1
|
Wright CX, Fournier S, Deng Y, Meng C, Tucker K, Spatz ES, Lichtman JH, Zhu C, Dreyer RP, Oen-Hsiao JM. Predictors of Health-Related Quality of Life Among Women Participating in an Appointment-Based Cardiac Rehabilitation Program. J Cardiovasc Nurs 2024:00005082-990000000-00182. [PMID: 38595128 DOI: 10.1097/jcn.0000000000001096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
BACKGROUND An alternative patient-centered appointment-based cardiac rehabilitation (CR) program has led to significant improvements in health outcomes for patients with cardiovascular disease. However, less is known about the effects of this approach on health-related quality of life (HRQoL), particularly for women. OBJECTIVE We examined the effects of a patient-centered appointment-based CR program on HRQoL by sex and examined predictors of HRQoL improvements specifically for women. METHODS Data were used from an urban single-center CR program at Yale New Haven Health (2012-2017). We collected information on patient demographics, socioeconomic status, and clinical characteristics. The Outcome Short-Form General Health Survey (SF-36) was used to measure HRQoL. We evaluated sex differences in SF-36 scores using t tests and used a multivariate linear regression model to examine predictors of improvements in HRQoL (total SF-36 score) for women. RESULTS A total of 1530 patients with cardiovascular disease (23.7% women, 4.8% Black; mean age, 64 ± 10.8 years) were enrolled in the CR program. Women were more likely to be older, Black, and separated, divorced, or widowed. Although women had lower total SF-36 scores on CR entry, there was no statistically significant difference in CR adherence or total SF-36 score improvements between sexes. Women who were employed and those with chronic obstructive pulmonary disease were more likely to have improvements in total SF-36 scores. CONCLUSION Both men and women participating in an appointment-based CR program achieved significant improvements in HRQoL. This approach could be a viable alternative to conventional CR to optimize secondary outcomes for patients.
Collapse
|
2
|
Nemani RRS, Gade BS, Panchumarthi D, Bathula BVSR, Pendli G, Panjiyar BK. Role of Cardiac Rehabilitation in Improving Outcomes After Myocardial Infarction. Cureus 2023; 15:e50886. [PMID: 38249185 PMCID: PMC10799544 DOI: 10.7759/cureus.50886] [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] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Myocardial infarction, an integral part of acute coronary syndrome (ACS), occurs due to atherosclerotic narrowing of the coronary (heart) blood vessels. Acute coronary syndrome, being one of the major cardiovascular diseases (CVDs), has led to a significant amount of mortality and morbidity, the majority of it due to MI. Over a long period following an MI, the physical, psychological, social, emotional, and occupational well-being are greatly impacted. Cardiac rehabilitation (CR) can address the above and help improve long-term well-being and overall quality of life. The benefits of CR include enhanced exercise capacity, risk factor reduction, improved quality of life (QOL), reduced mortality, and hospital readmissions. We used a systematic literature review (SLR) approach in this article to provide a global overview of cutting-edge CR in the post-MI phase. We reviewed 45 articles from journals of good repute published between 2013 and December 1st, 2023, focusing on seven selected papers for in-depth analysis. The analysis was focused on factors such as the positive outcomes of CR and the effects of CR post-MI. There are only a few statistically significant studies in a few domains of CR benefits, namely decreased mortality, cardiac events, depression, depression-associated mortality, hospital readmissions, increased left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD), left ventricular end-systolic volume (LVESV), metabolic equivalent of task (MET), maximal oxygen consumption (VO2max), and the six-minute walk test (6MWT), and as a result, increased physical performance. Further research is needed to enhance the understanding of its mechanisms and statistically prove its effectiveness in all other domains. As CR continues to evolve, referral and participation in CR should be increased as it improves overall health and well-being.
Collapse
Affiliation(s)
| | | | | | | | - Ganesh Pendli
- Medicine, PES Institue of Medical Sciences and Research, Kuppam, IND
| | - Binay K Panjiyar
- Research, Texas Tech University Health Sciences Center, Odessa, USA
- Internal Medicine, Harvard Medical School, Boston, USA
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| |
Collapse
|
3
|
Puri SN, Lalwani L. A Comparison Between Cardiac Telerehabilitation Program and Outpatient Hospital-Based Cardiac Rehabilitation Program for Patients Undergoing Coronary Artery Bypass Graft (CABG) Surgery: A Review. Cureus 2023; 15:e48488. [PMID: 38073989 PMCID: PMC10704402 DOI: 10.7759/cureus.48488] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/08/2023] [Indexed: 06/09/2024] Open
Abstract
Coronary artery disease (CAD) is a prevalent and possibly fatal cardiovascular ailment, and it is treated surgically by coronary artery bypass grafting (CABG). The coronary arteries, which supply the heart with oxygen and nutrients, are the most commonly affected. Even though CABG is a frequently employed procedure to restore cardiac blood flow, prolonged rehabilitation is necessary for long-term success. For patients with heart disease, cardiac rehabilitation (CR) involves a comprehensive therapeutic approach. It consists of risk mitigation, regular exercise, health education, and efficient stress management. Information and communication technology is used in telerehabilitation (TR), a rehabilitation service that offers a flexible choice that improves self-management. This study examined novel approaches and effective intervention elements while comparing cardiac TR with center-based programs in terms of risk factor management, patient commitment, and satisfaction.
Collapse
Affiliation(s)
- Saurabh N Puri
- Department of Cardiorespiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education And Research (DU), Wardha, IND
| | - Lajwanti Lalwani
- Department of Cardiorespiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education And Research (DU), Wardha, IND
| |
Collapse
|
4
|
Adam T, Al Sharif AI, Alamri TSM, Al-Nashri RAO, Alluwimi AIM, Samkri AY, Alharthi MA, Moafa AY, Alsaadi NA, Alraimi AMS, Alquzi RHM. The State of Cardiac Rehabilitation in Saudi Arabia: Barriers, Facilitators, and Policy Implications. Cureus 2023; 15:e48279. [PMID: 38058323 PMCID: PMC10695855 DOI: 10.7759/cureus.48279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2023] [Indexed: 12/08/2023] Open
Abstract
Cardiovascular disease (CVD) is a critical public health issue in Saudi Arabia, where it is the leading cause of death. The economic burden of CVD in the country is expected to triple by 2035, reaching $9.8 billion. This paper provides an overview of CVD in Saudi Arabia and its risk factors, impact on healthcare, and effects on patients' quality of life. The review emphasizes the potential of cardiac rehabilitation (CR) programs in addressing the CVD epidemic. CR programs have been shown to reduce morbidity, mortality, and hospital readmissions while improving patients' cardiovascular health and overall well-being. However, these programs are underutilized and inaccessible in Saudi Arabia. The paper highlights the urgent need for CR programs in the country and suggests key strategies for implementation. These include increasing patient referrals, tailoring programs to individual needs, enhancing patient education, and making CR accessible through home-based options. Fostering multidisciplinary collaboration and developing tailored guidelines for Arab countries can further enhance the impact of CR programs. In conclusion, this review underscores the vital importance of comprehensive CR programs in Saudi Arabia to combat the rising CVD burden, improve patient quality of life, and align with the goals of the Saudi 2030 Vision for a healthier society.
