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Chen L, Li H, Gou X, Dong H, Yang S, Dong F, Wu J. Coping as a mediator of the relationship between kinesiophobia and illness perception in atrial fibrillation patients: A cross-sectional mediation analysis. J Adv Nurs 2024. [PMID: 38924140 DOI: 10.1111/jan.16262] [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: 10/30/2023] [Revised: 04/15/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Abstract
AIM(S) To explore the mediating role of coping styles in the association between illness perception and kinesiophobia in atrial fibrillation patients. DESIGN A cross-sectional survey. METHODS Between June 2021 and November 2022, data were collected using a self-designed demographic questionnaire, the Brief Illness Perception Questionnaire (BIPQ), Tampa Scale for Kinesiophobia Heart (TSK-SV Heart) and Medical Coping Modes Questionnaire (MCMQ). The sample comprised 474 atrial fibrillation patients recruited from three hospitals in China. To analyse the data, multiple linear regression models with forced entry were employed, and the mediation Mode 4 of the PROCESS macro in SPSS was implemented. RESULTS In total, 57.8% of patients exhibited a high level of kinesiophobia. Regression analyses uncovered associations between kinesiophobia and various demographic and disease characteristics, as well as assessments of both illness perception and coping styles. Path analysis results indicated that illness perception reduced kinesiophobia through the mediating effect of confrontation, while avoidance and resignation intensified kinesiophobia. The mediating factor of coping styles explained a significant 53% of the overall effect. CONCLUSIONS Coping styles mediate the relationship between illness perception and kinesiophobia, resulting in a shift in coping styles as illness perception decreases and ultimately leading to reduced kinesiophobia. IMPACT Coping styles play a mediating role in the relationship between kinesiophobia and illness perception. The results suggest healthcare providers in identifying high-risk individuals and tailoring interventions to effectively break the vicious cycle of kinesiophobia. Therefore, screening and intervening with patients showcasing heightened illness perception aims to promote a transformation in coping styles, subsequently reducing atrial fibrillation kinesiophobia. REPORTING METHOD The results of the observations were reported in adherence to the STROBE criteria. PATIENT OR PUBLIC CONTRIBUTION No patient and public involvement.
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Affiliation(s)
- Limei Chen
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Husheng Li
- Department of Nursing, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinyu Gou
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hui Dong
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shenglan Yang
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fengwei Dong
- Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jing Wu
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Minjie Z, Zhijuan X, Xinxin S, Xinzhu B, Shan Q. The effects of cognitive behavioral therapy on health-related quality of life, anxiety, depression, illness perception, and in atrial fibrillation patients: a six-month longitudinal study. BMC Psychol 2023; 11:431. [PMID: 38062475 PMCID: PMC10704769 DOI: 10.1186/s40359-023-01457-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Atrial fibrillation (AF) often leads to an impaired Health-Related Quality of Life (HRQoL) in many patients. Moreover, psychological factors such as depression, anxiety, and illness perception have been found to significantly correlate with HRQoL. This study aims to evaluate the long-term effectiveness of Cognitive Behavioral Therapy (CBT) in enhancing HRQoL and mitigating psychological distress among AF patients. METHODS Employing a prospective, open design with pseudo-randomization, this study encompassed pre-tests, post-treatment evaluations, and a 6-month follow-up. A total of 102 consecutive patients diagnosed with paroxysmal AF were initially enrolled. Out of these, 90 were assigned to two groups; one to receive a 10-week CBT treatment specifically focusing on anxiety, and the other to receive standard care. Outcome measures were evaluated using tools such as the Item Short Form Health Survey (SF-12), General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), University of Toronto Atrial Fibrillation Severity Scale (AFSS), and Brief Illness Perception Questionnaire (BIPQ). These assessments were conducted at pre-treatment, post-treatment, and at the 6-month follow-up mark. We explored the effectiveness of CBT using Generalized Estimating Equations (GEE). RESULTS Our analysis revealed a notable improvement in the CBT group relative to the control group. All metrics displayed consistent improvement across a 6-month duration. At the 6-month checkpoint, the CBT group exhibited a more favorable SF-12 Mental Component Score (MCS) (50.261 ± 0.758 vs. 45.208 ± 0.887, p < 0.001), reduced GAD-7 (4.150 ± 0.347 vs. 8.022 ± 0.423, p < 0.001), BIPQ (34.700 ± 0.432 vs. 38.026 ± 0.318, p < 0.001), and AFSS (9.890 ± 0.217 vs. 10.928 ± 0.218, p = 0.001) scores when compared to the TAU group. Conversely, the SF-12 PCS (44.212 ± 0.816 vs. 47.489 ± 0.960, p = 0.139) and PHQ-9 scores (8.419 ± 0.713 vs. 10.409 ± 0.741, p = 0.794) manifested no significant difference between the two groups. CONCLUSION The findings suggest that CBT is effective in improving HRQoL and reducing psychological distress among patients with AF at 6 month follow-up. This highlights the potential benefits of integrating CBT into the therapeutic regimen for AF patients. TRIAL REGISTRATION Retrospectively registered with ClinicalTrials.gov (NCT05716828). The date of registration : 5 June 2023.
