liu.seSearch for publications in DiVA
Change search
Link to record
Permanent link

Direct link
BETA
Alternative names
Publications (10 of 83) Show all publications
Alehagen, U., Aaseth, J., Alexander, J., Svensson, E., Johansson, P. & Larsson, A. (2018). Less fibrosis in elderly subjects supplemented with selenium and coenzyme Q10A mechanism behind reduced cardiovascular mortality?. Biofactors, 44(2), 137-147
Open this publication in new window or tab >>Less fibrosis in elderly subjects supplemented with selenium and coenzyme Q10A mechanism behind reduced cardiovascular mortality?
Show others...
2018 (English)In: Biofactors, ISSN 0951-6433, E-ISSN 1872-8081, Vol. 44, no 2, p. 137-147Article in journal (Refereed) Published
Abstract [en]

Background: In an intervention study where 221 healthy elderly persons received selenium and coenzyme Q10 as a dietary supplement, and 222 received placebo for 4 years we observed improved cardiac function and reduced cardiovascular mortality. As fibrosis is central in the aging process, we investigated the effect of the intervention on biomarkers of fibrogenic activity in a subanalysis of this intervention study. Material and Methods: In the present subanalysis 122 actively treated individuals and 101 controls, the effect of the treatment on eight biomarkers of fibrogenic activity were assessed. These biomarkers were: Cathepsin S, Endostatin, Galectin 3, Growth Differentiation Factor-15 (GDF-15), Matrix Metalloproteinases 1 and 9, Tissue Inhibitor of Metalloproteinases 1 (TIMP 1) and Suppression of Tumorigenicity 2 (ST-2). Blood concentrations of these biomarkers after 6 and 42 months were analyzed by the use of T-tests, repeated measures of variance, and factor analyses. Results: Compared with placebo, in those receiving supplementation with selenium and coenzyme Q10, all biomarkers except ST2 showed significant decreased concentrations in blood. The changes in concentrations, that is, effects sizes as given by partial eta(2) caused by the intervention were considered small to medium. Conclusion: The significantly decreased biomarker concentrations in those on active treatment with selenium and coenzyme Q10 compared with those on placebo after 36 months of intervention presumably reflect less fibrogenic activity as a result of the intervention. These observations might indicate that reduced fibrosis precedes the reported improvement in cardiac function, thereby explaining some of the positive clinical effects caused by the intervention. (c) 2017 BioFactors, 44(2):137-147, 2018

Place, publisher, year, edition, pages
WILEY, 2018
Keywords
fibrosis; intervention; selenium; coenzyme Q10
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-147583 (URN)10.1002/biof.1404 (DOI)000430002200004 ()29220105 (PubMedID)
Note

Funding Agencies|County Council of Ostergotland; University of Linkoping; Alehagen

Available from: 2018-04-26 Created: 2018-04-26 Last updated: 2019-04-12
Lundgren, J., Johansson, P., Jaarsma, T., Andersson, G. & Kärner Köhler, A. (2018). Patient Experiences of Web-Based Cognitive Behavioral Therapy for Heart Failure and Depression: Qualitative Study. Journal of Medical Internet Research, 20(9), Article ID e10302.
Open this publication in new window or tab >>Patient Experiences of Web-Based Cognitive Behavioral Therapy for Heart Failure and Depression: Qualitative Study
Show others...
2018 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 20, no 9, article id e10302Article in journal (Refereed) Published
Abstract [en]

Background: Web-based cognitive behavioral therapy (wCBT) has been proposed as a possible treatment for patients with heart failure and depressive symptoms. Depressive symptoms are common in patients with heart failure and such symptoms are known to significantly worsen their health. Although there are promising results on the effect of wCBT, there is a knowledge gap regarding how persons with chronic heart failure and depressive symptoms experience wCBT. Objective: The aim of this study was to explore and describe the experiences of participating and receiving health care through a wCBT intervention among persons with heart failure and depressive symptoms. Methods: In this qualitative, inductive, exploratory, and descriptive study, participants with experiences of a wCBT program were interviewed. The participants were included through purposeful sampling among participants previously included in a quantitative study on wCBT. Overall, 13 participants consented to take part in this study and were interviewed via telephone using an interview guide. Verbatim transcripts from the interviews were qualitatively analyzed following the recommendations discussed by Patton in Qualitative Research amp; Evaluation Methods: Integrating Theory and Practice. After coding each interview, codes were formed into categories. Results: Overall, six categories were identified during the analysis process. They were as follows: "Something other than usual health care," "Relevance and recognition," "Flexible, understandable, and safe," "Technical problems," "Improvements by real-time contact," and "Managing my life better." One central and common pattern in the findings was that participants experienced the wCBT program as something they did themselves and many participants described the program as a form of self-care. Conclusions: Persons with heart failure and depressive symptoms described wCBT as challenging. This was due to participants balancing the urge for real-time contact with perceived anonymity and not postponing the work with the program. wCBT appears to be a valuable tool for managing depressive symptoms.

