Gesundheitsversorgung bei koronarer Herzerkrankung mit psychischer Komorbidität

2020 ◽  
Author(s):  
Ursula Köstler
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cross Sectional Study ◽  
Services Research ◽  
Cross Sectional ◽  
Mental Comorbidities ◽  
Current Guidelines ◽  
Comorbid Mental Disorders

Current guidelines on the prevention of patients with coronary heart disease recommend screening for mental comorbidities (depression, anxiety, cognitive dysfunction) in order to establish the appropriate diagnosis for and treatment of comorbid mental disorders. So far, there is no empirical evidence that the guidelines are being implemented by practitioners. This prospective, multi-method cross-sectional study on health services research uses a qualitative design to interview patients, relatives and practitioners. Treatments, potential barriers and the quality of care for patients with coronary heart disease are analysed. The results show that the degree of implementation of the guidelines is low. Improvements in medical and social care towards patient-centred care point to a changed role of the general practitioner in the care of this patient group.

scholarly journals Detection and treatment of mental disorders in patients with coronary heart disease (MenDis-CHD): A cross-sectional study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243800
Author(s):  
Samia Peltzer ◽  
Hendrik Müller ◽  
Ursula Köstler ◽  
Frank Schulz-Nieswandt ◽  
Frank Jessen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Mental Disorders ◽  
Detection Rate ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medication Therapy

Mental disorders (MD) are associated with an increased risk of developing coronary heart disease (CHD) and with higher CHD-related morbidity and mortality. There is a strong recommendation to routinely screen CHD patients for MDs, diagnosis, and treatment by recent guidelines. The current study aimed at mapping CHD patients' (1) state of diagnostics and, if necessary, treatment of MDs, (2) trajectories and detection rate in healthcare, and (3) the influence of MDs and its management on quality of life and patient satisfaction. The design was a cross-sectional study in three settings (two hospitals, two rehabilitation clinics, three cardiology practices). CHD patients were screened for MDs with the Hospital Anxiety and Depression Scale (HADS), and, if screened-positive, examined for MDs with the Structured Clinical Interview for DSM-IV (SCID-I). Quality of Life (EQ-5D), Patient Assessment of Care for Chronic Conditions (PACIC), and previous routine diagnostics and treatment for MDs were examined. Descriptive statistics, Chi-squared tests, and ANOVA were used for analyses. Analyses of the data of 364 patients resulted in 33.8% positive HADS-screenings and 28.0% SCID-I diagnoses. The detection rate of correctly pre-diagnosed MDs was 49.0%. Physicians actively approached approximately thirty percent of patients on MDs; however, only 6.6% of patients underwent psychotherapy and 4.1% medication therapy through psychotherapists/psychiatrists. MD patients scored significantly lower on EQ-5D and the PACIC. The state of diagnostic and treatment of comorbid MDs in patients with CHD is insufficient. Patients showed a positive attitude towards addressing MDs and were satisfied with medical treatment, but less with MD-related advice. Physicians in secondary care need more training inadequately addressing mental comorbidity.

scholarly journals Factors Related to the Quality of Life of Patients with Coronary Heart Disease at Saiful Anwar General Hospital, Malang

2021 ◽  
Author(s):  
Mazidah Imanuna ◽  
Hartati Eko Wardani ◽  
Tika Dwi Tama
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
General Hospital ◽  
Disease Risk ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Cross Sectional

Most coronary heart disease (CHD) patients experience a decrease in quality of life that can worsen the prognosis. To the best of our knowledge, no previous study has identified the quality of life of CHD patients in Saiful Anwar General Hospital and its predictors. Hence, this study was conducted to determine the factors related to the quality of life of patients with CHD at Saiful Anwar General Hospital. A cross-sectional study was conducted by selecting 90 patients diagnosed with CHD in 2019 purposively. The instruments used in this study were the DASS-21, SF-36 and social support. Data were analysed using univariate and bivariate with binary logistic regression. The study found that the quality of life of patients with CHD has an average value of 63.29. As many as 88.9% of CHD patients were categorized as having a good quality of life. There was no relationship between the independent variables and the quality of life. Further research needs to be done on potential variables related to the risk factors of the CHD patients’ quality of life, which can subsequently be used as a guideline for optimizing and improving the patients’ quality of life. Keywords: coronary heart disease, risk factors, quality of life

