverse cardiovascular events, quality of life, hospitalizations, lipidogram, creatinine, NYHA class, smoking, physical behavior, and emotional state were significantly improved. In addition, illness perception, knowledge, and beliefs were substantially ameliorated (all p < 0.001). All this was related to the type and dose of psychological intervention. (4) Conclusions: Patients with ACS can receive significant benefits through individualized psychoeducation sessions. The cardiac rehabilitation program should include personalized psychological and educational intervention by type and dose.
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Affiliation(s)
- Sabina Alexandra Cojocariu
- Department of Medical Specialties (I), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, University Street nr 16, 700115 Iasi, Romania; (S.A.C.); (R.A.S.); (C.S.); (F.M.); (M.-M.L.-C.)
| | - Alexandra Maștaleru
- Department of Medical Specialties (I), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, University Street nr 16, 700115 Iasi, Romania; (S.A.C.); (R.A.S.); (C.S.); (F.M.); (M.-M.L.-C.)
- Clinical Rehabilitation Hospital–Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr 14, 700661 Iasi, Romania
- Correspondence: (A.M.); (E.C.)
| | - Radu Andy Sascău
- Department of Medical Specialties (I), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, University Street nr 16, 700115 Iasi, Romania; (S.A.C.); (R.A.S.); (C.S.); (F.M.); (M.-M.L.-C.)
- Institute of Cardiovascular Disease “Prof. Dr. George. I.M. Georgescu”, Address: Carol I Boulevard nr 50, 700503 Iasi, Romania
| | - Cristian Stătescu
- Department of Medical Specialties (I), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, University Street nr 16, 700115 Iasi, Romania; (S.A.C.); (R.A.S.); (C.S.); (F.M.); (M.-M.L.-C.)
- Institute of Cardiovascular Disease “Prof. Dr. George. I.M. Georgescu”, Address: Carol I Boulevard nr 50, 700503 Iasi, Romania
| | - Florin Mitu
- Department of Medical Specialties (I), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, University Street nr 16, 700115 Iasi, Romania; (S.A.C.); (R.A.S.); (C.S.); (F.M.); (M.-M.L.-C.)
- Clinical Rehabilitation Hospital–Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr 14, 700661 Iasi, Romania
| | - Elena Cojocaru
- Department of Morphofunctional Sciences I, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
- Saint Mary Emergency Medicine Children Hospital, Vasile Lupu Street nr 62, 700309 Iasi, Romania;
- Correspondence: (A.M.); (E.C.)
| | - Laura Mihaela Trandafir
- Saint Mary Emergency Medicine Children Hospital, Vasile Lupu Street nr 62, 700309 Iasi, Romania;
- Department of Mother and Child, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Maria-Magdalena Leon-Constantin
- Department of Medical Specialties (I), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, University Street nr 16, 700115 Iasi, Romania; (S.A.C.); (R.A.S.); (C.S.); (F.M.); (M.-M.L.-C.)
- Clinical Rehabilitation Hospital–Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr 14, 700661 Iasi, Romania
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Dabbaghipour N, Javaherian M, Moghadam BA. Effects of cardiac rehabilitation on cognitive impairments in patients with cardiovascular diseases: a systematic review. Int J Neurosci 2020; 131:1124-1132. [PMID: 32449872 DOI: 10.1080/00207454.2020.1773823] [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] [Indexed: 12/29/2022]
Abstract
BACKGROUND One of the most common problems associated with cardiovascular diseases (CVDs) is cognitive impairments (CIs) leading to reduced quality of life and treatment adherence in patients. The aim of this systematic review was to examine the effects of cardiac rehabilitation (CR) on cognitive function in CVD patients. MATERIAL AND METHOD PubMed, Scopus, Web of Science and Ovid MEDLINE databases were searched for identification the relevant studies without language restriction. We included the studies published from root to August 2019, evaluating the effects of CR on at least one type of cognitive functions through valid neuropsychological tests. Finally, nine studies with different study designs were entered in this systematic review. The full texts of these studies were critically appraised with various quality assessment tools. RESULT Patients were evaluated by different cognitive domains including global cognition, attention, executive function, memory and language prior to and following CR program among included studies. Most of the included studies reported significant cognitive improvement of the attention/executive function and memory domains. Two studies showed statistically significant improvement in global cognition using Modified Mini-Mental State (3MS) and Montreal Cognitive Assessment (MoCA) tools. Similar effects were not found in language domain. CONCLUSION It seems that cognitive impairments in CVD patients can be improved with CR program. Because this review is limited by low number of included studies, and there were various study designs without control groups, the results should be generalized cautiously. Further studies are recommended.
