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Cheng L, Zhong Z, Ding S, Duan Y, Sun N, Zheng F. Low body mass index and disease duration as factors associated with depressive symptoms of Chinese inpatients with chronic heart failure. J Health Psychol 2023; 28:1227-1237. [PMID: 37209015 DOI: 10.1177/13591053231173583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023] Open
Abstract
Depression is common in patients with chronic heart failure (CHF), and is associated with an increased risk of adverse health outcomes. There is a paucity of data on this subject from the developing countries. The aim was to examine the prevalence and related factors of depressive symptoms among Chinese inpatients with CHF. A cross-sectional study was conducted. PHQ-9 questionnaire was used to assess depressive symptoms. The overall prevalence of depressive symptoms was 7.5%. Low BMI (OR = 4.837, CI = 1.278-18.301, p = 0.02), disease duration 3-5 years (OR = 5.033, CI = 1.248-20.292, p = 0.023) and 5-10 years (OR = 5.848, CI = 1.440-23.744, p = 0.013) were risk factors for depressive symptoms, while being married (OR = 0.304, CI = 0.123-0.753, p = 0.010) was protective factor. We should pay more attention to patients without a spouse, with low BMI and whose disease duration is between 3 and 10 years in Chinese inpatients with CHF.
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Affiliation(s)
| | | | | | | | - Na Sun
- Central South University, China
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2
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Zhang X, Huang X, Peng Y, Huang L, Lin L, Chen L, Lin Y. Mediating effects of general self-efficacy on social support and quality of life in patients after surgical aortic valve replacement. Nurs Open 2023; 10:6935-6944. [PMID: 37475145 PMCID: PMC10495726 DOI: 10.1002/nop2.1947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 06/19/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023] Open
Abstract
AIM To explore whether general self-efficacy can mediate the relationship between social support and quality of life in patients after surgical aortic valve replacement. DESIGN A cross-sectional design. METHODS The final analysis included 283 patients who underwent surgical aortic valve replacement from May 2021 to September 2021. They completed a set of questionnaires, including the Chinese version of the General Self-Efficacy Scale, the Chinese Questionnaire of Quality of life in Patients with Cardiovascular Diseases and the Social Support Rating Scale. The PROCESS Macro in SPSS was used to analyse the mediating effect. RESULTS Quality of life and all of its dimensions were significantly related to social support and general self-efficacy. A significant indirect effect of social support existed through general self-efficacy in relation to quality of life with the mediation effect ratio of 32.82%.
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Affiliation(s)
- Xuecui Zhang
- The School of NursingFujian Medical UniversityFuzhouChina
| | - Xizhen Huang
- Department of Cardiovascular Surgery, Union HospitalFujian Medical UniversityFuzhouChina
| | - Yanchun Peng
- Department of Nursing, Union HospitalFujian Medical UniversityFuzhouChina
| | - Long Huang
- The School of NursingFujian Medical UniversityFuzhouChina
| | - Lingyu Lin
- Department of Cardiovascular Surgery, Union HospitalFujian Medical UniversityFuzhouChina
| | - Liangwan Chen
- Department of Cardiovascular Surgery, Union HospitalFujian Medical UniversityFuzhouChina
- Key Laboratory of Cardio‐Thoracic SurgeryFujian Medical University, Fujian Province UniversityFuzhouChina
| | - Yanjuan Lin
- Department of Cardiovascular Surgery, Union HospitalFujian Medical UniversityFuzhouChina
- Department of Nursing, Union HospitalFujian Medical UniversityFuzhouChina
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3
