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Journal ArticleDOI

Psychosocial predictors of cardiac rehabilitation quality-of-life outcomes.

TL;DR: Psychosocial characteristics were interrelated, and they predicted postrehabilitation QoL outcome directly or indirectly through depression symptom severity.
About: This article is published in Journal of Psychosomatic Research.The article was published on 2006-01-01. It has received 44 citations till now. The article focuses on the topics: Psychosocial & Hostility.
Citations
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Journal ArticleDOI
TL;DR: The success of CR may critically depend on the interdependence of the body and mind and this interaction needs to be reflected through the assessment and management of PSRFs in line with robust scientific evidence by trained staff, integrated within the core CR team.
Abstract: A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality of life (HRQoL) and prognosis in patients with established CHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system. Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening questions, standardised questionnaires, or structured clinical interviews. Psychotherapy and medication can be considered to alleviate any PSRF-related symptoms and to enhance HRQoL, but the evidence for a definite beneficial effect on cardiac endpoints is inconclusive. A multimodal behavioural intervention, integrating counselling for PSRFs and coping with illness should be included within comprehensive CR. Patients with clinically significant symptoms of distress should be referred for psychological counselling or psychologically focused interventions and/or psychopharmacological treatment. To conclude, the success of CR may critically depend on the interdependence of the body and mind and this interaction needs to be reflected through the assessment and management of PSRFs in line with robust scientific evidence, by trained staff, integrated within the core CR team.

219 citations


Cites background from "Psychosocial predictors of cardiac ..."

  • ...Hostility has been shown to contribute to lower baseline and follow-up HRQoL in CR.(120) A reduction in psychological stress, including symptoms of hostility, through exercise-based CR, has been shown to explain, in part, a reduced mortality risk for CHD patients....

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  • ...Depression and depressive symptoms are highly relevant to CR....

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  • ...There is some overlap between hostility and anger-proneness; hostile behaviours may show in overt expression of angry feelings and verbal aggressiveness.4 CR may decrease hostility and anger significantly.135,136 Hostility has been shown to contribute to lower baseline and follow-up HRQoL in CR.120 A reduction in psychological stress, including symptoms of hostility, through exercise-based CR, has been shown to explain, in part, a reduced mortality risk for CHD patients.24 Type D personality is characterised by increased levels of negative emotions (i.e. negative affectivity), such as worrying, depressive feelings and irritability, with a greater use of maladaptive coping strategies plus a tendency towards social inhibition and isolation.137,138 Type D is present in approximately one-third of patients with CVD....

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  • ...Social support during CR can stem from various sources such as health professionals, family members and employers(119) and, by its association with depression may contribute to post-rehabilitation quality of life (QoL).(120) Marital and family concerns should be addressed in support interventions....

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  • ...It has been shown that job stressors can successfully be reduced through CR.111...

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Journal ArticleDOI
TL;DR: A framework for understanding the cultural experience of the Mexican American population is presented and implications for innovative health promotion practices with women and their families are presented.
Abstract: Based on an in-depth analysis of current empirical research, this article presents a framework for understanding the cultural experience of the Mexican American population and presents implications for innovative health promotion practices with women and their families. The framework sheds light on the complex ways in which individuals from this population integrate their cultural values in their everyday responses to health. Three patterns emerge: (a) cultural expectations and beliefs can be shared by and work complementarily in the family and the larger social context; (b) cultural beliefs can be a source of tension and stress as a result of pressures in the environment; and (c) cultural values can become less important than other concerns, such as problems related to access when dealing with the healthcare system.

70 citations

Journal ArticleDOI
TL;DR: Coping has emerged as an important factor in explaining some quality-of-life domains but not others, which has important implications especially when employing HRQoL as an outcome measure in clinical trials.

69 citations


Cites background from "Psychosocial predictors of cardiac ..."

  • ...Those who experienced elevated depressive symptoms employed maladaptive coping strategies and reported a poorer HRQoL [50]....

