Abstract 062: Physiological and Psychological Stress Response are Related to QOL and Functional Status Among People Living With a Left Ventricular Assist Device

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Martha Abshire ◽  
Gayle G Page ◽  
Chakra Budhathoki ◽  
Patricia M Davidson ◽  
Stuart D Russell ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stress Response ◽  
Sleep Quality ◽  
Functional Status ◽  
Psychological Stress ◽  
Healthcare Utilization ◽  
Perceived Stress ◽  
Left Ventricular ◽  
Cortisol Awakening Response

Background: Advanced heart failure patients with left ventricular assist device (LVAD) have experienced emotional distress and psychological sequelae following implant. However, few studies have examined stress among patients with LVAD. The purpose of this study was to describe physiological and psychological stress response and then to examine relationships between physiological and psychological stress response and outcomes (quality of life (QOL), functional status and healthcare utilization) in patients with LVAD. Design: A descriptive observational study design was used to examine physiological and psychological stress response among LVAD patients. Methods: Data was collected for patients more than 3 months post-LVAD implantation (N = 44). Relationships among indicators of physiological (salivary cortisol, sleep quality) and psychological stress, (perceived stress, depression and fatigue) and outcomes (quality of life, functional status as measured by Six Minute Walk Test (6MWT) and healthcare utilization, using hospitalization rate) were examined using descriptive statistics and logistic regression models. Results: The sample was average age 57.7 years, mostly male (73%), married (70.5%) and racially diverse (white 46%, black 43%, other 11%). Median LVAD support was 18.2 months. Normal cortisol awakening response was seen in most participants (61%). LVAD patients reported moderate levels of psychological stress and sleep quality and enjoy a good quality of life (73 out of 100, SD ± 13.5). At the bivariate level, normal cortisol awakening response was correlated with low depressive symptoms (p< 0.02). Poor sleep quality was correlated with increased psychological stress response and QOL (p< 0.01). Perceived stress was positively associated with healthcare utilization (p<0.01). In multivariate analysis, cortisol and sleep quality were independent predictors of 6MWT > 300 meters (R 2 = 0.33, chi 2 = 0.002), but not for QOL and healthcare utilization when controlling for psychological stress. Conclusions: This is the first report of salivary cortisol and perceived stress in outpatients with LVAD. Associations were seen between sleep quality, psychological stress response and QOL. Cortisol and sleep quality were predictive of functional status among patients with LVAD. Future research should explore if those with a higher stress profile (abnormal cortisol awakening response, worse sleep quality, perceived stress, depression, fatigue) would benefit from tailored supportive interventions to lower perceived stress, improve sleep quality and improve QOL.

scholarly journals Sleep Quality in Residents of Assisted Living Facilities: Effect on Quality of Life, Functional Status, and Depression

2010 ◽  
Vol 58 (5) ◽  
pp. 829-836 ◽  
Author(s):  
Jennifer L. Martin ◽  
Lavinia Fiorentino ◽  
Stella Jouldjian ◽  
Karen R. Josephson ◽  
Cathy A. Alessi
Keyword(s):  
Quality Of Life ◽  
Sleep Quality ◽  
Functional Status ◽  
Assisted Living ◽  
Assisted Living Facilities

Sleep quality in patients with systemic sclerosis: relationship between the clinical variables, depressive symptoms, functional status, and the quality of life

2013 ◽  
Vol 33 (8) ◽  
pp. 1973-1979 ◽  
Author(s):  
Mustafa Akif Sariyildiz ◽  
Ibrahim Batmaz ◽  
Mahmut Budulgan ◽  
Mehtap Bozkurt ◽  
Levent Yazmalar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Systemic Sclerosis ◽  
Sleep Quality ◽  
Functional Status ◽  
Clinical Variables

scholarly journals Structural Relationships Between Depression, Perceived Stress, Sleep Quality, and Quality of Life: Evidence from Iranian Elderly

Thrita ◽  
2020 ◽  
Vol 8 (2) ◽  
Author(s):  
Mahmoud Kamali Zarch ◽  
Mohammad Hossein Sorbi
Keyword(s):  
Quality Of Life ◽  
Sleep Quality ◽  
Direct Effect ◽  
Perceived Stress ◽  
Longitudinal Research ◽  
Depression Scale ◽  
Structural Relationships ◽  
Quality Of Life Scale ◽  
Significant Direct Effect

