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M. Gouva - One of the best experts on this subject based on the ideXlab platform.
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Quality of life in patients with type 2 diabetes mellitus: a cross-sectional study
International Journal of Pharmaceutical and Healthcare Marketing, 2019Co-Authors: Vasiliki Sionti, Evangelia Kotrotsiou, Giorgos Papageorgiou, Dimitrios Peschos, George Charalambous, Pavlos Christodoulides, Victoria Zakopoulou, M. GouvaAbstract:The purpose of this paper is to investigate certain social and psychological parameters and to compare them with basic demographic information, such as the gender and the education, of patients suffering from Type 2 diabetes mellitus (T2DM).,A cross-sectional study of Type 2 diabetic patients was conducted. In total, 200 patients with T2DM were enrolled in the study. Psychological factors were assessed with questionnaires, including the Symptom Checklist 90-R (SCL-90-R), the Short-Form Health Survey (SF-36), the Life Orientation Test-Revised (LOT-R) and the Cardiac Anxiety Questionnaire (CAQ). The associations of psychological with socio-demographic factors were assessed through logistic regression analyses.,Women patients had higher levels of heart-focused Anxiety psychopathology than men, and therefore, women tend to avoid activities that burden the heart. Men patients had a significantly higher index of physical functionality than women. No differences were recorded by the SCL-90R questionnaire between men and women. For the patients with elementary education, lower levels of mental health (SF-36-MCS) were observed.,The chronicity of the disease aggravates the psychopathology of the patients thereby creating adverse impact not only on health but also on efforts for compliance. A personalized approach by the health professionals could contribute in addressing the psychological factors that accompany T2DM.
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Symptoms of Cardiac Anxiety in Family Members of Intensive Care Unit Patients
American journal of critical care : an official publication American Association of Critical-Care Nurses, 2016Co-Authors: Zoe Konstanti, M. Gouva, Elena Dragioti, Georgios Nakos, Vasilios KoulourasAbstract:BACKGROUND Studies have shown an association between intensive care unit environments and symptoms of psychological distress in family members of critically ill patients. OBJECTIVE To investigate levels of Cardiac Anxiety in family members of intensive care unit patients. METHODS From March 2012 to July 2013, on the third day after the patient's admission, 223 family members of 147 patients completed the Cardiac Anxiety Questionnaire. A total score was calculated from 3 subscales: fear and worry about heart sensations, avoidance of activities reproducing Cardiac symptoms, and heart-focused attention and monitoring of Cardiac activity. RESULTS Among the family members, 142 were women (63.7%) and 81 (36.3%) were men, 150 (67.3%) were married, and 37 (16.6%) were unemployed. Their mean score for overall Cardiac Anxiety was 1.11 (SD, 0.64), significantly higher (P < .001) than for the general Greek population. Although all 3 subscales scores were significantly higher than for the general population, the highest score was recorded for the avoidance subscale (mean, 1.77; SD, 0.68). The relationship to the patient had a significant effect on heart-focused attention (F5 = 3.51; P = .03). The mean score for patients' siblings (2.0; SD, 0.01) differed significantly (P = .02) from the mean for other family member groups. Older adults (P = .02) and married participants (P = .05) reported higher levels of fear and worry related to Cardiac stimuli, and women further reported higher levels of cardioprotective avoidance behavior (P = .02). CONCLUSIONS A noticeable number of family members of critical care patients had moderate to severe Cardiac Anxiety during the hospitalization of their relatives.
