1
|
Lanini LLS, Euler S, Zuccarella-Hackl C, Fuentes Artiles R, Niederseer D, Auschra B, von Känel R, Jellestad L. Differential associations of sex and age with changes in HRQoL during outpatient cardiac rehabilitation. J Patient Rep Outcomes 2024; 8:11. [PMID: 38261156 PMCID: PMC10805744 DOI: 10.1186/s41687-024-00688-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
INTRODUCTION Cardiovascular diseases (CVD) represent the world's leading cause of death. Health-related quality of life (HRQoL) is a widely applied concept of patients' perceived health and is directly linked to CVD morbidity, mortality, and re-hospitalization rates. Cardiac rehabilitation (CR) improves both cardiovascular outcomes and HRQoL. Regrettably, CR is still underutilized, especially in subgroups like women and elderly patients. The aim of our study was to investigate the predictive potential of sex and age on change of HRQoL throughout outpatient CR. METHODS 497 patients of outpatient CR were retrospectively assessed from August 2015 to September 2019 at the University Hospital Zurich. A final sample of 153 individuals with full HRQoL data both at CR entry and discharge was analyzed. HRQoL was measured using the 36-Item Short Form Survey (SF-36) with its physical (PCS) and mental (MCS) component scale. In two-factorial analyses of variance, we analyzed sex- and age-specific changes in HRQoL scores throughout CR, adjusting for psychosocial and clinical characteristics. Age was grouped into participants over and under the age of 65. RESULTS In both sexes, mean scores of physical HRQoL improved significantly during CR (p <.001), while mean scores of mental HRQoL improved significantly in men only (p =.003). Women under the age of 65 had significantly greater physical HRQoL improvements throughout CR, compared with men under 65 (p =.043) and women over 65 years of age (p =.014). Sex and age did not predict changes in mental HRQoL throughout CR. CONCLUSIONS Younger women in particular benefit from CR with regard to their physical HRQoL. Among older participants, women report equal improvements of physical HRQoL than men. Our results indicate that sex- and age-related aspects of HRQoL outcomes should be considered in CR.
Collapse
Affiliation(s)
- Lorenza L S Lanini
- Faculty of Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Sebastian Euler
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Claudia Zuccarella-Hackl
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - David Niederseer
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Bianca Auschra
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Lena Jellestad
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| |
Collapse
|
2
|
Upadhyay V, Bhandari SS, Rai DP, Dutta S, García-Grau P, Vaddiparti K. Improving depression and perceived social support enhances overall quality of life among myocardial infarction survivors: necessity for integrating mental health care into cardiac rehabilitation programs. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022; 58. [PMID: 35966720 PMCID: PMC9373032 DOI: 10.1186/s41983-022-00521-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Depression and low perceived social support (PSS) have been found to deleteriously affect quality of life (QoL) among myocardial infarction (MI) survivors. The complex relationship between these variables has not been assessed. We wanted to assess first the prevalence of depression among MI survivors and whether depression mediates the effect of PSS on QoL and, second, whether the physical and social domains of QoL mediated the effect of depression and PSS on the emotional domain. This cross-sectional study was done among MI survivors using Cardiac Depression Scale, MacNew Quality of Life After Myocardial Infarction Questionnaire and Multidimensional Scale of Perceived Social Support to assess for depression, QoL and PSS respectively. Results: A total of 103 MI survivors were included in the study, and the mean age was 59.66 (± 10.42) years. Depression was found in 21.36% of the participants. The indirect effect of PSS on QoL with depression as a mediator was significant (b = 0.15, p < 0.001, 95% CI 0.12, 0.18). The direct effect of PSS on QoL controlling for depression was also significant (b = 0.05, p < 0.001, 95% CI = 0.02, 0.07). Depression as a mediator in the relationship explained 75.3% of the effect of PSS on QoL. PSS and depression did not have a significant direct effect on emotional QoL, but it became significant when the physical and social domains were included in the model. The total indirect effects of PSS and depression on emotional QoL were b = 0.16, p < 0.001, 95% CI = 0.05, 0.17 and b = − 0.05, p < 0.001, 95% CI = 0.06, − 0.03, respectively. Conclusion: Depression and poor PSS impair physical and social domains, which impairs the emotional domain of QoL; as such, overall QoL is undermined. As limited physical and social activity because of depression and poor PSS may increase the risk of further cardiovascular events, a holistic approach which includes mental health care is warranted.
Collapse
|
3
|
Hosseini Z, Homayuni A, Etemadifar M. Barriers to quality of life in patients with multiple sclerosis: a qualitative study. BMC Neurol 2022; 22:174. [PMID: 35562707 PMCID: PMC9102679 DOI: 10.1186/s12883-022-02700-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic progressive disease of the central nervous system that affects the patients' quality of life. This research was conducted with the aim of identifying the barriers of quality of life in patients with MS. METHODS This qualitative study was conducted through a conventional content analysis approach. We used the purposeful sampling with maximum diversity in terms of gender, age, education, marital status and employment. Data were collected through semi-structured interviews with 18 patients with multiple sclerosis referred to the MS Association of Isfahan. Interviews were conducted to the point of information saturation. RESULTS Through the content analysis of the interviews, we identified 2 main categories and 11 sub-categories. The main categories include intrapersonal problems (physical problems, psychological disorders, turbulent future, functional limitations, job loss and pennilessness), and environmental barriers (disease and treatment process, fatigue of caregivers, information deficiency about MS, family tensions, lack of social support and fun and entertainment). CONCLUSIONS In order to improve the quality of life in these patients, there is a need for attention and practical measures in the field of identified factors. By removing barriers such as providing educational and counseling services to the patients and their families, adapting the urban structure, providing financial support and adequate insurance coverage, the authorities can take measures to ensure patients' health and improve their quality of life.
Collapse
Affiliation(s)
- Zahra Hosseini
- Health Education and Promotion, Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Atefeh Homayuni
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Masoud Etemadifar
- Neurology, Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
4
|
Takeuchi M, Ogita M, Wada H, Takahashi D, Nozaki Y, Nishio R, Yasuda K, Takahashi N, Sonoda T, Yatsu S, Shitara J, Tsuboi S, Dohi T, Suwa S, Miyauchi K, Daida H. Comparison of long-term mortality between living alone patients vs. living together patients with acute coronary syndrome treated with percutaneous coronary intervention. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2020; 6:332-337. [PMID: 32044997 DOI: 10.1093/ehjqcco/qcaa011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 01/24/2020] [Accepted: 02/01/2020] [Indexed: 02/06/2023]
Abstract
AIMS Living alone is reported as an independent risk factor for cardiovascular disease. However, little is known about the association between clinical outcomes and living alone in patients with acute coronary syndrome (ACS). The aim of this study was to determine whether living alone is an independent prognostic risk factor for long-term mortality stratified by age in patients with ACS who were treated with primary percutaneous coronary intervention (PCI). METHODS AND RESULTS We conducted an observational cohort study of ACS patients who underwent PCI between January 1999 and May 2015 at Juntendo University Shizuoka Hospital, Japan. The primary endpoint was all-cause death. Among 2547 ACS patients, 381 (15.0%) patients were living alone at the onset of ACS. The cumulative incidence of all-cause death was comparable between living alone and living together (34.8% vs. 34.4%, log-rank P = 0.63). However, among younger population (aged <65 years), the incidence of all-cause death was significantly higher in the living alone group (log-rank P = 0.01). Multivariate Cox hazard analysis revealed a significant association between living alone and all-cause death, even after adjusting for other risk factors (hazard ratio 2.30, 95% confidence interval 1.38-3.84, P = 0.001). CONCLUSION Although living alone was not significantly associated with long-term clinical outcomes in patients with ACS, it was a predictive risk factor among younger ACS patients. Careful attention should be paid to patients' lifestyle, especially younger patients with ACS.
Collapse
Affiliation(s)
- Mitsuhiro Takeuchi
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Manabu Ogita
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Hideki Wada
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Daigo Takahashi
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Yui Nozaki
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Ryota Nishio
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Kentaro Yasuda
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Norihito Takahashi
- Department of Cardiovascular Medicine, Juntendo University, Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku Tokyo 113-8421, Japan
| | - Taketo Sonoda
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Shoichiro Yatsu
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Jun Shitara
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Shuta Tsuboi
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Tomotaka Dohi
- Department of Cardiovascular Medicine, Juntendo University, Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku Tokyo 113-8421, Japan
| | - Satoru Suwa
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Katsumi Miyauchi
- Department of Cardiovascular Medicine, Juntendo University, Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku Tokyo 113-8421, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University, Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku Tokyo 113-8421, Japan
| |
Collapse
|
5
|
Wlodarczyk D, Zietalewicz U. How gender-specific are predictors of post-MI HRQoL? A longitudinal study. Health Qual Life Outcomes 2020; 18:202. [PMID: 32586341 PMCID: PMC7318476 DOI: 10.1186/s12955-020-01439-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 06/05/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose Extant research shows that health-related quality of life (HRQoL) differs between female and male survivors of myocardial infarction (MI), but the reasons for this are not fully understood. We aimed to examine the predictors of HRQoL in female and male survivors during the first year after MI. Methods At timepoints 1 and 2, the sample comprised 222 MI survivors (59 women and 163 men; mean age 53.84 years, range 24–65) referred for in-patient cardiac rehabilitation. This number dropped to 140 participants (42 women and 98 men) at the third timepoint, approximately one year after the MI. We examined the gender differences in various predictors of physical and mental HRQoL: demographic factors (e.g., age, education, marital status), disease-related factors (pre- and post-MI), personality and coping with stress. Results Initially, both physical and mental HRQoL were lower in women than men, but the differences disappeared at timepoint 3. Stepwise regressions performed separately for men and women revealed that the factors shaping HRQoL were different in both genders; they also changed over time. Substantially fewer factors predicted physical HRQoL in women than in men. Trait anxiety seems to play a similarly negative role in both genders. Conclusions The psychosocial resources that influence HRQoL were different for women and men. There were also differences concerning predictors of HRQoL dimensions. Further studies with a different or broader range of predictors are needed, especially among women.
