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Bouchard K, Dans M, Higdon G, Quinlan B, Tulloch H. Caregiver Distress and Coronary Artery Disease: Prevalence, Risk, Outcomes, and Management. Curr Cardiol Rep 2022; 24:2081-2096. [PMID: 36418650 DOI: 10.1007/s11886-022-01810-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Caregivers of patients with coronary artery disease (CAD) are integral to the health care system and contribute substantially to patients' management. The purpose of this review is to provide a narrative synthesis of existing research on caregiving for patients who experienced an acute coronary syndrome (MI/unstable angina) and/or coronary revascularization (PCI/CABG). RECENT FINDINGS Thirty-one articles are included in this review. Overall, caregiver distress is low to moderate, ranging from 6 to 67% of caregivers, and seems to dissipate over time for most caregivers. Interventions have demonstrated success in reducing the distress of caregivers of patients with CAD. Due to the heterogeneity in study samples, measurements used, and timing of assessments and programming, these results are far from definitive. Although evidence is accumulating, further advancement in caregiving science and clinical care is required to adequately understand and respond to the needs of caregivers throughout the patient's illness trajectory.
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Affiliation(s)
- Karen Bouchard
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y4W7, Canada
| | - Michael Dans
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y4W7, Canada
| | - Gloria Higdon
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y4W7, Canada
| | - Bonnie Quinlan
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y4W7, Canada
| | - Heather Tulloch
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y4W7, Canada.
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Laflamme SZ, Bouchard K, Sztajerowska K, Lalande K, Greenman PS, Tulloch H. Attachment insecurities, caregiver burden, and psychological distress among partners of patients with heart disease. PLoS One 2022; 17:e0269366. [PMID: 36121800 PMCID: PMC9484654 DOI: 10.1371/journal.pone.0269366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 05/20/2022] [Indexed: 11/19/2022] Open
Abstract
Caregiver psychological distress (i.e., depression and anxiety) is harmful to both caregiver and patient. Different affect-regulation strategies associated with attachment orientations may impact a caregiver’s perception of their caregiving role as a burden, thereby contributing to their psychological distress. The aim of the present investigation was to examine the links among attachment orientations, caregiver burden, and psychological distress in a cardiac context. Participants (N = 181, Mage = 61.79, SD = 10.49; males = 24.7%) were romantic partners of patients with heart disease (i.e., informal caregivers) who completed validated questionnaires. The majority of caregivers had partners with coronary artery disease (n = 127, 70. 2%). 66.3% of caregivers reported low burden, 87.6% reported low levels of depression and 89.9% reported low levels of anxiety. The mean anxious attachment score was 2.74 (SD = 1.37) and the mean avoidant attachment score was 2.95 (SD = 1.26). Four mediation analyses were run using PROCESS macro for IBM SPSS (version 26). Statistical models showed that the relationships between attachment anxiety and psychological distress were mediated by caregiver burden [abanxiety= 0.15, 95% C.I. (0.04, 0.29); abdepression = 0.15, 95% C.I. (0.05, 0.28)] and that attachment avoidance was not a significant covariate (cvanxiety = −0.02, p>0.05; cvdepression = 0.40, p>0.05). The relationships between attachment avoidance and psychological distress were also mediated by caregiver burden [abanxiety = 0.23, 95% C.I. (0.10, 0.42); abdepression = 0.21, 95% C.I. (0.09, 0.37]with attachment anxiety as a significant covariate (cvanxiety = 1.09, p<0.001; cvdepression = 1.09, p<0.001). Interventions for caregivers reporting attachment insecurity and burden should be explored to potentially lessen caregiver distress as they support their partners with heart disease.
