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Śliż D, Jodczyk AM, Łakoma K, Kucharska A, Panczyk M, Rostkowska OM, Turlej K, Młynarska A, Drożdż J, Jarzębska-Wódka M, Wierzbiński P, Grabowski M, Ukleja A, Adamczyk N, Baska A, Wiecha S, Barylski M, Poliwczak AR, Mamcarz A. Examining the Nutrition of Cardiological Patients in Hospitals: Evaluating the Discrepancy between Received Diets and Reference Diet Based on ESC 2021 Guidelines-Hospital Diet Medical Investigation) (HDMI) Study. Nutrients 2023; 15:4606. [PMID: 37960260 PMCID: PMC10650773 DOI: 10.3390/nu15214606] [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: 10/09/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Cardiovascular diseases (CVDs) are the leading causes of death worldwide. CVDs have become the dominant cause of death and have been a significant health challenge since the second half of the 20th century in the Polish population. The aim of our HDMI (hospital diet medical investigation) study was to examine the quality of the hospital diets given to cardiac patients and assess how much they adhere to the European Society of Cardiology (ESC) 2021 guidelines. By comparing the diets received by patients with the recommended dietary patterns outlined in the ESC 2021 guidelines, we sought to identify discrepancies. The study was conducted in two steps: creating a 7-day model menu and comparing it with the received diets and then making comparisons with ESC 2021 guidelines. Additionally, we designed a survey to obtain the characteristics of the hospitals. The results show that the nutrition in hospitals remains substandard. None of the diets had an appropriate salt supply or predominance of plant-based food patterns. Only 1/7 diets avoided sweetened beverages, and 2/7 diets had an appropriate amount of fiber. This underscores a gap in the healthcare system to improve patients' health by implementing dietary interventions that foster the development of healthy eating habits.
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Affiliation(s)
- Daniel Śliż
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
- Polish Society of Lifestyle Medicine, 00-388 Warsaw, Poland
| | - Alicja Monika Jodczyk
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
- Polish Society of Lifestyle Medicine, 00-388 Warsaw, Poland
| | - Klaudia Łakoma
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
- Polish Society of Lifestyle Medicine, 00-388 Warsaw, Poland
| | - Alicja Kucharska
- Department of Human Nutrition, Medical University of Warsaw, 01-445 Warsaw, Poland
| | - Mariusz Panczyk
- Department of Education and Research in Health Sciences, Medical University of Warsaw, 00-518 Warsaw, Poland
| | - Olga Maria Rostkowska
- Department of Transplantation Medicine, Nephrology and Internal Medicine, Medical University of Warsaw, 02-006 Warsaw, Poland
| | - Karolina Turlej
- Department of Human Nutrition, Medical University of Warsaw, 01-445 Warsaw, Poland
| | - Agnieszka Młynarska
- Department of Gerontology and Geriatric Nursing, Medical University of Silesia, 40-635 Katowice, Poland
| | - Jarosław Drożdż
- Department of Cardiology, Medical University of Lodz, 92-213 Lodz, Poland
| | | | | | - Marcin Grabowski
- 1st Chair and Department and of Cardiology Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Anna Ukleja
- 1st Chair and Department and of Cardiology Medical University of Warsaw, 02-097 Warsaw, Poland
| | | | - Alicja Baska
- Polish Society of Lifestyle Medicine, 00-388 Warsaw, Poland
- School of Public Health, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
| | - Szczepan Wiecha
- Department of Physical Education and Health in Biala Podlaska, Faculty in Biala Podlaska, Jozef Pilusdski University of Physical Education, 00-968 Warsaw, Poland
| | - Marcin Barylski
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Lodz, 90-647 Lodz, Poland
| | - Adam Rafał Poliwczak
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Lodz, 90-647 Lodz, Poland
| | - Artur Mamcarz
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
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2
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Pan R, Fan Q, Tao R. Depression Following Acute Coronary Syndrome: A Review. Rev Cardiovasc Med 2023; 24:247. [PMID: 39076389 PMCID: PMC11270108 DOI: 10.31083/j.rcm2409247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/20/2023] [Accepted: 04/04/2023] [Indexed: 07/31/2024] Open
Abstract
Depression is common among patients with acute coronary syndrome (ACS). Although multiple studies have confirmed that depression is an independent risk factor for poor outcomes in ACS, general awareness of this issue is still limited. Ongoing research has described detailed aspects of depression in ACS, with various mechanistic hypotheses put forward to explain the complexity of this comorbidity. Several investigations have explored management strategies in this subgroup of patients, including screening for depression, antidepressant treatment, and cardiac rehabilitation. However, evidence of long-term improvement in clinical outcomes is still scarce, and a more comprehensive understanding of the underlying mechanisms that link depression with ACS is required to further improve disease management.
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Affiliation(s)
- Roubai Pan
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 200025 Shanghai, China
| | - Qin Fan
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 200025 Shanghai, China
| | - Rong Tao
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 200025 Shanghai, China
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Tiede A, Baumann S, Krolo F, Gaertner B, John U, Freyer-Adam J. Health behaviors of general hospital patients with at-risk alcohol use: Change over two years after discharge. Gen Hosp Psychiatry 2023; 81:76-81. [PMID: 36841219 DOI: 10.1016/j.genhosppsych.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVE Little is known about the natural course of health-related behaviors such as tobacco smoking, at-risk alcohol use, vegetable and fruit intake and physical activity in general hospital patients after discharge. The aim was to investigate whether patients identified with at-risk alcohol use change their health-related behaviors over two years. METHODS Eighteen to 64-year-old patients with at-risk alcohol use were identified through systematic screening as part of a randomized controlled trial. Patients with indication of an alcohol use disorder were excluded. Data of patients who received treatment as usual were analyzed (n = 220). Alcohol use, tobacco smoking, vegetable/ fruit intake, physical activity and body-mass-index were assessed at baseline, after 6, 12, 18, and 24 months. Latent growth models were calculated. RESULTS Twenty-four months after discharge, participants reported less physical activity (p = .04), a higher body-mass-index (p = .01), no change in vegetable/ fruit intake (p = .11) and smoking status (p = .87), fewer cigarettes per week among smokers (p < .001), and less alcohol use (p < .001) compared to baseline. CONCLUSIONS The data revealed that patients with at-risk alcohol use increased or did not change energy-balance related behaviors and decreased substance-use related behaviors over 2 years after hospitalization. These findings underline the need of implementing multi-behavioral interventions into routine care.
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Affiliation(s)
- Anika Tiede
- Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research, Site Greifswald, Greifswald, Germany.
| | - Sophie Baumann
- Department of Methods in Community Medicine, Institute of Community Medicine, University Medicine Greifswald, Germany.
| | - Filipa Krolo
- Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research, Site Greifswald, Greifswald, Germany.
| | - Beate Gaertner
- Robert Koch Institute Berlin, Department of Epidemiology and Health Monitoring, Berlin, Germany.
| | - Ulrich John
- German Centre for Cardiovascular Research, Site Greifswald, Greifswald, Germany; Department of Prevention Research and Social Medicine, Institute of Community Medicine, University Medicine Greifswald, Germany.
| | - Jennis Freyer-Adam
- Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research, Site Greifswald, Greifswald, Germany.