Collapse
Affiliation(s)
- Dorota Wlodarczyk
- Department of Medical Psychology and Medical Communication, Medical University of Warsaw, Warsaw, Poland
| | - Urszula Zietalewicz
- Department of Medical Psychology and Medical Communication, Medical University of Warsaw, Warsaw, Poland.
| |
Collapse
|
6
|
Yamaguchi D, Izawa A, Matsunaga Y. The Association of Depression with Type D Personality and Coping Strategies in Patients with Coronary Artery Disease. Intern Med 2020; 59:1589-1595. [PMID: 32612062 PMCID: PMC7402968 DOI: 10.2169/internalmedicine.3803-19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objective Depression in patients with coronary artery disease (CAD) has been a risk factor for adverse cardiovascular events. However, personality types, strategies for coping with stressors, and their associations with depression have not been fully elucidated in patients with CAD. This study explored depression in patients with CAD and examined its association with personality types and coping strategies. Methods A prospective observational study of 89 patients with CAD was conducted between August 2016 and July 2018. The presence of depression and type D personality and types of coping strategies were measured one month after percutaneous coronary intervention. A logistic regression analysis was performed to identify characteristics associated with depression. Results Generally, the incidence of depression and type D personality was 55.1% and 44.9%, respectively. The incidence of depression in patients with type D and non-type D personality was 72.5% and 40.8%, respectively. Patients with type D personality coped less frequently using a planning strategy but frequently using a responsibility-shifting strategy. A logistic regression analysis showed that the presence of depression was significantly associated with type D personality and inversely associated with a planning strategy. Conclusion The high prevalence of depression in patients with CAD was associated with type D personality and a low rate of adoption of a planning strategy. Specific coping interventions in patients with CAD with type D personality may be potential targets for improving coping skills and preventing the development of depression.
Collapse
Affiliation(s)
| | - Atsushi Izawa
- School of Health Sciences, Shinshu University, Japan
| | | |
Collapse
|
7
|
Kristofferzon ML, Engström M, Nilsson A. Coping mediates the relationship between sense of coherence and mental quality of life in patients with chronic illness: a cross-sectional study. Qual Life Res 2018; 27:1855-1863. [PMID: 29623597 PMCID: PMC5997720 DOI: 10.1007/s11136-018-1845-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE The aim of the present study was to investigate relationships between sense of coherence, emotion-focused coping, problem-focused coping, coping efficiency, and mental quality of life (QoL) in patients with chronic illness. A model based on Lazarus' and Folkman's stress and coping theory tested the specific hypothesis: Sense of coherence has a direct and indirect effect on mental QoL mediated by emotion-focused coping, problem-focused coping, and coping efficiency in serial adjusted for age, gender, educational level, comorbidity, and economic status. METHODS The study used a cross-sectional and correlational design. Patients (n = 292) with chronic diseases (chronic heart failure, end-stage renal disease, multiple sclerosis, stroke, and Parkinson) completed three questionnaires and provided background data. Data were collected in 2012, and a serial multiple mediator model was tested using PROCESS macro for SPSS. RESULTS The test of the conceptual model confirmed the hypothesis. There was a significant direct and indirect effect of sense of coherence on mental QoL through the three mediators. The model explained 39% of the variance in mental QoL. CONCLUSIONS Self-perceived effective coping strategies are the most important mediating factors between sense of coherence and QoL in patients with chronic illness, which supports Lazarus' and Folkman's stress and coping theory.
Collapse
Affiliation(s)
- Marja-Leena Kristofferzon
- Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Kungsbäcksvägen 47, 801 76, Gävle, Sweden.
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
| | - Maria Engström
- Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Kungsbäcksvägen 47, 801 76, Gävle, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Nursing Department, Medicine and Health College, Lishui University, Lishui, China
| | - Annika Nilsson
- Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Kungsbäcksvägen 47, 801 76, Gävle, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| |
Collapse
|
8
|
Kiajamali M, Hosseini M, Estebsari F, Nasiri M, Ashktorab T, Abdi A, Mahmoudi A, Abadi ASA. Correlation between social support, self-efficacy and health-promoting behavior in hemodialysis patients hospitalized in Karaj in 2015. Electron Physician 2017; 9:4820-4827. [PMID: 28894541 PMCID: PMC5586999 DOI: 10.19082/4820] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 03/25/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND In hemodialysis, as a choice of treatment due to long treatment duration, the patient encounters limitations. Perceived social support, perceived self-efficacy and health promoting activities are important strategies to facilitate and maintain their health. AIM To determine the correlation between social support, self-efficacy and health promoting behaviors in hemodialysis patients hospitalized in Karaj city in 2015. METHODS This cross-sectional descriptive correlational study was carried out on 200 hemodialysis patients who were selected from four hospitals in Karaj based on cluster sampling. Data were collected using these methods: "General Questionnaire", "Perceived Self-Efficacy Scale", "Multidimensional Perceived Social Support Scale" and "Health-Promoting Lifestyle Profile 2". Data were analyzed by SPSS version 22 and the EQS 6.1. Independent t-test, Mann-Whitney U, Kruskal-Wallis test, spearman correlation coefficient was used to analyze the data. To determine the relation between perceived self-efficacy, perceived social support and health promoting behavior, structural equation modeling was applied. RESULTS Self-efficacy has a significant positive correlation with social support (r=0.592, p<0.001) and significant negative correlation with health-promoting behaviors (r=-0.709, p<0.001), and social support has a significant negative correlation with health-promoting behaviors (r=-0.709, p<0.001). Also, results showed that perceived self-efficacy had a greater role than perceived social support in explaining health-promoting behaviors. CONCLUSION The relationship between health promoting behaviors, self-efficacy and social support reveals a necessity for Community Health Nursing planners, matrons and hospital managers and nurses to pay more attention to the needs of patients under hemodialysis. It is recommended that due to some unexpected findings in this study, further studies shall be fulfilled on the factors effective on the discussed variables.
Collapse
Affiliation(s)
- Mahmoud Kiajamali
- M.Sc. in Community Health Nursing, Alborz Hospital, Alborz Province, Tehran, Iran
| | - Meimanat Hosseini
- Ph.D. in Nursing, Assistant Professor of Community Health Nursing Dept., Faculty Member of Nursing & Midwifery School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Estebsari
- Ph.D. in Health Promotion and Education, Assistant Professor of Community Health Nursing Dept., Faculty Member of Nursing & Midwifery School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maliheh Nasiri
- Ph.D. in Statistics, Assistant Professor of Biostatistics Dept., Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tahereh Ashktorab
- Ph.D. in Nursing, Associate Professor, Faculty Member of Nursing & Midwifery Dept., Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Aazam Mahmoudi
- M.Sc. in Nursing, Alborz Hospital, Alborz Province, Iran
| | - Atefe Salimi Akin Abadi
- MSc Student in Medical Surgical Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
9
|
Kang K, Gholizadeh L, Inglis SC, Han HR. Correlates of health-related quality of life in patients with myocardial infarction: A literature review. Int J Nurs Stud 2017; 73:1-16. [PMID: 28511032 DOI: 10.1016/j.ijnurstu.2017.04.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 04/24/2017] [Accepted: 04/27/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND By the increasing emphasis on health-related quality of life (HRQoL) in patients with myocardial infarction (MI), it is necessary to explore factors that affect HRQoL in this population. OBJECTIVES This study aimed to identify correlates of HRQoL in patients with MI. DESIGN A literature review of the factors that affect HRQoL in patients with MI (1995-2016). DATA SOURCES Three main databases-CINAHL, MEDLINE and PsychINFO-were searched to retrieve relevant peer-reviewed articles published in English. REVIEW METHODS In consultation with a medical librarian, we identified relevant MeSH terms and used them for searching the literature: health-related quality of life/quality of life/HRQoL/QoL, myocardial infarction/heart attack/MI and predict*/factor. Data elements were extracted and narratively described variables synthesised into four categories. RESULTS A total of 48 studies met the inclusion criteria and were included in the review. Correlates of HRQoL in patients with MI were identified in the following categories: demographic, behavioural, disease-related, and psychosocial factors. Specific correlates included age and gender-identity for demographic factors; physical activity and smoking for behavioural factors; severity of MI, symptoms, and comorbidities for disease-related factors; anxiety and depression for psychosocial factors. CONCLUSIONS Identifying correlates of HRQoL can help identify patients who are at risk for poor HRQoL in the recovery or rehabilitation stage of post-MI. Future intervention should focus on adjustable correlates such as behavioural and psychosocial factors to promote HRQoL among patients after experiencing MI.
Collapse
Affiliation(s)
- Kyoungrim Kang
- University of Technology Sydney, Sydney, NSW, Australia.
| | | | | | - Hae-Ra Han
- The Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
10
|
Fuochi G, Foà C. Quality of life, coping strategies, social support and self-efficacy in women after acute myocardial infarction: a mixed methods approach. Scand J Caring Sci 2017; 32:98-107. [DOI: 10.1111/scs.12435] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 01/04/2017] [Indexed: 12/13/2022]
Affiliation(s)
- G. Fuochi
- Department of Philosophy, Sociology, Education and Applied Psychology; University of Padua; Padua Italy
| | - C. Foà
- University Teaching Hospital of Parma; Parma Italy
| |
Collapse
|
11
|
Toukhsati SR, Hare DL. Towards Optimal Heart Failure Care: Couples-Oriented Strategies to Improve Patient Adherence and Health Outcomes. Curr Cardiol Rev 2016; 12:243-8. [PMID: 27280305 PMCID: PMC5011186 DOI: 10.2174/1573403x12666160606122451] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 12/18/2015] [Accepted: 01/11/2016] [Indexed: 12/20/2022] Open
Abstract
Psychosocial factors play an important role in the development and progression of cardiovascular diseases (CVD), such as chronic heart failure (CHF). In particular, psycho-cognitive disturbance is common in CHF, which presents additional challenges to secondary prevention and management strategies. This review provides a summary of the contemporary psycho-cardiology literature, including coverage of common mood and cognitive symptoms, and explores some of the pathophysiologic evidence linking psycho-cognition to CHF, with particular emphasis on sympathetic nervous system activation and neuroendocrine functioning. Social support is identified as a strategy by which to reduce depressive symptoms, manage cognitive impairment and to, potentially, improve health outcomes through improved patient self care and adherence. Recent research outcomes suggest that the integration of family caregivers into CHF psycho-educational disease management programs, as providers and recipients of support, may achieve best outcomes. In this regard, couples-oriented strategies that promote communication, emotional attachment and support may enhance health-promoting behaviours in patients and their partners.
