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Associations between disease severity, coping and dimensions of health-related quality of life in patients admitted for elective coronary angiography - a cross sectional study.

Ulvik B, Nygård O, Hanestad BR, Wentzel-Larsen T, Wahl AK - Health Qual Life Outcomes (2008)

Bottom Line: CAD and left ventricular ejection fraction (LVEF) were significantly associated with symptoms of angina pectoris and dyspnea.Angina pectoris and dyspnea were both associated with impaired physical function, and dyspnea was also negatively related to social function.Overall, less perceived burden and better overall QOL were observed in patients using more confronting coping strategy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway. Bjorg.Ulvik@hib.no

ABSTRACT

Background: In patients with suspected coronary artery disease (CAD), the overall aim was to analyse the relationships between disease severity and both mental and physical dimensions of health related quality of life (HRQOL) using a modified version of the Wilson and Cleary model.

Methods: Using a cross-sectional design, 753 patients (74% men), mean age 62 years, referred for elective cardiac catheterisation were included. The measures included 1) physiological factors 2) symptoms (disease severity, self-reported symptoms, anxiety and depression 3) self-reported functional status, 4) coping, 5) perceived disease burden, 6) general health perception and 7) overall quality of life. To analyse relationships, we performed linear and ordinal logistic regressions.

Results: CAD and left ventricular ejection fraction (LVEF) were significantly associated with symptoms of angina pectoris and dyspnea. CAD was not related to symptoms of anxiety and depression, but less depression was found in patients with low LVEF. Angina pectoris and dyspnea were both associated with impaired physical function, and dyspnea was also negatively related to social function. Overall, less perceived burden and better overall QOL were observed in patients using more confronting coping strategy.

Conclusion: The present study demonstrated that data from cardiac patients to a large extent support the suggested model by Wilson and Cleary.

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Related in: MedlinePlus

A modified version of the Wilson & Cleary model. LVEF: Left ventricular ejection fraction; AFS: Angina Frequency Scale; CCS: Canadian Cardiovascular Society classification; NYHA: New York Heart Association; HADS: Hospital Anxiety and Depression Scale; ECS: Exertional Capacity Scale; SF: Social Function; Coping: Confrontive coping, Normalising Optimistic Coping, Combined Emotive coping; Burden: Perception of living with angina pectoris.
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Figure 1: A modified version of the Wilson & Cleary model. LVEF: Left ventricular ejection fraction; AFS: Angina Frequency Scale; CCS: Canadian Cardiovascular Society classification; NYHA: New York Heart Association; HADS: Hospital Anxiety and Depression Scale; ECS: Exertional Capacity Scale; SF: Social Function; Coping: Confrontive coping, Normalising Optimistic Coping, Combined Emotive coping; Burden: Perception of living with angina pectoris.

Mentions: Coping is not made explicit in the model developed by Wilson & Cleary. However, coping may be seen as any effort to manage or adapt to perceived external or internal demands [19]. Thereby, one may propose that coping is a mediator between functional status and the perception of burden in the HRQOL model by Wilson and Cleary [5]. According to Lazarus and Folkman [19], coping covers both problem-focused and emotion-focused coping. The first is aimed at changing the situation causing the distress and to relieve the perceived problem, while the second is aimed at changing the emotions caused by the stressful event. We therefore suggest that different coping strategies used by patients admitted for elective coronary angiography may have an impact on their perceived burden, general health perception and overall QOL. Figure 1 outlines the modified version of the Wilson and Cleary model used in the present study.


Associations between disease severity, coping and dimensions of health-related quality of life in patients admitted for elective coronary angiography - a cross sectional study.

Ulvik B, Nygård O, Hanestad BR, Wentzel-Larsen T, Wahl AK - Health Qual Life Outcomes (2008)

A modified version of the Wilson & Cleary model. LVEF: Left ventricular ejection fraction; AFS: Angina Frequency Scale; CCS: Canadian Cardiovascular Society classification; NYHA: New York Heart Association; HADS: Hospital Anxiety and Depression Scale; ECS: Exertional Capacity Scale; SF: Social Function; Coping: Confrontive coping, Normalising Optimistic Coping, Combined Emotive coping; Burden: Perception of living with angina pectoris.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2414820&req=5

Figure 1: A modified version of the Wilson & Cleary model. LVEF: Left ventricular ejection fraction; AFS: Angina Frequency Scale; CCS: Canadian Cardiovascular Society classification; NYHA: New York Heart Association; HADS: Hospital Anxiety and Depression Scale; ECS: Exertional Capacity Scale; SF: Social Function; Coping: Confrontive coping, Normalising Optimistic Coping, Combined Emotive coping; Burden: Perception of living with angina pectoris.
Mentions: Coping is not made explicit in the model developed by Wilson & Cleary. However, coping may be seen as any effort to manage or adapt to perceived external or internal demands [19]. Thereby, one may propose that coping is a mediator between functional status and the perception of burden in the HRQOL model by Wilson and Cleary [5]. According to Lazarus and Folkman [19], coping covers both problem-focused and emotion-focused coping. The first is aimed at changing the situation causing the distress and to relieve the perceived problem, while the second is aimed at changing the emotions caused by the stressful event. We therefore suggest that different coping strategies used by patients admitted for elective coronary angiography may have an impact on their perceived burden, general health perception and overall QOL. Figure 1 outlines the modified version of the Wilson and Cleary model used in the present study.

Bottom Line: CAD and left ventricular ejection fraction (LVEF) were significantly associated with symptoms of angina pectoris and dyspnea.Angina pectoris and dyspnea were both associated with impaired physical function, and dyspnea was also negatively related to social function.Overall, less perceived burden and better overall QOL were observed in patients using more confronting coping strategy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway. Bjorg.Ulvik@hib.no

ABSTRACT

Background: In patients with suspected coronary artery disease (CAD), the overall aim was to analyse the relationships between disease severity and both mental and physical dimensions of health related quality of life (HRQOL) using a modified version of the Wilson and Cleary model.

Methods: Using a cross-sectional design, 753 patients (74% men), mean age 62 years, referred for elective cardiac catheterisation were included. The measures included 1) physiological factors 2) symptoms (disease severity, self-reported symptoms, anxiety and depression 3) self-reported functional status, 4) coping, 5) perceived disease burden, 6) general health perception and 7) overall quality of life. To analyse relationships, we performed linear and ordinal logistic regressions.

Results: CAD and left ventricular ejection fraction (LVEF) were significantly associated with symptoms of angina pectoris and dyspnea. CAD was not related to symptoms of anxiety and depression, but less depression was found in patients with low LVEF. Angina pectoris and dyspnea were both associated with impaired physical function, and dyspnea was also negatively related to social function. Overall, less perceived burden and better overall QOL were observed in patients using more confronting coping strategy.

Conclusion: The present study demonstrated that data from cardiac patients to a large extent support the suggested model by Wilson and Cleary.

Show MeSH
Related in: MedlinePlus