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Brief Behavioral Health Intervention Program for Patients with Stable Coronary Artery Disease
Title
Brief Behavioral Health Intervention Program for Patients with Stable Coronary Artery Disease.
Creator
Wiener, Chelsea, Cassisi, Jeffrey, Gupta, Rema, Paulson, Daniel, University of Central Florida
Abstract / Description
Healthy eating, physical activity, stress management, and smoking cessation are widely recognized as essential for preventing and treating coronary artery disease (CAD). Research on lifestyle programs for patients with CAD has largely focused on long-term interventions (e.g., several months to one-year in duration). Further, many studies have recruited patients immediately post-cardiac event. By contrast, evaluation of brief lifestyle interventions for stable patients treated in outpatient...
Show moreHealthy eating, physical activity, stress management, and smoking cessation are widely recognized as essential for preventing and treating coronary artery disease (CAD). Research on lifestyle programs for patients with CAD has largely focused on long-term interventions (e.g., several months to one-year in duration). Further, many studies have recruited patients immediately post-cardiac event. By contrast, evaluation of brief lifestyle interventions for stable patients treated in outpatient cardiology is lacking. The present study evaluated the feasibility, acceptability, and efficacy of a 3-session behavioral health lifestyle program for patients with stable CAD being treated in an outpatient cardiology clinic. Thirty-three patients were randomized to the Intervention Group (IG) or to Treatment as Usual (TAU). Outcome measures were assessed at Post-treatment (two-weeks after Baseline) and at 30-day Follow-up. Reliable change and parametric analyses were used to evaluate study outcomes. Results indicated that the program was both feasible and acceptable to patients, as determined by a priori criteria: over 60 percent of referred and eligible patients agreed to participate, over 75 percent of consented IG participants completed the program through 30-day Follow-up, and over 80 percent of participants reported that they would recommend the program to other patients. With regard to treatment outcomes, data from 28 participants were available. Reliable change analyses revealed that at both Post-treatment and 30-day Follow-up, significantly more IG than TAU participants exhibited an increase in self-efficacy as compared with Baseline. There were no observed between-group differences on other study measures, though repeated-measures ANOVAs were underpowered. Overall, results support the feasibility and acceptability of brief lifestyle interventions in outpatient cardiology care and highlight the role of behavioral health providers on integrated cardiology care teams in helping to increase patient self-efficacy in managing chronic disease.
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Date Issued
2019
Identifier
CFE0007876, ucf:52770
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0007876
Relationships Between Information Adequacy, Illness Perceptions, and Distress Among Survivors of Differentiated Thyroid Cancer
Title
Relationships Between Information Adequacy, Illness Perceptions, and Distress Among Survivors of Differentiated Thyroid Cancer.
Creator
Wiener, Chelsea, Cassisi, Jeffrey, Gupta, Rema, Paulson, Daniel, University of Central Florida
Abstract / Description
Patients and survivors of differentiated thyroid cancer (DTC) report experiencing significant distress despite excellent disease prognosis. Predictors of distress in this population, however, are largely unexplored. Two factors that relate to distress in other cancer populations are patient subjective experiences with information provision and patient illness perceptions. Thus, evaluation of information experiences and illness perceptions among survivors of DTC is warranted. In particular,...
Show morePatients and survivors of differentiated thyroid cancer (DTC) report experiencing significant distress despite excellent disease prognosis. Predictors of distress in this population, however, are largely unexplored. Two factors that relate to distress in other cancer populations are patient subjective experiences with information provision and patient illness perceptions. Thus, evaluation of information experiences and illness perceptions among survivors of DTC is warranted. In particular, the unique prognosis and treatment associated with DTC invites investigation of the relationship between patient subjective experiences with information quantity (termed (")information adequacy(") in this study) and distress in this population. Thus, the primary goals of this thesis are 1) to examine how information adequacy and illness perceptions relate to distress in survivors of DTC, and 2) to investigate illness perceptions as a mechanism by which information adequacy and distress are related. Further, research suggests that distress and reduced emotional functioning among survivors of thyroid cancer extend years after initial diagnosis; however, the relationship between time and distress among survivors of DTC remains unclear and understudied. The extent to which time moderates relationships between information adequacy, illness perceptions, and distress also remains unexplored. Thus, secondary goals of this thesis are 1) to examine the relationship between time (specifically (")years-since-diagnosis(")) and distress, and 2) to examine time as a moderator of relationships between information adequacy, illness perceptions, and distress in survivors of DTC.A sample of 284 participants identified in the Patient Reported Outcomes Following Initial Treatment and Long-term Evaluation of Survivorship (PROFILES) registry were included in structural equation modeling. Relationships between information adequacy, illness perceptions, and distress were evaluated in Model 1. Results largely supported the hypothesized model: greater information adequacy was associated with better illness perceptions, better illness perceptions were associated with less distress, and greater information adequacy was indirectly related to less distress via better illness perceptions. A direct relationship between information adequacy and distress, however, was not observed. Secondary thesis aims were explored in Model 2. Results did not support moderation hypotheses, and a direct relationship between years-since-diagnosis and distress was not demonstrated. A revised model yielded ancillary findings that having fewer years-since-diagnosis was associated with worse illness perceptions, and with greater distress via worse illness perceptions. Thus, overall study results revealed a notable relationship between illness perceptions and distress among survivors of DTC. Future research should investigate whether interventions to address illness perceptions result in decreased distress in this population. The demonstrated link between information adequacy and illness perceptions invites further investigation of informational interventions in particular as a method to address illness perceptions. Future research should also investigate the extent to which illness perceptions mediate relationships between information experiences and distress in other cancer populations.
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Date Issued
2016
Identifier
CFE0006197, ucf:51100
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0006197