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Wrzeciono A, Mazurek J, Cieślik B, Kiper P, Gajda R, Szczepańska-Gieracha J. Psychologically-enhanced cardiac rehabilitation for psychological and functional improvement in patients with cardiovascular disease: a systematic review with meta-analysis and future research directions. Physiotherapy 2024; 125:101412. [PMID: 39098055 DOI: 10.1016/j.physio.2024.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/24/2024] [Accepted: 07/03/2024] [Indexed: 08/06/2024]
Abstract
OBJECTIVE To systematically review the effectiveness of psychologically-enhanced cardiac rehabilitation (CR) in improving psychological and functional outcomes in patients with cardiovascular disease. DATA SOURCES A systematic search was performed in PubMed, Scopus, Cochrane Library, Embase, and Web of Science, up to January 31, 2024. STUDY SELECTION Two reviewers independently identified randomized clinical trials that evaluated the effectiveness of psychologically-enhanced CR in improving psychological and functional outcomes in patients with cardiovascular disease. The search yielded 1848 results. Finally, data from 14 studies (1531 participants) were included in the review. DATA EXTRACTION AND DATA SYNTHESIS Information regarding cardiac rehabilitation phase, duration of the intervention, group characteristics, measured outcomes, and the conclusions drawn by the authors was extracted. The Revised Cochrane risk-of-bias tool for Randomized Trials was used to evaluate the methodological quality. RESULTS Pooled results indicate that psychologically-enhanced CR is more effective than specific cardiac training alone in maintaining lower resting blood pressure, with a mean difference of -3.09 (95% CI: -5.18 to -1.00). Furthermore, psychologically-enhanced CR shows superiority in improving patients' quality of life compared to specific cardiac training alone, with a standardized mean difference of 0.15 (95% CI: 0.01 to 0.31). Analyses of depression and anxiety level, exercise tolerance, and blood lipid profile did not show significant differences between the two treatment conditions. CONCLUSION Psychologically-enhanced CR shows a positive effect on reducing resting blood pressure and improving the quality of life. However, the supportive methods were of limited effectiveness in addressing the psychological aspects of health. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42022304063. CONTRIBUTION OF THE PAPER.
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Affiliation(s)
- Adam Wrzeciono
- Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Justyna Mazurek
- University Rehabilitation Centre, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Błażej Cieślik
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venezia, Italy.
| | - Paweł Kiper
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venezia, Italy
| | - Robert Gajda
- Department of Kinesiology and Health Prevention, Jan Dlugosz University in Częstochowa, 42-200 Częstochowa, Poland; Center for Sports Cardiology at the Gajda-Med Medical Center in Pultusk, 06-102 Pultusk, Poland
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Mierzyńska A, Jaworska I, Piotrowicz R, Kowalik I, Pencina M, Opolski G, Zareba W, Banach M, Orzechowski P, Główczynska R, Szalewska D, Pluta S, Kalarus Z, Irzmanski R, Piotrowicz E. The Influence of Hybrid Comprehensive Telerehabilitation on Anxiety in Heart Failure Patients: The TELEREH-HF Randomized Clinical Trial. J Clin Psychol Med Settings 2024; 31:403-416. [PMID: 38108961 DOI: 10.1007/s10880-023-09985-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 12/19/2023]
Abstract
Telerehabilitation for heart failure (HF) patients is beneficial for physical functioning, prognosis, and psychological status. The study aimed at evaluating the influence of hybrid comprehensive telerehabilitation (HCTR) on the level of anxiety in comparison to usual care (UC). The TELEREH-HF study was a multicenter prospective RCT in 850 clinically stable HF participants. Patients underwent clinical examinations, including the assessment of anxiety, at entry and after the 9-week training program (HCTR) or observation (UC). The State-Trait Anxiety Inventory (STAI) was used. 20.3% HCTR and 20.1% UC patients reported high level of anxiety as a state at baseline, with higher STAI results in younger participants (< 63 y.o.) (p = .048 for HCTR; p = .026 for UC). At both stages of the study, patients with lower level of physical capacity (measured by a peak VO2) had shown significantly higher level of anxiety. There were no significant changes in anxiety levels during the 9-week observation for the entire study population, although there were different patterns of change in anxiety (both trait and state) in younger and older groups,with the decrease in younger patients, and the increase-in the older group.Trial registry number NCT02523560 (Clinical Trials.gov), date of registration: August 14, 2015.
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Affiliation(s)
- Anna Mierzyńska
- National Institute of Cardiology, 04-628, Warsaw, Poland.
- Department of Cardiac Surgery, Military Institute of Medicine - National Research Institute, 04-141, Warsaw, Poland.
| | - Izabela Jaworska
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Silesian Medical University, 41-800, Zabrze, Poland
| | - Ryszard Piotrowicz
- National Institute of Cardiology, 04-628, Warsaw, Poland
- College of Rehabilitation, 01-234, Warsaw, Poland
| | - Ilona Kowalik
- National Institute of Cardiology, 04-628, Warsaw, Poland
| | - Michael Pencina
- Duke University's School of Medicine, Durham, NC, 27710, USA
| | - Grzegorz Opolski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Wojciech Zareba
- University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Maciej Banach
- Department of Hypertension, Medical University of Łódź, 90-419, Łódź, Poland
| | - Piotr Orzechowski
- Telecardiology Center, National Institute of Cardiology, 04-628, Warsaw, Poland
| | - Renata Główczynska
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Dominika Szalewska
- Department of Rehabilitation Medicine, Medical University of Gdańsk, 80-210, Gdańsk, Poland
| | - Sławomir Pluta
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases, Silesian Medical University, 41-800, Zabrze, Poland
| | - Zbigniew Kalarus
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases, Silesian Medical University, 41-800, Zabrze, Poland
| | - Robert Irzmanski
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Łódź, 90-419, Łódź, Poland
| | - Ewa Piotrowicz
- Telecardiology Center, National Institute of Cardiology, 04-628, Warsaw, Poland
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Pietrabissa G, Marchesi G, Gondoni LA, Castelnuovo G. Exploring the Relationship of Anxiety and Depressive Symptoms and Impulsiveness with the Quality of Life of Older Patients with Cardiovascular Disease: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:646. [PMID: 38791860 PMCID: PMC11121691 DOI: 10.3390/ijerph21050646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 05/09/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND This study aimed to evaluate the relationship of selected clinical (i.e., body mass index, BMI) and psychological factors (i.e., anxiety, depression, and impulsiveness) with the quality of life (QoL) of elderly patients with cardiovascular disease (CVD) in a single clinical center in Italy. METHODS A total of 238 patients of older age (≥65 years) with CVD who voluntarily attended a single clinical center for weight loss and cardiac rehabilitation were sequentially recruited and tested upon admission to the hospital based on pre-established inclusion criteria. RESULTS The findings indicated that anxiety and depressive symptoms were moderately associated with lower QoL. Additionally, there were noteworthy but minor negative connections between impulsivity and QoL. Furthermore, BMI was inversely associated with the perceived QoL of the participants, and when incorporated into the regression analysis, BMI alone significantly accounted for 11.8% of the variability in QoL. This percentage increased to 18.4% with the inclusion of impulsiveness in the model and further to 34.3% with the addition of anxiety and depressive symptoms. However, after introducing anxiety and depression, the association between impulsivity and QoL ceased to be statistically significant. CONCLUSIONS Integrating the routine assessment and treatment of psychological factors into the care of older patients with CVD is important for optimizing their overall health outcomes and improving their QoL.