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Journal ArticleDOI
TL;DR: Findings suggest that both emotion regulation and illness-focused coping strategies are integral parts of the illness-related negative emotions—health relationship.
Abstract: In this study we examined whether emotion regulation and illness-focused coping strategies mediate and/ or moderate the relation of illness-related negative emotions to patients’ subjective health. One hundred and thirty-five cardiac patients participated in the study. Illness-focused coping strategies were found to mediate the relation of emotions to physical functioning, whereas emotion regulation strategies mediated the relation to psychological well-being. Moreover, an emotion regulation strategy (i.e. emotion suppression) and two illness-focused coping strategies (instrumental coping and adherence) moderated the two relationships. These findings suggest that both emotion regulation and illness-focused coping strategies are integral parts of the illness-related negative emotions—health relationship.

53 citations


Cites result from "Psychosocial predictors of cardiac ..."

  • ...…those suggested by the CSM (Leventhal et al., 1980), the modal model of emotion (Gross and Thompson, 2007) and the transactional theory of stress and coping (Lazarus and Folkman, 1984), and also to the findings of several other studies (e.g. Gilbar, 2005; Gross and John, 2003; Shen et al., 2006)....

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  • ..., 1980), the modal model of emotion (Gross and Thompson, 2007) and the transactional theory of stress and coping (Lazarus and Folkman, 1984), and also to the findings of several other studies (e.g. Gilbar, 2005; Gross and John, 2003; Shen et al., 2006)....

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Journal ArticleDOI
TL;DR: Factors predicting HRQoL in newly diagnosed coronary heart disease patients can be divided into 3 groups: sociodemographic, clinical, and psychosocial and the importance of assessing factors that predict HRZoL at baseline and throughout the trajectory of this chronic illness is shown.
Abstract: Background Newly diagnosed coronary heart disease patients can experience significant negative changes in their health-related quality of life (HRQoL). No existing literature review was found related to factors predicting HRQoL in newly diagnosed coronary heart disease patients. Purpose The aim of this study was to identify factors predicting HRQoL in newly diagnosed coronary heart disease patients. Review methods We searched studies published between 1997 and 2009 with combinations of key words including factors, predictor, health-related quality of life, quality of life, first diagnosed coronary heart disease patients, and coronary heart disease patients. Data sources were ProQuest, ScienceDirect, CINAHL, PsychINFO, PubMed, and Scopus. Seventeen studies were identified that primarily examined HRQoL from 6 weeks to 12 months after diagnosis. Conclusions Factors predicting HRQoL in newly diagnosed coronary heart disease patients can be divided into 3 groups: sociodemographic, clinical, and psychosocial. Characteristics in each category most strongly predictive of HRQoL in newly diagnosed coronary heart disease patients were: Sociodemographic positive predictors were baseline HRQoL, education level, and marital status; sociodemographic negative predictors included number of cardiovascular risks and female gender. Age was an inverse predictor. Clinical negative predictors included angina, physical functioning, and fatigue. Psychosocial positive predictors included social support and a sense of coherence, whereas depression, anxiety and depression, overall psychosocial characteristics or mood disturbance, anxiety, and hostility were negative predictors. Clinical implications This review identifies predictors of HRQoL and shows the importance of assessing factors that predict HRQoL at baseline and throughout the trajectory of this chronic illness because the concept of HRQoL changes over time but the predictors remain constant.

50 citations


Cites background or result from "Psychosocial predictors of cardiac ..."

  • ...A small number of studies were gender specific.(6,30) This might be a confounding factor and may limit generalizability....

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  • ...Most of the studies included both genders, except for 2 studies that reported only women(21,31) and 2 studies that reported only men.(6,30) The number of participants and age ranges for each study are included in Table 1....

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  • ...According to Shen et al,(30) predicted QoL outcome was directly and independently predicted by baseline QoL positively, by hostility negatively, and by depression symptom severity negatively.(30) Furthermore, psychosocial characteristics (hostility negatively, social support positively, and maladaptive coping...

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  • ...One characteristic included in 2 reports that differed from the other studies was coping.(8,30) One study(13)...

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  • ...The psychosocial characteristics that were found most commonly to be negative predictors of HRQoL in newly diagnosed CHD patients included depression,(6,9,27,30,35) followed by lack of social support,(6,31,27) anxiety and depression,(28,29) overall psychosocial characteristics or mood disturbance,(14,31) anxiety,(35) and hostility.(30) Only sense of coherence(6,27,33) was a positive predictor of HRQoL at this time....