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Affiliation(s)
- Zheng Minjie
- Department of Medical Psychology, Peking University People's Hospital, Beijing, China
| | - Xie Zhijuan
- Department of Medical Psychology, Peking University People's Hospital, Beijing, China
| | - Shi Xinxin
- Department of Medical Psychology, Peking University People's Hospital, Beijing, China
| | - Bai Xinzhu
- Department of Medical Psychology, Peking University People's Hospital, Beijing, China
| | - Qu Shan
- Department of Medical Psychology, Peking University People's Hospital, Beijing, China.
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Picariello F, Chilcot J, Chalder T, Herdman D, Moss-Morris R. The Cognitive and Behavioural Responses to Symptoms Questionnaire (CBRQ): Development, reliability and validity across several long-term conditions. Br J Health Psychol 2023; 28:619-638. [PMID: 36690909 DOI: 10.1111/bjhp.12644] [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: 09/21/2022] [Revised: 12/07/2022] [Accepted: 01/06/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Cognitive and behavioural responses to symptoms can worsen or maintain the severity of symptoms across long-term conditions (LTCs). Although the Cognitive and Behavioural Responses Questionnaire (CBRQ) has been used in research, its original development and psychometric properties as a transdiagnostic measure have not been reported. Our aim was to evaluate the psychometric properties of the CBRQ and a recently proposed short version, across different LTCs. DESIGN Psychometric validation study. METHODS Confirmatory factor analysis (CFA) tested the factor structure of the CBRQ in two datasets from the CBRQ's original development; (chronic fatigue syndrome, N = 230; and multiple sclerosis, N = 221) and in additional groups: haemodialysis (N = 174), inflammatory bowel disease (N = 182) and chronic dizziness (N = 185). Scale reliability and construct validity were assessed. The factor structure of the shortened CBRQ (CBRQ-SF) was also assessed. RESULTS CFA revealed that a 7-or 8-factor structure had generally appropriate fit supporting the originally proposed 7 factors (Fear avoidance, Damage beliefs, Catastrophising, Embarrassment avoidance, Symptom focusing, All-or-nothing behaviour and Avoidance/Resting behaviour). Omega coefficients indicated satisfactory internal reliability. Correlations with related constructs suggested construct validity. The scale appeared sensitive to change. The CBRQ-SF also displayed good psychometric quality, with a better model fit than the CBRQ. CONCLUSIONS The CBRQ and the shortened version were shown to be reliable and valid at assessing a range of cognitive and behavioural responses to symptoms, highlighting the multi-symptom, transdiagnostic properties of this questionnaire. Further research is necessary to determine the test-retest reliability and sensitivity to change of the CBRQ and CBRQ-SF and a thorough evaluation of the content validity of the items.