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Wang B, Lei L, Zhang H, Miao F, Zhang L, Tian A, Li J. Change in Depressive Symptoms During the First Month of Discharge and 1-Year Clinical Outcomes in Patients Hospitalized for Heart Failure. J Am Heart Assoc 2022; 11:e027438. [PMID: 36515248 PMCID: PMC9798811 DOI: 10.1161/jaha.122.027438] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background The patterns of depressive symptom change during the first month after discharge, as well as their prognostic implications, and predictors of persistent or new-onset depressive symptoms are not well characterized. Methods and Results We included patients hospitalized for heart failure undergoing Patient Health Questionnaire-2 before discharge and at 1 month after discharge in a multicenter prospective cohort. We characterized 4 patterns of change in depressive symptoms-persistent, new-onset, remitted depressive symptoms, and no depressive symptom-and examined the associations between the 4 patterns and 1-year clinical outcomes. We analyzed the factors associated with persistent or new-onset depressive symptoms. A total of 4130 patients were included. Among 1175 (28.5%) symptomatic patients and 2955 (71.5%) symptom-free patients before discharge, 817 (69.5%) had remission, and 366 (12.2%) had new-onset depressive symptoms, respectively. Compared with no depressive symptom, persistent depressive symptoms were associated with an increased risk of cardiovascular death (hazard ratio [HR], 2.10 [95% CI, 1.59-2.79]) and heart failure rehospitalization (HR, 1.56 [95% CI, 1.30-1.87]); new-onset depressive symptoms were associated with an increased risk of cardiovascular death (HR, 1.78 [95%CI, 1.32-2.40]) and heart failure rehospitalization (HR, 1.54 [95% CI, 1.29-1.83]). Remitted depressive symptoms were associated with a slightly increased risk of cardiovascular death but had no significant association with heart failure rehospitalization. Patients who were female or had poor socioeconomic status, stroke history, renal dysfunction, or poor health status had a higher risk of persistent or new-onset depressive symptoms. Conclusions Sex, socioeconomic status, clinical characteristics, and health status help identify patients with high risks of depressive symptoms at 1 month after discharge. Dynamic capture of depressive symptom change during this period informs long-term risk stratifications and targets patients who require psychological interventions and social support to improve clinical outcomes. Registration URL: https://www.clinicaltrials.gov; Unique identifier (NCT02878811).
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Affiliation(s)
- Bin Wang
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China,Fuwai Hospital, Chinese Academy of Medical SciencesShenzhenPeople’s Republic of China
| | - Lubi Lei
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China
| | - Haibo Zhang
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China
| | - Fengyu Miao
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China
| | - Lihua Zhang
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China
| | - Aoxi Tian
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China
| | - Jing Li
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China,Fuwai Hospital, Chinese Academy of Medical SciencesShenzhenPeople’s Republic of China,Central China Subcenter of the National Center for Cardiovascular DiseasesZhengzhouPeople’s Republic of China
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4
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Heo S, Lennie TA, Moser DK, Dunbar SB, Pressler SJ, Kim J. Testing of a health-related quality of life model in patients with heart failure: A cross-sectional, correlational study. Geriatr Nurs 2022; 44:105-111. [PMID: 35104725 PMCID: PMC8995344 DOI: 10.1016/j.gerinurse.2022.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 01/18/2023]
Abstract
Psychological symptoms, physical symptoms, and behavioral factors can affect health-related quality of life (HRQOL) through different pathways, but the relationships have not been fully tested in prior theoretical models. The purpose of this study was to examine direct and indirect relationships of demographic (age), biological/physiological (comorbidity), psychological (depressive symptoms), social (social support), physical (physical symptoms and functional status), and behavioral (dietary sodium adherence) factors to HRQOL. Data from 358 patients with heart failure were analyzed using structural equation modeling. There was a good model fit: Chi-square = 5.488, p = .241, RMSEA = .032, CFI = .998, TLI = .985, and SRMR = .018. Psychological symptoms, physical symptoms, and demographic factors were directly and indirectly associated, while behavioral and biological/physiological factors were indirectly associated with HRQOL through different pathways. Behavioral factors need to be included, and psychological factors and physical factors need to be separated in theoretical models of HRQOL.
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Affiliation(s)
- Seongkum Heo
- Georgia Baptist College of Nursing, Mercer University, 3001 Mercer University Drive, Atlanta, Georgia, 30341, USA.
