The role of illness perceptions in relation to depression symptoms and functional performance in patients with heart failure /
Notice bibliographique
Résumé
Background. Congestive heart failure (CHF) and depression, two leading problems in the community, are independently known to result in significant functional impairments, deterioration in quality of life and high mortality. While depression has been found to be a significant predictor of cardiac events and cardiac mortality, the importance of concurrent depression in patients with CHF has only recently been addressed. Studies of adjustment to chronic illnesses suggest that patients' beliefs about their illness or illness perceptions are important factors that may not only explain variations in patients' response to the same level of disease severity but may also influence more directly patients' outcomes such as adherence to treatment regimen, psychological and physical outcomes. Objectives. The objectives of this study were to assess the relationships between six dimensions of illness perceptions ( Identity, Timeline, Consequences, Personal Control, Treatment Control and Coherence), and later measures of depression symptoms and functional performance in patients with CHF, and to explore the moderating effect of social support in the relationships between illness perceptions and later depression symptoms and functional performance. Methods. A longitudinal study was conducted on 142 ambulatory CHF patients treated at the Heart Failure Clinic at the Montreal Heart Institute. Patients included in the study had left ventricular ejection fraction (LVEF) of less than 40% and were able to speak and read French or English. Baseline assessment included depressive symptoms (Cardiac Depression Scale, CDS), functional performance, (Functional Performance Inventory, FPI-SF), illness perceptions (Revised Illness Perceptions Questionnaire, IPQ-R), and social support (Interpersonal Relationship Inventory, IPRI). Four-month telephone follow-up included assessment of depressive symptoms and functional performance. Results. The prevalence of depressive symptoms was high, with 46.3% (n=136) of the sample reporting depressive symptoms, 27.9% moderately severe depression and 18.4% severe depression. After controlling for age, sex, education, living alone, LVEF, and comorbidity, patients who reported a greater number of symptoms identified with heart failure label ( Identity), more serious Consequences, longer illness duration (Timeline), weaker beliefs about Personal Control and the effectiveness of Treatment Control, and lower understanding of their illness (Coherence), reported significantly higher levels of depression symptoms and lower functional performance. In the longitudinal analyses, after controlling for baseline depression, beliefs about Treatment Control at baseline explained significant additional variance in depression at follow-up (p<.01). Weaker beliefs about Personal Control were significantly associated with higher depression symptoms and worse functioning at lower levels of social support, but these relationships were not apparent at higher levels of social support. Conclusions. Depression was highly prevalent in this sample of outpatients with CHF, confirming the need for improved recognition of depression in this group. Patients' beliefs about their illness appear to be particularly relevant in patients adjusting to CHF. Interventions that modify or take into account patients' negative beliefs about illness may have the potential to influence behaviour and reduce depression symptoms in CHF.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».