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EPA-0598 – Psychological risk factors in essential hypertension:new insights to gender variations
European Psychiatry, 2014Co-Authors: Elena Dragioti, M. Gouva, D. TsartsalisAbstract:Introduction Modern psychosomatic research has found multiple evidence for an impact of psychosocial factors on the development of arterial hypertension. Aims To evaluate the burden of these factors among the two sexes. Methods A sample of 198 hypertensive patients (89 men – 108 women, mean age 52,9 years, SD = 11,81 ranged 26–78) participated to the present study. The questionnaires included: a) questionnaire recording social-demographic characteristics and clinical features, b)The Short Form 36 (SF-36) General Health Survey questionnaire, c) the Beck Depression Inventory –II, d) Eysenck Personality Questionnaire and e) The Cardiac Anxiety Questionnaire (CAQ-greek version). SPSS for Windows 14.0 and STATA 10 were used for statistical analysis. Results Age was not differ significantly among the two sexes (t = −1.638, p =.028). Models of stepwise approach logistic regression, examining the associations between gender and psychological issues, were performed. Model 1 was adjusted for age, socio-demographic variables and clinical parametres. Quality of life, depression, personality traits, and Cardiac Anxiety scores were introduced in step model 2. In model 3, after controlling for age, socio-demographic variables and clinical features female hypertensive participants had a higher risk of somatization (OR=1.46, 95% CI=1.02–1.29), paranoid ideation (OR=1.23, 95% CI=1.04 –1.46) and psychotisism (OR=1.37, 95% CI=1.14–2.45). Conclusions Findings support the hypothesis that hypertensive women shows a serious psychological dysfunctional behaviour, which can be attributed to their gender. Since this relation was not explained by relevant confounders there is a need for create preventive methods or treatment programmes in order to minimaze these effects
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EPA-1585 - The role of identifications in women specific fears
European Psychiatry, 2014Co-Authors: T. Paralikas, Evangelia Kotrotsiou, Elena Dragioti, S. Kotrotsiou, M. GouvaAbstract:Introduction Because the biologically related members of a family shareunique properties, identifications with family members are the strongest andhardest to change. Hence, beliefs about self and the balance ofconfidence or doubt depend, in part, on the behaviors of all members of thefamily. Objectives To investigate therelationship of family identifications in female Anxiety and fear related tohealth behaviors. Aim To examine the impact offamily identifications in women with specific fears which are raised from bodilysensations. Methods A community sample of 101women (mean age 20.81 years, SD = 0.91 ranged 20-25) participated to thepresent study. The girls completed a) the Symptom Check-List Revised (SCL-90) b)the Cardiac Anxiety Questionnaire (CAQ) c) the Fear of Pain and b)questionnaire concerning socio-demographic information and questions for familyidentifications. Results Themajority of women reported that they matched to the father in terms ofidentifications (47.1%). Age and birth order were not contributed on familyidentifications (F (5)= 2.188, p=.062 and F(3)=1.244, p=.299 respectively). Multivariate analysis by using ANOVA found statistical significant associationsbetween family nature identifications and fear of pain, while the most stronglyadvocacy to a family member was correlated with heart focused Anxiety. Theresults are summarized in table 1. Conclusion On the whole our resultshighlighted the role of family identifications and increasing female fear andavoidance behaviors. Table 1. Impact of family identifications on female Cardiac Anxiety and Fear Bodily Pain. Variables Nature identifications Character identifications Most strongly advocacy to a family member Fear CAQ .323 .901 .543 Avoidance CAQ .972 .804 .045* Attention CAQ .367 .948 .008** Total CAQ .452 .938 .044* Minor Fear of Pain .038* .871 .161 Severe Fear of Pain .318 .610 .385 Medical Fear of Pain .007** .909 .349 Total FPQ .026* .944 .200
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Quality of life and Psychopathology in Essential Hypertension with Dyslipidaemia
2014Co-Authors: D. Tsartsalis, E. Dragkioti, M. Gouva, P. Sakkas, K. Kontoaggelos, C. Pitsavos, C. Papageorgiou, C. Stefanadis, I. KallikazarosAbstract:Background:Patients with chronic conditions like hypertension may experience many negative emotions which increase their risk for poor quality of lifeas well as the development of Anxiety and depression symptomatology. However little is known about hypertension accompanied by dyslipidaemia. Aim: This study aimed to investigate the possible differences between hypertensive patients with dyslipidaemia and hypertensive patients without dyslipidaemia on quality of life and mental health. Methods:One hundred and nineteen-seven patients with essential hypertension participated and classified into two groups― dyslipidemic and non dyslipidaemic ― based on the levels of hypertension and cholesterol after medical examination. Along with a questionnaire regarding demographics and clinical features the SF-36 Health Survey, the Symptom Checklist-90-R, and the Cardiac Anxiety Questionnaire were administered. Results: Lower levels of Physical Functioning (p=.001), Role –Physical (p=.046), Vitality (p=.000), Bodily Pain (p=.004), General Health (p=.000) and Physical Component Summary (p=.000)betweendyslipidemic and non dyslipidaemichypertensive patients were found. Significant differences between groups were also observed in all dimensions of psychopathology with exception to Hostility (p=.097), and Phobic Anxiety (p=.472). Apart from the avoidance subscale (p=.018), no difference onheart focused Anxiety between the two groups was found. Logistic regression model found that dyslipidaemic hypertensive patients had in general a higher risk of impairment regarding quality of life and psychopathology. Conclusions: There is a significant association between presence of dyslipidaemia and deteriorated quality of life as well as mental symptomatology inhypertensive patients. The need for a more target therapeutic schema is outlined.
