1
|
Nissen NK, Guldin MB, Nielsen CP, Ørtenblad L. Do Interventions Meet the Needs of Caregivers of Cardiac Patients?: A Scoping Review. J Cardiovasc Nurs 2024:00005082-990000000-00211. [PMID: 39039633 DOI: 10.1097/jcn.0000000000001122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
BACKGROUND Interventions targeting the needs of caregivers of cardiac patients are few, and in most cases, no effect is found on caregivers' well-being. A closer look at the existing interventions will provide a solid foundation for future efforts to develop effective interventions targeted at caregivers of cardiac patients. OBJECTIVE The study's objective was to scrutinize and discuss interventions targeting caregivers of cardiac patients and contribute to reflections that will improve future interventions. METHODS Systematic scoping of the literature within the field was conducted through a literature search in PubMed, EMBASE, CINAHL, PsycINFO, and Cochrane Library from January 2011 to May 2022. The development of search terms and inclusion criteria was inspired by the Patient problem/population, Intervention, Comparison/Control, and Outcome approach, and the Medical Research Council framework for developing and evaluating complex interventions served as the underlying basis for the analysis. RESULTS Eleven articles were included. The interventions reported in the articles were generally not systematically developed and did not include field-specific, methodological, and theoretical reflections. Furthermore, the development process behind the studies seemed not to be transparent. CONCLUSIONS Lack of systematic methodology and methodological transparency in the reviewed studies hinders further testing of interventions and might explain lack of evidence for effective interventions within the field. More systematic, needs-based, and well-documented interventions targeting caregivers of various kinds of cardiac patients are needed to develop the field to the benefit of caregivers, patients, and society.
Collapse
|
2
|
Rapelli G, Donato S, Giusti EM, Pietrabissa G, Parise M, Pagani AF, Spatola CAM, Bertoni A, Castelnuovo G. Recognizing and Appreciating the Partner's Support Protects Relationship Satisfaction during Cardiac Illness. J Clin Med 2024; 13:1180. [PMID: 38398491 PMCID: PMC10890017 DOI: 10.3390/jcm13041180] [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: 12/22/2023] [Revised: 02/05/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND This study aimed to examine whether dyadic coping (DC) is associated with relationship satisfaction (RS) among couples facing cardiac diseases. Furthermore, the moderating role of both partners' anxiety and depression was tested. METHODS One hundred cardiac patients (81.5% men) and their partners (81.5% women) completed a self-report questionnaire during hospitalization. The Actor-Partner Interdependence Model (APIM) and moderation analyses were used to assess the above associations. RESULTS Results showed that positive DC was significantly related to higher levels of RS, and negative DC was related to lower levels of RS. Furthermore, patient and partner psychological distress significantly moderated the link between DC and RS: patient-perceived positive DC was associated with higher partner RS when partner depression was high; partner-perceived positive DC was associated with higher patient RS when patient anxiety was low; patient-perceived negative DC has associated with lower patient RS when patient anxiety and depression were high. CONCLUSION This study showed that positive DC is associated with a more satisfying relationship and identified under what conditions of cardiac-related distress this can happen. Furthermore, this study underlined the importance of examining DC in addition to the individual coping skills as a process pertaining to personal well-being and couple's outcomes.
Collapse
Affiliation(s)
- Giada Rapelli
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy;
| | - Silvia Donato
- Department of Psychology, Catholic University of Sacred Heart, 20123 Milan, Italy; (S.D.); (A.B.); (G.C.)
- Family Studies and Research University Centre, Catholic University of Sacred Heart, 20123 Milan, Italy
| | - Emanuele Maria Giusti
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy
| | - Giada Pietrabissa
- Department of Psychology, Catholic University of Sacred Heart, 20123 Milan, Italy; (S.D.); (A.B.); (G.C.)
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy
| | - Miriam Parise
- Department of Psychology, Catholic University of Sacred Heart, 20123 Milan, Italy; (S.D.); (A.B.); (G.C.)
- Family Studies and Research University Centre, Catholic University of Sacred Heart, 20123 Milan, Italy
| | | | - Chiara A. M. Spatola
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy;
| | - Anna Bertoni
- Department of Psychology, Catholic University of Sacred Heart, 20123 Milan, Italy; (S.D.); (A.B.); (G.C.)
- Family Studies and Research University Centre, Catholic University of Sacred Heart, 20123 Milan, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Sacred Heart, 20123 Milan, Italy; (S.D.); (A.B.); (G.C.)
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy
| |
Collapse
|
3
|
Kumar R, Chhillar N, Gupta DS, Kaur G, Singhal S, Chauhan T. Cholesterol Homeostasis, Mechanisms of Molecular Pathways, and Cardiac Health: A Current Outlook. Curr Probl Cardiol 2024; 49:102081. [PMID: 37716543 DOI: 10.1016/j.cpcardiol.2023.102081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/18/2023]
Abstract
The metabolism of lipoproteins, which regulate the transit of the lipid to and from tissues, is crucial to maintaining cholesterol homeostasis. Cardiac remodeling is referred to as a set of molecular, cellular, and interstitial changes that, following injury, affect the size, shape, function, mass, and geometry of the heart. Acetyl coenzyme A (acetyl CoA), which can be made from glucose, amino acids, or fatty acids, is the precursor for the synthesis of cholesterol. In this article, the authors explain concepts behind cardiac remodeling, its clinical ramifications, and the pathophysiological roles played by numerous various components, such as cell death, neurohormonal activation, oxidative stress, contractile proteins, energy metabolism, collagen, calcium transport, inflammation, and geometry. The levels of cholesterol are traditionally regulated by 2 biological mechanisms at the transcriptional stage. First, the SREBP transcription factor family regulates the transcription of crucial rate-limiting cholesterogenic and lipogenic proteins, which in turn limits cholesterol production. Immune cells become activated, differentiated, and divided, during an immune response with the objective of eradicating the danger signal. In addition to creating ATP, which is used as energy, this process relies on metabolic reprogramming of both catabolic and anabolic pathways to create metabolites that play a crucial role in regulating the response. Because of changes in signal transduction, malfunction of the sarcoplasmic reticulum and sarcolemma, impairment of calcium handling, increases in cardiac fibrosis, and progressive loss of cardiomyocytes, oxidative stress appears to be the primary mechanism that causes the transition from cardiac hypertrophy to heart failure. De novo cholesterol production, intestinal cholesterol absorption, and biliary cholesterol output are consequently crucial processes in cholesterol homeostasis. In the article's final section, the pharmacological management of cardiac remodeling is explored. The route of treatment is explained in different steps: including, promising, and potential strategies. This chapter offers a brief overview of the history of the study of cholesterol absorption as well as the different potential therapeutic targets.
Collapse
Affiliation(s)
| | - Neelam Chhillar
- Deparetment of Biochemistry, School of Medicine, DY Patil University, Navi Mumbai, India
| | - Dhruv Sanjay Gupta
- Department of Pharmacology, SPP School of Pharmacy & Technology Management, SVKM's NMIMS, Mumbai, India
| | - Ginpreet Kaur
- Department of Pharmacology, SPP School of Pharmacy & Technology Management, SVKM's NMIMS, Mumbai, India
| | - Shailey Singhal
- Cluster of Applied Sciences, University of Petroleum and Energy Studies, Dehradun, India
| | - Tanya Chauhan
- Division of Forensic Biology, National Forensic Sciences University, Delhi Campus (LNJN NICFS) Delhi, India
| |
Collapse
|
4
|
Bouchard K, Gareau A, Sztajerowska K, Greenman PS, Lalande K, Tulloch H. Better together: Relationship quality and mental health among cardiac patients and spouses. FAMILY PROCESS 2023; 62:1624-1639. [PMID: 36404415 DOI: 10.1111/famp.12836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/11/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Reductions in marital relationship quality are pervasive post-cardiac event. It is not yet understood how relationship quality is linked to mental health outcomes in couples where one member has established cardiovascular disease (CVD) and the interdependence within dyads is seldom measured. This research is required as psychological distress has been independently linked to CVD incidence, morbidity, and mortality. This study assessed associations of relationship quality with depression and anxiety among patients with CVD and their spouses. Participants completed questionnaires measuring four dimensions of relationship quality and mental health. Data were analyzed using an Actor-Partner Interdependence Model with hierarchical moderation analyses. 181 dyads (N = 362 participants) comprised the study sample. Most patients had coronary artery disease (66.3%) and 25.9% were female. Patients reported higher relationship satisfaction and fewer anxiety symptoms than did spouses. Patients and spouses with high dyadic consensus and affectional expression reported fewer mental health symptoms, but only when the other partner also perceived high levels of consensus and affectional expression in the relationship. Patients and spouses with low dyadic cohesion reported worse mental health symptoms (actor effects), but those effects were no longer significant when both the patient and the spouse appraised the relationship as having high levels of dyadic cohesion. Taken together, relationship quality is linked to mental health symptoms in patients with CVD and their spouses. Longitudinal and experimental studies are now warranted to further substantiate the cross-sectional findings of this study.
