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See detailPhysical activity and depression predict event-free survival in heart transplant candidates
Spaderna, Heike; Vögele, Claus UL; Barten, Markus J. et al

in Health Psychology (2014), 33(11), 1328-1336

Objective: This study prospectively evaluated the relationship of physical activity (PA), depression and anxiety to event-free survival during waiting-time for heart transplantation in ambulatory patients ... [more ▼]

Objective: This study prospectively evaluated the relationship of physical activity (PA), depression and anxiety to event-free survival during waiting-time for heart transplantation in ambulatory patients enrolled in the “Waiting for a New Heart Study”. Methods: Data from 227 ambulatory patients newly listed for heart transplantation was analyzed. Everyday PA (number of activities, caloric expenditure), depression, and anxiety at time of listing were assessed via questionnaires. Events were defined as death, high-urgency transplantation, delisting due to clinical deterioration, and mechanical circulatory support device implantation (MCSD). Associations of PA scores, depression and anxiety with event-free survival were analyzed using Cox proportional hazards models. Covariates included age, sex, BMI, and objective indicators of disease severity. Results: After a median follow-up of 478 days (6-1849 days), 132 events occurred (46 deaths, 20 MCSDs, 54 high-urgency transplantations, 12 delistings). A higher number of activities was significantly associated with a reduced hazard ratio (HR) to experience an event (HR=.88, 95% CI .81-.96), while depression increased this risk (HR=1.64, 95% CI 1.16-2.32). Both effects remained significant in multivariate analyses (HR=.91, 95% CI .83-.99; HR=1.60, 95% CI 1.12-2.29, p-values<.02). No significant interactions between PA scores and emotions were observed and anxiety was unrelated to survival. Conclusion: Both everyday physical activity and the absence of depression prolonged event-free survival in ambulatory heart transplant candidates. These findings were independent of objective measures of disease severity. Patients waiting for cardiac transplantation may benefit from interventions focused on increasing their everyday physical activity and reducing depressive symptoms. [less ▲]

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See detailForty years on: Childhood intelligence predicts health in middle adulthood.
Wrulich, Marius UL; Brunner, Martin; Stadler, Gertraud et al

in Health Psychology (2014), 33(3), 292-296

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See detailWhat can we learn from patients with heart failure about exercise adherence? A systematic review of qualitative papers.
Tierney, Stephanie; Mamas, Mamas; Skelton, Dawn et al

in Health Psychology (2011), 30(4), 401-10

OBJECTIVES: Keeping physically active has been shown to bring positive outcomes for patients diagnosed with heart failure (HF). However, a number of individuals with this health problem do not undertake ... [more ▼]

OBJECTIVES: Keeping physically active has been shown to bring positive outcomes for patients diagnosed with heart failure (HF). However, a number of individuals with this health problem do not undertake regular exercise. A review of extant qualitative research was conducted to explore what it can tell us about barriers and enablers to physical activity among people with HF. METHODS: A systematic search, involving electronic databases and endeavors to locate gray literature, was carried out to identify relevant qualitative studies published from 1980 onward. Data from retrieved papers were combined using framework analysis. Papers read in full numbered 32, and 20 were included in the review. RESULTS: Synthesis of results from the 20 studies resulted in 4 main themes: Changing soma, negative emotional response, adjusting to altered status, and interpersonal influences. How individuals responded to their diagnosis and their altered physical status related to their activity levels, as did the degree of encouragement to exercise coming from family, friends, and professionals. These findings can be connected to the theory of behavioral change developed by Bandura, known as social cognitive theory (SCT). CONCLUSIONS: SCT may be a useful framework for developing interventions to support patients with HF in undertaking and maintaining regular exercise patterns. Specific components of SCT that practitioners may wish to consider include self-efficacy and outcome expectancies. These were issues referred to in papers for the systematic review that appear to be particularly related to exercise adherence. [less ▲]

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See detailAwareness of breathing: The structure of language descriptors of respiratory sensations
Petersen, Sibylle UL; Orth, Bernhard; Ritz, Thomas

in Health Psychology (2008), 27(1), 122-127

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