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Knowledge, Attitude, and Practice Toward Cardiovascular Diseases in the Lebanese Population. Glob Heart 2022; 17:47. [PMID: 36051313 PMCID: PMC9336688 DOI: 10.5334/gh.1138] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/12/2022] [Indexed: 11/20/2022] Open
Abstract
Background & Objective: Cardiovascular diseases (CVD) are the leading cause of death globally. Assessing CVD knowledge, attitude, and practice (KAP) is necessary to spread awareness about CVD in Lebanon, their corresponding risk factors, and behaviors in which individuals can avoid or minimize the possibility of developing a CVD. Subjects & Methods: This was a case-control analytical study that targeted 921 CVD and non-CVD subjects. A questionnaire form was used to collect data related to patients’ demographics, socioeconomic status, habits, medical and family history, KAP towards CVD, and source of information. Data was analyzed using SPSS v.25. Results: Data from 921 participants were distributed over the CVD group (52.6% males aged 58.3 ± 13.7 years [n = 460]) and the non-CVD group (47.7% males aged 36.3 ± 15.4 years [n = 461]). CVD patients were significantly older than non-CVD subjects (p < 0.001). All three KAP scores of both groups were of poor to fair levels. Both CVD knowledge and attitude mean scores in CVD patients (26.6 ± 5.2 over 40 [66.50%] and 63.3 ± 10.2 over 85 [74.47%], respectively) were significantly higher than the ones of non-CVD subjects (23.5 ± 7.9 over 40 [58.75%] and 61.4 ± 12.4 over 85 [72.74%], respectively, p < 0.001). However, the CVD mean practice score was significantly lower in CVD patients (6.0 ± 1.7 over 9 [66.67%]) than the one of non-CVD subjects (6.3 ± 2.2 over 9 [70.00%] p < 0.001). Mostly, educational level (p < 0.001), governorate (p < 0.01), and smoking (p < 0.001) were predictors of KAP CVD in both groups. Conclusion: With an overall limited knowledge, attitude, and practice toward CVDs, the Lebanese population (with CVD or non-CVD) needs targeted national campaigns about CVD according to the identified predictors of CVD KAP to prevent and to alleviate the complications due to CVDs.
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Al-Zaru IM, Shahrour G, Masha'al D, Hayajneh AA. Depression and adherence to healthy lifestyle behaviors among patients with coronary artery diseases in Jordan. Heliyon 2022; 8:e09752. [PMID: 35800254 PMCID: PMC9253920 DOI: 10.1016/j.heliyon.2022.e09752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/22/2022] [Accepted: 06/15/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Ibtisam M. Al-Zaru
- Adult Health Nursing Department, Faculty of Nursing/ WHO Collaborating Center, Jordan University of Science and Technology, P.O. Box: 3030, Irbid, 22110, Jordan
- Corresponding author.
| | - Ghada Shahrour
- Community and Mental Health Department, Faculty of Nursing/ WHO Collaborating Center, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Dina Masha'al
- Adult Health Nursing Department, Faculty of Nursing/ WHO Collaborating Center, Jordan University of Science and Technology, P.O. Box: 3030, Irbid, 22110, Jordan
| | - Audai A. Hayajneh
- Adult Health Nursing Department, Faculty of Nursing/ WHO Collaborating Center, Jordan University of Science and Technology, P.O. Box: 3030, Irbid, 22110, Jordan
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Ghaddar F, Zeidan RK, Salameh P, Tatari S, Achkouty G, Maupas-Schwalm F. Risk Factors for Coronary Heart Disease Among Lebanese Women: A Case–Control Study. Vasc Health Risk Manag 2022; 18:297-311. [PMID: 35464735 PMCID: PMC9021001 DOI: 10.2147/vhrm.s350108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/30/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Women are increasingly concerned by coronary heart disease (CHD), with peculiarities of their own, particularly concerning risk factors. The aim of the study was to assess the risk factors for CHD in Lebanese women over forty. Patients and Methods A case–control study was carried out in 6 hospitals in Beirut and Mount-Lebanon, from December 2018 to December 2019 including 1500 patients (1200 controls and 300 cases). Women were stratified into pre- and post-menopausal groups. Personal and medical data were collected from hospital records and during an interview where validated questionnaires were used. Binary logistic regressions were performed to investigate potential predictors of CHD in the 2 groups. Results In post-menopausal women, dyslipidemia (adjusted odds ratio [aOR], 3.018; 95% confidence interval, 2.102–4.332), hypertension (aOR: 2.449, [1.386–4.327]), a family history of CHD (aOR: 2.724, [1.949–3.808]), cigarette