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Maria GC, Christos AP, Theodoros DK, Ioannis AN, Charalambos IK. Adjustment Mechanisms in the Acute Phase of Myocardial Infarction in Men. Psychol Rep 2023; 126:133-149. [PMID: 34455859 DOI: 10.1177/00332941211040425] [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: 01/14/2023]
Abstract
AIM Stress and Coping Model and Post-Traumatic Growth Theory indicate adjustment procedures concepts after a crisis. The objective of this study was to assess the relationships between causal attributions, coping strategies and post-traumatic growth in male patients with acute myocardial infarction and variable cardiac function severity. METHODS Seventy-eight male patients surviving a myocardial infarction, were divided into two sub-groups based on left ventricular ejection fraction measurements [Group A (left ventricular ejection fraction: <45%, n = 34), Group B (left ventricular ejection fraction: ≥45%, n = 44)] and were interviewed after the acute phase of myocardial infarction, on the last day of their coronary unit stay. Medical data was obtained from their medical records. Causal Attributions' List, Coping Orientation to Problems Experienced and Post-Traumatic Growth Inventory were used. RESULTS Causal attributions were found to be related to active coping, emotional support, religious coping and self-blame in both groups. Planning, positive reinterpretation and active coping were the strategies associated positively with most of the post-traumatic inventory subscales in total data analyses. CONCLUSIONS Diverse coping strategies were associated with posttraumatic growth factors. It is important to assess adjustment mechanisms in the acute phase of myocardial infarction. A tailored scheme therapy, considering patient's needs, has to be planned.
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Affiliation(s)
| | | | - D Karamitsos Theodoros
- 1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - A Nimatoudis Ioannis
- Department of Psychiatry, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - I Karvounis Charalambos
- 1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
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Know Your Numbers: Patient and Physician Disparity in Cardiovascular Risk Perception After an Acute Coronary Syndrome. J Cardiopulm Rehabil Prev 2022; 42:E99-E100. [DOI: 10.1097/hcr.0000000000000732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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3
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Saeidi M, Komasi S, Compare A. A Systematic Review of the Instruments Used for Evaluating Causal Beliefs and Perceived Heart Risk Factors. J Tehran Heart Cent 2021; 15:88-97. [PMID: 33552203 PMCID: PMC7827124 DOI: 10.18502/jthc.v15i3.4217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: The etiologies and causal beliefs of heart disease are considered one of the 5 dimensions of health self-regulatory model. Thus, the present study aimed to review the literature and screen the appropriate tools for evaluating the causal beliefs and perceived heart risk factors (PHRFs). Methods: The review samples encompassed all published articles from 1992 to March 2017. A systematic search was conducted across 6 databases: the Web of Science, Scopus, Medline, EBSCO, ProQuest, PsycINFO, and Google Scholar. The qualitative evaluation of the articles was examined using the checklists of the Critical Appraisal Skills Programme (CASP) by 2 independent investigators. After the application of the criteria for inclusion in the study, 22 studies were obtained according to the PRISMA guidelines. Results: A total of 10 504 (50.5% male) patients at an average age of 57.85±10.75 years participated in 22 studies under review. The results of the systematic review showed that 22 tools were available to measure PHRFs. The instruments were categorized into 4 groups of valid scales (6 studies), invalid questionnaires (6 studies), checklists (3 studies), and open-ended single items (7 studies). Only 23.2% of the measuring instruments were sufficiently valid. Conclusion: The results of this systematic review showed that a limited number of valid tools were available to measure PHRFs. Considering the importance of studying cardiac patients' perception of the etiology of disease and the paucity of standards and valid grading scales, it seems necessary to design and provide tools with broader content that can cover all aspects of patients' beliefs.
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Affiliation(s)
- Mozhgan Saeidi
- Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saeid Komasi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Angelo Compare
- Department of Human and Social Sciences, University of Bergamo, Italy
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Friedrich O, Kunschitz E, Pongratz L, Wieländer S, Schöppl C, Sipötz J. Classification of illness attributions in patients with coronary artery disease. Psychol Health 2021; 36:1368-1383. [PMID: 33410711 DOI: 10.1080/08870446.2020.1851688] [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: 10/22/2022]
Abstract
OBJECTIVE To examine patient-reported causal attributions in patients with coronary artery disease and classify them according to attribution theory. DESIGN Patients with angiographically verified coronary artery disease (n = 459) were asked to report causal attributions by answering the respective open-ended item of the Brief Illness Perception Questionnaire. MAIN OUTCOME MEASURES Groups resulting from classifications were characterised with regard to sociodemographic and clinical variables, Quality of Life (SF-12), depression (PHQ-9), anxiety (GAD-7), and illness perception (BIPQ). RESULTS Stress emerged as the single most important attribution followed by various behavioural factors and genetic predisposition. There was a remarkable mismatch between the presence of modifiable risk factors (smoking, obesity) and patient-reported illness attributions. Based on the results of the descriptive categorisation of illness attributions we developed a transparent, easily reproducible scheme for dimensional classification of the fifteen most common responses according to attribution theory. The classification resulted in four groups: Behaviour/Emotional State, Past Behaviour/Emotional State, Physical/Psychological Trait and External. CONCLUSION We found a pattern of illness attributions largely in line with previous trials. The dimensional classification resulted in four groups and highlighted potential entry points for physician-patient communication aimed at establishing beneficial disease self-management.