Place, publisher, year, edition, pages
JMIR PUBLICATIONS, INC, 2018
Keywords
cognitive therapy; content analysis; depression; heart failure; internet; patient experience; telehealth
National Category
Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-151795 (URN)10.2196/10302 (DOI)000444499200001 ()30185405 (PubMedID)
Note

Funding Agencies|Swedish Research Council [2015-02600]; Region Ostergotland, Sweden [LIO-531701, LIO-629211]; Medical Research Council of Southeast Sweden [FORSS-470121]; Swedish Heart and Lung Association [E082/14, E 087/13]; A-L and A Andersson Foundation for psychiatric research [LIO 5611101]

Available from: 2018-10-04 Created: 2018-10-04 Last updated: 2019-04-12
Broström, A., Wahlin, A., Alehagen, U., Ulander, M. & Johansson, P. (2018). Sex-Specific Associations Between Self-reported Sleep Duration, Cardiovascular Disease, Hypertension, and Mortality in an Elderly Population.. Journal of Cardiovascular Nursing, 33(5), 422-428
Open this publication in new window or tab >>Sex-Specific Associations Between Self-reported Sleep Duration, Cardiovascular Disease, Hypertension, and Mortality in an Elderly Population.
Show others...
2018 (English)In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 33, no 5, p. 422-428Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Both short and long sleep durations have been associated to increased mortality. Knowledge about sex-specific differences among elderly regarding associations between sleep duration, cardiovascular health, and mortality is sparse.

OBJECTIVE: The aims of this study are to examine the association between self-reported sleep duration and mortality and to investigate whether this association is sex specific and/or moderated by cardiovascular morbidity, and also to explore potential mediators of sleep duration effects on mortality.

METHODS: A population-based, observational, cross-sectional design with 6-year follow-up with mortality as primary outcome was conducted. Self-rated sleep duration, clinical examinations, echocardiography, and blood samples (N-terminal fragment of proBNP) were collected. A total of 675 persons (50% women; mean age, 78 years) were divided into short sleepers (≤6 hours; n = 231), normal sleepers (7-8 hours; n = 338), and long sleepers (≥9 hours; n = 61). Data were subjected to principal component analyses. Cardiovascular disease (CVD) and hypertension factors were extracted and used as moderators and as mediators in the regression analyses.

RESULTS: During follow-up, 55 short sleepers (24%), 68 normal sleepers (20%), and 21 long sleepers (34%) died. Mediator analyses showed that long sleep was associated with mortality in men (hazard ratio [HR], 1.8; P = .049), independently of CVD and hypertension. In men with short sleep, CVD acted as a moderator of the association with mortality (HR, 4.1; P = .025). However, when using N-terminal fragment of proBNP, this effect became nonsignificant (HR, 3.1; P = .06). In woman, a trend to moderation involving the hypertension factor and short sleep was found (HR, 4.6; P = .09).

CONCLUSION: Short and long sleep duration may be seen as risk markers, particularly among older men with cardiovascular morbidity.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2018
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-154038 (URN)10.1097/JCN.0000000000000393 (DOI)000457865500009 ()28060086 (PubMedID)
Available from: 2019-01-24 Created: 2019-01-24 Last updated: 2019-05-02
Mourad, G., Jaarsma, T., Strömberg, A., Svensson, E. & Johansson, P. (2018). The associations between psychological distress and healthcare use in patients with non-cardiac chest pain: does a history of cardiac disease matter?. BMC Psychiatry, 18(1), Article ID 172.
Open this publication in new window or tab >>The associations between psychological distress and healthcare use in patients with non-cardiac chest pain: does a history of cardiac disease matter?
Show others...
2018 (English)In: BMC Psychiatry, ISSN ISSN 1471-244X, Vol. 18, no 1, article id 172Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Psychological distress such as somatization, fear of body sensations, cardiac anxiety and depressive symptoms is common among patients with non-cardiac chest pain, and this may lead to increased healthcare use. However, the relationships between the psychological distress variables and healthcare use, and the differences in relation to history of cardiac disease in these patients has not been studied earlier. Therefore, our aim was to explore and model the associations between different variables of psychological distress (i.e. somatization, fear of body sensations, cardiac anxiety, and depressive symptoms) and healthcare use in patients with non-cardiac chest pain in relation to history of cardiac disease.

