Cardiovascular disease and meaning in life: A systematic literature review and conceptual model

Integrative model for self-perception of well-being in cancer

PURPOSE

Continual illness uncertainty can affect how people perceive and interpret their well-being. Some cognitive and spiritual factors may be involved in the management of disruptive thoughts and emotions that can emerge during the experience of cancer.

MATERIAL AND METHODS

An evidence-based integrative model was developed to evaluate and show the role that mindfulness, acceptance, self-efficacy, uncertainty, meaning, and purpose in life play in the self-perception of well-being in individuals with cancer. This evidence-based integrative model was conducted using relevant and selected studies.

RESULTS

An integrative model for self-perception of well-being has been proposed. This model integrates evidence-based findings and provides clear principles for clinicians and researchers. This integrative model proposes that mindfulness, acceptance, self-efficacy perception, and uncertainty can predict how people with cancer perceive their well-being. The model also posits that meaning and purpose in life can act as mediators or moderators of this prediction.

CONCLUSIONS

This integrative model involves the multidimensionality of human beings and facilitates the understanding of some key factors for the design of therapeutic approaches such as Acceptance & Commitment Therapy or Meaning-Centered Psychotherapy.IMPLICATIONS FOR REHABILITATIONMindfulness, acceptance, self-efficacy, uncertainty, meaning, and purpose in life can be highly relevant for clinical oncology.An integrative model is proposed to understand the combined influence of these factors on patients with cancer.This model may favor a better integration of well-known interventions, such as Mindfulness-based approaches, Acceptance and Commitment Therapy (ACT), and Meaning-Centered Psychotherapy (MCP).

Psychological Health and Ischemic Heart Disease in Women: A Review of Current Evidence and Clinical Considerations across the Healthspan

PURPOSE OF REVIEW

Psychological health encompasses a constellation of negative and positive factors-i.e., psychosocial stress, depression, anxiety, trauma, loneliness and social isolation, anger and hostility, optimism, and a sense of purpose. This narrative review presents current evidence at the intersection of psychological health, risk of ischemic heart disease (IHD), and IHD-related outcomes, with an emphasis on associations in women.

RECENT FINDINGS

For women, relations between psychological health and IHD reflect important sex and gender differences in biological and psychosocial factors. Although efforts devoted to understanding psychological health and IHD risk have varied by psychological factor-scientific evidence is strongest for psychosocial stress and depression, while anxiety, trauma, and positive psychological factors warrant more investigation-less optimal psychological health is consistently associated with an earlier and greater risk of IHD morbidity and mortality in women. Still, many past prospective studies of psychological factors and IHD risk had a limited representation of women, did not include analyses by sex, or failed to account for other influential, sex-specific factors. Thus, there are multiple pathways for further, rigorous investigation into psychological health-IHD associations, mechanisms, and empirically supported psychological interventions to mitigate IHD risk among women. Given the robust evidence linking psychological health with women's risk for IHD, implementing routine, brief, psychological screening is recommended. Significant life events, developmental milestones specific to women, and IHD diagnoses or events could cue further psychological assessment and referral, efforts which will mutually strengthen the evidence for integrated psychological and IHD care and delivery of such care to this vulnerable group.

Investigating the reciprocity between cognition and behavior in adaptation to large-scale disasters

Cognition and behavior could reciprocally impact each other and together determine mental health amid large-scale disasters such as COVID-19. This study reports a six-month cohort study of a population-representative sample of Hong Kong residents (N = 906) from March-August 2021 (T1) to September 2021-February 2022 (T2). Cross-lagged panel analyses reveal that T1 poor behavioral functioning as indicated by high daily routine disruptions is inversely associated with T2 cognitive adaptation as indicated by self-efficacy and meaning-making but not vice versa. T1 routine disruptions but not cognitive adaptation are positively associated with T2 probable depression/anxiety. The positive link between T1 routine disruptions and T2 probable disorders is mediated by poor cognitive adaptation at T2. The present findings suggest that upholding daily behavioral functioning relative to positive states of mind could have a more pivotal role in mental health amid large-scale disasters. Future studies can test interventions that enhance the sustainment of regular daily routines.