smoking (aOR: 2.317, [1.574–3.410]) and common non-rheumatic joint pain (aOR: 1.457, [1.053–2.016]) were strongly associated with CHD. Conversely, living in Mount Lebanon seemed protective, compared to Beirut (aOR: 0.589, [0.406–0.854]), as well as having a moderate monthly income (aOR: 0.450, [0.220–0.923]), adhering to a Mediterranean diet (aOR: 0.965, [0.936–0.994]), and practicing physical activity [PA] (aOR: 0.396, [0.206–0.759] and 0.725, [0.529–0.992], respectively for high and moderate vs low PA). In pre-menopausal women, dyslipidemia (aOR: 6.938, [1.835–26.224]), hypertension (aOR: 6.195, [1.318–29.119]), family histories of dyslipidemia (aOR: 6.143, [1.560–24.191]) and CHD (aOR: 4.739, [1.336–16.805]) reached statistical significance. Conclusion The identification of factors associated with CHD in women, some of which are frequent and trivialized in post-menopause, underlines the need to put in place specific and dedicated CHD prevention strategies in women.
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Affiliation(s)
- Fatima Ghaddar
- Doctoral School of Biology Health and Biotechnologies, Toulouse University, Toulouse, France
- Correspondence: Fatima Ghaddar, Doctoral school of Biology Health and Biotechnologies, Toulouse University, Toulouse, France, Tel +32 470 53 71 52, Email
| | - Rouba K Zeidan
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Public Health II, Lebanese University, Mount-Lebanon, Lebanon
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon
- CERIPH, Center for Research in Public Health, Faculty of Public Health, Lebanese University, Mount-Lebanon, Lebanon
| | - Pascale Salameh
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon
- Department of Research, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
- School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Souzan Tatari
- Cardiology department, Rafik Hariri University Hospital, Beirut, Lebanon
| | - Guy Achkouty
- Cardiology Department, Mount Lebanon University Hospital, Mount-Lebanon, Lebanon
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El-Ali Z, El-Kassas G, Ziade FM, Shivappa N, Hébert JR, Zmerly H, Bissar N. Evaluation of circulating levels of Interleukin-10 and Interleukin-16 and dietary inflammatory index in Lebanese knee osteoarthritis patients. Heliyon 2021; 7:e07551. [PMID: 34337179 PMCID: PMC8318856 DOI: 10.1016/j.heliyon.2021.e07551] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/28/2021] [Accepted: 07/08/2021] [Indexed: 01/15/2023] Open
Abstract
Objectives To investigate plasma concentrations of Interleukin-16 (IL-16) and Interleukin-10 (IL-10) in Lebanese knee osteoarthritis (KOA) patients and to examine the association between the diet-associated inflammation and increased risk for KOA. Methods A total of 208 study participants were assigned to one of the 3 groups: Diagnosed Knee Osteoarthritis group (DKOA) (N = 78); Undiagnosed Knee Osteoarthritis group (UKOA) (N = 60) and controls matched on age, sex and sociodemographic characteristics (N = 70). UKOA represents KOA features before they are altered by therapeutic intervention and lifestyle modifications that follow the diagnosis. Energy-adjusted dietary inflammatory index (E-DII™) scores were calculated using 2-day 24-hour recalls. IL-10 and IL-16 were measured using commercially available sandwich enzyme-linked immunosorbent assay kits. Results The UKOA group and controls did not show any significant difference in plasma IL-16 levels (p = 0.28), whereas significantly higher levels of IL-10 were observed in the UKOA group compared to controls (21 ± 41 vs 7.5 ± 12 pg/mL; p = 0.01). The UKOA group had significantly higher IL-16 levels compared to the DKOA group (177 ± 215 vs 80 ± 57 pg/ml; p = 0.001) and significantly higher IL-10 levels compared to the DKOA group (21 ± 41 vs 8 ± 14 pg/mL; p = 0.02). Significantly higher levels of IL-16 were observed in the control group compared to the DKOA group (140 ± 161 vs 80 ± 57 pg/ml; p = 0.009) whereas the DKOA group and controls did not show any significant difference in plasma IL-10 levels (p = 0.82). Additionally, we found significantly higher E-DII scores in the UKOA group compared to controls (0.53 ± 1.028 vs 0.04 ± 1.580; p = 0.04) and in the UKOA group compared to the DKOA group (0.53 ± 1.028 vs -0.37 ± 1.899; p = 0.001). However, there was significant difference in E-DII scores between the DKOA group and controls (p = 0.16). Conclusions Our findings indicate an association between circulating levels of IL-10 and KOA in Lebanese population, and a potential role of pro-inflammatory diet in KOA pathology. We did not find an association between circulating levels of IL-16 and KOA.