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Diab A, Dastmalchi LN, Gulati M, Michos ED. A Heart-Healthy Diet for Cardiovascular Disease Prevention: Where Are We Now? Vasc Health Risk Manag 2023; 19:237-253. [PMID: 37113563 PMCID: PMC10128075 DOI: 10.2147/vhrm.s379874] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
Purpose of Review The relationship between cardiovascular health and diet is evolving. Lifestyle modifications including diet changes are the primary approach in managing cardiometabolic risk factors. Thus, understanding different diets and their impact on cardiovascular health is important in guiding primary and secondary prevention of cardiovascular disease (CVD). Yet, there are many barriers and limitations to adopting a heart healthy diet. Recent Findings Diets rich in fruits, vegetables, legumes, whole grains, and lean protein sources, with minimization/avoidance of processed foods, trans-fats, and sugar sweetened beverages, are recommended by prevention guidelines. The Mediterranean, DASH, and plant-based diets have all proven cardioprotective in varying degrees and are endorsed by professional healthcare societies, while other emerging diets such as the ketogenic diet and intermittent fasting require more long-term study. The effects of diet on the gut microbiome and on cardiovascular health have opened a new path for precision medicine to improve cardiometabolic risk factors. The effects of certain dietary metabolites, such as trimethylamine N-oxide, on cardiometabolic risk factors, along with the changes in the gut microbiome diversity and gene pathways in relation to CVD management, are being explored. Summary In this review, we provide a comprehensive up-to-date overview on established and emerging diets in cardiovascular health. We discuss the effectiveness of various diets and most importantly the approaches to nutritional counseling where traditional and non-traditional approaches are being practiced, helping patients adopt heart healthy diets. We address the limitations to adopting a heart healthy diet regarding food insecurity, poor access, and socioeconomic burden. Lastly, we discuss the need for a multidisciplinary team-based approach, including the role of a nutrition specialist, in implementing culturally-tailored dietary recommendations. Understanding the limitations and finding ways to overcome the barriers in implementing heart-healthy diets will take us miles in the path to CVD prevention and management.
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Affiliation(s)
- Alaa Diab
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Medicine, Greater Baltimore Medical Center, Baltimore, MD, USA
| | - L Nedda Dastmalchi
- Division of Cardiology, Temple University Hospital, Philadelphia, PA, USA
| | - Martha Gulati
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, LA, USA
| | - Erin D Michos
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Correspondence: Erin D Michos, Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Blalock 524-B, 600 N. Wolfe Street, Baltimore, MD, 21287, USA, Tel +410-502-6813, Email
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Greco A, Adorni R, De Matteis C, D’Addario M, Fattirolli F, Franzelli C, Giannattasio C, Luyckx K, Steca P. Latent change models of lifestyle in acute coronary syndrome patients: Are lifestyle changes associated with resilience changes? Health Psychol Open 2023; 10:20551029231167836. [PMID: 37007212 PMCID: PMC10064170 DOI: 10.1177/20551029231167836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
This study aimed to examine the role of resilience resources in patients' lifestyle changes after the first Acute Coronary event. 275 Italian patients (84.0% men; mean age = 57.5, SD = 7.9) participated in a longitudinal study. Resilience resources (Self-esteem, Dispositional Optimism, Sense of Coherence – SOC, General and Disease-specific Self-efficacy), and lifestyles (diet, physical activity, and smoking) were assessed twice (at baseline and after 6 months). Path analysis using latent change models was performed to model the combined effect of levels and changes of the resilience resources over lifestyle changes. Patients with strong SOC at baseline were less prone to smoke and more prone to decrease smoking; enhancement in SOC was associated with a smoking decrease. High Disease-specific Self-efficacy at baseline was associated with an improvement in all lifestyles; enhancement in Disease-specific Self-efficacy predicted an increase in physical activity. Findings underline the need to design psychological interventions that promote patients' Disease-specific Self-efficacy and SOC.
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Affiliation(s)
- Andrea Greco
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Roberta Adorni
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
- Roberta Adorni, Department of Psychology, University of Milano-Bicocca Piazza dell’Ateneo Nuovo, 1, 20126, Milano, Italy.
| | - Chiara De Matteis
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Marco D’Addario
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Francesco Fattirolli
- Department of Experimental & Clinical Medicine, University of Florence, Florence, Italy
- Cardiac Rehabilitation Unit, Careggi University Hospital, Florence, Italy
| | | | - Cristina Giannattasio
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Cardiology IV, “A. De Gasperis” Department, Ospedale Niguarda Ca’ Granda, Milan, Italy
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
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de Carvalho Costa IMNB, da Silva DG, Oliveira JLM, Silva JRS, Pereira LMC, Vieira Sousa Alves L, de Andrade FA, de Góes Jorge J, de Oliveira LMSM, de Almeida RR, Oliveira VB, Martins LS, Costa JO, de Souza MFC, Voci SM, Almeida-Santos MA, Aidar FJ, Baumworcele L, Sousa ACS. Adherence to Secondary Prevention Measures after Acute Coronary Syndrome in Patients Associated Exclusively with the Public and Private Healthcare Systems in Brazil. Prev Med Rep 2022; 29:101973. [PMID: 36161134 PMCID: PMC9502285 DOI: 10.1016/j.pmedr.2022.101973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/28/2022] [Accepted: 08/27/2022] [Indexed: 11/24/2022] Open
Abstract
Adherence to secondary prevention measures after acute coronary syndrome (ACS) is essential to prevent disease recurrence. In Brazil, the Brazilian Unified Health System (SUS, in Portuguese), and the private healthcare system (PHCS) coexist. We aimed to evaluate the adherence to secondary prevention in patients with ACS who were assisted by either SUS or PHCS. In this longitudinal prospective study, patients with ACS were admitted to the four cardiological reference hospitals of Sergipe, three of which assisted PHCS users, and one, SUS users. We analyzed the two patient care models with multiple logistic regression models for adherence to physical activity, pharmacotherapy, and smoking cessation. We enrolled 581 volunteers in this study: 44.1 % from SUS and 55.9 % from PHCS. PHCS users showed greater adherence to pharmacotherapy at both 30 and 180 (p = 0.001) days after ACS with better results in all classes of medications (p < 0.05) than SUS users did. They also showed better adherence to physical activity (p = 0.047). There was no distinction between the groups regarding smoking cessation. The secondary prevention measures after ACS were more effective in PHCS users than in SUS users due to better adherence, especially to pharmacotherapy and regular physical activity.