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Affiliation(s)
- Oliver Friedrich
- Karl Landsteiner Institute for Scientific Research in Clinical Cardiology, Hanusch Hospital, Vienna, Austria
| | - Evelyn Kunschitz
- Karl Landsteiner Institute for Scientific Research in Clinical Cardiology, Hanusch Hospital, Vienna, Austria.,II. Medical Department for Cardiology, Hanusch Hospital, Vienna, Austria
| | - Lisa Pongratz
- II. Medical Department for Cardiology, Hanusch Hospital, Vienna, Austria
| | - Sophia Wieländer
- II. Medical Department for Cardiology, Hanusch Hospital, Vienna, Austria
| | - Christine Schöppl
- II. Medical Department for Cardiology, Hanusch Hospital, Vienna, Austria
| | - Johann Sipötz
- Karl Landsteiner Institute for Scientific Research in Clinical Cardiology, Hanusch Hospital, Vienna, Austria.,II. Medical Department for Cardiology, Hanusch Hospital, Vienna, Austria
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The latency period between type 2 diabetes and development of Coronary Artery Disease based on psychological factors. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2019.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Soroush A, Shams-Alizadeh N, Vahdat A, Mohebi Z, Saeidi M, Komasi S. Role of perceived heart risk factors by outpatient population in predicting cardiovascular risk. J Cardiovasc Thorac Res 2019; 11:100-108. [PMID: 31384403 PMCID: PMC6669426 DOI: 10.15171/jcvtr.2019.18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 05/10/2019] [Indexed: 01/17/2023] Open
Abstract
Introduction: Regarding the expanding population in developing countries who are at risk for cardiovascular diseases (CVDs), identification and management of effective factors are important in reducing the risk of CVDs. So, the present study aimed to assess the role of perceived heart risk factors (PHRFs) in the prediction of cardiovascular risk among outpatient patients.
Methods: The samples of this cross-sectional study included 150 outpatient patients who attend the clinic of Imam Reza hospital during October-December 2016. The participants were completed the Perceived Heart Risk Factors Scale (PHRFS) and Cardiovascular Risk Assessment Questionnaire (CRAQ). Data analyzed through Pearson correlation and multiple regression analyses.
Results: Based on the findings, 28%, 40%, 22.7%, and 9.3% of patients were low, medium, high, and severely high-risk, respectively. The strongest predictors of the cardiovascular risk were physiological (β=-0.273; P=0.004), psychological (β=0.236; P=0.020), and biological risk factors (β=0.209; P=0.016), respectively. In addition, the strongest predictor of the lifestyle risk was physiological risk factors (β=-0.264; P=0.007). Other variables do not play a significant role in predict the lifestyle risk (P>0.05). Our model was able to explain 9.2% of cardiovascular risk variance and 5.7% of cardiovascular risk caused by lifestyle variance.
Conclusion: The higher patients’ perception about biological and psychological risk factors is concerned as an alarm for increased cardiovascular risk while higher perception about physiological risk factors is associated with reduced cardiovascular risk caused by lifestyle and total cardiovascular risk. The programs reducing cardiovascular risk should target the high-risk groups to save cost and time.
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Affiliation(s)
- Ali Soroush
- Heart Research Center, Imam Ali Hospital, Kermanshah University of Medical Sciences. Kermanshah, Iran
| | - Nasim Shams-Alizadeh
- Lifestyle Modification Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Afsoon Vahdat
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zeinab Mohebi
- Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mozhgan Saeidi
- Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saeid Komasi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Stability in Cardiac Attributions Before and After Cardiac Rehabilitation. Rehabil Nurs 2019; 44:115-122. [PMID: 30830885 DOI: 10.1097/rnj.0000000000000113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study examined temporal patterns in causal attributions generated by patients with cardiovascular disease before and after cardiac rehabilitation (CR). DESIGN Qualitative, descriptive survey. METHODS Eighty-six participants were asked what they believed was the primary cause of their cardiac events. Cardiac attributions were collected at the beginning of CR, at the end of CR, and 15 months after baseline. FINDINGS Content analyses showed that heredity and behavior were the most commonly generated causes. Most participants showed stability in attributions over time, although we found a trend for more participants endorsing behavioral attributions at the end of the study. CONCLUSIONS Cardiac attributions remain relatively stable across time. CLINICAL RELEVANCE Cardiac rehabilitation staff should approach patients differently, depending on their causal narratives. Some patients enter CR understanding that behavior played a causal role, whereas some do not. Encouraging appreciation of the importance of behavior in cardiovascular disease onset and recurrence is vital.
