Life Satisfaction and longitudinal changes in physical activity, diabetes and obesity among patients with cardiovascular diseases.

in BMC Public Health (2017), (17), 925

Patients with cardiovascular disease who underwent coronary angiography at the National Institute of Cardiac Surgery and Cardiological Intervention (INCCI) in Luxembourg were surveyed for cardiovascular ... [more ▼]

Patients with cardiovascular disease who underwent coronary angiography at the National Institute of Cardiac Surgery and Cardiological Intervention (INCCI) in Luxembourg were surveyed for cardiovascular risk factors (CVRF) (hypertension, hypercholesterolemia, diabetes, obesity, physical inactivity, tobacco consumption). In 2013/14, their life satisfaction (LS) was also assessed. Our aim was to analyse the relationships between LS on one hand and <br />longitudinal changes in CVRF between 2008/09 and 2013/14 and socioeconomic factors on the other. <br />Methods: 1289 patients completed a self-administered questionnaire. Life Satisfaction, originally recorded on a 1 to 10 scale of complete satisfaction was dichotomized into two groups: ≤ 7 and. >7. We then performed logistic multiple regressions. The event on which the probability was modelled, was LS > 7. Data were adjusted on age, sex and income. Longitudinal changes in CVRF were assessed by their presence or absence in 2008/09 and 2013/ 14 (categories: ‘no-no’; ‘no-yes’; ‘yes-no’; ‘yes-yes’). <br />Results: Physical activity in 2008/09 and 2013/14 was associated with a lower LS (OR = 0.469). The same pattern was observed for obesity and physical inactivity: lower LS was related to the presence of these risks (yes-yes; no-yes) in 2013/14 (mean OR for obesity and physical inactivity in 2013/14: 0.587 and 0.485 respectively), whereas their presence or absence in 2008/09 was not related to LS. Finally, patients who suffered from diabetes in 2008 <br />were more likely to experience a decline in LS, particularly if their diabetes was less severe in 2013/14 (OR = 0.462). <br />Conclusions: The lowest LS was observed when obesity or physical inactivity was present in 2013/14, newly or otherwise. The same trend was seen in diabetes among patients who had it in 2008/9, but were less severely affected in 2013/14. In secondary prevention, CVD-related upheavals could be minimised if professionals and patients ecame ‘Partners in Healthcare’ to better adhere to healthy lifestyles, as well as to reduce CVRF, and thereby enhance LS. [less ▲]

Impact of Patients’ Communication with the Medical Practitioners, on Their Adherence Declared to Preventive Behaviours, Five Years after a Coronary Angiography, in Luxembourg

in PLoS ONE (2016), 11(6), 0157321

Patients of the National Institute of Cardiac Surgery and Interventional Cardiology in Luxembourg who underwent coronary angiography were surveyed for hypertension, hypercholesterolemia, diabetes and ... [more ▼]

Patients of the National Institute of Cardiac Surgery and Interventional Cardiology in Luxembourg who underwent coronary angiography were surveyed for hypertension, hypercholesterolemia, diabetes and overweight/obesity between 2008/9 and 2013/4. For each cardiovascular risk factor (CVRFs), we analysed the associations between the quality of the patients' communication with the medical practitioner and their adherence declared to preventive behaviours. Methods 1,289 completed a self-administered questionnaire on communication with the medical practitioner (P’Com-5 items scale; Cronbach 0.87). 61.8%stopped smoking, 57.9% reduced or stopped their consumption of salt, 71.9% of fat, and 62.8%of sugar, and whereas 65% increased their consumption of fruit and vegetables and 19.8% increased their physical activity. Around 37% reported having made changes following their doctor's advice. 90% were followed by a cardiologist and 95.9% by an attending physician. Results No link was observed between declaration of physical activity, smoking, fats, and quality of communication. Significant associations: for increased consumption of fruit and vegetables was linked with the quality of doctor-patient communication when patients were overweight (OR = 1.081), obese (OR = 1.130), hypercholesterolemic (OR = 1.102), hypertensive (OR = 1.084) or diabetic (OR = 1.103). Reduction in salt intake was linked only to patients with hypertension (OR = 1.102), whereas reduction or cessation of sugar consumption was linked to overweight (OR = 1.093), and more so obese, (OR = 1.106), hypercholesterolemics (OR = 1.103) and diabetics (OR = 1.173). Conclusions Good doctor-patient communication was related to nutrition, particularly increased consumption of fresh fruits and vegetables. Accurate perception of CVRFs by both patients and medical practitioners is essential for CV protection. The aim of instructing patients is to encourage them to make informed decisions about how to change their lifestyle. In routinely, P’Com-5 scale can collect data to assess the improvement of the professional skills. It can be used in medical training to enhance the quality of the therapeutic communication, especially for nutritional coaching, and to evaluate its efficacy in reducing CVRFs. [less ▲]