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Affiliation(s)
- Zeina El-Ali
- Department of Biological Sciences, Faculty of Science, Beirut Arab University, Lebanon
| | - Germine El-Kassas
- Head of Clinical Nutrition Department, Saudi German Hospital Cairo, Egypt
| | - Fouad M Ziade
- Faculty of Public Health III, Lebanese University, Tripoli, Lebanon
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - James R Hébert
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Hassan Zmerly
- Villa Erbosa Hospital, Bologna, Italy.,UCM Malta - Ludes Lugano Campus, Switzerland
| | - Nisrine Bissar
- Faculty of Health Sciences, Beirut Arab University, Lebanon
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Alghamdi AS, Alzahrani MS, Alsolami BM, Thabet SA, Alghamdi BS, Kinsara AJ. A Community-Based, Cross-Sectional Study Assessing the Level of Awareness and Insight Related to Cardiovascular Diseases. Cureus 2021; 13:e15681. [PMID: 34277271 PMCID: PMC8281779 DOI: 10.7759/cureus.15681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 11/16/2022] Open
Abstract
Objective The disease outcome had been shown to improve with improving patient knowledge. The study had two objectives, firstly to assess the level of knowledge about cardiovascular diseases (CVDs) in the general population, and secondly, to provide written educational material regarding the risk factors, major symptoms, and the prevention of CVDs. Method The target population was the residents living in the Western region of Saudi Arabia, aged 18 years and above. All were invited to participate voluntarily. A pre-structured questionnaire was designed to collect data related to age, gender, marital status, education level, occupation, lifestyle habits, and a history of heart diseases, as well as cardiac symptoms, and risk factors. The educational material was provided after the questionnaire. Results The majority of the participants were female (74.8%). The risk factors most frequently identified were lack of exercise, stress, and obesity. Chest pain was recognized as a major symptom (87.6%). Other symptoms included dyspnea, syncope, and excessive sweating. The level of knowledge regarding the risk factors for cardiovascular disease was poor. Only 18.5% were knowledgeable about the risk factors. The majority (60%) could identify the preventable factors, including smoking cessation (92.2%), a high level of cholesterol (88.6%), and hypertension (78.7%). The majority (83.7%) read the educational material and 99% reported that the lecture increased their knowledge about cardiovascular disease. Conclusion Although cardiovascular risk factors are common, there is a big gap in the knowledge in our population. Further, alarming symptoms that bring the patients to medical care are also deficient. A call for action at different levels is urgent. Simple educational material in a basic language and virtual education are useful and cheap tools that must be practiced wherever possible. Education is welcomed by the participants.
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Affiliation(s)
- Ali S Alghamdi
- Internal Medicine, College of Medicine-Western Region, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Jeddah, SAU
| | - Muhanad S Alzahrani
- Internal Medicine, College of Medicine-Western Region, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Basel M Alsolami
- Internal Medicine, College of Medicine-Western Region, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Salman A Thabet
- Internal Medicine, College of Medicine-Western Region, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Basel S Alghamdi
- Internal Medicine, College of Medicine-Western Region, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Abdulhalim J Kinsara
- Cardiology, College of Medicine-Western Region, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Jeddah, SAU
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Shim J, Kim K. Factors Affecting the Intention to Modify Lifestyle in the Cardiovascular Disease Risk Group in Korea. Healthcare (Basel) 2021; 9:healthcare9050496. [PMID: 33922181 PMCID: PMC8145458 DOI: 10.3390/healthcare9050496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/20/2021] [Accepted: 04/20/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to identify people at risk of cardiovascular diseases (CVD) using the Framingham risk score (FRS) and to examine their willingness to modify their lifestyle. A descriptive correlational study with 1229 participants, aged 30-74 years, without cardiovascular or cerebrovascular diseases who visited a health examination center in South Korea was conducted. Of 1229 participants, 455 were identified as high risk for CVD with an FRS of 10 or higher. A logistic regression analysis confirmed age, sex, muscle training, and weekly drinking frequency as predictors of intention to quit smoking; age, smoking, and waist to height ratio (WHtR) as predictors of intention to quit drinking; sex and WHtR as predictors of intention to engage in physical exercise; and hypertension and body mass index as predictors of intention of muscle training. People at high risk for CVD lack willingness to modify their lifestyle, and aggressive, customized intervention is needed to promote lifestyle modification.