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Saeidi M, Komasi S. A Predictive Model of Perceived Susceptibility during the Year before Coronary Artery Bypass Grafting. J Tehran Heart Cent 2018; 13:6-12. [PMID: 29997664 PMCID: PMC6037624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Background: Based on the protective health model, one of the most important components of etiological factors leading to protective health behaviors is perceived risk or perceived susceptibility. Accordingly, the present study was conducted to assess the uncontrolled and controlled effects of some factors in predicting perceived susceptibility among coronary artery bypass graft (CABG) patients. Methods: The data for the present cross-sectional study were gathered via assessment of 1052 CABG patients who referred to an outpatient cardiac rehabilitation clinic in a hospital in Iran between 2010 and 2014. The patients completed a checklist containing demographics, risk factors, and a single closed-ended question regarding perceived susceptibility at the beginning of their rehabilitation program. Binary logistic regression analysis was applied to identify the demographic and clinical correlations related to perceived susceptibility. Results: Totally, 776 (73.8%) of the 1052 participants were male. The mean age of the patients was 58.0 ± 9.1 years. The results revealed that only 13.7% of the patients had perceived susceptibility; in addition, higher age (p value = 0.003) and family history of cardiac diseases (p value = 0.001) were able to significantly predict perceived susceptibility. When the demographic variables were controlled, once again age and family history of cardiac diseases were able to significantly increase perceived susceptibility by approximately 1.04 and 29.6 times, respectively. Conclusion: Our results revealed that higher age and family history of cardiac diseases were able to significantly predict perceived susceptibility among our CABG patients.
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Affiliation(s)
- Mozhgan Saeidi
- Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saeid Komasi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Komasi S, Soroush A, Saeidi M. Cardiac patients' perception about psychological risk factors on chest pain intensity and discomfort. CASPIAN JOURNAL OF INTERNAL MEDICINE 2018; 9:204-205. [PMID: 29732043 PMCID: PMC5912233 DOI: 10.22088/cjim.9.2.204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Saeid Komasi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Soroush
- Lifestyle Modification Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mozhgan Saeidi
- Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Timmermans I, Denollet J, Pedersen SS, Meine M, Versteeg H. Patient-reported causes of heart failure in a large European sample. Int J Cardiol 2018; 258:179-184. [PMID: 29426633 DOI: 10.1016/j.ijcard.2018.01.113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 01/15/2018] [Accepted: 01/24/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Patients diagnosed with chronic diseases develop perceptions about their disease and its causes, which may influence health behavior and emotional well-being. This is the first study to examine patient-reported causes and their correlates in patients with heart failure. METHODS European heart failure patients (N = 595) completed questionnaires, including the Brief Illness Perceptions Questionnaire. Using deductive thematic analysis, patient-reported causes were categorized into physical, natural, behavioral, psychosocial, supernatural and other. Clinical data were collected from medical records. RESULTS Patients who did not report any cause (11%) were on average lower educated and participated less often in cardiac rehabilitation. The majority of the remaining patients reported physical causes (46%, mainly comorbidities), followed by behavioral (38%, mainly smoking), psychosocial (35%, mainly (work-related) stress), and natural causes (32%, mainly heredity). There were socio-demographic, clinical and psychological group differences between the various categories, and large discrepancies between prevalence of physical risk factors according to medical records and patient-reported causes; e.g. 58% had hypertension, while only 5% reported this as a cause. Multivariable analyses indicated trends towards associations between physical causes and poor health status (Odds ratio (OR) = 1.41, 95% confidence interval (95% CI) = 0.95-2.09, p = 0.09), psychosocial causes and psychological distress (OR = 1.54, 95% CI = 0.94-2.51, p = 0.09), and behavioral causes and a less threatening view of heart failure (OR = 0.64, 95% CI = 0.40-1.01, p = 0.06). CONCLUSION European patients most frequently reported comorbidities, smoking, stress, and heredity as heart failure causes, but their causal understanding may be limited. There were trends towards associations between patient-reported causes and health status, psychological distress, and illness perceptions.