Collapse
Affiliation(s)
- Samia R Toukhsati
- Department of Cardiology, Austin Health, P.O. Box: 5555, Heidelberg, Australia.
| | | |
Collapse
|
12
|
Malinauskaite I, Slapikas R, Courvoisier D, Mach F, Gencer B. The fear of dying and occurrence of posttraumatic stress symptoms after an acute coronary syndrome: A prospective observational study. J Health Psychol 2016; 22:208-217. [PMID: 26311815 DOI: 10.1177/1359105315600233] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of the study was to investigate whether experiencing fear of dying after acute coronary syndrome predicts later posttraumatic stress symptoms. We enrolled 90 patients hospitalized with main diagnosis of acute coronary syndrome and assessed baseline characteristics. One month after discharge, we collected the Posttraumatic Stress Scale. A total of 24 patients (26.7%) developed posttraumatic stress symptoms 1 month after the acute coronary syndrome event. Patients with posttraumatic stress symptoms reported significantly greater fear of dying, helplessness, avoidance-focused coping, and severe anxiety. In our prospective study, fear of dying was associated with occurrence of posttraumatic stress symptoms in patients hospitalized with acute coronary syndrome.
Collapse
Affiliation(s)
- Ieva Malinauskaite
- 1 Geneva University Hospital, Switzerland.,2 Lithuanian University of Health Sciences Hospital, Lithuania
| | | | | | | | | |
Collapse
|
13
|
Stefanick ML, Brunner RL, Leng X, Limacher MC, Bird CE, Garcia DO, Hogan PE, LaMonte MJ, Mackey RH, Johnson KC, LaCroix A, Robinson JG, Seguin RA, Tindle HA, Wassertheil-Smoller S. The Relationship of Cardiovascular Disease to Physical Functioning in Women Surviving to Age 80 and Above in the Women's Health Initiative. J Gerontol A Biol Sci Med Sci 2016; 71 Suppl 1:S42-53. [PMID: 26858324 DOI: 10.1093/gerona/glv087] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is highly prevalent at ages 80 and above. The association of physical functioning (PF), a key to an optimal aging trajectory, with CVD and specific CVD diagnosis in women who survive to age 80 and above has not been described previously and has important public health significance given our aging population. METHODS Women's Health Initiative participants aged 80 years or older at the time of self-reporting PF (RAND SF-36) were studied in relationship to CVD diagnosis, whether present at study baseline (1993-1998) or diagnosed during follow-up through 2012. Cross-sectional analyses utilized demographic, medical, lifestyle, and psycho-social questionnaire data from baseline or updated at the time of self-reported PF. RESULTS Among 27,145 older Women's Health Initiative participants, 22.0% (N = 5,959) had been diagnosed with CVD, specifically: 11.3% (N = 3,071) with coronary heart disease; 4.7% (N = 1,279), stroke; 5.2% (N = 1,397), venous thromboembolism; 2.7% (N = 737), peripheral arterial disease; and 2.7% (N = 725), congestive heart failure. PF scores (mean ± SE) were significantly (p < .0001) higher without CVD (60.0 ± 26.9), compared with any CVD (47.9 ± 27.3), and for each specific CVD diagnosis: coronary heart disease (48.8 ± 27.1); stroke (44.8 ± 27.9); venous thromboembolism (48.9 ± 27.4); peripheral arterial disease (41.9 ± 2.2); and congestive heart failure (38.8 ± 26.1). Regardless of CVD diagnosis, higher PF was associated with: younger age at the time of PF assessment; lower body mass index; higher recreational physical activity; better self-reported general health; fewer hip fractures after age 55; no history of arthritis; and no recent use of non-steroidal anti-inflammatory drugs. CONCLUSIONS Older women with any CVD, and particularly women with congestive heart failure or peripheral arterial disease, reported significantly lower PF compared to women with no CVD. Regardless of CVD diagnosis, higher PF was strongly associated with a more active lifestyle and lower body mass index, suggesting potential intervention targets for more optimal aging.
Collapse
Affiliation(s)
- Marcia L Stefanick
- Department of Medicine, Stanford Prevention Research Center and Department of Obstetrics & Gynecology, School of Medicine, Stanford University, California.
| | - Robert L Brunner
- Department of Family and Community Medicine, University of Nevada School of Medicine, Reno
| | - X Leng
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Marian C Limacher
- Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville
| | | | - David O Garcia
- Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson
| | - Patricia E Hogan
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo - SUNY, New York
| | - Rachel H Mackey
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pennsylvania
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis
| | - Andrea LaCroix
- Department of Family and Preventative Medicine, University of California San Diego, La Jolla, California
| | | | - Rebecca A Seguin
- Division of Nutritional Sciences, Cornell University, Ithica, New York
| | - Hilary A Tindle
- Center for Research on Health Care, University of Pittsburgh, Pennsylvania
| | | |
Collapse
|
14
|
Linder J, Hidayatallah N, Stolerman M, McDonald TV, Marion R, Walsh C, Dolan S. Perceptions of an implantable cardioverter-defibrillator: A qualitative study of families with a history of sudden life-threatening cardiac events and recommendations to improve care. ACTA ACUST UNITED AC 2016; 29:3-14. [PMID: 25383067 DOI: 10.23861/ejbm20132929] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To identify major concerns associated with implantable cardioverter-defibrillators (ICDs) and to provide recommendations to adult and pediatric physicians involved in the care of patients with ICDs. BACKGROUND Cardiac ion channelopathies are a well-recognized cause of sudden cardiac death in infants, children, adolescents, and young adults. ICDs are effective in preventing sudden death from fatal arrhythmias in patients with known cardiac channelopathies. There is a paucity of research on the effect of ICDs on quality of life in patients with cardiac channelopathy diagnoses, especially young patients. METHODS A qualitative study interviewing patients and families affected by inherited arrhythmias was conducted. Fifty participants with personal or family histories of cardiac events or sudden death were interviewed individually or in focus groups by clinical psychologists. All interviews were transcribed verbatim and then analyzed and coded based on current qualitative research theory to identify themes related to the research question. Twenty-four participants discussed ICDs in their interviews. RESULTS Participants reported concerns about ICDs, and these concerns were categorized into six themes: (1) comprehension and physician-patient communication; (2) anxiety; (3) restrictions and fallacies; (4) complications; (5) utility; and (6) alternative therapy. Participants noted communication breakdowns between providers and their colleagues, and between providers and their patients. Participants and their families experienced many different forms of anxiety, including worry about the aesthetics of the ICDs and fears of being shocked. Multiple restrictions, fallacies, and complications were also cited. CONCLUSION Interview themes were used to formulate recommendations for counseling and educating patients with ICDs.
Collapse
Affiliation(s)
| | | | | | - Thomas V McDonald
- Departments of Medicine and Molecular Pharmacology, Albert Einstein College of Medicine/Wilf Family Cardiovascular Research Institute, Bronx, NY
| | - Robert Marion
- Department of Pediatrics, Children's Hospital at Montefiore/Albert Einstein College of Medicine, Bronx, NY
| | - Christine Walsh
- Department of Pediatrics, Children's Hospital at Montefiore/Albert Einstein College of Medicine, Bronx, NY
| | - Siobhan Dolan
- Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore, Bronx, NY
| |
Collapse
|
15
|
Zaninotto P, Sacker A, Breeze E, McMunn A, Steptoe A. Gender-specific changes in well-being in older people with coronary heart disease: evidence from the English Longitudinal Study of Ageing. Aging Ment Health 2016; 20:432-40. [PMID: 25774880 PMCID: PMC5577641 DOI: 10.1080/13607863.2015.1020410] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The objective of this study is to investigate gender-specific trajectories in well-being among older people with coronary heart disease (CHD) and to compare them with those of healthy people. METHOD The study included a sample of 4496 participants from the first three waves of the English Longitudinal Study of Ageing (2002-2003 to 2006-2007). We measured well-being using quality of life (CASP-19; 'control', 'autonomy', 'pleasure' and 'self-realization') and depressive caseness (three or more symptoms on the CESD-8; Centre for Epidemiologic Study Depression scale). RESULTS After adjustment, at two- and four-years follow-ups, women had three points higher quality of life than men (p < 0.001). When looking at each quality of life's domain we found that women reported higher scores of autonomy compared to men. The gender difference in the probability of having depressive caseness reduced to 7 percentage points at four-year follow-up from 13 percentage points in the previous occasions. Men's quality of life declined progressively over time by 3 points (p < 0.001) (equivalent to the effect of having diabetes) but no changes in prevalence of depressive caseness were found. Women's quality of life only declined after four-year follow-up by less than 2 points (p < 0.001), while in the same period their probability of reporting depressive caseness reduced by 6 percentage points (p < 0.001). CONCLUSION Women had better quality of life than men in the two and four years following a CHD event, and were not more likely than men to report depressive caseness in the long term. Men's quality of life deteriorated progressively over time, among women it did not deteriorate in the first two years following a CHD event; women had a long-term improvement in depressive caseness.