Life satisfaction, five-years after a coronary angiography, between physical exercise and socio-economic inequalities.

in Pracana, Clara (Ed.) Health Psychology (2015)

Five-years after undergoing a coronary angiography, socioeconomic status and health related behaviours are known to affect life satisfaction (LS), but their respective influence remains unclear. Our aim ... [more ▼]

Five-years after undergoing a coronary angiography, socioeconomic status and health related behaviours are known to affect life satisfaction (LS), but their respective influence remains unclear. Our aim was to analyze patients’ LS and its relationships with cardiovascular diseases, risk factors and preventive behaviours developed in the last 5 years and socioeconomic conditions. Methods: Based on records from the National Institute of Cardiac Surgery and Cardiological Intervention in Luxembourg, 3632 survivors who underwent coronary angiography between 2008 and 2009 were contacted in 2013 by letter to complete a self-questionnaire assessing LS [1-10] and other cofounder factors. Data were analysed via multiple regression models. Results. Life satisfaction of 1289 volunteers (69.2 years) was 7.3/10. Majority were men, Luxembourgish, secondary education level, employees and manual workers, and those with an income of 36000 euros or more per year. Being a woman, not living in couple and having a low middle income were negatively associated with the LS level. Patients who suffered in the last 5 years from angina pectoris, diabetes, hypercholesterolemia, obesity, or who stopped smoking because of the disease were more likely to have lower LS, in contrast to those who participate in regular physical activity or exercise. Conclusions: Patients’ LS indicator was lower than the national life satisfaction in Luxembourg (7.8/10) which was higher than that from the European (7.0 for EU-27). Coaching patients with interventions that foster healthy attitudes can help sustain rehabilitation and enhance life satisfaction, adding beyond a reduction of socioeconomic inequalities. [less ▲]

Life satisfaction, cardiovascular risk factors, unhealthy behaviours and socioeconomic inequality, 5 years after coronary angiography.

in BMC Public Health (2015), (15), 668-678

Five years after coronary angiography, life satisfaction (LS) among patients may be related to incidents of cardiovascular diseases, risk factors and unhealthy behaviours and socioeconomic conditions, but ... [more ▼]

Five years after coronary angiography, life satisfaction (LS) among patients may be related to incidents of cardiovascular diseases, risk factors and unhealthy behaviours and socioeconomic conditions, but their respective influence remains unclear. Our aim is to analyze LS and its relationships with those factors. Methods. Among the 4,391 patients initially contacted, 547 deaths were reported and 209 had an invalid address. In 2013-2014, 3,635 patients who underwent coronary angiography in 2008-2009 at the National Institute of Cardiac Surgery and Cardiological Intervention in Luxembourg were asked to complete a self-administered questionnaire assessing LS [1-10] and other variables. Data were analysed via multiple regression models adjusted initially on age, sex and income, and for a second time with the addition of all CVRF. Results. LS of 1,289 volunteers (69.2 years) was 7.3/10. Most were men, Luxembourgish, employees and manual workers, had secondary education and an income of 36,000 euros or more per year. LS was lowest in female patients, and those with a low to middle income. Patients who lived in a couple had the best LS. Patients with a history in the previous 5 years of physical inactivity (regression coefficient: -0.903), angina pectoris (rc -0.843), obesity (rc -0.512), diabetes, or hypercholesterolemia, were more likely to have lower LS. The previous associations were mostly maintained on the second analysis, with the exceptions of diabetes and obesity. In addition, patients who stopped smoking because of peer pressure (rc -0.011) had a lower LS. Conclusions. The finding that LS was lowest among female patients calls for further research on symptoms, and potential risk factors. Also, certain patient profiles are linked with low LS: ‘inclined abstainers’ who intended to modify their behaviours, but could not do so, and ‘disinclined abstainers’ who had no intention of changing and were insufficiently concerned to do so. Patients who stopped smoking and perceived it as unpleasant also had low LS. ‘Disinclined actors’ were those patients who had to adjust their lifestyles, but were ambivalent about their intentions and the behaviour, which they continued. Health promotion programs would benefit from targeting factors that moderate the unfavourable intention-behaviour relationship and can help enhance LS. [less ▲]