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D’Addario M, Adorni R, Steca P, Capelli R, Zanatta F, Fattirolli F, Franzelli C, Giannattasio C, Greco A. Associations between Lifestyle Changes and Adherence to COVID-19 Restrictions in Older Adults with Hypertension. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137853. [PMID: 35805511 PMCID: PMC9265744 DOI: 10.3390/ijerph19137853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/20/2022] [Accepted: 06/24/2022] [Indexed: 11/16/2022]
Abstract
COVID-19 has changed people’s routines and imposed new ways of living. This study investigated variations in lifestyles (namely, physical activity, diet, alcohol consumption, and cigarette smoking) between the prepandemic and the pandemic period in a sample of older adults with hypertension. Moreover, it investigated predictors of adherence to government restrictions during the first lockdown period, evidencing the role of relevant sociodemographic indicators and lifestyle changes. A sample of 105 older Italian adults (M_age = 70 years; SD = 5.83) with hypertension was enrolled from a previous longitudinal study and interviewed on the phone between May and August 2020. Updated information about sociodemographic indicators and lifestyle changes was collected. Adherence to restrictions was explored through several questions regarding compliance with home confinement, facemask use, and the observance of social distancing. Results evidenced that only 33% of the respondents abided by all the national restrictions. During the first pandemic peak, considerable changes in lifestyles occurred, particularly regarding physical activity, which diminished in 70% of the sample. Women, unemployed/retired people, and individuals who decreased their amount of physical activity reported higher adherence to rules. Maintaining a healthy lifestyle over time is essential for disease prevention. Therefore, it is essential to continue to inform the population about the importance of a healthy lifestyle, and it is necessary to provide guidelines to maintain and promote it even during housebound periods.
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Affiliation(s)
- Marco D’Addario
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (M.D.); (P.S.); (F.Z.)
| | - Roberta Adorni
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (M.D.); (P.S.); (F.Z.)
- Correspondence:
| | - Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (M.D.); (P.S.); (F.Z.)
| | - Roberto Capelli
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy; (R.C.); (A.G.)
| | - Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (M.D.); (P.S.); (F.Z.)
| | - Francesco Fattirolli
- Department of Medical and Surgical Critical Care, Cardiac Rehabilitation Unit, University of Florence, 50139 Florence, Italy;
- Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Cristina Franzelli
- Cardiac/Pulmonary Rehabilitation, ASST Gaetano Pini—CTO, 20122 Milan, Italy;
| | - Cristina Giannattasio
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy;
- Cardiology IV, “A. De Gasperis” Department, Ospedale Niguarda Ca’ Granda, 20162 Milan, Italy
| | - Andrea Greco
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy; (R.C.); (A.G.)
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Siewert-Markus U, Ulbricht S, Gaertner B, Zyriax BC, Dörr M, Tobschall S, Baumann S, John U, Freyer-Adam J. Behavioral Health Risk Factors and Motivation to Change among Cardiovascular General Hospital Patients Aged 50 to 79 Years. Nutrients 2022; 14:nu14091963. [PMID: 35565928 PMCID: PMC9105822 DOI: 10.3390/nu14091963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 02/01/2023] Open
Abstract
Little is known about the (co-)occurrence of smoking, alcohol at-risk drinking, physical inactivity and overweight, and the motivation to change these behavioral health risk factors (HRFs) in older general hospital patients with cardiovascular disease. Between October and December 2016, all consecutively admitted patients aged 50 to 79 years were proactively recruited on 3 cardiology wards and asked to participate in a survey on HRFs and behavior change motivation. Of the eligible patients, 80.4% participated in the survey (n = 328). The mean age was 66.5 years (standard deviation 9.0), and 65.5% were male. At least 1 HRF was present in 91.8% (n = 280), at least 2 HRFs in 54.4% (n = 166), and 3 or 4 HRFs in 12.1% (n = 37) of participants. The proportion of older adults who contemplated or were changing or planning to change their behavior to meet health behavior recommendations ranged between 66.0% (smoking) and 93.2% (alcohol consumption). The results indicate a notable co-occurrence of behavioral HRFs in older patients with cardiovascular disease. The majority of older adults were at least considering changing the respective behavior. To prevent and treat diseases efficiently, hospitalization may be a suitable moment for systematic multiple HRF screening and intervention.
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Affiliation(s)
- Ulrike Siewert-Markus
- Institute for Medical Psychology, University Medicine Greifswald, 17475 Greifswald, Germany; (S.T.); (J.F.-A.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 17475 Greifswald, Germany; (S.U.); (M.D.); (S.B.); (U.J.)
- Correspondence: ; Tel.: +49-(0)3834-86-5610; Fax: +49-(0)3834-86-5605
| | - Sabina Ulbricht
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 17475 Greifswald, Germany; (S.U.); (M.D.); (S.B.); (U.J.)
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | | | - Birgit-Christiane Zyriax
- Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany;
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg, 20251 Hamburg, Germany
| | - Marcus Dörr
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 17475 Greifswald, Germany; (S.U.); (M.D.); (S.B.); (U.J.)
- Department of Internal Medicine B, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Stefanie Tobschall
- Institute for Medical Psychology, University Medicine Greifswald, 17475 Greifswald, Germany; (S.T.); (J.F.-A.)
| | - Sophie Baumann
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 17475 Greifswald, Germany; (S.U.); (M.D.); (S.B.); (U.J.)
- Section Methods in Community Medicine, Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Ulrich John
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 17475 Greifswald, Germany; (S.U.); (M.D.); (S.B.); (U.J.)
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Jennis Freyer-Adam
- Institute for Medical Psychology, University Medicine Greifswald, 17475 Greifswald, Germany; (S.T.); (J.F.-A.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 17475 Greifswald, Germany; (S.U.); (M.D.); (S.B.); (U.J.)
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9
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Greco A, Brugnera A, D’Addario M, Compare A, Franzelli C, Maloberti A, Giannattasio C, Fattirolli F, Steca P. A three-year longitudinal study of healthy lifestyle behaviors and adherence to pharmacological treatments in newly diagnosed patients with acute coronary syndrome: hierarchical linear modeling analyses. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01369-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Abstract
Aim
Healthy lifestyle behaviors and a good adherence to pharmacological treatments are important predictors of lower recurrence rates and better overall outcomes among patients with an established acute coronary syndrome (ACS). The present study sought to investigate the longitudinal trajectories of these behaviors years after the onset of an ACS.
Subject and methods
We recruited a sample of 275 newly diagnosed consecutive patients at their first ACS event (mean age: 57.1 ± 7.87 years; 84% males) admitted to a cardiac rehabilitation program from three large public hospitals in Northern Italy. Patients completed a battery of sociodemographic questionnaires, which evaluated healthy lifestyles (smoking status, alcohol intake, diet, and physical activity) and adherence to pharmacological treatments, at five time-points (pre-event, 6-, 12-, 24-, and 36-month follow-ups). Longitudinal trajectories were examined through hierarchical (generalized) linear models, controlling for several demographic and clinical variables.
Results
We found significant changes in all healthy lifestyles from pre-event to the 6-month follow-up, suggesting the adoption of healthier behaviors soon after the cardiac event. However, from the 6-month up to the 3-year follow-up, patients experienced small but significant declines in their self-reported levels of healthy dietary behaviors and physical activity. Further, we found that the odds of being at medium risk of non-adherence to the pharmacological treatments significantly increased over the course of 3 years.
Conclusion
Given the negative long-term trajectories in specific lifestyles and adherence to pharmacological treatments, cardiac rehabilitation programs are suggested to provide repeated psychological interventions aimed at fostering patients’ capabilities to self-regulate their habitual behaviors.
