1,720,993 research outputs found
HEART BEATS: A DYADIC RESEARCH ON PATIENTS WITH HEART DISEASE AND THEIR PARTNERS
No full textQuesta ricerca ha un approccio diadico che coinvolge sia i pazienti con malattie cardiovascolari che il loro partner durante l'ospedalizzazione. Il primo studio indaga l'effetto del coping diadico (DC) sulla soddisfazione coniugale dei partner considerando l'effetto moderatore del distress psicologico dei partner. I risultati mostrano che l'effetto benefico del DC positivo e comune sulla soddisfazione coniugale si verifica quando il distress psicologico dei partner è basso, al contrario il DC negativo diminuisce la soddisfazione coniugale tra coloro che hanno alti livelli di distress psicologico. Il secondo studio si propone di indagare la relazione tra DC, aderenza farmacologica e patient activation. La relazione è mediata dall'autoefficacia per la salute del paziente: il DC positivo e comune aumentano l'autoefficacia che a sua volta aumenta l'aderenza farmacologica e la patient activation; al contrario il DC negativo è dannoso durante il ricovero e anche dopo la dimissione. Il terzo studio indaga la relazione tra il distress psicologico e la qualità del supporto del partner (iperprotezione, ostilità e supporto al patient engagement) attraverso il ruolo moderatore del DC. I risultati mostrano che un alto distress psicologico è associato ad un peggior supporto del partner tra coloro che hanno basso DC positivo e alto DC negativo.This research has a dyadic approach involving both patients with cardiovascular disease and their partner during the hospitalization. The first study investigates the effect of dyadic coping (DC) on partners’ marital satisfaction considering the moderating effect of the partners’ psychological distress. The results show that the beneficial effect of positive and common DC on marital satisfaction occurs when the partners’ psychological distress is low, on the contrary negative DC decreases marital satisfaction among those who have high levels of psychological distress. The second study aims to investigate the relationship between DC, adherence to medications and patient activation. The relationship is mediated by the patient health self-efficacy: positive and common DC increase patient health self-efficacy which in turn increases adherence to medication and patient activation; on the contrary, the negative DC is detrimental during hospitalization and also over time after discharge. The third study investigates the relationship between psychological distress and the quality of partner support (overprotection, hostility and support for patient engagement) through the moderating role of DC. The results show that high psychological distress increases worse partner support among those with low levels of positive DC and high negative DC
La coppia di fronte alla malattia cardiaca: il ruolo della relazione nel processo di cura
No full textUna malattia cardiaca acuta e il processo di cura ad essa legato possono mettere a dura prova non solo il benessere del paziente colpito da un evento cardiaco, ma anche quello dei suoi familiari. In questa situazione critica la relazione di coppia può essere un elemento cardine sia nel promuovere che nell'ostacolare l'adattamento del paziente e la riuscita del processo di cura. La ricerca sulla gestione dello stress nella coppia ha evidenziato come la modalità con cui pazienti e partner fronteggiano la malattia cardiaca non possa essere compresa in termini meramente individuali, ma debba essere affrontata a partire da una prospettiva diadica e relazionale, come ben evidenziato nella letteratura sul coping diadico. Alla luce di queste premesse il presente capitolo è articolato in due parti. Una prima parte sarà dedicata a mostrare l'importanza di assumere una prospettiva diadica e relazionale nell’ambito della malattia cardiaca, offrendo una review della letteratura sul tema e presentando i risultati di una recente ricerca volta ad esplorare il ruolo di fattori individuali e relazionali in pazienti e partner alle prese con un evento cardiaco acuto. Infine, il capitolo presenta alcune implicazioni per la ricerca e l'intervento in quest'ambito
Assessing the needs and perspectives of patients with obesity and obstructive sleep apnea syndrome following continuous positive airway pressure therapy to inform health care practice: A focus group study
Full text linkObjective: This study aims to investigate the lived experience in patients with
obstructive sleep apnea syndrome (OSAS) and comorbid obesity following
after continuous positive airway pressure (CPAP) therapy made with the
disease the device, and to identify barriers and facilitators to the use of CPAP
to improve rehabilitation provision and aid in disease self-management.
Methods: Qualitative research was conducted using three focus groups with
a representative sample of 32 inpatients (37% female) undergoing a 1-month
pulmonary rehabilitation program at the IRCSS Istituto Auxologico Italiano San
Giuseppe Hospital, Verbania, Italy. The focus groups were recorded on tape, and
contemporaneous notes were made. The tapes were transcribed verbatim, and
Interpretative Phenomenological Analysis was used to develop themes.
Results: Six main themes were extracted: (1) Living the diagnosis as a shock; (2)
You should not sleep on it: the importance of prevention; (3) The adjustment
to CPAP; (4) Barriers and facilitators to the use of CPAP; (5) Three in a bed; and
(6) The relationship with the healthcare system.