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Affiliation(s)
- Federica Picariello
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, UK
| | - Joseph Chilcot
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, UK
| | - Trudie Chalder
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, UK
| | - David Herdman
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, UK.,St George's University Hospitals NHS Foundation Trust, London, UK
| | - Rona Moss-Morris
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, UK
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Rosenstrøm S, Risom SS, Kallemose T, Dixen U, Hove JD, Brødsgaard A. Clinical outcomes of a short-term family-focused intervention for patients with atrial fibrillation-A randomised clinical trial. PLoS One 2023; 18:e0282639. [PMID: 36928447 PMCID: PMC10019651 DOI: 10.1371/journal.pone.0282639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 02/16/2023] [Indexed: 03/18/2023] Open
Abstract
AIMS To evaluate a family-focused intervention for patients with atrial fibrillation (AF) in addition to conventional care and to establish its effect on health-related quality of life (HRQoL), anxiety, depression, AF symptoms, and family support. BACKGROUND AF is a widespread heart disease affecting the well-being of patients and their family members physically and psychologically. Supporting patients and their family members could potentially facilitate regaining family strength and improve HRQoL. METHODS Patients with newly diagnosed AF were randomised to standard care or additional family-focused intervention with change in global score of the Atrial Fibrillation Quality of Life Questionnaire (AFEQT) as primary outcome after six months' follow-up. Secondary outcomes included the Hospital Anxiety and Depression Score, the European Heart Rhythm Association score, the Ice Expressive Family Functioning Questionnaire, and the Ice Family-Perceived Support Questionnaire (ICE-FPSQ). RESULTS Sixty-eight patients received standard care (n = 35) or family focused intervention (n = 33). The median change at the six-month follow-up on the global AFEQT score was 4.17 (-1.46-9.17) in the control group and 5.83 (-2.5-30) in the intervention group, yielding a median difference of -1.67 (p = 0.500). Change in ICE-FPSQ showed significant positive scores in favour of intervention (p < 0.001); other secondary outcome changes were non-significant. CONCLUSION The family-focused intervention had a small positive but non-significant effect on HRQoL compared to standard care. To address the impact of AF on the patients and family members seems to improve anxiety and depression scores and perceived family support.
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Affiliation(s)
- Stine Rosenstrøm
- Department of Cardiology, Copenhagen University Hospital, Amager Hvidovre, Capital Region of Denmark
- Nursing and Health Care, Department of Public Health, University of Aarhus, Aarhus, Denmark
- * E-mail:
| | - Signe Stelling Risom
- Department of Cardiology, Herlev and Gentofte University Hospital, Hellerup, Denmark
- Institute of Nursing and Nutrition, University College, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Thomas Kallemose
- Department of Clinical Research, Copenhagen University Hospital, Amager Hvidovre, Capital Region of Denmark
| | - Ulrik Dixen
- Department of Cardiology, Copenhagen University Hospital, Amager Hvidovre, Capital Region of Denmark
- Dept of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jens Dahlgaard Hove
- Department of Cardiology, Copenhagen University Hospital, Amager Hvidovre, Capital Region of Denmark
- Dept of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne Brødsgaard
- Nursing and Health Care, Department of Public Health, University of Aarhus, Aarhus, Denmark
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Amager Hvidovre, Capital Region of Denmark
- Department of Obstetrics and Gynaecology, Copenhagen University Hospital, Amager Hvidovre, Capital Region of Denmark