scholarly journals Relationship between childhood secondhand smoke exposure and the occurrence of hyperlipidaemia and coronary heart disease among Chinese non-smoking women: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e048590
Author(s):  
Kewei Wang ◽  
Yuanqi Wang ◽  
Ruxing Zhao ◽  
Lei Gong ◽  
Lingshu Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Secondhand Smoke ◽  
Chinese Women ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Shs Exposure

ObjectiveThe objective of this study was to evaluate the influence of secondhand smoke (SHS) exposure during childhood on type 2 diabetes mellitus, hypertension, hyperlipidaemia and coronary heart disease among Chinese non-smoking women.MethodsIn this cross-sectional study, the SHS exposure data in childhood were obtained using a questionnaire survey. Self-reported childhood SHS exposure was defined as the presence of at least one parent who smoked during childhood.ResultsOf the 6522 eligible participants, 2120 Chinese women who had never smoked were assessed. The prevalence of SHS exposure in the entire population was 28.1% (596). SHS exposure during childhood was not significant for the standard risk factors of type 2 diabetes mellitus (p=0.628) and hypertension (p=0.691). However, SHS was positively associated with hyperlipidaemia (p=0.037) after adjusting for age, obesity, education status, physical activity, alcohol consumption, current SHS exposure status, diabetes mellitus and hypertension. In addition, childhood SHS increased the occurrence of coronary heart disease (p=0.045) among non-smokers after further adjusting for hyperlipidaemia.ConclusionSHS exposure during childhood is associated with prevalent hyperlipidaemia and coronary heart disease in adulthood among non-smoking Chinese women.

scholarly journals Exploring the relationship between coronary heart disease and type 2 diabetes: a cross-sectional study of secondary prevention among diabetes patients

BJGP Open ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. bjgpopen18X101636 ◽  
Author(s):  
Bjørn Gjelsvik ◽  
Anh Thi Tran ◽  
Tore J Berg ◽  
Åsne Bakke ◽  
Ibrahimu Mdala ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Coronary Heart Disease ◽  
Ldl Cholesterol ◽  
South Asians ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

BackgroundCoronary heart disease (CHD) and stroke are the major causes of death among people with diabetes.AimTo describe the prevalence and onset of CHD and stroke among patients with type 2 diabetes mellitus (T2DM) in primary care in Norway, and explore the quality of secondary prevention.Design & settingA cross-sectional study of data was undertaken from electronic medical records (EMRs) of 10 255 patients with T2DM in general practice. The study took place in five counties of Norway (Oslo, Akershus, Rogaland, Hordaland, and Nordland). Quality of care was assessed based on national guideline recommendations.MethodSummary statistics with adjustments and binary logistic regression models were used.ResultsIn total, 2260 patients (22.1%) had CHD and 759 (7.4%) had stroke. South Asians had significantly more CHD than ethnic Norwegians (29.5%, 95% confidence interval [CI] = 26.1 to 33.0 versus 21.5%, CI = 20.6 to 22.3) and other ethnic groups, and experienced onset of CHD or stroke at a mean of 7 years before Norwegians. In 47.9% of the patients, CHD was diagnosed before T2DM. Treatment target for low-density lipoprotein (LDL) cholesterol was reached for 30.0% and for systolic blood pressure (SBP) for 65.1% of the patients with CHD. Further, 20.9% of patients with CHD were present smokers, and only 5.0% of patients reached all four treatment targets (no smoking, HbA1c ≤7.0%, SBP <135 mmHg, LDL-cholesterol <1.8 mmol/l).ConclusionThe diagnosis of CHD preceded the diagnosis of T2DM in half of the patients. The prevalence of CHD was highest and onset earlier among ethnic South Asians. More intensive treatment of lipids, blood pressure, and smoking are needed in patients with T2DM and CHD.

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