Download fulltext
HTML
M L, S., Das, S., Behera, S. K., & Biswal, S. (2024). Effects of Cognitive and Emotional Impairment Management Bundle among Patients with Coronary Artery Disease: A Randomized Control Double-blinded Trial. Sudan Journal of Medical Sciences (SJMS), 19(2), 200–210. https://doi.org/10.18502/sjms.v19i2.14163
https://doi.org/10.18502/sjms.v19i2.14163
statistics
- 4 Abstract Views
- 2 PDF Views
- 0 HTML Views
authors
-
Sarika M L
Sarika M L
SUM Nursing College, Siksha O Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
-
Sasmita Das
Sasmita Das
SUM Nursing College, Siksha O Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
-
Suresh Kumar Behera
Suresh Kumar Behera
Head of Department of Cardiology, IMS and SUM Hospital, Siksha O Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
-
Swarupa Biswal
Swarupa Biswal
SUM Nursing College, Siksha O Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
Published Date
- Jun 28, 2024
Effects of Cognitive and Emotional Impairment Management Bundle among Patients with Coronary Artery Disease: A Randomized Control Double-blinded Trial
Abstract
Background: Cardiovascular diseases are the major non-communicable disease causing increased mortality and morbidity worldwide. Among cardiovascular diseases, coronary artery disease is one of the life-threatening diseases. The majority of patients, after the acute event of coronary artery disease, suffer from mental stress, depression, and cognitive impairments. Therefore, this study mainly focuses on the effect of the Cognitive and Emotional Impairment Management Bundle (CEIMB) among patients with coronary artery disease.
Methods: This randomized, controlled, double-blinded trial was conducted in a tertiary care center among patients with coronary artery disease. The samples were recruited from the coronary intensive care unit through purposive sampling technique. After the sample selection, they were allotted to control (n1 = 55) and intervention (n2 = 56) groups through block randomization. The intervention was provided through three sessions. The study was registered under the Clinical Trial registry of the country. The statistical analysis was done using the SPSS ver. 25. The analysis was done by mean, standard deviation, frequency, percentage, and two-way repeated measures ANOVA.
Results: The mean age of the participants in the control group was 56.6 ± 6.1 years, and in the experimental group was 57.6 ± 6.4 years. The majority of the participants (39.3%) in the intervention group had severe depression, moderate levels of stress (30.4%), and medication adherence (96.4%). In the experimental group, depression, stress, medication adherence, and cognition had a statistically significant difference at different periods (<0.05).
Conclusion: The impaired mental status and cognitive level of the patients after the cardiac event negatively influences the patient's prognosis, contributing to readmission and premature death.
Keywords:
depression, stress, medication adherence, cognitive level, coronary artery disease patients
References
[1] World Health Organization. (2021, June 11). Cardiovascular diseases (CVDs). World Health Organization. http://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
[2] DiSante, J. L., Bires, A. M., Cline, T. W., & Waterstram-Rich, K. (2017). An analysis of the prevalence of depression post-myocardial infarction. Critical Care Nursing Quarterly, 40, 124–136. https://doi.org/10.1097/CNQ.0000000000000149
[3] Gupta, M.D., Kunal, S., Jha, M., Girish, M.P., Mishra, P., Shukla, M., Bundela, N., Batra, V., Bansal, A., Mukhopadhyay, S., & Yusuf, J. (2023). Psychosocial stress and well-being in patients presenting with acute myocardial infarction in a tertiary care center. Indian Heart Journal, 7(4), 298–303.
