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Evans S, Olive L, Dober M, Knowles S, Fuller-Tyszkiewicz M, O E, Gibson P, Raven L, Gearry R, McCombie A, van Niekerk L, Chesterman S, Romano D, Mikocka-Walus A. Acceptance commitment therapy (ACT) for psychological distress associated with inflammatory bowel disease (IBD): protocol for a feasibility trial of the ACTforIBD programme. BMJ Open 2022; 12:e060272. [PMID: 35688593 PMCID: PMC9189839 DOI: 10.1136/bmjopen-2021-060272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Inflammatory bowel disease (IBD) involves an abnormal immune response to healthy gut bacteria. When a person develops IBD, their susceptibility to anxiety and/or depression increases. The ACTforIBD programme, specifically designed for people with IBD and comorbid psychological distress, draws on acceptance and commitment therapy (ACT), which promotes acceptance of situations that cannot be solved such as persistent physical symptoms. There are no ACT trials for IBD using an active control group or a telemedicine approach, which is important to improve accessibility, particularly in the context of the ongoing COVID-19 pandemic. The ACTforIBD programme is administered online with a 4-hour therapist involvement per participant only; if successful it can be widely implemented to improve the well-being of many individuals with IBD. METHODS AND ANALYSIS Our team have codesigned with consumers the ACTforIBD programme, an 8-week intervention of 1-hour sessions, with the first three sessions and the last session delivered one-to-one by a psychologist, and the other sessions self-directed online. This study aims to evaluate the feasibility and preliminary efficacy of ACTforIBD to reduce psychological distress in patients with IBD. Using a randomised controlled trial, 25 participants will be randomised to ACTforIBD, and 25 patients to an active control condition. ETHICS AND DISSEMINATION This protocol has been approved by Deakin University Research Ethics Committee in September 2021 (Ref. 2021-263) and the New Zealand Central Health and Disability Ethics Committee in December 2021 (Ref. 2021 EXP 11384). The results of this research will be published in peer-reviewed journals and shared with various stakeholders, including community members, policy-makers and researchers, through local and international conferences. TRIAL REGISTRATION NUMBER ACTRN12621001316897.
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Affiliation(s)
- Subhadra Evans
- Psychology, Deakin University Faculty of Health, Burwood, Victoria, Australia
| | - Lisa Olive
- School of Pyschology, Deakin, Geelong, Victoria, Australia
| | - Madeleine Dober
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Simon Knowles
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | | | - Eric O
- Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Peter Gibson
- Gastroenterology, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
| | - Leanne Raven
- Crohn's and Colitis Australia, Camberwell, Victoria, Australia
| | - Richard Gearry
- Department of Medicine, Christchurch School of Medicine and Health Sciences, Medicine, Christchurch, New Zealand
| | - Andrew McCombie
- Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Leesa van Niekerk
- School of Psychological Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | | | - Daniel Romano
- School of Pyschology, Deakin, Geelong, Victoria, Australia
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Ma C. Rehospitalisation rates and associated factors within 6 months after hospital discharge for patients with chronic heart failure: A longitudinal observational study. J Clin Nurs 2019; 28:2526-2536. [DOI: 10.1111/jocn.14830] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 01/21/2019] [Accepted: 02/09/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Chunhua Ma
- School of Nursing; Guangzhou Medical University; Guangzhou China
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A journey through chaos and calmness: experiences of mindfulness training in patients with depressive symptoms after a recent coronary event - a qualitative diary content analysis. BMC Psychol 2018; 6:46. [PMID: 30213276 PMCID: PMC6136221 DOI: 10.1186/s40359-018-0252-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 07/24/2018] [Indexed: 12/18/2022] Open
Abstract