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Taylor EC, O'Neill M, Hughes LD, Moss-Morris R. Atrial fibrillation, quality of life and distress: a cluster analysis of cognitive and behavioural responses. Qual Life Res 2022; 31:1415-1425. [PMID: 34618326 PMCID: PMC9023425 DOI: 10.1007/s11136-021-03006-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Few studies have examined specific cognitive and behavioural responses to symptoms, which may impact health-related outcomes, in conjunction with illness representations, as outlined by the Common-Sense-Model. Patients with atrial fibrillation (AF) report poor quality-of-life (QoL) and high distress. This cross-sectional study investigated patterns/clusters of cognitive and behavioural responses to illness, and illness perceptions, and relationships with QoL, depression and anxiety. METHODS AF patients (N = 198) recruited at cardiology clinics completed the AF-Revised Illness Perception Questionnaire, Atrial-Fibrillation-Effect-on-Quality-of-Life Questionnaire, Patient Health Questionnaire-8 and Generalized Anxiety Disorder Questionnaire. Cluster analysis used Ward's and K-means methods. Hierarchical regressions examined relationships between clusters with QoL, depression and anxiety. RESULTS Two clusters of cognitive and behavioural responses to symptoms were outlined; (1) 'high avoidance'; (2) 'low symptom-focussing'. Patients in Cluster 1 had lower QoL (M = 40.36, SD = 18.40), greater symptoms of depression (M = 7.20, SD = 5.71) and greater symptoms of anxiety (M = 5.70, SD = 5.90) compared to patients in Cluster 2 who had higher QoL (M = 59.03, SD = 20.12), fewer symptoms of depression (M = 3.53, SD = 3.56) and fewer symptoms of anxiety (M = 2.56, SD = 3.56). Two illness representation clusters were outlined; (1) 'high coherence and treatment control', (2) 'negative illness and emotional representations'. Patients in Cluster 2 had significantly lower QoL (M = 46.57, SD = 19.94), greater symptoms of depression (M = 6.12, SD = 5.31) and greater symptoms of anxiety (M = 4.70, SD = 5.27), compared with patients in Cluster 1 who had higher QoL (M = 61.52, SD = 21.38), fewer symptoms of depression (M = 2.85, SD = 2.97) and fewer symptoms of anxiety (M = 2.16, SD = 3.63). Overall, clusters of cognitive and behavioural responses to symptoms, and illness perceptions significantly explained between 14 and 29% of the variance in QoL, depression and anxiety. CONCLUSION Patterns of cognitive and behavioural responses to symptoms, and illness perceptions are important correlates of health-related outcomes in AF patients.
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Affiliation(s)
- Elaina C Taylor
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th Floor Bermondsey Wing, Guy's Hospital, London Bridge, London, SE1 9RT, UK.
- University of Derby, Kedleston Road, Derby, DE22 1GB, UK.
| | - Mark O'Neill
- Divisions of Imaging Sciences & Biomedical Engineering & Cardiovascular Medicine, King's College London, 4th Floor North Wing, St Thomas' Hospital, London, UK
| | - Lyndsay D Hughes
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th Floor Bermondsey Wing, Guy's Hospital, London Bridge, London, SE1 9RT, UK
| | - Rona Moss-Morris
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th Floor Bermondsey Wing, Guy's Hospital, London Bridge, London, SE1 9RT, UK
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Living with Atrial Fibrillation: A Family Perspective. Nurs Res Pract 2022; 2022:7394445. [PMID: 35280493 PMCID: PMC8916854 DOI: 10.1155/2022/7394445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/29/2021] [Accepted: 02/11/2022] [Indexed: 11/19/2022] Open
Abstract
Aim The aim of this study was to obtain insights from patients and their family members on how families are living with atrial fibrillation. Background Atrial fibrillation is the most common cardiac arrhythmia and is often described as an emerging global epidemic affecting an estimated 33.5 million people worldwide. Living with atrial fibrillation not only affects the patient but also may negatively influence family members' perceived health. The perspective of the family has previously been understudied, and more knowledge on how patients and their family members cope and adjust to life with atrial fibrillation may be helpful when developing future support for patients and their family members when coping with atrial fibrillation. Methods A qualitative phenomenological study with an inductive, descriptive research approach based on Giorgi's descriptive method was used. Data were gathered through 12 dyadic family interviews. The COnsolidated criteria for REporting Qualitative research checklist was followed while conducting the study. Results Three major themes emerged: emotional differences, changes in family life, and uncertainty about the future. Atrial fibrillation had multiple effects on the family. Frequently, several adjustments and adaptations had to be made to accommodate life with atrial fibrillation. Conclusion Patients with atrial fibrillation and their family members feel a need to talk about their emotions and worries. They required support and guidance to manage the challenges of living with atrial fibrillation. These results will be used in a family-focused intervention designed to support families in adjusting and managing their everyday lives with atrial fibrillation.
