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Michalski P, Kosobucka-Ozdoba A, Pietrzykowski Ł, Kasprzak M, Grzelakowska K, Rzepka-Cholasińska A, Kubica A. Functioning in an Illness and Quality of Life versus the Prevalence of Depression and Anxiety Disorders in Patients with High Cardiovascular Risk. NURSING REPORTS 2024; 14:2596-2604. [PMID: 39330745 PMCID: PMC11434633 DOI: 10.3390/nursrep14030191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 09/13/2024] [Accepted: 09/18/2024] [Indexed: 09/28/2024] Open
Abstract
BACKGROUND A chronic disease occurring in a person's life is a stressor, disrupting every aspect of their life. OBJECTIVES This study aims to assess the relationship between functioning in chronic illness and quality of life with the prevalence of symptoms of depression and anxiety in patients with high cardiovascular risk. MATERIAL AND METHODS This study included 200 patients (aged 18-80 years) under the care of a primary care physician, diagnosed with hypertension and/or hypercholesterolemia, and/or diabetes between 6 and 24 months before the enrollment. The presented analysis assessed the symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS); and the quality of life of patients with cardiovascular disease using the Heart Quality of Life (HeartQoL) questionnaire and functioning in chronic illness using the Functioning in Chronic Illness Scale (FCIS). RESULTS The HADS scores amounted to 4.34 ± 3.414 points for the HADS-Anxiety subscale and 3.20 ± 2.979 points for the HADS-Depression subscale. The score indicative of functioning in chronic illness assessed with the FCIS was 98.32 ± 13.89 points. The independent predictors of HADS-anxiety were HeartQoL Emotional and FCIS Global, while HeartQoL Global and FCIS Global were the independent predictors for HADS-depression. Better functioning in chronic illness (FCIS Global) was associated with less frequent symptoms of anxiety and depression based on the HADS: HADS-Anxiety (R Spearmann = -0.3969; p < 0.0001) and HADS-Depression (R Spearmann = -0.5884; p < 0.0001). Higher HeartQoL scores, both globally, as well as in emotional and physical dimensions, were associated with a lower severity of anxiety and depression assessed with the HADS: HADS-Anxiety (R Spearmann = -0.2909; p = 0.0001) and HADS-Depression (R Spearmann = -0.2583; p = 0.0002). CONCLUSIONS The quality of life and functioning in chronic illness are connected with symptoms of depression and anxiety. When assessing the severity of the depression symptoms in relation to the individual aspects of functioning in chronic illness, the areas requiring supportive-educational intervention can be identified. The assessment of both functioning in a chronic disease and the severity of the depression symptoms should be included in a standard nursing diagnosis and further supportive and educational intervention.
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Affiliation(s)
- Piotr Michalski
- Department of Cardiac Rehabilitation and Health Promotion, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Marii Sklodowskiej-Curie St. 9, 85-094 Bydgoszcz, Poland; (P.M.); (A.K.-O.); (A.R.-C.); (A.K.)
| | - Agata Kosobucka-Ozdoba
- Department of Cardiac Rehabilitation and Health Promotion, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Marii Sklodowskiej-Curie St. 9, 85-094 Bydgoszcz, Poland; (P.M.); (A.K.-O.); (A.R.-C.); (A.K.)
| | - Łukasz Pietrzykowski
- Department of Cardiac Rehabilitation and Health Promotion, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Marii Sklodowskiej-Curie St. 9, 85-094 Bydgoszcz, Poland; (P.M.); (A.K.-O.); (A.R.-C.); (A.K.)
| | - Michał Kasprzak
- Department of Cardiology and Internal Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Marii Sklodowskiej-Curie St. 9, 85-094 Bydgoszcz, Poland; (M.K.); (K.G.)
| | - Klaudyna Grzelakowska
- Department of Cardiology and Internal Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Marii Sklodowskiej-Curie St. 9, 85-094 Bydgoszcz, Poland; (M.K.); (K.G.)
| | - Alicja Rzepka-Cholasińska
- Department of Cardiac Rehabilitation and Health Promotion, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Marii Sklodowskiej-Curie St. 9, 85-094 Bydgoszcz, Poland; (P.M.); (A.K.-O.); (A.R.-C.); (A.K.)
| | - Aldona Kubica
- Department of Cardiac Rehabilitation and Health Promotion, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Marii Sklodowskiej-Curie St. 9, 85-094 Bydgoszcz, Poland; (P.M.); (A.K.-O.); (A.R.-C.); (A.K.)
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Abou Kamar S, Oostdijk B, Andrzejczyk K, Constantinescu A, Caliskan K, Akkerhuis KM, Umans V, Brugts JJ, Boersma E, van Dalen B, Kardys I. Temporal evolution of anxiety and depression in chronic heart failure and its association with clinical outcome. Int J Cardiol 2024; 411:132274. [PMID: 38880425 DOI: 10.1016/j.ijcard.2024.132274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 06/06/2024] [Accepted: 06/13/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Although anxiety and depression have been associated with adverse outcomes in chronic heart failure (HF), data on temporal evolution of these symptoms are scarce. We aimed to investigate the association between repeatedly measured depression and anxiety symptoms and clinical outcome in chronic HF patients. METHODS In this prospective observational study, outpatients with chronic HF were included and followed-up for a maximum of 2.5 years. The hospital anxiety and depression scale (HADS) questionnaire was conducted every six months. The primary endpoint was a composite of HF hospitalization, cardiovascular death, heart transplantation and left ventricular assist device (LVAD) implantation. Cox and joint models were used to investigate the association between the HADS score and the endpoint. RESULTS A total of 362 patients filled out a median (25th-75th percentile) of 3 [2-4] questionnaires each. Mean ± SD age was 63 ± 13 years, 72% were men. Anxiety scores remained relatively stable leading up to the endpoint, while depression scores increased. Higher baseline depression scores were significantly associated with the endpoint (hazard ratio [HR] 1.68 and 95% confidence interval [CI] 1.19-2.36 per log(score+1), p = 0.003), while higher baseline anxiety scores did not reach statistical significance (HR [95% CI] 1.34 [0.99-1.83], p = 0.061). When repeatedly measured, both higher anxiety (HR [95% CI] 1.57[1.07-2.30], p = 0.022) and depression (HR [95% CI] 2.04 [1.39-3.06], p < 0.001) scores were significantly associated with the endpoint. CONCLUSION Serial measurements of depression and anxiety symptoms identify chronic HF patients with increased risk of adverse clinical outcomes. Screening for both disorders should be considered in clinical practice.
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Affiliation(s)
- S Abou Kamar
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Cardiology, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - B Oostdijk
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - K Andrzejczyk
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - A Constantinescu
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - K Caliskan
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - K M Akkerhuis
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - V Umans
- Department of Cardiology, Northwest Clinics, Alkmaar, the Netherlands
| | - J J Brugts
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - E Boersma
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - B van Dalen
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Cardiology, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - I Kardys
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
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Pietrzykowski Ł, Kosobucka-Ozdoba A, Michalski P, Kasprzak M, Ratajczak J, Rzepka-Cholasińska A, Siódmiak J, Grzelakowska K, Kubica A. The Impact of Anxiety and Depression Symptoms on Cardiovascular Risk Factor Control in Patients Without a History of Atherosclerotic Cardiovascular Disease. Vasc Health Risk Manag 2024; 20:301-311. [PMID: 38978994 PMCID: PMC11230116 DOI: 10.2147/vhrm.s461308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 06/08/2024] [Indexed: 07/10/2024] Open
Abstract
Background Anxiety and depression by affecting lifestyle interfere with preventive actions aimed at eliminating or reducing modifiable risk factors for cardiovascular diseases (CVD). Purpose The objective of the study was to assess the impact of anxiety and depression on the achievement of therapeutic goals regarding CVD risk factors in patients without a history of atherosclerotic CVD. Patients and Methods The study included 200 patients (median age 52.0 [IQR 43.0-60.5] years). Control of the basic risk factors was assessed: blood pressure, BMI, waist circumference, physical activity, smoking status, LDL cholesterol, triglycerides, and blood glucose. The data analysis included a comparison of the number of controlled risk factors and the percentage of subjects who achieved the therapeutic goal for each of the cardiovascular risk factors. The risk of CVD was assessed with SCORE2 and SCORE2-OP. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). On both subscales (HADS Anxiety and HADS Depression), subjects could achieve normal, borderline, and abnormal scores. Results The median number of controlled CVD risk factors was 4.0 (IQR 3.0-5.0), and the median CVD risk assessed with SCORE2 and SCORE2-OP was 3.0% (IQR 1.5-7.0%). Median scores for HADS Anxiety were 3.0 (IQR 2.0-6.0) and for HADS Depression 3.0 (1.0-5.0). Patients with symptoms of anxiety and depression had significantly fewer controlled risk factors (HADS Anxiety p=0.0014; HADS Depression p=0.0304). Among subjects with anxiety and depression, there was a significantly lower percentage of those with a normal waist circumference (HADS Anxiety p=0.0464; HADS Depression p=0.0200) and regular physical activity (HADS Anxiety p=0.0431; HADS Depression p=0.0055). Among subjects with anxiety, there was a significantly lower percentage of those with a normal BMI (p=0.0218) and normal triglyceride concentrations (p=0.0278). Conclusion The presence of anxiety and depression may affect the control of CVD risk factors in individuals without a history of atherosclerotic CVD. Assessment of anxiety and depression symptoms should be part of a comprehensive examination of patients with high CVD risk.
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Affiliation(s)
- Łukasz Pietrzykowski
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland
| | - Agata Kosobucka-Ozdoba
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland
| | - Piotr Michalski
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland
| | - Michał Kasprzak
- Department of Cardiology and Internal Medicine, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland
| | - Jakub Ratajczak
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland
| | - Alicja Rzepka-Cholasińska
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland
| | - Joanna Siódmiak
- Department of Laboratory Medicine, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland
| | - Klaudyna Grzelakowska
- Department of Cardiology and Internal Medicine, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland
| | - Aldona Kubica
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland
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Mierzyńska A, Jaworska I, Piotrowicz R, Kowalik I, Pencina M, Opolski G, Zareba W, Banach M, Orzechowski P, Główczynska R, Szalewska D, Pluta S, Kalarus Z, Irzmanski R, Piotrowicz E. The Influence of Hybrid Comprehensive Telerehabilitation on Anxiety in Heart Failure Patients: The TELEREH-HF Randomized Clinical Trial. J Clin Psychol Med Settings 2024; 31:403-416. [PMID: 38108961 DOI: 10.1007/s10880-023-09985-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 12/19/2023]
Abstract
Telerehabilitation for heart failure (HF) patients is beneficial for physical functioning, prognosis, and psychological status. The study aimed at evaluating the influence of hybrid comprehensive telerehabilitation (HCTR) on the level of anxiety in comparison to usual care (UC). The TELEREH-HF study was a multicenter prospective RCT in 850 clinically stable HF participants. Patients underwent clinical examinations, including the assessment of anxiety, at entry and after the 9-week training program (HCTR) or observation (UC). The State-Trait Anxiety Inventory (STAI) was used. 20.3% HCTR and 20.1% UC patients reported high level of anxiety as a state at baseline, with higher STAI results in younger participants (< 63 y.o.) (p = .048 for HCTR; p = .026 for UC). At both stages of the study, patients with lower level of physical capacity (measured by a peak VO2) had shown significantly higher level of anxiety. There were no significant changes in anxiety levels during the 9-week observation for the entire study population, although there were different patterns of change in anxiety (both trait and state) in younger and older groups,with the decrease in younger patients, and the increase-in the older group.Trial registry number NCT02523560 (Clinical Trials.gov), date of registration: August 14, 2015.