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OUP accepted manuscript. Eur J Cardiovasc Nurs 2022; 21:717-723. [DOI: 10.1093/eurjcn/zvab129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 11/24/2021] [Accepted: 12/17/2021] [Indexed: 11/14/2022]
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Bagheri H, Shakeri S, Nazari AM, Goli S, Khajeh M, Mardani A, Vlaisavljevic Z. Effectiveness of nurse-led counselling and education on self-efficacy of patients with acute coronary syndrome: A randomized controlled trial. Nurs Open 2021; 9:775-784. [PMID: 34766453 PMCID: PMC8685773 DOI: 10.1002/nop2.1129] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/21/2021] [Accepted: 10/31/2021] [Indexed: 02/04/2023] Open
Abstract
Aim Adherence to lifestyle recommendations, medical regimens and cardiac rehabilitation is poor among patients with acute coronary syndrome. The aim of this study was to examine the effect of nurse‐led counselling and education using a person‐centred care approach on short‐term cardiac self‐efficacy in patients with acute coronary syndrome. Design A parallel, two‐armed, randomized controlled trial was conducted. Methods One hundred twenty patients who were hospitalized with diagnosis of acute coronary syndrome were selected and randomly assigned into intervention (n = 60) or control (n = 60) groups. In the intervention group, in addition to routine care, the nurse‐led counselling and education programme included two face‐to‐face sessions, two telephone counselling and education sessions, using the person‐centred care approach. Participants in the control group received only routine care. Data were collected using the cardiac self‐efficacy scale before the intervention and 1 month after discharge. Results After the intervention, we found that cardiac self‐efficacy, including the perceived self‐efficacy to control symptoms and maintain function, was statistically significantly higher in the intervention group than the control group.
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Affiliation(s)
- Hossein Bagheri
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Sara Shakeri
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ali-Mohammad Nazari
- Department of Midwifery, Faculty of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Shahrbanoo Goli
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mahboobeh Khajeh
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Abbas Mardani
- Nursing Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Zeljko Vlaisavljevic
- University Clinical Center of Serbia, Clinic for Gastroenterology and Hepatoligia, Belgarade, Serbia.,Medical School of Vocational Studies Medika, Department of Nursing, Belgarade, Serbia
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12
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Adorni R, Zanatta F, D’Addario M, Atella F, Costantino E, Iaderosa C, Petarle G, Steca P. Health-Related Lifestyle Profiles in Healthy Adults: Associations with Sociodemographic Indicators, Dispositional Optimism, and Sense of Coherence. Nutrients 2021; 13:nu13113778. [PMID: 34836035 PMCID: PMC8624048 DOI: 10.3390/nu13113778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/16/2021] [Accepted: 10/22/2021] [Indexed: 01/20/2023] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. Promoting healthy behaviors throughout life is an essential prevention tool. This study investigated the associations among lifestyle profiles (including diet, alcohol consumption, physical activity, cigarette smoking, and cardiovascular screening), sociodemographic factors (gender, age, education, and family history of CVDs), and psychological factors (sense of coherence and dispositional optimism). In total, 676 healthy adults (mean age = 35 years; range = 19-57; 46% male) participated in an online survey. Lifestyle profiles were identified through cluster analysis, and a multinomial logistic regression was then performed to explore their association with sociodemographic and psychological variables. Results show that men were more likely than women to belong to the lifestyle profile with the highest amount of physical activity (OR = 2.40; p < 0.001) and the greatest attention to cardiovascular screening (OR = 2.09; p < 0.01). Lower dispositional optimism was associated with the profile paying the greatest attention to cardiovascular screening (OR = 0.67; p < 0.05). Sense of coherence, in terms of lower comprehensibility (OR = 0.67; p < 0.05) and higher manageability (OR = 1.43; p < 0.05), was associated with the lifestyle profile characterized by an unhealthy diet, sedentary lifestyle, and nonsmoking. This study shed light on factors associated with different co-occurring health-related behaviors that should be considered in planning effective communication strategies promoting adherence to health claims.
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13
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Monzani D, Pancani L, Rusconi P, Pravettoni G. Perceived Onset Time of Medical Conditions: The Interplay Between Subjective Fear and Risk in Four Lifestyle Domains. Psychol Rep 2021; 125:2981-3005. [PMID: 34324370 DOI: 10.1177/00332941211036028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Engaging in unhealthy behaviors (e.g., smoking, drinking) and not engaging in healthy ones (e.g., exercising, consuming fruit and vegetables) are both relatively prevalent among individuals despite the available information about their risks for health. People's perception of an event's time course can be used to gauge their risk perception for that event thus casting light on any possible misperception and suggesting directions for health-promoting interventions. This study investigates people's perception of the time of onset of 5 noncommunicable diseases (e.g., "having high blood pressure") associated with 4 health-related behaviors: Smoking, drinking, exercising, and eating fruit and vegetable. Participants from Italy (N = 214) and the UK (N = 151) gave onset time estimates of how long they thought it would take for 5 noncommunicable diseases to occur in the life of an 18-year-old person who starts or stops adopting those health-related behaviors. Results showed that participants who rated the noncommunicable diseases as more likely to themselves perceived the onset time of these diseases as more temporally proximal. Participants who were more afraid of developing the noncommunicable diseases estimated their onset time as delayed.
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Affiliation(s)
- Dario Monzani
- Department of Oncology and Hemato-Oncology, University of Milan, Italy; Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Luca Pancani
- Department of Psychology, University of Milano - Bicocca, Italy
| | - Patrice Rusconi
- School of Psychology, University of Surrey, UK; Department of Cognitive Sciences, Psychology, Education and Cultural Studies, 18980University of Messina, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Italy; Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
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14
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Brouwer-Goossensen D, Scheele M, van Genugten L, Lingsma HF, Dippel DWJ, Koudstaal PJ, den Hertog HM. Motivational interviewing in a nurse-led outpatient clinic to support lifestyle behaviour change after admission to a stroke unit: a randomized controlled trial. Eur J Cardiovasc Nurs 2021; 21:36-45. [PMID: 33824973 DOI: 10.1093/eurjcn/zvab001] [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: 03/31/2020] [Revised: 09/23/2020] [Accepted: 01/12/2021] [Indexed: 11/13/2022]
Abstract
AIMS Modification of health behaviour is an important part of stroke risk management. However, the majority of people with cardiovascular disease fail to sustain lifestyle modification in the long term. We aimed to evaluate the effectiveness of motivational interviewing to encourage lifestyle behaviour changes after transient ischaemic attack (TIA) or minor ischaemic stroke. METHODS AND RESULTS We performed a randomized controlled open-label phase II trial with blinded endpoint assessment. The intervention consisted of three 15-minute visits in 3 months by a motivational interviewing trained nurse practitioner. Patients in the control group received standard consultation after 1 and 3 months by a nurse practitioner. Primary outcome was lifestyle behaviour change, defined as smoking cessation and/or increased physical activity (30 min/day) and/or healthy diet improvement (5 points at the Food Frequency Questionnaire) at 6 months. We adjusted for age and sex with multivariable logistic regression. Between January 2014 and February 2016, we included 136 patients (of whom 68 were assigned to the intervention group). Twenty-five of 55 patients in the intervention group (45%) and 27 of 61 patients in the control group (44%) had changed their lifestyle at 6 months. We found no effect of motivational interviewing on lifestyle behaviour change after 6 months (aOR 0.99; 95% confidence interval: 0.44-2.26). CONCLUSION Our results do not support the effectiveness of motivational interviewing in supporting lifestyle behaviour change after TIA or ischaemic stroke. However, the overall lifestyle behaviour change was high and might be explained by the role of specialized nurses in both groups.