[4] Hosseini, S. H., Ghaemian, A., Mehdizadeh, E., & Ashraf, H. (2014). Contribution of depression and anxiety to impaired quality of life in survivors of myocardial infarction. International Journal of Psychiatry in Clinical Practice, 18, 175–181. https://doi.org/10.3109/13651501.2014.940049
[5] Schmaal, L., Veltman, D. J., van Erp, T. G. M., Sämann, P. G., Frodl, T., Jahanshad, N., Loehrer, E., Tiemeier, H., Hofman, A., Niessen, W. J., Vernooij, M. W., Ikram, M. A., Wittfeld, K., Grabe, H. J., Block, A., Hegenscheid, K., Völzke, H., Hoehn, D., Czisch, M., . . . Hibar, D. P. (2016). Subcortical brain alterations in major depressive disorder: Findings from the ENIGMA Major Depressive Disorder working group. Molecular Psychiatry, 21, 806–812. https://doi.org/10.1038/mp.2015.69
[6] Hussain, S., Jamal, S. Z., & Qadir, F. (2018). Medication adherence in post myocardial infarction patients. Journal of Ayub Medical College, Abbottabad, 30(4), 552–557.
[7] Gonarkar, S. B., & Dhande, P. P. (2016). Medication adherence and its determinants in myocardial infarction patients: An Indian scenario. Journal of Clinical and Preventive Cardiology, 5(1), 2–8. https://doi.org/10.4103/2250-3528.183983
[8] Kasprzak, D., Kaczmarek-Majer, K., Rzeźniczak, J., Klamecka-Pohl, K., Ganowicz-Kaatz, T., Słomczyński, M., Budzianowski, J., Pieszko, K., Hiczkiewicz, J., Tykarski, A., & Burchardt, P. (2023). Cognitive impairment in cardiovascular patients after myocardial infarction: Prospective clinical study. Journal of Clinical Medicine, 12(15), 4954. https://doi.org/10.3390/jcm12154954
[9] Bahall, M. (2019). Prevalence and associations of depression among patients with cardiac diseases in a public health institute in Trinidad and Tobago. BMC Psychiatry, 19, 4. https://doi.org/10.1186/s12888-018-1977-3
[10] Chang, Y. L., Chiou, A. F., Cheng, S. M., & Lin, K. C. (2016). Tailored educational supportive care programme on sleep quality and psychological distress in patients with heart failure: A randomised controlled trial. International Journal of Nursing Studies, 61(155), 219–229. https://doi.org/10.1016/j.ijnurstu.2016.07.002
[11] Bhavanani, A. B., Ramanathan, M., & Madanmohan. (2014). Immediate effect of alternate nostril breathing on cardiovascular parameters and reaction time. Online International Interdisciplinary Research Journal, 4, 297–302.
[12] Marion Miller and Wendy Bennett. (2011). Neuro-linguistic kinesiology mental fitness for professionals. https://balancekinesiology.co.nz/wp-content/uploads/2011/12/5min-Switch-On.pdf
[13] Ibrahim, A., Koyuncu, G., Koyuncu, N., Suzer, N. E., Cakir, O. D., & Karcioglu, O. (2019). The effect of Benson relaxation method on anxiety in the emergency care. Medicine, 98, e15452. https://doi.org/10.1097/MD.0000000000015452
[14] Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety & stress scales (2nd ed.). Psychology Foundation.