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Affiliation(s)
- Simone Zofia Laflamme
- Division of Cardiac Prevention and Rehabilitation, Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Karen Bouchard
- Division of Cardiac Prevention and Rehabilitation, Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Karolina Sztajerowska
- Division of Cardiac Prevention and Rehabilitation, Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Kathleen Lalande
- Division of Cardiac Prevention and Rehabilitation, Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Paul S. Greenman
- Division of Cardiac Prevention and Rehabilitation, Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Institut du Savoir Montfort, Ottawa, Ontario, Canada
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Québec, Canada
| | - Heather Tulloch
- Division of Cardiac Prevention and Rehabilitation, Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- * E-mail:
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Evaluation of Psychological Distress, Self-Care, and Medication Adherence in Association with Hypertension Control. Int J Hypertens 2022; 2022:7802792. [PMID: 36059588 PMCID: PMC9436608 DOI: 10.1155/2022/7802792] [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: 05/04/2022] [Revised: 08/03/2022] [Accepted: 08/10/2022] [Indexed: 11/18/2022] Open
Abstract
Background. Most of the patients with hypertension (HTN) who undergo medical therapy unaccompanied by psychological and behavioral interventions may not achieve their goal in HTN treatment. Self-care is a key factor in controlling HTN. Given that depression, stress, and anxiety are the most psychological disorders in chronic illnesses. Their impact on self-care, quality of life, and HTN control must be studied more. Methods. We analyzed the difference in medication adherence in 252 patients with low vs. high psychological distress. Also, patients with controlled and uncontrolled HTN were compared according to their psychological distress scores. We further assessed the relation of psychological distress, self-care, and medication adherence with patients’ demographic characteristics. Results. 61.3% of our participants were female with a mean age of 60.6 ± 11.35 and male participants had a mean age of 60.5 ± 11.55. The psychological distress score was significantly higher in women with uncontrolled HTN (
value = 0.044). Also, individuals with controlled HTN tend to have a higher medication adherence score (
value = 0.01) and higher self-care score (
value = 0.033). Hypertensive females had a higher psychological distress score (3.35 ± 2.05) and a lower self-care score (64.05 ± 8.16). There was a positive relationship between age and drug adherence. The self-care score was higher (65.95 ± 7.88) in patients having lower psychological distress levels. Conclusion. A lower psychological distress score can result in better self-care, enhancing the probability of better HTN control; thus, psychological interventions may be necessary for the treatment of HTN. However, more studies are needed to assess the effectiveness of this intervention.
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Sherman M, Mirzoev R. Dynamics of psychovegetative syndrome in patients during the period of rehabilitation after coronary bypass. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:77-83. [DOI: 10.17116/jnevro202212201177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Patient periprocedural stress in cardiovascular medicine: friend or foe? ADVANCES IN INTERVENTIONAL CARDIOLOGY 2021; 17:259-271. [PMID: 34819962 PMCID: PMC8596718 DOI: 10.5114/aic.2021.109176] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/17/2021] [Indexed: 01/24/2023] Open
Abstract
Stress, a disruption of homeostasis, is an unavoidable part of everyday life. In medical procedures, stress profoundly affects both operators and patients. Although the stress reaction has evolved to aid survival of physical trauma, it may also be harmful, by aggravating the baseline medical condition and/or creating new stress-related medical problems. Stress responses comprise several protective mechanisms that are particularly relevant in the clinical setting (e.g., a procoagulatory state and blood loss counteraction, preservation of blood perfusion pressure, prevention of hypoglycemia, enhanced immune response). Beneficial psychological effects prevent recurrence of traumatic memories, and promote patient compliance and positive lifestyle changes. In contrast, overt acute stress responses may lead to severe pathological conditions such as cytokine storm, post-traumatic stress disorder, takotsubo syndrome, deep venous thrombosis and pulmonary embolism, myocardial infarction, life-threatening arrhythmias and sudden cardiac death. There is also evidence that stress exposure may promote atherosclerosis and reduce long-term benefits from the intervention (increase in major adverse clinical events, in-stent restenosis, etc.). Insights into the role of stress on the operator’s performance have recently led to the introduction of counteractive measures such as simulation training. Conversely, very little is known about the effect of the patient’s periprocedural stress on the outcomes of cardiovascular procedures. Recent data show that the patient periprocedural stress affects the well-being of whole families. This review, focused on topics particularly relevant to cardiovascular interventions, provides a mechanistic insight into beneficial and harmful effects of periprocedural patient stress, including the array of available stress-relieving measures.
