Self-Reported Physical Health, Mental Health and Participation in Health-Promoting Behaviours of Rural and Urban South Australian Adults With a History of Cardiovascular Disease (CVD)

Differences between rural ( n = 18) and urban ( n = 66) centenarians are examined across the following variables: physical health, activities of daily living, mental health, and life satisfaction. Results demonstrate higher levels of morale in rural residents and higher levels of functional health as exhibited by urban elders. Qualitative data support trends of increased degrees of independence among the rural participants. The absence of robust differences in rural and urban centenarians is discussed in terms of a leveling-off effect.

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Anxiety and Depression in Patients Who Undergo a Cerebrovascular Procedure

10.21203/rs.2.20492/v2 ◽

2020 ◽

Author(s):

Lauren Lombardo ◽

Richard Shaw ◽

Kathleen Sayles ◽

Dorothea Altschul

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Physical Health ◽

Global Mental Health ◽

Anxiety And Depression ◽

Life Outcomes ◽

Quality Of Life Outcomes ◽

Significant Difference ◽

History Of

Abstract Background: Observe the relationship of anxiety and depression on quality of life outcomes after open and endovascular cerebrovascular procedures. Methods: We retrospectively analyzed 349 patients who underwent a procedure for aneurysm, arteriovenous malformation, intraparenchymal hemorrhage, carotid stenosis, acute stroke, and conventional catheter angiogram over three years at a community hospital. We correlated pre-procedural anxiety and depression with Global Physical Health, Global Mental Health, and Modified Rankin Scale scores. We performed univariate and multivariate linear and logistic regression analyses adjusting for past medical history and sociodemographic factors. Results: Anxiety or depression occurred in eighteen percent of patients. Patients with anxiety or depression were more likely to be female (81% vs 60.8%; p=0.002) and younger (54 vs. 59 years old; p=0.025). The groups did not differ in type or urgency of procedure, smoking or history of diabetes, or cardiovascular disease. Patients with anxiety or depression reported lower mental health scores at 30 days (45.1 vs 48.2; p=0.002) post-procedure. In multivariate analyses, anxious or depressed patients had worse mental health scores at 30 days (t=-2.893; p=0.008) than those who did not have a history of anxiety or depression. There was no difference between groups in length of stay, mortality, physical health t-scores, functionality scores, or six month quality of life outcomes. Conclusions: Patients undergoing cerebrovascular procedures who self-reported anxiety or depression showed a significant difference in mental health outcomes at 30 days, but six month mental health and other medical and functional outcomes measures were similar to patients without these diagnoses.

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Predictors of cerebrovascular event reoccurrence in patients with depression: a retrospective cohort study

BMJ Open ◽

10.1136/bmjopen-2019-031927 ◽

2020 ◽

Vol 10 (1) ◽

pp. e031927 ◽

Cited By ~ 1

Author(s):

Wa Cai ◽

Christoph Mueller ◽

Hitesh Shetty ◽

Gayan Perera ◽

Robert Stewart

Keyword(s):

Mental Health ◽

Physical Health ◽

Cox Regression ◽

Previous History ◽

Research Centre ◽

Cerebrovascular Event ◽

Case Register ◽

Physical Health Problems ◽

History Of

ObjectivesTo identify predictors of recurrent cerebrovascular morbidity in a cohort of patients with depression and a cerebrovascular disease (CBVD) history.MethodsWe used the Maudsley Biomedical Research Centre Case Register to identify patients aged 50 years or older with a diagnosis of depressive disorder between 2008 and 2017 and a previous history of hospitalised CBVD. Using depression diagnosis as the index date we followed patients until first hospitalised CBVD recurrence or death due to CBVD. Sociodemographic data, symptom and functioning scores of Health of the Nation Outcome Scales, medications and comorbidities were extracted and modelled in multivariate survival analyses to identify predictors of CBVD reoccurrence.ResultsOf 1292 patients with depression and CBVD (mean age 75.6 years; 56.6% female), 264 (20.4%) experienced fatal/non-fatal CBVD recurrence during a median follow-up duration of 1.66 years. In multivariate Cox regression models, a higher risk of CBVD recurrence was predicted by older age (HR, 1.02; 95% CI, 1.01 to 1.04) (p=0.002), physical health problems (moderate to severe HR, 2.47; 95% CI, 1.45 to 4.19) (p=0.001), anticoagulant (HR, 1.40; 95% CI, 1.01 to 1.93) (p=0.041) and antipsychotic medication (HR, 0.66; 95% CI 0.44 to 0.99) (p=0.047). Neither depression severity, mental health symptoms, functional status, nor antidepressant prescribing were significantly associated with CBVD recurrence.ConclusionsApproximately one in five patients with depression and CBVD experienced a CBVD recurrence over a median follow-up time of 20 months. Risk of CBVD recurrence was largely dependent on age and physical health rather than on severity of depressive symptoms, co-morbid mental health or functional problems, or psychotropic prescribing.