Collapse
Affiliation(s)
- Paola Zaninotto
- Research Department of Epidemiology and Public Health, 1-19 Torrington Place, UCL, WC1E 7HB London, Phone 0044(0)2076791668
| | - Amanda Sacker
- Department of Epidemiology and Public Health, 1-19 Torrington Place, UCL, WC1E 7HB London, Phone 0044(0)2076791711
| | - Elizabeth Breeze
- Research Department of Epidemiology and Public Health, 1-19 Torrington Place, UCL, WC1E 7HB London, Phone 0044(0)2076791656
| | - Anne McMunn
- Research Department of Epidemiology and Public Health, 1-19 Torrington Place, UCL, WC1E 7HB London, Phone 0044(0)2076791730
| | - Andrew Steptoe
- Research Department of Epidemiology and Public Health, 1-19 Torrington Place, UCL, WC1E 7HB London, Phone 0044(0)2076791804
| |
Collapse
|
16
|
Jankowska-Polańska B, Uchmanowicz I, Dudek K, Łoboz-Grudzień K. Sex differences in the quality of life of patients with acute coronary syndrome treated with percutaneous coronary intervention after a 3-year follow-up. Patient Prefer Adherence 2016; 10:1279-87. [PMID: 27499616 PMCID: PMC4959765 DOI: 10.2147/ppa.s106577] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The aims of this study were to analyze the dynamics of quality of life (QoL) changes after 36 months from the percutaneous coronary intervention (PCI) depending on sex and identify baseline predictors of the follow-up QoL of patients hospitalized for acute coronary syndrome (ACS) and subjected to PCI. METHODS AND RESULTS The study included 137 patients, females (n=67) and males (n=70), with ACS who underwent PCI. The QoL was assessed using the MacNew Heart Disease Health-Related Quality of Life questionnaire. The group of females scored lower in all the domains of the MacNew Heart Disease Health-Related Quality of Life questionnaire in the initial measurement (B 1), in the measurement after 6 months (B 2), and in the long-term follow-up measurement (36 months - B 3). Despite the fact that both groups achieved improved QoL, its values were higher in the males. The average growth rate of the QoL score in the period from the sixth month to 36th month was higher in females than in males. In the univariate and multivariate analyses, significant independent predictors with a negative influence on the long-term QoL score included female sex (ρ=-0.190, β=-0.21), age >60 years (ρ=-0.255, β=-0.186), and diabetes (ρ=-0.216, β=-0.216). CONCLUSION In a 36-month follow-up of ACS patients treated with PCI, there were no statistically significant differences in QoL between sexes. In the entire cohort, there was improvement in QoL, which was higher in the case of the females studied. For the entire group, significant independent determinants of lower QoL 3 years after ACS included female sex, age >60 years, and diabetes.
Collapse
Affiliation(s)
| | - Izabella Uchmanowicz
- Department of Clinical Nursing, Wrocław Medical University
- Correspondence: Izabella Uchmanowicz, Department of Clinical Nursing, Wrocław Medical University, ul K Bartla 5, 51-618 Wrocław, Poland, Tel +48 71 784 1824, Fax +48 71 345 9324, Email
| | - Krzysztof Dudek
- Department of Logistics and Transport Systems, Faculty of Mechanical Engineering, Wrocław University of Technology
| | - Krystyna Łoboz-Grudzień
- Department of Clinical Nursing, Wrocław Medical University
- Cardiology Unit, T Marciniak Lower Silesian Specialist Hospital, Emergency Medicine Centre, Wrocław, Poland
| |
Collapse
|
17
|
Fiabane E, Giorgi I, Candura SM, Argentero P. Psychological and Work Stress Assessment of Patients following Angioplasty or Heart Surgery: Results of 1-year Follow-up Study. Stress Health 2015; 31:393-402. [PMID: 24554616 DOI: 10.1002/smi.2564] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 01/16/2014] [Accepted: 01/19/2014] [Indexed: 11/11/2022]
Abstract
The aim of this study was to explore changes in subjective psychological health and perceived work stress among patients who returned to work (RTW) after a multidisciplinary cardiac rehabilitation (CR) following cardiac interventions. A total of 108 patients were evaluated at the beginning of their CR, at 6 and 12 months after discharge. Self-report questionnaires were used to assess depression, anxiety, illness perception and work stress at each time stage. Results showed reports of depressive symptoms significantly decreased (p < 0.05) and subjective mental (p = 0.001) and physical health (p < 0.001) improved over time. Patients revealed a decrease in Type A behaviour pattern (p < 0.001) and in job satisfaction levels (p = 0.01), greater internal locus of control (p < 0.01) and increased use of the coping strategy 'Involvement' (p < 0.01). Major findings are that cardiac patients had an improvement in subjective psychological health and did not perceive increased work stress after their RTW. Patients' psychological health and work stress need to be assessed during the CR and should be also carefully monitored after the RTW in order to identify patients' psychological and work-related barriers and facilitate a safe and successful work reintegration.
Collapse
Affiliation(s)
- Elena Fiabane
- Department of Brain and Behavioral Sciences, University of Pavia, Italy.,Psychological Unit, Salvatore Maugeri Foundation, Work and Rehabilitation, IRCCS, Scientific Institute of Pavia, Italy
| | - Ines Giorgi
- Psychological Unit, Salvatore Maugeri Foundation, Work and Rehabilitation, IRCCS, Scientific Institute of Pavia, Italy
| | - Stefano M Candura
- Occupational Medicine Unit, University of Pavia and Salvatore Maugeri Foundation, Work and Rehabilitation, IRCCS, Scientific Institute of Pavia, Italy
| | | |
Collapse
|
18
|
Tilburgs B, Nijkamp MD, Bakker EC, van der Hoeven H. The influence of social support on patients’ quality of life after an intensive care unit discharge: A cross-sectional survey. Intensive Crit Care Nurs 2015; 31:336-42. [DOI: 10.1016/j.iccn.2015.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 06/26/2015] [Accepted: 07/02/2015] [Indexed: 10/23/2022]
|
19
|
Smoking Cessation After Acute Myocardial Infarction in Relation to Depression and Personality Factors. Int J Behav Med 2015; 23:234-42. [DOI: 10.1007/s12529-015-9514-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
20
|
Leung Yinko SSL, Pelletier R, Behlouli H, Norris CM, Humphries KH, Pilote L. Health-related quality of life in premature acute coronary syndrome: does patient sex or gender really matter? J Am Heart Assoc 2014; 3:jah3598. [PMID: 25074696 PMCID: PMC4310372 DOI: 10.1161/jaha.114.000901] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background Limited data exist as to the relative contribution of sex and gender on health‐related quality of life (HRQL) among patients with acute coronary syndrome (ACS). This study aims to evaluate the effect of sex and gender‐related variables on long‐term HRQL among young adults with ACS. Methods and Results GENESIS‐PRAXY (GENdEr and Sex determInantS of cardiovascular disease: from bench to beyond‐Premature Acute Coronary SYndrome) is a multicenter, prospective cohort study (January 2009 to August 2013) of adults aged 18 to 55 years, hospitalized with ACS. HRQL was measured at baseline, 1, 6, and 12 months using the Short Form‐12 and Seattle Angina Questionnaire (SAQ) among 1213 patients. Median age was 49 years. Women reported worse HRQL than men over time post‐ACS, both in terms of physical and mental functioning. Gender‐related factors were more likely to be predictors of HRQL than sex. Femininity score, social support, and housework responsibility were the most common gender‐related predictors of HRQL at 12 months. We observed an interaction between female sex and social support (β=0.44 [95% confidence interval, 0.01, 0.88]; P=0.047) for the physical limitation subscale of the SAQ. Conclusions Young women with ACS report significantly poorer HRQL than young men. Gender appears to be more important than sex in predicting long‐term HRQL post‐ACS. Specific gender‐related factors, such as social support, may be amenable to interventions and could improve the HRQL of patients with premature ACS.
Collapse
Affiliation(s)
- Sylvie S L Leung Yinko
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada (S.L.L.Y., R.P., H.B., L.P.)
| | - Roxanne Pelletier
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada (S.L.L.Y., R.P., H.B., L.P.)
| | - Hassan Behlouli
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada (S.L.L.Y., R.P., H.B., L.P.)
| | - Colleen M Norris
- Faculties of Nursing, Medicine and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (C.M.N.)
| | - Karin H Humphries
- Division of Cardiology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (K.H.H.) Providence Health Care Research Institute, St. Paul's Hospital, Vancouver British, Columbia, Canada (K.H.H.)
| | - Louise Pilote
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada (S.L.L.Y., R.P., H.B., L.P.) Division of General Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada (L.P.)
| | | |
Collapse
|
21
|
Zhu LX, Ho SC, Sit JWH, He HG. Retraction: Effects of a transtheoretical model-based exercise stage-matched intervention on exercise behaviour and quality of life in patients with coronary heart disease: a randomized controlled trial. J Adv Nurs 2014; 70:2414. [DOI: 10.1111/jan.12469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Li-Xia Zhu
- School of Nursing; The Hong Kong Polytechnic University; Hong Kong China
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Shuk-Ching Ho
- School of Nursing; The Hong Kong Polytechnic University; Hong Kong China
| | - Janet Wing Hung Sit
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong China
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| |
Collapse
|
22
|
Using a patient-generated mental-health measure 'PSYCHLOPS' to explore problems in patients with coronary heart disease. Br J Gen Pract 2014; 64:e354-63. [PMID: 24868073 DOI: 10.3399/bjgp14x680137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Patients with coronary heart disease (CHD) who are depressed have an increased risk of further cardiac events and higher mortality. AIM To use a patient generated instrument (PSYCHLOPS) to define categories of concerns in patients with CHD. To define the psychometric characteristics of patients in each category. DESIGN AND SETTING Cross-sectional study set in general practices in south London. METHOD Of 3325 patients on the CHD registers in 15 general practices, 655 completed six baseline psychometric and functional instruments: PSYCHLOPS, HADS-Depression, HADS-Anxiety, Clinical Interview Schedule-Revised, SF12-Mental and SF12-Physical. Content analysis was used to categorise patients based on their main problem, as elicited by PSYCHLOPS. Mean psychometric scores were adjusted for confounding by age, sex, deprivation and ethnicity and calculated for each response category. RESULTS Response categories were: physical problems, both non-cardiac (23.2%) and cardiac (6.0%); social problems: relationship/family (18.2%), money (7.5%), work (3.1%); functional (9.8%); psychological (6.9%); miscellaneous (7.3%); 'no problem' (18.2%). The highest psychological distress scores were found in 'physical, cardiac' and 'psychological' categories. The 'no problem' category had significantly lower psychological distress and higher functional capacity than other categories. CONCLUSIONS PSYCHLOPS enabled the identification of subtypes of CHD patients, based on a classification of self-reported problems. A high proportion of CHD patients report social problems. Psychological distress was highest in those reporting cardiac or psychological symptoms. Services should be aligned to the reported needs of patients.