Tiny Jaarsma - One of the best experts on this subject based on the ideXlab platform.
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The associations between psychological distress and health-related quality of life in patients with non-Cardiac chest pain
Health and quality of life outcomes, 2020Co-Authors: Ghassan Mourad, Anna Strömberg, Tiny Jaarsma, Jenny Alwin, Peter JohanssonAbstract:Recurrent chest pain episodes with no clear explanation may affect patients’ psychological wellbeing and health-related quality of life (HRQoL) negatively. Despite the fact that a significant amount of patients with non-Cardiac chest pain (NCCP) might have a history of Cardiac Disease (CD), there is today a lack of knowledge on how CD influences the association between psychological wellbeing and HRQoL in patients with NCCP. Therefore, the aim of this study is to describe HRQoL in patients with NCCP, with or without history of CD, and to explore the association between HRQoL and Cardiac Anxiety, depressive symptoms, fear of body sensations and somatization. Five hundred fifty-two patients discharged with NCCP from four hospitals in Southeast Sweden completed the EQ-5D, Cardiac Anxiety Questionnaire, Patient Health Questionnaire-9, Body Sensations Questionnaire, and Patient Health Questionnaire-15. Fifty precent reported at least moderate problems regarding pain/discomfort and 25% reported at least moderate problems in the HRQoL dimensions mobility, usual activities, and Anxiety/depression. Patients with NCCP and history of CD reported significantly lower HRQoL (p ≤ 0.05) compared to patients with NCCP without CD. In the total study population, Cardiac Anxiety, depressive symptoms, and somatization had weak significant negative associations (beta = 0.187–0.284, p
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The associations between psychological distress and health-related quality of life in patients with non-Cardiac chest pain
Health and Quality of Life Outcomes, 2020Co-Authors: Ghassan Mourad, Anna Strömberg, Tiny Jaarsma, Jenny Alwin, Peter JohanssonAbstract:Background Recurrent chest pain episodes with no clear explanation may affect patients’ psychological wellbeing and health-related quality of life (HRQoL) negatively. Despite the fact that a significant amount of patients with non-Cardiac chest pain (NCCP) might have a history of Cardiac Disease (CD), there is today a lack of knowledge on how CD influences the association between psychological wellbeing and HRQoL in patients with NCCP. Therefore, the aim of this study is to describe HRQoL in patients with NCCP, with or without history of CD, and to explore the association between HRQoL and Cardiac Anxiety, depressive symptoms, fear of body sensations and somatization. Methods Five hundred fifty-two patients discharged with NCCP from four hospitals in Southeast Sweden completed the EQ-5D, Cardiac Anxiety Questionnaire, Patient Health Questionnaire-9, Body Sensations Questionnaire, and Patient Health Questionnaire-15. Results Fifty precent reported at least moderate problems regarding pain/discomfort and 25% reported at least moderate problems in the HRQoL dimensions mobility, usual activities, and Anxiety/depression. Patients with NCCP and history of CD reported significantly lower HRQoL ( p ≤ 0.05) compared to patients with NCCP without CD. In the total study population, Cardiac Anxiety, depressive symptoms, and somatization had weak significant negative associations (beta = 0.187–0.284, p
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The associations between psychological distress and healthcare use in patients with non-Cardiac chest pain: does a history of Cardiac disease matter?