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Fatalism Moderates the Relationship Between Family History of Cardiovascular Disease and Engagement in Health-Promoting Behaviors Among At-Risk Rural Kentuckians

The Journal of Rural Health ◽

10.1111/jrh.12094 ◽

2014 ◽

Vol 31 (2) ◽

pp. 206-216 ◽

Cited By ~ 8

Author(s):

Gia Mudd-Martin ◽

Mary Kay Rayens ◽

Terry A. Lennie ◽

Misook L. Chung ◽

Yevgeniya Gokun ◽

...

Keyword(s):

Cardiovascular Disease ◽

At Risk ◽

Family History ◽

Health Promoting Behaviors ◽

History Of ◽

Health Promoting ◽

The Relationship

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A qualitative study exploring the barriers and facilitators of implementing a cardiovascular disease risk reducing intervention for people with severe mental illness into primary care contexts across England: the ‘PRIMROSE’ trial.

10.21203/rs.2.15800/v2 ◽

2020 ◽

Author(s):

Suzan Hassan ◽

Samira Heinkel ◽

Alexandra Burton ◽

Ruth Blackburn ◽

Tayla McCloud ◽

...

Keyword(s):

Mental Health ◽

Cardiovascular Disease ◽

Primary Care ◽

Mental Illness ◽

Collective Action ◽

Physical Health ◽

Severe Mental Illness ◽

Mental Health Stigma ◽

Cvd Risk ◽

Healthcare Settings

Abstract Background: People with severe mental illness (SMI) are at greater risk of earlier mortality due to physical health problems including cardiovascular disease (CVD). There is limited work exploring whether physical health interventions for people with SMI can be embedded and/or adopted within specific healthcare settings. This information is necessary to optimise the development of services and interventions within healthcare settings. This study explores the barriers and facilitators of implementing a nurse-delivered intervention (‘PRIMROSE’) designed to reduce CVD risk in people with SMI in primary care, using Normalisation Process Theory (NPT), a theory that explains the dynamics of embedding or ‘normalising’ a complex intervention within healthcare settings .Methods: Semi-structured interviews were conducted between April-December 2016 with patients with SMI at risk of CVD who received the PRIMROSE intervention, and practice nurses and healthcare assistants who delivered it in primary care in England. Interviews were audio recorded, transcribed and analysed using thematic analysis. Emergent themes were then mapped on to constructs of NPT.Results: 15 patients and 15 staff participated. The implementation of PRIMROSE was affected by the following as categorised by the NPT domains: 1) Coherence, where both staff and patients expressed an understanding of the purpose and value of the intervention, 2) Cognitive participation, including mental health stigma and staff perceptions of the compatibility of the intervention to primary care contexts, 3) Collective action, including 3.1. interactional workability in terms of lack of patient engagement despite flexible appointment scheduling. The structured nature of the intervention and the need for additional nurse time were considered barriers, 3.2. Relational integration i.e. whereby positive relationships between staff and patients facilitated implementation, and access to ‘in-house’ staff support was considered important, 3.3. Skill-set workability in terms of staff skills, knowledge and training facilitated implementation, 3.4. Contextual integration regarding the accessibility of resources sometimes prevented collective action. 4) Reflexive monitoring, where the staff commonly appraised the intervention by suggesting designated timeslots and technology may improve the intervention. Conclusions: Future interventions for physical health in people with SMI could consider the following items to improve implementation: 1) training for practitioners in CVD risk prevention to increase practitioners knowledge of physical interventions 2) training in severe mental illness to increase practitioner confidence to engage with people with SMI and reduce mental health stigma and 3) access to resources including specialist services, additional staff and time. Access to specialist behaviour change services may be beneficial for patients with specific health goals. Additional staff to support workload and share knowledge may also be valuable. More time for appointments with people with SMI may allow practitioners to better meet patient needs.

