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Holmlund L, Hörnsten C, Hörnsten Å, Olsson K, Valham F, Hellström Ängerud K. More positive patient-reported outcomes in patients newly diagnosed with atrial fibrillation: a comparative longitudinal study. Eur J Cardiovasc Nurs 2024; 23:618-626. [PMID: 38170563 DOI: 10.1093/eurjcn/zvad139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/29/2023] [Accepted: 12/23/2023] [Indexed: 01/05/2024]
Abstract
AIMS To compare patient-reported outcomes (PROs) in patients newly (<6 months) diagnosed with atrial fibrillation (AF) with those who have had a longer diagnosis (≥6 months) and to investigate whether or not these outcomes change over a 6-month period. METHODS AND RESULTS In this longitudinal survey study, 129 patients with AF completed the Revised Illness Perception Questionnaire, the Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia, and the Hospital Anxiety and Depression Scale at baseline and after 6 months. At baseline, patients newly diagnosed with AF (n = 53), compared with patients with a previous diagnosis (n = 76), reported AF as more temporary (P = 0.003) and had a higher belief in personal and treatment control (P = 0.004 and P = 0.041, respectively). At a 6-month follow-up, patients newly diagnosed reported a lower symptom burden (P = 0.004), better health-related quality of life (HRQoL); (P = 0.015), and a higher personal control (P < 0.001) than patients previously diagnosed. Over time, in patients newly diagnosed, symptom burden and the anxiety symptom score decreased (P = 0.001 and P = 0.014, respectively) and HRQoL improved (P = 0.002). CONCLUSION Patients newly diagnosed with AF reported more positive PROs both at baseline and at a 6-month follow-up than patients with a previous diagnosis of AF. Therefore, it is important to quickly capture patients newly diagnosed to support their belief in their own abilities. Such support may, alongside medical treatments, help patients manage the disease, which may lead to reduced symptom burden and better HRQoL over time.
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Affiliation(s)
- Lena Holmlund
- Department of Nursing, Umeå University, Linnaeus väg 9, 907 36 Umeå, Sweden
| | - Carl Hörnsten
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
| | - Åsa Hörnsten
- Department of Nursing, Umeå University, Linnaeus väg 9, 907 36 Umeå, Sweden
| | - Karin Olsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Fredrik Valham
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Sands I, Picariello F, Maple H, Chilcot J. Psychosocial and Clinical Associations of Fatigue Severity and Fatigue-Related Impairment in Kidney Transplant Recipients. Behav Med 2024; 50:153-163. [PMID: 36803685 DOI: 10.1080/08964289.2022.2159311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 11/29/2022] [Accepted: 12/06/2022] [Indexed: 02/22/2023]
Abstract
Debilitating fatigue is common in people living with kidney disease and often persists after a kidney transplant. Current understanding of fatigue is centered around pathophysiological processes. Little is known about the role of cognitive and behavioral factors. The aim of this study was to evaluate the contribution of these factors to fatigue among kidney transplant recipients (KTRs). A cross-sectional study of 174 adult KTRs who completed online measures of fatigue, distress, illness perceptions, and cognitive and behavioral responses to fatigue. Sociodemographic and illness-related information was also collected. 63.2% of KTRs experienced clinically significant fatigue. Sociodemographic and clinical factors explained 16.1% and 31.2% of the variance in the fatigue severity and fatigue impairment, respectively, increasing by 28% and 26.8% after adding distress. In adjusted models, all the cognitive and behavioral factors except for illness perceptions were positively associated with increased fatigue-related impairment, but not severity. Embarrassment avoidance emerged as a key cognition. In conclusion, fatigue is common following kidney transplantation and associated with distress and cognitive and behavioral responses to symptoms, particularly embarrassment avoidance. Given the commonality and impact of fatigue in KTRs, treatment is a clinical need. Psychological interventions targeting distress and specific beliefs and behaviors related to fatigue may be beneficial.
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Affiliation(s)
- Imogen Sands
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Federica Picariello
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Hannah Maple
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Joseph Chilcot
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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van den Houdt SCM, Mommersteeg PMC, Widdershoven J, Kupper N. Sex and Gender Differences in Psychosocial Risk Profiles Among Patients with Coronary Heart Disease - the THORESCI-Gender Study. Int J Behav Med 2024; 31:130-144. [PMID: 37170007 PMCID: PMC10803502 DOI: 10.1007/s12529-023-10170-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Psychosocial factors tend to cluster and exhibit differences associated with sex assigned at birth. Gender disparities, though, remain uncharted so far. The current study aimed to first explore the clustering of eight established psychosocial risk factors among patients with coronary heart disease (CHD), followed by examining how sex and gender differences characterize these psychosocial risk profiles, while adjusting for the effect of age. METHOD In total, 532 patients with CHD (Mage = 68.2 ± 8.9; 84% male) completed the comprehensive psychosocial screener and questionnaires to gauge gender identity, traits, and sociocultural norm scores. A three-step latent profile analysis (LPA) was performed to identify latent profiles and their correlates. RESULTS LPA revealed six psychosocial risk profiles: (1) somewhat distressed overall (32%); (2) low distress (27%); (3) anger, hostility, and Type D (15%); (4) emotional distress and trauma (11%); (5) anxiety (9%); and (6) high overall distress (7%). Masculine traits and older age increased the odds to belong to the low distress profile (#2), while feminine traits and a feminine gender norm score increased the chance to belong to profiles with moderate to high distress. The effects of gender identity and feminine traits were sex dependent. CONCLUSION The current study's findings explain heterogeneity among patients with CHD by considering the joint occurrence of psychosocial risk factors, and the role of sex, age, and gender within those profiles. Being more sensitive to the roles that sex, gender, and an integrated set of risk factors play may ultimately improve treatment and adherence.
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Affiliation(s)
- Sophie C M van den Houdt
- Center of Research On Psychological Disorders and Somatic Diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands
| | - Paula M C Mommersteeg
- Center of Research On Psychological Disorders and Somatic Diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands
| | - Jos Widdershoven
- Center of Research On Psychological Disorders and Somatic Diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands
- Department of Cardiology, Elisabeth-TweeSteden Hospital, Doctor Deelenlaan 5, 5042 AD, Tilburg, the Netherlands
| | - Nina Kupper
- Center of Research On Psychological Disorders and Somatic Diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands.
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Holmlund L, Hörnsten C, Valham F, Olsson K, Hörnsten Å, Ängerud KH. Illness Perceptions and Health-Related Quality of Life in Women and Men With Atrial Fibrillation. J Cardiovasc Nurs 2024; 39:49-57. [PMID: 37074949 DOI: 10.1097/jcn.0000000000000995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
BACKGROUND Health-related quality of life (HRQoL) is worse in patients with atrial fibrillation (AF) compared with other populations. Factors affecting HRQoL in patients with AF are not fully clarified. Illness perceptions are important determinants of disease management and may affect HRQoL. OBJECTIVE The aims of this study were to describe illness perceptions and HRQoL in women and men with AF and to explore the relationship between illness perceptions and HRQoL in patients with AF. METHODS This cross-sectional study included 167 patients with AF. Patients completed the Revised Illness Perception Questionnaire and HRQoL questionnaires: Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmias, the three-level version of the EuroQol 5-dimensional questionnaire, and EuroQol visual analog scale. Subscales of the Revised Illness Perception Questionnaire significant in correlation analysis with the Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmias HRQoL total scale were included in a multiple linear regression model. RESULTS Mean age was 68.7 ± 10.4 years, and 31.1% were women. Women reported lower personal control ( P = .039) and worse HRQoL measured with the Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmias physical subscale ( P = .047) and the EuroQol visual analog scale ( P = .044) compared with men. Illness identity ( P < .001), consequences ( P = .031), emotional representation ( P = .014), and timeline cyclical ( P = .022) were related to and adversely affected HRQoL. CONCLUSIONS This study found a relationship between illness perceptions and HRQoL. Some subscales of illness perceptions negatively affected HRQoL in patients with AF, which indicates that efforts to change illness perceptions may be helpful in improving HRQoL. Patients should be given the opportunity to talk about the disease, their symptoms, their emotions, and the consequences of the disease to enable increased HRQoL. A challenge for healthcare will be to design support for each patient based on his/her illness perceptions.
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Vasilaki M, Vlachou E, Kavga A, Govina O, Dokoutsidou E, Evangelou E, Ntikoudi A, Mantoudi A, Alikari V. Fatigue among Patients with Type 2 Diabetes Mellitus: The Impact of Spirituality and Illness Perceptions. Healthcare (Basel) 2023; 11:3154. [PMID: 38132044 PMCID: PMC10742637 DOI: 10.3390/healthcare11243154] [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: 10/22/2023] [Revised: 11/30/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023] Open
Abstract
Type 2 Diabetes Mellitus (T2DM) can cause fatigue, negatively affecting the daily functioning and health of individuals. The purpose of this study was to investigate the impact of spirituality and illness perceptions on fatigue among patients with Type 2 Diabetes Mellitus. In this cross-sectional, descriptive study, 100 patients with Type 2 Diabetes Mellitus completed the Fatigue Assessment Scale, the FACIT Sp-12 scale, and the Illness Perception Questionnaire-Revised assessing fatigue, spirituality, and illness perceptions, respectively. The mean age of the sample was 52.18 ± 15.53 years and 65% were insulin-treated patients. The mean score for the FACIT Sp-12 scale was 31.86 ± 7.7, for the FAS 27.0 ± 7.63, and for the Consequences and Emotional Representations of IPQ-R 25.5 ± 5.3. Statistically negative significant correlations were observed between the FACIT Sp-12 total score and the FAS subscales (r = -0.44 to -0.48, p < 0.01) and positive correlations between the "IP-Consequences and Emotional Representations" subscales and FAS scores. The total score of the FACIT Sp-12 (β = -0.35) was a negative predictor while Consequences and Emotional Representations (β = 0.28) were positive predictors of the total FAS Score. Participants scored moderate levels of total fatigue. Spirituality and positive illness perceptions may have a protective effect on the fatigue of patients with Type 2 Diabetes Mellitus.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Victoria Alikari
- Post Graduate Program “Management of Chronic Diseases–Diabetes Nursing Care”, Department of Nursing, University of West Attica, 12243 Egaleo, Greece; (M.V.); (E.V.); (A.K.); (O.G.); (E.D.); (E.E.); (A.N.); (A.M.)
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van den Houdt SCM, Widdershoven J, Kupper N. Patient and healthcare professionals' perceived barriers and facilitators to the implementation of psychosocial screening in cardiac practice: A Delphi study. Gen Hosp Psychiatry 2023; 85:104-113. [PMID: 37862959 DOI: 10.1016/j.genhosppsych.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Psychosocial risk factors contribute to the incidence and progression of coronary heart disease (CHD). Psychosocial screening may identify individuals who are at risk and aid them with getting appropriate care. To successfully implement psychosocial screening in the cardiology practice, the current study aims to identify key barriers and facilitators to its implementation and evaluate their perceived importance among health care professionals (HCPs) and patients. METHODS We took a modified 3-round Delphi study approach to gain insight into key determinants that could either impede or ease implementation. Round 1 gathered data from HCPs (n = 9; cardiologists, medical psychologists, cardiac nurses) and CHD patients (n = 21), which we transcribed verbatim, coded, and processed into unique determinants. In rounds 2 and 3, participants were asked to select the most relevant determinants and rank them based on importance. Subsequently, determinants were classified by implementation level. RESULTS Patients were generally more positive towards screening. HCP barriers included time-constraints, disruption of primary activities, and limited knowledge on psychosocial risk and screening, while patient barriers were commonly related to accessibility and patient characteristics (e.g., health literacy, motivation). Facilitators of both groups mainly pertained to the use of the screener and follow-up care, such as increasing the accessibility and the benefits of the screener. CONCLUSION Barriers may be targeted by enhancing the effects of the facilitators. Increasing the accessibility to the screener and interventions, improving information provision, and appointing a contact person to oversee the screening process may ease the screening and care process for both patients and HCPs.
