Lynn V Doering1, Belinda Chen1, Mario Deng2, Donna Mancini3, Jon Kobashigawa4, Kathleen Hickey5. 1. 1 Los Angeles School of Nursing, University of California, USA. 2. 2 David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, Los Angeles, USA. 3. 3 Department of Medicine, Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, USA. 4. 4 Cedars-Sinai Heart Institute, Los Angeles, USA. 5. 5 Columbia University School of Nursing, New York, USA.
Abstract
BACKGROUND: Perceived control has been associated with improved mental health and health-related quality of life (HRQOL) in cardiac populations. However, this concept has not been well-studied in heart transplant groups. AIMS: We examine the relationship of perceived control to symptoms of anxiety and depression and HRQOL after transplant. We also examine the extent to which anxiety and depressive symptoms mediate the relationship between perceived control and HRQOL. METHODS: Our cross-sectional analysis included 113 adult heart transplant patients from the NEW HEART study. High versus low perceived control groups were determined by median split for chi-square and t-test analyses. Hierarchical multiple linear regression models were used to examine the influence of perceived control on symptoms of depression and anxiety and HRQOL. Mediation analyses included Baron and Kenny's four-step regression approach and Preacher and Hayes' bootstrapping technique to test the indirect effect of perceived control on HRQOL. RESULTS: Heart transplant patients who reported lower perceived control were more likely to be female ( p=0.003), and had significantly more depressive symptoms ( p<0.001) and anxiety ( p<0.001), and lower HRQOL ( p<0.001) than those with higher perceived control. Perceived control was a significant predictor in regression models of depressive and anxiety symptoms and HRQOL. In mediation analyses, depressive and anxiety symptoms mediated the effect of perceived control on HRQOL. CONCLUSION: Perceived control is associated with improved depressive and anxiety symptoms and HRQOL after transplant. The relationship between perceived control and HRQOL is mediated by depressive and anxiety symptoms. Future interventions should target perceived control to improve overall HRQOL.
BACKGROUND: Perceived control has been associated with improved mental health and health-related quality of life (HRQOL) in cardiac populations. However, this concept has not been well-studied in heart transplant groups. AIMS: We examine the relationship of perceived control to symptoms of anxiety and depression and HRQOL after transplant. We also examine the extent to which anxiety and depressive symptoms mediate the relationship between perceived control and HRQOL. METHODS: Our cross-sectional analysis included 113 adult heart transplant patients from the NEW HEART study. High versus low perceived control groups were determined by median split for chi-square and t-test analyses. Hierarchical multiple linear regression models were used to examine the influence of perceived control on symptoms of depression and anxiety and HRQOL. Mediation analyses included Baron and Kenny's four-step regression approach and Preacher and Hayes' bootstrapping technique to test the indirect effect of perceived control on HRQOL. RESULTS: Heart transplant patients who reported lower perceived control were more likely to be female ( p=0.003), and had significantly more depressive symptoms ( p<0.001) and anxiety ( p<0.001), and lower HRQOL ( p<0.001) than those with higher perceived control. Perceived control was a significant predictor in regression models of depressive and anxiety symptoms and HRQOL. In mediation analyses, depressive and anxiety symptoms mediated the effect of perceived control on HRQOL. CONCLUSION: Perceived control is associated with improved depressive and anxiety symptoms and HRQOL after transplant. The relationship between perceived control and HRQOL is mediated by depressive and anxiety symptoms. Future interventions should target perceived control to improve overall HRQOL.
Authors: Y Brocks; A Zittermann; D Grisse; G Schmid-Ott; S Stock-Gießendanner; U Schulz; J Brakhage; A Benkler; J Gummert; Katharina Tigges-Limmer Journal: Prog Transplant Date: 2017-03-22 Impact factor: 1.187
Authors: Seongkum Heo; Terry A Lennie; Susan J Pressler; Sandra B Dunbar; Misook L Chung; Debra K Moser Journal: Eur J Cardiovasc Nurs Date: 2014-01-15 Impact factor: 3.908