Intensive Patients’ Education and Lifestyle Improving Program in CAD Patients

2018 ◽  
Vol 41 (9) ◽  
pp. 1254-1269
Author(s):  
Chunyan Nie ◽  
Tianzhu Li ◽  
Xiaoxia Guo

The objective of this article is to investigate the effects of intensive patients’ education and lifestyle improving program (IPEL) on anxiety, depression, and overall survival (OS) in coronary artery disease (CAD) patients with anxiety and depression. In all, 224 CAD patients with anxiety and depression were randomly assigned to IPEL or control group. In Stage I, the IPEL group received IPEL and usual care, while the control group only received usual care. In Stage II, patients were further followed up and OS analysis was performed. Hospital Anxiety and Depression Scale–anxiety (HADS-A) and HADS–depression (HADS-D) were used to assess anxiety and depression. IPEL reduced HADS-A score at Month 9 (M9)/M12, and the percentage of anxiety at M12 and HADS-A score changed. IPEL reduced HADS-D score at M12, and the percentage of depression at M12 and HADS-D score changed compared with control. Patients with nonanxiety/nondepression at M12 in the IPEL group showed better OS. IPEL reduces anxiety and depression and improves OS in CAD patients.

2014 ◽  
Vol 27 (4) ◽  
pp. 450-460 ◽  
Author(s):  
Satpal Kaur ◽  
Nor Zuraida Zainal ◽  
Wah Yun Low ◽  
Ravindran Ramasamy ◽  
Jaideep Singh Sidhu

2019 ◽  
Vol 100 (4) ◽  
pp. 565-570
Author(s):  
I V Dubatova ◽  
V G Voyakina ◽  
S V Lepyavka ◽  
A V Safronenko ◽  
I A Demidov

Aim. To identify and compare the level of anxiety and depression in therapeutic patients with somatic pathology, establish the structure of the gender distribution of anxiety and depressive disorders. Methods. The study involved 126 people: 74 (58.73%) women and 52 (41.27%) men aged 21–59 years. 59 patients had diseases of the respiratory system (chronic bronchitis in the acute stage with an asthmatic component), 67 patients with cardiovascular diseases (40 subjects with coronary heart disease, 27 subjects with arterial hypertension). In 11 patients with coronary artery disease and 13 patients with hypertension, type I thyrotoxicosis was diagnosed. Clinical psychopathological, psychometric, psychological and statistical methods were used in the study. Psychometric tests were used: the Depression Scale of the Center for Epidemiological Research; Hospital Anxiety and Depression Scale and Taylor Anxiety Disorder Scale adapted by T.A. Nemchinova and V.G. Norakidze, adapted standardized multivariate questionnaire for personality research. Results. According to the severity of anxiety and depressive disorders, patients were divided into the groups: group 1 with severe level, group 2 with a moderate (subclinical) level, and group 3 with mild (not exceeding the norm) anxiety and depressive disorders. Severe and moderate disorders are most characteristic for the pathology of cardiovascular system. In coronary artery disease and arterial hypertension, abnormal (severe and moderate) anxiety and depressive disorders were observed in 24/29 (82.76%) and 20/22 (90.9%) patients, respectively. In patients with abnormal anxiety and depressive disorders, the number of women prevailed over men in the subgroup with hypertension (80% versus 20%, p=0.025) as well as in combination of hypertension with type 1 thyrotoxicosis (85.7% versus 14.3%, р=0.029). Conclusion. In patients, severe and moderate anxiety and depressive disorders are associated with the development of the pathology of cardiovascular system: coronary heart disease and arterial hypertension.


2020 ◽  
Vol 13 (3) ◽  
pp. 43-59
Author(s):  
Μaria Goudinoudi ◽  
Vasiliki Karra ◽  
Konstantinos Ekmetzoglou ◽  
Anna Korombeli ◽  
Evangelia Kouskouni

Introduction: Religious faith and spirituality often seem to affect physical and psychological functioning of patients with chronic diseases. Aim: To investigate the relationship between religiosity/spirituality of coronary patients with anxiety and depression which may be experienced during their hospitalization. Methods: A cross-sectional study was conducted involving 172 patients (23 female and 149 male) with coronary artery disease, who were hospitalized in a general hospital of Attica region with an acute coronary syndrome diagnosis. HADS scale was used for the investigation of hospital anxiety and depression and the Belief and Values Scale was used to evaluate the patients’ religious faith and spirituality. Results: Moderate levels of religiosity/spirituality and no to moderate levels of anxiety and depression were found in coronary patients. No statistically significant correlations were found between the HADS subscales and the Beliefs and Values Scale (p> 0.001), although individuals who have experienced strong spiritual experiences, experienced less anxiety and depression in hospital. There were found statistically significant correlations (p <0.001) with gender, religious beliefs, patients’ age with Belief and Values Scale. There were also statistically significant correlations (p<0.001) of HADS subscales with family status, age, smoking habits, stress and medication. Conclusion: Highly religious coronary patients are less likely to experience anxiety and depression during hospitalization, though confounders seem to interfere and make it difficult to interpret this relationship. Further research is required in order to explore the impact of religiosity on psychological distress of hospitalized coronary patients.