Collapse
Affiliation(s)
- Tasneem Adam
- Medical Affairs, College of Applied Medical Sciences, King Saud Medical City, Riyadh, SAU
| | - Abdullah I Al Sharif
- Healthcare Planning and Development, Ministry of Health, Kingdom of Saudi Arabia, Riyadh, SAU
- College of Medicine, Alfaisal University, Riyadh, SAU
| | | | - Rawan Ahmad O Al-Nashri
- General Practice, Primary Healthcare Center, General Directorate of Health Affairs, Aseer, SAU
| | | | - Amani Yosef Samkri
- General Practice, Al Aziziah Primary Health Care Center, Ministry of Health, Makkah, SAU
| | | | | | - Nawaf A Alsaadi
- Medical Affairs, College of Medicine, King Saud Medical City, Riyadh, SAU
| | | | | |
Collapse
|
5
|
Zhamaliyeva LM, Zhamankulova DG, Abenova NA, Koshmaganbetova GK. Educational Intervention Effects on Depression and Anxiety in Patients after Myocardial Infarction: A Randomized Controlled Trial. J Cardiovasc Dev Dis 2023; 10:267. [PMID: 37504523 PMCID: PMC10380402 DOI: 10.3390/jcdd10070267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/07/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023] Open
Abstract
Depression and anxiety in cardiovascular disease worsen the prognosis of patients. Treatments for these disorders often provide limited improvement. The present study aimed to test, for the first time, the impact of educational technology on anxiety and depressive symptoms in patients participating in a cardiac rehabilitation program. A 12-month randomized controlled trial was conducted, in which 207 patients were randomly assigned to either the experimental (n = 76) or control (n = 69) groups. The intervention involved a structured patient education program provided by medical students who had undergone specially designed training in cardiac rehabilitation. The primary outcomes were death, hospitalization, heart failure, and recurrent myocardial infarction. The study also assessed anxiety and depression. A year later, the experimental group showed a statistically significant decrease in anxiety and depression on the HADS scale, with reductions of 2.0 and 1.9 points, respectively (p < 0.05). The control group showed reductions of 1.5 and 1.2 points (p < 0.05). The difference in the Hamilton Rating Scale for Depression between the groups at 12 months was -1.29 in favor of the main group (95% CI, -0.7 to -1.88), and the standardized mean difference was 0.36 (95% CI, 0.03 to 0.69). No treatment-related adverse events were observed. The results suggest that educational interventions can have a positive impact on mental health. The study's strengths include a structured intervention, randomization, and long-term follow-up. The limitations include the lack of blinding of study participants and a relatively small sample size.
Collapse
Affiliation(s)
- Lazzat M Zhamaliyeva
- Department of Family Medicine, West Kazakhstan Marat Ospanov Medical University, Aktobe 030019, Kazakhstan
| | - Damira G Zhamankulova
- Department of Internal Diseases, West Kazakhstan Marat Ospanov Medical University, Aktobe 030019, Kazakhstan
| | - Nurgul A Abenova
- Department of General Practice 1, West Kazakhstan Marat Ospanov Medical University, Aktobe 030019, Kazakhstan
| | - Gulbakit K Koshmaganbetova
- Department of Master's and Doctoral Studies, West Kazakhstan Marat Ospanov Medical University, Aktobe 030019, Kazakhstan
| |
Collapse
|
6
|
Zhang W, Supervia M, Dun Y, Lennon RJ, Ding R, Sandhu G, Tilbury T, Squires RW, Vardar U, Tabatabaei N, Thomas RJ. The Association Between a Second Course of Cardiac Rehabilitation and Cardiovascular Outcomes Following Repeat Percutaneous Coronary Intervention Events. J Cardiopulm Rehabil Prev 2023; 43:101-108. [PMID: 35940745 DOI: 10.1097/hcr.0000000000000717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Survivors of coronary artery disease (CAD) events are at risk for repeat events. Although evidence supports cardiac rehabilitation (CR) after an initial CAD event, it is unclear whether a repeat course of CR (CR × 2) is beneficial after a recurrent CAD event. The purpose of this study was to determine the association of CR × 2 with clinical outcomes in persons undergoing repeat percutaneous coronary intervention (PCI). METHODS We assessed the prevalence of CR × 2 and its impact on cardiovascular outcomes in individuals who experienced a repeat PCI at the Mayo Clinic hospitals between January 1, 1998, and December 31, 2013. Landmark analyses were used to calculate unadjusted and propensity score adjusted mortality rates and cardiovascular (CV) events rates for patients who underwent CR × 2 compared with those who did not. RESULTS Among 240 individuals who had a repeat PCI and who had participated in CR after their first PCI, 97 (40%) participated in CR × 2. Outcomes were assessed for a mean follow-up time of 7.8 yr (IQR 7.1-9.0 yr). Propensity score-based inverse probability weighting analysis revealed that CR × 2 was associated with significantly lower target lesion revascularization (HR = 0.47: 95% CI, 0.26-0.86; P = .014), lower combined end point of CV death, myocardial infarction, and target lesion revascularization (HR = 0.57: 95% CI, 0.36-0.89; P = .014), and lower CV hospitalization (HR = 0.60; 95% CI, 0.43-0.84; P = .003). CONCLUSION A second course of CR following repeat PCI is associated with a lower risk of adverse clinical outcomes. These findings support current policies that allow for repeat courses of CR following recurrent CV events.
Collapse
Affiliation(s)
- Wenliang Zhang
- Xiangya Hospital, Central South University, Changsha, China (Drs Zhang and Dun); Department of Physical Medicine and Rehabilitation, Gregorio Marañon General University Hospital, Gregorio Marañon Health Research Institute, Madrid, Spain (Dr Supervia); Departments of Quantitative Health Sciences (Mr Lennon) and Cardiovascular Medicine (Drs Sandhu, Tilbury, Squires, and Thomas), Mayo Clinic, Rochester, Minnesota; Cardiovascular Department, Peking University People's Hospital, Beijing, China (Dr Ding); Department of Cardiology, Olmsted Medical Center, Rochester, Minnesota (Dr Tabatabaei); Halifax Health, Daytona Beach, Florida (Dr Tabatabaei); and Department of Medicine, John H. Stroger Hospital of Cook County, Chicago, Illinois (Dr Vardar)
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Severe Mental Illness and Cardiovascular Disease: JACC State-of-the-Art Review. J Am Coll Cardiol 2022; 80:918-933. [PMID: 36007991 DOI: 10.1016/j.jacc.2022.06.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/08/2022] [Accepted: 06/21/2022] [Indexed: 11/23/2022]
Abstract
People with severe mental illness, consisting of schizophrenia, bipolar disorder, and major depression, have a high burden of modifiable cardiovascular risk behaviors and conditions and have a cardiovascular mortality rate twice that of the general population. People with acute and chronic cardiovascular disease are at a higher risk of developing mental health symptoms and disease. There is emerging evidence for shared etiological factors between severe mental illness and cardiovascular disease that includes biological, genetic, and behavioral mechanisms. This state-of-the art review will describe the relationship between severe mental illness and cardiovascular disease, explore the factors that lead to poor cardiovascular outcomes in people with severe mental illness, propose strategies to improve the cardiovascular health of people with severe mental illness, and present areas for future research focus.
Collapse
|
8
|
Raei M, Ghasemi M, Hushmandi K, Shirmohammadi-Khoram N, Omolbanin Seyedrezaei S, Rostami H, Vahedian-Azimi A. Effectiveness of Family-Centered Empowerment Model on Psychological Improvement of Patients With Myocardial Infarction: A Bayesian Multivariate Approach. Front Public Health 2022; 10:878259. [PMID: 35910936 PMCID: PMC9333087 DOI: 10.3389/fpubh.2022.878259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
Objective There is a limited understanding of the impact of the family-centered empowerment model (FCEM) on the psychological symptoms in post-myocardial infarction (MI). This study aimed to evaluate the effectiveness of the FCEM on the psychological improvement of patients with MI. Methods The present study was a randomized controlled trial (RCT) where patients experienced a standard home cardiac rehabilitation (CR) or CR utilizing the FCEM approach. The empowerment of patients was estimated during nine assessments, such as pre- and post-intervention. Factors, such as quality of life (QoL), state and trait anxiety, and perceived stress, were evaluated. A Bayesian multivariate mixed-effects model was used to simultaneously investigate the effect of the intervention group on study outcomes across the time. Results Among all the participants in this study, 24 (34.3%) were women with a total mean ± standard deviation (SD) of 61.40 ± 12.83 and 24.87 ± 3.80 for age and body mass index (BMI). The participants who were in the FCEM group had a significantly higher mean level of perceived stress (β = 28.80), state anxiety (β = 16.20), trait anxiety (β = 3.65), physical (β = 38.54), and mental QoL (β = 42.14). Moreover, the individuals in the FCEM group had a significantly higher mean level of general health (β = 31.64) in the physical dimension of QoL, vitality (β = 15.04), mental role limitation (β = 21.84), and mental health (β = 18.16) in the mental dimension of QoL. Conclusions The FCEM can be a valuable treatment mechanism for patients with post-MI to improve their stress, anxiety, and QoL.