Collapse
Affiliation(s)
- Karen Bouchard
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | | | | | - Paul S Greenman
- Université du Québec en Outaouais, Gatineau, Québec City, Canada
| | | | - Heather Tulloch
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
5
|
Rapelli G, Giusti EM, Tarquinio C, Varallo G, Franceschini C, Musetti A, Gorini A, Castelnuovo G, Pietrabissa G. Psychological couple-oriented interventions for patients with heart disease and their partners: a scoping review and guidelines for future interventions. Front Psychol 2023; 14:1194767. [PMID: 37842689 PMCID: PMC10570454 DOI: 10.3389/fpsyg.2023.1194767] [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: 03/27/2023] [Accepted: 08/21/2023] [Indexed: 10/17/2023] Open
Abstract
Objective This scoping review aims to provide an accessible summary of available evidence on the efficacy of psychological couple-based interventions among patients with heart disease and their partners focusing on specific aspects and strategies by assessing different emotional and physical cardiac-related outcome measures. Methods A literature search was performed in PubMed, Scopus, Medline, PsycINFO, and Web of Science databases using the keywords "heart diseases" and "couple-based intervention." A literature search using systematic methods was applied. Data were extracted to address the review aims and were presented as a narrative synthesis. Results The database search produced 11 studies. Psychological couple-based interventions varied in terms of the type of intervention, personnel, format (group or individual, phone or in person), number of sessions, and duration. Most of the contributions also lacked adequate details on the training of professionals, the contents of the interventions, and the theoretical models on which they were based. Finally, although partners were involved in all the treatment, in most studies, the psychological strategies and outcomes were focused on the patient. Conclusion The variability of the psychological couple-based interventions of included studies represents a challenge in summarizing the existing literature. Regarding their impact, psychological interventions for patients with cardiovascular disease and their partners were found to moderately improve patients' and partners' outcomes.
Collapse
Affiliation(s)
- Giada Rapelli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Emanuele Maria Giusti
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Claudia Tarquinio
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Giorgia Varallo
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural, University of Parma, Parma, Italy
| | - Alessandra Gorini
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Milan, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Giada Pietrabissa
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| |
Collapse
|
6
|
Loureiro M, Parola V, Duarte J, Mendes E, Oliveira I, Coutinho G, Martins MM, Novo A. Interventions for Caregivers of Heart Disease Patients in Rehabilitation: Scoping Review. NURSING REPORTS 2023; 13:1016-1029. [PMID: 37606457 PMCID: PMC10443275 DOI: 10.3390/nursrep13030089] [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: 02/01/2023] [Revised: 06/29/2023] [Accepted: 07/24/2023] [Indexed: 08/23/2023] Open
Abstract
Map the interventions/components directed to the caregivers of heart disease patients in cardiac rehabilitation programs that promote their role and health. METHODS The Joanna Briggs Institute method was used to guide this scoping review. Two independent reviewers assessed articles for relevance and extracted and synthesized data. Inclusion criteria comprised articles published in English, Spanish, and Portuguese since 1950. The following databases were searched: CINAHL Complete (Via EBSCO), Medline (via PubMed), Scopus, PEDro, and Repositórios Científicos de Acesso Aberto de Portugal (RCAAP). RESULTS From 351 articles retrieved, 10 were included in the review. The interventions identified directed to the caregiver were: educational interventions and lifestyle changes; physical exercise; psychological interventions/stress management; and a category "Other" with training interventions in basic life support, elaboration of guidelines/recommendations, and training for the role of caregiver. CONCLUSIONS It was found that most of the related cardiac rehabilitation interventions are aimed at the dyad heart failure patient and their caregivers/family. Including specific interventions targeting caregivers improves the caregiver's health and empowers them. Patient care planning should include interventions specifically aimed at them that result in health gains for caregivers and patients, striving to improve the quality of care. This study was not registered.
Collapse
Affiliation(s)
- Maria Loureiro
- Instituto Ciências Biomédicas Abel Salazar, Cintesis-NursID, Centro Hospitalar e Universitário de Coimbra, 3000-602 Coimbra, Portugal
| | - Vítor Parola
- Nursing School of Coimbra (ESEnfC), The Health Sciences Research Unit: Nursing (UICISA:E), Portugal Centre for Evidence-Based Practice: A Joanna Briggs Institute Centre of Excellence, 3004-011 Coimbra, Portugal
| | - João Duarte
- Instituto Ciências Biomédicas Abel Salazar, Cintesis-NursID, Centro Hospitalar e Universitário de Coimbra, 3000-602 Coimbra, Portugal
| | - Eugénia Mendes
- Instituto Politécnico de Bragança-Escola Superior de Saúde, Cintesis-NursID, 5300-121 Bragança, Portugal
| | - Isabel Oliveira
- Escola Superior de Saúde Norte Cruz Vermelha Portuguesa Oliveira de Azeméis, Center for Health Studies and Research of the University of Coimbra, 3040-156 Coimbra, Portugal
| | - Gonçalo Coutinho
- Faculdade de Medicina de Coimbra, Centro Hospitalar e Universitário de Coimbra, 3000-602 Coimbra, Portugal
| | | | - André Novo
- Instituto Politécnico de Bragança-Escola Superior de Saúde, Cintesis-NursID, 5300-121 Bragança, Portugal
| |
Collapse
|
7
|
Bouchard K, Gareau A, Greenman PS, Lalande K, Sztajerowska K, Tulloch H. What's love got to do with it? Relationship quality appraisals and quality of life in couples facing cardiovascular disease. Health Psychol Behav Med 2023; 11:2237564. [PMID: 37484832 PMCID: PMC10360988 DOI: 10.1080/21642850.2023.2237564] [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: 01/23/2023] [Accepted: 07/08/2023] [Indexed: 07/25/2023] Open
Abstract
Objective Changes in couples' relationship quality are common post-cardiac event but it is unclear how relationship quality is linked to patients' and spouses' quality of life (QoL). The purpose of the present study was to examine the association between relationship quality on QoL in patient-spouse dyads within six months of a cardiac event. Methods Participants (N = 181 dyads; 25.9% female patients), recruited from a large cardiac hospital, completed validated questionnaires measuring demographic, relationship (Dyadic Adjustment Scale; DAS) and QoL variables (Heart-QoL & Quality of life of Cardiac Spouses Questionnaire). An Actor-Partner Interdependence Model was used to investigate actor (i.e. responses influencing their own outcome) and partner effects (responses influencing their partner's outcome) of relationship quality and QoL. Results Patients' and spouses' perceptions of relationship quality were in the satisfied range (DAS > 108; 65% of sample) and, as expected, patients reported lower general physical QoL than did their spouse (t(180) = -10.635, p < .001). Patient and spouse relationship quality appraisals were positively associated with their own physical (patient β = .25; spouse β = .05) and emotional/social (patient β = .21; spouse β = .04) QoL. No partner effects were identified. Conclusion High quality relationship appraisals appear to matter for patients' and spouses' QoL after the onset of CVD.
