Mediating effect of coping strategy and psychological status between illness perception and quality of life among patients with atrial fibrillation: a cross-sectional study.

BACKGROUND: This study investigated the mediating effects of coping strategies and psychological status on the relationship between illness perception and health-related quality of life (HRQoL) among patients with atrial fibrillation (AF). METHODS: This cross-sectional study enrolled 178 patients with AF who were admitted to a tertiary hospital in Beijing City in mainland from March 2020 and June 2022. Assessments were made for HRQoL using the Short Form Health Survey depressive symptoms using the Patient Health Questionnaire-9, anxiety using the Generalized Anxiety Disorder-7 (GAD-7), illness perception using the Brief Illness Perception Questionnaire (BIPQ), AF symptoms using the Atrial Fibrillation Severity Scale (AFSS), and coping strategies using the Brief-COPE Scale. RESULTS: Significant correlations were observed between illness perception, emotional variables, coping strategies, and HRQoL scores. The regression analysis found that BIPQ, GAD, Maladaptive coping and Problem-focused coping are significant predictors of PCS (F = 20.906, R2 = 0.326, p < 0.01) and MCS (F = 31.24, R2 = 0.419, p < 0.01). Bootstrap samples were used to conduct mediation analysis. The indirect effects of GAD-7 and Problem-focused coping (PC) on the impact of BIPQ on QoL were significant. GAD accounted for 13.2-19.3% of the variance in the total effect across different models, while PC accounted for 22.1-25.8%. The results also indicated a significant chain effect in the illness percepitong-anxiety-coping style-QoL model, which can explain 4.3-10.2% of the total effect, respectively. CONCLUSIONS: The perception of illness significantly influenced HRQoL in patients with AF, as mediated by emotional symptoms and coping strategies. This highlights the importance of anxiety and problem-focused coping mechanisms. These findings underscore the need for a holistic, patient-centered approach to AF management that incorporates emotional well-being and coping strategies. TRIAL REGISTRATION: Retrospectively registered with ClinicalTrials.gov (NCT05974098). The date of registration: 1 August 2023.

The effects of cognitive behavioral therapy on health-related quality of life, anxiety, depression, illness perception, and in atrial fibrillation patients: a six-month longitudinal study.

BACKGROUND: Atrial fibrillation (AF) often leads to an impaired Health-Related Quality of Life (HRQoL) in many patients. Moreover, psychological factors such as depression, anxiety, and illness perception have been found to significantly correlate with HRQoL. This study aims to evaluate the long-term effectiveness of Cognitive Behavioral Therapy (CBT) in enhancing HRQoL and mitigating psychological distress among AF patients. METHODS: Employing a prospective, open design with pseudo-randomization, this study encompassed pre-tests, post-treatment evaluations, and a 6-month follow-up. A total of 102 consecutive patients diagnosed with paroxysmal AF were initially enrolled. Out of these, 90 were assigned to two groups; one to receive a 10-week CBT treatment specifically focusing on anxiety, and the other to receive standard care. Outcome measures were evaluated using tools such as the Item Short Form Health Survey (SF-12), General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), University of Toronto Atrial Fibrillation Severity Scale (AFSS), and Brief Illness Perception Questionnaire (BIPQ). These assessments were conducted at pre-treatment, post-treatment, and at the 6-month follow-up mark. We explored the effectiveness of CBT using Generalized Estimating Equations (GEE). RESULTS: Our analysis revealed a notable improvement in the CBT group relative to the control group. All metrics displayed consistent improvement across a 6-month duration. At the 6-month checkpoint, the CBT group exhibited a more favorable SF-12 Mental Component Score (MCS) (50.261 ± 0.758 vs. 45.208 ± 0.887, p < 0.001), reduced GAD-7 (4.150 ± 0.347 vs. 8.022 ± 0.423, p < 0.001), BIPQ (34.700 ± 0.432 vs. 38.026 ± 0.318, p < 0.001), and AFSS (9.890 ± 0.217 vs. 10.928 ± 0.218, p = 0.001) scores when compared to the TAU group. Conversely, the SF-12 PCS (44.212 ± 0.816 vs. 47.489 ± 0.960, p = 0.139) and PHQ-9 scores (8.419 ± 0.713 vs. 10.409 ± 0.741, p = 0.794) manifested no significant difference between the two groups. CONCLUSION: The findings suggest that CBT is effective in improving HRQoL and reducing psychological distress among patients with AF at 6 month follow-up. This highlights the potential benefits of integrating CBT into the therapeutic regimen for AF patients. TRIAL REGISTRATION: Retrospectively registered with ClinicalTrials.gov (NCT05716828). The date of registration : 5 June 2023.