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Affiliation(s)
- Ivy Timmermans
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands; CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
| | - Johan Denollet
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands; Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
| | - Susanne S Pedersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark; Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Mathias Meine
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Henneke Versteeg
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
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11
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Soroush A, Komasi S, Saeidi M, Heydarpour B, Carrozzino D, Fulcheri M, Marchettini P, Rabboni M, Compare A. Coronary artery bypass graft patients' perception about the risk factors of illness: Educational necessities of second prevention. Ann Card Anaesth 2017; 20:303-308. [PMID: 28701594 PMCID: PMC5535570 DOI: 10.4103/aca.aca_19_17] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Patients’ beliefs about the cause of cardiac disease (perceived risk factors) as part of the global psychological presentation are influenced by patients’ health knowledge. Hence, the present study aimed to assess the relationship between actual and perceived risk factors, identification of underestimated risk factors, and indication of underestimation of every risk factor. Materials and Methods: In this cross-sectional study, data of 313 coronary artery bypass graft (CABG) patients admitted to one hospital in the west of Iran were collected through a demographic interview, actual risk factors’ checklist, open single item of perceived risk factors, and a life stressful events scale. Data were analyzed by means of Spearman's correlation coefficients and one-sample Z-test for proportions. Results: Although there are significant relations between actual and perceived risk factors related to hypertension, family history, diabetes, smoking, and substance abuse (P < 0.05), there is no relation between the actual and perceived risk factors, and patients underestimate the role of actual risk factors in disease (P < 0.001). The patients underestimated the role of aging (98.8%), substance abuse (95.2%), overweight and obesity (94.9%), hyperlipidemia (93.1%), family history (90.3%), and hypertension (90%) more than diabetes (86.1%), smoking (72.5%), and stress (54.7%). Conclusion: Cardiac patients seem to underestimate the role of aging, substance abuse, obesity and overweight, hyperlipidemia, family history, and hypertension more than other actual risk factors. Therefore, these factors should be highlighted to patients to help them to (i) increase the awareness of actual risk factors and (ii) promote an appropriate lifestyle after CABG surgery.
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Affiliation(s)
- Ali Soroush
- Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences; Lifestyle Modification Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saeid Komasi
- Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences; Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mozhgan Saeidi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behzad Heydarpour
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Danilo Carrozzino
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Mario Fulcheri
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Paolo Marchettini
- Department of Neurology, San Raffaele Hospital Milano and Pain center, Centro Diagnostico Italiano, Milano, Italy
| | - Massimo Rabboni
- Department of Psychiatry, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Angelo Compare
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
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Saeidi M, Komasi S. Reliability and validity of perceived heart risk factors scale. Ann Card Anaesth 2017; 20:114-116. [PMID: 28074811 PMCID: PMC5290683 DOI: 10.4103/0971-9784.197851] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Mozhgan Saeidi
- Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saeid Komasi
- Cardiac Rehabilitation Center, Imam Ali Hospital; Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Komasi S, Saeidi M. What is role of sex and age differences in marital conflict and stress of patients under Cardiac Rehabilitation Program? ARYA ATHEROSCLEROSIS 2016; 12:138-145. [PMID: 27752271 PMCID: PMC5055372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND To investigate the role of sex and age differences in marital conflict and stress of patients who were under cardiac rehabilitation (CR) program. METHODS The data of this cross-sectional study were collected from the database of the CR Department of Imam Ali Hospital, Kermanshah, Iran. The demographics and medical data of 683 persons were collected from January 2003 and January 2010 using medical records, the Beck Anxiety Inventory, the Beck Depression Inventory, the Hudson's Index of Marital Stress, and the Structured Clinical Interview for axis I disorders. Data were analyzed through Analysis of Covariance and Bonferroni test. RESULTS About 74.8% of the subjects were male. After adjustment for age, educational level, anxiety, and depression-the findings showed that women in CR program had a higher level of marital stress compared to men (54.75 ± 2.52 vs. 49.30 ± 0.89; P = 0.042). Furthermore, it was revealed that women who aged 56-65 years and more experienced higher level of marital stress compared to younger patients (P < 0.050); however, no significant difference was observed between different age groups in male patients (P > 0.050). CONCLUSION Marital conflict and stress threaten healthiness of women who aged 56-65 years more prominently than does in males or younger patients. Regarding the effect of marital stress on recurrence of the disease and cardiac-related morbidity and mortality in women, providing effective education and interventions to this group of patients, especially older women and even their spouses could be one of the useful objectives of CR programs.
