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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Heart transplantation has become an established procedure for the treatment of terminal heart failure. However, due to a shortage of donor organs, the waiting period for a donor organ is increasing. Cross-sectional and retrospective studies have indicated that there is tremendous psychological distress during this waiting period. The aim of this study was to assess this phase systematically and longitudinally. At the beginning of their waiting period, 62 patients at the Heidelberg Transplantation Centre were examined with regard to their physical complaints, quality of life, and level of depression. Four months later the remaining 42 patients were re-examined. The sample showed a significant increase (p<0.001) in subjective physical symptoms and an impairment in social activities (p<0.05) and everyday life (p<0.05), and a significant increase in depression (p<0.001), despite the relatively short time period. These results show the necessity of supportive psychotherapy for patients undergoing heart transplantation.
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PMID:Psychological distress in patients awaiting heart transplantation. 983 41

Studies of Asian Pacific American populations are often flawed because while the population is quite heterogeneous, researchers usually collapse them into a single category, making it impossible to assess the health status or needs of individual Asian Pacific American ethnic groups. Using a probability sample of Guam residents, the analysis reported here addresses the problem by documenting the health status and characteristics of Chamorro and Filipino hypertensives. In contrast to predictions from the literature, Chamorros have a higher prevalence of hypertension than Filipinos. Additional results show that hypertensive Chamorro men and women are from lower socioeconomic status levels than their Filipino counterparts, while hypertensive men and women of both ethnic groups appear equally likely to be overweight and to suffer diabetes. Male hypertensives are at greater risk for psychological distress than normotensives, and have a greater chance of heart failure. Compared to Filipinos, hypertensive Chamorros are more likely to evaluate their overall physical health as poor.
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PMID:The health status and characteristics of hypertensives in Guam. 1005 Jan 85

From a medical perspective, heart transplantation is now an established procedure for the treatment of patients with terminal heart failure. For the patient involved, it presents itself as a situation of great psychological distress, particularly during the waiting period. In the last few years, this situation has grown worse due to the decline in the number of donor organs and the resulting longer waiting period. The aim of this study was to systematically evaluate this phase of the transplantation procedure in a follow-up study. 52 patients could be assessed in follow-up. Although the patients had already differed from the healthy control group in the areas of depression, quality of life, and physical complaints (p < 0.001) at the beginning of the study, there was a significant increase of depression and a further decline in the reported quality of life in the course of the study. The patients presented themselves as having a low internal and a significantly increased external and fatalistic locus of control. The study stresses the necessity for supportive psychotherapeutic therapy in these patients.
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PMID:[Quality of life, depression and coping behavior in patients awaiting heart transplant]. 1041 38

Since the first publication of isosorbide mononitrate 30% immediate-release 70% sustained-release (IR-SR) formulation in 1985, a considerable body of literature concerning its clinical efficacy and safety has become available. Theoretically, the formulation has the advantage over conventional isosorbide mononitrate or dinitrate (ISMN/ISDN) that it has a simpler and more predictable pharmacokinetic profile. The objectives of this paper are to review published data so far and to see whether the theoretical advantages translate into better clinical effectiveness. 1. After oral administration, isosorbide mononitrate IR-SR has a rapid onset of action (30 minutes), and effects are evident for up to 17 hours. 2. The antianginal effects of once-daily isosorbide mononitrate IR-SR increased with increasing dosages, were generally larger than those of either placebo or equipotent doses of conventional ISMN/ISDN, and were somewhat larger than those of the beta blocker bupranolol. The effects were generally similar to those of sustained release nifedipine. 3. Patients showed significantly greater improvement in some quality-of-life indices with once-daily isosorbide mononitrate IR-SR than with twice or three times daily regimens of conventional ISMN/ISDN. This was particularly so with mobility, psychological distress, and life satisfaction indices. 4. Tolerance did not develop after 13 months of once daily isosorbide dinitrate IR-SR. No rebound increase in incidence of ischemic episodes was observed after discontinuation of treatment. 5. Long-term efficacy data both of isosorbide mononitrate IR-SR and of conventional ISMN/ISDN are limited so far. Large studies in patients with angina pectoris and patients with heart failure addressing long-term effects are ongoing, and some of the data will be completed within the next months. Isosorbide mononitrate IR-SR has a rapid onset of action and has been shown to be clinically efficient and, in addition, to be more so than conventional ISMN / ISDN. Nitrate tolerance with continued use of the formulation has not yet been reported. Long-term effects on morbidity and mortality are currently being assessed.
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PMID:Isosorbide mononitrate 30% immediate-release 70% sustained-release formulation: a review. DUMQOL (DUtch Mononitrate Quality of Life) Study Group. 1095 15

Heart failure (HF) has a profound impact on patients' health-related quality of life (HRQL). Little is known about factors relating to HRQL in elderly Chinese HF patients. The objective of this cross-sectional correlational study was to identify the demographic, psychosocial, and clinical factors associated with HRQL in this group of patients. Cross-sectional data were obtained from a consecutive sample of hospitalized HF patients (n = 227) with measures of HRQL, psychological distress, perceived social support, and health perception. Functional status was measured with the New York Heart Association Classification (NYHA). In stepwise regression analysis, four variables, including psychological distress, health perception, NYHA classification, and educational level explained 51.8% (p =.01) of the variance in HRQL. These findings suggest that improving HRQL of HF patients entails improving their psychological status, functional status, and health perception.
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PMID:Health-related quality of life in elderly Chinese patients with heart failure. 1536 44