The Mediator Role of Meaning in Life in the Life Quality of Patients With Chronic Heart Failure

PURPOSE

Heart failure (HF) is a highly recurrent disease with a high sudden death rate and a substantial influence on disease-related quality of life (QOL). Social support, symptom distress, care needs, and meaning in life all have significant impacts on QOL. We hypothesized that meaning in life plays a mediating role in the relationship of social support, symptom distress, and care needs with QOL among patients with chronic HF.

METHODS

Based on cross-sectional analysis, we recruited 186 HF outpatients who completed structured questionnaires for social support, symptom distress, care needs, meaning in life, and QOL. Structural equation modeling was used to analyze the mediating role of meaning in life in the relationship of social support, symptom distress, and care needs with QOL.

RESULTS

The final model showed good model fit. Meaning in life was associated with global QOL (β = 0.18, p = .032). Although symptom distress (β = -0.26, p = .005) and care needs (β = -0.36, p = .021) were negatively associated with global QOL, meaning in life played a partial mediating role between symptom distress and global QOL (β = -0.02, p = .023) and between care needs and global QOL (β = -0.07, p = .030). However, meaning in life played a complete mediating role between social support and global QOL (β = 0.08, p = .047). The model showed that meaning in life, symptom distress, and care needs explained 50% of global QOL.

CONCLUSIONS

In patients with chronic HF, meaning in life played a mediating role in the relationship of social support, symptom distress, and care needs with QOL. Implementing an intervention to enrich meaning in life may help patients manage the issues caused by symptoms and alleviate their unmet needs.

A pathway to greater meaning in life and well-being for senior executives beset by anti-meaning

Introduction

Although work is a significant source of meaning for most people, the role of senior executive generates different meaning and well-being complexities than those experienced or faced by general employees. This study explored how meaning and anti-meaning components affect senior executives' experiences of meaning in life and well-being. The findings enabled devising a pathway to enhance senior executives' net experiences of meaning in life and well-being.

Methods

A cross-sectional, semi-structured interview study design was used to gather rich qualitative data. Eight participants from southern and eastern Africa, who had held the position of chief executive officer or managing director for at least five years, were interviewed.

Results

The findings demonstrated that senior executives' work roles provide a significant source of meaning. However, the roles are accompanied by unavoidable anti-meanings, which are likely to generate additional anti-meanings if not tempered sufficiently, thus reducing the net meaning experienced.

Discussion

From the findings, a practical pathway was devised to assist top executives to deal with the bipolar relationship between meaning and anti-meaning. Consulting and counseling practitioners can utilize the pathway to guide, support, and counsel senior executives towards improved meaning, temper anti-meaning and improve well-being.

One Meaning for Two Persons: An Actor-Partner Interdependence Model Analysis of Meaning in Life, Anxiety, and Depression Among Rehabilitation Patients and Caregivers

OBJECTIVE

Patients and caregivers in the inpatient physical rehabilitation setting are presented with life-changing medical conditions, and their meaning in life can change dramatically. Meaning in life is associated with fewer depressive and anxiety symptoms, but little is known about how they are related interdependently among patients and caregivers. In the current study, we aim to explore their dyadic relationships.

DESIGN

Actor-partner interdependence model through structural equation modeling for dyadic analyses.

SETTING AND PARTICIPANTS

A total of 160 pairs of patients and caregivers recruited from 6 inpatient rehabilitation hospitals in China.

METHODS

Cross-sectional surveys were conducted among pairs of rehabilitation patients and caregivers. The presence of and search for meaning were measured with the Meaning in Life Questionnaire.

RESULTS

In 2 separate models, we found that patients' presence of meaning was negatively associated with their own depression (β = -0.61, P < .001) and anxiety (β = -0.55, P < .001), as well as their caregivers' depression (β = -0.32, P < .001) and anxiety (β = -0.31, P < .001). However, the caregivers' presence of meaning was only negatively associated with their own depression (β = -0.25, P < .05) and anxiety (β = -0.21, P < .05). A search for meaning was not significantly associated with depression or anxiety.