BMC psychiatry, 2018Co-Authors: Ghassan Mourad, Anna Strömberg, Tiny Jaarsma, Erland Svensson, Peter JohanssonAbstract:Psychological distress such as somatization, fear of body sensations, Cardiac Anxiety and depressive symptoms is common among patients with non-Cardiac chest pain, and this may lead to increased healthcare use. However, the relationships between the psychological distress variables and healthcare use, and the differences in relation to history of Cardiac disease in these patients has not been studied earlier. Therefore, our aim was to explore and model the associations between different variables of psychological distress (i.e. somatization, fear of body sensations, Cardiac Anxiety, and depressive symptoms) and healthcare use in patients with non-Cardiac chest pain in relation to history of Cardiac disease. In total, 552 patients with non-Cardiac chest pain (mean age 64 years, 51% women) responded to the Patient Health Questionnaire-15, Body Sensations Questionnaire, Cardiac Anxiety Questionnaire, Patient Health Questionnaire-9 and one question regarding number of healthcare visits. The relationships between the psychological distress variables and healthcare visits were analysed using Structural Equation Modeling in two models representing patients with or without history of Cardiac disease. A total of 34% of the patients had previous Cardiac disease. These patients were older, more males, and reported more comorbidities, psychological distress and healthcare visits. In both models, no direct association between depressive symptoms and healthcare use was found. However, depressive symptoms had an indirect effect on healthcare use, which was mediated by somatization, fear of body sensations, and Cardiac Anxiety, and this effect was significantly stronger in patients with history of Cardiac disease. Additionally, all the direct and indirect effects between depressive symptoms, somatization, fear of body sensations, Cardiac Anxiety, and healthcare use were significantly stronger in patients with history of Cardiac disease. In patients with non-Cardiac chest pain, in particular those with history of Cardiac disease, psychological mechanisms play an important role for seeking healthcare. Development of interventions targeting psychological distress in these patients is warranted. Furthermore, there is also a need of more research to clarify as to whether such interventions should be tailored with regard to history of Cardiac disease or not.
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The associations between psychological distress and healthcare use in patients with non-Cardiac chest pain: does a history of Cardiac disease matter?
BMC Psychiatry, 2018Co-Authors: Ghassan Mourad, Anna Strömberg, Tiny Jaarsma, Erland Svensson, Peter JohanssonAbstract:Background Psychological distress such as somatization, fear of body sensations, Cardiac Anxiety and depressive symptoms is common among patients with non-Cardiac chest pain, and this may lead to increased healthcare use. However, the relationships between the psychological distress variables and healthcare use, and the differences in relation to history of Cardiac disease in these patients has not been studied earlier. Therefore, our aim was to explore and model the associations between different variables of psychological distress (i.e. somatization, fear of body sensations, Cardiac Anxiety, and depressive symptoms) and healthcare use in patients with non-Cardiac chest pain in relation to history of Cardiac disease. Methods In total, 552 patients with non-Cardiac chest pain (mean age 64 years, 51% women) responded to the Patient Health Questionnaire-15, Body Sensations Questionnaire, Cardiac Anxiety Questionnaire, Patient Health Questionnaire-9 and one question regarding number of healthcare visits. The relationships between the psychological distress variables and healthcare visits were analysed using Structural Equation Modeling in two models representing patients with or without history of Cardiac disease. Results A total of 34% of the patients had previous Cardiac disease. These patients were older, more males, and reported more comorbidities, psychological distress and healthcare visits. In both models, no direct association between depressive symptoms and healthcare use was found. However, depressive symptoms had an indirect effect on healthcare use, which was mediated by somatization, fear of body sensations, and Cardiac Anxiety, and this effect was significantly stronger in patients with history of Cardiac disease. Additionally, all the direct and indirect effects between depressive symptoms, somatization, fear of body sensations, Cardiac Anxiety, and healthcare use were significantly stronger in patients with history of Cardiac disease. Conclusions In patients with non-Cardiac chest pain, in particular those with history of Cardiac disease, psychological mechanisms play an important role for seeking healthcare. Development of interventions targeting psychological distress in these patients is warranted. Furthermore, there is also a need of more research to clarify as to whether such interventions should be tailored with regard to history of Cardiac disease or not.
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Psychological distress and healthcare use in patients with non-Cardiac chest pain: does a history of Cardiac disease matter?
2017Co-Authors: Ghassan Mourad, Anna Strömberg, Tiny Jaarsma, Erland Svensson, Peter JohanssonAbstract:Background: Patients with non-Cardiac chest pain (NCCP) suffer psychological distress such as somatization, fear of body sensations, Cardiac Anxiety and depressive symptoms, which can increase heal ...
Nina Øyen - One of the best experts on this subject based on the ideXlab platform.