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Affiliation(s)
- Saeid Komasi
- Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mozhgan Saeidi
- Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Schumacher TL, Burrows TL, Thompson DI, Callister R, Spratt NJ, Collins CE. The Role of Family in a Dietary Risk Reduction Intervention for Cardiovascular Disease. Healthcare (Basel) 2016; 4:E74. [PMID: 27706027 PMCID: PMC5198116 DOI: 10.3390/healthcare4040074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 09/13/2016] [Accepted: 09/22/2016] [Indexed: 12/04/2022] Open
Abstract
Diet is an essential strategy for the prevention of primary and secondary cardiovascular disease (CVD) events. The objectives were to examine: how families at increased risk of CVD perceived personal risk, their motivations to make dietary changes, their understanding of diet, and the influence of other family members. Individuals (>18 years) who completed an Australian family-based CVD risk reduction program were invited to a semi-structured telephone interview. Responses were recorded, transcribed verbatim and analysed using a systematic deductive approach with coding derived from key concepts developed as part of the interview structure. Seventeen participants from eight families were interviewed (aged 18-70 years, 47% male, five with CVD diagnosis). Key themes indicated both intrinsic and extrinsic motivations to improve heart health, variations in risk perception, recognition of the role diet plays in heart health, and the extent of family influences on eating patterns. Discrepancies between perceived and actual CVD risk perception impacted on perceived "need" to modify current dietary patterns towards heart health recommendations. Therefore, strategies not reliant on risk perception are needed to engage those with low risk perception. This could involve identifying and accessing the family "ringleader" to influence involvement and capitalising on personal accountability to other family members.
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Affiliation(s)
- Tracy L Schumacher
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, NSW, Australia.
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, NSW, Australia.
| | - Tracy L Burrows
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, NSW, Australia.
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, NSW, Australia.
| | - Deborah I Thompson
- USDA/ARS Children's Nutrition Research Centre, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, NSW, Australia.
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan 2308, NSW, Australia.
| | - Neil J Spratt
- Priority Research Centre for Translational Neuroscience and Mental Health & Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, NSW, Australia.
- Hunter New England Local Health District & Hunter Medical Research Institute, New Lambton Heights 2305, NSW, Australia.
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, NSW, Australia.
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, NSW, Australia.
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Saeidi M, Komasi S, Heydarpour B, Momeni K, Zakiei A. Those Who Perceive Their Disease as a Physiological or Psychological Risk Factor Experience More Anxiety at the Beginning of the Cardiac Rehabilitation Program. Res Cardiovasc Med 2016; 5:e29291. [PMID: 28203550 PMCID: PMC5297864 DOI: 10.5812/cardiovascmed.29291] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 05/06/2015] [Accepted: 05/06/2015] [Indexed: 11/30/2022] Open
Abstract
Background: In a cardiac patient, anxiety is the result of the individual’s perception of the treatment and is characterized by inability to predict, control, or achieve the desired treatment outcomes. Objectives: This study was carried out to investigate the extent of clinical anxiety in patients who underwent a cardiac rehabilitation program with different attitudes toward the disease risk factors. Patients and Methods: The administrative data of this retrospective study were obtained from the database of the cardiac rehabilitation department of a hospital in Iran. The demographic and clinical information of 603 patients from April 2006 to April 2011 was collected using compiled forms of this database, the Beck anxiety inventory, and the structured clinical interview for axis I disorders. The univariate analysis of variance and the Bonferroni post-hoc analysis were used for data analysis. Results: After controlling for gender and educational level, we observed statistically significant differences in the modified means between the patients who considered the behavioral risk factors and those who considered the physiological risk factors (P = 0.012, MD = 5.03) and between the patients who regarded the behavioral risk factors and those who regarded the psychological risk factors (P = 0.0005, MD = 5.32) as the underlying cause of their cardiac condition, which means that the level of anxiety in the physiological and psychological groups was higher than that in the behavioral group. Conclusions: The anxiety of patients can be controlled through alteration in their attitudes toward the disease risk factors on the grounds that psychological or physiological factors per se do not trigger the occurrence of the disease, whereas behavioral risk factors, as the controlling agent, significantly influence its occurrence.
