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Psychological Factors in Heart Failure
A Review of the Literature
Kenneth M. A. MacMahon, PhD;
Gregory Y. H. Lip, MD
Arch Intern Med. 2002;162:509-516.
Congestive heart failure (CHF) is the end stage of many diseases of
the heart and a major cause of morbidity and mortality. The incidence of CHF
is increasing steadily as treatment for its coronary antecedents, such as
myocardial infarction, advances. Treatment of CHF generally relies on a battery
of pharmacological interventions, alongside exercise and diet regimens. It
is only in recent years that the psychological impact of heart failure has
been explored, which is reflected by the absence of standardized psychological
assessment for patients with CHF. In this article, we review studies that
have addressed the effects of depression, anxiety, coping style, and level
of social support in CHF. From the available evidence, it appears that patients
generally experience moderate levels of depression, but not greatly heightened
anxiety. Level of social support and style of coping with the disease are,
however, important prognostic factors. It is difficult to draw definitive
conclusions owing to the paucity of literature. Further work examining this
issue is needed if the psychological issues of heart failure are not to be
neglected.
From the University Department of Medicine, City Hospital, Birmingham,
England.
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OTHER ARTICLES NOTED (Nov 01 to 18 Oct 02)
Evid. Based Nurs. 2003;6:e1-1.
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Review: no definite conclusions can be drawn as to the effect of psychological factors in congestive heart failure
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