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Ai AL, Appel HB, Lin CJ. Sex and Psychosocial Differences in Acute Stress Symptoms Prior to Open-Heart Surgery. Int J Behav Med 2024:10.1007/s12529-024-10287-1. [PMID: 38730199 DOI: 10.1007/s12529-024-10287-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Acute stress symptoms can occur while cardiac patients await open-heart surgery (OHS). The distress leads to poor outcomes. This study aimed to investigate the association of sex and psychosocial factors (quality-of-life and character strengths). METHOD Our study cohort included 481 pre-OHS patients (female 42%; mean age 62 years). Medical indices/factors were obtained from the Society of Thoracic Surgeon's national database. Multiple regression analyses were performed following pre-planned steps and adjusting medical factors. RESULTS Our findings revealed that sex differences in trauma-related symptoms were associated with poor mental well-being, alongside comorbidities. Both mental well-being and comorbidity factors were directly related to acute stress symptoms, while dispositional optimism had an inverse association with this outcome. CONCLUSION To improve OHS outcomes, our findings suggest healthcare providers be attentive to pre-OHS acute stress symptoms, pay greater attention to the emotional well-being of their female patients, and develop supportive interventions to enhance personality strengths.
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Affiliation(s)
- Amy L Ai
- Florida State University, College of Social Work, 296 Champions Way, Tallahassee, FL, 32306-2570, USA.
| | - Hoa B Appel
- Florida State University, College of Social Work, 296 Champions Way, Tallahassee, FL, 32306-2570, USA.
- University of Washington Bothell, School of Nursing and Health Studies, 17927 113th Ave NE, Bothell, WA, 98011, USA.
| | - Chyongchiou J Lin
- Florida State University, College of Social Work, 296 Champions Way, Tallahassee, FL, 32306-2570, USA.
- The Ohio State University, College of Nursing, 1577 Neil Avenue, Columbus, OH, 43210, USA.
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Kovacs AH, Lebovic G, Raptis S, Blais S, Caldarone CA, Dahdah N, Dallaire F, Drolet C, Grewal J, Hancock Friesen CL, Hickey E, Karur GR, Khairy P, Leonardi B, Keir M, McCrindle BW, Nadeem SN, Ng MY, Shah AH, Tham EB, Therrien J, Warren AE, Vonder Muhll IF, Van de Bruaene A, Yamamura K, Farkouh ME, Wald RM. Patient-Reported Outcomes After Tetralogy of Fallot Repair. J Am Coll Cardiol 2023; 81:1937-1950. [PMID: 37164527 DOI: 10.1016/j.jacc.2023.03.385] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/01/2023] [Accepted: 03/02/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Comprehensive assessment of tetralogy of Fallot (TOF) outcomes extends beyond morbidity and mortality to incorporate patient-reported outcomes (PROs), including quality of life (QOL) and health status (HS). OBJECTIVES This study explored PROs in adolescents and adults with TOF and delineated variables associated with PROs. METHODS This was a cross-sectional observational study within a larger prospective registry of adolescents and adults with repaired TOF and moderate or greater pulmonary regurgitation from North America, Europe, and Asia. Participants completed PROs, including a QOL linear analogue scale (QOL-LAS) and an HS visual analogue scale (HS-VAS). Scores were classified according to age cohorts: <18, 18 to 25, 26 to 40, and >40 years. RESULTS The study included 607 patients (46.3% female; median age 28.5 years). Median QOL-LAS scores (0-100) were similar across age cohorts (85, 80, 80, 80; P = 0.056). Median HS-VAS scores (0-100) were lowest for the oldest cohort (77) compared with the 3 younger cohorts (85, 80, 80) (P = 0.004). With advancing age, there were increased reports of poor mobility (P < 0.001) and pain or discomfort (P = 0.004); problems in these dimensions were reported by 19.1% and 37.2% of patients aged >40 years, respectively. Of factors associated with superior PROs on multivariable regression modeling (ie, being White, being nonsyndromic, having employment, and having better left ventricular function; P < 0.05), asymptomatic status (functional class I) was the variable associated with the greatest number of QOL and HS measures (P < 0.001). CONCLUSIONS Strategies to improve TOF outcomes should consider PROs alongside conventional clinical variables. Factors associated with poorer PROs represent opportunities to intervene to improve the lives of patients with TOF.