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Rodrigues HF, Furuya RK, Dantas RAS, Morelato RDC, Dessotte CAM. Relationship between emotional states before cardiac valve surgeries with postoperative complications. Rev Gaucha Enferm 2020; 41:e20190025. [PMID: 32348418 DOI: 10.1590/1983-1447.2020.20190025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 10/21/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate associations between preoperative anxiety and depression symptoms and postoperative complications and the sociodemographic and clinical characteristics of patients undergoing valve repair surgery. METHOD Observational, exploratory and prospective study. The consecutive non-probabilistic sample consisted of patients undergoing their first valve repair surgery. Data were collected from September 2013 to September 2015, in a university hospital in the interior of São Paulo, Brazil. Symptoms were assessed using the Hospital Anxiety and Depression Scale and analyzed using Mann-Whitney and Spearman correlation; alpha was established at 5%. RESULTS Among the 70 participants, depressive symptoms were more frequent among women (p=0.042) and among patients experiencing postoperative agitation (p=0.039) Conclusion: In this study, depressive symptoms were associated with being a woman and postoperative agitation; the same was not true in regard to anxiety symptoms.
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Affiliation(s)
| | | | - Rosana Aparecida Spadoti Dantas
- Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brasil
| | - Rafaela Dias Coloni Morelato
- Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brasil
| | - Carina Aparecida Marosti Dessotte
- Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brasil
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Correa-Rodríguez M, Abu Ejheisheh M, Suleiman-Martos N, Membrive-Jiménez MJ, Velando-Soriano A, Schmidt-RioValle J, Gómez-Urquiza JL. Prevalence of Depression in Coronary Artery Bypass Surgery: A Systematic Review and Meta-Analysis. J Clin Med 2020; 9:E909. [PMID: 32225052 PMCID: PMC7230184 DOI: 10.3390/jcm9040909] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/20/2020] [Accepted: 03/25/2020] [Indexed: 02/07/2023] Open
Abstract
Coronary artery bypass graft surgery (CABG) might adversely affect the health status of the patients, producing cognitive deterioration, with depression being the most common symptom. The aim of this study is to analyse the prevalence of depression in patients before and after coronary artery bypass surgery. A systematic review and meta-analysis was carried out, involving a study of the past 10 years of the following databases: CINAHL, LILACS, MEDLINE, PsycINFO, SciELO, Scopus, and Web of Science. The total sample comprised n = 16,501 patients. The total number of items was n = 65, with n = 29 included in the meta-analysis. Based on the different measurement tools used, the prevalence of depression pre-CABG ranges from 19-37%, and post-CABG from 15-33%. There is a considerable presence of depression in this type of patient, but this varies according to the measurement tool used and the quality of the study. Systematically detecting depression prior to cardiac surgery could identify patients at potential risk.