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Affiliation(s)
- Dorien Brouwer-Goossensen
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Maaike Scheele
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Lenneke van Genugten
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Hester F Lingsma
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Diederik W J Dippel
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Peter J Koudstaal
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
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15
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Liljeroos T, Puthoopparambil SJ, Wallert J, Held C, Olsson EMG. Self-perceived cognitive status and cognitive challenges associated with cardiac rehabilitation management: experiences of elderly myocardial infarction patients. Disabil Rehabil 2021; 44:3834-3842. [PMID: 33621136 DOI: 10.1080/09638288.2021.1888321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE The study aimed to explore the self-perceived cognitive status and cognitive challenges associated with lifestyle changes in cardiac rehabilitation among elderly myocardial infarction (MI) patients (≥65 years). Further, the study explored coping strategies developed to manage these challenges in the everyday life. METHODS Nine patients were included in the study. Data were collected by telephone or in person, between 6 and 12 weeks post MI, using semi-structured interviews. Data were analysed inductively, using thematic analysis. RESULTS Four major themes were identified, highlighting elderly MI patients' experiences of their cognitive status and cardiac rehabilitation management: (1) A change in cognition over time, (2) Situating the MI within a challenging and changing life context, (3) Navigating the hurdles of cardiac rehabilitation, and (4) Being seen within the healthcare system. CONCLUSION Elderly MI patients are situated in a complex life context, dealing with a transition to retirement, multiple health issues and age-related cognitive decline. In this context, the MI experience is marginalised, and cognitive decline normalized. By adopting individually tailored interventions and improving healthcare provider continuity and accessibility, cognitive challenges associated with cardiac rehabilitation could be easier to overcome.IMPLICATIONS FOR REHABILITATIONSelf-perceived cognitive impairment, in particular regarding memory, seems fairly common among elderly MI patients and should likely be identified prior to hospital discharge in order to optimize the prospects of self-care.There seems to exist an unmet need to implement the practice of individually adapted education and information further, in accordance with current recommendations for elderly cardiac patients.The overall health and cognitive status, social network and the objective living conditions (e.g., distance from service and housing) should be taken into account when planning the patient's cardiac rehabilitation management.Healthcare providers likely need to strengthen the continuity of care and increase its accessibility for elderly MI patients, in particular following the transfer from hospital care to local health centres.
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Affiliation(s)
- Thea Liljeroos
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - John Wallert
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden
| | - Claes Held
- Uppsala Clinical Research Centre, Uppsala University, Uppsala, Sweden.,Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden
| | - Erik M G Olsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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16
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Hisam A, Haq ZU, Khan Z, Doherty P, Pell J. Mobile Health Augmented Cardiac Rehabilitation (MCard) in Post-Acute Coronary Syndrome Patients: A randomised controlled trial protocol. Pak J Med Sci 2021; 37:890-896. [PMID: 34104184 PMCID: PMC8155414 DOI: 10.12669/pjms.37.3.3664] [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] [Indexed: 11/15/2022] Open
Abstract
Objectives To determine the effectiveness of mobile health augmented cardiac rehabilitation (MCard) on health-related quality of life (HRQoL), clinical and behavioural outcomes in post-ACS. Methods A single-centre, single-blinded, two-arm randomised controlled trial is planned at Armed Forces Institute of Cardiology (AFIC), Pakistan. The duration was two years, that is from January 2019 till December 2020. A total of 160 participants were recruited and randomly allocated to the control group or the intervention group. Intervention is a mobile health augmented cardiac rehabilitation (MCard), a medically supervised cardiac rehabilitation program for 23-24 weeks. The phase one includes individual counselling during the hospital stay and in phase two includes communication of standardised messages related to healthy lifestyle modification through a specifically designed software. Results This clinical trial results will give insight into the impact of MCard in improving the health outcomes (HRQoL, clinical and behavioural) of participants. If proven to be effective, this technology can be scaled up and implemented in other cardiac centres in the country. It utilises fewer human resources and can be delivered at a lower cost. Conclusion The study protocol will be giving evidence either MCard can contribute to improving the HRQoL, clinical and behavioural outcomes of post-ACS patients following hospital discharge. Considering the COVID-9 situation, this is the perfect time to implement and evaluate the effectiveness of MCard on health outcomes among post-ACS patients.
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Affiliation(s)
- Aliya Hisam
- Dr. Aliya Hisam, MBBS, MPH, FCPS, PhD Scholar. Department of Community Medicine Army Medical College, NUMS, Rawalpindi, Pakistan
| | - Zia Ul Haq
- Prof Zia Ul Haq, MBBS, MPH, PhD, Department of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Zohaib Khan
- Dr. Zohaib Khan, MBBS, PhD, Department of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Patrick Doherty
- Dr. Patrick Doherty, PhD. Department of Health Sciences, University of York, United Kingdom
| | - Jill Pell
- Prof. Jill Pell, MBChB, MD, FFPH. Institutes of Health & Wellbeing, University of Glasgow, United Kingdom
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17
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Protein Intake and Physical Activity in Newly Diagnosed Patients with Acute Coronary Syndrome: A 5-Year Longitudinal Study. Nutrients 2021; 13:nu13020634. [PMID: 33669214 PMCID: PMC7919823 DOI: 10.3390/nu13020634] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/05/2021] [Accepted: 02/13/2021] [Indexed: 12/16/2022] Open
Abstract
Cardiovascular disease is one of the most common causes of hospitalization and is associated with high morbidity and mortality rates. Among the most important modifiable and well-known risk factors are an unhealthy diet and sedentary lifestyle. Nevertheless, adherence to healthy lifestyle regimes is poor. The present study examined longitudinal trajectories (pre-event, 6-, 12-, 24-, 36-, and 60-month follow-ups) of protein intake (fish, legumes, red/processed meat) and physical activity in 275 newly-diagnosed patients with acute coronary syndrome. Hierarchical Generalized Linear Models were performed, controlling for demographic and clinical variables, the season in which each assessment was made, and the presence of anxiety and depressive symptoms. Significant changes in protein intake and physical activity were found from pre-event to the six-month follow-up, suggesting the adoption of healthier behaviors. However, soon after the six-month follow-up, patients experienced significant declines in their healthy behaviors. Both physical activity and red/processed meat intake were modulated by the season in which the assessments took place and by anxiety symptoms over time. The negative long-term trajectory of healthy behaviors suggests that tailored interventions are needed that sustain patients’ capabilities to self-regulate their behaviors over time and consider patient preference in function of season.