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Affiliation(s)
- Anna Mierzyńska
- National Institute of Cardiology, 04-628, Warsaw, Poland.
- Department of Cardiac Surgery, Military Institute of Medicine - National Research Institute, 04-141, Warsaw, Poland.
| | - Izabela Jaworska
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Silesian Medical University, 41-800, Zabrze, Poland
| | - Ryszard Piotrowicz
- National Institute of Cardiology, 04-628, Warsaw, Poland
- College of Rehabilitation, 01-234, Warsaw, Poland
| | - Ilona Kowalik
- National Institute of Cardiology, 04-628, Warsaw, Poland
| | - Michael Pencina
- Duke University's School of Medicine, Durham, NC, 27710, USA
| | - Grzegorz Opolski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Wojciech Zareba
- University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Maciej Banach
- Department of Hypertension, Medical University of Łódź, 90-419, Łódź, Poland
| | - Piotr Orzechowski
- Telecardiology Center, National Institute of Cardiology, 04-628, Warsaw, Poland
| | - Renata Główczynska
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Dominika Szalewska
- Department of Rehabilitation Medicine, Medical University of Gdańsk, 80-210, Gdańsk, Poland
| | - Sławomir Pluta
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases, Silesian Medical University, 41-800, Zabrze, Poland
| | - Zbigniew Kalarus
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases, Silesian Medical University, 41-800, Zabrze, Poland
| | - Robert Irzmanski
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Łódź, 90-419, Łódź, Poland
| | - Ewa Piotrowicz
- Telecardiology Center, National Institute of Cardiology, 04-628, Warsaw, Poland
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Peng B, Meng H, Guo L, Zhu J, Kong B, Qu Z, Shuai W, Huang H. Anxiety disorder and cardiovascular disease: a two-sample Mendelian randomization study. ESC Heart Fail 2024; 11:1174-1181. [PMID: 38279876 DOI: 10.1002/ehf2.14676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/18/2023] [Accepted: 12/27/2023] [Indexed: 01/29/2024] Open
Abstract
AIMS Cardiovascular disease is the leading cause of death worldwide. Anxiety disorders are common psychiatric conditions associated with cardiovascular outcomes. This two-sample Mendelian randomization (MR) study investigated the causal relationship between anxiety disorders and coronary heart disease (CHD), myocardial infarction (MI), heart failure (HF), and atrial fibrillation (AF). METHODS Single nucleotide polymorphisms (SNPs) associated with anxiety disorders (16 730 cases; 101 021 controls) were obtained from the UK Biobank genome-wide association study (GWAS). Cardiovascular outcome data were derived from the FinnGen study (CHD: 21 012 cases and 197 780 controls; MI: 12 801 cases and 187 840 controls; HF: 23 397 cases and 194 811 controls; and AF: 22 068 cases and 116 926 controls). Inverse variance weighted (IVW), MR-Egger, weighted median, simple mode, and weighted mode analyses examined causality. RESULTS IVW analysis demonstrated significant causal relationships between anxiety disorders and increased risk of CHD [odds ratio (OR): 4.496; 95% confidence interval (CI): 1.777-11.378; P = 0.002], MI (OR: 5.042; 95% CI: 1.451-17.518; P = 0.011), and HF (OR: 3.255; 95% CI: 1.461-7.252; P = 0.004). No relationship was observed with AF (OR: 1.775; 95% CI: 0.612-5.146; P = 0.29). Other methods showed non-significant associations. Two-way analysis indicated no reverse causality. CONCLUSIONS Anxiety disorders were causally associated with greater risk of CHD, MI, and HF but not AF among individuals of European descent. Further research on mediating mechanisms and in diverse populations is warranted.
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Affiliation(s)
- Bo Peng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Cardiovascular Research Institute of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Hong Meng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Cardiovascular Research Institute of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Liang Guo
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Cardiovascular Research Institute of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Jun Zhu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Cardiovascular Research Institute of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Bin Kong
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Cardiovascular Research Institute of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Zongze Qu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Cardiovascular Research Institute of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Wei Shuai
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Cardiovascular Research Institute of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Cardiology, Wuhan, China
| | - He Huang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Cardiovascular Research Institute of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Cardiology, Wuhan, China
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Locatelli G, Iovino P, Pasta A, Jurgens CY, Vellone E, Riegel B. Cluster analysis of heart failure patients based on their psychological and physical symptoms and predictive analysis of cluster membership. J Adv Nurs 2024; 80:1380-1392. [PMID: 37788062 DOI: 10.1111/jan.15890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/16/2023] [Accepted: 09/18/2023] [Indexed: 10/04/2023]
Abstract
AIM Patients with heart failure experience multiple co-occurring symptoms that lower their quality of life and increase hospitalization and mortality rates. So far, no heart failure symptom cluster study recruited patients from community settings or focused on symptoms predicting most clinical outcomes. Considering physical and psychological symptoms together allows understanding how they burden patients in different combinations. Moreover, studies predicting symptom cluster membership using variables other than symptoms are lacking. We aimed to (a) cluster heart failure patients based on physical and psychological symptoms and (b) predict symptom cluster membership using sociodemographic/clinical variables. DESIGN Secondary analysis of MOTIVATE-HF trial, which recruited 510 heart failure patients from a hospital, an outpatient and a community setting in Italy. METHODS Cluster analysis was performed based on the two scores of the Hospital Anxiety-Depression scale and two scores of the Heart-Failure Somatic Perception Scale predicting most clinical outcomes. ANOVA and chi-square test were used to compare patients' characteristics among clusters. For the predictive analysis, we split the data into a training set and a test set and trained three classification models on the former to predict patients' symptom cluster membership based on 11 clinical/sociodemographic variables. Permutation analysis investigated which variables best predicted cluster membership. RESULTS Four clusters were identified based on the intensity and combination of psychological and physical symptoms: mixed distress (high psychological, low physical symptoms), high distress, low distress and moderate distress. Clinical and sociodemographic differences were found among clusters. NYHA-class (New York Heart Association) and sleep quality were the most important variables in predicting symptom cluster membership. CONCLUSIONS These results can support the development of tailored symptom management intervention and the investigation of symptom clusters' effect on patient outcomes. The promising results of the predictive analysis suggest that such benefits may be obtained even when direct access to symptoms-related data is absent. IMPLICATIONS These results may be particularly useful to clinicians, patients and researchers because they highlight the importance of addressing clusters of symptoms, instead of individual symptoms, to facilitate symptom detection and management. Knowing which variables best predict symptom cluster membership can allow to obtain such benefits even when direct access to symptoms-data is absent. IMPACT Four clusters of heart failure patients characterized by different intensity and combination of psychological and physical symptoms were identified. NYHA class and sleep quality appeared important variables in predicting symptom cluster membership. REPORTING METHOD The authors have adhered to the EQUATOR guidelines STROBE to report observational cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION Patients were included only for collecting their data.
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Affiliation(s)
- Giulia Locatelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, New South Wales, Sydney, Australia
| | - Paolo Iovino
- Health Sciences Department, University of Florence, Florence, Italy
| | - Alessandro Pasta
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Corrine Y Jurgens
- Connell School of Nursing, Boston College, Massachusetts, Boston, USA
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Department of Nursing and Obstetrics, Wroclaw Medical University, Wroclaw, Poland
| | - Barbara Riegel
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, New South Wales, Sydney, Australia
- School of Nursing, University of Pennsylvania, Pennsylvania, Philadelphia, USA
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Yang W, Sun L, Hao L, Zhang X, Lv Q, Xu X, Wang Y, Li Y, Zhou L, Zhao Y, Zang X, Wang Y. Effects of the family customised online FOCUS programme on patients with heart failure and their informal caregivers: a multicentre, single-blind, randomised clinical trial. EClinicalMedicine 2024; 69:102481. [PMID: 38370538 PMCID: PMC10874718 DOI: 10.1016/j.eclinm.2024.102481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/20/2024] [Accepted: 01/25/2024] [Indexed: 02/20/2024] Open
Abstract
Background Living with heart failure can severely affect the physical and mental health of patients with heart failure and their caregivers. Available dyadic self-care interventions for heart failure are scarce, especially in China. We aimed to develop and test the family FOCUS programme. Methods This single-blind, randomised, controlled study was conducted at four hospitals in Tianjin, China. Patients with heart failure (aged at least 18 years) and their caregiver (dyads) were randomly assigned to either the intervention (n = 71) or control (n = 71) group in a 1:1 ratio. The primary outcomes of this study were patient self-care, with three specific dimensions (self-care maintenance, symptom perception, and self-care management), and caregiver contribution to self-care, mirroring these three dimensions. The outcomes were assessed at baseline (T0) and 4 (T1), 12 (T2), and 24 (T3) weeks post-discharge, respectively. This work is registered on ChiCTR, ChiCTR2100053168. Findings Between May 20, 2022, and September 30, 2022, 142 dyads with heart failure were enrolled. The intervention group exhibited dropout rates of 6%, 8.5%, and 18.3% at 4, 12, and 24 weeks after discharge, while the control group showed 9.9%, 12.3%, and 25.4%. Compared with the control group, patients in the intervention group reported improved self-care maintenance (β: 8.5, 95% CI: 0.7, 16.4) and management (β: 7.2, 95% CI: 0.1, 14.3) at T1, as well as improved symptom perception at both T1 (β: 9.7, 95% CI: 1.5, 17.9) and T2 (β: 9.6, 95% CI: 0.6, 18.6). Furthermore, caregiver contributions to self-care maintenance, self-care management, and symptom perception (excluding T3) exhibited significant improvements at all timepoints. Interpretation Although the significant improvements in patients' self-care were not long-lasting, this study suggested that the family FOCUS programme consistently enhanced caregivers' contributions to self-care. Future work could explore the effect of the family FOCUS programme on families with multiple chronic conditions. Funding The National Natural Science Foundation of China.