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Anxiety and Depression in Patients Who Undergo a Cerebrovascular Procedure

10.21203/rs.2.20492/v1 ◽

2020 ◽

Author(s):

Lauren Lombardo ◽

Richard Shaw ◽

Kathleen Sayles ◽

Dorothea Altschul

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Physical Health ◽

Global Mental Health ◽

Anxiety And Depression ◽

Life Outcomes ◽

Quality Of Life Outcomes ◽

Significant Difference ◽

History Of

Abstract Background: Observe the relationship of anxiety and depression on quality of life outcomes after open and endovascular cerebrovascular procedures. Methods: We retrospectively analyzed 349 patients who underwent a procedure for aneurysm, arteriovenous malformation, intraparenchymal hemorrhage, carotid stenosis, acute stroke, and conventional catheter angiogram over three years at a community hospital. We correlated pre-procedural anxiety and depression with Global Physical Health, Global Mental Health, and Modified Rankin Scale scores. We performed univariate and multivariate linear and logistic regression analyses adjusting for past medical history and sociodemographic factors. Results: Anxiety or depression occurred in eighteen percent of patients. Patients with anxiety or depression were more likely to be female (81% vs 60.8%; p=0.002) and younger (54 vs. 59 years old; p=0.025). The groups did not differ in type or urgency of procedure, smoking or history of diabetes, or cardiovascular disease. Patients with anxiety or depression reported lower mental health scores at 30 days (45.1 vs 48.2; p=0.002) post-procedure. In multivariate analyses, anxious or depressed patients had worse mental health scores at 30 days (t=-2.893; p=0.008) than those who did not have a history of anxiety or depression. There was no difference between groups in length of stay, mortality, physical health t-scores, functionality scores, or six month quality of life outcomes. Conclusions: Patients undergoing cerebrovascular procedures who self-reported anxiety or depression showed a significant difference in mental health outcomes at 30 days, but six month mental health and other medical and functional outcomes measures were similar to patients without these diagnoses.

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Anxiety and Depression in Patients Who Undergo a Cerebrovascular Procedure

10.21203/rs.2.20492/v3 ◽

2020 ◽

Author(s):

Lauren Lombardo ◽

Richard Shaw ◽

Kathleen Sayles ◽

Dorothea Altschul

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Physical Health ◽

Global Mental Health ◽

Anxiety And Depression ◽

Life Outcomes ◽

Quality Of Life Outcomes ◽

Significant Difference ◽

History Of

Abstract Background: Observe the relationship of anxiety and depression on quality of life outcomes after open and endovascular cerebrovascular procedures. Methods: We retrospectively analyzed 349 patients who underwent a procedure for aneurysm, arteriovenous malformation, intraparenchymal hemorrhage, carotid stenosis, acute stroke, and conventional catheter angiogram over three years at a community hospital. We correlated pre-procedural anxiety and depression with Global Physical Health, Global Mental Health, and Modified Rankin Scale scores. We performed univariate and multivariate linear and logistic regression analyses adjusting for past medical history and sociodemographic factors. Results: Anxiety or depression occurred in eighteen percent of patients. Patients with anxiety or depression were more likely to be female (81% vs 60.8%; p=0.002) and younger (54 vs. 59 years old; p=0.025). The groups did not differ in type or urgency of procedure, smoking or history of diabetes, or cardiovascular disease. Patients with anxiety or depression reported lower mental health scores at 30 days (45.1 vs 48.2; p=0.002) post-procedure. In multivariate analyses, anxious or depressed patients had worse mental health scores at 30 days (t=-2.893; p=0.008) than those who did not have a history of anxiety or depression. There was no difference between groups in length of stay, mortality, physical health t-scores, functionality scores, or six month quality of life outcomes. Conclusions: Patients undergoing cerebrovascular procedures who self-reported anxiety or depression showed a significant difference in mental health outcomes at 30 days, but six month mental health and other medical and functional outcomes measures were similar to patients without these diagnoses.

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A qualitative study exploring the barriers and facilitators of implementing a cardiovascular disease risk reducing intervention for people with severe mental illness into primary care contexts across England: the ‘PRIMROSE’ trial.

10.21203/rs.2.15800/v3 ◽

2020 ◽

Author(s):

Suzan Hassan ◽

Samira Heinkel ◽

Alexandra Burton ◽

Ruth Blackburn ◽

Tayla McCloud ◽

...