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Affiliation(s)
- Sophie C M van den Houdt
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, the Netherlands
| | - Jos Widdershoven
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, the Netherlands; Department of Cardiology, Elisabeth-TweeSteden hospital, the Netherlands
| | - Nina Kupper
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, the Netherlands.
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Jennings CS, Astin F, Prescott E, Hansen T, Gale Chris P, De Bacquer D. Illness perceptions and health literacy are strongly associated with health-related quality of life, anxiety, and depression in patients with coronary heart disease: results from the EUROASPIRE V cross-sectional survey. Eur J Cardiovasc Nurs 2023; 22:719-729. [PMID: 36351004 DOI: 10.1093/eurjcn/zvac105] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 10/12/2023]
Abstract
AIMS To (1) Describe the sociodemographic and risk factor profiles of a sample of patients with coronary disease, (2) Explore associations between illness perceptions and health literacy with sociodemographic characteristics and risk factors, health-related quality of life (HRQoL), anxiety, and depression. METHODS AND RESULTS Conducted as part of the ESC Prevention of CVD Project and EUROASPIRE V survey, patients were consecutively and retrospectively identified 6 months to 2 years after an acute event or elective procedure from 12 countries and interviewed. Three thousand four hundred and eight participants (76% male, mean age 64 years) were recruited, 16% were smokers, 38% obese, 60% physically inactive, and 41% hypertensive. Forty percent had attended cardiac rehabilitation. More threatening illness perceptions were associated with female gender (P < 0.0001), lower income (P < 0.0001), lower education (P = 0.02), obesity (P < 0.0001), sedentary behaviour (P < 0.0001), and diabetes (P < 0.0001). Poorer health literacy was associated with obesity (P = 0.02) and sedentary behaviour (P = 0.0001). Threatening illness perceptions were strongly associated with anxiety, depression, and poorer ratings of HRQoL after multivariable adjustment (all P < 0.001). Poor health literacy was associated with anxiety and depression (P < 0.0001) and poorer ratings of HRQoL (HeartQol scores P = 0.03). Results were consistent across regions of Europe, age, gender, and socio-economic strata. CONCLUSIONS Interventions like cardiac rehabilitation should be targeted at vulnerable groups given the strong associations between more threatening illness perceptions, lower health literacy, lower HRQoL, and higher levels of anxiety and depression. The delivery and content of these interventions should be accessible for those with low health literacy.
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Affiliation(s)
- C S Jennings
- Honorary Professor of Nursing and Interdisciplinary Relations, National Institute for Prevention and Cardiovascular Health, University of Galway, Croí Heart & Stroke Centre, Croí House, Moyola Lane, Newcastle, Galway, H91 FF68, Ireland
| | - F Astin
- Professor of Nursing, School of Health, Wellbeing and Social Care, Faculty of Wellbeing, Education and Language Studies, The Open University, Horlock Building, Walton Hall, Milton Keynes, MK7 6AA, UK
| | - E Prescott
- Professor of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - T Hansen
- Zealand University Hospital, Denmark
| | - P Gale Chris
- Professor of Cardiovascular Medicine, Leeds Institute of Cardiovascular and Metabolic Medicine and Leeds Institute for Data Analytics, University of Leeds; Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Level 11, Worsely Building, Leeds, UK
| | - D De Bacquer
- Professor of Epidemiology, Research Methodology and Biostatistics, Department of Public Health and Primary Care, Ghent University, C. Heymanslaan 10-4K3, 9000 Gent, Belgium
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Striberger R, Zarrouk M, Kumlien C, Axelsson M. Illness perception, health literacy, self-efficacy, adherence and quality of life in patients with intermittent claudication - a longitudinal cohort study. BMC Nurs 2023; 22:167. [PMID: 37198627 DOI: 10.1186/s12912-023-01329-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/05/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Patients with intermittent claudication need lifelong treatment with secondary prevention to prevent cardiovascular events and progression of atherosclerotic disease. Illness perception, health literacy, self-efficacy, adherence to medication treatment, and quality of life are factors influencing patients' self-management. Knowledge of these factors could be important when planning for secondary prevention in patients with intermittent claudication. AIM to compare illness perception, health literacy, self-efficacy, adherence to treatment, and quality of life in in patients with intermittent claudication. METHODS A longitudinal cohort study was conducted with 128 participants recruited from vascular units in southern Sweden. Data were collected through medical records and questionnaires regarding illness perception, health literacy, self-efficacy, adherence to treatment, and quality of life. RESULTS In the subscales in illness perception, patients with sufficient health literacy reported less consequences and lower emotional representations of the intermittent claudication. They also reported higher self-efficacy and higher quality of life than patients with insufficient health literacy. In comparison between men and women in illness perception, women reported higher illness coherence and emotional representations associated with intermittent claudication compared to men. A multiple regression showed that both consequences and adherence were negative predictors of quality of life. When examining changes over time, a significant increase in quality of life was seen between baseline and 12 months, but there were no significant differences in self-efficacy.. CONCLUSION Illness perception differs in relation to level of health literacy and between men and women. Further, the level of health literacy seems to be of importance for patients' self-efficacy and quality of life. This illuminates the need for new strategies for improving health literacy, illness perception, and self-efficacy over time. For example, more tailored information regarding secondary prevention could be provided to strengthen self-management to further improve quality of life in patients with intermittent claudication.
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Affiliation(s)
- Rebecka Striberger
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, SE-20506, Sweden.
- Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden.
| | - Moncef Zarrouk
- Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Christine Kumlien
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, SE-20506, Sweden
- Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden
| | - Malin Axelsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, SE-20506, Sweden
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Acikgoz M, Piri Cinar B, Celebi U, Aciman Demirel E, Karpuz Seren B, Atasoy HT. Illness perception and quality of life in patients with migraine and tension-type headache. Neurol Res 2023; 45:370-380. [PMID: 36413440 DOI: 10.1080/01616412.2022.2148512] [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: 11/23/2022]
Abstract
INTRODUCTION Migraine and tension-type headache (TTH) are important health problems because cause loss of workforce, affect quality of life and are frequently associated with anxiety and depression. Illness perception is defined as a cognitive aspect of illness. The aim of this study is to determinethe relationship of migraine and TTH with quality of life, illness perception, anxiety and depression. MATERIALS AND METHODS Demographic information and headache characteristics of 160 patients (80 migraine, 80 TTH) who has applied to our hospital's neurology outpatient clinics were recorded. Hospital anxiety depression scale, illness perception questionnaire and quality of life short form-36 (SF-36) were applied to these patients. RESULTS Headache severity and duration were higher in migraine patients. Migraine sufferers believed that their illness would last longer and the results would be worse. Negative emotional representations were more common in TTH patients. Understanding of the disease was higher in younger and those with higher levels of education. Social functionality and bodily pain scores were worse than those of TTH patients. Headache severity and duration were higher in women. Anxiety and depression were associated with headache frequency, duration, and severity. It was determined that the severity, duration and frequency of headache also affected the quality of life. CONCLUSION Informing patients in detail about their diseases and increasing their education level can contribute to the improvement of headache representations. In addition, screening and treatment of anxiety and depression may be other interventions that can improve patients' adherence to treatment and quality of life.
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Affiliation(s)
- Mustafa Acikgoz
- Department of Neurology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Bilge Piri Cinar
- Department of Neurology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Ulufer Celebi
- Department of Neurology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Esra Aciman Demirel
- Department of Neurology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Burcu Karpuz Seren
- Department of Neurology, Zonguldak Ataturk State Hospital, Zonguldak, Turkey
| | - Hüseyin Tugrul Atasoy
- Department of Neurology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
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Validity of a German Comprehensive Psychosocial Screening Instrument based on the ESC Cardiovascular Prevention Guidelines. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2023; 69:76-97. [PMID: 36927319 DOI: 10.13109/zptm.2023.69.1.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Background: Following guidelines for cardiovascular disease prevention of the European Society for Cardiology (ESC), the current study validated the German Comprehensive Psychosocial Screening Instrument in participants who underwent coronary angiography. Methods: 314 participants (Mage = 69.7 ± 12.0; 69 % male) completed the German Comprehensive Psychosocial Screening Instrument and validated comparison scales to measure depression (PHQ-9), anxiety (GAD-7), Type D personality (DS14), work stress (ERI), family stress (SMSS), trauma (PC-PTSD), and anger and hostility (Z-scale of MMPI-2). Results: Confirmatory factor analysis (CFA) confirmed that the psychosocial risk factors were separate entities rather than a signs or symptoms of a single broad indication of distress (CFI = .872, RMSEA = .056, SRMR = .058). Intraclass coefficients (ICC), kappa and diagnostic accuracy indicators (receiver operator characteristic [ROC] curves, sensitivity, specificity, and the positive and negative predictive values [PPV; NPV]) indicated that most screener scales were sufficient to good. We also compared patients with established coronary heart disease (CHD; n = 213) to those with no current CHD (n = 100) and found overall similar results. Discussion: The German version of the Comprehensive Psychosocial Screening Instrument has an acceptable performance. Aside from minor improvements, the screening instrument could be implemented in the cardiological practice to screen patients on multidimensional psychosocial risk.
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Darsin Singh SK, Ahmedy FB, Noor ABYA, Abdullah KL, Abidin IZ, Suhaimi AB. Changes in Perception of Illness during Cardiac Rehabilitation Programme among Patients with Acute Coronary Syndrome: A Longitudinal Study. Healthcare (Basel) 2023; 11:healthcare11030311. [PMID: 36766886 PMCID: PMC9914116 DOI: 10.3390/healthcare11030311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/21/2023] Open
Abstract
Little is known about the changes in perception of illness among patients with the acute coronary syndrome (ACS) during cardiac rehabilitation programme (CRP). The purpose of this study is to determine changes in perception of illness with ACS patients during CRP to evaluate the association of patients' characteristics with the perception of illness at the end of Phase II of CRP. A descriptive longitudinal study was conducted among 450 patients who attended 8-weeks of Phase II CRP at 2 public hospitals in Malaysia and perception of illness was assessed using Brief Illness Perception Questionnaire (BIPQ). The assessment was conducted before Phase II (T0), during the 4th session (T1), and at the end of right after the 8th session (T2). One-way repeated measures of ANOVA analysed the changes of perception at T1 and T2 while logistic regression analysis evaluated the association of patients' characteristics with the perception of illness at T2. Perception of illness changed during and after CRP from T0 to T1, and T1 to T2 (p < 0.001). The patient viewed ACS as an illness that changed from being more acute to a chronic condition as the sessions progressed. Previous history of acute myocardial infarction (OR = 2.380, 95% CI 1.46, 5.49) and angioplasty intervention were both found to be associated with the perception of illness (OR = 3.857, 95% CI 1.55, 9.61). Perception of illness changed during CRP and these changes are associated with patients' previous history of cardiac events. Phase II can be viewed as the second window of opportunity for healthcare professionals to intervene early in modifying the perception of illness.
