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Coping, Sense of Coherence and the Dimensions of Affect in Patients with Chronic Heart Failure
Department of Cardiology Danderyd Hospital AB, S-182 88 Stockholm.ORCID iD: 0000-0002-1139-9489
Sophiahemmet University College, Stockholm.
2010 (English)In: European Journal of Cardiovascular Nursing, ISSN 1873-1953, E-ISSN 1474-5151, ISSN 1474-5151, Vol. 9, no 2, 118-125 p.Article in journal (Refereed) Published
Abstract [en]

Background: Living with chronic heart failure has an impact on several important dimensions of an individual's life. A patient's use of coping strategies may influence his or her health condition and emotional well-being.

Aim: To investigate factors that may relate to the coping strategies used by individuals with chronic heart failure and how the coping strategies are associated with positive and negative affect.

Methods: A cross-sectional research design was used. The participants provided demographic data and filled out three questionnaires: Sense of Coherence scale, Brief COPE and Positive Affect Negative Affect Schedule.

Results: No differences in relation to coping strategies were found with regard to New York Heart Association class. Substance use was associated with gender and age. Sense of coherence was negatively associated with denial, behavioural disengagement, venting and self-blame, and positively associated with acceptance. It was found that avoidant coping positively and sense of coherence negatively, predicted negative affect. Problem focused coping positively predicted positive affect. Socially supported coping predicted both negative and positive affect.

Conclusion: The present study found that the employment of different coping strategies and sense of coherence had an impact on affect and therefore also the emotional well-being among patients with chronic heart failure.

Place, publisher, year, edition, pages
Sage Publications, 2010. Vol. 9, no 2, 118-125 p.
Keyword [en]
chronic heart failure, coping, coping strategy, affect, sense of coherence
National Category
Nursing Health Sciences Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:rkh:diva-347DOI: 10.1016/j.ejcnurse.2009.11.006PubMedID: 20022304OAI: oai:DiVA.org:rkh-347DiVA: diva2:551404
Available from: 2012-09-11 Created: 2012-09-11 Last updated: 2015-09-07Bibliographically approved
In thesis
1. Coping and emotional well-being in patients with chronic heart failure
Open this publication in new window or tab >>Coping and emotional well-being in patients with chronic heart failure
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Chronic heart failure (CHF) is a serious illness, with a profound impact on the patient. Poor health-related quality of life (HRQoL) as well as anxiety and depression are prevalent in CHF and predict mortality and rehospitalization, yet, psychosocial factors are infrequently treated and cared for.

Aim: To gather scientific evidence on illness perception and coping strategies to predict emotional well-being in patients with CHF and to establish a measurement model of coping strategies. Furthermore, to evaluate a nurse-led psychoeducational intervention, Coping Effectiveness Training (CET) adapted for patients with CHF.

Methods: Studies I-III were cross sectional. Study IV was a randomized controlled trial aimed to improve emotional well-being (one-year follow-up). All studies used patient reported outcome measures and clinical data via medical journals.

Results: Younger age and male gender were associated with higher levels of alcohol usage and/or drugs to cope, p < 0.01. Poor sense of coherence was associated with maladaptive coping (I). A four factorial model of Brief COPE displayed the best psychometric properties (II). Avoidant coping influenced negative affect (NA) (I), worse HRQoL (II) and greater anxiety and depression (III). CET (IV) improved personal control in the intervention group (IG) compared to the control group (CG), p = 0.036. Improved scores for the IG were detected in emotional well-being and HRQoL, p = ns. The IG demonstrated reduced NA, p = 0.022, excluding cases with clinical anxiety and depression. Time to cardiovascular readmission or death was non-significantly lower in the IG vs the CG (Hazard ratio 0.58 [0.29-1.18]) adjusted p = 0.135.

Conclusions: Personal resources seemed to influence the coping strategies used by patients with CHF. Avoidant coping had an adverse influence on emotional wellbeing and illness perception in CHF. The perceived sense of control and illness burden were of importance for emotional well-being. A CET intervention for patients with CHF increased sense of control over the illness. CET also reduced NA in patients with no or mild symptoms of anxiety and depression.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet, 2015. 82 p.
Keyword
Heart failure; Coping; Illness perception; Emotional well-being; Quality of life; Intervention; Randomized controlled trial
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:rkh:diva-1899 (URN)978-91-7676-001-7 (ISBN)
Public defence
2015-09-11, Sal Henry Dunant, Teknikringen 1, Stockholm, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2015-09-07 Created: 2015-09-03 Last updated: 2015-09-07Bibliographically approved

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