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Wang J, Liu S, Bao Z, Gao M, Peng Y, Huang Y, Yu T, Wang L, Sun G. Patients' experiences across the trajectory of atrial fibrillation: A qualitative systematic review. Health Expect 2022; 25:869-884. [PMID: 35174590 PMCID: PMC9122416 DOI: 10.1111/hex.13451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/21/2022] [Accepted: 01/27/2022] [Indexed: 12/01/2022] Open
Abstract
Aim This study aimed to synthesize qualitative evidence on experiences of patients with atrial fibrillation (AF) during the course of diagnosis and treatment. We addressed three main questions: (a) What were the experiences of patients with AF during the course of diagnosis and treatment? (b) How did they respond to and cope with the disease? (c) What were the requirements during disease management? Design In this study, qualitative evidence synthesis was performed using the Thomas and Harden method. Data Sources Electronic databases, including PubMed, the Cochrane Library, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, the China Biomedical Database, the WanFang Database, Chinese National Knowledge Infrastructure and VIP, were searched. The databases were searched from inception to August 2021. Review Methods Two researchers independently selected studies using qualitative assessment and review instruments for quality evaluation and thematic synthesis for the data analysis. Results A total of 2627 studies were identified in the initial search and 15 studies were included. Five analytical themes were generated: ‘Diagnosing AF’; ‘The impact of AF on the patients’; ‘Self‐reorientation in the therapeutic process’; ‘Living with AF and QoL’; and ‘External support to facilitate coping strategies.’ Conclusions Our findings point out unique experiences of patients across the trajectory of AF related to delayed diagnosis, feelings of nonsupport, disappointment of repeated treatment failure and multiple distress associated with unpredictable symptoms. Future research and clinical practice are expected to improve the quality of medical diagnosis and treatment, optimize administrative strategy and provide diverse health support for patients with AF. Impact Understanding the experiences and needs of patients with AF in the entire disease process will inform future clinical practice in AF integrated management, which would be helpful in improving the professionalism and confidence of healthcare providers. In addition, our findings have implications for improving the effectiveness of AF diagnostic and treatment services. Patient or Public Contribution This paper presents a review of previous studies and did not involve patients or the public.
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Affiliation(s)
- Jie Wang
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Shenxinyu Liu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhipeng Bao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Min Gao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuanyuan Peng
- School of Nursing, Sanda University, Shanghai, China
| | - Yangxi Huang
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Tianxi Yu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lin Wang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Guozhen Sun
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Shan Q, Xinxin S, Zhijuan X, Rongjing D, Minjie Z. Effects of Cognitive Behavior Therapy on Depression, Illness Perception, and Quality of Life in Atrial Fibrillation Patients. Front Psychiatry 2022; 13:830363. [PMID: 35599772 PMCID: PMC9120611 DOI: 10.3389/fpsyt.2022.830363] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/14/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AF Patients with depression resulted in a markedly reduced quality of life. The purpose of this study was to evaluate the efficacy of cognitive behavior therapy (CBT) on the health-related quality of life (HRQoL). METHODS It was A longitudinal randomized controlled trial with a pre and 12-weeks post-test. Ninety persons were randomly assigned to either a CBT group (CBT) (n = 45) or a treatment as usual (TAU) group (n = 45). The outcome were changes in the HRQoL [12-item Short Form Health Survey, SF12, divided into two domains: the physical component summary (PCS) and the mental component summary (MCS)], changes in psychological distress [Hamilton Depression Rating Scale (HAM-D) and Patient Health Questionnaire-9 (PHQ-9)], and Illness Perception [Brief Illness Perception Questionnaire (BIPQ)]. RESULTS There were statistically significant differences in score reduction for PHQ-9 (t = 3.186, P = 0.002), HAMD (t = 2.611, P = 0.011), BIPQ (t = 7.660, P < 0.001), and MCS (t = 4.301, P < 0.001) between CBT group and TAU group. CONCLUSIONS CBT improved HRQoL, Illness Perception and reduced Depressive symptoms in atrial fibrillation.