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Affiliation(s)
- JaeLan Shim
- Department of Nursing, Dongguk University, Seoul 38066, Korea
| | - KyungAe Kim
- College of Nursing, Kyungdong University, Wonju 26495, Korea
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Alruways AFH, Alotaibi NA, Rashikh MA, Alnufeie AA, Alshammari YJD, Alharthy MR, Alanazi FJM. Awareness and prevalence of coronary artery disease risk factors among Saudi adults in Dawadmi, Riyadh province: A cross-sectional study. J Family Med Prim Care 2021; 9:5629-5637. [PMID: 33532406 PMCID: PMC7842469 DOI: 10.4103/jfmpc.jfmpc_934_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 08/31/2020] [Accepted: 09/22/2020] [Indexed: 12/01/2022] Open
Abstract
Objective: Coronary artery disease (CAD) is one of the leading causes of death and disability worldwide. Amongst the Middle East countries, Saudi Arabia is facing rapid progressive urbanization by the adoption of a westernized lifestyle and food habits, which contribute to the rising burden of CAD. We aim to evaluate the awareness and prevalence of CAD risk factors among Saudi adults. Methods: This was a cross-sectional study conducted between January and March 2020. Data were collected through an online survey using a self-administered questionnaire. Data assessed on socio-demographic variables, family history of CAD, knowledge of risk factors, symptoms, and complications of CAD. Results data were entered and analyzed using IBM SPSS statistics, version 25. All comparisons were considered significant at P < 0.05. Results: A total of 311 subjects (48.6% men and 51.4% women) included, and most of the participants were between 18 and 25 years. A majority of the participants did not hear about CAD (82%) and unaware of any risk factors (26.4%), symptoms (25.1%), and complications (72.7%) of CAD. The prevalence of a family history of CAD (9.3%), overweight/obesity (58.6%), physical inactivity (79.1%), and smoking (24.1%) observed considerably high among the participants. Conclusion: The present study reveals that a significantly low level of awareness and a high prevalence of CAD risk factors found among Saudi adults. Therefore, the awareness program is needed at the public level to increase the knowledge of CAD risk factors so that persons with high risk for future CAD can be prevented.
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Li Z, Zhao T, Tan X, Lei S, Huang L, Yang L. Polymorphisms in PCSK9, LDLR, BCMO1, SLC12A3, and KCNJ1 are Associated with Serum Lipid Profile in Chinese Han Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3207. [PMID: 31480784 PMCID: PMC6747169 DOI: 10.3390/ijerph16173207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 08/30/2019] [Accepted: 08/31/2019] [Indexed: 12/14/2022]
Abstract
Unfavorable serum lipid levels are the most important risk factors for coronary artery disease (CAD), cerebral infarction, and other cardiovascular and cerebrovascular diseases. This study included 2323 Han Chinese in southern China. We collected medical reports, lifestyle details, and blood samples of individuals and used the polymerase chain reaction-ligase detection reaction method to genotype single-nucleotide polymorphisms (SNPs). Two SNPs showed a strong evidence of association with total cholesterol (TC): rs1003723 and rs6413504 in the low-density lipoproteins receptor (LDLR). Two SNPs in LDLR showed a strong evidence of association with low-density lipoprotein cholesterol (LDL-C), rs1003723 and rs6413504. Two SNPs showed a strong evidence of association with triglycerides (TG), namely, rs662145 in pro-protein convertase subtilisin-kexin type 9 (PCSK9) and rs11643718 in the solute carrier family 12 member 3 (SLC12A3). For the TC, LDL-C, and TG levels, these SNPs generated strong combined effects on these lipid levels. For each additional dangerous gene, TC increased by 0.085 mmol/L (p = 7.00 × 10-6), and LDL-C increased by 0.075 mmol/L (p = 9.00 × 10-6). The TG increased by 0.096 mmol/L (p = 2.90 × 10-5). Compared with those bearing no risk alleles, the risk of hypertriglyceridemia, hypercholesterolemia, and dyslipidemia increased in those with two or more risk alleles and one risk gene. Polymorphisms of PCSK9, LDLR, and SLC12A3 were associated with the plasma lipid levels in people in southern China. These results provide a theoretical basis for gene screening and the prevention of dyslipidemia.
