Virginia Erickson

Perceived control reduces emotional stress in patients with heart failure.

We studied patients with heart failure (HF) to determine if perceived control reduces emotional distress (i.e., anxiety, depression and hostility) in chronic, debilitating cardiac illness and whether the demographic, clinical and psychologic characteristics of patients with high and low perceived control differed. Psychological assessment of 222 patients with heart failure included an evaluation of perceived control using the Control Attitudes Scale, as well as anxiety, depression and hostility using the Multiple Affect Adjective Checklist. Using multivariate analysis to control for differences in demographic and clinical characteristics, we found that patients with high perceived control had significantly greater 6-minute walk distances and less emotional distress than patients with low perceived control. Interventions designed to increase perceived control may be an important aspect of HF care, but require testing in randomized trials.

Sleep disturbance symptoms in patients with heart failure.

Sleep disturbances have a major impact on physical functioning, emotional well-being, and quality of life, but are not well described in patients with heart failure (HF). Eighty-four HF patients completed a sleep survey and provided demographic and clinical data. Seventy percent of the patients were male with a mean age of 54 years and a mean left ventricular ejection fraction of 22%. Forty-seven patients (56%) reported trouble sleeping and one-third used sleeping medication. The most frequently reported problems were inability to sleep flat (51%), restless sleep (44%), trouble falling asleep (40%), and awakening early (39%). Using logistic regression, physiological variables were tested as predictors of sleep disturbance. Severity of HF, age, gender, etiology, obesity, smoking, and use of beta-blockers were not predictors of sleep disturbance. HF patients experience significant sleep disturbances, which are not predicted by severity of symptoms or clinical status. Problems with sleep are an important component of a clinical assessment in this vulnerable population.

Development of a tool to assess risk for falls in women in hospital obstetric units

Because women hospitalized in obstetric units are typically young and healthy, they might be overlooked when health care providers assess for risk for falls. Recent literature has identified pregnant and postpartum women as being prone to falls, with hospitalization compounding their risk. A review of current practices among perinatal units for assessing risk for falls revealed that existing fall risk tools, which were created for geriatric and/or medical surgical patients, are used. Without any focused prevention efforts, hospitalized obstetric patients are vulnerable to a preventable event. The Obstetric Fall Risk Assessment System™ is intended to improve safety among hospitalized women on obstetric units, using an assessment tool and scoring system to determine fall risk.

Rapid assessment of quality of life in patients with advanced heart failure

prior to HT tended to be more hostile ( -.243, p .07). Number of rejections contributed to anxiety ( .389, p .02) and depression ( .292, p .03). Those receiving cyclosporine had more anxiety ( -.301, p .02), depression ( -.338, p .01), and hostility ( -.392, p .004) than those receiving tacrolimus. Conclusion: Many women are likely to experience emotional distress at levels above normative values after HT. Cyclosporine’s cosmetic side effects (hirsutism and gingival hyperplasia) may contribute to higher levels of emotional distress. Annual psychological assessment should be part of post transplant evaluation.

Do psychological scores improve as an effect of time and treatment in advanced heart failure patients

Do Psychological Scores Improve as an Effect of Time and Treatment in Advanced Heart Failure Patients? Lorraine S. Evangelista, Cheryl Westlake, Kathleen Dracup, Virginia Erickson, Gregg C. Fonarow4—School of Nursing, University of California, Los Angeles, Los Angeles, CA; School of Nursing, California State University Fullerton, Fullerton, CA; School of Nursing, University of California, San Francisco, San Francisco, CA; Ahmanson Cardiomyopathy Heart Failure Center, UCLA Medical Center, Los Angeles, CA