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Jaarsma, Tiny, Professor
Alternative names
Publications (10 of 301) Show all publications
Kraai, I. H., Vermeulen, K. M., Hillege, H. L. & Jaarsma, T. (2018). "Not getting worse": a qualitative study of patients perceptions of treatment goals in patients with heart failure. Applied Nursing Research, 39, 41-45
Open this publication in new window or tab >>"Not getting worse": a qualitative study of patients perceptions of treatment goals in patients with heart failure
2018 (English)In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 39, p. 41-45Article in journal (Refereed) Published
Abstract [en]

Background Knowledge of patient reported outcomes helps to provide personalized care on a patient level, optimize care on a population level, and identify the most appropriate patient reported outcomes for clinical trials. To be able to provide personalized care to patients with HF, it is important to know which treatment goals patients with HF consider the most important. This is particularly useful for interventions aimed at improving symptoms, functional status, or health-related quality of life. Aim: The aim of this study was (1) to explore which treatment goals patients with heart failure (HF) perceive as important for their treatment and (2) to identify which treatment goals take priority over other treatment goals. Methods: The study had a qualitative design and included one focus group interview with 6 patients with HF. Data were analyzed using qualitative content analysis. Results: The overall theme of this study was found to be Not getting worse. This theme was composed of 4 categories that described how the patients perceived the goals of treatment: to decrease symptoms, to improve physical function, to prevent readmission, and to live a normal life. None of the participants mentioned improved survival or being cured of their HF as a treatment goal. Conclusion Not getting worse was perceived as the treatment goal that matters to patients with HF and is in line with currently used endpoints for the evaluation of a treatment in a clinical trial. More research is necessary to develop endpoints that are consistent with the perception of patients, useful for clinical practice, and measurable.

Place, publisher, year, edition, pages
Saunders Elsevier, 2018
Keywords
Cardiovascular; Focus group; Patient centered care; Qualitative; Heart failure
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-145774 (URN)10.1016/j.apnr.2017.10.010 (DOI)000425838500007 ()29422175 (PubMedID)
Note

Funding Agencies|Dutch Ministry of Health, Welfare, and Sport

Available from: 2018-03-22 Created: 2018-03-22 Last updated: 2018-04-20
Tingström, P., Jaarsma, T. & Nilsson, S. (2018). Patient empowerment and general self-efficacy in patients with coronary heart disease: a cross-sectional study. BMC Family Practice, 19, Article ID 76.
Open this publication in new window or tab >>Patient empowerment and general self-efficacy in patients with coronary heart disease: a cross-sectional study
2018 (English)In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 19, article id 76Article in journal (Refereed) Published
Abstract [en]

Abstract

Background:

In managing a life with coronary heart disease and the possibility of planning and following a

rehabilitation plan, patients

’ empowerment and self-efficacy are considered important. However, currently there is

limited data on levels of empowerment among patients with coronary heart disease, and demographic and clinical

characteristics associated with patient empowerment are not known.

The purpose of this study was to assess the level of patient empowerment and general self-efficacy in patients six

to 12 months after the cardiac event. We also aimed to explore the relationship between patient empowerment,

general self-efficacy and other related factors such as quality of life and demographic variables.

Methods:

A sample of 157 cardiac patients (78% male; age 68 ± 8.5 years) was recruited from a Swedish hospital.

Patient empowerment was assessed using the SWE-CES-10. Additional data was collected on general self-efficacy

and well-being (EQ5D and Ladder of Life). Demographic and clinical variables were collected from medical records

and interviews.

Results:

The mean levels of patient empowerment and general self-efficacy on a 0–4 scale were 3.69 (±0.54) and

3.13 (±0.52) respectively, and the relationship between patient empowerment and general self-efficacy was weak

(

r = 0.38). In a simple linear regression, patient empowerment and general self-efficacy were significantly correlated

with marital status, current self-rated health and future well-being. Multiple linear regressions on patient empowerment

(Model 1) and general self-efficacy (Model 2) showed an independent significant association between patient

empowerment and current self-rated health. General self-efficacy was not independently associated with any of the

variables.