Objectives: This study tested structural relationships between depression, perceived stress, sleep quality, and quality of life through path analysis. Methods: In this cross-sectional study, 360 elderly Iranian people were selected using multistage cluster sampling from April 2 to December 6, 2018. The instruments included a demographic form, the geriatric depression scale (GDS), the quality of life scale (QOLS), the perceived stress scale (PSC), and the Pittsburgh sleep quality index (PSQI). To analyze the data, the researchers used SPSS-21, LISREL-8.80, and the Sobel test. Results: The results showed that depression had a significant direct effect on sleep quality, but not on stress. The effect of depression and stress on the quality of life was found to be 45%. Further, depression, stress, and sleep quality had a significant direct effect on the quality of life. This could explain 85% of changes in the quality of life of the elderly. Moreover, depression with the mediating variable of sleep quality had an indirect effect on the quality of life. Conclusions: It can be concluded that providing conditions for a high quality of life level and a good sleep status can help to improve mental health in elderly people. However, further experimental and longitudinal research is needed in this respect, and it is necessary to study other mediating factors on quality of life in elderly

scholarly journals Psychophysiological stress response of newly-diagnosed breast cancer patients with and without risk of metabolic syndrome

Salud Mental ◽  
2019 ◽  
Vol 42 (3) ◽  
pp. 111-120
Author(s):  
Veronica Neri-Flores ◽  
Juan Alejandro Torres-Domínguez ◽  
Alejandro Mohar-Betancourt ◽  
María Dolores Rodríguez-Ortiz ◽  
Andrea Castro-Sánchez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Stress Response ◽  
Coping Strategies ◽  
Perceived Stress ◽  
Social Life ◽  
Muscle Activation ◽  
Stressful Situation ◽  
Convenience Sample

Introduction. Little is known about how metabolic comorbidity affects stress response during breast cancer (BRCa) after a recent diagnosis. Objective. To evaluate the physiological and psychological differences between the BRCa-RSxM groups and those with BRCa alone, and the influence of psychological variables and comorbidity in terms of stress response. Method. Comparative non-experimental causal-descriptive study. Fifty patients recently diagnosed with BRCa (25 with BRCa and 25 with BRCa-RSxM) in a convenience sample participated. Frontal muscle activity and skin conductance were recorded in response to stressful conditions. Quality of life, perceived stress, and coping strategies scales were used. Results. The presence of comorbidity (p = .001; p = .02), perceived stress (p = .004; p = .03), and social quality of life (p = .01; p = .01) influenced muscle activation and conductance during the emotional stressor (ES). Putting the stressful situation into perspective as a cognitive coping strategy was related to a decrease in activation (p = .04). An increase in physiological activation during the cognitive stressor (CS) was influenced by comorbidity (p = .05) and quality of social life (p = .01; p = .01). In turn, a decrease was influenced by the increase in age (p = .02). Discussion. Physiological vulnerability, coping strategies (behavioral and cognitive), and prior learning influenced the resulting reaction during the stressful situation. Conclusion. A metabolic disease, as a prelude to an oncological, may cause physiological vulnerability to respond adequately to stressful conditions.

scholarly journals Mid-term outcomes with the use of extracorporeal membrane oxygenation for cardiopulmonary failure secondary to massive pulmonary embolism

2020 ◽  
Vol 58 (5) ◽  
pp. 923-931
Author(s):  
Federico Sertic ◽  
Dieynaba Diagne ◽  
Lexy Chavez ◽  
Thomas Richards ◽  
Ashley Berg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Hospital Mortality ◽  
Functional Status ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Acute Pe