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18
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Abbamonte JM, Cristofari NV, Weiss SM, Kumar M, Jayaweera DT, Jones DL. Heart Health and Behavior Change in HIV-Infected Individuals. AIDS Behav 2021; 25:615-622. [PMID: 32892296 DOI: 10.1007/s10461-020-03022-w] [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] [Indexed: 11/28/2022]
Abstract
Management of cardiovascular disease risk requires many lifestyle changes involving diet, smoking, and exercise. Individuals with arterial plaque are encouraged to adopt these changes to promote longevity through a variety of interventions. This study examined behavioral changes in response to the standard of care after detection of arterial plaque, specifically among HIV-infected cocaine users. 127 individuals (HIV - COC - n = 43, HIV + COC - n = 19, HIV + COC + n = 35, HIV - COC + n = 30) were followed after a standard of care intervention and assessed 1 and 2 years later on a variety of lifestyle (diet, exercise, smoking) and physiological (blood pressure, body mass index, number of arterial plaques) outcomes. Arterial plaque was found to increase over time (b = 0.003, SE = 0.002, p = .031), and a composite measure of cardiovascular disease risk did not change (b = - 0.004, SE = 0.01, p = .548). Following provision of a standard of care cardiovascular risk reduction intervention, important health behaviors related to CVD risk were resistant to change among both those HIV-infected and uninfected and among cocaine users and non-users.
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Affiliation(s)
- John M Abbamonte
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Dominion Towers Suite 404A, 1400 NW 10th Avenue, Miami, FL, 33136, USA
| | - Nicholas V Cristofari
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Dominion Towers Suite 404A, 1400 NW 10th Avenue, Miami, FL, 33136, USA
| | - Stephen M Weiss
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Dominion Towers Suite 404A, 1400 NW 10th Avenue, Miami, FL, 33136, USA
| | - Mahendra Kumar
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Dominion Towers Suite 404A, 1400 NW 10th Avenue, Miami, FL, 33136, USA
| | | | - Deborah L Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Dominion Towers Suite 404A, 1400 NW 10th Avenue, Miami, FL, 33136, USA.
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19
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Combined profiles derived from cardiovascular risk factors, health-promoting lifestyle, and post-traumatic stress disorder symptoms. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2019.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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20
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Thomas K, Nilsson E, Festin K, Henriksson P, Lowén M, Löf M, Kristenson M. Associations of Psychosocial Factors with Multiple Health Behaviors: A Population-Based Study of Middle-Aged Men and Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041239. [PMID: 32075162 PMCID: PMC7068361 DOI: 10.3390/ijerph17041239] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/07/2020] [Accepted: 02/11/2020] [Indexed: 12/11/2022]
Abstract
Background: The health behaviors smoking, risky alcohol consumption, insufficient physical activity, and poor diet constitute the main contributors to non-communicable diseases. Clustering of risk behaviors is common and increases the risk of these diseases. Despite health benefits, it is difficult to change health behaviors. Psychosocial factors could play a role in health behavior change, with research showing relationships between unfavorable psychosocial factors and health risk behaviors. However, many studies only investigated one or two health behaviors at a time. The present study, therefore, aimed to investigate associations between a broad range of psychosocial factors and multiple health risk behaviors in a general middle-aged population in Sweden. Methods: A cross-sectional design was used to investigate a random sample from the general population in Sweden (n = 1007, 45–69 years, 50% women). Questionnaire data on health behaviors (smoking, alcohol consumption, physical activity, and fruit/vegetable intake) and psychosocial factors, with both psychological and social resources (social integration, emotional support, perceived control, self-esteem, sense of coherence and trust) and psychological risk factors (cynicism, vital exhaustion, hopelessness and depressiveness), were analyzed. Logistic and ordinal logistic regression were used to analyze associations between psychosocial factors and multiple (0–1, 2 or 3–4) health risk behaviors. Results: A total of 50% of the sample had two health risk behaviors and 18% had three health risk behaviors. After adjusting for age, sex, education, employment status, and immigrant status, eight out of 10 psychosocial factors (exceptions: social integration and self-esteem) showed significant odds ratios (ORs) in the expected directions; low levels of psychosocial resources and high levels of psychosocial risk factors were associated with multiple risk behaviors. The strongest associations with multiple risk behaviors were seen for vital exhaustion (adjusted (adj.) OR 1.28; confidence interval (CI) 1.11–1.46), depressiveness (adj. OR 1.32, CI 1.14–1.52), and trust (adj. OR 0.80, CI 0.70–0.91). When controlling for all psychosocial factors in the same model, only the association with trust remained statistically significant (adj. OR 0.89, CI 0.73–1.00, p = 0.050). Associations with individual health behaviors were fewer and scattered, with no psychosocial factor being related to all four behaviors. Conclusions: Examining associations between a broad range of psychosocial factors and multiple health risk behaviors revealed consistent and significant associations for almost all psychosocial factors. These associations were stronger compared to associations to single health risk behaviors. Our findings support the relevance of considering psychosocial aspects in interventions aimed at health behavior change, especially for people with multiple health risk behaviors.
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Affiliation(s)
- Kristin Thomas
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health, Linköping University, SE-581 83 Linköping, Sweden; (E.N.); (K.F.); (P.H.); (M.L); (M.K.)
- Correspondence: ; Tel.: +46-1328-2546
| | - Evalill Nilsson
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health, Linköping University, SE-581 83 Linköping, Sweden; (E.N.); (K.F.); (P.H.); (M.L); (M.K.)
| | - Karin Festin
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health, Linköping University, SE-581 83 Linköping, Sweden; (E.N.); (K.F.); (P.H.); (M.L); (M.K.)
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health, Linköping University, SE-581 83 Linköping, Sweden; (E.N.); (K.F.); (P.H.); (M.L); (M.K.)
- Department of Biosciences and Nutrition, Karolinska Institute, 141 83 Huddinge, Sweden
| | - Mats Lowén
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health, Linköping University, SE-581 83 Linköping, Sweden; (E.N.); (K.F.); (P.H.); (M.L); (M.K.)
| | - Marie Löf
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health, Linköping University, SE-581 83 Linköping, Sweden; (E.N.); (K.F.); (P.H.); (M.L); (M.K.)
- Department of Biosciences and Nutrition, Karolinska Institute, 141 83 Huddinge, Sweden
| | - Margareta Kristenson
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health, Linköping University, SE-581 83 Linköping, Sweden; (E.N.); (K.F.); (P.H.); (M.L); (M.K.)
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21
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Aggarwal M, Grady A, Desai D, Hartog K, Correa L, Ostfeld RJ, Freeman AM, McMacken M, Gianos E, Reddy K, Batiste C, Wenger C, Blankstein R, Williams K, Allen K, Seifried RM, Aspry K, Barnard ND. Successful Implementation of Healthful Nutrition Initiatives into Hospitals. Am J Med 2020; 133:19-25. [PMID: 31494109 DOI: 10.1016/j.amjmed.2019.08.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/14/2019] [Accepted: 08/28/2019] [Indexed: 02/05/2023]
Abstract
Poor dietary quality is a leading contributor to mortality in the United States, and to most cardiovascular risk factors. By providing education on lifestyle changes and, specifically, dietary changes, hospitals have the opportunity to use the patient experience as a "teachable moment." The food options provided to inpatients and outpatients can be a paradigm for patients to follow upon discharge from the hospital. There are hospitals in the United States that are showcasing novel ways to increase awareness of optimal dietary patterns and can serve as a model for hospitals nationwide.