Collapse
Affiliation(s)
- Karen Bouchard
- Prevention and Rehabilitation Center, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - Paul S. Greenman
- Prevention and Rehabilitation Center, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
- Université du Québec en Outaouais, Gatineau, Canada
- Monfort Hospital, Ottawa, Canada
| | - Kathleen Lalande
- Prevention and Rehabilitation Center, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | | | - Heather Tulloch
- Prevention and Rehabilitation Center, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| |
Collapse
|
8
|
Tan CWY, Xu Y, Lee JYC. Severe distress & denial among Asian patients with Type 2 Diabetes Mellitus in the primary care: A prospective, multicentre study. Diabetes Res Clin Pract 2023; 197:110574. [PMID: 36773673 DOI: 10.1016/j.diabres.2023.110574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 01/29/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023]
Abstract
AIMS To determine the point-prevalence and distribution of diabetes distress among primary care Asians with Type 2 Diabetes Mellitus (T2DM) and evaluate its association with cardiovascular risk. METHODS This was a prospective, multicentre study conducted in two outpatient clinics. Patients aged ≥ 21 years with uncontrolled T2DM (HbA1c > 7.0 % [53 mmol/mol]) and polypharmacy were stratified based on their Framingham Risk Score (FRS-high ≥ 10 %, low < 10 %) and matched in accordance to their baseline HbA1c. Cardiovascular risk was estimated using FRS while diabetes distress was measured using Problem Areas in Diabetes (PAID) scale (denial 0-10, severe distress ≥ 40). RESULTS Of 1940 patients approached, 210 were recruited. A final 132 (62.9 %) participants were eligible for analysis. Median PAID score was 17.5 (IQR 6.25-41.56), with an even distribution in each distress category. There was no significant difference in PAID scores between the high and low FRS groups (20.00vs13.75, p = 0.446). Additionally, PAID score distribution within each group was similar (McNemar-Bowker test, p = 0.477). However, a high prevalence of severe distress (31.4 %) and denial (33.8 %) was detected. Among those in denial, 58.7 % had accompanying intermediate-high 10-year cardiovascular risk. CONCLUSION In our sample of Asian primary care patients, a high prevalence of severe diabetes distress and denial was detected although no clear association between cardiovascular risk and diabetes distress was found. Future studies should assess the longitudinal changes and impact of other risk factors in diabetes distress. (Abstract: 199 words).
Collapse
Affiliation(s)
- Cheryl Wei Yan Tan
- National Healthcare Group Pharmacy, Singapore; Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.
| | - Yingqi Xu
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore; Health Services Research Centre, Singapore Health Services, Singapore
| | - Joyce Yu-Chia Lee
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore; School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine.
| |
Collapse
|
9
|
Bouchard K, Dans M, Higdon G, Quinlan B, Tulloch H. Caregiver Distress and Coronary Artery Disease: Prevalence, Risk, Outcomes, and Management. Curr Cardiol Rep 2022; 24:2081-2096. [PMID: 36418650 DOI: 10.1007/s11886-022-01810-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Caregivers of patients with coronary artery disease (CAD) are integral to the health care system and contribute substantially to patients' management. The purpose of this review is to provide a narrative synthesis of existing research on caregiving for patients who experienced an acute coronary syndrome (MI/unstable angina) and/or coronary revascularization (PCI/CABG). RECENT FINDINGS Thirty-one articles are included in this review. Overall, caregiver distress is low to moderate, ranging from 6 to 67% of caregivers, and seems to dissipate over time for most caregivers. Interventions have demonstrated success in reducing the distress of caregivers of patients with CAD. Due to the heterogeneity in study samples, measurements used, and timing of assessments and programming, these results are far from definitive. Although evidence is accumulating, further advancement in caregiving science and clinical care is required to adequately understand and respond to the needs of caregivers throughout the patient's illness trajectory.
Collapse
Affiliation(s)
- Karen Bouchard
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y4W7, Canada
| | - Michael Dans
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y4W7, Canada
| | - Gloria Higdon
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y4W7, Canada
| | - Bonnie Quinlan
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y4W7, Canada
| | - Heather Tulloch
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y4W7, Canada.
| |
Collapse
|
10
|
Laflamme SZ, Bouchard K, Sztajerowska K, Lalande K, Greenman PS, Tulloch H. Attachment insecurities, caregiver burden, and psychological distress among partners of patients with heart disease. PLoS One 2022; 17:e0269366. [PMID: 36121800 PMCID: PMC9484654 DOI: 10.1371/journal.pone.0269366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 05/20/2022] [Indexed: 11/19/2022] Open
Abstract
Caregiver psychological distress (i.e., depression and anxiety) is harmful to both caregiver and patient. Different affect-regulation strategies associated with attachment orientations may impact a caregiver’s perception of their caregiving role as a burden, thereby contributing to their psychological distress. The aim of the present investigation was to examine the links among attachment orientations, caregiver burden, and psychological distress in a cardiac context. Participants (N = 181, Mage = 61.79, SD = 10.49; males = 24.7%) were romantic partners of patients with heart disease (i.e., informal caregivers) who completed validated questionnaires. The majority of caregivers had partners with coronary artery disease (n = 127, 70. 2%). 66.3% of caregivers reported low burden, 87.6% reported low levels of depression and 89.9% reported low levels of anxiety. The mean anxious attachment score was 2.74 (SD = 1.37) and the mean avoidant attachment score was 2.95 (SD = 1.26). Four mediation analyses were run using PROCESS macro for IBM SPSS (version 26). Statistical models showed that the relationships between attachment anxiety and psychological distress were mediated by caregiver burden [abanxiety= 0.15, 95% C.I. (0.04, 0.29); abdepression = 0.15, 95% C.I. (0.05, 0.28)] and that attachment avoidance was not a significant covariate (cvanxiety = −0.02, p>0.05; cvdepression = 0.40, p>0.05). The relationships between attachment avoidance and psychological distress were also mediated by caregiver burden [abanxiety = 0.23, 95% C.I. (0.10, 0.42); abdepression = 0.21, 95% C.I. (0.09, 0.37]with attachment anxiety as a significant covariate (cvanxiety = 1.09, p<0.001; cvdepression = 1.09, p<0.001). Interventions for caregivers reporting attachment insecurity and burden should be explored to potentially lessen caregiver distress as they support their partners with heart disease.
Collapse
Affiliation(s)
- Simone Zofia Laflamme
- Division of Cardiac Prevention and Rehabilitation, Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Karen Bouchard
- Division of Cardiac Prevention and Rehabilitation, Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Karolina Sztajerowska
- Division of Cardiac Prevention and Rehabilitation, Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Kathleen Lalande
- Division of Cardiac Prevention and Rehabilitation, Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Paul S. Greenman
- Division of Cardiac Prevention and Rehabilitation, Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Institut du Savoir Montfort, Ottawa, Ontario, Canada
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Québec, Canada
| | - Heather Tulloch
- Division of Cardiac Prevention and Rehabilitation, Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- * E-mail:
| |
Collapse
|
11
|
Rapelli G, Donato S, Parise M, Pagani AF, Castelnuovo G, Pietrabissa G, Giusti E, Bertoni A. Yes, I can (with you)! Dyadic coping and self-management outcomes in cardiovascular disease: The mediating role of health self-efficacy. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2604-e2617. [PMID: 34985787 DOI: 10.1111/hsc.13704] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/18/2021] [Accepted: 12/17/2021] [Indexed: 06/14/2023]
Abstract
Cardiac patients show alarming levels of nonadherence to medications. It is important to consider also patient activation levels. Furthermore, the partner could have a supporting role in these processes. The aim of this study was to investigate the mediating role of patient health self-efficacy (HSE) in the link between dyadic coping (DC) and two self-management outcomes (i.e. medication adherence and patient activation) across the first 6 months of cardiac disease. One hundred couples completed two self-report questionnaires during the hospitalisation for cardiac disease and 6 months after discharge. A longitudinal and dyadic research design was adopted. Cross-sectional analyses at T0 revealed that patient-provided and perceived positive DC and common DC are positively associated with HSE, which in turn is positively associated with medication adherence. HSE mediated the association between patient positive and common DC styles, with the only exception of Patient-provided positive DC, and patient activation. Conversely, patient-provided and perceived negative DC are negatively associated with HSE, which in turns is positively associated with medication adherence and patient activation. Prospective analyses showed that only patient-perceived negative DC at discharge is negatively associated with HSE at T1, which in turns is positively associated with patient activation over time. These results suggest to consider patient perceived and provided DC as antecedents of self-management outcomes via patient HSE. Furthermore, our results recommend to pay particular attention to negative DC, whose negative consequences are manifested also over time, planning interventions targeting partners' awareness of their own DC style.