Collapse
Affiliation(s)
- Mehdi Raei
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Ghasemi
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Kiavash Hushmandi
- Department of Food Hygiene and Quality Control, Division of Epidemiology & Zoonoses, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | | | | | - Hosein Rostami
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
- *Correspondence: Amir Vahedian-Azimi ;
| |
Collapse
|
9
|
Garfein J, Guhl EN, Swabe G, Sekikawa A, Barinas-Mitchell E, Forman DE, Magnani JW. Racial and Ethnic Differences in Cardiac Rehabilitation Participation: Effect Modification by Household Income. J Am Heart Assoc 2022; 11:e025591. [PMID: 35730601 PMCID: PMC9333381 DOI: 10.1161/jaha.122.025591] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background Cardiac rehabilitation (CR) is associated with improved cardiovascular outcomes. Racial and ethnic differences in CR have been identified, but whether income may attenuate these disparities remains unknown. We evaluated (1) racial/ethnic differences in CR participation in a contemporary sample of insured US adults, and (2) assessed how household income modifies associations between race or ethnicity and CR participation. Methods and Results We identified 107 199 individuals with a CR‐qualifying diagnosis between January 1, 2016 and December 31, 2018 in Optum’s de‐identified Clinformatics database. We evaluated associations between race or ethnicity and participation in CR, and assessed interaction between race or ethnicity and annual household income. The mean±SD age of all participants was 70.4±11.6 years; 37.4% were female and 76.0% were White race. Overall, 28 443 (26.5%) attended ≥1 CR sessions. After adjustment, compared with White individuals, the probability of attending CR was 31% lower for Asian individuals (95% CI, 27%–36%), 19% lower for Black individuals (95% CI, 16%–22%), and 43% lower for Hispanic individuals (95% CI, 40%–45%), all P<0.0001. The time to CR attendance was also significantly longer for Asian, Black, and Hispanic individuals. Associations between race or ethnicity and attendance at CR differed significantly across household income categories (P interaction=0.0005); however, Asian, Black, and Hispanic individuals were less likely to attend CR at all incomes. Conclusions In a geographically and racially diverse cohort, participation in CR was low overall, and was lowest among Asian, Black, and Hispanic candidates. Household income may impact the link between race or ethnicity and attendance at CR, but substantial racial and ethnic disparities exist across incomes.
Collapse
Affiliation(s)
- Joshua Garfein
- Department of Medicine University of Pittsburgh School of Medicine Pittsburgh PA
| | - Emily N Guhl
- Heart and Vascular Institute University of Pittsburgh Medical Center Pittsburgh PA.,Department of Epidemiology, Graduate School of Public Health University of Pittsburgh PA
| | - Gretchen Swabe
- Department of Medicine University of Pittsburgh School of Medicine Pittsburgh PA
| | - Akira Sekikawa
- Department of Epidemiology, Graduate School of Public Health University of Pittsburgh PA
| | - Emma Barinas-Mitchell
- Department of Epidemiology, Graduate School of Public Health University of Pittsburgh PA
| | - Daniel E Forman
- Department of Medicine University of Pittsburgh School of Medicine Pittsburgh PA.,Heart and Vascular Institute University of Pittsburgh Medical Center Pittsburgh PA
| | - Jared W Magnani
- Department of Medicine University of Pittsburgh School of Medicine Pittsburgh PA.,Heart and Vascular Institute University of Pittsburgh Medical Center Pittsburgh PA.,Department of Epidemiology, Graduate School of Public Health University of Pittsburgh PA
| |
Collapse
|
10
|
Association between Early Mobilization in the ICU and Psychiatric Symptoms after Surviving a Critical Illness: A Multi-Center Prospective Cohort Study. J Clin Med 2022; 11:jcm11092587. [PMID: 35566716 PMCID: PMC9099642 DOI: 10.3390/jcm11092587] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/18/2022] [Accepted: 04/29/2022] [Indexed: 02/08/2023] Open
Abstract
This is a prospective multicenter cohort study aiming to investigate the association between early mobilization (EM), defined as a rehabilitation level of sitting at the edge of the bed or higher within 72 h of ICU admission, and psychiatric outcome. Consecutive patients, admitted to the ICU for more than 48 h, were enrolled. The primary outcome was the incidence of psychiatric symptoms at 3 months after hospital discharge defined as the presence of any of three symptoms: depression, anxiety, or post-traumatic stress disorder (PTSD). Risk ratio (RR) and multiple logistic regression analysis were used. As a sensitivity analysis, two methods for inverse probability of treatment weighting statistics were performed. Of the 192 discharged patients, 99 (52%) were assessed. The patients who achieved EM had a lower incidence of psychiatric symptoms compared to those who did not (25% vs. 51%, p-value 0.008, odds ratio (OR) 0.27, adjusted p = 0.032). The RR for psychiatric symptoms in the EM group was 0.49 [95% Confidence Interval, 0.29–0.83]. Sensitivity analysis accounting for the influence of death, loss to follow-up (OR 0.28, adjusted p = 0.008), or potential confounders (OR 0.49, adjusted p = 0.046) consistently showed a lower incidence of psychiatric symptoms in the EM group. EM was consistently associated with fewer psychiatric symptoms.
Collapse
|
11
|
Choo CC, Tan YZ, Zhang MWB. A Smartphone App for Attentional Bias Retraining in Smokers: Mixed Methods Pilot Study. JMIR Form Res 2022; 6:e22582. [PMID: 34982037 PMCID: PMC8764608 DOI: 10.2196/22582] [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: 07/16/2020] [Revised: 12/10/2020] [Accepted: 10/15/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Smoking is a global health threat. Attentional bias influences smoking behaviors. Although attentional bias retraining has shown benefits and recent advances in technology suggest that attentional bias retraining can be delivered via smartphone apps, there is a paucity of research on this topic. OBJECTIVE This study aims to address this gap by exploring the use of attentional bias retraining via a novel smartphone app using a mixed methods pilot study. In the quantitative phase, it is hypothesized that participants in the training group who undertake attentional bias retraining via the app should have decreased levels of attentional bias, subjective craving, and smoking frequency, compared with those in the control group who do not undertake attentional bias retraining. The qualitative phase explores how the participants perceive and experience the novel app. METHODS In all, 10 adult smokers (3 females and 7 males) between the ages of 26 and 56 years (mean 34.4 years, SD 9.97 years) were recruited. The participants were randomly allocated to the training and control groups. In weeks 1 and 3, participants from both groups attempted the standard visual probe task and rated their smoking frequency and subjective craving. In week 2, the participants in the training group attempted the modified visual probe task. After week 3, participants from both groups were interviewed about their views and experiences of the novel app. RESULTS The results of the quantitative analysis did not support this study's hypothesis. The qualitative data were analyzed using thematic analysis. The results yielded 5 themes: ease, helpfulness, unhelpful aspects, barriers, and refinement. CONCLUSIONS Findings from the qualitative study were consistent with those from previous studies on health-related smartphone apps. The qualitative results were helpful in understanding the user perspectives and experiences of the novel app, indicating that future research in this innovative area is necessary.
Collapse
Affiliation(s)
- Carol C Choo
- College of Healthcare Sciences, Division of Tropical Health and Medicine, James Cook University, Queensland, Australia
| | - Yi Zhuang Tan
- Department of Psychology, James Cook University, Singapore, Singapore
| | - Melvyn W B Zhang
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| |
Collapse
|
12
|
Sun KP, Xie WP, Liu JF, Chen Q, Cao H. Quality of life analysis of children with patent ductus arteriosus after closure treatment: A single-centre study. J Paediatr Child Health 2021; 57:1936-1941. [PMID: 34142752 DOI: 10.1111/jpc.15617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/26/2021] [Accepted: 06/07/2021] [Indexed: 01/22/2023]
Abstract
AIM To explore the changes in quality of life (QoL) in children who underwent patent ductus arteriosus (PDA) closure and the difference in the QoL between the post-operative patients and healthy children. METHODS The Pediatric Quality of Life Inventory 4.0 scale was used to assess the QoL of 48 children before and after receiving PDA closure and 50 healthy children who underwent physical examination in our hospital. Relevant clinical data were collected and analysed. RESULTS In this study, a total of 45 patients completed the follow-up, and all the children in the control group completed the follow-up. The results showed that the patients' QoL had been improved after PDA closure, and the scores of emotional functioning and social functioning had been significantly improved compared with those in the pre-operative status. In comparing the QoL between the patient group and the control group, the results before treatment were worse than those of the control group. After treatment, the gap between the score of QoL of the patients and the healthy control group was reduced to some extent. However, in terms of social functioning, the patients' feedback was not as positive as healthy children. CONCLUSION For children with PDA, closure treatment can significantly improve their clinical symptoms and QoL. However, there is still a gap compared with healthy children, so health education and further intervention after treatment are still necessary.