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Affiliation(s)
- Giada Pietrabissa
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (G.M.); (G.C.)
- Clinical Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, 28824 Oggebbio, Italy
| | - Gloria Marchesi
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (G.M.); (G.C.)
| | - Luca Alessandro Gondoni
- Division of Cardiological Rehabilitation, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, 28824 Oggebbio, Italy;
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (G.M.); (G.C.)
- Clinical Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, 28824 Oggebbio, Italy
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Ye C, Wang T, Wang H, Lian G, Xie L. Causal relationship between genetic proxies for calcium channel blockers and the risk of depression: a drug-target Mendelian randomization study. Front Psychiatry 2024; 15:1377705. [PMID: 38800057 PMCID: PMC11117141 DOI: 10.3389/fpsyt.2024.1377705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/17/2024] [Indexed: 05/29/2024] Open
Abstract
Background Calcium channel blockers (CCBs) are widely used in the clinical management of hypertension. Depression, a common comorbidity of hypertension, is an important issue in the management of hypertension. However, the impact of CCBs on depression risk remains controversial. We aim to investigate the causal effect of CCBs on depression through drug-target Mendelian randomization (MR) analysis. Methods To proxy CCBs, we utilized the genetic variations located in or around drug target genes that were related to systolic blood pressure (SBP). Coronary artery disease (CAD) served as the positive control outcome. Genetic summary data of SBP, CAD, and depression were obtained from genome-wide association studies (GWAS) based on European population. Inverse variance weighted (IVW) method was applied as the main analysis to estimate the causal effect. Cochran's Q test, MR-Egger intercept, MR pleiotropy residual sum and outlier (MR-PRESSO) and leave-one-out sensitivity analysis were used to test the robustness of the results. Meta-analysis was applied to further confirm whether causal relationships existed between CCBs and depression. Results The IVW results failed to reveal any causal relationship between genetic proxies for CCBs and depression (P > 0.05). Cochran's Q test showed no evidence of heterogeneity (P > 0.05). The MR-Egger intercept test suggested no evidence of directional pleiotropy, and the MR pleiotropy residual sum and outlier (MR-PRESSO) global test for horizontal pleiotropy was also not significant (P > 0.05). Leave-one-out analysis did not reveal any genetic variant that influenced the results. In addition, the meta-analysis further confirmed the absence of a causal relationship. Conclusion The present study indicates no association of genetic proxies for CCBs with depression. Further studies are necessary to provide definitive evidence.
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Affiliation(s)
- Chaoyi Ye
- Department of Geriatrics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- Branch of National Clinical Research Center for Aging and Medicine, Fujian Province, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Provincial Clinical Research Center for Geriatric Hypertension Disease, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Geriatrics, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Tingjun Wang
- Department of Geriatrics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Branch of National Clinical Research Center for Aging and Medicine, Fujian Province, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Provincial Clinical Research Center for Geriatric Hypertension Disease, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Geriatrics, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Huajun Wang
- Department of Geriatrics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Branch of National Clinical Research Center for Aging and Medicine, Fujian Province, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Provincial Clinical Research Center for Geriatric Hypertension Disease, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Geriatrics, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Guili Lian
- Department of Geriatrics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Branch of National Clinical Research Center for Aging and Medicine, Fujian Province, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Provincial Clinical Research Center for Geriatric Hypertension Disease, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Geriatrics, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Liangdi Xie
- Department of Geriatrics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Branch of National Clinical Research Center for Aging and Medicine, Fujian Province, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Provincial Clinical Research Center for Geriatric Hypertension Disease, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Geriatrics, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
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Bag Soytas R, Levinoff EJ, Smith L, Doventas A, Morais JA, Veronese N, Soysal P. Predictive Strategies to Reduce the Risk of Rehospitalization with a Focus on Frail Older Adults: A Narrative Review. EPIDEMIOLOGIA 2023; 4:382-407. [PMID: 37873884 PMCID: PMC10594531 DOI: 10.3390/epidemiologia4040035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 09/16/2023] [Accepted: 09/25/2023] [Indexed: 10/25/2023] Open
Abstract
Frailty is a geriatric syndrome that has physical, cognitive, psychological, social, and environmental components and is characterized by a decrease in physiological reserves. Frailty is associated with several adverse health outcomes such as an increase in rehospitalization rates, falls, delirium, incontinence, dependency on daily living activities, morbidity, and mortality. Older adults may become frailer with each hospitalization; thus, it is beneficial to develop and implement preventive strategies. The present review aims to highlight the epidemiological importance of frailty in rehospitalization and to compile predictive strategies and related interventions to prevent hospitalizations. Firstly, it is important to identify pre-frail and frail older adults using an instrument with high validity and reliability, which can be a practically applicable screening tool. Comprehensive geriatric assessment-based care is an important strategy known to reduce morbidity, mortality, and rehospitalization in older adults and aims to meet the needs of frail patients with a multidisciplinary approach and intervention that includes physiological, psychological, and social domains. Moreover, effective multimorbidity management, physical activity, nutritional support, preventing cognitive frailty, avoiding polypharmacy and anticholinergic drug burden, immunization, social support, and reducing the caregiver burden are other recommended predictive strategies to prevent post-discharge rehospitalization in frail older adults.
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Affiliation(s)
- Rabia Bag Soytas
- Department of Medicine, Division of Geriatric Medicine, McGill University, Montreal, QC H3G 1A4, Canada; (R.B.S.); (E.J.L.); (J.A.M.)
| | - Elise J. Levinoff
- Department of Medicine, Division of Geriatric Medicine, McGill University, Montreal, QC H3G 1A4, Canada; (R.B.S.); (E.J.L.); (J.A.M.)
| | - Lee Smith
- Center for Health Performance and Wellbeing, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK
| | - Alper Doventas
- Division of Geriatrics, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul 34320, Turkey;
| | - José A. Morais
- Department of Medicine, Division of Geriatric Medicine, McGill University, Montreal, QC H3G 1A4, Canada; (R.B.S.); (E.J.L.); (J.A.M.)
