Browsing by Subject "Heart failure--Psychological aspects"
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Item Measuring emotional representation of heart failure symptoms in older adults(2008-08) Delville, Carol Lynn; McDougall, Graham J.Chronic heart failure (HF) affects one in five Americans over age 40. It is the leading cause of emergency room visits and hospitalizations. More Medicare dollars are spent for the diagnosis and treatment of HF than any other condition. This study examined emotional representation of HF symptoms after a five-minute verbalization of feelings about these symptoms: 1) What are the characteristics of language used by participants in a verbalization of feelings related to HF symptoms? 2) How does positive affect, negative affect, heart rate (HR), blood pressure (BP), salivary alpha-amylase (sAA), and salivary cortisol (sC) vary over time after verbalization of feelings related to HF symptoms? And 3) What are the significant relationships between emotional word usage, positive and negative affect, HR, BP, sAA, and sC after verbalization of feelings about HF symptoms? A sample of sixty-adults (46 males) with symptomatic HF had a mean age of 71.99 years (SD 9.40), mean education 14.14 (SD 2.86), and Mini-Mental State Exam mean of 29.10 (SD 1.64). They were primarily Caucasian (85%) and married (56.67%) and had a mean time since diagnosis of HF of 104.75 months (SD 106.01). Participants' positive and negative emotional words usages were similar to samples with cancer, HIV/AIDES, and caregivers of chronically ill children. Positive and negative affect, BP, and HR were stable over time. Negative affect scores nearly doubled the reported means for healthy older adults. After speaking about HF symptoms, pulse pressure (F= 5.42, p= .007) and cortisol decreased (t=2.27, p= .027), whereas sAA was elevated (t= -4.31, p< .001). This finding was unexpected in a sample where 90% of the participants were treated with [beta]-blocking medications. Activation of the sympathetic nervous system (SNS) occurred after speaking about feelings related to HF in 70% of this sample. This is relevant given the role of the SNS in HF progression. This was the first study to explore relationships between a description of symptoms, hemodynamic measures, and neurohormonal responses from a verbal description of HF symptoms. This study has demonstrated that human emotions are a representation of the daily health experience of older adults with symptomatic HF.Item The relationship of illness representation and self-care behaviors to health-related quality of life in older individuals with heart failure(2005) Voelmeck, Wayne Francis; Stuifbergen, Alexa, 1955-This descriptive correlational study used a convenience sample of 98 individuals with Heart Failure (HF) ages 55 to 97 years (M = 74.4, SD= 10.5) to explore the relationships between the illness representations, HF self-care behaviors, and healthrelated quality of life (HRQOL). The majority of the sample was male (59%). While most of the participants were Anglo, 12% were African-American and 9% identified themselves as Latino/Hispanic. Participants had been living with their diagnosis for a median time of 3.5 years (M = 6.1 years, SD = 8.12). Each experienced, on average, at least one hospitalization due to HF in the past 12 months (M = 1.1 visits, SD = 2.02) with the median time since admission for the entire group at 1.1 years (M = 2.1 years, SD = 3.13). Approximately 65% of the group were functionally impaired (Class III/IV) according to the Specific Activity Scale (SAS). The average-item Illness Perception Questionnaire-Revised (IPQ-R) scores indicated participants viewed their HF as having serious consequences (M = 3.57, SD = .88) and a chronic course (M = 3.89, SD = 1.03), being under their personal (M = 4.11, SD = .55) and medical (M = 3.65, SD = .63) control but still exhibiting cyclical disruptions in their lives (M = 2.84, SD = .90). Respondents were neutral on the internal (M = 2.55, SD = .78) and external (M = 2.44, SD = .59) causal attribution subscales. Scores on the Self-Care of HF Index (SCHFI) did not correlate significantly with the IPQ-R subscales or scores on the Living with HF Questionnaire (LHFQ). Using hierarchical regression, SAS functional classification (Β =9.96, p <.01), identity (Β =2.01, p <.01), and consequences (Β =1.20, p <.01) explained 64% of the total variance in LHFQ scores. SCHFI total scores did not account for a significant increase in the variance of the LHFQ scores. Implications and recommendations for future studies are discussed.