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Affiliation(s)
- Mozhgan Saeidi
- Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
| | - Saeid Komasi
- Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
- Corresponding author: Saeid Komasi, Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Shahid Beheshti Blvd., Kermanshah, IR Iran. Tel: +98-8338380698, Fax: +98-8338360043, E-mail:
| | - Behzad Heydarpour
- Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
| | - Khodamorad Momeni
- Department of Psychology, Kermanshah Razi University, Kermanshah, IR Iran
| | - Ali Zakiei
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
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Komasi S, Saeidi M. A Perceived Risk Factor May Lead to Increased Anxiety and Depression in Cardiovascular Patients. ACTA ACUST UNITED AC 2016. [DOI: 10.17795/jjcdc-34159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Reporting of Posttraumatic Stress Disorder and Cardiac Misconceptions Following Cardiac Rehabilitation. J Cardiopulm Rehabil Prev 2016; 35:238-45. [PMID: 25689163 DOI: 10.1097/hcr.0000000000000100] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Approximately 15% of cardiac patients experience posttraumatic stress disorder (PTSD), double the incidence seen in the general community. Posttraumatic stress disorder can seriously affect psychological and physical recovery. This study assessed how many patients reported symptoms of PTSD following a cardiac event and examined whether there was any change after completing a cardiac rehabilitation (CR) program. Associations between PTSD and anxiety, depression, and cardiac misconceptions were also explored. METHODS This was a prospective cohort study using repeated measures. All patients eligible for the hospital CR program were invited to complete questionnaires assessing psychological distress and beliefs about heart disease before (T1) and after (T2) completing the CR program. RESULTS Questionnaires at T1 were returned by 105 patients. Of these, 24% reported symptoms of PTSD, 18% high anxiety, and 9% high levels of depression. At T2, 67 patients returned questionnaires, showing that 9% of patients continued to experience PTSD. These patients experienced significantly higher levels of anxiety (t = -4.77; P < .001) and depression (t = -3.64; P < .001). Intrusive thoughts and hyperarousal were significantly lower at T2 (t = 2.32; P = .02 and t = 3.01; P = .01, respectively). More misconceptions were associated with higher levels of anxiety and depression; however, the number of cardiac misconceptions remained similar throughout. Caucasians reported significantly fewer misconceptions than non-Caucasian patients, except for beliefs about myocardial infarction. Patients had fewer misconceptions about their own specific condition. CONCLUSIONS These findings suggest that screening for symptoms of PTSD after completion of a CR program would be helpful in identifying patients who would benefit from specialist psychological support.
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Saeidi M, Soroush A, Komasi S, Moemeni K, Heydarpour B. Attitudes Toward Cardiovascular Disease Risk Factors Among Patients Referred to a Cardiac Rehabilitation Center: Importance of Psychological Attitudes. ACTA ACUST UNITED AC 2015. [DOI: 10.17795/semj22281] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pagels AA, Söderquist BK, Heiwe S. DIFFERENCES IN ILLNESS REPRESENTATIONS IN PATIENTS WITH CHRONIC KIDNEY DISEASE. J Ren Care 2015; 41:146-55. [PMID: 25753248 DOI: 10.1111/jorc.12117] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To explore the impact of chronic kidney disease (CKD) on individual illness representations, including symptoms and causal attributions. DESIGN AND MEASURES Fifty-four patients responded to the Illness Perception Questionnaire (IPQ-R) and a further seven patients undertook cognitive interviews regarding the IPQ-R. All respondents had CKD stage 2-5, not undergoing renal replacement therapy. RESULTS Those in earlier CKD stages and those with fewer symptoms perceived a significantly different understanding of their condition than those in more advanced disease stages or with more symptoms. Behavioural and psychological attributions were commonly referred to as contributing causes to CKD. These attributions were associated to negative illness representations. An uncertainty assessing symptoms attributed to CKD was indicated, especially in earlier disease stages. CONCLUSION Illness representations differ with CKD stages and symptom burden. The patients in earlier disease stages or with fewer symptoms did not hold as strong beliefs about their illness as being a threat as those in advanced stages or with more symptoms. Self-blame emerged as a common causal attribution. Patients did not always relate symptoms to CKD, therefore this study identifies a gap in patients' disease knowledge, especially in earlier stages of the condition.
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Affiliation(s)
- Agneta A Pagels
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | | | - Susanne Heiwe
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden
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Alkhatib A. Sedentary risk factors across genders and job roles within a university campus workplace: preliminary study. J Occup Health 2013; 55:218-24. [PMID: 23485570 DOI: 10.1539/joh.12-0158-oa] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES The aim of this study was to investigate whether sedentary job role and gender are reflected by sedentary risk factors within a university campus. METHODS Following institutional ethical approval, 80 U.K. university campus employees were recruited, and 34 of them (age 47.8 ± 11.9 years, height 169 ± 1.0 cm, body mass 72.0 ± 14.1 kg) were measured for their systolic (SBP) and diastolic blood pressure (DBP), blood glucose (Glu), total serum blood cholesterol (Cho), dominant (DHG) and nondominant handgrip strength (NHG), body fat percentage (Fat%), trunk flexibility (Flex), peak cardiorespiratory capacity (V.O2max), and answered a physical activity questionnaire (IPAQ). The data were analyzed using two-way ANOVA with job role and gender as independent factors, and each measured risk as a dependent factor. RESULTS Gender had significant effects (p<0.05), and males demonstrated higher Glu, SBP, DBP and BMI than females (p<0.05). Females had higher Flex and Fat%, and lower DHG and NHG (p<0.05). Job role neither affected measured risk factors nor interacted with gender. However, both groups demonstrated high BMI, Fat% and Glu values, with these risk factors being above the recommended healthy thresholds. IPAQ hours correlated positively with Glu (p<0.05) but with none of the remaining tests. CONCLUSIONS Sedentary risk factors are prevalent within university employees irrespective of job role but not irrespective of gender. The results may provide a baseline for initiating tailored organizational targeted policies aimed at reducing sedentary risk factors associated with the university workplace.