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, 90133 Palermo, Italy;
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34320, Turkey;
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Sumaqa YA, Hayajneh FA, Alhamory S, Rayan A, Alnaeem M, Al Tarawneh TR, Assaf Alrida NA, Abu-abbas M, Suhemat A, Ayasreh IR. Consequences of Psychological Aspects: From Jordanian Heart Failure Patients' Beliefs. SAGE Open Nurs 2023; 9:23779608231189128. [PMID: 37528905 PMCID: PMC10387668 DOI: 10.1177/23779608231189128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/14/2023] [Accepted: 06/27/2023] [Indexed: 08/03/2023] Open
Abstract
Introduction Psychological aspects are common in patients with heart failure (HF). Psychological aspects have negative consequences in patients with HF. Objective This study was conducted to gain a deeper understanding of the consequences of psychological aspects in Jordanian patients with HF. Methods This study is a qualitative study conducted with the participation of 24 patients with HF. Data were collected using semi-structured interviews. Results The main theme of the findings can be expressed as "Consequences of psychological aspects of HF." The following four sub-themes emerged from the data: social isolation, disturbance of feelings, being non-compliant, and growing burden on the health care system. Conclusion The findings revealed the need for informing healthcare providers about the negative consequences of psychological aspects and develop clinical guidelines to evaluate psychological aspects to support these patients.
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Affiliation(s)
| | | | | | - Ahmad Rayan
- Faculty of Nursing, Zarqa University, Zarqa, Jordan
| | | | | | | | | | - Aida Suhemat
- Faculty of Nursing, University of Mutah, Alkarak, Jordan
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Ma Q, Zhang FB, Yao ES, Pan S. Neutrophilic granulocyte percentage is associated with anxiety in Chinese hospitalized heart failure patients. BMC Cardiovasc Disord 2022; 22:494. [PMID: 36404328 PMCID: PMC9677905 DOI: 10.1186/s12872-022-02940-y] [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: 08/14/2022] [Accepted: 11/08/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND In patients with heart failure, anxiety disorder is common and associated with adverse prognosis. This study intended to find more confounding factors of Chinese heart failure patients. METHODS We enrolled 284 hospitalized heart failure patients, whose New York Heart Association (NYHA) classed as II-IV and left ventricular ejection fraction (LVEF) ≤ 45%. All the patients were scaled in Hamilton Rating Scale for Anxiety (14-items) (HAM-A14). Ordinal logistic regression analysis was performed to examine the association of correlated factors with anxiety disorder. RESULTS There were 184 patients had anxiety accounting for 64.8% of all 284 hospitalized heart failure patients. The neutrophilic granulocyte percentage, urea nitrogen, total bilirubin and brain natriuretic peptide were positively associated with HAM-A14 score, meanwhile, the hemoglobin, red blood cells counts, albumin and LVEF were negatively associated with HAM-A14 score (All P < 0.05). After the adjustments of sex, hemoglobin, urea nitrogen, total bilirubin, albumin and brain natriuretic peptide, the neutrophilic granulocyte percentage was significantly associated with anxiety (OR = 43.265, P = 0.012). The neutrophilic granulocyte percentage was 0.616 ± 0.111, 0.640 ± 0.102, 0.681 ± 0.106 and 0.683 ± 0.113 in heart failure patients with no anxiety, possible anxiety, confirmed anxiety and obvious anxiety, respectively. CONCLUSIONS Neutrophilic granulocyte percentage as well as the traditional risk factors such as sex, urea nitrogen and brain natriuretic peptide is associated with anxiety in hospitalized heart failure patients.
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Affiliation(s)
- Qian Ma
- grid.411680.a0000 0001 0514 4044First Department of Cardiology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang People’s Republic of China
| | - Feng-bo Zhang
- grid.412631.3The Clinical Laboratory Medical Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang People’s Republic of China
| | - En-sheng Yao
- grid.411680.a0000 0001 0514 4044Department of Neurology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang People’s Republic of China
| | - Shuo Pan
- Cardiovascular Department, People’s Hospital of Shaanxi Province, Xi’an, Shaanxi People’s Republic of China
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Anxiety in heart failure patients and its association with socio-demographic and clinical characteristics: a cross-sectional study. Porto Biomed J 2022; 7:e177. [PMID: 36186120 PMCID: PMC9521754 DOI: 10.1097/j.pbj.0000000000000177] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 12/12/2021] [Indexed: 11/26/2022] Open
Abstract
Anxiety is one of the most frequent psychiatric disorders in heart failure (HF) patients. However, it is often neglected in clinical practice and studies about the particular relationship with the New York Heart Association (NYHA) classes for HF are scarce. In this context, this study aims to analyze the presence of anxiety symptoms in HF outpatients and also its association with sociodemographic and clinical characteristics of these patients.
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Honzawa A, Nishitani-Yokoyama M, Shimada K, Kunimoto M, Matsubara T, Matsumori R, Kasuya H, Fujiwara K, Doi M, Takagi-Kawahara K, Abulimiti A, Xu J, Shimada A, Yamamoto T, Amano A, Asai T, Daida H, Minamino T. Effects of Phase II Cardiac Rehabilitation on Physical Function and Anxiety Levels in Frail Patients. Circ Rep 2022; 4:308-314. [PMID: 35860349 PMCID: PMC9257457 DOI: 10.1253/circrep.cr-22-0008] [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: 02/14/2022] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Frailty is an important prognostic factor in patients with cardiovascular diseases (CVD), and patients with CVD have a high rate of concurrent psycho-emotional stress, as well as depressive mood and anxiety symptoms. Despite this, few reports have examined the effects of the efficacy of Phase II cardiac rehabilitation (CR) in frail patients, including improvements in anxiety levels. Methods and Results: In all, 137 patients (mean [±SD] age 65.8±13.0 years; 71% male) who participated in Phase II CR and were assessed after CR completion were included in this study. Patients were evaluated using the Kihon Checklist (KCL) form at the beginning of CR and were divided into the 3 groups according to KCL scores: frail (n=34, 25%), pre-frail (n=40, 29%), and non-frail (n=63, 46%). Physical function and anxiety levels were compared among the 3 groups. The pre-frail and frail groups had significantly higher state anxiety and trait anxiety than the non-frail group (P<0.01). At the end of Phase II CR, all 3 groups showed significant improvements in the 6-min walking distance (P<0.05). State anxiety improved significantly in the non-frail and pre-frail groups, whereas trait anxiety only improved in the non-frail group. Conclusions: Physical function was improved in frail patients who participated in Phase II CR. However, there was no significant improvement in their level of anxiety.