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Affiliation(s)
- María Correa-Rodríguez
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración N. 60, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria, IBS, 18012 Granada, Spain
| | - Moath Abu Ejheisheh
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración N. 60, 18016 Granada, Spain
| | - Nora Suleiman-Martos
- Faculty of Health Sciences, University of Granada, Campus Universitario de Ceuta, C/Cortadura del Valle s/n, 51001 Ceuta, Spain
| | | | - Almudena Velando-Soriano
- University Hospital Virgen de las Nieves. Andalusian Health Service. Av. de las Fuerzas Armadas 2, 18014 Granada, Spain
| | | | - José Luis Gómez-Urquiza
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración N. 60, 18016 Granada, Spain
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Salari A, Rouhi Balasi L, Ashouri A, Moaddab F, Zaersabet F, Nourisaeed A. Medication Adherence and its Related Factors in Patients Undergoing Coronary Artery Angioplasty. J Caring Sci 2018; 7:213-218. [PMID: 30607362 PMCID: PMC6311628 DOI: 10.15171/jcs.2018.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 07/25/2018] [Indexed: 11/30/2022] Open
Abstract
Introduction: Percutaneous Coronary Intervention (PCI) has
no effect on coronary artery atherosclerosis, thus the modification of physiological risk
factors seems essential to prevent coronary artery disease (CAD). Then PCI patients have
to receive multiple drug therapies in an attempt to prevent the recurrence of cardiac
events. In spite of the evidence based on medication adherence to prevent post-PCI CAD
development, medication adherence is the main concern for health care system. Accordingly,
this study aims to determine the medication adherence and its related factors among these
patients. Methods: In this cross-sectional study, the statistical
community was the patients undergoing PCI at medical educational hospital of Dr. Heshmat
in Rasht, Iran. 269 patients were selected by convenient sampling method. The data were
collected by a questionnaire consisting of 4 parts, namely the socio-individual factors,
Morisky medication adherence scale, hospital anxiety and depression scale and cardiac
patient’s self-efficacy scale. Data analysis was done by descriptive statistics and the
significance variables in univariate analysis were examined in a multi logistic regression
model through considering co-linearity. Results: The results showed that 75 patients (28%) didn’t
adhere to the medication. In addition, the majority of them were reported to have clinical
anxiety (44.2%) and mild depression (55.8%). Also, based on the results derived from
multiple logistic regressions, only the spouse's educational level and family history of
coronary artery disease were significant predictors of medication adherence. Conclusion: The current study findings display lack of
complete post-PCI medication adherence, which underscores the importance of the existence
of cardiac rehabilitation systems in the society. Therefore, it is recommended that
cardiac rehabilitation centers be built in the society.
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Affiliation(s)
- Arsalan Salari
- Department of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Leila Rouhi Balasi
- Department of Nursing, Faculty of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Asieh Ashouri
- Department of Health Education and Promotion, Health and Environment Research Center, Faculty of Health, Guilan University of Medical Sciences, Rasht, Iran
| | - Fatemeh Moaddab
- Department of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Fatemeh Zaersabet
- Department of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Azam Nourisaeed
- Department of Psychology, Islamic Azad University of Guilan, Rasht, Iran
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Rodrigues HF, Furuya RK, Dantas RAS, Rodrigues AJ, Dessotte CAM. Association of preoperative anxiety and depression symptoms with postoperative complications of cardiac surgeries. Rev Lat Am Enfermagem 2018; 26:e3107. [PMID: 30517589 PMCID: PMC6280174 DOI: 10.1590/1518-8345.2784.3107] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 10/08/2018] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE to investigate the associations of preoperative anxiety and depression symptoms with postoperative complications and with sociodemographic and clinical characteristics of patients submitted to the first coronary artery bypass graft. METHOD observational, analytical and longitudinal study. A consecutive non-probabilistic sample consisted of patients submitted to coronary artery bypass graft. To evaluate the symptoms, the Hospital Anxiety and Depression Scale was used. tracheal intubation for more than 48 hours, hemodynamic instability, sensorineural deficit, agitation, hyperglycemia, infection, nausea, vomiting, pain and death were classified as complications. The Mann-Whitney and Spearman Correlation tests were used, with a significance level of 0.05. RESULTS a total of 75 patients participated. The group that presented hemodynamic instability in the postoperative period had a greater median for the anxiety symptoms (p = 0.012), as well as the women (p = 0.028). The median of the depression symptoms was higher in the group presenting nausea (p = 0.002), agitation (p <0.001), tracheal intubation for more than 48 hours (p = 0.018) and sensorineural deficit (p = 0.016). CONCLUSION there was association of the symptoms of preoperative anxiety with hemodynamic instability in the postoperative period and with the female gender, as well as association of depression symptoms with the following complications: nausea, agitation, time of intubation in the postoperative period and sensorineural deficit.