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Predictors of Heart-Focused Anxiety in Patients Undergoing Genetic Investigation and Counseling of Long QT Syndrome or Hypertrophic Cardiomyopathy: A One Year Follow-up
Journal of Genetic Counseling, 2012Co-Authors: Anniken Hamang, Geir Egil Eide, Berit Rokne, Karin Nordin, Cathrine Bjorvatn, Nina ØyenAbstract:Since Long QT syndrome and Hypertrophic cardiomyopathy are inherited Cardiac disorders that may cause syncope, palpitations, serious arrhythmias, and sudden Cardiac death, at-risk individuals may experience heart-focused Anxiety. In a prospective multi-site study, 126 Norwegian patients attending genetic counseling were followed 1 year with multiple administration of questionnaires, including the Cardiac Anxiety Questionnaire, measuring three distinct symptoms of heart-focused Anxiety- avoidance , attention, and fear— in mixed linear analyses. Overall, at 1-year follow-up, patients with clinical diagnosis as compared to patients at genetic risk had significantly higher scores of avoidance ( p
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General Anxiety, depression, and physical health in relation to symptoms of heart-focused Anxiety-a cross sectional study among patients living with the risk of serious arrhythmias and sudden Cardiac death
Health and quality of life outcomes, 2011Co-Authors: Anniken Hamang, Geir Egil Eide, Berit Rokne, Karin Nordin, Nina ØyenAbstract:To investigate the role of three distinct symptoms of heart-focused Anxiety (cardio-protective avoidance, heart-focused attention, and fear about heart sensations) in relation to general Anxiety, depression and physical health in patients referred to specialized cardio-genetics outpatient clinics in Norway for genetic investigation and counseling. Participants were 126 patients (mean age 45 years, 53.5% women). All patients were at higher risk than the average person for serious arrhythmias and sudden Cardiac death (SCD) because of a personal or a family history of an inherited Cardiac disorder (familial long QT syndrome or hypertrophic cardiomyopathy). Patients filled in, Hospital Anxiety and Depression Scale, Short-Form 36 Health Survey, and Cardiac Anxiety Questionnaire, two weeks before the scheduled counseling session. The patients experienced higher levels of general Anxiety than expected in the general population (mean difference 1.1 (p < 0.01)). Hierarchical regression analyses showed that avoidance and fear was independently related to general Anxiety, depression, and physical health beyond relevant demographic covariates (age, gender, having children) and clinical variables (clinical diagnosis, and a recent SCD in the family). In addition to heart-focused Anxiety, having a clinical diagnosis was of importance for physical health, whereas a recent SCD in the family was independently related to general Anxiety and depression, regardless of disease status. Avoidance and fear may be potentially modifiable symptoms. Because these distinct symptoms may have important roles in determining general Anxiety, depression and physical health in at-risk individuals of inherited Cardiac disorders, the present findings may have implications for the further development of genetic counseling for this patient group.
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General Anxiety, depression, and physical health in relation to symptoms of heart-focused Anxiety-a cross sectional study among patients living with the risk of serious arrhythmias and sudden Cardiac death
Health and Quality of Life Outcomes, 2011Co-Authors: Anniken Hamang, Geir Egil Eide, Berit Rokne, Karin Nordin, Nina ØyenAbstract:Objective To investigate the role of three distinct symptoms of heart-focused Anxiety (cardio-protective avoidance , heart-focused attention , and fear about heart sensations) in relation to general Anxiety, depression and physical health in patients referred to specialized cardio-genetics outpatient clinics in Norway for genetic investigation and counseling. Methods Participants were 126 patients (mean age 45 years, 53.5% women). All patients were at higher risk than the average person for serious arrhythmias and sudden Cardiac death (SCD) because of a personal or a family history of an inherited Cardiac disorder (familial long QT syndrome or hypertrophic cardiomyopathy). Patients filled in, Hospital Anxiety and Depression Scale, Short-Form 36 Health Survey, and Cardiac Anxiety Questionnaire, two weeks before the scheduled counseling session. Results The patients experienced higher levels of general Anxiety than expected in the general population (mean difference 1.1 (p < 0.01)). Hierarchical regression analyses showed that avoidance and fear was independently related to general Anxiety, depression, and physical health beyond relevant demographic covariates (age, gender, having children) and clinical variables (clinical diagnosis, and a recent SCD in the family). In addition to heart-focused Anxiety, having a clinical diagnosis was of importance for physical health, whereas a recent SCD in the family was independently related to general Anxiety and depression, regardless of disease status. Conclusion Avoidance and fear may be potentially modifiable symptoms. Because these distinct symptoms may have important roles in determining general Anxiety, depression and physical health in at-risk individuals of inherited Cardiac disorders, the present findings may have implications for the further development of genetic counseling for this patient group.