Collapse
Affiliation(s)
- Giada Rapelli
- Department of Psychology, Università Cattolica del Sacro Cuore - Milano, Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Silvia Donato
- Department of Psychology, Università Cattolica del Sacro Cuore - Milano, Milan, Italy
- Family Studies and Research University Centre, Università Cattolica del Sacro Cuore -Milano, Largo Gemelli, 1, 20123, Milan, Italy
| | - Miriam Parise
- Department of Psychology, Università Cattolica del Sacro Cuore - Milano, Milan, Italy
- Family Studies and Research University Centre, Università Cattolica del Sacro Cuore -Milano, Largo Gemelli, 1, 20123, Milan, Italy
| | - Ariela F Pagani
- Department of Humanities, University of Urbino, Via Saffi, 15 - 61019 Urbino, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Università Cattolica del Sacro Cuore - Milano, Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Giada Pietrabissa
- Department of Psychology, Università Cattolica del Sacro Cuore - Milano, Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Emanuele Giusti
- Department of Psychology, Università Cattolica del Sacro Cuore - Milano, Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Anna Bertoni
- Department of Psychology, Università Cattolica del Sacro Cuore - Milano, Milan, Italy
- Family Studies and Research University Centre, Università Cattolica del Sacro Cuore -Milano, Largo Gemelli, 1, 20123, Milan, Italy
| |
Collapse
|
12
|
Thomson P, Angus NJ, Andreis F, Rushworth GF, Mohan AR, Chung ML, Leslie SJ. Longitudinal evaluation of the effects of illness perceptions and beliefs about cardiac rehabilitation on quality of life of patients with coronary artery disease and their caregivers. Health Qual Life Outcomes 2020; 18:158. [PMID: 32460825 PMCID: PMC7254753 DOI: 10.1186/s12955-020-01405-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients' negative illness perceptions and beliefs about cardiac rehabilitation (CR) can influence uptake and adherence to CR. Little is known about the interpartner influence of these antecedent variables on quality of life of patients with coronary artery disease (CAD) and their family caregivers. The aims of the study were: 1) to assess differences in illness perceptions, beliefs about CR and quality of life between patients with CAD and their family caregivers upon entry to a CR programme and at 6 months follow-up; and 2) to examine whether patients' and caregivers' perceptions of the patient's illness and beliefs about CR at baseline predict their own and their partner's quality of life at 6 months. METHODS In this longitudinal study of 40 patient-caregiver dyads from one CR service, patients completed the Brief Illness Perception Questionnaire and Beliefs about Cardiac Rehabilitation Questionnaire at baseline and 6 months; and caregivers completed these questionnaires based on their views about the patient's illness and CR. The Short-Form 12 Health Survey was used to assess patients' and caregivers' perceived health status. Dyadic data were analysed using the Actor-Partner Interdependence Model. RESULTS Most patients (70%) were men, mean age 62.45 years; and most caregivers (70%) were women, mean age 59.55 years. Caregivers were more concerned about the patient's illness than the patients themselves; although they had similar scores for beliefs about CR. Patients had poorer physical health than caregivers, but their level of mental health was similar. Caregivers' poorer mental health at 6 months was predicted by the patient's perceptions of timeline and illness concern (i.e. partner effects). Patient's and caregiver's illness perceptions and beliefs about CR were associated with their own physical and mental health at 6 months (i.e. actor effects). CONCLUSIONS Overall, the patients and caregivers had similar scores for illness perceptions and beliefs about CR. The actor and partner effect results indicate a need to focus on specific illness perceptions and beliefs about CR, targeting both the individual and the dyad, early in the rehabilitation process to help improve patients and caregivers physical and mental health (outcomes).
Collapse
Affiliation(s)
- Patricia Thomson
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK94LA, Scotland, UK.
| | - Neil J Angus
- School of Health, Social Care and Life Sciences, University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, Scotland, UK
| | - Federico Andreis
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK94LA, Scotland, UK
| | - Gordon F Rushworth
- Highland Pharmacy Education & Research Centre, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, Scotland, UK
| | - Andrea R Mohan
- School of Nursing and Health Sciences, University of Dundee, Dundee, DD1 4HN, Scotland, UK
| | - Misook L Chung
- College of Nursing, University of Kentucky, Lexington, KY, 40506, USA
| | - Stephen J Leslie
- Cardiac Unit, Raigmore Hospital, NHS Highland, Old Perth Road, Inverness, IV2 3UJ, Scotland, UK
| |
Collapse
|
13
|
Tulloch H, Bouchard K, Clyde MJ, Madrazo L, Demidenko N, Johnson S, Greenman P. Learning a new way of living together: a qualitative study exploring the relationship changes and intervention needs of patients with cardiovascular disease and their partners. BMJ Open 2020; 10:e032948. [PMID: 32381534 PMCID: PMC7223018 DOI: 10.1136/bmjopen-2019-032948] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 02/09/2020] [Accepted: 03/30/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Cardiovascular disease (CVD) not only affects the patient, but has implications for the partner. Emerging evidence suggests that supportive couple relationships enhance CVD outcomes and reduce patient and partner distress. To date, however, little research has been done to address the couple relationship as a potentially important component of cardiac care. This article examines the impact of CVD on the couple relationship and assesses the perceived needs and desired intervention components of patients with CVD and their partners. DESIGN Qualitative study using directed and conventional content analysis. SETTING Single-centre, tertiary cardiac care hospital that serves a population of 1.4 million in the Champlain region of Ontario, Canada. PARTICIPANTS Patients with CVD and their partners (n=32, 16 couples) participated in focus groups. Patients were mainly male (75%), white (87.5%), aged 64.4 years (range 31-81 years), with varied cardiac diagnoses (50% coronary artery disease; 18.75% valve disease; 18.75% heart failure; 12.5% arrhythmia). RESULTS Five categories were generated from the data reflecting changes within the couple relationship as a result of CVD: (1) emotional and communication disconnection; (2) overprotection of the patient; (3) role changes; (4) adjustment to lifestyle changes; and (5) positive relationship changes. Three categories were constructed regarding intervention needs and desired resources: (1) practical resources; (2) sharing with peers; and (3) relationship enhancement. CONCLUSIONS Overall, the data suggest that there were profound changes in the couple relationship as a result of CVD, and that there is considerable need to better support the caregiving spouses and the couple as a unit. These results call for interventions designed to provide instrumental support, peer-sharing opportunities and relationship quality enhancement to help couples cope with CVD. Future studies should examine whether couples-based programming embedded into cardiac rehabilitation can be effective at improving relationship quality and reducing patient and partner stress in the aftermath of a cardiac event.
Collapse
Affiliation(s)
- Heather Tulloch
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Karen Bouchard
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Matthew J Clyde
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | | | | | - Susan Johnson
- Ottawa Couple and Family Institute, Ottawa, Ontario, Canada
| | - Paul Greenman
- Département de Psychoéducation et de Psychologie, Universite du Quebec en Outaouais, Gatineau, Quebec, Canada
| |
Collapse
|
14
|
Hyde EK, Martin DE, Rieger KL. Factors shaping the provision of sexual health education for adults with acute coronary syndrome: A scoping review. PATIENT EDUCATION AND COUNSELING 2020; 103:877-887. [PMID: 31767244 DOI: 10.1016/j.pec.2019.11.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 11/08/2019] [Accepted: 11/15/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Each year, 63,000 Canadians are diagnosed with acute coronary syndrome (ACS) and 73 % survive. Sexual health education for ACS survivors is recommended but is not routinely provided. A scoping review was performed to inform health care providers about factors shaping sexual health education for ACS survivors. METHODS Three databases were searched, 208 studies were screened, and 24 were included in this scoping review. Significant points from the selected studies were charted and synthesized. RESULTS This review confirmed absent to limited provision of sexual health education to individuals with ACS. Key factors influencing lack of provision of sexual health were categorized according to macro, meso, and micro levels. At the macro level, societal and cultural factors were noted. The meso level included healthcare environment and limited healthcare provider knowledge. At the micro level, healthcare professional-healthcare consumer relationships and role clarity were noted. CONCLUSION A sex positive approach may facilitate provision of sexual health education. PRACTICE IMPLICATIONS This scoping review points to the need to use a sex positive lens to identify and remove barriers to facilitate the provision of sexual health education. Providing this education may result in reduced fear, depression, and anxiety in ACS survivors.