Positive effect of Balint group on burnout and self-efficacy of head nurses in China: a randomized controlled trial.

Background: Burnout is common among nurses and can lead to negative outcomes of medical care. This study aimed to explore the effectiveness of Balint groups to reduce burnout in head nurses in a Chinese hospital. Methods: This was a randomized controlled trial with a pre- and post-test. A total of 80 head nurses were randomly assigned to either a Balint group (n = 40) or a control group (n = 40). Participants participated in Balint group for a period of 3 months. Participants in both groups completed the Maslach Burnout Inventory-Human Services Survey and the General Self-Efficacy Scale at the beginning and end of the study. Balint group members also completed the Group Climate Questionnaire-Short Form. Results: In the Balint group, 33 participants attended all Balint groups, while the 40 participants in the control group had no intervention. Analysis of variance with repeated measures demonstrated a statistically significant difference on the Maslach Burnout Inventory subscale of sense of personal achievement (F = 9.598, p = 0.003) between the Balint and control groups. However, there were no significant differences between the groups on the subscales of emotional exhaustion (F = 0.110, p = 0.740) and depersonalization (F = 0.75, p = 0.387), and the General Self-Efficacy Scale (F = 0.709, p = 0.403). Conclusions: Balint groups helped reduce burnout among head nurses in terms of personal achievement.

Effects of Cognitive Behavior Therapy on Depression, Illness Perception, and Quality of Life in Atrial Fibrillation Patients.

Background: AF Patients with depression resulted in a markedly reduced quality of life. The purpose of this study was to evaluate the efficacy of cognitive behavior therapy (CBT) on the health-related quality of life (HRQoL). Methods: It was A longitudinal randomized controlled trial with a pre and 12-weeks post-test. Ninety persons were randomly assigned to either a CBT group (CBT) (n = 45) or a treatment as usual (TAU) group (n = 45). The outcome were changes in the HRQoL [12-item Short Form Health Survey, SF12, divided into two domains: the physical component summary (PCS) and the mental component summary (MCS)], changes in psychological distress [Hamilton Depression Rating Scale (HAM-D) and Patient Health Questionnaire-9 (PHQ-9)], and Illness Perception [Brief Illness Perception Questionnaire (BIPQ)]. Results: There were statistically significant differences in score reduction for PHQ-9 (t = 3.186, P = 0.002), HAMD (t = 2.611, P = 0.011), BIPQ (t = 7.660, P < 0.001), and MCS (t = 4.301, P < 0.001) between CBT group and TAU group. Conclusions: CBT improved HRQoL, Illness Perception and reduced Depressive symptoms in atrial fibrillation.

Validity and reliability of the depression and somatic symptoms scale for screening depression among patients with coronary heart disease / 中华行为医学与脑科学杂志

Objective:To assess the validity and reliability of the depression and somatic symptoms scale among patients with coronary heart disease.Methods:Totally 246 patients with coronary heart disease were assessed with depression and somatic symptoms scale (DSSS), Hamilton depression rating scale for depression (HAMD) and patients’ health questionnaire depression scale-9 item (PHQ-9). The structural validity was evaluated with exploratory factor analysis and confirmatory factor analysis. The validity as a screening tool was evaluated with the gold standard diagnosed by psychiatrists who were trained with the mini international neuropsychological interview (MINI) according to ICD-10. Receiver operating characteristic (ROC) curve was used to identify cutoff scores for depression. Cronbach α coefficient was used to evaluate the internal consistency.Results:Exploratory factor analysis yielded two factors: depression factor and somatic factor, and the cumulative variance was 51.8%. The fitting indexes of confirmatory factor analysis were as follows: χ2/ df=3.636, RMR=0.077, RMSEA=0.104, IFI=0.804, TLI=0.781, CFI=0.802. The intraclass correlation coefficient of DSSS and HAMD was 0.54. The area under ROC curve (AUC) was 0.828, and the best boundary value was 17 points (sensitivity and specificity: 81% and 75%, respectively). The total scores and subscale scores for internal consistency of DSSS were higher in the depression group than those in the non-depression group ( P<0.01). Cronbach α coefficient for internal consistency of DSSS was 0.917. Conclusion:The DSSS has good validity and reliability among patients with coronary heart disease for screening depression, and can be used to screen depression among patients with coronary heart disease in general hospital.