Collapse
Affiliation(s)
- Kai-Peng Sun
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.,Fujian Children's Hospital, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Wen-Peng Xie
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.,Fujian Children's Hospital, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Jian-Feng Liu
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.,Fujian Children's Hospital, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Qiang Chen
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.,Fujian Children's Hospital, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Hua Cao
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.,Fujian Children's Hospital, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| |
Collapse
|
13
|
Ozdemir S, Teo I, Bundoc FG, Malhotra C, Yeo KK, David Sim KL, Finkelstein EA. Role in decision making among congestive heart failure patients and its association with patient outcomes: a baseline analysis of the SCOPAH study. PATIENT EDUCATION AND COUNSELING 2021; 104:496-504. [PMID: 32928597 DOI: 10.1016/j.pec.2020.08.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/24/2020] [Accepted: 08/21/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE We investigated the predictors of patient-experienced and preferred roles for decision making, and the association between patient-experienced role in decision making and patient outcomes among congestive heart failure (HF) patients in a multi-ethnic Asian population. METHODS We surveyed 246 HF patients classified as New York Heart Association class 3/4. Multivariable regressions were used to analyse the associations between patient-experienced roles and patient outcomes. RESULTS Patients who were male, attained higher education, and had a higher cognitive score were more likely to experience and prefer active roles in decision making. Younger patients and patients with lower symptom burden were more likely, while married patients were less likely to prefer leading decision making. Patients with collaborative (family and/or physician) decision making reported higher emotional well-being and sense of meaning/peace. Collaborative and patient-led decision making were associated with higher perceived control over illness. Those who were led by others or made decisions alone reported lower quality of physician communication. CONCLUSION Collaborative decision making was associated with higher emotional well-being, sense of meaning/peace, and higher perceived control over illness among HF patients. PRACTICE IMPLICATIONS Physicians should explain the benefits of shared decision making and encourage patients to participate in treatment decisions.
Collapse
Affiliation(s)
- Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, 169857, Singapore; Health Services and System Research, Duke-NUS Medical School, 8 College Road, 169857, Singapore.
| | - Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, 169857, Singapore; Health Services and System Research, Duke-NUS Medical School, 8 College Road, 169857, Singapore.
| | - Filipinas Gines Bundoc
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, 169857, Singapore; Health Services and System Research, Duke-NUS Medical School, 8 College Road, 169857, Singapore.
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, 169857, Singapore; Health Services and System Research, Duke-NUS Medical School, 8 College Road, 169857, Singapore.
| | - Khung Keong Yeo
- National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore.
| | | | - Eric Andrew Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, 169857, Singapore; Health Services and System Research, Duke-NUS Medical School, 8 College Road, 169857, Singapore; Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA.
| |
Collapse
|
14
|
Young L, Zhang Q, Lian E, Roberts K, Weintraub N, Dong Y, Zhu H, Xu H, Schafer P, Dunlap S. Factors Predicting the Utilization of Center-Based Cardiac Rehabilitation Program. Geriatrics (Basel) 2020; 5:geriatrics5040066. [PMID: 32998237 PMCID: PMC7709641 DOI: 10.3390/geriatrics5040066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/18/2020] [Accepted: 09/22/2020] [Indexed: 12/16/2022] Open
Abstract
Although cardiac rehabilitation (CR) is clearly beneficial to improving patients’ physical functioning and reducing heart disease progression, significant proportions of patients do not complete CR programs. To evaluate the prevalence and predictors of completion of a center-based CR program in eligible cardiac patients, existing data collected from electronic medical records were used. To identify the predictors of CR completion, we used principal components analysis (PCA) and an artificial neural network (ANN) module. Among 685 patients, 61.4% (n = 421) completed the program, 31.7% (n = 217) dropped out, and 6.9% (n = 47) were referred but failed to initiate the program. PCA was conducted to consolidate baseline data into three factors—(1) psychosocial factors (depression, anxiety, and quality of life), (2) age, and (3) BMI, which explained 66.8% of the total variance. The ANN model produced similar results as the PCA. Patients who completed CR sessions had greater extremity strength and flexibility, longer six-minute walk distance, more CR knowledge, and a better quality of life. The present study demonstrated that patients who were older, obese, and who had depression, anxiety, or a low quality of life were less likely to complete the CR program.
Collapse
Affiliation(s)
- Lufei Young
- College of Nursing, Augusta University, Augusta, GA 30912, USA
- Correspondence:
| | - Qi Zhang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China;
| | - Eric Lian
- Departments of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (E.L.); (N.W.); (P.S.); (S.D.)
| | - Kimberly Roberts
- Department of Nursing, School of Health Sentences, Georgia Highlands College, Rome, GA 30161, USA;
| | - Neal Weintraub
- Departments of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (E.L.); (N.W.); (P.S.); (S.D.)
- Vascular Biology Center, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Yanbin Dong
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (Y.D.); (H.Z.)
| | - Haidong Zhu
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (Y.D.); (H.Z.)
| | - Hongyan Xu
- Department of Biostats & Data, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
| | - Pascha Schafer
- Departments of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (E.L.); (N.W.); (P.S.); (S.D.)
| | - Stephanie Dunlap
- Departments of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (E.L.); (N.W.); (P.S.); (S.D.)
| |
Collapse
|
15
|
Postoperative Psychological Disorders Among Heart Transplant Recipients: A Meta-Analysis and Meta-Regression. Psychosom Med 2020; 82:689-698. [PMID: 32541547 DOI: 10.1097/psy.0000000000000833] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This meta-analysis evaluates the pooled prevalence of depression, anxiety, adjustment disorder, and posttraumatic stress disorder (PTSD) among heart transplant recipients globally and determines underlying moderators. METHODS The authors searched PubMed, Embase, PsychINFO, BIOSIS, Science Direct, and Cochrane CENTRAL databases from inception to March 1, 2019, and 1321 records and 42 full-text articles were selected and reviewed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We calculated the pooled prevalence proportion of depression, anxiety, adjustment disorder, and PTSD using random-effects models. Meta-regression was performed to identify important moderators that contribute to heterogeneity. RESULTS Twenty studies met the inclusion criteria and comprised 2169 patients. The pooled prevalence of depression was 21.6% (95% confidence interval [CI] = 16.8%-27.3%), anxiety 11.1% (95% CI = 3.8%-28.5%), adjustment disorder 11.0% (95% CI = 3.1%-32.1%), and PTSD 13.5% (95% CI = 8%-21.8%). There was significant heterogeneity. Meta-regression was conducted to account for the heterogeneity of the prevalence proportion. Predisposing factors, for example, New York Heart Association classes II and III/IV, steroid treatment, and acute rejection of transplant (<3 months), were associated with high prevalence of depression. Protective factors, for example, age and higher ejection fraction after transplant of patients, were associated with low prevalence of depression. Female sex, single status, and number of months since transplant were associated with high prevalence of anxiety. Single status was associated with high prevalence of both adjustment disorder and transplant-related PTSD. CONCLUSIONS The prevalence of psychiatric conditions, particularly depression, is high in heart transplant recipients. The identified protective and risk factors may guide psychological interventions in heart transplant recipients.