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Predictors of Heart-Focused Anxiety in Patients Undergoing Genetic Investigation and Counseling of Long QT Syndrome or Hypertrophic Cardiomyopathy: A One Year Follow-up
Journal of genetic counseling, 2011Co-Authors: Anniken Hamang, Geir Egil Eide, Berit Rokne, Karin Nordin, Cathrine Bjorvatn, Nina ØyenAbstract:Since Long QT syndrome and Hypertrophic cardiomyopathy are inherited Cardiac disorders that may cause syncope, palpitations, serious arrhythmias, and sudden Cardiac death, at-risk individuals may experience heart-focused Anxiety. In a prospective multi-site study, 126 Norwegian patients attending genetic counseling were followed 1 year with multiple administration of questionnaires, including the Cardiac Anxiety Questionnaire, measuring three distinct symptoms of heart-focused Anxiety- avoidance, attention, and fear—in mixed linear analyses. Overall, at 1-year follow-up, patients with clinical diagnosis as compared to patients at genetic risk had significantly higher scores of avoidance (p < .002), attention (p < .005), and fear (p < .007). Sudden Cardiac death in close relatives, uncertainty whether other relatives previously had undergone genetic testing, patients’ perceived general health, self-efficacy expectations and procedural satisfaction with genetic counseling were influential in predicting the different symptoms of heart-focused Anxiety over time.
Jan Mårtensson - One of the best experts on this subject based on the ideXlab platform.
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Effectiveness of Enhanced External Counterpulsation Treatment on Symptom Burden, Medication Profile, Physical Capacity, Cardiac Anxiety, and Health-Related Quality of Life in Patients With Refractory Angina Pectoris.
The Journal of cardiovascular nursing, 2020Co-Authors: Liyew Desta, Anders Broström, Jan MårtenssonAbstract:BACKGROUND Patients with refractory angina pectoris experience recurrent symptoms that limit their functional capacity, including psychological distress and impaired health-related quality of life (HRQoL), despite optimized medical therapy. Enhanced external counterpulsation (EECP) is an evidence-based alternative noninvasive treatment. Although physical well-being and mental well-being are equally important components of health, few studies have investigated the psychological effects of EECP in patients with refractory angina pectoris. OBJECTIVE The aim of this study was to evaluate the effects of EECP treatment in patients with refractory angina pectoris regarding medication profile, physical capacity, Cardiac Anxiety, and HRQoL. METHODS This quasi-experimental study with 1-group pretest-posttest design includes a 6-month follow-up of 50 patients (men, n = 37; mean age, 65.8 years) who had undergone 1 EECP course. The following pretreatment and posttreatment data were collected: medication use, 6-minute walk test results, functional class according to the Canadian Cardiovascular Society, and self-reported (ie, questionnaire data) Cardiac Anxiety and HRQoL. In addition, the questionnaires were also completed at a 6-month follow-up. RESULTS After EECP treatment, patients used significantly less nitrates (P < .001), walking distance increased on average by 46 m (P < .001), and Canadian Cardiovascular Society class improved (P < .001). In addition, all but 1 subscale of Cardiac Anxiety and all HRQoL components improved significantly (P < .05). The positive effects for Cardiac Anxiety and HRQoL were maintained at the 6-month follow-up. CONCLUSIONS Enhanced external counterpulsation treatment resulted in reduced symptom burden, improved physical capacity, and less Cardiac Anxiety, leading to increased physical activity and enhanced life satisfaction for patients with refractory angina pectoris. Enhanced external counterpulsation treatment should be considered to improve the life situation for these patients.
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P2682Long-term effects of enhanced external counterpulsation treatment on symptom burden, usage of nitrates, physical capacity and health-related quality of life in patients with refractory angina pectoris
European Heart Journal, 2019Co-Authors: Liyew Desta, Anders Broström, Jan MårtenssonAbstract:Abstract Background Patients with refractory angina pectoris (RAP) suffer from debilitating symptoms with considerable limitation of functional capacity and impaired health-related quality of life (HRQoL) despite optimized medical therapy. Recurrent angina symptoms are strongly associated with psychological distress and Cardiac Anxiety (i.e., a subtype of Anxiety related to Cardiac sensations). Enhanced external counterpulsation (EECP) is an alternative non-invasive treatment for these patients. An EECP course includes 35 1-hour sessions over 7 weeks. No previous study has explored long-term EECP effects on Cardiac Anxiety in patients with RAP. Objective To evaluate the effects of EECP treatment in patients with RAP regarding usage of nitrates, physical capacity, Cardiac Anxiety and HRQoL. Methods A quasi experimental design with long-term follow-up (6 months) involving 50 patients (men=37, 47–91 years) who had finished one course of EECP. Assessment of average use of nitrates, six-minute walk test, functional class with Canadian Cardiovascular Society (CCS) classification and questionnaires for Cardiac Anxiety and HRQoL were collected pre and post treatment. In addition, the questionnaires were collected 6 months after completion of EECP. Results Patients used significantly less nitrates (p<0.001) compared to at the start of treatment. They enhanced the walking distance on average by 46 m after EECP (p<0.001) and CCS class also improved (p<0.001). All subscales except for one in Cardiac Anxiety were significantly reduced (p<0.05). All dimensions in HRQoL improved significantly (p<0.01). The positive effects in both Cardiac Anxiety and HRQoL were maintained 6 months after the treatment. Conclusions Patients with RAP received beneficial effects from EECP. Reduced symptom burden and improved physical capacity enable engagement in physical activities. Furthermore, less Cardiac Anxiety and improved HRQoL may enhance life satisfaction for these patients. EECP treatment should be considered to a greater extent to improve the life situation for these patients.