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Affiliation(s)
- Weiling Yang
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Li Sun
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Lili Hao
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Xiaonan Zhang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Qingyun Lv
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Xueying Xu
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Yaqi Wang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Yanting Li
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Lihui Zhou
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Xiaoying Zang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Tianjin, China
- School of Integrative Medicine, Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Al-Maskari A, Al-Zaabi G, AL-Mamari HA, Al-mawali M, Nadar SK. Psychological impact of first admission with cardiovascular disease in a tertiary hospital in Oman. J Taibah Univ Med Sci 2024; 19:28-34. [PMID: 37868102 PMCID: PMC10585295 DOI: 10.1016/j.jtumed.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/05/2023] [Accepted: 08/30/2023] [Indexed: 10/24/2023] Open
Abstract
Background and objectives Cardiovascular diseases (CVD) are associated with substantial psychological effects that can adversely influence long term prognosis. The aim of this study was to determine the psychological effect of the first hospital admission for acute coronary syndrome (ACS) or congestive heart failure (CHF) in an adult Omani population. Methods This cross-sectional questionnaire based study used the Hospital Anxiety and Depression Scale. Patients were recruited from the in-patient cardiology and medical wards of our institution. Patients with a prior hospital admission for CHF and ACS were excluded. The questionnaire was administered between days 3 and 7 after admission once patients were clinically stable. Results The study included 116 patients (mean age 60.3 + 13.8 years; 78 (67.8%) men), comprising 52 patients with ACS and 64 patients with CHF. Based on the scores, a total of 45 (38.8%) patients had moderate to severe anxiety, and 32 (27.6%) had moderate to severe depression. Patients with severe anxiety tended to be younger, and no other factors predicted anxiety or depression. The proportion of patients with severe depression was higher among patients with CHF (31.4%), and no other differences were observed between patients with ACS or CHF. Conclusion A substantial proportion of patients admitted to our institution in Oman with CVD had severe anxiety and depression. Treating physicians and caregivers should be more open to identifying these patients, and steps should be taken to address their psychological wellbeing along with the medical management of their illness.
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Affiliation(s)
- Ahmed Al-Maskari
- Department of Nursing, Directorate of Nursing, Sultan Qaboos University Hospital, Muscat, Oman
| | - Ghanima Al-Zaabi
- Department of Nursing, Directorate of Nursing, Sultan Qaboos University Hospital, Muscat, Oman
| | - Hafsa A. AL-Mamari
- Department of Medicine, College of Medicine and Health Science, Sultan Qaboos University, Muscat, Oman
| | - Manar Al-mawali
- Department of Medicine, College of Medicine and Health Science, Sultan Qaboos University, Muscat, Oman
| | - Sunil K. Nadar
- Department of Cardiology, Sultan Qaboos University Hospital, Muscat Oman
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9
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Kosobucka-Ozdoba A, Pietrzykowski Ł, Michalski P, Ratajczak J, Grzelakowska K, Kasprzak M, Kubica J, Kubica A. Achieving Cardiovascular Risk Management Goals and Patient Quality of Life. J Cardiovasc Dev Dis 2024; 11:45. [PMID: 38392259 PMCID: PMC10888579 DOI: 10.3390/jcdd11020045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/18/2024] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
(1) Background: Eliminating or reducing the severity of modifiable risk factors of cardiovascular disease (CVD) and undertaking health-promoting behaviors is the basis for prevention. (2) Methods: This study included 200 subjects without a history of CVD, aged 18 to 80 years, who had been diagnosed with hypertension, hypercholesterolemia, or diabetes 6 to 24 months before study enrolment. (3) Results: The median 10-year CV risk assessed by the SCORE2 and SCORE2-OP algorithms was 3.0 (IQR 1.5-7.0). An increase in mean cardiovascular risk in the range from low and moderate to very high was associated with a decrease in quality of life both in individual subscales and the overall score. The median number of controlled risk factors was 4.0 (IQR 3.0-5.0). As the mean number of controlled risk factors increased, the quality of life improved in both of HeartQoL questionnaire subscales (emotional p = 0.0018; physical p = 0.0004) and the overall score (global p = 0.0001). The median number of reported health-promoting behaviors undertaken within 3 years before study enrolment was 3.0 (IQR 2.0-4.0). The highest quality of life in each of the studied dimensions was found in people who reported undertaking three health-promoting behaviors. (4) Conclusions: Controlling CVD risk factors and undertaking health-promoting behaviors has a positive impact on the quality of life of patients without a history of atherosclerotic CVD.
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Affiliation(s)
- Agata Kosobucka-Ozdoba
- Department of Cardiac Rehabilitation and Health Promotion, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland
| | - Łukasz Pietrzykowski
- Department of Cardiac Rehabilitation and Health Promotion, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland
| | - Piotr Michalski
- Department of Cardiac Rehabilitation and Health Promotion, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland
| | - Jakub Ratajczak
- Department of Cardiac Rehabilitation and Health Promotion, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland
| | - Klaudyna Grzelakowska
- Department of Cardiology and Internal Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland
| | - Michał Kasprzak
- Department of Cardiology and Internal Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland
| | - Jacek Kubica
- Department of Cardiology and Internal Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland
| | - Aldona Kubica
- Department of Cardiac Rehabilitation and Health Promotion, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland
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10
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Roy R, Mayer MM, Dzekem BS, Laiteerapong N. Screening for Emotional Distress in Patients with Cardiovascular Disease. Curr Cardiol Rep 2023; 25:1165-1174. [PMID: 37610597 DOI: 10.1007/s11886-023-01936-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 08/24/2023]
Abstract
PURPOSE OF REVIEW In this article, we discuss the relationship between emotional distress and common cardiovascular disease condition, including coronary artery disease, atrial fibrillation, congestive heart failure, mechanical circulatory support, and heart transplant. We review screening measures that have been studied and used in clinical practice for each condition, as well as priorities for future research. RECENT FINDINGS Studies consistently demonstrate failing to identify and treat emotional distress in patients with cardiovascular disease is associated with adverse outcomes. However, routine emotional distress screening is not formally recommended for all cardiovascular disease conditions and is limited to depression screening in select patient populations. Future research should focus on evaluating the validity and reliability of standardized screening measures across the scope of emotional distress in patients with or at risk for cardiovascular disease. Other areas of future research include implementation of evidence-based pharmaceutical treatments and integrated behavioral health approaches and interventions.
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Affiliation(s)
- Rukmini Roy
- Department of Medicine, University of Chicago, 5841 S Maryland Avenue, MC 3051, Chicago, IL 60637, USA
| | - Michael M Mayer
- Department of Medicine, University of Chicago, 5841 S Maryland Avenue, MC 3051, Chicago, IL 60637, USA
| | - Bonaventure S Dzekem
- Department of Medicine, University of Chicago, 5841 S Maryland Avenue, MC 3051, Chicago, IL 60637, USA
| | - Neda Laiteerapong
- Department of Medicine, University of Chicago, 5841 S Maryland Avenue, MC 3051, Chicago, IL 60637, USA.
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Avenue, MC 3051, Chicago, IL 60637, USA.
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11
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Ulin K, Fors A, Ali L, Ekman I, Jansson I. Flip focus and emphasise patient resources in person-centred care over the telephone-A retrospective descriptive study. Scand J Caring Sci 2023; 37:797-804. [PMID: 36932728 DOI: 10.1111/scs.13164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 02/17/2023] [Accepted: 03/03/2023] [Indexed: 03/19/2023]
Abstract
AIM The study aim was to describe the content of person-centred health plans, formulated via telephone conversations between registered nurses and patients with chronic obstructive pulmonary disease and/or chronic heart failure. METHOD Patients who had been hospitalised due to worsening chronic obstructive pulmonary disease and/or chronic heart failure were enrolled. After hospital discharge, the patients received a person-centred telephone support where a health plan was co-created with registered nurses who had received training in the theory and practice of person-centred care. A retrospective descriptive review of 95 health plans using content analysis was conducted. RESULTS The health plan content revealed personal resources such as optimism and motivation in patients with chronic obstructive pulmonary disease and/or chronic heart failure. Although patients reported severe dyspnoea symptoms, the most common goals were to engage in physical activity and to be able to manage social life and leisure activities. Additionally, the health plans illustrated that patients were capable of using their own interventions to reach their goals rather than accessing municipal and health care support. CONCLUSION The focus on listening, that person-centred telephone care affords, promotes the patient's own goals, interventions, and resources, which can be used to tailor support and engage the patient as an active partner in their care. The flipped focus from patient to person highlights the person's own resources, which in turn may contribute to a reduced need for hospital care.
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Affiliation(s)
- Kerstin Ulin
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Andreas Fors
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Gothenburg, Sweden
| | - Lilas Ali
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Inger Ekman
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Inger Jansson
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
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12
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Rajasree Katta M, Prasad S, Tiwari A, Abdelgawad Abouzid MR, Mitra S. The effectiveness of cognitive-behavioral therapy for heart failure patients: a narrative review. J Int Med Res 2023; 51:3000605231198371. [PMID: 37694958 PMCID: PMC10498714 DOI: 10.1177/03000605231198371] [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: 01/21/2023] [Accepted: 08/14/2023] [Indexed: 09/12/2023] Open
Abstract
Heart failure (HF) remains a major cause of morbidity, mortality and healthcare costs, despite available treatments. Psychological issues such as depression, anxiety and poor self-care are prevalent in HF patients. Such issues adversely affect patients' daily lives and increase hospitalization and mortality rates; therefore, effective approaches to address these are needed. Cognitive-behavioral therapy (CBT) has been proposed as potentially useful for psychological comorbidities in HF patients, but its efficacy is not well-established. This narrative review aimed to summarize the evidence on the effectiveness of CBT for HF patients. A search was conducted using PubMed and Google Scholar for randomized controlled trials (RCTs) on CBT for HF patients. Ten studies (nine RCTs and one case study) were included in the review. CBT was found to be an effective intervention for managing depression, anxiety, low quality of life, and impaired social and physical functioning in HF patients. The results suggest that CBT can improve psychological well-being and enhance the benefits of rehabilitation programs. Face-to-face CBT appears to be superior to conventional therapy and can be implemented in cardiac rehabilitation settings. Further research is needed to evaluate the efficacy of internet-based CBT for cardiac patients and identify factors that promote treatment adherence.
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Affiliation(s)
| | - Sakshi Prasad
- Faculty of Medicine, Vinnytsia National Medical University, Vinnytsya, Ukraine
| | - Atit Tiwari
- B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | | | - Saloni Mitra
- Bogomolets National Medical University, Kyiv, Ukraine
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13
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Tönis KJM, Kraiss JT, Linssen GCM, Bohlmeijer ET. The effects of positive psychology interventions on well-being and distress in patients with cardiovascular diseases: A systematic review and Meta-analysis. J Psychosom Res 2023; 170:111328. [PMID: 37098284 DOI: 10.1016/j.jpsychores.2023.111328] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/28/2023] [Accepted: 04/02/2023] [Indexed: 04/27/2023]
Abstract
OBJECTIVE Positive psychology interventions (PPIs) have been found to be effective for psychiatric and somatic disorders. However, a systematic review and meta-analysis of studies examining the effectiveness of PPIs for patients with cardiovascular disease (CVD) is lacking. This systematic review and meta-analysis aims to synthesize studies examining the effectiveness of PPIs and to examine their effects on mental well-being and distress using meta-analyses. METHODS This study was preregistered on OSF (https://osf.io/95sjg/). A systematic search was performed in PsycINFO, PubMed and Scopus. Studies were included if they examined the effectiveness of PPIs on well-being for patients with CVD. Quality assessment was based on the Cochrane tool for assessing risk of bias. Three-level mixed-effects meta-regression models were used to analyze effect sizes of randomized controlled trials (RCTs). RESULTS Twenty studies with 1222 participants were included, of which 15 were RCTs. Included studies showed high variability in study and intervention characteristics. Meta-analyses showed significant effects for mental well-being (β = 0.33) and distress (β = 0.34) at post-intervention and the effects were still significant at follow-up. Five of the 15 RCTs were classified as having fair quality, while the remaining had low quality. CONCLUSION These results suggest that PPIs are effective in improving well-being and distress in patients with CVD and could therefore be a valuable addition for clinical practice. However, there is a need for more rigorous studies that are adequately powered and that help us understand what PPIs are most effective for which patient.