Weight Loss Aassociated With Socioeconomic Status in Patients With Angina Pectoris, 5 Yeras After and Angiography

in Cardiology (2015), (132 (104)), 60

The aim of the study is to assess the association between weight loss and socioeconomic status (SES) in patients with cardiovascular disease (CVD) such as angina pectoris. Method: In 2013-2014, 1,873 ... [more ▼]

The aim of the study is to assess the association between weight loss and socioeconomic status (SES) in patients with cardiovascular disease (CVD) such as angina pectoris. Method: In 2013-2014, 1,873 patients out of 4,391 that had undergone an angiography in 2008- 2009 participated in a follow-up study. Among these patients, 457 suffered from angina pectoris and were obese or overweight at baseline. A self-administered questionnaire was completed. Moderate weight loss was defined as the loss of 5%-10%, severe weigh loss as more than 10% of baseline weight. Household-income was used as proxy for SES. Logistic regression was applied to assess the association between weight loss and SES. Results: During the reference period, 28% of the participants lost weight. A moderate weight loss was higher in patients with a household income between 3000€ and 4500€ per month (OR: 2.3; CI 95%: 1.0-5.2) and higher than 4500€ per month (OR: 3.0; CI 95%: 1.3-7.2) compared to the lowest income group (less than 3000€ per month). A severe weight loss was not associated with income. However, a severe weight loss was higher for retired patients (OR: 4.3; CI 95%: 1.1- 17.0) compared to non-retired. Conclusion: The potential reduction of health inequality by an elimination of social inequalities in weight loss among patients with angina pectoris might be substantial. Moderate weight loss in overweight patients with angina pectoris at baseline could be associated with household income. Intervention strategies in secondary prevention should address these social inequalities in order to support equity in health. [less ▲]

Patients with cardiovascular risk factors were more likely to have lower life satisfaction.

in Circulation (2015), 132

Five years after coronary angiography, life satisfaction (LS) among patients may be related to incidents of cardiovascular diseases, risk factors and unhealthy behaviours and socioeconomic conditions but ... [more ▼]

Five years after coronary angiography, life satisfaction (LS) among patients may be related to incidents of cardiovascular diseases, risk factors and unhealthy behaviours and socioeconomic conditions but their respective influence remains unclear. Our aim is to analyze LS and its relationships with those factors. Methods. Among the 4,391 patients initially contacted, 547 deaths were reported and 209 had an invalid address. 3,635 patients who underwent coronary angiography in 2008-2009 at the National Institute of Cardiac Surgery and Cardiological Intervention (INCCI) in Luxembourg completed a self-questionnaire assessing LS [1-10] and other covariates. Data were analysed via multiple regression models adjusted initially on age, sex and income, and for a second time with the addition of all CVRF. Results. LS of 1,289 volunteers (69.2 years) was 7.3/10. Most were men, Luxembourgish, employees and manual workers, had secondary education and an income of 36,000 euros or more per year. LS was lowest in female patients, those with a low to middle income. Patients who live in couple had the best LS. Patients with a history in the previous 5 years of physical inactivity (regression coefficient: – 0.903), angina pectoris (rc -0.843), obesity (rc -0.512), diabetes, or hypercholesterolemia, were more likely to have lower LS. The previous associations were mostly maintained on the second analysis, with the exceptions of diabetes and obesity. In addition, patients who stopped smoking because of peer pressure (rc -0.011) had a lower LS. Conclusions. Profiles of patients are linked with least LS: ‘inclined abstainers’ who intended to modify their behaviours, but could not do it, and ‘disinclined abstainers’ who had no intention of changing and were insufficiently concerned to do so. Patients who stopped smoking and perceived it as unpleasant also had the lowest LS. ‘Declined actors’ were those patients who had to adjust their lifestyles, but were ambivalent about their intentions and the behaviour, which they continued. Health promotion programs would benefit from targeting factors that moderate the unfavourable intention-behaviour relationship and can help enhance LS. [less ▲]