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Affiliation(s)
| | | | - Rosana Aparecida Spadoti Dantas
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Alfredo José Rodrigues
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brasil
| | - Carina Aparecida Marosti Dessotte
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
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Tuomisto S, Koivula M, Åstedt-Kurki P, Helminen M. Family involvement in rehabilitation: Coronary artery disease-patients' perspectives. J Clin Nurs 2018; 27:3020-3031. [PMID: 29679418 DOI: 10.1111/jocn.14494] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2018] [Indexed: 12/30/2022]
Abstract
AIMS AND OBJECTIVES To describe coronary artery disease patients' perceptions of family involvement in rehabilitation and the connection between background factors and family involvement. BACKGROUND Coronary artery disease patients' hospital stays can be very concise. Family members can support rehabilitation, but many challenges can emerge. There is a need to nurture patients and family members in an individual way and to recognise their concerns. More accurate patient education should be available for patients and their family members. DESIGN This study is a descriptive cross-sectional study. METHODS Data were collected from patients with coronary artery disease at least 6 weeks after discharge from hospital (n = 169) with a postal questionnaire. The Family Involvement in Rehabilitation (FIRE) scale measures family members' promotion of patients' rehabilitation and issues encumbering rehabilitation in family. The data have been analysed with statistical methods. Both parametric and nonparametric tests were used to evaluate group differences. RESULTS Patients with coronary artery disease perceived that family promotes their rehabilitation significantly. Respondents also perceived challenges at home. Family relations before hospitalisation were related to all subareas of family promoting rehabilitation and one subarea of issues encumbering rehabilitation in family. Patients with symptoms at rest also had more encumbrance on their rehabilitation. Patients who had undergone coronary artery bypass surgery perceived more challenges than percutaneous coronary intervention (PCI) patients in many subareas of issues encumbering rehabilitation in family. CONCLUSIONS Family relations prior to illness and the rigour of heart symptoms are significantly relevant to challenges that can occur between patient and their family members. RELEVANCE TO CLINICAL PRACTICE Healthcare staff need to pay attention to coronary artery disease patients' individual situation, and patient education should be more family-centred. In the future, it would be noteworthy to collect more data from family members of patients with coronary artery disease and to find out their perceptions of family involvement.
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Affiliation(s)
- Sonja Tuomisto
- Pirkanmaa Hospital District, Tampere, Finland.,Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland
| | - Meeri Koivula
- Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland
| | - Päivi Åstedt-Kurki
- Pirkanmaa Hospital District, Tampere, Finland.,Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland
| | - Mika Helminen
- Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland.,Science Center, Pirkanmaa Hospital District, Tampere University Hospital, Tampere, Finland
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Ayton DR, Barker AL, Peeters GMEE, Berkovic DE, Lefkovits J, Brennan A, Evans S, Zalcberg J, Reid C, Stoelwinder J(J, McNeil J. Exploring patient-reported outcomes following percutaneous coronary intervention: A qualitative study. Health Expect 2018; 21:457-465. [PMID: 29130585 PMCID: PMC5867323 DOI: 10.1111/hex.12636] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Percutaneous coronary intervention (PCI) is a common cardiac procedure used to treat obstructive coronary artery disease. Patient-centred care is a priority in cardiovascular health having been shown to increase patient satisfaction, engagement with rehabilitation activities and reduce anxiety. Evidence indicates that patient-centred care is best achieved by routine collection of patient-reported outcomes (PROs). However, existing patient-reported outcome measures (PROMs) have limited the patient involvement in their development. AIMS To identify and explore outcomes, patients perceive as important following PCI. METHODS A qualitative design was adopted. Eight focus groups and five semi-structured interviews were conducted with 32 patients who had undergone PCI in the previous 6 months. Outcomes were identified and mapped under the U.S. Food and Drug Administration (FDA) patient-reported outcome (PROs) domains of feeling (physical and psychological outcomes), function and evaluation. Inductive and deductive analysis methods were used with open, axial and thematic coding. RESULTS Consistent with prior studies, patients identified feeling and function outcomes such as reductions in physical and psychological symptoms and the ability to perform usual activities as important. Participants also identified a range of new outcomes, including confidence to return to usual activities and evaluation domains such as adverse effects of medications and the importance of patient communication. CONCLUSION The findings of this research should be considered in the design of a cardiac PROM for PCI patients. A PROM which adequately assesses these outcomes can provide clinicians and hospital staff with a foundation in which to address these concerns or symptoms.