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Affiliation(s)
- Sukhbeer Kaur Darsin Singh
- Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia
- Department of Nursing Science, Faculty of Medicine, Universiti of Malaya, Kuala Lumpur 50603, Wilayah Persekutuan, Malaysia
| | - Fatimah Binti Ahmedy
- Department of Medical Education, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia
- Correspondence: (F.B.A.); (A.B.Y.A.N.)
| | - Abqariyah Binti Yahya Ahmad Noor
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti of Malaya, Kuala Lumpur 50603, Wilayah Persekutuan, Malaysia
- Correspondence: (F.B.A.); (A.B.Y.A.N.)
| | - Khatijah Lim Abdullah
- Department of Nursing, School of Medical and Life Sciences, Sunway University, Subang Jaya 47500, Selangor, Malaysia
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Imran Zainal Abidin
- Deparment of Medicine, Faculty of Medicine, Universiti of Malaya, Kuala Lumpur 50603, Wilayah Persekutuan, Malaysia
| | - Anwar Bin Suhaimi
- Department of Rehabilitation Medicine, Faculty of Medicine, Universiti of Malaya, Kuala Lumpur 50603, Wilayah Persekutuan, Malaysia
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Ravn MB, Uhd M, Svendsen ML, Ørtenblad L, Maribo T. Why Do Patients With Ischaemic Heart Disease Drop Out From Cardiac Rehabilitation in Primary Health Settings. A Qualitative Audit of Patient Charts. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:837174. [PMID: 36188975 PMCID: PMC9397838 DOI: 10.3389/fresc.2022.837174] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/14/2022] [Indexed: 01/08/2023]
Abstract
Background Cardiac rehabilitation (CR) and medical treatment are integrated parts of the intervention for cardiac patients and are a class 1A recommendation. However, CR dropout is reported to be relatively high and little is known about the reasons for CR dropout in primary health settings. Aim This study investigates causes for CR dropout through a qualitative audit of medical charts among patients with ischaemic heart disease. Methods This was a qualitative retrospective audit of patient's medical charts. Patients who dropped out from CR between 1 January and 31 December 2018 in five primary health settings were included. Local patient charts provided information related to causes and formed the basis of the analysis. Data were analyzed using thematic analysis. Results A total of 690 patients were referred for and commenced CR and 199 (29%) dropped out. Twenty-five (12.6%) patients finished CR but were excluded due to standards of ≥180 days between CR meetings, leaving 118 patients included. Four themes as causes for patient's dropout were identified: (1) CR-programmes, (2) logistical, (3) intrapersonal and (4) clinical factors. Conclusion This study identified new focus areas to which health professionals may attend in reducing drop-out from CR. Organisation of CR, challenges with combining labor market attachment and CR, focus on patient education and comorbidities. The results underline the importance of health professionals emphasizing the benefits of CR and explains that CR enhances long-term labor market attachment. Furthermore, health professionals should encourage participation in patient education and adapt exercise to the individual patient's potential.
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Affiliation(s)
- Maiken Bay Ravn
- Department of Public Health, Centre for Rehabilitation Research, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
- *Correspondence: Maiken Bay Ravn
| | - Maria Uhd
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | | | | | - Thomas Maribo
- Department of Public Health, Centre for Rehabilitation Research, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
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13
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Grauman Å, Viberg Johansson J, Falahee M, Veldwijk J. Public perceptions of myocardial infarction: Do illness perceptions predict preferences for health check results. Prev Med Rep 2022; 26:101683. [PMID: 35145837 PMCID: PMC8802064 DOI: 10.1016/j.pmedr.2021.101683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/21/2021] [Accepted: 12/26/2021] [Indexed: 11/28/2022] Open
Affiliation(s)
- Åsa Grauman
- Centre for Research Ethics & Bioethics, Uppsala University, Uppsala, Sweden
- Corresponding author at: Centre for Research Ethics & Bioethics, Uppsala University, Box 564, SE-751 22 Uppsala, Sweden.
| | - Jennifer Viberg Johansson
- Centre for Research Ethics & Bioethics, Uppsala University, Uppsala, Sweden
- The Institute of Future Studies, Stockholm, Sweden
| | - Marie Falahee
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Jorien Veldwijk
- Centre for Research Ethics & Bioethics, Uppsala University, Uppsala, Sweden
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Netherlands
- Erasmus Choice Modelling Centre, Erasmus University, Rotterdam, Netherlands
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14
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Ogunrinde BJ, Adetunji AA, Muyibi SA, Akinyemi JO. Illness perception amongst adults with multimorbidity at primary care clinics in Southwest Nigeria. Afr J Prim Health Care Fam Med 2021; 13:e1-e8. [PMID: 34476972 PMCID: PMC8424730 DOI: 10.4102/phcfm.v13i1.2738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 05/12/2021] [Accepted: 05/15/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although shreds of evidence are emerging to show the role of illness perceptions in the health outcomes of patients, most of the previous studies have been on single chronic conditions. AIM To assess the illness perceptions and the associated factors amongst adults with multimorbidity. SETTING General outpatient clinics of the University College Hospital, Ibadan, Nigeria. METHODS A cross-sectional study was conducted amongst a systematic sample of 403 adults with multimorbidity. Data on illness perception and other variables were collected using interviewer-administered questionnaires. Descriptive statistics, chi-square test, t-test and analysis of variance were employed for analyses. RESULTS The age of the participants ranged from 18 to 97 years, with a mean of 60.9 years (standard deviation [s.d.] ± 14.3 years). The majority of participants (57.3%) were women. Ninety-four (23.3%) respondents had only two morbid conditions, whilst 31.2% had at least four morbid conditions. Prioritisation sub-domain of illness perception recorded the highest score (mean = 2.0, s.d. ± 0.8), whilst the treatment burden sub-domain was the lowest (mean = 0.8, s.d. ± 0.7). A significant bivariate relationship was observed between emotional representation (p = 0.001), prioritisation (p = 0.013) and causal relationship (p = 0.013) sub-domains and age group of study participants. Emotional burden associated with illnesses declined as educational level increased (p = 0.039). CONCLUSION Patient's characteristics such as age, education and the number of morbidities are associated with illness perception. Healthcare providers should pay attention to these factors whilst addressing illness perception as a way to achieve better clinical outcomes.
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15
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Qin H, Mayer H, Öztürk B, Badr Eslam R. Patients’ Perspectives With Acute Coronary Syndrome After Percutaneous Coronary Intervention. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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16
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McBride E, Marlow LAV, Chilcot J, Moss-Morris R, Waller J. Distinct Illness Representation Profiles Are Associated With Anxiety in Women Testing Positive for Human Papillomavirus. Ann Behav Med 2021; 56:78-88. [PMID: 33881145 PMCID: PMC8691260 DOI: 10.1093/abm/kaab022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background Testing positive for human papillomavirus (HPV) at cervical cancer screening has been associated with heightened anxiety. To date, the cognitive determinants of heightened anxiety remain unclear, making it difficult to design effective interventions. Purpose This study investigated latent illness representation profiles in women testing positive for HPV with no abnormal cells (normal cytology) and explored associations between these profiles and anxiety. Methods Women aged 24–66 (n = 646) who had tested HPV-positive with normal cytology at routine HPV primary screening in England completed a cross-sectional survey shortly after receiving their result. Results Latent profile analysis identified three distinct profiles of illness representations (termed “adaptive,” “negative,” and “negative somatic”), which differed significantly in their patterns of illness perceptions. Hierarchal linear regression revealed that these latent illness representation profiles accounted for 21.8% of the variance in anxiety, after adjusting for demographic and clinical characteristics. When compared with adaptive representations (Profile 1), women with negative representations (Profile 2) and negative somatic representations (Profile 3) had significantly higher anxiety, with clinically meaningful between-group differences (mean difference [MD] = 17.26, confidence interval [CI]: 14.29–20.22 and MD = 13.20, CI: 9.45–16.96 on the S-STAI-6, respectively). Conclusion The latent illness representation profiles identified in this study provide support for the role of negative beliefs contributing to anxiety in women testing HPV-positive with normal cytology. Characteristics specific to subgroups of highly anxious women (Profiles 2 and 3) could be used by policymakers to target information in routine patient communications (e.g., test result letters) to reduce unnecessary burden. Future research should adopt longitudinal designs to understand the trajectory of illness representations from HPV diagnosis through to clearance versus persistence.
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Affiliation(s)
- Emily McBride
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Laura A V Marlow
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Joseph Chilcot
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rona Moss-Morris
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jo Waller
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
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17
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Ganz FD, Raanan O, Shafir G, Levy D, Klempfner R, Beigel R, Iakobishvili Z. Illness perceptions of Israeli hospitalized patients with acute coronary syndrome. Nurs Crit Care 2021; 27:157-164. [PMID: 33780082 DOI: 10.1111/nicc.12616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/29/2020] [Accepted: 02/16/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Illness perceptions (IPs) can affect cardiac health behaviours and outcomes. AIMS AND OBJECTIVES To investigate IPs among patients hospitalized with acute coronary syndrome (ACS). DESIGN Longitudinal survey. METHODS The ACS Israel Study is a national, biennial registry, enrolling all patients with ACS admitted to cardiac intensive care or cardiology wards in Israel within a 2-month period. Data includes demographics, medical history, and treatment for ACS using an electronic database. In 2018, a nursing component was added, including the Brief Illness Perception Questionnaire. Data were analysed using descriptive statistics and a two-stage cluster analysis. RESULTS A total of 990 subjects were surveyed. Mean age was 62.8 (SD = 12.5) and most respondents were male and married. Mean IP scores ranged from 3.28 to 6.06. Three clusters were found; one only of women and two only of men (one cluster with lower IPs and little previous medical history and cardiac risk factors and the second with higher IPs, greater medical history, and cardiac risk factors. Those with higher education scored lower on several IPs. CONCLUSIONS Subjects were moderately cognitively and emotionally impacted by their illness. Men tended to perceive their illness as having either a relatively strong or a relatively weak emotional and cognitive impact on their lives, where women were somewhere in-between. Participants with an academic education perceived less of an impact of the illness while those with a previous history of chronic disease reported the opposite. It is recommended that educational interventions and in-depth qualitative studies be designed that investigate the development of IPs during hospitalization to potentially improve cardiac health behaviours, especially among those without a previous medical history and cardiac risk factors. RELEVANCE TO CLINICAL PRACTICE Those without a history of chronic disease or a lower level of education are less likely to absorb the full impact of a cardiac event while hospitalized and should, therefore, be monitored more closely and coached with greater intensity than other groups while still in-hospital.
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Affiliation(s)
- Freda DeKeyser Ganz
- Faculty of Medicine, Hebrew University, Jerusalem, Israel.,Faculty of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel
| | - Ofra Raanan
- School of Nursing, Sheba Medical Center School of Nursing, Ramat Gan, Israel
| | - Gennady Shafir
- Haemek Medical Center, Cardiac Intensive Care Unit, Haemek Hospital, Afula, Israel
| | - Dassy Levy
- Division of Cardiology, Rambam Medical Center, Haifa, Israel
| | - Robert Klempfner
- Department of Cardiology, Cardiac Rehabilitation Institute, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Roy Beigel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Cardiology, Sheba Medical Center, Ramat Gan, Israel
| | - Zaza Iakobishvili
- Department of Community Cardiology, Tel-Aviv Jaffa District, Clalit Health Services, Tel Aviv, Israel.,Department of Cardiology, Samson Assuta Ashdod University Hospital, Ashdod, Israel.,Faculty of Health Sciences, Ben-Gurion University in the Negev, Beersheba, Israel
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18
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Thomson P, Angus NJ, Andreis F, Rushworth GF, Mohan AR, Chung ML, Leslie SJ. Longitudinal evaluation of the effects of illness perceptions and beliefs about cardiac rehabilitation on quality of life of patients with coronary artery disease and their caregivers. Health Qual Life Outcomes 2020; 18:158. [PMID: 32460825 PMCID: PMC7254753 DOI: 10.1186/s12955-020-01405-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients' negative illness perceptions and beliefs about cardiac rehabilitation (CR) can influence uptake and adherence to CR. Little is known about the interpartner influence of these antecedent variables on quality of life of patients with coronary artery disease (CAD) and their family caregivers. The aims of the study were: 1) to assess differences in illness perceptions, beliefs about CR and quality of life between patients with CAD and their family caregivers upon entry to a CR programme and at 6 months follow-up; and 2) to examine whether patients' and caregivers' perceptions of the patient's illness and beliefs about CR at baseline predict their own and their partner's quality of life at 6 months. METHODS In this longitudinal study of 40 patient-caregiver dyads from one CR service, patients completed the Brief Illness Perception Questionnaire and Beliefs about Cardiac Rehabilitation Questionnaire at baseline and 6 months; and caregivers completed these questionnaires based on their views about the patient's illness and CR. The Short-Form 12 Health Survey was used to assess patients' and caregivers' perceived health status. Dyadic data were analysed using the Actor-Partner Interdependence Model. RESULTS Most patients (70%) were men, mean age 62.45 years; and most caregivers (70%) were women, mean age 59.55 years. Caregivers were more concerned about the patient's illness than the patients themselves; although they had similar scores for beliefs about CR. Patients had poorer physical health than caregivers, but their level of mental health was similar. Caregivers' poorer mental health at 6 months was predicted by the patient's perceptions of timeline and illness concern (i.e. partner effects). Patient's and caregiver's illness perceptions and beliefs about CR were associated with their own physical and mental health at 6 months (i.e. actor effects). CONCLUSIONS Overall, the patients and caregivers had similar scores for illness perceptions and beliefs about CR. The actor and partner effect results indicate a need to focus on specific illness perceptions and beliefs about CR, targeting both the individual and the dyad, early in the rehabilitation process to help improve patients and caregivers physical and mental health (outcomes).