Collapse
Affiliation(s)
- Emily K Hyde
- College of Nursing, Rady Faculty of Health Sciences, Helen Glass Centre for Nursing, 89 Curry Place, University of Manitoba, Winnipeg, MB R3T 2N2 Canada.
| | - Donna E Martin
- College of Nursing, Rady Faculty of Health Sciences, Helen Glass Centre for Nursing, 89 Curry Place, University of Manitoba, Winnipeg, MB R3T 2N2 Canada.
| | - Kendra L Rieger
- College of Nursing, Rady Faculty of Health Sciences, Helen Glass Centre for Nursing, 89 Curry Place, University of Manitoba, Winnipeg, MB R3T 2N2 Canada.
| |
Collapse
|
15
|
Pačarić S, Turk T, Erić I, Orkić Ž, Petek Erić A, Milostić-Srb A, Farčić N, Barać I, Nemčić A. Assessment of the Quality of Life in Patients before and after Coronary Artery Bypass Grafting (CABG): A Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041417. [PMID: 32098322 PMCID: PMC7068373 DOI: 10.3390/ijerph17041417] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 02/19/2020] [Accepted: 02/19/2020] [Indexed: 01/21/2023]
Abstract
The aim of this study was to examine the quality of life and to report on the utility and QALY measures in patients before and after coronary artery bypass grafting (CABG); to investigate whether the SF-12 is comparable with the SF-36 for measuring health-related quality of life of patients with CABG; and to determine the impact of individual predictors on poor quality of life assessment after rehabilitation. This prospective study was conducted between January 2017 and December 2018 at the University Hospital Center Osijek, at three time points: pre-operation, 1 month after surgery, and after rehabilitation. The study was conducted with the SF-36 and SF-12 health questionnaires on 47 participants. After rehabilitation, there was a significant improvement in all domains of quality of life. The highest score was given to the change in pain (BP); mean scores were 63.8 (95% CI 56.9 to 70.6) (p = 0.001). The lowest grade (the lowest quality) after rehabilitation was in the domain of limitations due to physical difficulties (RP); arithmetic mean was 48.5 (95% CI 41 to 55.9) (p < 0.001). Quality-adjusted life-year was 0.41 (95% CI 0.38–0.44) after the CABG. The results of this study show that patients with coronary heart disease have poor quality of life before surgery. One month after the surgery, the quality of life improved, but was still inadequate. One year after surgery, satisfactory results were obtained in almost all subscales. The SF-36, SF-12, and its components, can be used effectively in patients with CABG. Age, gender, lifestyle, and risk factors in our sample of participants are not predictors of poor quality of life assessment after rehabilitation.
Collapse
Affiliation(s)
- Stana Pačarić
- University Hospital Centre Osijek, Osijek 31 000, Croatia; (S.P.); (T.T.); (I.E.); (Ž.O.); (A.P.E.); (A.N.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia; (A.M.-S.); (I.B.)
| | - Tajana Turk
- University Hospital Centre Osijek, Osijek 31 000, Croatia; (S.P.); (T.T.); (I.E.); (Ž.O.); (A.P.E.); (A.N.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia
| | - Ivan Erić
- University Hospital Centre Osijek, Osijek 31 000, Croatia; (S.P.); (T.T.); (I.E.); (Ž.O.); (A.P.E.); (A.N.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia
| | - Želimir Orkić
- University Hospital Centre Osijek, Osijek 31 000, Croatia; (S.P.); (T.T.); (I.E.); (Ž.O.); (A.P.E.); (A.N.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia
| | - Anamarija Petek Erić
- University Hospital Centre Osijek, Osijek 31 000, Croatia; (S.P.); (T.T.); (I.E.); (Ž.O.); (A.P.E.); (A.N.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia; (A.M.-S.); (I.B.)
| | - Andrea Milostić-Srb
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia; (A.M.-S.); (I.B.)
| | - Nikolina Farčić
- University Hospital Centre Osijek, Osijek 31 000, Croatia; (S.P.); (T.T.); (I.E.); (Ž.O.); (A.P.E.); (A.N.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia; (A.M.-S.); (I.B.)
- Correspondence: ; Tel.: +385-98-186-85-69
| | - Ivana Barać
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia; (A.M.-S.); (I.B.)
| | - Ana Nemčić
- University Hospital Centre Osijek, Osijek 31 000, Croatia; (S.P.); (T.T.); (I.E.); (Ž.O.); (A.P.E.); (A.N.)
| |
Collapse
|
16
|
Pre-surgical Caregiver Burden and Anxiety Are Associated with Post-Surgery Cortisol over the Day in Caregivers of Coronary Artery Bypass Graft Surgery Patients. Int J Behav Med 2019; 26:316-322. [PMID: 30793258 PMCID: PMC6529383 DOI: 10.1007/s12529-019-09775-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background The relationship between pre-surgical distress and diurnal cortisol following surgery has not been investigated prospectively in caregivers of coronary artery bypass graft (CABG) patients before. We aimed to examine the relationship between pre-surgical anxiety and caregiver burden and diurnal cortisol measured 2 months after the surgery in the caregivers of CABG patients. Method We used a sample of 103 caregivers of elective CABG patients that were assessed 28.86 days before and 60.94 days after patients’ surgery. Anxiety and caregiver burden were assessed using the anxiety subscale of the Hospital Anxiety and Depression Scale and the Oberst Burden Scale respectively. Saliva samples were collected to measure cortisol area under the curve with respect to ground (AUCg) and diurnal cortisol slope. Anxiety and caregiver burden were entered into linear regression models simultaneously. Results While high levels of pre-surgical anxiety were positively associated with increased follow-up levels of AUCg (β = 0.30, p = 0.001), greater pre-surgery perceived burden score was associated with steeper cortisol slope (β = 0.27, p = 0.017) after controlling for a wide range of covariates. Conclusion These outcomes support the utility of psychological interventions aimed to increase the awareness of caregiving tasks and demands in informal caregivers.
Collapse
|
17
|
|
18
|
The Relationship between Burden and Depression in Spouses of Chronic Kidney Disease Patients. DEPRESSION RESEARCH AND TREATMENT 2018; 2018:8694168. [PMID: 29862072 PMCID: PMC5971334 DOI: 10.1155/2018/8694168] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 02/04/2018] [Accepted: 03/25/2018] [Indexed: 01/02/2023]
Abstract
The purpose of the present study was to investigate the burden and depression in spouses of patients with chronic kidney disease (CKD). The interrelation between burden and depression in family caregivers has been pointed out by previous researches in several chronic diseases and researchers agree that they clearly go together and one cannot talk about one without considering the other. More particularly, in the present study, the caregiver burden, the depression, anxiety, and also health-related quality of life and demographic factors of spouses of patients with CKD were examined, using self-report questionnaires. Participants were 50 spouses of patients with CKD, 29 of whom were dialysis dependent and 21 were not dialysis dependent. Group differences were examined for participants. Results confirm the interrelation between caregiver burden and depression in spouses. The increased perceived burden related to higher levels of depression. Low levels of caregiver burden, depression, anxiety, and satisfactory quality of life were found in spouses, with no differences between them relevant to whether the patients were dialysis dependent or not. All the above parameters interrelated. Implications for the findings and future research directions are discussed.