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Affiliation(s)
- Darshini R. Ayton
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVicAustralia
| | - Anna L. Barker
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVicAustralia
| | | | - Danielle E. Berkovic
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVicAustralia
| | - Jeffrey Lefkovits
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVicAustralia
| | - Angela Brennan
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVicAustralia
| | - Sue Evans
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVicAustralia
| | - John Zalcberg
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVicAustralia
| | - Christopher Reid
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVicAustralia
- NHMRC Centre for Research Excellence in Cardiovascular Outcomes ImprovementCurtin UniversityPerthWAAustralia
| | - Johannes (Just) Stoelwinder
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVicAustralia
| | - John McNeil
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVicAustralia
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Esplendori GF, Siqueira Costa AL, Souza-Talarico JND. Relação entre estresse percebido com coping e estressores de pacientes em pré-operatório de revascularização miocárdica. AQUICHAN 2018. [DOI: 10.5294/aqui.2018.18.1.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
La enfermedad coronaria se destaca entre las enfermedades cardiovasculares al victimizar pacientes en todo el mundo. En el periodo preoperatorio de cirugía de revascularización miocárdica (CRM), ocurre estrés. Objetivo: averiguar la relación entre estrés percibido con coping y con estresores de pacientes en preoperatorio de CRM. Materiales y método: enfoque cuantitativo y transversal. La muestra se compuso de 105 pacientes coronariopatas internados en hospital cardiológico. Se utilizaron Escala de Estrés Percibido, Inventario de Estrategias de Coping y dos preguntas abiertas cuyas respuestas fueron cuantificadas y categorizadas. Para el análisis de datos, se utilizó regresión lineal multivariada. Resultados: mayor estrés percibido se relacionó con mayor Escape y esquiva (β = 0,416, p < 0,001), mayor Afrontamiento (β = 0,353, p = 0,001), menor Autocontrol (β = –0,226, p = 0,024), Sexo femenino (β = –0,173, p = 0,048) y “Síntomas clínicos” (β = 0,235, p = 0,015). “Búsqueda por ocupar la mente” (β = –0,196, p = 0,047) y “Afrontar la cirugía como instru- mento de mejoría/cura” (β = –0,255, p = 0,009) se relacionaron con menor estrés percibido. Conclusiones: el estrés percibido sufre variabilidad según determinados estresores y coping. Tales relaciones se deben tener en cuenta para la planeación de la asistencia en enfermería con el fin de reducir el estrés preoperatorio de pacientes coronariopatas.
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The effect of an islamic praise (Zikr) on postoperative anxiety of patients undergoing coronary artery bypasses graft surgery: A randomized clinical trial on Iranian Shia Muslims. Res Cardiovasc Med 2017. [DOI: 10.5812/cardiovascmed.41388] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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Abstract
Patients with cardiovascular disease and their partners frequently have concerns about sexual intimacy, and sexual counseling is needed across health care settings to ensure that patients receive information to safely resume sexual activity. The purpose of this review is to provide practical, evidence-based approaches to enable health care providers to discuss sexual counseling, illustrated by several case scenarios. Evidence shows that patients expect health care providers to initiate sexual activity discussions, although providers may be hesitant and often rely on patients to ask questions. Although some providers cite lack of knowledge or confidence in their ability to provide sexual counseling, others mention time pressures in the clinical setting. Although such barriers exist, sexual counseling can be individualized to the cardiac condition of a patient with a few select questions. The representative examples of patients with angina pectoris, myocardial infarction, coronary artery bypass surgery, heart failure, and implantable cardioverter defibrillator are used to illustrate key points and provide a model for sexual counseling in practice.
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