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Affiliation(s)
- Monica Aggarwal
- Division of Cardiology, University of Florida, Gainesville, Florida.
| | - Ariel Grady
- Department of Medicine, University of Florida, Gainesville, Florida
| | - Daya Desai
- University of Florida, Gainesville, Florida
| | | | - Lilian Correa
- Department of Medicine, NYC Health + Hospitals/Bellevue, New York
| | | | - Andrew M Freeman
- Division of Cardiology, Department of Medicine, National Jewish Health, Denver, Colo
| | | | - Eugenia Gianos
- Division of Cardiology, Lenox Hill Hospital, Northwell Health, New York, NY
| | - Koushik Reddy
- Division of Cardiology, James A. Haley VA Medical Center, Tampa, Fla
| | - Columbus Batiste
- Division of Cardiology, Kaiser Permanente Riverside Medical Center, Riverside, Calif
| | - Christopher Wenger
- Division of Preventative Cardiology, Lancaster General Hospital/Penn Medicine, Lancaster, Pa
| | - Ron Blankstein
- Division of Cardiology, Brigham and Women's Hospital, Boston, Mass
| | - Kim Williams
- Division of Cardiology, Rush University Medical Center, Chicago, Ill
| | - Kathleen Allen
- Geisel School of Medicine, Dartmouth Medical School, Hanover, NH
| | - Rebecca M Seifried
- Division of Cardiology, Walter Reed National Military Medical Center, Bethesda, Md
| | - Karen Aspry
- Brown University, Warren Alperty Medical School, Providence, RI
| | - Neal D Barnard
- George Washington University School of Medicine, and Physicians Committee for Responsible Medicine, Washington, DC
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22
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Zhao E, Lowres N, Woolaston A, Naismith SL, Gallagher R. Prevalence and patterns of cognitive impairment in acute coronary syndrome patients: A systematic review. Eur J Prev Cardiol 2019; 27:284-293. [PMID: 31645116 DOI: 10.1177/2047487319878945] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Minimising risk factors through secondary prevention behaviour is challenging for patients following an acute coronary syndrome. Cognitive impairment can potentially make these changes more difficult. However, cognitive impairment prevalence in acute coronary syndrome patients is poorly understood. DESIGN This study was based on a systematic review. METHODS A systematic review was conducted of PubMed, Medline, PsycINFO and Cochrane databases up to March 2019, to identify studies reporting the prevalence of cognitive impairment in acute coronary syndrome patients. Predefined inclusion criteria were specified, including use of a validated cognitive impairment screening tool. Studies were excluded if patients had diagnosed dementia or coronary artery bypass graft surgery. Strengthening The Reporting of Observational Studies in Epidemiology and Cochrane Risk of Bias tools were used to assess quality. RESULTS From 747 potential studies, nine were included. The total sample size was 6457 (range 53-2174), mean age range was 51.3-77.4 years, and range of proportions of males was 57-100%. Reported cognitive impairment prevalence rates varied substantially (9-85%) with no clear pattern over time. From the two studies which examined domains, verbal fluency, memory and language were affected the most. Meta-analysis could not be undertaken due to diverse screening tools (n = 9), cut-off scores and screening timepoints. CONCLUSIONS Cognitive impairment in acute coronary syndrome patients is currently poorly described, and likely affects a substantial number of acute coronary syndrome patients who remain undetected and have the potential to develop to dementia in the future. As domains are most affected, this could impact understanding and retention of health education. Research is needed to accurately determine the prevalence of cognitive impairment in acute coronary syndrome patients and create suitable standardised measures and thresholds.
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Affiliation(s)
- Emma Zhao
- Charles Perkins Centre, University of Sydney, Australia.,Sydney Nursing School, University of Sydney, Australia
| | - Nicole Lowres
- Charles Perkins Centre, University of Sydney, Australia.,Stroke Prevention, Heart Research Institute, Sydney, Australia
| | | | - Sharon L Naismith
- Charles Perkins Centre, University of Sydney, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Australia
| | - Robyn Gallagher
- Charles Perkins Centre, University of Sydney, Australia.,Stroke Prevention, Heart Research Institute, Sydney, Australia
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23
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de Oliveira LMSM, Costa IMNBDC, da Silva DG, Silva JRSS, Barreto-Filho JAS, Almeida-Santos MA, Oliveira JLM, Buarque MDBM, Vieira DADS, Sousa ACS. Readmission of Patients with Acute Coronary Syndrome and Determinants. Arq Bras Cardiol 2019; 113:42-49. [PMID: 31271598 PMCID: PMC6684196 DOI: 10.5935/abc.20190104] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/23/2018] [Accepted: 11/01/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Acute coronary syndrome (ACS) is responsible for high rates of hospital admission and readmission, which are associated with increased costs for the patient and the health system, and increased in-hospital mortality rates. OBJECTIVE To evaluate readmission in patients with ACS and its determinants. METHODS This was a retrospective cohort study of adult and elderly patients with ACS, readmitted to public and private referral cardiology hospitals within one year after the first hospitalization for ACS. The occurrence of readmissions, the time elapsed from the first to the second admission, and the use of medications at admission were collected from the medical records. Associations between categorical variables were evaluated by the chi-square test or the Fisher's exact test. Multiple logistic regression was used to evaluate predictors for readmissions. A p < 0.05 was set as statistically significant. RESULTS Readmission rate was 21.5% (n = 115) and mean time between admissions was 122.7 ± 112.1 days. The patients were mostly men (64.0%), mean age of 63.15 ± 12.3 years. Among readmitted patients, 7% had a prognosis of "death", and 68.7% were readmitted more than once within a one-year period. The main reasons of readmission were cardiovascular diseases including ACS. Private health care and the diagnosis of congestive heart failure were associated with multiple logistic regression. CONCLUSION ACS was the main cause of readmission, with higher prevalence among users of supplemental health care. Readmissions were associated with previous diagnosis of congestive heart failure and the type of health care provided.