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Affiliation(s)
- K J M Tönis
- Department of Psychology, Health, and Technology, University of Twente, the Netherlands.
| | - J T Kraiss
- Department of Psychology, Health, and Technology, University of Twente, the Netherlands
| | - G C M Linssen
- Department of Cardiology, Ziekenhuisgroep Twente, Almelo, Hengelo, the Netherlands
| | - E T Bohlmeijer
- Department of Psychology, Health, and Technology, University of Twente, the Netherlands
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14
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A bibliometric analysis of research on heart failure comorbid with depression from 2002 to 2021. Heliyon 2023; 9:e13054. [PMID: 36755587 PMCID: PMC9900509 DOI: 10.1016/j.heliyon.2023.e13054] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
Heart failure (HF) with depression is a common comorbidity associated with worse clinical status and quality of life. Although there have been numerous high-quality studies and relevant reviews on HF comorbid with depression, few bibliometric analyses of this field have been reported. In order to understand the development process, research hotspots and future directions, this review analyzes the papers on HF comorbid with depression from January 2002 to December 2021 through CiteSpace and VOSviewer. Visual cooperative networks between countries, authors and institutions were conducted to understand the basic development status of HF comorbid with depression. Furthermore, we performed co-occurrence analysis, burst detection, and timeline analysis for keywords to understand this field's research directions and hotspots. Finally, a detailed review and analysis of the classical literature in this field were conducted based on co-citation analysis. This bibliometric analysis provides an overview of studies on HF comorbid with depression and emphasizes the research on comorbidity mechanisms and more effective interventions as a priority for future research.
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Key Words
- AHF, acute heart failure
- BDI, beck depression inventory
- Bibliometric analysis
- CAD, coronary artery disease
- CBT, cognitive-behavioral therapy
- CHF, chronic heart failure
- CVDs, cardiovascular diseases
- Depression
- HF, heart failure
- Heart failure
- MDD, major depression disorder
- PHQ-9, patient health questionnaire-9
- Research trends
- SCAD, stable coronary artery disease
- SSRIs, selective serotonin reuptake inhibitors
- US, United States
- WoSCC, web of science core collection
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15
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Manolis TA, Manolis AA, Melita H, Manolis AS. Neuropsychiatric disorders in patients with heart failure: not to be ignored. Heart Fail Rev 2022:10.1007/s10741-022-10290-2. [DOI: 10.1007/s10741-022-10290-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
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16
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Soares VL, Pereira C, Carvalho AC, Mota TP, Groehs RV, Bacal F, Matos LDNJD. Prevalence and Association Between Cognition, Anxiety, and Depression in Patients Hospitalized with Heart Failure. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2022. [DOI: 10.36660/ijcs.20210226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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17
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Nguyen TT, Nguyen TX, Nguyen TTH, Nguyen TN, Nguyen HTT, Nguyen HTT, Nguyen AT, Pham T, Vu HTT. Symptom Burden among Hospitalised Older Patients with Heart Failure in Hanoi, Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13593. [PMID: 36294170 PMCID: PMC9602984 DOI: 10.3390/ijerph192013593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to assess the symptom burden among older patients hospitalised for heart failure. This hospital-based, cross-sectional study was conducted at the National Geriatric Hospital, Hanoi, Vietnam, from June 2019 to August 2020. Face-to-face interviews were performed to gather the following information: socio-demographic characteristics, heart failure classification, and clinical characteristics (comorbidities, polypharmacy, pro-B-type natriuretic peptide, left ventricular ejection fraction (LVEF), symptom burden, and depression). Symptom burden was assessed using the Edmonton Symptom Assessment Scale (ESAS), and depression was measured using the Patient Health Questionnaire. A total of 314 patients participated in the study. The mean participant age was 72.67 (SD = 9.42) years. The most frequently reported symptoms on the ESAS were shortness of breath (95.5%), fatigue (94.8%), and anxiety (81.2%). In univariate analyses, depression was significantly associated with heart failure class (p < 0.05). Multivariate linear regression revealed that major depression was significantly associated with total symptom burden score (Beta: 11.74; 95% CI: 9.24-14.23) and LVEF (Beta: -0.09; 95% CI: -0.17-(-0.007)). Patients hospitalised for heart failure experienced a high burden of symptoms. Further studies addressing adverse outcomes and expanding to community-dwelling older people are essential. Palliative care approaches that target symptom reduction should be considered in patients with heart failure.
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Affiliation(s)
- Thanh Thi Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi 100000, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Thanh Xuan Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi 100000, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Thu Thi Hoai Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi 100000, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Tam Ngoc Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi 100000, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Huong Thi Thu Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi 100000, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Huong Thi Thanh Nguyen
- Dinh Tien Hoang Institute of Medicine, Hanoi 100000, Vietnam
- Physiology Department, Hanoi Medical University, Hanoi 100000, Vietnam
| | - Anh Trung Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi 100000, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Thang Pham
- Department of Geriatrics, Hanoi Medical University, Hanoi 100000, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Huyen Thi Thanh Vu
- Department of Geriatrics, Hanoi Medical University, Hanoi 100000, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
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Linde K, Olm M, Teusen C, Akturk Z, von Schrottenberg V, Hapfelmeier A, Dawson S, Rücker G, Löwe B, Schneider A. The diagnostic accuracy of widely used self-report questionnaires for detecting anxiety disorders in adults. Hippokratia 2022. [DOI: 10.1002/14651858.cd015292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Klaus Linde
- Institute of General Practice and Health Services Research, School of Medicine; Technical University of Munich; Munich Germany
| | - Michaela Olm
- Institute of General Practice and Health Services Research, School of Medicine; Technical University of Munich; Munich Germany
| | - Clara Teusen
- Institute of General Practice and Health Services Research, School of Medicine; Technical University of Munich; Munich Germany
| | - Zekeriya Akturk
- Institute of General Practice and Health Services Research, School of Medicine; Technical University of Munich; Munich Germany
| | - Victoria von Schrottenberg
- Institute of General Practice and Health Services Research, School of Medicine; Technical University of Munich; Munich Germany
| | - Alexander Hapfelmeier
- Institute of General Practice and Health Services Research, School of Medicine; Technical University of Munich; Munich Germany
- Institute for AI and Informatics in Medicine, School of Medicine; Technical University of Munich; Munich Germany
| | - Sarah Dawson
- Cochrane Common Mental Disorders; University of York; York UK
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
| | - Gerta Rücker
- Institute of Medical Biometry and Statistics; University Medical Center - University of Freiburg; Freiburg Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Antonius Schneider
- Institute of General Practice and Health Services Research, School of Medicine; Technical University of Munich; Munich Germany
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19
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Anxiety in heart failure patients and its association with socio-demographic and clinical characteristics: a cross-sectional study. Porto Biomed J 2022; 7:e177. [PMID: 36186120 PMCID: PMC9521754 DOI: 10.1097/j.pbj.0000000000000177] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 12/12/2021] [Indexed: 11/26/2022] Open
Abstract
Anxiety is one of the most frequent psychiatric disorders in heart failure (HF) patients. However, it is often neglected in clinical practice and studies about the particular relationship with the New York Heart Association (NYHA) classes for HF are scarce. In this context, this study aims to analyze the presence of anxiety symptoms in HF outpatients and also its association with sociodemographic and clinical characteristics of these patients.
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20
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Chernoff RA, Messineo G, Kim S, Pizano D, Korouri S, Danovitch I, IsHak WW. Psychosocial Interventions for Patients With Heart Failure and Their Impact on Depression, Anxiety, Quality of Life, Morbidity, and Mortality: A Systematic Review and Meta-Analysis. Psychosom Med 2022; 84:560-580. [PMID: 35354163 DOI: 10.1097/psy.0000000000001073] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this systematic review and meta-analysis was to evaluate the ability of psychosocial interventions to reduce depression and anxiety, improve quality of life, and reduce hospitalization and mortality rates in patients with heart failure. METHODS Studies of psychosocial interventions published from 1970 to 2021 were identified through four databases (PubMed, Ovid MEDLINE, PsycINFO, Cochrane). Two authors independently conducted a focused analysis and reached a final consensus on the studies to include, followed by a quality check by a third author. A risk of bias assessment was conducted. RESULTS Twenty-three studies were identified, but only 15 studies of mostly randomized controlled trials with a total of 1370 patients with heart failure were included in the meta-analysis. Interventions were either cognitive behavioral therapy (CBT) or stress management. The pooled intervention effect was in favor of the intervention for depression (combined difference in standardized mean change [DSMC]: -0.41; 95% confidence interval [CI] = -0.66 to -0.17; p = .001) and anxiety (combined DSMC: -0.33; 95% CI = -0.51 to -0.15; p < .001) but was only a trend for quality of life (combined DSMC: 0.14; 95% CI = -0.00 to 0.29; p = .053). Evidence was limited that interventions produced lower rates of hospitalization (5 of 5 studies showing a beneficial effect) or death (1 of 5 with a beneficial effect). CONCLUSIONS CBT and stress management interventions significantly reduced depression and anxiety compared with control conditions. CBT significantly improved quality of life compared with controls, but stress management did not. Longer treatment duration seemed to be an important factor related to treatment success.
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Affiliation(s)
- Robert Alan Chernoff
- From the Department of Psychiatry and Behavioral Neurosciences (Chernoff, Messineo, Pizano, Korouri, Danovitch, IsHak), and Biostatistics Core (Kim), Cedars-Sinai Medical Center, Los Angeles, CA
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21
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Abstract
BACKGROUND An estimated 6.5 million American adults live with heart failure (HF). Elevated anxiety symptoms may worsen HF symptoms and contribute to decreases in overall quality of life (QOL). Mindfulness has been associated with better psychological health with lower levels of anxiety symptoms. Mindfulness may be a modifiable target for reducing anxiety symptoms and increasing QOL in patients with HF. OBJECTIVE The objective of this study is to examine the relationships among anxiety symptoms, dispositional mindfulness, and QOL in patients with symptomatic HF. METHODS In this cross-sectional study, we conducted a secondary analysis of baseline data from 70 participants. We performed descriptive statistics, bivariate Pearson correlations, and multiple linear regression. RESULTS The sample included 70 individuals with a mean age of 65 ± 10.5 years, 89% male, mean left ejection fraction of 45.7 ± 13.6, mean total QOL of 36.9 ± 21.7, mean total mindfulness of 82.2 ± 12.8, and mean anxiety of 4.8 ± 2.9. In multiple regression analyses, total mindfulness was significantly associated with lower anxiety (β = -0.491, P < .01), greater observational mindfulness was significantly associated with lower anxiety (β = -0.377, P < .01), and greater nonreactivity to inner experience was significantly associated with lower anxiety (β = -0.320, P < .05). Lower anxiety was associated with greater total QOL (β = 0.488, P < .01), greater physical QOL (β = 0.381, P < .01), and greater emotional QOL (β = 0.639, P < .01). CONCLUSIONS Mindfulness may be a way of improving both anxiety symptoms and QOL in this population.