| | - Terry A. Lennie
- College of Nursing, University of Kentucky, 760 Rose Street, Lexington, Kentucky, 40536, USA
| | - Debra K. Moser
- College of Nursing, University of Kentucky, 760 Rose Street, Lexington, Kentucky, 40536, USA
| | - Sandra B. Dunbar
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, GA 30322
| | - Susan J. Pressler
- School of Nursing, Indiana University, 600 Barnhill Dr, Indianapolis, IN 46202
| | - JinShil Kim
- College of Nursing, Gachon University, 191 Hambakmeoro, Yeonsu-gu, Incheon, 21936, South Korea
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5
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OUP accepted manuscript. Eur J Prev Cardiol 2022; 29:1124-1141. [DOI: 10.1093/eurjpc/zwac006] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/25/2021] [Accepted: 01/04/2022] [Indexed: 11/12/2022]
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6
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Trenta AM, Luciani M, Moro M, Patella S, Di Mauro S, Vellone E, Ausili D. Self-care in Adults With a Retro-auricular Left Ventricular Assist Device: An Interpretive Description. Clin Nurs Res 2021; 31:553-562. [PMID: 34886692 DOI: 10.1177/10547738211063538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Having a retro-auricular left ventricular assist device (LVAD) requires patients to learn specific self-care behaviors, with a considerable burden; the present study aimed at exploring and describing the experience of self-care in this population. An Interpretive Description was conducted, informing the analysis with the Middle-Range Theory of Self-care of Chronic Illness. A purposeful sample of ten people with a retro-auricular LVAD participated in in-depth, semi-structured interviews. Four themes were identified: Innovations and Limitations in Daily Life, Problems Detection, Response to Problems, and Learning Process. All of these were deeply influenced by a cross-cutting theme: Support System. People with a retro-auricular LVAD have self-care needs different from those of people with heart failure or with the abdominal version of the device, and there is a great need for targeted intervention that could be developed in consideration of our findings.
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Affiliation(s)
- Alessia Martina Trenta
- Cardiology Center Monzino IRCCS, Milan, MI, Italy.,University of Milano-Bicocca, Monza, MB, Italy.,University of Rome Tor Vergata, Rome, Italy
| | | | - Massimo Moro
- Cardiology Center Monzino IRCCS, Milan, MI, Italy
| | - Sara Patella
- Cardiology Center Monzino IRCCS, Milan, MI, Italy
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7
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Spindler H, Hollingdal M, Refsgaard J, Dinesen B. Motivating patients in cardiac rehabilitation programs: A multicenter randomized controlled trial. Int J Telerehabil 2021; 13:e6365. [PMID: 34345341 PMCID: PMC8287717 DOI: 10.5195/ijt.2021.6365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Concerns have been raised about motivation and psychological distress when implementing telerehabilitation in patients with heart failure. The current study compared conventional and telerehabilitation in two groups (n=67; n=70) of patients with heart failure at 0, 6, and 12 months on measures of motivation (Self-Determination Theory measures) and psychological distress (Hospital Anxiety and Depression scale). We found no significant changes in motivation across groups, although our telerehabilitation group had a slightly lower level of controlled motivation and higher levels of relatedness. In addition, there were no differences between groups with regard to psychological distress. This study demonstrates that telerehabilitation motivates patients with heart failure to the same degree as conventional rehabilitation, and that telerehabilitation is not associated with increased psychological distress. As such, telerehabilitation offers an alternative to conventional rehabilitation and addresses some of the barriers for participating in rehabilitation identified in the literature.
