Positive psychological profiles based on perceived health clustering in patients with cardiovascular disease: a longitudinal study

Abstract

ObjectivesPsychological well-being and sociodemographic factors have been associated with cardiovascular health. Positive psychological well-being research is limited in the literature; as such, this study aimed to investigate how patients with cardiovascular disease could be classified according to their perceived mental and physical health, and to identify positive psychological profiles based on this classification and test their stability over time.Design and settingLongitudinal study with patients from a public hospital located in Córdoba (Spain).ParticipantsThis study comprised 379 cardiovascular patients (87.3% men) tested at three measurement points.Outcome measuresParticipants reported their sociodemographic variables (age, sex, educational level, employment and socioeconomic status) at phase 1, while their perceived health and variables relating to positive psychological well-being were tested at this and two subsequent time points (average interval time: 9 months).ResultsThe two-step cluster analysis classified participants into three groups according to their mental and physical health levels, p<0.001: high (n=76), moderate (n=113) and low (n=189) perceived health clusters. Low perceived health was the largest cluster, comprising almost half of patients. Clusters significantly differed according to sex, p=0.002, and socioeconomic level, p=0.004. The profile analysis indicated that participants in the high perceived health cluster showed high positive affect, positivity, life satisfaction, and self-efficacy in emotion regulation, and less negative affect and use of passive strategies over the three measurement points (95% CI, all ps<0.01). Moreover, psychological profile stability for each cluster was generally found over an 18-month period, all ps<0.05.ConclusionCardiovascular patients may differ in terms of their perceived health and, accordingly, in terms of other relevant variables. Perceived health clusters generated varying and generally stable psychological profiles based on positive psychological well-being variables. Psychological interventions should be adapted to patients’ requirements.

Predicting physical activity and quality of life in coronary heart disease patients: An 18-month path analysis of motivational and emotional factors.

“…Moreover, as described by prior works (Castillo-Mayén, Luque, Rubio, et al, 2021; Modica et al, 2019; Sandberg et al, 2015), functional coping strategies, affective balance, and stronger intention to adopt healthier behaviors were found determinant in achieving better cardiovascular health. Overall, this finding extends the current body of knowledge that already established strong relationships between positive psychological profiles and the adoption of healthier behaviors, and how these relations are longitudinally associated with better perceived cardiovascular health (Adorni et al, 2022; Castillo-Mayén, Luque, Rubio, et al, 2021; Roshanaei-Moghaddam et al, 2009). In addition to this, the present work not only sheds light on the indirect role of psychological and behavioral factors in the longitudinal improvement of HRQoL, but it may also provide future preventive intervention programs with crucial components to be targeted in order to enhance patients’ self-management skills following a cardiac event.…”

“…This inference may find its reliability not only after controlling the path analysis for baseline HRQoL scores, but also providing evidence of significant improvements in HRQoL over 18 months. Moreover, as described by prior works (Castillo-Mayén, Luque, Rubio, et al, 2021; Modica et al, 2019; Sandberg et al, 2015), functional coping strategies, affective balance, and stronger intention to adopt healthier behaviors were found determinant in achieving better cardiovascular health. Overall, this finding extends the current body of knowledge that already established strong relationships between positive psychological profiles and the adoption of healthier behaviors, and how these relations are longitudinally associated with better perceived cardiovascular health (Adorni et al, 2022; Castillo-Mayén, Luque, Rubio, et al, 2021; Roshanaei-Moghaddam et al, 2009).…”

“…Overall, the configuration of positive psychological profiles, characterized, for example, by a stronger intention to adopt healthier behaviors, reduced anxiety and depression symptoms, and functional self-regulation abilities, were suggested to positively affect perceived health in patients with CVDs (Modica et al, 2019), which not only may facilitate the adoption and maintenance of self-care conducts but it may also indirectly contribute to impacting patients’ perception of their own physical and psychological status. Accordingly, recent longitudinal research has shown significant evidence explaining the associations of psychological constructs such as cardiac self-efficacy, emotions regulation and balance, and coping strategies with HRQoL (Castillo-Mayén, Luque, Rubio, et al, 2021; Luque et al, 2020; Tabernero et al, 2019, 2021). HRQoL allows to elicit patients’ perspectives of their health status and also represents an additional and complementary measure to objective biomedical outcomes (Pedersen et al, 2007).…”

Effectiveness of Mindfulness and Positive Strengthening mHealth Interventions for the Promotion of Subjective Emotional Wellbeing and Management of Self-Efficacy for Chronic Cardiac Diseases

“…The instrument consists of 20 items and uses a Likert scale of five points, where 1 = "totally disagree" and 5 = "strongly agree": 10 items (e.g., "excited") measure positive affect and 10 items (e.g., "worried") measure negative affect. The Cronbach's alpha coefficients in the original study were 0.87 and 0.86, respectively; in a Spanish sample of patients with CVDs, the reliabilities of the measure were 0.88 and 0.80, respectively [49]. In the current sample, the reliability for positive affect was α = 0.89 at baseline and α = 0.91 at post-test 3, and for negative affect, the reliability was α = 0.87 at baseline and α = 0.89 at post-test 3.…”

“…However, these characteristics should be taken into account in further studies, as low socioeconomic status may be related to poorer health outcomes. In this regard, a recent study found that patients with CVDs who reported lower income were included in a cluster of low self-reported mental and physical health, which in turn was associated with a profile of poorer psychological wellbeing [49]. Therefore, patients with lower socioeconomic status may benefit even more from these psychological interventions.…”