Conclusions:

Patients with a diagnosis of coronary heart disease reported high levels of empowerment and general

self-efficacy at six to 12 months after the event. Clinical and demographic variables were not independently associated

with empowerment or low general self-efficacy. Patient empowerment and general self-efficacy were not mutually

interchangeable, and therefore both need to be measured when planning for secondary prevention in primary health

care.

Trial registration:

NCT01462799.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Patient empowerment, General self-efficacy, Coronary heart disease, Self-rated health, Well-being, Primary health care
National Category
Clinical Medicine Health Sciences
Identifiers
urn:nbn:se:liu:diva-148478 (URN)10.1186/s12875-018-0749-y (DOI)000434076700001 ()
Funder
The Swedish Heart and Lung Association, E091/10, E122/11, E083/12, E103/13
Note

Funding agencies: Swedish Heart and Lung Association [E091/10, E122/11, E083/12, E103/13]; County Council/Region Ostergotland, Sweden [LIO-92281, LIO-125151, LIO-27535, LIO-354951, LIO-433801]

Available from: 2018-06-12 Created: 2018-06-12 Last updated: 2018-06-18
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?
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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: 2018-06-28
Lycholip, E., Aamodt, I. T., Lie, I., Simbelyte, T., Puronaite, R., Hillege, H., . . . Celutkiene, J. (2018). The dynamics of self-care in the course of heart failure management: data from the IN TOUCH study. Patient Preference and Adherence, 12, 1113-1122
Open this publication in new window or tab >>The dynamics of self-care in the course of heart failure management: data from the IN TOUCH study
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2018 (English)In: Patient Preference and Adherence, ISSN 1177-889X, E-ISSN 1177-889X, Vol. 12, p. 1113-1122Article in journal (Refereed) Published
Abstract [en]

Introduction: Self-care is an important patient-reported outcome (PRO) for heart failure (HF) patients, which might be affected by disease management and/or telemonitoring (TM). The number of studies reporting the influence of TM on self-care is limited. Aims: This study aimed: to assess whether TM, in addition to information-and-communication-technology (ICT)-guided disease management system (ICT-guided DMS), affects self-care behavior; to evaluate the dynamics of self-care during the study; to investigate factors contributing to self-care changes; and to identify a patient profile that predisposes the patient to improvement in self-care. Methods: In the INnovative ICT-guided-DMS combined with Telemonitoring in OUtpatient clinics for Chronic HF patients (IN TOUCH) study, 177 patients were randomized to either ICT-guided DMS or TM+ICT-guided DMS, with a follow-up of 9 months. The current analysis included 118 participants (mean age: 69 +/- 11.5 years; 70% male) who filled the following PRO instruments: the nine-item European Heart Failure Self-care Behaviour scale (EHFScBs), Hospital Anxiety and Depression scale (HADs), and Minnesota Living with HF Questionnaire (MLHFQ). Results: The baseline level of self-care was better in the TM+ICT-guided-DMS group (n=58) compared to ICT-guided-DMS group (n=60, p=0.023). Self-care behavior improved in the ICT-guided-DMS group (p amp;lt; 0.01) but not in the TM+ICT-guided-DMS group. Factors associated with self-care worsening were as follows: higher physical subscale of MLHFQ (per 10 points, p amp;lt; 0.05), lower left ventricular ejection fraction (LVEF) (per 5%, p amp;lt; 0.05), lower New York Heart Association (NYHA) class (class III vs class II, p amp;lt; 0.05). The subgroups of patients who had an initial EHFScBs total score amp;gt; 28, or from 17 to 28 with concomitant HADs depression subscale (HADs_D) score amp;lt;= 8, demonstrated the greatest potential to improve self-care during the study. Conclusion: TM did not have an advantage on self-care improvement. Poor physical aspect of quality of life. lower LVEF, and lower NYHA class were associated with self-care worsening. The greatest self-care improvement may be achieved in those patients who have low or medium initial self-care level in the absence of depression.