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Affiliation(s)
- Helle Spindler
- Department of Psychology and Behavioral Sciences, Aarhus University, Denmark
| | | | - Jens Refsgaard
- Cardiology Ward, Regional Hospital Viborg, Viborg, Denmark
| | - Birthe Dinesen
- Laboratory for Welfare Technology - Telehealth & Telerehabilitation, Sport Sciences-Performance and Technology, Department of Health Science and Technology, Aalborg University, Denmark
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8
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Johansson P, Lundgren J, Andersson G, Svensson E, Mourad G. Internet-based cognitive behavioural therapy and association to self-efficacy, depressive symptoms and physical activity: A secondary analysis of a randomized controlled trial in patients with cardiovascular disease (Preprint). JMIR Cardio 2021; 6:e29926. [PMID: 35657674 PMCID: PMC9206200 DOI: 10.2196/29926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/05/2022] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions Trial Registration
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Affiliation(s)
- Peter Johansson
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
- Unit of Internal Medicine, Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping Univerisity, Norrköping, Sweden
| | - Johan Lundgren
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | | | - Ghassan Mourad
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
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9
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Spatola CAM, Giusti EM, Rapelli G, Goodwin C, Cattivelli R, Pietrabissa G, Malfatto G, Facchini M, Castelnuovo G, Molinari E. Cardiac-specific experiential avoidance predicts change in general psychological well-being among patients completing cardiac rehabilitation. Appl Psychol Health Well Being 2021; 13:715-727. [PMID: 33811743 DOI: 10.1111/aphw.12260] [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: 08/05/2020] [Revised: 12/29/2020] [Accepted: 01/14/2021] [Indexed: 11/29/2022]
Abstract
Previous studies have shown that experiential avoidance (EA) is associated with physical and psychological well-being in medical and non-medical samples. The aims of the present study were to evaluate the reciprocal association between psychological well-being and EA over time among cardiac rehabilitation (CR) patients with moderately to severely low levels of psychological well-being. Pre-CR data on demographic characteristics, measures of psychological well-being, and cardiac-specific EA were collected from 915 CR patients, as well as post-CR psychological well-being and EA data, from 800 of these patients. A cross-lagged model was estimated to examine the relationship between EA and psychological well-being among patients with moderately to severely low levels of psychological well-being based on questionnaire scores. Both EA and psychological well-being significantly changed during CR and were negatively associated with each other at both pre- and post-CR. Results from cross-lagged structural equation modeling supported a nonreciprocal association between EA and psychological well-being during CR. Pre-CR assessment of EA in patients showing low levels of well-being at the beginning of CR could help to identify patients at risk for worse psychological outcomes. EA could be a promising target of psychological treatments administered during CR.
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Affiliation(s)
- Chiara A M Spatola
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Emanuele Maria Giusti
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Giada Rapelli
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Christina Goodwin
- Department of Psychiatry & Behavioral Health, Cooper University Health Care, Camden, NJ, USA.,Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Roberto Cattivelli
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Giada Pietrabissa
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Gabriella Malfatto
- Department of Cardiovascular, Neurological and Metabolic Sciences, Ospedale San Luca, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Mario Facchini
- Department of Cardiovascular, Neurological and Metabolic Sciences, Ospedale San Luca, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Enrico Molinari
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
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10
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Wang B, Xia L, Yu J, Feng Y, Hong J, Wang W. The multiple mediating effects of health literacy and self-care confidence between depression and self-care behaviors in patients with heart failure. Heart Lung 2020; 49:842-847. [PMID: 33011463 DOI: 10.1016/j.hrtlng.2020.09.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/10/2020] [Accepted: 09/15/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous researchers have found that depression can influence self-care behaviors of patients with heart failure (HF). However, the specific path of depression on self-care behaviors remains unclear. OBJECTIVES To determine the multiple mediating effects of health literacy and self-care confidence between depression and self-care behaviors in patients with HF. METHODS A cross sectional study on HF patients (n = 310) was conducted at a tertiary hospital in China. The Chinese versions of the Hospital Anxiety and Depression Scale (HADS-D), Health Literacy Scale for Patients with Chronic Disease and Self-care of Heart Failure Index (C-SCHFI) were used to assess depression, health literacy, self-care confidence and self-care behaviors of the HF patients respectively. RESULTS Depression had significant negative correlations with health literacy (r = -0.40, P < 0.01), self-care confidence (r = -0.41, P < 0.01), self-care maintenance (r = -0.18, P < 0.01) and management (r = -0.19, P < 0.01). After controlling for covariates, mediation modeling analysis showed that health literacy and self-care confidence were mediating variables between depression and self-care management and all the three paths were significant. A higher level of depression debilitated health literacy (β = -0.23, P < 0.001), and a higher degree of health literacy was associated with better self-care confidence (β = 0.31, P < 0.001) which contributed to better self-care management (β = 0.43, P < 0.001). Total mediation effect was -0.1940 with 95% CI from -0.2702 to -0.1266. However, self-care confidence did not mediate between depression and self-care maintenance. CONCLUSION Health literacy and self-care confidence exert a multiple mediating effect on the relationship between depression and self-care management. The relationship between variables should be considered when developing the tailored interventions for patients with HF to enhance their self-care behaviors.