Background Psychological distress with symptoms of depression and anxiety is common and unrecognized in patients with coronary artery disease (CAD). Efforts have been made to treat psychological distress in CAD with both conventional methods, such as antidepressant drugs and psychotherapy, and non-conventional methods, such as stress management courses. However, studies focusing on the experiences of mindfulness training in this population are still scarce. Therefore, the aim of this study was to explore immediate experiences of mindfulness practice among CAD patients with depressive symptoms. Methods A qualitative content analysis of diary entries, written immediately after practice sessions and continuously during an 8-week long Mindfulness Based Stress Reduction course (MBSR), was applied. Results Twelve respondents participated in the study. The main category: a journey through chaos and calmness captured the participants’ concurrent experiences of challenges and rewards over time. This journey appears to reflect a progressive development culminating in the harvesting of the fruits of practice at the end of the mindfulness training. Descriptions of various challenging facets of mindfulness practice – both physical and psychological - commonly occurred during the whole course, although distressing experiences were more predominant during the first half. Furthermore, the diary entries showed a wide variety of ways of dealing with these struggles, including both constructive and less constructive strategies of facing difficult experiences. As the weeks passed, participants more frequently described an enhanced ability to concentrate, relax and deal with distractions. They also developed their capacity to observe the content of their mind and described how the practice began to yield rewards in the form of well-being and a sense of mastery. Conclusions Introducing MBSR in the aftermath of a cardiac event, when depressive symptoms are present, is a complex and delicate challenge in clinical practice. More nuanced information about what to expect as well as the addition of motivational support and skillful guidance during the course should be given in accordance with the participants’ experiences and needs. Trial registration The trial was retrospectively registered in clinicaltrials.gov (registration number: NCT03340948). Electronic supplementary material The online version of this article (10.1186/s40359-018-0252-1) contains supplementary material, which is available to authorized users.
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Donnelly TT, Al Suwaidi JM, Al-Qahtani A, Asaad N, Singh R. Arab Men and Women's Conceptualization of Mental Health and Depression: A Qualitative Study from the Middle East. J Immigr Minor Health 2018; 21:1102-1114. [PMID: 30120675 DOI: 10.1007/s10903-018-0809-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cardiovascular diseases are the leading cause of death worldwide. Among cardiovascular patients, depression is associated with an increased morbidity and mortality. Understanding how depression is conceptualized from cardiovascular patients' perspective can help with prevention, early detection, and treatment for depression. This might reduce cardiovascular morbidity and mortality, and save health care costs. To the best of our knowledge, there is no study in the Gulf region exploring depression among Arab cardiovascular patients. The purpose of this exploratory ethnographic qualitative research is to investigate how Arab male and female patients with cardiovascular disease conceptualize mental health and depression. Two theoretical frameworks guided this research: (1) The Ecological Perspective, and (2) Kleinman's Explanatory Model of Health and Illness. Using maximum variation purposive sampling, thirty (30) male and twenty-five (25) female, self-identified, Arab cardiovascular patients were recruited as research participants. Individual in-depth interviews were conducted using a semi-structured questionnaire. Thematic analysis was performed to generate themes. Nvivo 10, a qualitative data analysis software, was used to organize the narrative data. The participants in this study placed great emphasis on the manifestations of mental illness and their impact on both themselves and their families. Four major themes were identified from their narratives: psychological and physical disturbances; unfavorable personal characteristics; work issues and financial constraints; lack of family and social support. The knowledge generated in this study might help increase awareness, prevention of and treatment for depression among cardiovascular patients in Qatar. The findings from this study can also be used to inform a multi-disciplinary and multi-sectoral intervention approach that is contextualized to meet the mental health care needs of Arab cardiovascular patients, thus reducing cardiovascular diseases morbidity and mortality in Qatar and the Gulf region.
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Affiliation(s)
- Tam Truong Donnelly
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada.
