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Coping and emotiona...
Coping and emotional well-being in patients with chronic heart failure
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- Nahlen Bose, Catarina (author)
- Dept of Clinical Sciences, Danderyd Hospital; Division of CardiovascularMedicine, Karolinska Institutet
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- Saboonchi, Fredrik, Professor (thesis advisor)
- Röda Korsets Högskola, Avdelningen Medicin och Folkhälsa,Karolinska Institutet, Department of Clinical Neuroscience, Division of Insurance medicine
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- Björling, Gunilla, Ph.D. (thesis advisor)
- Röda Korsets Högskola, Avdelningen Vård och Omvårdnad,Karolinska Institutet; Department of Clinical Sciences Danderyd Hospital, Division of Anaesthesia and Intensive Care
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- Elfström, Magnus L, Associate Professor (thesis advisor)
- Mälardalen University, Academy of Health, Care and Social Welfare, Division of Psychology
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- Persson, Hans, Associate Professor (thesis advisor)
- Karolinska Institutet; Department of Clinical Sciences Danderyd Hospital, Division of Cardiovascular Medicine
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- Mårtensson, Jan, Professor (opponent)
- Jönköping University, School of Health Sciences, Department of Nursing Science
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- ISBN 9789176760017
- Stockholm : Karolinska Institutet, 2015
- English 82 s.
- Related links:
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http://hdl.handle.ne...
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https://urn.kb.se/re...
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Abstract
Subject headings
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- Background: Chronic heart failure (CHF) is a serious illness, with a profound impact on the patient. Poor health-related quality of life (HRQoL) as well as anxiety and depression are prevalent in CHF and predict mortality and rehospitalization, yet, psychosocial factors are infrequently treated and cared for.Aim: To gather scientific evidence on illness perception and coping strategies to predict emotional well-being in patients with CHF and to establish a measurement model of coping strategies. Furthermore, to evaluate a nurse-led psychoeducational intervention, Coping Effectiveness Training (CET) adapted for patients with CHF.Methods: Studies I-III were cross sectional. Study IV was a randomized controlled trial aimed to improve emotional well-being (one-year follow-up). All studies used patient reported outcome measures and clinical data via medical journals.Results: Younger age and male gender were associated with higher levels of alcohol usage and/or drugs to cope, p < 0.01. Poor sense of coherence was associated with maladaptive coping (I). A four factorial model of Brief COPE displayed the best psychometric properties (II). Avoidant coping influenced negative affect (NA) (I), worse HRQoL (II) and greater anxiety and depression (III). CET (IV) improved personal control in the intervention group (IG) compared to the control group (CG), p = 0.036. Improved scores for the IG were detected in emotional well-being and HRQoL, p = ns. The IG demonstrated reduced NA, p = 0.022, excluding cases with clinical anxiety and depression. Time to cardiovascular readmission or death was non-significantly lower in the IG vs the CG (Hazard ratio 0.58 [0.29-1.18]) adjusted p = 0.135.Conclusions: Personal resources seemed to influence the coping strategies used by patients with CHF. Avoidant coping had an adverse influence on emotional wellbeing and illness perception in CHF. The perceived sense of control and illness burden were of importance for emotional well-being. A CET intervention for patients with CHF increased sense of control over the illness. CET also reduced NA in patients with no or mild symptoms of anxiety and depression.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences (hsv//eng)
Keyword
- Heart failure; Coping; Illness perception; Emotional well-being; Quality of life; Intervention; Randomized controlled trial
- Heart failure
Publication and Content Type
- vet (subject category)
- dok (subject category)
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