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Reges O, Vilchinsky N, Leibowitz M, Manor D, Mosseri M, Kark JD. Perceptions of cause of illness in acute myocardial infarction patients: a longitudinal study. PATIENT EDUCATION AND COUNSELING 2011; 85:e155-e161. [PMID: 21310582 DOI: 10.1016/j.pec.2010.12.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2010] [Revised: 10/31/2010] [Accepted: 12/31/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To assess change in patient's attributions of illness over the long term in patients with acute myocardial infarction (AMI). METHODS 178 patients were asked during the index hospitalization and 2-2.5 years after discharge whether they thought each of 13 possible factors may have contributed to their illness. Two dichotomous variables, conventional attribution (attribution to traditional risk factors, CA) and psychosocial attribution (PA), were defined and assessed for each patient. RESULTS General stress, cigarette smoking, and heredity were the most commonly mentioned attribution for the AMI. The proportion of individuals with positive CA increased at follow up. There was little congruence between patients' attributions and actual self-reported risk factors, either at baseline or at follow up. Age, education, country of birth, and anxiety were found as independent predictors of illness attribution. The participation in a cardiac prevention and rehabilitation program (CPRP) did not contribute to a significant change in CA attributions. CONCLUSION Substantial proportions of patients have a poor understanding of the causes of their AMI both at onset of the illness and 2-2.5 years later, notwithstanding CPRP. PRACTICE IMPLICATIONS The health care system can ill afford complacency with regards patient education and understanding.
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Affiliation(s)
- Orna Reges
- Meir Medical Center, Department of Cardiology, Kfar Saba, Israel.
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23
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Chan CW, Lopez V, Chung JWY. A qualitative study of the perceptions of coronary heart disease among Hong Kong Chinese people. J Clin Nurs 2010; 20:1151-9. [DOI: 10.1111/j.1365-2702.2010.03526.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lytsy P, Burell G, Westerling R. Views on treatment necessity, harm, and benefits in patients using statins. Med Decis Making 2009; 30:594-609. [PMID: 20008151 DOI: 10.1177/0272989x09353196] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Patients with dyslipidemia and high overall risk of ischemic heart disease are those most likely to benefit from treatment with statins. The objective of this study was to investigate patients' views of the necessity, harm, and expected benefits of their statin treatment, as well as factors associated with these treatment beliefs. One main objective was to investigate whether cardiovascular risk level and previous coronary heart disease affect the way patients view these different aspects of their medication. METHODS A total of 829 statin users were recruited while visiting a pharmacy to collect their statin medication (response rate, 69.4%). Patients returned a questionnaire assessing their medical history, concurrent risk status, social demographic factors, as well as their views and expectations regarding their statin treatment. RESULTS Previous ischemic heart disease, or high risk of such disease, was not associated with a more favorable notion on statin treatment. Having an internal health locus of control as well as being satisfied with the physician's treatment explanation were factors associated with more positive views on expected treatment effect. The views on necessity, harm, and treatment benefit were closely associated with each other. CONCLUSION The main findings in this study suggest that cardiovascular risk level and previous coronary heart disease are not associated with the way patients value potential benefits of statin treatment. Patients' views of the treatment's necessity, harm, and benefits do not seem to be independent dimensions of patient beliefs but rather represent one overall question: is this good for me?