[15] Thompson, K., Kulkarni, J., & Sergejew, A. A. (2000). Reliability and validity of a new Medication Adherence Rating Scale (MARS) for the psychoses. Schizophrenia Research, 42, 241–247. https://doi.org/10.1016/S0920-9964(99)00130-9
[16] Pfeiffer, E. (1975). A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. Journal of the American Geriatrics Society, 23, 433–441. https://doi.org/10.1111/j.1532-5415.1975.tb00927.x
[17] Daniel, M., Agewall, S., Berglund, F., Caidahl, K., Collste, O., Ekenbäck, C., Frick, M., Henareh, L., Jernberg, T., Malmqvist, K., Schenck-Gustafsson, K., Spaak, J., Sundin, Ö., Sörensson, P., Y-Hassan, S., Hofman-Bang, C., & Tornvall, P. (2018). Prevalence of anxiety and depression symptoms in patients with myocardial infarction with non-obstructive coronary arteries. The American Journal of Medicine, 131(9), 1118–1124. https://doi.org/10.1016/j.amjmed.2018.04.040
[18] Murphy, B., Le Grande, M., Alvarenga, M., Worcester, M., & Jackson, A. (2020). Anxiety and depression after a cardiac event: Prevalence and predictors. Frontiers in Psychology, 10, 3010. https://www.frontiersin.org/articles/10.3389/fpsyg.2019.03010
[19] Vaswani, D. (2020). Psychological stress in myocardial infarction patients. Indian Journal of Cardiovascular Disease in Women WINCARS, 5, 27–37. https://doi.org/10.1055/s-0040-1708575
[20] Ofori, S. N., & Adiukwu, F. N. (2018). Screening for depressive symptoms among patients attending specialist medical outpatient clinics in a tertiary hospital in southern Nigeria. Psychiatry Journal, 2018, 7603580. https://doi.org/10.1155/2018/7603580
[21] Arnold, S. V., Smolderen, K. G., Buchanan, D. M., Li, Y., & Spertus, J. A. (2012). Perceived stress in myocardial infarction: Long-term mortality and health status outcomes. Journal of the American College of Cardiology, 60(18), 1756–1763. https://doi.org/10.1016/j.jacc.2012.06.044
[22] Pietrzykowski, Ł., Michalski, P., Kosobucka, A., Kasprzak, M., Fabiszak, T., Stolarek, W., Siller-Matula, J. M., & Kubica, A. (2020). Medication adherence and its determinants in patients after myocardial infarction. Scientific Reports, 10(1), 12028. https://doi.org/10.1038/s41598-020-68915-1
[23] Bansilal, S., Castellano, J. M., Garrido, E., Wei, H. G., Freeman, A., Spettell, C., Garcia-Alonso, F., Lizano, I., Arnold, R. J., Rajda, J., Steinberg, G., & Fuster, V. (2016). Assessing the impact of medication adherence on long-term cardiovascular outcomes. Journal of the American College of Cardiology, 68(8), 789–801. https://doi.org/10.1016/j.jacc.2016.06.005
[24] Varnfield, M., Karunanithi, M., Lee, C. K., Honeyman, E., Arnold, D., Ding, H., Smith, C., & Walters, D. L. (2014). Smartphone-based home care model improved use of cardiac rehabilitation in postmyocardial infarction patients: Results from a randomised controlled trial. Heart (British Cardiac Society), 100(22), 1770–1779. https://doi.org/10.1136/heartjnl-2014-305783
[25] Glozier, N., Christensen, H., Naismith, S., Cockayne, N., Donkin, L., Neal, B., Mackinnon, A., & Hickie, I. (2013). Internet-delivered cognitive behavioural therapy for adults with mild to moderate depression and high cardiovascular disease risks: A randomised attention-controlled trial. PLoS One, 8(3), e59139. https://doi.org/10.1371/journal.pone.0059139
[26] Gökçe, E., & Arslan, S. (2019). Possible effect of video and written education on anxiety of patients undergoing coronary angiography. Journal of Perianesthesia Nursing, 34(2), 281–288. https://doi.org/10.1016/j.jopan.2018.06.100
[27] Mobini Bidgoli, M., Taghadosi, M., Gilasi, H., & Farokhian, A. (2016). The effect of sukha pranayama on anxiety in patients undergoing coronary angiography: A single -blind randomized controlled trial. Journal of Cardiovascular and Thoracic Research, 8(4), 170–175. https://doi.org/10.15171/jcvtr.2016.34
[2] DiSante, J. L., Bires, A. M., Cline, T. W., & Waterstram-Rich, K. (2017). An analysis of the prevalence of depression post-myocardial infarction. Critical Care Nursing Quarterly, 40, 124–136. https://doi.org/10.1097/CNQ.0000000000000149
[3] Gupta, M.D., Kunal, S., Jha, M., Girish, M.P., Mishra, P., Shukla, M., Bundela, N., Batra, V., Bansal, A., Mukhopadhyay, S., & Yusuf, J. (2023). Psychosocial stress and well-being in patients presenting with acute myocardial infarction in a tertiary care center. Indian Heart Journal, 7(4), 298–303.
