Beatriz Rueda

A prospective study of the effects of psychological resources and depression in essential hypertension.

This study examined the influence of perceived health competence (PHC) and coping strategies in hypertension. Depressive mood state and dimensions of quality of life (QOL) (social support, satisfaction, well-being and free time) were also considered. One hundred and fifty participants were surveyed cross-sectionally and prospectively. Regression analysis revealed that the main predictors of the dimensions of QOL were PHC and depressive mood state. Emotional coping negatively predicted well-being. Unexpectedly, task-focused coping was unrelated to QOL domains. Longitudinal analyses did not support these relations. The data suggest that, in hypertension, PHC constitutes an important resource, whereas depressive mood state deteriorates QOL.

Gender and Social Support in the Context of Cardiovascular Disease

ABSTRACT Objective: Gender and social support (SS) can affect the level of adjustment to cardiovascular disease (CVD). In this study we attempted to determine the effects of both factors on negative mood state, quality of life (QOL) and perceived health control (PHC) in patients at high CVD risk or with CVD. We also tested for an interactive effect of gender and SS. Method: One hundred and fifty-three chronic outpatients (89 females and 60 males; 4 provided no information on gender) were assessed. Levels of social support were measured. Other psychosocial variables included were negative mood state, domains of QOL (satisfaction and free time) and PHC. Results: The results, as expected, indicated main effects of gender and social support. Females experienced higher negative mood state and lower PHC in comparison with males. Patients with low SS reported less satisfaction, free time and PHC and had more negative mood state. No interaction of gender by social support was found. Conclusions: Levels of social support and gender are important aspects that influence emotional and psychological functioning in patients with CVD. Specific interventions designed for females and individuals with poor emotional and instrumental support may contribute to positive changes in their adjustment.

Relationships among Stress, Experiential Avoidance and Depression in Psychiatric Patients

This study investigated the specific association of stressful life events (SLE) and experiential avoidance (EA) with depression in patients with mental disorders. It also analyzed the possible mediating role of depression in the relation of EA to well-being and life satisfaction. A total of 147 patients (mean age = 40.16 years) diagnosed with anxiety, mood or adjustment disorder were recruited from a mental health centre. They completed measures of SLE, EA, depression, well-being and life satisfaction. Regression analyses showed that SLE and EA were positively related to depression (R 2 = .45), although the contribution made by EA was higher (β = .61, p < .001) than the one made by SLE (β = .19, p < .01). Bootstrap mediation analyses revealed that there was an indirect effect from EA to physical well-being (B = -4.52, SE = .70, p < .001, 95% CI [-6.03, -3.20]) and satisfaction (B = -.14, SE = .02, p < .001, 95%, CI [-.19 -.09]) through depression. This indirect effect was less consistently supported with respect to emotional well-being (B = -3.33, SE = .48, p < .001, 95%, CI [-4.30, -2.41]). These findings give support to the hypothesis that EA could be an important factor contributing to depression in patients with mental disorders. The results also provide evidence that depression seems to play an important mediational role when considering the negative impact that EA exerts on patients´ well-being and satisfaction.

Coping strategies, depressive symptoms and quality of life in hypertensive patients: Mediational and prospective relations

This study examined whether depressive symptoms mediated the association between coping strategies and quality of life (QoL) in a sample of hypertensive patients, and the prospective contribution of depressive symptoms and coping strategies in the prediction of their QoL. One hundred and fifty patients (50% males and 50% females) with a diagnosis of essential hypertension were recruited from a general hospital. Symptoms of depression, coping and QoL measures (global score and dimensions) were collected at baseline. Sixty-three participants completed the QoL questionnaire again one year later (T2). The results indicated that the relations between emotion coping and QoL (global score, satisfaction and social support) were totally mediated by depressive symptoms. The association between emotion coping and well-being was, however, partially mediated by depressive symptoms. Furthermore, only baseline instrumental coping strategies predicted higher levels of QoL (global score, well-being and social support) at T2. Neither emotion coping nor depressive symptoms were significantly associated with prospective QoL. These findings suggest that depressive symptoms may be a mechanism linking the manner in which patients cope with their hypertension and their QoL. They also emphasise the adaptive role played by instrumental coping responses in the management of hypertension in the long term.

Benefit Finding in Cardiac Patients: Relationships with Emotional Well-Being and Resources after Controlling for Physical Functional Impairment

Benefit finding (BF) is defined as the individuals perception of positive change as a result of coping with an adverse life event. The beneficial effects of BF on well-being could be because BF favors the improvement of resources like self-efficacy, social support and effective coping. The main objective of this longitudinal 8 week study was to explore, in a sample of cardiac patients (n = 51), the combined contribution of BF and these resources to the positive affect. Moreover, we wanted to check whether these resources were derived from BF or, on the contrary, these resources were antecedents of BF. Results showed that after controlling for functional capacity, only effective coping could predict the positive affect at Time 1 (β = .32, p < .05), while the BF predicted it at Time 2 (β = .23, p < .001). Only social support predicted BF (β = .26, p < .05), but not the opposite. We discussed the desirability of promoting these processes to improve the emotional state of cardiac patients.

Anxiety and Depression in Hypertensive Women: Influence on Symptoms and Alexithymia

Introduction: Due to strong religious faith and beliefs against blood transfusions, Jehovah’s Witness patients often pose tight spot for obstetrician-gynecologists. Myelosuppressive effects of chemotherapy in gynecology-oncology settings are additional source of worry.Background: Acute renal failure (ARF) continues to be a challenging problem in critically ill patients. We reviewed the nephrology consultations in our ICU to assess the necessity of those consultations and if there are any clinical criteria to indicate a necessary consultation.Objectives: Depression and anxiety are common mental disorders in women with cardiovascular disease. However, little research has examined the role of these disorders among women suffering from essential hypertension (EH). The present study explored the prevalence of both depression and anxiety in women with hypertension. It also examined the relationships of depression and anxiety with the frequency and severity of physical symptoms, alexithymia and the dimensions of difficulty in identifying and describing feelings (DIF and DDF).