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Affiliation(s)
- Akio Honzawa
- Cardiovascular Rehabilitation and Fitness, Juntendo University Hospital
| | | | - Kazunori Shimada
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Mitsuhiro Kunimoto
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Tomomi Matsubara
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Rie Matsumori
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Hiroki Kasuya
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Kei Fujiwara
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Mayumi Doi
- Cardiovascular Rehabilitation and Fitness, Juntendo University Hospital
| | | | - Abidan Abulimiti
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Jianying Xu
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Akie Shimada
- Department of Cardiovascular Surgery, Juntendo University Graduate School of Juntendo Medicine
| | - Taira Yamamoto
- Department of Cardiovascular Surgery, Juntendo University Graduate School of Juntendo Medicine
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University Graduate School of Juntendo Medicine
| | - Tohru Asai
- Department of Cardiovascular Surgery, Juntendo University Graduate School of Juntendo Medicine
| | - Hiroyuki Daida
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
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Jóźwik S, Wrzeciono A, Cieślik B, Kiper P, Szczepańska-Gieracha J, Gajda R. The Use of Virtual Therapy in Cardiac Rehabilitation of Male Patients with Coronary Heart Disease: A Randomized Pilot Study. Healthcare (Basel) 2022; 10:745. [PMID: 35455922 PMCID: PMC9031657 DOI: 10.3390/healthcare10040745] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/16/2022] Open
Abstract
The study aimed to evaluate the effectiveness of virtual reality therapy (VRT) in the treatment of anxiety-depressive disorders and in reducing stress levels in a group of men with coronary heart disease (CHD) participating in cardiac rehabilitation (CR). The study included 34 men with CHD who were assigned to the experimental group (EG) or the control group (CG). CR in the EG was supported by 8 VRT sessions, while CR in the CG was supplemented with 8 SAT sessions. Anxiety-depressive disorders were assessed using the Hospital Anxiety and Depression Scale (HADS). Perceived stress was assessed using the Perception of Stress Questionnaire (PSQ). In the EG, all measured parameters improved after the intervention. Significant reductions in HADS total score, the HADS-A, general stress score, emotional tension, and the external stress were obtained. In the CG, a deterioration in all measured parameters was observed. Significant changes were obtained in the general stress score and intrapsychic stress. The analysis between groups showed that the effectiveness of psychological interventions significantly differed between groups. The study results confirmed that supplementing standard CR with VRT leads to an improvement in the mental state of the patients and thus has a positive effect on the course of CR. However, the small sample size and high withdrawal rate prompt cautious interpretation of the results.
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Affiliation(s)
- Sandra Jóźwik
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, 51-612 Wroclaw, Poland; (S.J.); (A.W.); (J.S.-G.)
| | - Adam Wrzeciono
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, 51-612 Wroclaw, Poland; (S.J.); (A.W.); (J.S.-G.)
| | - Błażej Cieślik
- Department of Kinesiology and Health Prevention, Jan Dlugosz University in Częstochowa, 42-200 Częstochowa, Poland;
| | - Paweł Kiper
- Physical Medicine and Rehabilitation Unit, Azienda ULSS 3 Serenissima, 30126 Venice, Italy;
| | - Joanna Szczepańska-Gieracha
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, 51-612 Wroclaw, Poland; (S.J.); (A.W.); (J.S.-G.)
| | - Robert Gajda
- Department of Kinesiology and Health Prevention, Jan Dlugosz University in Częstochowa, 42-200 Częstochowa, Poland;
- Center for Sports Cardiology at the Gajda-Med Medical Center in Pultusk, 06-102 Pultusk, Poland
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11
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The Analysis of the Relationship between the Quality of Life Level and Expectations of Patients with Cardiovascular Diseases under the Home Care of Primary Care Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063300. [PMID: 35328988 PMCID: PMC8949918 DOI: 10.3390/ijerph19063300] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/06/2022] [Accepted: 03/09/2022] [Indexed: 02/04/2023]
Abstract
The World Health Organization defines quality of life as a person’s perception of his or her life situation in relation to the culture and value system in which he or she lives, in relation to and with respect to his or her functioning assumptions, expectations, and standards set by environmental conditions. Meeting the expectations of patients with CVD is one of the factors that positively influences their health status and leads to better diagnostic and treatment outcomes. The aim of this study was to answer three main questions related to patients with chronic cardiovascular disease: (1) What is their quality of life? (2) Are patients’ expectations about the quality of care provided by primary health care physicians/nurses met (and at what level)? (3) Is there a correlation between patients’ quality of life and their expectations of primary health care physicians/nurses? The study involved 193 Polish CVD patients who were cared for at home by a family nurse practitioner working in primary health care facilities. Data were collected from March 2016 to January 2017. The WHOQOL-BREF Quality of Life Questionnaire and the Author Interview Questionnaire were used for the study. Data analysis was based on the Spearman correlation coefficient test. There was a statistically significant association between patients’ expectations of the physician regarding information about the course of the disease and quality of life in the following domains: environmental r = 0.20, p = 0.006, psychological: r = 0.18, p = 0.015, physical: r = 0.18, p = 0.013, and social: r = 0.16, p = 0.025. Patients who did not expect the nurse to be courteous, understanding, or interested were found to have higher quality of life scores in psychological (r = −0.17, p = 0.023) and physical (r = −0.15, p = 0.044) domains. There was a statistically significant relationship between expectations of care from nurses regarding intimacy during care activities and the level of satisfaction with one’s own health (r = −0.15, p = 0.038) and quality of life (r = −0.14, p = 0.045), as well as quality of life in the domains of physical (r = 0.21, p = 0.004), social (r = 0.19, p = 0.010), and psychological (r = 0.16, p = 0.024). There is a need to define the expectations of patients with chronic cardiovascular disease in primary care, as lack of expectations of a physician/nurse continues to be associated with lower quality of life in all domains.
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12
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Sunayama T, Matsue Y, Dotare T, Maeda D, Iso T, Morisawa T, Saitoh M, Yokoyama M, Jujo K, Takahashi T, Minamino T. Multidomain Frailty as a Therapeutic Target in Elderly Patients with Heart Failure. Int Heart J 2022; 63:1-7. [DOI: 10.1536/ihj.21-839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Tsutomu Sunayama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Taishi Dotare
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Daichi Maeda
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Takashi Iso
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Tomoyuki Morisawa
- Department of Physical Therapy Faculty of Health Science, Juntendo University
| | - Masakazu Saitoh
- Department of Physical Therapy Faculty of Health Science, Juntendo University
| | - Miho Yokoyama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Kentaro Jujo
- Department of Cardiology, Nishiarai Heart Center Hospital
| | - Tetsuya Takahashi
- Department of Physical Therapy Faculty of Health Science, Juntendo University
| | - Tohru Minamino
- Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development
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13
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Satici S, Iyngkaran P, Battersby M, Andrew S, De Courten M. Defining Vulnerable Patients with Heart Failure: Opportunistic Lessons from Covid-19. Curr Cardiol Rev 2022; 18:e280921196849. [PMID: 34602040 PMCID: PMC9893135 DOI: 10.2174/1573403x17666210928121625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/30/2021] [Accepted: 07/30/2021] [Indexed: 11/22/2022] Open
Abstract
Congestive Heart Failure is a chronic disease that can be associated with poor outcomes. Some patients are more vulnerable, while others who are vulnerable appear absent or silent to health services. COVID-19 pandemic is a good opportunity to explore this important area. This review focuses on chronic disease, heart failure and those who require greater consideration.