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Affiliation(s)
- Per Lytsy
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
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Association of medical noncompliance and long-term adverse outcomes, after myocardial infarction in a minority and uninsured population. Transl Res 2009; 154:78-89. [PMID: 19595439 DOI: 10.1016/j.trsl.2009.05.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Revised: 04/25/2009] [Accepted: 05/15/2009] [Indexed: 11/21/2022]
Abstract
The association of noncompliance with evidence-based medical therapies after myocardial infarction (MI) on long-term outcomes is not well recognized in minority and uninsured populations. Consecutive MI patients at a large urban hospital were followed for compliance with evidence-based medications (aspirin, clopidogrel, statins, beta blockers, and angiotensin converting enzyme inhibitors [ACEIs]/angiotensin receptor blockers [ARBs]). Noncompliance was defined as proportion of days covered < or =80%. The outcome was combined mortality and MI. Kaplan-Meier analyses were used to explore the impact of noncompliance > or =4 medications. Of the 509 patients (86% minorities, 77% uninsured, and 54% diabetics), 132 (25.9%) presented with ST segment elevation with myocardial infarction (STEMI) and 377 (74.1%) with a non-ST segment elevation with myocardial infarction (NSTEMI), revascularization was performed in 297 (58.4%) patients, 72 (14.2%) patients died, 22 (4.3%) patients had an MI, and 91 (17.9%) patients had either event at a median follow-up of 2 (0.5-2.9) years. Noncompliance > or = 4 medications was significantly associated with adverse survival compared with compliant patients (29.7% vs 78.9%). After adjusting for traditional risk factors, The Global Registry of Acute Coronary Events risk score for predicting death during 6 months post-discharge, revascularization, left ventricular (LV) function, coronary artery disease (CAD) severity, and punctual clinic visits, noncompliance with > or = 4 evidence-based medications was an independent factor associated with death or MI (hazard ratio [HR], 2.83; 95% confidence interval [CI]=1.60-5.01) in this minority and uninsured population.
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Causal beliefs, cardiac denial and pre-hospital delays following the onset of acute coronary syndromes. J Behav Med 2008; 31:498-505. [DOI: 10.1007/s10865-008-9174-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Accepted: 08/26/2008] [Indexed: 10/21/2022]
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Brown GA, Lynott F, Heelan KA. A fitness screening model for increasing fitness assessment and research experiences in undergraduate exercise science students. ADVANCES IN PHYSIOLOGY EDUCATION 2008; 32:212-218. [PMID: 18794243 DOI: 10.1152/advan.00025.2007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
When students analyze and present original data they have collected, and hence have a cultivated sense of curiosity about the data, student learning is enhanced. It is often difficult to provide students an opportunity to practice their skills, use their knowledge, and gain research experiences during a typical course laboratory. This article describes a model of an out-of-classroom experience during which undergraduate exercise science students provide a free health and fitness screening to the campus community. Although some evidence of the effectiveness of this experience is presented, this is not a detailed evaluation of either the service or learning benefits of the fitness screening. Working in small learning groups in the classroom, students develop hypotheses about the health and fitness of the population to be screened. Then, as part of the health and fitness screening, participants are evaluated for muscular strength, aerobic fitness, body composition, blood pressure, physical activity, and blood cholesterol levels. Students then analyze the data collected during the screening, accept or reject their hypotheses based on statistical analyses of the data, and make in-class presentations of their findings. This learning experience has been used successfully to illustrate the levels of obesity, hypercholesterolemia, and lack of physical fitness in the campus community as well as provide an opportunity for students to use statistical procedures to analyze data. It has also provided students with an opportunity to practice fitness assessment and interpersonal skills that will enhance their future careers.
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Affiliation(s)
- Gregory A Brown
- Human Performance Laboratory, Department of Health, Physical Education, Recreation, and Leisure Studies, The University of Nebraska at Kearney, Kearney, NE 68849, USA.
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Sohn M, Stotts NA, Benowitz N, Christopherson D, Kim KS, Jang YS, Ahn MS, Froelicher ES. Beliefs about health, smoking, and future smoking cessation among South Korean men hospitalized for cardiovascular disease. Heart Lung 2007; 36:339-47. [PMID: 17845880 DOI: 10.1016/j.hrtlng.2006.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2005] [Accepted: 11/13/2006] [Indexed: 11/28/2022]
Abstract
BACKGROUND A particularly high rate of smoking among South Korean men corresponds to high rates of cardiovascular disease. OBJECTIVES This study evaluated South Korean men hospitalized with cardiovascular disease to explore beliefs about the health benefits of smoking cessation, to determine smoking cessation intentions, and to identify factors associated with confidence in quitting smoking. METHODS This was a cross-sectional, descriptive study. RESULTS Of the study's 97 participants, only 78% believed that smoking cessation avoids or decreases the chance of developing heart disease; 93% reported their intention to quit; 74% had moderate to high confidence about quitting within the month after hospital discharge; and 88% preferred to quit by themselves without help. Significant predictors of low confidence in quitting were being married (odds ratio: 5.54, 95% confidence interval: 1.33-23.08); being alcohol dependent (odds ratio: 3.25, confidence interval: 1.20-8.80); and starting to smoke at or before 20 years of age (odds ratio: 2.96, confidence interval: 1.14-7.68). CONCLUSION The study's participants were motivated to quit smoking for their health, but they must be educated to understand that smoking is addictive and that special intervention is needed.
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Affiliation(s)
- Min Sohn
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California, USA
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