Collapse
|
23
|
Long-term prognostic significance of living alone and other risk factors in patients with acute myocardial infarction. Ir J Med Sci 2014; 184:153-8. [DOI: 10.1007/s11845-014-1079-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 02/03/2014] [Indexed: 10/25/2022]
|
24
|
The relationships among satisfaction with social support, quality of life, and survival 5 to 10 years after heart transplantation. J Cardiovasc Nurs 2013; 28:407-16. [PMID: 22580630 DOI: 10.1097/jcn.0b013e3182532672] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite the fact that social support has been found to be important to cardiovascular health, there is a paucity of information regarding the relationship between social support and outcomes long-term after heart transplantation (HT). OBJECTIVES Therefore, the purposes of our retrospective analyses of a prospective, longitudinal study were to examine (1) the relationship between satisfaction with social support and post-HT health-related quality of life (HRQOL) and survival and (2) whether 2 types of social support (emotional and tangible) were predictors of survival and HRQOL. METHODS Data were collected from 555 HT patients over a 5-year period (78% male, 88% white; mean age, 53.8 years at time of transplantation) at 4 US medical centers using the following instruments: Social Support Index, Quality of Life Index, Heart Transplant Stressor Scale, Jalowiec Coping Scale, and medical records review. Statistical analyses included t tests, correlations, Kaplan-Meier survival actuarials, and linear and multivariable regression. RESULTS Patients were very satisfied with overall social support from 5 to 10 years after HT (0 = very satisfied, 1 = very dissatisfied), which was stable across time (P = .74). Satisfaction with emotional social support (P = .53) and tangible social support (P = .61) also remained stable over time. When stratified into low, medium, and high levels of satisfaction, satisfaction with social support was not related to survival (P = .24). At 5 years, overall satisfaction with social support was a predictor of HRQOL (r = 0.59, P < .0001), and satisfaction with emotional social support was a predictor of HRQOL at 10 years after HT (r = 0.66, P < .0001). CONCLUSIONS Patients were very satisfied over time with emotional and tangible social support. While social support explained quality of life outcomes, it did not predict survival. Knowledge of relationships among social support, stress, and outcomes may assist clinicians to address social support needs and resources long-term after HT.
Collapse
|
25
|
Fransson EI, Arenhall E, Steinke EE, Fridlund B, Nilsson UG. Perceptions of intimate relationships in partners before and after a patient's myocardial infarction. J Clin Nurs 2013; 23:2196-204. [DOI: 10.1111/jocn.12492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2013] [Indexed: 12/01/2022]
Affiliation(s)
| | - Eva Arenhall
- School of Health and Medical Sciences; Örebro University; Örebro Sweden
- Department of Cardiology; Örebro University Hospital; Örebro Sweden
| | | | - Bengt Fridlund
- School of Health Sciences; Jönköping University; Jönköping Sweden
| | - Ulrica G Nilsson
- School of Health and Medical Sciences; Örebro University; Örebro Sweden
| |
Collapse
|
26
|
Kristofferzon ML, Ternesten-Hasséus E. A study of two generic health-related quality of life questionnaires--Nottingham Health Profile and Short-Form 36 Health Survey--and of coping in patients with sensory hyperreactivity. Health Qual Life Outcomes 2013; 11:182. [PMID: 24168525 PMCID: PMC3842640 DOI: 10.1186/1477-7525-11-182] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 10/22/2013] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Sensory hyperreactivity (SHR) is one explanation for airway symptoms induced by chemicals and scents. Little is known about health-related quality of life (HRQOL) and coping, in this group of patients. A study was done in patients with SHR to (1) compare the Nottingham Health Profile (NHP) and the Short-Form 36 Health Survey (SF-36) in regard to their suitability, validity, reliability, and acceptability; (2) evaluate how the patients cope with the illness; (3) assess whether there are differences between women and men with respect to HRQOL and coping; and (4) assess whether there are differences between patients and normative data with respect to HRQOL and coping. METHODS A total of 115 patients (91 women) with SHR were asked to answer five questionnaires: a study-specific questionnaire, the Chemical Sensitivity Scale for Sensory Hyperreactivity (CSS-SHR), the NHP, the SF-36, and the Jalowiec Coping Scale-60. RESULTS Eighty-three patients (72%; 70 women) completed all questionnaires. The SF-36 scores were less skewed and more homogeneously distributed and showed fewer floor and ceiling effects than the NHP scores. The SF-36 was also discriminated better between patients with high and low CSS-SHR scores. The reliability standard for both questionnaires was satisfactory. There were no gender differences in HRQOL. Patients with SHR had significantly lower HRQOL scores than the normative data in comparable domains of the NHP and the SF-36: emotional reactions/mental health, energy/vitality, physical mobility/functioning, and pain/bodily pain. In social isolation/functioning, the results were different; the NHP scores were similar to the normative data and the SF-36 scores were lower. The most commonly used coping styles were optimistic, self-reliant, and confrontational. Women used optimistic coping more than men. Compared with the normative group, patients with SHR used confrontational and optimistic coping more and emotive coping less. CONCLUSIONS The current findings showed that both the NHP and the SF-36 were reliable instruments; but the results suggest that the SF-36 is a more sensitive instrument than the NHP for elucidating HRQOL in patients with SHR. Patients with SHR experienced a poor HRQOL and they followed the Western tradition of preferring problem-focused coping strategies to palliative and emotive strategies.
Collapse
Affiliation(s)
| | - Ewa Ternesten-Hasséus
- Department of Respiratory Medicine and Allergology, Institution of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
| |
Collapse
|
27
|
Yates BC, Schumacher KL, Norman JE, Krogstrand KS, Meza J, Shurmur S. Intervention fidelity in a translational study: lessons learned. Res Theory Nurs Pract 2013; 27:131-48. [PMID: 24053002 DOI: 10.1891/1541-6577.27.2.131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article examined the intervention fidelity strategies used and lessons learned in a translational study. In this study, the behavioral intervention was delivered within an existing clinical practice environment, outpatient cardiac rehabilitation (CR). The primary lessons learned were that the fidelity components of design, training, and delivery of the intervention were the most different from fidelity strategies used in typical intervention studies. The design component needed to take into account the unique characteristics of the clinical environments where the study was conducted and build these unique differences into the study design. Training and delivery of the intervention was different because existing CR staff delivered the intervention in this study; which is unlike typical intervention studies where research staff are trained to deliver the intervention. Monitoring receipt and enactment fidelity components were similar to monitoring in usual intervention studies probably because these components focus on monitoring the behaviors of the research participant. Translational research presents unique challenges and requires the development of a flexible and novel intervention fidelity plan tailored to a particular study.
Collapse
Affiliation(s)
- Bernice C Yates
- College of Nursing, University of Nebraska Medical Center, Omaha, NE 68198-5330, USA.
| | | | | | | | | | | |
Collapse
|
28
|
Baldacchino D, Torskenaes K, Kalfoss M, Borg J, Tonna A, Debattista C, Decelis N, Mifsud R. Spiritual coping in rehabilitation- a comparative study: part 2. ACTA ACUST UNITED AC 2013; 22:402-8. [PMID: 23588017 DOI: 10.12968/bjon.2013.22.7.402] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Spiritual coping, which may or may not contain religiosity, may enhance adaptation of clients with chronic illness. Part 1 of this article (Baldacchino et al, 2013) presented the research methodology of this cross-sectional comparative study, which explored the spiritual coping of clients with chronic illness receiving rehabilitation services in Malta (n=44) (lower limb amputation: n=10, chronic heart disease: n=9, osteoarthritis in an institution: n=10 and in the community: n=15) and Norway (n=16) (post-hip/shoulder surgery: n=5; chronic heart disease: n=5; chronic pain: n=6). Data were collected from seven purposive samples by focus groups. Roy's adaptation model (1984) and Neuman's Systems Model (2010) guided the study. Part2 discusses the findings, which consist of one main spiritual coping theme and three sub-themes: 'adopting religious coping strategies, relationship with God, and time for reflection and counting one's blessings'. Commonalities were found in the findings except in one dimension, which was found only in the Malta group, that is, being supported by others with a similar condition. This difference may be a result of the environment in the rehabilitation centres, cultural, and geographical differences between the two countries. While considering the limitations of this study, recommendations are proposed to the rehabilitation and education sectors and further trans-cultural comparative longitudinal research with mixed method approach on various clients with acute, chronic and life-threatening illness.
Collapse
|
29
|
Son H, Thomas SA, Friedmann E. Longitudinal Changes in Coping for Spouses of Post–Myocardial Infarction Patients. West J Nurs Res 2013; 35:1011-25. [DOI: 10.1177/0193945913484814] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Spouses are the key in the recovery and coping of patients after a myocardial infarction (MI). The purpose of this study was to examine changes in coping for spouses of post-MI patients over time. The study determined the contributions of a spouse’s demographic factors and of time since the MI to the changes in coping. A secondary data analysis from the Patients’ and Families’ Psychological Response to Home Automated External Defibrillator Trial was conducted. On average, older spouses coped better than younger spouses. Coping significantly decreased over time. The spouse’s coping decreased for spouses whose baseline coping was higher. Coping decreased more rapidly for spouses of patients who experienced an MI more recently. Patients and spouses need support to improve coping after an MI.