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22
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Meta approaches in knowledge synthesis in nursing: A bibliometric analysis. Nurs Outlook 2021; 69:815-825. [PMID: 33814160 DOI: 10.1016/j.outlook.2021.02.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 01/31/2021] [Accepted: 02/13/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To analyze the bibliometric patterns of meta-approaches use in nursing research literature. METHODS Descriptive, exploratory and historical bibliometrics analyses were used. The papers were harvested from the Web of Science Core Collection. FINDINGS The search resulted in 2065 publications. The trends in using most individual meta approaches show that the use of meta-analysis is increasing exponentially, the use of meta-synthesis is increasing linearly, while the use of meta-ethnography is constant in last 6 years. Most productive countries were United States of America, United Kingdom and Peoples Republic of China. Most publications were published in the Journal of Advanced Nursing, International Journal of Nursing Studies, and Journal of Clinical Nursing. Twenty-seven percent of all publications were funded. Thirty-four meta approaches were identified. DISCUSSION The study revealed that the trend in the literature production is positive. Research community use of meta-approaches in nursing exhibit considerable growth. Regional concentration of literature production was observed.
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Wang L, Fang W, An Y, Chen C, Fan X. Identification of factors associated with social dysfunction in patients with heart failure. Eur J Cardiovasc Nurs 2021; 20:475-484. [PMID: 33778889 DOI: 10.1093/eurjcn/zvaa027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 06/29/2020] [Accepted: 11/24/2020] [Indexed: 11/13/2022]
Abstract
AIMS Social dysfunction is adversely associated with individuals' physical and mental quality of life. However, little is known about the status of social dysfunction and its associated factors in patients with heart failure. Our study aimed to reveal the prevalence of social dysfunction, and the associations between fatigue, dyspnoea, anxiety, depression, social connectedness, and social dysfunction in patients with heart failure. METHODS AND RESULTS We assessed the social dysfunction, fatigue, dyspnoea, anxiety, depression, and social connectedness using self-report questionnaires among 291 patients (64.13 ± 11.84 years, 53.3% male) with heart failure. Two stepwise forward logistic regression models were employed to identify the factors associated with social dysfunction, and the area under receiver operating characteristic curve was used to calculate the variance of the associated factors accounting for social dysfunction. Of the 291 patients, 76.6% reported social dysfunction. The logistic regression model after adjusting co-variables showed that fatigue [odds ratio (OR) 4.233, 95% confidence interval (CI) 1.778-10.081], dyspnoea (OR 0.866, 95% CI 0.756-0.991), depression (OR 1.173, 95% CI 1.037-1.328) were positively associated with social dysfunction, whereas social connectedness (OR 0.394, 95% CI 0.203-0.764) was negatively associated with social dysfunction. Four factors explained 84.5% of the variance of social dysfunction in patients with heart failure. CONCLUSIONS Social dysfunction is prevalent in patients with heart failure, and fatigue, dyspnoea, depression, and social connectedness are the associated factors. The findings indicate that the key to helping heart failure patients return to social life may be to attenuate fatigue, dyspnoea, and depression and to improve social connectedness.
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Affiliation(s)
- Lyu Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Wenjie Fang
- Department of Gerontology, School of Humanities, Shandong Management University, Jinan, Shandong, PR China
| | - Yan An
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Cancan Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Xiuzhen Fan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
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Rebora P, Spedale V, Occhino G, Luciani M, Alvaro R, Vellone E, Riegel B, Ausili D. Effectiveness of motivational interviewing on anxiety, depression, sleep quality and quality of life in heart failure patients: secondary analysis of the MOTIVATE-HF randomized controlled trial. Qual Life Res 2021; 30:1939-1949. [PMID: 33616815 PMCID: PMC8233269 DOI: 10.1007/s11136-021-02788-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 11/30/2022]
Abstract
Purpose Anxiety, depression, poor sleep quality and lower quality of life (QOL) are associated with worse outcomes in heart failure (HF) patients. Motivational interview (MI) has been effective in different patient populations to promote self-care. However, its effect on anxiety, depression, sleep quality and QOL in HF patients is unknown. The aim of this study was to evaluate the effect of MI on anxiety, depression, sleep quality and QOL over 12 months from the intervention. Methods This was a planned, secondary outcome analysis of the MOTIVATE-HF study, a three-arm randomized controlled trial (1:1:1) evaluating the effect of MI in improving self-care in HF patients. In Arm 1, the patient received MI, while in Arm 2, the patient and the caregiver received MI. Arm 3, the control group, received standard treatment. Endpoints were evaluated with the Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI), the 12-Item Short-Form Health Survey (SF-12) and the Kansas City Cardiomyopathy Questionnaire (KCCQ) every three months for one year. Results We enrolled and randomized 510 HF patient and caregiver dyads (155 dyads in Arm 1, 177 dyads in Arm 2, and 178 dyads in Arm 3). A total of 238 HF patients and 235 caregivers completed the 12-month trial. No significant changes were seen in anxiety, depression and sleep quality over time among the three study arms, but disease-specific QOL improved in the intervention groups, especially in Arm 2. Conclusion Clinicians may want to include both patients and caregivers when providing MI interventions. Further research is needed to investigate the required intensity of MI to be effective on sleep quality, anxiety and depression (ClinicalTrials.gov Identifier: NCT02894502). Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-02788-3).
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Affiliation(s)
- Paola Rebora
- Department of Medicine and Surgery, University of Milano - Bicocca, Via Cadore 48, 20900 Monza, Italy
| | - Valentina Spedale
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy
| | - Giuseppe Occhino
- Biostatistics and Bioimaging Centre, University of Milano - Bicocca, Via Cadore 48, 20900 Monza, Italy
| | - Michela Luciani
- Department of Medicine and Surgery, University of Milano - Bicocca, Via Cadore 48, 20900 Monza, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy
| | - Barbara Riegel
- University of Pennsylvania School of Nursing, 418 Curie Boulevard, Philadelphia, PA 19104-4217 USA
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milano - Bicocca, Via Cadore 48, 20900 Monza, Italy
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Zwas DR, Keren A, Amir O, Gotsman I. Treatment of Heart Failure Patients with Anxiolytics Is Associated with Adverse Outcomes, with and without Depression. J Clin Med 2020; 9:jcm9123967. [PMID: 33297471 PMCID: PMC7762354 DOI: 10.3390/jcm9123967] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/26/2020] [Accepted: 12/03/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Few studies have evaluated the effect of pharmacologic treatment of anxiety on outcomes in heart failure (HF) patients. This study examined the impact of treatment with anxiolytics on clinical outcomes in a real-world sample of HF patients with and without depression. METHODS Patients diagnosed with HF were retrieved from a large HMO database. Patients prescribed anxiolytic medication and patients diagnosed with depression and/or prescribed anti-depressant medication were followed for cardiac-related hospitalizations and death. RESULTS The study cohort included 6293 HF patients. Treatment with anxiolytics was associated with decreased one-year survival compared to untreated individuals, with a greater reduction in survival seen in patients diagnosed with depression and/or treated with anti-depressants. Multi-variable analysis adjusting for age, sex, NYHA class, cardiac risk factors and laboratory parameters found that treatment with anxiolytics remained a predictor of mortality even when adjusting for depression. Depression combined with anxiolytic treatment was predictive of increased mortality, and treatment with anxiolytics alone, depression alone and anxiolytic treatment together with depression were each associated with an increased hazard ratio for a composite outcome of death and hospitalization. CONCLUSIONS In this real-world study of HF patients, both treatment with anxiolytics and depression were associated with increased mortality, and anxiolytic therapy remained a predictor of mortality when adjusting for depression. Treatment of anxiety together with depression was associated with the highest risk of mortality. Safe and effective treatment for anxiety and depression is warranted to alleviate the detrimental impact of these disorders on quality and of life and adverse events.
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Affiliation(s)
- Donna R. Zwas
- Heart Institute, Hadassah University Hospital, Jerusalem 91120, Israel; (A.K.); (O.A.); (I.G.)
- Heart Failure Center, Clalit Health Services, Tel Aviv 16250, Israel
- Correspondence: ; Tel.: +972-2-6776564; Fax: +972-2- 6411028
| | - Andre Keren
- Heart Institute, Hadassah University Hospital, Jerusalem 91120, Israel; (A.K.); (O.A.); (I.G.)
- Heart Failure Center, Clalit Health Services, Tel Aviv 16250, Israel
| | - Offer Amir
- Heart Institute, Hadassah University Hospital, Jerusalem 91120, Israel; (A.K.); (O.A.); (I.G.)
| | - Israel Gotsman
- Heart Institute, Hadassah University Hospital, Jerusalem 91120, Israel; (A.K.); (O.A.); (I.G.)
- Heart Failure Center, Clalit Health Services, Tel Aviv 16250, Israel
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Abstract
Purpose of Review Palliative care is increasingly acknowledged as beneficial in supporting patients and families affected by heart failure, but policy documents have generally focused on the chronic form of this disease. We examined palliative care provision for those with acute heart failure, based on the recently updated National Consensus Project Clinical Practice Guidelines for Quality Palliative Care. Recent Findings The commonest reason for hospitalization in those > 65 years, acute heart failure admissions delineate crisis points on the unpredictable disease trajectory. Palliative care is underutilized, often perceived as limited to end-of-life care rather than determined by regular systematic needs assessment. No dominant paradigm of palliative care provision has emerged from the nascent evidence base related to this clinical cohort, underscoring the need for further research. Summary Embedding palliative support as mainstream to heart failure care from the point of diagnosis may better ensure treatment strategies for those admitted with acute heart failure remain consistent with patients’ preferences and values.
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Fino P, Sousa RM, Carvalho R, Sousa N, Almeida F, Pereira VH. Cognitive performance is associated with worse prognosis in patients with heart failure with reduced ejection fraction. ESC Heart Fail 2020; 7:3059-3066. [PMID: 32822110 PMCID: PMC7524225 DOI: 10.1002/ehf2.12932] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 07/13/2020] [Accepted: 07/19/2020] [Indexed: 11/08/2022] Open
Abstract
AIMS Heart failure (HF) is a complex clinical syndrome with multiple comorbidities. Cognitive impairment, stress, anxiety, depression, and lower quality of life are prevalent in HF. Herein, we explore the interplay between these parameters and study their value to predict major adverse cardiovascular events (MACEs) and health-related quality of life (HrQoL) in patients with HF with reduced ejection fraction using guideline recommended assessment tools. METHODS AND RESULTS We conducted a longitudinal study using a sample of 65 patients from two hospitals. A battery of tests was applied to assess cognition [Montreal Cognitive Assessment (MoCA)], stress (Perceived Stress Scale-10), anxiety, and depression (Hospital Anxiety and Depression Scale) at baseline. MACEs were registered using clinical records. HrQoL was estimated using the Kansas City Cardiomyopathy Questionnaire (KCCQ). A descriptive statistical analysis was conducted, and multiple linear and Cox regression models conducted to determine the predictive value of neurocognitive parameters and HrQoL in MACE. Both MoCA [hazard ratio = 0.906 (0.829-0.990); P = 0.029] and KCCQ scores were predictors of MACE, but not of overall mortality. Anxiety, depression, and stress scores did not predict MACE. However, anxiety (β = -0.326; P = 0.012) and depression levels (β = -0.309; P = 0.014) were independent predictors of the KCCQ score. CONCLUSIONS The MoCA score and HrQoL were predictors of MACE-free survival. Anxiety and depression were good predictors of HrQoL, but not of MACE-free survival.