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Affiliation(s)
- Sakine Satici
- General Physician and Master of Research student, Victoria University, Melbourne, Victoria, Australia
| | - Pupalan Iyngkaran
- Cardiologist (Heart Failure & Cardiac Imaging) and Adjunct Senior Lecturer, Werribee Mercy Sub School, School of Medicine, University of Notre Dame, Sydney, Australia
| | - Malcolm Battersby
- College of Medicine and Public Health, Flinders University, Senior Consultant Psychiatrist, Southern Adelaide Local Health Network, Mental Health Division, Flinders Medical Centre, Flinders Drive, Bedford Park SA 5042, GPO Box 2100, Adelaide SA 5001
| | - Sharon Andrew
- Nursing and Adjunct Mitchell Institute, Victoria University, PO Box 14428 Melbourne, Victoria 8001, Australia
| | - Maximilian De Courten
- Mitchell Institute for Education and Health Policy, Victoria University, 300 Queen St, Melbourne 3000, Victoria, Australia
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14
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Pushkarev GS, Matskeplishvili ST, Kuznetsov VA, Guskova OA, Enina TN. Association between anxiety and mortality in patients with congestive heart failure after implantation of cardiac electronic devices. J Psychosom Res 2021; 152:110686. [PMID: 34864238 DOI: 10.1016/j.jpsychores.2021.110686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 11/21/2021] [Accepted: 11/24/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Several studies suggest that psychological factors including anxiety are associated with negative outcomes and in particular higher mortality rates among heart failure (HF) patients. However, the impact of anxiety on mortality in patients with implanted cardiac devices has not been fully appreciated. The aim of this study was to assess the association between state (SA) and trait (TA) anxiety and all-cause mortality in patients with HF after cardiac electronic devices implantation. METHODS The monocentric prospective study enrolled 265 patients (215 men and 50 women) aged 23 to 84 years (mean age 57.1 ± 10.0), who received cardiac resynchronization therapy or cardioverter-defibrillator implantation. Mean duration of prospective follow-up was 62.3 ± 36.6 months. State-Trait Anxiety Inventory (STAI) was used to measure anxiety symptoms. Cox proportional hazards multivariate regression model was used to calculate hazard ratio (HR) of all-cause mortality with 95% confidence interval (95% CI). RESULTS During the prospective follow-up period, 45 (17.0%) patients died due to all causes. According to quantitative analysis, HR for death used for SA scale was 1.04 (95% CI 1.00-1.07, p = 0.07) and for the TA scale 1.02 (95% CI 0.99-1.05, p = 0.21). Analysis of categorical indicators found statistically significant higher HR of mortality in patients with severe SA (2.35, 95% CI 1.17-4.71, p = 0.02), and TA (2.02, 95% CI 1.04-3.94, p = 0.04). CONCLUSION High levels of SA and TA was significantly and independently associated with a high risk of all-cause mortality in patients, who underwent implantation of cardiac electronic devices.
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Affiliation(s)
- Georgiy S Pushkarev
- State Autonomous Healthcare Institution of the Tyumen Region: Multidisciplinary Consultative and Diagnostic Center, Tyumen, Russia.
| | | | - Vadim A Kuznetsov
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
| | - Olga A Guskova
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
| | - Tatyana N Enina
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
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15
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Bodolea C, Hiriscau EI, Buzdugan EC, Grosu AI, Stoicescu L, Vesa Ș, Cauli O. The Association between Peripheral Blood Cells and the Frailty Syndrome in Patients with Cardiovascular Diseases. Endocr Metab Immune Disord Drug Targets 2021; 20:1419-1433. [PMID: 32787768 PMCID: PMC8226153 DOI: 10.2174/1871530320666200813135905] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/02/2020] [Accepted: 06/11/2020] [Indexed: 12/24/2022]
Abstract
Background Frailty syndrome is characterized by multisystem dysregulation frequently found in older individuals or even in younger patients with chronic disabling diseases such as cardiovascular diseases. Objective To determine whether peripheral blood cell count, and its subpopulations, red blood cell and platelets, morphology and different ratios (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and red blood distribution width-to-platelet ratio) are associated with cardiac frail patients, and through this to improve the prediction of frailty status in patients with cardiovascular diseases. Methods An observational, retrospective, cohort study enrolling 179 patients with cardiovascular disease divided into two groups: non-frail group (100 pts) and frail group (79 pts), a cohort detached from the Frail.RO study. The frailty was evaluated based on the Fried criteria; haematological markers, sociodemographic data, and variables related to cardiovascular diseases and comorbidities were also recorded. Results Lower lymphocytes, platelet count, and neutrophil-to-lymphocyte ratio were significantly associated with a more severe frailty syndrome. Regarding red blood cells, haemoglobin concentration and red cell distribution width significantly correlated with the severity of the frailty syndrome. Receiver operating characteristic curve analysis for these markers associated with the frailty syndrome revealed an acceptable sensitivity of 66% and specificity of 65% to identify frail individuals. Malnutrition and hypercholesterolemia are relevant predictors for identifying frailty in hospitalized cardiovascular patients. Conclusion The evaluation of peripheral blood cell composition routinely measured in clinical practice can represent a valuable, but limited indicator, to diagnose frailty syndrome and eventually, the effects of interventions in frail patients with cardiovascular diseases.
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Affiliation(s)
- Constantin Bodolea
- ICU Department, ”Iuliu Hațieganu”, University of Medicine and Pharmacy, Cluj-Napoca, Romania,ICU Department, ”Iuliu Hațieganu” University Clinical Municipal Hospital, Cluj-Napoca, Romania
| | - Elisabeta I Hiriscau
- ICU Department, ”Iuliu Hațieganu” University Clinical Municipal Hospital, Cluj-Napoca, Romania,Nursing Department, ”Iuliu Hațieganu”, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Elena-Cristina Buzdugan
- Internal Medicine Department, ”Iuliu Hațieganu”University of Medicine and Pharmacy, Cluj-Napoca, Romania,Cardiology Unit, University Clinical Municipal Hospital, Cluj-Napoca, Romania
| | - Alin I Grosu
- Internal Medicine Department, ”Iuliu Hațieganu”University of Medicine and Pharmacy, Cluj-Napoca, Romania,Cardiology Unit, University Clinical Municipal Hospital, Cluj-Napoca, Romania
| | - Laurențiu Stoicescu
- Internal Medicine Department, ”Iuliu Hațieganu”University of Medicine and Pharmacy, Cluj-Napoca, Romania,Cardiology Unit, University Clinical Municipal Hospital, Cluj-Napoca, Romania
| | - Ștefan Vesa
- Department of Clinical Pharmacology,”Iuliu Hațieganu”University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Omar Cauli
- Department of Nursing, University of Valencia, Valencia, Spain
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16
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Kalantarzadeh M, Alavi M, Yousefi H, Maghsoudi J, Hungerford C, Cleary M. Coping with chronic cardiovascular disease in Iran: A qualitative study. Nurs Health Sci 2021; 23:843-851. [PMID: 34302418 DOI: 10.1111/nhs.12869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 12/30/2022]
Abstract
The effects of chronic cardiovascular disease can challenge the achievement of treatment goals and recovery outcomes. This study explores the ways in which patients cope with the effects of chronic cardiovascular disease, from the perspectives of patients, family caregivers, and health professionals. The qualitative study was conducted from May 2019 to September 2020 in Isfahan, Iran. Thirteen people with chronic cardiovascular disease, 6 family caregivers, and 16 healthcare professionals participated in semi-structured individual interviews. Transcripts were analysed thematically. Findings suggest that people with chronic cardiovascular disease use a range of coping strategies, both positive and negative, to adjust to their conditions. The positive strategies include managing their health-related symptoms, drawing on religious or spiritual beliefs, and accessing social and relational supports. Negative strategies can include over-reliance on family members for support, leading to reduced activity and loss of independence. Understanding the nature of the strategies used by patients provides an important means by which health service providers can support patients to further develop positive coping strategies. This, in turn, will enable patients to achieve higher levels of wellbeing.