2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Puja Sharma Dhital ◽  
Kalpana Sharma ◽  
Pratik Poudel ◽  
Pankaj Raj Dhital

Psychiatric morbidity such as anxiety and depression is common among patients with coronary artery disease (CAD). The coexistence of psychiatric morbidity negatively affects the outcome of treatment and increases the overall burden of disease in CAD patients. The objective of the study was to identify the level of anxiety and depression among patients with CAD. Descriptive, cross-sectional research design and purposive sampling were used and a total of 168 patients having coronary artery disease were selected purposively for the study from the patients attending cardiac outpatient department of Sahid Gangalaal National Heart Center, Kathmandu, Nepal. Data was collected on 2017 by using pretested semistructured interview schedule, Hospital Anxiety and Depression Scale. The findings showed that 27.4% of the respondents had anxiety caseness and 23.8% of the respondents had depression caseness. Bivariate analysis showed that patient’s level of anxiety was significantly associated with sex, family income, occupation status, and self-esteem. Higher level of anxiety (42.4%) was found in female than male patients. Likewise, level of depression was significantly associated with education status, occupation status, presence of comorbidities, physical exercise, and self-esteem of the patients. There was significant positive relationship between anxiety and depression score. Thus anxiety and depression were common among patients with CAD. Hence, anxiety and depression in CAD patients need be monitored regularly, provide regular counseling services, and refer the patients for the treatment when needed.


Cephalalgia ◽  
2003 ◽  
Vol 23 (6) ◽  
pp. 451-455 ◽  
Author(s):  
C Wacogne ◽  
JP Lacoste ◽  
E Guillibert ◽  
FC Hugues ◽  
C Le Jeunne

This study investigated the intensity of stress, anxiety and depression in a sample of 141 migraineurs compared with a control group of 109 non-migraine workers matched for age and sex. Stress was measured using the Perceived Stress Questionnaire, and anxiety and depression using the Hospital Anxiety and Depression Scale. Results indicated that stress and anxiety were higher in the migraine group than in the control group and above the clinical level. Depression scores remained low in both groups, under clinical relevance. Stress is a primordial factor in the triggering and perpetuation of migraine attacks. The high score of the items ‘morning fatigue’, ‘intrusive thoughts about work’, ‘feeling under pressure’, ‘impatience’, and ‘irritability’ of the stress questionnaire in the migraineurs is particularly significant in the intensive stress response. It seems necessary to manage stress to improve the daily life of migraineurs and to study the link between stress, anxiety and migraine.


Medicina ◽  
2020 ◽  
Vol 56 (9) ◽  
pp. 467
Author(s):  
Andrzej Knapik ◽  
Józefa Dąbek ◽  
Weronika Gallert-Kopyto ◽  
Ryszard Plinta ◽  
Anna Brzęk

Background and objectives: Recommendations for the control of stable patients with coronary artery disease (CAD) related to an adequate level of physical activity (PA). Practical experience shows that the PA level in most people with CAD is definitely too low in relation to the guidelines. The cause may be psychological factors and among them the fear of movement—kinesiophobia. The aim of this project was to examine the evaluation of psychometric features of the Polish version of the Tampa Scale for Kinesiophobia Heart (TSK Heart), used in people with CAD. Materials and methods: The study involved 287 patients with stable CAD: 112 women and 175 men. Age: 63.50 (SD = 11.49) years. Kinesiophobia was assessed using TSK Heart, physical activity (PA)—using the International Physical Activity Questionnaire (IPAQ), and anxiety and depression was examined using the Hospital Anxiety and Depression Scale (HADS). The structure of TSK was examined using principal component analysis (PCA), internal cohesion (Cronbach’s alpha, AC), and content validity was calculated by linear regression. Results: PCA showed a three-factor TSK structure. One-dimensionality and satisfactory reliability were found: TSK Heart: AC = 0.878. Kinesiophobia as a predictor of PA: R2 = 0.162 (p = 0.000000). Anxiety and depression—TSK: R2 = 0.093 (p = 0.00000). Conclusions: The Polish version of TSK Heart for cardiac patients is characterized by good psychometric features. The use of it can improve the cooperation of rehabilitation teams for patients with CAD.