Collapse
Affiliation(s)
| | - Sue A. Thomas
- University of Maryland School of Nursing, Baltimore, USA
| | | |
Collapse
|
30
|
Simmonds RL, Tylee A, Walters P, Rose D. Patients' perceptions of depression and coronary heart disease: a qualitative UPBEAT-UK study. BMC FAMILY PRACTICE 2013; 14:38. [PMID: 23509869 PMCID: PMC3606418 DOI: 10.1186/1471-2296-14-38] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Accepted: 02/21/2013] [Indexed: 11/11/2022]
Abstract
BACKGROUND The prevalence of depression in people with coronary heart disease (CHD) is high but little is known about patients' own perceptions and experiences of this. This study aimed to explore (i) primary care (PC) patients' perceptions of links between their physical condition and mental health, (ii) their experiences of living with depression and CHD and (iii) their own self-help strategies and attitudes to current PC interventions for depression. METHOD Qualitative study using consecutive sampling, in-depth interviews and thematic analysis using a process of constant comparison. 30 participants from the UPBEAT-UK cohort study, with CHD and symptoms of depression. All participants were registered on the General Practitioner (GP) primary care, coronary register. RESULTS A personal and social story of loss underpinned participants' accounts of their lives, both before and after their experience of having CHD. This theme included two interrelated domains: interpersonal loss and loss centred upon health/control issues. Strong links were made between CHD and depression by men who felt emasculated by CHD. Weaker links were made by participants who had experienced distressing life events such as divorce and bereavement or were living with additional chronic health conditions (i.e. multimorbidity). Participants also felt 'depressed' by the 'medicalisation' of their lives, loneliness and the experience of ageing and ill health. Just under half the sample had consulted their GP about their low mood and participants were somewhat ambivalent about accessing primary care interventions for depression believing the GP would not be able to help them with complex health and social issues. Talking therapies and interventions providing the opportunity for social interaction, support and exercise, such as Cardiac Rehabilitation, were thought to be helpful whereas anti-depressants were not favoured. CONCLUSIONS The experiences and needs of patients with CHD and depression are diverse and include psycho-social issues involving interpersonal and health/control losses. In view of the varying social and health needs of patients with CHD and depression the adoption of a holistic, case management approach to care is recommended together with personalised support providing the opportunity for patients to develop and achieve life and health goals, where appropriate.
Collapse
Affiliation(s)
- Rosemary L Simmonds
- Service User Research Enterprise (SURE), Institute of Psychiatry, King’s College London, London, UK
- Health Services and Population Research Department, Institute of Psychiatry, King’s College London, De Crespigny Park, PO Box 34, London, SE5 8AF, UK
| | - Andre Tylee
- Section of Primary Care Mental Health, Institute of Psychiatry, King’s College London, London, UK
- Health Services and Population Research Department, Institute of Psychiatry, King’s College London, De Crespigny Park, PO Box 34, London, SE5 8AF, UK
| | - Paul Walters
- Section of Primary Care Mental Health, Institute of Psychiatry, King’s College London, London, UK
- Health Services and Population Research Department, Institute of Psychiatry, King’s College London, De Crespigny Park, PO Box 34, London, SE5 8AF, UK
| | - Diana Rose
- Service User Research Enterprise (SURE), Institute of Psychiatry, King’s College London, London, UK
- Health Services and Population Research Department, Institute of Psychiatry, King’s College London, De Crespigny Park, PO Box 34, London, SE5 8AF, UK
| |
Collapse
|
31
|
White-Williams C, Grady KL, Naftel DC, Myers S, Wang E, Rybarczyk B. The relationship of socio-demographic factors and satisfaction with social support at five and 10 yr after heart transplantation. Clin Transplant 2012; 27:267-73. [PMID: 23278755 DOI: 10.1111/ctr.12057] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Despite the fact that social support has been found to be important to cardiovascular health, there is a paucity of information regarding the relationship between social support and outcomes long term after heart transplantation (HT). The purposes of this study were to examine demographic and psychosocial characteristics and their relationship to social support after HT and to identify whether socio-demographic variables are predictors of satisfaction with social support post-HT. METHODS Data were collected from 555 HT patients (pts) (78% men, 88% white, mean age = 53.8 yr at time of transplant) at four US medical centers using the following instruments: Social Support Index, QOL Index, HT Stressor Scale, Jalowiec Coping Scale, Sickness Impact Profile, Cardiac Depression Scale, and medical records review. Statistical analyses included t-tests, correlations, and linear and multivariate regression. RESULTS There were no associations between education and ethnicity and perception of social support at five and 10 yr after HT. Married and older pts reported higher satisfaction with social support after HT. Being married and having higher education were predictors of better overall satisfaction with social support at 10 yr post-heart transplantation. CONCLUSIONS Knowledge of relationships between socio-demographic factors and social support may assist clinicians to address social support needs and resources long term after HT.
Collapse
|
32
|
Yaghoubi A, Tabrizi JS, Mirinazhad MM, Azami S, Naghavi-Behzad M, Ghojazadeh M. Quality of life in cardiovascular patients in iran and factors affecting it: a systematic review. J Cardiovasc Thorac Res 2012; 4:95-101. [PMID: 24250995 DOI: 10.5681/jcvtr.2012.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2012] [Accepted: 10/10/2012] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Cardiovascular diseases are always one of the major causes of mortality in the world affecting all aspects of patients' lives. Therefore, this study was conducted to summarize and provide a clear view of quality of life in these patients in Iran through a systematic review on the results of previously conducted studies. METHODS In a systematic review, required information was collected by searching keywords of Iran, quality of life, heart failure, cardiac, heart, and their Persian equivalents in databases of Science Direct, Pubmed, IRAN doc, SID, Medlib and Magiran. The selected time period for searching articles was since 2000 to 2012. Inclusion criteria were: releasing of article during 2000 to 2012, articles reporting patients' quality of life in any domains of heart diseases, and articles published in Persian and English. Extracted results first were summarized in Extraction Table, and then analyzed manually. RESULTS Finally 18 of 1592 found articles were included in the study. A total of 3,797 cardiac patients' quality of life was measured using six different tools, the most important one of which was SF36 questionnaire. Among eight dimensions of SF36 questionnaire, the highest mean was for social role functioning with average score of 58.37 and the lowest for physical limitation (physical role functioning) with score of 42.95. Overall, mean of eight dimensions was 53.19. Among 4 general domains of quality of life, physical activity had the lowest average of 43.63 and average of general dimensions of quality of life was 47.65. The most important factors affecting quality of life were sex, age, education, marital status, occupational status, suffering duration, number of hospitalizations etc. CONCLUSION The results of the studies showed relatively low quality of life of cardiovascular patients in general. Therefore, according to the introduced effective factors in this study, it is necessary to consider regular programs for improving quality of life in these patients and providing suitable and qualitative services.
Collapse
Affiliation(s)
- Alireza Yaghoubi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | | | | | | |
Collapse
|
33
|
Abstract
Disability can include different aspects of patient’s quality of life from physical to psychosocial to employment. Disability in IBD patients contributes to loss of workplace personnel, increased sick leave, and other indirect costs to society. Considerations for more expensive treatment regimens should include their potential to reduce indirect costs to the individual patients and to society in general. The recently developed tool could help establish specific criteria in a set of these diseases that have varied effects and severity.
Collapse
Affiliation(s)
- Bincy P Abraham
- Section of Gastroenterology and Hepatology, Baylor College of Medicine, 1709 Dryden Street, Suite 800, Houston, TX 77030, USA.
| | | |
Collapse
|
34
|
Roohafza H, Talaei M, Pourmoghaddas Z, Rajabi F, Sadeghi M. Association of social support and coping strategies with acute coronary syndrome: A case–control study. J Cardiol 2012; 59:154-9. [DOI: 10.1016/j.jjcc.2011.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 11/10/2011] [Accepted: 12/12/2011] [Indexed: 10/14/2022]
|
35
|
Flemme I, Johansson I, Strömberg A. Living with life-saving technology - coping strategies in implantable cardioverter defibrillators recipients. J Clin Nurs 2011; 21:311-21. [DOI: 10.1111/j.1365-2702.2011.03847.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
|
36
|
Sjöström-Strand A, Ivarsson B, Sjöberg T. Women's experience of a myocardial infarction: 5 years later. Scand J Caring Sci 2010; 25:459-66. [PMID: 21175730 DOI: 10.1111/j.1471-6712.2010.00849.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Myocardial infarction (MI) has long been seen as a male disease despite the fact that it is also a health problem for women. Factors that may influence their recovery, such as co-morbidity and requirements for support, have received less scientific attention. AIM To explore and describe how women conceived their health and daily life 5 years after an MI. METHOD An explorative and descriptive approach inspired by phenomenography was chosen as the design. The present study includes 12 women who have been described in earlier short-term studies. FINDINGS The women described how the MI caused limitations in their lives even 5 years after the MI. They experienced physical restrictions, fatigue and also other health complaints. Furthermore, the older women suffered from various co-morbidities such as diabetes, kidney disease, high blood pressure, and stroke. Some women did not perceive their heart disease to interfere in daily life. Many of the women had thoughts about having a new MI. Furthermore, some women were grateful and described it as having a second opportunity. CONCLUSION The present study indicates how women in the recovery process 5 years after an MI still need support to continue with lifestyle changes. The women continue to struggle with different kinds of issues, such as financial stress, co-morbidity and side effects of medication. Support from the health care only in the first year after the MI is not enough. The women should benefit from the possibility to visit or consult professionals in primary care with knowledge of CHD.
Collapse
Affiliation(s)
- Annica Sjöström-Strand
- Department of Cardiothoracic Surgery, Lund University and Skåne University Hospital/Lund, Lund, Sweden.
| | | | | |
Collapse
|
37
|
Rambod M, Rafii F. Perceived social support and quality of life in Iranian hemodialysis patients. J Nurs Scholarsh 2010; 42:242-9. [PMID: 20738734 DOI: 10.1111/j.1547-5069.2010.01353.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To describe the relationship between perceived social support and the quality of life in hemodialysis patients from an Islamic cultural background in Iran. DESIGN A cross-sectional, correlational design was used. Data were collected in hemodialysis units affiliated to Iran University of Medical Sciences. Two hundred and two Muslim hemodialysis patients were selected by census during 2007. METHODS The Persian versions of the Personal Resources Questionnaire 85 (PRQ-85) Part II and the Ferrans and Powers Quality of Life Index-dialysis version were used. The data were analyzed using chi-square test and Spearman's rho correlation coefficients. FINDINGS There were a statistically significant relationship between perceived social support and health-functioning (r = .65, p < or = .05), socioeconomic (r = .67, p < or = .05), psychological-spiritual (r = .63, p < or = .05), and family subscales of quality of life (r = .51, p < or = .05). Total quality of life was also significantly correlated with perceived social support (r = 0.72, p= .00). CONCLUSIONS Perceived social support is associated with quality of life in Iranian hemodialysis patients. CLINICAL RELEVANCE It is important to reflect on the impact of culture and religion of Iran on quality of life of hemodialysis patients and their perceived social support.
