Illness intrusiveness, health locus of control, and anxiety symptoms among veterans with congestive heart failure

Disease severity, illness intrusiveness, and health locus of control (HLC) each contribute to psychosocial wellbeing in patients with congestive heart failure (CHF). To better understand the relationships between these variables regarding anxiety symptoms, we analyzed data from 116 adult male veterans with comorbid CHF and anxiety. Results suggested that illness intrusiveness significantly mediated the relation of CHF severity to anxiety symptom severity, and that the illness intrusiveness domains of physical well-being/diet, work/finances, and other aspects of life (religious/spirituality, community/civic, self-improvement/expression) were also significant mediators of that relationship. The relation of illness intrusiveness to anxiety was not moderated by internal HLC. Findings highlight the importance of assessing and treating various aspects of illness intrusiveness to manage anxiety symptoms in CHF patients.

Consequences of Psychological Aspects: From Jordanian Heart Failure Patients' Beliefs

Introduction

Psychological aspects are common in patients with heart failure (HF). Psychological aspects have negative consequences in patients with HF.

Objective

This study was conducted to gain a deeper understanding of the consequences of psychological aspects in Jordanian patients with HF.

Methods

This study is a qualitative study conducted with the participation of 24 patients with HF. Data were collected using semi-structured interviews.

Results

The main theme of the findings can be expressed as "Consequences of psychological aspects of HF." The following four sub-themes emerged from the data: social isolation, disturbance of feelings, being non-compliant, and growing burden on the health care system.

Conclusion

The findings revealed the need for informing healthcare providers about the negative consequences of psychological aspects and develop clinical guidelines to evaluate psychological aspects to support these patients.

The influence of trait mindfulness on depression in multiple sclerosis: potential implications for treatment

PURPOSE

This study seeks to add to existing literature on depression and illness intrusiveness in chronic disorders by examining, (1) how the perceived intrusiveness of multiple sclerosis (MS) leads to depression, (2) and the mediating role trait mindfulness plays in this relationship METHODS: Participants (N = 755) were persons with MS (PwMS) recruited through the North American Research Committee on MS (NARCOMS) registry (a larger study). Participants completed the Illness Intrusiveness Ratings Scale, the Hospital Anxiety and Depression Scale and the Mindful Attention Awareness Scale. A mediation model assessed if trait mindfulness mediates the relationship between illness intrusiveness and depression RESULTS: Illness intrusiveness predicted trait mindfulness (a =  - 4.54; p < .001), trait mindfulness predicted depression (b =  - .04; p < .001); there was a direct effect of illness intrusiveness on depression (c' = 2.53; p < .001) and an indirect effect on depression (ab = .17, 95% BCa CI [.10, .25]) when trait mindfulness was in the model, which represented a medium size effect, R²_med = .10 [95% CI .07, .14] CONCLUSION: Trait mindfulness mediates the relationship between illness intrusiveness and depression in PwMS. Providers could provide psychoeducation on the benefits of mindfulness and mindfulness-based interventions.

A longitudinal analysis of chronic arm morbidity following breast cancer surgery

Arm morbidity (AM) arising from breast cancer (BC) treatment can detrimentally impact quality of life; often limiting a survivor's ability to participate in valued activities. The present study explored (a) the developmental time course of AM [restricted range of motion (ROM), pain, and arm volume changes], negative affect, and perceived disability in the immediate years post-surgery, and (b) the mediating role of perceived disability on the relationship between AM and negative affect over time. In this 5-year longitudinal study, BC survivors from four Canadian oncology clinics (n = 431) completed five annual clinical assessments, where differences in ROM (shoulder abduction, external rotation) and arm volume between the affected and non-affected arm were measured. The profile of mood states (POMS), disability of arm, shoulder, hand, and McGill Pain Questionnaire-Short form were completed. Results from general linear modeling showed that AM, negative affect, and perceived disability were greatest 1-year post-surgery, declined, and with the exception of arm volume changes, were significantly lower 5 years later. Negative affect was significantly associated with restrictions in shoulder abduction and external rotation (average r = -0.15; p < 0.05) and present arm pain (average r = 0.28, p < 0.01) at most assessments. The mediating role of perceived disability on the relationship between AM and negative affect was statistically significant in a majority of assessments. Perceived disability is the underlying factor driving the relationship between AM and mood disturbance over time. Rehabilitative therapy to improve survivors' functional well-being might mitigate the negative impacts of AM on emotional health.

Experiences of Patients Living With Heart Failure

The purpose of this study was to explore the experiences, needs, and coping strategies of patients living with heart failure in Singapore. A descriptive qualitative design was used. A purposive sample of 15 informants was recruited from two cardiology wards of a tertiary public hospital in Singapore. Individual face-to-face interviews were conducted with a semistructured interview guideline that was developed based on a review of the literature and a pilot study. Content analysis was adopted to analyze the data, and four main categories were identified: perceived causes, manifestations, and prognosis; enduring emotions; managing the condition; and needs from health care professionals. The informants were overwhelmed with the experience of living with heart failure due to the disruptive and uncertain nature of the condition. This study offers health care professionals practical and useful suggestions when providing holistic care for patients with heart failure.

Poor social support is associated with increases in depression but not anxiety over 2 years in heart failure outpatients

BACKGROUND

Heart failure (HF) is a major health problem in the United States, affecting 5.7 million American adults. Psychosocial distress, in particular depression, contributes to morbidity and mortality in patients with HF. Little is known about the interrelationship among disease severity, social support, and depression.

OBJECTIVE

The aim of this study was to examine the contributions of social support and disease severity to longitudinal changes in depression and anxiety of outpatients with HF.

METHODS

Patients (N = 108) enrolled in the Psychosocial Factors Outcome Study completed the Beck Depression Inventory-II, the State Trait Anxiety Inventory, and the Social Support Questionnaire-6 at study entry and every 6 months for up to 2 years.

RESULTS

At baseline, 30% of the patients were depressed and 42% were anxious. Social support amount contributed to changes in depression (P = .044) but not anxiety (P = .856). Depression increased over time for patients who had lower initial social support amount. Depression did not increase for those with higher initial social support amount. Neither New York Heart Association class nor treatment group (placebo or implantable cardioverter defibrillator) interacted with time to predict depression, which indicates that changes in depression were parallel for patients with New York Heart Association class II and class III HF and for those who received implantable cardioverter defibrillators and those who did not. Assessment of patients with HF should include depression and social support. Interventions to enhance social support among patients with HF who have low social support may help alleviate the development of depression.

CONCLUSIONS

Reducing psychological distress and increasing social support may improve health outcomes among HF outpatients. It is important for studies of HF to include assessment of depression, anxiety, and social support and evaluate their contributions to health outcomes.