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References
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Journal ArticleDOI
TL;DR: The difficulties inherent in obtaining consistent and adequate diagnoses for the purposes of research and therapy have been pointed out and a wide variety of psychiatric rating scales have been developed.
Abstract: The difficulties inherent in obtaining consistent and adequate diagnoses for the purposes of research and therapy have been pointed out by a number of authors. Pasamanick12in a recent article viewed the low interclinician agreement on diagnosis as an indictment of the present state of psychiatry and called for "the development of objective, measurable and verifiable criteria of classification based not on personal or parochial considerations, but on behavioral and other objectively measurable manifestations." Attempts by other investigators to subject clinical observations and judgments to objective measurement have resulted in a wide variety of psychiatric rating scales.4,15These have been well summarized in a review article by Lorr11on "Rating Scales and Check Lists for the Evaluation of Psychopathology." In the area of psychological testing, a variety of paper-and-pencil tests have been devised for the purpose of measuring specific

35,176 citations


"Psychosocial predictors of cardiac ..." refers methods in this paper

  • ...Beck Depression Inventory (BDI) The Beck Depression Inventory (BDI; [47]) was employed to assess the patient’s depressive symptom severity....

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Journal ArticleDOI
TL;DR: A multidimensional coping inventory to assess the different ways in which people respond to stress was developed and an initial examination of associations between dispositional and situational coping tendencies was allowed.
Abstract: We developed a multidimensional coping inventory to assess the different ways in which people respond to stress. Five scales (of four items each) measure conceptually distinct aspects of problem-focused coping (active coping, planning, suppression of competing activities, restraint coping, seeking of instrumental social support); five scales measure aspects of what might be viewed as emotional-focused coping (seeking of emotional social support, positive reinterpretation, acceptance, denial, turning to religion); and three scales measure coping responses that arguably are less useful (focus on and venting of emotions, behavioral disengagement, mental disengagement). Study 1 reports the development of scale items. Study 2 reports correlations between the various coping scales and several theoretically relevant personality measures in an effort to provide preliminary information about the inventory's convergent and discriminant validity. Study 3 uses the inventory to assess coping responses among a group of undergraduates who were attempting to cope with a specific stressful episode. This study also allowed an initial examination of associations between dispositional and situational coping tendencies.

10,143 citations


"Psychosocial predictors of cardiac ..." refers result in this paper

  • ...Consistent with prior research [49], results showed that items mainly fell into two groups of coping reactions—active and maladaptive coping....

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Book
01 Jan 1989

9,143 citations


"Psychosocial predictors of cardiac ..." refers methods in this paper

  • ...The model was subjected to SEM analysis based on the model of Bentler and Weeks [51] with the EQS program [52]....

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Journal ArticleDOI
TL;DR: A brief form of a previously published measure of coping assessing several responses known to be relevant to effective and ineffective coping called the COPE inventory is presented, which has proven to be useful in health-related research.
Abstract: Studies of coping in applied settings often confront the need to minimize time demands on participants. The problem of participant response burden is exacerbated further by the fact that these studies typically are designed to test multiple hypotheses with the same sample, a strategy that entails the use of many time-consuming measures. Such research would benefit from a brief measure of coping assessing several responses known to be relevant to effective and ineffective coping. This article presents such a brief form of a previously published measure called the COPE inventory (Carver, Scheier, & Wcintraub, 1989), which has proven to be useful in health-related research. The Brief COPE omits two scales of the full COPE, reduces others to two items per scale, and adds one scale. Psychometric properties of the Brief COPE arc reported, derived from a sample of adults participating in a study of the process of recovery after Hurricane Andrew.

5,820 citations


"Psychosocial predictors of cardiac ..." refers methods in this paper

  • ...Maladaptive coping The maladaptive coping scale was derived from the brief COPE inventory [48], which assesses an individual’s coping responses when encountering stress and adversity....

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Journal ArticleDOI
TL;DR: The development and evaluation of a brief, multidimensional, self-administered, social support survey that was developed for patients in the Medical Outcomes Study (MOS), a two-year study of patients with chronic conditions is described.

5,617 citations


"Psychosocial predictors of cardiac ..." refers background in this paper

  • ...In terms of their psychosocial characteristics, as a group in general, the participants were mildly depressed, reported comparable levels of perceived support as did other individuals with chronic illness [54], endorsed the use of maladaptive coping infrequently, and appeared to be neutral on the hostility scale....

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