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Affiliation(s)
- Adrienne H Kovacs
- Equilibria Psychological Health, Toronto, Ontario, Canada; Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Gerald Lebovic
- Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada
| | - Stavroula Raptis
- Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada
| | - Samuel Blais
- Division of Pediatrics, University of Sherbrooke, Sherbrokke, Quebec, Canada; Research Centre of the Sherbrooke University Hospital, Sherbrooke, Quebec, Canada
| | | | - Nagib Dahdah
- Division of Pediatric Cardiology, Sainte-Justine University Hospital Center, Montreal, Quebec, Canada
| | - Frédéric Dallaire
- Division of Pediatrics, University of Sherbrooke, Sherbrokke, Quebec, Canada; Research Centre of the Sherbrooke University Hospital, Sherbrooke, Quebec, Canada
| | - Christian Drolet
- Division of Pediatric and Congenital Cardiology, Department of Pediatrics, Laval University Hospital, Quebec City, Quebec, Canada
| | - Jasmine Grewal
- Yasmin and Amir Virani Provincial Adult Congenital Heart Program, Vancouver, British Columbia, Canada
| | | | - Edward Hickey
- Division of Cardiovascular Surgery, Texas Children's Hospital, Houston, Texas, USA
| | - Gauri Rani Karur
- Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
| | - Paul Khairy
- Adult Congenital Center, Montreal Heart Institute, University of Montreal, Montreal, Quebec, Canada
| | - Benedetta Leonardi
- Department of Pediatric Cardiology, Cardiac Surgery and Heart Lung Transplantation, Bambino Gesù Hospital and Research Institute, Scientific Institute for Research, Hospitalization, and Health Care, Rome, Italy
| | - Michelle Keir
- Southern Alberta Adult Congenital Heart Disease Clinic, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - Brian W McCrindle
- Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Syed Najaf Nadeem
- Division of Cardiology, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada
| | - Ming-Yen Ng
- Department of Diagnostic Radiology, School of Clinical Medicine, The University of Hong Kong, Hong Kong; Department of Medical Imaging, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Ashish H Shah
- Division of Cardiology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Edythe B Tham
- Pediatric Cardiology, Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Judith Therrien
- MAUDE Unit (McGill University Health Network/Beth Raby Adult Congenital Heart Disease Clinic, Jewish General Hospital), Montreal, Quebec, Canada
| | - Andrew E Warren
- Division of Pediatric Cardiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | | | - Michael E Farkouh
- Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Rachel M Wald
- Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada; Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada; Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Division of Cardiology, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
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Barriault S, Jbilou J, Charbonneau A, Greenman PS, Grenier J, Chomienne MH. Relationship satisfaction and psychological wellbeing in men having participated in the MindTheHeart® psychoeducation intervention after an acute coronary syndrome. Health Psychol Open 2023; 10:20551029231179165. [PMID: 37273832 PMCID: PMC10233598 DOI: 10.1177/20551029231179165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
This study investigated the associations of relationship satisfaction, depression, and anxiety post-acute coronary syndrome in a sample of men having completed an early, couple-focused, and men-tailored psychoeducation intervention. A baseline sample of 50 male patients were followed over a 12-month period and completed the Couples Satisfaction Index and the Depression, Anxiety and Stress Scale. Results revealed a significant improvement in depression symptoms from T0 to T1, during which all participants completed the MindTheHeart® psychoeducation intervention. In addition, a hierarchical regression analysis showed that relationship satisfaction is an important predictor of this improvement in depression symptoms. Our preliminary findings point to the consideration of life partners in post-ACS interventions and encourage the exploration of this clinical approach in future research.