Place, publisher, year, edition, pages
DOVE MEDICAL PRESS LTD, 2018
Keywords
heart failure; self-care; telemonitoring; disease management; patient-reported outcomes
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-149751 (URN)10.2147/PPA.S162219 (DOI)000437184500001 ()29983549 (PubMedID)
Note

Funding Agencies|Dutch Ministry of Health, Department of Pharmaceutical Affairs and Medical Technology (GMT); NordForsks "Nordic Programme on Health and Welfare" [76015]

Available from: 2018-07-24 Created: 2018-07-24 Last updated: 2018-08-14Bibliographically approved
Luttik, M., Goossens, E., Ågren, S., Jaarsma, T., Mårtensson, J., Thompson, D. R., . . . Strömberg, A. (2017). Attitudes of nurses towards family involvement in the care for patients with cardiovascular diseases.. European Journal of Cardiovascular Nursing, 16(4), 299-308
Open this publication in new window or tab >>Attitudes of nurses towards family involvement in the care for patients with cardiovascular diseases.
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2017 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no 4, p. 299-308Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: There is increasing evidence supporting the relationship between family support and patient outcomes. Therefore, involving families in the care of cardiovascular patients is expected to be beneficial for patients. The quality of the encounter with families highly depends on the attitudes of nurses towards the importance of families in patient care.

AIM: The aim of this study was to describe the attitudes of nurses towards family involvement in patient care and to investigate the individual contributions of demographic, professional and regional background characteristics.

METHOD: A survey was distributed among cardiovascular nurses attending an international conference in Norway and a national conference in Belgium. Nurses were asked to complete a questionnaire, including the Families' Importance in Nursing Care - Nurses' Attitudes scale. The study population consisted of respondents from Belgium (n = 348) and from Scandinavian countries (Norway, Sweden and Denmark; n = 77).

RESULTS: In general, nurses viewed the family as important in care. However, attitudes towards actively inviting families to take part in patient care were less positive. Higher educational level and a main practice role in research, education or management were significantly associated with more positive attitudes. Furthermore, the attitudes of respondents living in Scandinavia were more positive as compared to the attitudes of respondents living in Belgium.

CONCLUSION: Education on the importance of families and active family involvement in patient care seems to be necessary in basic, undergraduate education, but also in clinical practice. More research is necessary in order to explore the cultural and regional differences in the attitudes of nurses towards the involvement of families in patient care.

Place, publisher, year, edition, pages
Sage Publications, 2017
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-133980 (URN)10.1177/1474515116663143 (DOI)000396200300005 ()27470053 (PubMedID)
Available from: 2017-01-17 Created: 2017-01-17 Last updated: 2018-05-02
Ingadottir, B., Blondal, K., Thue, D., Zoega, S., Thylén, I. & Jaarsma, T. (2017). Development, Usability, and Efficacy of a Serious Game to Help Patients Learn About Pain Management After Surgery: An Evaluation Study.. JMIR Serious Games, 5(2), Article ID e10.
Open this publication in new window or tab >>Development, Usability, and Efficacy of a Serious Game to Help Patients Learn About Pain Management After Surgery: An Evaluation Study.
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2017 (English)In: JMIR Serious Games, E-ISSN 2291-9279, Vol. 5, no 2, article id e10Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Postoperative pain is a persistent problem after surgery and can delay recovery and develop into chronic pain. Better patient education has been proposed to improve pain management of patients. Serious games have not been previously developed to help patients to learn how to manage their postoperative pain.

OBJECTIVE: The aim of this study was to describe the development of a computer-based game for surgical patients to learn about postoperative pain management and to evaluate the usability, user experience, and efficacy of the game.

METHODS: A computer game was developed by an interdisciplinary team following a structured approach. The usability, user experience, and efficacy of the game were evaluated using self-reported questionnaires (AttrakDiff2, Postoperative Pain Management Game Survey, Patient Knowledge About Postoperative Pain Management questionnaire), semi-structured interviews, and direct observation in one session with 20 participants recruited from the general public via Facebook (mean age 48 [SD 14]; 11 women). Adjusted Barriers Questionnaire II and 3 questions on health literacy were used to collect background information.