CONCLUSIONS AND IMPLICATIONS

The results indicate that the anxiety and depressive symptoms of rehabilitation inpatients and caregivers are associated with their own level of presence of meaning. Caregivers' depression and anxiety are interdependently associated with patients' presence of meaning. Clinicians should take dyadic interdependence into consideration when providing psychological services to rehabilitate patients and their caregivers. Meaning-centered interventions can be helpful for the dyads' meaning-making and mental health.

Cancer patients' experiences of moments of relational depth during psychological therapy: a qualitative study

OBJECTIVE

Research into psychological interventions for cancer patients has focused on the effectiveness of different treatment methods. Investigating common factors across treatments, such as qualities within the therapeutic relationship, has been neglected. This study explores cancer patients' experiences of moments of profound contact and engagement with their therapist, including any perceived impact.

METHODS

Semi-structured interviews were conducted with ten cancer patients. Eight participants reported having experienced moments of relational depth. Their transcripts were analyzed using thematic analysis.

FINDINGS

Five themes were identified: "Being physically and psychically vulnerable," "Being rescued from the waves," "Experiencing the calm after the storm," "More than a feeling," and "The therapist as 'a stranger and not a stranger'."

CONCLUSION

Both novice and experienced practitioners should be aware of the potential power of moments of relational depth for cancer patients: to normalize patients' increased vulnerability and emotionality, and to manage breaks and endings with relational sensitivity.

The effectiveness of Meaning-Centered Group Psychotherapy on improving spiritual well-being and reducing anxiety in Iranian male cardiovascular patients

BACKGROUND AND PURPOSE

Cardiovascular diseases (CVDs) are the most important cause of death in Iran and the Kermanshah province. One of the most important problems that cardiovascular patients are dealing with is the psychological consequences of their illness. This study aimed at investigating the effectiveness of Meaning-Centered Group Psychotherapy (MCGP) intervention in improving spiritual well-being and reducing anxiety in cardiovascular patients.

MATERIALS AND METHODS

The study population included all patients referred to specialized cardiovascular centers in Kermanshah province in 2019. The participants consisted of 30 patients who were randomly assigned into experimental and control groups after the primary and secondary screening. The experimental group received routine treatment + MCGP (8 weeks and 90-120 min per session) and the control group only received routine treatment. The dependent variables were assessed by Spiritual Well-Being Scale and Beck Anxiety Inventory before and after receiving the treatment and 2 months after the treatment. ANCOVA and multivariate analysis of covariance were applied to the data through SPSS-22. IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.

RESULTS

The results of covariance analysis showed that MCGP increased spiritual/existential well-being and decreased anxiety in the experimental group (P < 0.001), while no significant difference was traced in the control group.

CONCLUSION

The findings of this randomized controlled trial provide good evidence for the effectiveness of MCGP as a treatment to improve the psychological and spiritual/existential distress in patients with CVDs.

Addressing Psychosocial Factors in Cognitive Impairment Screening from a Holistic Perspective: The DeCo-Booklet Methodology Design and Pilot Study

Cognitive impairment (CI), an intermediate phase between the decline in physiological cognition and dementia, is known to be mediated by a variety of risk and protective factors, with age being the most influential of these. The multifactorial nature of CI and the worldwide phenomenon of an aging population makes decoupling old age from disease through the concept of healthy aging (HA) a matter of major interest. Focusing on psychosocial variables and psychological constructs, here we designed and piloted a data collection booklet (DeCo-B) to assess CI and HA from a holistic perspective. The DeCo-B comprises six sections: sociodemographic factors, CI, meaning in life, psychosocial factors, health problems, and lifestyle. The estimated prevalence of CI and HA in our cohort were 24.4% and 6.6%, respectively. Spearman correlations mainly identified pairwise associations between the meaning in life domains and psychosocial variables. Moreover, age, marital status, purpose in life, resilience, chronic pain, cognitive reserve, and obstructive sleep apnea were significantly associated with an increased risk of CI. Our results showed that DeCo-B is a suitable tool for researching how modifiable risk and protective factors influence cognitive status. The complex interrelationships between variables should be further investigated and, for practical reasons, the questionnaire should be optimized in future work.