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Affiliation(s)
- Qu Shan
- Department of Psychiatry, Peking University People's Hospital, Beijing, China
| | - Shi Xinxin
- Department of Psychiatry, Peking University People's Hospital, Beijing, China
| | - Xie Zhijuan
- Department of Psychiatry, Peking University People's Hospital, Beijing, China
| | - Ding Rongjing
- Department of Cardiology, Peking University People's Hospital, Beijing, China
| | - Zheng Minjie
- Department of Psychiatry, Peking University People's Hospital, Beijing, China
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Examining Adherence to Medication in Patients With Atrial Fibrillation: The Role of Medication Beliefs, Attitudes, and Depression. J Cardiovasc Nurs 2021; 35:337-346. [PMID: 32084080 DOI: 10.1097/jcn.0000000000000650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND/OBJECTIVES This study examined whether beliefs about medicines, drug attitudes, and depression independently predicted anticoagulant and antiarrhythmic adherence (focusing on the implementation phase of nonadherence) in patients with atrial fibrillation (AF). METHODS This cross-sectional study was part of a larger longitudinal study. Patients with AF (N = 118) completed the Patient Health Questionnaire-8. The Beliefs about Medicines Questionnaire, Drug Attitude Inventory, and Morisky-Green-Levine Medication Adherence Scale (self-report adherence measure), related to anticoagulants and antiarrhythmics, were also completed. Correlation and multiple logistic regression analyses were conducted. RESULTS There were no significant differences in nonadherence to anticoagulants or antiarrhythmics. Greater concerns (r = 0.23, P = .01) were significantly, positively associated with anticoagulant nonadherence only. Depression and drug attitudes were not significantly associated with anticoagulant/antiarrhythmic adherence. Predictors reliably distinguished adherers and nonadherers to anticoagulant medication in the regression model, explaining 14% of the variance, but only concern beliefs (odds ratio, 1.20) made a significant independent contribution to prediction (χ = 11.40, P = .02, with df = 4). When entered independently into a regression model, concerns (odds ratio, 1.24) significantly explained 10.3% of the variance (χ = 7.97, P = .01, with df = 1). Regressions were not significant for antiarrhythmic medication (P = .30). CONCLUSIONS Specifying medication type is important when examining nonadherence in chronic conditions. Concerns about anticoagulants, rather than depression, were significantly associated with nonadherence to anticoagulants but not antiarrhythmics. Anticoagulant concerns should be targeted at AF clinics, with an aim to reduce nonadherence and potentially modifiable adverse outcomes such as stroke.
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Woo BFY, Bulto LN, Hendriks JML, Lim TW, Tam WWS. The information needs of patients with atrial fibrillation: A scoping review. J Clin Nurs 2021; 32:1521-1533. [PMID: 34390046 DOI: 10.1111/jocn.15993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/29/2021] [Accepted: 07/23/2021] [Indexed: 12/19/2022]
Abstract
AIMS AND OBJECTIVES To identify the atrial fibrillation (AF)-specific information needs of patients with AF. BACKGROUND Patients' understanding of AF is pertinent to optimising treatment and outcomes, thus highlighting the need for effective patient education. The information required to deliver effective AF-specific patient education is less examined. METHODS Guided by Arksey and O'Malley's framework, a scoping review was conducted for studies reporting the AF-specific information needs of patients with AF. Systematic searches were conducted across six databases (Medline, PubMed, CINAHL, Scopus, PsycINFO and ProQuest). All analyses were narrated in prose and outlined in tables. The PRISMA-ScR checklist was used to report this review. RESULTS The systematic search yielded 3816 articles, of which 22 were included. Three major themes emerged from the thematic analysis. Each theme was supported by three subthemes. First, in 'Understanding AF', patients reported the need for 'Easy-to-understand information', information on the 'Screening and diagnosis' of AF and 'Trajectory of disease and its associated risks'. Second, in 'Treating AF', patients required information on the 'Role of anticoagulation', 'Existing or novel therapeutic options' and 'Monitoring effectiveness of treatment'. Lastly, in 'Living with AF', patients needed education in 'Symptom management', 'Secondary prevention of risks' and 'Recognition of emergency situations'. CONCLUSIONS This review has identified the key AF-specific information needs of patients with AF. Being cognisant of the information needs of patients with AF, healthcare providers may become more effective in developing person-centred patient education interventions. RELEVANCE TO CLINICAL PRACTICE Delivering relevant patient education is an important cornerstone for atrial fibrillation care. Nurses by convention play a professional role in patient education. It may be facilitative for nurses to refer to the review findings when developing and implementing patient education interventions. Being in the midst of an ongoing pandemic, patient education strategies may require the use of telecommunication technologies.
