Psychological interventions for depression and anxiety in patients with coronary heart disease, heart failure or atrial fibrillation

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the efficacy and costs of psychological interventions (alone, or with CR or pharmacotherapy, or both) in adults who have a diagnosis of CHD, HF or AF compared to no intervention, or treatment as usual, on psychological and clinical outcomes

The use of the Nursing Activities Score in clinical settings: an integrative review

ABSTRACT Objective analyze how studies have approached the results obtained from the application of the Nursing Activities Score (NAS) based on Donabedian’s model of healthcare organization and delivery. Method CINAHL and PubMed databases were searched for papers published between 2003 and March 2015. Results 36 articles that met the inclusion criteria were reviewed and double-coded by three independent coders and analyzed based on the three elements of Donabedian’s health care quality framework: structure, process and outcome. The most frequently addressed, but not always tested, variables were those that fell into the structure category. Conclusion variables that fell into the process category were used less frequently. Beside NAS, the most frequently used variables in the outcome category were mortality and length of stay. However, no study used a quality framework for healthcare or NAS to evaluate costs, and it is recommended that further research should explore this approach

A psychometric evaluation of the Caregiver Contribution to Self-Care of Heart Failure Index in a Thai population.

BACKGROUND: Caregivers are major contributor to the self-care of patients with heart failure. The Caregiver Contribution to Self-Care of Heart Failure Index (CC-SCHFI) measures these contributions across three scales: self-care maintenance (symptom monitoring and treatment adherence); self-care management (dealing with symptoms); and confidence in contributing to the self-care (self-efficacy in managing self-care) of patients with heart failure. Informal caregivers play a vital role in supporting family members with heart failure in Thailand, yet no validated tool exists to measure their contribution. We examined the psychometric properties of the CC-SCHFI in a Thai population. METHODS: The CC-SCHFI was translated into Thai using a standard forward and backward translation procedure. A cross-sectional design was used to examine the psychometric properties of the Thai version of the CC-SCHFI in 100 family caregivers of heart failure patients in Southern Thailand. Confirmatory factor analysis was used to assess construct validity, and factor score determinacy coefficients were computed to evaluate internal consistency reliability. RESULTS: The Thai version of the CC-SCHFI demonstrated acceptable internal consistency (composite reliability of each scale ranged from 0.76 to 0.99). Reliability estimates were adequate for each scale (McDonald's omega ranged from 0.75 to 0.96). Confirmatory factor analysis supported the original factor structure of the instrument, with good fit indices for all three scales (comparative fit index = 0.98-1.00; root-mean-square error of approximation = 0.00-0.07). CONCLUSIONS: The Thai version of the CC-SCHFI appears to be a valid and reliable instrument for measuring caregiver contributions to self-care maintenance and self-care management as well as contributing to caregiver confidence in the self-care of Thai heart failure patients

Psychosocial interventions for patients after a cardiac event

A large body of evidence links depression and coronary artery disease and includes findings that patients who experience depression at the time of an acute cardiac event die sooner than their nondepressed counterparts. Although cardiac rehabilitation programs addressing medical, lifestyle, and psychosocial issues have positive effects on behavioral change, significantly reduce the risk of having future cardiac events, and reduce mortality, depressed mood and social isolation can compromise the positive effects of these programs. Systematic reviews have shown the effectiveness of psychological interventions for cardiac patients; however, comparison of interventions is difficult due to variation in target population, severity of depression, “dose” and mode of delivery of the intervention delivered, variation in outcome measures used, varied follow-up periods, and lack of detail on intervention content. Brief interventions have been shown to be effective in reducing depression, as has Internet-delivered cognitive-behavioral therapy for adults with high CVD risk. Interventions comprising psychological and social support-enhancing components, when compared with usual care, are also effective in reducing depressive symptoms in cardiac patients. Although effect sizes reflect a small benefit of these psychosocial interventions, it appears that they improve social support and possibly mental health quality of life, but no firm conclusions can be drawn as to whether these interventions impact on cardiac mortality and morbidity. Notwithstanding methodological limitations and the modest effects achieved, psychological and psychosocial interventions are worth implementing, post-cardiac event, as unresolved depression is a major cause of death and disability in cardiac patients

Type D personality, stress, coping and performance on a novel sport task

We investigated (1) the relationship between Type D personality, stress intensity appraisal of a self-selected stressor, coping, and perceived coping effectiveness and (2) the relationship between Type D personality and performance. In study one, 482 athletes completed the Type D personality questionnaire (DS14), stress thermometer and MCOPE in relation to a recently experienced sport stressor. Type D was associated with increased levels of perceived stress and selection of coping strategies (more emotion and avoidance coping) as well as perceptions of their effectiveness. In study two, 32 participants completed a rugby league circuit task and were assessed on pre-performance anxiety, post-performance affect and coping. Type D was associated with poorer performance (reduced distance; more errors), decreases in pre-performance self-confidence and more use of maladaptive resignation/withdrawal coping. Findings suggest that Type D is associated with maladaptive coping and reduced performance. Type D individuals would benefit from interventions related to mood modification or enhancing interpersonal functioning