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Affiliation(s)
- Patricia Thomson
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK94LA, Scotland, UK.
| | - Neil J Angus
- School of Health, Social Care and Life Sciences, University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, Scotland, UK
| | - Federico Andreis
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK94LA, Scotland, UK
| | - Gordon F Rushworth
- Highland Pharmacy Education & Research Centre, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, Scotland, UK
| | - Andrea R Mohan
- School of Nursing and Health Sciences, University of Dundee, Dundee, DD1 4HN, Scotland, UK
| | - Misook L Chung
- College of Nursing, University of Kentucky, Lexington, KY, 40506, USA
| | - Stephen J Leslie
- Cardiac Unit, Raigmore Hospital, NHS Highland, Old Perth Road, Inverness, IV2 3UJ, Scotland, UK
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19
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Abstract
BACKGROUND Illness perception is composed of thoughts, ideas, and beliefs about illness, and a negative illness perception is known to be associated with poor outcomes. Among men and women, clinical outcomes after heart valve surgery are known to differ, but knowledge about differences in illness perception is sparse. OBJECTIVES The aim of this study is to describe the differences in illness perception among men and women after open heart valve surgery and to identify sociodemographic and clinical characteristics associated with worse illness perception in men and women. METHODS In a national cross-sectional study combined with register-based clinical and sociodemographic information, data on illness perception were collected with the Brief Illness Perception Questionnaire. Worse illness perception was defined as the worst quartile of each item of the Brief Illness Perception Questionnaire. Multiple logistic regression analyses were conducted to explore characteristics associated with worse illness perception. RESULTS Of 1084 eligible patients, 32% (n = 349) completed the questionnaire (67% men; mean age, 68 years). Compared with men, women reported significantly worse scores of illness perception in 6 of 8 items. Furthermore, being female, age, length of stay, and comorbidity were associated with worse illness perception (worse quartile of scores). Age, higher educational level, and comorbidity were found to be associated with worse illness perception for men and length of stay for women. CONCLUSION After open heart valve surgery, illness perception differs among men and women, with women having worse illness perception. Among the total population, being female, age, a longer length of stay, and comorbidity were also associated with worse illness perception.
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20
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Thomson P, Rushworth GF, Andreis F, Angus NJ, Mohan AR, Leslie SJ. Longitudinal study of the relationship between patients' medication adherence and quality of life outcomes and illness perceptions and beliefs about cardiac rehabilitation. BMC Cardiovasc Disord 2020; 20:71. [PMID: 32046646 PMCID: PMC7011382 DOI: 10.1186/s12872-020-01378-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 02/06/2020] [Indexed: 01/11/2023] Open
Abstract
Background Adherence to medication regimens is essential for preventing and reducing adverse outcomes among patients with coronary artery disease (CAD). Greater understanding of the relation between negative illness perceptions, beliefs about cardiac rehabilitation (CR) and medication adherence may help inform future approaches to improving medication adherence and quality of life (QoL) outcomes. The aims of the study are: 1) to compare changes in illness perceptions, beliefs about CR, medication adherence and QoL on entry to a CR programme and 6 months later; 2) to examine associations between patients’ illness perceptions and beliefs about CR at baseline and medication adherence and QoL at 6 months. Methods A longitudinal study of 40 patients with CAD recruited from one CR service in Scotland. Patients completed the Medication Adherence Report Scale, Brief Illness Perception Questionnaire, Beliefs about CR questionnaire and the Short-Form 12 Health Survey. Data were analysed using the Wilcoxon Signed Ranks test, Pearson Product Moment correlation and Bayesian multiple logistic regression. Results Most patients were men (70%), aged 62.3 mean (SD 7.84) years. Small improvements in ‘perceived suitability’ of CR at baseline increased the odds of being fully adherent to medication by approximately 60% at 6 months. Being fully adherent at baseline increased the odds of staying so at 6 months by 13.5 times. ‘Perceived necessity, concerns for exercise and practical barriers’ were negatively associated with reductions in the probability of full medication adherence of 50, 10, and 50%. Small increases in concerns about exercise decreased the odds of better physical health at 6 months by about 50%; and increases in practical barriers decreased the odds of better physical health by about 60%. Patients perceived fewer consequences of their cardiac disease at 6 months. Conclusions Patients’ beliefs on entry to a CR programme are especially important to medication adherence at 6 months. Negative beliefs about CR should be identified early in CR to counteract any negative effects on QoL. Interventions to improve medication adherence and QoL outcomes should focus on improving patients’ negative beliefs about CR and increasing understanding of the role of medication adherence in preventing a future cardiac event.
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Affiliation(s)
- Patricia Thomson
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK94LA, Scotland, UK.
| | - Gordon F Rushworth
- Highland Pharmacy Education & Research Centre, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, Scotland, UK
| | - Federico Andreis
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK94LA, Scotland, UK
| | - Neil J Angus
- School of Health, Social Care and Life Sciences, University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, Scotland, UK
| | - Andrea R Mohan
- School of Nursing and Health Sciences, University of Dundee, Dundee, Scotland, UK
| | - Stephen J Leslie
- Cardiac Unit, Raigmore Hospital, NHS Highland, Old Perth Road, Inverness, IV2 3UJ, Scotland, UK
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Barsaei M, Feizollahzadeh H, Jabbarzadeh F, Hasankhani H, Shabanloei R. The Meaning of Life Related to Heart Disease and Its Relationship to Quality of Life After Repeat Coronary Artery Angioplasty. Creat Nurs 2020; 26:48-55. [PMID: 32024739 DOI: 10.1891/1078-4535.26.1.48] [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: 11/25/2022]
Abstract
PURPOSE Following angioplasty for coronary artery disease, patients may search for a new meaning of life. The purpose of this study was to determine patients' meaning of life related to heart disease and its relationship to quality of life after repeat coronary artery angioplasty. METHODS The current descriptive-correlation study recruited 144 patients with coronary artery disease admitted to hospitals in Karaj, Iran. Data were collected using a demographics questionnaire, the Meaning in Heart Disease (MHD) instrument, and the Iranian version of the Short Form Health Survey (SF-12), and were analyzed with descriptive statistics and the Pearson correlation. FINDINGS There was a significant relationship between the meaning of life related to heart disease (creating illusions, changing goals, reattribution, and meaning congruence) and quality of life scores (p <.05). CONCLUSION The majority of the patients undergoing repeat angioplasty used the creation of illusions to support a positive attitude toward their heart disease. Nursing interventions based on the individual patient's meaning of life can promote health and life quality.
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22
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Wallström S, Ali L, Ekman I, Swedberg K, Fors A. Effects of a person-centred telephone support on fatigue in people with chronic heart failure: Subgroup analysis of a randomised controlled trial. Eur J Cardiovasc Nurs 2019; 19:393-400. [PMID: 31782661 DOI: 10.1177/1474515119891599] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Fatigue is a prevalent symptom that is associated with various conditions. In patients with chronic heart failure (CHF), fatigue is one of the most commonly reported and distressing symptoms and it is associated with disease progression. Person-centred care (PCC) is a fruitful approach to increase the patient's ability to handle their illness. AIM The aim of this study was to evaluate the effects of PCC in the form of structured telephone support on self-reported fatigue in patients with CHF. METHOD This study reports a subgroup analysis of a secondary outcome measure from the Care4Ourselves randomised intervention. Patients (n=77) that were at least 50 years old who had been hospitalized due to worsening CHF received either usual care (n=38) or usual care and PCC in the form of structured telephone support (n=39). Participants in the intervention group created a health plan in partnership with a registered nurse. The plan was followed up and evaluated by telephone. Self-reported fatigue was assessed using the Multidimensional Fatigue Inventory 20 (MFI-20) at baseline and at 6 months. Linear regression was used to analyse the change in MFI-20 score between the groups. RESULTS The intervention group improved significantly from baseline to the 6-month follow-up compared with the control group regarding the 'reduced motivation' dimension of the MFI-20 (Δ -1.41 versus 0.38, p=0.046). CONCLUSION PCC in the form of structured telephone support shows promise in supporting patients with CHF in their rehabilitation, improve health-related quality of life and reduce adverse events. TRIAL REGISTRATION ISRCTN.com ISRCTN55562827.
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Affiliation(s)
- Sara Wallström
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Lilas Ali
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Psychiatric Department, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Inger Ekman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Karl Swedberg
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,National Heart and Lung Institute, Imperial College, London, UK
| | - Andreas Fors
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Närhälsan Research and Development Primary Health Care, Region Västra Götaland, Sweden
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23
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Picariello F, Norton S, Moss-Morris R, Macdougall IC, Chilcot J. A prospective study of fatigue trajectories among in-centre haemodialysis patients. Br J Health Psychol 2019; 25:61-88. [PMID: 31742834 PMCID: PMC7004141 DOI: 10.1111/bjhp.12395] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/15/2019] [Indexed: 12/01/2022]
Abstract
Objectives Fatigue is common and debilitating among dialysis patients. The aim of this study was to understand the longitudinal trajectory of fatigue and consider sociodemographic, clinical, and psychological factors that are related to variation in fatigue levels over time. Design A prospective study of fatigue with yearly assessments over 3 years among prevalent in‐centre haemodialysis (HD) patients. Methods Fatigue severity was measured using the Chalder Fatigue Questionnaire and fatigue‐related functional impairment using the Work and Social Adjustment Scale. The trajectories of fatigue outcomes were examined using piecewise growth models, using length of time on dialysis as time. Sociodemographic, clinical, and psychological predictors of fatigue were assessed using linear growth models, using follow‐up time. Results One hundred and seventy‐four prevalent HD patients completed baseline measures, 118 at 12 months, 84 at 24 months, and 66 at 36 months. Fatigue severity scores decreased by 0.15 each year. Fatigue‐related functional impairment increased by 1.17 each year. In adjusted linear growth models, non‐white ethnicity was a significant predictor of lower initial fatigue severity (B = −2.95, 95% CI −5.51 to −0.40) and a greater reduction in fatigue severity of 1.60 each year (95% CI 0.35–2.36). A one‐point increase in damage beliefs was associated with a 0.36 increase in fatigue‐related functional impairment each year (95% CI −0.61 to −0.01). Conclusion Damage beliefs predicted an increase in fatigue‐related functional impairment over time. However, the data strongly suggested that fatigue outcomes vary by length of time on dialysis. Statement of contribution What is already known on this subject?At least 1 in 2 haemodialysis (HD) patients are clinically fatigued. Growing evidence is available on the important role of psychological factors in fatigue across chronic conditions. The contribution of psychological factors, beyond distress, to fatigue in HD has not been examined to date.