METHODS: In total, 552 patients with non-cardiac chest pain (mean age 64 years, 51% women) responded to the Patient Health Questionnaire-15, Body Sensations Questionnaire, Cardiac Anxiety Questionnaire, Patient Health Questionnaire-9 and one question regarding number of healthcare visits. The relationships between the psychological distress variables and healthcare visits were analysed using Structural Equation Modeling in two models representing patients with or without history of cardiac disease.

RESULTS: A total of 34% of the patients had previous cardiac disease. These patients were older, more males, and reported more comorbidities, psychological distress and healthcare visits. In both models, no direct association between depressive symptoms and healthcare use was found. However, depressive symptoms had an indirect effect on healthcare use, which was mediated by somatization, fear of body sensations, and cardiac anxiety, and this effect was significantly stronger in patients with history of cardiac disease. Additionally, all the direct and indirect effects between depressive symptoms, somatization, fear of body sensations, cardiac anxiety, and healthcare use were significantly stronger in patients with history of cardiac disease.

CONCLUSIONS: In patients with non-cardiac chest pain, in particular those with history of cardiac disease, psychological mechanisms play an important role for seeking healthcare. Development of interventions targeting psychological distress in these patients is warranted. Furthermore, there is also a need of more research to clarify as to whether such interventions should be tailored with regard to history of cardiac disease or not.

Keywords
Cardiac anxiety, Cardiac disease, Depressive symptoms, Fear of body sensations, Healthcare visits, Non-cardiac chest pain, Somatization
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-148445 (URN)10.1186/s12888-018-1689-8 (DOI)000434313300001 ()29866125 (PubMedID)
Note

Funding agencies: County Council of Ostergotland, Sweden [LIO-439131]; Medical Research of Southeast Sweden [FORSS-475291]

Available from: 2018-06-11 Created: 2018-06-11 Last updated: 2019-05-02
Mourad, G., Jaarsma, T., Strömberg, A., Svensson, E. & Johansson, P. (2017). Psychological distress and healthcare use in patients with non-cardiac chest pain: does a history of cardiac disease matter?. In: Abstract book: . Paper presented at EuroHeartCare, Jönköping, Sweden, 18-20 May 2017 (pp. S3-S3). Sage Publications, 16 (S1), Article ID 24.
Open this publication in new window or tab >>Psychological distress and healthcare use in patients with non-cardiac chest pain: does a history of cardiac disease matter?
Show others...
2017 (English)In: Abstract book, Sage Publications, 2017, Vol. 16 (S1), p. S3-S3, article id 24Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Background: Patients with non-cardiac chest pain (NCCP) suffer psychological distress such as somatization, fear of body sensations, cardiac anxiety and depressive symptoms, which can increase healthcare use. It is unknown how these variables are related and whether the relationships differ between patients with or without history of cardiac disease.

Objective: To explore and model the associations between somatization, fear of body sensations, cardiac anxiety, depressive symptoms, and healthcare use in patients with NCCP with or without history of cardiac disease.

Methods: Data were collected in Sweden in 670 patients (mean age 65±16 years, 51% women) within one month from discharge using the Patient Health Questionnaire-15, Body Sensations Questionnaire, Cardiac Anxiety Questionnaire, and Patient Health Questionnaire-9. Structural Equation Modelling analyses were used to explore the relationships between somatization, fear of body sensations, cardiac anxiety, depressive symptoms and healthcare use in NCCP patients with or without history of cardiac disease.

Results: About 40% of the NCCP patients had previous diagnosis of cardiac disease. Patients with NCCP and a history of cardiac disease were older (71 vs. 60 years), had more comorbidities (4.7 vs. 2.8), and reported significantly higher scores in somatization (p=0.02), cardiac anxiety (p<0.001), and depressive symptoms (p=0.02), and greater healthcare use (p<0.001). Depressive symptoms were not directly associated with healthcare use (Chi-Square=68.28, df=10, P-value=0.000, RMSEA=0.099, CFI=0.96). In patients with history of cardiac disease, the impact of depressive symptoms on healthcare use was mediated by somatization, fear of body sensations, and cardiac anxiety (Chi-Square=7.61, df=8, P-value=0.48, RMSEA=0.000, CFI=0.99). In patients with no history of cardiac disease, the impact of depressive symptoms on healthcare use was directly mediated by cardiac anxiety (Chi-Square=4.17, df=7, P-value=0.76, RMSEA=0.000, CFI=0.99).