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Affiliation(s)
- Mozhgan Kalantarzadeh
- School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mousa Alavi
- Department of Mental Health Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hojatollah Yousefi
- Nursing and Midwifery Care Research Center, Department of Adult Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jahangir Maghsoudi
- Nursing and Midwifery Care Research Center, Mental Health Nursing Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Michelle Cleary
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Sydney, New South Wales, Australia
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17
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Marin TS, Walsh S, May N, Jones M, Gray R, Muir-Cochrane E, Clark RA. Screening for depression and anxiety among patients with acute coronary syndrome in acute care settings: a scoping review. JBI Evid Synth 2021; 18:1932-1969. [PMID: 32813429 DOI: 10.11124/jbisrir-d-19-00316] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The aim of this review was to scope the literature for publications on the practice of screening for depression and anxiety in acute coronary syndrome patients in acute care by identifying instruments for the screening of anxiety and/or depression; determining if screening for anxiety and/or depression has been integrated into cardiac models of care and clinical pathways; and identifying any evidence practice gap in the screening and management of anxiety and/or depression in this population. INTRODUCTION Depression in acute coronary syndrome is bidirectional. Depression is an independent risk factor for cardiovascular disease, and comorbid depression is associated with a twofold greater risk of mortality in patients with cardiovascular disease. The presence of acute coronary syndrome increases the risk of depressive disorders or anxiety during the first one to two years following an acute event, and both depression and anxiety are associated with a higher risk of further acute coronary health concerns. Clinical practice guidelines have previously recommended routine screening for depression following a cardiac event, although many current guidelines do not include recommendations for screening in an acute setting. To date there have been no previous scoping reviews investigating depression and anxiety screening in patients with acute coronary syndrome in the acute care setting. INCLUSION CRITERIA Adults (18 years and over) with acute coronary syndrome who are screened for anxiety and/or depression (not anxiety alone) in an acute care setting. METHODS A systematic search of the literature was conducted by a research librarian. Research studies of any design published in English from January 1, 2012, to May 31, 2018, were included. Data were extracted from the included studies to address the three objectives. Purposefully designed tables were used to collate information and present findings. Data are also presented as figures and by narrative synthesis. RESULTS Fifty-one articles met the inclusion criteria. Primary research studies were from 21 countries and included 21,790 participants; clinical practice guidelines were from two countries. The most common instruments used for the screening of depression and anxiety were: i) the Hospital Anxiety and Depression Scale (n = 18); ii) the Beck Depression Inventory (n = 16); and iii) the nine-item Patient Health Questionnaire (n = 7). Eleven studies included screening for anxiety in 2181 participants (30% female) using the full version of the Hospital Anxiety and Depression Scale. The State-Trait Anxiety Inventory was used to screen 444 participants in three of the studies. Four studies applied an intervention for those found to have depression, including two randomized controlled trials with interventions targeting depression. Of the seven acute coronary syndrome international guidelines published since 2012, three (43%) did not contain any recommendations for screening for depression and anxiety, although four (57%) had recommendations for treatment of comorbidities. CONCLUSIONS This review has identified a lack of consistency in how depression and anxiety screening tools are integrated into cardiac models of care and clinical pathways. Guidelines for acute coronary syndrome are not consistent in their recommendations for screening for depression and/or anxiety, or in identifying the best screening tools.
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Affiliation(s)
- Tania S Marin
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.,JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Sandra Walsh
- Department of Rural Health, University of South Australia, Warnambool, Australia
| | - Nikki May
- South Australian Health Library Service, Flinders Medical Centre, Bedford Park, Australia
| | - Martin Jones
- Department of Rural Health, University of South Australia, Warnambool, Australia
| | - Richard Gray
- School of Nursing and Midwifery, LaTrobe University, Bundoora, Australia
| | - Eimear Muir-Cochrane
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Robyn A Clark
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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18
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Chu H, Chen L, Yang X, Qiu X, Qiao Z, Song X, Zhao E, Zhou J, Zhang W, Mehmood A, Pan H, Yang Y. Roles of Anxiety and Depression in Predicting Cardiovascular Disease Among Patients With Type 2 Diabetes Mellitus: A Machine Learning Approach. Front Psychol 2021; 12:645418. [PMID: 33995200 PMCID: PMC8113686 DOI: 10.3389/fpsyg.2021.645418] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/17/2021] [Indexed: 12/18/2022] Open
Abstract
Cardiovascular disease (CVD) is a major complication of type 2 diabetes mellitus (T2DM). In addition to traditional risk factors, psychological determinants play an important role in CVD risk. This study applied Deep Neural Network (DNN) to develop a CVD risk prediction model and explored the bio-psycho-social contributors to the CVD risk among patients with T2DM. From 2017 to 2020, 834 patients with T2DM were recruited from the Department of Endocrinology, Affiliated Hospital of Harbin Medical University, China. In this cross-sectional study, the patients' bio-psycho-social information was collected through clinical examinations and questionnaires. The dataset was randomly split into a 75% train set and a 25% test set. DNN was implemented at the best performance on the train set and applied on the test set. The receiver operating characteristic curve (ROC) analysis was used to evaluate the model performance. Of participants, 272 (32.6%) were diagnosed with CVD. The developed ensemble model for CVD risk achieved an area under curve score of 0.91, accuracy of 87.50%, sensitivity of 88.06%, and specificity of 87.23%. Among patients with T2DM, the top five predictors in the CVD risk model were body mass index, anxiety, depression, total cholesterol, and systolic blood pressure. In summary, machine learning models can provide an automated identification mechanism for patients at CVD risk. Integrated treatment measures should be taken in health management, including clinical care, mental health improvement, and health behavior promotion.
