behavioural and psychological aspects of cardiac rehabilitation Flashcards
(27 cards)
what percentage of patients report high levels of anxiety and depression following a cardiac event?
- anxiety = 20-20%
- depression = 15-20%
higher levels of anxiety and depression are associated with who?
younger adults
what type of patients is more likely to drop out of cardiac rehab?
those with elevated anxiety and depression
what age group has the highest dropout rate out of cardiac rehab programs?
those below 65
what is the percent increase of coronary artery disease in those with anxiety?
26%
anxiety is associated with what percentage risk of cardiovascular mortality?
41%
what percent higher are those of stroke when also having anxiety?
71%
what percent higher are those at risk of heart failure when experiencing anxiety?
35%
what physiological pathways contribute to cardiovascular risk factors/mortality?
- increased inflammation
- ventricular, platelet and autonomic dysfunction (elevated heart rate)
what are the 2 most common causes of disability in high-income countries
- cardiovascular disease
- depression
what are the key health system and economic indicators relating to CVS and depression?
- rising medical costs
- increased health service utilization
- lost productivity
what is commonly experienced as a reaction to an acute coronary event?
- depressed mood
- can be of a temporary nature = an adjustment disorder
does CVD or depression come first?
either, or both
what needs to be demonstrated for depression to be causally related to CVD?
depression was a ‘risk factor’ rather than just a ‘risk marker’
what studies suggest that the presence of depression doubles the risk of developing new CVD?
aetiological studies
whata are some putative (causation) mechanisms that are biologically plausible for the connection between depression and cvd?
- alterations in the autonomic nervous system
- platelet receptors and function
- coagulopathic factors
- plasminogen activator inhibitor-1
- fibrinogen
- pro-inflammatory cytokines
- poor adherence to medical treatment
what are soem treatment methods for depression in CVD?
- cardiac rehabilitation
- pharmacotherapy or medications
- disease management programs
- cognitive behaviour therapy
what are some barriers to rehabilitation?
- location
- those living in more rural areas may have to travel far distances to complete the programs
- work responsibilities
- lack of time
- work, family, and/or caregiving responsibilities that limit their time availability
what are some sex differences when it comes to CVD and rehab?
- women present with a greater number of modifiable risk factors and have worse physical and mental health compared to men
- women have a greater period of perceived barrier to cardiac rehab program
- women tend to bear the majority of family/caretaker responsibilities
what are disease management programs (DMP)?
structured treatment plans that aim to help people better manage their chronic disease and maintain and improve their quality of life
who are DMPs available to?
those with
- asthma
- COPD
- breast cancer
- type 1 & 2 diabetes
- coronary artery disease
what is the main aim of disease management programs?
- reduce symptoms associated with a chronic disease and keep them from getting worse
- help people cope with their disease and to show them ways of dealing with the demands of their treatment in everyday life
how is treatment provided in a disease management program?
- the doctor will prepare an individual treatment plan based on the specification of the DMP
- includes medication, training courses, and regular check-ups
what is done to assure quality in a DMP?
documenting and evaluating patient data regularly