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Affiliation(s)
- Patrícia Fino
- Life and Health Sciences Research Institute (ICVS), School of Health SciencesUniversity of MinhoBragaPortugal
- ICVS/3B's, PT Government Associate LaboratoryBraga/GuimarãesPortugal
- Clinical Academic CenterBragaPortugal
| | - Rita Matos Sousa
- Life and Health Sciences Research Institute (ICVS), School of Health SciencesUniversity of MinhoBragaPortugal
- ICVS/3B's, PT Government Associate LaboratoryBraga/GuimarãesPortugal
- Clinical Academic CenterBragaPortugal
| | - Renata Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Health SciencesUniversity of MinhoBragaPortugal
- ICVS/3B's, PT Government Associate LaboratoryBraga/GuimarãesPortugal
- Clinical Academic CenterBragaPortugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Health SciencesUniversity of MinhoBragaPortugal
- ICVS/3B's, PT Government Associate LaboratoryBraga/GuimarãesPortugal
- Clinical Academic CenterBragaPortugal
| | - Filipa Almeida
- Cardiology DepartmentHospital Senhora da OliveiraGuimarãesPortugal
| | - Vítor Hugo Pereira
- Life and Health Sciences Research Institute (ICVS), School of Health SciencesUniversity of MinhoBragaPortugal
- ICVS/3B's, PT Government Associate LaboratoryBraga/GuimarãesPortugal
- Clinical Academic CenterBragaPortugal
- Hospital Santa Maria MaiorBarcelosPortugal
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Chen Z, Feng Y, Zhang RB, Li X, Xu JB. Effect of grelin on TRX expression in chronic heart failure tissue: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e20294. [PMID: 32481311 PMCID: PMC7249932 DOI: 10.1097/md.0000000000020294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The aim of this study is to explore the effect of grelin on TRX expression (TRXE) in chronic heart failure tissue (CHFT). METHODS We will search electronic databases from inception to the March 1, 2020 in MEDLINE, EMBASE, Cochrane Library, CINAHL, PEDro, the Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. We will not apply any limitations to the language and publication status. Any randomized controlled trials (RCTs) that studied the effect of grelin on TRXE in CHFT will be included. Study quality will be checked by Cochrane risk of bias and evidence quality will be appraised by Grading of Recommendations Assessment Development and Evaluation. All extracted data will be analyzed by RevMan 5.3 Software. RESULTS This study will summarize the present RCTs to assess the effect of grelin on TRXE in CHFT. CONCLUSION The results of this study will provide conclusive evidence of the effect of grelin on TRXE in CHFT. SYSTEMATIC REVIEW REGISTRATION INPLASY202040078.
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Affiliation(s)
| | - Yao Feng
- Department of Acupuncture and Moxibustion
| | - Ru-bing Zhang
- Third Ward of Cardiology Department, First Affiliated Hospital of Jiamusi University
| | - Xin Li
- Department of General Medicine, Jiamusi Central Hospital, Jiamusi, China
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Abstract
BACKGROUND We have a limited understanding of the biological underpinnings of symptoms in heart failure (HF), particularly in response to left ventricular assist device (LVAD) implantation. OBJECTIVE The aim of this study was to quantify the degree to which symptoms and biomarkers change in parallel from before implantation through the first 6 months after LVAD implantation in advanced HF. METHODS This was a prospective cohort study of 101 patients receiving an LVAD for the management of advanced HF. Data on symptoms (dyspnea, early and subtle symptoms [HF Somatic Perception Scale], pain severity [Brief Pain Inventory], wake disturbance [Epworth Sleepiness Scale], depression [Patient Health Questionnaire], and anxiety [Brief Symptom Inventory]) and peripheral biomarkers of myocardial stretch, systemic inflammation, and hypervolumetric mechanical stress were measured before implantation with a commercially available LVAD and again at 30, 90, and 180 days after LVAD implantation. Latent growth curve and parallel process modeling were used to describe changes in symptoms and biomarkers and the degree to which they change in parallel in response to LVAD implantation. RESULTS In response to LVAD implantation, changes in myocardial stretch were closely associated with changes in early and subtle physical symptoms as well as depression, and changes in hypervolumetric stress were closely associated with changes in pain severity and wake disturbances. Changes in systemic inflammation were not closely associated with changes in physical or affective symptoms in response to LVAD implantation. CONCLUSIONS These findings provide new insights into the many ways in which symptoms and biomarkers provide concordant or discordant information about LVAD response.
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van der Mheen M, van der Meulen MH, den Boer SL, Schreutelkamp DJ, van der Ende J, de Nijs PFA, Breur JMPJ, Tanke RB, Blom NA, Rammeloo LAJ, ten Harkel ADJ, du Marchie Sarvaas GJ, Utens EMWJ, Dalinghaus M. Emotional and behavioral problems in children with dilated cardiomyopathy. Eur J Cardiovasc Nurs 2020; 19:291-300. [PMID: 31552760 PMCID: PMC7153220 DOI: 10.1177/1474515119876148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/25/2019] [Accepted: 08/23/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Dilated cardiomyopathy (DCM) in children is an important cause of severe heart failure and carries a poor prognosis. Adults with heart failure are at increased risk of anxiety and depression and such symptoms predict adverse clinical outcomes such as mortality. In children with DCM, studies examining these associations are scarce. AIMS We studied whether in children with DCM: (1) the level of emotional and behavioral problems was increased as compared to normative data, and (2) depressive and anxiety problems were associated with the combined risk of death or cardiac transplantation. METHODS To assess emotional and behavioral problems in children with DCM, parents of 68 children, aged 1.5-18 years (6.9±5.7 years), completed the Child Behavior Checklist. RESULTS Compared to normative data, more young children (1.5-5 years) with DCM had somatic complaints (24.3% vs. 8.0%; p < .001), but fewer had externalizing problems (5.4% vs. 17.0%; p = .049). Overall internalizing problems did not reach significance. Compared to normative data, more older children (6-18 years) showed internalizing problems (38.7% vs. 17.0%; p = .001), including depressive (29.0% vs. 8.0%; p < .001) and anxiety problems (19.4% vs. 8.0%; p = .023), and somatic complaints (29.0% vs. 8.0%; p < .001). Anxiety and depressive problems, corrected for heart failure severity, did not predict the risk of death or cardiac transplantation. CONCLUSION Children of 6 years and older showed more depressive and anxiety problems than the normative population. Moreover, in both age groups, somatic problems were common. No association with outcome could be demonstrated.
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Affiliation(s)
- Malindi van der Mheen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC – Sophia Children’s Hospital, Rotterdam, The Netherlands
| | | | - Susanna L den Boer
- Department of Pediatrics, Erasmus MC – Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - Dayenne J Schreutelkamp
- Department of Pediatric Intensive Care, Erasmus MC – Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - Jan van der Ende
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC – Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - Pieter FA de Nijs
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC – Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - Johannes MPJ Breur
- Department of Pediatrics, Wilhelmina Children’s Hospital, UMC Utrecht, The Netherlands
| | - Ronald B Tanke
- Department of Pediatrics, Radboud UMC, Nijmegen, The Netherlands
| | - Nico A Blom
- Department of Pediatrics, Amsterdam UMC, Emma Children’s Hospital, The Netherlands
| | - Lukas AJ Rammeloo
- Department of Pediatrics, Amsterdam UMC, VU University Medical Center, The Netherlands
| | | | | | - Elisabeth MWJ Utens
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC – Sophia Children’s Hospital, Rotterdam, The Netherlands
- Research Institute of Child Development and Education, University of Amsterdam, The Netherlands
- Academic Centre for Child and Adolescent Psychiatry the Bascule, Amsterdam UMC, Academic Medical Centre, The Netherlands
| | - Michiel Dalinghaus
- Department of Pediatrics, Erasmus MC – Sophia Children’s Hospital, Rotterdam, The Netherlands
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Thomson P, Howie K, Leslie SJ, Angus NJ, Andreis F, Thomson R, Mohan ARM, Mondoa C, Chung ML. Evaluating emotional distress and health-related quality of life in patients with heart failure and their family caregivers: Testing dyadic dynamics using the Actor-Partner Interdependence Model. PLoS One 2020; 15:e0227129. [PMID: 31914152 PMCID: PMC6948731 DOI: 10.1371/journal.pone.0227129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 12/12/2019] [Indexed: 12/28/2022] Open
Abstract
PURPOSE 1) To compare levels of emotional symptoms and health-related quality of life between patients with heart failure and their family caregivers; and 2) to examine whether patients' and caregivers' emotional symptoms were associated with their own, as well as their partner's health-related quality of life. METHOD In this cross-sectional study, 41 patients-caregiver dyads (78% male patients, aged 68.6 years; and 83% female caregivers, aged 65.8 years) completed all nine dimensions of the Brief Symptom Inventory and the Minnesota Living with Heart failure Questionnaire. Dyadic data were analysed for 6 sub-scales of the Brief Symptom Inventory, using the Actor-Partner Interdependence Model. RESULTS There were no statistically significant differences in emotional symptoms and health-related quality of life between patients with heart failure and their caregivers. Patients' and caregivers' emotional symptoms were associated with their own health-related quality of life. Caregivers' anxiety, phobic anxiety, obsession-compulsion, depression and hostility negatively influenced their partner's (i.e. the patient's) health-related quality of life. There were no partner effects of patients' emotional symptoms on the health-related quality of life of caregivers. CONCLUSIONS The results of this study suggest that patients may be particularly vulnerable to the emotional distress, i.e. thoughts, impulses and actions of their caregivers. It may be possible to improve patients' health-related quality of life by targeting specific detrimental emotional symptoms of caregivers.