Collapse
Affiliation(s)
- Maasoumeh Rambod
- Medical-Surgical Nursing Department, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | | |
Collapse
|
38
|
Kristofferzon ML, Johansson I, Brännström M, Arenhall E, Baigi A, Brunt D, Fridlund B, Nilsson U, Persson S, Rask M, Wieslander I, Ivarsson B. Evaluation of a Swedish Version of the Watts Sexual Function Questionnaire (WSFQ) in Persons with Heart Disease: A Pilot Study. Eur J Cardiovasc Nurs 2010; 9:168-74. [DOI: 10.1016/j.ejcnurse.2009.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Revised: 12/10/2009] [Accepted: 12/15/2009] [Indexed: 10/20/2022]
Affiliation(s)
- Marja-Leena Kristofferzon
- Department of Caring Science and Sociology, University of Gävle, SE-801 76 Gävle, Sweden
- Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Ingela Johansson
- Department of Medical and Health Sciences, Division of Nursing Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping Heart Centre, Linköping University Hospital, Sweden
- Molde University College, Faculty of Health Sciences, Molde, Norway
| | | | - Eva Arenhall
- Department of Cardiology, Örebro University Hospital and School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Amir Baigi
- General Practice and Public Health, Halland County Council, Falkenberg, Sweden
| | - David Brunt
- School of Health Sciences and Social Work, Växjö University, Växjö, Sweden
| | - Bengt Fridlund
- School of Health Sciences and Social Work, Växjö University, Växjö, Sweden
- School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Ulrica Nilsson
- Department of Anaesthesia and Intensive Care and Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden
| | - Sylvi Persson
- School of Health Sciences and Social Work, Växjö University, Växjö, Sweden
| | - Mikael Rask
- School of Health Sciences and Social Work, Växjö University, Växjö, Sweden
| | - Inger Wieslander
- School of Health Sciences, Jönköping University, Jönköping, Sweden
- School of Social and Health Sciences, Halmstad University, Halmstad, Sweden
| | - Bodil Ivarsson
- Department of Cardiothoracic Surgery, Lund University Hospital and Lund University, Lund, Sweden
| | | |
Collapse
|
39
|
Hedlund M, Ronne-Engström E, Carlsson M, Ekselius L. Coping strategies, health-related quality of life and psychiatric history in patients with aneurysmal subarachnoid haemorrhage. Acta Neurochir (Wien) 2010; 152:1375-82; discussion 1382. [PMID: 20440628 PMCID: PMC2901493 DOI: 10.1007/s00701-010-0673-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2009] [Accepted: 04/20/2010] [Indexed: 11/26/2022]
Abstract
Purpose Subarachnoid haemorrhage (SAH) reduces health-related quality of life (HRQoL) and increases the risk of psychiatric sequels such as depression and posttraumatic stress disorder. Especially those with a psychiatric history and those using maladaptive coping strategies are at risk for such sequels. The extent to which HRQoL after SAH was related to a history of psychiatric morbidity and to the use of various coping strategies was assessed. Methods Patients admitted to the Uppsala University Hospital with aneurysmal SAH (n = 59) were investigated prospectively. Seven months after SAH, data were collected using the Structured Clinical Interview for DSM-IV axis I disorders, the Short Form-36 (SF-36) Health Survey and the Jalowiec Coping Scale. Results Patients with SAH had lower HRQoL than the general Swedish population in all eight domains of the SF-36. The lower HRQoL was almost entirely in the subgroup with a psychiatric history. HRQoL was also strongly correlated to the use of coping. Physical domains of SF-36 were less affected than mental domains. Those with a psychiatric history used more coping than the remainder with respect to all emotional coping scales. Coping and the presence of a psychiatric history were more strongly related to mental than to physical components of HRQoL. Conclusions A psychiatric history and the use of maladaptive emotional coping were related to worse HRQoL, more to mental than to physical aspects.
Collapse
|
40
|
Yates BC, Kosloski K, Kercher K, Dizona P. Testing a Model of Physical and Psychological Recovery After a Cardiac Event. West J Nurs Res 2010; 32:871-93. [DOI: 10.1177/0193945910362067] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Little is known about the specific sources and types of support that assist patients in alleviating stress and achieving positive recovery outcomes after a cardiac event. The purpose of this study is to examine the effects of illness-related stress, emotional and tangible support from a significant other, and informational support from a health care provider on physical and psychological recovery outcomes in cardiac patients 8 weeks after their cardiac event. The sample consists of 220 cardiac patients. Data analysis uses structural equation modeling. Final fit indices were as follows: χ2 ( df = 110) = 156.169, comparative fit index = .963, Tucker—Lewis index = .949, and root mean square error of approximation = .044 suggesting an acceptable model. Illness-related stress has direct effects on depression, physical recovery, and activity levels. Partner emotional support has a direct effect on depression. The findings provide direction for developing social support interventions aimed at improving recovery outcomes.
Collapse
Affiliation(s)
- Bernice C. Yates
- University of Nebraska Medical Center, College of Nursing, Omaha,
| | | | | | - Paul Dizona
- University of Nebraska Medical Center, College of Nursing, Omaha
| |
Collapse
|
41
|
Tung HH, Hunter A, Wei J, Chang CY. Gender differences in coping and anxiety in patients after coronary artery bypass graft surgery in Taiwan. Heart Lung 2009; 38:469-79. [PMID: 19944871 PMCID: PMC7132377 DOI: 10.1016/j.hrtlng.2009.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2008] [Revised: 01/21/2009] [Accepted: 01/28/2009] [Indexed: 11/26/2022]
Abstract
BACKGROUND Greater use of coping strategies and lower anxiety levels may be related to positive outcomes after coronary artery bypass graft surgery; however, the relationship between them, including by gender, has not been examined in Taiwan. METHODS Cross-sectional survey research design and purposive sampling were used in this study, for which 50 men and 50 women were recruited from a medical center in northern Taiwan. RESULTS After coronary artery bypass graft surgery, both male and female patients used more problem-focused coping strategies than emotion-focused coping strategies. In comparison with men, women tended to use more blaming of self and had slightly higher scores on both state and trait anxiety. CONCLUSION Clinicians need to be aware that the use of appropriate coping strategies can reduce patient anxiety, a finding that needs to be considered when designing effective interventions for these patients.
Collapse
Affiliation(s)
- Heng-Hsin Tung
- National Taipei College of Nursing, Tungs' Taichung MetroHabor Hospital, Taipei, Taiwan
| | | | | | | |
Collapse
|
42
|
A population-based study on ways of dealing with daily stress: comparisons among individuals with mental disorders, with long-term general medical conditions and healthy people. Soc Psychiatry Psychiatr Epidemiol 2009; 44:666-74. [PMID: 19039509 DOI: 10.1007/s00127-008-0482-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2008] [Revised: 03/26/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Stress plays an important role in the etiology of mental and physical disorders. The effect of stress on health may be moderated by how people deal with stress. The objectives of this analysis were to (1) estimate the population proportions using various ways of dealing with stress in healthy people, in people with mental disorders and substance dependence and in individuals with general medical conditions only, and (2) identify factors associated with ways of dealing with stress. METHODS Data from the Canadian Community Health Survey, Mental Health and Well-being (CCHS-1.2) were used (n = 36,984). This was a national mental health survey which used a probability sample and incorporated a version of the Composite International Diagnostic Interview. RESULTS Participants with mental disorders differed from healthy people in ways of dealing with stress. Among participants with mental disorders, women were more likely to report that they "talk to others" and "eat more/less" to deal with stress. Men were more likely to use "avoid people" and "drink alcohol" to deal with stress than women. Age differences within groups in ways of dealing with stress were found and having a history of mental disorders was also associated with reported ways of dealing with stress. CONCLUSIONS Ways of dealing with stress differ by gender and age, but there is no over-arching pattern of maladaptive coping associated with mental disorders that applies across illness, age and gender categories. Healthy behaviors should be promoted as ways to relieve stress, leading to better self-care skills.
Collapse
|
43
|
Sundler AJ, Dahlberg K, Ekenstam C. The meaning of close relationships and sexuality: women's well-being following a myocardial infarction. QUALITATIVE HEALTH RESEARCH 2009; 19:375-387. [PMID: 19224880 DOI: 10.1177/1049732309331882] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Relationships and sexuality following heart attack (MI) have been studied; nevertheless, little is known about the meaning of social support and relationships to health and well-being after an MI. To our knowledge, no qualitative studies have further investigated the phenomenon. In this study we explore the meaning of close relationships and sexuality to women's health and well-being following MI. Ten women were interviewed using a reflective lifeworld approach and phenomenological epistemology. The meaning of women's close relationships following an MI appears to be closely intertwined with their long-term health process; both health processes and the relationships are affected. Suffering after an MI can be compared to taking a fall in that close relationships can become a safety net. Close relationships and sexuality are integrated into their lived bodies, and in that way have profound influence in their lifeworld experiences. Not all close relationships are intimate; however, all close and meaningful relationships can provide power and strength to the women's health processes. At the same time, these relationships also appear to drain energy and cause suffering.