Peter Johansson - One of the best experts on this subject based on the ideXlab platform.
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The associations between psychological distress and health-related quality of life in patients with non-Cardiac chest pain
Health and quality of life outcomes, 2020Co-Authors: Ghassan Mourad, Anna Strömberg, Tiny Jaarsma, Jenny Alwin, Peter JohanssonAbstract:Recurrent chest pain episodes with no clear explanation may affect patients’ psychological wellbeing and health-related quality of life (HRQoL) negatively. Despite the fact that a significant amount of patients with non-Cardiac chest pain (NCCP) might have a history of Cardiac Disease (CD), there is today a lack of knowledge on how CD influences the association between psychological wellbeing and HRQoL in patients with NCCP. Therefore, the aim of this study is to describe HRQoL in patients with NCCP, with or without history of CD, and to explore the association between HRQoL and Cardiac Anxiety, depressive symptoms, fear of body sensations and somatization. Five hundred fifty-two patients discharged with NCCP from four hospitals in Southeast Sweden completed the EQ-5D, Cardiac Anxiety Questionnaire, Patient Health Questionnaire-9, Body Sensations Questionnaire, and Patient Health Questionnaire-15. Fifty precent reported at least moderate problems regarding pain/discomfort and 25% reported at least moderate problems in the HRQoL dimensions mobility, usual activities, and Anxiety/depression. Patients with NCCP and history of CD reported significantly lower HRQoL (p ≤ 0.05) compared to patients with NCCP without CD. In the total study population, Cardiac Anxiety, depressive symptoms, and somatization had weak significant negative associations (beta = 0.187–0.284, p
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The associations between psychological distress and health-related quality of life in patients with non-Cardiac chest pain
Health and Quality of Life Outcomes, 2020Co-Authors: Ghassan Mourad, Anna Strömberg, Tiny Jaarsma, Jenny Alwin, Peter JohanssonAbstract:Background Recurrent chest pain episodes with no clear explanation may affect patients’ psychological wellbeing and health-related quality of life (HRQoL) negatively. Despite the fact that a significant amount of patients with non-Cardiac chest pain (NCCP) might have a history of Cardiac Disease (CD), there is today a lack of knowledge on how CD influences the association between psychological wellbeing and HRQoL in patients with NCCP. Therefore, the aim of this study is to describe HRQoL in patients with NCCP, with or without history of CD, and to explore the association between HRQoL and Cardiac Anxiety, depressive symptoms, fear of body sensations and somatization. Methods Five hundred fifty-two patients discharged with NCCP from four hospitals in Southeast Sweden completed the EQ-5D, Cardiac Anxiety Questionnaire, Patient Health Questionnaire-9, Body Sensations Questionnaire, and Patient Health Questionnaire-15. Results Fifty precent reported at least moderate problems regarding pain/discomfort and 25% reported at least moderate problems in the HRQoL dimensions mobility, usual activities, and Anxiety/depression. Patients with NCCP and history of CD reported significantly lower HRQoL ( p ≤ 0.05) compared to patients with NCCP without CD. In the total study population, Cardiac Anxiety, depressive symptoms, and somatization had weak significant negative associations (beta = 0.187–0.284, p
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The associations between psychological distress and healthcare use in patients with non-Cardiac chest pain: does a history of Cardiac disease matter?