2018 ◽  
Vol 9 (2) ◽  
pp. 63
Author(s):  
Anil Kumar Roy ◽  
Nilesh Maruti Gujar ◽  
Arif Ali ◽  
Utpal Borah

Background: Studies have shown that caregivers of the persons with the neurological illness have high levels of psychological distress, depression and caregiver’s burden. The aim of the study was to find out anxiety, depression and caregiver’s burden among the caregivers of persons with neurological illness (PWNI). Method: Thirty caregivers of PWNI attending the Centre of Rehabilitation Sciences, LGB Regional Institute of Mental Health, Tezpur, Assam were selected using purposive sampling technique for the present study. Socio-demographic and clinical data sheet, Zarit Burden Interview Scale and The Hospital Anxiety and Depression Scale were used. Results: The results shown that in Hospital Anxiety and Depression Scale, 26.6% of the caregivers' scores were in the abnormal range in the domain of depression. While in the domain of anxiety, 16.6% scored in the abnormal range. In Zarit Burden of Scale, 13.3% of the caregivers were having little or no burden, 26.6% of the caregivers were having mild to moderate level of burden, 20% were having moderate to severe burden and 30% were having a severe burden of care. Care burden has significant positive correlation with depression (r= .124, p≤ 0.01 and anxiety (r= .124, p≤ 0.05). Conclusion: Caregivers of PWNI have been found to be at higher risk of mental health problems and care burden. The importance of addressing the burden of caregivers involved in the care of PWNI need to be taken into consideration while providing treatment and rehabilitation of PWNI.     Keywords: Anxiety, depression, burden, neurological illness


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.P Dias Ferreira Reis ◽  
R Ramos ◽  
P Modas Daniel ◽  
S Aguiar Rosa ◽  
L Almeida Morais ◽  
...  

Abstract Aim In patients (pts) with suspected coronary artery disease (CAD), computed tomographic angiography (CTA) may improve pt selection for invasive coronary angiography (ICA) as alternative to functional testing. However. the role of CTA in symptomatic pts after abnormal functional test (FT) is incompletely defined. Methods and results This randomized clinical trial conducted in single academic tertiary center selected 218 symptomatic pts with mild to moderately abnormal FT referred to ICA to receive either the originally intended ICA (n=103) or CTA (n=115). CTA interpretation and subsequent care decisions were made by the clinical team. Pts with high risk features on FT, previous acute coronary syndrome, previously documented CAD, chronic kidney disease (GFR&lt;60ml/min/1.73m2) or persistent atrial fibrillation were excluded. The primary endpoint was the percentage of ICA with no significant obstructive CAD (no stenosis ≥50%) in each group. Diagnostic (DY) and revascularization (RY) yields of ICA in either group were also assessed. Pts were followed up for at least 1 year for the primary safety endpoint of all cause death/ nonfatal myocardial infarction/ stroke. Unplanned revascularization (UP) and symptomatic status (SS) were also evaluated. Pts averaged 68±9 years of age, 60% were male, 29% were diabetic. Nuclear perfusion stress test was used in 33.9% in CTA group and 31.1% in control group (p=0.655). Mean post (functional) test probability of obstructive CAD was 34%. Overall prevalence of obstructive CAD was 32.1%. In the CTA group, ICA was cancelled by referring physicians in 83 of the pts (72.2%) after receiving CTA results. For those undergoing ICA, non-obstructive CAD was found in 5 pts (15.6%) in the CTA-guided arm and 60 (58.3%) in the usual care arm (p&lt;0.001 Mean cumulative radiation exposure related to diagnostic work up was similar in both groups (6±14 vs 5±14mSv, p=0.152). Both DY (84.4% vs 41.7, p&lt;0.001) and RY (71.9% vs 38.8%, p=0.001) yields were significantly higher for CTA-guided ICA as compared to standard FT-guided ICA. The rate of the primary safety endpoint was similar between both groups (1.9% vs 0%, p=0.244), as well as the rates of UP (0.9% vs 0.9%, p=1.000) and SS (persistent angina: 29.6% vs 24.8%, p=0.425). Conclusions In pts with suspected CAD and mild to moderately abnormal ischemia test, a diagnostic strategy including CTA as gatekeeper is safe, effective and significantly improves diagnostic and revascularization yields of ICA. Funding Acknowledgement Type of funding source: None


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