What does this study add?Ethnicity played a role in the initial level of fatigue severity and over time. Damage beliefs predicted an increase in fatigue‐related impairment over time. Data strongly suggested that fatigue outcomes vary by length of time on dialysis.
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Affiliation(s)
- Federica Picariello
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Sam Norton
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Rona Moss-Morris
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | | | - Joseph Chilcot
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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Atwa ZT, Wahed WYA. The impact of illness perception and socio-clinico-demographic factors on perceived quality of life in children and adolescents with thalassemia intermedia. Pediatr Blood Cancer 2019; 66:e27735. [PMID: 30924610 DOI: 10.1002/pbc.27735] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 03/12/2019] [Accepted: 03/15/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND/OBJECTIVES β-Thalassemia intermedia (β-TI) accounts for up to one-fourth of β-thalassemia patients. Evaluating and improving quality of life (QOL) should be a goal in β-TI follow-up and management strategies. Patients' perceptions of their illness and its treatment may impact their QOL. This study aimed to evaluate QOL and the factors that affect it in children with β-TI and to determine the impact of the patients' and their mothers' perceptions of the illness on patients' QOL. DESIGN/METHODS This was a case-control study. A total of 143 children and adolescents (71 β-TI patients and 72 healthy controls) were enrolled. QOL, as perceived by the children and their mothers, was assessed using the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scale. Perceptions of the illness by the mothers and children were assessed using the Brief Illness Perceptions Questionnaire (Brief IPQ). The patients' clinical and sociodemographic data were extracted from their medical records. RESULTS The controls had higher QOL scores in nearly all domains (P < 0.01). The patients and mothers who had higher illness perception scores had better QOL scores (P < 0.01). Patient age and serum ferritin levels correlated negatively with QOL, while mean hemoglobin levels correlated positively. The use of hydroxyurea in treatment and high illness perception were independent predictors of better QOL. CONCLUSION QOL is significantly affected in β-TI patients; maintaining a suitable hemoglobin level and standard levels of body iron are associated with better QOL. Patients' and their mothers' perceptions of the illness play an important role in QOL.
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Affiliation(s)
- Zeze Th Atwa
- Paediatrics Department, Faculty of Medicine, Fayoum University Hospital, Fayoum University, Fayoum, Egypt
| | - Wafaa Y Abdel Wahed
- Public Health and Community Medicine Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
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Sadeghi Akbari A, Cheraghi MA, Kazemnejad A, Nomali M, Zakerimoghadam M. Effect of Illness Perception Correction - Based Educational Program on Quality Of Life and Self- Care in Patients with Heart Failure: a Randomized Controlled Trial. J Caring Sci 2019; 8:89-93. [PMID: 31249818 PMCID: PMC6589485 DOI: 10.15171/jcs.2019.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 10/22/2018] [Indexed: 11/22/2022] Open
Abstract
Introduction: Because of the chronic nature of Heart Failure (HF), low Quality of Life (QoL) and poor self-care are prevalent among patients with HF. Thus, the aim of this study was to evaluate the effect of illness perception correction- based educational program on QoL,and self- care in patients with HF. Methods: In this randomized controlled trial, 78 eligible patients were included in the study from Rajaei Heart Center (Tehran, Iran) and randomly assigned into intervention and control group with 1:1 allocation ratio. The intervention was a combination of illness perception correction- based education program (30- minute sessions over 3 consecutive days) and 10-minute phone calls made once a week in the course of 8 weeks. The control group received usual care. The primary outcome was quality of life and secondary outcomes were self- care and illness- perception which were measured at baseline and at the end of the study. SPSS version 13 was used for the analysis. Results: Out of 76 eligible patients, 70 patients with HF finished the study. Although the mean of quality of life, self-care, and illness perception were not different at baseline, QoL (45.2 (8.3) VS 66.8 (15.4); P<0.001), self-care (18.5 (4.5) VS 37.1 (7.2); P<0.001), and illness- perception (183.6 (8.4) VS 151.2 (24.5); P<0.001) improved following the program in the intervention group in comparison to the control group. Conclusion: According to the study findings, this program can be applied by nurses for patients with HF as a discharge plan in order to improve their QoL, self-care, and their illness perception.
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Affiliation(s)
- Ali Sadeghi Akbari
- Department of Medical Surgical Nursing, Tabas Faculty of Nursing, Birjand UDepartment of Medical Surgical Nursing, Tabas Faculty of Nursing, Birjand University of Medical Sciences, Birjand, Iranniversity of Medical Sciences, Birjand, Iran
| | - Mohammad Ali Cheraghi
- Department of Critical Care Nursing, Faculty of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mahin Nomali
- Department of Critical Care Nursing, Faculty of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Maasoumeh Zakerimoghadam
- Department of Critical Care Nursing, Faculty of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Sawyer AT, Harris SL, Koenig HG. Illness perception and high readmission health outcomes. Health Psychol Open 2019; 6:2055102919844504. [PMID: 31041109 PMCID: PMC6482662 DOI: 10.1177/2055102919844504] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
This review identified associations between illness perception and health outcomes of patients with a medical diagnosis included in the Hospital Readmissions Reduction Program. Inclusion criteria were English language, use of quantitative methodology, health outcomes specified, and identifiable effect size and statistical significance of the relationship. Most of the 31 studies in this review showed that favorable illness perception has been associated with better health outcomes, while unfavorable illness perception has been associated with worse outcomes. A multifaceted approach might include behavioral, clinical, educational, and psychosocial components to improve one’s illness perception through educative, cognitive-behavioral, or psychodynamic counseling.
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Bagherian-Sararoudi R, Maracy M, Sanei H, Shiri M. Factors in relation with fatigue and illness perception in patients with myocardial infarction and the changes in fatigue due to intervention on illness perception: Research design, methodology, and preliminary results. ARYA ATHEROSCLEROSIS 2019; 15:74-81. [PMID: 31440289 PMCID: PMC6679657 DOI: 10.22122/arya.v15i2.1888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/16/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND In physical diseases including cardiovascular diseases (CVDs), illness perception (IP) plays an important role in illness outcomes. Fatigue is a major bothersome symptom after myocardial infarction (MI). This manuscript presents the research design, methodology, and primary findings of a study on factors in relation with fatigue and IP in patients with MI, and changes in fatigue after intervention on IP. METHODS 241 patients with MI who experienced a first-time acute MI (AMI) participated in this study in 2016-2017. During hospitalization, the demographic and clinical information of participants were collected. After four months, the information regarding fatigue, IP, coping with stress, type D personality, perceived social support (PSS), and locus of control of the participants was collected at their houses. About one year later, based on the results of phase one of the study, a psychoeducation course was conducted for 35 of the patients as intervention group while 36 patients were supervised as control group. Two months later, the role of IP in fatigue changes of the participants was assessed. RESULTS 155 (65%) of the patients had positive family history of coronary heart disease (CHD). 103 (43%) were cigarette smokers, 100 (43.5%) had high blood cholesterol, and 72 (30%) had sedentary life style before MI. CONCLUSION The overview of the factors related to fatigue and IP of the patients with MI could help the care teams to provide better care in the recovery period of the illness.
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Affiliation(s)
- Reza Bagherian-Sararoudi
- Associate Professor, Behavioral Sciences Research Center AND Department of Health Psychology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammadreza Maracy
- Professor, Department of Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Sanei
- Professor, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medicine Sciences, Isfahan, Iran
| | - Mansoor Shiri
- PhD Candidate, Behavioral Sciences Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Rahimi Kordshooli K, Rakhshan M, Ghanbari A. The Effect of Family-Centered Empowerment Model on the Illness Perception in Heart Failure Patients: a Randomized Controlled Clinical Trial. J Caring Sci 2018; 7:189-195. [PMID: 30607359 PMCID: PMC6311623 DOI: 10.15171/jcs.2018.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 07/21/2018] [Indexed: 01/16/2023] Open
Abstract
Introduction: Heart failure is a chronic medical condition that, despite the existing therapies, involves different aspects of an individual's life (such as self-care capability). Illness perception is one of the most important variables which seem to improve the self-efficacy skills in chronic diseases such as heart failure. Therefore, this study aimed to investigate the effect of family-centered empowerment model on the perception of the illness in heart failure patients. Methods: This interventional study was performed on 70 heart failure patients, assigned into control and experimental groups, admitted to the heart clinic of Hazrate Fatemeh hospital in Shiraz. After the convenience sampling, the patients were divided into two control and intervention groups by block randomization method. For experimental group, the family-centered empowerment modeling was done in 5 sessions. The research materials included demographic information and Brief illness perception questionnaires (B-IPQ). Data were analyzed using SPSS v.13 software. The statistical tests included Wilcoxon, Man-Whitney, and Independent t-test. P value less than 0.05 was considered as significant. Results: In this study, both control and experimental groups were homogeneous with demographic information. Before the intervention in different dimensions of illness perception, all of the values in both groups were the same; However, after the intervention, a significant difference was observed in all of the dimensions of illness perception, except for Time line; so that the most and the least changes were related to the concern (1.09 (0.61) vs 3 (0.93)), and identity dimensions (0.97 (0.61) vs 2.11 (0.67)), respectively. Conclusion: On the basis of the above, it can be concluded that this model modifies the illness perceptions in heart failure patients. Cardiac nurses should consider family- based empowerment model as a treatment for heart failure patients.
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Affiliation(s)
- Khadijeh Rahimi Kordshooli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahnaz Rakhshan
- Department of Medical-Surgical Nursing, Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Ghanbari
- Research Center of Anesthesiology and Critical Care, Shiraz University of Medical Sciences, Shiraz, Iran
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Picariello F, Moss-Morris R, Macdougall IC, Norton S, Da Silva-Gane M, Farrington K, Clayton H, Chilcot J. Cognitive-behavioural therapy (CBT) for renal fatigue (BReF): a feasibility randomised-controlled trial of CBT for the management of fatigue in haemodialysis (HD) patients. BMJ Open 2018; 8:e020842. [PMID: 29523571 PMCID: PMC5855165 DOI: 10.1136/bmjopen-2017-020842] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 02/01/2018] [Accepted: 02/12/2018] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Fatigue is one of the most common and disabling symptoms in end-stage kidney disease, particularly among in-centre haemodialysis patients. This two-arm parallel group feasibility randomised controlled trial will determine whether a fully powered efficacy trial is achievable by examining the feasibility of recruitment, acceptability and potential benefits of a cognitive-behavioural therapy (CBT)-based intervention for fatigue among in-centre haemodialysis patients. METHODS We aim to recruit 40 adult patients undergoing in-centre haemodialysis at secondary care outpatient dialysis units, who meet clinical levels of fatigue. Patients will be randomised individually (using a 1:1 ratio) to either a 4-6 weeks' CBT-based intervention (intervention arm) or to a waiting-list control (control arm). The primary feasibility outcomes include descriptive data on numbers within each recruiting centre meeting eligibility criteria, rates of recruitment, numbers retained postrandomisation and treatment adherence. To assess the potential benefits of the cognitive-behavioural therapy for renal fatigue intervention, secondary self-report outcomes include measures of fatigue severity (Chalder Fatigue Questionnaire), fatigue-related functional impairment (Work and Social Adjustment Scale), sleep quality (Pittsburgh Sleep Quality Index), depression (Patient Health Questionnaire-9) and anxiety (Generalised Anxiety Disorder-7). Changes in fatigue perceptions (Brief Illness Perception Questionnaire), cognitive and behavioural responses to fatigue (Cognitive and Behavioural Responses to Symptoms Questionnaire), sleep hygiene behaviours (Sleep Hygiene Index) and physical activity (International Physical Activity Questionnaire-short form) will also be explored. These self-report measures will be collected at baseline and 3 months postrandomisation. Nested qualitative interviews will be conducted postintervention to explore the acceptability of the intervention and identify any areas in need of improvement. The statistician and assessor will be blinded to treatment allocation. ETHICS AND DISSEMINATION A National Health Service (NHS) Research Ethics Committee approved the study. Any amendments to the protocol will be submitted to the NHS Committee and study sponsor. TRIAL REGISTRATION NUMBER ISRCTN91238019;Pre-results.