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Affiliation(s)
- Haiyun Chu
- Department of Medical Psychology, Harbin Medical University, Harbin, China
| | - Lu Chen
- Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China
| | - Xiuxian Yang
- Department of Medical Psychology, Harbin Medical University, Harbin, China
| | - Xiaohui Qiu
- Department of Medical Psychology, Harbin Medical University, Harbin, China
| | - Zhengxue Qiao
- Department of Medical Psychology, Harbin Medical University, Harbin, China
| | - Xuejia Song
- Department of Medical Psychology, Harbin Medical University, Harbin, China
| | - Erying Zhao
- Department of Medical Psychology, Harbin Medical University, Harbin, China
| | - Jiawei Zhou
- Department of Medical Psychology, Harbin Medical University, Harbin, China
| | - Wenxin Zhang
- Department of Medical Psychology, Harbin Medical University, Harbin, China
| | - Anam Mehmood
- Department of Medical Psychology, Harbin Medical University, Harbin, China
| | - Hui Pan
- Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China
| | - Yanjie Yang
- Department of Medical Psychology, Harbin Medical University, Harbin, China
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19
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Szlenk-Czyczerska E, Guzek M, Bielska DE, Ławnik A, Polański P, Kurpas D. Factors Differentiating Rural and Urban Population in Determining Anxiety and Depression in Patients with Chronic Cardiovascular Disease: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3231. [PMID: 33804785 PMCID: PMC8003959 DOI: 10.3390/ijerph18063231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/14/2021] [Accepted: 03/17/2021] [Indexed: 01/26/2023]
Abstract
The aim of this cross-sectional study was to analyze selected variables differentiating rural from urban populations, as well as identify potentially increased levels of depression and anxiety in patients with chronic cardiovascular disease. The study was carried out in 193 patients. The study used the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS), the Health Behavior Inventory Questionnaire (HBI), the WHOQOL-BREF Quality of Life Questionnaire, and the Hospital Anxiety and Depression Scale-Modified Version (HADS-M). Spearman's rank correlation coefficient test and logistic regression were used for analyses. In rural patients, we observed a relationship between anxiety and age (1/OR = 1.04; 95% CI: 0.91-0.99), the assessment of satisfied needs (1/OR = 293.86; 95% CI: 0.00001-0.56), and quality of life (QoL) in physical (OR = 1.56; 95% CI: 1.11-2.33), social (1/OR = 1.53; 95% CI: 0.04-0.94), and environmental domains (OR = 1.67; 95% CI: 1.06-3.00), as well as between depression and QoL in physical (1/OR = 1.39; 95% CI: 0.50-0.97) and psychological (OR = 1.37; 95% CI: 1.01-1.93) domains. In city patients, we observed a relationship between the drug and Qol in the physical (1/OR = 1.25; 95% CI: 0.62-0.98) and psychological (OR = 1.49; 95% CI: 1.13) domains. Younger patients living in a rural area with a lower assessment of met needs, a higher level of QoL in physical and environmental domains, and a lower social domain, as well as patients living in a city with a lower QoL in the physical domain and a higher psychological domain, have a greater chance of developing anxiety and depressive disorders.
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Affiliation(s)
| | - Marika Guzek
- Medical and Diagnostic Centre (MDC), 9 Niklowa Street, 08-110 Siedlce, Poland;
| | - Dorota Emilia Bielska
- Department of Family Medicine, Medical University of Białystok, 1 J. Kilińskiego Street, 15-089 Białystok, Poland;
| | - Anna Ławnik
- Faculty of Health Sciences, Pope John Paul II State School of Higher Education, 95/97 Sidorska Street, 21-500 Biala Podlaska, Poland;
| | - Piotr Polański
- Family Physician’s Practice, Non-Public Healthcare Center, 4 Nad Potokiem Street, 58-350 Mieroszow, Poland;
| | - Donata Kurpas
- Department of Family Medicine, Wrocław Medical University, 1 Syrokomli Street, 51-141 Wrocław, Poland;
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20
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Moludi J, Khedmatgozar H, Nachvak SM, Abdollahzad H, Moradinazar M, Sadeghpour Tabaei A. The effects of co-administration of probiotics and prebiotics on chronic inflammation, and depression symptoms in patients with coronary artery diseases: a randomized clinical trial. Nutr Neurosci 2021; 25:1659-1668. [PMID: 33641656 DOI: 10.1080/1028415x.2021.1889451] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND It has been shown that dysbiosis might have a role in developing of chronic inflammation and depression. In this study, we are interested in exploring of anti-inflammatory and anti-depressant effects of Lactobacillus Rhamnosus G (LGG), a probiotic strain, alone or in combination with a prebiotic, Inulin, in patients with coronary artery disease (CAD). METHODS This randomized, double-blind clinical trial was held on 96 patients with CAD. Patients were randomly allocated into four different groups: LGG [a capsule/day, contained 1.9 × 109 colony-forming unit of Lactobacillus Rhamnosus G], inulin (15 g/day), co-supplemented (LGG and inulin), and placebo. Participants consumed the supplements for two months. Beck Depression Inventory (BDI), MacNew questionnaire and Spielberger state-trait anxiety inventory (STAI-Y) were used to assess depression, quality of life and anxiety, respectively. Serum levels of C-reactive protein (hs-CRP), lipopolysaccharide (LPS), tumor necrosis factor (TNF)-α, and Interleukin (IL)-10 were also measured. RESULTS Probiotic-Inulin Co-supplementation significantly decreased BDI (-11.52 ± 0+3.20 vs. +2.97 ± 0.39, P = 0.001), STAI-state (-17.63 ± 3.22 vs. -0.60 ± 0.33, P = 0.021), and STAI-trait (-24.31 ± 7.41 vs. -1.45 ± 0.66, P = 0.020) scores, hs-CRP (-1.69 ± 0+66 vs. +0.82 ± 0.39 mg/dL, P = 0.020), LPS (-22.02 ± 5.40 vs. +0.31 ± 0.18 (EU/L), P = 0.047), and TNF-α (-25.05 ± 7.41 vs. +0.79 ± 0.71 (ng/L), P = 0.032) in comparison to placebo. CONCLUSION Co-supplementation of probiotics and inulin in CAD subjects for eight weeks had beneficial effects on depression, anxiety, and inflammatory biomarkers. Adding inulin to probiotic supplements improved psychological outcomes and inflammatory biomarkers more effectively than two supplements separately.Trial registration: Iranian Registry of Clinical Trials identifier: IRCT20180712040438N4..