- Cumming School of Medicine, Community Health Sciences, University of Calgary, PF 2234, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
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Navidian A, Mobaraki H, Shakiba M. The effect of education through motivational interviewing compared with conventional education on self-care behaviors in heart failure patients with depression. PATIENT EDUCATION AND COUNSELING 2017; 100:1499-1504. [PMID: 28262273 DOI: 10.1016/j.pec.2017.02.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 02/22/2017] [Accepted: 02/24/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To determine the effect of education based on motivational interviewing on self-care behaviors in heart failure patients with depression. METHODS In this study, 82 patients suffering from heart failure whose depression had been confirmed were selected and divided into two groups. The Self-Care Heart Failure Index was utilized to evaluate self-care behavior. The intervention group received four sessions of self-care behavior education based on the principles of motivational interviewing, and the control group received four sessions of conventional education on self-care behavior. At 8 weeks after finishing the interventions, the self-care behaviors of both groups were evaluated. Data were analyzed using paired and independent t-tests, Chi-square, and analysis of covariance, as appropriate. RESULTS The average increase in the overall scores and the scores on the three sub-scales of self-care behavior (maintenance, management, and confidence) of the heart failure patients with depression were significantly higher after education based on motivational interviewing than after conventional self-care education (p<0.05). CONCLUSIONS Motivational interviewing had a significant positive effect on self-care behaviors in patients with heart failure and depression. PRACTICE IMPLICATIONS Due to the effectiveness of the MI, using motivational interviewing for education in depressed HF patients is recommended.
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Affiliation(s)
- Ali Navidian
- Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
| | | | - Mansour Shakiba
- Department of Psychiatry, Zahedan University of Medical Sciences, Zahedan, Iran.
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Donnelly TT, Al Suwaidi JM, Al-Qahtani A, Asaad N, Qader NA, Singh R, Fung TS, Mueed I, Sharara S, El Banna N, Omar S. Depression in Cardiovascular Patients in Middle Eastern Populations: A Literature Review. J Immigr Minor Health 2016; 17:1259-76. [PMID: 24923859 DOI: 10.1007/s10903-014-0052-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Cardiovascular disease (CVD) is increasing in Middle Eastern countries. Depression is associated with increased morbidity and mortality rates among cardiovascular (CV) patients. Early detection of and intervention for depression among CV patients can reduce morbidity and mortality and save health care costs. Public information on mental health care needs of Arab CV patients living in Middle East regions is scattered and limited. This literature review surveyed and summarized research studies to learn what is known about the relationship between depression and CVD in Middle Eastern populations. The information will raise awareness among health care professionals and policy makers regarding the clinical significance of depression in Arab CV patients. It might contribute to development of culturally appropriate and effective mental health care services. Multiple databases were searched and 60 articles were assessed, including studies that investigated depression in Arab CV patient populations, physiological mechanisms of depression-CVD comorbidity, and intervention strategies that affect CV risk in depressed Arab patients. We discuss the extent to which this issue has been explored in Arab populations living in Middle East regions and Arab populations living abroad. We recommend that more comprehensive and in-depth research studies be conducted with Arab cardiac patients to enable implementation of culturally appropriate and effective mental health care interventions.