Collapse
|
19
|
Vilchinsky N. Unrecognized, Undiagnosed, and Untreated: Cardiac-Disease-Induced PTSD among Patients' Partners. Front Psychol 2017; 8:1265. [PMID: 28790957 PMCID: PMC5524733 DOI: 10.3389/fpsyg.2017.01265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 07/11/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Noa Vilchinsky
- Department of Psychology, Bar-Ilan UniversityRamat Gan, Israel
| |
Collapse
|
20
|
Vilchinsky N, Ginzburg K, Fait K, Foa EB. Cardiac-disease-induced PTSD (CDI-PTSD): A systematic review. Clin Psychol Rev 2017; 55:92-106. [DOI: 10.1016/j.cpr.2017.04.009] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 04/18/2017] [Accepted: 04/23/2017] [Indexed: 11/25/2022]
|
21
|
Fait K, Vilchinsky N, Dekel R, Levi N, Hod H, Matetzky S. Cardiac Disease-Induced Post-traumatic Stress Symptoms (CDI-PTSS) Among Patients' Partners. Stress Health 2017; 33:169-176. [PMID: 27256207 DOI: 10.1002/smi.2686] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 04/10/2016] [Accepted: 04/10/2016] [Indexed: 11/06/2022]
Abstract
It is well established that a patient's partner can be deeply affected by the traumatizing nature of the patient's illness. Yet, no study to date has focused on post-traumatic stress symptoms (PTSS) among partners of patients coping with an acute coronary syndrome (ACS). The current study's main aims were to address this gap and to evaluate cardiac disease-induced (CDI) PTSS prevalence in partners of patients who experienced ACS. Patients who experienced ACS and their partners were interviewed by telephone 2 to 6 months after patients' hospitalization. All patients and partners were screened for CDI-PTSS. Demographic and medical variables as well as partners' level of exposure to the cardiac event were assessed. Prevalence of CDI-PTSS was higher among partners than among patients. Partners' number of CDI-PTSS was not significantly associated with patients' number of CDI-PTSS or with any of the other explanatory factors measured, except for education level. The preliminary results that arose from the current study point to the vast number of individuals who must act as caregivers for their ill partners while having to cope with their own PTSS. Much effort should be channelled into integrating partners into cardiac recovery programmes. Copyright © 2016 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Keren Fait
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Noa Vilchinsky
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Rachel Dekel
- The Louis & Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat-Gan, Israel
| | - Nitza Levi
- Leviev Heart Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Hanoch Hod
- Leviev Heart Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shlomi Matetzky
- Leviev Heart Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| |
Collapse
|
22
|
Ye ZJ, Qiu HZ, Li PF, Liang MZ, Wang SN, Quan XM. Resilience model for parents of children with cancer in mainland China-An exploratory study. Eur J Oncol Nurs 2017; 27:9-16. [PMID: 28279395 DOI: 10.1016/j.ejon.2017.01.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 07/02/2016] [Accepted: 01/08/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE Parents have psychosocial functions that are critical for the entire family. Therefore, when their child is diagnosed with cancer, it is important that they exhibit resilience, which is the ability to preserve their emotional and physical well-being in the face of stress. The Resilience Model for Parents of Children with Cancer (RMP-CC) was developed to increase our understanding of how resilience is positively and negatively affected by protective and risk factors, respectively, in Chinese parents with children diagnosed with cancer. METHODS To evaluate the RMP-CC, the latent psychosocial variables and demographics of 229 parents were evaluated using exploratory structural equation modeling (SEM) and logistic regression. RESULTS The majority of goodness-of-fit indices indicate that the SEM of RMP-CC was a good model with a high level of variance in resilience (58%). Logistic regression revealed that two demographics, educational level and clinical classification of cancer, accounted for 12% of this variance. CONCLUSIONS Our results indicate that RMP-CC is an effective structure by which to develop mainland Chinese parent-focused interventions that are grounded in the experiences of the parents as caregivers of children who have been diagnosed with cancer. RMP-CC allows for a better understanding of what these parents experience while their children undergo treatment. Further studies will be needed to confirm the efficiency of the current structure, and would assist in further refinement of its clinical applications.
Collapse
Affiliation(s)
- Zeng Jie Ye
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong province, China; College of Economics and Management, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China.
| | - Hong Zhong Qiu
- College of Economics and Management, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Peng Fei Li
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Mu Zi Liang
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Shu Ni Wang
- College of Economics and Management, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Xiao Ming Quan
- Nursing Department of the First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong province, China.
| |
Collapse
|
23
|
Bdair IAA, ConsTantino RE. Barriers and Promoting Strategies to Sexual Health Assessment for Patients with Coronary Artery Diseases in Nursing Practice: A Literature Review. Health (London) 2017. [DOI: 10.4236/health.2017.93034] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
24
|
Saltmarsh N, Murphy B, Bennett P, Higgins R, Macvean M, Le Grande M, Thompson D, Ski C, Worcester M, Jackson A. Distress in partners of cardiac patients: relationship quality and social support. ACTA ACUST UNITED AC 2016. [DOI: 10.12968/bjca.2016.11.8.397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Nadine Saltmarsh
- Research Fellow, Australian Centre for Heart Health; Department of Psychology and Counselling, La Trobe University, Bendigo, Australia
| | - Barbara Murphy
- Associate Professor, Australian Centre for Heart Health, Melbourne; Faculty of Health, Deakin University; Department of Psychology, University of Melbourne; Department of Behavioural Medicine, University of Newcastle, Australia
| | - Pauleen Bennett
- Associate Professor, Department of Psychology and Counselling, La Trobe University, Bendigo, Australia
| | - Rosemary Higgins
- Associate Professor, Australian Centre for Heart Health, Melbourne; Department of Psychology, Deakin University, Melbourne; Department of Physiotherapy, University of Melbourne, Australia
| | - Michelle Macvean
- Former Research Fellow, Heart Research Centre, Melbourne, Australia
| | - Michael Le Grande
- Research Fellow, Australian Centre for Heart Health, Melbourne; Faculty of Health, Deakin University, Melbourne, Australia
| | - David Thompson
- Professor, University of Melbourne, Department of Psychiatry, Melbourne, Australia
| | - Chantal Ski
- Associate Professor, University of Melbourne, Department of Psychiatry, Melbourne, Australia
| | - Marian Worcester
- Former Director, Heart Research Centre, Melbourne; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Alun Jackson
- Professor, Australian Centre for Heart Health, Melbourne; Faculty of Health, Deakin University, Melbourne, Australia; Centre on Behavioural Health, Hong Kong University, Hong Kong
| |
Collapse
|
25
|
Nadarajah SR, Buchholz SW, Wiegand DL, Berger A. The lived experience of individuals in cardiac rehabilitation who have a positive outlook on their cardiac recovery: A phenomenological inquiry. Eur J Cardiovasc Nurs 2016; 16:230-239. [DOI: 10.1177/1474515116651977] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Susan W Buchholz
- Adult Health and Gerontological Nursing, Rush University College of Nursing, USA
| | - Debra L Wiegand
- Department of Organizational Systems and Adult Health, University of Maryland, Baltimore, USA
| | - Ann Berger
- Pain and Palliative Care, Clinical Center, National Institutes of Health, USA
| |
Collapse
|
26
|
George-Levi S, Vilchinsky N, Rafaeli E, Liberman G, Khaskiaa A, Mosseri M, Hod H. Caregiving styles and anxiety among couples: coping versus not coping with cardiac illness. ANXIETY STRESS AND COPING 2016; 30:107-120. [PMID: 27376169 DOI: 10.1080/10615806.2016.1206530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVES partners' caregiving efforts are not always beneficial to both recipient and provider. Bowlby's conceptualization of caregiving style as a stable predisposition may clarify such caregiving effects. The relationship between caregiving style (compulsive and sensitive) and anxiety among couples coping with cardiac illness and a matching control group not coping with cardiac illness were assessed. We hypothesized that one's compulsive caregiving would associate positively, and one's sensitive caregiving would associate negatively, with one's and one's partner's anxiety across contexts (cardiac and non-cardiac) and gender. DESIGN A comparative design of 131 couples with a diagnosis of husbands' acute cardiac syndrome and 68 matched couples in the community was applied. METHODS The Adult Caregiving Questionnaire and the Brief Symptoms Inventory were administered. RESULTS Structural equation modeling revealed that one's compulsive caregiving was positively associated with one's anxiety, across most contexts. Multi-group analyses revealed that the associations between one's compulsive caregiving and one's partner's anxiety levels differed depending on gender and context. CONCLUSIONS The distress which emerges in an individual who takes on a caregiving role and in his/her partner seems to result not only from the demands of the concrete caregiving situation but also from one's and one's partner's developmental history.
