Uncertainty and depressive symptoms as mediators of quality of life in patients with heart failure

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Uncertainty in illness is regarded as a source of stress in many chronic diseases and is negatively related to health-related quality of life (HRQoL). However, studies on the relationship between uncertainty and HRQoL in patients with heart failure are limited. This study used Mishel’s theory of uncertainty in illness to investigate the mediating role of uncertainty in illness and depressive symptoms between symptom distress and HRQoL in patients with heart failure. This study used a cross-sectional correlation design. Participants were recruited by convenience sampling from outpatient services and medical wards of cardiology departments of a medical center in northern Taiwan. Data were collected for uncertainty, depressive symptoms, symptoms distress of heart failure, and HRQoL using self-report questionnaires. Demographics and clinical characteristics were analyzed with descriptive statistics. The mutual effects of disease characteristics, symptom distress, uncertainty in illness, depressive symptoms and HRQoL, as well as the overall model fitness, were analyzed by with structural equation modeling. We collected 147 qualified questionnaires. The mean score for the Mishel Uncertainty in Illness Scale for patients with heart failure was 73.5 (SD = 18.55); 65.3% of participants had a score of ≧13 on the Beck Depressive Inventory-II, indicating mild depression. Uncertainty, depressive symptoms, and HRQoL were directly related to symptom distress. Symptom distress and depressive symptoms were both mediators between uncertainty and depressive symptoms. Depressive symptoms also mediated emotional support and HRQoL. Uncertainty and depressive symptoms were important factors in the pathway between symptom distress and HRQoL for heart failure patients. We suggest providing heart failure patients with tailored interventions for effective self-management of symptoms based on Mishel’s theory of uncertainty in illness, which could help control disease symptoms, alleviate uncertainty and depression as well as improve HRQoL.

Related collections

Most cited references 46

Record: found
Abstract: found
Article: not found

SPSS and SAS procedures for estimating indirect effects in simple mediation models.

Kristopher J Preacher, Andrew Hayes (2004)

Researchers often conduct mediation analysis in order to indirectly assess the effect of a proposed cause on some outcome through a proposed mediator. The utility of mediation analysis stems from its ability to go beyond the merely descriptive to a more functional understanding of the relationships among variables. A necessary component of mediation is a statistically and practically significant indirect effect. Although mediation hypotheses are frequently explored in psychological research, formal significance tests of indirect effects are rarely conducted. After a brief overview of mediation, we argue the importance of directly testing the significance of indirect effects and provide SPSS and SAS macros that facilitate estimation of the indirect effect with a normal theory approach and a bootstrap approach to obtaining confidence intervals, as well as the traditional approach advocated by Baron and Kenny (1986). We hope that this discussion and the macros will enhance the frequency of formal mediation tests in the psychology literature. Electronic copies of these macros may be downloaded from the Psychonomic Society's Web archive at www.psychonomic.org/archive/.

0 comments Cited 367 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes.

Thomas Rutledge, Veronica Reis, Sarah E Linke … (2006)

This article describes a meta-analysis of published associations between depression and heart failure (HF) in regard to 3 questions: 1) What is the prevalence of depression among patients with HF? 2) What is the magnitude of the relationship between depression and clinical outcomes in the HF population? 3) What is the evidence for treatment effectiveness in reducing depression in HF patients? Key word searches of the Medline and PsycInfo databases, as well as reference searches in published HF and depression articles, identified 36 publications meeting our criteria. Clinically significant depression was present in 21.5% of HF patients, and varied by the use of questionnaires versus diagnostic interview (33.6% and 19.3%, respectively) and New York Heart Association-defined HF severity (11% in class I vs. 42% in class IV), among other factors. Combined results suggested higher rates of death and secondary events (risk ratio = 2.1, 95% confidence interval 1.7 to 2.6), trends toward increased health care use, and higher rates of hospitalization and emergency room visits among depressed patients. Treatment studies generally relied on small samples, but also suggested depression symptom reductions from a variety of interventions. In sum, clinically significant depression is present in at least 1 in 5 patients with HF; however, depression rates can be much higher among patients screened with questionnaires or with more advanced HF. The relationship between depression and poorer HF outcomes is consistent and strong across multiple end points. These findings reinforce the importance of psychosocial research in HF populations and identify a number of areas for future study.

0 comments Cited 327 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: not found
Article: not found

Preliminary development of a scale of social support: Studies on college students

Manuel Barrera, Irwin N Sandler, Thomas Ramsay (1981)

0 comments Cited 219 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Ting-Yu Chen: Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: VisualizationRole: Writing – original draft

Chi-Wen Kao:

ORCID: http://orcid.org/0000-0003-4003-7564

Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: SupervisionRole: ValidationRole: Writing – review & editing

Shu-Meng Cheng: Role: InvestigationRole: ResourcesRole: ValidationRole: Writing – review & editing

Yue-Cune Chang: Role: Formal analysisRole: SoftwareRole: Writing – review & editing

Andrew Soundy: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 14 November 2018

Publication date Collection: 2018

Volume: 13

Issue: 11

Electronic Location Identifier: e0205953

Affiliations

[1 ] Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan

[2 ] Chung-Jen Junior College of Nursing, Health Sciences and Management, Chiayi, Taiwan

[3 ] Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan

[4 ] School of Nursing, National Defense Medical Center, Taipei, Taiwan

[5 ] Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

[6 ] National Defense Medical Center, School of Medicine, Taipei, Taiwan

[7 ] Department of Mathematics, Tamkang University, Taipei, Taiwan

University of Birmingham, UNITED KINGDOM

Author notes

Competing Interests: The authors have declared that no competing interests exist.

[¤a]

Current address: Chung-Jen Junior College of Nursing, Health Sciences and Management, Da-Hu, Hu-Bei Village, Da-Lin Township, Chia-Yi County, Taiwan

[¤b]

Current address: Department of Nursing, Tri-Service General Hospital, Neihu District, Taipei City, Taiwan

‡ These authors also contributed equally to this work.

* E-mail: chiwenkao@ 123456ndmctsgh.edu.tw

Author information

Chi-Wen Kao http://orcid.org/0000-0003-4003-7564

Article

Publisher ID: PONE-D-18-13149

DOI: 10.1371/journal.pone.0205953

PMC ID: 6235604

PubMed ID: 30427855

SO-VID: bae03468-6982-4a24-9e2f-2a7e001b4dd8

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 3 May 2018

Date accepted : 4 October 2018

Page count

Figures: 3, Tables: 4, Pages: 13

Funding

The authors received no specific funding for this work.

Custom metadata

Data Availability All relevant data are within the paper and its Supporting Information files.

Uncertainty and depressive symptoms as mediators of quality of life in patients with heart failure

Read this article at

Abstract

Related collections

PLOS Climate

Most cited references 46

SPSS and SAS procedures for estimating indirect effects in simple mediation models.

Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes.

Preliminary development of a scale of social support: Studies on college students

Author and article information

Contributors

Journal

Affiliations

Author notes

Author information

Article

History

Page count

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 239

Cited by 14

Most referenced authors 1,154