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Affiliation(s)
| | - Jalila Jbilou
- Université de Moncton, Moncton, NB, Canada
- Centre de Formation Médicale du
Nouveau-Brunswick, Moncton, NB, Canada
| | | | | | - Jean Grenier
- University of Ottawa, Ottawa, ON, Canada
- Institut du Savoir Montfort, Ottawa, ON, Canada
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Kähkönen JE, Krämer UM, Buades-Rotger M, Beyer F. Regulating interpersonal stress: the link between heart-rate variability, physical exercise and social perspective taking under stress. Stress 2021; 24:753-762. [PMID: 33818287 DOI: 10.1080/10253890.2021.1907339] [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] [Indexed: 10/21/2022] Open
Abstract
Social interactions can be stressful, especially if they involve provocation or ambiguity. At the same time, such interactions necessitate social cognition. The question thus arises how stress affects social cognition and how personality attributes modulate this effect. The aim of the current study was to investigate the link between emotional reactivity, physical exercise, and social cognition under stress. As a measure of social cognition, we used spontaneous perspective taking, i.e., the degree to which participants represented the mental state of another agent. Studying young female participants, we investigated how physiological regulation, measured through resting heart-rate variability, is related to spontaneous social perspective taking under stress, and to predicted anger in an ambiguous social scenario. When controlling for resting heart rate, vagally mediated heart-rate variability was negatively correlated with the effect of stress on perspective taking, indicating that good physiological regulation supports social cognition under stress. Further, participants who reported to exercise at least once a week showed higher perspective taking under stress than less active participants. Finally, we found tentative evidence for participants who exercised regularly to show reduced predicted anger in response to an ambiguous provocation. Our findings suggest that good physiological regulation and regular physical exercise support social cognition under stress.
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Affiliation(s)
- Jenni E Kähkönen
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK
| | - Ulrike M Krämer
- Department of Neurology, University of Lübeck, Lübeck, Germany
- Department of Psychology, University of Lübeck, Lübeck, Germany
| | - Macià Buades-Rotger
- Department of Neurology, University of Lübeck, Lübeck, Germany
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Frederike Beyer
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK
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Jbilou J, Grenier J, Chomienne MH, Talbot F, Tulloch H, D'Antono B, Greenman P. Understanding men's psychological reactions and experience following a cardiac event: a qualitative study from the MindTheHeart project. BMJ Open 2019; 9:e029560. [PMID: 31562150 PMCID: PMC6773299 DOI: 10.1136/bmjopen-2019-029560] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Emotional issues such as depression, anxiety and post-traumatic stress disorder are common following a cardiac event. Despite their high prevalence, they often go undiagnosed and research suggests that men in particular are at higher risk. Therefore, a better understanding of men's experiences with a cardiac event and ensuing health services is key for adapting approaches that meet their needs. The aim of this study was to describe the self-reported emotional challenges that men face following a cardiac event and to understand their patterns of psychosocial adjustment. DESIGN Qualitative study (focus groups and one-on-one interviews) using an interpretive phenomenal analysis. SETTING Clinical settings (cardiac departments in hospitals, cardiac rehabilitation programme and family medicine clinics) and in the community in three Canadian provinces. PARTICIPANTS A total of 93 men participated in the study through 22 focus groups and 5 semi-structured interviews, none has been excluded based on comorbidities. RESULTS Four major themes emerged: (1) managing uncertainty and adversity; (2) distancing, normalising and accepting; (3) conformity to traditional masculine norms and (4) social, literacy and communication challenges. CONCLUSIONS Healthcare professionals caring for men following a cardiac event must be aware of the psychological and social adjustments that accompany the physical challenges. However, there is a lack of explicit guidelines, tools and clinical training in men-sensitive approaches. Further research is required to better inform clinical practices and healthcare services.
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Affiliation(s)
- Jalila Jbilou
- Psychology, Universite de Moncton, Moncton, New Brunswick, Canada
- Centre de formation médicale du Nouveau Brunswick, Universite de Moncton, Moncton, New Brunswick, Canada
| | - Jean Grenier
- Institut du Savoir Montfort, Hopital Montfort, Ottawa, Ontario, Canada
| | - Marie-Helene Chomienne
- Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - France Talbot
- Psychology, Universite de Moncton, Moncton, New Brunswick, Canada
| | - Heather Tulloch
- University of Ottawa Heart Institute, Cardiac Prevention and Rehabilitation, University of Ottawa, Ottawa, Ontario, Canada
| | - Bianca D'Antono
- Psychology Department and Research Centre at the Montreal Heart Institute, Universite de Montreal, Montreal, Quebec, Canada
| | - Paul Greenman
- Institut du Savoir Montfort, Hopital Montfort, Ottawa, Ontario, Canada
- Département de Psychoéducation et de Psychologie, Universite du Quebec en Outaouais, Gatineau, Quebec, Canada
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