Collapse
Affiliation(s)
- Sivan George-Levi
- a Department of Psychology , Bar-Ilan University , Ramat-Gan , Israel
| | - Noa Vilchinsky
- a Department of Psychology , Bar-Ilan University , Ramat-Gan , Israel
| | - Eshkol Rafaeli
- a Department of Psychology , Bar-Ilan University , Ramat-Gan , Israel
| | - Gabriel Liberman
- b Data-graph, Research and Statistical Counseling , Holon , Israel
| | - Abid Khaskiaa
- c Department of Cardiology , Meir Medical Center , Kefar Saba , Israel
| | - Morris Mosseri
- c Department of Cardiology , Meir Medical Center , Kefar Saba , Israel
| | - Hanoch Hod
- d Department of Cardiology , Sheba Medical Center , Ramat-Gan , Israel
| |
Collapse
|
27
|
Psychological distress in spouses of somatically Ill: longitudinal findings from the Nord-Trøndelag Health Study (HUNT). Health Qual Life Outcomes 2014; 12:139. [PMID: 25214043 PMCID: PMC4173137 DOI: 10.1186/s12955-014-0139-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 08/29/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies of caregiver burden and somatic illness tend to be based on relatively small, clinical samples. Longitudinal, population based studies on this topic are still scarce and little is known about the long-term impact of partner illness on spousal mental health in the general population. In this study we investigate whether spouses of partners who either have become somatically ill or cured from illness in an 11 year period - or who have long-term illness - have different mental health scores compared to spouses of healthy partners. METHODS Approximately 9000 couples with valid self-report data on a Global Mental Health (GMH) scale and somatic illness status were identified. The diagnoses stroke, angina pectoris, myocardial infarction and severe physical disability, were transformed into a dichotomous 'any illness'-scale, and also investigated separately. Analyses of variance (ANOVA) stratified by sex were conducted with spousal GMH score at follow-up (1995-97, T2) as the outcome variable, adjusting for spousal GMH score at baseline (1984-86, T1) and several covariates. RESULTS Results showed that male and female spouses whose partners had become somatically ill since T1 had significantly poorer mental health than partners in the reference category, comprising couples healthy at both time points. Further, female spouses of partners who had recovered from illness since T1 had significantly better mental health than controls. Of the somatic conditions, physical disability had the most significant contribution on spousal GMH, for both sexes, in addition to stroke on male spouses' GMH. The effect sizes were small. Some of the loss of spousal mental health seems to be mediated by the ill persons' psychological distress. CONCLUSION The occurrence of partner illness during the follow-up period affect the mental health of spouses negatively, while partner recovery appeared to be associated with improved mental health scores for female spouses. Of the measured conditions, physical disability had the largest impact on spousal distress, but for some conditions the distress of the ill person mediated much of the loss of mental health among spouses.
Collapse
|
28
|
Roohafza H, Sadeghi M, Khani A, Andalib E, Alikhasi H, Rafiei M. Psychological state in patients undergoing coronary artery bypass grafting surgery or percutaneous coronary intervention and their spouses. Int J Nurs Pract 2014; 21:214-20. [PMID: 24750214 DOI: 10.1111/ijn.12234] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Percutaneous coronary intervention (PCI) and the coronary artery bypass grafting surgery (CABG) are well accepted treatments for coronary artery disease. Many patients and their spouses experience increased level of stress, anxiety and depression before and after going under the procedure. One hundred and ninety-six cardiac patients who were candidate for CABG or PCI procedures and their spouses were asked to complete Hospital Anxiety and Depression Scale and General Health Questionnaire-12 before and 1 month after procedures. Anxiety, depression and stress level in patients and their spouses going under the procedures significantly reduced over time. Scores of anxiety, depression and stress in patients and their spouses were correlated. There was no difference in the level of anxiety, depression and stress between CABG and PCI groups before to after procedures. We suggest providing information about the procedures to both patients and their spouses to deal better with their own psychological state.
Collapse
Affiliation(s)
- Hamidreza Roohafza
- Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | | | | | | |
Collapse
|
29
|
Leigh ES, Wikman A, Molloy GJ, Randall G, Steptoe A. The psychosocial predictors of long-term distress in partners of patients with acute coronary syndrome. Psychol Health 2014; 29:737-52. [DOI: 10.1080/08870446.2014.882921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
30
|
Reid J, Ski CF, Thompson DR. Psychological interventions for patients with coronary heart disease and their partners: a systematic review. PLoS One 2013; 8:e73459. [PMID: 24039950 PMCID: PMC3764157 DOI: 10.1371/journal.pone.0073459] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Accepted: 07/21/2013] [Indexed: 11/20/2022] Open
Abstract
Objectives Despite evidence that patients with coronary heart disease (CHD) and their partners report significant psychological distress, and suggestions that involving partners in interventions alleviates such distress, no systematic reviews have examined this. The objective of this study was to systematically review evidence on the effectiveness of psychological interventions for patients with CHD and their partners. Methods CENTRAL, Medline, EMBASE, CINAHL and PsycINFO databases were searched through October 2012. Randomized controlled trials evaluating psychological interventions for patients with CHD and their partners were included. Selection of studies, study appraisal, data extraction and analysis were undertaken using standard methods. Results Seven studies comprising 673 dyads (patient and partner) were included. Psychological interventions result in modest improvements in patients' health-related quality of life, blood pressure, knowledge of disease and treatment, and satisfaction with care, and in partners' anxiety, knowledge and satisfaction. There was a non-significant trend for improvements in anxiety for patients, and depressive symptoms for both patients and partners. There was no evidence of a significant effect on mortality, morbidity or other cardiovascular risk factors for patients, or social support for patients and partners. Conclusions Psychological interventions for patients with CHD and their partners were found to improve health-related quality of life, blood pressure, knowledge, and satisfaction with care for patients, and anxiety, knowledge, and satisfaction with care for partners. However, as the overall quality of the evidence was low, these results should be interpreted with caution.
Collapse
Affiliation(s)
- Jane Reid
- Cardiovascular Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
| | - Chantal F. Ski
- Cardiovascular Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
| | - David R. Thompson
- Cardiovascular Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
- * E-mail:
| |
Collapse
|
31
|
Thomson P, Niven CA, Peck DF, Eaves J. Patients' and partners' health-related quality of life before and 4 months after coronary artery bypass grafting surgery. BMC Nurs 2013; 12:16. [PMID: 23829859 PMCID: PMC3744164 DOI: 10.1186/1472-6955-12-16] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 07/03/2013] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Patients having coronary artery bypass grafting (CABG) often depend on their partners for assistance before and after surgery. Whilst patients' physical and mental health usually improves after surgery little is known about the partners' health-related quality of life (HRQoL) in CABG. If the partners' physical and emotional health is poor this can influence their caregiving role and ability to support the patient. This study aimed: to increase understanding of patients' and partners' HRQoL before and after CABG; to explore whether patients' and partners' pre-operative socio-demographics and HRQoL predict their own, and also partners' HRQoL 4 months after CABG. METHODS This prospective study recruited 84 dyads (patients 84% males, aged 64.5 years; partners 94% females, aged 61.05 years). Patients' and partners' perceived health status was assessed using the Short-Form 12 Health Survey. Patients' physical limitation, angina symptoms and treatment satisfaction were assessed using the Seattle Angina Questionnaire. Partners' emotional, physical and social functioning was assessed using the Quality of Life of Cardiac Spouses Questionnaire. Data were analysed using hierarchical multiple (logistic) regressions, repeated measures analysis of variance, paired t test and Chi square. RESULTS Patients most likely to have poorer physical health post-operatively were associated with partners who had poorer pre-operative physical health. Partners most likely to have poorer emotional, physical and social functioning post-operatively were associated with patients who had poorer pre-operative mental health. Patients" and partners' poorer post-operative HRQoL was also explained by their poorer pre-operative HRQoL. CONCLUSION The partners' involvement should be considered as part of patients' pre-operative assessment. Special attention needs be paid to patients' pre-operative mental health since it is likely to impact on their post-operative mental health and the partner's emotional, physical and social functioning.
Collapse
Affiliation(s)
- Patricia Thomson
- School of Nursing, Midwifery and Health, BG Bomont Building, University of Stirling, Stirling FK9 4LA, Scotland
| | - Catherine A Niven
- School of Nursing, Midwifery and Health, BG Bomont Building, University of Stirling, Stirling FK9 4LA, Scotland
| | - David F Peck
- School of Nursing, Midwifery and Health, BG Bomont Building, University of Stirling, Stirling FK9 4LA, Scotland
| | - Jennifer Eaves
- School of Nursing, Midwifery and Health, BG Bomont Building, University of Stirling, Stirling FK9 4LA, Scotland
| |
Collapse
|
32
|
Karademas EC. The psychological well-being of couples experiencing a chronic illness: A matter of personal and partner illness cognitions and the role of marital quality. J Health Psychol 2013; 19:1347-57. [DOI: 10.1177/1359105313488983] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study aimed to examine the effects of 75 cardiac patients’ and their spouses’ illness cognitions of acceptance and helplessness on their own and their partner’s psychological symptoms, as well as the impact of marital quality. Dyadic responses were examined with the Actor–Partner Interdependence Model, while PROCESS was used to examine possible conditional indirect effects. Patients’ and spouses’ cognitions were related to their partners’ symptoms through the partners’ cognitions. These relationships were not statistically significant at the higher levels of marital quality. Thus, there seems to be a flow of information between partners, while marital quality may impact self-regulation processes.