RESULTS: Theories of self-care and adult learning, evidence for the educational needs of patients about pain management, and principles of gamification were used to develop the computer game. Ease of use and usefulness received a median score between 2.00 (IQR 1.00) and 5.00 (IQR 2.00) (possible scores 0-5; IQR, interquartile range), and ease of use was further confirmed by observation. Participants expressed satisfaction with this novel method of learning, despite some technological challenges. The attributes of the game, measured with AttrakDiff2, received a median score above 0 in all dimensions; highest for attraction (median 1.43, IQR 0.93) followed by pragmatic quality (median 1.31, IQR 1.04), hedonic quality interaction (median 1.00, IQR 1.04), and hedonic quality stimulation (median 0.57, IQR 0.68). Knowledge of pain medication and pain management strategies improved after playing the game (P=.001).

CONCLUSIONS: A computer game can be an efficient method of learning about pain management; it has the potential to improve knowledge and is appreciated by users. To assess the game's usability and efficacy in the context of preparation for surgery, an evaluation with a larger sample, including surgical patients and older people, is required.

Place, publisher, year, edition, pages
J M I R Publications, Inc., 2017
Keywords
evaluation studies, knowledge, pain management, patient education, self care, surgical procedures, operative, video games
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-139107 (URN)10.2196/games.6894 (DOI)28490419 (PubMedID)
Available from: 2017-07-01 Created: 2017-07-01 Last updated: 2018-05-14Bibliographically approved
Verheijden Klompstra, L., Jaarsma, T., Mårtensson, J. & Strömberg, A. (2017). Exergaming Through the Eyes of Patients with Heart Failure: A Qualitative Content Analysis Study. Games for Health Journal, 6(3), 152-158
Open this publication in new window or tab >>Exergaming Through the Eyes of Patients with Heart Failure: A Qualitative Content Analysis Study
2017 (English)In: Games for Health Journal, ISSN 2161-783X, E-ISSN 2161-7856, Vol. 6, no 3, p. 152-158Article in journal (Refereed) Published
Abstract [en]

Objective: Exergaming appears to be a promising tool to increase exercise capacity in patients with chronic heart failure (HF). Therefore, it is important to obtain more in-depth knowledge about preferences, attitudes, use, and abilities in regard to exergaming. The aim of this study was to describe the experiences of patients with HF when using an exergame platform at home. Materials and Methods: A qualitative descriptive study using content analysis was conducted on interviews with 14 patients with HF (6 women, ages ranging between 56 and 81 years). The patients were recruited from three centers in Sweden included in a randomized controlled study. These patients had access to an exergame platform at home and were advised to exergame for 30 minutes per day. Results: The analysis resulted in three categories describing patients experience of exergaming: (1) making exergaming work, (2) added value of exergaming, and (3) low appeal of exergaming. Conclusion: This is the first study that explores how patients with HF experience using an exergame platform at home. The study provided important information on what aspects to discuss when initiating an exergame platform at home and following patients who may want to use an exergame platform at home. The results also revealed that this technology may be suitable for some patients, while others prefer other kinds of physical activity.

Place, publisher, year, edition, pages
MARY ANN LIEBERT, INC, 2017
Keywords
Content analysis; Experiences; Exergame; Heart failure; Wii
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-139290 (URN)10.1089/g4h.2016.0087 (DOI)000403900500004 ()28422516 (PubMedID)
Note

Funding Agencies|Swedish National Science Council [K2013-69X-22302-01-3]; Swedish Heart and Lung Association [E085/12]; Swedish Heart-Lung Foundation [20130340]; Vardal Foundation [2014-0018]; FORSS [474681]; Swedish National Science Council/Swedish research council for health, working life, and welfare (VR-FORTE) [2014-4100]