Collapse
|
16
|
Kim C, Choi I, Cho S, Han JY, Kim AR, Kim WS, Jee S, Lee JH, Joo MC, Bang HJ, Joa KL, Han EY, Baek S, Shim JI, Choi JA. Cardiac rehabilitation and 5-year mortality after acute myocardial infarction. Report from 11 tertiary hospitals in Korea (ETHIK Study). Eur J Phys Rehabil Med 2020; 56:489-495. [PMID: 32383573 DOI: 10.23736/s1973-9087.20.06081-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND The participation rate for cardiac rehabilitation (CR) remains low in some Europe and Asia including Korea. AIM To investigate effects of CR on prognosis improvements in terms of recurrence, readmission, revascularization, and mortality rates in patients with acute myocardial infarction (AMI) in Korea. DESIGN A retrospective cohort study. SETTING Eleven Tertiary Hospitals In Korea (ETHIK Study). POPULATION Data from a total of 7299 patients between January 2012 and December 2015 were collected, of which data from 7136 patients were linked to insurance claims data. In the final analysis, 6743 patients were included. METHODS Patients who participated in the CR program while receiving outpatient treatment were classified into CR group. Those who did not participate in CR programs were classified into the non-CR group. RESULTS Kaplan-Meier survival analyses showed five-year survival rate of 96.9% in the CR group and 93.3% in the non-CR group. The hazard ratio (HR) for total 5-year mortality in the CR group was approximately 0.41 (95% CI: 0.27-0.63) times that of the non-CR group, indicating a reduction in the risk of mortality by approximately 59% in propensity score weighted cohort of 1878 patients. The HR for major adverse cardiac events (MACE) with respect to 5-year mortality, MI recurrence, revascularization, and readmission due to cardiovascular disease in CR group was 0.96 times that of non-CR group (95% CI: 0.83-1.12), without significant difference between the two groups. CONCLUSIONS In this study, 5-year mortality decreased by 59% in patients with AMI who had participated in CR compared to those who did not. CLINICAL REHABILITATION IMPACT This finding should be very helpful in emphasizing the need for CR in a country like Korea where CR has not yet been actively implemented.
Collapse
Affiliation(s)
- Chul Kim
- InJe University Sanggye Paik Hospital, Seoul, South Korea
| | - Insun Choi
- National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - Songhee Cho
- National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - Jae-Young Han
- Chonnam National University Medical School and Hospital, Gwangju, South Korea -
| | - Ae-Ryoung Kim
- KyungPook National University Hospital, Daegu, South Korea
| | - Won-Seok Kim
- Seoul National University College of Medicine, Bundang Hospital, Seoul National University, Seongnam, Korea
| | - Sungju Jee
- Chungnam National University Hospital, Daejeon, South Korea
| | - Jong H Lee
- Dong-A University College of Medicine, Dong-A Medical Center, Busan, South Korea
| | - Min C Joo
- Wonkwang University Hospital, Jeonbuk-Do, South Korea
| | - Heui J Bang
- Chungbuk National University Hospital, Chungbuk-Do, South Korea
| | | | - Eun Y Han
- Jeju University Hospital, Jeju-Do, South Korea
| | - Sora Baek
- Kangwon National University School of Medicine, Kangwon National University Hospital, Gangwon-Do, South Korea
| | - Jung-Im Shim
- National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - Jin A Choi
- National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| |
Collapse
|
17
|
Motivational Conflicts and the Psychological Structure of Perfectionism in Patients with Anxiety Disorders and Patients with Essential Hypertension. Behav Sci (Basel) 2020; 10:bs10010025. [PMID: 31906380 PMCID: PMC7017307 DOI: 10.3390/bs10010025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/18/2019] [Accepted: 12/28/2019] [Indexed: 02/01/2023] Open
Abstract
Many studies have shown connections between perfectionism, motivation, and anxiety disorders (AD), as well as essential hypertension (EH). The objective of this study is to examine the connections between motivation and the structure of perfectionism in AD patients and EH patients compared to healthy individuals. Projective and semi-projective tests (thematic apperception test (TAT) of Heckhausen, Multi-Motive Grid) were used to measure motivation, while a perfectionism questionnaire by Hewitt and Flett was used to determine perfectionism levels. The participants were 21 AD patients, 21 EH patients, and 33 healthy individuals. EH patients show higher level of other-oriented perfectionism, and AD patients demonstrate increased levels of self-oriented perfectionism compared to the healthy group. Both groups of patients are motivated by fear of failure rather than hope for success, and they also demonstrate an increased fear of rejection. AD patients have an increased fear of power of other people. In EH patients, the fear of power seems to play a significant role as it correlates with many other variables. In EH patients, the other-oriented perfectionism is connected to achievement motivation, whereas in AD patients the same is true for socially prescribed perfectionism. Overall, studying motivation and perfectionism in relation to various disorders seems to offer research prospects.
Collapse
|
18
|
The effects of cardiac rehabilitation on haemodynamic parameters measured by impedance cardiography in patients with coronary artery disease. VOJNOSANIT PREGL 2020. [DOI: 10.2298/vsp200810126s] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background / Aim. Well-organized cardiovascular rehabilitation (CVR) reduces
cardiovascular burden by influencing cardiovascular risk factors, improving
the quality of life and reducing mortality and hospital readmission.
However, its effects on hemodynamic status are largely unknown. The aim of
our study was to evaluate the influence of three-week CVR program on
hemodynamic status and to investigate if there is a correlation between
physical strain tolerance and hemodynamic parameters measured by impedance
cardiography (ICG) before and after CVR program in patients with coronary
artery disease. Methods. Fifty-two patients attended a three-week CVR
program. At the beginning and at the end of rehabilitation program
laboratory tests, exercise stress tests (EST) and ICG measurements were
taken. Results. Patients showed better strain tolerance on the second
exercise stress test (EST2) by achieving higher strain level (Z=2,315;
p=0,021) and longer duration of test (Z=2,305; p=0,021). There was a strong
positive correlation between the level of EST2 and cardiac output (CO)
(r=0,538; p<0,001) and stroke volume (SV) (r=0,380; p=0,017) on the second
ICG (ICG2). Also, there was a strong negative correlation between EST2 level
and systemic vascular resistance (SVR) (r=-0,472; p=0,002) and SVR index
(SSVRI) (r=-0,407; p=0,010) on ICG2. There was a strong positive correlation
between EST2 duration and CO (r=0.517; p=0.001) as well as between EST2
duration and SV (r=0.340; p=0.034), and a strong negative correlation
between EST2 duration and SVR (r=-0.504; p=0.001) as well as between EST2
duration and SVRI (r=-0.448; p=0.004), according to ICG2. Conclusion. Our
study showed that a well-designed CVR program can lead to better physical
strain tolerance. Furthermore, CVR led to a significant positive correlation
between EST and cardiac output as well as between EST and stroke volume
measured by ICG. On the other hand, there was a significant negative
correlation between EST and vascular related parameters according to ICG at
the end of the CVR program.
Collapse
|
19
|
Yaghoobi H, Mohammadi S, Sardashti S, Abbaspour S, Hossein-Abadi TS. Comparison of the Effect of Aerobic and Resistance Training on Cardiovascular Risk Factors in Parkinson's Women. Open Nurs J 2019. [DOI: 10.2174/1874434601913010186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
People with low-mobility are at increased risk for cardiovascular disease. Patients with Parkinson's Disease (PD) are less interested in participating in exercise activities due to the nature of the disease. Regular exercise and physical activity can play protective roles against heart disease by reducing risk factors. This study aimed to compare the effects of aerobic and resistance training on cardiovascular risk factors in women with PD.
Materials and Methods:
This quasi-experimental study was carried out on 45 women with PD who were randomly assigned to one of three groups: aerobic, resistance groups, and control group. Before and after training sessions, variables of weight, Body Mass Index (BMI), heart rate at rest state, maximum oxygen consumption, blood pressure, and lipid profiles of participants were measured. Data were analyzed using SPSS software version 21 and Paired Sample t-test, ANOVA and Bonferroni post-hoc test. A significant level of P≤0.05 was considered.
Results:
Demographics of physiological characteristics of subjects was congruent in all three groups in the baseline. After aerobic and resistance training, levels of triglyceride, LDL, total cholesterol, fat percentage, resting heart rate, weight, BMI and systolic blood pressure were significantly decreased (p<0.05). This change was more pronounced in the aerobic group; in contrast, variables of maximum oxygen consumption and HDL were meaningfully increased in participants of both experimental groups (p<0.05).