Collapse
|
33
|
Dekel R, Vilchinsky N, Liberman G, Leibowitz M, Khaskia A, Mosseri M. Marital satisfaction and depression among couples following men's acute coronary syndrome: testing dyadic dynamics in a longitudinal design. Br J Health Psychol 2013; 19:347-62. [PMID: 23552169 DOI: 10.1111/bjhp.12042] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 02/07/2013] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The current study examined the contribution of marital satisfaction to symptoms of depression among patients with acute coronary syndrome (ACS) and their partners. METHOD The sample comprised of 91 ACS male patients and their female partners. Data were collected at the time of initial hospitalization and 6 months later. Patients' and partners' assessments of marital satisfaction were measured using the ENRICH scale. Symptoms of depression were measured using the Brief Symptoms Inventory (BSI). Dyadic analysis applying the Actor-Partner Inter-dependence Model (APIM) was used. RESULTS Different patterns emerged for the two phases. In the acute phase, only the Actor effect was significant: for both patients and partners, one's greater marital satisfaction was associated with one's lower levels of depression. In the chronic phase, both Actor and Partner effects were significant, while different trends were found for patients and partners. Partners' marital satisfaction was associated with their own and the patients' decreased depression symptoms, whereas among patients, higher levels of marital satisfaction were associated with elevated levels of depression both for themselves and for their partners. CONCLUSIONS A dyadic perspective and phases of illness have to be taken into account in understanding adjustment and developing interventions following ACS. STATEMENT OF CONTRIBUTION What is already known on this subject? The contribution of marital satisfaction to psychological adjustment following cardiac illness has been explored, but mainly from the perspective of one partner only. Different phases of an illness present different challenges for both patients and family members. What does this study add? A dyadic perspective on recovery from cardiac illness. The partner's contribution during the different phases of the illness.
Collapse
Affiliation(s)
- Rachel Dekel
- School of Social Work and Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | | | | | | | | | | |
Collapse
|
34
|
Nilsson UG, Ivarsson B, Alm-Roijer C, Svedberg P. The desire for involvement in healthcare, anxiety and coping in patients and their partners after a myocardial infarction. Eur J Cardiovasc Nurs 2013; 12:461-7. [DOI: 10.1177/1474515112472269] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ulrica G Nilsson
- Centre of Health Care Sciences Orebro University Hospital, Örebro and School of Health and Medical Sciences, Örebro University, Sweden
| | - Bodil Ivarsson
- Department of Cardiothoracic Surgery, Skåne University Hospital and Lund University, Sweden
| | | | - Petra Svedberg
- School of Social and Health Sciences, Halmstad University, Sweden
| | | |
Collapse
|
35
|
Borren I, Tambs K, Idstad M, Ask H, Sundet JM. Psychological distress and subjective well-being in partners of somatically ill or physically disabled: the Nord-Trøndelag Health Study. Scand J Psychol 2012; 53:475-82. [PMID: 23170864 DOI: 10.1111/sjop.12009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study investigated the cross-sectional associations between various somatic conditions in one partner and the level of distress and well-being in the spouse. The study is based on survey data from the Norwegian Nord-Trøndelag Health Study, HUNT II (1995-1997). A sample of 9,797 married or cohabiting couples with valid data on subjective well-being (SWB), psychological distress (Hopkins Symptom Check List (SCL)-10) and somatic illness were identified. Regression analyses stratified by sex were conducted with SCL-10 and SWB scores as dependent variables and a joint somatic score as predictor, including; stroke, cancer, angina, myocardial infarction and physical disability (PD). The contribution of each somatic condition was also explored. Spouses of persons previously diagnosed with at least one somatic condition scored significantly lower on SWB and significantly higher on SCL-10 than spouses of healthy persons, though effect sizes were small. The effect seems to be at least partly mediated by the ill partner's psychological distress. Of the specific conditions, PD had the most significant contribution for both genders, though an association between male angina and spousal distress/SWB was also demonstrated.
Collapse
Affiliation(s)
- Ingrid Borren
- Norwegian Institute of Public Health, Division of Mental Health, PO Box 4404, Nydalen, N-0403 Oslo, Norway.
| | | | | | | | | |
Collapse
|
36
|
Andersson EK, Borglin G, Sjöström-Strand A, Willman A. Standing alone when life takes an unexpected turn: being a midlife next of kin of a relative who has suffered a myocardial infarction. Scand J Caring Sci 2012; 27:864-71. [DOI: 10.1111/j.1471-6712.2012.01094.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 08/22/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Ewa Kazimiera Andersson
- School of Health Science; Blekinge Institute of Technology; Karlskrona Sweden
- Department of Health Sciences; Lund University; Lund Sweden
| | - Gunilla Borglin
- School of Health Science; Blekinge Institute of Technology; Karlskrona Sweden
- Department of Nursing; Karlstad University; Karlstad Sweden
| | | | - Ania Willman
- School of Health Science; Blekinge Institute of Technology; Karlskrona Sweden
- Department of Care Science; Malmö University; Malmö Sweden
| |
Collapse
|
37
|
Thomson P, Molloy GJ, Chung ML. The effects of perceived social support on quality of life in patients awaiting coronary artery bypass grafting and their partners: testing dyadic dynamics using the Actor-Partner Interdependence Model. PSYCHOL HEALTH MED 2011; 17:35-46. [PMID: 21678197 DOI: 10.1080/13548506.2011.579988] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Patients awaiting coronary artery bypass grafting (CABG) need support from their partners or family caregivers to manage their self care successfully and to maximise quality of life. Partners need social support to help overcome the stressful tasks of an unexpected caregiving role. It is not known whether the individual's perceived social support contributes to their own, as well as their partner's quality of life. The aims of this study were to assess differences in social support and quality of life in patients and partners awaiting CABG, and to examine whether patients' and partners' perceived social support predicted their own, as well as their partner's quality of life before CABG. This cross-sectional study recruited 84 dyads (patients 84% males, aged 64.5 years and partners 94% females, aged 61.05 years). Perceived social support was assessed using the Medical Outcomes Study Social Support survey, with sub-scales for informational/emotional support, affectionate support, tangible support and positive social interaction. Quality of life was assessed using the Short-Form 12 Health Survey. Dyadic data were analysed using the Actor-Partner Interdependence Model, with distinguishable dyad regression. Results revealed the patients' informational/emotional support exhibited an actor effect on their own mental health (ß = 0.19, p = 0.001); indicating those with low informational/emotional support had poorer mental health. There was a partner effect of the patients' informational/emotional support on their partner's mental health (ß = 0.14, p = 0.024), indicating the patients' informational/emotional support was associated with the partner's mental health. None of the other types of social support exhibited an actor effect or a partner effect on the patient's or the partner's mental or physical health. More research into the relationship between social support and mental health is needed to help inform the design of interventions that target the dyad.
Collapse
Affiliation(s)
- Patricia Thomson
- School of Nursing, Midwifery & Health, BG Bomont Building, University of Stirling, Stirling FK9 4LA, Scotland, UK.
| | | | | |
Collapse
|
38
|
DeFrank JT, Brewer N. A model of the influence of false-positive mammography screening results on subsequent screening. Health Psychol Rev 2010; 4:112-127. [PMID: 21874132 PMCID: PMC3160720 DOI: 10.1080/17437199.2010.500482] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Decades of empirical research have demonstrated psychological and behavioural consequences of false-positive medical tests. To organise this literature and offer novel predictions, we propose a model of how false-positive mammography results affect return for subsequent mammography screening. We propose that false-positive mammography results alter how women think about themselves (e.g., increasing their perceived likelihood of getting breast cancer) and the screening test (e.g., believing mammography test results are less accurate). We further hypothesise that thoughts elicited by the false-positive experience will, in turn, affect future use of screening mammography. In addition, we discuss methodological considerations for statistical analyses of these mediational pathways and propose two classes of potential moderators. While our model focuses on mammography screening, it may be applicable to psychological and behavioural responses to other screening tests. The model is especially timely as false-positive medical test results are increasingly common, due to efforts to increase uptake of cancer screening, new technologies that improve existing tests' ability to detect disease at the cost of increased false alarms, and growing numbers of new medical tests.
Collapse
Affiliation(s)
- Jessica T. DeFrank
- Department of Health Behavior and Health Education, UNC Gillings School of Global Public Health, 325 Rosenau Hall, CB# 7440, Chapel Hill, NC 27599, USA
| | - Noel Brewer
- Department of Health Behavior and Health Education, UNC Gillings School of Global Public Health, 325 Rosenau Hall, CB# 7440, Chapel Hill, NC 27599, USA
| |
Collapse
|