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Affiliation(s)
- Federica Picariello
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rona Moss-Morris
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Sam Norton
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Maria Da Silva-Gane
- Department of Renal Medicine, Lister Hospital, Stevenage, UK
- University of Hertfordshire, Hertfordshire, UK
| | - Ken Farrington
- Department of Renal Medicine, Lister Hospital, Stevenage, UK
- University of Hertfordshire, Hertfordshire, UK
| | - Hope Clayton
- Department of Renal Medicine, Lister Hospital, Stevenage, UK
| | - Joseph Chilcot
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Kim HS, Kim HK, Kang KO, Kim YS. Determinants of health-related quality of life among outpatients with acute coronary artery disease after percutaneous coronary intervention. Jpn J Nurs Sci 2018; 16:3-16. [DOI: 10.1111/jjns.12209] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 11/19/2017] [Accepted: 01/03/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Hee Sun Kim
- College of Nursing, Research Institute of Nursing Science; Chonbuk National University; Jeonju South Korea
| | - Hyun Kyung Kim
- College of Nursing, Research Institute of Nursing Science; Chonbuk National University; Jeonju South Korea
| | - Kyung Ok Kang
- Chonbuk National University Hospital; Jeonju South Korea
| | - Yi Sik Kim
- Division of Cardiology, Department of Internal Medicine; Chonbuk National University Hospital; Jeonju South Korea
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Vos RC, Kasteleyn MJ, Heijmans MJ, de Leeuw E, Schellevis FG, Rijken M, Rutten GE. Disentangling the effect of illness perceptions on health status in people with type 2 diabetes after an acute coronary event. BMC FAMILY PRACTICE 2018; 19:35. [PMID: 29499658 PMCID: PMC5833109 DOI: 10.1186/s12875-018-0720-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 01/29/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Chronically ill patients such as people with type 2 diabetes develop perceptions of their illness, which will influence their coping behaviour. Perceptions are formed once a health threat has been recognised. Many people with type 2 diabetes suffer from multimorbidity, for example the combination with cardiovascular disease. Perceptions of one illness may influence perceptions of the other condition. The aim of the current study was to evaluate the effect of an intervention in type 2 diabetes patients with a first acute coronary event on change in illness perceptions and whether this mediates the intervention effect on health status. The current study is a secondary data analysis of a RCT. METHODS Two hundred one participants were randomised (1:1 ratio) to the intervention (n = 101, three home visits) or control group (n = 100). Outcome variables were diabetes and acute coronary event perceptions, assessed with the two separate Brief Illness Perceptions Questionnaires (BIPQs); and health status (Euroqol Visual Analog Scale (EQ-VAS)). The intervention effect was analysed using ANCOVA. Linear regression analyses were used to assess whether illness perceptions mediated the intervention effect on health status. RESULTS A positive intervention effect was found on the BIPQ diabetes items coherence and treatment control (F = 8.19, p = 0.005; F = 14.01, p < 0.001). No intervention effect was found on the other BIPQ diabetes items consequence, personal control, identity, illness concern and emotional representation. Regarding the acute coronary event, a positive intervention effect on treatment control was found (F = 7.81, p = 0.006). No intervention effect was found on the other items of the acute coronary event BIPQ. Better diabetes coherence was associated with improved health status, whereas perceiving more treatment control was not. The mediating effect of the diabetes perception 'coherence' on health status was not significant. CONCLUSION Targeting illness perceptions of people with diabetes after an acute coronary event has no effect on most domains, but can improve the perceived understanding of their diabetes. Discussing perceptions prevents people with type 2 diabetes who recently experienced an acute coronary event from the perception that they will lose control of both their diabetes and the acute coronary event. Illness perceptions of diabetes patients should therefore be discussed in the dynamic period after an acute coronary event. TRIAL REGISTRATION Nederlands trial register; NTR3076 , Registered September 20 2011.
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Affiliation(s)
- Rimke Cathelijne Vos
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Marise Jeannine Kasteleyn
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
| | | | - Elke de Leeuw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - François Georges Schellevis
- NIVEL (Netherlands institute for health services research), Utrecht, the Netherlands.,Department of general practice and elderly care medicine/EMGO Institute for health and care research, VU University Medical Center, Amsterdam, the Netherlands
| | - Mieke Rijken
- NIVEL (Netherlands institute for health services research), Utrecht, the Netherlands
| | - Guy Emile Rutten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
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Abstract
BACKGROUND Sexual activity after myocardial infarction (MI) is a concern for patients and often a challenge for health care professionals to address. It is widely recognized that most patients, of both sexes, report sexual problems or concerns after MI. However, there are reported differences between men and women. Women with sexual concerns may seek less help from health care providers and are more inclined to conceal them because of cultural barriers. OBJECTIVE The aim of the current study is to present a comprehensive review of the literature describing women's sexual issues after MI. METHOD A systematic search of the relevant literature was performed within international databases, including PubMed/Medline, Scopus, ScienceDirect, and ProQuest, as well as Google Scholar using relevant keywords. Also, Persian electronic databases such as Magiran, Scientific Information Databases, and Iran Medex were searched from the inception to October 2014. Articles focusing on the sexual issues after MI only in women, as well as articles on both sexes where women's results could be separated, were included in this review. RESULTS A total of 8 articles were included in the final dataset. The main themes of women's sexual concerns after MI were "loss or decrease of sexual activity," "dissatisfaction of sexual relationship," "doubt about resumption time of sexual activity," "fear of reinfarction or sudden death during sexual activity after MI," "knowledge deficit regarding sexual activity after MI," and "poor performance of health care providers in sexual counseling." DISCUSSION The results of this review demonstrate that women's post-MI sexual activity is affected by many concerns. The concerns may be a knowledge deficit related to not receiving necessary consultation on this topic. Nurses, as first-line care givers, can provide appropriate consultation and education for patients post-MI. As a result, breaking taboo imposed by cultural barriers, personal assumptions, or lack of confidence on giving sexual consultation may ultimately help patients to improve their quality of life.
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Petriček G, Buljan J, Prljević G, Vrcić-Keglević M. Perceived needs for attaining a 'new normality' after surviving myocardial infarction: A qualitative study of patients' experience. Eur J Gen Pract 2017; 23:35-42. [PMID: 28253827 PMCID: PMC5774293 DOI: 10.1080/13814788.2016.1274726] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: A comprehensive understanding of the various aspects of patients’ myocardial infarction (MI) experiences may help to guide these patients and their relatives through the many uncertainties they face and help them to stabilize their lives after the disruption they experienced. Objectives: To explore MI patients’ experiences of life with MI, the challenges they face during the process of accepting their condition, and the setting and resetting of their personal goals. Methods: Thirty semi-structured, individual interviews were conducted. The grounded theory method was used, and Atlas.ti qualitative data analysis software was used to facilitate the analysis. Results: Three main themes and explanatory models emerged from the data analysis: a good adaptation – the ‘new normality;’ maladjustment – a continuous search for a ‘new normality;’ and perceived needs in the search for a new normality. Patients perceived several areas of need that they felt must be met before they could reach the state of a new normality. These needs included overcoming the anxiety of a possible MI recurrence; acquiring knowledge about MI in general and about ‘my MI’ in particular; the need for a timeline; for patience and steadiness; for both objective and subjective health status improvement; for taking control over the disease; and living within a supportive context. Conclusion: When faced with a dramatic life event, most patients succeed in achieving a new normality in which they live changed but still satisfying lives. The needs experienced by patients when searching for a new normality may guide practitioners in leading patient-centred consultations. Most MI patients achieve a new normality. My physical identity is new: my body is different but still functional. My personal identity is new: I am not the same as before, the disease is part of me, but I retain parts of my previous self.
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Affiliation(s)
- Goranka Petriček
- a Department of Family Medicine , 'Andrija Štampar' School of Public Health, School of Medicine, University of Zagreb , Zagreb , Croatia.,b 'Zagreb Centar' Health Centre , Zagreb , Croatia
| | - Josip Buljan
- a Department of Family Medicine , 'Andrija Štampar' School of Public Health, School of Medicine, University of Zagreb , Zagreb , Croatia.,c Family Medicine Office Josip Buljan , Velika Kopanica , Croatia
| | - Gordana Prljević
- a Department of Family Medicine , 'Andrija Štampar' School of Public Health, School of Medicine, University of Zagreb , Zagreb , Croatia.,d Family Medicine Office Gordana Prljević , Krapinske Toplice , Croatia
| | - Mladenka Vrcić-Keglević
- a Department of Family Medicine , 'Andrija Štampar' School of Public Health, School of Medicine, University of Zagreb , Zagreb , Croatia.,b 'Zagreb Centar' Health Centre , Zagreb , Croatia
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Järemo P, Arman M, Gerdle B, Larsson B, Gottberg K. Illness beliefs among patients with chronic widespread pain - associations with self-reported health status, anxiety and depressive symptoms and impact of pain. BMC Psychol 2017; 5:24. [PMID: 28679446 PMCID: PMC5499007 DOI: 10.1186/s40359-017-0192-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 06/20/2017] [Indexed: 12/31/2022] Open
Abstract
Background Chronic widespread pain (CWP) is a disabling condition associated with a decrease in health. Illness beliefs are individual and are acquired during life. Constraining beliefs may prevent patients from regaining health. Understanding these patients’ illness beliefs may be a way to improve the health care they are offered. The aim of this study was to describe illness beliefs among patients with CWP and associations with self-reported health, anxiety and depressive symptoms, and impact of pain. Method In this cross-sectional study, questionnaires were sent by mail to 330 patients including socio-demographic information, the Illness Perception Questionnaire (IPQ-R), the Short-Form General Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Data were analysed using descriptive statistics, non-parametric tests and linear regression analyses. Results Patients experienced and related a high number of symptoms to CWP (mean (SD) 9 (3)). The patients believed their illness to be long lasting, to affect their emotional well being, and to have negative consequences for their lives. Some 72% reported having severe or very severe pain, and impact of pain according to SF-36 was negatively correlated to several illness beliefs dimensions, anxiety- and depressive symptoms. In regression analyses, the Identity, Consequences and Personal control dimensions of IPQ-R and Anxiety- and Depressive symptoms explained 32.6–56.1% of the variance in the two component scores of SF-36. Conclusion Constraining illness beliefs in patients with CWP are related to worse health status, especially in cases of high number of physical or mental symptoms, beliefs of negative consequences or the illness affecting them emotionally. Identification and understanding of these beliefs may reduce patients’ suffering if they are taken into consideration in rehabilitation programs and in development of new evidence-based interventions aimed at increasing health in patients with CWP.
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Affiliation(s)
- P Järemo
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, S-141 83, Huddinge, Sweden.
| | - M Arman
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, S-141 83, Huddinge, Sweden
| | - B Gerdle
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - B Larsson
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - K Gottberg
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, S-141 83, Huddinge, Sweden
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Abstract
Introducción. Después de un infarto agudo de miocardio, los pacientes experimentan altos niveles de estrés emocional y ansiedad. Estas percepciones limitan sus comportamientos saludables.Objetivo. Determinar el nivel de autoeficacia general en pacientes post-infarto agudo de miocardio según la edad, género, estado de rehabilitación y atención en una unidad de cardiología en Girardot.Materiales y métodos. Investigación descriptiva, evaluada a través de la Escala general de autoeficacia versión ll, en una población de 149 personas entre los 35 y 65 años. Para el análisis estadístico de los resultados se utilizaron medidas estadísticas descriptivas y pruebas de correlación.Resultados. La edad de los participantes tuvo una media de 52 años. El análisis de la autoeficacia por grupo de edad evidenció incidencia mínima de la autoeficacia en el grupo de edad. Según el género, los hombres se percibieron más autoeficaces que las mujeres. Además, los pacientes que no asistieron a la rehabilitación cardíaca tuvieron un nivel de autoeficacia general ligeramente mayor en comparación con los rehabilitados.Conclusiones. No hubo relación entre la edad, el género y la rehabilitación frente al nivel de autoeficacia. Estas variables dependieron de otras diferentes a las del estudio.
