A picture paints a thousand words: Heart drawings reflect acute distress and illness perception and predict posttraumatic stress symptoms after acute myocardial infarction

Role of illness perception in explanation of severity of post-traumatic stress disorder symptoms after cardiovascular problems

BACKGROUND

Given the role of post-traumatic stress disorder (PTSD) in morbidity and mortality of cardiac patients, the present study was conducted to determine the relationship between the perception of heart disease and severity of PTSD symptoms.

METHODS

Sampled using simple random sampling, 202 cardiovascular patients (50.5% women) were selected and included in this cross-sectional study. The patients admitted to a hospital from January to May 2017 in western Iran were selected and asked to complete the self-report demographic and cardiac risk factors inventory, Brief Illness Perception Questionnaire (Brief-IPQ), and National Stressful Events Survey PTSD Short Scale (NSESSS) checklist. The results were analyzed using the Pearson correlation coefficient and multiple regression analysis.

RESULTS

The mean age of patients was 53.5 ± 11.9 years. The results of the correlation coefficient showed a significant relationship between all the components of illness perception, except personal and treatment control, with PTSD (P < 0.05). The regression model could predict 22.5% of PTSD variance and the greatest role was for the emotional representation (P = 0.002) and female sex (P = 0.008).

CONCLUSION

The perception of cardiovascular patients of the cognitive and emotional components of the disease, especially in women, plays a significant role in experiencing the symptoms of PTSD. Thus, health professionals have to monitor all these components, especially the patient's perceptions and emotional reactions, and to come up with proper and timely interventions for patients at risk to control the adverse effects of PTSD after cardiovascular events.

"Picture this"- Patients' Drawings of Non-Muscle Invasive Bladder Cancer: A Novel Method to Help Understand How Patients Perceive Their Condition

BACKGROUND

There is a paucity of data regarding patient experiences of living with non-muscle-invasive bladder cancer (NMIBC).

OBJECTIVES

To investigate patients' beliefs about NMIBC utilising both a well-established verbal/linguistic method, the Brief Illness Perception Questionnaire (B-IPQ) in addition to a novel visual/perceptual method, that is, asking patients to draw their bladder as it is now and as they perceive it will be in the future.

METHODS

Cross-sectional study of patients with NMIBC. Patients completed: (i) the B-IPQ, and (ii) 2 drawings of their bladder: as they perceived it currently and as they perceived it would look in 5 years' time.

RESULTS

A total of 118 patients completed the B-IPQ, of which 96 produced 2 bladder drawings. Forty-seven per cent of patients depicted no change in their bladder across time, 35% depicted improvements, while 18% drew their NMIBC as deteriorating between the two time points. Patients who drew their NMIBC worsening over time reported significantly stronger beliefs in the severity of current consequences from their NMIBC (F(2,94) = 9.07, p < 0.001, m = 5.68, 95% CI 4.38-6.88) and greater current concerns about their NMIBC (F(2,94) = 6.17, p < 0.01, m = 7.06, 95% CI 5.47-8.66). This was unrelated to cancer grade, cancer stage, treatment or demographic variables.

CONCLUSION

This is the first study to explore beliefs about NMIBC in a sample of patients with NMIBC attending routine clinics using both a well-established and a novel method of assessing patients' perceptions. Results highlight the usefulness of a simple non-verbal technique, in identifying patients' concerns about the condition. Almost one fifth of patients with NMIBC may experience significant concerns about the worsening of their condition, which appear to be independent of demographic, histopathological, and treatment related variables. Further exploration of the psychological concerns of individuals with NMIBC is required in order to appropriately plan for needs led multidisciplinary approach in their care.