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Affiliation(s)
- Narges Dabbaghipour
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javaherian
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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Lukoševičiūtė J, Šmigelskas K. Illness Perception and Its Changes During Six Months After Cardiac Rehabilitation. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2019. [DOI: 10.1027/2512-8442/a000034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Illness perception is a concept that reflects patients' emotional and cognitive representations of disease. This study assessed the illness perception change during 6 months in 195 patients (33% women and 67% men) with acute coronary syndrome, taking into account the biological, psychological, and social factors. At baseline, more threatening illness perception was observed in women, persons aged 65 years or more, with poorer functional capacity (New York Heart Association [NYHA] class III or IV) and comorbidities ( p < .05). Type D personality was the only independent factor related to more threatening illness perception (βs = 0.207, p = .006). At follow-up it was found that only self-reported cardiovascular impairment plays the role in illness perception change (βs = 0.544, p < .001): patients without impairment reported decreasing threats of illness, while the ones with it had a similar perception of threat like at baseline. Other biological, psychological, and social factors were partly associated with illness perception after an acute cardiac event but not with perception change after 6 months.
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Affiliation(s)
- Justė Lukoševičiūtė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Kastytis Šmigelskas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Health Psychology, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Impact of a brief psychological intervention on lifestyle, risk factors and disease knowledge during phase I of cardiac rehabilitation after acute coronary syndrome. Rev Port Cardiol 2019; 38:361-368. [PMID: 31221489 DOI: 10.1016/j.repc.2018.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 08/16/2018] [Accepted: 09/10/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION This study examined the efficacy of a brief inpatient psychoeducational intervention on knowledge about acute coronary syndromes (ACS), control of risk factors, and adaptive health habits and lifestyle. The intervention was intended to facilitate rehabilitation after ACS and its short- and medium-term impact was assessed. METHODS One hundred and twenty-one patients with ACS, admitted to a central cardiology unit in Portugal, were randomized to an experimental group (EG, n=65) or a control group (CG, n=56). We used the Portuguese versions of the Knowledge Questionnaire and the Health Habits Questionnaire. Patients were assessed at hospital admission, hospital discharge and one- and two-month follow-up. RESULTS The intervention had a significant impact, increasing knowledge about ACS (F=500.834; p=0.000) in the EG, which was maintained at two-month follow-up, and changing health habits at two-month follow-up (F=218.129; p=0.000). The CG demonstrated decreased knowledge (F=3.368; p=0.069) during the same period. CONCLUSIONS A brief inpatient psychoeducational intervention has a positive effect on knowledge about ACS, risk factor control and promotion of positive health habits, and is effective in improving cardiac rehabilitation.
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Impact of a brief psychological intervention on lifestyle, risk factors and disease knowledge during phase I of cardiac rehabilitation after acute coronary syndrome. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.repce.2018.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abreu A. In-hospital psychological intervention in cardiac rehabilitation following acute coronary syndrome: Brief is better than nothing. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.repce.2019.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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In-hospital psychological intervention in cardiac rehabilitation following acute coronary syndrome: Brief is better than nothing. Rev Port Cardiol 2019; 38:369-372. [DOI: 10.1016/j.repc.2019.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Breve intervenção psicológica em doentes internados após síndrome coronária aguda: essencial ou acessória? Rev Port Cardiol 2017; 36:651-654. [DOI: 10.1016/j.repc.2017.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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