Conclusion:
The results showed that both types of aerobic and resistance training can reduce the risk factors of cardiovascular disease in women with PD, while the effect of aerobic training on reducing risk factors was more than resistance training.
Collapse
|
20
|
Choo CC, Lee JJW, Kuek JHL, Ang KK, Yu JH, Ho CS, Ho RC. Mindfulness and hemodynamics in asians: a literature review. Asian J Psychiatr 2019; 44:112-118. [PMID: 31369945 DOI: 10.1016/j.ajp.2019.07.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/20/2019] [Accepted: 07/23/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Mindfulness interventions have been increasingly incorporated into clinical settings. Evidence supporting mindfulness practices are predominantly established in Western populations. Neurophysiological evidence has not been established to support the effectiveness of mindfulness practice in Asian populations. Greater understanding of the neurophysiological mechanisms underlying mindfulness would enable hemodynamics as measured by fNIRS to be used to monitor mindfulness practice as an adjunct to psychotherapy with Asian clients. METHOD Research relating to fNIRS and hemodynamics for mindfulness in Asians was reviewed. The inclusion criteria for this review were recent publications in peer-reviewed journals from 2008 to 2018, with the search terms 'fNIRS', 'hemodynamics' and 'mindfulness', for studies in Asia. FINDINGS Databases included Medline, PubMed, PSYCINFO, Google Scholar and SCOPUS. Initial searches yielded 86 results. Five duplicated articles were removed, and remaining abstracts were screened; and assessed for eligibility against the structured performa. Three full text papers which fit the inclusion criteria were included in the current review. CONCLUSION This review highlighted the paucity of rigorous empirically validated research for hemodynamics as measured with fNIRS for mindfulness practice in Asia.
Collapse
Affiliation(s)
- Carol C Choo
- Department of Psychology, College of Healthcare Sciences, James Cook University, 387380, Singapore.
| | - John J W Lee
- Department of Psychology, College of Healthcare Sciences, James Cook University, 387380, Singapore.
| | - Jonathan H L Kuek
- Department of Psychology, College of Healthcare Sciences, James Cook University, 387380, Singapore.
| | - Kai Keng Ang
- Institute for Infocomm Research, Agency for Science, Technology and Research, 1 Fusionopolis Way, 138632, Singapore; College of Engineering, School of Computer Science and Engineering, Nanyang Technological University, 639798, Singapore.
| | - Juan Hong Yu
- Institute for Infocomm Research, Agency for Science, Technology and Research, 1 Fusionopolis Way, 138632, Singapore.
| | - Cyrus S Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, 119228, Singapore.
| | - Roger C Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, 119228, Singapore; Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, 119228, Singapore; Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 70000, Viet Nam; Faculty of Education, Huaibei Normal University, 100 Dongshan Road, Huaibei 235000, China.
| |
Collapse
|
21
|
Tan YZ, Zhang MWB, Choo ACC. Perspectives on Modifying Attentional Biases Amongst Individuals with Tobacco Use Disorder Using Technology: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152644. [PMID: 31344921 PMCID: PMC6695590 DOI: 10.3390/ijerph16152644] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 07/16/2019] [Accepted: 07/20/2019] [Indexed: 12/20/2022]
Abstract
Smoking remains a significant health problem. Attentional biases influence smoking behaviours, but have not been the target of psychosocial interventions. The first part of this perspective article will provide an overview of the theoretical constructs underlying attentional biases, methods of measuring attentional biases, and evidence for attentional bias modification amongst individuals with tobacco use disorders. The second part of this article will outline how the advent of technological advances could be harnessed in attentional bias modification for smokers. As there is potential for attentional bias training to be delivered via mobile app, literature was reviewed over the recent decade, 2009 to 2019, to examine available research evidence. The search terms were “web-based” or “mobile based”, and “attention bias modification” or “attentional bias” and “smoking” or “tobacco use”. The PsycINFO, Scopus, and PubMed databases were initially used to identify papers with the above-mentioned inclusion criteria. Five papers were included in the review. Lastly, an integrated perspective will be provided, from both clinical and research standpoints. In conclusion, more research is needed to address the gaps in knowledge and to provide an evidence base for the implementation of mobile phone technologies for attention retraining in smokers.
Collapse
Affiliation(s)
- Yi Zhuang Tan
- Department of Psychology, College of Healthcare Sciences, James Cook University, Singapore 387380, Singapore
| | - Melvyn W B Zhang
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore.
| | - And Carol C Choo
- Department of Psychology, College of Healthcare Sciences, James Cook University, Singapore 387380, Singapore
| |
Collapse
|
22
|
Choo CC, Chew PKH, Tan P, Choo JQ, Choo AMH, Ho RC, Quah TC. Health-Related Quality of Life in Pediatric Patients with Leukemia in Singapore: A Cross-Sectional Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122069. [PMID: 31212740 PMCID: PMC6617504 DOI: 10.3390/ijerph16122069] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 11/17/2022]
Abstract
There has been a paradigm shift in health service delivery to a more holistic approach, which considers Quality of Life (QoL) and overall functioning. Health-Related Quality of Life (HRQoL) is a multidimensional construct that encompasses physical functioning as well as psychosocial aspects of emotional and social functioning. This study explored factors related to HRQoL in Asian pediatric patients with leukemia in Singapore. The available variables included: age, treatment duration, household income, gender, ethnicity, religion, diagnosis, and phase of treatment. It is hypothesized that the relationships will be significant. In the current study, there were 60 patients (60% males) with leukemia; their ages ranged from 1 to 21 years (Mean = 8.03, Standard Deviation = 4.55). The hypothesis was partially supported. Age had a significant positive relationship with physical functioning, r(60) = 0.28, p < 0.05, physical health, r(60) = 0.28, p < 0.05, and the total HRQoL score, r(60) = 0.29, p < 0.05. Treatment duration had a positive relationship with school functioning, r(60) = 0.28, p < 0.05. All other correlations were statistically non-significant. The effects of the available psychosocial variables of gender, ethnicity, and religion were examined on scores from the Pediatric Quality of Life Inventory (PedsQL). Ethnicity had a significant effect on social functioning, U = 292.00, p < 0.05, r = 0.3 (medium effect size). Specifically, Chinese (Median = 85.00, n = 33) had significantly higher scores on social functioning than others (Median = 70.00, n = 27). The remaining comparisons were statistically non-significant. The current findings added to QoL research, and provided an impetus for more research in the area of HRQoL for children with leukemia in Singapore.
Collapse
Affiliation(s)
- Carol C Choo
- Department of Psychology, College of Healthcare Sciences, James Cook University, Singapore 387380, Singapore.
| | - Peter K H Chew
- Department of Psychology, College of Healthcare Sciences, James Cook University, Singapore 387380, Singapore.
| | - Pinhong Tan
- Department of Pediatrics, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore.
| | - Jessica Q Choo
- Department of Pediatrics, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore.
| | - Amanda M H Choo
- Cambridge Biomedical Campus, University of Cambridge School of Clinical Medicine, Cambridge CB2 0SP, UK.
| | - Roger C Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore.
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 117599, Singapore.
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 70000, Vietnam.