[4] Hosseini, S. H., Ghaemian, A., Mehdizadeh, E., & Ashraf, H. (2014). Contribution of depression and anxiety to impaired quality of life in survivors of myocardial infarction. International Journal of Psychiatry in Clinical Practice, 18, 175–181. https://doi.org/10.3109/13651501.2014.940049
[5] Schmaal, L., Veltman, D. J., van Erp, T. G. M., Sämann, P. G., Frodl, T., Jahanshad, N., Loehrer, E., Tiemeier, H., Hofman, A., Niessen, W. J., Vernooij, M. W., Ikram, M. A., Wittfeld, K., Grabe, H. J., Block, A., Hegenscheid, K., Völzke, H., Hoehn, D., Czisch, M., . . . Hibar, D. P. (2016). Subcortical brain alterations in major depressive disorder: Findings from the ENIGMA Major Depressive Disorder working group. Molecular Psychiatry, 21, 806–812. https://doi.org/10.1038/mp.2015.69
[6] Hussain, S., Jamal, S. Z., & Qadir, F. (2018). Medication adherence in post myocardial infarction patients. Journal of Ayub Medical College, Abbottabad, 30(4), 552–557.
[7] Gonarkar, S. B., & Dhande, P. P. (2016). Medication adherence and its determinants in myocardial infarction patients: An Indian scenario. Journal of Clinical and Preventive Cardiology, 5(1), 2–8. https://doi.org/10.4103/2250-3528.183983
[8] Kasprzak, D., Kaczmarek-Majer, K., Rzeźniczak, J., Klamecka-Pohl, K., Ganowicz-Kaatz, T., Słomczyński, M., Budzianowski, J., Pieszko, K., Hiczkiewicz, J., Tykarski, A., & Burchardt, P. (2023). Cognitive impairment in cardiovascular patients after myocardial infarction: Prospective clinical study. Journal of Clinical Medicine, 12(15), 4954. https://doi.org/10.3390/jcm12154954
[9] Bahall, M. (2019). Prevalence and associations of depression among patients with cardiac diseases in a public health institute in Trinidad and Tobago. BMC Psychiatry, 19, 4. https://doi.org/10.1186/s12888-018-1977-3
[10] Chang, Y. L., Chiou, A. F., Cheng, S. M., & Lin, K. C. (2016). Tailored educational supportive care programme on sleep quality and psychological distress in patients with heart failure: A randomised controlled trial. International Journal of Nursing Studies, 61(155), 219–229. https://doi.org/10.1016/j.ijnurstu.2016.07.002
[11] Bhavanani, A. B., Ramanathan, M., & Madanmohan. (2014). Immediate effect of alternate nostril breathing on cardiovascular parameters and reaction time. Online International Interdisciplinary Research Journal, 4, 297–302.
[12] Marion Miller and Wendy Bennett. (2011). Neuro-linguistic kinesiology mental fitness for professionals. https://balancekinesiology.co.nz/wp-content/uploads/2011/12/5min-Switch-On.pdf
[13] Ibrahim, A., Koyuncu, G., Koyuncu, N., Suzer, N. E., Cakir, O. D., & Karcioglu, O. (2019). The effect of Benson relaxation method on anxiety in the emergency care. Medicine, 98, e15452. https://doi.org/10.1097/MD.0000000000015452
[14] Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety & stress scales (2nd ed.). Psychology Foundation.