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Affiliation(s)
- Patricia Thomson
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
- * E-mail:
| | - Kate Howie
- Faculty of Natural Sciences, University of Stirling, Stirling, United Kingdom
| | - Stephen J. Leslie
- Cardiac Unit, Raigmore Hospital, NHS Highland, Inverness, Scotland, United Kingdom
| | - Neil J. Angus
- Centre for Health Science, School of Health, Social Care and Life Sciences, University of the Highlands and Islands, Inverness, Scotland, United Kingdom
| | - Federico Andreis
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | - Robert Thomson
- College of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Andrea R. M. Mohan
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | - Catherine Mondoa
- Cardiology Unit, Forth Valley Royal Hospital, NHS Forth Valley, Larbert, Scotland, United Kingdom
| | - Misook L. Chung
- College of Nursing, University of Kentucky, Lexington, KY, United States of America
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Gottschling J, Dörendahl J, Prell T, Karbach J, Bunz M, Kindermann I, Moussaoui J, Spinath FM, Wedegärtner S, Witte OW, Greiff S, Segal DL. Measuring Anxiety in Older Adults: Development, Diagnostic Accuracy, and Preliminary Validation of a Short-Form of the German Geriatric Anxiety Scale (GAS-G-SF). J Pers Assess 2019; 102:196-204. [PMID: 31625412 DOI: 10.1080/00223891.2019.1677679] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Anxiety symptoms and anxiety disorders are highly prevalent among older adults, and are associated with considerable distress, functional impairment, and burden. Also, there is growing need for brief instruments to measure anxiety symptoms in primary care and geriatric medical settings. Therefore, the current study focuses on the development and psychometric evaluation of a short-form of the Geriatric Anxiety Scale (GAS-G), a well-established anxiety instrument for use with older adults. Study 1 draws on the original data from the GAS-G validation study (N = 242) to develop the short-form (GAS-G-SF) and determines whether the results replicate with the short-form. Study 2 extends the validation of the GAS-G-SF to a clinical sample (N = 156; 62 patients with heart disease, 94 patients with Parkinson's disease). Overall, the GAS-G-SF showed promising psychometric properties in terms of internal consistency and validity. Also, the GAS-G-SF showed good discriminatory power based on receiver operating characteristic curve analysis in both studies. These results support the utility of the GAS-G-SF as a brief assessment measure for anxiety.
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Affiliation(s)
| | - Jan Dörendahl
- Cognitive Science & Assessment, University of Luxembourg, Luxembourg
| | - Tino Prell
- Department of Neurology, Jena University Hospital, Jena, Germany.,Center for Healthy Ageing, Jena University Hospital, Jena, Germany
| | - Julia Karbach
- Department of Psychology, University of Koblenz-Landau, Landau, Germany
| | - Maxie Bunz
- Clinic for Internal Medicine III, Cardiology, Angiology, & Intensive Care Medicine, Saarland University Hospital, Homburg, Germany.,Department of Environmental Medicine, German Environment Agency, Berlin, Germany
| | - Ingrid Kindermann
- Clinic for Internal Medicine III, Cardiology, Angiology, & Intensive Care Medicine, Saarland University Hospital, Homburg, Germany
| | | | - Frank M Spinath
- Department of Psychology, Saarland University, Saarbruecken, Germany
| | - Sonja Wedegärtner
- Clinic for Internal Medicine III, Cardiology, Angiology, & Intensive Care Medicine, Saarland University Hospital, Homburg, Germany
| | - Otto W Witte
- Department of Neurology, Jena University Hospital, Jena, Germany.,Center for Healthy Ageing, Jena University Hospital, Jena, Germany
| | - Samuel Greiff
- Cognitive Science & Assessment, University of Luxembourg, Luxembourg
| | - Daniel L Segal
- Psychology Department, University of Colorado at Colorado Springs, Colorado Springs, CO USA
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He L, Wang T, Chen BW, Lu FM, Xu J. Puerarin inhibits apoptosis and inflammation in myocardial cells via PPARα expression in rats with chronic heart failure. Exp Ther Med 2019; 18:3347-3356. [PMID: 31602208 PMCID: PMC6777288 DOI: 10.3892/etm.2019.7984] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 07/12/2019] [Indexed: 12/15/2022] Open
Abstract
Chronic heart failure affects myocardial energy metabolism and cardiac function. Puerarin has been reported to improve cardiac function through regulation of energy metabolism in mice with myocardial infarction. The aim of the current study was to determine whether puerarin can improve body weight and reduce inflammation and apoptosis in rats with chronic heart failure. Rats were divided into three groups: Puerarin, PBS and sham group. Transverse aortic constriction was performed to induce chronic heart failure in the puerarin an PBS groups. Cardiac function, apoptosis and inflammation were evaluated following a 4-week treatment in rats with chronic heart failure. The results demonstrated that puerarin significantly increased the survival rate of rats and improved cardiac function compared with the PBS group. In addition, puerarin decreased lactate dehydrogenase and succinate dehydrogenase activity compared with the PBS group. Puerarin treatment increased the expression levels of glucose transporter type 4 and decreased the expression levels of CD36. Additionally, puerarin decreased the levels inflammatory factors, including tumor necrosis factor α, interleukin (IL)-1β and IL-6 in serum and myocardial tissue compared with the PBS group. Puerarin upregulated peroxisome proliferator-activated receptor α (PPARα) and its downstream target genes nuclear respiratory factor 1, FOS proto-oncogene, YY1 transcription factor, acetyl-coenzyme A carboxylase a, Fas cell surface death receptor, L-type pyruvate kinase and acetyl-coenzyme A dehydrogenase medium chain in myocardial cells from rats with chronic heart failure. These results demonstrated that puerarin inhibited apoptosis and inflammation in myocardial cells via the PPARα pathway. In conclusion, the present study indicated that puerarin may exhibit antiapoptotic and anti-inflammatory activity through the PPARα pathway in rats with chronic heart failure.
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Affiliation(s)
- Le He
- Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, P.R. China
| | - Tong Wang
- Department of Endocrinology, Tianjin Yellow River Hospital, Tianjin 300110, P.R. China
| | - Bing-Wei Chen
- Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, P.R. China
| | - Feng-Min Lu
- Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, P.R. China
| | - Jing Xu
- Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, P.R. China
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Gao WQ, Wang FZ, Wang SN, Zhang FN. Effect of cognitive behavioral therapy for heart failure: A systematic review protocol of randomized controlled trial. Medicine (Baltimore) 2019; 98:e16803. [PMID: 31415391 PMCID: PMC6831328 DOI: 10.1097/md.0000000000016803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This proposed study will systematically assess the effect and safety of cognitive-behavioral therapy (CBT) for heart failure (HF). METHODS We will search the following electronic databases for randomized controlled trials assessing the effect of CBT in patients with HF: PUBMED, EMBASE, Cochrane Library, Web of Science, Scopus, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Information, and Wanfang Data from their inceptions to present without any language limitations. Two authors will independently conduct the study selection, data extraction, and methodological quality assessment. The methodological quality will be evaluated by Cochrane risk of bias tool. RESULTS This study will assess the efficacy and safety of CBT for patients with HF. The primary outcomes consist of depression and anxiety. The secondary outcomes comprise of all-cause mortality, change in body weight, urine output, change in serum sodium; and any adverse events. CONCLUSION The results of this study will summarize the up-to-date evidence on the effect and safety of CBT for HF. PROSPERO REGISTRATION NUMBER PROSPERO CRD42019135932.
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Affiliation(s)
| | - Feng-Zhi Wang
- Department of Pharmacy, First Affiliated Hospital of Jiamusi University, Jiamusi
| | - Shu-Nan Wang
- First Ward of Cardiology Department, Qiqihar Medical College Affiliated No.3 Hospital, Qiqihar, China
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Flint KM, Fairclough DL, Spertus JA, Bekelman DB. Does heart failure-specific health status identify patients with bothersome symptoms, depression, anxiety, and/or poorer spiritual well-being? EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2019; 5:233-241. [PMID: 30649237 PMCID: PMC6613596 DOI: 10.1093/ehjqcco/qcy061] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 12/03/2018] [Accepted: 12/29/2018] [Indexed: 01/06/2023]
Abstract
AIMS Patients with heart failure often have under-recognized symptoms, depression, anxiety, and poorer spiritual well-being ('QoL domains'). Ideally all patients should have heart failure-specific health status and quality of life (QoL) domains routinely evaluated; however, lack of time and resources are limiting in most clinical settings. Therefore, we aimed to evaluate whether heart failure-specific health status was associated with QoL domains and to identify a score warranting further evaluation of QoL domain deficits. METHODS AND RESULTS Participants (N = 314) enrolled in the Collaborative Care to Alleviate Symptoms and Adjust to Illness trial completed measures of heart failure-specific health status [Kansas City Cardiomyopathy Questionnaire, KCCQ (score 0-100, 0 = worst health status)], additional symptoms (Memorial Symptom Assessment Scale), depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), and spiritual well-being (Facit-Sp) at baseline. Mean ± standard deviation (SD) KCCQ score was 46.9 ± 19.3, mean age was 65.5 ± 11.4, and 79% were male. Prevalence of QoL domain deficits ranged from 11% (nausea) to 47% (depression). Sensitivity/specificity of KCCQ for each QoL domain ranged from 20-40%/80-96% for KCCQ ≤ 25, 61-84%/48-62% for KCCQ ≤ 50, 84-97%/26-40% for KCCQ ≤ 60, and 96-100%/8-13% for KCCQ ≤ 75. Patients with KCCQ ≤ 60 had mean ± SD 4.5 ± 2.5 QoL domain deficits (maximum 12), vs. 1.6 ± 1.6 for KCCQ > 60 (P < 0.001). Similar results were seen for KCCQ ≤25 (6.6 ± 2.4 vs. 3.3 ± 2.4), KCCQ ≤ 50 (4.8 ± 2.6 vs. 2.5 ± 2) and KCCQ ≤ 75 (4.0 ± 2.6 vs. 1.0 ± 1.2) (all P < 00001). CONCLUSION KCCQ ≤ 60 had good sensitivity for each QoL domain deficit and for patients with at least one QoL domain deficit. Screening for QoL domain deficits should target patients with lower KCCQ scores based on a clinic's KCCQ score distribution and clinical resources for addressing QoL domain deficits.
