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SPSC 3275 > behavioural and psychological aspects of cardiac rehabilitation > Flashcards

behavioural and psychological aspects of cardiac rehabilitation Flashcards

1
Q

what percentage of patients report high levels of anxiety and depression following a cardiac event?

A
  • anxiety = 20-20%
  • depression = 15-20%
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2
Q

higher levels of anxiety and depression are associated with who?

A

younger adults

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3
Q

what type of patients is more likely to drop out of cardiac rehab?

A

those with elevated anxiety and depression

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4
Q

what age group has the highest dropout rate out of cardiac rehab programs?

A

those below 65

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5
Q

what is the percent increase of coronary artery disease in those with anxiety?

A

26%

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6
Q

anxiety is associated with what percentage risk of cardiovascular mortality?

A

41%

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7
Q

what percent higher are those of stroke when also having anxiety?

A

71%

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8
Q

what percent higher are those at risk of heart failure when experiencing anxiety?

A

35%

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9
Q

what physiological pathways contribute to cardiovascular risk factors/mortality?

A
  • increased inflammation
  • ventricular, platelet and autonomic dysfunction (elevated heart rate)
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10
Q

what are the 2 most common causes of disability in high-income countries

A
  • cardiovascular disease
  • depression
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11
Q

what are the key health system and economic indicators relating to CVS and depression?

A
  • rising medical costs
  • increased health service utilization
  • lost productivity
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12
Q

what is commonly experienced as a reaction to an acute coronary event?

A
  • depressed mood
  • can be of a temporary nature = an adjustment disorder
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13
Q

does CVD or depression come first?

A

either, or both

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14
Q

what needs to be demonstrated for depression to be causally related to CVD?

A

depression was a ‘risk factor’ rather than just a ‘risk marker’

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15
Q

what studies suggest that the presence of depression doubles the risk of developing new CVD?

A

aetiological studies

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16
Q

whata are some putative (causation) mechanisms that are biologically plausible for the connection between depression and cvd?

A
  • 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
17
Q

what are soem treatment methods for depression in CVD?

A
  • cardiac rehabilitation
  • pharmacotherapy or medications
  • disease management programs
  • cognitive behaviour therapy
18
Q

what are some barriers to rehabilitation?

A
  • 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
19
Q

what are some sex differences when it comes to CVD and rehab?

A
  • 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
20
Q

what are disease management programs (DMP)?

A

structured treatment plans that aim to help people better manage their chronic disease and maintain and improve their quality of life

21
Q

who are DMPs available to?

A

those with

  • asthma
  • COPD
  • breast cancer
  • type 1 & 2 diabetes
  • coronary artery disease
22
Q

what is the main aim of disease management programs?

A
  • 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
23
Q

how is treatment provided in a disease management program?

A
  • the doctor will prepare an individual treatment plan based on the specification of the DMP
    • includes medication, training courses, and regular check-ups
24
Q

what is done to assure quality in a DMP?

A

documenting and evaluating patient data regularly

25
Q

what is needed to prevent cardiac rehab dropout in women?

A

modular and flexible programs

26
Q

what is the leading cause of death in women?

A

cardiovascular disease (51%)

27
Q

what are the reasons for women dropping out of cardiac rehab?

A
  • self-reported health
  • health beliefs
  • family caregiver role
  • work conflicts
  • transportation
  • distance
  • perception of the objective
  • exercise component
  • bad timing
  • CR equipment
  • financial assistance for transportation
  • long waiting list

SPSC 3275 (6 decks)

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