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      What Do We Know About Young Adult Cardiac Patients' Experience? A Systematic Review

      systematic-review

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          Abstract

          Background: Studies interested in patients coping with a cardiac illness usually focus on children, teenagers, and adults above the age of 55. Apart from the field of congenital heart diseases, there is a general lack of literature regarding young adult cardiac patients (18–55 years old) who seem to cope with psychosocial issues. Therefore, the objective of this paper was to gather all the research carried out concerning the psychological experiences of young adult cardiac patients.

          Methods and Results: A comprehensive, systematic review was conducted on quantitative, qualitative, and mixed-method studies in PsycINFO, PubMed, ScienceDirect, and Cochrane Library databases. Out of the 10,747 articles found, 32 were included. While we aimed to include many cardiac diseases, coronary patients dominated the data. Five main themes emerged: emotional states (depression, anxiety, emotional distress, and stress), quality of life (health-related quality of life, physical functioning, and sexuality), adjusting to the medical environment (coping with the disease, health behavior change, financial barriers, and interactions with medical professionals), social life (social support and work), and identity (parenthood, new challenges, and new meanings). The results highlighted that their levels of depression, anxiety, stress, and quality of life were sometimes worse than in the general population and than in older and younger patients coping with a cardiac illness. Social isolation, identity changes, work, and parenthood were the specific challenges that this population had to face. Furthermore, young adult cardiac patients showed worse health behavior profiles than the general population and felt that they lacked information from professionals, especially regarding sexuality. Compared to men, women had worse psychosocial outcomes, especially regarding depression, stress, emotional distress, and quality of life.

          Conclusions: Young adult cardiac patients are to be considered with their own identity and challenges. They may be in need of specific interventions, some dedicated to women, and better communication is necessary with their families and professional caregivers so as to improve the patient's mental health, quality of life, coping skills, and adherence.

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            Age, clinical presentation, and outcome of acute coronary syndromes in the Euroheart acute coronary syndrome survey.

            Age is one of the most powerful determinants of prognosis in myocardial infarction, but there is comparatively little recent data across the whole spectrum of acute coronary syndromes (ACS). We examined the impact of increasing age on clinical presentation and hospital outcome in a large sample of patients with ACS. Patients (n = 10 253) from the Euroheart ACS survey in 103 hospitals in 25 countries were investigated. There was a significant inverse association between the age and the likelihood of presenting with ST-elevation. For each decade of life, the odds of presenting with ST-elevation decreased by 0.82 [95% confidence interval (CI) 0.79-0.84]; P or =85 years, with no major differences across different types of admission or discharge diagnoses. Elderly ACS patients were less likely to present with ST-elevation but had substantial in-hospital mortality, yet they were markedly less intensively treated and investigated.
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              Prevalence and Measurement of Anxiety in Samples of Patients With Heart Failure

              Objectives: Rates of anxiety in patients with heart failure (HF) vary widely, and not all assessment instruments used in this patient population are appropriate. It is timely to consolidate the evidence base and establish the prevalence and variance of anxiety in HF samples. Methods: A systematic review, meta-analysis, and meta-regression were conducted to identify the prevalence, variance, and measurement of anxiety in patients with HF. Results: A total of 14,367 citations were identified, with 73 studies meeting inclusion criteria. A random effects pooled prevalence of 13.1% (95% confidence interval [CI], 9.25%–16.86%) for anxiety disorders, 28.79% (95% CI, 23.30%–34.29) for probable clinically significant anxiety, and 55.5% (95% CI, 48.08%–62.83%) for elevated symptoms of anxiety was identified. Rates of anxiety were highest when measured using the Brief Symptom Scale-Anxiety scale (72.3%) and lowest when measured using the Generalised Anxiety Disorder-7 (6.3%). Conclusion: Many patients with HF would benefit if screened for anxiety and treated. The conceptualization and measurement of anxiety accounted for most variance in prevalence rates. The Generalised Anxiety Disorder-7 or the Hospital Anxiety and Depression Scale appear to be the most appropriate instruments for this clinical population, with evidence to suggest they can discriminate between depression and anxiety, omit somatic items that may contaminate identification of anxiety in a population with physical comorbidities, and provide thresholds with which to differentiate patients and target treatments. Although there are limitations with the collation of diverse measurement methods, the current review provides researchers and clinicians with a more granular knowledge of prevalence estimates of anxiety in a population of HF patients.
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                Author and article information

                Contributors
                Journal
                Front Psychol
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                07 July 2020
                2020
                : 11
                : 1119
                Affiliations
                Université de Paris, LPPS , Boulogne-Billancourt, France
                Author notes

                Edited by: Noa Vilchinsky, Bar-Ilan University, Israel

                Reviewed by: Barbara Murphy, Australian Centre for Heart Health, Australia; Carmen María Galvez-Sánchez, University of Jaén, Spain

                *Correspondence: Jonathan Journiac jonathan.journiac@ 123456gmail.com

                This article was submitted to Psychology for Clinical Settings, a section of the journal Frontiers in Psychology

                Article
                10.3389/fpsyg.2020.01119
                7358619
                62c5d0e6-e93c-4fd0-b476-f1bd278eddb1
                Copyright © 2020 Journiac, Vioulac, Jacob, Escarnot and Untas.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 25 November 2019
                : 30 April 2020
                Page count
                Figures: 2, Tables: 4, Equations: 0, References: 111, Pages: 19, Words: 14386
                Categories
                Psychology
                Systematic Review

                Clinical Psychology & Psychiatry
                young,adults,cardiac,experience,review
                Clinical Psychology & Psychiatry
                young, adults, cardiac, experience, review

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