Keyword(s):

Mental Health ◽

Cardiovascular Disease ◽

Primary Care ◽

Mental Illness ◽

Collective Action ◽

Physical Health ◽

Severe Mental Illness ◽

Mental Health Stigma ◽

Cvd Risk ◽

Healthcare Settings

Abstract Background: People with severe mental illness (SMI) are at greater risk of earlier mortality due to physical health problems including cardiovascular disease (CVD). There is limited work exploring whether physical health interventions for people with SMI can be embedded and/or adopted within specific healthcare settings. This information is necessary to optimise the development of services and interventions within healthcare settings. This study explores the barriers and facilitators of implementing a nurse-delivered intervention (‘PRIMROSE’) designed to reduce CVD risk in people with SMI in primary care, using Normalisation Process Theory (NPT), a theory that explains the dynamics of embedding or ‘normalising’ a complex intervention within healthcare settings .Methods: Semi-structured interviews were conducted between April-December 2016 with patients with SMI at risk of CVD who received the PRIMROSE intervention, and practice nurses and healthcare assistants who delivered it in primary care in England. Interviews were audio recorded, transcribed and analysed using thematic analysis. Emergent themes were then mapped on to constructs of NPT.Results: 15 patients and 15 staff participated. The implementation of PRIMROSE was affected by the following as categorised by the NPT domains: 1) Coherence, where both staff and patients expressed an understanding of the purpose and value of the intervention, 2) Cognitive participation, including mental health stigma and staff perceptions of the compatibility of the intervention to primary care contexts, 3) Collective action, including 3.1. interactional workability in terms of lack of patient engagement despite flexible appointment scheduling. The structured nature of the intervention and the need for additional nurse time were considered barriers, 3.2. Relational integration i.e. whereby positive relationships between staff and patients facilitated implementation, and access to ‘in-house’ staff support was considered important, 3.3. Skill-set workability in terms of staff skills, knowledge and training facilitated implementation, 3.4. Contextual integration regarding the accessibility of resources sometimes prevented collective action. 4) Reflexive monitoring, where the staff commonly appraised the intervention by suggesting designated timeslots and technology may improve the intervention. Conclusions: Future interventions for physical health in people with SMI could consider the following items to improve implementation: 1) training for practitioners in CVD risk prevention to increase practitioners knowledge of physical interventions 2) training in severe mental illness to increase practitioner confidence to engage with people with SMI and reduce mental health stigma and 3) access to resources including specialist services, additional staff and time. Access to specialist behaviour change services may be beneficial for patients with specific health goals. Additional staff to support workload and share knowledge may also be valuable. More time for appointments with people with SMI may allow practitioners to better meet patient needs.

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Childhood adversities in UK treatment-seeking military veterans

BMJ Military Health ◽

10.1136/jramc-2019-001297 ◽

2020 ◽

pp. jramc-2019-001297 ◽

Cited By ~ 2

Author(s):

Jana Ross ◽

C Armour ◽

D Murphy

Keyword(s):

Mental Health ◽

Physical Health ◽

Mental Health Problems ◽

Military Veterans ◽

Childhood Adversities ◽

Physical Health Outcomes ◽

Common Mental Health Problems ◽

History Of ◽

Mental Health Difficulties ◽

Mental And Physical Health

IntroductionThe long-term consequences of adverse childhood experiences (ACEs) on adult physical and mental health are well documented in the literature. The current study sought to examine this relationship in a sample of UK treatment-seeking military veterans.MethodsThe data were collected through a cross-sectional self-report survey from military veterans who have sought help for mental health difficulties from a veteran-specific UK-based charity. The response rate was 67.2% (n=403) and the effective sample for this study consisted of 386 male veterans. Participants’ history of ACEs and current mental/physical health difficulties were assessed. A latent class analysis was conducted to categorise participants into subgroups based on their ACEs and the relationship of these to the mental and physical health outcomes was examined.ResultsFive classes of veterans with different combinations of ACEs were identified. A total of 97% reported at least one ACE. There were minimal differences between the classes on mental and physical health outcomes, but the total number of ACEs was related to aggression, common mental health problems and post-traumatic stress disorder (PTSD).ConclusionsNo combination of ACEs was specifically predictive of adverse mental/physical health difficulties in our sample. Instead, those with a higher number of ACEs may be more prone to developing problems with aggression, common mental health problems and PTSD. Assessing the history of childhood adversities in military veterans is therefore important when veterans are seeking help for mental health difficulties, as some of these may be related to childhood adversities and may need to be addressed in treatment.

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