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Affiliation(s)
- Kelsey M Flint
- Rocky Mountain Regional VA Medical Center, Cardiology, Department of Medicine, 1700 North Wheeling Street, Aurora, CO, USA
- Colorado Cardiovascular Outcomes Research Consortium, 13199 E Montview Blvd, Suite 300, Mail Stop F443, Denver, CO, USA
| | - Diane L Fairclough
- Department of Biostatics and Informatics, Colorado School of Public Health, 13199 E Montview Blvd, Suite 339, Aurora, CO, USA
| | - John A Spertus
- Saint Luke’s Mid America Heart Institute, University of Missouri-Kansas City, 4401 Wornall Rd, Kansas City, MO, USA
| | - David B Bekelman
- Colorado Cardiovascular Outcomes Research Consortium, 13199 E Montview Blvd, Suite 300, Mail Stop F443, Denver, CO, USA
- Rocky Mountain Regional VA Medical Center, Palliative Care, Department of Medicine, 1700 North Wheeling Street, Aurora, CO, USA
- Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Colorado, 12631 E 17th Ave, Anschutz Medical Campus, Aurora, CO, USA
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Albus C, Waller C, Fritzsche K, Gunold H, Haass M, Hamann B, Kindermann I, Köllner V, Leithäuser B, Marx N, Meesmann M, Michal M, Ronel J, Scherer M, Schrader V, Schwaab B, Weber CS, Herrmann-Lingen C. Significance of psychosocial factors in cardiology: update 2018. Clin Res Cardiol 2019; 108:1175-1196. [DOI: 10.1007/s00392-019-01488-w] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/29/2019] [Indexed: 12/13/2022]
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Shu Q, Wu L, Zhang R, Zhang Q, Huang J, Meng Y. Age-dependent changes in cardiac performance, motor function, QoL, and mental status in metoprolol-treated chronic heart failure patients. Sci Rep 2019; 9:453. [PMID: 30679746 PMCID: PMC6345765 DOI: 10.1038/s41598-018-37520-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/06/2018] [Indexed: 01/11/2023] Open
Abstract
No previous study reports the effect of age on cardiac performance, motor function and quality of life (QoL) in Chinese chronic heart failure (CHF) patients. This single-center, prospective study enrolled CHF patients with resting heart rate (RHR) > 80 bpm, who were treated with metoprolol and were followed up at 1, 3, 6, and 12 months. Changes in cardiac, motor, and QoL parameters between patients aged ≥60 years and those aged <60 years were compared at all time points. P < 0.05 was considered significant. A total of 154 patients were enrolled (median age: 66.39 years; 116 aged ≥60 years, 38 aged <60 years; 95% New York Heart Association class III-IV). RHR decreased significantly in both patient groups (P < 0.0001 for both groups). Patients aged ≥60 years had a significant improvement in both ejection fraction (EF) at 6 and 12 months and in cardiac index (CI) at 3, 6, and 12 months. However, no major difference was observed in motor function in both groups. Significantly higher SF-8 scores showed greater improvement in QoL in the <60 age group at 12 months (P = 0.0008). Metoprolol demonstrated improvement in cardiac performance, motor function, QoL, and anxiety with increase in depression and burnout in both genders; however, the findings were independent of age.
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Affiliation(s)
- Qiuhong Shu
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China
| | - Liyong Wu
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China
| | - Ran Zhang
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China
| | - Qian Zhang
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China
| | - Jingjing Huang
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China
| | - Yong Meng
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China.
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Zahid I, Baig MA, Ahmed Gilani J, Waseem N, Ather S, Farooq AS, Ghouri A, Siddiqui SN, Kumar R, Sahil, Suman, Kumar R, Kumar R, Mulla AA, Siddiqi R, Fatima K. Frequency and predictors of depression in congestive heart failure. Indian Heart J 2018; 70 Suppl 3:S199-S203. [PMID: 30595257 PMCID: PMC6309877 DOI: 10.1016/j.ihj.2018.10.410] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 10/03/2018] [Accepted: 10/18/2018] [Indexed: 01/09/2023] Open
Abstract
Background Depression in congestive heart failure (CHF) patients can increase morbidity and mortality. Given the ever-rising prevalence of CHF patients with depression, it is vital that we understand the predictors of depression in these patients to identify and better manage these patients. The main objective of this study was to evaluate the frequency and predictors of depression in CHF patients. Methods A cross-sectional study was conducted in a tertiary care hospital. Patients with a diagnosis of CHF for more than 6 months based on signs and left ventricular ejection fraction <40% were included. Patients were interviewed with the Patient Health Questionnaire-9 (PHQ-9) consisting of nine items in line with the Diagnostic and Statistical Manual (DSM) - IV criteria to assess depression. Each item was scored from 0 to 3, and a PHQ-9 score of 10 or greater suggested clinical depression. Data were analyzed on SPSS, v22, and a p < 0.05 was considered significant. Results Of 170 participants, 102 (60%) had depression. Among these 102 patients, 42% (n = 43) had mild depression, and the rest (n = 59) had moderate-to-severe depression. Predictors of depression were New York Heart Association stage 3 or 4 (p = 0.001), previous myocardial infarction (p = 0.001), living without a partner (p = 0.001), lack of a joint family system (p = 0.001), sedentary lifestyle (p = 0.001), aged 70 years or more (p = 0.01), and having been admitted in a hospital at least once in the past two months (p = 0.002). Conclusion Depression is common among patients with CHF. It is associated with multiple factors and needs to be addressed and targeted urgently.
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Affiliation(s)
| | | | | | | | | | | | - Amna Ghouri
- Dow University of Health Sciences, Pakistan.
| | | | - Ram Kumar
- Chandka Medical College, Larkana, Pakistan.
| | - Sahil
- Chandka Medical College, Larkana, Pakistan.
| | - Suman
- Chandka Medical College, Larkana, Pakistan.
| | - Raj Kumar
- Chandka Medical College, Larkana, Pakistan.
| | - Ravi Kumar
- Chandka Medical College, Larkana, Pakistan.
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Østergaard B, Mahrer-Imhof R, Wagner L, Barington T, Videbæk L, Lauridsen J. Effect of family nursing therapeutic conversations on health-related quality of life, self-care and depression among outpatients with heart failure: A randomized multi-centre trial. PATIENT EDUCATION AND COUNSELING 2018; 101:1385-1393. [PMID: 29567335 DOI: 10.1016/j.pec.2018.03.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 02/23/2018] [Accepted: 03/04/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To evaluate the short-term (3 months) effects of family nursing therapeutic conversations (FNTC) on health-related quality of life, self-care and depression in outpatients with Heart failure (HF). METHODS A randomised multi-centre trial was conducted in three Danish HF clinics. The control group (n = 167) received usual care, and the intervention group (n = 180) received FNTCs as supplement to usual care. Primary outcome was clinically significant changes (6 points) in Kansas City Cardiomyopathy Questionnaire (KCCQ) summary score between groups. Secondary outcomes were changes in self-care behaviour and depression scores. Data were assessed before first consultation and repeated after three months. RESULTS No statistically significant difference was found in the change of KCCQ, self-care and depression scores between the groups. KCCQ scores of patients in the FNTC group changed clinically significant in seven domains, compared to one domain in the control group, with the highest improvement in self-efficacy, social limitation and symptom burden. CONCLUSION FNTC was not superior to standard care of patients with HF regarding health-related quality of life, self-care and depression. IMPLICATION FOR PRACTICE Addressing the impact of the disease on the family, might improve self-efficacy, social limitation and symptom burden in patients with heart failure.
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Affiliation(s)
- Birte Østergaard
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark.
| | - Romy Mahrer-Imhof
- Nursing Science & Care Ltd, Winterthur Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Lis Wagner
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Torben Barington
- OPEN Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Lars Videbæk
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Jørgen Lauridsen
- COHERE, Department of Business and Economics, University of Southern Denmark, Odense, Denmark
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Using Unsupervised Machine Learning to Identify Subgroups Among Home Health Patients With Heart Failure Using Telehealth. ACTA ACUST UNITED AC 2018; 36:242-248. [DOI: 10.1097/cin.0000000000000423] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bordoni B, Marelli F, Morabito B, Sacconi B. Depression and anxiety in patients with chronic heart failure. Future Cardiol 2018; 14:115-119. [DOI: 10.2217/fca-2017-0073] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Bruno Bordoni
- Foundation Don Carlo Gnocchi IRCCS, Department of Cardiology, Institute of Hospitalization & Care with Scientific Address, S Maria Nascente, Via Capecelatro 66, Milan 20100, Italy
| | - Fabiola Marelli
- CRESO, School of Osteopathic Centre for Research & Studies, Gorla Minore (VA) Piazza XXV Aprile 4, 21055, Italy
- CRESO, School of Osteopathic Centre for Research & Studies, Via Fanella, 91 61032 Fano (Pesaro Urbino), Italy
| | - Bruno Morabito
- CRESO, School of Osteopathic Centre for Research & Studies, Gorla Minore (VA) Piazza XXV Aprile 4, 21055, Italy
- CRESO, School of Osteopathic Centre for Research & Studies, Via Fanella, 91 61032 Fano (Pesaro Urbino), Italy
- Department of Radiological, Oncological & Anatomopathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Beatrice Sacconi
- Department of Radiological, Oncological & Anatomopathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
- Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, Viale Regina Elena 291, Rome, Italy
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Müller-Tasch T, Löwe B, Lossnitzer N, Frankenstein L, Täger T, Haass M, Katus H, Schultz JH, Herzog W. Anxiety and self-care behaviour in patients with chronic systolic heart failure: A multivariate model. Eur J Cardiovasc Nurs 2017; 17:170-177. [PMID: 28718661 DOI: 10.1177/1474515117722255] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND While comprehensive evidence exists regarding negative effects of depression on self-care behaviours in patients with chronic heart failure (CHF), the relation between anxiety and self-care behaviours in patients with CHF is not clear. The aim of this study was to analyse the interactions between anxiety, depression and self-care behaviours in patients with CHF. METHODS The self-care behaviour of CHF outpatients was measured using the European Heart Failure Self-care Behaviour Scale (EHFScBS). The Patient Health Questionnaire (PHQ) was used to assess anxiety, the PHQ-9 was used to measure depression severity. Differences between patients with and without anxiety were assessed with the respective tests. Associations between anxiety, self-care and other predictors were analysed using linear regressions. RESULTS Of the 308 participating patients, 35 (11.4%) fulfilled the PHQ criteria for an anxiety disorder. These patients took antidepressants more frequently (11.8% versus 2.3%, p = .02), had had more contacts with their general practitioner within the last year (11.8 ± 16.1 versus 6.7 ± 8.6, p = .02), and had a higher PHQ-9 depression score (12.9 ± 5.7 versus 6.5 ± 4.7, p < .01) than patients without anxiety disorder. Anxiety and self-care were negatively associated (ß = -0.144, r2 = 0.021, p = 0.015). The explanation of variance was augmented in a multivariate regression with the predictors age, sex, education, living with a partner, and New York Heart Association (NYHA) class ( r2 = 0.098) when anxiety was added ( r2 = 0.112). Depression further increased the explanation of variance (ß = -0.161, r2 = 0.131, p = 0.019). CONCLUSIONS Anxiety is negatively associated with self-care behaviour in patients with CHF. However, this effect disappears behind the stronger influence of depression on self-care. The consideration of mental comorbidities in patients with CHF is important.
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Affiliation(s)
- Thomas Müller-Tasch
- 1 Department of Psychosomatic Medicine and Psychotherapy, Klinikum am Weissenhof, Germany.,2 Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Bernd Löwe
- 3 Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.,4 Schön Clinic Hamburg-Eilbek, Hamburg, Germany
| | - Nicole Lossnitzer
- 2 Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Lutz Frankenstein
- 5 Department of Cardiology, University of Heidelberg, Heidelberg, Germany
| | - Tobias Täger
- 5 Department of Cardiology, University of Heidelberg, Heidelberg, Germany
| | - Markus Haass
- 6 Department of Cardiology, Theresien Hospital Mannheim, Mannheim, Germany
| | - Hugo Katus
- 5 Department of Cardiology, University of Heidelberg, Heidelberg, Germany
| | - Jobst-Hendrik Schultz
- 2 Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Wolfgang Herzog
- 2 Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
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Moser DK, Arslanian-Engoren C, Biddle MJ, Chung ML, Dekker RL, Hammash MH, Mudd-Martin G, Alhurani AS, Lennie TA. Psychological Aspects of Heart Failure. Curr Cardiol Rep 2016; 18:119. [DOI: 10.1007/s11886-016-0799-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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