Collapse
|
44
|
Kristofferzon ML, Löfmark R, Carlsson M. Managing consequences and finding hope--experiences of Swedish women and men 4-6 months after myocardial infarction. Scand J Caring Sci 2008; 22:367-75. [PMID: 18840220 DOI: 10.1111/j.1471-6712.2007.00538.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Research has focused more on symptoms, risk factors and treatment, than on individuals' experiences of illness and recovery after myocardial infarction (MI). Therefore, the aim of the study was to describe the experiences of present everyday life of women and men 4-6 months after MI and their expectations for the future. Semi-structured interviews were conducted with 20 women and 19 men from January 2000 to November 2001. Data were analysed with content analysis. Two themes, 'Managing consequences of MI' and 'Finding a meaning in what had happened', were generated. The first theme reveals that many of the patients had not established a stable health condition, even if symptoms and emotional distress had diminished over time. They had to manage health problems, lifestyle modifications, emotional reactions and changes in social life. The support from their social network encouraged them to move on. The second theme shows that patients also found positive consequences of what they had gone through, new life values and hopes in the future. The conclusions were that most of the patients moved on and began to regain a balance in everyday life, but some patients still struggled hard to find this balance. Those patients experienced large difficulties with managing their everyday life and felt a lack of support from their social network. Health professionals can be an important resource in helping patients in their adaptation to changes if they are more sensitive to patients' needs of support both in a short- and long-term perspective.
Collapse
Affiliation(s)
- Marja-Leena Kristofferzon
- Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
| | | | | |
Collapse
|
45
|
Baigi A, Hildingh C, Virdhall H, Fridlund B. Sense of coherence as well as social support and network as perceived by patients with a suspected or manifest myocardial infarction: a short-term follow-up study. Clin Rehabil 2008; 22:646-52. [PMID: 18586816 DOI: 10.1177/0269215507086237] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare sense of coherence as well as social support and network as perceived by ischaemic heart disease patients at baseline and two weeks post-discharge in terms of age, sex, educational and marital status. DESIGN Multicentre study with a prospective short-term follow-up design. SETTING A university hospital, a central hospital and a district hospital in southern Sweden. SUBJECTS Consecutive sample of 246 patients with a suspect or manifest myocardial infarction. MAIN MEASURES The Lubben Social Network Scale (LSNS-R), the Medical Outcome Study (MOS) Social Support Survey and the Sense of Coherence Scale were included in a self-administered questionnaire and answered twice, together with sociodemographic variables. RESULTS Bivariate analyses indicated changes in social support (practical support increased in men and decreased in women; both P= 0.003) and social network (family network increased among >65 year olds; P= 0.001, men; P= 0.013, and women; P= 0.033, those with a low; P=0.017, and intermediate; P= 0.033, educational level, as well as those cohabiting; P= 0.0001), but did not reveal any difference in sense of coherence. CONCLUSIONS Sociodemographic variables have no influence on sense of coherence but do affect social support (i.e. practical support and social network, family). Ischaemic heart disease patients' short stay in hospital implies that the network outside the hospital has to assume responsibility, but at the same time it is important for health care professionals to have sufficient knowledge to be able to support the specific needs of patients and their family members.
Collapse
Affiliation(s)
- Amir Baigi
- Department of Primary Health Care, Göteborg University, Göteborg, Sweden
| | | | | | | |
Collapse
|
46
|
Nissen NK, Madsen M, Olsen Zwisler AD. Health service interventions targeting relatives of heart patients: A review of the literature. Scand J Public Health 2008; 36:818-26. [DOI: 10.1177/1403494808092249] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims: Relatives of heart patients experience anxiety, uncertainty, and low quality of life, and the hospitalization of a heart patient is associated with increased risk of death for the partner. Relatives' physical and mental problems may be rectified by activities established by the health services to support relatives and to enable them to handle the situation. This study systematically reviewed the literature on the latest health service interventions targeting relatives of heart patients. Methods: The literature about interventions targeting relatives of heart patients has been systematically reviewed to clarify what the health services do for relatives of heart patients and to assess the effects of interventions. We searched Medline, EMBASE, PsycINFO, CINAHL database, CSA and the Cochrane Library from January 2000 to March 2006. Results: Only six scientific articles reported on interventions testing health service activities for relatives of heart patients, and one literature review scrutinized earlier studies within the field. All the interventions indicate positive effects on patients' and/or relatives' health and well-being, in accordance with nurses' assessments. Nevertheless, the few studies and their questionable quality means that full evidence on the effects of the interventions is lacking. Conclusions: Future research should clarify the evidence for health service interventions and draw up guidelines for activities for the relatives of heart patients.
Collapse
Affiliation(s)
| | - Mette Madsen
- Institute of Public Health, University of Copenhagen, Denmark
| | | |
Collapse
|
47
|
O'Sullivan D, McCarthy G. An exploration of the relationship between fatigue and physical functioning in patients with end stage renal disease receiving haemodialysis. J Clin Nurs 2008; 16:276-84. [PMID: 17931321 DOI: 10.1111/j.1365-2702.2007.01965.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To measure fatigue and physical functioning in patients with end stage renal disease (ESRD) receiving haemodialysis and to investigate the relationships between fatigue and physical functioning. BACKGROUND Fatigue and reduced physical functioning are among the most bothersome symptoms experienced by individuals receiving haemodialysis for ESRD. Research has shown that increasing activity levels has resulted in decreased fatigue levels and improved physical functioning in individuals with cancer. Establishing whether or not a relationship exists between both concepts in haemodialysis patients is a preliminary step in identifying potential fatigue reducing strategies necessary for improved wellbeing. METHOD A quantitative exploratory correlational design was used with 46 individuals completing the Multi-dimensional Fatigue Inventory, the Medical Outcomes Study Short-Form 36-item questionnaire and a Demographic Questionnaire. RESULTS Results indicated fatigue was prevalent with highest scores achieved for physical fatigue; reduced activity and general fatigue. Substantial limitations in physical functioning were found. A significant moderate negative relationship between general fatigue and physical functioning indicated that, as physical functioning levels increased, fatigue levels decreased. A significant difference was also found between general fatigue scores for males and females. Significant relationships were found between overall physical functioning, older age and employment status. CONCLUSION The research indicates the prevalence of fatigue and limitations in physical functioning in individuals with ESRD. However, as physical functioning increased fatigue decreased; a finding relevant to clinical nursing. RELEVANCE TO CLINICAL PRACTICE Understanding the levels of fatigue and the value of exercise is of relevance to clinical practice thus assessment of fatigue and physical functioning ability in the clinical setting is necessary.
Collapse
Affiliation(s)
- Dawn O'Sullivan
- Catherine McAuley School of Nursing and Midwifery, Brookfield Health Science Complex, Cork, Ireland
| | | |
Collapse
|
48
|
Larsson K, Lööf L, Rönnblom A, Nordin K. Quality of life for patients with exacerbation in inflammatory bowel disease and how they cope with disease activity. J Psychosom Res 2008; 64:139-48. [PMID: 18222127 DOI: 10.1016/j.jpsychores.2007.10.007] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2007] [Revised: 09/10/2007] [Accepted: 10/04/2007] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Health-related quality of life (HRQoL) for patients with ulcerative colitis (UC) or Crohn's disease (CD) is influenced by symptoms and treatments. Periods with increased disease activity are specifically trying, but the knowledge of how patients manage this is sparse. The aim of this cross-sectional study was to examine (1) HRQoL for patients with UC or CD, (2) how patients cope with increased disease activity, and (3) if coping is associated with HRQoL. METHODS A postal questionnaire was sent to patients with UC and CD who attended the gastroenterology and surgery department at a Swedish university hospital. Coping, HRQoL, and emotional well-being were assessed by Jalowiec Coping Scale, Short Form-36 Health survey, Short Health Scale, and the Hospital Anxiety and Depression Scale. RESULTS Patients with increased disease activity reported impaired HRQoL and emotional distress. This was more prevalent among patients with CD, as compared to patients with UC. Optimistic, self-reliant and confrontive coping strategies were most frequently used to manage stressors, with no differences found between patients in exacerbation or remission or between patients with UC or CD. CONCLUSION Impaired HRQoL and emotional distress is prevalent among patients with exacerbation in UC and CD. Thus, a complete evaluation of psychosocial status and management of psychosocial distress should be included in the clinical treatment of the patient. Patients use a variety of coping strategies in an effort to manage increased disease activity. However, these results did not support any associations between coping and HRQoL.
Collapse
Affiliation(s)
- Kjerstin Larsson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala Science Park, Uppsala, Sweden.
| | | | | | | |
Collapse
|
49
|
|
50
|
Gulliksson M, Burell G, Lundin L, Toss H, Svärdsudd K. Psychosocial factors during the first year after a coronary heart disease event in cases and referents. Secondary Prevention in Uppsala Primary Health Care Project (SUPRIM). BMC Cardiovasc Disord 2007; 7:36. [PMID: 18031575 PMCID: PMC2213687 DOI: 10.1186/1471-2261-7-36] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2007] [Accepted: 11/21/2007] [Indexed: 01/19/2023] Open
Abstract
Background A large number of studies have reported on the psychosocial risk factor pattern prior to coronary heart disease events, but few have investigated the situation during the first year after an event, and none has been controlled. We therefore performed a case-referent study in which the prevalence of a number of psychosocial factors was evaluated. Methods Three hundred and forty-six coronary heart disease male and female cases no more than 75 years of age, discharged from hospital within the past 12 months, and 1038 referents from the general population, matched to the cases by age, sex and place of living, received a postal questionnaire in which information on lifestyle, psychosocial and quality of life measures were sought. Results The cases were, as expected, on sick leave to a larger extent than the referents, reported poorer fitness, poorer perceived health, fewer leisure time activities, but unexpectedly reported better social support, and more optimistic views of the future than the referents. There were no significant case-referent differences in everyday life stress, stressful life events, vital exhaustion, depressive mood, coping or life orientation test. However, women reported less favourable situations than men regarding stressful life events affecting others, vital exhaustion, depressive mood, coping, self-esteem, sleep, and symptom reporting, and female cases reported the most unfavourable situation of all groups. Conclusion In this first controlled study of the situation during the first year after a CHD event disease and gender status both appeared to be determinants of psychological well-being, with gender status apparently the strongest. This may have implications for cardiac rehabilitation programmes.
Collapse
Affiliation(s)
- Mats Gulliksson
- Family Medicine and Clinical Epidemiology Section, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
| | | | | | | | | |
Collapse
|