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Affiliation(s)
- Zheng Li
- Medical School, Hangzhou Normal University, Hangzhou 310000, China
| | - Tianyu Zhao
- Medical School, Hangzhou Normal University, Hangzhou 310000, China
- Medical School, Shihezi University, Shihezi 832000, China
| | - Xiaohua Tan
- Medical School, Hangzhou Normal University, Hangzhou 310000, China
| | - Song Lei
- Medical School, Hangzhou Normal University, Hangzhou 310000, China
- Medical School, Shihezi University, Shihezi 832000, China
| | - Liu Huang
- Medical School, Hangzhou Normal University, Hangzhou 310000, China
| | - Lei Yang
- Medical School, Hangzhou Normal University, Hangzhou 310000, China.
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Slepecky M, Kotianova A, Prasko J, Majercak I, Kotian M, Gyorgyova E, Zatkova M, Chupacova M, Ociskova M, Sollar T. Relation of personality factors and life events to waist/height ratio and percentage of visceral fat in women and men. Psychol Res Behav Manag 2019; 12:499-511. [PMID: 31308771 PMCID: PMC6613611 DOI: 10.2147/prbm.s214303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 05/30/2019] [Indexed: 12/19/2022] Open
Abstract
PURPOSE The investigation aimed to explore the association between personality traits, stressful life events, quality of life on anthropometric characteristics (waist/height ratio and percentage of visceral fat). METHOD A total of 227 participants took part in this cross-sectional study. Participants completed the Social Readjustment Rating Scale (SRRS), Temperament and Character Inventory-Revised, Type-D Scale (DS-14), EuroQol Group 5-Dimension Self-Report Questionnaire (EQ-5D), and demographic questionnaire. Two anthropometric parameters were measured: Waist/height ratio and Percentage of the visceral fat. RESULTS The average age of participants was 39.6±12.9 years, 60.4% women. The 41.8% of participants were overweight or obese. Regression analysis found a significant link between Harm-avoidance and EQ-5D visual analog scale (VAS) with Waist/height ratio in women and Reward dependence and Cooperativeness with Waist/height ratio in men. In regression analysis, the score of life events (SRRS) has statistically significant linked to Percentage of the visceral fat in women. The regression analysis also found a significant link between Novelty seeking, DS14, Negative affectivity, and EQ-5D VAS with Percentage of the visceral fat in women. CONCLUSION Significant associations between live events, personality traits, and body anthropometric measures were recognized. The differences were recognized between women and men. Outcomes propose some promising tools by which personality factors may influence overweight and obesity.
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Affiliation(s)
- Milos Slepecky
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic
| | - Antonia Kotianova
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic
| | - Jan Prasko
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic.,Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc 77520, The Czech Republic
| | - Ivan Majercak
- 1st Department of Internal Medicine, Faculty of Medicine, Pavol Josef Safarik University in Košice, Košice, The Slovak Republic.,Internal Medicine and Cardiology, Private practice MUDr Ivan Majercak, Košice, The Slovak Republic
| | - Michal Kotian
- Department of clinical psychology, Psychagogia, Liptovsky Mikulas, 03101, The Slovak Republic
| | - Erika Gyorgyova
- Internal Medicine and Cardiology, Private practice MUDr Ivan Majercak, Košice, The Slovak Republic
| | - Marta Zatkova
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic
| | - Michaela Chupacova
- Department of clinical psychology, Psychagogia, Liptovsky Mikulas, 03101, The Slovak Republic
| | - Marie Ociskova
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc 77520, The Czech Republic
| | - Tomas Sollar
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic.,Institute of Applied Psychology, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic
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