The role of illness perceptions in relation to depression symptoms and functional performance in patients with heart failure /
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".