Conclusions: The associations between psychological distress and healthcare use were different for patients with or without cardiac disease. In both groups depressive symptoms had no direct association with healthcare use.

Place, publisher, year, edition, pages
Sage Publications, 2017
Series
European Journal Of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953
National Category
Other Medical Sciences
Identifiers
urn:nbn:se:liu:diva-142715 (URN)
Conference
EuroHeartCare, Jönköping, Sweden, 18-20 May 2017
Funder
Region ÖstergötlandMedical Research Council of Southeast Sweden (FORSS)
Available from: 2017-10-31 Created: 2017-10-31 Last updated: 2017-12-04Bibliographically approved
Karlström, P., Johansson, P., Dahlström, U., Boman, K. & Alehagen, U. (2017). The impact of time to heart failure diagnosis on outcomes in patients tailored for heart failure treatment by use of natriuretic peptides. Results from the UPSTEP study. International Journal of Cardiology, 236, 315-320
Open this publication in new window or tab >>The impact of time to heart failure diagnosis on outcomes in patients tailored for heart failure treatment by use of natriuretic peptides. Results from the UPSTEP study
Show others...
2017 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 236, p. 315-320Article in journal (Refereed) Published
Abstract [en]

Background: Heart failure (HF) is a life-threatening condition and optimal handling is necessary to reduce risk of therapy failure. The impact of the duration of HF diagnosis on HF outcome has not previously been examined. The objectives of this study were (I) to evaluate the impact of patient age on clinical outcomes, (II) to evaluate the impact of duration of the HF disease on outcomes, and (III) to evaluate the impact of age and HF duration on B-type Natriuretic Peptide (BNP) concentration in a population of HF patients. Methods and results: In the UPSTEP (Use of PeptideS in Tailoring hEart failure Project) study we retrospectively evaluated how age and HF duration affected HF outcome. HF duration was divided into amp;lt; 1 year, 1-5 years and amp;gt; 5 years. A multivariate Cox proportional hazard regression analysis showed that HF duration influenced outcome more than age, even when adjusted for comorbidities(amp;lt; 1 year versus amp;gt; 5 years: HR 1.65; 95% CI 1.28-2.14; P amp;lt; 0.0002) on HF mortality and hospitalisations. The influence of age on BNP showed increased BNP as age increased. However, there was a significant effect on BNP concentration when comparing HF duration of less than one year to HF duration to more than five years, even when adjusted for age. Conclusions: Patients with longer HF duration had significantly worse outcome compared to those with short HF duration, even when adjusted for patient age and comorbidities. Age did not influence outcome but had an impact on BNP concentration; however, BNP concentration increased as HF duration increased. (C) 2017 Elsevier B.V. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD, 2017
Keywords
Heart failure; B-type Natriuretic Peptides; Age; Heart failure duration; Heart failure outcome
National Category
General Practice
Identifiers
urn:nbn:se:liu:diva-138904 (URN)10.1016/j.ijcard.2017.02.054 (DOI)000402476500055 ()28268084 (PubMedID)
Note

Funding Agencies|Regional Research Foundation in south-eastern Sweden [FORSS-3963, FORSS-5677, FORSS-F2004-223]; Regional Research Foundation in northern Sweden [33/2006, 20/2007]; Swedish Heart-Lung Foundation [2000596]; Biosite International and Infiniti Medical AB

Available from: 2017-06-27 Created: 2017-06-27 Last updated: 2018-04-18
Karlström, P., Johansson, P., Dahlström, U., Boman, K. & Alehagen, U. (2016). Can BNP-guided therapy improve health-related quality of life, and do responders to BNP-guided heart failure treatment have improved health-related quality of life? Results from the UPSTEP study.. BMC Cardiovascular Disorders, 16
Open this publication in new window or tab >>Can BNP-guided therapy improve health-related quality of life, and do responders to BNP-guided heart failure treatment have improved health-related quality of life? Results from the UPSTEP study.
Show others...
2016 (English)In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 16Article in journal (Refereed) Published
Abstract [en]

Background: To investigate whether B-type natriuretic peptide (NP)-guided treatment of heart failure (HF) patients improved their health related quality of life (Hr-QoL) compared to routine HF treatment, and whether changes in Hr-QoL differed depending on whether the patient was a responder to NP-guided therapy or not.