Abstract OBJECTIVES There has been increasing interest in using extracorporeal membrane oxygenation (ECMO) to rescue patients with pulmonary embolism (PE) in the advanced stages of respiratory or haemodynamic decompensation. We examined mid-term outcomes and risk factors for in-hospital mortality. METHODS We conducted a retrospective study of 36 patients who required ECMO placement (32 veno-arterial ECMO, 4 veno-venous) following acute PE. Survival curves were estimated using the Kaplan–Meier method. Risk factors for in-hospital mortality were assessed by logistic regression analysis. Functional status and quality of life were assessed by phone questionnaire. RESULTS Overall survival to hospital discharge was 44.4% (16/36). Two-year survival conditional to discharge was 94% (15/16). Two-year survival after veno-arterial ECMO was 39% (13/32). In patients supported with veno-venous ECMO, survival to discharge was 50%, and both patients were alive at follow-up. In univariable analysis, a history of recent surgery (P = 0.064), low left ventricular ejection fraction (P = 0.029), right ventricular dysfunction ≥ moderate at weaning (P = 0.083), on-going cardiopulmonary resuscitation at ECMO placement (P = 0.053) and elevated lactate at weaning (P = 0.002) were risk factors for in-hospital mortality. In multivariable analysis, recent surgery (P = 0.018) and low left ventricular ejection fraction at weaning (P = 0.013) were independent factors associated with in-hospital mortality. At a median follow-up of 23 months, 10 patients responded to our phone survey; all had acceptable functional status and quality of life. CONCLUSIONS Massive acute PE requiring ECMO support is associated with high early mortality, but patients surviving to hospital discharge have excellent mid-term outcomes with acceptable functional status and quality of life. ECMO can provide a stable platform to administer other intervention with the potential to improve outcomes. Risk factors for in-hospital mortality after PE and veno-arterial ECMO support were identified.

scholarly journals One-Year Echocardiographic, Functional, and Quality of Life Outcomes After Ultrasound-Facilitated Catheter-Based Fibrinolysis for Pulmonary Embolism

2020 ◽  
Vol 13 (8) ◽  
Author(s):  
Gregory Piazza ◽  
Keith M. Sterling ◽  
Victor F. Tapson ◽  
Kenneth Ouriel ◽  
Andrew S.P. Sharp ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Embolism ◽  
Functional Status ◽  
Left Ventricular ◽  
Diameter Ratio ◽  
Left Ventricular Diameter ◽  
Submassive Pulmonary Embolism ◽  
Dosing Regimens ◽  
Minute Walk

Background: Accelerated tPA (tissue-type plasminogen activator) dosing regimens for ultrasound-facilitated, catheter-directed fibrinolysis improve short-term computed tomographic-measured right ventricular (RV)-to-left ventricular diameter ratio in massive and submassive pulmonary embolism. The impact on RV remodeling, functional status, and quality of life over the long-term remains unclear. Methods: To study 1-year changes in RV remodeling, functional status, and quality of life, we assessed patients with acute submassive pulmonary embolism randomly assigned to 1 of 4 tPA dosing regimens for ultrasound-facilitated, catheter-directed fibrinolysis in the OPTALYSE-PE trial (Optimum Duration and Dose of r-tPA With the Acoustic Pulse Thrombolysis Procedure for Intermediate-Risk Pulmonary Embolism; 8 mg/2 hours, 8 mg/4 hours, 12 mg/6 hours, and 24 mg/6 hours). Echocardiographic assessment included RV-to-left ventricular diameter ratio within 4 hours of treatment end, and at 48 hours, 30 days, 90 days, and 1 year. Functional status was assessed by 6-minute walk test at 30 days, 90 days, and 1 year and PROMIS-PF-6b scores at 30 days, 90 days, 180 days, 270 days, and 1 year. Quality of life was evaluated by PEmb-QOL scores at 30 days, 90 days, 180 days, 270 days, and 1 year. Results: Mean RV-to-left ventricular diameter ratio decreased from baseline to 4 hours and further at 48 hours and 30 days, with reductions maintained at 90 days and 1 year in all groups. Mean 6-minute walk distance, PROMIS-PF-6b, and PEmb-QOL scores improved over the course of 1 year in all groups. Conclusions: Accelerated lower-dose tPA regimens for ultrasound-facilitated, catheter-directed fibrinolysis resulted in sustained recovery of RV-to-left ventricular diameter ratio and tricuspid annular plane systolic excursion and improvements in functional status and quality of life over 1 year. Registration: URL: https://www.ClinicalTrials.gov . Unique Identifier: NCT02396758.

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