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Affiliation(s)
| | - Lili Xia
- School of Nursing, Anhui Medical University, China
| | - Jia Yu
- School of Nursing, Anhui Medical University, China
| | - Yuan Feng
- School of Nursing, Anhui Medical University, China
| | | | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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11
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Konrad C, Lossnitzer N, Boehlen FH, Haefeli WE, Holleczek B, Brenner H, Schoettker B, Wild B. Coping resources of heart failure patients - a comparison with cancer patients and individuals having no chronic condition results from the esther study. Heart Lung 2020; 49:829-835. [PMID: 33011461 DOI: 10.1016/j.hrtlng.2020.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Heart failure (HF) and cancer patients share similarities in symptom burden and depression prevalence. Coping resources, such as optimism have been associated with improved health-related quality of life (HRQoL) and mental health. OBJECTIVES To investigate a wide range of resources in a large population-based sample of HF patients; to compare resources between three groups: HF patients, cancer patients, and individuals having no chronic condition. METHODS This cross-sectional analysis was performed among n = 2761 subjects who participated in home visits during the 11-year follow-up of the epidemiological ESTHER study. Resources were assessed by trained medical doctors through a questionnaire that lists 26 items. One-way analyses of covariance (ANCOVAs) controlled for sociodemographic variables and depression were performed to compare resources between groups. RESULTS Family and self-efficacy were the most frequently reported resources in all groups. HF patients reported optimism significantly less frequently as a resource in comparison to cancer patients (p=.031). HF patients showed significantly lower levels of resource factor 3 (positive attitude), compared to cancer patients (p=.006), and not chronically ill participants (p=.037). CONCLUSIONS Family and self-efficacy seem to be the most important resources, regardless of diagnosis. HF patients appear to have significantly lower levels of resources concerning positive attitude, compared to cancer patients, and not chronically ill individuals. We suggest the development of psychosocial interventions to enhance optimism in HF.
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Affiliation(s)
- Cinara Konrad
- Heidelberg University Hospital, Department of General Internal Medicine and Psychosomatics, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
| | - Nicole Lossnitzer
- Heidelberg University Hospital, Department of General Internal Medicine and Psychosomatics, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Friederike H Boehlen
- Heidelberg University Hospital, Department of General Internal Medicine and Psychosomatics, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Walter E Haefeli
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Germany
| | - Bernd Holleczek
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Saarland Cancer Registry, Saarbruecken, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Ben Schoettker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Network Aging Research, University of Heidelberg, Germany
| | - Beate Wild
- Heidelberg University Hospital, Department of General Internal Medicine and Psychosomatics, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
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12
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Depression, Anxiety, Perceived Stress, and Their Changes Predict Greater Decline in Physical Health Functioning over 12 Months Among Patients with Coronary Heart Disease. Int J Behav Med 2019; 26:352-364. [PMID: 31218559 DOI: 10.1007/s12529-019-09794-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although the deleterious impact of psychological distress on patients with coronary heart disease (CHD) is recognized, few studies have examined the influence of change in psychological distress on health outcomes over time. This study investigated whether three common manifestations of distress (depression, anxiety, and perceived stress) and their changes predicted the decline in physical functioning in CHD patients over 12 months. In addition, perceived social support was examined as a buffer of psychological distress or a direct predictor of physical functioning. METHODS Participants were 255 CHD patients with a mean age of 63 (SD = 8.65) years, including 208 men and 47 women. Psychological distress and physical functioning were assessed at baseline, 6 months and 12 months. Hierarchical regression analyses were conducted to examine the influences of psychological factors on physical functioning over 12 months. All models were adjusted for baseline physical functioning, age, gender, marital status, education, BMI, and length of participation at a wellness center. RESULTS For each psychological distress variable (depression, anxiety, or perceived stress), both the baseline (βs = - 0.19 to - 0.32, ps = 0.008 to < 0.001) and its respective change over time (βs = - 0.17 to - 0.38, ps = 0.020 to < 0.001) independently and significantly predicted greater decline in physical functioning at 6 and 12 months, after adjusting for covariates. Perceived social support predicted greater improvement in physical functioning at 12 months (β = 0.13, p = 0.050), but it did not buffer impact of psychological distress. CONCLUSIONS Findings underscore the importance of monitoring various forms of psychological distress continuously over time for CHD patients.
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