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Affiliation(s)
- Brigitte F Y Woo
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lemma N Bulto
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Caring Futures Institute, College of Nursing and Helth Sciences, Flinders University, Adelaide, SA, Australia
| | - Jeroen M L Hendriks
- Caring Futures Institute, College of Nursing and Helth Sciences, Flinders University, Adelaide, SA, Australia
- Department of Cardiology Royal Adelaide Hospital, Centre for Heart Rhythm Disorders, University of Adelaide, Adelaide, SA, Australia
| | - Toon Wei Lim
- National University Heart Centre, National University Hospital, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wilson W S Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Rosenstrøm S, Risom SS, Ejlertsen C, Hove JD, Brødsgaard A. Dancing with atrial fibrillation - How arrhythmia affects everyday life of family members: A qualitative study. PLoS One 2021; 16:e0254130. [PMID: 34228743 PMCID: PMC8259977 DOI: 10.1371/journal.pone.0254130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/20/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common cardiac arrhythmia. Patients with AF often experience debilitating symptoms, stress and reduced health-related quality of life. Previous qualitative research on AF has primarily focused on the patient. AF, however, can also be burdensome for the patient's family. AIM The aim of this study was to explore how family members experience life when a close member in the family has AF. METHOD Transcribed focus group interviews were analysed using content analysis approach inspired by Graneheim and Lundman. RESULTS Two focus group interviews were conducted with 11 family members. The overall theme was Dancing with AF. The theme emerged from three categories: 1) Handling AF as a living condition, 2) Influencing the roles of family members, 3) Fear of AF attack. AF had a very significant impact on the patients' family members, forcing them to reconstruct their daily lives. CONCLUSIONS AF has multiple consequences for family members and can give rise to conflicts concerning family roles. Family members have a lack of knowledge of AF and fear of how AF can cause changes in the family members' everyday lives. This study demonstrates that there is a need for further research of ways to support the family members of patients with AF.
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Affiliation(s)
- Stine Rosenstrøm
- Department of Cardiology, Copenhagen University Hospital, Amager Hvidovre, Hvidovre, Capital Region of Denmark
- Department of Public Health, Nursing and Health Care, University of Aarhus, Aarhus, Denmark
| | - Signe Stelling Risom
- Department of Cardiology, Herlev and Gentofte University Hospital, Hellerup, Denmark
- Institute of Nursing and Nutrition, University College, Copenhagen, Denmark
- Copenhagen University, Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Camilla Ejlertsen
- Department of Public Health, Nursing and Health Care, University of Aarhus, Aarhus, Denmark
- Department of Gynecology and Obstetrics, Copenhagen University Hospital, Amager Hvidovre, Hvidovre, Capital Region of Denmark
| | - Jens Dahlgaard Hove
- Department of Cardiology, Copenhagen University Hospital, Amager Hvidovre, Hvidovre, Capital Region of Denmark
| | - Anne Brødsgaard
- Department of Public Health, Nursing and Health Care, University of Aarhus, Aarhus, Denmark
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