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Affiliation(s)
- Tam Truong Donnelly
- University of Calgary-Qatar, P.O. Box 23133, Al Rayyan Campus, Al Forousiya Road, Doha, Qatar,
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Psychological resources are associated with reduced incidence of coronary heart disease. An 8-year follow-up of a community-based Swedish sample. Int J Behav Med 2015; 22:77-84. [PMID: 24430130 PMCID: PMC4311061 DOI: 10.1007/s12529-014-9387-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND A large number of studies have provided clear evidence for a link between the risk of coronary heart disease and psychological risk factors. Much less attention has been given to the potential protective effect of psychological resources. PURPOSE The major aim of this study was to investigate the independent association between psychological resources and incidence of coronary heart disease (CHD) in an 8-year follow-up study of a Swedish community-based cohort. METHODS The cohort consisted of 484 men and 497 women, aged 45-69 years at baseline. The incidence of first-time major event of CHD was analysed in relation to baseline levels of psychological resources, including mastery, self-esteem, and sense of coherence as well as psychological risk factors including cynicism and hostile affect, vital exhaustion, hopelessness, and depressive symptoms. In Cox proportional hazard models, adjustments were made for age, sex, eight traditional cardiovascular risk factors, and depressive symptoms. RESULTS A total of 56 CHD events had occurred after the 8-year follow-up. After adjustment for age, sex, and eight traditional risk factors, a significantly decreased risk of CHD was found for mastery (HR 0.62 per SD, p = 0.003), self-esteem (HR 0.64, p = 0.004), and sense of coherence (HR 0.70, p = 0.031). An increased risk of CHD was found for vital exhaustion (HR 1.46, p = 0.014), hopelessness (HR 1.59, p = 0.003), and depressive symptoms (HR 1.45, p = 0.009). After further adjustment for depressive symptoms, significant associations remained for mastery (HR 0.67, p = 0.034), self-esteem (HR 0.69, p = 0.048), and hopelessness (HR 1.48, p = 0.023). CONCLUSIONS The psychological resources, mastery and self-esteem, showed robust protective effects on CHD, also after adjustment for established risk factors as well as depressive symptoms. In parallel, hopelessness was an independent risk factor for CHD. The results may have implications for novel approaches in preventive efforts.
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Hendryx M, Innes-Wimsatt KA. Increased Risk of Depression for People Living in Coal Mining Areas of Central Appalachia. ECOPSYCHOLOGY 2013. [DOI: 10.1089/eco.2013.0029] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Michael Hendryx
- Department of Health Policy, Management and Leadership, School of Public Health, West Virginia University, Morgantown, West Virginia
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Davidson KW. Depression and coronary heart disease. ISRN CARDIOLOGY 2012; 2012:743813. [PMID: 23227360 PMCID: PMC3514821 DOI: 10.5402/2012/743813] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 10/14/2012] [Indexed: 12/28/2022]
Abstract
There are exciting findings in the field of depression and coronary heart disease. Whether diagnosed or simply self-reported, depression continues to mark very high risk for a recurrent acute coronary syndrome or for death in patients with coronary heart disease. Many intriguing mechanisms have been posited to be implicated in the association between depression and heart disease, and randomized controlled trials of depression treatment are beginning to delineate the types of depression management strategies that may benefit the many coronary heart disease patients with depression.
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Affiliation(s)
- Karina W Davidson
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University, New York, NY 10032, USA
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Excess health care service utilization and costs associated with underrecognition of psychiatric comorbidity in a medical/surgical inpatient setting. Qual Manag Health Care 2011; 20:98-102. [PMID: 21467896 DOI: 10.1097/qmh.0b013e3182134af0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Psychiatric comorbidity is common among chronically medically ill populations and the presence of psychiatric conditions tends to be associated with increased costs and excess utilization of general medical services. The purpose of this pilot investigation was to determine whether differences in nonpsychiatric inpatient hospitalization frequency, duration, and costs existed between patients receiving outpatient psychiatric treatment and patients without identified psychiatric problems. Length of stay and cost information for patients that had at least 1 inpatient medical/surgical hospitalization during a 6-month period was extracted from the hospital's inpatient billing database (n = 10,865). The medical record numbers of these patients were then cross-referenced against the outpatient psychiatry-billing database for the same 6-month period, thereby identifying all patients that had both a nonpsychiatric inpatient hospitalization and an outpatient psychiatry visit (n = 149). Patients identified as having outpatient psychiatry involvement had significantly more nonpsychiatric hospitalizations on average (mean = 1.60) than nonpsychiatric patients (mean = 1.34) during the study period (t4381 = 2.94, P = .003). There was no difference in the total costs associated with these hospitalizations between the 2 groups. Those that had a psychiatry consult during the nonpsychiatric hospitalization had a significantly higher length of stay and costs than those without. Thus, the criteria used to determine whether or not a psychiatry consultation is triggered, and the timing of the consultation request need further study.
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