Methods: A secondary analysis of the UPSTEP-study, a Scandinavian multicentre study using a prospective, randomized, open, blinded evaluation design on patients with HF with New York Heart Association (NYHA) class II-IV. NP-guiding was aimed to reduce BNP <150 ng/L if<75 years or BNP<300 ng/L if>75 years. A responder was defined as a patient with a BNP<300 ng/L and/or a decrease in BNP of at least 40 % in week 16 compared to study start. Short form-36 (SF-36) was used to measure Hr-QoL. At the study start, 258 patients presented evaluable SF-36 questionnaires, 131 in the BNP group and 127 in the control group. At the study end 100 patients in the NP-guided group and 98 in the control group, presenting data from both the study start and the study end.

Results: There were no significant differences in Hr-QoL between NP-guided HF treatment and control group; however significant improvements could be seen in four of the eight domains in the NP-guided group, whereas in the control group improvements could be seen in six of the domains.

Among the responders improvements could be noted in four domains whereas in the non-responders improvements could be seen in only one domain evaluating within group changes.

Conclusions: Improved Hr-QoL could be demonstrated in several of the domains in both the NP-guided and the control group. In the responder group within group analyses showed more increased Hr-QoL compared to the non-responder group. However, all groups demonstrated increase in Hr-QoL.

Place, publisher, year, edition, pages
BioMed Central, 2016
Keywords
Heart failure, treatment guided by natriuretic peptides, Health related quality of life, responders, BNP, SF-36
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-124558 (URN)10.1186/s12872-016-0221-7 (DOI)000370472800001 ()
Note

Vid tiden för disputationen förelåg publikationen endast som manuskript

Funding agencies:  Swedish Heart-lung foundation [20060596]; Regional Research Foundation in south-eastern Sweden [FORSS-3963]; Regional Research Foundation in northern Sweden; Biosite international; Infiniti Medical AB

Available from: 2016-02-03 Created: 2016-02-03 Last updated: 2017-11-30Bibliographically approved
Mourad, G., Strömberg, A., Johansson, P. & Jaarsma, T. (2016). Depressive Symptoms, Cardiac Anxiety, and Fear of Body Sensations in Patients with Non-Cardiac Chest Pain, and Their Relation to Healthcare-Seeking Behavior: A Cross-Sectional Study. The patient, 9(1), 69-77
Open this publication in new window or tab >>Depressive Symptoms, Cardiac Anxiety, and Fear of Body Sensations in Patients with Non-Cardiac Chest Pain, and Their Relation to Healthcare-Seeking Behavior: A Cross-Sectional Study
2016 (English)In: The patient, ISSN 1178-1653, Vol. 9, no 1, p. 69-77Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Patients with non-cardiac chest pain (NCCP) suffer from recurrent chest pain and make substantial use of healthcare resources.

OBJECTIVE: To explore the prevalence of depressive symptoms, cardiac anxiety, and fear of body sensations in patients discharged with a NCCP diagnosis; and to describe how depressive symptoms, cardiac anxiety, and fear of body sensations are related to each other and to healthcare-seeking behavior.

METHODS: Cross-sectional design. Data were collected between late October 2013 and early January 2014 in 552 patients with NCCP from four hospitals in southeast Sweden, using the Patient Health Questionnaire-9, Cardiac Anxiety Questionnaire, and Body Sensations Questionnaire.

RESULTS: About 26 % (n = 141) of the study participants reported at least moderate depressive symptoms, 42 % (n = 229) reported at least moderate cardiac anxiety, and 62 % (n = 337) reported some degree of fear of body sensations. We found strong positive relationships between depressive symptoms and cardiac anxiety (r s = 0.49; P < 0.01), depressive symptoms and fear of body sensations (r s = 0.50; P < 0.01), and cardiac anxiety and fear of body sensations (r s = 0.56; P < 0.01). About 60 % of the participants sought care because of chest pain once, 26 % two or three times, and the rest more than three times. In a multivariable regression analysis, and after adjustment for multimorbidity, cardiac anxiety was the only variable independently associated with healthcare-seeking behavior.

CONCLUSION: Patients with NCCP and many healthcare consultations had high levels of depressive symptoms and cardiac anxiety, and moderate levels of fear of body sensations. Cardiac anxiety had the strongest relationship with healthcare-seeking behavior and may therefore be an important target for intervention to alleviate suffering and to reduce healthcare use and costs.