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Sigurdardottir AK, Sigurlásdóttir K, Ólafsson K, Svavarsdóttir MH. Perceived consequences, changeability and personal control of coronary heart disease are associated with health-related quality of life. J Clin Nurs 2017; 26:3636-3645. [DOI: 10.1111/jocn.13734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Arun K Sigurdardottir
- School of Health Sciences; University of Akureyri; Akureyri Iceland
- Akureyri Hospital; Akureyri Iceland
| | - Kolbrún Sigurlásdóttir
- School of Health Sciences; University of Akureyri; Akureyri Iceland
- Akureyri Hospital; Akureyri Iceland
| | - Kjartan Ólafsson
- School of Humanities and Social Sciences; University of Akureyri; Akureyri Iceland
| | - Margrét Hrönn Svavarsdóttir
- School of Health Sciences; University of Akureyri; Akureyri Iceland
- Department of Nursing; Faculty of Health, Care and Nursing; NTNU; Norwegian University of Science and Technology; Gjøvik Norway
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Abstract
OBJECTIVE The aim of the study was to examine how psychological stress changes over time in young and middle-aged patients after experiencing an acute myocardial infarction (AMI) and whether these changes differ between men and women. METHODS We analyzed data obtained from 2358 women and 1151 men aged 18 to 55 years hospitalized for AMI. Psychological stress was measured using the 14-item Perceived Stress Scale (PSS-14) at initial hospitalization and at 1 month and 12 months after AMI. We used linear mixed-effects models to examine changes in PSS-14 scores over time and sex differences in these changes, while adjusting for patient characteristics and accounting for correlation among repeated observations within patients. RESULTS Overall, patients' perceived stress decreased over time, especially during the first month after AMI. Women had higher levels of perceived stress than men throughout the 12-month period (difference in PSS-14 score = 3.63, 95% confidence interval = 3.08 to 4.18, p < .001), but they did not differ in how stress changed over time. Adjustment for patient characteristics did not alter the overall pattern of sex difference in changes of perceived stress over time other than attenuating the magnitude of sex difference in PSS-14 score (difference between women and men = 1.74, 95% confidence interval = 1.32 to 2.16, p < .001). The magnitude of sex differences in perceived stress was similar in patients with versus without post-AMI angina, even though patients with angina experienced less improvement in PSS-14 score than those without angina. CONCLUSIONS In young and middle-aged patients with AMI, women reported higher levels of perceived stress than men throughout the first 12 months of recovery. However, women and men had a similar pattern in how perceived stress changed over time.
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Picariello F, Moss-Morris R, Macdougall IC, Chilcot AJ. The role of psychological factors in fatigue among end-stage kidney disease patients: a critical review. Clin Kidney J 2016. [PMID: 28638608 PMCID: PMC5469558 DOI: 10.1093/ckj/sfw113] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Fatigue is a common and debilitating symptom, affecting 42-89% of end-stage kidney disease patients, persisting even in pre-dialysis care and stable kidney transplantation, with huge repercussions on functioning, quality of life and patient outcomes. This paper presents a critical review of current evidence for the role of psychological factors in renal fatigue. To date, research has concentrated primarily on the contribution of depression, anxiety and subjective sleep quality to the experience of fatigue. These factors display consistent and strong associations with fatigue, above and beyond the role of demographic and clinical factors. Considerably less research is available on other psychological factors, such as social support, stress, self-efficacy, illness and fatigue-specific beliefs and behaviours, and among transplant recipients and patients in pre-dialysis care. Promising evidence is available on the contribution of illness beliefs and behaviours to the experience of fatigue and there is some indication that these factors may vary according to treatment modality, reflecting the differential burdens and coping necessities associated with each treatment modality. However, the use of generic fatigue scales casts doubt on what specifically is being measured among dialysis patients, illness-related fatigue or post-dialysis-specific fatigue. Therefore, it is important to corroborate the available evidence and further explore, qualitatively and quantitatively, the differences in fatigues and fatigue-specific beliefs and behaviours according to renal replacement therapy, to ensure that any model and subsequent intervention is relevant and grounded in the experiences of patients.
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Affiliation(s)
- Federica Picariello
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, UK
| | - Rona Moss-Morris
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, UK
| | | | - And Joseph Chilcot
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, UK
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Dealing with a life changing event: The influence of spirituality and coping style on quality of life after survival of a cardiac arrest or myocardial infarction. Resuscitation 2016; 109:81-86. [DOI: 10.1016/j.resuscitation.2016.09.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 06/29/2016] [Accepted: 09/16/2016] [Indexed: 11/19/2022]
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Al-Smadi AM, Ashour A, Hweidi I, Gharaibeh B, Fitzsimons D. Illness perception in patients with coronary artery disease: A systematic review. Int J Nurs Pract 2016; 22:633-648. [PMID: 27687787 DOI: 10.1111/ijn.12494] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 08/19/2016] [Accepted: 08/30/2016] [Indexed: 11/28/2022]
Abstract
The aim of this study was to conduct a systematic review that investigates the differences in illness perception with age and gender in patients diagnosed with coronary artery disease. Previous studies show some discrepancies regarding the influence of age and gender on the specific dimensions of coronary artery disease patients' illness perception. A systematic review using a narrative synthesis process included preliminary synthesis, exploration of relationships and assessment of the robustness of the synthesis and findings was conducted. Search terms were used to identify research studies published between 1996 and December 2014 across four key databases: CINAHL, Medline, PsycINFO and Web of Science. A total of 14 studies met the inclusion criteria of the review. The review found that men had a stronger perception that their own behaviour had caused their illness than women. In addition, older patients had lower perceptions of the consequences and chronicity of their illness. This analysis concludes that some dimensions of illness perception vary according to age and gender of patients with coronary artery disease. These differences should be taken into consideration, particularly when providing health education and cardiac rehabilitation.
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Affiliation(s)
| | | | - Issa Hweidi
- Jordan University of Science and Technology, Irbid, Jordan
| | | | - Donna Fitzsimons
- University of Ulster and Belfast Health and Social Care Trust, Belfast, UK
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Feng HP, Chien WC, Cheng WT, Chung CH, Cheng SM, Tzeng WC. Risk of anxiety and depressive disorders in patients with myocardial infarction: A nationwide population-based cohort study. Medicine (Baltimore) 2016; 95:e4464. [PMID: 27559951 PMCID: PMC5400317 DOI: 10.1097/md.0000000000004464] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Anxiety and depressive symptoms are associated with adverse cardiovascular events after an acute myocardial infarction (MI). However, most studies focusing on anxiety or depression have used rating scales or self-report methods rather than clinical diagnosis. This study aimed to investigate the association between psychiatrist-diagnosed psychiatric disorders and cardiovascular prognosis.We sampled data from the National Health Insurance Research Database; 1396 patients with MI were recruited as the study cohort and 13,960 patients without MI were recruited as the comparison cohort. Cox proportional hazard regression models were used to examine the effect of MI on the risk of anxiety and depressive disorders.During the first 2 years of follow-up, patients with MI exhibited a significantly higher risk of anxiety disorders (adjusted hazard ratio [HR] = 5.06, 95% confidence interval [CI]: 4.61-5.54) and depressive disorders (adjusted HR = 7.23, 95% CI: 4.88-10.88) than those without MI did. Greater risk for anxiety and depressive disorders was observed among women and patients aged 45 to 64 years following an acute MI. Patients with post-MI anxiety had a 9.37-fold (95% CI: 4.45-19.70) higher risk of recurrent MI than those without MI did after adjustment for age, sex, socioeconomic status, and comorbidities.This nationwide population-based cohort study provides evidence that MI increases the risk of anxiety and depressive disorders during the first 2 years post-MI, and post-MI anxiety disorders are associated with a higher risk of recurrent MI.
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Affiliation(s)
- Hsin-Pei Feng
- Institute of Medical Sciences and School of Nursing, National Defense Medical Center, Taipei City, Taiwan (ROC)
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital and School of Public Health, National Defense Medical Center, Taipei City, Taiwan (ROC)
| | - Wei-Tung Cheng
- Kaohsiung Armed Forces General Hospital Gangshan Branch, Kaohsiung CityTaiwan (ROC)
| | - Chi-Hsiang Chung
- Taiwanese Injury Prevention and Safety Promotion Association, School of Public Health, National Defense Medical Center, Taipei City, Taiwan (ROC)
| | - Shu-Meng Cheng
- Internal Medicine, School of Medicine and Division of Cardiology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan (ROC)
| | - Wen-Chii Tzeng
- School of Nursing, National Defense Medical Center, Taipei City, Taiwan (ROC)
- Correspondence: Wen-Chii Tzeng, School of Nursing, National Defense Medical Center, Taipei City, Taiwan (ROC) (e-mail: )
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Wieslander I, Mårtensson J, Fridlund B, Svedberg P. Women's experiences of how their recovery process is promoted after a first myocardial infarction: Implications for cardiac rehabilitation care. Int J Qual Stud Health Well-being 2016; 11:30633. [PMID: 27172514 PMCID: PMC4864844 DOI: 10.3402/qhw.v11.30633] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2016] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND A rapid improvement in the care of myocardial infarction (MI) in the emergency services has been witnessed in recent years. There is, however, a lack of understanding of the factors involved in a successful recovery process, after the initial stages of emergency care among patients, and in particular those who are women. Both preventive and promotive perspectives should be taken into consideration for facilitating the recovery process of women after a MI. AIM To explore how women's recovery processes are promoted after a first MI. METHODS A qualitative content analysis was used. FINDINGS The women's recovery process is a multidirectional process with a desire to develop and approach a new perspective on life. The women's possibility to approach new perspectives on life incorporates how they handle the three dimensions: behaviour, that is, women's acting and engaging in various activities; social, that is, how women receive and give support in their social environment; and psychological, that is, their way of thinking, reflecting, and appreciating life. CONCLUSIONS The personal recovery of women is a multidirectional process with a desire to develop and approach a new perspective on life. It is important for cardiac rehabilitation nurses to not only focus on lifestyle changes and social support but also on working actively with the women's inner strength in order to promote the recovery of the women.