- Faculty of Education, Huaibei Normal University, 100 Dongshan Road, Huaibei 235000, China.
| | - Thuan Chong Quah
- Department of Pediatrics, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore.
| |
Collapse
|
23
|
Spindler H, Leerskov K, Joensson K, Nielsen G, Andreasen JJ, Dinesen B. Conventional Rehabilitation Therapy Versus Telerehabilitation in Cardiac Patients: A Comparison of Motivation, Psychological Distress, and Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030512. [PMID: 30759761 PMCID: PMC6388222 DOI: 10.3390/ijerph16030512] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/03/2019] [Accepted: 02/09/2019] [Indexed: 12/16/2022]
Abstract
Telerehabilitation (TR) has gained attention as a promising rehabilitation format. Our study examined how patients responded to TR and whether it provided adequate support for their lifestyle changes and self-care efforts when compared to conventional rehabilitation (CR). Cardiac patients (n = 136) were randomly assigned to a TR or CR group. The TR group was provided with relevant health care technology for a period of three months, and both groups filled in questionnaires on their motivation for lifestyle changes and self-care psychological distress, and quality of life at 0, 3, 6, and 12 months. Patients in both groups were found to be equally motivated for lifestyle changes and self-care (p < 0.05) and they experienced similar levels of psychological distress and quality of life. TR is comparable to conventional rehabilitation in motivating patients, preventing psychological distress and improving quality of life. Although we observed an initial increase in autonomous motivation in the telerehabilitation group, this positive difference in motivation does not last over time. As such, neither rehabilitation format seems able to ensure long-term motivation. Therefore, TR may serve as a viable replacement for conventional rehabilitation when considered relevant. Further research is needed to enhance long-term motivation, and maybe telerehabilitation can help to achieve this.
Collapse
Affiliation(s)
- Helle Spindler
- Department of Psychology and Behavioral Sciences, Aarhus University, 8000 Aarhus, Denmark.
| | - Kasper Leerskov
- SMI®, Department of Health Science and Technology, Aalborg University, 9200 Aalborg East, Denmark.
| | - Katrine Joensson
- Department of Micro- and Nanotechnology, The Technical University of Denmark, 2800 Kgs. Lyngby, Denmark.
| | - Gitte Nielsen
- Department of Cardiology, Vendsyssel Hospital, 9800 Hjoerring, Denmark.
| | - Jan Jesper Andreasen
- Department of Cardiothoracic Surgery, Aalborg University Hospital, 9000 Aalborg, Denmark.
- Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark.
| | - Birthe Dinesen
- Laboratory of Welfare Technologies - Telehealth and Telerehabilitation, Department of Health Science and Technology, Aalborg University, 9200 Aalborg East, Denmark.
| |
Collapse
|
24
|
Socioeconomic Inequalities in Health-Related Quality of Life among Patients with Cardiovascular Diseases in Vietnam. BIOMED RESEARCH INTERNATIONAL 2018; 2018:2643814. [PMID: 30356405 PMCID: PMC6178168 DOI: 10.1155/2018/2643814] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 09/06/2018] [Indexed: 12/13/2022]
Abstract
Purpose This study aims to explore the sociodemographic differences in health-related quality of life (HRQOL) among Vietnamese patients with cardiovascular diseases (CVD). Methods A cross-sectional survey of 600 cardiovascular disease patients (300 inpatients and 300 outpatients) being treated at the Hanoi Heart Hospital was completed between July and December 2016. Data about HRQOL were collected by using the EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) and EuroQOL-visual analogue scale (VAS). Sociodemographic characteristics were collected. A multivariate Tobit regression was used to detect the correlations between HRQOL and sociodemographic factors. Results Our sample had an average EQ-5D index of 0.82 (SD=0.21) and VAS score of 77.8 (SD=13.6). Participants were most likely to report problems in pain/discomfort (38.8%) and anxiety/depression (35.2%) and were least likely to report problems related to self-care (19.8%). Age and sex were strongly associated with the EQ-5D index and the VAS. Having health insurance and the number of hospital visits were negatively associated with HRQOL, while participation in the chronic disease management program had the positive relationship. Conclusions HRQOL among patients with CVD was moderately lower compared to the Vietnamese general population. Sociodemographic characteristics were strongly associated with HRQOL suggesting that addressing these inequalities should be prioritized in delivering services. Patients should also be encouraged to participate in the chronic disease management program due to its positive effects on quality of life.
Collapse
|
25
|
Ho RCM, Chua AC, Tran BX, Choo CC, Husain SF, Vu GT, McIntyre RS, Ho CSH. Factors Associated with the Risk of Developing Coronary Artery Disease in Medicated Patients with Major Depressive Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102073. [PMID: 30248896 PMCID: PMC6210477 DOI: 10.3390/ijerph15102073] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/12/2018] [Accepted: 09/20/2018] [Indexed: 12/11/2022]
Abstract
Background: The aim of this study was to identify factors associated with high Framingham Risk Score (FRS) in medicated patients with major depressive disorder (MDD). Methods: We examined 61 medicated patients with MDD (mean age 37.77 ± 7.67, 90.2% women) and 43 non-depressed controls (mean age 38.26 ± 9.20, 90.7% women). We administered the Hamilton Depression Rating Scale (HAM-D) and measured systolic blood pressure (SBP), diastolic BP (DBP), mean arterial BP (MAP), pulse wave velocity (PWV), intima-media thickness (IMT), interleukin-6 (IL-6) and triglycerides. Results: We found that medicated patients with MDD had significantly higher levels of HAM-D score (p < 0.01), SBP (p = 0.015), MAP (p = 0.037), IL−6 level (p = 0.007), as compared with controls. Medicated patients who remained moderately to severely depressed showed significantly higher SBP (p = 0.049), DBP (p = 0.009), MAP (p = 0.024), IL−6 level (p = 0.019), left PWV (p = 0.004) and average PWV (p = 0.026) than those with mild depression. Multivariate regression showed that the interaction effect between HAM-D score and triglyceride level (p = 0.018) was significantly associated with FRS in medicated patients with MDD. Conclusions: This study highlights that the interaction effect of the severity of depression and the triglyceride level, was a modifiable factor positively associated with high FRS.
Collapse
Affiliation(s)
- Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
- Biomedical Global Institute of Healthcare Research & Technology (BIGHEART), National University of Singapore, Singapore 119228, Singapore.
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 70000, Vietnam.
| | - Anna C Chua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Bach X Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
- Vietnam Young Physicians' Association, Hanoi 100000, Vietnam.
| | - Carol C Choo
- College of Healthcare Sciences, James Cook University, Singapore 387380, Singapore.
| | - Syeda Fabeha Husain
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Giang T Vu
- Institute for Global Health Innovations, Duy Tan University, Hanoi 73000, Vietnam.
| | - Roger S McIntyre
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada.
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON M5G 2C4, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada.
- Department of Toxicology and Pharmacology, University of Toronto, Toronto, ON M5S 1A8, Canada.
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Health System, Singapore 119228, Singapore.
| |
Collapse
|
26
|
Scapellato ML, Comiati V, Buja A, Buttignol G, Valentini R, Burati V, La Serra L, Maccà I, Mason P, Scopa P, Volpin A, Trevisan A, Spinella P. Combined Before-and-After Workplace Intervention to Promote Healthy Lifestyles in Healthcare Workers (STI-VI Study): Short-Term Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15092053. [PMID: 30235849 PMCID: PMC6164287 DOI: 10.3390/ijerph15092053] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/07/2018] [Accepted: 09/14/2018] [Indexed: 12/23/2022]
Abstract
Health care workers (HCWs) are prone to a heavy psycho-physical workload. Health promotion programs can help prevent the onset of chronic and work-related diseases. The aim of the STI-VI ‘before-and-after’ study, with assessments scheduled at 6 and 12 months, was to improve the lifestyle of HCWs with at least one cardiovascular risk factor. A tailored motivational counseling intervention, focusing on dietary habits and physical activity (PA) was administered to 167 HCWs (53 males; 114 females). BMI, waist circumference, blood pressure, and cholesterol, triglyceride, and blood glucose levels were measured before and after the intervention. The 6-month results (total sample and by gender) showed a marked effect on lifestyle: PA improved (+121.2 MET, p = 0.01), and diets became more similar to the Mediterranean model (+0.8, p < 0.001). BMI dropped (−0.2, p < 0.03), and waist circumference improved even more (−2.5 cm; p < 0.001). Other variables improved significantly: total and LDL cholesterol (−12.8 and −9.4 mg/dL, p < 0.001); systolic and diastolic blood pressure (−4.4 and −2.5 mmHg, p < 0.001); blood glucose (−1.5 mg/dL, p = 0.05); and triglycerides (significant only in women), (−8.7 mg/dL, p = 0.008); but HDL cholesterol levels dropped too. If consolidated at 12 months, these results indicate that our intervention can help HCWs maintain a healthy lifestyle and work ability.