Place, publisher, year, edition, pages
ADIS INT LTD, 2016
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-117694 (URN)10.1007/s40271-015-0125-0 (DOI)000368734300008 ()25840677 (PubMedID)
Note

Funding agencies: County Council of Ostergotland, Sweden; Medical Research of Southeast Sweden (FORSS)

Available from: 2015-05-07 Created: 2015-05-07 Last updated: 2017-05-03Bibliographically approved
Hendriks, J., Walfridsson, U., Johansson, P. & Strömberg, A. (2016). Editorial Material: E-health in patients with atrial fibrillation in EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING, vol 15, issue 4, pp 200-202. European Journal of Cardiovascular Nursing, 15(4), 200-202
Open this publication in new window or tab >>Editorial Material: E-health in patients with atrial fibrillation in EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING, vol 15, issue 4, pp 200-202
2016 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 15, no 4, p. 200-202Article in journal, Editorial material (Other academic) Published
Abstract [en]

n/a

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD, 2016
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-129669 (URN)10.1177/1474515115616723 (DOI)000377126300001 ()26546593 (PubMedID)
Available from: 2016-06-27 Created: 2016-06-23 Last updated: 2017-11-28
Mourad, G., Strömberg, A., Jonsbu, E., Gustafsson, M., Johansson, P. & Jaarsma, T. (2016). Guided Internet-delivered cognitive behavioural therapy in patients with non-cardiac chest pain: -a pilot randomized controlled study. In: Abstract book: . Paper presented at EuroHeartCare Aten, Grekland 15-16 April 2016 (pp. S44-S44). Sage Publications, 15 (S1), Article ID P116.
Open this publication in new window or tab >>Guided Internet-delivered cognitive behavioural therapy in patients with non-cardiac chest pain: -a pilot randomized controlled study
Show others...
2016 (English)In: Abstract book, Sage Publications, 2016, Vol. 15 (S1), p. S44-S44, article id P116Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Background: Patients with recurrent episodes of non-cardiac chest pain (NCCP) suffer from cardiac anxiety as they misinterpret the pain as being cardiac-related and avoid physical activity that they think could threaten their life. This could lead to increased healthcare utilization and costs. These patients might benefit from help and support to evaluate the perception and management of their chest pain. 

Objective: To test the feasibility of a short guided Internet-delivered cognitive behavioural intervention and the effects on chest pain, cardiac anxiety, fear of body sensations and depressive symptoms in patients with NCCP compared to usual care.

Methods: A pilot randomized controlled study was conducted. Fifteen patients, 9 men and 6 women between the age of 22 and 76 (median age of 66 years, q1-q3 57-73) were randomly assigned to either intervention (n=7) or control (n=8) group. Patients had recurrent NCCP and suffered from cardiac anxiety or fear of body sensations. The intervention consisted of a 4-session guided Internet-delivered cognitive behavioural therapy program containing psychoeducation, exposure to physical activity, and relaxation. The control group received usual care. All patients completed a web-based questionnaire on socio-demographic variables, chest pain frequency, cardiac anxiety, fear of body sensations, and depressive symptoms. 

Results: Five out of the 7 patients in the intervention group completed all sessions as planned and two completed only parts of the program. The program was perceived as user-friendly with comprehensible language, adequate and varied content, and manageable homework assignments. The patients were engaged in the program for about 45-60 minutes per day and about 22 minutes’ therapist time was required to guide, support and give feedback to each patient throughout the program. Participating in the program empowered and motivated many of the patients to be active and complete the program. In general, patients in both the intervention and control groups improved with regard to chest pain frequency, cardiac anxiety, fear of body sensations, and depressive symptoms, but there were no significant differences between the groups. 

Conclusions: A short guided Internet-delivered cognitive behavioural therapy program was feasible. Patients in both the intervention and control groups improved with regard to chest pain frequency, cardiac anxiety, fear of body sensations, and depressive symptoms, but no significant differences were found between the groups. Patients should be followed-up for longer periods to measure the long-term effects of the intervention.

Place, publisher, year, edition, pages
Sage Publications, 2016
Series
European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953
National Category
Other Medical Sciences
Identifiers
urn:nbn:se:liu:diva-142713 (URN)10.1177/1474515116634263 (DOI)
Conference
EuroHeartCare Aten, Grekland 15-16 April 2016
Available from: 2017-10-31 Created: 2017-10-31 Last updated: 2017-12-04Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7431-2873

Search in DiVA

Show all publications