Available from: 2017-07-07 Created: 2017-07-07 Last updated: 2018-05-07
Jaarsma, T., Cameron, J., Riegel, B. & Strömberg, A. (2017). Factors Related to Self-Care in Heart Failure Patients According to the Middle-Range Theory of Self-Care of Chronic Illness: a Literature Update. Current Heart Failure Reports, 14(2), 71-77
Open this publication in new window or tab >>Factors Related to Self-Care in Heart Failure Patients According to the Middle-Range Theory of Self-Care of Chronic Illness: a Literature Update
2017 (English)In: Current Heart Failure Reports, ISSN 1546-9530, E-ISSN 1546-9549, Vol. 14, no 2, p. 71-77Article, review/survey (Refereed) Published
Abstract [en]

As described in the theory of self-care in chronic illness, there is a wide range of factors that can influence self-care behavior. The purpose of this paper is to summarize the recent heart failure literature on these related factors in order to provide an overview on which factors might be suitable to be considered to make self-care interventions more successful.

Place, publisher, year, edition, pages
Springer, 2017
Keywords
Heart failure; Self-care; Self-care maintenance; Self-care management; Self-care monitoring
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-146068 (URN)10.1007/s11897-017-0324-1 (DOI)28213768 (PubMedID)
Available from: 2018-03-27 Created: 2018-03-27 Last updated: 2018-04-25
Kärner Köhler, A., Nilsson, S., Jaarsma, T. & Tingström, P. (2017). Health beliefs about lifestyle habits differ between patients and spouses 1 year after a cardiac event – a qualitative analysis based on the Health Belief Model. Scandinavian Journal of Caring Sciences, 31(2), 332-341
Open this publication in new window or tab >>Health beliefs about lifestyle habits differ between patients and spouses 1 year after a cardiac event – a qualitative analysis based on the Health Belief Model
2017 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 2, p. 332-341Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Spousal concordance on risk factors and lifestyle habits exists and can partly be explained by patients' and spouses' health beliefs and underuse of cardiac rehabilitation. However, there have been very few qualitative comparisons of health beliefs between patients and spouses after a cardiac event.

AIM:

To examine and qualitatively compare the health beliefs of patients with coronary heart disease and their spouses about lifestyle habits, 1 year after the cardiac event.

DESIGN:

Explorative and descriptive.

METHOD:

Semi-structured focus group interviews were conducted with patients (n = 14) 1 year after a cardiac event, as well as individual interviews with spouses (n = 8). The transcriptions underwent a deductive qualitative content analysis, within the framework of the Health Belief Model.

FINDINGS:

Patients' and spouses' health beliefs about lifestyle habits qualitatively differed in most predetermined main analytical categories of the Health Belief Model. The patients relied more on their own capacity and the healthcare system than on collaboration with their spouses who instead emphasised the importance of mutual activities to establish lifestyle habits. The spouses therefore experienced problems with different family preferences compared to the patients' wishes. Moreover, only patients believed supervised exercise was beneficial for risk reduction of coronary heart disease and they related barriers for medication to a self-healing body and a meaningless life without relatives and old habits. Patients and spouses agreed that despite the severity of illness, life was captured and that normalisation to a life as usual was possible.

CONCLUSION:

The patients' and spouses' qualitatively different health beliefs regarding health-related behaviours imply a new approach. Nurses and associated professionals need to follow-up patients' and spouses' in primary health care to support them in a tailored way, for example in problem-based sessions. Recognition and understanding of their different views and otherness could lead to compromises and goals to work with.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
Coronary Heart Disease, Primary Care, Health Psychology, Qualitative content analysis.
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-130771 (URN)10.1111/scs.12351 (DOI)000404644100014 ()27439667 (PubMedID)
Projects
The COR-PRIM study
Funder
Region Östergötland, Lio-433801
Note

Funding agencies: Swedish Heart and Lung Association [E103/13, E090/14]; Region Ostergotland, Sweden [LIO-433801]

Available from: 2016-08-23 Created: 2016-08-23 Last updated: 2018-07-02
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?
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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
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