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Affiliation(s)
| | - Ingrid Maria Novais Barros de Carvalho Costa
- Universidade Federal de Sergipe - Departamento de
Pós-Graduação em Ciências da Saúde, São
Cristovão, SE - Brazil
- Instituto Federal de Educação Ciência e
Tecnologia de Sergipe, São Cristovão, SE - Brazil
| | | | | | - José Augusto Soares Barreto-Filho
- Universidade Federal de Sergipe - Departamento de
Pós-Graduação em Ciências da Saúde, São
Cristovão, SE - Brazil
- Universidade Federal de Sergipe - Departamento de Medicina,
São Cristovão, SE - Brazil
- Fundação São Lucas - Centro de Ensino e
Pesquisa, Aracaju, SE - Brazil
| | | | - Joselina Luzia Meneses Oliveira
- Universidade Federal de Sergipe - Departamento de
Pós-Graduação em Ciências da Saúde, São
Cristovão, SE - Brazil
- Universidade Federal de Sergipe - Departamento de Medicina,
São Cristovão, SE - Brazil
| | | | | | - Antônio Carlos Sobral Sousa
- Universidade Federal de Sergipe - Departamento de
Pós-Graduação em Ciências da Saúde, São
Cristovão, SE - Brazil
- Universidade Federal de Sergipe - Departamento de Medicina,
São Cristovão, SE - Brazil
- Fundação São Lucas - Centro de Ensino e
Pesquisa, Aracaju, SE - Brazil
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Marzorati C, Monzani D, Mazzocco K, Pavan F, Cozzi G, De Cobelli O, Monturano M, Pravettoni G. Predicting trajectories of recovery in prostate cancer patients undergone Robot-Assisted Radical Prostatectomy (RARP). PLoS One 2019; 14:e0214682. [PMID: 30946773 PMCID: PMC6448842 DOI: 10.1371/journal.pone.0214682] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 03/18/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To identify trends of patients' urinary and sexual dysfunctions from a clinical and psychological perspective and understand whether sociodemographic and medical predictors could differentiate among patients following different one-year longitudinal trajectories. METHODS An Italian sample of 478 prostate cancer patients undergone Robot-Assisted Radical Prostatectomy completed the EPIC-26 survey between July 2015 and July 2016 at the pre-hospitalization (T0), 45 days (T1) and 3 (T2), 6 (T3), 9 (T4), and 12 months (T5) after surgery. Sociodemographic and clinical characteristics (age, BMI, diabetes, nerve-sparing procedure) were also collected. Latent Class Growth Analysis was conducted separately for sexual dysfunction and urinary incontinence EPIC-26 subscales. The association between membership in the two longitudinal trajectories of urinary and sexual dysfunctions was assessed by considering Chi-square test and its related contingency table. RESULTS People who have a high level of urinary incontinence at T1 are likely to have a worse recovery. Age, BMI and pre-surgical continence may affect the level of incontinence at T1 and the recovery trajectories. Patients with low and moderate sexual problems at T1 can face a moderate linear recovery, while people with high level of impotence immediately after surgery may take a longer period to solve sexual dysfunctions. Age and the pre-surgical sexual condition may impact the recovery. Finally, a great proportion of patients reported both steady problems in sexual function and constant high levels of urinary incontinence over time. CONCLUSIONS This study highlights different categories of patients at risk who may be important to know in order to develop personalized medical pathways and predictive models in a value-based healthcare.
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Affiliation(s)
- Chiara Marzorati
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Dario Monzani
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Ketti Mazzocco
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Francesca Pavan
- Patient Safety & Risk Management Service, European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriele Cozzi
- Division of Urology, European Institute of Oncology IRCCS, Milan, Italy
| | - Ottavio De Cobelli
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Division of Urology, European Institute of Oncology IRCCS, Milan, Italy
| | - Massimo Monturano
- Patient Safety & Risk Management Service, European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
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25
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Kwon M, Kang J. Mediating effect of illness perception on the relationship between Type D personality and health behaviors among coronary artery disease patients. Health Psychol Open 2018; 5:2055102918817228. [PMID: 30574338 PMCID: PMC6299319 DOI: 10.1177/2055102918817228] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to investigate the relationship between Type D personality and health behaviors of coronary artery disease patients and to determine the mediating effect of illness perception on this relationship. The participants were 142 coronary artery disease patients who underwent percutaneous coronary intervention in a university hospital in Korea. Type D personality, illness perception, and health behaviors were surveyed using structured questionnaires. The collected data were analyzed by a series of hierarchical multiple regressions. A total of 28.9 percent patients had Type D personality. Type D Patients were observed to have low illness perception and low health behaviors. There was a positive correlation between illness perception and health behaviors. The direct effect of Type D personality on health behaviors was significant (β = -.209, p = .013). However, the indirect effect of Type D personality on health behaviors via illness perception became low and non-significant (β = .007, p = .934). Based on the above results, it can be concluded that illness perception has a complete mediating effect on the relationship between Type D personality and health behaviors. The development of interventions that can improve illness perception is needed to improve health behaviors of Type D coronary artery disease patients.
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Affiliation(s)
- Miri Kwon
- Samsung Changwon Hospital, South Korea
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Ehrler F, Gschwind L, Meyer P, Christian L, Blondon K. SMART-MEDS: Development of a Medication Adherence App for Acute Coronary Syndrome Patients based on a Gamified Behaviour Change Model. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2018; 2018:413-421. [PMID: 30815081 PMCID: PMC6371311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Patient adherence to medications is crucial for reducing cardiovascular risk after an acute coronary syndrome (ACS). Although causes for low adherence are diverse, forgetfulness and lack of awareness about treatment importance are accountable for many cases. As a result, medication reminder apps have attempted to tackle this problem. In our work, we present the development of an app with gamification mechanisms to foster adherence and to support the behavior change processes of the Health Access Process Approach (HAPA) theoretical framework. To design our intervention, we relied on a user-centric approach. We listed the main factors related to high and low adherence from the Medication Adherence Reasons Scale (MAR-Scale) and identified functionalities that could address it. We focused in particular on forgetfulness, knowledge and beliefs about medication as the main barriers for adherence. We implemented a quiz and storytelling as gamification strategies to help motivate patients complete their medication journal and to maintain adherence on the long-term.
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Affiliation(s)
| | | | | | - Lovis Christian
- University Hospitals of Geneva, Geneva, Switzerland
- University Hospitals of Geneva, Geneva, Switzerland
| | - Katherine Blondon
- University Hospitals of Geneva, Geneva, Switzerland
- University Hospitals of Geneva, Geneva, Switzerland
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de Gregorio C. Physical Training and Cardiac Rehabilitation in Heart Failure Patients. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1067:161-181. [PMID: 29453669 DOI: 10.1007/5584_2018_144] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Regardless of advances in medical and interventional treatment of cardiovascular disease (CVD), a limited number of patients attend a cardiac rehabilitation (CR) programme on a regular basis. Due to modern therapies more individuals will be surviving an acute cardiovascular event, but the expected burden of chronic heart failure will be increasing worldwide.However, both in high- and low-income countries, secondary prevention after an acute myocardial infarction or stroke has been implemented in less than a half of eligible patients.Combined interventions are still needed to reduce decompensations, hospitalizations and mortality in heart failure patients from any origin. In addition to medical treatments, regular exercise has been demonstrated to improve metabolic and hemodynamic conditions in both asymptomatic risk factor carriers and cardiac patients. Risk factor control and exercise should gather together for an effective management of patients.Exercise-based training is a core component of primary and secondary prevention. It should involve healthy carriers of cardiovascular risk factors, and patients with cardiomyopathy as well. The supposed attenuated effect of CR in the era of advanced revascularization and structural interventions is due to the heterogeneity of training models and physical training in the literature. Moreover, lifestyle modification, psycho-social challenges and patient's compliance are potential confounders.In this chapter the most recent evidences about training modalities and potential benefit of CR in heart failure patients are discussed.
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Affiliation(s)
- Cesare de Gregorio
- Department of Clinical and Experimental Medicine - Cardiology Unit, University Hospital Medical School "Gaetano Martino", Messina, Italy.
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