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Affiliation(s)
- Jalal Moludi
- Student Research Committee, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Research Center for Environmental Determinants of Health (RCEDH)s, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamed Khedmatgozar
- Center for Biotechnology and Genomics, Texas Tech University, Lubbock, TX, USA
| | - Seyed Mostafa Nachvak
- Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hadi Abdollahzad
- Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradinazar
- Research Center for Environmental Determinants of Health (RCEDH)s, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Sadeghpour Tabaei
- Department of Cardiac Surgery, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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21
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Zhu J, Ying W, Zhang L, Peng G, Chen W, Anto EO, Wang X, Lu N, Gao S, Wu G, Yan J, Ye J, Wu S, Yu C, Yue M, Huang X, Xu N, Ying P, Chen Y, Tan X, Wang W. Psychological symptoms in Chinese nurses may be associated with predisposition to chronic disease: a cross-sectional study of suboptimal health status. EPMA J 2020; 11:551-563. [PMID: 33078069 PMCID: PMC7556591 DOI: 10.1007/s13167-020-00225-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/28/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Suboptimal health status (SHS) is a reversible state between ideal health and illness and it can be effectively reversed by risk prediction, disease prevention, and personalized medicine under the global background of predictive, preventive, and personalized medicine (PPPM) concepts. More and more Chinese nurses have been troubled by psychological symptoms (PS). The correlation between PS and SHS is unclear in nurses. The purpose of current study is to investigate the prevalence of SHS and PS in Chinese nurses and the relationship between SHS and PS along with predisposing factors as well as to discuss the feasibility of improving health status and preventing diseases according to PPPM concepts in Chinese nurses. METHODS A cross-sectional study was conducted with the cluster sampling method among 9793 registered nurses in Foshan city, China. SHS was evaluated with the Suboptimal Health Status Questionnaire-25 (SHSQ-25). Meanwhile, the PS of depression and anxiety were evaluated with Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) self-assessment questionnaires. The relationship between PS and SHS in Chinese nurses was subsequently analyzed. RESULTS Among the 9793 participants, 6107 nurses were included in the final analysis. The prevalence of SHS in the participants was 74.21% (4532/6107) while the symptoms of depression and anxiety were 47.62% (2908/6107) and 24.59% (1502/6107) respectively. The prevalence of SHS in the participants with depression and anxiety was significantly higher than those without the symptoms of depression (83.3% vs 16.7%, P < 0.001) and anxiety (94.2% vs 5.8%, P < 0.0001). The ratio of exercise habit was significantly lower than that of non-exercise habit (68.8% vs 78.4%, P < 0.001) in SHS group. CONCLUSIONS There is a high prevalence of SHS and PS in Chinese nurses. PS in Chinese nurses are associated with SHS. Physical exercise is a protective factor for SHS and PS so that the exercise should be strongly recommended as a valuable preventive measure well in the agreement with PPPM philosophy. Along with SDS and SAS, SHSQ-25 should also be highly recommended and applied as a novel predictive/preventive tool for the health measures from the perspectives of PPPM in view of susceptible population and individual screening, the predisposition to chronic disease preventing, personalization of intervention, and the ideal health state restoring.
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Affiliation(s)
- Jinxiu Zhu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
- Institute of Clinical Electrocardiography, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Wenjuan Ying
- Nursing Research Institute, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Li Zhang
- Nursing Department, Foshan First People’s Hospital, Foshan, 528000 Guangdong China
| | - Gangyi Peng
- Division of Medical Administration, Health commission of Guangdong Province, Guangzhou, 510060 China
| | - Weiju Chen
- Nursing Department, The First Affiliated Hospital, Ji’nan University, Guangzhou, 510630 China
| | - Enoch Odame Anto
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027 Australia
| | - Xueqing Wang
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027 Australia
| | - Nan Lu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Shanshan Gao
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Guihai Wu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Jingyi Yan
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Jianfeng Ye
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Shenglin Wu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Chengzhi Yu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Minghui Yue
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Xiru Huang
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Nuo Xu
- Nursing Research Institute, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Pengxiang Ying
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Yanhong Chen
- Nursing Research Institute, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Xuerui Tan
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Wei Wang
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027 Australia
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22
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Wang G, Liu X, Yang Q. Symptom clusters and quality of life in Chinese patients with heart failure. Collegian 2020. [DOI: 10.1016/j.colegn.2019.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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23
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Lázaro-Pérez C, Martínez-López JÁ, Gómez-Galán J, López-Meneses E. Anxiety About the Risk of Death of Their Patients in Health Professionals in Spain: Analysis at the Peak of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5938. [PMID: 32824258 PMCID: PMC7460391 DOI: 10.3390/ijerph17165938] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/08/2020] [Accepted: 08/12/2020] [Indexed: 12/20/2022]
Abstract
The COVID-19 health crisis has had a global effect, but the consequences in the different countries affected have been very different. In Spain, in a short period of time, health professionals went from a situation of stability to living with a working environment characterized by overcrowded hospitals, lack of individual protection equipment, non-existent or contradictory work protocols, as well as an unknown increase in mortality. Although in their professional activity health workers are closely linked to death processes, in recent months, working conditions and health emergencies have drawn an unheard of working scenario, with the stress and anxiety they may suffer when faced with the death of their patients. The present quantitative research was carried out in different hospitals in Spain on health professionals during the month of April 2020. Through the subscale of anxiety in the face of the death of others, developed by Collett-Lester, it has been verified that health professionals have had to develop their work in a context of precariousness, putting at risk both their individual and collective health, notably increasing anxiety in the face of the death of their patients. The predictive variables of this anxiety have been the absence of individual protection equipment, as well as high levels in the burnout subscales of emotional exhaustion and depersonalization.
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Affiliation(s)
- Cristina Lázaro-Pérez
- Department of Sociology, University of Murcia, Campus Universitario, 11, 30100 Murcia, Spain;
| | - Jose Ángel Martínez-López
- Department of Social Work and Social Services, University of Murcia, Avda. Teniente Flomesta, 5, 30003 Murcia, Spain;
| | - José Gómez-Galán
- Department of Education, University of Extremadura, Avda. de Elvas, s/n, 06006 Badajoz, Spain
- College of Education, Ana G. Méndez University, Cupey Campus, San Juan, PR 00926, USA
| | - Eloy López-Meneses
- Department of Education and Social Psychology, Faculty of Social Sciences, University Pablo de Olavide, 41013 Seville, Spain;
- Research Institute in Social Sciences and Education, Vice-Rectory for Research and Postgraduate, University of Atacama, Copiapó 1530000, Chile
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24
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Assessing the quality of life and depression among patients with heart failure and heart attack. HEALTH PSYCHOLOGY REPORT 2020. [DOI: 10.5114/hpr.2020.95910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BackgroundHealth-related quality and of life and depression are major issues among patients with heart diseases. The aim of the current study was to assess the levels of quality of life and depression among patients with heart failure and heart attack as well as the correlation between these domains and the differences in both categories.Participants and procedureIn this cross-sectional study the following tools were used: a) the Missoula-VITAS Quality of Life Index (MVQoLI-15), which examines 5 domains of quality of life, and b) the Center for Epidemiological Studies Depression Scale (CES-D), which measures depression among patients. Finally, a questionnaire about sociodemographic elements was completed by the patients. Data were analyzed through IBM Statistics SPSS 20.0. The statistical level was set at 0.05%.ResultsThe mean value of CES-D Total and MVQoLI-15 were higher for the patients suffering from heart failure than those suffering from a heart attack. However, the dimensions of MVQoLI-15 Interpersonal Relationships, Well-Being and Transcendence were lower for heart failure patients compared to the levels of the patients suffering from a heart attack. According to the Pearson r test, there was a statistically significant negative correlation be-tween the quality of life and depression (p = .001) in the overall sample.ConclusionsPatients with heart failure experience more depression and lower quality of life than heart attack patients.
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25
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Cauli O. Neuro-Psychiatric Disorders: From Diagnosis to Care. Diseases 2019; 7:diseases7030048. [PMID: 31284423 PMCID: PMC6787584 DOI: 10.3390/diseases7030048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/04/2019] [Indexed: 11/16/2022] Open
Abstract
Neuro-psychiatric disorders are an important cause of poor quality of life, disability, and premature mortality [...]
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Affiliation(s)
- Omar Cauli
- Department of Nursing, University of Valencia, 46010 Valencia, Spain.
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