Dyspnea is a common symptom of heart failure frequently relied upon to assess clinical functioning. The purpose of this study is to explore a broad range of medical, psychological, and social factors that correlate with dyspnea in heart failure patients. Seventy-six participants ranged from well-compensated, ambulatory subjects to those with recent hospitalization for acutely decompensated heart failure. The sample was predominantly male, mean age of 63.5 years, with mild depressive symptoms in 25%. Correlation analysis revealed that dyspnea significantly correlated with depression, fatigue, and overall health perception. Standard regression analyses indicated that depression, fatigue, and overall health perception uniquely contributed to dyspnea, explaining 38.0% of the total variance. The present study confirms that dyspnea is multifactorial, with links to psychological distress and overall health perception.
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PMID:Psychological and social factors that correlate with dyspnea in heart failure. 1695 32

Recent evidence suggests that psychosocial factors such as self-efficacy, psychological distress, perceived social support, and marital quality have prognostic significance for morbidity and mortality after heart failure. Previously, we reported that interview and observational measures of marital quality obtained from 189 patients with heart failure (139 men and 50 women) and their spouses predicted all-cause patient mortality during the next 4 years, independent of the baseline illness severity (New York Heart Association class). We present additional follow-up results for this sample, with Cox regression analyses showing that a couple-level composite measure of marital quality continued to predict survival during an 8-year period (p <0.001), especially when the patient was a woman, and did so substantially better than individual (patient-level) risk and protective factors, such as psychological distress, hostility, neuroticism, self-efficacy, optimism, and breadth of perceived emotional support. In conclusion, relationship factors may be especially relevant in managing a difficult chronic condition such as heart failure, which makes stringent and complex demands on patients and their families.
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PMID:Effect of marital quality on eight-year survival of patients with heart failure. 1702 73

Psychological distress is common among patients with heart failure (HF); however, somatic symptoms are also common and may confound its assessment. Understanding the contributions of symptoms to psychological distress may assist in focusing treatment. The purpose of this study was to evaluate differences between HF patients and a non-HF comparison group on psychological distress (anxiety and depression); the association of anxiety and depression with common somatic symptoms of HF (fatigue, sleep disturbance, dyspnea, and excessive daytime sleepiness); and the extent to which somatic symptoms and HF diagnosis explain psychological distress. In this cross-sectional study, 61 stable systolic HF outpatients and a comparison group of 57 persons recruited from the community completed the Centers for the Epidemiological Studies of Depression Scale, Profile of Mood States-Short Form, Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Multidimensional Assessment of Fatigue Scale, and the Multidimensional Assessment of Dyspnea Scale. The HF patients scored higher on depression, as measured by the Centers for the Epidemiological Studies of Depression Scale, but not on the other depression or anxiety scales. Group-related differences in depression were explained by sleep disturbance, fatigue, and excessive daytime sleepiness, after accounting for the effects of age, sex, minority status, comorbidity, and physical function.
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PMID:Somatic symptoms explain differences in psychological distress in heart failure patients vs a comparison group. 1717 May 93

Severe pain is highly prevalent, with rates of 40% to 70% in patients with advanced cancer, liver disease, heart failure, human immunodeficiency virus, and renal failure. Wide variations in pain assessment and reporting methods and the measurement of multiple symptoms should be addressed in future studies. Regarding psychological approaches, determining whether hypnotherapy or other individual psychotherapeutic interventions reduce pain and/or psychological distress in a palliative care population is difficult. Interest is increasing in the concept of demoralization syndromes and the role of posttraumatic stress disorder in modulating responses to pain at the end of life. We review evidence from multiple studies that the use of rehabilitative therapy improves functional status and pain control among patients with advanced cancer, and we raise the possibility that rehabilitation therapy will be helpful in patients with other advanced diseases. We summarize ongoing clinical trials of electronic order sets, clinical care pathways, and care management pathways to improve pain management in palliative care. Wagner's Chronic Illness Model provides a way of analyzing how healthcare systems can be changed to provide adequate and continuing pain management in palliative care. Much work remains to ensure that pain is recognized, treated, and monitored effectively.
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PMID:Pain and palliative medicine. 1755 79

Quality of life is an important outcome measure in patients with end-stage heart failure waiting for heart transplantation. The purpose of this study was to investigate the relationship between aspects of quality of life and physiological and psychosocial variables in patients with end-stage heart failure. A total of 123 patients participated in the study. The functional status was assessed with New York Heart Association (NYHA) functional classification, a 6-minute walk test (6 MWT) and peak oxygen uptake (pVO(2)). Health related quality of life (HRQOL) was measured with Medical Outcomes Study, 36-item Short Form Survey (SF-36), and Minnesota Living with Heart Failure Questionnaire (MLHFQ). Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) were used to assess psychological symptoms. A significant relationship was found between HRQOL (SF-36 and MLHFQ) and functional status (NYHA, 6 MWT and pVO(2)) (p < 0.05). Psychological symptoms (BDI) were associated with HRQOL (p < 0.05). In addition to clinical derangements, functional limitation and psychological distress can lead to limitations in activities of daily life through impairment of quality of life. It would be helpful to evaluate psychological symptoms and quality of life in patients with end-stage heart failure besides routine clinical evaluations.
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PMID:Health related quality of life in patients awaiting heart transplantation. 1821 84


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