Conclusion: Results of this study suggest potential avenues for interventions to
increase adherence to CPAP, including the provision of information and continued
support. Individual counseling providing strategies aimed at helping the person
to cope with the emotional problem and relational difficulties associated with
the use of CPAP, and at strengthening self-efficacy and self-management skills
are also encouraged for optimal care during the rehabilitation program
Essere in due è meglio di uno: Il supporto coniugale nella malattia cardiaca
No full textIntroduzione. La malattia cardiaca acuta coinvolge non solo il paziente, ma anche le sue relazioni, tra le quali la relazione di coppia assume un ruolo cruciale(Bertoni, Donato, Graffigna, Barello, & Parise, 2015; Bodenmann, 2000). La letteratura scientifica dedica però ancora un'attenzione limitata all'aspetto relazionale: sono pochi gli studi che intervistano i partner ed esaminano il legame tra malattia e coppia, sia in termini di ricadute su essa, sia nel considerare la relazione coniugale come possibile fattore interveniente nella cura (Vilchinsky et al., 2011).Questa ricerca indaga:1)se appartenere ad una relazione di coppia ha delle ricadute sul benessere del paziente; 2)quali effetti hanno diverse forme di supporto del partner (iperprotezione, supporto ostile, supporto al patient engagement) sul benessere del paziente e sul suo engagement nel processo di cura.
Metodo. La ricerca ha coinvolto 252 pazienti e 152 partner durante il ricovero in ospedale(T0) e circa 8-10 mesi dopo(T1).È stato somministrato un questionario self-report volto a indagare diversi costrutti tra cui il benessere psico-fisico del paziente in termini di ansia, depressione e disturbi somatici, il patient engagement (PE) e diverse forme di supporto coniugale.
Risultati. I risultati rivelano che lo stato civile del paziente non predice il PE. Il tipo di supporto fornito dal partner, se si esprime attraverso l’iperprotezione, aumenta la somatizzazione del paziente e diminuisce il PE, mentre se assume la forma di supporto ostile predice un incremento di sintomi depressivi.Conclusioni:I risultati dimostrano come il partner giochi un ruolo cruciale nel processo di cura a seguito di un evento cardiaco acuto.Non sempre la sua azione produce effetti positivi: se il partner è iperprotettivo o ostile il paziente mostra un incremento dei sintomi. L'assenza di differenze in termini di benessere tra pazienti in coppia o meno fa ipotizzare che non sia tanto la presenza di un legame quanto la qualità di questo a proteggere il paziente nel suo percorso di cura
Study protocol of a randomized controlled trial of motivational interviewing-based intervention to improve adherence to continuous positive airway pressure in patients with obstructive sleep apnea syndrome: The MotivAir study
Full text linkObjective: This study aims to evaluate the effectiveness of the MotivAir program-a phone-based intervention based on Motivational Interviewing (MI) principles and techniques-in enhancing adherence to Continuous Positive Airway Pressure (CPAP) therapy among patients with Obstructive Sleep Apnea Syndrome (OSAS). Methods: A multicenter randomized controlled trial (RCT) design with random allocation at the level of the individual will be conducted to compare the impact of the experimental program (usual care plus MI) with a control group receiving usual care only in improving selected clinical and psychological parameters in the patients. A minimum sample of 80 participants (40 patients per group) will be recruited in each center according to the inclusion criteria. After the initial screening, participants will be randomly assigned to either the experimental group or the control condition. The program will last 180 days and will be delivered by a trained nurse. The impact of the MotivAir program on selected primary (adherence to CPAP in terms of average hours of usage per night and the Apnea-Hypopnea Index, AHI) and secondary (motivation, perceived competence, quality of life, sleepiness) outcomes will be measured at baseline, and after 1-, 3-, and 6-month from CPAP initiation. Discussion: Participants are expected to show an increased level of adherence to CPAP and to acquire the skills and self-confidence necessary to deal with the psychological consequences of their chronic condition
Marital Adjustment
No full textThe definition of this construct is one of the most controversial topics in the literature. On the basis of various contributions, marital adjustment can be defined as a multidimensional indicator of the quality of marital relationship.