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Affiliation(s)
- Inger Wieslander
- School of Social and Health Sciences, Halmstad University, Halmstad, Sweden
- School of Health Sciences, Jönköping University, Jönköping, Sweden;
| | - Jan Mårtensson
- School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Bengt Fridlund
- School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Petra Svedberg
- School of Social and Health Sciences, Halmstad University, Halmstad, Sweden
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43
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Waring ME, McManus DD, Lemon SC, Gore JM, Anatchkova MD, McManus RH, Ash AS, Goldberg RJ, Kiefe CI, Saczynski JS. Perceiving one's heart condition to be cured following hospitalization for acute coronary syndromes: Implications for patient-provider communication. PATIENT EDUCATION AND COUNSELING 2016; 99:455-461. [PMID: 26519237 PMCID: PMC4779389 DOI: 10.1016/j.pec.2015.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 08/28/2015] [Accepted: 10/11/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE We examined the proportion of patients perceiving their heart condition to be cured following hospitalization for ACS and identified characteristics associated with these perceptions. METHODS We conducted a prospective cohort study of adults hospitalized with ACS (N=396). Patient interviews during hospitalization and one week post-discharge provided demographic and psychosocial characteristics. Medical records provided clinical characteristics. At one week, patients who rated "My heart condition is cured" as "definitely true" or "mostly true" were considered to perceive their heart condition cured. RESULTS Participants were aged 60.7 (SD:11.0) years, 26.5% female, and 89.0% non-Hispanic white; 16.7% had unstable angina, 59.6% NSTEMI, and 23.7% STEMI. One week post-discharge, 30.3% perceived their heart condition to be cured. Characteristics associated with cure perceptions were older age (OR=2.2; 95% CI: 1.2-4.0 for ≥65 years vs <55 years), male sex (OR=2.4; 95%CI: 1.3-4.2), history of hypertension (OR=1.8; 95%CI: 1.1-3.1), history of stroke (OR=4.2; 95%CI: 1.1-16.7), no history of CHD (OR=2.8; 95%CI: 1.6-4.9), and receipt of CABG during hospitalization (OR=4.8, 95%CI: 1.9-12.0 vs medical management). CONCLUSION One week post-discharge, 3 in 10 patients perceived their heart condition to be cured. PRACTICE IMPLICATIONS Conversations with patients should frame ACS as a chronic disease and dispel cure perceptions.
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Affiliation(s)
- Molly E Waring
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA.
| | - David D McManus
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA; Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01605, USA; Meyers Primary Care Institute, 425 Lake Avenue North, Worcester, MA 01605, USA.
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01605, USA.
| | - Joel M Gore
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01605, USA.
| | - Milena D Anatchkova
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA; Evidera, 430 Bedford Street, Suite 300, Lexington Office Park, Lexington, MA 02420, USA.
| | - Richard H McManus
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA.
| | - Arlene S Ash
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA.
| | - Robert J Goldberg
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA.
| | - Catarina I Kiefe
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA.
| | - Jane S Saczynski
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA; School of Pharmacy, Northeastern University, 360 Huntington Avenue, R218 TF, Boston, MA 02115, USA.
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Alsén P, Eriksson M. Illness perceptions of fatigue and the association with sense of coherence and stress in patients one year after myocardial infarction. J Clin Nurs 2016; 25:526-33. [PMID: 26818377 DOI: 10.1111/jocn.13088] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Pia Alsén
- Department of Health Science; University West; Trollhättan Sweden
| | - Monica Eriksson
- Department of Health Science; University West; Trollhättan Sweden
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45
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Simonÿ CP, Dreyer P, Pedersen BD, Birkelund R. Empowered to gain a new foothold in life--A study of the meaning of participating in cardiac rehabilitation to patients afflicted by a minor heart attack. Int J Qual Stud Health Well-being 2015; 10:28717. [PMID: 26631916 PMCID: PMC4668264 DOI: 10.3402/qhw.v10.28717] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2015] [Indexed: 11/14/2022] Open
Abstract
This study aimed to investigate what it means to patients afflicted by a minor heart attack to participate in cardiac rehabilitation (CR). CR is well-established internationally to support patients towards moving forward in satisfying, healthy, and well-functioning lives. Studies indicate that patients achieve improvement in quality of life when participating in CR. However, knowledge of how patients are supported during CR is sparse. Moreover, knowledge of what participating in CR means to patients afflicted by a minor heart attack is lacking. In-depth knowledge in this area is crucial in order to understand these patients' particular gains and needs. In a phenomenological-hermeneutic frame field observations, focus group interviews, and individual interviews were conducted among 11 patients during and after their participation in CR. Field notes and transcribed interviews underwent three-phased interpretation. It was found that patients were supported to gain renewed balance in their lives during CR. Three themes were identified: (1) receiving a helpful but limited caring hand, (2) being supported to find new values in life, and (3) developing responsibility for the remaining time. The patients were carefully guided through a difficult time and supported to continue in healthy everyday lives. They were given hope which enabled them to find themselves a new foothold in life with respect to their own sense of well-being. This guidance and a sense of hopefulness were provided by heart specialists and more seasoned heart patients. In conclusion, patients were empowered to achieve a healthier lifestyle and improve their personal well-being during CR. However, structural barriers in the programme prevented adequate support regarding the patients' total needs. Knowledge of the benefits of CR emphasizes the significance of the programme and highlights the importance of high inclusion. Efforts should be made to develop more flexible and longer lasting programmes and further involvement of relatives must be considered.
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Affiliation(s)
- Charlotte P Simonÿ
- Section of Nursing Science, Institute of Health, Aarhus University, Aarhus, Denmark
- Department of quality and education, Slagelse Hospital Region Zealand, Slagelse, Denmark;
| | - Pia Dreyer
- Section of Nursing Science, Institute of Health, Aarhus University, Aarhus, Denmark
- Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark
| | - Birthe D Pedersen
- Research Unit of Nursing, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Regner Birkelund
- Section of Health Services Research, Lillebaelt Hospital, Vejle, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
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46
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Psychosocial and Clinical Correlates of Fatigue in Haemodialysis Patients: the Importance of Patients’ Illness Cognitions and Behaviours. Int J Behav Med 2015; 23:271-281. [DOI: 10.1007/s12529-015-9525-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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47
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Eriksson LE, Fritzell K, Rixon L, Björk J, Wettergren L. The role of illness perceptions in adherence to surveillance in patients with familial adenomatous polyposis (FAP). Psychooncology 2015; 25:699-706. [PMID: 26425823 DOI: 10.1002/pon.3997] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 09/03/2015] [Accepted: 09/07/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The aim of the study was to examine patients' beliefs about having familial adenomatous polyposis (FAP), a hereditary colorectal cancer syndrome, and how these beliefs are associated with adherence to endoscopic surveillance. METHODS Adult patients diagnosed with FAP on the national Swedish polyposis register who had undergone prophylactic colorectal surgery (n 209, response rate 76%) completed the Illness Perception Questionnaire (IPQ). Logistic regression analysis was used to investigate the relationships between illness perceptions and adherence, when controlling for demographic and clinical factors. RESULTS FAP was less distressing in men and those with fewer symptoms, reporting less serious consequences and more coherent understanding of FAP. Non-adherence (14%) to surveillance was associated with being older, having undergone surgery less recently and no history of malignancy. Patients' beliefs about their FAP were able to explain unique variance in non-adherence, in particular those who believed FAP was less distressing. CONCLUSIONS Patients who were non-adherent to endoscopic surveillance had more positive perceptions about their FAP and, in particular, were less emotionally affected compared to those who adhered. As non-adherence implies a greater risk of future malignancies, special efforts are required to effectively prevent cancer in all patients with FAP. Those who have lived with the condition for a long time, and are not troubled by gastrointestinal symptoms or worried about their FAP, may be in need of specific information and support. Further prospective research is required to examine emotional predictors and consequences of non-adherence. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Lars E Eriksson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Solna, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.,School of Health Sciences, City University London, London, United Kingdom
| | - Kaisa Fritzell
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,The Swedish Polyposis Registry, Department of Gastroenterology and Hepatology, Karolinska University Hospital, Stockholm, Sweden
| | - Lorna Rixon
- School of Health Sciences, City University London, London, United Kingdom
| | - Jan Björk
- The Swedish Polyposis Registry, Department of Gastroenterology and Hepatology, Karolinska University Hospital, Stockholm, Sweden.,Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lena Wettergren
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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48
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Riley GA, Hough A, Meader LM, Brennan AJ. The course and impact of family optimism in the post-acute period after acquired brain injury. Brain Inj 2015; 29:804-12. [DOI: 10.3109/02699052.2015.1004754] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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49
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Morris G, Berk M, Galecki P, Walder K, Maes M. The Neuro-Immune Pathophysiology of Central and Peripheral Fatigue in Systemic Immune-Inflammatory and Neuro-Immune Diseases. Mol Neurobiol 2015; 53:1195-1219. [PMID: 25598355 DOI: 10.1007/s12035-015-9090-9] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 01/05/2015] [Indexed: 01/18/2023]
Abstract
Many patients with systemic immune-inflammatory and neuro-inflammatory disorders, including depression, rheumatoid arthritis, systemic lupus erythematosus, Sjögren's disease, cancer, cardiovascular disorder, Parkinson's disease, multiple sclerosis, stroke, and chronic fatigue syndrome/myalgic encephalomyelitis, endure pathological levels of fatigue. The aim of this narrative review is to delineate the wide array of pathways that may underpin the incapacitating fatigue occurring in systemic and neuro-inflammatory disorders. A wide array of immune, inflammatory, oxidative and nitrosative stress (O&NS), bioenergetic, and neurophysiological abnormalities are involved in the etiopathology of these disease states and may underpin the incapacitating fatigue that accompanies these disorders. This range of abnormalities comprises: increased levels of pro-inflammatory cytokines, e.g., interleukin-1 (IL-1), IL-6, tumor necrosis factor (TNF) α and interferon (IFN) α; O&NS-induced muscle fatigue; activation of the Toll-Like Receptor Cycle through pathogen-associated (PAMPs) and damage-associated (DAMPs) molecular patterns, including heat shock proteins; altered glutaminergic and dopaminergic neurotransmission; mitochondrial dysfunctions; and O&NS-induced defects in the sodium-potassium pump. Fatigue is also associated with altered activities in specific brain regions and muscle pathology, such as reductions in maximum voluntary muscle force, downregulation of the mitochondrial biogenesis master gene peroxisome proliferator-activated receptor gamma coactivator 1-alpha, a shift to glycolysis and buildup of toxic metabolites within myocytes. As such, both mental and physical fatigue, which frequently accompany immune-inflammatory and neuro-inflammatory disorders, are the consequence of interactions between multiple systemic and central pathways.
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Affiliation(s)
- Gerwyn Morris
- Tir Na Nog, Bryn Road seaside 87, Llanelli, SA152LW, Wales, UK
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, P.O. Box 291, Geelong, 3220, Australia.,Orygen Youth Health Research Centre and the Centre of Youth Mental Health, Poplar Road 35, Parkville, 3052, Australia.,The Florey Institute for Neuroscience and Mental Health, University of Melbourne, Kenneth Myer Building, Royal Parade 30, Parkville, 3052, Australia.,Department of Psychiatry, University of Melbourne, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville, 3052, Australia
| | - Piotr Galecki
- Department of Adult Psychiatry, Medical University of Lodz, Lodz, Poland
| | - Ken Walder
- Metabolic Research Unit, Deakin University, Geelong, Australia
| | - Michael Maes
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, P.O. Box 291, Geelong, 3220, Australia. .,Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. .,Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Londrina, Brazil. .,Impact Strategic Research Center, Deakin University, Geelong, Australia.
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50
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Skaggs BG, Yates BC. Functional Status and Search for Meaning After Percutaneous Coronary Intervention. West J Nurs Res 2014; 38:248-61. [PMID: 25512267 DOI: 10.1177/0193945914561129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to determine the differences in the search for meaning and functional status (psychological and physical) between persons who undergo percutaneous coronary intervention and have recurrent angina symptoms and those who do not have recurrent symptoms. Participants (224; 147 male, 77 female) who underwent PCI completed the following study materials: Meaning in Heart Disease instrument, Hospital Anxiety and Depression Scale, and SF36v2™. Persons with recurrent angina symptoms (40% of the sample) were more likely to have higher disrupted meaning, greater anxiety, greater depression, lower physical functioning, and greater use of meaning-based coping (searching for answers and refocusing global meaning) compared with individuals without recurrent symptoms. Interventions are needed to identify the risk of recurrent symptoms after percutaneous coronary intervention and provide coping and cognitive behavioral interventions focused on managing the psychological and physical disruptions.
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Affiliation(s)
- Brenda G Skaggs
- Department of Veterans Affairs Medical Center, Oklahoma City, OK, USA
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