Collapse
Affiliation(s)
- Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Vera Comiati
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Alessandra Buja
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Giulia Buttignol
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Romina Valentini
- Department of Medicine, University of Padova, 35128 Padova, Italy.
- Dietetic and Clinical Nutrition Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Valentina Burati
- Department of Medicine, University of Padova, 35128 Padova, Italy.
| | - Lucia La Serra
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Isabella Maccà
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Paola Mason
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Pasquale Scopa
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Anna Volpin
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Andrea Trevisan
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Paolo Spinella
- Department of Medicine, University of Padova, 35128 Padova, Italy.
- Dietetic and Clinical Nutrition Unit, Padova University Hospital, 35128 Padova, Italy.
| |
Collapse
|
27
|
Kim KH, Park SA. Horticultural therapy program for middle-aged women’s depression, anxiety, and self-identify. Complement Ther Med 2018; 39:154-159. [DOI: 10.1016/j.ctim.2018.06.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/24/2018] [Accepted: 06/25/2018] [Indexed: 01/26/2023] Open
|
28
|
Baghai TC, Varallo-Bedarida G, Born C, Häfner S, Schüle C, Eser D, Zill P, Manook A, Weigl J, Jooyandeh S, Nothdurfter C, von Schacky C, Bondy B, Rupprecht R. Classical Risk Factors and Inflammatory Biomarkers: One of the Missing Biological Links between Cardiovascular Disease and Major Depressive Disorder. Int J Mol Sci 2018; 19:ijms19061740. [PMID: 29895759 PMCID: PMC6032328 DOI: 10.3390/ijms19061740] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 06/06/2018] [Accepted: 06/08/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Cardiovascular disorders (CVD) and major depressive disorder (MDD) are the most frequent diseases worldwide responsible for premature death and disability. Behavioral and immunological variables influence the pathophysiology of both disorders. We therefore determined frequency and severity of MDD in CVD and studied whether MDD without CVD or other somatic diseases influences classical and inflammatory biomarkers of cardiovascular risk. In addition, we investigated the influence of proinflammatory cytokines on antidepressant treatment outcome. METHODS In a case-control design, 310 adults (MDD patients without CVD, CVD patients, and cardiologically and psychiatrically healthy matched controls) were investigated. MDD patients were recruited after admission in a psychiatric university hospital. Primary outcome criteria were clinical depression ratings (HAM-D scale), vital signs, classical cardiovascular risk factors and inflammatory biomarkers which were compared between MDD patients and healthy controls. RESULTS We detected an enhanced cardiovascular risk in MDD. Untreated prehypertension and signs directing to a metabolic syndrome were detected in MDD. Significantly higher inflammatory biomarkers such as the high sensitivity C-reaktive protein (hsCRP) and proinflammatory acute phase cytokines interleukine-1β (IL-1β) and interleukine-6 (IL-6) underlined the higher cardiovascular risk in physically healthy MDD patients. Surprisingly, high inflammation markers before treatment were associated with better clinical outcome and faster remission. The rate of MDD in CVD patients was high. CONCLUSIONS Patients suffering from MDD are at specific risk for CVD. Precise detection of cardiovascular risks in MDD beyond classical risk factors is warranted to allow effective prophylaxis and treatment of both conditions. Future studies of prophylactic interventions may help to provide a basis for prophylactic treatment of both MDD and CVD. In addition, the high risk for MDD in CVD patients was confirmed and underlines the requirement for clinical attention.
Collapse
Affiliation(s)
- Thomas C Baghai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University of Munich, Nußbaumstraße 7, D-80336 Munich, Germany.
- Department of Psychiatry and Psychotherapy, University Regensburg, Universitätsstraße 84, D-93053 Regensburg, Germany.
| | - Gabriella Varallo-Bedarida
- Department of Internal Medicine-Preventive Cardiology, Ludwig-Maximilian-University of Munich, Ziemssenstraße 1, D-80336 Munich, Germany.
| | - Christoph Born
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University of Munich, Nußbaumstraße 7, D-80336 Munich, Germany.
| | - Sibylle Häfner
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University of Munich, Nußbaumstraße 7, D-80336 Munich, Germany.
| | - Cornelius Schüle
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University of Munich, Nußbaumstraße 7, D-80336 Munich, Germany.
| | - Daniela Eser
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University of Munich, Nußbaumstraße 7, D-80336 Munich, Germany.
| | - Peter Zill
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University of Munich, Nußbaumstraße 7, D-80336 Munich, Germany.
| | - André Manook
- Department of Psychiatry and Psychotherapy, University Regensburg, Universitätsstraße 84, D-93053 Regensburg, Germany.
| | - Johannes Weigl
- Department of Psychiatry and Psychotherapy, University Regensburg, Universitätsstraße 84, D-93053 Regensburg, Germany.
| | - Somayeh Jooyandeh
- Department of Psychiatry and Psychotherapy, University Regensburg, Universitätsstraße 84, D-93053 Regensburg, Germany.
| | - Caroline Nothdurfter
- Department of Psychiatry and Psychotherapy, University Regensburg, Universitätsstraße 84, D-93053 Regensburg, Germany.
| | - Clemens von Schacky
- Department of Internal Medicine-Preventive Cardiology, Ludwig-Maximilian-University of Munich, Ziemssenstraße 1, D-80336 Munich, Germany.
| | - Brigitta Bondy
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University of Munich, Nußbaumstraße 7, D-80336 Munich, Germany.
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University of Munich, Nußbaumstraße 7, D-80336 Munich, Germany.
- Department of Psychiatry and Psychotherapy, University Regensburg, Universitätsstraße 84, D-93053 Regensburg, Germany.
- Max-Planck Fellow at the Max-Planck-Institute for Psychiatry, Kraepelinstraße 2-10, D-80804 Munich, Germany.
| |
Collapse
|
29
|
Choo CC, Chew PKH, Ho CS, Ho RC. Quality of Life in Patients With a Major Mental Disorder in Singapore. Front Psychiatry 2018; 9:727. [PMID: 30713508 PMCID: PMC6346635 DOI: 10.3389/fpsyt.2018.00727] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 12/10/2018] [Indexed: 11/29/2022] Open
Abstract
Background: There has been a paradigm shift in mental health service delivery, from a focus on reducing symptoms to a more holistic approach, which considers Quality of Life (QoL). Method: This study aimed to explore prediction of Quality of Life (QoL) in Asian patients with a major mental disorder i.e., depression or schizophrenia in Singapore. In the current study, there were 43 patients (65.1% females) with depression. Their ages ranged from 18 to 65 (M = 44.63, SD = 12.22). The data were combined with the data on patients with schizophrenia, where there were 43 patients (65.1% females) with schizophrenia, their ages ranging from 18 to 65 (M = 44.60, SD = 12.19). Results: The components of QoL were examined i.e., Physical Component Summary (PCS) and Mental Component Summary (MCS). For all patients, social support and age accounted for 17.3% of the variance in PCS, F (2, 83) = 8.66, p < 0.001. For patients with depression, disorder severity, age, and duration of treatment accounted for 48.3% of the variance in PCS, F (3, 39) = 12.15, p < 0.001. For patients with schizophrenia, education (Primary or Lower vs. Post-Secondary or Higher) and emotional coping accounted for 21.3% of the variance in PCS, F (2, 40) = 5.40, p < 0.01. For all patients, self-efficacy and age accounted for 27.0% of the variance in MCS, F (2, 83) = 15.37, p < 0.001. For patients with depression, disorder severity accounted for 45.6% of the variance in MCS, F (1, 41) = 34.33, p < 0.001. For patients with schizophrenia, number of hospitalizations accounted for 18.5% of the variance in MCS, F (1, 41) = 9.29, p < 0.01. Conclusion: The findings were discussed in regards to implications in interventions to enhance QoL of patients with schizophrenia and depression in Singapore.
Collapse
Affiliation(s)
- Carol C Choo
- Department of Psychology, College of Healthcare Sciences, James Cook University, Singapore, Singapore
| | - Peter K H Chew
- Department of Psychology, College of Healthcare Sciences, James Cook University, Singapore, Singapore
| | - Cyrus S Ho
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Roger C Ho
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.,Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| |
Collapse
|