Gender Differences in Illness Behavior After Cardiac Surgery

Modica, Maddalena; Ferratini, Maurizio; Spezzaferri, Rosa; Maria, Renata De; Previtali, Emanuele; Castiglioni, Paolo

doi:10.1097/hcr.0000000000000043

Cited by 22 publications

(35 citation statements)

References 27 publications

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“…22 Reports of differences in physical function, favoring men, have also been reported in the general cardiac surgical literature. 29, 30 Differences in anxiety/depression by gender are also supported by the literature, early and later after heart transplantation, 26, 31, 32 after cardiac surgery, 33, 34 and in patients with heart failure. 35 Our findings suggest an opportunity to focus attention on subgroups of patients to maximize HRQOL before and after device implantation.…”

Section: Discussionmentioning

confidence: 53%

Age and gender differences and factors related to change in health-related quality of life from before to 6 months after left ventricular assist device implantation: Findings from Interagency Registry for Mechanically Assisted Circulatory Support

Grady

Wissman

Naftel

et al. 2016

The Journal of Heart and Lung Transplantation

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Background Gaps in the literature exist regarding health-related quality of life (HRQOL) early after left ventricular assist device (LVAD) surgery. The purposes of our study were to describe HRQOL over time, by age and gender, and identify risk factors for poor HRQOL early after LVAD implant. Methods Patients (n=7,353) from INTERMACS received a continuous flow LVAD as a primary implant at 133 U.S. hospitals. Of these, 5,640 patients had pre LVAD HRQOL data, and 3,353 patients had 6 month post LVAD HRQOL data. There were 2,748 patients with data at both time periods. HRQOL was measured using the EQ-5D-3L instrument. Data were collected pre-implant and 3 and 6 months post-operatively. Statistical analyses included chi square, t-tests, Pearson correlation coefficients, and multiple regression. Results Overall HRQOL and dimensions of HRQOL improved from before to 6 months after device implant when examined by age and gender. However, younger patients and women reported significantly more problems regarding all dimensions before implant and significantly more problems regarding pain/discomfort and anxiety/depression at both 3 and 6 months after implant. An increase in overall HRQOL from before to 6 months after implant was related to pre implant INTERMACS level 1. Factors related to a decrease in HRQOL from before to 6 months after implant were listed for heart transplant before surgery, co-morbidities, better preoperative HRQOL, adverse events within 6 months after implant, and bridge to transplant moderately likely and unlikely, and NYHA class 4 at 6 months post LVAD (R2=41%). Conclusions Overall HRQOL and dimensions of HRQOL improve in subgroups of patients from before to 6 months after surgery, although differences in improvement exist. Adverse events are risk factors for decreased HRQOL across time and support the ongoing need to improve device technology with the aim of reducing adverse events.

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Section: Discussionmentioning

confidence: 53%

Age and gender differences and factors related to change in health-related quality of life from before to 6 months after left ventricular assist device implantation: Findings from Interagency Registry for Mechanically Assisted Circulatory Support

Grady

Wissman

Naftel

et al. 2016

The Journal of Heart and Lung Transplantation

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show abstract

“…Being male was a significant predictor of increased anxiety. Modica et al (19) found that the different ways in which male and female cardiac patients frequencies and percentages their disease may be related to the outcomes of a CR program. They pointed out that men use denial mechanisms significantly more often than women do.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Clinical Anxiety Aggravation at the End of a Cardiac Rehabilitation Program

et al. 2016

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Background: Anxiety is one of the most primary and common reactions to a cardiac event can lead to hypertension, tachycardia, and high cardiac output. Objectives: To investigate the predictors of clinical anxiety aggravation at the end of a cardiac rehabilitation (CR) program. Patients and Methods:This retrospective study used a database of a CR ward of a hospital in Iran. The demographic and clinical information of 574 patients participating in the CR program from April 2005 through April 2010 were analyzed. In order to determine the predictors of anxiety, binary logistic regression was performed. Results: After adjustment for gender, age and education, the results showed that 16.7% of the patients completed their CR program with increased levels of clinical anxiety. The following study variables were independently predictive of increased anxiety at the end of the CR program: male gender (OR = 2.04, 95% CI = 1.11 to 3.33, P = 0.048), no history of diabetes (OR = 4.24, 95% CI = 172 to 10.44, P = 0.002), family history of cardiac disease (OR = 2.63, 95% CI = 1.03 to 6.74, P = 0.043), and not quitting smoking (OR = 3.29, 95% CI = 1.38 to 7.85, P = 0.007). These variables could explain 9% -15% of the variance in the dependent variable. Conclusions: It is possible to predict higher anxiety levels at the end of the CR program and implement preventive measures to control anxiety by considering certain demographic and clinical variables. Future studies should assess the predictive power of other variables.

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“…In this study, the number of the men who considered at least one uncontrollable biological risk factor as the cause of their disease was threefold that of the women. This is while based on a study by Modica et al (2014), there is a significant difference between men and women in terms of coping with a cardiac condition after surgery. In other words, men resort to the denial mechanism significantly more commonly than women when contending with a cardiac condition following surgery, which can affect the result of a cardiac rehabilitation program (16).…”

Section: Discussionmentioning

confidence: 99%

“…This is while based on a study by Modica et al (2014), there is a significant difference between men and women in terms of coping with a cardiac condition after surgery. In other words, men resort to the denial mechanism significantly more commonly than women when contending with a cardiac condition following surgery, which can affect the result of a cardiac rehabilitation program (16). In fact, the denial of the current situation by men is followed by treatment resistance, with its corollary impact on the anxiety scores in different ways.…”

Section: Discussionmentioning

confidence: 99%

Those who perceive their disease as a physiological or psychological risk factor experience more anxiety at the beginning of the cardiac rehabilitation program

et al. 2016

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Gender Differences in Illness Behavior After Cardiac Surgery

Cited by 22 publications

References 27 publications

Age and gender differences and factors related to change in health-related quality of life from before to 6 months after left ventricular assist device implantation: Findings from Interagency Registry for Mechanically Assisted Circulatory Support

Age and gender differences and factors related to change in health-related quality of life from before to 6 months after left ventricular assist device implantation: Findings from Interagency Registry for Mechanically Assisted Circulatory Support

Predictors of Clinical Anxiety Aggravation at the End of a Cardiac Rehabilitation Program

Those who perceive their disease as a physiological or psychological risk factor experience more anxiety at the beginning of the cardiac rehabilitation program

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