BMC psychiatry, 2018Co-Authors: Ghassan Mourad, Anna Strömberg, Tiny Jaarsma, Erland Svensson, Peter JohanssonAbstract:Psychological distress such as somatization, fear of body sensations, Cardiac Anxiety and depressive symptoms is common among patients with non-Cardiac chest pain, and this may lead to increased healthcare use. However, the relationships between the psychological distress variables and healthcare use, and the differences in relation to history of Cardiac disease in these patients has not been studied earlier. Therefore, our aim was to explore and model the associations between different variables of psychological distress (i.e. somatization, fear of body sensations, Cardiac Anxiety, and depressive symptoms) and healthcare use in patients with non-Cardiac chest pain in relation to history of Cardiac disease. In total, 552 patients with non-Cardiac chest pain (mean age 64 years, 51% women) responded to the Patient Health Questionnaire-15, Body Sensations Questionnaire, Cardiac Anxiety Questionnaire, Patient Health Questionnaire-9 and one question regarding number of healthcare visits. The relationships between the psychological distress variables and healthcare visits were analysed using Structural Equation Modeling in two models representing patients with or without history of Cardiac disease. A total of 34% of the patients had previous Cardiac disease. These patients were older, more males, and reported more comorbidities, psychological distress and healthcare visits. In both models, no direct association between depressive symptoms and healthcare use was found. However, depressive symptoms had an indirect effect on healthcare use, which was mediated by somatization, fear of body sensations, and Cardiac Anxiety, and this effect was significantly stronger in patients with history of Cardiac disease. Additionally, all the direct and indirect effects between depressive symptoms, somatization, fear of body sensations, Cardiac Anxiety, and healthcare use were significantly stronger in patients with history of Cardiac disease. In patients with non-Cardiac chest pain, in particular those with history of Cardiac disease, psychological mechanisms play an important role for seeking healthcare. Development of interventions targeting psychological distress in these patients is warranted. Furthermore, there is also a need of more research to clarify as to whether such interventions should be tailored with regard to history of Cardiac disease or not.
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The associations between psychological distress and healthcare use in patients with non-Cardiac chest pain: does a history of Cardiac disease matter?
BMC Psychiatry, 2018Co-Authors: Ghassan Mourad, Anna Strömberg, Tiny Jaarsma, Erland Svensson, Peter JohanssonAbstract:Background Psychological distress such as somatization, fear of body sensations, Cardiac Anxiety and depressive symptoms is common among patients with non-Cardiac chest pain, and this may lead to increased healthcare use. However, the relationships between the psychological distress variables and healthcare use, and the differences in relation to history of Cardiac disease in these patients has not been studied earlier. Therefore, our aim was to explore and model the associations between different variables of psychological distress (i.e. somatization, fear of body sensations, Cardiac Anxiety, and depressive symptoms) and healthcare use in patients with non-Cardiac chest pain in relation to history of Cardiac disease. Methods In total, 552 patients with non-Cardiac chest pain (mean age 64 years, 51% women) responded to the Patient Health Questionnaire-15, Body Sensations Questionnaire, Cardiac Anxiety Questionnaire, Patient Health Questionnaire-9 and one question regarding number of healthcare visits. The relationships between the psychological distress variables and healthcare visits were analysed using Structural Equation Modeling in two models representing patients with or without history of Cardiac disease. Results A total of 34% of the patients had previous Cardiac disease. These patients were older, more males, and reported more comorbidities, psychological distress and healthcare visits. In both models, no direct association between depressive symptoms and healthcare use was found. However, depressive symptoms had an indirect effect on healthcare use, which was mediated by somatization, fear of body sensations, and Cardiac Anxiety, and this effect was significantly stronger in patients with history of Cardiac disease. Additionally, all the direct and indirect effects between depressive symptoms, somatization, fear of body sensations, Cardiac Anxiety, and healthcare use were significantly stronger in patients with history of Cardiac disease. Conclusions In patients with non-Cardiac chest pain, in particular those with history of Cardiac disease, psychological mechanisms play an important role for seeking healthcare. Development of interventions targeting psychological distress in these patients is warranted. Furthermore, there is also a need of more research to clarify as to whether such interventions should be tailored with regard to history of Cardiac disease or not.
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Psychological distress and healthcare use in patients with non-Cardiac chest pain: does a history of Cardiac disease matter?
2017Co-Authors: Ghassan Mourad, Anna Strömberg, Tiny Jaarsma, Erland Svensson, Peter JohanssonAbstract:Background: Patients with non-Cardiac chest pain (NCCP) suffer psychological distress such as somatization, fear of body sensations, Cardiac Anxiety and depressive symptoms, which can increase heal ...