[15] Thompson, K., Kulkarni, J., & Sergejew, A. A. (2000). Reliability and validity of a new Medication Adherence Rating Scale (MARS) for the psychoses. Schizophrenia Research, 42, 241–247. https://doi.org/10.1016/S0920-9964(99)00130-9
[16] Pfeiffer, E. (1975). A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. Journal of the American Geriatrics Society, 23, 433–441. https://doi.org/10.1111/j.1532-5415.1975.tb00927.x
[17] Daniel, M., Agewall, S., Berglund, F., Caidahl, K., Collste, O., Ekenbäck, C., Frick, M., Henareh, L., Jernberg, T., Malmqvist, K., Schenck-Gustafsson, K., Spaak, J., Sundin, Ö., Sörensson, P., Y-Hassan, S., Hofman-Bang, C., & Tornvall, P. (2018). Prevalence of anxiety and depression symptoms in patients with myocardial infarction with non-obstructive coronary arteries. The American Journal of Medicine, 131(9), 1118–1124. https://doi.org/10.1016/j.amjmed.2018.04.040
[18] Murphy, B., Le Grande, M., Alvarenga, M., Worcester, M., & Jackson, A. (2020). Anxiety and depression after a cardiac event: Prevalence and predictors. Frontiers in Psychology, 10, 3010. https://www.frontiersin.org/articles/10.3389/fpsyg.2019.03010
[19] Vaswani, D. (2020). Psychological stress in myocardial infarction patients. Indian Journal of Cardiovascular Disease in Women WINCARS, 5, 27–37. https://doi.org/10.1055/s-0040-1708575
[20] Ofori, S. N., & Adiukwu, F. N. (2018). Screening for depressive symptoms among patients attending specialist medical outpatient clinics in a tertiary hospital in southern Nigeria. Psychiatry Journal, 2018, 7603580. https://doi.org/10.1155/2018/7603580
[21] Arnold, S. V., Smolderen, K. G., Buchanan, D. M., Li, Y., & Spertus, J. A. (2012). Perceived stress in myocardial infarction: Long-term mortality and health status outcomes. Journal of the American College of Cardiology, 60(18), 1756–1763. https://doi.org/10.1016/j.jacc.2012.06.044
[22] Pietrzykowski, Ł., Michalski, P., Kosobucka, A., Kasprzak, M., Fabiszak, T., Stolarek, W., Siller-Matula, J. M., & Kubica, A. (2020). Medication adherence and its determinants in patients after myocardial infarction. Scientific Reports, 10(1), 12028. https://doi.org/10.1038/s41598-020-68915-1
[23] Bansilal, S., Castellano, J. M., Garrido, E., Wei, H. G., Freeman, A., Spettell, C., Garcia-Alonso, F., Lizano, I., Arnold, R. J., Rajda, J., Steinberg, G., & Fuster, V. (2016). Assessing the impact of medication adherence on long-term cardiovascular outcomes. Journal of the American College of Cardiology, 68(8), 789–801. https://doi.org/10.1016/j.jacc.2016.06.005
[24] Varnfield, M., Karunanithi, M., Lee, C. K., Honeyman, E., Arnold, D., Ding, H., Smith, C., & Walters, D. L. (2014). Smartphone-based home care model improved use of cardiac rehabilitation in postmyocardial infarction patients: Results from a randomised controlled trial. Heart (British Cardiac Society), 100(22), 1770–1779. https://doi.org/10.1136/heartjnl-2014-305783
[25] Glozier, N., Christensen, H., Naismith, S., Cockayne, N., Donkin, L., Neal, B., Mackinnon, A., & Hickie, I. (2013). Internet-delivered cognitive behavioural therapy for adults with mild to moderate depression and high cardiovascular disease risks: A randomised attention-controlled trial. PLoS One, 8(3), e59139. https://doi.org/10.1371/journal.pone.0059139
[26] Gökçe, E., & Arslan, S. (2019). Possible effect of video and written education on anxiety of patients undergoing coronary angiography. Journal of Perianesthesia Nursing, 34(2), 281–288. https://doi.org/10.1016/j.jopan.2018.06.100
[27] Mobini Bidgoli, M., Taghadosi, M., Gilasi, H., & Farokhian, A. (2016). The effect of sukha pranayama on anxiety in patients undergoing coronary angiography: A single -blind randomized controlled trial. Journal of Cardiovascular and Thoracic Research, 8(4), 170–175. https://doi.org/10.15171/jcvtr.2016.34