Evolution of the Construct Marital adjustment is one of the most studied dimensions in the couple and family research literature. According to Spanier (1976, p. 15), already by the 1970s, marital adjustment was “probably the most frequently investigated dependent variable in the field”. Also during the last 30 years, family researchers and scholars have maintained a strong interest on marital adjustment, as an outcome (Shriner 2009). The literature on marital adjustment reveals a variety of factors that are related to the dyadic adjustment (e.g., individual aspects like personality traits, irrational beliefs, and dysfunctional emotions Abbasi 2017; Filipović et al. 2016 and relational aspects like romantic attachment and dyadic coping (Young et al. 2017). Over the last decade, a substantial number of studies have focused on the role of personality traits in predicting the quality of adult romantic relationships (Abbasi 2017; Lampis et al. 2018; Rusu et al. 2019)
The long wave of COVID-19: a case report using Imagery Rehearsal Therapy for COVID-19-related nightmares after admission to intensive care unit
Full text linkIntroductionThe COVID-19 pandemic caused several psychological consequences for the general population. In particular, long-term and persistent psychopathological detriments were observed in those who were infected by acute forms of the virus and need specialistic care in the Intensive Care Unit (ICU). Imagery rehearsal therapy (IRT) has shown promising results in managing nightmares of patients with different traumas, but it has never been used with patients admitted to ICUs for severe COVID-19 despite this experience being considered traumatic in the literature. MethodsThe purpose of this case study is to describe the application of a four-session IRT for the treatment of COVID-related nightmares in a female patient after admission to the ICU. A 42-year-old Caucasian woman who recovered from a pulmonary rehabilitation program reported shortness of breath, dyspnea, and everyday life difficulties triggered by the long-COVID syndrome. She showed COVID-related nightmares and signs of post-traumatic symptoms (i.e., hyperarousal, nightmares, and avoidance of triggers associated with the traumatic situation). Psychological changes in the aftermath of a trauma, presence, and intensity of daytime sleepiness, dream activity, sleep disturbances, aspects of sleep and dreams, and symptoms of common mental health status are assessed as outcomes at the baseline (during the admission to pneumology rehabilitation) at 1-month (T1) and 3-month follow-up (T2). Follow-up data were collected through an online survey. ResultsBy using IRT principles and techniques, the patient reported a decrease in the intensity and frequency of bad nightmares, an increase in the quality of sleep, and post-traumatic growth, developing a positive post-discharge. ConclusionImagery rehearsal therapy may be effective for COVID-19-related nightmares and in increasing the quality of sleep among patients admitted to the ICU for the treatment of COVID-19. Furthermore, IRT could be useful for its brevity in hospital settings
Partner Support
No full textThe term partner support traditionally refers to the process of responding with helping acts (behavioral as well as psychological) to a difficulty or problem of one’s partner in a couple relationship. More recently, this definition was extended as to include responses apt to sustain the partner when facing positive events and life opportunities as well.
Historically, from the interest for general social support, researchers have recognized the relevant role of the specific relationships on the effects produced by social support. Couple relationship scholars, in particular, have drawn attention on the fact that intimate partners are especially important sources of support, who cannot be easily substituted. Indeed, social epidemiology has often used marital status as a measure of social support availability
Cross-Lagged Relations Between Exercise Capacity and Psychological Distress During Cardiac Rehabilitation
No full textBackground: Poorer mental health is associated with lower exercise capacity, above and beyond the effect of other cardiovascular risk factors. However, the directionality of this relationship remains unclear.Purpose: The main aim of the present study was to clarify, with a cross-lagged panel design, the relationship between psychological status and exercise capacity among patients in a cardiac rehabilitation (CR) program.Methods: A clinical sample of 212 CR patients completed exercise-capacity testing and measures of depression and anxiety (Hospital Anxiety and Depression Scale) pre-CR and post-CR. Demographic and clinical data, including BMI and smoking history, were also collected. Multivariate stepwise regression analysis was performed to identify the best predictors of exercise capacity at discharge. Structural equation modeling was utilized to quantify the cross-lagged effect between exercise capacity and psychological distress.Results: Multivariate regression analysis revealed that higher levels of psychological distress pre-CR are predictively associated with less improvement in exercise capacity post-CR, beyond the effects of age, sex, and baseline functional status. Results from structural equation modeling supported a 1-direction association, with psychological distress pre-CR predicting lower exercise capacity post-CR over and above autoregressive effects.Conclusions: Study results did not support the hypothesis of a bidirectional relationship between psychological distress and EC. High levels of psychological distress pre-CR appeared to be longitudinally associated with lower exercise capacity post-CR, but not vice versa. This finding highlights the importance of assessing and treating both anxiety and depression in the early phase of secondary prevention programs
“Cardiotoxic” and “cardioprotective” partner support for patient activation and distress: Are two better than one?
No full textObjective: The study aimed to test whether the presence of a partner was always beneficial to people with cardiac disease and how different types of partner behaviors promoted or hindered their activation and distress.Background: Cardiac disease challenges not only patients but also their partners, whose support is not always effective. Method: A cross-sectional dyadic research design, in which both partners completed a self-report questionnaire during hospitalization, was adopted. The associations between partner support and patient outcomes were tested using stepwise regression analysis.
Results: The mere presence of a partner was not associated with distress or activation of a person with cardiac illness. On the contrary, the quality of partner support is differently linked with outcomes of person with cardiac illness; in particular, partner support for activation is significantly associated with lower levels of depression, anxiety, and somatization of person with cardiac disease, whereas overprotection is significantly associated with lower levels of activation. Conclusion: Partner support may be a double-edged sword:Partners may be a powerful ally in illness management but also a barrier to it when partner support is ineffective. Implications: This study highlights the importance of integrating partners in cardiac recovery programs and provides suggestions for the design of couple-based interventions
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